title: Outcomes and complications of osseointegrated hearing aids in irradiated temporal bones.
abstract: To compare the complication rate for osseointegrated hearing aids (OIHA) in patients with or without irradiation.
  
  
  
  Retrospective case review.
  
  
  
  We studied patients with OIHAs implanted between January 1, 2005, and July 15, 2013 in a tertiary university center with a referral otology and neurotology practice. Demographics, history of oncologic surgery, follow-up length after OIHA implantation, radiation history and dosage, postoperative complications, and chronologic relationship between oncologic resection, OIHA implantation, and irradiation were reviewed to collect information. Soft tissue complications were graded according to a modified Holgers classification.
  
  
  
  The study included 48 patients. Twenty-nine patients (32 implants) did not undergo radiotherapy and 19 patients (19 implants) did. In the radiotherapy group, six patients had OIHAs implanted before radiotherapy, and 13 had OIHAs implanted in irradiated bone. Of these 13 patients, one had OIHA implanted during primary oncologic surgery; 11 had OIHA implanted during secondary surgery; and one patient did not have oncologic surgery. Patients with both OIHA implantation and radiotherapy had more complications than patients without radiotherapy (31.6% vs. 24.1%, P > 0.05) and more major complications than patients without radiotherapy (26.3% vs. 3.4%, P > 0.05). Patients with OIHAs implanted before radiotherapy did not have any complications. There were significantly fewer and less severe complications in patients with OIHAs implanted during primary oncologic resection than in patients with OIHAs implanted secondarily (0/8 vs. 8/11, P < 0.05).
  
  
  
  The rate and severity of complications of OIHAs can be minimized by implanting the device before irradiation, ideally at the time of primary oncologic surgery.
  
  
  
  4. Laryngoscope, 126:1187-1192, 2016.
authors.affiliation: Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A.
authors.forename: Marc-Elie
authors.initials: ME
authors.lastname: Nader
authors.affiliation: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A.
authors.forename: Beth M
authors.initials: BM
authors.lastname: Beadle
authors.affiliation: Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A.
authors.forename: Diana B
authors.initials: DB
authors.lastname: Roberts
authors.affiliation: Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A.
authors.forename: Paul W
authors.initials: PW
authors.lastname: Gidley
mesh_terms: D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D006310:Hearing Aids / Q000009:adverse effects*; D006314:Hearing Loss, Conductive / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016348:Osseointegration / Q000528:radiation effects; D011183:Postoperative Complications; D011878:Radiotherapy / Q000009:adverse effects*; D012189:Retrospective Studies; D013701:Temporal Bone / Q000528:radiation effects / Q000601:surgery*
keywords: Complications; osseointegrated hearing aids; radiotherapy