title: A Comparative Review of Osseointegration Failure Between Osseointegrated Bone Conduction Device Models in Pediatric Patients.
abstract: OBJECTIVE
  Compare rates of osseointegration failure (OIF) between system 2 (200 series) and system 3 (BI300) osseointegrated bone conduction device (OCBD) models.
  
  
  METHODS
  Case series with chart review.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  Pediatric patients who were implanted with either system 2 or system 3 OCBD between May 2009 and July 2014 at Arkansas Children's Hospital.
  
  
  METHODS
  Implantation with either system 2 or system 3 OCBD using 3- and 4-mm implants with 5.5- and 8.5-mm abutments (system 2) or 6- and 9-mm abutments (system 3).
  
  
  METHODS
  OIF with resulting loss of flange-fixture.
  
  
  RESULTS
  OIF occurred in 28.6% (14/49) of implanted fixtures in system 2 compared with 8.0% (2/25) of implanted fixtures in system 3 (p = 0.042). The average time to complication for system 2 was 13 months compared with 3 months for system 3. The causes of OIF in system 2 were trauma (n = 4), chronic soft tissue disease (n = 5), or idiopathic in nature (n = 5). System 3 failures were both because of trauma. Using the combined cohorts, the average age of patients who experienced OIF was 8.7 years, compared with 11.4 years in patients without OIF (p = 0.047). There was no difference in OIF among 3-mm and 4-mm screws (p = 0.876), linear and flap technique (p = 0.375), or surgeons (p = 0.211).
  
  
  CONCLUSIONS
  System 3 OCBD showed a significantly reduced rate of OIF compared with system 2 in our study. Modification to the system 2 implant resulted in improved rate of OIF. Younger age was independently associated with a higher rate of OIF when evaluating both systems.
authors.affiliation: *Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences †Arkansas Children's Hospital, Little Rock, Arkansas.
authors.forename: Kurt L
authors.initials: KL
authors.lastname: Nelson
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Cox
authors.forename: Gresham T
authors.initials: GT
authors.lastname: Richter
authors.forename: John L
authors.initials: JL
authors.lastname: Dornhoffer
mesh_terms: D000293:Adolescent; D001131:Arkansas; D001844:Bone Conduction; D002648:Child; D002675:Child, Preschool; D005260:Female; D006310:Hearing Aids; D006801:Humans; D008297:Male; D016348:Osseointegration / Q000502:physiology*; D017211:Treatment Failure