A New Wide-Diameter Bone-Anchored Hearing Implant—Prospective 1-Year Data on Complications, Implant Stability, and Survival

Abstract

ObjectiveTo investigate a new wide bone-anchored hearing implant considering initial stability, stability over time, implant loss, and skin reaction.Study DesignConsecutive, prospective case series.SettingTertiary referral center.PatientsTwenty adult patients were enrolled. All operations were 1-stage, single-incision technique with subcutaneous reduction.Intervention(s)Measurement of implant stability.Main Outcome Measure(s)Implant stability quotient (ISQ) values were recorded using resonance frequency analysis at the time of implantation and at 10 days, 6 weeks, 6 months, and 1 year after surgery. Skin and soft tissue reactions according to Holgers grading system.ResultsImplant stability quotient measurements revealed a significant increase in ISQ during the first 10 days after operation, and the ISQ values continued to rise throughout the 1-year observation period. No implants were lost. Skin and soft tissue reactions were rare and minor, as no reaction was seen in 93% of the follow-up examinations and no grade 4 reactions occurred.ConclusionThe new wide implant showed good stability at surgery. Osseointegration was fast, and implant stability increased throughout the 1-year observation period. No implants were lost. Skin and soft tissue reactions were rare and minor.

Stability, survival, and tolerability of a 4.5-mm-wide bone-anchored hearing implant: 6-month data from a randomized controlled clinical trial

“…Therefore, comparisons between different studies should be made very carefully. Foghsgaard and Caye-Thomasen [ 8 ] also studied the test implant and found an increasing trend in ISQ in the first year after surgery; however, they noted a slight decrease at the second follow-up visit (mean 7.3 weeks), when loading was applied. In our results, the ISQ was never lower than at surgery.…”

“…Recently, the designs of these bone-anchored hearing implants have evolved to include wider diameters, based on the known advantages of wider implants in dentistry [ 7 ]. These 4.5-mm-wide implants provide a larger contact surface between the implant and the bone compared to the 3.75-mm-wide implants of the previous generation, which results in higher reported implant stability quotients (ISQ) and high implant survival rates [ 8 , 9 ]. Moreover, wider implants appear to have higher levels of initial stability, which allows for early loading of the implant with the device.…”

Clinical evaluation of a new laser‐ablated titanium implant for bone‐anchored hearing in 34 patients: 1‐year experience

“…Implant survival and soft tissue tolerability seem comparable to the standard wide‐diameter implants used in healthy adults. However, due to the retrospective, multicentre nature of this study, using multiple surgical techniques, caution is needed in drawing conclusions especially regarding soft tissue tolerability.…”

“…Successful bone‐anchored hearing implantation requires good osseointegration of the titanium implant in the temporal bone and low skin‐related complication rates. The introduction of wider diameter implants, providing an enlarged bone‐implant interface and thus a larger interface for osseointegration, has resulted in up to 3‐year survival rates of >96% in healthy adult patients . Despite the low incidence of implant loss in healthy adults, in certain patient groups, ie patients with compromised bone quality or in children, the incidence is much higher, varying between 3.5%‐10.5% even with these wider diameter implants .…”

“…The introduction of wider diameter implants, providing an enlarged bone-implant interface and thus a larger interface for osseointegration, has resulted in up to 3-year survival rates of >96% in healthy adult patients. [1][2][3] Despite the low incidence of implant loss in healthy adults, in certain patient groups, ie patients with compromised bone quality or in children, the incidence is much higher, varying between 3.5%-10.5% even with these wider diameter implants. [4][5][6] To improve implant survival in these populations as well, further optimisation of implant material, design and surgical technique remains needed.…”