AI Article Synopsis

  • The study aimed to assess the outcomes of percutaneous bone-anchored hearing implant (BAHI) surgery in children with syndromic versus nonsyndromic conditions over a span of 13 years.
  • Researchers found that syndromic patients generally faced more complications, such as higher ASA scores, implant extrusions, and severe skin reactions post-surgery compared to nonsyndromic patients.
  • Despite these challenges, the overall stability of the implants was similar between the two groups, suggesting BAHI surgery remains a viable option for syndromic patients, albeit with added risks.

Article Abstract

Objective: To evaluate and compare perioperative outcomes of percutaneous bone-anchored hearing implant (BAHI) surgery in syndromic and nonsyndromic pediatric patients.

Study Design: Retrospective cohort study.

Setting: McGill University Health Centre in Montreal, Quebec, Canada.

Patients: Forty-one pediatric patients (22 syndromic, 19 nonsyndromic) who underwent percutaneous BAHI surgery between March 2008 and April 2021.

Intervention: Percutaneous BAHI surgery.

Main Outcome Measures: Patient demographics (age at surgery, gender, implant laterality), operative information (American Society of Anesthesia [ASA] score, anesthesia type, surgical technique, implant/abutment characteristics), and postoperative outcomes (implant stability, soft tissue integrity, surgical revisions, implant failure).

Results: The most frequent syndromes among implanted patients were Treacher Collins (27.3%), Goldenhar (13.6%), Trisomy 21 (13.6%), and Nager (9.1%). Syndromic patients were more frequently given higher ASA scores: 2 ( p = 0.003) and 3 ( p = 0.014). All cases of implant extrusion were in syndromic patients: two posttraumatic and two failures to osseointegrate. Nine (40.9%) syndromic patients experienced a Holgers Grade 4 skin reaction at one of their postoperative follow-up visits as compared to 0% of nonsyndromic patients ( p < 0.001). Implant stability was similar between cohorts at all postoperative time-points, except for significantly greater nonsyndromic implant stability quotient scores at 16 weeks ( p = 0.027) and 31+ weeks ( p = 0.016).

Conclusions: Percutaneous BAHI surgery is a successful rehabilitation option in syndromic patients. However, it presents a relatively higher incidence of implant extrusion and severe postoperative skin reactions as compared to nonsyndromic patients. In light of these findings, syndromic patients may be great candidates for novel transcutaneous bone conduction implants.

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Source
http://dx.doi.org/10.1097/MAO.0000000000003922DOI Listing

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