Complicaciones en osteointegración percutánea: ¿es necesario un cambio de paradigma?

Marta Núñez; Juan Castro Jiménez; Francisco Fernández-Nogueras Jiménez; Juan Manuel Espinosa Sánchez; Juan Garcia-Valdecasas Bernal

doi:10.51445/sja.auditio.vol7.2023.0089

Authors

Marta Núñez Hospital Universitario Virgen de las Nieves https://orcid.org/0000-0002-1865-5000
Juan Castro Jiménez Department of Otolaryngology, Hospital Universitario Virgen de las Nieves, Granada, Spain. https://orcid.org/0000-0001-5152-9690
Francisco Fernández-Nogueras Jiménez Department of Otolaryngology, Hospital Universitario Virgen de las Nieves, Granada, Spain.
Juan Manuel Espinosa Sánchez Department of Otolaryngology, Instituto de Investigación Biosanitaria ibs.GRANADA, Hospital Universitario Virgen de las Nieves, Granada, Spain. 3 Otology & Neurotology Group CTS495, Department of Genomic Medicine, GENYO, Centre for Genomics and Oncological Research, Pfizer/University of Granada/Andalusian Regional Government, Granada, Spain. 4 Division of Otolaryngology, Department of Surgery, University of Granada, Granada, Spain. 5 Sensorineural Pathology Programme, Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), Madrid, Spain. https://orcid.org/0000-0001-8436-5629
Juan Garcia-Valdecasas Bernal Department of Otolaryngology, Instituto de Investigación Biosanitaria ibs.GRANADA, Hospital Universitario Virgen de las Nieves, Granada, Spain. https://orcid.org/0000-0002-1139-6229

DOI:

https://doi.org/10.51445/sja.auditio.vol7.2023.0089

Keywords:

Percutaneous bone conduction implant, local complications, Holgers, BAHA

Abstract

Introduction: Percutaneous bone conduction implants are the standard osseointegration model used to provide an alternative treatment option for conductive and mixed hearing loss. In recent years, the indications for these implants have increased, despite concerns about their use because of local complications. The aim of this study was to describe the complications of percutaneous osseointegrated devices implanted at our hospital.
Material and methods: A retrospective longitudinal study was conducted in 57 consecutive patients who received a Baha®-type percutaneous bone conduction implantation. The main clinical indications were chronic otitis media and ear malformations. Local periimplant complications were described using the Holgers classification.
Results: After a mean follow-up of 12 months (range: 4-48 months), 26.31% of patients had some type of peri-implant soft tissue complication. Only one patient (1.75%) had major reactions requiring removal of the implant. Complications in the paediatric age group were notably higher, affecting 42.85% of the children.
Conclusions: The local complication rate in our study was at the lower end of the range described in the literature, which reports a very wide range of rates, even reaching 70%. Most complications are minor and resolve with topical antibiotic treatment. However, the rate is higher in children.

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