Anatomical Results with Titanium Implants in the Mastoid Region

1997 ◽  
Vol 76 (4) ◽  
pp. 231-236 ◽  
Author(s):  
D. Portmann ◽  
P. Boudard ◽  
D. Herman
Keyword(s):  
Soft Tissue ◽  
Pure Titanium ◽  
Tissue Reaction ◽  
Titanium Implants ◽  
Skin Reactions ◽  
Aural Rehabilitation ◽  
Bone Anchored Hearing Aid ◽  
Surgical Implantation ◽  
Mastoid Region

We report our experience with titanium implants for extra-aural rehabilitation in the mastoid region with a bone-anchored hearing aid (BAHA) and auricular prosthesis. The purpose of this study was to evaluate the clnical status of the soft tissue adjacent to 63 skin-penetrating devices in 43 patients and to compare our findings with those of other reports. Forty-four fixtures have been implanted in 36 patients for the BAHA and 19 in seven patients for the auricular prostheses. The evaluation concerns osseointegration, pain in the mastoid area, skin reaction around the abutment and removal of the abutment. Three implants extruded; one due to trauma and two with no explanation. Follow-up ranged from 3 to 60 months after surgical implantation. The first outpatient check-up was performed at three months after implantation and then every six months. The soft tissue reaction around the percutaneous unit was classified at each control according to the classification proposed by Holgers et al.1 There was no irritation (type 0) in 87.5% of the controls for the BAHA group and in 87.2% for the group of auricular prostheses. No adverse skin reactions were noted in 61.36% of the BAHA group and in 66.66% of the auricular prosthesis group. Results of this study confirm the skin's ability to tolerate a skin-penetrating unit made of pure titanium. The importance of reducing the thickness of the skin around the implant and of local hygienic conditions is emphasized.

Long-Term follow-up with the Bone-Anchored Hearing Aid: A Review of the First 100 Patients between 1977 and 1985

1994 ◽  
Vol 73 (2) ◽  
pp. 112-114 ◽  
Author(s):  
Anders Tjellström ◽  
Gösta Granström
Keyword(s):  
Hearing Aids ◽  
Tissue Reaction ◽  
Mastoid Process ◽  
Skin Reactions ◽  
Single Episode ◽  
Long Term Follow Up ◽  
Bone Anchored Hearing Aid ◽  
The Stability

Skin-penetrating implants have been used since 1977 for retention of Bone Anchored Hearing Aids, or BAHA. This paper analyzes the stability of the implants and the frequency of skin reactions in the first one hundred consecutive patients operated upon at Sahlgrens Hospital, Göteborg. The follow-up time varied between 8 and 16 years. Ninety percent of the implants were found to be stable. Five percent were explanted due to direct trauma. Another five percent lost integration but often after many years in use. Adverse skin reactions were seen, but 79% of the patients had no or one single episode of soft tissue reaction. A percutaneous coupling in the mastoid process will give rise to only minor clinical problems and could be considered as a simple, predictable and safe device.

Midterm outcomes of total hip arthroplasty with a modular Birmingham head

2019 ◽  
pp. 112070001987738 ◽  
Author(s):  
Duncan W Cushnie ◽  
Brent A Lanting ◽  
Richard McCalden ◽  
Douglas DR Naudie ◽  
James L Howard
Keyword(s):  
Soft Tissue ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Femoral Stem ◽  
Tissue Reaction ◽  
Harris Hip Score ◽  
Total Hip ◽  
Tissue Reactions ◽  
Clinical Records

Introduction: Birmingham Hip Resurfacing (BHR) implants may be combined with a conventional femoral stem to create a modular metal-on-metal total hip arthroplasty (BHR MoM THA). There is little outcome data regarding this construct. This study examines midterm outcomes of BHR MoM THA compared to oxidised zirconium total hip arthroplasty (THA). Methods: A retrospective institutional review identified all patients receiving BHR MoM THA between April 2005 and February 2011 and a matched control cohort of zirconium THA patients. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Harris Hip Score (HHS), and SF-12 Health status scores were obtained. Revisions and complications were collected from clinical records. Radiographs were assessed for evidence of component malposition, loosening, osteolysis, or heterotopic ossification. Results: 63 modular BHR MoM THA were identified in 61 patients (36 with BHR cups, 27 with R3 cups) and 63 zirconium THA in 58 matched controls. Mean follow-up was 58 months. 14 BHR MoM THA hips (22.2%) were revised (4 infections, 1 dislocation, 9 soft tissue reactions) compared to 3 (4.8%) zirconium THA (all infections). At latest follow-up, 18.4% of surviving BHR MoM THA hips were painful compared to 0.5% of zirconium THA controls ( p < 0.001). WOMAC, HHS, and SF-12 did not differ significantly between surviving members of the 2 groups. Discussion: BHR MoM THA demonstrated a high revision rate, largely for adverse local soft tissue reaction and pain. Among those not revised, many reported some residual pain despite similar quality of life measures to those who received zirconium THA.

Surgical and audiological evaluation of the Baha BA400

2015 ◽  
Vol 129 (1) ◽  
pp. 32-37 ◽  
Author(s):  
M Iseri ◽  
K S Orhan ◽  
M H Yarıktaş ◽  
A Kara ◽  
M Durgut ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Surgical Technique ◽  
Hearing Aid ◽  
Tertiary Care ◽  
Case Series ◽  
Retrospective Case ◽  
Skin Reactions ◽  
Bone Anchored Hearing Aid ◽  
The One ◽  
Tissue Reduction

AbstractObjective:Despite extensive soft tissue reduction, the most common complications associated with bone-anchored hearing aid systems, also known as bone-anchored hearing implants, are related to adverse skin reactions around the abutment. The necessary soft tissue reduction also adds complexity to the surgical procedure. This study aimed to evaluate the surgical and audiological outcomes of a new connective interface of the Cochlear™ Baha® BA400 device implanted using the one-stage surgical technique.Method:A multicentre, retrospective case series is presented, including data collected from three tertiary care institutions.Results:In total, 16 patients who had undergone bone-anchored hearing aid surgery over a 10- to 12-month period were assessed for hearing performance, implant stability and surgical complications.Conclusion:This case series indicates that new abutments with a hydroxyapatite coating can be implanted percutaneously without soft tissue reduction. Furthermore, device implantation using this surgical technique may have some advantages compared with a conventional device and procedure combination over 12- to 16-months of follow up.

Efficacy and Safety of Carbon Ion Radiotherapy in Bone and Soft Tissue Sarcomas

2002 ◽  
Vol 20 (22) ◽  
pp. 4466-4471 ◽  
Author(s):  
Tadashi Kamada ◽  
Hirohiko Tsujii ◽  
Hiroshi Tsuji ◽  
Tsuyoshi Yanagi ◽  
Jun-etsu Mizoe ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Total Dose ◽  
Local Control ◽  
Dose Escalation ◽  
Soft Tissue Sarcomas ◽  
Carbon Ion Radiotherapy ◽  
Skin Reactions ◽  
Carbon Ion ◽  
Acute Skin Reactions

PURPOSE: To evaluate the tolerance for and effectiveness of carbon ion radiotherapy in patients with unresectable bone and soft tissue sarcomas. PATIENTS AND METHODS: We conducted a phase I/II dose escalation study of carbon ion radiotherapy. Fifty-seven patients with 64 sites of bone and soft tissue sarcomas not suited for resection received carbon ion radiotherapy. Tumors involved the spine or paraspinous soft tissues in 19 patients, pelvis in 32 patients, and extremities in six patients. The total dose ranged from 52.8 to 73.6 gray equivalent (GyE) and was administered in 16 fixed fractions over 4 weeks (3.3 to 4.6 GyE/fraction). The median tumor size was 559 cm3 (range, 20 to 2,290 cm3). The minimum follow-up was 18 months. RESULTS: Seven of 17 patients treated with the highest total dose of 73.6 GyE experienced Radiation Therapy Oncology Group grade 3 acute skin reactions. Dose escalation was then halted at this level. No other severe acute reactions (grade > 3) were observed in this series. The overall local control rates were 88% and 73% at 1 year and 3 years of follow-up, respectively. The median survival time was 31 months (range, 2 to 60 months), and the 1- and 3-year overall survival rates were 82% and 46%, respectively. CONCLUSION: Carbon ion radiotherapy seems to be a safe and effective modality in the management of bone and soft tissue sarcomas not eligible for surgical resection, providing good local control and offering a survival advantage without unacceptable morbidity.

Simplified bone-anchored hearing aid insertion using a linear incision without soft tissue reduction

2013 ◽  
Vol 127 (S2) ◽  
pp. S33-S38 ◽  
Author(s):  
J Husseman ◽  
J Szudek ◽  
P Monksfield ◽  
D Power ◽  
S O'Leary ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissues ◽  
Hearing Aid ◽  
Skin Flap ◽  
Standard Technique ◽  
Modified Technique ◽  
Skin Reactions ◽  
Invasive Approach ◽  
Bone Anchored Hearing Aid ◽  
Tissue Reduction

AbstractBackground:Numerous techniques have been described to manage the skin and other soft tissues during bone-anchored hearing aid insertion. Previously, generally accepted techniques have sometimes led to distressing alopecia and soft tissue defects. Now, some surgeons are rejecting the originally described split skin flap in favour of a less invasive approach.Objective:To investigate bone-anchored hearing aid placement utilising a single, linear incision with either no or minimal underlying soft tissue reduction.Patients and methods:Thirty-four adults were prospectively enrolled to undergo single-stage bone-anchored hearing aid placement with this modified technique. A small, linear incision was used at the standard position and carried down through the periosteum. Standard technique was then followed with placement of an extended length abutment. Patients were reviewed regularly to assess wound healing, including evaluation with Holgers' scale.Results:Only 14.7 per cent of patients had a reaction score of 2 or higher. Most complications were limited to minor skin reactions that settled with silver nitrate cautery and/or antibiotics. None required revision surgery for tissue overgrowth, and there were no implant failures.Conclusion:Our results suggest this to be a simple and effective insertion technique with favourable cosmesis and patient satisfaction.

Use of a bioabsorbable anterior cervical plate in the treatment of cervical degenerative and traumatic disc disruption

2002 ◽  
Vol 97 (4) ◽  
pp. 473-480 ◽  
Author(s):  
Alexander R. Vaccaro ◽  
John A. Carrino ◽  
Benjamin H. Venger ◽  
Todd Albert ◽  
Peter M. Kelleher ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Tissue Reaction ◽  
Content Type ◽  
Single Level ◽  
Soft Tissue Reaction ◽  
Solid Fusion ◽  
Cervical Plate ◽  
Anterior Cervical Plate ◽  
Fine Print

Object. Anterior cervical discectomy and fusion (ACDF) is a widely accepted treatment for anterior degenerative or traumatic instability of the cervical spine. To reduce or eliminate complications such as implant migration and failure, imaging degradation, and fusion stress shielding that are occasionally associated with spinal instrumentation, attention has been given to the use of bioresorbable anterior cervical plate (ACP) devices. This paper is a preliminary report of a retrospective series in which a resorbable mesh and screw system was used for graft containment in single-level ACDF. Methods. A review of patient charts and imaging studies was conducted to determine functional outcome, fusion success, and potential soft-tissue reaction to implant resorption. Nine patients with a cervical degenerative disc disease or traumatic disc disruption were treated between October 2001 and March 2002. Follow up averaged 206 days. Eight patients were found to have an excellent result, one patient had a good result, and no patients had a satisfactory or poor result. At the time of follow-up examination, 77% of patients were found to have a radiographically solid fusion. The two patients without a solid fusion were examined only an average 8 months postoperatively and manifested no symptoms related to fusion nonhealing. No significant soft-tissue reaction was noted clinically or radiographically in any of the patients. Conclusions. The results of this preliminary study indicate that bioresorbable ACP systems for single-level ACDF are both safe and effective.

Evaluation of implant losses and skin reactions around extraoral bone-anchored implants: A 0- to 8-year follow-up

2000 ◽  
Vol 122 (2) ◽  
pp. 272-276 ◽  
Author(s):  
Eugene N. Myers ◽  
Ronaldo A. Reyes ◽  
Anders Tjellström ◽  
Gösta Granström
Keyword(s):  
Hearing Aids ◽  
High Frequency ◽  
Titanium Implants ◽  
Young Age ◽  
Mastoid Process ◽  
Age Group ◽  
Skin Reactions ◽  
Number Of Patients

This is an 8-year follow-up of a group of 214 patients who underwent surgical insertion of titanium implants in the mastoid process for the retention of bone-anchored hearing aids and auricular prostheses. The skin reactions around the implants and the various factors dealing with implant loss were evaluated. The number of patients who never had any episode of adverse skin reactions during the 8-year period is 70% and is about the same as previously reported. The frequency and degree of adverse skin reactions were noted to be decreasing with time. The young age group had the highest incidence of adverse skin reactions, and this high frequency is consistent with results of earlier reports. None of the remaining group of patients (30%) who had 1 or more episodes of adverse skin reactions lost their implants because of this problem; most implant losses were primarily the result of loss of integration. The probability of losing an implant because of adverse skin reactions is quite low; however, these skin reactions, if left untreated, may eventually lead to implant loss or withdrawal.

scholarly journals Will Zirconia Implants Replace Titanium Implants?

2021 ◽  
Vol 11 (15) ◽  
pp. 6776
Author(s):  
Liana Preto Webber ◽  
Hsun-Liang Chan ◽  
Hom-Lay Wang
Keyword(s):  
Soft Tissue ◽  
Clinical Results ◽  
Titanium Implants ◽  
Tissue Response ◽  
Advantages And Disadvantages ◽  
New Material ◽  
Soft Tissue Response ◽  
Zirconia Implants

This review aims to discuss the advantages and disadvantages of zirconia implants compared with titanium implants. Moreover, it intends to review the relevant available long-term literature of these two materials regarding osteointegration, soft-tissue, microbiota, and peri-implantitis, focusing on clinical results. Briefly, titanium implants are a reliable alternative for missing teeth; however, they are not incapable of failure. In an attempt to provide an alternative implant material, implants made from ceramic-derivate products were developed. Owing to its optimal osseointegration competence, biocompatibility, and esthetic proprieties, zirconium dioxide (ZrO2), also known as zirconia, has gained popularity among researchers and clinicians, being a metal-free alternative for titanium implants with its main use in the anterior esthetic zones. This type of implant may present similar osseointegration as those noted on titanium implants with a greater soft-tissue response. Furthermore, this material does not show corrosion as its titanium analog, and it is less susceptible to bacterial adhesion. Lastly, even presenting a similar inflammatory response to titanium, zirconia implants offer less biofilm formation, suggesting less susceptibility to peri-implantitis. However, it is a relatively new material that has been commercially available for a decade; consequently, the literature still lacks studies with long follow-up periods.

A one-stage surgical procedure for placement of percutaneous implants for the bone-anchored hearing aid

1994 ◽  
Vol 108 (12) ◽  
pp. 1031-1035 ◽  
Author(s):  
E. A. M. Mylanus ◽  
C. W. R. J. Cremers
Keyword(s):  
Hearing Aid ◽  
Bone Conduction ◽  
Titanium Implant ◽  
Clinical Results ◽  
Two Stage ◽  
Skin Reactions ◽  
One Stage ◽  
Bone Anchored Hearing Aid ◽  
Percutaneous Implants

AbstractThe bone-anchored hearing aid (BAHA) is an alternative to the conventional bone conduction hearing aid. The transducer is coupled to a percutaneous titanium implant which is traditionally inserted into the temporal bone in two stages. This study focusses on a one-stage surgical technique for the implantation of percutaneous implants. The preliminary clinical results of 33 one-stage implants in 33 patients are presented.Post-operative necrosis of the skin grafts did not occur. After a follow-up which varied from nine to 25 months, 31 out of the 33 fixtures (94 per cent) were anchored firmly in the skull. Twenty-six out of the 33 implants (79 per cent) remained free from potentially dangerous skin reactions. The results were statistically comparable to those obtained with two-stage implants at the same clinic. Although longer follow-up is needed before a general statement can be made about replacing the two-stage technique, the preliminary one-stage results are promising.

PLA Screw Fixation of Lisfranc Injuries

2002 ◽  
Vol 23 (11) ◽  
pp. 1003-1007 ◽  
Author(s):  
David B. Thordarson ◽  
Graham Hurvitz
Keyword(s):  
Soft Tissue ◽  
Screw Fixation ◽  
Tissue Reaction ◽  
X Rays ◽  
Short Term ◽  
Small Series ◽  
Loss Of Reduction ◽  
K Wires ◽  
Lisfranc Injuries

Fourteen patients with Lisfranc injuries were treated with open reduction and internal fixation with PLA absorbable screw fixation by a single surgeon. From one to four PLA screws were used in each case (average two). In four patients, K-wires were inserted and removed at six weeks following surgery for instability of the fourth and/or fifth tarsometatarsal joints. Average follow-up was 20 months (range, three to 45 months). No patient was noted to have a soft tissue reaction to the screws. No evidence of osteolysis was noted on any of the follow-up X-rays at the screw sites. No loss of reduction was noted in any follow-up X-rays compared to immediate postoperative radiographs. The use of absorbable screws in this small series was found to be safe, without reaction and obviated the need for screw removal at short-term follow-up.

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