133 5 General Discussion implant systems. The absolute ISQ data did not provide an indication of potential fixture failure, however this must be considered with caution as this sample size was small (n=5). In Chapter 3.2 a prospective study is presented for 31 consecutive children with Down syndrome, all aged between 5 and 16 years of age. A total of 43 Ponto BHX Oticon™ laser ablated titanium implant systems were used in this study group. 3 children underwent unilateral single stage implantation, whilst the remaining 28 children received a total of 40 implants as two stage procedures. 12 children had bilateral implants, 19 had unilateral implants (implant diameter 4.5 mm: implant length 3 and 4 mm). Manufacturer pre-mounted abutments of lengths 6, 9 and 12 mm were used in the three single stage surgeries (n=3). Individual abutments of the same length choices were applied at all second stage surgeries (N=40 abutments). A high implant survival rate (95.3%) and low adverse skin reactions rate (3.2%) are presented which are in keeping with those recorded in the published literature. These outcomes are much improved compared to all the previous BAHI systems used at the Birmingham Children’s Hospital. The conclusions regarding the outcomes for the resonance frequency analysis are for this study, in line with chapter 3.1. Chapter 4 contains two studies that report on the outcomes identified of a novel, nonimplantable, adhesive retained bone conduction hearing system in children (ADHEAR) produced by MED-EL. In Chapter 4.1 twenty-one children aged between 5 and 15 years with a conductive hearing loss of greater than or equal to 25 dB HL in the better hearing ear were recruited. These children were fitted with the adhesive ADHEAR system. All the children had previous experience with a transcutaneous bone conducting hearing system prior to the study. 21 children had unilateral, and 1 child (4.5%) had bilateral CHL acquired aetiology (CSOM). All children were provided with a single adhesive ADHEAR device. Audiological comparisons were made using pure-tone thresholds; unaided, with a Ponto softband, and with the adhesive ADHEAR system. Quality of life impact was assessed with two well recognized and validated questionnaires; GCBI and LAS as well as the manufacturer’s questionnaire. Patients were excluded from the study if there was evidence of fluctuation of hearing loss; 15 dB in either direction over the previous 24-month period. Of the 21 children, 8 had acquired
RkJQdWJsaXNoZXIy MTk4NDMw