Chapter 2 40 1.1. Objectives To evaluate clinical outcomes of the OticonTM wide BAHI system (Oticon Medical) implanted between January 2014 - 2016 with a focus on skin complication rates and fixture loss over a mean follow up period of 5.4 years at Birmingham Children’s Hospital. 2. Methods Retrospective 5-year longitudinal case record review of a cohort of 47 children who were implanted with the Oticon™ wide implant system at Birmingham Children’s Hospital (BCH). Following ethical approval from the local research and development department a retrospective case series review of all patients who had undergone implantation of the OticonTM wide BAHI fixture was undertaken. Over the 5 year period, medical records were updated if patients, carers or medical professionals raised concerns requiring either consultation by medical or audiological staff. These records were then reviewed for references to these medical complications, specifically soft tissue reactions, revision rate, failure of fixture and loss of abutment from trauma. Follow up data was compiled in May 2020 and is reported in this paper resulting in a mean follow up period for this study of 5.4 years (range 4.2-6.3). 2.1. Patients All children on the paediatric BAHI program at BCH who were implanted with the Oticon™ wide fixture between January 2014 and January 2016 were included in this study. No child was excluded from the review. The demographics were recorded including age (defined as age at first stage surgery in cases of sequential implantation), gender and significant comorbidities. The underlying aetiology for BAHI surgery was also noted. 2.2. Surgical technique This centre’s preferred methodology for implantation in children is a two-stage procedure. The first stage involved placing two fixtures (implants) on each required side, one acting as a sleeper. After a three month osseointegration period the second stage was performed when an abutment was placed on one of two implanted fixtures. Two soft tissue surgical techniques were employed by the operating surgeons: Surgeon 1: ‘U’ shaped incision for implant placement followed by a 4 mm skin punch with tissue preservation at second stage for abutment positioning. Surgeon 2: L inear incision for implant placement followed by a linear incision with minimal soft tissue reduction for second stage for abutment positioning.
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