Five year clinical outcomes and evaluation of the Oticon 4.5mm 47 2 and complications recording were complete. Retrospective studies however are limited to the nature of missing data. The wide range of indications for surgery and physical and psychological comorbidity of recipients poses a potential for confounding results in this study, comparison to other published literature is limited due to the wide variation within our study cohort and should therefore be done with caution. The absence of uniform standard for surgery was also limitation for the current study with two separated methods being applied to the cohort, one performing minimal soft tissue reduction at second stage. However, patient demographics, post operative protocol and routine follow up were identical between the two groups. One difficulty in comparing outcomes of different studies is the variation in outcome reporting. An absence of uniform outcome reporting standards (Holger’s score) is evident in this study limits conclusions drawn from direct comparisons and relies on different outcome measures such as antibiotic use. Soft tissue evaluation was performed by the same specialist nurse for all included patients and only those who required medical or surgical intervention were recorded as a complication. 5. Conclusion The OticonTM wide implant produces comparable results to previous studies regarding periabutment skin complications. However, it appears superior to previous implant systems adopted at BCH with regards to both skin complication and revision surgery rates. Fixture failure rate is higher when compared to previous alternative wide diameter implant however this did demonstrate significantly worse soft tissue complication in the paediatric population. The reduced complication rate corresponds to a reduction in the number of additional outpatient appointments and visits to the BAHI specialist nursing team. Role of funding source This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Declaration of competing interest No authors involved with the paper have any actual or potential conflict of interest including any financial, personal or other relation ships with other people or organizations that could inappropriately in fluence, or be perceived to influence, their work.
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