Do complications of percutaneous osseointegration justify a switch to transcutaneous devices? A retrospective longitudinal study on complications

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.