Percutaneous implants in the temporal bone for securing a bone conductor: surgical methods and results.

Clinical results of an extended follow-up of percutaneous titanium implants for application of bone conductors are presented. A simplified 1-stage surgical procedure is introduced. This study entails a consecutive series of 163 implants in 155 patients 9 to 80 years old who received a bone conductor coupled to a percutaneous titanium implant since June 1988 at the University Hospital Nijmegen. The maximum follow-up is 7 years. The bone conductor can be connected to a percutaneous abutment fixed to a titanium fixture anchored in the temporal bone. Several clinical trials from different clinics have shown its efficacy in patients with a conductive or mixed hearing loss. In this study attention is paid to the following issues: the occurrence of skin reactions, the condition of the skin around the abutment, the stability of the fixture, and a simplified surgical technique.