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Objective: The purpose of this study was to investigate whether a new self-tapping implant for a bone-anchored hearing aid (BAHA) had the same high frequency of osseointegration as previous implants requiring pre-tapping.Method: Over a three-year period, 144 consecutive implants were placed in the mastoid for BAHA and evaluated.Results: Two implants were lost; both were of the self-tapping type. One was in an 11-year-old boy, who lost his implant six weeks after surgery when the BAHA was fitted. The other was in an elderly man, a heavy smoker with diabetes. Using Fisher's exact test, there was no significant difference between the two groups (p>0.30).Conclusion: Self-tapping implants facilitate surgery and shorten operating time. Over a short follow up, we did not find any significant difference; however, it is important to follow these implants over a longer time period. [ABSTRACT FROM AUTHOR]

The article discusses a study which investigated the placing of osseointegrated dental implants in teenagers.

Purpose: Congenital anophthalmia (A) and microphthalmia (M) are rare developmental defects, which could be isolated or syndromic. Our objective was to describe a cohort of children and young adults with A/M treated with ocular prosthesis, emphasizing clinical features, diagnosis, treatment, and follow-up., Methods: Eighteen individuals (10 female) with unilateral A (n = 3) and M (n = 15) with a mean age of 9.5 years (range 0.8-31.8) and treated with ocular prosthesis were included. Data on medical history, clinical examinations and management of ocular prosthesis were collected. Genetic screening with microarray and whole-exome sequencing targeting 121 A/M-related genes was performed., Results: A/M appeared isolated (seven cases) or as part of a syndromic condition (11 cases). In 4/16 patients, mutations were detected in TFAP2A, CHD7, FOXE3 and BCOR-genes. In one patient, a possibly causal microdeletion 10q11 was shown. Associated ocular anomalies such as cataract and cysts were found in 16 (89%) of the A/M eyes, and in nine (50%) ophthalmological findings were found in the fellow eyes. The median ages at which the conformer and ocular prosthesis first were initiated were 7.8 months and 1.5 years. 16/17 patients fulfilled satisfactory orbital growth and cosmetic results when treated with ocular prosthesis from an early age., Conclusion: Based upon our findings, a multidisciplinary approach, including genetic assessment, is necessary to cover all aspects of A/M. Imaging, ultrasound and visual evoked potentials should be included. Early management is crucial for the outcome, in terms of non-ocular findings, vision in the fellow eye, and for facial cosmetic development., (© 2020 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)

Purpose: To evaluate health-related quality of life (HR-QoL), vision-related (VR-)QoL and perceptual visual dysfunction (PVD) among individuals with anophthalmia (A) and microphthalmia (M) treated with ocular prosthesis., Methods: The study comprised 15 individuals (mean age 6.6 years; range 1.7-14.1) with unilateral A or M. Three validated instruments measuring HR-QoL and VR-QoL were used: The Pediatric QoL Inventory (PedsQL), consisting of physical and psychosocial self-report and parent-proxy report (2-18 years); Children's Visual Function Questionnaire (CVFQ); and Effects of Youngsters' Eyesight on Quality of Life (EYE-Q). Perceptual visual dysfunctions (PVDs) were assessed by history taking according to a specific protocol., Results: A/M children and their parents showed low HR-QoL scores (PedsQL total score: 66.3; 69.6) compared with controls (83.0; 87.61) (p = 0.0035 and <0.0001, respectively, unpaired t-test). No differences were found between A/M children and parents, but parents tended to underestimate their children's emotional state. A/M children with subnormal visual acuity (VA) for age scored lower in physical health compared with A/M children with normal VA (p = 0.03, Mann-Whitney U-test). No significant VR-QoL differences between A/M children and references or between A/M children with subnormal or normal VA for age were found. More A/M children than controls exhibited PVDs in ≥1 area (7/11 versus 4/118; p < 0.0001, Fisher's exact test)., Conclusion: A/M individuals show poor HR-QoL and increased PVDs. No difference in QoL was found between children and parents, though the children tended to score lower in emotional well-being. A/M children with subnormal VA showed lower physical health score. These problems indicate the necessity of a thorough multidisciplinary assessment and follow-up of children with A/M., (© 2020 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.)

Anophthalmia/microphthalmia (A/M) are rare congenital eye malformations. Early intervention with ocular prosthesis can stimulate orbital growth and prevent facial asymmetry. We reviewed medical records from 18 individuals with A/M (0.8-31 years) treated with ocular prosthesis at Sahlgrenska University Hospital between 2000 and 2012. A majority had other ocular findings. Seven had subnormal visual acuity in the fellow eye, one third were in contact with vision support services and half of the group wore glasses. Eleven individuals had extra-ocular findings such as cardiac defect, hearing impairment and neuropsychiatric disorders, possibly indicating syndromic conditions. We suggest that investigation of A/M children should include ultrasound of the eye, optionally visual evoked potential and magnetic resonance imaging of the CNS. The ophthalmologist should initiate treatment with prosthesis, pediatric assessment, hearing tests and genetic counseling, but should also monitor visual development of the fellow eye.

This study was undertaken on 100 children aged 16 years or under intended for installation of osseointegrated implants. Of these, 76 had implants installed for bone-anchored hearing aids or prostheses. The main indication for implant installation was a bilateral ear malformation. Surgery was generally performed as a two-stage procedure with a healing time of 3 to 4 months in between. Available bone thickness was on average 2.5 mm, and lack of bone necessitated bone augmentation in 12 patients. Thirty-nine percent of implants were installed in contact with the dura, sigmoid sinus, or an air cell. Implant failures were 5.8% of 170 inserted fixtures. Adverse skin reactions appeared in 9.1% of patients over a 21-year follow-up period. Revision surgery was undertaken in 22% of patients because of appositional growth of the temporal bone. Of the 24 children considered but not found suitable for osseointegration surgery, plastic surgery was considered a better option, or growth of the temporal bone was awaited. It is concluded that the rate of implant failure is lower in children; the frequency of skin reactions is the same as in adults, but revision surgery is more common in young patients because of new bone formation. Our clinical experience supported by the data presented in this article suggests that the concept could be used with good functional and aesthetic results in children.