Complications in pediatric osseointegrated implantation

Objective. To report an accurate complication rate in pediatric osseointegrated implants in a large cohort of patients from a major center and to characterize the complications observed. Setting. Tertiary care pediatric hospital. Study Design. Case series with chart review of all consecutive patients receiving otologic osseointegrated implants at Cincinnati Children's Hospital since 2001. Subjects and Methods. All patients undergoing osseointegrated implant placement were identified at Cincinnati Children's Hospital, and complication rates were tabulated and stratified to major and minor based on the need for surgical revision. Evaluations of syndromic and body mass index associations were performed, along with evaluation of length of follow-up. Results. Forty-three patients were identified with 88 implants placed. Eighteen (42%) children had a diagnosis of a craniofacial syndrome. Overall, 19 (41.9%) returned to the operating suite, with a complication rate of 46.1%. A long duration of follow-up was obtained, and with this was identified an increasing risk of complications over time. Also identified was a significantly increased complication risk associated with a craniofacial syndrome. Body mass index was not found to be associated with complications. Conclusion. Osseointegrated implants require frequent maintenance care from the surgeon. Complication rates are higher for children with a diagnosis of a craniofacial syndrome, and the risk of a complication increases significantly over a prolonged period of time.