目的:共振频率分析(RFA)是一种可靠的,评估骨锚式听力植入物(BAHIs)稳定性的非侵入性方法,虽然手术-,植入-,和宿主相关因素可以影响其结果。
背景:BAHI在恢复听力功能中起着重要作用。然而,植入物和宿主相关因素导致植入物过早挤压。为了缓解这种情况,评估植入物稳定性的非侵入性方法,以及对导致BAHI故障的因素的更好理解,是需要的。
方法:我们评估了RFA在锯骨(模拟骨骼材料)中量化植入物稳定性的实用性,29个人体尸体样本,以及29名儿科和27名成人参与者的前瞻性队列,并确定了与植入物稳定性相关的因素。为了验证RFA在BAHI中的使用,我们将RFA衍生的植入物稳定性商(ISQ)估计值与机械推出测试获得的峰值载荷进行了比较.
结果:ISQ和峰值载荷显着相关(Spearmanrho=0.48,p=0.0088),和ISQ可靠地预测峰值负载高达1kN。然后我们发现在尸体样本中,桥台长度,内部表骨量,供体年龄与植入物稳定性显著相关。我们在我们的前瞻性患者队列中验证了研究结果,并表明微创Ponto手术(MIPS;与线性切口相比),更长的植入持续时间(>16周),年龄较大(>25岁),较短的基牙长度(≤10mm)与更好的植入物稳定性相关。最后,我们对锯骨和患者植入物中ISQ测量的短期可重复性进行了表征.
结论:一起,我们的研究结果支持使用ISQ作为植入物稳定性的量度,并强调影响植入物稳定性的重要考虑因素,包括手术方法,植入持续时间,年龄,和桥台长度。
OBJECTIVE: Resonance frequency analysis (RFA) is a reliable, noninvasive method to assess the stability of bone-anchored hearing implants (BAHIs), although surgical-, implant-, and host-related factors can affect its outcome.
BACKGROUND: BAHI plays an important role in restoring hearing function. However, implant- and host-related factors contribute to premature implant extrusion. To mitigate this, noninvasive methods to assess implant stability, along with a better understanding of factors contributing to BAHI failure, are needed.
METHODS: We evaluated the utility of RFA to quantify implant stability in sawbone (bone mimicking material), 29 human cadaveric samples, and a prospective cohort of 29 pediatric and 27 adult participants, and identified factors associated with implant stability. To validate the use of RFA in BAHI, we compared RFA-derived implant stability quotient (ISQ) estimates to peak loads obtained from mechanical push-out testing.
RESULTS: ISQ and peak loads were significantly correlated (Spearman rho = 0.48, p = 0.0088), and ISQ reliably predicted peak load up to 1 kN. We then showed that in cadaveric samples, abutment length, internal table bone volume, and donor age were significantly associated with implant stability. We validated findings in our prospective patient cohort and showed that minimally invasive Ponto surgery (MIPS; versus linear incision), longer implantation durations (>16 wk), older age (>25 yr), and shorter abutment lengths (≤10 mm) were associated with better implant stability. Finally, we characterized the short-term reproducibility of ISQ measurements in sawbone and patient implants.
CONCLUSIONS: Together, our findings support the use of ISQ as a measure of implant stability and emphasize important considerations that impact implant stability, including surgical method, implant duration, age, and abutment lengths.