Low Cost Osseointegrated Implant System for Developing Countries

Kayla M. Foyt, Jason Roberts

Division of Otolaryngology/Head and Neck Surgery, Albany Medical Center, Albany, NY, USA.

DOI: 10.4236/ijohns.2013.25039                

Abstract

Objective: Osseointegrated hearing implants have been readily available and extensively used in developed countries for over twenty years. Despite a great need for this technology, use of these implants in developing countries has been limited due to the prohibitive cost of the surgical implant system as well as the implant devices themselves. To address this problem we have developed a drill and implant system that mimics the currently available instrumentation using materials that are readily available at a fraction of the cost. Study Design: Proof of Concept. Methods: The construction of the drill and implant system will be described. Testing of the system so that it adhered to Cochlear’s^TM Bone anchored hearing aid system specifications including the drill speed and torque settings were measured. Temperature readings were also recorded during procedures performed on human cadaveric temporal bones. Results: The speed of the drill with the guide drill and countersink drill bits ranged from 1400 revolutions per minute (rpm) to 2300 rpm’s. The temperature change of the room temperature temporal bones varied from 0 degrees to +0.2 degrees Fahrenheit during the drilling process with both drill bits. All five implants were stable in the cadaver bone after being checked for initial stability. Conclusion: This low cost implant system may make the BAHA technology more easily available to developing countries pending future studies with animal models.

Keywords

Quality of Life; Implants; Otology; BAHA; Hearing Loss

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	A. Tjellstrom, et al., “Osseointegrated Titanium Implants in the Temporal Bone,” American Journal of Otolaryngology, Vol. 2, No. 4, 1981, pp. 304-310.
[2]	S. Bouhabel, P. Arcand and I. Saliba, “Congenital Aural Atresia: Bone-Anchored Hearing Aid vs. External Auditory Canal Reconstruction,” International Journal of Pediatric Otorhinolaryngology, Vol. 76, No. 2, 2012, pp. 272-277. doi:10.1016/j.ijporl.2011.11.020
[3]	Y. Fan, et al., “Efficancy in Patient with Outer and Middle Ear Deformities of Using Bone-Anchored Hearing Aids,” Chinese Journal of Otorhinolaryngology Head and Neck Surgery, Vol. 47, No. 4, 2012, pp. 265-269.
[4]	A. D. Snik, et al., “The Bone-Anchored Hearing Aid for Children: Recent Developments,” International Journal of Audiology, Vol. 47, No. 9, 2008, pp. 554-559. doi:10.1080/14992020802307354
[5]	C. M. Steward, J. H. Clark and J. K. Niparko, “BoneAnchored Devices in Single-Sided Deafness,” Advances in Oto-Rhino-Laryngology, Vol. 71, 2011, pp. 92-102. doi:10.1159/000323589
[6]	M. K. S. Hol, et al., “Bone-Anchored Hearing Aids in Unilateral Inner Ear Deafness: An Evaluation of Audiometric and Patient Outcome Measurements,” Otology & Neurotology, Vol. 26, No. 5, 2005, pp. 999-1006. doi:10.1097/01.mao.0000185065.04834.95
[7]	R. M. Janssen, P. Hong and N. K. Chadha, “Bilateral Bone-Anchored Hearing Aids for Bilateral Permanent Conductive Hearing Loss: A Systematic Review,” Otolaryngology—Head and Neck Surgery, Vol. 147, No. 3, 2012, pp. 412-422.
[8]	S. A. Hadi, N. Ashfaq, A. Bey and S. Khan, “Biological Factors Responsible for Failure of Osseointegration in Oral Implants,” Biology and Medicine, Vol. 3, No. 2, 2011, pp. 164-170.
[9]	D. L. Brisman, “The Effect of Speed, Pressure, and Time on Bone Temperature during the Drilling of Implant Sites,” International Journal of Oral & Maxillofacial Implants, Vol. 11, No. 1, 1996, pp. 35-37.
[10]	A. F. Snik, et al., “Consensus Statements on the BAHA System: Where Do We Stand at Present,” Annals of Otology, Rhinology, and Laryngology, Vol. 114, No. 12, 2005, pp. 2-12.
[11]	S. Roman, R. Nicollas and J. M. Triglia, “Practice Guidelines for Bone-Anchored Hearing Aids in Children,” European Annals of Otorhinolaryngology, Head and Neck Diseases, Vol. 128, No. 5, 2011, pp. 253-258.
[12]	C. A. J. Dun, et al., “An Overview of Different Systems: The Bone-Anchored Hearing Aid,” Advances in OtoRhino-Laryngology, Vol. 71, 2011, pp. 22-31.
[13]	R. Branemark, et al., “Osseointegration in Skeletal Reconstruction and Rehabilitation: A Review,” Journal of Rehabilitation Research & Development, Vol. 38, No. 2, 2001, pp. 175-181.