Hostname: page-component-76fb5796d-qxdb6 Total loading time: 0 Render date: 2024-04-25T14:48:59.260Z Has data issue: false hasContentIssue false
  • English
  • Français

Biofilm formation on bone-anchored hearing aids

Published online by Cambridge University Press:  19 August 2011

P Monksfield ,
I L C Chapple ,
J B Matthews ,
M M Grant ,
O Addison ,
A P Reid ,
D W Proops  and
R L Sammons
P Monksfield
Affiliation:
Dept of Otolaryngology, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Queen Elizabeth Medical Q2 Centre, Birmingham, UK
I L C Chapple
Affiliation:
Oral Pathology Unit, University of Birmingham School of Dentistry, Birmingham, UK
J B Matthews
Affiliation:
Oral Pathology Unit, University of Birmingham School of Dentistry, Birmingham, UK
M M Grant
Affiliation:
Oral Pathology Unit, University of Birmingham School of Dentistry, Birmingham, UK
O Addison
Affiliation:
Biomaterials Unit, University of Birmingham School of Dentistry, Birmingham, UK
A P Reid
Affiliation:
Dept of Otolaryngology, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Queen Elizabeth Medical Q2 Centre, Birmingham, UK
D W Proops
Affiliation:
Dept of Otolaryngology, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Queen Elizabeth Medical Q2 Centre, Birmingham, UK
R L Sammons*
Affiliation:
Biomaterials Unit, University of Birmingham School of Dentistry, Birmingham, UK
*
Address for correspondence: Dr R L Sammons, University of Birmingham School of Dentistry, St Chad's Queensway, Birmingham B4 6NN, UK Fax: +44 (0)121 237 2932 E-mail: r.l.sammons@bham.ac.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To investigate microbiological biofilm contamination of retrieved bone-anchored hearing aids.

Materials and methods:

Nine failed, retrieved bone-anchored hearing aids and 16 internal screws were examined by scanning electron microscopy. A fixture from a failing implant, which had been removed and disassembled under aseptic conditions, was cultured. Finally, an internal screw from a new, unimplanted fixture was examined by scanning electron microscopy.

Results:

Debris was seen on the fixture and abutment of all bone-anchored hearing aids, and on the heads of the 16 internal screws. On eight screws, biofilm extended down the shaft to the threads, where it was several micrometres thick. Culture of a failing fixture yielded staphylococcus. The new, unimplanted fixture internal screw showed evidence of scratching and metallic debris on the threads, which may interfere with close fitting of the screw and subsequently facilitate microleakage.

Conclusion:

There may be a link between internal microbial contamination and failure of bone-anchored hearing aids.

Keywords

BiofilmsOsseointegrationbone-anchored hearing aidMicroscopy, Electron, Scanning
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 11 , November 2011 , pp. 1125 - 1130
Copyright
Copyright © JLO (1984) Limited 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1House, JW, Kutz, JW Jr. Bone-anchored hearing aids: incidence and management of postoperative complications. Otol Neurotol 2007;28:213–17CrossRefGoogle ScholarPubMed
2Ricci, G, Della Volpe, A, Faralli, M, Longari, F, Gulla, M, Mansi, N et al. Results and complications of the Baha system (bone anchored hearing aid). Eur Arch Otorhinolaryngol 2010;267:1539–1945CrossRefGoogle ScholarPubMed
3Doshi, J, McDermott, AL, Reid, A, Proops, D. The use of bone-anchored hearing aid Baha® in children with severe behavioural problems – the Birmingham Baha® programme experience. Int J Pediatr Otorhinolaryngol 2010;74:608–10CrossRefGoogle ScholarPubMed
4Dun, CAJ, de Wolf, MJF, Mylanus, EAM, Snik, AF, Hol, MKS, Cremers, C. Bilateral bone-anchored hearing aid application in children: the Nijmegen experience from 1996–2008. Otol Neurotol 2010;31:615–23CrossRefGoogle Scholar
5De Wolf, MJF, Shival, MLC, Hol, MKS, Mylanus, EAM, Cremers, C, Snik, AFM. Benefit and quality of life in older bone-anchored hearing aid users. Otol Neurotol 2010;31:766–72CrossRefGoogle ScholarPubMed
6Holgers, KM, Paulsson, M, Bjursten, LM, Tjellström, A, Ljungh, Å. Selected microbial findings in association with percutaneous titanium implants. Int J Oral Maxillofac Implants 1994;5:565–70Google Scholar
7Gillett, D, Fairley, JW, Chandrashaker, TS, Bean, A, Gonzalez, J. Bone-anchored hearing aids: results of the first eight years of a programme in a district general hospital, assessed by the Glasgow benefit inventory. J Laryngol Otol 2006;120:537–42CrossRefGoogle Scholar
8Holgers, KM, Ljungh, Å. Cell surface characteristics of microbiological isolates from human percutaneous titanium implants in the head and neck. Biomaterials 1999;20:1319–26CrossRefGoogle ScholarPubMed
9Lustig, LR, Arts, HA, Brackmann, DE, Francis, HF, Molony, T, Megerian, CA et al. Hearing rehabilitation using the BAHA bone-anchored hearing aid: results in 40 patients. Otol Neurotol 2001;22:328–34CrossRefGoogle ScholarPubMed
10Grant, MM, Monksfield, P, Proops, D, Brine, M, Addison, O, Sammons, RL et al. Fluid exudates from inflamed bone-anchored hearing aids demonstrate elevated levels of cytokines and biomarkers of tissue and bone metabolism. Otol Neurotol 2010;31:433–9CrossRefGoogle ScholarPubMed
11Post, CJ. Role of biofilms in otolaryngologic infections: update 2007. Curr Opin Otolaryngol Head Neck Surg 2007;15:347–51CrossRefGoogle ScholarPubMed
12Macassey, E, Dawes, P. Biofilms and their role in otorhinolaryngological disease. J Laryngol Otol 2008;122:1273–8CrossRefGoogle ScholarPubMed
13Fey, PD. Modality of bacterial growth presents unique targets: how do we treat biofilm-mediated infections? Curr Opin Microbiol 2010;13:610–15CrossRefGoogle ScholarPubMed
14Fux, CA, Stoodley, P, Hall-Stoodley, L, Costerton, JW. Bacterial biofilms: a diagnostic and therapeutic challenge. Expert Rev Anti Infect Ther 2003;1:667–83CrossRefGoogle ScholarPubMed
15Stewart, PS, Franklin, MJ. Physiological heterogeneity in biofilms. Nat Rev Microbiol 2008;6:199–210CrossRefGoogle ScholarPubMed
16Wilson, M. Bacterial biofilms and human disease. Sci Prog 2001;84:235–54CrossRefGoogle ScholarPubMed
17Cos, P, Tote, K, Horemans, T, Maes, L. Biofilms: an extra hurdle for effective antimicrobial therapy. Curr Pharm Des 2010;16:2279–95CrossRefGoogle ScholarPubMed
18do Nascimento, C, Barbosa, RES, Issa, JPM, Watanabe, E, Ito, IY, Albuquerque, RF Jr. Bacterial leakage along the implant-abutment interface of premachined or cast components. Int J Oral Maxillofac Surg 2008;37:177–80CrossRefGoogle ScholarPubMed
19Baldwin, L, Hunt, J. Host inflammatory response to NiCr, CoCr, and Ti in a soft tissue implantation model. J Biomed Mater Res 2006;79:574–81CrossRefGoogle Scholar
20Quirynen, M, Bollen, CM, Eyssen, H, van Steenberghe, D. Microbial penetration along the implant components of the Branemark System. Clin Oral Implants Res 1994;5:239–44CrossRefGoogle ScholarPubMed
21Quirynen, M, van Steenberghe, D. Bacterial colonization of the internal part of two-stage implants. Clin Oral Implants Res 1993;4:158–61CrossRefGoogle ScholarPubMed
22Håkansson, B, Reinfeld, S, Eeg-Olofsson, M, Östli, P, Taghavi, H, Adler, J et al. A novel bone conduction implant (BCI): engineering aspects and pre-clinical studies. Int J Audiol 2010;49:203–15CrossRefGoogle ScholarPubMed