{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T01:41:50Z","timestamp":1782178910124,"version":"3.54.5"},"reference-count":10,"publisher":"Cambridge University Press (CUP)","issue":"5","license":[{"start":{"date-parts":[[2008,10,17]],"date-time":"2008-10-17T00:00:00Z","timestamp":1224201600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Laryngol. Otol."],"published-print":{"date-parts":[[2009,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0022215108003952_sec1\"><jats:title>Objective:<\/jats:title><jats:p>Bone-anchored hearing aid surgery in younger children is a two-stage procedure, with a titanium fixture being allowed to osseointegrate for several months before an abutment is fitted through a skin graft. In the first procedure, it has been usual to place a reserve or sleeper fixture approximately 5\u00a0mm from the primary fixture as a backup in case the primary fixture fails to osseointegrate. This ipsilateral sleeper fixture is expensive, is often not used, and is placed in thinner calvarial bone where it is less likely to osseointegrate successfully. The authors have implanted the sleeper fixture on the contralateral side, with the additional objective of reducing the number of procedures for bilateral bone-anchored hearing aid implantation, providing a cost-effective use for the sleeper.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215108003952_sec2\"><jats:title>Methods:<\/jats:title><jats:p>The authors implanted the bone-anchored hearing aid sleeper fixture in the contralateral temporal bone instead of on the ipsilateral side in seven successive paediatric cases with bilateral conductive hearing loss requiring two-stage bone-anchored hearing aids, treated at the Royal Manchester Children's Hospital, UK.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215108003952_sec3\"><jats:title>Results:<\/jats:title><jats:p>The seven patients ranged in age from five to 15 years, with a mean age of 10 years; in addition, a 20-year-old with learning disability was also treated. In each case, the contralateral sleeper fixture was not needed as a backup fixture, but was used in four patients (57 per cent) as the basis for a second-side bone-anchored hearing aid.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215108003952_sec4\"><jats:title>Conclusions:<\/jats:title><jats:p>In children with bilateral conductive hearing loss, in whom a bilateral bone-anchored hearing aid is being considered and the second side is to be operated upon at a later date, we recommend placing the sleeper fixture on the contralateral side at the time of primary first-side surgery. Our technique provides a sleeper fixture located in an optimal position, where it also offers the option of use for a second-side bone-anchored hearing aid and reduces the number of procedures needed.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0022215108003952","type":"journal-article","created":{"date-parts":[[2008,10,17]],"date-time":"2008-10-17T09:32:50Z","timestamp":1224235970000},"page":"555-557","source":"Crossref","is-referenced-by-count":5,"title":["An approach to bilateral bone-anchored hearing aid surgery in children: contralateral placement of sleeper fixture"],"prefix":"10.1017","volume":"123","author":[{"given":"J M","family":"Bernstein","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P Z","family":"Sheehan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2008,10,17]]},"reference":[{"key":"S0022215108003952_ref10","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.133.1.51"},{"key":"S0022215108003952_ref5","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199804000-00016"},{"key":"S0022215108003952_ref4","doi-asserted-by":"publisher","DOI":"10.3109\/00206090109073111"},{"key":"S0022215108003952_ref2","doi-asserted-by":"publisher","DOI":"10.1121\/1.428314"},{"key":"S0022215108003952_ref8","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215100136217"},{"key":"S0022215108003952_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2005.10.008"},{"key":"S0022215108003952_ref6","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1258\/0022215021911338","article-title":"Speech intelligibility with bilateral bone-anchored hearing aids: the Birmingham experience","volume":"116","author":"Dutt","year":"2002","journal-title":"J Laryngol Otol"},{"key":"S0022215108003952_ref3","doi-asserted-by":"publisher","DOI":"10.1177\/000348949810700301"},{"key":"S0022215108003952_ref9","doi-asserted-by":"publisher","DOI":"10.1258\/0022215021909935"},{"key":"S0022215108003952_ref7","first-page":"39","article-title":"Osseointegrated systems and their applications in the head and neck","volume":"3","author":"Tjellstrom","year":"1989","journal-title":"Adv Otolaryngol Head Neck Surg"}],"container-title":["The Journal of Laryngology &amp; Otology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0022215108003952","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,5,14]],"date-time":"2019-05-14T18:56:39Z","timestamp":1557860199000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0022215108003952\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,10,17]]},"references-count":10,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2009,5]]}},"alternative-id":["S0022215108003952"],"URL":"https:\/\/doi.org\/10.1017\/s0022215108003952","relation":{},"ISSN":["0022-2151","1748-5460"],"issn-type":[{"value":"0022-2151","type":"print"},{"value":"1748-5460","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,10,17]]}}}