A Potential Interaction Between Bisphosphonates and Osseointegration of Bone-Anchored Hearing Aid Implants Leading to Late Device Extrusion.

Bisphosphonate therapy is commonly used to treat patients suffering from osteoporosis due to its clinical effectiveness and its generally benign safety profile; however, osteonecrosis of the jaw is a rare side effect that can occur in some patients. A far less elucidated area of concern is the effect of these medications on osseointegrated implants, which require adequate bone formation to ensure long-term viability of the implant. To date, there are no reports in the otolaryngology literature examining the interplay between osteoporosis, bisphosphonate therapy, and osseointegrated bone-anchored hearing aids (BAHA). In this case report, we describe an osteoporotic patient on bisphosphonates experiencing late bilateral failure of her osseointegrated BAHA implants shortly after starting therapy. Certainly, direct causality cannot be determined from this single report, but the temporal relationship described in this case suggests a potential interaction between bisphosphonate use and delayed failure of the osseointegrated hearing devices. Consequently, otolaryngologists who implant osseointegrated hearing devices should consider offering preoperative counseling to patients receiving bisphosphonate therapy.

Controllable X-Ray Pulse Trains from Enhanced Self-Amplified Spontaneous Emission.

We report the demonstration of optical compression of an electron beam and the production of controllable trains of femtosecond, soft x-ray pulses with the Linac Coherent Light Source (LCLS) free-electron laser (FEL). This is achieved by enhanced self-amplified spontaneous emission with a 2 µm laser and a dechirper device. Optical compression was achieved by modulating the energy of an electron beam with the laser and then compressing with a chicane, resulting in high current spikes on the beam which we observe to lase. A dechirper was then used to selectively control the lasing region of the electron beam. Field autocorrelation measurements indicate a train of pulses, and we find that the number of pulses within the train can be controlled (from 1 to 5 pulses) by varying the dechirper position and undulator taper. These results are a step toward attosecond spectroscopy with x-ray FELs as well as future FEL schemes relying on optical compression of an electron beam.