Alejandro Castro

Quality of life in postlingually deaf patients following cochlear implantation.

Most cochlear implant studies are focused on improvement of speech perception associated with implantation. The goal of this study was to assess the impact of cochlear implantation on quality of life changes in Spanish users. Thirty postlingually deaf patients fitted with a cochlear implant completed the Glasgow Benefit Inventory, a questionnaire dealing with communication abilities, and an open-ended questionnaire. The Glasgow Benefit Inventory revealed a positive effect in 93% of patients. The use of a cochlear implant significantly enhanced discrimination ability, telephone use and self-confidence. A high degree of satisfaction was achieved in all situations except with background noise. Ninety-six percent of patients would recommend the operation to a friend. A dramatic improvement in quality of life following cochlear implantation is revealed by a great majority of patients. The results cannot only be explained by enhancements to auditory perception.

Musical Perception and Enjoyment in Post-Lingual Patients With Cochlear Implants

OBJECTIVES To evaluate music perception and enjoyment following cochlear implantation and its impact on quality of life (QOL). MATERIAL AND METHOD Eighty-eight adult post-lingually deaf cochlear implant users entered the study. The music questionnaire analyzed musical background, listening habits, and quality of musical sound through the cochlear implant. Music perception was evaluated with the Primary Measures of Music Audiation (PMMA). The Glasgow Benefit Inventory evaluated the quality of life (QOL). The music questionnaires, the PMMA and the GBI were completed by 84 %, 74 %, and 82 % of patients, respectively. RESULTS Subjective enjoyment of music and listening habits decreased post-implantation when compared with prior to deafness. Mean scores for music perception were: tone 71 %, rhythm 78 %, timbre 61 %, songs 59 %, and melodies 23 %. The quality of music sound through the cochlear implant was associated with music enjoyment and with QOL. CONCLUSIONS Music enjoyment and perception are possible with a cochlear implant. The quality of music sound through the cochlear implant influences post-operative QOL.

Percepción y disfrute de la música en pacientes poslocutivos con implante coclear

Objetivos Evaluar la percepcion y el disfrute de la musica tras la implantacion coclear y su impacto en la calidad de vida. Material y metodo Participaron en el estudio 88 adultos con sordera poslocutiva y portadores de un implante coclear. El cuestionario de la musica analizo la experiencia musical, los habitos musicales y la calidad del sonido musical a traves del implante coclear. Para estudiar la percepcion de la musica se empleo el PMMA (Primary Measures of Music Audiation). La calidad de vida fue evaluada mediante el GBI (Glasgow Benefit Inventory). El cuestionario de la musica, el PMMA y el GBI fueron contestados por el 84, el 74, y el 82 % de los pacientes, respectivamente. Resultados El disfrute de la musica y los habitos musicales disminuyeron tras el implante coclear cuando se compararon con la situacion previa a la sordera. Los valores medios de percepcion de la musica fueron: tono, el 71 %; ritmo, el 78 %; timbre, el 61 %; canciones, el 59 %, y melodias, el 23 %. La calidad del sonido de la musica a traves del implante coclear se relaciono con el disfrute de la musica y con la calidad de vida. Conclusiones Es posible disfrutar y percibir la musica con un implante coclear. La calidad del sonido de la musica a traves del implante influye en la calidad de vida.

Calidad de vida en pacientes con implante coclear

Several articles show the audiologic benefits of cochlear implants, although it is still necessary to prove their impact on quality of life. In this study, 36 Med-El processor users were included. The Glasgow Benefit Inventory (GBI) was used to measure changes in quality of life, and another questionnaire was used to evaluate the communication abilities. Eighty-six percent of the patients answered our questionnaire. The quality of life improved significantly according to the specific questionnaire. The average total benefit obtained with the GBI was +41, and the average scores related to general, social and physics benefits were +57, +16, and +3, respectively. No significant difference was found between quality of life and other parameters like insertion depth of the array, etiology or duration of the deafness.

Laryngeal function preservation following supracricoid partial laryngectomy

Supracricoid partial laryngectomy is a surgical technique that preserves laryngeal function.

Oncologic Outcomes after Supracricoid Partial Laryngectomy

Objective. To review the oncologic outcomes of a series of supracricoid partial laryngectomy. Design. Case series with chart review. Setting. La Paz University Hospital, Madrid, Spain. Patients. Forty-one patients with glottic or supraglottic squamous cell carcinoma who underwent supracricoid partial laryngectomy between 1998 and 2008 at the authors’ institution. Main Outcome Measure. Local control rate, specific-disease survival rate, and overall survival rate. Results. All patients were male, with a mean age of 56 years (range, 38-71 years). Forty-one percent of tumors were classified as locally advanced carcinomas (T3-T4). Thirty-three patients (80%) underwent supracricoid laryngectomy with cricohyoidoepiglottopexy. Epiglottis was resected in the remaining 8 patients. One patient died in the immediate postoperative period because of cardiac tamponade, 6 developed pneumonia, 2 had a postoperative bleeding that required reintervention, and 2 developed pharyngocutaneous fistula. The median follow-up period was 43 months. More than 85% of the patients completed more than 2 years of follow-up. Five-year actuarial local control rate was 80%, being 92% for T1-T2 tumors and 67% for locally advanced tumors. Thirty-five patients (85%) preserved their larynx. The 6 patients who underwent total laryngectomy had a local recurrence or a regional recurrence that infiltrated the larynx. No laryngectomy was performed for functional reasons. Conclusion. Supracricoid partial laryngectomy is an oncologically safe procedure to preserve laryngeal functions in selected patients with glottic and supraglottic carcinomas.

Comparison of different mobile telephones in Combi40+ users.

Abstract Conclusion. Telephone usage is a difficult challenge for cochlear implanted patients. A significant number of cochlear implanted patients are able to carry on a land-line or mobile telephone conversation. The telephone model may be a critical factor for telephone performance. Objectives. The goals of this study were to evaluate speech discrimination through land-line and mobile telephones in Combi40 + users, and to compare different mobile telephone models to find out which could be more advisable for them. Patients and methods. Eighteen Combi40 + implantees were tested with CID sentences and bisyllabic words presented through land-line and mobile telephones, in both quiet and noisy environments. Results. Mean scores for telephonic speech discrimination were over 85% for CID sentences and 28–59% for bisyllabic words. The Siemens M55 was superior to the other mobile telephones tested.

Calidad de vida de los pacientes con BAHA

Objetivo El objetivo de este estudio es cuantificar los cambios en la calidad de vida en los pacientes con implantes osteointegrados (BAHA). Pacientes y metodo Se incluyo a 28 pacientes. El instrumento empleado para medir la calidad de vida fue el Glasgow Benefit Inventory y un cuestionario con 2 preguntas abiertas, uso del BAHA, modificacion de los acufenos y dolor postoperatorio. Resultados La puntuacion media del Glasgow Benefit Inventory total fue 38, y en las subescalas general, social y fisica, 54, 10 y 1, respectivamente. No se encontro relacion significativa entre el grado de audicion preoperatorio, la etiologia o el tipo de hipoacusia y la calidad de vida. La tasa de acufenos disminuyo del 37,5 al 20,8 % tras la colocacion del BAHA, con diferencias significativas. Conclusiones Nuestros resultados muestran que el uso del BAHA se asocia a una gran mejoria en la calidad de vida. Asimismo, muestran que su uso tiene un efecto positivo en los acufenos.

Quality of life of patients with BAHA

OBJECTIVE The aim of this study is to quantify changes in quality of life due to the use of BAHA. PATIENTS AND METHOD Twenty-eight patients were included. The instrument used to quantify the change in quality of life was the Glasgow Benefit Inventory and a questionnaire including 2 open questions, BAHA use, change in tinnitus, and postoperative pain. RESULTS The average total benefit score with the Glasgow Benefit Inventory was 38, and the general, social, and physical score were 54, 10, and 1, respectively. There was no significant association between preoperative hearing, aetiology or type of hearing loss, and quality of life. Tinnitus rate went from 37.5% to 20.8% following BAHA; this difference being significant. CONCLUSIONS Our results show that the use of BAHA is associated with a great improvement in quality of life. Also, they show that its use has a positive effect upon tinnitus.

Valor predictivo de la paratohormona en la hipocalcemia postiroidectomía

INTRODUCTION AND OBJECTIVE The risk of developing hypocalcemia is the reason for prolonged hospitalisation after total thyroidectomy. The objective of this study was to validate parathyroid hormone measurement for predicting post-thyroidectomy hypocalcemia. MATERIAL AND METHODS Eighty-two patients who underwent total or completion thyroidectomy from February 2009 to March 2010 were enrolled in this prospective study to determine the best timing and cutoff point of parathyroid hormone to predict hypocalcemia. Patients with any condition that could interfere with calcium homeostasis were excluded from the survey. Parathyroid hormone and serum calcium levels were determined preoperatively, immediately after surgery and a number of hours later. RESULTS Treatment for hypocalcemia was required in 16.7% of patients. A percent of delayed decrease in parathyroid hormone was chosen as the best measurement to predict hypocalcemia. An 80% or higher decrease in delayed parathyroid hormone levels had 100% sensitivity (95% CI: 77.2-100%) and 87% specificity (95% CI: 77-93%) for selecting patients for early discharge. Using this test, 73.2% of the patients could have been discharged 24 hours after surgery. A 98% decrease in delayed parathyroid hormone levels could select candidates for early calcium replacement with 98.6% specificity (95% CI: 92.2-99.7%). CONCLUSIONS The decrease in postoperative delayed parathyroid hormone levels is a good predictor of post-thyroidectomy hypocalcemia. A decrease of 80% or more in delayed parathyroid hormone level is a test with excellent sensibility and specificity for selecting candidates for early discharge. The 98% cutoff point has high specificity for selecting patients for early calcium replacement.