Antonio Morant

Complicaciones y fallos de la implantación coclear

INTRODUCTION Cochlear implantation is a relatively safe surgery performed on profound bilateral hearing loss patients. Its surgical indications have increased and the age of implantation has decreased over the last years. As with any other surgery, it presents complications; device failure is one of the most important, given its potential risk for the need to explant and reimplant the device. OBJECTIVE To evaluate cochlear implant complications, determine possible causes and discuss medical and surgical management. MATERIAL AND METHODS A retrospective study of cochlear implants was performed. A total of 246 implants over an eleven-year period were evaluated. The sample consisted of 123 implants in patients younger than 10 years old, and 123 in those older than 10 years old; there were 138 males and 108 females. The devices implanted were 129 Advance Bionics, 95 MED-El, and 22 Cochlear. Complications and device failures were analysed. RESULTS A total of 28 complications were reported, which corresponds to 11.38% of all implants. Seven minor complications and 21 mayor complications were found. Device Failure was the most frequent complication, reported in 6.5% of all implants, and it was more frequent among children less than 10 years old. CONCLUSIONS Cochlear implant surgery has a low complication rate. Complications are usually resolved easily, but device failure continues to be a problem. It is important to keep studying the causes of such failure to find possible solutions that can lead to lowering and resolving its appearance.

Auditory Neuropathy in Children

Auditory neuropathy is a sensorineural disorder characterized by absent or abnormal auditory brainstem evoked potentials and normal cochlear outer hair cell function. A variety of processes is thought to be involved in its pathophysiology and their influence on hearing may be different. We present here the diagnostic sequence and management of two new cases of auditory neuropathy in breastfeeding children.Auditory neuropathy is a sensorineural disorder characterized by absent or abnormal auditory brainstem evoked potentials and normal cochlear outer hair cell function. A variety of processes is thought to be involved in its pathophysiology and their influence on hearing may be different. We present here the diagnostic sequence and management of two new cases of auditory neuropathy in breastfeeding children.

Cochlear implant complications and failures

Abstract Introduction Cochlear implantation is a relatively safe surgery performed on profound bilateral hearing loss patients. Its surgical indications have increased and the age of implantation has decreased over the last years. As with any other surgery, it presents complications; device failure is one of the most important, given its potential risk for the need to explant and reimplant the device. Objective To evaluate cochlear implant complications, determine possible causes and discuss medical and surgical management. Material and methods A retrospective study of cochlear implants was performed. A total of 246 implants over an eleven-year period were evaluated. The sample consisted of 123 implants in patients younger than 10 years old, and 123 in those older than 10 years old; there were 138 males and 108 females. The devices implanted were 129 Advance Bionics, 95 MED-El, and 22 Cochlear. Complications and device failures were analysed. Results A total of 28 complications were reported, which corresponds to 11.38% of all implants. Seven minor complications and 21 mayor complications were found. Device Failure was the most frequent complication, reported in 6.5% of all implants, and it was more frequent among children less than 10 years old. Conclusions Cochlear implant surgery has a low complication rate. Complications are usually resolved easily, but device failure continues to be a problem. It is important to keep studying the causes of such failure to find possible solutions that can lead to lowering and resolving its appearance.

Benefits of the HiRes 120 coding strategy combined with the Harmony processor in an adult European multicentre study

Abstract Conclusion: The Harmony processor was found to be reliable, comfortable and offered a substantially increased battery life compared with the previous generation processor. No significant improvement in speech understanding with HiRes was demonstrated from objective measures, but the majority of subjects showed a clear subjective preference for the combination HiRes 120/Harmony processor. Objectives: To evaluate experience with the Harmony™ sound processor, together with the HiRes 120 strategy. Methods: Postlingually deafened adults implanted with a CII or HiRes 90K were included and divided into three groups: (1) experienced users using the Platinum body-worn processor; (2) experienced users who had been using other processors; (3) new users with the Harmony processor from first fitting. The latter group entered a randomized crossover protocol where half were initially fitted with HiRes and half with HiRes 120. The initial strategy was used for 3 months and the alternative for a further 3 months. Speech perception tests and questionnaires were performed. Results: The study included 65 subjects. Implementing HiRes 120 was straightforward. The speech test group results did not show significant differences between HiRes and HiRes 120. However, the questionnaires showed significantly higher ratings for HiRes 120 in some instances. Subjects were highly satisfied with the Harmony processor.

Paediatric cochlear implantation in the critical period of the auditory pathway, our experience

Abstract Introduction Numerous experimental and clinical studies have suggested a critical or sensitive period in which the auditory pathway develops its greatest potential in terms of plasticity and learning. Early cochlear implantation performed in prelingual deaf children in this period provides a better prognosis for language acquisition. The aim of this study is to show the importance of cochlear implantation before this critical period ends. Methods We conducted an observational, longitudinal, retrospective study of 57 children suffering profound prelingual bilateral sensorineural hearing loss who had received Advanced Bionics implants at our ENT department between June 1998, and November 2006. Data on their audiometric thresholds, the disyllabic word test adapted to children, open-set sentences recognition test and the Nottingham scale were analyzed. Results The analysis of audiometric thresholds showed no differences between children receiving the implants at different ages. However, statistically significant differences (P Conclusions Our results are in line with other publications showing differences in auditory performance when comparing children with early implants versus children receiving the implants at a later age. We found the greatest differences at 4 years of age. Nevertheless, these findings should not exclude children over this age from implantation.

La implantación coclear pediátrica en el periodo crítico de la vía auditiva, nuestra experiencia

INTRODUCTION Numerous experimental and clinical studies have suggested a critical or sensitive period in which the auditory pathway develops its greatest potential in terms of plasticity and learning. Early cochlear implantation performed in prelingual deaf children in this period provides a better prognosis for language acquisition. The aim of this study is to show the importance of cochlear implantation before this critical period ends. METHODS We conducted an observational, longitudinal, retrospective study of 57 children suffering profound prelingual bilateral sensorineural hearing loss who had received Advanced Bionics implants at our ENT department between June, 1998, and November, 2006. Data on their audiometric thresholds, the disyllabic word test adapted to children, open-set sentences recognition test and the Nottingham scale were analyzed. RESULTS The analysis of audiometric thresholds showed no differences between children receiving the implants at different ages. However, statistically significant differences (p<0.05) were found in speech tests between groups of children receiving the implants before and after 4 years of age. CONCLUSIONS Our results are in line with other publications showing differences in auditory performance when comparing children with early implants versus children receiving the implants at a later age. We found the greatest differences at 4 years of age. Nevertheless, these findings should not exclude children over this age from implantation.