Isabel Sanchez-Cuadrado

Retrosigmoid implantation of an active bone conduction stimulator in a patient with chronic otitis media

Percutaneous bone conduction implants are widely used in patients with conductive and mixed hearing loss with no benefit from conventional air conduction hearing aids. These devices have several complications including skin reaction, wound infection, growth of skin over the abutment, and implant extrusion. We describe a case of a transcutaneous bone conduction implantation (Bonebridge, Med-el) in a patient with conductive hearing loss due to chronic otitis media. Surgical planification was performed with the software 3D slicer 4.1. According to this program, the implant transductor was positioned in the retrosigmoid area. Aided thresholds demonstrate a significant benefit, with an improvement from 68dB to 25dB. Speech discrimination scores improved 35dB. The patient is very happy and uses her device daily. The Bonebridge implant is a promising transcutaneous bone conduction implant for patients with conductive hearing loss. Retrosigmoid implantation may be useful in cases with mastoid pathology or previous surgery.

Laryngeal function preservation following supracricoid partial laryngectomy

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

Pros and Cons of Round Window Vibroplasty in Open Cavities: Audiological, Surgical, and Quality of Life Outcomes.

Objective To evaluate the audiological, surgical, quality of life, and quality of sound outcomes in adults with open cavities implanted with the Vibrant Soundbridge (VSB) implant using round window (RW) vibroplasty approach. Study Design Retrospective study. Setting Otolaryngology department, tertiary referral hospital. Subjects and Methods Twelve adult patients with conductive or mixed hearing loss, all with previous middle ear surgery, underwent RW vibroplasty in an open cavity. Compound action potential thresholds were assessed during surgery. Surgical complications were recorded. Subjective benefit was evaluated using the Nijmegen Cochlear Implant Questionnaire (NCIQ), Glasgow Benefit Inventory (GBI), and Hearing Implant Sound Quality Index (HISQUI29) tests. Results Mean follow-up was 42 months (range 12–76). There was no significant change in bone conduction thresholds after surgery. Mean functional gain was 34.3 dB and speech discrimination score at 65 dB significantly improved from 14 to 83%. Extrusion of the wire link was the main surgical complication in four patients. All NCIQ domains improved after surgery. All patients had a positive overall GBI score (mean 35.0). Mean HISQUI29 score was 152.8, on average the quality of sound being defined as “very good.” Conclusion VSB is an effective method of hearing restoration for adults with open cavities suffering from conductive or mixed hearing loss. Intraoperative electrocochleography may be considered of significant help to check the coupling to the inner ear. The high rate of extrusion suggests that middle ear obliteration may be considered in these patients.

Reliability and validity of the Nijmegen Cochlear Implant Questionnaire in Spanish

The Nijmegen Cochlear Implant Questionnaire (NCIQ) is a specific and quantifiable self-assessment health-related quality of life (QoL) questionnaire. It was developed to determine the subjective benefits of a cochlear implant (CI). The present study aimed to determine the validity and reliability of the NCIQ in Spanish. Seventy-six adult, Spanish speaking, CI users and 28 control subjects answered the NCIQ. Reliability of the questionnaire was determined using Cronbach’s α coefficient and the validity established using Pearson’s correlation coefficient. All questionnaire respondents performed significantly better in all sub-domains with a cochlear implant than before cochlear implantation. The Cronbach’s α score exceeded 0.70 in most sub-domains and the total score. The objective measures: bisyllables tested without lip-reading and with masking; and bisyllables, tested without lip-reading and without masking were correlated with the sub-domain ‘advanced sound perception’. To determine health-related QoL the NCIQ in Spanish is a reliable self-assessment questionnaire and a valuable instrument in determining the subjective benefit of a CI.

Which ear should we choose for cochlear implantation in the elderly: The poorer or the better? Audiometric outcomes, quality of sound, and quality-of-life results

Abstract Conclusions: Cochlear implantation in the poorer ear of an elderly patient does not predict poorer post-operative audiological, quality-of-life (QoL), and quality of sound results. Objectives: To determine whether choosing the ‘better’ or the ‘poorer’ ear for cochlear implantation impacts performance outcome in an elderly population. Methods: Forty-two out of 73 elderly (≥ 60 years) cochlear implant users with some residual hearing in at least one ear were selected. Three criteria were used to group the patients as ‘better’ or ‘poorer’ ear implanted; (C1) based on previous use of hearing aid, (C2) pre-operative PTA, and (C3) pre-operative speech discrimination. The Glasgow Benefit Inventory (GBI) and the Hearing Implant Sound Quality Index (HISQUI) were used to measure QoL and quality of sound, respectively. Results: The mean post-operative PTA was 38.7 ± 7.2 dBHL. In quiet, the mean disyllabic SDS at 65dBSPL was 75.4 ± 18.5, whereas the discrimination of sentences was 95.0% ± 6.9. The mean total GBI score was 30.9 ± 21.8, 92.9% of patients reporting a positive score. The mean HISQUI score was 111.3 ± 36.0, which corresponds to ‘moderate’ sound quality. No significant differences were found between both groups in terms of audiological outcomes, HISQUI scores or GBI scores when considering each of the three criteria.

Validation of the Hearing Implant Sound Quality Index (HISQUI19) to assess Spanish-speaking cochlear implant users’ auditory abilities in everyday communication situations

Abstract Conclusion: The Spanish-language HISQUI19 is a reliable and easy-to-use tool for quantifying the self-perceived level of auditory benefit that cochlear implant (CI) users experience in everyday listening situations. Objectives: To validate the Spanish-language version of The Hearing Implant Sound Quality Index (HISQUI19), a questionnaire for quantifying the self-perceived level of auditory benefit that CI users experience in everyday listening situations. Methods: Adult Spanish-speaking subjects with a CI were asked to complete a Spanish-language version of the HISQUI19. Reliability of the questionnaire was determined using Cronbach’s α coefficient; exploratory factor analyses with a rotated (varimax) factor solution was applied to check construct validity; external validity was confirmed using Pearson’s correlation. Test–re-test analysis was also performed. The MED-EL Assessment Database was used to assist in the administration, reporting, and data collection. Results: Sixty-six of 77 subjects completed and returned the HISQUI19. The mean score auditory ability score (mean ± standard deviation) of the HISQUI19 was 79.9 ± 24.0, a ‘moderate’ auditory benefit. An inverse relationship was found between the HISQUI19 score and age at implantation. Gender and side of implantation did not influence self-perceived functioning. The objective measures (disyllables tested without lip-reading and in quiet) were correlated with the Total Score.

Is There an Age Limit for Cochlear Impantation

Objective: Evaluate quality of life following cochlear implantation in older postlocutive adults. Method: Postlingually deaf adults 60 years or older who underwent implantation in 3 institutions were included. Data concerning demographics and audiometric evaluation were collected and studied. Patients were divided in 2 groups (< 70 and ≥ 70 years). GBI was used to quantify quality of life. Results: Eighty-one patients were included. The mean age at implantation was 68 years (range, 60-82 years). A significant improvement in speech recognition after cochlear implantation was observed (P < .01). The results of the GBI questionnaire showed an important benefit on the total scale (mean, 40) and on the 3 different subscales (53, 24, and 4, respectively). These results were similar to those of younger postlocutive candidates. However, particular cases with decreased quality of life were identified, in spite of acceptable audiologic results. The difference between the <70 and ≥70 years groups was not significant. Conclusion: Elderly CI users improve their quality of life, with similar outcomes to those achieved by younger adults. Because of particular conditions of this population, care must be taken when indicating a CI. Cochlear implantation should not be denied on the basis of age alone.

Guía clínica sobre implantes de conducción de vía ósea

INTRODUCTION AND GOALS During the last decade there have been multiple and relevant advances in conduction and mixed hearing loss treatment. These advances and the appearance of new devices have extended the indications for bone-conduction implants. The Scientific Committee of Audiology of the Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello SEORL-CCC (Spanish Society of Otolaryngology and Head and Neck Surgery), together with the Otology and Otoneurology Committees, have undertaken a review of the current state of bone-conduction devices with updated information, to provide a clinical guideline on bone-conduction implants for otorhinolaryngology specialists, health professionals, health authorities and society in general. METHODS This clinical guideline on bone-conduction implants contains information on the following: 1) Definition and description of bone-conduction devices; 2) Current and upcoming indications for bone conduction devices: Magnetic resonance compatibility; 3) Organization requirements for a bone-conduction implant programme. RESULTS AND CONCLUSIONS The purpose of this guideline is to describe the different bone-conduction implants, their characteristics and their indications, and to provide coordinated instructions for all the above-mentioned agents for decision making within their specific work areas.

Guía clínica sobre implantes cocleares

INTRODUCTION In the last decade numerous hospitals have started to work with patients who are candidates for a cochlear implant (CI) and there have been numerous and relevant advances in the treatment of sensorineural hearing loss that extended the indications for cochlear implants. OBJECTIVES To provide a guideline on cochlear implants to specialists in otorhinolaryngology, other medical specialities, health authorities and society in general. METHODS The Scientific Committees of Otology, Otoneurology and Audiology from the Spanish Society of Otolaryngology and Head and Neck Surgery (SEORL-CCC), in a coordinated and agreed way, performed a review of the current state of CI based on the existing regulations and in the scientific publications referenced in the bibliography of the document drafted. RESULTS The clinical guideline on cochlear implants provides information on: a) Definition and description of Cochlear Implant; b) Indications for cochlear implants; c) Organizational requirements for a cochlear implant programme. CONCLUSIONS A clinical guideline on cochlear implants has been developed by a Committee of Experts of the SEORL-CCC, to help and guide all the health professionals involved in this field of CI in decision-making to treathearing impairment.

Implantes activos de oído medio

Active middle ear implants are surgically implanted prosthesis, which intend to stimulate the ossicular chain or the inner ear fluids through the oval or round windows. These implants may be useful for the treatment of certain patients with sensorineural hearing loss as well as for conductive or mixed hearing loss. This clinical guide attempts to summarize the current knowledge concerning the basic characteristics and indications of the most commonly used middle ear implants, including Vibrant Soundbrige (Med-el, Innsbruck), Carina (Cochlear, Australia), and CodacsTM. (Cochlear, Australia).