scholarly journals Factors affecting outcome of cochlear implant: an observational study

2020 ◽  
Vol 6 (10) ◽  
pp. 1811
Author(s):  
Parth Patni ◽  
Deepak Dalmia ◽  
Udayanila T. ◽  
Harish Katakdhond ◽  
Karthika Bhagavan
Keyword(s):  
Observational Study ◽  
Cochlear Implant ◽  
Cochlear Implantation ◽  
Speech Intelligibility ◽  
Age Groups ◽  
Auditory Deprivation ◽  
Implant Surgery ◽  
Factors Affecting ◽  
Significant Difference ◽  
Cochlear Implant Surgery

<p><strong>Background: </strong>Aim and objectives of the study was to evaluate various factors affecting outcome in cochlear implant surgery.<strong></strong></p><p><strong>Methods: </strong>A hospital based retrospective observational study in which 51 patients who underwent cochlear implant surgery from July 2017 to January 2019 were evaluated at Dr. Babasaheb Ambedkar Memorial Hospital, Byculla, Mumbai using 3 parameters i.e. Revised CAP score (CAP), meaningful auditory integration scale (MAIS), speech intelligibility rating (SIR) at various intervals postoperatively and outcome was evaluated.</p><p><strong>Results: </strong>It was found that the postoperative mean scores in all age groups were comparable but not significant at 3, 6 and 9 months interval while the difference was statistically significant at 12 and 24 months interval post implantation with less than 2 years age group performing better than other age groups patients with less than 2 years duration of auditory deprivation, the mean scores were found to be statistically significant at 12 and  24 months implantation Relationship to common causes such as prenatal infections, low birth weight, prolonged labour, hyperbilirubinemia, meningitis and consanguineous marriage were considered but not significant. No significant difference was observed in parent’s education level, urban-rural population to the outcome of cochlear implantation.</p><p><strong>Conclusions: </strong>Two most important factors that affect the outcome cochlear implantation are the age at implantation and the duration of auditory deprivation. Other factors are important but not significant and do not affect the outcome significantly.</p>

Cochlear implant surgery and perioperative dizziness is associated with utricular hyperfunction

2021 ◽  
pp. 1-10
Author(s):  
Michelle Truong ◽  
Christo Bester ◽  
Kumiko Orimoto ◽  
Maria Vartanyan ◽  
Debra Phyland ◽  
...  
Keyword(s):  
Observational Study ◽  
Cochlear Implant ◽  
Cochlear Implantation ◽  
Subjective Visual Vertical ◽  
Implant Surgery ◽  
Otolith Function ◽  
Cochlear Implant Surgery ◽  
Visual Vertical ◽  
Perioperative Complication ◽  
Utricular Function

BACKGROUND: Dizziness is a common perioperative complication after cochlear implantation (CI). To date, the exact cause behind this phenomenon remains unclear. There is recent evidence to suggest that otolith function, specifically utricular, may be affected shortly after CI surgery, however whether these changes are related to patient symptoms has not yet been investigated. OBJECTIVE: To determine whether CI surgery and perioperative dizziness is associated with changes on utricular function. METHODS: We performed an observational study on patients undergoing routine CI surgery. Utricular function was assessed using the Subjective Visual Vertical (SVV), and perioperative dizziness was determined using a questionnaire. The study followed patients before surgery and then again 1-day, 1-week and 6-weeks after implantation. RESULTS: Forty-one adult CI recipients participated in the study. The SVV deviated away from the operated ear by an average of 2.17° a day after implantation, 0.889° 1 week and –0.25° 6 weeks after surgery. Dizziness contributed to a tilt of 0.5° away from the implanted ear. These deviations were statistically significant. CONCLUSIONS: CI surgery causes utricular hyperfunction in the operated ear that resolves over 6 weeks. SVV tilts were greater in participants experiencing dizziness, suggesting that utricular hyperfunction may contribute to the dizziness.

scholarly journals Cochlear implant surgery at the Clinical Center of Vojvodina - ten-year experience

2014 ◽  
Vol 67 (suppl. 1) ◽  
pp. 25-31
Author(s):  
Dragan Dankuc ◽  
Darja Segan ◽  
Zoran Komazec ◽  
Ljiljana Vlaski ◽  
Slobodanka Lemajic-Komazec ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Facial Nerve ◽  
Cochlear Implant ◽  
Surgical Procedures ◽  
Cochlear Implantation ◽  
Facial Nerve Paralysis ◽  
Nerve Paralysis ◽  
Implant Surgery ◽  
Clinical Center ◽  
Cochlear Implant Surgery

Introduction. The first cochlear implant surgery was performed at the Center for Cochlear Implantation of the Department of Ear, Nose and Throat Diseases, Clinical Center of Vojvodina in 2002 after long preparations and that was the first successful cochlear implantation in Serbia. Material and Methods. Over the period from November 2002 to November 2013, 99 patients underwent surgical procedures and 100 cochlear implants were placed. Results. The analysis encompassed 99 patients, the youngest and the oldest one being 1 year and 61 years old, respectively. Prelingual and postlingual deafness developed in 84 (84.9%) and in 15 (15.1%), respectively. Postlingual deafness was observed in all 11 adult patients. The prelingual deafness was diagnosed in 84 (95.4%) children, whereas in four (4.6%) children it occurred after the development of speech between 6 and 8 years of age. Progressive hearing loss was observed in 11 patients - seven adults and four children. The majority of our patients, i.e. 74 (74.75%) manifested idiopathic deafness of unknown cause. A range of usually reported hearing loss etiologies included ototoxic medications in seven (7.07%), hereditary factor in six (6.06%), and bacterial meningitis in four (4.04%) patients. Somewhat less common causes were perinatal hypoxia in three (3.03%), premature birth in three (3.03%), Down syndrome in one (1.01%), and chronic otitis media in one (1.01%) patient. Conclusion. Both intraoperative and postoperative complications were analyzed in the investigated patient population. The complications developed in 11 patients, i.e. in 10.5% of 105 surgical procedures. The majority of procedures (89.5%) were not accompanied by any post-surgical complications. Unsuccessful implantation in a single-step procedure and transient facial nerve paralysis can be considered most frequent among our patients, whereas cochlear ossification and transient ataxia occurred more rarely. Stimulation of facial nerve, intraoperative perilymph liquid gusher, device failure and late infections were recorded extremely rarely.

S237 – Computerized Tomography in the Prediction of CSF Gusher

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P154-P155
Author(s):  
Vanessa S Rothholtz ◽  
Mahmood F Mafee ◽  
Nancy M Young
Keyword(s):  
Cochlear Implant ◽  
Temporal Bone ◽  
Computerized Tomography ◽  
Cochlear Implantation ◽  
Statistical Significance ◽  
Internal Auditory Canal ◽  
Implant Surgery ◽  
Tegmen Tympani ◽  
Cochlear Implant Surgery ◽  
Temporal Bone Anatomy

Objectives 1) Identify anatomic variations of the temporal bone in children with and without cochlear malformations who experienced an intra-operative cerebrospinal fluid (CSF) gusher at the time of cochlear implantation. 2) Compare the anatomic findings in the current study to those described in prior studies. Methods A retrospective case-controlled chart review was performed on patients undergoing cochlear implant surgery. Computerized tomography images were analyzed in a single-blind fashion for characteristics and measurements of both the right and left cochlea, internal auditory canal, cochlear aperture, facial nerve canal, vestibular aqueduct, cochlear aqueduct, oval window, round window, vestibule, mastoid, tegmen tympani and semi-circular canals. After verifying equal variances, data was statistically evaluated utilizing the paired 2-tailed t test with criterion for statistical significance set at p < 0.05. Results The average age at implantation for this series of children was 4 years old. 70% of patients had cochlear malformations. 25% of patients had an abnormal internal auditory canal (IAC) and 30% had a widened cochlear aperture. Most patients with an abnormal IAC had an abnormal cochlear aperture; however, some patients with a normal IAC also had an abnormal cochlear aperture. Correlations between the temporal bone anatomy and the incidence of CSF gushers will be discussed. Conclusions Specific characteristics of the temporal bone anatomy may lead to an increased incidence of CSF gusher in cochlear implant surgery. Computerized tomography of the temporal bone can assist in the surgeon in evaluation and planning for cochlear implantation.

scholarly journals Multicentre cohort study of cochlear implantation outcomes in Thailand

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e054041
Author(s):  
Patorn Piromchai ◽  
Napas Tanamai ◽  
Sivaporn Kiatthanabumrung ◽  
Suwicha Kaewsiri ◽  
Kanthong Thongyai ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cohort Study ◽  
Cochlear Implant ◽  
Cochlear Implantation ◽  
Secondary Outcome ◽  
University Hospitals ◽  
Implant Surgery ◽  
Cochlear Implant Surgery ◽  
The Mean

ObjectivesTo report the status and outcomes of cochlear implantation in Thailand.DesignCohort study.SettingTertiary care and university hospitals.ParticipantsPatients who underwent cochlear implant surgery in Thailand.InterventionsThis project collected data from all government and university hospitals in Thailand where cochlear implant surgery was performed between 2016 and 2020.Primary and secondary outcome measuresBaseline characteristics, operation data, complications, audiological outcomes and quality of life were reported.ResultsThis study included 458 patients, and nearly half of the patients were children and adolescents (46.94%). The mean age of the patients was 2.96±5.83 years. At 1 year postoperatively, the mean pure tone average of the hearing threshold in the implanted ear significantly improved from unaided preoperative baseline (mean difference (MD) 64.23 dB HL; 95% CI 59.81 to 68.65; p<0.001). The mean speech recognition threshold also improved (MD 55.96 dB HL; 95% CI 49.50 to 62.42, p<0.001). The quality-of-life scores of the EQ-5D-5L, PedsQL and HUI3 questionnaires at 1 year showed improved mobility (range, 0–5; MD 0.65; 95% CI 0.05 to 1.25; p=0.037), hearing (range, 0–6; MD 0.96; 95% CI 0.30 to 1.61; p=0.006) and speech (range, 0–5; MD 0.44; 95% CI 0.04 to 0.84; p=0.031). Common complications included electrode dislodgement (2.18%), vertigo (1.23%) and meningitis (1.93%).ConclusionsExcellent audiological outcomes and improvement in the quality of life in the mobility, hearing and speech domains were observed in patients who underwent cochlear implantation in Thailand.

scholarly journals Cochlear Implant Surgical Technique: Our Experience

2018 ◽  
Vol 01 (01) ◽  
pp. 007-010
Author(s):  
Milind Kirtane ◽  
Kashmira Chavan
Keyword(s):  
Surgical Technique ◽  
Cochlear Implant ◽  
Cochlear Implantation ◽  
Electrode Array ◽  
Surgical Approaches ◽  
Implant Surgery ◽  
Original Technique ◽  
Cortical Mastoidectomy ◽  
Cochlear Implant Surgery ◽  
Posterior Tympanotomy

Abstract Introduction Different surgical approaches have been adopted for cochlear implantation, with cortical mastoidectomy–posterior tympanotomy being the most commonly followed technique. Method In this article, we describe the surgical technique for cochlear implant followed at our center, which has been successfully implemented in more than 2,500 cochlear implant surgeries. Cochlear implant surgery using the cortical mastoidectomy–posterior tympanotomy technique has been performed in more than 2,500 cases with some modifications to the original technique over a period of time. Results In spite of not using tie-down holes and securing down the receiver–stimulator with sutures, no cases of receiver–stimulator displacement or outward electrode migration have been noted with the current technique of creating a snug-fitting subperiosteal pocket along with a hook for the electrode array. Conclusion Adhering to a strict intraoperative surgical protocol plays an extremely important role in carrying out successful cochlear implant surgeries with minimal complications.

scholarly journals Factors affecting audiological performance and speech intelligibility in prelingually deaf children after cochlear implantation: a study

2019 ◽  
Vol 5 (4) ◽  
pp. 1035 ◽  
Author(s):  
Abhipsa Hota
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Cochlear Implantation ◽  
Speech Intelligibility ◽  
Deaf Children ◽  
Auditory Deprivation ◽  
Factors Affecting ◽  
Negative Relation ◽  
Auditory Performance ◽  
Prelingually Deaf

<p class="abstract"><strong>Background:</strong> The primary aim is to understand the factors affecting the audiological, speech and language outcome in prelingually deaf children, with bilateral severe to profound sensorineural hearing loss, who have undergone cochlear implantation.</p><p class="abstract"><strong>Methods:</strong> 40 prelingually deaf children, with bilateral severe to profound sensorineural hearing loss, who have undergone cochlear implantation were enrolled. Auditory performance and speech intelligibility was gauged by revised categories of auditory performance (CAP) score and speech intelligibility rating (SIR) respectively, preoperatively and at 3 months, 6 months and 1 year post cochlear implantation. These values were analysed using statistical package for social sciences with respect to duration of auditory deprivation, duration of use of hearing aid prior to cochlear implantation, duration of auditory verbal therapy prior to cochlear implantation and age of child at cochlear implantation.  </p><p class="abstract"><strong>Results:</strong> There is a negative relation between CAP and duration of auditory deprivation at 6 months and 1 year post cochlear implantation. Also, negative relation is seen between CAP and age of child at cochlear implantation at 6 months and 1 year post cochlear implantation. There is a negative relation between SIR and duration of auditory deprivation at 6 months and 1 year post cochlear implantation. Also, negative relation is seen between SIR score and age of child at cochlear implantation at 3 months, 6 months and 1 year post cochlear implantation.</p><p class="abstract"><strong>Conclusions:</strong> Lesser the auditory deprivation and younger the child at cochlear implantation, better is the audiological performance and speech intelligibility post cochlear implantation.</p><p> </p>

scholarly journals Correlation between behaviorally measured comfort (c) levels and electrically evoked stapedius reflex thresholds (ESRT) in children with unilateral cochlear implant

2019 ◽  
Vol 11 (4) ◽  
pp. 201-206
Author(s):  
Roshani Mishra ◽  
Aparna Nandurkar
Keyword(s):  
Cochlear Implant ◽  
Cochlear Implantation ◽  
Pediatric Population ◽  
Adult Population ◽  
Age Groups ◽  
Acoustic Stimulation ◽  
Comfort Level ◽  
Clear Cut ◽  
Significant Difference ◽  
Stapedius Reflex

Introduction: Decrease in the lower age limit for paediatric cochlear implantation and increasing records of cochlear implantation in children with associated impairments demand quick and easily available objective measurements to provide MAP in these children as their speech and language ability may not be adequate to provide clear cut explanation about comfort level. Providing adequate amount of acoustic stimulation in this golden period of life (i.e. 0-2 years) is important in ensuring the proper utilization of acoustic cues. Findings of adult population cannot be directly applied to younger children and till date there is no Indian study reporting relationship between Electrically Evoked Stapedial Reflex Thresholds (ESRT) and behavioural Comfort levels, especially in pediatric population. Aim: The present study aimed to assess the correlation between behaviorally measured comfort (C) levels and Electrically Evoked Stapedius Reflex Thresholds (ESRT) in children with unilateral cochlear implant. Method: Children (n=40) with age range of 4-12 years, who received the same type of CI and electrode configuration, were selected for the study. Participants were divided into two groups – younger and older - based on their chronological age. Behavioural C-level measurement and ESRT measurement were done after tympanometry for both the groups. Correlation between the two measures was obtained and comparison between the two groups was done. Results and discussion: Recorded ESRT was consistently higher than the behaviorally obtained C-level for both the groups. The correlation between ESRT and C-level varies from moderate to very strong and strong to very strong for the younger and older groups respectively. No statistically significant difference was found between the correlations for the two age groups. Conclusions: High correlations were found between the ESRT and behaviorally obtained C-levels. Thus ESRT can be utilized as a tool for programming in younger implant recipients.

scholarly journals A PRELIMINARY STUDY ON ANALYSIS OF PHONOLOGICAL PROCESSES IN TAMIL SPEAKING HEARING IMPAIRED CHILDREN WITH COCHLEAR IMPLANTS

2021 ◽  
Vol 9 (01) ◽  
pp. 769-773
Author(s):  
Dhinakaran N. ◽  
◽  
Karthikeyan B.M ◽  
Keyword(s):  
Cochlear Implant ◽  
Cochlear Implants ◽  
Speech Intelligibility ◽  
Hearing Impaired ◽  
Phonological Processes ◽  
Implant Surgery ◽  
Younger Age ◽  
Cochlear Implant Surgery ◽  
Impaired Children ◽  
Hearing Impaired Children

Phonological Processes are simplification of sounds which occur among the children during the younger age and will gradually diminish giving an adult like speech form. The aim of the present study is to analyze the occurrence of phonological processes among hearing impaired children who underwent cochlear implant surgery during their younger age as an early intervention. The subjects included in the study were 10 children (5 male and 5 female) who were diagnosed with congenital total hearing impairment and underwent cochlear implant surgery and attending Auditory verbal therapy. The task given to the subjects in the present study is to repeat the words in Tamil Articulation Test followed by the Clinician. The words were recorded and further analyzed for the occurrence of phonological processes. The results show that a total of 26 phonological processes (both typical and atypical) occurred with a maximum occurrence of Depalatalization and minimally of Final Consonant Deletion. The results of the present study help in providing a better knowledge about the occurrence of phonological processes which helps the speech language pathologist in intervening hearing impaired children with cochlear implants and to improve their speech intelligibility.

Another reason for intra-operative imaging during cochlear implantation

2008 ◽  
Vol 122 (4) ◽  
Author(s):  
M Viccaro ◽  
E De Seta ◽  
E Covelli ◽  
V Marvaso ◽  
R Filipo
Keyword(s):  
Cochlear Implant ◽  
Semicircular Canal ◽  
Cochlear Implantation ◽  
Electrode Array ◽  
Neural Response ◽  
Radiological Assessment ◽  
Implant Surgery ◽  
Stimulation Intensity ◽  
Cochlear Implant Surgery ◽  
The Right

AbstractObjective:We report a case of a rare cochlear implant complication: the introduction of the electrode array into the superior semicircular canal, with intra-operative measurements of neural response reactions suggesting reasonable functioning of the implant.Case report:A two-year old patient affected by congenital, profound, sensorineural deafness underwent bilateral cochlear implantation at the ENT clinic of the ‘La Sapienza’ University of Rome. Two Clarion 90k devices were implanted, and electrophysiological and radiological checks were performed. After the introduction of the array in the right side, neural response imaging was performed, and a neural potential was found only on two apical electrodes, at a stimulation intensity of 431 clinical units. The situation differed on the left side, where neural response imaging was present at a stimulation intensity of 300 clinical units on the two electrodes tested (one apical electrode (number three), and one middle electrode (number nine)). Intra-operative radiological assessment with a transorbital plain films was performed as usual in order to assess the position of the electrodes inside the cochlea. This radiography showed the electrode array to be in the superior semicircular canal in the right ear.Conclusion:Intra-operative monitoring tests during cochlear implant surgery play different roles; measurement of impedances and neural response imaging can evaluate the integrity of implant electrodes and the status of the electrode–cochlea interface, but it must not be the sole way in which correct positioning of the array is confirmed. In our opinion, intra-operative radiological assessment is mandatory during cochlear implant surgery.

The incidence of hyperthermia during cochlear implant surgery in children

2017 ◽  
Vol 131 (10) ◽  
pp. 900-906 ◽  
Author(s):  
A Schwartz ◽  
D Kaplan ◽  
V Rosenzweig ◽  
M Klein ◽  
B F Gruenbaum ◽  
...  
Keyword(s):  
Cochlear Implant ◽  
Cochlear Implantation ◽  
Medical Center ◽  
Ophthalmic Surgery ◽  
Beer Sheva ◽  
Implant Surgery ◽  
Cochlear Implant Surgery ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Clinical Triad

AbstractBackground:Inadvertent hyperthermia during anaesthesia is a rare but life-threatening complication. We have encountered several cases of severe hyperthermia in paediatric patients undergoing anaesthesia for cochlear implantation.Methods:This study aimed to describe the clinical characteristics of children who developed hyperthermia while undergoing cochlear implantation, and to explore possible mechanisms and predisposing factors. The anaesthetic charts of all patients aged under 18 years who underwent cochlear implantation, or mastoid or ophthalmic surgery, between 1 January 2006 and 31 December 2009, at Soroka Medical Center in Beer Sheva, Israel, were reviewed. Patients undergoing mastoid and ophthalmic surgical procedures were used as controls.Results:A larger percentage of patients who underwent cochlear implant surgery (10 per cent) developed hyperthermia compared to controls (0.7 per cent, p < 0.05). In five of the seven cases, hyperthermia appeared in combination with tachycardia and hypercapnia, adhering to the clinical triad of malignant hyperthermia.Conclusion:Patients undergoing cochlear implantation are susceptible to developing intra-operative hyperthermia. This article describes the hyperthermic events that occur during paediatric cochlear implantation, and attempts to identify potential triggers of hyperthermia.

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