scholarly journals Comparison of residual hearing preservation and auditory based performance after paediatric cochlear implantation by round window insertion versus cochleostomy technique: an ambispective cohort study

2021 ◽  
Vol 7 (9) ◽  
pp. 1455
Author(s):  
Dayana Antony ◽  
Aneena Chacko ◽  
Ravi A.
Keyword(s):  
Cohort Study ◽  
Cochlear Implant ◽  
Cochlear Implantation ◽  
Round Window ◽  
Tertiary Care ◽  
Sensorineural Deafness ◽  
Hearing Preservation ◽  
Care Hospital ◽  
Residual Hearing ◽  
Round Window Insertion

<p class="abstract"><strong>Background:</strong> Cochlear implantation (CI) has revolutionized the treatment of sensorineural deafness. The aim of the study was to compare auditory based performance in cochlear implants who underwent round window insertion and cochleostomy.</p><p class="abstract"><strong>Methods:</strong> Ambispective cohort study was done among the children who underwent perilingual cochlear implant in a tertiary care hospital for period of 1 year. Children who satisfied the inclusion criteria were selected and randomly subdivided into 2 groups: group A- round window insertion and group B-cochleostomy. Pre- and post-operative pure tone average (PTA) and residual hearing preserved were evaluated among the cochleostomy and round window insertion groups separately. Post-operatively, children were evaluated, from three months to 1 year from the activation of cochlear implant, with the use of scores such as Category of Auditory Performance (CAP), Meaningful Auditory Integration Scale (MAIS), Speech Intelligibility rating (SIR) and Meaningful use of speech scale (MUSS score) to measure speech production skills by auditory verbal therapist.   </p><p class="abstract"><strong>Results:</strong> A total of 80 patients were included in the study. Complete hearing preservation (within 10 dB) was significantly high in round window insertion group compared to   cochleostomy technique (p&lt;0.001). None the subjects had complete loss of residual hearing. On evaluating the post CI performance, MAIS score in the round window insertion group (9.34, 18.21, 27.79) were significantly better compared to cochleostomy group during the 3 months, 6 months and 12 months follow-up.</p><p class="abstract"><strong>Conclusions:</strong> Round window insertion technique is significantly more successful in complete hearing preservation at low frequencies compared to cochleostomy technique. Among the auditory scores, only MAIS in the round window insertion group was found to be significantly better compared to cochleostomy group.</p>

Cochlear implant placement: round window approach

2014 ◽  
Vol 36 (v1supplement) ◽  
pp. 1 ◽  
Author(s):  
Douglas D. Backous
Keyword(s):  
Clinical Trials ◽  
Surgical Technique ◽  
Cochlear Implant ◽  
Cochlear Implantation ◽  
Round Window ◽  
Hearing Preservation ◽  
Residual Hearing ◽  
Implant Placement ◽  
Single Sided Deafness ◽  
Window Approach

The indications for cochlear implantation continue to extend to patients with increased levels of residual hearing. Single-sided deafness and tinnitus are currently under various clinical trials as even further expansion of the application of cochlear implant device and programming technology is underway. This video details a round window and hearing preservation approach for cochlear implant placement, and incorporates the most recent advances in surgical technique.The video can be found here: http://youtu.be/bDqkbboXrU4.

scholarly journals Evaluation of Intracochlear Trauma Caused by Insertion of Cochlear Implant Electrode Arrays through Different Quadrants of the Round Window

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Graziela de Souza Queiroz Martins ◽  
Rubens Vuono Brito Neto ◽  
Robinson Koji Tsuji ◽  
Eloisa Maria Mello Santiago Gebrim ◽  
Ricardo Ferreira Bento
Keyword(s):  
Cochlear Implant ◽  
Round Window ◽  
Electrode Array ◽  
Hearing Preservation ◽  
Round Window Membrane ◽  
Residual Hearing ◽  
Electrode Arrays ◽  
Minimal Trauma ◽  
Electrode Insertion ◽  
Temporal Bones

Hypothesis. This study aimed to evaluate whether there is a difference in the degree of intracochlear trauma when the cochlear implant electrode arrays is inserted through different quadrants of the round window membrane.Background. The benefits of residual hearing preservation in cochlear implant recipients have promoted the development of atraumatic surgeries. Minimal trauma during electrode insertion is crucial for residual hearing preservation.Methods. In total, 25 fresh human temporal bones were subjected to mastoidectomy and posterior tympanotomy. The cochlear implant electrode array was inserted through the anterosuperior quadrant of the round window membrane in 50% of the bones and through the anteroinferior quadrant in the remaining 50%. The temporal bones were dehydrated, embedded in epoxy, serially polished, stained, viewed through a stereomicroscope, and photographed with the electrode arraysin situ. The resulting images were analyzed for signs of intracochlear trauma.Results. Histological examinations revealed varying degrees of damage to the intracochlear structures, although the incidence and severity of intracochlear trauma were not influenced by the quadrant of insertion.Conclusions. The incidence and severity of intracochlear trauma were similar in all samples, irrespective of electrode array insertion through the anterosuperior or anteroinferior quadrant of the round window membrane.

scholarly journals A maradványhallás megőrzésének lehetőségei cochlearis implantáció során Nucleus CI532 Slim Modiolar elektródasorral

2018 ◽  
Vol 159 (41) ◽  
pp. 1680-1688 ◽  
Author(s):  
Roland Nagy ◽  
János András Jarabin ◽  
Balázs Dimák ◽  
Ádám Perényi ◽  
Ferenc Tóth ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Minimally Invasive ◽  
Cochlear Implantation ◽  
Basilar Membrane ◽  
Round Window ◽  
Spiral Ganglion ◽  
Hearing Threshold ◽  
Electrode Array ◽  
Hearing Preservation ◽  
Residual Hearing

Abstract: During the rehabilitation of hearing-impaired patients, the preservation of residual acoustic hearing following cochlear implantation by minimizing the implantation trauma allows for improved hearing performance. To achieve this, minimally invasive, soft surgery methods and thinner, atraumatic electrodes were required. In our present study, we reported a case where Cochlear® Nucleus CI532 Slim Modiolar electrode was implanted in a patient with residual hearing. Our aim was to study the possible preservation of postoperative acoustic residual hearing by audiological monitoring. Since childhood, due to her congenital hearing loss, she has been wearing a conventional, airborne hearing correction device on both ears. Six months before cochlear implantation, we measured the progression on both sides of the hearing loss, so we decided to perform cochlear implantation. The patient had residual hearing on both ears prior to surgery thus the Cochlear® Nucleus CI532 Slim Modiolar Implant was used. The minimally invasive surgery was performed on the patient’s right ear through the round window approach. Compared to the preoperative hearing threshold (average 85 dBHL) in the 4th postoperative week, an initial hearing threshold progression of 20–25 dBHL was observed between 0.25 and 1.0 kHz, while of 5–10 dBHL between 2.0–4.0 kHz. Hearing threshold measured in the 6th month showed a slight progression in the range above 1 kHz, but improved by the 12th month, to the results achieved at the 4th week. The effects of cochlear implantation on residual hearing have been studied in numerous studies, in which several key surgical and technical factors have been identified. Nucleus CI532 is a Slim Modiolar electrode profile that is close to the modiolus, so it is expected to have a lower endocochlear hydrodynamic load since it lies in the covering of the osseus spiral lamina, thus less influencing the dynamics of the basilar membrane. However, the perimodiolar location of the electrode array allows the adjacent nerve elements of the spiral ganglion to be stimulated with a lower electrical intensity and a reduced surface that may be neuroprotective. Preservation of acoustic residual hearing following cochlear implantation improves the patient’s speech perception and the sound localization skills, particularly in difficult circumstances. Long-term residual hearing preservation may also be of great importance in the subsequent feasibility for regenerative procedures and drug treatments. Orv Hetil. 2018; 159(41): 1680–1688.

Residual hearing preservation after cochlear implantation via round window or cochleostomy approach

2015 ◽  
Vol 125 (7) ◽  
pp. 1715-1719 ◽  
Author(s):  
Chuan-Hung Sun ◽  
Chuan-Jen Hsu ◽  
Peir-Rong Chen ◽  
Hung-Pin Wu
Keyword(s):  
Cochlear Implantation ◽  
Round Window ◽  
Hearing Preservation ◽  
Residual Hearing

Preservation of residual hearing following cochlear implantation: comparison between three surgical techniques

2007 ◽  
Vol 122 (3) ◽  
pp. 246-252 ◽  
Author(s):  
S Berrettini ◽  
F Forli ◽  
S Passetti
Keyword(s):  
Cochlear Implant ◽  
Cochlear Implantation ◽  
Surgical Techniques ◽  
Electrode Array ◽  
Lateral Wall ◽  
Hearing Preservation ◽  
Acoustic Stimulation ◽  
Residual Hearing ◽  
Electrode Arrays ◽  
Electrode Insertion

AbstractThe preservation of residual hearing is becoming a high priority in cochlear implant surgery. It allows better speech understanding and ensures long-lasting and stable performance; it also allows the possibility, in selected cases, of combining electro-acoustic stimulation in the same ear.We present the results of a retrospective study of the conservation of residual hearing in three different groups of patients who had undergone cochlear implantation using three different cochlear implant electrode arrays, combined with three different surgical techniques for the cochleostomy. The study aimed to evaluate which approach allowed greater preservation of residual hearing.The best residual hearing preservation results (i.e. preservation in 81.8 per cent of patients) were achieved with the Contour Advance electrode array, using the Advance Off-Stylet technique and performing a modified anterior inferior cochleostomy; this combination enabled reduced trauma to the lateral wall of the cochlea during electrode insertion.

Conductive Component After Cochlear Implantation in Patients With Residual Hearing Conservation

2014 ◽  
Vol 23 (4) ◽  
pp. 359-364 ◽  
Author(s):  
Richard A. Chole ◽  
Timothy E. Hullar ◽  
Lisa G. Potts
Keyword(s):  
Hearing Loss ◽  
Cochlear Implant ◽  
Cochlear Implantation ◽  
Round Window ◽  
Bone Conduction ◽  
Surgical Techniques ◽  
Residual Hearing ◽  
Conductive Component ◽  
Conductive Hearing ◽  
New Onset

Purpose Changes in auditory thresholds following cochlear implantation are generally assumed to be due to damage to neural elements. Theoretical studies have suggested that placement of a cochlear implant can cause a conductive hearing loss. Identification of a conductive component following cochlear implantation could guide improvements in surgical techniques or device designs. The purpose of this study is to characterize new-onset conductive hearing losses after cochlear implantation. Method In a prospective study, air- and bone-conduction audiometric testing were completed on cochlear implant recipients. An air–bone gap equal to or greater than 15 dB HL at 2 frequencies determined the presence of a conductive component. Results Of the 32 patients with preoperative bone-conduction hearing, 4 patients had a new-onset conductive component resulting in a mixed hearing loss, with air-conduction thresholds ranging from moderate to profound and an average air–bone gap of 30 dB HL. One had been implanted through the round window, 2 had an extended round window, and 1 had a separate cochleostomy. Conclusions Loss of residual hearing following cochlear implantation may be due in part to a conductive component. Identifying the mechanism for this conductive component may help minimize hearing loss. Postoperative hearing evaluation should measure both air- and bone-conduction thresholds.

scholarly journals Clinical characteristics and factors related to antibiotic-associated diarrhea in elderly patients with pneumonia: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yoko Takedani ◽  
Tsukasa Nakamura ◽  
Noriko Fukiwake ◽  
Toshihiro Imada ◽  
Junji Mashino ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Elderly Patients ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Tertiary Care ◽  
Multivariate Logistic Regression Model ◽  
Care Hospital ◽  
Antibiotic Associated Diarrhea ◽  
Elderly Inpatients

Abstract Background Antibiotic-associated diarrhea (AAD) is a common problem among elderly inpatients because many elderly patients are admitted for pneumonia or other conditions that necessitate antibiotic treatment. In the super aging population, more patients are suffering from pneumonia than before, but the incidence or risk factors for AAD among many elderly patients have not been well scrutinized. Methods We conducted a retrospective cohort study of elderly patients diagnosed with pneumonia from April 2014 to March 2019 who were admitted to the Department of General Medicine of a Tertiary Care Hospital in Japan. Patients (≥ 65 years of age) who were diagnosed with bacterial pneumonia or aspiration pneumonia and treated with antibiotics were included. We defined AAD by diarrhea with more than three loose or watery stools per day and included patients who had these symptoms for either one day or two or more consecutive days. We also assessed the length of hospital stay and in-hospital mortality. The potential risk factors for AAD included age, sex, body weight, body mass index, smoking, alcohol, activities of daily living (ADL),　comorbidities, vital signs, laboratories, the severity of pneumonia, antibiotic and other medication use. Results There were 1,067 patients, the mean age was 83 years, and men accounted for 59 %. β-Lactamase inhibitors were frequently prescribed antibiotics in 703 patients (66 %), and proton pump inhibitors (PPIs) were also commonly administered (48 %). AAD developed in 322 patients (30 %). The multivariate logistic regression model showed that β-lactamase inhibitors (OR 1.43, 95 % CI 1.05–1.95) and PPIs (OR 1.37, 95 % CI 1.03–1.83) were associated with AAD as well as age (OR 1.03 per year, 95 % CI 1.01–1.05). Conclusions AAD was common among elderly inpatients with pneumonia, and β-lactamase inhibitors and PPIs were associated with AAD. Strict use of such medication should be considered to decrease the risk of AAD.

scholarly journals Cochlear implantation: a review of the literature and the Nijmegen results

1997 ◽  
Vol 111 (11) ◽  
pp. 1008-1017 ◽  
Author(s):  
Mohammad Jamal A. Makhdoum ◽  
Ad F. M. Snik ◽  
Paul van den Broek
Keyword(s):  
Cochlear Implant ◽  
Hearing Aids ◽  
Cochlear Implantation ◽  
Sensorineural Deafness ◽  
Deaf Children ◽  
Subject Selection ◽  
Profound Deafness ◽  
Deaf Adults ◽  
Adults And Children ◽  
To Receive

AbstractThe field of cochlear implantation is developing rapidly. In subjects with bilateral profound deafness who gain no benefit from conventional hearing aids the aim of cochlear implantation is to provide a means for them to receive auditory sensations. Throughout the world, most cochlear implant centres are still continuing their research efforts to improve the results with this technique. Although it is still difficult to predict how an individual will perform with a cochlear implant, the success of cochlear implantation can no longer be denied. In this paper, we review some recent papers and reports, and the results of the various Nijmegen cochlear implant studies. Data about subject selection, examinations, surgery and the outcome are discussed. Our results were in good agreement with those of other authors. It can be concluded once again that cochlear implantation is an effective treatment for postlingually deaf adults and children, and for prelingually (congenital or acquired) deaf children with profound bilateral sensorineural deafness.

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