scholarly journals Effect of IV Midazolam Premedication on the Recovery of Pediatric Patients after Isoflurane Anesthesia for Cochlear Implant Surgery

2019 ◽  
Vol 13 (1) ◽  
pp. 47-52
Author(s):  
Mona R. Hosny ◽  
Ashraf N. Saleh ◽  
Wail A. Abdelaal ◽  
Tahany M. Rabie
Keyword(s):  
Cochlear Implant ◽  
Pediatric Patients ◽  
Statistical Significance ◽  
Randomized Study ◽  
Saline Group ◽  
Double Blind ◽  
Implant Surgery ◽  
Isoflurane Anesthesia ◽  
Cochlear Implant Surgery ◽  
Midazolam Premedication

Purpose: Midazolam, given by varying routes, is widely used as a premedication. This study was performed to investigate the effect of IV midazolam premedication on the recovery characteristics from isoflurane anesthesia in pediatric patients undergoing cochlear implant surgery. Methods: In this double-blind randomized study, a total of 60 unilateral cochlear implants procedures were performed on 60 children aged 1 – 6 years. They were 29 males (48.3%) and 31 females (51.7%). Patients were randomly allocated in one of two groups (M and S). Each group included 30 participants. Patients in group M received 0.01 mg/kg IV midazolam in 2 ml of 0.9% saline, while patients in group S received equal volume of 0.9% saline, two minutes before induction. Recovery times from discontinuation of isoflurane were recorded. Postoperative pain was assessed using Objective Pain Discomfort Score (OPDS). Emergence Agitation (EA) was recorded based on Aono’s four-point scale. Results: There were statistically significant differences between patients pre-medicated with IV midazolam and those of the normal saline group as regards all measured recovery parameters (p<0.001). Patients in group M scored higher than those in Group S on the OPDS. Yet, this difference didn't show statistical significance (p=0.438) Among patients pre-medicated with midazolam, 17 (56.6%) suffered from EA compared to 12 (40%) patients from the other group. This difference did not reach statistical significance (p=0.196). Conclusion: Premedication with IV midazolam delayed recovery in pediatric patients undergoing moderately-long procedures when isoflurane was used as the inhalation anesthetic, while its effect on EA remains uncertain.

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 EXPRESS: Efficacy and Safety of Tadalafil in a Pediatric Population with Pulmonary Arterial Hypertension: Phase 3 randomized, Double Blind Placebo-Controlled Study

2021 ◽  
pp. 204589402110249
Author(s):  
David D Ivy ◽  
Damien Bonnet ◽  
Rolf MF Berger ◽  
Gisela Meyer ◽  
Simin Baygani ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Statistical Significance ◽  
Significance Testing ◽  
Efficacy And Safety ◽  
Phase 3 ◽  
Statistical Significance Testing ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Treatment Groups ◽  
Pulmonary Arterial

Objective: This study evaluated the efficacy and safety of tadalafil in pediatric patients with pulmonary arterial hypertension (PAH). Methods: This phase-3, international, randomized, multicenter (24 weeks double-blind placebo controlled period; 2-year, open-labelled extension period), add-on (patient’s current endothelin receptor antagonist therapy) study included pediatric patients aged <18 years with PAH. Patients received tadalafil 20 mg or 40 mg based on their weight (Heavy-weight: ≥40 kg; Middle-weight: ≥25—<40 kg) or placebo orally QD for 24 weeks. Primary endpoint was change from baseline in 6-minute walk (6MW) distance in patients aged ≥6 years at Week 24. Sample size was amended from 134 to ≥34 patients, due to serious recruitment challenges. Therefore, statistical significance testing was not performed between treatment groups. Results: Patient demographics and baseline characteristics (N=35; tadalafil=17; placebo=18) were comparable between treatment groups; median age was 14.2 years (6.2 to 17.9 years) and majority (71.4%, n=25) of patients were in HW cohort. Least square mean (SE) changes from baseline in 6MW distance at Week 24 was numerically greater with tadalafil versus placebo (60.48 [20.41] vs 36.60 [20.78] meters; placebo-adjusted mean difference [SD] 23.88 [29.11]). Safety of tadalafil treatment was as expected without any new safety concerns. During study period 1, two patients (1 in each group) discontinued due to investigator’s reported clinical worsening, and no deaths were reported. Conclusions: The statistical significance testing was not performed between the treatment groups due to low sample size, however, the study results show positive trend in improvement in non invasive measurements, commonly utilized by clinicians to evaluate the disease status for children with PAH. Safety of tadalafil treatment was as expected without any new safety signals.

scholarly journals Qualitative assessment of YouTube videos as a source of patient information for cochlear implant surgery

2021 ◽  
pp. 1-4
Author(s):  
C Thomas ◽  
J Westwood ◽  
G F Butt
Keyword(s):  
Cochlear Implant ◽  
Cochlear Implants ◽  
Qualitative Assessment ◽  
Supplementary Information ◽  
Implant Surgery ◽  
Critical Elements ◽  
Positive Elements ◽  
Cochlear Implant Surgery ◽  
Youtube Videos

Abstract Background YouTube is increasingly used as a source of healthcare information. This study evaluated the quality of videos on YouTube about cochlear implants. Methods YouTube was searched using the phrase ‘cochlear implant’. The first 60 results were screened by two independent reviewers. A modified Discern tool was used to evaluate the quality of each video. Results Forty-seven videos were analysed. The mean overall Discern score was 2.0 out of 5.0. Videos scored higher for describing positive elements such as the benefits of a cochlear implant (mean score of 3.4) and scored lower for negative elements such as the risks of cochlear implant surgery (mean score of 1.3). Conclusion The quality of information regarding cochlear implant surgery on YouTube is highly variable. These results demonstrated a bias towards the positive attributes of cochlear implants, with little mention of the risks or uncertainty involved. Although videos may be useful as supplementary information, critical elements required to make an informed decision are lacking. This is of particular importance when patients are considering surgery.

Use of negative pressure wound therapy to treat a cochlear implant infection around the auricle: a case report

2020 ◽  
Vol 29 (10) ◽  
pp. 568-571
Author(s):  
Seita Fukushima ◽  
Noritaka Komune ◽  
Kenichi Kamizono ◽  
Nozomu Matsumoto ◽  
Kazutaka Takaiwa ◽  
...  
Keyword(s):  
Cochlear Implant ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Neck Region ◽  
Wound Therapy ◽  
Head And Neck Region ◽  
Implant Surgery ◽  
Uncontrolled Diabetes ◽  
Cochlear Implant Surgery ◽  
Bilateral Sensorineural Hearing Loss

Although negative pressure wound therapy (NPWT) is widely used, its application to the head and neck region remains challenging due to anatomical complexities. This report presents the case of a female patient presenting with mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes, uncontrolled diabetes and severe bilateral sensorineural hearing loss. The patient had undergone cochlear implant surgery and five months later the wound was infected with methicillin-resistant Staphylococcus aureus (MRSA). NPWT was started shortly after removing the internal receiver and was stopped 11 days later. NPWT helped in controlling infection and led to a successful wound closure. In this case, NPWT was effective in treating infectious wounds around the auricle after cochlear implant surgery. Declaration of interest: The authors have no financial support for this article and no conflict of interest directly relevant to the content of this article.

External Auditory Canal Closure in Cochlear Implant Surgery

2003 ◽  
Vol 24 (3) ◽  
pp. 404-408 ◽  
Author(s):  
Hussam K. El-Kashlan ◽  
H. Alexander Arts ◽  
Steven A. Telian
Keyword(s):  
Cochlear Implant ◽  
External Auditory Canal ◽  
Implant Surgery ◽  
Cochlear Implant Surgery
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