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 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>

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.

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.

Navigation as a quality management tool in cochlear implant surgery

2004 ◽  
Vol 118 (10) ◽  
pp. 764-770 ◽  
Author(s):  
Jörg Schipper ◽  
Antje Aschendorff ◽  
Iakovos Arapakis ◽  
Thomas Klenzner ◽  
Christian Barna Teszler ◽  
...  
Keyword(s):  
Quality Management ◽  
Cochlear Implant ◽  
Navigation System ◽  
Cochlear Implantation ◽  
Computer Assisted Surgery ◽  
Management Tool ◽  
Computer Assisted ◽  
Implant Surgery ◽  
Lateral Skull Base ◽  
Cochlear Implant Surgery

This cadaver study assessed the value of navigation in cochlear implant surgery. Cochlear implantation was simulated on a cadaver using a Stryker-Leibinger navigation system and a Nucleus 24 Contour implant. A conventional surgical strategy consisting of mastoidectomy, posterior tympanotomy, and cochleostomy was performed. The navigated surgical procedure was evaluated for accuracy, reliability, reproducibility, and practicability. The technology of computer-assisted surgery is applicable in cochlear implantation and beneficial in as much as the navigation-controlled implantation constitutes a non-invasive instrument of quality management. Nevertheless, in order to keep the point accuracy below one millimeter, a referencing methodusing concealed bordering anatomical structures may be further needed to perform the cochleostomy reliably under the guidance of a navigation system. More reproducible reference systems are needed if navigated lateral skull base surgery is to be fully relied upon.

scholarly journals Management Options for Patients With Nasopharyngeal Carcinoma Undergoing Cochlear Implantation

2020 ◽  
pp. 014556132094727
Author(s):  
Chee-Yee Lee ◽  
Wei-Chieh Lin ◽  
Chung-Ching Lin ◽  
Chuan-Jen Hsu ◽  
Hung-Pin Wu
Keyword(s):  
Hearing Loss ◽  
Nasopharyngeal Carcinoma ◽  
Cochlear Implant ◽  
Otitis Media ◽  
Hearing Aids ◽  
Cochlear Implantation ◽  
Chronic Otitis Media ◽  
Management Options ◽  
Implant Surgery ◽  
Cochlear Implant Surgery

Objectives: Cochlear implantation (CI) has been successfully used to restore hearing in patients with severe to profound hearing loss. In addition to hearing loss, irradiated patients with nasopharyngeal carcinoma (NPC) also often have chronic otitis media and Eustachian tube (ET) dysfunction. These features may result in difficulties in CI. We conducted this study to review the management options for irradiated patients with NPC undergoing CI. Furthermore, we investigated the results of CI in irradiated patients with NPC with chronic otitis media and obstructive ET dysfunction, accordingly to different treatment strategies. Methods: We retrospectively reviewed the data of patients with NPC who underwent CI in our hospital between 2006 and 2020. All subjects were found to be eligible according to the following inclusion criteria: had NPC, received irradiation, underwent cochlear implant surgery, and had chronic otitis media with obstructive ET dysfunction. Results: A total of 9 patients with obstructive ET dysfunction and chronic otitis media underwent cochlear implant surgery. Seven patients with an inflamed ETs underwent a 2-stage operation. Two patients with obliterated ETs, we performed a single-stage CI surgery. Only 1 patient had otitis media effusion after the surgery. Conclusion: With the proper management of chronic otitis media and ET dysfunction, cochlear implant is an effective treatment for irradiated patients with NPC when conventional hearing aids failed.

scholarly journals Perspective of Parents of Pre-Implant Children with Regard to Quality of Life and Health Care Services of Cochlear Implantation Programme in Kerala

2021 ◽  
Vol 8 (19) ◽  
pp. 1420-1425
Author(s):  
Sameer Pootheri
Keyword(s):  
Health Care ◽  
Cochlear Implant ◽  
Hearing Aids ◽  
Cochlear Implantation ◽  
Health Care Services ◽  
Female Ratio ◽  
Implant Surgery ◽  
Care Services ◽  
Cochlear Implant Surgery ◽  
The Government

BACKGROUND State Initiative on Disabilities [SID] survey (2015) states that 2.32 % of Kerala population are affected with one or the other form of disabilities; the Sruthitharangam scheme of Kerala Government since 2012 provides free cochlear implant surgery and rehabilitation to children with bilateral profound sensorineural hearing loss among children of 0 - 5 years age group. We wanted to measure the expectations of the parents and their perspectives before cochlear implant surgery which depends upon their understanding of the whole process of surgery and the rehabilitation after surgery and its final outcomes. METHODS 67 parents of pre-implant children were interviewed with an open-ended questionnaire to know their perspective of government aided pre-implant programme in the state of Kerala. Children were using Hearing aids of Behind the Ear (BTE) TBE 110 HT model supplied by the government, free of cost. Children were attending pre-implant Auditory Verbal Therapy (AVT) with hearing aids at Centre for Audiology and Speech Pathology [CASP] Govt. Medical College, Kozhikode, for a minimum of 3 months. All the data was analysed using mean and percentage calculations. RESULTS 67 pre-implant children used their hearing aids for a minimum of 3 - month period and the age range was between 12 months to 36 months. The mean age of children was 2.1 ± 0.43 years. 41 male and 26 female children, with a male to female ratio of 1.53: 1 were included in the study. Analysis of the questionnaire showed 8 benefits, 11 shortcomings, 5 expectations and 8 suggestions. CONCLUSIONS The parentally reported expectations, short comings, and outcomes of the use of hearing aids could be related to many factors like health care services provided by the government, and the after services of hearing aids involved. These findings help us to understand the parental perspectives of the success of cochlear implantation which can be useful during parental counselling sessions. Study is also useful to the implant centres to revise their practices accordingly and improve the information given to candidate families. KEYWORDS Hearing Impairment, Cochlear Implant, Pre-Implant Children and Hearing Aid

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