Cochlear implants in children: A cross-sectional investigation on the influence of geographic location in Saudi Arabia

INTRODUCTION: The role of the family in detecting a child's hearing difficulty and the age at which an implantation is done have been identified as strong predictors of the outcomes of pediatric cochlear implantation. In the absence of screening programs for hearing loss in Saudi neonates, the family's role is of paramount importance. The aim of this study was to investigate the influence of geographic location on the course of identification, examination, and cochlear implantation in children in Saudi Arabia. MATERIALS AND METHODS: Pediatric patients who had received either unilateral or bilateral cochlear implantation at King Abdulaziz University Hospital in Riyadh, Saudi Arabia, between January 1, 2012, and December 31, 2014, were surveyed. RESULTS: A total of 156 pediatric patients have had a cochlear implant between January 1, 2012, and December 31, 2014. The one-way analysis of variance test to compare the means of the independent sample groups in various geographic zones showed that with a hundred percent access to primary health care, the geographic location of the population had an influence on the detection of hearing loss but not on the cochlear implantation. CONCLUSION: This study found that the geographic location of the population has an influence on the time of detection of hearing loss in children but not on the time of cochlear implantation. Raising parental awareness of the importance of early detection of hearing loss is necessary. Further research is also required to define the role of factors such as the income and the educational level of parents on the early detection of neonatal hearing loss

Lateral sinus thrombosis in children: Case series

Lateral sinus thrombosis is rare but potentially fatal condition. The consequences of misdiagnosis of this condition are detrimental. Aims: To review our experience in lateral sinus thrombosis secondary to otogenic disease in pediatric population. Settings and Design: Retrospective study of case series treated in two teaching hospitals over five years. Materials and Methods: Clinically and radiologically diagnosed cases of lateral sinus thrombosis were identified through database search. Results: Lateral sinus thrombosis was the result of chronic suppurative otitis media in 7 cases, with 3 patients (42.85%) having cholesteatoma. There were no associated intracranial complications in any of the patients. Two patients (28.57%) underwent medical treatment, and 5 patients (71.43%) had surgical treatment. Aggressive and early surgical intervention treatment was initiated according to evaluation of preoperative findings. The sigmoid sinus was aspirated in three patients. Complete re-canalization or lysis of the thrombus was achieved. Anticoagulant agent was used in 1 patient (14.28%). Six patients (85.82%) presented with the typical lateral sinus thrombosis clinical features, and 1 patient (14.28%) presented with otorrhea solely. Mastoidectomy was undertaken in 5 patients (71.42%) with canal wall up in 2 patients (28.57%) and canal wall down in 2 patients (28.57%). Myringotomy, ventilation tube insertion, and cortical mastoidectomy were done in 1 patient (14.28%). Conclusions: Early and aggressive surgical intervention of lateral sinus thrombosis otogenic complication can minimize mortality, hospitalization period, and length of medical treatment. High index of suspicion is important