Perspective Chapter: Cochlear Implant Activation in the Immediate Postoperative Period at the Operating Room

Cochlear implant (CI) activation usually takes place at about 30 days postoperative (PO). In our service, CI surgery is performed with local anesthesia and sedation, so Activation is possible with the patient’s cooperation, immediately after the CI surgery, still in the Operating Room (OR). The objective of this study was to provide the patient with hearing experience with the CI and to assess auditory perception immediately after surgery while still in the OR, and to compare Impedance Telemetry (IT), Neural Response Telemetry (NRT) and Comfort (C) level at two moments: in the OR and at the definitive Activation, approximately 30 days PO. Nine adults (12 ears) with acquired (post-lingual) deafness were included. Auditory perception was evaluated through Ling Sounds, musical instruments and clapping, presented in two different programming maps, elaborated using t-NRT, comparing between the two moments. We observed that while still in the OR, the patient can already present auditory detection and recognition responses. The values ​​of impedance, t-NRT and “C” level on both dates differed with statistical significance. We concluded that it is possible to provide the patient with an auditory experience with the CI immediately after surgery, and that the auditory experience and the values ​​of electrode IT, NRT and “C” level vary significantly between the two moments

Intensive Olfactory Training in Post-COVID Patients: A Randomized Multicenter Clinical Trial

Introduction: Olfactory dysfunction (OD) is one of the most reported symptoms of COVID -19. Previous studies have identified olfactory training (OT) as an important treatment for postinfectious OD, but little is known about its effect after SARS-CoV-2 infection and how it can be optimized. Objective: To assess whether OT can be optimized if performed intensively, with more fragrances over a shorter period in patients with persistent OD after COVID -19. Also, to determine the presence of other variables related to OD and treatment response in this population. Method: This multicenter randomized clinical trial recruited 80 patients with persistent OD with previous COVID-19 for less than three months. The patients were divided into two groups, who received treatment with 4 and 8 essences over four weeks. Subjective assessments and the University of Pennsylvania Smell Identification Test (UPSIT) were performed before and after treatment. Results: A significant improvement in olfaction was measured subjectively and on UPSIT in both groups, but without significant differences between groups. In addition, the presence of olfactory fluctuation was associated with higher UPSIT scores. Conclusion: These data suggest that intensifying the training by increasing the number of essences for 4 weeks does not show superiority over the classical method. Moreover, a fluctuating olfactory ability seems to be related to a better score in the UPSIT

Intraoperative Neural Response Telemetry and Neural Recovery Function: a Comparative Study between Adults and Children

Introduction Neural response telemetry (NRT) is a method of capturing the action potential of the distal portion of the auditory nerve in cochlear implant (CI) users, using the CI itself to elicit and record the answers. In addition, it can alsomeasure the recovery function of the auditory nerve (REC), that is, the refractory properties of the nerve. It is not clear in the literature whether the responses from adults are the same as those from children. Objective To compare the results of NRT and REC between adults and children undergoing CI surgery. Methods Cross-sectional, descriptive, and retrospective study of the results of NRT and REC for patients undergoing IC at our service. The NRT is assessed by the level of amplitude (microvolts) and REC as a function of three parameters: A (saturation level, in microvolts), t0 (absolute refractory period, in seconds), and tau (curve of the model function), measured in three electrodes (apical, medial, and basal). Results Fifty-two patients were evaluated with intraoperative NRT (26 adults and 26 children), and 24 with REC (12 adults and 12 children). No statistically significant difference was found between intraoperative responses of adults and children for NRTor for REC's three parameters, except for parameter A of the basal electrode. Conclusion The results of intraoperative NRT and REC were not different between adults and children, except for parameter A of the basal electrode

Epidemiologic Profile of an Otolaryngologic Emergency Service

Introduction According to current research, the number of patients seen in the emergency room is progressively increasing. There are few studies on the characteristics of ear, nose, and throat diseases treated in the emergency room. Objectives (1) To establish the epidemiologic profile of patients with these complaints treated at a referral emergency hospital in locoregional city Curitiba, and (2) to evaluate the calls that truly required emergency care. Methods This is a contemporary cross-study of urgent and emergency referrals to a hospital with otolaryngologic services during the year 2012. Data were collected and epidemiologic characteristics analyzed. Results We analyzed 1,067 patients: 312 presented in spring, 255 in summer, 253 in autumn, and 247 in winter. We found 17 diseases that were common during the year, with 244 (23.99%) upper respiratory tract infections being the most frequent disease. There was no statistically significant difference in the incidence of diseases, except that acute otitis media was most common during the summer (p = 0.02); distribution between the sexes was balanced. The predominant age group was adults. We found 9.27% cases were true emergencies. Conclusion Patients were 20 to 40 years, with upper respiratory tract infection the most incident disease; 9.27% of cases were emergencies

Cochlear Implant Activation in the Immediate Postoperative Period in the Operating Room

Introduction Cochlear implant (CI) activation usually takes place at ∼ 30 days postoperative (PO). In our service, CI surgery is performed with local anesthesia and sedation, so activation is possible with the patient's cooperation, immediately after the CI surgery, still in the operating room (OR)

Objective assessment of surgical technique in rotation and nasal projection variation

ABSTRACT INTRODUCTION: In rhinoplasty, facial esthetic analysis is critical for proper surgical planning. Parameters such as rotation and nasal projection should be routinely evaluated. Few studies have objectively assessed changes in facial angles postoperatively. OBJECTIVE: To evaluate the effectiveness of medial intercrural sutures and of rotation of the nasal tip on the increase of rotation and nasal projection in Caucasian patients undergoing primary rhinoplasty. METHODS: A prospective study carried out between 2011 and 2013, with 27 patients treated with primary rhinoplasty with a basic technique by the same surgeon, with medial intercrural sutures and rotation of the nasal tip. Rotation and nasal projection were measured from photographs obtained preoperatively and after 12 months. RESULTS: All 27 patients completed the study. The mean age was 27.1 years. There was a mean increase of 8.4° in the rotation - a statistically significant value. There was no significant change in the projection. CONCLUSION: The medial intercrural and nasal tip rotation sutures are effective in increasing nasal rotation in Caucasian patients undergoing rhinoplasty