Cochlear Implant in Single-Sided Deafness Children and Adults

Binaural hearing in humans ensures our effective communication as it improves the sound localization, the speech understanding in noise, the spatial awareness, the listening easiness, and the development of spoken language. The majority of the literature on patients with single-sided deafness and cochlear implantation involves adult patients; the cochlear implant is a viable and cost-effective treatment option for this population. So in this chapter, we will emphasize the importance of early treatment of unilateral hearing loss in the pediatric age and the emerging indication of the cochlear implant as a treatment

Electrical vestibular stimulation in humans. A narrative review

Background: In patients with bilateral vestibulopathy, the regular treatment options, such as medication, surgery, and/ or vestibular rehabilitation, do not always suffice. Therefore, the focus in this field of vestibular research shifted to electri- cal vestibular stimulation (EVS) and the development of a system capable of artificially restoring the vestibular func- tion. Key Message: Currently, three approaches are being investigated: vestibular co-stimulation with a cochlear im- plant (CI), EVS with a vestibular implant (VI), and galvanic vestibular stimulation (GVS). All three applications show promising results but due to conceptual differences and the experimental state, a consensus on which application is the most ideal for which type of patient is still missing. Summa- ry: Vestibular co-stimulation with a CI is based on “spread of excitation,” which is a phenomenon that occurs when the currents from the CI spread to the surrounding structures and stimulate them. It has been shown that CI activation can indeed result in stimulation of the vestibular structures. Therefore, the question was raised whether vestibular co- stimulation can be functionally used in patients with bilat- eral vestibulopathy. A more direct vestibular stimulation method can be accomplished by implantation and activa- tion of a VI. The concept of the VI is based on the technology and principles of the CI. Different VI prototypes are currently being evaluated regarding feasibility and functionality. So far, all of them were capable of activating different types of vestibular reflexes. A third stimulation method is GVS, which requires the use of surface electrodes instead of an implant- ed electrode array. However, as the currents are sent through the skull from one mastoid to the other, GVS is rather unspe- cific. It should be mentioned though, that the reported spread of excitation in both CI and VI use also seems to in- duce a more unspecific stimulation. Although all three ap- plications of EVS were shown to be effective, it has yet to be defined which option is more desirable based on applicabil- ity and efficiency. It is possible and even likely that there is a place for all three approaches, given the diversity of the pa- tient population who serves to gain from such technologies

The parents as assessors of the quality of life of their cochlear implanted children

Introducción y objetivo: El concepto de calidad de vida ha comenzado a utilizarse cada vez más en el campo de las evaluaciones en salud. Se ha empezado a investigar los efectos de la implantación a nivel del desarrollo social y emocional del niño. El objetivo es examinar los resultados de la salud relacionados con la calidad de vida en niños sordos implantados cocleares de entre 11 y 12 años de edad y sus padres. Método: Estudio observacional, descriptivo transversal en 24 niños prelocutivos implantados unilaterales o bilaterales sucesivos de 11 y 12 años de edad y sus padres. Utilizando el cuestionario de calidad de vida pediátrica PedsQL™ (Versión 4.0, español para España), para medir la salud relacionados con la calidad de vida, completado de forma independiente por niños y padres respectivamente. Resultados: Mediante la T-Student los resultados de niños y padres en las diferentes escalas evaluadas observamos que en las escalas de funcionamiento emocional y académica es donde se obtienen resultados estadísticamente significativos (p <0,05). Al comparar el resultado total del cuestionario con las diferentes escalas evaluadas, en todas ellas se obtienen resultados estadísticamente significativos (p <0,05). Discusión: Probado el éxito del implante coclear en las áreas del habla y del lenguaje, esto nos lleva actualmente a preguntas más allá de estas áreas; el rendimiento en el hogar, en la escuela y en diferentes contextos sociales. Pocos estudios exploran a través de entrevistas o cuestionarios las expectativas de los padres y la percepción de la calidad de vida de sus hijos usuarios de implantes coclear. Conclusiones: Los resultados del estudio muestran que los niños disfrutan de los beneficios del uso de su implante coclear. Ellos reportan beneficios en todas las áreas estudiadas (física, emocional, social y académica). Los padres son periodistas válidos sobre el estado de la calidad de vida global de sus hijos ya que dieron respuestas similares a las dadas por sus hijos.Introduction and objective: Quality of life refers to the hability of an individual to enjoy normal life activities, including aspects of functional capacity and well-being. The concept of quality of life has been increasingly used in the field of health assessments. Only recently have the effects of Cochlear implantation from the perspective of emotional and social development begun to be investigate. To examine the results of health-related quality of life in cochlear implanted children between 11 and 12 years of age and their parents. Method: Observational, transversal descriptive study .24 unilateral or successive bilateral children implanted prelingually between 11 and 12 years of age and their parents. The pediatric quality of life questionnaire Persil ™ (Version 4.0, Spanish for Spain) was used to measure health-related quality of life. It was completed independently by children and parents. Results: The results were analyzed by means of a T -Student test. The outcomes of children and parents at different scales evaluated show that statistically significant results appear on scales of emotional and academic functioning (p < 0.05). When comparing the overall result of the questionnaire with the different scales evaluated, all show statistically significant results (p < 0.05). Discussion: It has been proven the success of a cochlear implant in speech and language field, this leads us calls into question beyond these areas; yield at home, at school and in different social contexts. There are few studies that explain through parental questionnaires expectations and their perception of the quality of life in cochlear implanted in children. Conclusions: The results of the study show that children enjoy the benefits of using a cochlear implant. They report benefits in all areas studied (physical, emotional, social and academic). Parents are reliable reporters about the state of the overall quality of life of their children since their answers were similar to those given by their children

Electrical vestibular stimulation in humans: a narrative review

Background: In patients with bilateral vestibulopathy, the regular treatment options, such as medication, surgery, and/ or vestibular rehabilitation, do not always suffice. Therefore, the focus in this field of vestibular research shifted to electrical vestibular stimulation (EVS) and the development of a system capable of artificially restoring the vestibular function. Key Message: Currently, three approaches are being investigated: vestibular co-stimulation with a cochlear implant (CI), EVS with a vestibular implant (VI), and galvanic vestibular stimulation (GVS). All three applications show promising results but due to conceptual differences and the experimental state, a consensus on which application is the most ideal for which type of patient is still missing. Summary: Vestibular co-stimulation with a CI is based on “spread of excitation,” which is a phenomenon that occurs when the currents from the CI spread to the surrounding structures and stimulate them. It has been shown that CI activation can indeed result in stimulation of the vestibular structures. Therefore, the question was raised whether vestibular costimulation can be functionally used in patients with bilateral vestibulopathy. A more direct vestibular stimulation method can be accomplished by implantation and activation of a VI. The concept of the VI is based on the technology and principles of the CI. Different VI prototypes are currently being evaluated regarding feasibility and functionality. So far, all of them were capable of activating different types of vestibular reflexes. A third stimulation method is GVS, which requires the use of surface electrodes instead of an implanted electrode array. However, as the currents are sent through the skull from one mastoid to the other, GVS is rather unspecific. It should be mentioned though, that the reported spread of excitation in both CI and VI use also seems to induce a more unspecific stimulation. Although all three applications of EVS were shown to be effective, it has yet to be defined which option is more desirable based on applicability and efficiency. It is possible and even likely that there is a place for all three approaches, given the diversity of the patient population who serves to gain from such technologies

Los padres como observadores de la calidad de vida de sus hijos implantados cocleares

Introduction and objective: Quality of life refers to the hability of an individual to enjoy normal life activities, including aspects of functional capacity and well-being. The concept of quality of life has been increasingly used in the field of health assessments. Only recently have the effects of Cochlear implantation from the perspective of emotional and social development begun to be investigate. To examine the results of health-related quality of life in cochlear implanted children between 11 and 12 years of age and their parents. Method: Observational, transversal descriptive study .24 unilateral or successive bilateral children implanted prelingually between 11 and 12 years of age and their parents. The pediatric quality of life questionnaire Persil ™ (Version 4.0, Spanish for Spain) was used to measure health-related quality of life. It was completed independently by children and parents. Results: The results were analyzed by means of a T -Student test. The outcomes of children and parents at different scales evaluated show that statistically significant results appear on scales of emotional and academic functioning (p < 0.05). When comparing the overall result of the questionnaire with the different scales evaluated, all show statistically significant results (p < 0.05). Discussion: It has been proven the success of a cochlear implant in speech and language field, this leads us calls into question beyond these areas; yield at home, at school and in different social contexts. There are few studies that explain through parental questionnaires expectations and their perception of the quality of life in cochlear implanted in children. Conclusions: The results of the study show that children enjoy the benefits of using a cochlear implant. They report benefits in all areas studied (physical, emotional, social and academic). Parents are reliable reporters about the state of the overall quality of life of their children since their answers were similar to those given by their children.Introducción y objetivo: El concepto de calidad de vida ha comenzado a utilizarse cada vez más en el campo de las evaluaciones en salud. Se ha empezado a investigar los efectos de la implantación a nivel del desarrollo social y emocional del niño. El objetivo es examinar los resultados de la salud relacionados con la calidad de vida en niños sordos implantados cocleares de entre 11 y 12 años de edad y sus padres. Método: Estudio observacional, descriptivo transversal en 24 niños prelocutivos implantados unilaterales o bilaterales sucesivos de 11 y 12 años de edad y sus padres. Utilizando el cuestionario de calidad de vida pediátrica PedsQL™ (Versión 4.0, español para España), para medir la salud relacionados con la calidad de vida, completado de forma independiente por niños y padres respectivamente. Resultados: Mediante la T-Student los resultados de niños y padres en las diferentes escalas evaluadas observamos que en las escalas de funcionamiento emocional y académica es donde se obtienen resultados estadísticamente significativos (p <0,05). Al comparar el resultado total del cuestionario con las diferentes escalas evaluadas, en todas ellas se obtienen resultados estadísticamente significativos (p <0,05). Discusión: Probado el éxito del implante coclear en las áreas del habla y del lenguaje, esto nos lleva actualmente a preguntas más allá de estas áreas; el rendimiento en el hogar, en la escuela y en diferentes contextos sociales. Pocos estudios exploran a través de entrevistas o cuestionarios las expectativas de los padres y la percepción de la calidad de vida de sus hijos usuarios de implantes coclear. Conclusiones: Los resultados del estudio muestran que los niños disfrutan de los beneficios del uso de su implante coclear. Ellos reportan beneficios en todas las áreas estudiadas (física, emocional, social y académica). Los padres son periodistas válidos sobre el estado de la calidad de vida global de sus hijos ya que dieron respuestas similares a las dadas por sus hijos

Evaluación de la morfosintaxis como competencia gramatical del español entre niños con implantes cocleares y niños con audición normal

Introduction: The morphosyntactic aspects of language are important for the interpretation and production of complex messages. Material and Methods: An analytical and descriptive observational study of the morphosyntactic competence in the Spanish language of cochlear implanted children and normal hearing children using the BLOC battery (BLOC-screening version). Results and Discussion: The implanted children showed language skills appropriate for their age, compared with normal hearing children and similar hearing age. It is necessary studies that consider all the patterns and different dimensions of the language. An analysis of the effect of educational models on the acquisition of these patterns should also be considered.Introducción: Los aspectos morfosintácticas del lenguaje son importantes para la interpretación y la producción de mensajes complejos. Material y Métodos: Estudio observacional analítico y descriptivo de la competencia morfosintáctica en el idioma español de niños implantados cocleares y niños oyentes utilizando la batería BLOC (versión BLOC-screening). Resultados y discusión: Los niños implantados mostraron habilidades de lenguaje apropiadas para su edad, comparadas con los niños oyentes y edad auditiva similar. Se necesita un estudio más exhaustivo en muestras mayores y considerar todos los patrones y diferentes dimensiones del lenguaje. También debe considerarse un análisis del efecto de los modelos educativos en la adquisición de estos patrones

Transeptal suturing - a cost-efficient alternative for nasal packing in septal surgery

ABSTRACT INTRODUCTION: Nasal packing is routinely used in septal surgery to prevent postoperative bleeding. OBJECTIVE: To demonstrate the possibility of transeptal suture as a safe and effective way to avoid nasal packing and to improve efficiency. METHODS: This is a prospective, descriptive, inferential cost study comprising 92 patients. Two randomized groups of patients were analyzed, one with nasal packing and the other with transeptal suture. RESULTS: In the group of transeptal suture no patient experienced postoperative bleeding, and a statistically significant reduction of pain and headache was demonstrated. At the same time, we improved efficiency by saving on material costs. CONCLUSIONS: Transeptal suture is an effective and safe alternative to classic nasal packing in septal surgery. Moreover, it improves the efficiency of the intervention by saving costs

Stimulation crosstalk between cochlear and vestibular spaces during cochlear electrical stimulation

Abstract: ObjectivesPossible beneficial "crosstalk" during cochlear implant stimulation on otolith end organs has been hypothesized. The aim of this case-control study is to analyze the effect of electrical cochlear stimulation on the vestibule (otolith end-organ), when using a cochleo-vestibular implant, comparing vestibular stimulation (VI) and cochlear stimulation (CI).MethodsFour patients with bilateral vestibulopathy were included. A double electrode array research implant was implanted in all cases. Dynamic Gait Index (DGI), VOR gain measured by using vestibular head impulse test (vHIT), acoustic cervical myogenic responses (cVEMP) recordings, and electrical cVEMP were used in all cases. Trans-impedance Matrix (TIM) analysis was used to evaluate the current flow from the cochlea to the vestibule.ResultsWhile patients did not have any clinical vestibular improvement with the CI stimulation alone, gait metrics of the patients revealed improvement when the vestibular electrode was stimulated. The average improvement in the DGI was 38% when the vestibular implant was activated, returning to the normal range in all cases. Our findings suggest that any current flow from the cochlear space to the otolith organs was insufficient for effective cross-stimulation. The functional results correlated with the data obtained in TIM analysis, confirming that there is no current flow from the cochlea to the vestibule.ConclusionThe only way to produce effective electrical otolith end-organ stimulation, demonstrated with this research implant, is by direct electrical stimulation of the otolith end organs. No effective cross-stimulation was found from cochlear electrode stimulation.Level of Evidence4 Laryngoscope, 2023 We analyze in this research the possible beneficial "crosstalk" during cochlear implant stimulation on otolith end organs has been hypothesized. The aim of this study is to analyze the effect of electrical cochlear stimulation on the vestibule (otolith end organ), when using a cochleo-vestibular implant.imag