Cochlear implant complications and failures

Abstract Introduction Cochlear implantation is a relatively safe surgery performed on profound bilateral hearing loss patients. Its surgical indications have increased and the age of implantation has decreased over the last years. As with any other surgery, it presents complications; device failure is one of the most important, given its potential risk for the need to explant and reimplant the device. Objective To evaluate cochlear implant complications, determine possible causes and discuss medical and surgical management. Material and methods A retrospective study of cochlear implants was performed. A total of 246 implants over an eleven-year period were evaluated. The sample consisted of…

Surgical planning after sleep versus awake techniques in patients with obstructive sleep apnea

Objective/Hypothesis This study examined correlations between surgical recommendations based on either drug-induced sleep endoscopy (DISE) or common awake examination methods in patients with obstructive sleep apnea syndrome (OSAS). Study Design Prospective, blinded, clinical trial at a university hospital. Methods An otorhinolaryngologist designed surgical plans for patients with OSAS after clinical examination, lateral cephalometry, the Muller maneuver, and Friedman staging. A second otorhinolaryngologist blinded to the previous plans made surgical recommendations after DISE. A third person tested agreement between the two sets of plans using Cohen's kappa statistic and the chi-squared te…

Distortion product otoacoustic emissions in healthy newborns: normative data.

Distortion product otoacoustic emissions (DPOAE) offer an alternative to transiently evoked otoacoustic emissions (TEOAE) as an audiological test. The former can be used as a screening technique, and may also provide frequency-specific information about the functional state of the cochlea. We recorded DPOAE in a group of healthy newborns to establish the Characteristics of a DPOAE “audiogram” (DP-gram) in this population. The DP-gram can be obtained with characteristics quite similar to those observed in adults, with two sharp peaks of maximum amplitude at F2 frequencies of 2 kHz and 5-6 kHz, and a decline in DPOAE amplitude in mid frequencies. The results confirm the limitations of DPOAE r…

Complicaciones y fallos de la implantación coclear

Resumen Introduccion La implantacion coclear es una cirugia con poca morbimortalidad que se realiza a pacientes con hipoacusia neurosensorial profunda bilateral. Con el paso del tiempo sus indicaciones han aumentado, y la edad de implantacion ha disminuido. Sin embargo, como cualquier cirugia, presenta complicaciones, y dentro de estas el fallo tecnico constituye un motivo de preocupacion por la inminente necesidad de reimplante. Objetivo Evaluar las complicaciones derivadas de la implantacion coclear, determinar sus causas y discutir el manejo terapeutico. Material y metodos Se realizo un estudio retrospectivo de los implantes cocleares realizados. Se obtuvieron un total de 246 implantes e…

Randomized study comparing two tongue base surgeries for moderate to severe obstructive sleep apnea syndrome

To compare the effectiveness and morbidity of the tongue base radiofrequency and tongue base suspension techniques combined with uvulopalatopharyngoplasty for moderate to severe obstructive sleep apnea.Prospective and randomized surgical trial at a university hospital.In total, 57 patients received either tongue base radiofrequency reduction (n = 29) or tongue base suspension (n = 28). Apnea-hypopnea index, lowest oxygen saturation (polysomnography), Epworth score, and side effects were assessed. Success was defined as aor =50 percent reduction and final apneahypopnea index15/h, and an Epworth score11.The success rates of the two procedures were 57.1 percent and 51.7 percent, respectively (…

Cis-diaminedichloro platinum ototoxicity. An experimental study.

Four groups of guinea pigs received different doses of cis-platinum. SEM and TEM showed a direct relation between the dose and the damage. The first row of OHC is the first one to be damaged. The IHC are more resistant than the OHC. The pattern of destruction is similar to the one produced by the aminoglucoside antibiotics.

An experimental comparative study of dexamethasone, melatonin and tacrolimus in noise-induced hearing loss.

The calcineurin inhibitor tacrolimus (TCR) and the pineal gland hormone and antioxidant melatonin (MLT) have been shown to possess otoprotective properties against noise-induced hearing loss (NIHL). In contrast, dexamethasone (DXM) was not effective as an otoprotective agent against NIHL. Further studies are needed to understand the exact molecular mechanisms involved.Exposure to noise pollution and use of audio devices for long periods of time at high volume is known to cause hearing loss or NIHL. Our goal was to evaluate the effectiveness of various known compounds such as the anti-inflammatory DXM, the antioxidant MLT and the immunosuppressant TCR against NIHL.Thirty-two Wistar rats were…

Étude Histo-Physiologique De l'Action De l'hyaluroni-Dase Sur l'oreille Interne

Auditory Neuropathy in Children

Auditory neuropathy is a sensorineural disorder characterized by absent or abnormal auditory brainstem evoked potentials and normal cochlear outer hair cell function. A variety of processes is thought to be involved in its pathophysiology and their influence on hearing may be different. We present here the diagnostic sequence and management of two new cases of auditory neuropathy in breastfeeding children.

Consensus on Treatment of Obstructive Eustachian Tube Dysfunction With Balloon Eustachian Tuboplasty

Abstract Objective There is a great variability in diagnosis of obstructive Eustachian tube dysfunction and its treatment by balloon Eustachian tuboplasty (BET). The aim of this paper was to present a consensus on indications, contraindications, methodology, complications and results after BET. Material & Methods We obtained a consensus on BET, after a systematic review of the literature on BET from 1966 to November 2018, using MESH terms “Eustachian tube and (dilation or dysfunction)”, including a total of 1.943 papers in Spanish, English, German and French. We selected 139 papers with a relevant abstract, including two international consensuses, seven systematic revisions, and two randomi…

Impact of an oral appliance on obstructive sleep apnea severity, quality of life, and biomarkers

OBJECTIVE/HYPOTHESIS To investigate outcomes including efficacy, quality of life, and levels of inflammatory markers of a mandibular advancement device (MAD) for moderate-to-severe obstructive sleep apnea (OSA). STUDY DESIGN Case-control study. METHODS Patients with apnea-hypopnea index (AHI) ≥ 15/hr who only accepted MAD therapy (study group) or who refused any treatment (control group) were recruited. At baseline and at 6 months, polysomnography, Epworth Sleepiness Scale (ESS), Functional Outcomes of Sleep Questionnaire (FOSQ), C-reactive protein (CRP), interleukin 1β, interleukin 6, and tumor necrosis factor α (TNF-α) were assessed in both groups. RESULTS At baseline, the study group (n …

Consenso sobre el tratamiento de la disfunción tubárica obstructiva mediante dilatación con balón

Resumen Objetivo Existe una gran variabilidad en el diagnostico de la disfuncion tubarica obstructiva y su tratamiento mediante la dilatacion tubarica con balon (DTB). El objetivo de este trabajo es presentar unas recomendaciones de consenso sobre las indicaciones, contraindicaciones, metodologia, complicaciones y resultados de la DTB. Materiales y metodos Presentamos un consenso sobre la DTB, mediante revision sistematica de la literatura desde 1966 hasta noviembre de 2018, terminos MESH Eustachian tube and (dilation or dysfunction), recogiendo un total de 1.943 articulos en espanol, ingles, aleman y frances. Del total de articulos revisados se seleccionaron 139 cuyo abstract era relevante…

Efficacy of three drugs for protecting against gentamicin-induced hair cell and hearing losses

BACKGROUND AND PURPOSE Exposure to an ototoxic level of an aminoglycoside can result in hearing loss. In this we study investigated the otoprotective efficacy of dexamethasone (DXM), melatonin (MLT) and tacrolimus (TCR) in gentamicin (GM)-treated animals and cultures. EXPERIMENTAL APPROACH Wistar rats were divided into controls (treated with saline); exposed to GM only (GM); and three GM-exposed groups treated with either DXM, MLT or TCR. Auditory function and cochlear surface preparations were studied. In vitro studies of oxidative stress, pro-inflammatory cytokine mRNA levels, the MAPK pathway and caspase-3 activation were performed in organ of Corti explants from 3-day-old rats. KEY RESU…