Résumé
Abstract Introduction Facial nerve stimulation (FNS) is a complication in cochlear implant (CI) when the electrical current escapes from the cochlea to the nearby facial nerve. Different management to reduce its effects are available, although changes might result in a less-than-ideal fitting for the CI user, eventually reducing speech perception. Objective To verify the etiologies that cause FNS, to identify strategies in managing FNS, and to evaluate speech recognition in patients who present FNS. Methods Retrospective study approved by the Ethical Board of the Institution. From the files of a CI group, patients who were identified with FNS either during surgery or at any time postoperatively were selected. Data collection included: CI manufacturer, electrode array type, age at implantation, etiology of hearing loss, FNS identification date, number of electrodes that generated FNS, FNS management actions, and speech recognition in quiet and in noise. Results Data were collected from 7 children and 25 adults. Etiologies that cause FNS were cochlear malformation, head trauma, meningitis, and otosclerosis; the main actions included decrease in the stimulation levels followed by the deactivation of electrodes. Average speech recognition in quiet before FNS was 86% and 80% after in patients who were able to accomplish the test. However, there was great variability, ranging from 0% in quiet to 90% of speech recognition in noise. Conclusion Etiologies that cause FNS are related to cochlear morphology alterations. Facial nerve stimulation can be solved using speech processor programming parameters; however, it is not possible to predict outcomes, since results depend on other variables.
Résumé
Abstract Introduction Between 15% to 30% of individuals with bilateral prelingual sensorineural hearing loss present with associated disabilities. Cochlear implant (CI) is an alternative treatment that provides consistent access to environmental and speech sounds, which results in significant benefits regarding quality of life and auditory and language development. Objectives To study the auditory and communicative performance of individuals with CI and delayed neuropsychomotor development after a minimum of five years using the device. Methods A total of eight patients were included in the study. We collected the multidisciplinary clinical records of participants, as well as the answers for the questionnaires applied remotely, which included the Children with Cochlear Implants: Parental Perspectives (CCIPP), International Classification of Functioning, Disability and Health: Children and Youth Version (ICF-CY), and the Gross Motor Function Classification System (GMFCS). Results We found that throughout the years of CI use, the auditory threshold means improved significantly in all tested frequencies, as did the speech detection threshold and the language and hearing results. Regarding parental perception, parents evaluated aspects related to their children's social relations to be positive, and had worse perceptions regarding aspects related to their education. Conclusion We observed a progression in the participants' auditory and language skills throughout the years of CI use; even in the presence of other associated disabilities. Future multicentric studies with larger samples are needed to further the advancement of rehabilitation in patients with other associated disabilities.
Résumé
RESUMO Objetivo Verificar o efeito da cognição no benefício obtido com o uso de próteses auditivas e na qualidade de vida de idosos com perda auditiva. Método Foram avaliados 17 idosos com perda auditiva neurossensorial de grau moderado bilateral. Os idosos foram distribuídos em dois grupos segundo os resultados da triagem cognitiva 10-CS: G1- sete idosos sem alteração e G2- dez idosos com resultado sugestivo de alteração cognitiva. Protocolo de estudo: questionário de avaliação de restrição de participação - HHIE, escala de depressão geriátrica - EDG, questionário de qualidade de vida - SF36 e avaliação do esforço de escuta por meio da escala visual analógica. A seguir, os idosos receberam as próteses auditivas. Após três meses de uso efetivo da amplificação, o protocolo foi reaplicado com a inclusão do Questionário Internacional - QI-AASI. Resultados Caracterizou-se a amostra quanto à idade, escolaridade, Critério de Classificação Econômica Brasil - ABEP, grau da perda, reconhecimento de fala e índice de Inteligibilidade de fala (SII) da orelha com melhor audibilidade. O estudo estatístico revelou diferença somente com relação à idade. O estudo comparativo antes e após intervenção revelou melhora significante nos escores do 10-CS no grupo G2, na restrição de participação, esforço de escuta e alguns domínios do questionário de qualidade de vida. Não houve diferença no QI-AASI entre grupos segundo Fator 1, Fator 2 e Escore Total. Conclusão Houve melhora da qualidade de vida após três meses de uso de amplificação. Não houve efeito da cognição no benefício obtido com o uso de próteses auditivas.
ABSTRACT Purpose To verify the effects of cognition on the benefit obtained with the use of hearing aids and on the quality of life of elderly people with hearing loss. Methods 17 elderly people with moderate sensorineural hearing loss (SNHL) bilateral were evaluated. The elderly people were divided into two groups according to the results of 10-point cognitive screening 10-CS: G1- seven elderly people without change and G2-10 elderly people with a suggestive result of cognitive alteration. Study protocol: self-evaluation questionnaire - (Hearing Handicap Inventory for the Elderly (HHIE)), geriatric depression scale (GDS), quality of life questionnaire - (Short-Form 36 (SF36)) and evaluation of the listening effort through the Visual Analogue Scale (VAS). After the evaluation, the elderly people received hearing aids. After three months of effective amplification, the protocol was reapplied with the inclusion of the International Questionnaire for the Evaluation of Hearing Aids - (IOI-HA). Results The sample was characterized according to age, schooling, Critério de Classificação Econômico Brasil Associação Brasileira das Empresas de Pesquisa (ABEP), degree of loss, Índice Percentual de Reconhecimento da Fala (IPRF) and Speech Intelligibility Index (SII) of the ear with better audibility. The statistical study revealed that there was significant difference only in relation to age. The comparative study before and after the intervention revealed a significant improvement in the 10-CS scores in the group G2, in the participation restriction - HHIE, in the listening effort and in some areas of the SF36. There was no difference in QI-AASI between groups second the factor 1, factor 2 and Total Score. Conclusion There was improvement of the quality of life after three months of amplification use. There was no effect of cognition on the benefit obtained with the use of hearing aids.