Implantes cocleares bilaterales en la población infantil: adquisición de la binauralidad / Bilateral cochlear implants in children: acquisition of binaural hearing

Introducción y objetivos: Numerosos estudios han señalado el beneficio de los implantes cocleares bilaterales en la adquisición de la binauralidad y la bilateralidad. En los niños portadores de un implante coclear ¿se conseguiría adquirir la binauralidad tras un segundo implante? ¿Cuándo sería el momento ideal para implantarlos? El objetivo del estudio es analizar el efecto binaural en niños con implantes bilaterales y analizar las diferencias entre los sujetos implantados de manera simultánea y de manera secuencial con un intervalo corto y otro largo. Pacientes y métodos: Se incluyeron 90 pacientes implantados con una edad comprendida entre uno y 2 años (la primera cirugía), entre 2000 y 2008. Veinticinco niños eran usuarios unilaterales y 65 bilaterales, 17 implantados simultáneamente, 29 implantados de forma secuencial, realizándose el segundo implante antes del año (corto período interimplante) y 19 secuenciales en los que el segundo implante se realizó posteriormente al año de la primera cirugía (largo período interimplante). A todos los pacientes se les relizaron pruebas de percepción verbal en silencio, en ruido y una audiometría tonal liminar. Resultados: Prueba de percepción verbal en silencio: implantes simultáneos y secuenciales con corto período entre implante (media: 84,67%) frente a los implantes secuenciales con largo período entre implantes y los unilaterales (media: 79,66%) siendo estadísticamente significativo (p=0,023). Prueba de percepción verbal en ambiente ruidoso: implantes simultáneos y secuenciales con corto período entre implante (media del 77,17%) frente a los implantes secuenciales con largo período entre implantes y los unilaterales (media: 69,32%) siendo estadísticamente significativo (p=0,002). Conclusiones: Los implantados simultáneamente y los secuenciales de corto período adquirieron las ventajas de la binauralidad (AU)

Introduction and objectives: Several studies have indicated the benefit of bilateral cochlear implants in the acquisition of binaural hearing and bilateralism. In children with cochlear implants, is it possible to achieve binaurality after a second implant? When is the ideal time to implant them? The objective of this study was to analyse the binaural effect in children with bilateral implants and the differences between subjects with simultaneous and sequential implants with both short and long intervals. Patients and methods: There were 90 patients between 1 and 2 years of age (the first surgery), implanted between 2000 and 2008. Of these, 25 were unilateral users and 65 bilateral; 17 patients had received simultaneous implants, 29 had sequential implants before 12 months after the first one (short interimplant period) and 19 after 12 months (long period). All of them were tested for silent and noisy verbal perception and a tonal threshold audiometry was performed. Results: The silent perception test showed that the simultaneous and short period sequential implant patients (mean: 84.67%) versus unilateral and long period sequential implants (mean: 79.66%), had a statistically-significant difference (P=0,23). Likewise, the noisy perception test showed a difference with statistical significance (P=0,22) comparing the simultaneous implanted and short period sequential implants (mean, 77.17%) versus unilateral implanted and long period sequential ones (mean: 69.32%). Conclusions: The simultaneous and sequential short period implants acquired the advantages of binaural hearing (AU)

[Bilateral cochlear implants in children: acquisition of binaural hearing]. / Implantes cocleares bilaterales en la población infantil: adquisición de la binauralidad.

INTRODUCTION AND OBJECTIVES: Several studies have indicated the benefit of bilateral cochlear implants in the acquisition of binaural hearing and bilateralism. In children with cochlear implants, is it possible to achieve binaurality after a second implant? When is the ideal time to implant them? The objective of this study was to analyse the binaural effect in children with bilateral implants and the differences between subjects with simultaneous and sequential implants with both short and long intervals. PATIENTS AND METHODS: There were 90 patients between 1 and 2 years of age (the first surgery), implanted between 2000 and 2008. Of these, 25 were unilateral users and 65 bilateral; 17 patients had received simultaneous implants, 29 had sequential implants before 12 months after the first one (short interimplant period) and 19 after 12 months (long period). All of them were tested for silent and noisy verbal perception and a tonal threshold audiometry was performed. RESULTS: The silent perception test showed that the simultaneous and short period sequential implant patients (mean: 84.67%) versus unilateral and long period sequential implants (mean: 79.66%), had a statistically-significant difference (P=0,23). Likewise, the noisy perception test showed a difference with statistical significance (P=0,22) comparing the simultaneous implanted and short period sequential implants (mean, 77.17%) versus unilateral implanted and long period sequential ones (mean: 69.32%). CONCLUSIONS: The simultaneous and sequential short period implants acquired the advantages of binaural hearing.

Acúfeno e implante coclear. Experiencia preliminar / Tinnitus and cochlear implantation. Preliminary experience

Objetivo: Valorar el efecto del implante coclear en pacientes con «acúfeno incapacitante». Materiales: Realizamos una evaluación del efecto de la implantación coclear sobre la evolución del acúfeno incapacitante. Se han evaluado 3 adultos afectos de hipoacusia postlingual implantados en nuestro hospital, con acúfenos preimplantación. Los pacientes fueron evaluados de acuerdo con los efectos del acúfeno en las emociones de los pacientes y las actividades de la vida cotidiana. Resultados: De los tres, uno declaró la supresión del acúfeno, otros dos atenuación tras la cirugía, en diversos grados, no encontrando ningún paciente con peores resultados tras la implantación. Conclusiones: El efecto beneficioso de la implantación coclear sobre el acúfeno, reportado en nuestros pacientes, puede ser debido al enmascaramiento acústico, a través de la estimulación eléctrica del nervio acústico, y todo ello por la reorganización cerebral de las vías del sistema nervioso central (SNC) y las áreas de asociación cerebral tras la implantación coclear (AU)

Objective: To assess the effect of cochlear implantation in patients with disabling tinnitus. Materials: We conducted an evaluation of the effect of cochlear implantation on the development of disabling tinnitus. Three adults with pre-implantation tinnitus, implanted in our hospital, were evaluated for postlingual hearing loss. Patients were evaluated according to the effects of tinnitus on their emotions and activities of daily living. Results: One patient reported that the tinnitus disappeared and two reported different degrees of attenuation. We did not find any patients with worse outcomes after implantation. Conclusions: The beneficial effect of cochlear implantation on tinnitus reported in our patients may be due to acoustic masking, through electrical stimulation of the acoustic nerve, all from brain reorganisation of central nervous system (CNS) pathways and cerebral association areas after cochlear implantation (AU)

[Tinnitus and cochlear implantation. Preliminary experience]. / Acúfeno e implante coclear. Experiencia preliminar.

OBJECTIVE: To assess the effect of cochlear implantation in patients with disabling tinnitus. MATERIALS: We conducted an evaluation of the effect of cochlear implantation on the development of disabling tinnitus. Three adults with pre-implantation tinnitus, implanted in our hospital, were evaluated for postlingual hearing loss. Patients were evaluated according to the effects of tinnitus on their emotions and activities of daily living. RESULTS: One patient reported that the tinnitus disappeared and two reported different degrees of attenuation. We did not find any patients with worse outcomes after implantation. CONCLUSIONS: The beneficial effect of cochlear implantation on tinnitus reported in our patients may be due to acoustic masking, through electrical stimulation of the acoustic nerve, all from brain reorganisation of central nervous system (CNS) pathways and cerebral association areas after cochlear implantation.