Single-sided deafness and cochlear implantation in congenital and acquired hearing loss in children.

OBJECTIVE: To determine the audiological and clinical results of cochlear implantation in children below the age of 12 years old with congenital and acquired single-sided deafness. DESIGN: Observational, descriptive, transversal study. MAIN OUTCOME MEASURES: Speech reception thresholds, Cortical responses, Auditory Lateralization Test and SSQ questionnaire. PARTICIPANTS: Children < 12 implanted for congenital or acquired SSD. RESULTS: All the children with congenital SSD showed positive cortical responses. Positive results were obtained in the Auditory Lateralization Test for the following modalities: 0º, 45º and 90º. With respect to the Speech Test, the children with acquired SSD showed the following results: 92% and 100% in recognition and 48% and 68% (Azimuth modalities), Signal CI side 52% and 68% and Signal normal hearing side 44% - 60% (p < 0.05). In both group the processor was used for 6-12 hours. With respect to the SSQ questionnaire results, the parents were more satisfied within the post-operative period than within the pre-operative period (P<0.001). CONCLUSIONS: Cochlear implant provides children with congenital SSD with significant audiological and subjective benefits. Children with congenital SSD and implanted after a longer period may not have an important benefit (binaural) although other bilateral effects can be achieved. Children with post-lingual unilateral deafness and after a short period of hearing deprivation probably integrated the normal acoustic hearing with the cochlear implant electrical signal and showed binaural benefits.

Imaging evaluation of electrode placement and effect on electrode discrimination on different cochlear implant electrode arrays.

OBJECTIVE: The aim of the present study is to evaluate the effect of electrode discrimination based on electrode to modiolus distance in different cochlear implant models, using image information to estimate the outcomes after an implantation on electrode discrimination METHODS: A descriptive prospective randomized study performed during 16 months. A psychoacoustic platform was used to evaluate patients' electrode discrimination capabilities of patients. For the acquisition of the images, a cone beam computed tomography was used to assess postcochlear implantation of electrodes' position. We considered two other new measurements: the intracochlear position index, which indicates how far is the electrode from the modiolar wall, and the homogeneity factor (HF), which provides us with information about the distance between the electrodes and the modiolus RESULTS: 21 postlingually deaf adults showing different CI models [CI522 (n = 7), CI512 (n = 7), and CI532 (n = 7)] that corresponded to the lateral and perimodiolar array electrodes. The average success rate of the CI522 group was 47%, of the CI512 group was 48%, and of the CI532 group was 77%. There is statistically significant difference between groups CI532-CI522 (p = 0.0033) and CI532-CI512 (p = 0.0027) CONCLUSION: The Nucleus CI532 offers a better perimodiolar placement. HF and IPI measurements provide information about the electrodes location inside the cochlea, being related to electrode discrimination.

Health-Related Quality of Life in Adult Cochlear Implant Users: A Descriptive Observational Study.

Cochlear implantation has a significant impact on patients' social life, performance of activities, and self-esteem. The objective of this retrospective study was to assess the health-related quality of life of cochlear implant users aged under and over 60 years by a self-report using the Glasgow Health Status Inventory and the Abbreviated Profile of Hearing Aid Benefit. It was observed that quality of life values increased very rapidly straight after implantation regardless of age. Bilateral cochlear implant users showed better results in environments with background noise and in a reverberant room than unilateral cochlear implant users. Quality of life improved independently of hearing performance benefits for patients over 60 years at implantation.

Trastorno congénito de la glucosilación: experiencia en el primer paciente hipoacúsico tratado con implante coclear / Congenital disorders of glycosylation: first deaf patient treated with a cochlear implant

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Evaluación del muy bajo peso (≤ 1.500 g) al nacer como indicador de riesgo para la hipoacusia neurosensorial / Evaluation of very low birth weight (≤ 1.500 g) as a risk indicator for sensorineural hearing loss

Introducción y objetivo: La audición cumple un rol fundamental en la adquisición, desarrollo y mantenimiento de las propiedades del habla y del lenguaje. El peso al nacer es un indicador de maduración biológica del recién nacido (RN). El RN con muy bajo peso al nacer (MBPN ≤ 1500 g) y el gran prematuro es un grupo de población de mayor riesgo para hipoacusia neurosensorial. El objetivo del estudio es conocer el grado de hipoacusia, presencia de hipoacusia neurosensorial y la asociación a otro factor de riesgo para hipoacusia en el RN de MBPN, incluidos en el Programa de Cribaje Universal de la Hipoacusia del Complejo Hospitalario Universitario Insular Materno Infantil de Gran Canaria, período 2007-2010. Material y método: Estudio retrospectivo de 364 RN con MBPN, mediante otoemisiones acústicas provocadas transitorias y potenciales evocados auditivos de tronco cerebral. Resultados: Ciento doce RN (30.8%) fueron derivados a potenciales evocados auditivos de tronco cerebral. Veintidós RN (2,2%) presentaron diagnóstico de hipoacusia, 14 hipoacusias de transmisión, 8 hipoacusias neurosensoriales (HNS), y de estos, 2 con hipoacusia profunda bilateral. La asociación a otro factor de riesgo de los RN con MBPN se presenta en más de la cuarta parte de la muestra estudiada. Todos los diagnosticados de HNS fueron grandes prematuros. Conclusiones: El porcentaje de niños con diagnóstico de hipoacusia entre los RN con MBPN es superior al esperado en la población general. Todos los diagnosticados de HNS fueron grandes prematuros y presentaban uno o 2 factores de riesgo auditivo más, asociados al MBPN (AU)

Introduction and objective: Hearing plays an essential role in the acquisition, development and maintenance of the properties of the speech and language. Birth weight is an indicator of biological maturation of the newborn. Premature newborns with very low birth weight (VLBW < 1,500 g) constitute a group with the highest risk of sensorineural hearing loss. Our objective was to ascertain the degree of hearing loss, sensorineural hearing loss and presence of the association to other risk factors for hearing loss in VLBW infants included in the Universal Hearing Loss Screening Programme at the University Mother-Child Hospital of Gran Canaria (Spain) in the 2007-2010 period. Material and methods: This was a retrospective study of 364 infants with VLBW, measured by transient evoked otoacoustic emissions and auditory brainstem response. Results: There were 112 newborn (30.8%) referred for auditory brainstem response. A diagnosis of hearing loss was given to 22 newborns (2.2%), 14 had conductive hearing loss and 8, sensorineural hearing loss (SNHL), of which 2 had bilateral profound hearing loss. The VLBW newborn presented the association to another risk factor in more than a quarter of the sample studied. All those diagnosed with SNHL were premature. Conclusions: The percentage of VLBW newborns diagnosed with hearing loss is higher than expected in the general population. All those diagnosed with SNHL were premature and presented one or 2 hearing risk factors associated with VLBW (AU)

Evaluation of very low birth weight (≤ 1,500 g) as a risk indicator for sensorineural hearing loss.

INTRODUCTION AND OBJECTIVE: Hearing plays an essential role in the acquisition, development and maintenance of the properties of the speech and language. Birth weight is an indicator of biological maturation of the newborn. Premature newborns with very low birth weight (VLBW<1,500 g) constitute a group with the highest risk of sensorineural hearing loss. Our objective was to ascertain the degree of hearing loss, sensorineural hearing loss and presence of the association to other risk factors for hearing loss in VLBW infants included in the Universal Hearing Loss Screening Programme at the University Mother-Child Hospital of Gran Canaria (Spain) in the 2007-2010 period. MATERIAL AND METHODS: This was a retrospective study of 364 infants with VLBW, measured by transient evoked otoacoustic emissions and auditory brainstem response. RESULTS: There were 112 newborn (30.8%) referred for auditory brainstem response. A diagnosis of hearing loss was given to 22 newborns (2.2%), 14 had conductive hearing loss and 8, sensorineural hearing loss (SNHL), of which 2 had bilateral profound hearing loss. The VLBW newborn presented the association to another risk factor in more than a quarter of the sample studied. All those diagnosed with SNHL were premature. CONCLUSIONS: The percentage of VLBW newborns diagnosed with hearing loss is higher than expected in the general population. All those diagnosed with SNHL were premature and presented one or 2 hearing risk factors associated with VLBW.

Resultados de un programa de detección precoz de la hipoacusia neonatal / Results of an early hearing detection program

Introducción y objetivos: La hipoacusia neonatal es un problema de salud pública, que cumple los requisitos para ser sometido a cribado universal. El objetivo de este artículo es analizar los resultados obtenidos en el programa de detección precoz de la hipoacusia implementado en nuestro centro desde enero de 2007 hasta diciembre de 2010. Métodos: Se estudiaron 26.717 recién nacidos mediante otoemisiones acústicas transitorias (OEAT) en la fase de cribado auditivo. La etapa diagnóstica fue llevada a cabo en la unidad de hipoacusia del servicio. Resultados: En el período entre enero de 2007 y diciembre de 2010 nacieron 27.935 niños. Se practicó el screening a 26.717, de los cuales 24.173 presentaron OEAT positivas, 1.040 tuvieron OEAT ausentes y 1.504 presentaron OEAT en un oído estando ausentes en el oído contralateral. Presentaron factores de riesgo asociado para hipoacusia 4.674 recién nacidos. En una segunda fase del programa se practicó OEAT a 5.156 niños, de los cuales 4.626 presentaron otoemisiones positivas en ambos oídos, 323 no presentaron otoemisiones en un oído y 207 no pasaron esta segunda fase. Fueron derivados a potenciales evocados auditivos de tronco cerebral (PEATC) un 3,8% del total de niños estudiados. Veintiséis niños ingresaron al programa de implantes cocleares. Nuestro programa de detección precoz de la hipoacusia alcanzó una cobertura del 95,64%. Conclusiones: El programa de detección precoz de la hipoacusia de nuestro complejo es adecuado a nuestro funcionamiento, alcanzando una cobertura del 95,64% considerándose muy positiva la relación existente entre eficacia y eficiencia (AU)

Introduction and objectives: Neonatal hearing loss is a public health problem that meets the requirements for submission to universal screening. Our objective was to analyse the results of the early hearing detection and intervention program implemented at our centre between January 2007 and December 2010. Methods: We studied 26,717 newborns during the period mentioned, using transient otoacoustic emissions (TOAEs) for the screening. The diagnostic phase was carried out at the hearing loss department. Results: In our area, there were 27,935 births between January 2007 and December 2010. The screening was performed on 26,717 children. Of these, 24,173 had positive TOAEs, 1,040 had no TOAEs and 1,504 presented TOAEs in 1 ear with absence of TOAEs in the contralateral ear. Risk factors associated with hearing loss were found in 4,674 infants. In a second phase of the program, TOAEs were given to 5,156 children, of whom 4,626 had positive otoacoustic emissions in both ears, 323 had no TOAEs in 1 ear and 207 failed this second phase. Of all children studied, 3.8% were referred to auditory brainstem response (ABR) testing and 26 children entered the cochlear implant program. The program reached coverage of 95.64%. Conclusions: The early hearing detection and intervention program at our hospital is suitable for our environment, reaching 95.64% of coverage. We consider the relationship between effectiveness and efficiency to be positive (AU)

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.

Results of an early hearing detection program.

INTRODUCTION AND OBJECTIVES: Neonatal hearing loss is a public health problem that meets the requirements for submission to universal screening. Our objective was to analyse the results of the early hearing detection and intervention program implemented at our centre between January 2007 and December 2010. METHODS: We studied 26,717 newborns during the period mentioned, using transient otoacoustic emissions (TOAEs) for the screening. The diagnostic phase was carried out at the hearing loss department. RESULTS: In our area, there were 27,935 births between January 2007 and December 2010. The screening was performed on 26,717 children. Of these, 24,173 had positive TOAEs, 1,040 had no TOAEs and 1,504 presented TOAEs in 1 ear with absence of TOAEs in the contralateral ear. Risk factors associated with hearing loss were found in 4,674 infants. In a second phase of the program, TOAEs were given to 5,156 children, of whom 4,626 had positive otoacoustic emissions in both ears, 323 had no TOAEs in 1 ear and 207 failed this second phase. Of all children studied, 3.8% were referred to auditory brainstem response (ABR) testing and 26 children entered the cochlear implant program. The program reached coverage of 95.64%. CONCLUSIONS: The early hearing detection and intervention program at our hospital is suitable for our environment, reaching 95.64% of coverage. We consider the relationship between effectiveness and efficiency to be positive.