ABSTRACT
BACKGROUND: There have been remarkable developments in Cochlear Implants in the past years. Technical improvements lead to more reliable and durable devices. In cases of traumatic and atraumatic device failure a reimplantation of the Cochlear Implant is necessary. METHODS: In a retrospective study we examined 15 patients with 17 Cochlear reimplantation procedures after a traumatic or atraumatic device failure between 1996 and 2002. The reasons leading to the revision, the intraoperative findings, the perioperative complications and the postoperative audiological results as well as the personal evaluation of the revision procedure were analyzed. RESULTS: In our study there were 11 children and 4 adults. In 10 cases a traumatic and in 7 cases an atraumatic device failure lead to the reimplantation. In 13 of the 15 patients the revision surgery took place within 1 month after the date of device failure. The electrode array could be reinserted safely without any perioperative complications. The postoperative results showed a continuous development of speech perception in all patients. The personal evaluation of the reimplantation procedure was positive in all cases. CONCLUSIONS: Cochlear reimplantation in cases of traumatic or atraumatic device failure is a safe procedure without any serious perioperative complications. The timely reimplantation leads to a continuous development of speech perception.
Subject(s)
Cochlear Implantation , Cochlear Implants , Prosthesis Failure , Age Factors , Audiometry , Child , Child, Preschool , Follow-Up Studies , Humans , Length of Stay , Middle Aged , Reoperation , Retrospective Studies , Time FactorsABSTRACT
A study was conducted to compare the new MED-EL TEMPO+ ear-level speech processor with the CIS PRO+ body-worn processor in the COMBI 40/COMBI 40+ implant system. Speech tests were performed in 46 experienced subjects in two test sessions approximately 4 weeks apart. Subjects were switched over from the CIS PRO+ to the TEMPO+ in the first session and used only the TEMPO+ in the time between the two sessions. Speech tests included monosyllabic word tests and sentence tests via the telephone. An adaptive noise method was used to adjust each subject's scores to approximately 50%. Additionally, subjects had to complete a questionnaire based on their 4 weeks of experience with the TEMPO+. The speech test results showed a statistically significant improvement in the monosyllabic word scores with the TEMPO+. In addition, in the second session, subjects showed a significant improvement when using the telephone with the TEMPO+, indicating some learning in this task. In the questionnaire, the vast majority of subjects found that the TEMPO+ allows equal or better speech understanding and rated the sound quality of the TEMPO+ higher. All these objective and subjective results indicate the superiority of the TEMPO+ and are mainly attributed to a new coding strategy called CIS+ and its implementation in the TEMPO+. In other words, based on the results of this study, it appears that after switching over from the CIS PRO+ to the TEMPO+, subjects are able to maintain or even improve their own speech understanding capability.
Subject(s)
Cochlear Implants , Deafness/therapy , Adult , Aged , Cochlear Implants/standards , Deafness/etiology , Equipment Design , Female , Humans , Male , Middle Aged , Psychometrics , Speech Discrimination Tests , Speech Perception , Surveys and QuestionnairesABSTRACT
PROBLEM: Reliable evaluation of vestibular compensation in indispensable to determine whether labyrinth surgery or vestibular neurectomy is indicated. It is also important for postoperative follow-up. Vestibular compensation can manifest itself differently in distinct frequency ranges. METHOD: Twenty volunteers were examined in five distinct situations of daily vestibular stimulation. Measurement of angular and linear head acceleration was performed using accelerometers fixed on the volunteers' head. A 200 Hz AD fed data to a PC database. FFT was used for data analysis. RESULTS: Stimulus frequency of the vestibular system varies between 0.01 and 2 Hz. Most of the patients suffering from vestibular lesions showed a reduced vestibulo ocular reflex (VOR) below 0.1 Hz. In all cases of unilateral vestibular function loss, there was a correlation between the symptoms during movement and the corresponding frequency range of the distinct motion pattern. Rotatory vestibular pendular testing was used to document vestibular disorders in patients who had normal findings in routine vestibular testing. DISCUSSION: Clinical use of rotatory vestibular pendular testing results must be performed using broad stimulus frequency spectra (0.01-0.06 Hz). This method must be used in preoperative examination before labyrinth surgery as well as in estimating individual tolerance for vestibular stimulation in daily situations.
