ABSTRACT
El Implante de Tallo Cerebral, es un dispositivo protésico diseñado inicialmente para restaurar la función auditiva, en pacientes sordos como consecuencia de neurofibromatosis tipo II. El Implante de Tallo Cerebral (ABI) es el más utilizado y está diseñado para estimular directamente los núcleos cocleares del tallo cerebral, haciendo un bypass de la cóclea y el nervio auditivo, representando una alternativa potencial en pacientes con aplasia del nervio coclear, osificación coclear severa y malformaciones del oído interno, que no permitan la colocación de un implante coclear convencional. Con este artículo se pretende hacer una introducción de nuevas indicaciones, técnicas y resultados de este dispositivo.
Brain stem implant is a prosthetic device that was initially designed to restore the auditory function in patients that had become deaf as a consequence of a neurofibromatosis type II. Brain Stem Implant (ABI) is the most use done and has been designed to directly stimulate the cochlear nucleus of the brain stem. This is done by making a bypass of the cochlea and the auditory nerve, which in turn represents a potential alternative in patients that suffer from aplasia of the cochlear nerve, a severe cochlear ossification and malformations of the inner ear, which do not allow for the insertion of a conventional cochlear implant. This article is intended to make an introduction to new indications, techniques and results of this device.
Subject(s)
Humans , Cochlear Nucleus , Ear, InnerABSTRACT
La extrusión del implante coclear es una complicación mayor poco frecuente cuyas principales causas son una inadecuada técnica quirúrgica, una reacción de hipersensibilidad a los componentes del implante o el desarrollo de un proceso infeccioso ya sea agudo o crónico como en el caso de la formación de biofilms. La infección se puede presentar bajo dos formas: la primera como una infección por gérmenes asilados y la segunda que es la más severa conocida como biofilm, es decir una colonización de bacterias organizadas que les permite multiplicarse rápidamente y establecer un mecanismo de resistencia a los antibióticos que hace muy difícil su erradicación, llevando a extrusión y muy posiblemente a explantación si no se recurre a un tratamiento médico temprano. Reacciones de hipersensibilidad a alguno de los componentes del implante especialmente a la silicona debe ser sospechada en aquellos pacientes que presenten cambios inflamatorios a repetición en la piel sobre el implante sobre todo si los pacientes no presentan signos de infección sistémica y presentan cultivos negativos.
Cochlear implant extrusion is a not so frequent major complication whose main causes are an inadequate surgical technique, a hyper sensitivity reaction to the implant components or the presence of an infectious process be it acute or chronic as is the case of biofilm formation. The infection may appear in two forms: first as an infection that comes from isolated germs and the second which is the most severe one, known as biofilm, that is the colonization of organized bacteria which allows them to grow very rapidly and set a mechanism to resist antibiotics which makes it extremely hard to eradicate them, which leads to the extrusion and very likely to the removal in case the patient does not receive medical treatment soon. Hypersensitivity reactions to any of the implant components especially to silicone must be suspected in those patients that exhibit inflammatory changes repeatedly on their skin that is over the implant especially if the patients do not show the symptoms of a systematic infection and have negative cultures.
Subject(s)
Humans , Biofilms , Cochlear Implants , Infections , HypersensitivityABSTRACT
OBJECTIVES: To implement a minimal invasive approach in cochlear implant surgery for children and adults. In order to decrease surgical complications and morbidity with the surgery. SUBJECTS AND METHODS: During a 1-year period, 12 consecutive patients (5 female and 7 male; age range, 1.5 to 78 years; mean age, 14.5 years), who had cochlear implantation (1 Nucleus and 11 Clarion) through a new surgical approach, were prospectively evaluated. RESULTS: The surgical approach was accomplished in all the patients with no major complications. The mean surgical time was 3.2 hours and the mean time between surgery and process of programming was 2.7 weeks. CONCLUSION: The surgical trauma and postoperatory edema was decreased and allowed programming of the implant in a shorter period of time.
