The Listening Network and Cochlear Implant Benefits in Hearing-Impaired Adults.

Older adults with mild or no hearing loss make more errors and expend more effort listening to speech. Cochlear implants (CI) restore hearing to deaf patients but with limited fidelity. We hypothesized that patient-reported hearing and health-related quality of life in CI patients may similarly vary according to age. Speech Spatial Qualities (SSQ) of hearing scale and Health Utilities Index Mark III (HUI) questionnaires were administered to 543 unilaterally implanted adults across Europe, South Africa, and South America. Data were acquired before surgery and at 1, 2, and 3 years post-surgery. Data were analyzed using linear mixed models with visit, age group (18-34, 35-44, 45-54, 55-64, and 65+), and side of implant as main factors and adjusted for other covariates. Tinnitus and dizziness prevalence did not vary with age, but older groups had more preoperative hearing. Preoperatively and postoperatively, SSQ scores were significantly higher (Δ0.75-0.82) for those aged <45 compared with those 55+. However, gains in SSQ scores were equivalent across age groups, although postoperative SSQ scores were higher in right-ear implanted subjects. All age groups benefited equally in terms of HUI gain (0.18), with no decrease in scores with age. Overall, younger adults appeared to cope better with a degraded hearing before and after CI, leading to better subjective hearing performance.

El implante coclear como tratamiento del acúfeno / The cochlear implant as a tinnitus treatment

Introducción y objetivos: El acúfeno es un síntoma de elevada prevalencia en pacientes afectados de una cocleopatía. Estudiamos la evolución del acúfeno en pacientes sometidos a implantación coclear unilateral como tratamiento de la hipoacusia profunda. Métodos: Estudio longitudinal y retrospectivo de pacientes intervenidos de implantación coclear unilateral que presentaban acúfenos bilaterales. Se ha realizado valoración cuantitativa y cualitativa de los acúfenos previo a la cirugía, y a los 6 y 12 meses de la intervención quirúrgica. Resultados: Se han valorado 20 pacientes, intervenidos de implantación coclear unilateral con un dispositivo Nucleus® CI24RE con electrodo Contour Advance TM. Durante los periodos en que el dispositivo se encontraba en funcionamiento se ha evidenciado una mejoría significativa o desaparición de los acúfenos, en el oído homolateral al implante coclear en el 65% de los pacientes, y en el oído contralateral al implante en el 50% de los pacientes. En los periodos en que el dispositivo se encontraba desconectado; se comprobó una mejoría significativa o desaparición de los acúfenos, en el oído homolateral al implante coclear en el 50% de los pacientes, y en el oído contralateral al implante en el 45% de los pacientes. En un 10% de los pacientes ha aparecido un nuevo acúfeno en el oído homolateral al implante coclear. Conclusiones: Los acúfenos bilaterales que presentaban los pacientes sometidos a implantación coclear unilateral como tratamiento de la hipoacusia profunda, han mejorado en un porcentaje elevado de los casos tanto en el oído homolateral como en el contralateral al implante (AU)

Introduction and objectives: Tinnitus is a symptom of high prevalence in patients with cochlear pathology. We studied the evolution of tinnitus in patients undergoing unilateral cochlear implantation for treatment of profound hearing loss. Methods: This was a longitudinal, retrospective study of patients that underwent unilateral cochlear implantation and who had bilateral tinnitus. Tinnitus was assessed quantitatively and qualitatively before surgery and at 6 and 12 months after surgery. Results: We evaluated 20 patients that underwent unilateral cochlear implantation with a Nucleus® CI24RE Contour Advance TM electrode device. During the periods in which the device was in operation, improvement or disappearance of tinnitus was evidenced in the ipsilateral ear in 65% of patients, and in the contralateral ear, in 50%. In periods in which the device was disconnected, improvement or disappearance of tinnitus was found in the ipsilateral ear in 50% of patients, and in the ear contralateral to the implant in 45% of the patients. In 10% of the patients, a new tinnitus appeared in the ipsilateral ear. Conclusions: The patients with profound hearing loss and bilateral tinnitus treated with unilateral cochlear implantation improved in a high percentage of cases, in the ipsilateral ear and in the contralateral ear (AU)

The cochlear implant as a tinnitus treatment.

INTRODUCTION AND OBJECTIVES: Tinnitus is a symptom of high prevalence in patients with cochlear pathology. We studied the evolution of tinnitus in patients undergoing unilateral cochlear implantation for treatment of profound hearing loss. METHODS: This was a longitudinal, retrospective study of patients that underwent unilateral cochlear implantation and who had bilateral tinnitus. Tinnitus was assessed quantitatively and qualitatively before surgery and at 6 and 12 months after surgery. RESULTS: We evaluated 20 patients that underwent unilateral cochlear implantation with a Nucleus(®) CI24RE Contour Advance™ electrode device. During the periods in which the device was in operation, improvement or disappearance of tinnitus was evidenced in the ipsilateral ear in 65% of patients, and in the contralateral ear, in 50%. In periods in which the device was disconnected, improvement or disappearance of tinnitus was found in the ipsilateral ear in 50% of patients, and in the ear contralateral to the implant in 45% of the patients. In 10% of the patients, a new tinnitus appeared in the ipsilateral ear. CONCLUSIONS: The patients with profound hearing loss and bilateral tinnitus treated with unilateral cochlear implantation improved in a high percentage of cases, in the ipsilateral ear and in the contralateral ear.

Utilidad del material sustitutivo óseo en la cirugía del implante coclear, base de cráneo y senos paranasales: nuestra experiencia / Utility of bone replacement material in cochlear implant, skull base and sinus surgery: Our experience

Introducción: Para solucionar determinados problemas que nos surgen en la cirugía del implante coclear, de los senos paranasales y de la base de cráneo hemos introducido en nuestro servicio el uso de un cemento óseo (PolyBone®). Con el objetivo de lograr la elaboración de cementos óseos de uso quirúrgico, la unión de factores de crecimiento óseo y polifosfatos ha permitido el estudio de estos materiales biológicos. Material y resultados: Presentamos un total de 28 pacientes con edades comprendidas entre 2 y 69 años, y una edad media de 29,2 años en los que el PolyBone® nos ha servido como un arma terapéutica más en el área quirúrgica de la ORL. En dos de los pacientes (7,4%) aparecieron complicaciones. Una menor que solucionamos con tratamiento conservador y una complicación mayor, que requirió una cirugía de extracción del material y explantación del implante. En los otros 26 (92,6%) pacientes se obtuvieron excelentes resultados. Conclusiones: Existen diferentes materiales autólogos y aloplásticos que nos sirven de gran utilidad para el manejo de fístulas, relleno de cavidades, u obliteración de senos entre otros. El cirujano debe conocer las propiedades biológicas, características fundamentales, técnica de obtención y posibles aplicaciones quirúrgicas para ser capaz de prevenir futuras complicaciones. Entre estos materiales, el cemento óseo (PolyBone®) es una alternativa eficaz a tener en cuenta en el manejo quirúrgico de nuestra patología (AU)

Introduction: To solve certain problems that arise in cochlear implant, sinus and skull base surgery, the use of bone cement (PolyBone®) has been introduced in our department. With the goal of making use of surgical bone cements, combining bone growth factors and polyphosphates has allowed the study of these biological materials. Materials and Results: We present a total of 28 patients aged between 2 and 69 years (mean age of 29.2 years) in whom PolyBone® has been used as an additional therapeutic tool in the ENT surgical area. Complications occurred in 2 patients (7.4%). One was minor, solved with conservative treatment; one was a major complication that required surgery to extract the material and remove the implant. In the other 26 patients (92.6%), excellent results were achieved. Conclusions: Different autogenous and alloplastic materials are of great utility for fistula management, cavity filling or sinus obliteration, among other uses. The surgeon must understand their biological properties, fundamental characteristics, production technique and potential surgical applications to be able to prevent future complications. Among these materials, bone cement (PolyBone®) is an effective alternative that should be considered in surgical management of ENT pathology (AU)

[Utility of bone replacement material in cochlear implant, skull base and sinus surgery: our experience]. / Utilidad del material sustitutivo óseo en la cirugía del implante coclear, base de cráneo y senos paranasales: nuestra experiencia.

INTRODUCTION: To solve certain problems that arise in cochlear implant, sinus and skull base surgery, the use of bone cement (PolyBone®) has been introduced in our department. With the goal of making use of surgical bone cements, combining bone growth factors and polyphosphates has allowed the study of these biological materials. MATERIALS AND RESULTS: We present a total of 28 patients aged between 2 and 69 years (mean age of 29.2 years) in whom PolyBone® has been used as an additional therapeutic tool in the ENT surgical area. Complications occurred in 2 patients (7.4%). One was minor, solved with conservative treatment; one was a major complication that required surgery to extract the material and remove the implant. In the other 26 patients (92.6%), excellent results were achieved. CONCLUSIONS: Different autogenous and alloplastic materials are of great utility for fistula management, cavity filling or sinus obliteration, among other uses. The surgeon must understand their biological properties, fundamental characteristics, production technique and potential surgical applications to be able to prevent future complications. Among these materials, bone cement (PolyBone®) is an effective alternative that should be considered in surgical management of ENT pathology.

Evolución de la actividad mucociliar tubotimpánica, estudiada por gammagrafía, tras la colocación de tubos de ventilación en adultos con otitis media seromucosa crónica / Evolution of the tubotympanal mucociliary system activity evaluated with scintigraphy, after ventilation tube insertion in adults with chronic otitis media with effusion

Introducción y objetivos: La función mucociliar tubotimpánica está alterada en los pacientes con otitis media seromucosa. Nuestro objetivo es estudiar su situación y recuperación tras la colocación del drenaje transtimpánico. Métodos: Hemos evaluado la actividad mucociliar del oído medio y de la trompa de Eustaquio por gammagrafía, en 4 grupos de adultos con otitis media seromucosa crónica, tras la colocación del tubo de ventilación. La exploración se llevó a cabo 3 días (grupo I), 6 días (grupo II), 9 días (grupo III), y 12 días (grupo IV) tras la colocación del drenaje. Resultados: Tras excluir algunos pacientes con otorrea autolimitada, los que normalizaron la función mucociliar, resultaron ser en cada grupo: grupo I, 0 de 13, 0%; en el grupo II, 4 de 15 pacientes, 26,6%; para el grupo III: 14 de 18 casos, 88,8% y, por último, en el grupo IV, 18 de 18, 100%. Conclusiones: En los pacientes con otitis media seromucosa crónica la función mucociliar está alterada. La inserción del tubo de ventilación reestablece el aclaramiento mucociliar de forma progresiva, alcanzando la normalidad tras 12 días en todos los pacientes (AU)

Introduction and goals: Tubotympanal mucociliary function is damaged in patients with otitis media with effusion. Our objective was to study its situation and recovery after timopanostomy tube insertion. Methods: We evaluated the mucociliary activity of the ear and Eustachian tube with scintigraphy in four groups of adults with chronic otitis media with effusion after ventilation tube insertion. The test was performed on 3 days (Group I), 6 days (Group II), 9 days (Group III) and 12 days (Group IV) after tympanostomy tube insertion. Results: After excluding some patients with limited otorrhea, the percentages of patients that normalised mucociliary function in the different groups were: Group I, 0 of 13, 0%; Group II, 4 of 15 patients, 26,6%; Group III, 14 de 18 cases, 88,8%; and, in Group IV, 18 of 18, 100%. Conclusions: Mucociliary function is altered in patients with chronic otitis media with effusion. With the insertion of tympanostomy tubes, mucociliary clearance is restored progressively, reaching normal after 12 days in all the patients (AU)

[Evolution of the tubotympanal mucociliary system activity evaluated with scintigraphy, after ventilation tube insertion in adults with chronic otitis media with effusion]. / Evolución de la actividad mucociliar tubotimpánica, estudiada por gammagrafía, tras la colocación de tubos de ventilación en adultos con otitis media seromucosa crónica.

INTRODUCTION AND GOALS: Tubotympanal mucociliary function is damaged in patients with otitis media with effusion. Our objective was to study its situation and recovery after timopanostomy tube insertion. METHODS: We evaluated the mucociliary activity of the ear and Eustachian tube with scintigraphy in four groups of adults with chronic otitis media with effusion after ventilation tube insertion. The test was performed on 3 days (Group I), 6 days (Group II), 9 days (Group III) and 12 days (Group IV) after tympanostomy tube insertion. RESULTS: After excluding some patients with limited otorrhea, the percentages of patients that normalised mucociliary function in the different groups were: Group I, 0 of 13, 0%; Group II, 4 of 15 patients, 26,6%; Group III, 14 de 18 cases, 88,8%; and, in Group IV, 18 of 18, 100%. CONCLUSIONS: Mucociliary function is altered in patients with chronic otitis media with effusion. With the insertion of tympanostomy tubes, mucociliary clearance is restored progressively, reaching normal after 12 days in all the patients.