ABSTRACT
UNLABELLED: There is increasing evidence in medical literature which proves that post-operative outcomes in children implanted early are better. Initial setting of these children's stimulation parameters is challenging because of their limited communication abilities. Intraoperative electrical impedance measurements, electrically evoked stapedial reflex threshold (ESRT) and evoked compound action potential (ECAP) are used for implant settings in some centres as no cooperation is required from the child. Aim Evaluate the effects of intravenous anaesthesia on intraoperative monitoring of cochlear implant function in paediatric cochlear implantees at our centre. Method Prospective study from January 2011 to December 2011. COHORT: 29 children. Age - 18 months to 11 yrs. All children had bilateral severe to profound sensorineural hearing loss. Children with compromised neural/cochlear anatomy were excluded. Patients were maintained on an infusion of Fentanyl @ 0.3-0.6 ugm/kg/hr and Propofol @ 4-8 mg/kg/hr intraoperatively. Intraoperative measurements were done after performing the train of four test on the adductor pollicis muscle Results It was observed that ESRT was unaffected by intravenous anaesthesia. Electrical impedance and ECAP were not affected by any technique of anaesthesia. Conclusion Intravenous anaesthesia has little or no effect on the intraoperative auditory thresholds and is therefore recommended for determining these thresholds during cochlear implant surgery.
Subject(s)
Anesthesia, Intravenous , Cochlear Implantation/instrumentation , Cochlear Implants , Action Potentials/physiology , Auditory Threshold , Child , Child, Preschool , Cochlear Nerve , Electric Stimulation , Female , Humans , Infant , Male , Monitoring, Intraoperative , Prospective Studies , Stapedius/physiopathologyABSTRACT
Outcomes of cochlear implantation in individuals with known central nervous system conditions are varied. Long-standing deafness is also thought to correlate negatively with auditory performance in post-linguistically deaf adult implant users. We present a case study of cochlear implantation in a post-lingual adult having bilateral profound hearing loss for over 30 years in addition to multiple sclerosis unrelated to his deafness. Assessment of benefit in terms of speech-perception ability and quality of life reveal that long-term auditory deprivation and co-incidental multiple sclerosis are not a contraindication for cochlear implantation.
Subject(s)
Cochlear Implantation , Deafness/complications , Deafness/surgery , Multiple Sclerosis/complications , Atrophy , Brain/pathology , Cerebellum/pathology , Deafness/physiopathology , Deafness/psychology , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Multiple Sclerosis/diagnosis , Quality of Life , Severity of Illness Index , Speech Perception , Tomography, X-Ray ComputedABSTRACT
A neonatal hearing screening programme has been established in Pune, India. A total of 2621 babies were screened from August 2005 to August 2007 using otoacoustic emissions (OAE) followed by brainstem evoked response audiometry (BERA) for those who referred on the second OAE testing. Two hundred and forty nine babies were referred on the second OAE testing and of these only 52 came back and were further evaluated using BERA. Fifteen of these 52 babies were found to have a significant hearing loss. The significance of these results is discussed.
