Recurrent bacterial meningitis after cochlear implantation in a patient with a newly described labyrinthine malformation.

Authors report on a so far undescribed bilateral inner ear malformation with congenital deafness where a defect of both the medial and lateral bony labyrinthine wall allowed the herniation of a cerebrospinal fluid-filled endosteum sac into the tympanic cavity. The story of cochlear implantation in this ear and the series of following meningitis demonstrates the dilemma of indicating implantation in labyrinthine dysplasia and the difficulties of treating postimplantation meningitis. Routes of bacterial invasion from inner ear to intracranium is discussed regarding normal, dysplastic and surgically "disturbed" inner ear anatomy.

[The effect of complete upper denture on phonation]. / A teljes felsô lemezes fogpótlás hangképzésre gyakorolt hatása.

In case of total edentulousness the formation of vowels and consonants is impaired, due to the change of the morphology in the oral cavity. The aim of our study was to estimate the influence of the upper complete denture on the phonation of the patient. Patients wearing total upper denture were asked to utter special words with the prosthesis in the mouth and without it, and the change in the formation of "hissing" sounds were noted. The changes in the pronunciation of vowels and consonants were analyzed with the help of a computer program, which provided objective assessment. The data were analyzed statistically. When wearing the prosthesis the scores of the formant became higher and most examined sounds were pronounced faster (p = 0.006). The articulation of patients accustomed to wearing the full total prosthesis was influenced positively by having the prosthesis in the mouth. As a result of these findings it is recommended that the prosthesis be manufactured keeping these phonetic aspects in mind.

Cochlear implantation for treatment-induced ototoxic deafness in Langerhans cell histiocytosis. A case report.

A case is presented where the authors carried out a cochlear implantation on a girl whose deafness was induced by cytostatic agents. The normally hearing child was diagnosed with Langerhans cell histiocytosis at the age of 3 years and received polychemotherapy for almost 2 years. By her 5th year, she started to develop a bilateral, progressive sensorineural hearing loss, necessitating a hearing aid in both ears. While her histiocytosis was cured, her hearing ultimately deteriorated to total deafness on the right and profound hearing loss on the left ear. After 3 years, her hearing aids no longer provided adequate hearing for the postlingually deafened girl. At the age of 14, a cochlear implantation was performed on her right ear with excellent results.

Neural response telemetry in cochlear implant users.

Programming of multichannel cochlear implants requires subjective responses to a series of sophisticated psychophysical percepts. It is often difficult for cochlear implant patients (especially young prelinguistically deaf children) to provide adequate responses for device fitting. However, the neural response telemetry (NRT) system renders possible the measurement of the compound action potential threshold. We performed NRT examinations in 27 cochlear implant users with Nucleus 24-channel cochlear implants. Measurements were obtained from five electrodes (3, 5, 10, 15, and 20) in each patient. Our goal was to look for correlation between behavioral subjective thresholds and compound action potentials. The action potentials could be elicited in 23 patients in all measured electrodes. The NRT threshold values were highly correlated with electrical threshold levels obtained through subjective responses. Our results suggest that the electrically elicited neural responses may yield very important information for device fitting in patients with cochlear implants.

Successful cochlear implantation in a child after recovery from a head and neck malignancy: a case report.

We present the case of a successful pediatric cochlear implantation that was carried out following bilateral perilingual deafness caused by meningitis during the treatment of a childhood malignant tumor. A rhabdomyosarcoma localized in the frontobasal area was removed from the child at the age of 2 years. He then received 11 months of postoperative cytostatic treatment. A purulent meningitis developed at the end of the chemotherapy, resulting in a major-grade, bilateral sensorineural hearing loss (practically a perilingual deafness). After 6 tumor-free years and a meticulous preoperative assessment, a Nucleus 24 M cochlear implant was successfully implanted in the child's left ear. Two years after the operation, the child shows excellent hearing results and moderate speech development.