Local anesthesia for cochlear implant surgery: low risks for the patient and few costs for the hospital, a rational alternative.

OBJECTIVES: The aim of this article is to illustrate the possibility of performing a cochlear implant with local anesthesia and sedation, the anesthesic technique and the advantages of that in comparison to a general anesthesia. MATERIAL AND METHODS: We describe two successful surgeries done with local anesthesia, including the neural telemetry and the conditions the patient presented after the surgery, with a very good recovery and no complications during and after the procedure. RESULTS: The results of these two surgeries are described regarding the fast recovery, no symptoms of dizziness and vomiting after the surgeries, discharging from the hospital on the same day, and the immediate post operative period by meaning of complaints from the patient. CONCLUSION: Local anesthesia with sedation for cochlear implant surgery in adults is a very good alternative for lowering the morbidity of the patient, fewer risks, lower costs for the hospital, with a very good control of the surgery.

SDHB, SDHC, and SDHD mutation screen in sporadic and familial head and neck paragangliomas.

Mutations within three genes, SDHB, SDHC, and SDHD, encoding distinct subunits of a hetero-oligomeric protein known as the mitochondrial complex II, a component of the mitochondrial electron transport chain and the Krebs cycle have been implicated in the pathogenesis of hereditary paraganglioma (PGL). This study describes a mutation screen of SDHB, SDHC, and SDHD in blood and tumor samples of 14 sporadic and three familial cases of head and neck PGL (HNP). Germline mutations in SDHB and SDHD were identified in two of the three affected individuals with familial HNP. The SDHB mutation was a novel 3 base pair, in-frame deletion of AGC at nucleotide 583-585 encoding serine (delS195). The SDHD mutation was a C to T transition within codon 81 causing substitution of proline with leucine (P81L). In contrast to familial cases, no germline or somatic mutations were identified in the 14 sporadic cases of HNP. The presence of mutations within SDHB and SDHD in two of the three samples of familial PGLs and absence of mutations in sporadic cases is consistent with the significant contribution of these genes to familial but not sporadic PGL. The etiology of sporadic PGL remains to be elucidated.