Validation of Automatic Cochlear Measurements Using OTOPLAN® Software.

INTRODUCTION: Electrode length selection based on case-related cochlear parameters is becoming a standard pre-operative step for cochlear implantation. The manual measurement of the parameters is often time-consuming and may lead to inconsistencies. Our work aimed to evaluate a novel, automatic measurement method. MATERIALS AND METHODS: A retrospective evaluation of pre-operative HRCT images of 109 ears (56 patients) was conducted, using a development version of the OTOPLAN® software. Inter-rater (intraclass) reliability and execution time were assessed for manual (surgeons R1 and R2) vs. automatic (AUTO) results. The analysis included A-Value (Diameter), B-Value (Width), H-Value (Height), and CDLOC-length (Cochlear Duct Length at Organ of Corti/Basilar membrane). RESULTS: The measurement time was reduced from approximately 7 min ± 2 (min) (manual) to 1 min (AUTO). Cochlear parameters in mm (mean ± SD) for R1, R2 and AUTO, respectively, were A-value: 9.00 ± 0.40, 8.98 ± 0.40 and 9.16 ± 0.36; B-value: 6.81 ± 0.34, 6.71 ± 0.35 and 6.70 ± 0.40; H-value: 3.98 ± 0.25, 3.85 ± 0.25 and 3.76 ± 0.22; and the mean CDLoc-length: 35.64 ± 1.70, 35.20 ± 1.71 and 35.47 ± 1.87. AUTO CDLOC measurements were not significantly different compared to R1 and R2 (H0: Rx CDLOC = AUTO CDLOC: p = 0.831, p = 0.242, respectively), and the calculated intraclass correlation coefficient (ICC) for CDLOC was 0.9 (95% CI: 0.85, 0.932) for R1 vs. AUTO; 0.90 (95% CI: 0.85, 0.932) for R2 vs. AUTO; and 0.893 (95% CI: 0.809, 0.935) for R1 vs. R2. CONCLUSIONS: We observed excellent inter-rater reliability, a high agreement of outcomes, and reduced execution time using the AUTO method.

Comparison of polypharmacy and pharmacotherapy among seniors in social institutions in 2001 and 2019.

INTRODUCTION: Polypharmacy (polypharmacotherapy) is a serious problem among seniors. The aim of the work was to compare pharmacotherapy and polypharmacy among seniors in social facilities in 2001 and 2019. METHODOLOGY: As of December 31, 2001, we collected data on the pharmacotherapy of 151 residents of two retirement homes (average age 75.1 years, 68.9% women). We compared the results with the pharmacotherapy of residents of two facilities for seniors as of October 31, 2019 (237 seniors, average age 80.5 years, 73.4% women). According to the medical records, we determined and compared the regularly used medicines of all residents, the use of medicines by age and sex, the use of 0-4 medicines, 5-9 medicines, 5 or more medicines, 10 or more medicines and the groups of medicines according to the ATC classification. For statistical processing, we used the t-test and chi-square test. RESULTS: In 2001, residents regularly used a total of 891 medicines, 18 years later, they used a total of 2099 medicines. We observed a significant increase in the average number of regularly used medications per resident by more than a half (from 5.90 medications to 8.86 medications), in women from 6.11 drugs to 9.24 drugs and in men from 5.45 drugs to 7.81 drugs. The number of residents with polypharmacy (regular use of ≥ 5 drugs) increased by almost a quarter (from 70.2% to 87.3%), and the number of seniors with excessive polypharmacy (regular use of ≥ 10 drugs) increased 4.6 times (from 9, 3% to 43.5%). CONCLUSION: Our work confirmed that over the course of 18 years, the number of medications used by seniors in social-type institutions has increased. It also points to the trend of increasing polypharmacy and excessive polypharmacy among seniors, especially at the age of 75+ and among women.

Quality of life after cochlear implantation in children in Slovakia.

BACKGROUND: Cochlear implantation (CI) is the method of choice for treating severe and profound hearing loss in children. OBJECTIVE: To obtain and evaluate the quality of life of children after cochlear implantation and to compare the results with those of a normal­hearing (NH) control group. METHODS: Cross-sectional, observational design in a university-based ambulatory paediatric otolaryngology clinic. Participants included 40 subjects (21 parents of children after CI, 11 children after CI, 21 parents of normal­hearing children and 23 normal­hearing children). The children were between 3 and 17 years of age. Those participants who could not be contacted by telephone, did not provide all of the data in the database, did not answer the questionnaires completely or had an explantation of the cochlear implant in their anamnesis were excluded. A questionnaire aimed at the generic quality of life was sent to all participants, including children with implants and their parents, as well as normal­hearing children and their parents. The statistical analysis was performed using the IBM SPSS program. RESULTS: The questionnaires were anonymous. The only statistically significant differences within the subscales were seen in the group of parents of children aged 7-13 years. The parents of children with implants scored significantly higher in the 'Family' domain than the parents of the normal­hearing children (p = .003), suggesting that from the parental point of view, the situation at home is considered better in families of a child with an implant, as the family is a safe place for them, and the implant is considered a normal component of their life. CONCLUSION: The total quality of life score did not significantly differ between the group with cochlear implants and the normal­hearing group. Therefore, the analysis demonstrates that the hearing quality does not seem to negatively influence the quality of life in children with cochlear implants (Tab. 5, Fig. 2, Ref. 9). Text in PDF www.elis.sk Keywords: cochlear implantation in children, quality of life, KINDLR, SSQ12, Slovakia.