RESUMO
To compare the overall clinical outcomes of cochlear implantation in children with structural inner ear abnormalities, with results of implantation in children with radiologically 'normal' inner ears. To study the incidence and performance outcomes of cochlear implantation in children with inner ear malformations (IEMs). It is a retrospective case control study of 57 normal and 57 abnormal inner ear patients operated for cochlear implant between Jan 1, 2014 and Aug 1, 2017, by Veria technique. The age range was between 12 months and 15 years. The prevalence of IEMs was 13.8%. Of the 57 cases with IEMs, 33.3% were of enlarged vestibular acqueduct, 7% were of isolated Incomplete Partition type-2, 21.1% cases were of Mondini's dysplasia, 3.5% of Incomplete partition type-1 and 8.8% of cochlear nerve hypoplasia. Most commonly encountered malformation was EVA while IP-1 was the least common malformation. A CSF gusher was experienced in 11 cases. There was a statistically significant difference between the CAP and SIR scores of both IEM and control groups, both at 1 year and at 2 years (1 year CAP score p value < 0.001, 2 year CAP score p value 0.002 and 1 year SIR score, p value < 0.001, 2 year SIR score, p value 0.013). There was progressive improvement in the scores (of both groups) at the 2 year mark, compared to 1 year scores. Cochlear implantation is safe and surgically feasible in children with IEMs. However, the hearing outcome and speech perception outcomes are poor than those of patients with normal anatomy, with an exception seen in enlarged vestibular aqueduct.
RESUMO
OBJECTIVE: To study and analyse the result obtained in cochlear implantation by Veria technique and evaluate the incidence of surgical complications and their management. METHOD: Between Jan 1, 2014 to Jan 1, 2019, 602 cochlear implantations by Veria technique were done out of which 576 patients were analysed retrospectively for the study. The age range was between 18 months and 60 years. RESULT: All 576 patients were operated by Veria technique. Out of 576 patients, 57 (9.9%) had abnormal cochlear malformation. Cytomegalovirus (CMV) being the most common non genetic cause of congenital hearing loss accounting to 60%. The overall complication rate of 5.5% was observed in 576 implanted patients. CONCLUSION: The analysis of the results shows that this method has certain advantages, which are: it is simple and therefore the learning curve is fast; it is safe for the facial nerve, as the drilling is precisely controlled by the special perforator; it produces minimal bone trauma and due fast healing, it permits early fitting a few days after operation; it can be used for very small children where the mastoid may have not been yet sufficiently developed.
RESUMO
The objective of the study is to evaluate the surgical outcome between free nasoseptal mucoperichondrial flap using septal cartilage vs fascia lata using fat in terms of morbidity, hospital stay and postoperative complications. It is a retrospective comparitive study of 127 patients, diagnosed with CSF leak and who underwent repair of anterior skull base defect using free nasoseptal mucoperichondrial graft with septal cartilage in 73 cases compared with fascia lata with fat in 54 cases over the time frame of 5 years. The success rate with free nasoseptal flap with septal cartilage was 97.3% and that with fascia lata with fat was 96.3%. There was a significant association between mean hospital stay and the technique of CSF repair (unpaired t test, p -0.02). In our study the complications following the repair with free nasoseptal flap with septal cartilage was significantly less (p < 0.05, chi square test). The above study concludes that in patients treated with free nasoseptal flap using septal cartilage has less hospital stay, less post-operative morbidity in the form of pain, movement and dependence for cleaning and dressing in comparison to fascia lata using fat.
