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B022 Cochlear implantation in the presence of inner ear anomalies: surgical and functional outcomes
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Abstracts, ESPCI 2011 / International Journal of Pediatric Otorhinolaryngology 75 (2011) 10–32
Material and Methods: We present two cases that underwent revision surgery due to displacement of their magnet. The first case was a 6 years old boy that cochlear implant was done for him when he was 4 years old due to bilateral deafness, He had a trauma 2 years after implantation and his magnet was dislocated and another Case was a 6.5 years old boy that cochlear implant was done for him when he was 4 years old. He had falling down 2.5 years after implant and after that the magnet was displaced. Results: For these cases replacement of magnet performed by small surgery and the function of their implant return to normal. B022 Cochlear implantation in the presence of inner ear anomalies: surgical and functional outcomes D. Ulanovsk, J. Attias, N. Buller, M. Efrati, T. Greenstein, N. Ziskind, M. Peled, R. Vigler, L. Kornreich, E. Raveh. Department of Otolaryngology-Head and Neck Surgery: Audiology Institute; Radiology Department, Schneider Children’s Medical Center and Rabin Medical Center, Petah Tiqwa, Israel Aim: Cochlear malformations have been reported to occur in 15–20% of cochlear implant candidates. This study will present our surgical experience and rehabilitation outcome in patients with inner ear anomalies, implanted with cochlear implant. Material and Methods: Records of 253 cochlear implantations in 213 patients operated in since 2000 were reviewed. Results: There were 30 patients with anomalies in the operated ear (14%). CSF gusher occurred in 16 patients (54%) and was well controlled. Audiological results were good in post lingual progressive hearing loss patients with mild malformations and in pre lingual children with mild malformations implanted in young age. Worse results were found in severe anomalies, in pre lingual patients implanted at older age and in patients with poor compliance for rehabilitation. Conclusions: Cochlear implantation in patients with inner ear anomalies is surgically safe and can be equally successful. Severity of anomaly, can affect the outcome. B023 Technical considerations in cochlear implants in inner ear malformations. Prevalence and complications F. Di Gregorio1 , G. Filiberti2 , M.E. Zernotti3 . 1 Otolaryngology Department, Sanatorio Allende. C´ ordoba, Argentina; 2 ENT Department. Hospital Infantil, C´ ordoba, Argentina; 3 School of Medicine. Catholic University of Cordoba, Argentina Aim: To determine the prevalence of cochlear malformations among children implanted and describe surgical complications. Material and Methods: Retrospective study of the last 70 consecutive patients with cochlear implants. The number of patients with osseous or membranous malformations was 7. Results: We found 7 patients with inner ear malformations, representing 10% of the patients included in this study. Of the 7 patients implanted with congenital malformations 3 had common cavity (major malformations), two patients had minor malformations (Mondini dysplasia) and 2 large vestibular aqueduct. 3 patients underwent transatical approach and four underwent classical approach. Two patients had intraoperative gusher and two abnormal facial nerve courses. Therefore 40% of patients had complications Conclusions: These patients have a greater chance of intraoperative complications, especially the gusher and the aberrant facial nerve. These two complications are preventable if they are provided by surgeons and take the necessary precautions.
B024 Flex prototype electrode array for round window insertion: the Hannover experience O. Majdani, K. Fursen, ¨ Th. Lenarz. Hannover Medical School, Hannover, Germany Aim: In a clinical study, we applied a novel CI electrode Flex EAS 20 from MedEL to evaluate its potential for hearing preservation. Materials and Methods: The Sonata implant with the straight Flex EAS 20 electrode was used. The length of the intracochlear electrode is 19.5 mm. The electrode was inserted gently through an incision in Round Window. A total of 17 patients were implanted. Results: Of 17 patients implanted, 14 post-operative results were available. The residual hearing could be permanently preserved in 11 patients. One patient lost his residual hearing directly after surgery, and two had postoperatively unchanged hearing, which they lost four weeks postoperatively. In the patients with successful residual hearing preservation, the average postoperative hearing loss was 12.5 dB. Conclusions: By implanting the Flex EAS 20 electrode 92.9% of patients could save their residual hearing initially and 78.6% of patients on long term. B025 Modern technique of the cochlear implantation in national research center for audiology and hearing rehabilitation in Moscow V. Fedoseev, N. Mileshina, V. Bakhshinyan, N. Dmitriyev, G. Tavartkiladze. National Research Center for Audiology and Hearing Rehabilitation, Moscow, Russia Aim: The comparative analysis of the different surgical techniques of CI was performed. Material and Methods: CI were done in 930 children and adults from 1991 to 2010. Chronologically the cut of the skin was reduced from Lehnhardt’s extended cutting to post-auricular cut with periostal flap on the anterior leg; the implant fixation technique was changed from the ligature insertion through the intra-bone tunnel to the fixation only through periostal edges around implant’s bed. The difficulties: partial obliteration of the basal turn, Gusher syndrome, narrow facial recess, very think bone under a bed for the receiver-stimulator. Results and Conclusions: Nowadays the significant reduction in number of complications, surgery duration and volume with the minimization of postoperative manipulations took place from the beginning till recent practical use of cochlear implantation. B026 The results of cochlear implantation in children with the inner ear abnormalities V. Fedoseev, N. Mileshina, V. Bakhshinyan, L. Potalova, G. Tavartkiladze. National Research Center for Audiology and Hearing Rehabilitation, Moscow, Russia Aim: To analyze the results of CI in children with inner ear abnormalities. Materials and Methods: In 2005–2010 nine cochlear implantations were performed in patients with Mondini malformation, dysplasia of the vestibule, enlarged vestibular aqueduct syndrome and the stenosis of the IEC. MRI-scan confirmed the presence of the liquid in all cochlea. Results: Gusher Syndrome was observed in 5 cases. The registration of ESRT and NRT was performed in 7 cases. The electrode array was in close contact with the cochlear wall in all Mondini cases and was in the basal turn in case of vestibule dysplasia. The facial nerve stimulation was discovered in 2 cases. The follow-up results showed positive hearing and speech development in 8 cases and no result in 1 patient. Conclusions: Cochlear implantation in patients with inner ear anomalies is possible with full insertion of electrodes with high probability of Gusher and facial nerve stimulation.
Abstracts, ESPCI 2011 / International Journal of Pediatric Otorhinolaryngology 75 (2011) 10–32
Material and Methods: We present two cases that underwent revision surgery due to displacement of their magnet. The first case was a 6 years old boy that cochlear implant was done for him when he was 4 years old due to bilateral deafness, He had a trauma 2 years after implantation and his magnet was dislocated and another Case was a 6.5 years old boy that cochlear implant was done for him when he was 4 years old. He had falling down 2.5 years after implant and after that the magnet was displaced. Results: For these cases replacement of magnet performed by small surgery and the function of their implant return to normal. B022 Cochlear implantation in the presence of inner ear anomalies: surgical and functional outcomes D. Ulanovsk, J. Attias, N. Buller, M. Efrati, T. Greenstein, N. Ziskind, M. Peled, R. Vigler, L. Kornreich, E. Raveh. Department of Otolaryngology-Head and Neck Surgery: Audiology Institute; Radiology Department, Schneider Children’s Medical Center and Rabin Medical Center, Petah Tiqwa, Israel Aim: Cochlear malformations have been reported to occur in 15–20% of cochlear implant candidates. This study will present our surgical experience and rehabilitation outcome in patients with inner ear anomalies, implanted with cochlear implant. Material and Methods: Records of 253 cochlear implantations in 213 patients operated in since 2000 were reviewed. Results: There were 30 patients with anomalies in the operated ear (14%). CSF gusher occurred in 16 patients (54%) and was well controlled. Audiological results were good in post lingual progressive hearing loss patients with mild malformations and in pre lingual children with mild malformations implanted in young age. Worse results were found in severe anomalies, in pre lingual patients implanted at older age and in patients with poor compliance for rehabilitation. Conclusions: Cochlear implantation in patients with inner ear anomalies is surgically safe and can be equally successful. Severity of anomaly, can affect the outcome. B023 Technical considerations in cochlear implants in inner ear malformations. Prevalence and complications F. Di Gregorio1 , G. Filiberti2 , M.E. Zernotti3 . 1 Otolaryngology Department, Sanatorio Allende. C´ ordoba, Argentina; 2 ENT Department. Hospital Infantil, C´ ordoba, Argentina; 3 School of Medicine. Catholic University of Cordoba, Argentina Aim: To determine the prevalence of cochlear malformations among children implanted and describe surgical complications. Material and Methods: Retrospective study of the last 70 consecutive patients with cochlear implants. The number of patients with osseous or membranous malformations was 7. Results: We found 7 patients with inner ear malformations, representing 10% of the patients included in this study. Of the 7 patients implanted with congenital malformations 3 had common cavity (major malformations), two patients had minor malformations (Mondini dysplasia) and 2 large vestibular aqueduct. 3 patients underwent transatical approach and four underwent classical approach. Two patients had intraoperative gusher and two abnormal facial nerve courses. Therefore 40% of patients had complications Conclusions: These patients have a greater chance of intraoperative complications, especially the gusher and the aberrant facial nerve. These two complications are preventable if they are provided by surgeons and take the necessary precautions.
B024 Flex prototype electrode array for round window insertion: the Hannover experience O. Majdani, K. Fursen, ¨ Th. Lenarz. Hannover Medical School, Hannover, Germany Aim: In a clinical study, we applied a novel CI electrode Flex EAS 20 from MedEL to evaluate its potential for hearing preservation. Materials and Methods: The Sonata implant with the straight Flex EAS 20 electrode was used. The length of the intracochlear electrode is 19.5 mm. The electrode was inserted gently through an incision in Round Window. A total of 17 patients were implanted. Results: Of 17 patients implanted, 14 post-operative results were available. The residual hearing could be permanently preserved in 11 patients. One patient lost his residual hearing directly after surgery, and two had postoperatively unchanged hearing, which they lost four weeks postoperatively. In the patients with successful residual hearing preservation, the average postoperative hearing loss was 12.5 dB. Conclusions: By implanting the Flex EAS 20 electrode 92.9% of patients could save their residual hearing initially and 78.6% of patients on long term. B025 Modern technique of the cochlear implantation in national research center for audiology and hearing rehabilitation in Moscow V. Fedoseev, N. Mileshina, V. Bakhshinyan, N. Dmitriyev, G. Tavartkiladze. National Research Center for Audiology and Hearing Rehabilitation, Moscow, Russia Aim: The comparative analysis of the different surgical techniques of CI was performed. Material and Methods: CI were done in 930 children and adults from 1991 to 2010. Chronologically the cut of the skin was reduced from Lehnhardt’s extended cutting to post-auricular cut with periostal flap on the anterior leg; the implant fixation technique was changed from the ligature insertion through the intra-bone tunnel to the fixation only through periostal edges around implant’s bed. The difficulties: partial obliteration of the basal turn, Gusher syndrome, narrow facial recess, very think bone under a bed for the receiver-stimulator. Results and Conclusions: Nowadays the significant reduction in number of complications, surgery duration and volume with the minimization of postoperative manipulations took place from the beginning till recent practical use of cochlear implantation. B026 The results of cochlear implantation in children with the inner ear abnormalities V. Fedoseev, N. Mileshina, V. Bakhshinyan, L. Potalova, G. Tavartkiladze. National Research Center for Audiology and Hearing Rehabilitation, Moscow, Russia Aim: To analyze the results of CI in children with inner ear abnormalities. Materials and Methods: In 2005–2010 nine cochlear implantations were performed in patients with Mondini malformation, dysplasia of the vestibule, enlarged vestibular aqueduct syndrome and the stenosis of the IEC. MRI-scan confirmed the presence of the liquid in all cochlea. Results: Gusher Syndrome was observed in 5 cases. The registration of ESRT and NRT was performed in 7 cases. The electrode array was in close contact with the cochlear wall in all Mondini cases and was in the basal turn in case of vestibule dysplasia. The facial nerve stimulation was discovered in 2 cases. The follow-up results showed positive hearing and speech development in 8 cases and no result in 1 patient. Conclusions: Cochlear implantation in patients with inner ear anomalies is possible with full insertion of electrodes with high probability of Gusher and facial nerve stimulation.