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B048 Bilateral simultaneous cochlear implantation in young children
Abstracts, ESPCI 2011 / International Journal of Pediatric Otorhinolaryngology 75 (2011) 10–32
with free fitting deep insertion lateral wall electrodes (720 degrees, 30 mm insertion). Forces for the perimodiolar electrodes were against the modiolar wall. For the non pre shaped devices forces were constant and against the lateral wall of the model. Conclusions: Stimulation electrodes in the young and very young deaf patients will have to be explanted and re implanted more than once during their life time. Explantation forces should be minimized to protect the finite neural structure. B048 Bilateral simultaneous cochlear implantation in young children L. Migirov, Y. Shapira, J. Kronenberg. Sheba Medical Center, Otolaryngology & HNS, Ramat Gan, Israel Aim: To present our experience with bilateral simultaneous cochlear implantation in young children. Material and Methods: This ongoing study includes 22 children aged up to 3 years who underwent bilateral simultaneous cochlear implantation in Sheba Medical Center between 2001 and 2010. Results: Fifteen children were congenitally deaf, four had post-meningitis deafness and three others had congenital cytomegalovirus- related deafness. Twenty patients were implanted using the suprameatal technique and two others underwent the implantation with the posterior tympanotomy approach. The overall time of surgery was approximately 3 hours including anesthesia and drilling out the basal turn of the cochlea in three children with meningitis-related ossification. None of the children had any surgical complications. Conclusions: From the surgical perspective, the use of a nonmastoidectomy approach can be applied for bilateral simultaneous procedures in young children with undeveloped mastoid, anteriorly placed sigmoid sinus, narrow facial recess, and in children with partially ossified cochlear ducts. B049 Predicion of speech percetion with cochlear implants S. Haumann1 , N. Wardenga1 , T. Herzke2 , V. Hohmann2 , Th. Lenarz1 , 1 1 A. Lesinski-Schiedat1 , A. Buchner ¨ . Medical University of Hannover, Department of Otorhinolaryngoglogy, Hannover, Germany; 2 Center of Competence H¨ orTech, Oldenburg, Germany Aim: Speech perception shall be predicted before cochlear implant (CI) surgery using novel test procedures. Material and Methods: Newly introduced tests were Oldenburger and Freiburger Speech Test performed with an optimally fitted hearing aid simulated with the Master Hearing Aid system [1], Text Reception Threshold (TRT) Test aiming at the linguistic competence and questionnaires addressing state of health, subjective hearing and socio-economic status (SES). The speech tests were repeated with CI at the 6 month appointment. Based on these data a statistical model for predicting CI success using weighted correlations was developed. Results: Up to now data from 86 adults who obtained a CI have completed the 6 month appointment. With the statistical model the speech understanding with CI was predicted within an interval of 25%. Conclusions: The preliminary statistical model using the newly installed tests seems to allow predictions of CI performance. A more complex model is currently under development. B050 Control of refractory chronic otitis media prior to cohlear implantation M. Luntz, J. Khalaila, T. Shpak. Department of Otolaryngology – Head and Neck Surgery, Bnai Zion Medical Center, Haifa, Israel Aim: To present experience with 10 patients who suffered from refractory chronic otitis media (COM) and in whom cochlear implantation (CI) had to be staged for COM control. Material and Methods: A clinical and surgical patients’ review.
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Results: Mean group age was 45 years. Range of follow-up: 1–10 years. In 2 only tympanoplasty was required for COM control. 8 patients underwent lateral temporal bone resection with abdominal fat grafting for obliteration of the middle ear cleft and blind sac obliteration of the external-ear-canal, in one of these 8 temporoparietal fascia flap was needed as well. Implantation procedure was straightforward in all patients. Follow up was uneventful except for wound dehiscence in two patients, in one of them it was solved surgically. Conclusions: Temporal bone resection is a relatively time consuming procedure but gives optimal solution in for COM control when CI (or VSB) are planned for hearing restoration. B051 The advantage of very early activation in children with cochlear implant A. Murri, E. Briccola, L. Guerzoni, V. Mariani, P. Frontera, D. Cuda. ”Guglielmo da Saliceto” Hospital, ENT Department, Piacenza, Italy Aim: To summarize our experience on the activation of cochlear implantation in the first day after surgery (EA). Material and Methods: From 2008 to 2010 we activated 78CI in the first day after surgery. 51 were children. Mean age: 3,4yrs. In a subgroup of 30 children we analyzed the anxiety state of parents with the State-Trait Anxiety Inventory (STAI-Y) before the surgery and 1month after. The control group comprised 30 children with device-switch on after one month. The fitting was based on T- NRT results, verified in behavioural methods. All children use SP after discharge. Nobody had any complications. Results: The preliminary results indicate a reduction of parents state anxiety related to the EA. Conclusions: The EA parents are glad their baby hear at discharge. The advantages of EA are the shortcoming rehabilitation, the possibility to use the children brain plasticity immediately. B052 Multidisciplinary aetiological investigation of infant cochlear implants candidates P. Merkus1 , T.S. Goverts1 , C. Smits1 , Y.J.W. Simis1 , M.F. Mulder2 , J.M. van der Kamp3 , E.F. Hensen1 . 1 ENT/audiology, VU University Medical Center, Amsterdam, The Netherlands; 2 Paediatrics, VU University Medical Center, Amsterdam, The Netherlands; 3 Clinical Genetics, VU University Medical Center, Amsterdam, The Netherlands Aim: To develop a multidisciplinary diagnostic protocol to optimise the workup of infant CI candidates, in order to better integrate the aetiological investigation of congenital hearing loss and CI candidacy procedures. Material and Methods: A retrospective analysis in infants with bilateral sensorineural hearing loss of the procedures towards an aetiological diagnosis and the workup towards CI. Results: We found a great variety in the number of visits to the outpatient clinic needed in each patient (range 3–10). With an new diagnostic flow, the average number of visits was reduced, an aetiological diagnosis could be identified in the majority of the cases and the workup for cochlear implantation could be completed before the age of one year. Conclusions: A new multidisciplinary approach reduced the numbers of visits to a minimum without any loss in the CI work up. The aetiological investigation is now efficient and integrated with the CI candidacy diagnostics.
with free fitting deep insertion lateral wall electrodes (720 degrees, 30 mm insertion). Forces for the perimodiolar electrodes were against the modiolar wall. For the non pre shaped devices forces were constant and against the lateral wall of the model. Conclusions: Stimulation electrodes in the young and very young deaf patients will have to be explanted and re implanted more than once during their life time. Explantation forces should be minimized to protect the finite neural structure. B048 Bilateral simultaneous cochlear implantation in young children L. Migirov, Y. Shapira, J. Kronenberg. Sheba Medical Center, Otolaryngology & HNS, Ramat Gan, Israel Aim: To present our experience with bilateral simultaneous cochlear implantation in young children. Material and Methods: This ongoing study includes 22 children aged up to 3 years who underwent bilateral simultaneous cochlear implantation in Sheba Medical Center between 2001 and 2010. Results: Fifteen children were congenitally deaf, four had post-meningitis deafness and three others had congenital cytomegalovirus- related deafness. Twenty patients were implanted using the suprameatal technique and two others underwent the implantation with the posterior tympanotomy approach. The overall time of surgery was approximately 3 hours including anesthesia and drilling out the basal turn of the cochlea in three children with meningitis-related ossification. None of the children had any surgical complications. Conclusions: From the surgical perspective, the use of a nonmastoidectomy approach can be applied for bilateral simultaneous procedures in young children with undeveloped mastoid, anteriorly placed sigmoid sinus, narrow facial recess, and in children with partially ossified cochlear ducts. B049 Predicion of speech percetion with cochlear implants S. Haumann1 , N. Wardenga1 , T. Herzke2 , V. Hohmann2 , Th. Lenarz1 , 1 1 A. Lesinski-Schiedat1 , A. Buchner ¨ . Medical University of Hannover, Department of Otorhinolaryngoglogy, Hannover, Germany; 2 Center of Competence H¨ orTech, Oldenburg, Germany Aim: Speech perception shall be predicted before cochlear implant (CI) surgery using novel test procedures. Material and Methods: Newly introduced tests were Oldenburger and Freiburger Speech Test performed with an optimally fitted hearing aid simulated with the Master Hearing Aid system [1], Text Reception Threshold (TRT) Test aiming at the linguistic competence and questionnaires addressing state of health, subjective hearing and socio-economic status (SES). The speech tests were repeated with CI at the 6 month appointment. Based on these data a statistical model for predicting CI success using weighted correlations was developed. Results: Up to now data from 86 adults who obtained a CI have completed the 6 month appointment. With the statistical model the speech understanding with CI was predicted within an interval of 25%. Conclusions: The preliminary statistical model using the newly installed tests seems to allow predictions of CI performance. A more complex model is currently under development. B050 Control of refractory chronic otitis media prior to cohlear implantation M. Luntz, J. Khalaila, T. Shpak. Department of Otolaryngology – Head and Neck Surgery, Bnai Zion Medical Center, Haifa, Israel Aim: To present experience with 10 patients who suffered from refractory chronic otitis media (COM) and in whom cochlear implantation (CI) had to be staged for COM control. Material and Methods: A clinical and surgical patients’ review.
19
Results: Mean group age was 45 years. Range of follow-up: 1–10 years. In 2 only tympanoplasty was required for COM control. 8 patients underwent lateral temporal bone resection with abdominal fat grafting for obliteration of the middle ear cleft and blind sac obliteration of the external-ear-canal, in one of these 8 temporoparietal fascia flap was needed as well. Implantation procedure was straightforward in all patients. Follow up was uneventful except for wound dehiscence in two patients, in one of them it was solved surgically. Conclusions: Temporal bone resection is a relatively time consuming procedure but gives optimal solution in for COM control when CI (or VSB) are planned for hearing restoration. B051 The advantage of very early activation in children with cochlear implant A. Murri, E. Briccola, L. Guerzoni, V. Mariani, P. Frontera, D. Cuda. ”Guglielmo da Saliceto” Hospital, ENT Department, Piacenza, Italy Aim: To summarize our experience on the activation of cochlear implantation in the first day after surgery (EA). Material and Methods: From 2008 to 2010 we activated 78CI in the first day after surgery. 51 were children. Mean age: 3,4yrs. In a subgroup of 30 children we analyzed the anxiety state of parents with the State-Trait Anxiety Inventory (STAI-Y) before the surgery and 1month after. The control group comprised 30 children with device-switch on after one month. The fitting was based on T- NRT results, verified in behavioural methods. All children use SP after discharge. Nobody had any complications. Results: The preliminary results indicate a reduction of parents state anxiety related to the EA. Conclusions: The EA parents are glad their baby hear at discharge. The advantages of EA are the shortcoming rehabilitation, the possibility to use the children brain plasticity immediately. B052 Multidisciplinary aetiological investigation of infant cochlear implants candidates P. Merkus1 , T.S. Goverts1 , C. Smits1 , Y.J.W. Simis1 , M.F. Mulder2 , J.M. van der Kamp3 , E.F. Hensen1 . 1 ENT/audiology, VU University Medical Center, Amsterdam, The Netherlands; 2 Paediatrics, VU University Medical Center, Amsterdam, The Netherlands; 3 Clinical Genetics, VU University Medical Center, Amsterdam, The Netherlands Aim: To develop a multidisciplinary diagnostic protocol to optimise the workup of infant CI candidates, in order to better integrate the aetiological investigation of congenital hearing loss and CI candidacy procedures. Material and Methods: A retrospective analysis in infants with bilateral sensorineural hearing loss of the procedures towards an aetiological diagnosis and the workup towards CI. Results: We found a great variety in the number of visits to the outpatient clinic needed in each patient (range 3–10). With an new diagnostic flow, the average number of visits was reduced, an aetiological diagnosis could be identified in the majority of the cases and the workup for cochlear implantation could be completed before the age of one year. Conclusions: A new multidisciplinary approach reduced the numbers of visits to a minimum without any loss in the CI work up. The aetiological investigation is now efficient and integrated with the CI candidacy diagnostics.