Profile of patients assessed for cochlear implants (original) (raw)
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Crianças com implante coclear: habilidades comunicativas e qualidade de vida
Brazilian Journal of Otorhinolaryngology, 2012
Gi ven the multidimensional scope of cochlear implants, there is a growing need to assess clinical measures related communicative abilities and more general aspects involved in the effectiveness of treatment, such as quality of life. Aim: To translate and adapt an international questionnaire of quality of life to Brazilian Portuguese; to apply the questionnaire in parents of children with cochlear implant to assess quality of life of children after cochlear implantation; to analyze correlations among factors related to quality of life; to analyze correlations between quality of life and clinical measures of outcome. Method: prospective study in which parents of children with cochlear implants responded to validated instruments on quality of life and communication abilities. Results: The translation and adaptation of the questionnaire was satisfactorily completed. According to the data, cochlear implants had a positive effect on quality of life of the implanted children and their families. Observed correlations for the variable communication demonstrate a direct relationship between oral communication and other variables of quality of life.
Resultados audiológicos do implante coclear em idosos
Brazilian Journal of Otorhinolaryngology (Impresso), 2010
(HCFMUSP). 2 Doctoral degree, speech therapist of the otorhinolaryngology clinic division, HCFMUSP, coordinator of the speech therapy team of the cochlear implant group, HCFMUSP. 3 Doctoral degree, otorhinolaryngologist, HCFMUSP, coordinator of the cochlear implant group, HCFMUSP. 4 Full professor of the otorhinolaryngology discipline, Medical School, Sao Paulo University (FMUSP), head of the ophthalmology and otorhinolaryngology department, FMUSP.
Aspectos bioéticos e médico-legais do implante coclear em crianças
Brazilian Journal of Otorhinolaryngology, 2012
Cochl ear implants are the best treatment for congenital profound deafness. Pediatric candidates to implantation are seen as vulnerable citizens, and the decision of implanting cochlear devices is ultimately in the hands of their parents/guardians. The Brazilian Penal Code dictates that deaf people may enjoy diminished criminal capacity. Many are the bioethical controversies around cochlear implants, as representatives from the deaf community have seen in them a means of decimating their culture and intrinsic values. Objective: This paper aims to discuss, in bioethical terms, the validity of implanting cochlear hearing aids in children by analyzing their vulnerability and the social/cultural implications of the procedure itself, aside from looking into the medical/legal aspects connected to their criminal capacity. Materials and Methods: The topic was searched on databases Medline and Lilacs; ethical analysis was done based on principialist bioethics. Results: Cochlear implants are the best therapeutic option for people with profound deafness and are morally justified. The level of criminal capacity attributed to deaf people requires careful analysis of the subject's degree of understanding and determination when carrying out the acts for which he/she has been charged. Conclusion: Cochlear implants are morally valid. Implantations must be analyzed on an each case basis. ENT physicians bear the ethical responsibility for indicating cochlear implants and must properly inform the child's parents/guardians and get their written consent before performing the procedure.
Complicações em 550 cirurgias consecutivas de implante coclear
Brazilian Journal of Otorhinolaryngology, 2012
Cochl ear implantation is a safe and reliable method for auditory restoration in patients with severe to profound hearing loss. Objective: To describe the surgical complications of cochlear implantation. Materials and Methods: Information from 591 consecutive multichannel cochlear implant surgeries were retrospectively analyzed. All patients were followed-up for at least one year. Forty-one patients were excluded because of missing data, follow-up loss or middle fossa approach. Results: Of 550 cochlear implantation analyzed, 341 were performed in children or adolescents, and 209 in adults. The mean hearing loss time was 6.3 ± 6.7 years for prelingual loss and 12.1 ± 11.6 years for postlingual. Mean follow-up was 3.9 ± 2.8 years. Major complications occurred in 8.9% and minor in 7.8%. Problems during electrode insertion (3.8%) were the most frequent major complication followed by flap dehiscence (1.4%). Temporary facial palsy (2.2%), canal-wall lesion (2.2%) and tympanic membrane lesion (1.8%) were the more frequent minor complications. No death occurred. Conclusion: There was a low rate of surgical complications, most of them been successfully managed. These results confirm that cochlear implant is a safe surgery and most surgical complications can be managed with conservative measures or minimal intervention.
Percepção da fala em deficientes auditivos pré-linguais usuários de implante coclear
Pró-Fono Revista de Atualização Científica, 2010
TEMA: o implante coclear é um dispositivo eletrônico bastante promissor quanto aos benefícios, já que proporciona para a criança surda a apropriação da linguagem oral incidental. OBJETIVOS: avaliar o desempenho de audição do grupo das 60 primeiras crianças com deficiência auditiva neurossensorial pré-lingual implantadas no Centro de Pesquisas Audiológicas do Hospital de Reabilitação de Anomalias Craniofaciais da Universidade de São Paulo (CPA-HRAC/USP), após 16 anos de funcionamento do programa de implante coclear. MÉTODOS: foram avaliadas 57 crianças com idades entre 9 e 18 anos, utilizando os seguintes testes de percepção de fala: listas de reconhecimento de vocábulos monossílabos e dissílabos; listas de reconhecimento de sílabas sem sentido - Consonant Confusion Study - Confuse Program (apresentado no software do Sistema de Implante Coclear Nucleus, na sua unidade de programação - versão 6.90); listas de reconhecimento de sentenças e lista de palavras como procedimento de avaliaç...
Avaliação da qualidade de vida em crianças com implante coclear: revisão sistemática
Brazilian Journal of Otorhinolaryngology, 2013
The use of cochlear implant (CI) in children enables the development of listening and communication skills, allowing the child's progress in school and to be able to obtain, maintain and carry out an occupation. However, the progress after the CI has different results in some children, because many children are able to interact and participate in society, while others develop limited ability to communicate verbally. The need for a better understanding of CI outcomes, besides hearing and language benefits, has spurred the inclusion of quality of life measurements (QOL) to assess the impact of this technology. Objective: Identify the key aspects of quality of life assessed in children with cochlear implant. Method: Through a systematic literature review, we considered publications from the period of 2000 to 2011. Conclusion: We concluded that QOL measurements in children include several concepts and methodologies. When referring to children using CI, results showed the challenges in broadly conceptualizing which quality of life domains are important to the child and how these areas can evolve during development, considering the wide variety of instruments and aspects evaluated.
Implante coclear: audição e linguagem em crianças deficientes auditivas pré-linguais
Pró-Fono Revista de Atualização Científica, 2007
Background: cochlear implant in children, speech perception and oral language, hearing and oral language performance in children with pre-lingual profound sensory-neural hearing impairment, users of cochlear implant. Aim: to study the hearing and oral language performance of children with pre-lingual bilateral profound sensory neural hearing impairment, users of multi-channel cochlear implant considering the following aspects: age of the child when the research was carried out, time of hearing sensorial privation, time of cochlear implant use, type of cochlear implant, type of speech coding strategy used, familial permeability level in relation to the therapeutic process and cognitive style of the child. Method: participants of this study were 60 children who were assessed according to hearing and language categories. All of the variables were statistically analyzed. Psycho-social aspects, considering the child's cognitive style and the family's permeability level were also assessed. Results: regarding the hearing and language performance with the use of cochlear implant, the intermediate and advanced hearing categories were accomplished by more than half of the children. The statistically significant aspects in the performance of hearing and oral language were: the age of the child upon evaluation, time of hearing sensorial privation, time of cochlear implant use, type of implant, speech sounds coding strategy and familial permeability. Conclusion: the cochlear implant as a treatment for children with pre-lingual sensory-neural hearing impairment is highly effective, although complex, owing to the interaction of variables which interfere in the implanted child's performance. Further studies are needed for the understanding of the implantation complexity in young children. de permeabilidade da família no processo terapêutico e estilo cognitivo da criança. Método: as 60 crianças estudadas foram avaliadas quanto às categorias de audição e de linguagem. Todas as variáveis foram analisadas estatisticamente. Os aspectos psicossociais, considerando o estilo cognitivo da criança e o grau de permeabilidade da família também foram variáveis investigadas. Resultados: quanto ao desempenho de audição e de linguagem com o uso do implante coclear, as categorias auditivas intermediárias e avançadas foram alcançadas por mais da metade do grupo de crianças. Os aspectos estatisticamente significantes no desempenho de audição e de linguagem oral foram: a idade da criança na avaliação, o tempo de privação sensorial auditiva, o tempo de uso do implante coclear, o tipo de implante, a estratégia de codificação dos sons da fala e a permeabilidade da família. Conclusão: o implante coclear como tratamento de crianças com deficiência auditiva neurossensorial pré-lingual é altamente efetivo, embora complexo pela interação de variáveis que interferem no desempenho da criança implantada, desafiando novos estudos na compreensão da complexidade da implantação em crianças pequenas. Palavras-Chave: Implante Coclear; Percepção da Fala; Linguagem. Referenciar este material como: MORET, A. L. M.; BEVILACQUA, M. C.; COSTA, O. A. Cochlear implant: hearing and language in pre-lingual deaf children (original title: Implante coclear: audição e linguagem em crianças deficientes auditivas pré-linguais).
Comparación de complicaciones según la técnica utilizada en los implantes cocleares
Acta Otorrinolaringológica Española, 2012
Introduction: Complications are very sensitive indicators of the usefulness of a surgical technique. In cochlear implant surgery, there are 3 principal approaches: the classic approach uses the facial recess (FR), the suprameatal approach (SMA) does not require mastoidectomy and uses the creation of a tunnel over the facial nerve to enter the middle ear, and the endomeatal approach (EMA) is based on the completion of a groove in the posterior wall of external auditory canal. Material and methods: A multicentre review of 208 patients with cochlear implants was performed for comparing the different techniques. The complications were classified into major and minor. Results: Among the 208 implanted patients, 10.5% (22 of 208) had complications. Of these, 2.88% (6 of 208) were major complications and 7.69% (16 of 208) were minor complications. Comparing the results obtained by the different approaches, the FR technique had the lowest rate of major complications (1.1%), followed by the EMA technique with 2.38% and SMA with 3.75%. As for minor complications, operations in the SMA group had the lowest rate (6.25%), followed by the EMA group (7.14%) and the group operated on using the FR technique presented the highest (10%). Conclusions: The 3 techniques described show very similar rates of complications. Consequently, we can conclude that they are safe and are alternatives.
2013
Conflict of interests: No Author´s contribution: LFSFPB main researcher, research elaboration, chronogram elaboration, casebook, collecting, analysis of data, writing of the essay, submission and proceedings form the essay; JSB and MAFF advisers, research elaboration, chronogram elaboration, analysis of data, editing the article, final version approval; HGC, LRPLJ and DVSPL assistant researchers, research elaboration, data collection and writing the article.