[The time range in sequential bilateral cochlear implantation]. / Vremennoi interval pri posledovatel'noi binaural'noi kokhlearnoi implantatsii.

The article is devoted to the problems of binaural cochlear implantation, especially in patients with a long time interval between surgeries. The purpose of the study was to evaluate the effect of the time range between successive interventions in patients with binaural prosthetics using the CI system. MATERIALS AND METHODS: the study included 50 patients aged 10 to 14 years, divided into 3 study groups: patients with unilateral cochlear implantation (group I), patients with bilateral implantation with a less than 1 year range between operations (group II) and patients with bilateral implantation with a more than 5 year range between interventions (group III). Comparative analysis was carried out using speech audiometry in silence and noise, assessment of sound localization and questionnaires to assess the auditory dynamics and speech development. RESULTS: Patients in groups II and III showed comparable results in speech intelligibility in noise and sound localization. At the same time, these indicators turned out to be higher than in patients of group I. Patients from all three groups did not show statistically significant differences in speech intelligibility in silence and in the level of speech development. CONCLUSION: a long interval (more than 5 years) after the first implantation should not be considered as a contraindication to binaural implantation.

[Surgical tactic of cochlear implantation in patients with intraoperative CSF leakage]. / Khirurgicheskaya taktika pri kokhlearnoi implantatsii u patsientov s intraoperatsionnoi likvoreei.

Cochlear implantation (CI) is currently the recognized and most promising method of rehabilitation of patients suffering from profound hearing loss and deafness. During the surgical stage of CI, one of the most unpleasant intraoperative features is CSF leakage from the cochlea opening. Most often it occurs in patients with malformations of the inner ear, with temporal bone fractures and with cochlear otosclerosis. The difficulty of choosing the tactics of surgical intervention in these patients is caused by the large variability of the anatomical structures of the inner ear. In the period from 2017 to 2021, 1954 patients underwent CI, of which 83 were patients with cochlea malformations (65 intraoperative CSF leakages), 14 with the temporal bones fractures (2 intraoperative CSF leakage), 12 with cochlear otosclerosis (1 CSF leakage), while 3 spontaneous intraoperative CSF leakages were noted in patients with normal cochlea anatomy and hyperpnumotized temporal bone pyramid and enlarged vestibular aqueduct. The highest risk of intraoperative CSF leakage was observed in patients with inner ear malformations (common cavity - 10, incomplete partition type III - 15) and anomalies of the internal auditory canal - 5 (dilated IAC - more than 8.5 mm in diameter). Moderate risk of intraoperative CSF leakage was typical for patients with incomplete partition type I (15 patients) and type II (25 patients).

[Prospects for cochlear implantation in patients with auditory nerve dysplasia]. / Perspektivy kokhlearnoi implantatsii u patsientov s displaziei slukhovogo nerva.

Auditory nerve dysplasia (AND) can encompass various conditions of the auditory nerve (AN), ranging from true aplasia to hypoplasia. The purpose of this review is to discuss the prospect of cochlear implantation (CI) and subsequent auditory speech rehabilitation for AN abnormality. Studies of different authors when working with this category of children, possible results and methods of diagnostics of the AN condition are presented.

[The influence of hearing and vestibular impairments on cognitive function in elderly people.]

Cognitive function is a complex brain function that is important in the cognition of the reality and connecting with it. It has a complicated reflex basis, arises from external factors exposure, improves by growing up and learning till its maximum and declines in the elderly age. For several years it was believed that cognitive function drop is connected with ageing processes of the whole organism. However, the results of the latest studies show that it can be affected by many factors. Two of the most influencing factors are hearing and vestibular efficiency. Moreover, hearing and vestibular normalization can even improve the cognitive function. Unfortunately, studies, that describe the role of hearing and vestibular function in the cognitive sphere, are extremely rare. That is why further research is very important, especially in the rehabilitation tactics. For elderly patients with severe-to-profound hearing loss cochlear implantation is the optimal rehabilitation method. However, ear surgery can lead to such complication as vestibular dysfunction. That is why preoperative diagnostics and postoperative care are very important for preventing cognitive impairments.

[The significance of microanatomy of the round window in terms of cochlear implantation]. / Znachenie mikroanatomii okna ulitki dlya provedeniya kokhlearnoi implantatsii.

Sensoneural hearing loss is a polyetiological disease, which is often a secondary reflection of systemic pathology and is associated with damage of the cochlea and auditory nerve receptors. An important point in the surgical stage of cochlear implantation is the introduction of an implant active electrode into the cochleostomy spiral channel through the cochleostoma or round window. However, the issue of intra-cochlear structures surgical trauma in such surgical intervention seems to be very important, as it may reduce the success of subsequent rehabilitation. Therefore, the study of the anatomy of the round window and adjuscent areas was the objective of this work.

[The experience in surgical treatment of hearing loss in Van der Hoeve patients]. / Opyt khirurgicheskogo lecheniya tugoukhosti u patsientov s sindromom Van-der-Khuve.

Despite the rare incidence of Van der Hoeve syndrome in the population, the problem of treating patients with this type of disease is important for modern science and practical medicine. One of the most difficult tasks in treatment is to improve the quality of hearing. The world scientific community lacks a unified coordinated approach to the methods of auditory rehabilitation of patients with Van der Hoeve syndrome. In recent years, there have been tendencies in the scientific literature to increase the frequency of non-surgical approach due to the low incidence of satisfactory results of surgical treatment. In this regard, we present our experience of complex treatment of patients with Van der Hove syndrome, based on the use of modern surgical technologies and conservative pathogenetically substantiated treatment.

[Influence of hearing decline on cognitive function in elderly and senier age patients and its assessment after cochlear implantation (literature review).]

The study of the effect of cochlear implantation on cognitive function is an urgent problem, since the world is increasing the population of elderly and senile people who, as a rule, have certain hearing impairments. Age-related hearing loss is one of the most common health problems associated with aging, affecting two-thirds of people over the age of 70. However, few adults are tested for hearing loss, and even fewer are being treated. It is known that hearing loss - the most common sensory deficit-forms the prerequisites for narrowing the range of cognitive functions in the elderly and can serve as a factor accelerating the progression of cognitive changes. We analyzed the available research on the effects of hearing loss and cochlear implantation on cognitive function. It was revealed that for the most part, they had a small sample, the results were not subjected to the necessary statistical analysis, and the tests used were not adapted for hearing impaired people. After analyzing different tests for assessing cognitive function, HI-MoCA and RBANS-H tests were selected, which are adapted for hearing impaired people, which will allow to reliably assess cognitive function in the pre- and postoperative period, as well as to trace the effect of cochlear implantation on cognitive function in postoperative period.

[Round window niche area anatomy in terms of cochlear implantation]. / Anatomiia oblasti nishi okna ulitki primenitel'no k khirurgicheskomu étapu kokhlearnoi implantatsii.

Cochlear implantation is the most effective method of rehabilitation of patients with a high degree of hearing loss and deafness. This is a complex, multi-stage way of rehabilitation that includes selection of candidates for surgical intervention, a surgical stage and postoperative long-term auditory rehabilitation. In carrying out the surgical stage of cochlear implantation the round window niche area is of great interest, since the variability of its anatomical features affects the access to scala tympani. The article presents the data obtained from study of the round window niche area anatomy on cadaveric temporal bones. Variations of structures important for cochlear implantation have been determined.

[Topographic anatomy of the hook region and its significance for the choice of the surgical technique for the cochlear implantation]. / Topograficheskaia anatomiia oblasti 'rybolovnogo kriuchka' i ee znachenie pri vybore khirurgicheskoi tekhniki kokhlearnoi implantatsii.

The mode of the introduction of the active electrode of a cochlear implant into the cochlea remains a key issue as far as cochlear implantation is concerned. Especially much attention has recently been given to the relationship between the anatomical features of the basal region of the cochlea (the so-called 'fish hook') and the possibility to approach it. We have undertaken the attempt to optimize the approach to the tympanic canal (scala tympanica) of the cochlea with a view to reducing to a minimum the risk of an injury to the cochlear structures in the course of cochlear implantation. A total of 35 cadaveric temporal bones were examined to measure the fine structures of the hook region and evaluate the risk of their damages associated with various approaches to the tympanic canal.

[Organization of remote long-term support of the patients with cochlear implants in distant regions].

The concept of remote long-term support of the patients with cochlear implants is suggested to cope with the problem of the increasingly growing number of patients with cochlear pathology. The authors deem it necessary to provide intraoperative support and postoperative follow-up technologies for the patients living far from the cochlear implantation centres. A scheme for the remote selection of patients and their intraoperative monitoring is proposed with the use of implant telemetry, electrical stapedial reflex (eSRT) testing, auditory response telemetry (ART), and surgical on-line counseling. Remote follow-up and rehabilitation should include cochlear implant tuning, speech therapy, and on-line workshops for the patients and/or specialists. The choice and the use of software and hardware for this purpose are discussed. The concept of remote long-term support turned out to be an efficacious, reliable, time-saving, and cost-effective tool for providing high-tech medical aid to patients with ENT diseases in the Krasnoyarsk kray (territory).