Evaluation of Audiometric Thresholds and Speech Perception Sentence Test in Adults and Elderly After Cochlear Implantation.

AIM: To compare the audiometric thresholds and speech perception sentence test, between two groups with bilateral post-lingual, severe to profound sensorineural hearing loss. METHODS: Retrospective and analytical study, with 59 patients divided into 2 groups (under 60 years and above 60 years old) implanted between May/2002 and February/2007. RESULTS: The first group (control) included 30 patients with a mean age of 44 years. The audiometric threshold value in this group was 26 dB, and the average value of speech perception test was 94%. The second group included 29 patients with a mean age of 69 years. The average audiometric threshold was 29 dB, and the average value of SPT was 90%. The Mann-Whitney U-test was considered significant (P<0.05) only for 6-8 KHz frequencies and for SPT. CONCLUSION: Both groups had excellent outcomes in audiometric and speech testing with the use of CI, but with a significantly better performance in the adult group.

Hearing preservation and cochlear implants according to inner ear approach: multicentric evaluation / Preservação auditiva e implante coclear de acordo com a abordagem da orelha interna: avaliação multicêntrica

INTRODUCTION: Electroacoustic stimulation is an excellent option for people with residual hearing in the low frequencies, who obtain insufficient benefit with hearing aids. To be effective, the subject's residual hearing should be preserved during cochlear implant surgery. OBJECTIVES: To evaluate the hearing preservation in patients that underwent implant placement and to compare the results in accordance with the approach to the inner ear. METHODS: 19 subjects underwent a soft surgical technique, and the electrode MED-EL FLEX(tm) EAS, designed to be atraumatic, was used. We evaluated pre- and postoperative tonal audiometric tests with an average of 18.4 months after implantation, to measure the rate of hearing preservation. RESULTS: 17 patients had total or partial preservation of residual hearing; 5 had total hearing preservation and two individuals had no preservation of hearing. The insertion of the electrode occurred through a cochleostomy in 3 patients, and in 2 of these there was no hearing preservation; the other 16 patients experienced electrode insertion through a round window approach. All patients benefited from the cochlear implant, even those who are only using electrical stimulation. CONCLUSION: The hearing preservation occurred in 89.4% of cases. There was no significant difference between the forms of inner ear approach. .

INTRODUÇÃO: A estimulação eletroacústica é uma excelente opção para pessoas com audição residual nas baixas frequências, que obtêm benefício insuficiente com aparelhos auditivos. Para ser eficaz, a audição residual deve ser preservada durante a cirurgia de implante coclear. OBJETIVOS: Avaliar a preservação auditiva de pacientes implantados e comparar os resultados de acordo com a abordagem da orelha interna. MÉTODO: 19 indivíduos foram implantados com uma técnica cirúrgica para preservação auditiva, tendo sido utilizado o eletrodo MED-EL FLEXTM EAS, concebido para ser atraumático. Foram avaliados os exames audiométricos tonais no pré e pós-operatório, com uma média de 18,4 meses após o implante para medir a taxa de preservação da audição residual. RESULTADOS: 17 pacientes tiveram preservação total ou parcial da audição residual; cinco obtiveram preservação da audição total e dois indivíduos não tiveram preservação da audição. A inserção do eletrodo ocorreu por cocleostomia em 3 pacientes; em 2 destes pacientes não houve preservação da audição. Os outros 16 pacientes foram submetidos à abordagem pela janela redonda. Todos os pacientes foram beneficiados com o implante coclear, mesmo aqueles pacientes que utilizando apenas estimulação elétrica. CONCLUSÃO: A preservação auditiva ocorreu em 89,4% dos casos. Não houve diferença significativa entre as formas de abordagem da orelha interna. .

Hearing preservation and cochlear implants according to inner ear approach: multicentric evaluation.

INTRODUCTION: Electroacoustic stimulation is an excellent option for people with residual hearing in the low frequencies, who obtain insufficient benefit with hearing aids. To be effective, the subject's residual hearing should be preserved during cochlear implant surgery. OBJECTIVES: To evaluate the hearing preservation in patients that underwent implant placement and to compare the results in accordance with the approach to the inner ear. METHODS: 19 subjects underwent a soft surgical technique, and the electrode MED-EL FLEX™ EAS, designed to be atraumatic, was used. We evaluated pre- and postoperative tonal audiometric tests with an average of 18.4 months after implantation, to measure the rate of hearing preservation. RESULTS: 17 patients had total or partial preservation of residual hearing; 5 had total hearing preservation and two individuals had no preservation of hearing. The insertion of the electrode occurred through a cochleostomy in 3 patients, and in 2 of these there was no hearing preservation; the other 16 patients experienced electrode insertion through a round window approach. All patients benefited from the cochlear implant, even those who are only using electrical stimulation. CONCLUSION: The hearing preservation occurred in 89.4% of cases. There was no significant difference between the forms of inner ear approach.

Hearing Preservation after Cochlear Implantation: UNICAMP Outcomes.

Background. Electric-acoustic stimulation (EAS) is an excellent choice for people with residual hearing in low frequencies but not high frequencies and who derive insufficient benefit from hearing aids. For EAS to be effective, subjects' residual hearing must be preserved during cochlear implant (CI) surgery. Methods. We implanted 6 subjects with a CI. We used a special surgical technique and an electrode designed to be atraumatic. Subjects' rates of residual hearing preservation were measured 3 times postoperatively, lastly after at least a year of implant experience. Subjects' aided speech perception was tested pre- and postoperatively with a sentence test in quiet. Subjects' subjective responses assessed after a year of EAS or CI experience. Results. 4 subjects had total or partial residual hearing preservation; 2 subjects had total residual hearing loss. All subjects' hearing and speech perception benefited from cochlear implantation. CI diminished or eliminated tinnitus in all 4 subjects who had it preoperatively. 5 subjects reported great satisfaction with their new device. Conclusions. When we have more experience with our surgical technique we are confident we will be able to report increased rates of residual hearing preservation. Hopefully, our study will raise the profile of EAS in Brazil and Latin/South America.

Can cochlear implants decrease tinnitus?

Suppression of tinnitus by electrical stimulation via a cochlear implant has been studied in recent years. Some individuals who undergo cochlear implant surgery report total or partial relief of the symptoms even in the contralateral ear. The mechanisms involved in this suppression are not clear. The results obtained in our study demonstrated an improvement of 71% in 29 implant cases, confirming data found in the literature. Our aim was to study tinnitus in individuals before surgery and after cochlear implant activation and to observe improvement in the perception of tinnitus, comparing these results with data in the literature. We conducted a retrospective study of 29 postlingual adults who had profound sensorineural hearing loss and underwent cochlear implant surgery at the cochlear implant sector of the Otorhinolaryngology, Head and Neck Surgery Department, University of Campinas, São Paulo, Brazil, between May 2003 and June 2005. The device employed in this procedure was the Nucleus 24K multichannel device (Cochlear Ltd, Lane Cove, Australia). After the internal component was activated, patients completed a questionnaire. Before surgery, 21 of the 29 patients (72%) who later underwent cochlear implant surgery presented with tinnitus, which was bilateral in 14 cases (67%). After the cochlear implant was activated, seven patients (33%) presented with total suppression, and eight patients (39%) reported partial relief. In the 14 cases with bilateral symptoms, tinnitus was totally suppressed or decreased in both ears in 12 cases (86%). Individuals who underwent multichannel cochlear implant surgery presented with reduced tinnitus even in the contralateral ear.