[Hearing gain with binaural-bimodal adaptation in patients with a cochlear implants].

Binaural hearing allows the optimal performance of the auditory system with a better perception of the sounds that make up language and better discrimination in noisy environments. The use of binaural-bimodal stimulation includes a combination of 2 different pacing modes: a cochlear implant in one ear , and acoustic stimulation through a conventional hearing aid in the other. The aim of this study is to determine the hearing gain in patients with cochlear implant alone and hearing aid. Twenty prelingually hearing impaired patients, 11 female and 9 male subjects were recruited with mean age at implantation and 3.91 ± 1.56 years and 6.07 ± 2.18 years at the time of audiological assessment at six months post-implantation. Implanted patients were assessed per month after the surgery for the first telemetry subsequently were reassessed every month to make changes to schedules stimulation map according to the auditory responses and progress shown in speech therapy. When calculating the mean and standard deviation of the auditory response in implanted subjects, you can appreciate that in the group of patients with cochlear implant plus hearing aid using the values obtained were lower at all frequencies, indicating a higher gain using auditory hearing aid over a cochlear implant, in comparison to patients who only used the cochlear implant. Comparing auditory responses in patients implanted with and without hearing aid, statistically significant differences were observed at all frequencies except at 2 kHz, showing that there is a better discrimination in noisy environments. The patients use more AA gain greater hearing gain compared with patients who only used the IC.

[Modification of thresholds T in cochlear implant patients as an alternative programming time in relation to the time].

INTRODUCTION: Programming the cochlear implant (CI) has always been a challenge for all medical specialists in audiology, especially in pediatric patients without language secondary profound hearing loss. For this reason are searched alternatives to achieve normal hearing with the implant during programming in the shortest time possible. OBJECTIVE: To analyze whether through modification threshold T we get faster audiological threshold, describe the differences in time found in patients with sensorineural hearing loss IC users with thresholds T at 10% modified, and T thresholds modified according to clinical responses after obtaining audiological threshold within normal parameters and report the speech coding strategies commonly used at the start of the program and to reach above the hearing threshold to language area. MATERIAL AND METHODS: We performed an observational, cross-sectional, descriptive, comparative study in which we evaluated a total of 31 patients with sensorineural hearing loss, under six years, and both sexes, of cochlear implant users of Advanced Bionics, which were divided in two groups: Group I: 15 patients with modification of thresholds T to 10%, following the manufacturer's recommendations (unmodified) and Group II: 16 patients with T threshold modification according to clinical response cochlear (modified). Were reported strategies most used speech coding in both groups at the start of the program and to reach the threshold audiological within normal parameters. RESULTS: In patients in group I (not modified) were 256 days on average to reach threshold audiological and group II (modified) was 335.6 days. Without statistic significant p = 0.197, with an average of 295.8 days for both groups and the speech coding strategy more used was the Hi-Res P with Fidelity 120, modifying both groups only one patient from power up obtaining threshold. CONCKUSIONS: It was established that thresholds T patient's subjective threshold as compared to T of 10% automatically obtained by SoundWave is not necessary since there are no statistically significant differences in relation to time to take patients implanted normal hearing threshold. The speech coding strategies more widely used and accepted by the patient was the Hi-Res P with Fidelity 120.

Estandarización de la Audiometría de altas frecuencias / High frequency audiometry standarization

La aplicación primaria de la audiometría de altas frecuencias es útil en pacientes que tienen sospecha de otopatías por causas exógenas o endógenas con afección de las frecuencias mayores a 8 KHz. Se realizo este estudio con el objetivo de estandarizar la prueba en sujetos normo-oyentes que acuden al INCH. El análisis estadístico fue por "t de student" con intervalo de confianza del 95 por ciento. Se estudiaron 200 oídos, con promedio por frecuencias de 20 a 25 dB de 8 a 16 KHz y entre 25 y 28dB en 17 y 18 KHz. En el análisis de respuesta en decibeles entre ambos oídos no existió diferencia significativa (t menor que 0.05) entre ambos oídos. Se concluye que se puede considerar normal la audiometría de altas frecuencias en los pacientes cuya respuesta es hasta 25 dB de 8 a 16 KHz y hasta 30 dB en 17 y 18 KHz.

Hallazgos audiológicos en pacientes con hipoacusia súbita manejados con esteroides y extracto de ginkgo biloba / Audiologic findings in patients with sudden hearing loss treated with steroids and extract of ginkgo biloba

Propósito: Evaluar los resultados audiológicos en pacientes con hipoacusia súbita manejados con Ginkgo biliba y esteroides. Así mismo, evaluar el efecto de este tratamiento médico sobre el acúfeno que surge como secuela del padecimiento. Material y Métodos: Se realizó un estudio prospectivo, lineal y descriptivo, en el cual se revisó una muestra de 52 pacientes. Se administró tratamiento a base de esteroides y extracto de Ginkgo biloba. A todos los pacientes se les realizaron audiometrías seriadas cada 8 o 10 días hasta que se encontró estabilidad audiométrica. Resultados: En los umbrales de tonos puros, se observó mejoría de l a 30 dB HL en el 36.8 por ciento de los pacientes, de 31.60 dB HL en el 40.3 por ciento y de 61.90 dB HL en el 7.0 por ciento. La discriminación mejoró en el 61.66 por ciento. El acúfeno mostró mejoría importante en todos los casos. Conclusión: Aunque se ha reportado que en la hipoacusia súbita puede existir recuperación espontánea, la combinación de esteroides con extracto de Ginkgo biloba produjo recuperación en los umbrales de audiometría tonal y mejoría en la discriminación en la mayoría de los casos estudiados, incluso en pacientes que tenían de 1 a 2 meses de evolución y en los que no había existido mejoría espontánea. La recuperación no fue completa, pero si útil para obtener umbrales aceptables para la rehabilitación mediante una prótesis auditiva