ABSTRACT
INTRODUCTION AND OBJECTIVES: Neonatal hearing loss is a public health problem that meets the requirements for submission to universal screening. Our objective was to analyse the results of the early hearing detection and intervention program implemented at our centre between January 2007 and December 2010. METHODS: We studied 26,717 newborns during the period mentioned, using transient otoacoustic emissions (TOAEs) for the screening. The diagnostic phase was carried out at the hearing loss department. RESULTS: In our area, there were 27,935 births between January 2007 and December 2010. The screening was performed on 26,717 children. Of these, 24,173 had positive TOAEs, 1,040 had no TOAEs and 1,504 presented TOAEs in 1 ear with absence of TOAEs in the contralateral ear. Risk factors associated with hearing loss were found in 4,674 infants. In a second phase of the program, TOAEs were given to 5,156 children, of whom 4,626 had positive otoacoustic emissions in both ears, 323 had no TOAEs in 1 ear and 207 failed this second phase. Of all children studied, 3.8% were referred to auditory brainstem response (ABR) testing and 26 children entered the cochlear implant program. The program reached coverage of 95.64%. CONCLUSIONS: The early hearing detection and intervention program at our hospital is suitable for our environment, reaching 95.64% of coverage. We consider the relationship between effectiveness and efficiency to be positive.
Subject(s)
Hearing Loss/diagnosis , Neonatal Screening , Decision Trees , Early Diagnosis , Hearing Tests , Humans , Infant, NewbornABSTRACT
INTRODUCTION AND OBJECTIVES: Several studies have indicated the benefit of bilateral cochlear implants in the acquisition of binaural hearing and bilateralism. In children with cochlear implants, is it possible to achieve binaurality after a second implant? When is the ideal time to implant them? The objective of this study was to analyse the binaural effect in children with bilateral implants and the differences between subjects with simultaneous and sequential implants with both short and long intervals. PATIENTS AND METHODS: There were 90 patients between 1 and 2 years of age (the first surgery), implanted between 2000 and 2008. Of these, 25 were unilateral users and 65 bilateral; 17 patients had received simultaneous implants, 29 had sequential implants before 12 months after the first one (short interimplant period) and 19 after 12 months (long period). All of them were tested for silent and noisy verbal perception and a tonal threshold audiometry was performed. RESULTS: The silent perception test showed that the simultaneous and short period sequential implant patients (mean: 84.67%) versus unilateral and long period sequential implants (mean: 79.66%), had a statistically-significant difference (P=0,23). Likewise, the noisy perception test showed a difference with statistical significance (P=0,22) comparing the simultaneous implanted and short period sequential implants (mean, 77.17%) versus unilateral implanted and long period sequential ones (mean: 69.32%). CONCLUSIONS: The simultaneous and sequential short period implants acquired the advantages of binaural hearing.
Subject(s)
Cochlear Implantation/methods , Hearing Loss, Sensorineural/surgery , Child, Preschool , Cochlear Implants , Humans , InfantABSTRACT
OBJECTIVE: Our objective was to perform a retrospective analysis of patients with jugulotympanic paragangliomas. We present the results according to the surgical approach applied in each case. MATERIALS AND METHODS: This retrospective study presents the findings in 21 patients with jugulotympanic paragangliomas who were observed and treated in our department over a 12-year period (1999 to 2011). We performed a general otolaryngology exam, systemic evaluation and radiological exam. Surgical treatment was performed in 20 cases out of 21. In 1 case, treatment with stereotactic radiosurgery was carried out. RESULTS: The surgical approaches were: endaural, retroauricular transcanal, radical or modified mastoidectomy through facial recess and infratemporal fossa approach. Preoperative embolization was used in 12 cases. In all cases the diagnosis of paraganglioma was confirmed. The most frequent postoperative complications found were transitory palsy of the facial nerve, sensorineural hearing loss, imbalance, paralysis of the cranial nerves IX and XI and salivary fistula. No recurrences were found after 12 years of follow-up. One case of persistence was found in the case treated with radiosurgery. CONCLUSIONS: In our series surgery was found to be the elective therapy for patients with paraganglioma, with no recurrences after 12 years of follow-up. Preoperative embolization decreases surgery time and intraoperative bleeding. Stereotactic Radiotherapy cannot eliminate the tumour..
Subject(s)
Glomus Jugulare , Glomus Tympanicum , Paraganglioma , Adult , Aged , Female , Humans , Male , Middle Aged , Paraganglioma/diagnosis , Paraganglioma/surgery , Retrospective Studies , Temporal Bone , Time FactorsABSTRACT
Introducción y objetivos: La hipoacusia neonatal es un problema de salud pública, que cumple los requisitos para ser sometido a cribado universal. El objetivo de este artículo es analizar los resultados obtenidos en el programa de detección precoz de la hipoacusia implementado en nuestro centro desde enero de 2007 hasta diciembre de 2010. Métodos: Se estudiaron 26.717 recién nacidos mediante otoemisiones acústicas transitorias (OEAT) en la fase de cribado auditivo. La etapa diagnóstica fue llevada a cabo en la unidad de hipoacusia del servicio. Resultados: En el período entre enero de 2007 y diciembre de 2010 nacieron 27.935 niños. Se practicó el screening a 26.717, de los cuales 24.173 presentaron OEAT positivas, 1.040 tuvieron OEAT ausentes y 1.504 presentaron OEAT en un oído estando ausentes en el oído contralateral. Presentaron factores de riesgo asociado para hipoacusia 4.674 recién nacidos. En una segunda fase del programa se practicó OEAT a 5.156 niños, de los cuales 4.626 presentaron otoemisiones positivas en ambos oídos, 323 no presentaron otoemisiones en un oído y 207 no pasaron esta segunda fase. Fueron derivados a potenciales evocados auditivos de tronco cerebral (PEATC) un 3,8% del total de niños estudiados. Veintiséis niños ingresaron al programa de implantes cocleares. Nuestro programa de detección precoz de la hipoacusia alcanzó una cobertura del 95,64%. Conclusiones: El programa de detección precoz de la hipoacusia de nuestro complejo es adecuado a nuestro funcionamiento, alcanzando una cobertura del 95,64% considerándose muy positiva la relación existente entre eficacia y eficiencia (AU)
Introduction and objectives: Neonatal hearing loss is a public health problem that meets the requirements for submission to universal screening. Our objective was to analyse the results of the early hearing detection and intervention program implemented at our centre between January 2007 and December 2010. Methods: We studied 26,717 newborns during the period mentioned, using transient otoacoustic emissions (TOAEs) for the screening. The diagnostic phase was carried out at the hearing loss department. Results: In our area, there were 27,935 births between January 2007 and December 2010. The screening was performed on 26,717 children. Of these, 24,173 had positive TOAEs, 1,040 had no TOAEs and 1,504 presented TOAEs in 1 ear with absence of TOAEs in the contralateral ear. Risk factors associated with hearing loss were found in 4,674 infants. In a second phase of the program, TOAEs were given to 5,156 children, of whom 4,626 had positive otoacoustic emissions in both ears, 323 had no TOAEs in 1 ear and 207 failed this second phase. Of all children studied, 3.8% were referred to auditory brainstem response (ABR) testing and 26 children entered the cochlear implant program. The program reached coverage of 95.64%. Conclusions: The early hearing detection and intervention program at our hospital is suitable for our environment, reaching 95.64% of coverage. We consider the relationship between effectiveness and efficiency to be positive (AU)
Subject(s)
Humans , Male , Female , Infant, Newborn , Hearing Loss/epidemiology , Neonatal Screening/methods , Deafness/epidemiology , Early Diagnosis , Evaluation of the Efficacy-Effectiveness of InterventionsABSTRACT
Introducción y objetivos: Numerosos estudios han señalado el beneficio de los implantes cocleares bilaterales en la adquisición de la binauralidad y la bilateralidad. En los niños portadores de un implante coclear ¿se conseguiría adquirir la binauralidad tras un segundo implante? ¿Cuándo sería el momento ideal para implantarlos? El objetivo del estudio es analizar el efecto binaural en niños con implantes bilaterales y analizar las diferencias entre los sujetos implantados de manera simultánea y de manera secuencial con un intervalo corto y otro largo. Pacientes y métodos: Se incluyeron 90 pacientes implantados con una edad comprendida entre uno y 2 años (la primera cirugía), entre 2000 y 2008. Veinticinco niños eran usuarios unilaterales y 65 bilaterales, 17 implantados simultáneamente, 29 implantados de forma secuencial, realizándose el segundo implante antes del año (corto período interimplante) y 19 secuenciales en los que el segundo implante se realizó posteriormente al año de la primera cirugía (largo período interimplante). A todos los pacientes se les relizaron pruebas de percepción verbal en silencio, en ruido y una audiometría tonal liminar. Resultados: Prueba de percepción verbal en silencio: implantes simultáneos y secuenciales con corto período entre implante (media: 84,67%) frente a los implantes secuenciales con largo período entre implantes y los unilaterales (media: 79,66%) siendo estadísticamente significativo (p=0,023). Prueba de percepción verbal en ambiente ruidoso: implantes simultáneos y secuenciales con corto período entre implante (media del 77,17%) frente a los implantes secuenciales con largo período entre implantes y los unilaterales (media: 69,32%) siendo estadísticamente significativo (p=0,002). Conclusiones: Los implantados simultáneamente y los secuenciales de corto período adquirieron las ventajas de la binauralidad (AU)
Introduction and objectives: Several studies have indicated the benefit of bilateral cochlear implants in the acquisition of binaural hearing and bilateralism. In children with cochlear implants, is it possible to achieve binaurality after a second implant? When is the ideal time to implant them? The objective of this study was to analyse the binaural effect in children with bilateral implants and the differences between subjects with simultaneous and sequential implants with both short and long intervals. Patients and methods: There were 90 patients between 1 and 2 years of age (the first surgery), implanted between 2000 and 2008. Of these, 25 were unilateral users and 65 bilateral; 17 patients had received simultaneous implants, 29 had sequential implants before 12 months after the first one (short interimplant period) and 19 after 12 months (long period). All of them were tested for silent and noisy verbal perception and a tonal threshold audiometry was performed. Results: The silent perception test showed that the simultaneous and short period sequential implant patients (mean: 84.67%) versus unilateral and long period sequential implants (mean: 79.66%), had a statistically-significant difference (P=0,23). Likewise, the noisy perception test showed a difference with statistical significance (P=0,22) comparing the simultaneous implanted and short period sequential implants (mean, 77.17%) versus unilateral implanted and long period sequential ones (mean: 69.32%). Conclusions: The simultaneous and sequential short period implants acquired the advantages of binaural hearing (AU)
Subject(s)
Humans , Infant , Child, Preschool , Cochlear Implants/trends , Cochlear Implantation/methods , Hearing Loss, Sensorineural/surgeryABSTRACT
Objetivo: El objetivo de este trabajo es realizar un estudio retrospectivo en pacientes con diagnóstico de paraganglioma temporal, analizando los resultados según la conducta terapéutica aplicada para cada caso. Material y métodos: Se incluyó a 21 pacientes con diagnóstico de paraganglioma temporal tratados en nuestro servicio entre enero de 1999 y abril de 2011. A todos se les realizó un examen otorrinolaringológico, sistémico y de imagen. En 20 casos se realizó cirugía para su exéresis yen un caso se realizó tratamiento con cirugía estereotáxica. Resultados: Se realizó embolización preoperatoria en 12 casos. Los abordajes quirúrgicos fueron: extirpación endaural, resección transcanal tras abordaje retroauricular, mastoidectomía radical ampliada con abordaje de receso facial y abordaje infratemporal. El diagnóstico de paraganglioma fue confirmado en todos los casos. Las complicaciones postoperatorias más frecuentes fueron: paresia transitoria del VII par, hipoacusia neurosensorial, desequilibrio, parálisis del VII, parálisis del IX y el XI par y fístula salival. No se observó recidiva de enfermedad con seguimiento entre 1 y 12 años. En un caso tratado con radiocirugía persiste el tumor, estabilizado. Conclusiones: En nuestra serie la cirugía constituye la terapia con la que se logró la resección tumoral total en todos los casos. El uso de embolización preoperatoria reduce el tiempo quirúrgico y el sangrado intraoperatorio. La radiocirugía estereotáxica no permite la desaparición tumoral y persiste la enfermedad (AU)
Objective: Our objective was to perform a retrospective analysis of patients with jugulotympanic paragangliomas. We present the results according to the surgical approach applied in each case. Materials and methods: This retrospective study presents the findings in 21 patients with jugulotympanic paragangliomas who were observed and treated in our department over a 12-year period (1999 to 2011). We performed a general otolaryngology exam, systemic evaluation and radiological exam. Surgical treatment was performed in 20 cases out of 21. In 1 case, treatment with stereotactic radiosurgery was carried out. Results: The surgical approaches were: endaural, retroauricular transcanal, radical or modified mastoidectomy through facial recess and infratemporal fossa approach. Preoperative embolization was used in 12 cases. In all cases the diagnosis of paraganglioma was confirmed. The most frequent postoperative complications found were transitory palsy of the facial nerve, sensorineural hearing loss, imbalance, paralysis of the cranial nerves IX and XI and salivary fistula. No recurrences were found after 12 years of follow-up. One case of persistence was found in the case treated with radiosurgery. Conclusions: In our series surgery was found to be the elective therapy for patients with paraganglioma, with no recurrences after 12 years of follow-up. Preoperative embolization decreases surgery time and intraoperative bleeding. Stereotactic Radiotherapy cannot eliminate the tumour (AU)