Outcomes of Cochlear Implantation in Post-lingually Deaf Patients.

INTRODUCTION: Cochlear implantation has been mentioned as the most effective therapeutic intervention in deaf patients and especially those with post-lingual deafness. We aimed to assess hearing improvement of post-lingually deaf patients after cochlear implantation. MATERIALS AND METHODS: in this cross-sectional study all the post-lingually deaf patients who had undergone cochlear implantation (CI) surgery between December 2010 and February 2016 were assessed. Patients were recalled and after explaining the study process and signing an informed consent form, an audiometry was done by a single audiologist. In addition, demographic information, cause of hearing loss, age of onset, history of hearing aid use and surgical complications were recorded in a pre-designed checklist. RESULTS: Twenty-nine male and 21 female with a mean age of 22.52±19.45 years underwent analysis. Most of patients (80%) had progressed condition since childhood. Sudden sensorineural hearing loss (SSNHL) was the most prevalent (10%) known etiology of deafness followed by meningitis (6%), Trauma (2%) and ototoxic drugs (2%) in the remaining 20% of the patients. Patients had the highest mean (37.1±12.61 dB) in 4000 Hz frequency and the lowest mean of hearing threshold level (32.6±8.37 dB) was for 1000 Hz frequency. Mean hearing threshold level was significantly lower in patients with lower ages of cochlear implantation (p=0.435). Patients with higher ages of deafness onset showed lower degree of hearing improvement (p=0.462). CONCLUSION: The results of our study suggest that cochlear implantation significantly improves hearing function of post-lingual patients and can be considered as a certain cure for these patients in Iran.

Comparison of intelligence quotients of first- and second-generation deaf children with cochlear implants.

Hearing impairment is a common type of sensory loss in children. Studies indicate that children with hearing impairment are deficient in social, cognitive and communication skills. This study compared the intelligence quotients of first- and second-generation deaf children with cochlear implants. This research is causal-comparative. All 15 deaf children investigated had deaf parents and were selected from Baqiyatallah Cochlear Implant Center. The 15 children with cochlear implants were paired with similar children with hearing parents using purposive sampling. The findings show that the Hotelling trace of multivariate analysis of variance (F = 6.78, p < 0.01, ηP2 = 0.73) was significant. The tests of between-subjects effects for second-generation children was significantly higher than for first-generation children for all intelligence scales except knowledge. It can be assumed that second-generation children joined their family in the use of sign language as the primary experience before a cochlear implant. The use of sign language before cochlear implants is recommended.

Flap outcome using "c" shaped and "new" incisions in pediatric cochlear implantation.

BACKGROUND: Skin flap failure is a significant, though relatively uncommon complication of cochlear implant surgery. To achieve a good surgical result, a proper plan to locate the prospective implant is required. Thus, a new design of flap was evaluated in this regard. METHODS: Two hundred and eleven consecutive children undergoing cochlear implantation in Baqiyatallah Cochlear Implant Center were compared with 75 cases who were operated through the classic "C shaped" fashion from Jul/14/2007 to Feb/14/2009. RESULTS: There was one case of flap necrosis in the classic approach but there were no major flap complications in "new" design, also keloid formation as a minor complication was rare in the "new" method. CONCLUSION: The "new" design is easier to apply with fewer complications, so it can be recommended in children undergoing cochlear implantation.

Platelet count and neonatal sepsis: a high prevalence of Enterobacter spp.

INTRODUCTION: Sepsis is a common complication in the neonatal intensive care unit. It is most common in the smallest and most premature infants in whom the clinical presentation can be subtle and nonspecific. The objectives of the present study were to identify the most common organisms causing sepsis and their associations with thrombocytopenia. METHODS: This is a retrospective case analysis of blood culture positive patients between March 2003 and July 2007 in a single centre. We enrolled 53 eligible neonates whose blood culture yielded positively for any organism. Blood for the culture was obtained from a peripheral vessel. The data was analysed for differences in platelet and neutrophil count in terms of the microorganisms causing sepsis using chi-square and Fisher's exact tests, analysis of variance and Kruskal-Wallis, as appropriate. RESULTS: The most common organism in the blood culture was Enterobacter spp. with 21 cases (39.6 percent) and the least common was coagulase-positive Staphylococcus spp. The most common organisms in infants with normal weight and early onset sepsis were coagulase-positive Staphylococcus spp. (50 percent and 36.7 percent, respectively), while in other neonates with low birth weight, very low birth weight and late onset sepsis, the most common organism was Enterobacter spp. (40.9 percent, 71.4 percent and 47.8 percent, respectively). The patients with Enterobacter spp. sepsis had a higher incidence of thrombocytopenia. The mortality rate was 15.1 percent (8/53 cases), which was significantly higher among those with the Enterobacter spp. sepsis (five cases, p-value is 0.033). CONCLUSION: Our study shows the changes in the pattern of late onset neonatal infections in the neonatal intensive care unit. Enterobacter spp. is the most common organism causing neonatal sepsis accompanying thrombocytopenia.