Comparison of the MIPS technique versus linear incision with tissue preservation in osseointegrated implants in the Ponto model®.

BACKGROUND AND OBJECTIVES: The surgery of osseointegrated implants has undergone different modifications over the years with the aim of achieving better results and facilitating the surgical technique. Today the most commonly used technique is the linear incision with tissue preservation and placement of the abutment and implant. The long-term success of this technique has served as the basis for the development of the so-called minimally invasive surgical approach (MIPS). This study compares the short-, medium- and long-term results between the classic linear incision technique and the MIPS technique. MATERIAL AND METHODS: A prospective study was conducted on patients who had an osseointegrated implant placed between February 2016 and February 2020. A total of 59 surgeries were performed, 32 surgeries according to the linear incision technique with tissue preservation and 27 with MIPS technique. Outcomes were evaluated at one week, one month and one year. RESULTS: Statistically significant differences were achieved between the 2 groups at one week after surgery. Eighty per cent of the MIPS patients had Holgers grades 0-1 compared to 35% of the linear technique patients (p = 0.001). No statistically significant differences were observed at one month (p = 0.457) and one year (p = 0.228). One case with grade 4 was recorded which resulted in implant extrusion one month after surgery with the MIPS technique. A new osseointegrated implant was placed 2 months after the fall using the same MIPS technique with good results. We were also able to verify that the duration of surgery was much shorter with the MIPS technique and better tolerated in terms of postoperative discomfort by the patient. CONCLUSIONS: In our experience, the MIPS technique is the technique of choice for surgery of osseointegrated Ponto model implants as it is simpler, faster and presents fewer problems in the immediate postoperative period, with similar long-term postoperative results.

Enlarged vestibular aqueduct as a cause of postneonatal deafness.

INTRODUCTION: The enlarged vestibular aqueduct (EVA) is the most frequent malformation of the inner ear associated with sensorineural hearing loss (5-15%). It exists when the diameter in imaging tests is greater than 1.5 mm at its midpoint. The association between hearing loss and EVA has been described in a syndromic and non-syndromic manner. It can appear as a familial or isolated form and the audiological profile is highly variable. The gene responsible for sensorineural hearing loss associated with EVA is located in the same region described for Pendred syndrome, where the SCL26A4 gene is located. OBJECTIVE: To describe a series of children diagnosed with EVA in order to study their clinical and audiological characteristics, as well as the associated genetic and vestibular alterations. METHOD: Retrospective study of data collection of children diagnosed with EVA, from April 2014 to February 2023. RESULTS: Of the 17 cases, 12 were male and 5 were female. 5 of them were unilateral and 12 bilateral. In 5 cases, a cranial traumatism triggered the hearing loss. Genetic alterations were detected in 3 cases: 2 mutations in the SCL26A4 gene and 1 mutation in the MCT1 gene. 13 patients (76.5%) were rehabilitated with hearing aids and 9 of them required cochlear implantation. DISCUSSION: The clinical importance of AVD lies in the fact that it is a frequent finding in the context of postneonatal hearing loss. It is convenient to have a high suspicion to diagnose it with imaging tests, to monitor its evolution, and to rehabilitate early.

Sordera infantil con discapacidad asociada (DA+): recomendaciones CODEPEH / Deaf children with additional disabilities (AD+): CODEPEH recommendations

Aproximadamente el 40% de los niños con sordera tienen añadido un trastorno del desarrollo o un problema médico importante, que puede retrasar la edad de diagnóstico de la hipoacusia y/o precisar de la intervención de otros profesionales. Esta situación se designa como «hipoacusia o sordera con discapacidad añadida» (DA+). El motivo por el que la población de niños con problemas auditivos es más propensa a asociar discapacidades añadidas radica en que los factores de riesgo para la hipoacusia se superponen con los de muchas otras discapacidades. Estos factores pueden influir en diversos aspectos del desarrollo, incluida la adquisición del lenguaje. Es importante comprobar que se recibe la adecuada atención, la efectividad de audífonos o implantes, así como de las estrategias de intervención logopédica, y la adherencia de la familia a sesiones y citas. Los desafíos que plantea la DA+ son su detección precoz, para permitir una temprana y adecuada intervención, y la necesidad de una colaboración transdisciplinar fluida entre todos los profesionales que han de intervenir, junto con la implicación de la familia. (AU)

Approximately 40% of children with deafness have an additional developmental disorder or major medical problem, which may delay the age of diagnosis of hearing loss and/or require intervention by other professionals. This situation is referred to as “deafness with added disability” (AD+). The reason why the population of hearing-impaired children is more likely to have associated added disabilities is that the risk factors for hearing impairment overlap with those for many other disabilities. These factors can influence various aspects of development, including language acquisition. It is important to check that appropriate care is received, the effectiveness of hearing aids or implants, as well speech therapy intervention strategies, and family adherence to sessions and appointments. The challenge posed by AD+ is early detection, to allow early and appropriate intervention, and the need for fluid transdisciplinary collaboration between all professionals involved, together with the involvement of the family. (AU)

Cribado auditivo neonatal universal e hipoacusia diferida o de desarrollo tardío / Universal neonatal hearing screening and delayed hearing loss or late-developmental hearing loss

Objetivo Determinar el porcentaje de niños que presentan una hipoacusia bilateral permanente posnatal para estudiar su incidencia, los factores de riesgo relacionados, su diagnóstico y su tratamiento.MétodosEstudio retrospectivo de recogida de datos de niños diagnosticados de hipoacusia fuera del periodo neonatal en la Unidad de Hipoacusia del Hospital Universitario Central de Asturias, desde abril de 2014 hasta abril de 2021.ResultadosUn total de 52 casos cumplieron los criterios de inclusión. La tasa de detección de hipoacusias congénitas del programa de cribado neonatal en el mismo periodo de estudio fue de 1,5 niños por cada 1000 recién nacidos al año; sumando las hipoacusias posnatales da como resultado una tasa de hipoacusia bilateral infantil de 2,7 niños por 1000 (55,5% y 44,4%, respectivamente). Presentan factores de riesgo de hipoacusia 35, siendo 23 de riesgo retrococlear. La edad media de la derivación fue de 91,9 meses (18-185). La adaptación audioprotésica se indicó en 44 casos (84,6%). En 8 casos (15,4%) se indicó la implantación coclear.DiscusiónAunque la hipoacusia congénita representa la mayoría de las sorderas en la infancia, la hipoacusia posnatal tiene una incidencia importante. Esta puede responder principalmente a: 1) que el deterioro auditivo puede surgir en los primeros años de vida, 2) que la hipoacusia leve, así como las pérdidas auditivas en frecuencias graves son indetectables por el cribado neonatal en algunos casos, 3) que algunos niños pueden presentar falsos negativos en los resultados.ConclusiónLa hipoacusia posnatal requiere la identificación de factores de riesgo y el seguimiento a largo plazo de los niños que la sufren, ya que es preciso que sea detectada y tratada precozmente. (AU)

Objective To determine the percentage of children with permanent bilateral postnatal hearing loss in order to study its incidence, related risk factors, diagnosis and treatment.MethodsRetrospective study to collect data on children diagnosed with hearing loss outside the neonatal period in the Hearing Loss Unit of the Hospital Universitario Central de Asturias, from April 2014 to April 2021.Results52 cases met the inclusion criteria. The detection rate of congenital hearing loss in the neonatal screening programme in the same study period was 1.5 children per thousand newborns per year, adding postnatal hearing loss results in a rate of infant bilateral hearing loss of 2.7 children per thousand (55.5% and 44.4% respectively). Thirty-five children presented risk factors for hearing loss, of which 23 were at retrocochlear risk. The mean age at referral was 91.9 (18-185) months. Hearing aid fitting was indicated in 44 cases (84.6%). Cochlear implantation was indicated in eight cases (15.4%).DiscussionAlthough congenital hearing loss accounts for the majority of childhood deafness, postnatal hearing loss has a significant incidence. This may be mainly due to: 1) that hearing impairment may arise in the first years of life, 2) that mild hearing loss as well as hearing loss in severe frequencies are undetectable by neonatal screening in some cases, 3) that some children may have false negative results.ConclusionPostnatal hearing loss requires identification of risk factors and long-term follow-up of children with hearing loss, as it needs to be detected and treated early. (AU)

Deaf children with additional disabilities (AD+): CODEPEH recommendations.

Approximately 40% of children with deafness have an additional developmental disorder or major medical problem, which may delay the age of diagnosis of hearing loss and/or require intervention by other professionals. This situation is referred to as "deafness with added disability" (AD+). The reason why the population of hearing-impaired children is more likely to have associated added disabilities is that the risk factors for hearing impairment overlap with those for many other disabilities. These factors can influence various aspects of development, including language acquisition. It is important to check that appropriate care is received, the effectiveness of hearing aids or implants, as well speech therapy intervention strategies, and family adherence to sessions and appointments. The challenge posed by AD+ is early detection, to allow early and appropriate intervention, and the need for fluid transdisciplinary collaboration between all professionals involved, together with the involvement of the family.

Universal neonatal hearing screening and delayed hearing loss or late-developmental hearing loss.

OBJECTIVE: To determine the percentage of children with permanent bilateral postnatal hearing loss in order to study its incidence, related risk factors, diagnosis and treatment. METHODS: Retrospective study to collect data on children diagnosed with hearing loss outside the neonatal period in the Hearing Loss Unit of the Hospital Universitario Central de Asturias, from April 2014 to April 2021. RESULTS: 52 cases met the inclusion criteria. The detection rate of congenital hearing loss in the neonatal screening programme in the same study period was 1.5 children per thousand newborns per year, adding postnatal hearing loss results in a rate of infant bilateral hearing loss of 2.7 children per thousand (55.5% and 44.4% respectively). Thirty-five children presented risk factors for hearing loss, of which 23 were at retrocochlear risk. The mean age at referral was 91.9 (18-185) months. Hearing aid fitting was indicated in 44 cases (84.6%). Cochlear implantation was indicated in eight cases (15.4%). DISCUSSION: Although congenital hearing loss accounts for the majority of childhood deafness, postnatal hearing loss has a significant incidence. This may be mainly due to: (1) that hearing impairment may arise in the first years of life, (2) that mild hearing loss as well as hearing loss in severe frequencies are undetectable by neonatal screening in some cases, (3) that some children may have false negative results. CONCLUSION: postnatal hearing loss requires identification of risk factors and long-term follow-up of children with hearing loss, as it needs to be detected and treated early.

Ototoxicity in childhood: Recommendations of the CODEPEH (Commission for the Early Detection of Childhood Hearing Loss) for prevention and early diagnosis.

Ototoxicity is defined as the damage, reversible or irreversible, produced in the inner ear by various substances that are called ototoxic and that can cause hearing loss and/or an alteration of the vestibular system. Permanent hearing loss significantly affects quality of life and is especially important in children. The lack or delay in its detection is frequent, since it often progresses in an inconspicuous manner until it affects communication and overall development. This impact can be minimized by following a strategy of audiological monitoring of ototoxicity, which allows for its early detection and treatment. This document recommends that children who are going to be treated with cisplatin or aminoglycosides be monitored. This CODEPEH review and recommendation document focuses on the early detection, prophylaxis, otoprotection, monitoring and treatment of ototoxicity caused by aminoglycosides and platinum-based antineoplastics in the paediatric population.

Ototoxicidad en la edad pediátrica: recomendaciones de la CODEPEH (Comisión para la Detección Precoz de la Hipoacusia infantil) para su prevención y diagnóstico precoz / Ototoxicity in childhood: Recommendations of the CODEPEH (Commission for the Early Detection of childhood Hearing Loss) for prevention and early diagnosis

La ototoxicidad se define como el daño, reversible o irreversible, producido sobre el oído interno por diversas sustancias que se denominan ototóxicos y que causan una hipoacusia y/o una alteración del sistema vestibular.La hipoacusia permanente afecta significativamente a la calidad de vida y es especialmente importante en el caso de niños. Es frecuente la falta o el retraso en su detección, dado que muchas veces progresa de forma poco llamativa hasta que afecta a la comunicación y al desarrollo global. Este impacto puede minimizarse siguiendo una estrategia de monitorización audiológica de la ototoxicidad, que permita su detección y tratamiento precoz. Se recomienda implantar dicha monitorización en los niños que van a ser tratados con cisplatino o aminoglucósidos.Este documento de revisión y recomendaciones de la CODEPEH se enfoca a la detección precoz, la profilaxis, la otoprotección, el seguimiento y el tratamiento de la ototoxicidad por aminoglucósidos y antineoplásicos derivados del platino en la población pediátrica. (AU)

Ototoxicity is defined as the damage, reversible or irreversible, produced in the inner ear by various substances that are called ototoxic and that can cause hearing loss and/or an alteration of the vestibular system.Permanent hearing loss significantly affects quality of life and is especially important in children. The lack or delay in its detection is frequent, since it often progresses in an inconspicuous manner until it affects communication and overall development. This impact can be minimized by following a strategy of audiological monitoring of ototoxicity, which allows for its early detection and treatment. This document recommends that children who are going to be treated with cisplatin or aminoglycosides be monitored.This CODEPEH review and recommendation document focuses on the early detection, prophylaxis, otoprotection, monitoring and treatment of ototoxicity caused by aminoglycosides and platinum-based antineoplastics in the paediatric population. (AU)

Ototoxicidad en pacientes oncológicos: experiencia y propuesta de un protocolo de vigilancia / Ototoxicity in cancer survivors: experience and proposal of a surveillance protocol

Introducción: La ototoxicidad se presenta en diversos porcentajes según estudios tras el tratamiento con quimioterapia basada en platino y/o radioterapia craneal. El objetivo es mostrar nuestra experiencia en la monitorización de la ototoxicidad. Material y métodos: Se realizó una revisión del 1999 al 2019 en el registro de pacientes oncológicos pediátricos de nuestro hospital y remitidos a la Unidad de Hipoacusia Infantil. Resultados: 46 pacientes fueron remitidos a nuestra unidad. 41 pacientes recibieron platinos como parte de su tratamiento, 17 pacientes fueron sometidos a una intervención neuroquirúrgica y 18 pacientes recibieron radioterapia craneal. A todos se les realizó una anamnesis y otoscopia, y la monitorización se llevó a cabo con una audiometría tono-verbal y/o productos de distorsión. Se objetivó una hipoacusia como secuela del tratamiento en ocho pacientes (21,05% de los pacientes remitidos para seguimiento audiológico). Fue imposible determinar la situación audiológica al finalizar el tratamiento en ocho pacientes. La adaptación audioprotésica fue necesaria en dos pacientes. En la coordinación con Oncología Pediátrica, se consideró oportuno el cambio de cisplatino por carboplatino por ototoxicidad importante durante el tratamiento en un único paciente. Conclusión: Es imprescindible una adecuada coordinación con Oncología Pediátrica para realizar una vigilancia activa de la ototoxicidad y modificar, si es posible, la dosificación o el tipo de quimioterápico en caso de verse afectada la audición. En nuestra experiencia, y siguiendo las recomendaciones actuales, realizamos una valoración pretratamiento, una monitorización durante el tratamiento, al finalizarlo y después de forma anual por el riesgo de desarrollo diferido de una hipoacusia. (AU)

Introduction: Ototoxicity occurs in different percentages in patients after treatment with platinum-based chemotherapy or cranial radiation therapy. The aim of this study was to present experience in ototoxicity monitoring. Material and methods: A review was made of the registry of paediatric cancer patients referred to the Children's Hearing Loss Unit from 1999 to 2019. Results: Of the 46 patients referred to this unit, 41 had received platinum as part of their treatment, 17 patients underwent neurosurgery, and 18 patients received cranial radiation therapy. An anamnesis and otoscopy were performed on all of them, and the monitoring was carried out with tone-verbal audiometry and/or distortion products. Hearing loss was observed in eight patients (21.05% of patients referred for audiological follow-up) as a consequence of the treatment. It was impossible to determine the audiological situation in eight patients at the end of treatment. Hearing aid adaption was necessary in two patients. In coordination with Paediatric Oncology, a change from cisplatin to carboplatin due to bilateral grade two ototoxicity was considered appropriate during treatment in one patient. Conclusion: Adequate coordination with Paediatric Oncology is essential to carry out active surveillance for ototoxicity and to modify, if possible, the dosage or type of chemotherapy in case hearing is affected. In our experience, and following current recommendations, a pre-treatment assessment is usually performed, as well as monitoring during treatment, at the end of treatment, and annually thereafter due to the risk of a later development of hearing loss. (AU)

Ototoxicity in cancer survivors: Experience and proposal of a surveillance protocol.

INTRODUCTION: Ototoxicity occurs in different percentages in patients after treatment with platinum-based chemotherapy or cranial radiation therapy. The aim of this study was to present our experience in ototoxicity monitoring. MATERIAL AND METHODS: A review was made of the registry of paediatric cancer patients referred to the Children's Hearing Loss Unit from 1999 to 2019. RESULTS: Of the 46 patients referred to this unit, 41 had received platinum as part of their treatment, 17 patients underwent neurosurgery, and 18 patients received cranial radiation therapy. An anamnesis and otoscopy were performed on all of them, and the monitoring was carried out with tone-verbal audiometry and/or distortion products. Hearing loss was observed in eight patients (21.05% of patients referred for audiological follow-up) as a consequence of the treatment. It was impossible to determine the audiological situation in eight patients at the end of treatment. Hearing aid adaption was necessary in two patients. In coordination with Paediatric Oncology, a change from cisplatin to carboplatin due to bilateral grade two ototoxicity was considered appropriate during treatment in one patient. CONCLUSION: Adequate coordination with Paediatric Oncology is essential to carry out active surveillance for ototoxicity and to modify, if possible, the dosage or type of chemotherapy in case hearing is affected. In our experience, and following current recommendations, a pre-treatment assessment is usually performed, as well as monitoring during treatment, at the end of treatment, and annually thereafter due to the risk of a later development of hearing loss.

New-born Hearing Screening Programmes in 2020: CODEPEH Recommendations.

Programmes for early detection of congenital hearing loss have been successfully implemented mainly in developed countries, after overcoming some conceptual errors argued against their implementation and some criticism of their efficacy. However, some difficulties and weaknesses are still identified in these programmes: the detection of late-onset hearing loss and the percentage of children who did not pass the screening and did not complete the process of diagnosis and treatment, these being cases that are lost in the process. The purpose of this Document is to analyse these problems to determine areas for improvement and to emphasize one of the basic principles for the success of the programmes: continuous training for the interdisciplinary team. The result of the review process carried out by CODEPEH has been drafted as Recommendations for updating the Programmes with the evidence of the last decade, including advances in screening technology, the impact of the present knowledge on congenital infection by cytomegalovirus, genetic hearing loss research and control systems of lost to follow-up cases, treatment and follow up.

Programas de cribado de la hipoacusia congénita en 2020: recomendaciones CODEPEH / New-born hearing screening programmes in 2020: CODEPEH recommendations

Los programas de detección precoz de la hipoacusia congénita se han extendido de forma exitosa, especialmente en países desarrollados, superando los errores conceptuales argumentados contra su implantación o las críticas a su eficacia. No obstante, aún se identifican algunas dificultades y debilidades: la detección de la hipoacusia de desarrollo tardío y el porcentaje de niños que no pasaron el cribado y no completan el diagnóstico ni el tratamiento, siendo casos que se pierden en el proceso son algunas de ellas.El objetivo del presente documento es analizar estos problemas para determinar puntos de mejora e incidir en un principio básico del éxito de los programas: la formación continuada del equipo interdisciplinario.El resultado del trabajo de revisión llevado a cabo por la CODEPEH se plasma en la formulación de unas recomendaciones orientadas a actualizar los programas con las evidencias aparecidas en la última década, incorporando los progresos de la tecnología, los conocimientos actuales sobre la infección congénita por citomegalovirus y los estudios genéticos de la hipoacusia en los programas, así como los sistemas de control de la pérdida de casos en el proceso, el tratamiento y el seguimiento. (AU)

Programs for early detection of congenital hearing loss have been successfully implemented mainly in developed countries, after overcoming some conceptual errors argued against their implementation and some criticism of their efficacy. However, some difficulties and weaknesses are still identified in these programs: the detection of late-onset hearing loss and the percentage of children who did not pass the screening and did not complete the process of diagnosis and treatment, these being cases that are lost in the process.The purpose of this Document is to analyse these problems to determine areas for improvement and to emphasize one of the basic principles for the success of the programs: continuous training for the interdisciplinary team.The result of the review process carried out by CODEPEH has been drafted as Recommendations for updating the Programs with the evidence of the last decade, including advances in screening technology, the impact of the present knowledge on congenital infection by cytomegalovirus, genetic hearing loss research and control systems of lost to follow-up cases, treatment and follow up. (AU)

Desarrollo y validación de la versión abreviada del Transsexual Voice Questionnaire for Male-to-Female Transsexuals en español / Development and validation of the Spanish abbreviated version of the Transsexual Voice Questionnaire for Male-to-Female Transsexuals

OBJETIVO: El objetivo de este estudio es crear y validar un cuestionario abreviado de la versión española del Transsexual Voice Questionnaire for Male-to-Female Transsexuals (VeTVQMtF). METODOLOGÍA: El estudio fue dirigido por 2 hospitales de referencia para la feminización quirúrgica de la voz y por un departamento universitario de psicología y rehabilitación vocal, todos ellos en España. MATERIAL Y MÉTODOS: Se realizó un estudio prospectivo de 51 mujeres transexuales a las que se les intervino de feminización quirúrgica de la voz entre enero 2017 y diciembre 2018. La VeTVQMtF fue rellenada por las mujeres transexuales antes y después de la cirugía y los 10 ítems de este cuestionario que más variaron fueron seleccionados por un grupo de expertos en feminización de la voz, para desarrollar la versión abreviada de la VeTVQMtF (VeTVQMtF-10). Se estudió la correlación entre la puntuación total y la puntuación de cada ítem en la VeTVQMtF y en la VeTVQMtF-10. Se analizó la consistencia interna de la VeTVQMtF-10. RESULTADOS: Se encontró una buena correlación entre los 2 cuestionarios (coeficiente de Pearson > 0,90), una buena correlación entre la puntuación total y la puntuación de cada ítem de la VeTVQMtF-10 y una correlación negativa entre la de la VeTVQMtF y la frecuencia fundamental de la voz tras la cirugía. El alfa Cronbach fue de 0,79. CONCLUSIÓN: La VeTVQMtF-10 es una versión abreviada válida de la VeTVQMtF y podría usarse para valorar la calidad de vida relacionada con la voz en mujeres transexuales en el idioma español

OBJECTIVE: The aim of this study was to create and validate an abbreviated version of the Spanish Transsexual Voice Questionnaire for Male-to-Female Transsexuals (SvTVQMtF). SETTING: The study was conducted by two referral hospitals for voice feminization surgery and by a university department of psychology and speech therapy, all in Spain. Subjects and methods: We prospectively studied 51 male-to-female transsexuals who underwent voice feminization surgery between January 2017 and December 2018. The SvTVQMtF was completed before and after surgery, and the 10 items with the greatest variation were selected by clinical consensus of an expert panel to develop the short version of the SvTVQMtF (SvTVQMtF-10). The correlation between the total score and the score for each item on the SvTVQMtF and the SvTVQMtF-10 was studied. The internal consistency of the SvTVQMtF-10 was analysed. RESULTS: Good correlation (Pearson coefficient above .90) was found between the two questionnaires. A significant correlation was found between the total SvTVQMtF-10 score and the score for each item. A significant negative correlation was found between the SvTVQMtF and fundamental frequency after voice feminization surgery. Cronbach's Alpha was .79. CONCLUSION: The SvTVQMtF-10 is a valid short version of the SvTVQMtF and can be used to quantify voice-related quality of life in MtF transsexuals

Development and validation of the Spanish abbreviated version of the Transsexual Voice Questionnaire for Male-to-Female Transsexuals. / Desarrollo y validación de la versión abreviada del Transsexual Voice Questionnaire for Male-to-Female Transsexuals en español.

OBJECTIVE: The aim of this study was to create and validate an abbreviated version of the Spanish Transsexual Voice Questionnaire for Male-to-Female Transsexuals (SvTVQMtF). SETTING: The study was conducted by two referral hospitals for voice feminization surgery and by a university department of psychology and speech therapy, all in Spain. SUBJECTS AND METHODS: We prospectively studied 51 male-to-female transsexuals who underwent voice feminization surgery between January 2017 and December 2018. The SvTVQMtF was completed before and after surgery, and the 10 items with the greatest variation were selected by clinical consensus of an expert panel to develop the short version of the SvTVQMtF (SvTVQMtF-10). The correlation between the total score and the score for each item on the SvTVQMtF and the SvTVQMtF-10 was studied. The internal consistency of the SvTVQMtF-10 was analysed. RESULTS: Good correlation (Pearson coefficient above .90) was found between the two questionnaires. A significant correlation was found between the total SvTVQMtF-10 score and the score for each item. A significant negative correlation was found between the SvTVQMtF and fundamental frequency after voice feminization surgery. Cronbach's α was .79. CONCLUSION: The SvTVQMtF-10 is a valid short version of the SvTVQMtF and can be used to quantify voice-related quality of life in MtF transsexuals.

Aplicación de la tecnología de enrutamiento inalámbrico contralateral de la señal (CROS) en usuarios de implante coclear unilateral / Application of Wireless Contralateral Routing of Signal (CROS) Technology in Unilateral Cochlear Implant Users

INTRODUCCIÓN: La implantación unilateral en la hipoacusia profunda bilateral deja al paciente en una situación de audición monoaural, con los consiguientes problemas audiológicos, en especial por la incapacidad de percepción de la palabra en ambientes con ruido de fondo, por el efecto sombra de la cabeza. Se puede mejorar su rendimiento auditivo aprovechando los sistemas inalámbricos de enrutamiento de la señal (CROS), para dotarlos de una entrada de sonido bilateral. MÉTODO: Se estudiaron 12 usuarios unilaterales de implante coclear adultos, con experiencia con un procesador de sonido Naída CI Q70 que tiene capacidad de comunicación inalámbrica con el CROS. La comprensión del habla en cabina en silencio y en ruido se llevó a cabo utilizando como estímulos el test de oraciones grabadas en español en 3 condiciones: habla dirigida hacia el oído no implantado con y sin CROS activado y habla de frente con UltraZoom. Tras un mes de uso del dispositivo CROS, se evaluó la satisfacción del usuario utilizando cuestionarios. RESULTADOS: En silencio, la diferencia media entre el implante unilateral solo y el implante unilateral con el dispositivo CROS fue del 27,6%, mientras que en presencia de ruido fue del 32,5%. Si se comparan las puntuaciones entre presentar activada o no la opción UltraZoom al utilizar CROS, se demuestra un beneficio de un 35% de inteligibilidad. Todos los sujetos puntuaron su experiencia de uso como satisfactoria. CONCLUSIÓN: El dispositivo CROS utilizado con implante coclear unilateral produce un beneficio objetivo y subjetivo en el reconocimiento de la palabra cuando la señal se dirige hacia el mismo. En este estudio no se reprodujo la condición de presentación de la señal verbal en el oído implantado con ruido en el adaptado con el CROS por haberse demostrado previamente que la discriminación verbal se deteriora de forma importante con respecto al implante unilateral sin CROS

INTRODUCTION: Single cochlear implantation usually provides substantial speech intelligibility benefits but bilaterally deaf, unilaterally implanted subjects will continue to experience limitations due to the head shadow effect, like single-sided deaf individuals. In the treatment of individuals with single-sided deafness one option is contralateral routing of signal (CROS) devices, which constitute a non-surgical intervention of the second ear in unilaterally implanted individuals. METHOD: Twelve experienced adult cochlear implant users with Naída Q70 processor and the CROS device used in combination participated in the study. For the study 3 conditions were provided: cochlear implant only, omnidirectional microphone mode (CROS deactivated); cochlear implant plus CROS activated, omnidirectional microphone mode and cochlear implant plus CROS activated, UltraZoom mode. Speech reception thresholds were determined in quiet and noise. Subjective feedback regarding the practical usability of the CROS device and the perceived benefit were collected. RESULTS: There was a 27.6% improvement in speech understanding in quiet and 32.5% improvement in noise when CROS device was activated. Using advanced directional microphones, a statistically significant benefit of 35% was obtained. The responses to the questionnaires revealed that the subjects perceived benefit in their everyday lives when using the CROS device with their cochlear implants. CONCLUSION: The investigated CROS device used by unilateral CI recipients in cases where bilateral implantation is not an option provides both subjective and objective speech recognition benefit when the signal is directed to the CROS device. Unfavourable conditions where speech is presented from the cochlear implant side and noise from the CROS side or diffusely were not included in this evaluation since the CROS device adds additional noise and performance is expected to decrease as has previously been shown

[Ototoxicity in cancer survivors: experience and proposal of a surveillance protocol]. / Ototoxicidad en pacientes oncológicos: experiencia y propuesta de un protocolo de vigilancia.

INTRODUCTION: Ototoxicity occurs in different percentages in patients after treatment with platinum-based chemotherapy or cranial radiation therapy. The aim of this study was to present experience in ototoxicity monitoring. MATERIAL AND METHODS: A review was made of the registry of paediatric cancer patients referred to the Children's Hearing Loss Unit from 1999 to 2019. RESULTS: Of the 46 patients referred to this unit, 41 had received platinum as part of their treatment, 17 patients underwent neurosurgery, and 18 patients received cranial radiation therapy. An anamnesis and otoscopy were performed on all of them, and the monitoring was carried out with tone-verbal audiometry and/or distortion products. Hearing loss was observed in eight patients (21.05% of patients referred for audiological follow-up) as a consequence of the treatment. It was impossible to determine the audiological situation in eight patients at the end of treatment. Hearing aid adaption was necessary in two patients. In coordination with Paediatric Oncology, a change from cisplatin to carboplatin due to bilateral grade two ototoxicity was considered appropriate during treatment in one patient. CONCLUSION: Adequate coordination with Paediatric Oncology is essential to carry out active surveillance for ototoxicity and to modify, if possible, the dosage or type of chemotherapy in case hearing is affected. In our experience, and following current recommendations, a pre-treatment assessment is usually performed, as well as monitoring during treatment, at the end of treatment, and annually thereafter due to the risk of a later development of hearing loss.

Aftosis oral y laringitis, ¿otra forma de presentación de la enfermedad relacionada con IgG4? / Aphthous stomatitis and laryngitis, another form of presentation of an IgG4-related disease?

La enfermedad relacionada con IgG4 (ER-IgG4) se caracteriza por un infiltrado linfoplasmocítico rico en células plasmáticas IgG4 positivas, fibrosis estoriforme y flebitis obliterativa. Se puede presentar como seudotumor orbitario, parotidomegalia, nefritis túbulo intersticial, fibrosis retroperitoneal o pancreatitis, aunque prácticamente cualquier órgano puede verse afectado. Presentamos el caso de una mujer de 37 años, que presenta un cuadro de disfonía severa y aftosis oral dolorosa recurrente, con unos hallazgos histopatológicos a nivel laríngeo que muestran infiltrado linfoplasmocítico y positividad para IgG4, así como amplios estudios descartando otras etiologías, por lo que se confirma una laringitis por ER-IgG4, cuya descripción en la literatura es excepcional

IgG4-related disease is characterized by a lymphoplasmacytic infiltrate rich in IgG4-positive plasma cells, storiform fibrosis and obliterative phlebitis. It can present as parotid gland enlargement, tubulointerstitial nephritis, retroperitoneal fibrosis or pancreatitis, although nearly any organ can be affected. We report the case of a 37-year-old woman who presented with severe dysphonia and recurrent painful aphthous ulcers, with histopathological findings at the level of the larynx that revealed a lymphoplasmacytic infiltrate and IgG4 positivity. In addition, extensive studies were performed to rule out other diseases. Thus the diagnosis was IgG4-related laryngitis, an exceptional finding in the literature

Application of Wireless Contralateral Routing of Signal (CROS) Technology in Unilateral Cochlear Implant Users. / Aplicación de la tecnología de enrutamiento inalámbrico contralateral de la señal (CROS) en usuarios de implante coclear unilateral.

INTRODUCTION: Single cochlear implantation usually provides substantial speech intelligibility benefits but bilaterally deaf, unilaterally implanted subjects will continue to experience limitations due to the head shadow effect, like single-sided deaf individuals. In the treatment of individuals with single-sided deafness one option is contralateral routing of signal (CROS) devices, which constitute a non-surgical intervention of the second ear in unilaterally implanted individuals. METHOD: Twelve experienced adult cochlear implant users with Naída Q70 processor and the CROS device used in combination participated in the study. For the study 3 conditions were provided: cochlear implant only, omnidirectional microphone mode (CROS deactivated); cochlear implant plus CROS activated, omnidirectional microphone mode and cochlear implant plus CROS activated, UltraZoom mode. Speech reception thresholds were determined in quiet and noise. Subjective feedback regarding the practical usability of the CROS device and the perceived benefit were collected. RESULTS: There was a 27.6% improvement in speech understanding in quiet and 32.5% improvement in noise when CROS device was activated. Using advanced directional microphones, a statistically significant benefit of 35% was obtained. The responses to the questionnaires revealed that the subjects perceived benefit in their everyday lives when using the CROS device with their cochlear implants. CONCLUSION: The investigated CROS device used by unilateral CI recipients in cases where bilateral implantation is not an option provides both subjective and objective speech recognition benefit when the signal is directed to the CROS device. Unfavourable conditions where speech is presented from the cochlear implant side and noise from the CROS side or diffusely were not included in this evaluation since the CROS device adds additional noise and performance is expected to decrease as has previously been shown.

Diagnóstico y tratamiento precoz de la hipoacusia unilateral o asimétrica en la infancia: recomendaciones CODEPEH / Early diagnosis and treatment of unilateral or asymmetrical hearing loss in children: CODEPEH recommendations

El objetivo del presente documento es contribuir a la mejora del manejo de la hipoacusia unilateral y de la hipoacusia asimétrica en la infancia. Las sorderas unilaterales afectan a uno por mil de los recién nacidos, aumentando su prevalencia con la edad, debido a los casos de aparición diferida o adquirida. Aunque se ha minimizado el impacto de estas sorderas sobre el desarrollo y los aprendizajes del niño, si no son tratadas provocan secuelas sobre el desarrollo del habla y del lenguaje, así como en el desarrollo global, afectando a la calidad de vida del niño y de su familia. El resultado del trabajo de revisión llevado a cabo se plasma en la formulación de unas recomendaciones orientadas a la mejora clínica diagnóstica y terapéutica de la hipoacusia unilateral y de la hipoacusia asimétrica

The aim of this document is to improve the management and the treatment of unilateral or asymmetrical hearing loss in children. One in one thousand newborn infants has unilateral hearing loss and this prevalence increases with age, due to cases of acquired and delayed-onset hearing loss. Although the impact on the development and learning processes of children of these kinds of hearing loss have usually been minimized, if they are not treated they will impact on language and speech development, as well as overall development, affecting the quality of life of the child and his/her family. The outcomes of the review are expressed as recommendations aimed at clinical diagnosis and therapeutic improvement for unilateral or asymmetrical hearing los

Early diagnosis and treatment of unilateral or asymmetrical hearing loss in children: CODEPEH recommendations. / Diagnóstico y tratamiento precoz de la hipoacusia unilateral o asimétrica en la infancia: recomendaciones CODEPEH.

The aim of this document is to improve the management and the treatment of unilateral or asymmetrical hearing loss in children. One in one thousand newborn infants has unilateral hearing loss and this prevalence increases with age, due to cases of acquired and delayed-onset hearing loss. Although the impact on the development and learning processes of children of these kinds of hearing loss have usually been minimized, if they are not treated they will impact on language and speech development, as well as overall development, affecting the quality of life of the child and his/her family. The outcomes of the review are expressed as recommendations aimed at clinical diagnosis and therapeutic improvement for unilateral or asymmetrical hearing loss.