RESUMO
Cochlear implantation (CI) is an established technique for enabling speech perception in patients suffering from severe bilateral sensorineural hearing loss (SNHL). Thorough preoperative radiological assessment is essential for correctly evaluating the indication for surgery and safely performing cochlear implantation. CT and conventional and functional MRI are available for radiological assessment. Therefore, knowledge of the most frequent congenital syndromal, non-syndromal, and acquired malformations of inner ear structures is fundamental. This article provides information about imaging techniques prior to CI and relevant malformations of the inner ear. Safety aspects for patients with a cochlear implant undergoing MR imaging are also discussed.
Assuntos
Implantes Cocleares , Orelha Interna/anormalidades , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/cirurgia , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios X , Cóclea/anormalidades , Cóclea/diagnóstico por imagem , Orelha Interna/diagnóstico por imagem , Perda Auditiva Neurossensorial/diagnóstico por imagem , Humanos , Labirintite/diagnóstico por imagem , Neurorradiografia , Otosclerose/diagnóstico por imagem , Cuidados Pré-Operatórios , SegurançaRESUMO
BACKGROUND: Cochlear implantation has become the method of choice for the treatment of deaf patients. A better technology of stimulation opened a wider field of patients suitable for cochlear implantation. Aim of the present study was to evaluate to which extent senior patients benefit by cochlear implantation. PATIENTS AND METHODS: 36 patients between 65 and 85 years were tested by the Freiburger speech test for monosyllabic words and by the HSM sentence test with and without noise. The results were compared to those of younger implanted patients (16 - 64 years, n = 101). RESULTS: The speech perception for monosyllabic words did not differ significantly between both groups. A maximum plateau in speech perception for monosyllabic words was reached after 2 years at 55 %. The HSM sentence test revealed significant differences in the increase of speech perception between senior and younger patients in the first post surgical year. After one year elderly patients reached the same perception score as younger patients with a maximum of approximately 80 % after 3 years. At a signal to noise ratio of 15 % younger patients achieved a maximal perception of 55 % after 1 year whereas senior patients needed 4 years to reach this level. CONCLUSIONS: Senior patients benefited by cochlear implantation to the same extent as younger patients did. Senior patients gained a similar speech perception level as younger implanted patients although the elderly needed more time to reach the same scores. Nevertheless, cochlear implantation should not be denied due to age alone.
Assuntos
Implantes Cocleares , Surdez/reabilitação , Presbiacusia/reabilitação , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Masculino , Testes de Discriminação da Fala , Resultado do TratamentoRESUMO
A Solomon 4-group-design-style field experiment examined the ability of the NAMES Project Foundation's AIDS Memorial Quilt (AIDS Quilt) to motivate information seeking, personal discussion, and behavioral outcomes among those who viewed it. Results indicate that the AIDS Quilt intervention explained significant differences in information-seeking motivations and information-seeking behavior. Information-seeking motivation positively predicted actual information-seeking behavior, which in turn predicted increased discussion and decreased risky behavior. Information-seeking motivation in itself did not predict discussion or behavior. The results suggest that campaigns designed primarily to increase information-seeking motivation can result in desired behavioral outcomes.
Assuntos
Síndrome da Imunodeficiência Adquirida/prevenção & controle , Síndrome da Imunodeficiência Adquirida/psicologia , Comportamentos Relacionados com a Saúde , Educação em Saúde/métodos , Motivação , Análise de Variância , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Serviços de Informação/estatística & dados numéricos , Fatores de Risco , Assunção de Riscos , Autoeficácia , Comportamento Sexual/psicologia , Apoio Social , Inquéritos e QuestionáriosRESUMO
A survey of 273 children in Washington state used a predrinking behavior index as a behavioral outcome to assess media effects on precursors to drinking among children for whom alcohol consumption is not yet occurring. It also examined age trends in relevant beliefs and behaviors. Perceptions of advertising desirability, the extent to which it seemed appealing, increased steadily from third to ninth grade, whereas identification with portrayals, the degree to which individuals wanted to emulate portrayals, leveled off after sixth grade. Expectancies, positive social benefits perceived to be associated with drinking alcohol, also increased with age, particularly between sixth and ninth grade. When demographics and grade level were controlled, desirability predicted identification, and both predicted expectancies, which is consistent with media decision-making theory. Expectancies correlated with alcohol predrinking behavior, and expectancies predicted risky behavior, with demographics and grade level controlled. Predrinking behavior and reported risky behavior were correlated. The results provide cross-sectional support for the view that beliefs and desires developing by third grade prime children for future decisions regarding substance use.
Assuntos
Consumo de Bebidas Alcoólicas , Comunicação Persuasiva , Assunção de Riscos , Adolescente , Publicidade , Criança , Coleta de Dados , Tomada de Decisões , Humanos , WashingtonAssuntos
Audiometria de Resposta Evocada/instrumentação , Implantes Cocleares , Nervo Coclear/fisiopatologia , Surdez/reabilitação , Eletrodos , Seleção de Pacientes , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Surdez/fisiopatologia , Meato Acústico Externo , Estimulação Elétrica , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Processamento de Sinais Assistido por Computador/instrumentaçãoAssuntos
Vias Auditivas/fisiopatologia , Tronco Encefálico/cirurgia , Implante Coclear/métodos , Surdez/cirurgia , Neuroma Acústico/cirurgia , Complicações Pós-Operatórias/cirurgia , Mapeamento Encefálico , Tronco Encefálico/fisiopatologia , Nervo Coclear/fisiopatologia , Núcleo Coclear/fisiopatologia , Núcleo Coclear/cirurgia , Surdez/fisiopatologia , Potenciais Evocados Auditivos do Tronco Encefálico/fisiologia , Humanos , Complicações Pós-Operatórias/fisiopatologia , Desenho de Prótese , Resultado do TratamentoRESUMO
We herein present our preliminary experience with functional MR imaging of the direct electrical stimulation of the cochlear nerve using an MR imaging-compatible electrode placed in the external auditory meatus of five patients with binaural sensorineural hearing loss. The stimulator was placed outside the imager's bore, and the electrode produced virtually no susceptibility artifacts. In three of five patients, it was possible to activate the superior temporal gyrus during functional MR imaging. No side effects were observed.
Assuntos
Córtex Auditivo/fisiopatologia , Nervo Coclear/fisiopatologia , Surdez/diagnóstico , Imageamento por Ressonância Magnética , Implantes Cocleares , Surdez/fisiopatologia , Surdez/reabilitação , Dominância Cerebral/fisiologia , Imagem Ecoplanar , Estimulação Elétrica , Humanos , Processamento de Imagem Assistida por ComputadorRESUMO
This study consisted of a survey given to college students (N = 560) at a rural university in the Pacific Northwest. The sample was randomly assigned into four groups, following the Solomon four-group study design. The two levels of treatment included interventions consisting of a visit to the AIDS Memorial Quilt for the experimental groups and attendance at an unrelated event for the control groups. Pretests were completed 4 weeks prior to interventions; posttests were completed by the entire sample 4 weeks after the interventions. Results confirmed expected differences among the four groups in terms of social distance, perceptions of people with AIDS, self-efficacy, and discussion of risky behavior. The results suggest that the AIDS Memorial Quilt addresses issues centrally related to behavior change and indicates support for the message interpretation process and stages of change models.