Presbiacusia y trastornos del equilibrio en personas mayores. Revision bibliográfica de aspectos etiopatogénicos, consecuencias sobre la calidad de vida y efectos positivos de su tratamiento / Presbycusis and balance disorders in the elderly. Bibliographical review of ethiopathogenic aspects, consequences on quality of life and positive effects of its treatment

A día de hoy, todavía no disponemos de un conocimiento ni una concienciación adecuados sobre las consecuencias que alcanza en la calidad de vida la pérdida de audición en personas mayores. De la misma manera, tampoco existe información suficiente en cuanto a la relación de la presbiacusia y las alteraciones del equilibrio con otras comorbilidades. Dicho conocimiento puede contribuir a mejorar tanto la prevención como el tratamiento de estas patologías, a reducir su impacto en otras áreas como la cognición o la autonomía, así como para poseer una información más certera sobre el impacto económico que generan en la sociedad y en el sistema sanitario.Por ello, con la realización de este artículo de revisión nos planteamos actualizar la información sobre el tipo de hipoacusia y las alteraciones del equilibrio en personas mayores de 55 años, así como sus factores asociados; analizar el impacto que genera en la calidad de vida de estas personas y el que se puede generar a nivel personal y poblacional (tanto en el ámbito sociológico como económico) si se persigue una intervención temprana en estos pacientes. (AU)

At this time, we still do not have adequate knowledge and awareness of the consequences of hearing loss in the elderly on quality of life. Similarly, there is also insufficient information on the relationship of presbycusis and balance disorders with other comorbidities. Such knowledge can contribute to improve both prevention and treatment of these pathologies, to reduce their impact on other areas such as cognition or autonomy, as well as to have more accurate information on the economic impact they generate in society and in the health system.Therefore, with this review article we aim to update the information on the type of hearing loss and balance disorders in people over 55 years of age, and their associated factors; to analyze the impact on the quality of life of these people and the one which can be generated at a personal and population level (both sociological and economic) if an early intervention in these patients is pursued. (AU)

Presbycusis and balance disorders in the elderly. Bibliographical review of ethiopathogenic aspects, consequences on quality of life and positive effects of its treatment.

At this time, we still do not have adequate knowledge and awareness of the consequences of hearing loss in the elderly on quality of life. Similarly, there is also insufficient information on the relationship of presbycusis and balance disorders with other comorbidities. Such knowledge can contribute to improve both prevention and treatment of these pathologies, to reduce their impact on other areas such as cognition or autonomy, as well as to have more accurate information on the economic impact they generate in society and in the health system. Therefore, with this review article we aim to update the information on the type of hearing loss and balance disorders in people over 55 years of age, and their associated factors; to analyze the impact on the quality of life of these people and the one which can be generated at a personal and population level (both sociological and economic) if an early intervention in these patients is pursued.

Complications after cochlear implantation in adult patients. 10-Year retrospective analysis of a tertiary academic centre.

OBJECTIVE: Cochlear implants (CI) are electronic devices that enable the auditory rehabilitation and the management of individuals with severe to profound bilateral hearing loss, and nowadays, advanced age is not considered a contraindication for cochlear implantation and several studies have shown that older adults do benefit from CI, with improvements in hearing abilities and quality of life. METHODS: Retrospective analysis of patients older than 18 years who underwent cochlear implant surgery in a tertiary academic centre. RESULTS: 57 patients met the inclusion criteria: 25 (43.9%) male and 32 (56.1%) female. Total percentage of minor complication was 24.6% and major complication was 17.5%. The most common minor complication in our series was vestibular disorder, and the most common major complication was device failure. No correlation was found among age, previous meningitis, anatomical variables or comorbidities with the appearance of complications. CONCLUSION: Cochlear implantation is a safe surgical technique for rehabilitation of severe to profound sensorineural hearing loss. According to our results, neither the age over 65 years nor the presence of comorbidities does have a direct impact over the complication rates in our patients.

[Alterations of balance in patients under 16 years of age distributed by age groups]. / Alteraciones del equilibrio en pacientes menores de 16 años distribuidos por grupos de edad.

OBJECTIVE: To evaluate the prevalence and clinical characteristics of children with altered balance, as well as to establish the level of importance of the audiological, balance and imaging studies in the diagnosis of infantile vestibular pathology. PATIENTS AND METHOD: We report a descriptive, retrospective and non-randomized study performed at the Otorhinolaryngology Department of the Complejo Hospitalario Universitario de Santiago de Compostela (Santiago de Compostela University Hospital, Santiago de Compostela, Spain). The study included 125 patients under 16 years of age who consulted due to alterations in their balance over a period of twelve years (1996 to 2007); they are distributed into three groups based on age: 0 to 5, 6 to 10, and 11 to 15 years. RESULTS: Childhood benign paroxysmal vertigo (64 %) is the most frequent syndrome in our series, with 32.5 % of patients associating common migraine. Together with diagnoses of infantile positional vertigo and psychogenic vertigo, was more frequently found in the 11 to 15 year-old age group (P< .05). Age, gender and the results of the imaging studies (computerized tomography of the brain and magnetic resonance of the head) were not related to the presentation of associated migraine nor to the diagnosis (P>.05). CONCLUSIONS: Clinical history and the neuro-otological examination are the key elements of the diagnosis of infantile vestibular pathology; it is also important to standardize and group patients by age. Imaging studies only contribute high diagnostic performance in children presenting neurological symptoms, persistent headache or who have sustained head trauma.

Alteraciones del equilibrio en pacientes menores de 16 años distribuidos por grupos de edad / Alterations of balance in patients under 16 years of age distributed by age groups

Objetivo: Evaluar la prevalencia y las características clínicas de las alteraciones del equilibrio en los niños, así como establecer el grado de importancia de los estudios audiológicos, equilibriométricos y de imagen en el diagnóstico de la afección vestibular infantil. Pacientes y método: Presentamos un estudio descriptivo, retrospectivo y no aleatorizado, realizado en el Servicio de Otorrinolaringología del Complejo Hospitalario Universitario de Santiago de Compostela. Se incluyó a 125 pacientes menores de 16 años que consultaron por alteraciones del equilibrio a lo largo de 12 años (1996-2007); que se distribuyeron en 3 grupos en función de su edad: 0 a 5, 6 a 10,y 11 a 15 años. Resultados: El vértigo paroxístico benigno de la infancia (64 %) es el cuadro más frecuente en nuestra serie, en el32,5 % se asoció migraña común. Éste, junto a los diagnósticos de vértigo posicional infantil y vértigo psicógeno, se encontró con más frecuencia en el grupo etario de 11 a15 años (p < 0,05). La edad, el sexo y los resultados de los estudios de imagen (tomografía computarizada cerebral y resonancia magnética encefálica) no se relacionaron con el hecho de presentar migraña asociada ni con el diagnóstico (p > 0,05).Conclusiones: La historia clínica y la exploración otoneurológica son las piezas clave en el diagnóstico de la afección vestibular infantil; es importante protocolizarlas y sistematizarlas por grupos de edad. Los estudios de imágenes sólo aportan alto rendimiento diagnóstico en niños que presenten clínica neurológica, cefaleas persistentes o el antecedente de traumatismo craneoencefálico (AU)

Objective: To evaluate the prevalence and clinical characteristics of children with altered balance, as well as to establish the level of importance of the audiological, balance and imaging studies in the diagnosis of infantile vestibular pathology. Patients and method: We report a descriptive, retrospective and non-randomized study performed at the Otorhinolaryngology Department of the Complejo Hospitalario Universitario de Santiago de Compostela (Santiago de Compostela University Hospital, Santiago de Compostela, Spain). The study included 125 patients under 16 years of age who consulted due to alterations in their balance over a period of twelve years (1996 to 2007); they are distributed into three groups based on age: 0 to 5, 6 to 10, and 11 to 15 years. Results: Childhood benign paroxysmal vertigo (64 %) is the most frequent syndrome in our series, with 32.5 % of patients associating common migraine. Together with diagnoses of infantile positional vertigo and psychogenic vertigo, was more frequently found in the 11 to 15 year-old age group (P<0.05). Age, gender and the results of the imaging studies (computerized tomography of the brain and magnetic resonance of the head) were not related to the presentation of associated migraine nor to the diagnosis (P>0.05).Conclusions: Clinical history and the neuro-otological examinationare the key elements of the diagnosis of infantile vestibular pathology; it is also important to standardize and group patients by age. Imaging studies only contribute high diagnostic performance in children presenting neurological symptoms, persistent headache or who have sustained head trauma (AU)