Digisonic SP® Binaural cochlear implant: the coronal tunneled approach.

UNLABELLED: Cochlear implants represent a significant breakthrough in the treatment of hearing loss. Evidence indicates bilateral hearing brings significant benefits to patients, particularly when binaural hearing is offered. OBJECTIVE: To describe the first case of implantation of a Digisonic SP® Binaural Neurelec device in Brazil (the third implant placed in the Americas, after Mexico and Colombia) and the chosen surgical approach. METHOD: Description of a surgical approach. RESULTS: The procedure was successfully completed. DISCUSSION: The squelch effect, binaural summation, location of the sound source, and the shadow effect of the head are listed among the reasons to explain the superiority of binaural rehabilitation. Cost of treatment must be considered in the development of public health policies. CONCLUSION: The cost of cochlear implants has been one of the main impediments to bilateral rehabilitation. The Digisonic SP® Binaural Neurelec device addresses this issue and exposes patients to less risk through a minimally invasive implantation procedure.

Implante coclear Digisonic SP® Binaural: acesso coronal tunelizado / Digisonic SP® Binaural cochlear implant: the coronal tunneled approach

O implante coclear é um grande avanço no tratamento da surdez. Há grandes evidências que a audição bilateral traz diversas vantagens ao ser humano e muito mais quando se trata de audição binaural. OBJETIVO: Este artigo tem por objetivo descrever o primeiro caso operado no Brasil, sendo o terceiro país das Américas (México e Colômbia) a realizar, com implante binaural Neurelec Digisonic SP® demonstrando a técnica cirúrgica. MÉTODO: Descrição da técnica cirúrgica. RESULTADOS: Ver técnica cirúrgica. Procedimento ocorreu sem intercorrências. DISCUSSÃO: O efeito "squelch", a somação binaural, a localização da fonte sonora e o efeito sombra da cabeça são umas das principais razões que justificam a superioridade da reabilitação binaural. O custo do tratamento deve ser levado em conta em políticas de saúde pública. CONCLUSÃO: Custo do implante coclear é um dos grandes limitadores da bilateralidade na reabilitação desse grupo de pacientes, porém, com essa tecnologia, é possível solucionar esse problema, expondo o paciente a poucos riscos, com o uso de uma técnica cirúrgica pouco invasiva.

Cochlear implants represent a significant breakthrough in the treatment of hearing loss. Evidence indicates bilateral hearing brings significant benefits to patients, particularly when binaural hearing is offered. OBJECTIVE: To describe the first case of implantation of a Digisonic SP® Binaural Neurelec device in Brazil (the third implant placed in the Americas, after Mexico and Colombia) and the chosen surgical approach. METHOD: Description of a surgical approach. RESULTS: The procedure was successfully completed. DISCUSSION: The squelch effect, binaural summation, location of the sound source, and the shadow effect of the head are listed among the reasons to explain the superiority of binaural rehabilitation. Cost of treatment must be considered in the development of public health policies. CONCLUSION: The cost of cochlear implants has been one of the main impediments to bilateral rehabilitation. The Digisonic SP® Binaural Neurelec device addresses this issue and exposes patients to less risk through a minimally invasive implantation procedure.

Osteoma extra-canalicular do osso temporal / Extracanalicular osteoma of temporal bone

Osteoma do osso temporal é um raro tumor ósseo benigno, circunscrito, lento crescimento e origem desconhecida. Apresentamos o relato de um caso de osteoma de mastoide, em paciente do gênero feminino, 33 anos de idade, com história de dez anos de abaulamento em região mastoide direita, dolorosa nos últimos anos, submetida à conduta cirúrgica. A importância do diagnóstico diferencial reside na possibilidade de outras neoplasias mastóideas apresentarem prognóstico pior.

Temporal bone osteoma is a rare benign tumor that grows slowly and remains stable for many years. The reported patient was a 33-year-old woman who presented a ten-year history of a progressively enlarging mass behind her right ear. The diagnosis of mastoid osteoma was made and the patient underwent surgery for correction of cosmetic deformity. Other neoplasms of the mastoid region, such as osteosarcoma and osteoblastic metastasis, should be considered for the differential diagnosis.

Avaliação do ruído em Unidades de Terapia Intensiva / Noise Assessment in Intensive Care Units

As Unidades de Terapia Intensiva são ambientes em que existem inúmeras fontes geradoras de ruído. Recomenda-se, em diferentes ambientes hospitalares, níveis de pressão sonora entre 35 e 45db(A). OBJETIVO: Realizar mensuração dos níveis de pressão sonora de três Unidades de Terapia Intensiva de um hospital em Jundiaí, Estado de São Paulo, Brasil. FORMA DE ESTUDO: Observacional. MATERIAL E MÉTODOS: Foi utilizado decibelímetro Minipa modelo MSL1532C (USA) de acordo com as normas da Associação Brasileira de Normas Técnicas (NBR 10151), para medir os níveis sonoros nas Unidades de Terapia Intensiva em períodos variados, isto é, manhã, tarde e noite em horários de pico de atividade. RESULTADOS: Os valores encontrados durante as aferições dos níveis de pressão sonora foram de 64.1dB(A) na Primeira Unidade de Terapia Intensiva, 58.9 dB(A) na Unidade Coronariana e 64dB(A) na Segunda Unidade de Terapia Intensiva. CONCLUSÃO: Níveis elevados de pressão sonora em Unidades de Terapia Intensiva ainda significam um problema importante na morbidade dos pacientes de tais unidades de atendimento à saúde. Nenhuma das três UTI apresentaram níveis maiores que 85dB, demonstrando que não há risco ocupacional para as equipes de saúde nos ambientes pesquisados.

Intensive Care Units are environments with numerous noise sources. In different hospital environments it is recommended to have a sound pressure level between 35 and 45db(A). AIM: To measure the sound pressure levels in three ICU at a hospital in Jundiaí, State of São Paulo, Brazil. STUDY DESIGN: Observational. MATERIALS AND METHODS: we used a Minipa model MSL1532C (USA) sound meter, according to the Brazilian Technical Standards (NBR 10151), in order to measure sound levels in the ICUs at different moments, that is, the morning, afternoon and night at peak times of activity. RESULTS: The values found during the checking of the sound pressure levels were 64.1dB (A) in the First ICU, 58.9 dB (A) in the Coronary Unit and 64dB (A) in the second ICU. CONCLUSION: High sound pressure levels in ICU still mean an important health-related problem for patients in these units. None of the three ICU pad levels above 85dB, showing that there is no occupational risk for the health care teams in the environments studied.

Noise assessment in intensive care units.

UNLABELLED: Intensive Care Units are environments with numerous noise sources. In different hospital environments it is recommended to have a sound pressure level between 35 and 45db(A). AIM: To measure the sound pressure levels in three ICU at a hospital in Jundiaí, State of São Paulo, Brazil. STUDY DESIGN: Observational. MATERIALS AND METHODS: we used a Minipa model MSL1532C (USA) sound meter, according to the Brazilian Technical Standards (NBR 10151), in order to measure sound levels in the ICUs at different moments, that is, the morning, afternoon and night at peak times of activity. RESULTS: The values found during the checking of the sound pressure levels were 64.1dB (A) in the First ICU, 58.9 dB (A) in the Coronary Unit and 64dB (A) in the second ICU. CONCLUSION: High sound pressure levels in ICU still mean an important health-related problem for patients in these units. None of the three ICU pad levels above 85dB, showing that there is no occupational risk for the health care teams in the environments studied.