RESUMO
The aim of the present study was to compare the posterior tympanotomy (PT) technique to the endomeatal approach. The endomeatal approach (EMA) for Cochlear Implant (CI) surgery was performed on 98 patients with procident lateral sinus or a small mastoid cavity, on 103 ears (Group A). Conventional mastoidectomy and PT was performed on the other 104 patients, on 107 ears (Group B). Data on all patients were then collected for the following: intra- and post-operative complications, Tinnitus Handicap Inventory (THI), Vertigo Symptom Scale (VSS), duration of surgery, and postoperative discomfort. The difference in the total number of major and minor complications between the case group and the control group was not statistically significant. There was a statistically significant difference in discomfort between the two groups using the Visual Analogue Scale (VAS), both immediately postsurgery (p = 0.02) and after one month (p = 0.04). The mean duration of surgery was 102 ± 29 min for EMA and 118 ± 15 min for the PT technique (p = 0.008). EMA is a faster technique resulting in reduced postoperative patient discomfort in comparison to the PT method. The experience of the surgeon as well as the correct choice of surgical technique are fundamental to successful outcomes for cochlear implant surgery.
Assuntos
Implante Coclear , Implantes Cocleares , Adulto , Implante Coclear/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Zumbido , Resultado do Tratamento , Escala Visual AnalógicaRESUMO
Se revisa el caso de un paciente de ocho meses de edad, con acondroplasia y síntomas sugestivos de compresión cervicomedular. Los síntomas incluían convulsiones tónico-clónicas generalizadas, irritabilidad, episodios frecuentes de apnea, control cefálico nulo, flacidez generalizada, reflejos osteotendinosos abolidos y fontanela abombada. Los estudios radiológicos incluyeron tomografía computarizada (TC) y resonancia magnética (RM) que mostraron la compresión, y signos de mielopatía cervical crónica, esto último fue confirmado con estudio de potenciales evocados somatosensoriales (PESS) preoperatorios del nervio mediano. Al paciente se le hicieron descompresión de la fosa posterior y laminectomía de C-1. La monitorización con PESS intraoperatorios continuos se usó para observar los cambios electrofisiológicos que se pueden presentar con la descompresión medular, y además para ayudar a determinar la extensión de la descompresión requerida.
