RATIONALE: Cochlear implantation is the most effective method of rehabilitation for patients with severe to profound sensorineural hearing loss. Binaural hearing forms the basis of the development of hearing-associated cortical networks in infants and toddlers, but simultaneous bilateral implantation is often postponed due to the demands of classical surgical methods, which are associated with large incisions and a deep bony well. OBJECTIVE: The authors report on the use of a modern, thin implant type and the possibilities it provided to simplify the surgical technique. METHODS AND RESULTS: Recent models of the Cochlear™ Nucleus® implant family were studied in an international retrospective multi-center study: 6 otolaryngologists in 5 centers shared their experiences on 73 consecutively implanted, thin implants. The surgical incision could be made shorter than before and only shallow bony wells or none at all were created in 4 out of 5 centers. No complications occurred. DISCUSSION: This study underlines that implants with thin electronics capsules enable a simplified, fast and safe implantation procedure that allows simultaneous bilateral cochlear implantation.
- MeSH
- Electronics * MeSH
- Internationality * MeSH
- Cochlear Implantation MeSH
- Cochlear Implants * MeSH
- Humans MeSH
- Surveys and Questionnaires MeSH
- Retrospective Studies MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
Jednostranná hluchota často ovlivňuje kvalitu života pacientů po operacích vestibulárního schwannomu. Nejvíce hendikepující je zejména neschopnost rozlišit směr přicházejícího zvuku a ztráta diskriminace zvuků přicházejících z postižené strany, projevující se zejména zhoršením rozumění řeči v hluku. Implantát Baha (Bone-Anchored Hearing Aid) je nejefektivnější způsob rehabilitace sluchu na postižené straně. Jedná se o zařízení, které zachycuje a zpracovává zvuk a ve formě vibrací ho přenáší přímo do kostí lebky pomocí titanového implantátu. Díky pevnému spojení implantátu a kosti (procesem osseointegrace) se energie šíří až do kochley a na tekutiny vnitřního ucha. V případě jednostranné hluchoty je takto zachycen zvuk z hluché strany a přenesen na druhostrannou, slyšící kochleu. V období od září 2010 do prosince 2011 bylo implantováno devět jednostranně hluchých pacientů po operaci vestibulárního schwannomu. Pomocí dotazníkových studií bylo prokázáno zlepšení kvality života, 89 % pacientů používá Baha každý den, v rozmezí 8–12 hodin. Baha je jediné efektivní řešení jednostranné hluchoty.
Single-sided deafness (SSD) impairs quality of life in vestibular schwannoma surgery (VS) patients. The SSD patients suffer from multiple audiological difficulties, inability to identify a direction of a sound and to discriminate sounds coming from the affected side, presenting particularly as an impairment of speech recognition in noisy environments, are the most disabling. The Bone-Anchored Hearing Aid (Baha) represents the most effective option for rehabilitation of hearing in SSD patients. This device transforms sound into vibrations that are directly conducted to the cranial bones using a titanium implant. Thanks to a firm anchoring of the implant to the bone by a process of osseointegration, vibration energy is conveyed into the fluid of the inner ear. In SSD patients, the sound is transferred from the impaired side into the functioning contralateral cochlea. Nine SSD patients after VS surgery had been implanted between September 2010 and December 2011. The quality of life in SSD patients was evaluated with a questionnaire. 89% of our patients use Baha every day for 8 to 12 hours. Baha is the only known effective solution for SSD patients.
- MeSH
- Adult MeSH
- Deafness MeSH
- Prosthesis Implantation history instrumentation MeSH
- Hearing Loss, Unilateral MeSH
- Bone Conduction MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Osseointegration MeSH
- Otologic Surgical Procedures methods MeSH
- Speech Perception MeSH
- Hearing Disorders * therapy MeSH
- Aged MeSH
- Neuroma, Acoustic * MeSH
- Vibration MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
The aim of the present study was to determine whether immediate revision surgery has benefits for patients with iatrogenic bilateral recurrent laryngeal nerve (RLN) palsy. From January 1, 2004 to January 30, 2011, 29 consecutive patients underwent immediate revision after total thyroidectomy. The cohort comprised 29 patients, 2 males and 27 females, aged 23 to 76 years (median 52 years). Identification of the type and extent of injury of each branch was reported in the protocol, and reconstruction was performed whenever possible. A complete transection of the nerve or one of its branches was found in 14 and 5 nerves, respectively. In three patients, the nerve was completely or partially transected on both sides. Seven anatomically intact nerves were injured by loaded ligature, in one case there was a sign of thermal damage and four nerves showed signs of excessive manipulation (thinning of the nerve trunk). Primary end-to-end anastomosis was performed in seven completely transected RLN and four transected anterior branches of RLN. None of the reconstructed nerve trunks or its branches regained function, although good muscle tone was observed. 23 of 38 intact nerves (61%) regained function, and normal vocalcord mobility on both sides was restored in only four patients. In all cases with regained vocal-cord mobility, functional recovery occurred within 3 months after primary surgery. In conclusion, immediate revision after thyroidectomy may help to indicate the type of RLN damage, which is a predictor of functional recovery and one of major factors influencing future therapeutic management.
- MeSH
- Time Factors MeSH
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Parathyroidectomy adverse effects MeSH
- Recurrent Laryngeal Nerve Injuries diagnosis etiology surgery MeSH
- Reoperation MeSH
- Aged MeSH
- Thyroidectomy adverse effects MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
Akutní epiglotitis je potenciálně život ohrožující onemocnění, se kterým se můžeme setkat v ambulancích ORL, na oddělení urgentního příjmu, ambulancích první pomoci nebo praktických lékařů. Při dostatečně rychlé a adekvátní léčbě, která může zahrnovat i zajištění dýchacích cest, můžeme výrazně snížit riziko rozvoje komplikací a úmrtí.
Acute epiglotitis is a potentially life-threatening disease seen occasionally in otolaryngology emergency services, emergency wards, and GP's offices. Adequate and timely treatment that can include ensuring of respiratory airways may decrease risk of complications and death.
