Cochlear and Brainstem Implantation in Adult Patients - Results
Černý L.1, Skřivan J.2
Foniatrická klinika 1. LF UK a VFN, Praha, přednosta doc. MUDr. O. Dlouhá, CSc.1 Klinika ORL a chirurgie hlavy a krku 1. LF UK a FN Motol, Praha, přednosta prof. MUDr. J. Betka, DrSc.2 |
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Summary:
More than 100 adult patients were implanted in the Czech republic till now and the number has been growing
rapidly in the last 6 years. The results of retrospective study of all adult patients (N=46, mean age
40.1 y.) implanted in our implant centre in years 2000-2004 and rehabilitated in 2001-2006 are presented.
There were used both cochlear implant (N=43) and brainstem implant system (N=3) by Cochlear Nucleus
type 22 and 24, all of them unilaterally.
The aim of the study was to obtain an overview of results in correlation with pre-operative predictive factors
as duration of severe hearing loss, lip-reading ability and age of patients.
There were evaluated 100% of cases from the 5-year period. A detailed patient history was obtained, preoperative
and post-operative examination by pure tone audiometry, lip-reading ability by a video-test,
tests of speech understanding (open-set and closed-set word identification – CWA Czech Word Audiometry
in a free field) and quality of life assessment (adapted from International Outcome Inventory). The
results were obtained during periodical examinations (at least 1 year after the implantation).
The results were compared in 4 groups: brainstem implant systems (N=3, mean age 32.3 y.), cochlear
implants in long-term-progressive hearing loss (N=18, mean age 37.6 y., onset of severe hearing loss in
childhood, well-developed-speaking patients only), cochlear implants in sudden deafness (N=14, mean age
43.6 y., duration of hearing loss under 5 years – due to meningitis, antibiotics, trauma) and cochlear
implants in patients in older age (N 6, mean age 62.6 y., patients over 59 years only, both long-term-progressive
and sudden deafness together).
Based on our results we can see no risk of a worse post-operative performance in people older than 59
years (N=6, mean age 62.6 y.). There are better results in speech-understanding without lip-reading and
subjective satisfaction than in other groups. Also the results of patients with long-term-progressive hearing
loss (N=18, mean age 37.6 y.) are fully comparable with the mean results of all-cochlear-implanted
group (N=43).
Key words:
cochlear implant, auditory brainstem implant, predictors, post-operative performance.
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