1,720,975 research outputs found
Reperti neuroradiologici in bambini candidati ad impianto cocleare
No full textI protocolli preoperatori inerenti la diagnostica per immagini non sono completamente condivisi. Le indagini neuroradiologiche risultano utili nell'individuare eventuali controindicazioni( assenza della coclea o del nervo) o condizioni che possono aumentare il rischio operatorio ( malformazioni, fibrosi/ossificazione cocleare). La TC e la RM sono complementari per una completa analisi dell'orecchio medio e interno
Clinical applicability of transient evoked otoacoustic emissions: Identification and classification of hearing loss
No full textThe study aimed at the development of a clinically applicable methodology that could: (1) discriminate transient evoked otoacoustic emission (TEOAE) recordings from normal hearing or hearing impaired individuals; (2) classify the nature of the hearing loss as conductive or as cochlear, and (3) define clear-cut TEOAE clinical criteria. A classification algorithm based on a multivariate discriminant analysis of fast Fourier transform data from recordings evoked by click stimuli of 50 +/- 2, 62 +/- 2, 68 +/- 2 and 80 +/- 2 dB SPL was used to discriminate 302 normal subjects from 383 subjects suffering from mild to moderate hearing losses. The best discriminant model (QDF80) produced a sensitivity of 93.8% and a specificity of 79.4%. When extra correlation criteria were serially applied to the classification outcome, the specificity was increased to 85.3%, but the sensitivity was marginally decreased to 91.7%. The classification of the correctly identified hearing-impaired cases yielded 93.8% identification of conductive and 75.1% identification of cochlear cases. A sensitivity analysis of the misclassified hearing-impaired cases suggested that the TEOAE spectra are well correlated with the 2-kHz but poorly correlated with the 4-kHz octave frequency
Miglioramento dell’intelligibilità verbale in condizioni audiovisive - Studio su soggetti ipoacusici.
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Ear and brain neuroradiological findings in cochlear implant candidate children
No full textWe reviewed ear and brain neuroradiological findings of 80 cochlear-implanted candidated children. Majiority of our patients showed normal findings or unimportant abnormalities. Neuroradiological imaging plays an essential role for the pre-operative planning of cochlear implant, in particular to assess contraindications or conditions which could make difficult the surgical approach
Imaging of labyrinthine fibrosis and ossification
No full textBacterial meningitis is the most common cause of bilateral labyrinthine ossification. Frequently ossification predominates within the scala tympani of the basal turn. Fibrosis may precede ossification and zones of fibrosis and ossification may coexist.
Normally in implant surgery the electrode-array is inserted within the scala tympani through the round window or a cochleostomy. Bilateral cochlear fibrosis and ossification do not represent contraindication to implantation in deaf children, but they are factors that can modify surgical approach.
Both CT and MR are mandatory in preoperative diagnostic protocol of cochlear implant candidate children. CT shows very well labyrinthine ossification; both axial and coronal images should be acquired in order to avoid misdiagnosis of subtle basal turn calcifications. In labyrinthine fibrosis without ossification CT findings are usually normal, but T2- weighted images demonstrate lack of fluid of the inner ear. Enhancement
of fibrosis on post-contrast T1-weighted images means that fibrosis is still proliferative and suggests performing quickly a cochlear implantation
Postoperative complications in cochlear implants: a retrospective analysis of 438 consecutive cases.
No full textOur objective is to determine the complication rate in a population of infants, children, adolescents and adults, from a University Hospital Cochlear Implant program and to discuss their causes and treatments. The methods include a retrospective study of 438 consecutive patients in a tertiary referral centre, the Audiology Department of the University Hospital of Ferrara. All patients receiving cochlear implants, between 1 January 2003 and 31 December 2009, have been included. All complications and treatments were systematically reviewed with an average
duration of follow-up of 46 months (range 10–84 months).
The results reveal that the overall rate of complications in our group was 9.1% (40 of 438), and most of them were minor. Wound swelling and infections represent the most common complication occurred. There were no cases of transient or permanent facial palsy following surgery, and also we did not register any case of postsurgical meningitis.
Thirteen patients (3.0%) underwent explantation followed by reimplantation. In conclusion, we find that Cochlear implantation is a safe low-morbility technique with a relatively low complication rate in the presented population
Elettrococleografia in audiologia infantile
No full textLa determinazione della soglia uditiva in età infantile viene effettuata .mediante la registrazione dei potenziali uditivi evocati da stimoli acustici specifici. In particolare la elettrococleografia rappresenta una metodica di diagnosi obiettiva d'elezione in casi selezionati, generalmente affetti da disordine del generatore centrale a livello troncoencefalico, nei quali l'attendibilità di risultati dell'ABR risulta ridtotta. Nel capitolo sono descritte le caratteristiche di latenza e morfologia delle componenti del potenziale elettrococleografico e le applicazioni cliniche
Hearing threshold estimation by auditory steady state responses (ASSR) in children
No full textHearing threshold identification in very young children is always problematic and challenging. Electrophysiological testing such as auditory brainstem responses (ABR) is still considered the most reliable technique for defining the hearing threshold. However, over recent years there has been increasing evidence to support the role of auditory steady-state response (ASSR). Retrospective study. Forty-two children, age range 3-189 months, were evaluated for a total of 83 ears. All patients were affected by sensorineural hearing loss (thresholds >= 40 dB HL according to a click-ABR assessment). All patients underwent ABRs, ASSR and pure tone audiometry (PTA), with the latter performed according to the child's mental and physical development. Subjects were divided into two groups: A and B. The latter performed all hearing investigations at the same time as they were older than subjects in group A, and it was then possible to achieve electrophysiological and PTA tests in close temporal sequence. There was no significant difference between the threshold levels identified at the frequencies tested (0.25, 0.5, 1, 2 and 4 kHz), by PTA, ABR and ASSR between the two groups (Mann Whitney U test, p < 0.05). Moreover, for group A, there was no significant difference between the ASSR and ABR thresholds when the children were very young and the PTA thresholds subsequently identified at a later stage. Our results show that ASSR can be considered an effective procedure and a reliable test, particularly when predicting hearing threshold in very young children at lower frequencies (including 0.5 kHz)
Acute mastoiditis in children: the "Ferrara" experience
No full textObjective: This study aims to investigate the clinical features and outcomes of acute mastoiditis in children referred to the ENT/Audiology Department of the University of Ferrara from January 1994 to December 2005. It also aims to discuss risk factors and to find predictors for surgery. Methods: A retrospective study on case sheets of children with an acute mastoiditis diagnosis was carried out. Fifty-five cases fulfilled the inclusion criteria: they presented otoscopical evidence of acute otitis media and inflammatory findings of the mastoid area such as post-auricular swelling, redness or tenderness, protrusion of the auricle and/or radiological findings. Results: Twenty-six patients were only treated with antibiotic therapy, tympanocentesis alone was performed in 11 cases; in 5, a ventilation tube was positioned. Mastoidectomy was performed in 13 patients. The group who underwent mastoidectomy had a median hospital stay of 15 days (5-54), in this group were found the following complications: 1 meningitis, 1 meningo-encephalitis, 1 lateral and sigmoid sinus thrombosis, 1 facial palsy. Conclusion: the incidence of otomastoiditis does not seem to be decreasing, on the contrary, in some countries, it seems to be on the increase. Our experience cannot confirm a real increase of the incidence but we noted periodic variations during the time of observation. It is important, that careful attention is paid to the clinical assessment of children who are 2-years old or under, as they seem to be more exposed to the risk of clinical complications; therefore, it is highly recommended that the otologist and the paediatrician collaborate closely. © 2007 Elsevier Ireland Ltd. All rights reserved
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