Ourexperienceswithcochlearimplanta3oninsinglesideddeafness

pa3ents

MagdolnaSzőnyi,MariannaKüstel,NóraKecskemé3,AnitaGáborján,GáborRépássy,LászlóTamás

DepartmentofOtorhinolaryngology,HeadandNeckSurgery,SemmelweisUniversity,Budapest,Hungary

Mainsymptomsofacuteseveresensorineuralhearingloss

Ø severe,constant,therapyresistent0nnitus

Ø poorsoundlocaliza0onabili0esØ difficul0esofspeechpercep0onfromtheaffectedside,especiallyinnoise

Ø addi0onalsymptoms:depression,insomnia,concentra0ondifficul0es,headache

Congress travel is supported by MED-El.

Difficul3esintherapyØ Tinnitus

0nnitusmaskingornoisesuppressiondevicesareineffec0veincaseofprofoundhearinglossØ Soundlocaliza3onandspeechpercep3oninnoise

Croscontralateralrou0ngofsignalandbone-anchoredhearingaidsdonotrestorebinauralhearingand

sound localiza0on doesn'timprovespeechpercep0oninnoise

Cochlearimplanta3oninrehabilita3onofsingesideddeaffness

AdvantagesØ CIisrela0velynewmethod(lessthan10years)Ø reducing0nnitusseverityØ improvingsoundlocaliza0onØ beFerspeechpercep0oninnoiseAspectsofrehabilita3onØ asymmetricalhearinglossØ profoundhearinglosswithnomalhearingonthecontralateralear

Ø congenitalhearinglossorpreviouslyhearingear

Cochlearimplanta3oninrehabilita3onofsinglesideddeaffnessinourpa3ents

Selec3oncriteriaØ  opera0onbetween2015and2017Ø  acutesinglesidedprofoundsensorineural

hearinglossØ  postlingualadults

Cochlearimplanta3oninrehabilita3onofsinglesideddeaffnessinourpa3ents

16cochlearimplantedpa0ents

Ø  Group1:•  8pa0ents•  sensorineuralhearinglossonthe

contralateralear,asymmetricalØ  Group2:

•  8pa0ents•  profoundhearinglosswithnomalhearing

onthecontralateralear,unilateralØ  visualanaloguescale(1-10),preop.,postop.6

months

Group1Hearinglossofthecontralateralear

•  Averageofhearingthreshold•  (PTA500-1000-2000-4000Hz)

1

3

2 2

0

1

2

3

4

0-20 20-40 40-60 60-80Average of hearing threshold dB

Num

ber o

f pat

ient

s

Timebetweenacutehearinglossandcochlearimplanta3on

4

2 2

0

1

2

3

4

5

0-10 10-20 20-30

Years

Num

ber o

f pat

ient

s

Group1.Altera3onof3nnitusvisualanaloguescale(1-10)

No3nnitus No3nnitus3pa3ents 5pa3ents

Tinnitusintensity 5 1pa3ent

Tinnitusintensity

Tinnitusintensity

Tinnitusintensity

7

8

9

1pa3ent

1pa3ent

2pa3ents

Tinnitusintensity 1 2pa3ents

Tinnitusintensity 2 1pa3ent

In all patients tinnitus decreased

preoperative postoperative

Group1Altera3onofver3govisualanaloguescale(1-10)

ver3go

Nover3go5pa3ents 5pa3ents

Ver3goveryoben 6 1pa3ent

dizzinessimbalance 8 1pa3ent

ver3gooncein6month

1pa3ent

dizzinessimbalance

1pa3ent

In patients who had vertigo or dizziness this symptom decreased

6

1

9 1pa3ent ver3go 2 1pa3ent

preoperative

Nover3go

postoperative

recogni3onofsounds

Allpa3entsstatedimprovementsoundlocaliza3on

4pa3ents

2-4weeks

2pa3ents

1pa3ent

5pa3ents

2months

3-6months

speechpercep3on

2months

4months

Nospeechpece3on

2pa3ents

2pa3ents

Questionnaire measurement

Group2Timebetweenacutehearinglossandcochlear

implanta3on

•  normalcontralateralhearing

5

2

0 0

1

0

1

2

3

4

5

6

0-1 1-2 3-5 5-9 10-20

Years

Num

ber o

f pat

ient

s

Altera3onof3nnitusvisualanaloguescale(1-10)

No3nnitus No3nnitus2pa3ents 7pa3ents

Tinnitusintensity 4 2pa3ent

Tinnitusintensity

Tinnitusintensity

Tinnitusintensity

7

8

9

2pa3ent

1pa3ent

1pa3ents

Tinnitusintensity 1 1pa3ents

In all patients tinnitus decreased

preoperative postoperative

Altera3onofver3govisualanaloguescale(1-10)

Nover3go Nover3go5pa3ents 8pa3ents

4 2pa3ent

dizzinessimbalance 10 1pa3ent

In patients who had vertigo or dizziness this symptom decreased

ver3go

preoperative postoperative

recogni3onofsounds

7pa3entsstatedimprovementsoundlocaliza3on,8pa3ents

4pa3ents

2-4weeks

2pa3ents

6pa3ents

par3al

speechpercep3on

2months

5months

Nospeechpece3on

2pa3ents

2pa3ents

1pa3entstatednoimprovement

Questionnaire measurement

Conclusion

Tinnitus,ver3go,dizziness-CIissuccessfulrehabilita0onCommunica3on,qualityoflifeØ Group1(hearinglossofthecontralateralear)

100%statedimprovementØ Group2,(nomalhearingonthecontralateralear)

75%statedimprovement

Ø „WhenItakeofthespeechprocessorIfeelemp0ness,theworld0ltsononeside”

Ø „WhenIwearmyspeechprocessorIcanhearbeFeralsoontheotherear,atleast30%beFer”

Ø „UsingmyimplantandhearingaidtogetherIcanhearsoundsbeFer,IunderstandspeechbeFer,thesecompleteeachother”

Thank you for your attention

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