Our experiences with cochlear implanta3on in single sided deafness pa3ents

Transcription

1 Our experiences with cochlear implanta3on in single sided deafness pa3ents Magdolna Szőnyi, Marianna Küstel, Nóra Kecskemé3, Anita Gáborján, Gábor Répássy, László Tamás Department of Otorhinolaryngology, Head and Neck Surgery, Semmelweis University, Budapest, Hungary

2 Main symptoms of acute severe sensorineural hearing loss Ø severe, constant, therapy resistent 0nnitus Ø poor sound localiza0on abili0es Ø difficul0es of speech percep0on from the affected side, especially in noise Ø addi0onal symptoms: depression, insomnia, concentra0on difficul0es, headache Congress travel is supported by MED-El.

3 Difficul3es in therapy Ø 0nnitus masking or noise suppression devices are ineffec0ve in case of profound hearingloss Ø Sound localiza3on and speech percep3on in noise Cros contralateral rou0ng of signal and bone-anchored hearing aids do not restore binaural hearing and sound localiza0on doesn't improve speech percep0on in noise

4 Cochlear implanta3on in rehabilita3on of singe sided deaffness Advantages Ø CI is rela0vely new method ( less than 10 years) Ø reducing 0nnitus severity Ø improving sound localiza0on Ø befer speech percep0on in noise Aspects of rehabilita3on Ø asymmetrical hearing loss Ø profound hearing loss with nomal hearing on the contralateral ear Ø congenital hearing loss or previously hearing ear

5 Cochlear implanta3on in rehabilita3on of single sided deaffness in our pa3ents Selec3on criteria Ø opera0on between 2015 and 2017 Ø acute single sided profound sensorineural hearing loss Ø postlingual adults

6 Cochlear implanta3on in rehabilita3on of single sided deaffness in our pa3ents 16 cochlear implanted pa0ents Ø Group 1: 8 pa0ents sensorineural hearing loss on the contralateral ear, asymmetrical Ø Group 2: 8 pa0ents profound hearing loss with nomal hearing on the contralateral ear, unilateral Ø visual analogue scale (1-10), preop., postop.6 months

7 Group 1 Hearing loss of the contralateral ear Average of hearing threshold (PTA Hz) 4 Number of patients Average of hearing threshold db

8 Time between acute hearing loss and cochlear implanta3on 5 Number of patients Years

9 Group 1. Altera3on of 3nnitus visual analogue scale (1-10) preoperative No 3nnitus postoperative 3 pa3ents No 3nnitus 5 pa3ents 5 1 pa3ent 1 2 pa3ents 7 1 pa3ent 2 1 pa3ent pa3ents 1 pa3ent In all patients tinnitus decreased

10 Group 1 Altera3on of ver3go visual analogue scale (1-10) preoperative postoperative No ver3go 5 pa3ents No ver3go 5 pa3ents Ver3go very oben 6 1 pa3ent ver3go once in 6 month 6 1 pa3ent ver3go 9 1 pa3ent ver3go 2 1 pa3ent dizziness imbalance 8 1 pa3ent dizziness imbalance 1 1 pa3ent In patients who had vertigo or dizziness this symptom decreased

11 Questionnaire measurement sound localiza3on All pa3ents stated improvement recogni3on of sounds 2-4 weeks 5 pa3ents 2 months 3-6 months 2 pa3ents 1 pa3ent 2 months 4 pa3ents speech percep3on 4 months 2 pa3ents No speech pece3on 2 pa3ents

12 Group 2 Time between acute hearing loss and cochlear implanta3on normal contralateral hearing Number of patients Years

13 Altera3on of 3nnitus visual analogue scale (1-10) preoperative postoperative No 3nnitus 2 pa3ents No 3nnitus 7 pa3ents 4 2 pa3ent 1 1 pa3ents 7 2 pa3ent pa3ents 1 pa3ent In all patients tinnitus decreased

14 Altera3on of ver3go visual analogue scale (1-10) preoperative postoperative No ver3go 5 pa3ents No ver3go 8 pa3ents ver3go dizziness imbalance 4 2 pa3ent 10 1 pa3ent In patients who had vertigo or dizziness this symptom decreased

15 Questionnaire measurement sound localiza3on, 8 pa3ents 7 pa3ents stated improvement 1 pa3ent stated no improvement recogni3on of sounds 2-4 weeks par3al 6 pa3ents 2 pa3ents 2 months 4 pa3ents speech percep3on 5 months 2 pa3ents No speech pece3on 2 pa3ents

16 Conclusion, ver3go,dizziness - CI is successful rehabilita0on Communica3on, quality of life Ø Group 1 (hearing loss of the contralateral ear) 100% stated improvement Ø Group 2, (nomal hearing on the contralateral ear) 75% stated improvement

17 Our patients told Ø When I take of the speech processor I feel emp0ness, the world 0lts on one side Ø When I wear my speech processor I can hear befer also on the other ear, at least 30% befer Ø Using my implant and hearing aid together I can hear sounds befer, I understand speech befer, these complete each other Thank you for your attention