Especialización de Otología y Otoneurología

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Retrospective analysis of skin complications related to bone-anchored hearing aid implant: association with surgical technique, quality of life, and audiological benefit

Peñaranda, Daniel | 2018

Introduction The bone-anchored hearing aid is an effective form of auditory rehabilitation. Due to the nature of the implant, the most common complications are skin related. A number of alternative surgical implantation techniques have been used to reduce the frequency and severity of skin complications, including the U-shaped graft and the linear incision. Objective To assess skin complications and their association with surgical technique, quality of life, and audiological benefit in patients with bone-anchored hearing aids. Methods This was a retrospective study conducted in a tertiary referral center in Bogotá, Colombia. Patients who had been fitted with a bone-anchored hearing aid implant (unilaterally or bilaterally) for at least 6 months were included in the study. The Holgers classification was used to classify skin complications (Grade 0=none; Grade 1=erythema; Grade 2=erythema and discharge; Grade 3=granulation tissue; and Grade 4=inflammation/infection resulting in the removal of the abutment). The Glasgow Benefit Inventory questionnaire was used to determine quality of life, and the Abbreviated Profile of Hearing Aid Benefit questionnaire was used to determine the subjective audiological benefit. Results A total of 37 patients were included in the study (30 with unilateral implants and 7 with bilateral implant). Of the 44 implants evaluated, 31 (70.3%) were associated with skin complications (7 [15.9%] Grade 1; 4 [9.1%] Grade 2; 15 [34.1%] Grade 3, 5 [11.4%] Grade 4). The U-shaped graft was statistically associated with major complications (Grades 3 and 4) compared with the linear incision technique (p=0.045). No statistically significant differences were found between Abbreviated Profile of Hearing Aid Benefit scores and severity of complications. Similarly, no differences were found between Glasgow Benefit Inventory physical health questions and skin complications. Conclusion Despite the high frequency, skin complications did not seem to affect quality of life or subjective audiological benefits of patients with bone-anchored hearing aids.

Implante coclear en pacientes con hipoacusia neurosensorial unilateral: resultados auditivos y beneficios comunicativos

García Gómez, Juan Manuel | 2017-02-10

Objetivo: Determinar los resultados auditivos y beneficios comunicativos en pacientes adultos con hipoacusia neurosensorial profunda unilateral tratados con implante coclear. Diseño del estudio: Estudio observacional descriptivo tiposerie de casos. Localización: Fundación Santa Fe de Bogotá Pacientes: Se incluyeron 8 pacientes adultos con hipoacusia neurosensorial unilateral profunda postlingual Intervenciones: Pacientes sometidos a Implante coclear unilateral en la Fundación Santa Fe de Bogotá entre enero de 2011 y marzo 2016. Medición de resultados: Se revisaron las historias clínicas para extraer las características clínicas, los resultados audiológicos prequirúrgicos y postquirúrgicos incluyendo la medición postoperatoria de la audición binaural con implante encendido y apagado en ambiente de ruido y los resultados de los cuestionarios APHAB y SSQ-B Resultados: Mejoría de la discriminación en ambiente de ruido en especial para la presentación de señal de ruido de frente y señal por implante coclear, ruido por oído sano. Las evaluaciones de cuestionarios reportan mejoría en todas las subescalas para SSQ-B, especialmente en espacial y lenguaje; y beneficios en puntajes APHAB en todas las subescalasmenos en la de aversión al sonido donde se presentó empeoramiento. Conclusión: Los pacientes con hipoacusia neurosensorial unilateral manejados con implante coclear presentan resultados prometedores con respecto a las habilidades comunicativas y la discriminación del sonido en ambiente de ruido, es especial, cuando el ruido y señal la son presentados de frente y cuando la señal es presentada por implante coclear y ruido por oído sano.