Cochlear Implants: Evaluation of Effects of Various Parameters on Outcomes in Pediatric Patients at a Tertiary Care Centre for Unilateral Ear Implantation

Round Window Visibility in Cochlear Implantation : Pre-operative Prediction Using Various Radiological Parameters

Purpose

The round window approach has become the most preferred route for electrode insertion in cochlear implant surgery; however, it is not possible at times due to difficult round window membrane (RWM) visibility. Our study aims to investigate the relationship between preoperative radiological parameters and the surgical visibility of the RWM in Cochlear implant patients.

Methodology

A prospective cross-sectional study of 31 patients, age < 6 years, with bilateral severe to profound sensorineural hearing loss was conducted at a tertiary care hospital. The preoperative HRCT temporal bone scan was studied, and the parameters evaluated were facial nerve location, facial recess width, and RWM visibility prediction. All patients were operated on via the posterior tympanotomy. The surgical RWM visibility was done after optimal drilling of the posterior tympanotomy recess. The relationship between the radiological parameters and surgical visibility of RWM was evaluated.

Results

The difference in the facial nerve location as per the type of RWM was found to be significant (p value < 0.05). However, the facial recess width was not significantly associated with RWM visibility. The radiological prediction of RWM visibility by tracing the prediction line over RWM was significantly associated with intraoperative RWM visibility.

Conclusion

The goal to look for preoperative scans is to predict the ease or difficulty of RWM visibility during surgery. The difficult visualization of the RWM, can result in dire intraoperative consequences. A comprehensive understanding of preoperative radiological parameters, coupled with meticulous surgical planning, is crucial to address these challenges effectively by focusing on enhancing RWM visualization.

Non-Users and Limited Users of Cochlear Implants in Pediatric Patients: A Retrospective Cross-Sectional Study

To determine the prevalence of non-use and limited use of cochlear implants. To find out the reasons for the same. This study was carried out among the paediatric patients who underwent cochlear implantation under the SHP* scheme in Civil Hospital, Ahmedabad between 2013 and 2020.

STUDY DESIGN

Retrospective cross-sectional study.

STUDY SETTING

Civil Hospital Ahmedabad.

SAMPLE SIZE

150 paediatric patients. Patients were selected based on a random number generator. The data was collected through a telephonic interview based upon a preformed questionnaire. The study indicates that out of a total 150 participants, 109 (72.7%) used their cochlear implant regularly while 41 (27.3%) did not. Major issue faced by the participants was in the external device -damage to the device and monetary issues for its repair. The participants who have dropped the usage of their implants faced issues mostly after 2 years of usage. The age group of less than 3 years showed 15.6% of non-usage, while the age group of 3-6 years showed an increase to 34.5% of non-users. The age group of more than 6 years showed an even higher proportion (41.3%) of non-users. It is recommended that the government ensures the follow-up of the patients undergoing cochlear implantation for at least 2 years after the surgery. The proportion of non-users in the consecutive increasing age groups saw a rise in number. Therefore, it is recommended to divert the resources towards lower age groups to facilitate a better outcome.

Comparative analysis of story-grammar development: a cross-sectional study of Tamil-speaking child cochlear implant users and hearing peers in Tamil Nadu, India

OBJECTIVE

This cross-sectional comparative study aimed to analyse and compare the story-grammar components in Tamil-speaking children with and without hearing impairment (HI) narratives.

DESIGN

The study used a cross-sectional, comparative design to assess and compare narrative structures.

SETTING

Data were collected at the Sri Ramachandra Institute of Higher Education and Research in Chennai, India.

PARTICIPANTS

30 children participated in the study, including 15 children with severe to profound hearing loss who used cochlear implants and 15 with normal hearing. The participants were language-age-matched children aged 3-5 years, proficient in Tamil.

INTERVENTIONS

No specific interventions were implemented in this study.

MAIN OUTCOME MEASURES

The primary outcome measures focused on story-grammar components, including settings, characters, initiating events, internal plans, attempts, outcomes, and resolution. These components were evaluated through narrative retellings by the children.

RESULTS

Analysis of the narratives revealed significant differences between the two groups. Children with normal hearing demonstrated a higher representation of story-grammar elements than children with HI.

CONCLUSIONS

The findings suggest that children with normal hearing exhibit a more proficient understanding and utilisation of story structure in their story-telling than children with HI. This study highlights the importance of narrative analysis in language assessment, particularly for children with HI. Tailored interventions incorporating appropriate language stimulation techniques are needed to enhance children's narrative skills with HI. Further research in this area is warranted.