Evaluating factors associated with paediatric cochlear implant outcome in four cochlear implant satellite centres in Malaysia

INTRODUCTION

Many factors are associated with cochlear implant (CI) outcomes and various methods of assessment for auditory and speech performance outcomes in CI are available globally. The objective of this study is to identify factors relating to CI outcomes in paediatric population that suits local context.

MATERIALS AND METHODS

A total of 18 factors consisted of variables which emphasise on audiological, CI service team, speech therapy, and family-related factors. These factors were then retrospectively analyzed among CI recipients. The outcome measurements of categorical auditory performance II (CAP-II) and speech intelligibility rating (SIR) were used to individually study each factor. Kruskal-Wallis H Test and Fisher Exact Test used with p-value <0.05 were considered significant.

RESULTS

There were significant associations between post- CI CAP-II with type of hearing loss, hearing aid usage per day and mode of communication, attention, attending audiology and speech session, and siblings. For post-CI SIR, hearing aid usage per day, attention, mode of communication, attending audiology and speech session, initiatives, and siblings were statistically significant.

CONCLUSION

The factors affecting the outcome of CI are dynamic. Some of the factors have demonstrated to be associated with the auditory and speech outcome in CI recipients while some factors failed to replicate similar findings. Further prospective research may refine the outcome of individual factors.

Endoscopic ear surgery during COVID-19 pandemic

Similar to other surgical fraternities, endoscopic ear surgery (EES) faced great challenges during the COVID-19 pandemic. Many elective operations involving EES needed to be postponed, resulting in accumulated cases. Throughout one year during COVID-19, Hospital Sultan Ismail, Johor, Malaysia continued to perform various EES procedures. Although EES is an aerosol-generating procedure, it has become evidence that this minimallyinvasive surgical approach offers lesser bony drilling and shorter operative time as compared to open mastoidectomy. Thus, this reduced the risk of viral transmission to the surgeons and operating staffs.

Devastating Insomnia Experience Following General Anaesthesia for Mastoidectomy Surgery

Sleep disorder including insomnia is one of the complications of general anaesthesia. It is not uncommon and it is temporary but majority remains unnoticed and untreated. The effect of insomnia ranges from mild to severe, influencing both physical and mental health. Surgeon and anaesthetist need to identify this complication so that an appropriate treatment can be delivered. In complicated case, psychiatrist involvement is crucial. The treatment is symptomatic and temporary. We reported a case of distressful sleep disorder as a sequelae of general anaesthesia for mastoidectomy surgery. Subsequently after symptomatic treatment, he recovered completely and regained his normal sleep pattern.

A rare case of a sharp foreign body on the vocal cord

A foreign body (FB) in the upper aerodigestive tract is a common clinical problem that presents as as acute emergency. Sharp FB, such as fish bone or chicken bone, commonly lodges in the tonsil, base of tongue, vallecula or pyriform fossa. Dislodgement of a FB into the laryngopharynx is very rare and specifically onto the vocal cord is extremely uncommon. This case report illustrates a rare case of a sharp FB that was dislodged into the airway and stuck on to the right vocal cord, which was removed under local anaesthesia.