Koklear implant uygulanan hastaların cerrahi ve işitsel yönden retrospektif analizi
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Tarih
2015
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info:eu-repo/semantics/closedAccess
Özet
Bu çalışmada koklear implant cerrahisi uygulanan hastaların klinik özellikleri ve postoperatif dönemde karşılaşılan komplikasyonları değerlendirmeyi amaçladık. Ayrıca postoperatif dönemde işitsel performans skorlarını preoperatif dönemde eğitim alan ve almayan gruplar arasında ve operasyon yaşı 60 ayın altında ve üstünde olan gruplar arasında karşılaştırdık.
Hastaların klinik ve demografik özellikleri (cinsiyet, yaş, eşlik eden hastalıklar, opere edilen kulak yönü), intraoperatif ve postoperatif dönemde karşılaşılan komplikasyonları retrospektif olarak inceledik. Ayrıca hastaların operasyon yaşının, preoperatif dönemde eğitim alıp almamalarının ve uygulanan koklear implant modelinin hastaların işitsel performanslarına etkileri araştırıldı.
Dicle Üniversitesi Tıp Fakültesi KBB Anabilim Dalı’nda Kasım’10-Ocak’14 tarihleri arasında koklear implant uygulanan 80 hasta çalışmaya dahil edildi. Uygulanan cerrahi yöntem ve cihazlar incelendi. Bu hastalarından postoperatif dönemde düzenli konuşma eğitimi alan 45 hasta postoperatif işitsel performansları yönünden değerlendirildi. Bu hastalar preoperatif dönemde konuşma eğitimi alan ve almayanlar olmak üzere iki gruba ayrıldı. Postoperatif işitsel performansları ‘Dinlemenin Gelişim Profili Testi’ (LiP) skoru ve ‘Tek-İki- Üç Heceli Kelimeleri Tanıma Testi’ (MTP) skoru bakımından karşılaştırıldı. Hastalar ayrıca operasyon yaşına göre 60 aydan küçük (Grup 1) ve büyük (Grup 2) olmak üzere iki gruba kategorize edilerek yukarıda sözü edilen işitsel performans testleri bakımından karşılaştırıldı.
Sonuç olarak preoperatif dönemde eğitim alanlar almayanlara göre postoperatif 1., 3., 6., 12., 18., 24. aylarda daha yüksek LiP test skorlarına sahiptiler (hepsi için p<0,05). MTP test skorları bakımından preoperatif dönemde eğitim alanlar almayanlara kıyasla bütün postoperafif takip aylarında (1., 3., 6., 12., 18., 24. ay)daha yüksek işitsel performans sergilemekteydiler (hepsi için p<0,05). Çalışmamızda koklear implant uyguladığımız hastaların hiç birinde postoperatif majör ve minör komplikasyon görülmezken, 80 hastanın 4’ünde (%5) intraoperatif komplikasyon olarak perilenf sızıntısı gelişti. Bir hastada ise implant elektrodları kokleaya kısmen yerleştirilebildi.
Ayrıca çalışmamızda implant modelinin ve operasyon yaşının koklear implantasyon sonrası hastaların işitsel performansına istatistiksel olarak anlamlı bir etkileri olmadığı görüldü.
Anahtar sözcükler: Koklear implant, komplikasyon, işitsel performans, LiP testi, MTP testi
We aimed to evaluate the clinical characteristics and postoperative complications in patients who underwent cochlear implantation. Additionally, we compared the postoperative auditory performance scores of patient with or without preoperative speech education. Also, auditory performance scores of the patients with an operative age less than 60 months were compared to older ones. The clinical and demographical characteristics of the patients (including age, gender, concomitant disorders, operated ear side) and intra- and post-operative complications were evaluated. Also, potential effects of patient age, preoperatively received speech education and cochlear implant type on postoperative auditory performance were assessed. A total of 80 patients who underwent cochlear implantation at Dicle University Hospital between Nov’10 - Jan’14 were enrolled to the study. Implanted devices and techniques were recorded. Forty-five patients who underwent speech education postoperatively were divided into two according to the status of preoperative speech education receivers and others. The postoperative auditory performance scores which was evaluated by using ‘Listening Progress Profile’ (LiP) and ‘Monosyllable–Trochee-Polysyllable’ (MTP) tests were compared between these groups. The study population was further divided into two groups as the patients with an operative age of less than 60 months and older; and two groups were compared in terms of the mentioned auditory performance test scores. The patients who received preoperative speech education had higher auditory performance scores (for both LiP and MTP) at 1st, 3rd, 6th, 12th, 18th and 24th months of follow-up compared to the ones who did not (p<0.05 for all). None of the patients experienced intraoperative complication. However, perilymphatic leakage was developed in 4 of 80 patients (5%). Device electrodes were partially implanted in a patient. In addition, there was no significant difference in auditory performance scores regarding to device type and the age of operation. Key words: cochlear implant, complication, auditory performance, LiP test, MTP test.
We aimed to evaluate the clinical characteristics and postoperative complications in patients who underwent cochlear implantation. Additionally, we compared the postoperative auditory performance scores of patient with or without preoperative speech education. Also, auditory performance scores of the patients with an operative age less than 60 months were compared to older ones. The clinical and demographical characteristics of the patients (including age, gender, concomitant disorders, operated ear side) and intra- and post-operative complications were evaluated. Also, potential effects of patient age, preoperatively received speech education and cochlear implant type on postoperative auditory performance were assessed. A total of 80 patients who underwent cochlear implantation at Dicle University Hospital between Nov’10 - Jan’14 were enrolled to the study. Implanted devices and techniques were recorded. Forty-five patients who underwent speech education postoperatively were divided into two according to the status of preoperative speech education receivers and others. The postoperative auditory performance scores which was evaluated by using ‘Listening Progress Profile’ (LiP) and ‘Monosyllable–Trochee-Polysyllable’ (MTP) tests were compared between these groups. The study population was further divided into two groups as the patients with an operative age of less than 60 months and older; and two groups were compared in terms of the mentioned auditory performance test scores. The patients who received preoperative speech education had higher auditory performance scores (for both LiP and MTP) at 1st, 3rd, 6th, 12th, 18th and 24th months of follow-up compared to the ones who did not (p<0.05 for all). None of the patients experienced intraoperative complication. However, perilymphatic leakage was developed in 4 of 80 patients (5%). Device electrodes were partially implanted in a patient. In addition, there was no significant difference in auditory performance scores regarding to device type and the age of operation. Key words: cochlear implant, complication, auditory performance, LiP test, MTP test.
Açıklama
Anahtar Kelimeler
Koklear implant, Cochlear implant, Komplikasyon, Complication, İşitsel performans, Auditory performance, LiP testi, LIP test, MTP testi, MTP test
