The document outlines the steps to evaluate a patient's suitability for a cochlear implant, which generally takes two days and involves medical, imaging, audiological, psychological, and cochlear screening assessments. The evaluation identifies any contraindications and helps determine the appropriate implant type and postoperative care. Key steps include a medical exam, CT/MRI scans to check the cochlea, pure tone audiometry and speech tests to evaluate hearing, and a psychological screening to assess cognitive status and expectations. After completing the evaluation, the patient is informed if they qualify for an implant and counseled on potential risks, benefits, and post-implant support.
Most hearing loss can be helped through medication, surgery or amplification. An ear hearing test or hearing evaluation is key to maintaining effective communication, ear and balance health and overall well-being.
Most hearing loss can be helped through medication, surgery or amplification. An ear hearing test or hearing evaluation is key to maintaining effective communication, ear and balance health and overall well-being.
С писмото Президента на България Росен Плевнелиев потвърждава готовността си да е патрон на Световната седмица по предприемачество в България за втора поредна година.
"Мениджмънт за организационно съвършенство" НОВ ПОДХОД ЗА ФОРМИРАНЕ НА ЛИДЕРИ...gjadkov
"НОВ ПОДХОД ЗА ФОРМИРАНЕ НА ЛИДЕРИ И МЕНИДЖЪРИ" - 12 ноември 2008, конференция клуб 9000
Презентацията е свързана с визията за развитие на магистърска програма "Мениджмънт за организационно съвършенство".
www.excellence20.com
Most hearing loss can be helped through medication, surgery or amplification. An ear hearing test or hearing evaluation is key to maintaining effective communication, ear and balance health and overall well-being.
Most hearing loss can be helped through medication, surgery or amplification. An ear hearing test or hearing evaluation is key to maintaining effective communication, ear and balance health and overall well-being.
С писмото Президента на България Росен Плевнелиев потвърждава готовността си да е патрон на Световната седмица по предприемачество в България за втора поредна година.
"Мениджмънт за организационно съвършенство" НОВ ПОДХОД ЗА ФОРМИРАНЕ НА ЛИДЕРИ...gjadkov
"НОВ ПОДХОД ЗА ФОРМИРАНЕ НА ЛИДЕРИ И МЕНИДЖЪРИ" - 12 ноември 2008, конференция клуб 9000
Презентацията е свързана с визията за развитие на магистърска програма "Мениджмънт за организационно съвършенство".
www.excellence20.com
Иновацията през погледа на потребителите (BluePo!nt)BluePointShare
Иновациите през погледа на потребителите.
Изследването е осъществено от агенция за маркетингови проучвания и консултации BluePo!nt (http://www.bluepoint.bg/)
Презентация на Божидар Данев пред участниците в извънредно заседание на групата на работодателите на Европейския икономически и социален комитет (ЕИСК) на тема "Високо конкурентен реален сектор за устойчив икономически растеж и заетост" (Евксиноград, 6-7 юли 2015 г.)
Презентация реализирана от страна на Гергана Раковска, Претседател на Фондация Бизнеса за Образованието на Национален семинар "Обучение на кариерни консултанти", проведен в град София на 10-12 септември 2013г. Семинарът е организиран от страна на Национален Еврогайдънс и
Европас Център съвместно с Фондация Бизнеса за Образованието.
Preface
If not coincidence, at least it was in the same decade when endoscopic sinus surgery and computed tomography were introduced to Otolaryngologists, which have changed the approach to sinonasal problems dramatically. Probably, there are no such coincidences in the history of medicine where two new modalities of approaches appeared at the same time, to deal with the same problem and complement each other while doing so. The asset of improved visualization and magnification, available through endoscopes, has revolutionized the understanding of the pathophysiology of sinusitis, and resulted in better appreciation of the anatomy of the paranasal sinuses. However, non-invasive diagnostic endoscopy has its limits, and the deeper structures cannot be evaluated by endoscopy alone . Computed tomography, which has an ability to optimally display bone, soft tissue and air simultaneously, can not only complement endoscopic examination, it can provide a surgical road map delineating the anatomy, defining the obstructing lesions, and noting anatomic variations that may predispose to operative complications.
Computed tomography has scored over plain radiographs and polytomographs as an imaging modality in this area. Even though surpassing CT's capacity to image soft tissue, MRI is less suitable as an imaging modality for evaluation of this area because of the similar signal intensities for bone and air.
CT scanning has become imaging modality of choice and the cooperation required between the Radiologist and the Surgeon is mandatory for both evaluation and treatment of paranasal disorders. It is of paramount importance on the part of the Otolaryngologists to understand interpretation of CT films, Radiological anatomy of the paranasal sinuses, Anatomical variations and the pathology to complement the endoscopy findings for initial screening, surgical planning, reduce postoperative complications and to provide better results. This Presentations is prepared to help Otolaryngology colleagues to learn the Imaging/radiological aspects required for endoscopic sinus surgery.
From Caesar to Scientist - Rapid Experiments at IntuitBenBlank
20 Minute presentation from the 2013 Chief Innovation Officer Summit in NYC, highlighting why large organizations should consider learning how to run rapid experiments. If you value lean startup principles, this is a key capability your organization must have. Say hello if you want to know more!
Note: This presentation does not include my audio voice-over.
Surgical Technique of Cochlear Implantation: An Updatesemualkaira
Devices that amplify sound are essential for managing hearing impairment. Most hearing impairments can be treated with a modern
hearing aid. Cochlear implants are surgically implanted devices
that electronically stimulate the auditory nerve in the cochlea to
provide hearing. Criteria for cochlear implant selection include
moderate to severe sensorineural hearing loss and a patient who
still struggles to hear and understand despite the hearing aids being
properly adjusted. Advances in cochlear implants and the surgical
technique of cochlear implants have a long history full of innovations that have resulted in better surgical technique approaches,
fewer complications, and improved recovery. This review aims to
make an update on the surgical technique of cochlear implants.
Иновацията през погледа на потребителите (BluePo!nt)BluePointShare
Иновациите през погледа на потребителите.
Изследването е осъществено от агенция за маркетингови проучвания и консултации BluePo!nt (http://www.bluepoint.bg/)
Презентация на Божидар Данев пред участниците в извънредно заседание на групата на работодателите на Европейския икономически и социален комитет (ЕИСК) на тема "Високо конкурентен реален сектор за устойчив икономически растеж и заетост" (Евксиноград, 6-7 юли 2015 г.)
Презентация реализирана от страна на Гергана Раковска, Претседател на Фондация Бизнеса за Образованието на Национален семинар "Обучение на кариерни консултанти", проведен в град София на 10-12 септември 2013г. Семинарът е организиран от страна на Национален Еврогайдънс и
Европас Център съвместно с Фондация Бизнеса за Образованието.
Preface
If not coincidence, at least it was in the same decade when endoscopic sinus surgery and computed tomography were introduced to Otolaryngologists, which have changed the approach to sinonasal problems dramatically. Probably, there are no such coincidences in the history of medicine where two new modalities of approaches appeared at the same time, to deal with the same problem and complement each other while doing so. The asset of improved visualization and magnification, available through endoscopes, has revolutionized the understanding of the pathophysiology of sinusitis, and resulted in better appreciation of the anatomy of the paranasal sinuses. However, non-invasive diagnostic endoscopy has its limits, and the deeper structures cannot be evaluated by endoscopy alone . Computed tomography, which has an ability to optimally display bone, soft tissue and air simultaneously, can not only complement endoscopic examination, it can provide a surgical road map delineating the anatomy, defining the obstructing lesions, and noting anatomic variations that may predispose to operative complications.
Computed tomography has scored over plain radiographs and polytomographs as an imaging modality in this area. Even though surpassing CT's capacity to image soft tissue, MRI is less suitable as an imaging modality for evaluation of this area because of the similar signal intensities for bone and air.
CT scanning has become imaging modality of choice and the cooperation required between the Radiologist and the Surgeon is mandatory for both evaluation and treatment of paranasal disorders. It is of paramount importance on the part of the Otolaryngologists to understand interpretation of CT films, Radiological anatomy of the paranasal sinuses, Anatomical variations and the pathology to complement the endoscopy findings for initial screening, surgical planning, reduce postoperative complications and to provide better results. This Presentations is prepared to help Otolaryngology colleagues to learn the Imaging/radiological aspects required for endoscopic sinus surgery.
From Caesar to Scientist - Rapid Experiments at IntuitBenBlank
20 Minute presentation from the 2013 Chief Innovation Officer Summit in NYC, highlighting why large organizations should consider learning how to run rapid experiments. If you value lean startup principles, this is a key capability your organization must have. Say hello if you want to know more!
Note: This presentation does not include my audio voice-over.
Surgical Technique of Cochlear Implantation: An Updatesemualkaira
Devices that amplify sound are essential for managing hearing impairment. Most hearing impairments can be treated with a modern
hearing aid. Cochlear implants are surgically implanted devices
that electronically stimulate the auditory nerve in the cochlea to
provide hearing. Criteria for cochlear implant selection include
moderate to severe sensorineural hearing loss and a patient who
still struggles to hear and understand despite the hearing aids being
properly adjusted. Advances in cochlear implants and the surgical
technique of cochlear implants have a long history full of innovations that have resulted in better surgical technique approaches,
fewer complications, and improved recovery. This review aims to
make an update on the surgical technique of cochlear implants.
Surgical Technique of Cochlear Implantation: An Updatesemualkaira
Devices that amplify sound are essential for managing hearing impairment. Most hearing impairments can be treated with a modern
hearing aid. Cochlear implants are surgically implanted devices
that electronically stimulate the auditory nerve in the cochlea to
provide hearing. Criteria for cochlear implant selection include
moderate to severe sensorineural hearing loss and a patient who
still struggles to hear and understand despite the hearing aids being
properly adjusted. Advances in cochlear implants and the surgical
technique of cochlear implants have a long history full of innovations that have resulted in better surgical technique approaches,
fewer complications, and improved recovery. This review aims to
make an update on the surgical technique of cochlear implants
Surgical Technique of Cochlear Implantation: An Updatesemualkaira
Devices that amplify sound are essential for managing hearing impairment. Most hearing impairments can be treated with a modern
hearing aid. Cochlear implants are surgically implanted devices
that electronically stimulate the auditory nerve in the cochlea to
provide hearing. Criteria for cochlear implant selection include
moderate to severe sensorineural hearing loss and a patient who
still struggles to hear and understand despite the hearing aids being
properly adjusted. Advances in cochlear implants and the surgical
technique of cochlear implants have a long history full of innovations that have resulted in better surgical technique approaches,
fewer complications, and improved recovery. This review aims to
make an update on the surgical technique of cochlear implants.
Surgical Technique of Cochlear Implantation: An Updatesemualkaira
Devices that amplify sound are essential for managing hearing impairment. Most hearing impairments can be treated with a modern hearing aid. Cochlear implants are surgically implanted devices that electronically stimulate the auditory nerve in the cochlea to provide hearing. Criteria for cochlear implant selection include moderate to severe sensorineural hearing loss and a patient who still struggles to hear and understand despite the hearing aids being properly adjusted. Advances in cochlear implants and the surgical technique of cochlear implants have a long history full of innovations that have resulted in better surgical technique approaches, fewer complications, and improved recovery. This review aims to make an update on the surgical technique of cochlear implants.
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1. {ENT -CDM
How will you evaluate the patient if he is suitable
candidate for cochlear implant?
2. Evaluation generally takes two days as it involves a number of
steps required to achieve a clinical decision. It also helps to identify
any contraindications or potential complications.
The steps include:
1. Medical evaluation
2. CT scan & MRI
3. Audiological Evaluation
4. Psychological Screening
5. Cochlear Screening
3. A focused medical evaluation is crucial to help decide on
various aspects to the treatment including the type of
implant used to the type of postoperative care the
patient receives.
A medical evaluation assesses the following:
Overall health
History and etiology of the hearing loss
Physical condition of the ear and cochlea
Vaccination status
Medical Evaluation
4. High-resolution imaging (Computerized
Tomography, CT or Magnetic Resonance
Imaging, MRI) is used to estimate the
patency of the cochlea and to identify
any abnormal anatomical variations that
may affect insertion of the electrode.
CT Scan / MRI
6. Audiological Evaluation
Pure tone audiogram
Speech discrimination tests
Tympanometry
Auditory Brainstem responses (ABR)
7. Pure tone audiometry-
Performed by an audiometer, which measures the
quality of air conduction and bone conduction.
The threshold of bone conduction is a measure of
cochlear function
Speech discrimination test-
A list of one syllable phonetically balanced words
are delivered to the patient at a volume 30-40 dB
greater than his speech reception threshold (the
lowest sounds he can hear) and the percentage of
words heard correctly is recorded
8. Tympanometry-
Tympanometry involves changing the pressures in a
sealed external auditory canal and then measuring
how much sound is reflected to find the
compliance/stiffness of the tympano-ossicular
system
Auditory Brainstem Response-
To elicit brainstem responses to auditory stimulation
by clicks or tone bursts.
Used to find the integrity of the central auditory
pathways.
9. A psychosocial evaluation is more extensive and
includes developmental and educational
evaluations as well as family assessments.
Cognitive status or mental function
Disabilities other than hearing loss
Parents’ expectations following cochlear implants
Psychological Screening
10. Here the patient should be informed whether they
qualify for an implant based on the results of the entire
evaluation. The following should be explained to the
patient or their guardians in cases of children:
• If a cochlear implant is the best solution.
• Any existing factors that may impact the recipient’s
listening or speaking after the implantation.
• Detailed explanation about cochlear implants
• Potential risks and benefits of cochlear implantation
• Family members of the patient and the school
teachers and principal should also be informed well.
Cochlear Implant
counseling
12. Cochlear Implants – American Speech-
Language-Hearing association
Cochlear Implants – UCSF Medical Center
Dhingra - Ear , nose and throat
Cochlear Implants - SCIELO
References
Editor's Notes
General fitness will help define the patient’s ability to undergo general anesthesia and surgery. This rarely causes a contraindication but can affect the timing and preparation of the implant.
The etiology and history of the patient’s hearing loss cannot accurately predict the patient’s performance with the implant. However, there have been some correlations between certain causes and complications. For example, patients with hearing loss due to meningitis commonly develop cochlear ossifications that can impede the insertion of the electrode.
It is important to establish the anatomy of the patient’s ear as there can be anatomical variations that can affect the insertion of the electrode.
All patients must be fully vaccinated against meningitis
MRI is used to identify any absolute contraindications like cochlear nerve aplasia and/or labyrinthine aplasia; and relative contraindications like cochlear dysplasias particularly labyrinthitis ossificans.
The threshold of bone conduction is a measure of cochlear function.
The patient wears headphones and is asked to raise his hand when he can hear a sound. The sound is decreased in 5 decibel steps until the patient can no longer hear any sound.
An audiometer is a device which produces pure tones. You can alter the intensity of these tones in increments of 5 decibels.
A stiff tympanic membrane would reflect more sound energy than a compliant one
ABR is mainly used in uncompliant patients (infants).
Psychological evaluation is performed when there are concerns regarding cognitive or mental disorders which could affect the patient’s recovery after implantation.
It also helps to rule out disabilities other than hearing loss that can alter the course of treatment or the chances of recovery and might, in some cases, make a cochlear implant pointless.
Another important point is the tempering of unrealistic expectations and anticipating alternative pathways in case the treatment is not satisfactory.
Lastly, establishing a plan of rehabilitation and education before implantation helps make the overall treatment process smoother and less likely to by hindered by poor follow up or gaps in rehabilitative services.
