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Los aspectos bioéticos implicados en la decisión de realizar una implantación coclear a un niño surgen del hecho de que la utilización de este dispositivo puede cambiar significativamente el modo de estar en el mundo a través de las modificaciones psicológicas, lingüísticas y cognitivas que puede conllevar. El principal aspecto de controversia en este tema es quién tiene el derecho a tomar la decisión de un implante coclear en un menor. Se han estudiado retrospectivamente los niños evaluados en nuestro hospital para considerar la posibilidad de un implante coclear hasta el 31-5-01. Dicha población se desglosa en 37 niños implantados, 10 niños pendientes de cirugía o de completar estudio, y 21 niños excluidos del programa. Se analizan los motivos de exclusión de dichos candidatos y se exponen los problemas bioéticos implicados en dicha selección: Decisión de no implantar en niños pequeños de padres oyentes, problema cultural de las comunidades de sordos, problema del "menor maduro" y adolescentes, problemas socioculturales, patologías asociadas, y responsabilidad del equipo de implantes (AU)

The use of cochlear implants can modify significantly the way in which deaf children relate with the outside world through psychological, linguistic and cognitive changes. The main question about this subject is the ethical controversy with regards to who has the right to make such a decision for a young child. We present the children evaluated at our hospital in order to assess the cochlear implant option. That population was of 37 implanted children, 10 children waiting for surgery and 21 rejected children. We describe and analyze from the bioethical bases and methodology the problems found: decision of no implant in children of hearing parents, the deaf culture point of view, the mature minor doctrine, teenagers, social and cultural problems, multihandicapped children and responsibility of the implants team (AU)

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The use of cochlear implants can modify significantly the way in which deaf children relate with the outside world through psychological, linguistic and cognitive changes. The main question about this subject is the ethical controversy with regards to who has the right to make such a decision for a young child. We present the children evaluated at our hospital in order to assess the cochlear implant option. That population was of 37 implanted children, 10 children waiting for surgery and 21 rejected children. We describe and analyze from the bioethical bases and methodology the problems found: decision of no implant in children of hearing parents, the deaf culture point of view, the mature minor doctrine, teenagers, social and cultural problems, multihandicapped children and responsibility of the implants team.

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A retrospective study of 50 patients with an aural polyp located in the external auditory canal was made. Our main objective was to identify predictive factors for underlying cholesteatoma, as well as to determine our management strategy for aural polyps. We analyzed the most important findings of otological imaging, hearing loss, radiological examination, and medical or surgical treatment. The anatomopathological examination in some cases showed a rare pathology that should be considered in our diagnostic evaluation. The presence of cholesteatoma underlying the polyp in 52% of cases indicates the importance of the polyp location and radiological signs as predictive factors for the diagnosis of cholesteatoma.

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Tympanosclerosis is a pathological finding that is accompanied by two surgical drawbacks: first, poor functional results, and second, increased risk of surgical procedures. We reviewed 138 cases operated in our Service in order to describe the audiological outcome and discuss surgical options for tympanosclerosis.

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INTRODUCTION AND OBJECTIVES: Comparison of reports of the functional results of middle-ear surgery is difficult because there are no standardized criteria, such as; auditory activity, histology, evaluation of functional results, follow-up period, etc. Moreover, surgeons and patients often disagree over the results obtained. The functional results obtained in 246 middle-ear operations performed in our department for postotorrhea sequelae were analyzed. MATERIAL AND METHOD: Using the SMYTH and PATTERSON criteria, benefits were analyzed in 246 patients for whom functional results were available. RESULTS: Benefits were analyzed by type of surgery, type of ossiculoplasty, presence or absence of stapedial superstructure, and subjective patient assessment. DISCUSSION AND CONCLUSIONS: Results were analyzed as surgical evaluation of functional outcome in relation to subjective patient assessment. Guidelines for standardizing criteria for the functional evaluation of middle-ear surgery are proposed.

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The present work presents the review of 276 cases that underwent the following surgeries: 62 myringoplasties, 176 tympano-ossicular reconstructions, 9 functional second look surgery and 29 tympanoplasties with ossiculoplasties. Regarding two different parameters, results were as follows: 1) New eardrum after one-year evolution: 94% were complete, 3.8% were perforated and 2.3% had cholesteatoma pearls. 2) Hearing level after one-year evolution: 33% was the same, 29% gained less than 15 dB, 26.8% gained between 15 and 30 dB, and 11.2% gained over 30 dB.

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