RESUMO

Desórdenes en el espectro de la neuropatía auditiva (DENA) es el término más aceptado en la actualidad para definir la antes llamada neuropatía auditiva o desincronía auditiva. Su prevalencia es difícil de estimar debido a sus múltiples etiologías (hiperbilirrubinemia, enfermedades infecciosas, neuropatías sensoriomotoras, hereditarias y/o isquémico-hipóxicas). Clínicamente se manifiesta con alteraciones auditivas y comunicativas variables, desde una discapacidad leve o sin ella, hasta la sordera funcional profunda, que puede ser fluctuante o permanente. En los métodos diagnósticos no se evidencian los potenciales auditivos del tallo cerebral o se notan marcadamente anormales, y hay presencia de emisiones otoacústicas o de microfónicos cocleares. Para el tratamiento inicial de los desórdenes en el espectro de la neuropatía auditiva se sugiere hacer amplificación con audífonos en los casos leves, reservando el implante coclear para los estados más severos. El objetivo del artículo es hacer una revisión de la literatura acerca de los desórdenes en el espectro de la neuropatía auditiva.

Auditory Neuropathy Spectrum Disorders (ANSD) is the most currently accepted term to define the previously called auditory neuropathy or auditory dyssynchrony. Its prevalence is difficult to estimate due to multiple etiologies (hyperbilirubinemia, infectious diseases and sensory-motor, hereditary and/or ischemic-hypoxic neuropathies). Some individuals with AN have little or no communication difficulties while others are functionally deaf. Within the diagnostic criteria abnormal auditory nerve response in ABR are observed absent or markedly abnormal while otoacoustic emissions (OAEs) or the cochlear microphonic (CM) remain present and normal. Within the management of DENA is suggested that some children with ANSD appear to benefit from amplification and auditory based intervention while others require CI or other implants for the most severe cases. The objective of this article is to review the literature on disorders of the auditory neuropathy spectrum.

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RESUMO

Este estudio corresponde a un análisis descriptivo de los pacientes del Hospital Universitario Clínica San Rafael llevados a cirugía de implante coclear entre enero/2000 a diciembre/2010 y describe la ocurrencia de complicaciones menores y mayores en la cirugía de implante coclear con un mínimo de seguimiento de 12 meses. Las complicaciones de la cirugía de implante coclear se dividen en dos categorías; complicaciones menores y mayores. Las complicaciones menores son aquellas que pueden, o no, producir una disminución en el funcionamiento del implante, pero que se resuelven de manera espontánea o con tratamiento conservador, sin necesidad de realizar una nueva intervención quirúrgica, e incluyen: dolor local, tinnitus, vértigo, alteraciones del gusto, infección, fístula de líquido cefalorraquídeo y parálisis facial. Las complicaciones mayores son aquellas que requieren reintervención quirúrgica o explante. Se logró recopilar la información de 172 pacientes, 88 (51,16%) de sexo masculino y 84 (48,83%) de sexo femenino, con unas edades entre los 3 y los 71 años promedio de 22,1 años. El porcentaje global de complicaciones fue del 22,67% incluyendo las complicaciones menores y mayores, que corresponde a 39 implantes. El porcentaje de fallos es de 3,4%, que representa un total de 6 implantes. El porcentaje de reimplantes es de 5,2% del total, que corresponden a 09 implantes, siendo la causa más común falla técnica del dispositivo (06), seguido por falla por impacto (03). En cuanto a las complicaciones, se presentaron 12 complicaciones mayores que corresponden al 6,97%. El porcentaje de complicaciones menores en nuestro estudio fue de 15,6% (27)...

The following study corresponds to a descriptive analysis in patients from the Hospital Universitario Clínica San Rafael, which received cochlear implant surgery between january/2000 and december/2010. It describes the incidence of minor and major complications in the cochlear implant surgery, with a minimum follow up of 12 months. The complications of the cochlear implant surgery are divided in to two main categories: minor and major ones. The minor complications are those that can, or cannot, produce a decrease in the performance of the implant; but resolves spontaneously or with medical treatment, without making any surgery. Its clue symptoms involve: local pain, tinnitus, vertigo, taste alterations, infections, CSF fistula and facial paralysis. The major complications require a second surgery intervention or explants. The clinical histories of 172 patients were obtained, in which 88 (51,16%) were men and 84 (48,83%) were women, all with ages that comes from 3 to 71 years giving an average of 22.1 years old. The percentage of global complications was of 22,67% included the minor and major complications, that correspond to 39 implants. The fail percentage is of 3,4%, representing a total of 6 implants. The re-implants percentage corresponds to 5,2% from 9 implants that were in total, leading to the main cause of technical device fail (06), following by a fail for an impact cause (03). There were 12 major complications presented that correspond to 6.97%. The percentage of minor complications on the following study was of 15,6% (27)...

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Cochleosacculotomy has been described as a simple, efficacious treatment for relief of vertigo in patients with Meniere's disease in whom medical therapy has failed. We reviewed records of 11 elderly patients with good vestibular function who were thought to be ideal candidates for this procedure. Average follow-up was 17 months. Contrary to previous reports, long-term control of vertigo was poor, and more than 80% of the patients suffered a significant hearing loss from this procedure. Four of 11 patients required a second surgical procedure to control their vertigo. Audiometric measures revealed statistically significant postoperative increases in puretone thresholds at all frequencies and speech reception threshold, and a decrease in discrimination scores. Based on the results of this study, we no longer plan to use cochleosacculotomy for the treatment of elderly patients with Meniere's disease.

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