Programação remota dos sistemas de implante coclear

Abstract

O objetivo deste estudo foi investigar os recursos necessários para a viabilização da programação remota dos sistemas de Implante Coclear (IC) e verificar os benefícios e limitações para a implementação deste modelo de atendimento nos serviços de saúde auditiva do Brasil. Participaram dois usuários de IC multicanal acompanhados no Centro de Pesquisas Audiológicas (CPA) do Hospital de Reabilitação das Anomalias Craniofaciais (HRAC) da Universidade de São Paulo (USP) e dois profissionais que atuam na área de Audiologia. Um dos profissionais estava localizado no CPA/HRAC-USP, denominado Centro de Referência (CR) e outro localizado em um centro situado a mais de 1500 km de distância do CR, denominada Área Remota (AR), sem experiência prévia na programação deste dispositivo. O procedimento consistiu no treinamento do recurso selecionado para a programação remota entre o CR e a AR. Após a execução da teleconsulta, o profissional da AR e os sujeitos implantados responderam a um questionário previamente elaborado. O estudo revelou que dentre as vantagens da aplicação deste procedimento estão a descentralização dos serviços de saúde auditiva, o treinamento e capacitação de profissionais, a redução de custos para o Sistema Único de Saúde (SUS) e o acompanhamento sistemático de pacientes implantados. A teleconsulta é um modelo de acompanhamento dos sujeitos implantados efetivo, viável e inovador no Brasil. Entretanto, ainda é necessário realizar mais pesquisas para viabilizar o uso em escala nacional.

Remote programming of cochlear implants

“…Studies related to the RP of CI systems found in the literature evaluated the differences in the stimulation levels (15) , auditory thresholds, and speech perception in RP and LP (12,13,16,23) and also assessed the opinion of professionals and participants (5,12,14,16,23) . Caption: LP = direct programming; RP = remote programming; Min = minimum; Max = maximum.…”

“…Some studies found in the literature (5,12,14,16,23) administered questionnaires to participants to obtain their views on the RP (effectiveness, time, preference, and feasibility of application). This aspect was not measured in this study, as the main objective was to compare the auditory results, speech perception, and programming parameters of the RP and the LP.…”

“…Through teleconsultation, healthcare professionals can communicate quickly and directly with other professionals or patients, regardless of distance (1) . In the area of audiology, telehealth applies to various situations, such as the development of audiology-oriented teleeducation and teleconsultations (4) , remote audiologic diagnostics (through audiometry, otoacoustic emissions and brainstem auditory evoked potential exams) (5) , and remote programming (RP) of electronic devices such as cochlear implant (CI) and hearing-aid devices (3,(7)(8)(9) . To adjust the optimal stimulation parameters of the CI for each patient, the programming of the speech processor must be performed periodically.…”

“…Several patients using CI, along with their caregivers, need to travel from their home city to the center where they receive care, which involves transportation and accommodation costs, in addition to interfering in their school and/or professional activities. Therefore, the RP of CI systems is a promising resource to decentralize health services, conduct training of professionals in the field of audiology, and possibly reduce costs for SUS (5) . Some studies were conducted using the RP of CI systems.…”

“…Zumpano et al (5) performed RP in two CI users, with the participation of two speech-language pathologists -one, experienced in CI programming, and the other, without such experience, who received the remote support of the experienced professional. Both the CI users and the speech-language pathologists completed questionnaires at the end of the consultations, whose objectives were to verify the advantages, difficulties, and other aspects of the procedure performed.…”