Cochlear Implant : Anaesthesia Challenges

Abstract

Original ArticleIntroduction T he field of cochlear implantation has been expanding rapidly and now it is an acceptable therapeutic option for those patients with irreversible hearing loss and deafmutism. It has been hailed as one of the greatest advances in otology [1]. Cochlear implants are extremely expensive computerised electric prostheses that partially replace the functions of the cochlea (Fig 1). The surgery is time consuming and is performed under general anaesthesia via a trans-mastoid approach. The operative technique is complicated and necessitates preservation of functional integrity of the facial and cochlear nerve. The anaesthesiologist is an integral member of the cochlear implant team whose anaesthetic as well as communication skills are put to test. The technique of anaesthesia plays a crucial role in success of cochlear implant surgery as the anaesthesiologist has to produce conditions which facilitate use of nerve stimulators and treat troublesome post-operative complications such as nausea, vomiting and vertigo. This paper highlights certain important technical aspects of the surgery and our anaesthetic experience in a series of cases performed till now. A brief review of literature is also presented. Material and MethodsThe present study was carried out in the form of retrospective analysis of medical, surgical and anaesthetic records of all the children (age upto 15 years) who underwent implantation of cochlear devices at our institute over last five years. The analysis included pre-implant work up and preoperative screening of each child. Surgical aspects along with incidence of complications were also recorded. Anaesthetic technique was screened in detail and adverse events during entire peri-operative period were noted.Patients with irreversible hearing loss and not responding to hearing aids, were selected by the implant surgeon. Each

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Cochlear Implantation in a Child With Hypoplastic Left-heart Syndrome: Clinical Case

“…в своей публикации обратили внимание на особенности проведении анестезиологического пособия у пациентов с различными генетическими синдромами. Авторы рассматривали такие синдромы, как Тричера Коллинза, Клиппеля-Фейля, Пендреда, Альпорта, Джервелла и Ланге-Нильсена [11]. В этой же статье сделан акцент на важность выявления генетических заболеваний, которые могут менять ход операции.…”

Cochlear implantation in patient with Dandy-walker syndrome

“…The field of cochlear implants is growing rapidly due to improved quality of the implants, surgery less invasive, and wider dissemination of this type of treatment of deafness. Cochlear implants are extremely expensive prostheses that partially replace the functions of the cochlea 20 . The surgery is now much faster and less invasive than some years ago, with smaller incisions and less morbidity for the patient.…”