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Cochlear Implant Surgery and Anesthesia

Yıl 2015, Cilt: 24 Sayı: 2, 159 - 170, 05.03.2015
https://doi.org/10.17827/aktd.47056

Öz

Cochlear implant, converting mechanical sound energy into electrical signal, is a device that can enables to detection of sounds from cochlea. Cochlear implantation is the name of cochlear implants to be placed in the cochlea. This procedure brings up some difficulties in terms of anesthesia and surgery. Both range of patients population and surgical complications make different implantation applications. Besides age group of children who underwent surgery, this procedure can be applied to all age groups. During surgery, anesthesia technics which allow the immobil bloodness field and fascial nerve neuromonitorisation must be performed. During recovery period from surgery, it is important that patient’s head movement must be kept slow and controlled for preventing implant replacement. Also in this period, neuromuscular blocking must be fully reversed for fascial nerve examination. In this article, preoperative preparation, anesthetic management and surgical aspects of cochlear implantation surgery were reviewed

Kaynakça

  • Schultz B, Beger FA, Weber BP, Niclaus O, Lüllwitz E, Grouven U et al. Influence of EEG monitoring on intraoperative stapedius reflex threshold values in cochlear implantation in children. Paed Anaesthesia. 2003;13:790–6.
  • Lenarz T, Lesinski-Schiedat A, Von Der Haar-Heise S, Illg A, Bertram B, Battmer RD et al. Cochlear implantation in children under the age of two: the MHH experience with the Clarion_ cochlear implant. Ann Otol Rhinol Laryngol. 1999;108:44–9.
  • Colletti V, Carner M, Miorelli V, Guida M, Colletti L, Fiorino F.G. Cochlear implantation at under 12 months: report on 10 patients. Laryngoscope. 2005;115:445–9.
  • Waltzman SB, Roland JT Jr. Cochlear implantation in children younger than 12 months. Pediatrics. 2005;116:e487-93.
  • Trimble K, Blaser S, James AL, Papsin BC. Computed tomography and/or magnetic resonance imaging before paediatric cochlear implantation? developing an investigative strategy. Otol Neurotol. 2007;28:317-24.
  • Sennaroğlu L, Saatçi I. A new classification for cochleovestibular malformations. Laryngoscope. 2002;112:2230-41
  • Jackler RK, Luxford WM, House WF. Congenital malformations of the iner ear: a classification based on embryogenesis. Laryngoscope. 1987;97:2-14.
  • Goel L, Bennur SK, Jambhale S. Treacher-collins syndrome-a challenge for anaesthesiologists. Indian J Anaesth. 2009;53:496-500.
  • Stallmer ML, Vanaharam V, Mashour GA. Congenital cervical spine fusion and airway management: a case series of Klippel-fiel syndrome. J Clin Anesth. 2008;20:447-51.
  • Watanabe K, Hagiya K, Inomata S, Miyabe M, Tanaka M, Mizutani T. Bilateralvocal cord paralysis in a patient with chronic renal failure associated withAlport syndrome. J Anaesth 2010;24:472-3.
  • Ilhan A, Tuncer C, Komsuoglu SS, Kali S. Jervell and Lange-nielsen syndrome:neurologic and cardiologic evaluation. Pediatr Neurol. 1999;21:809-13.
  • Eckenhoff JE. Some anatomic considerations of the infant larynx influencing endotracheal anesthesia. Anesthesiology. 1951;12:401–9.
  • Taguchi N, Matsumiya N, Ishizawa Y, Dohi S, Nahito H. The relation between upper respiratory tract infection and mild hypoxemia during general anesthesia in children. Masui. 1992;41:251-4.
  • Tait AR, Malviya S, Voepel-Lewis T, Munro HM, Seiwert M, Pandit UA. Risk factors for perioperative adverse respiratory events in children with upper respiratory tract infections.Anesthesiology. 2001;95:299-306.
  • Wheeler M, Cote CJ, Todres ID. Pediatric airway. In A Practice of Anesthesia for Infants and Children (Eds CJ CoteJ,ID TodresD, GN Goudsouzian):70-90. Philadelphia, Saunders. 2001.
  • Dalal PG, Murray D, Messner AH, Feng A, McAllister J, Molter D. Pediatric laryngeal dimensions: an age-based analysis. Pediatr Anesthesiol. 2009;108:1475-9.
  • Hugo VA, Edward DM. Deliberately hypotension. In: Anesthesia (Ed RD Miller):1473. Philadelphia: Philadelphia, Churchill Livingstone, 2000.
  • Degoute CS, Ray Mj, Manchon M, Dubreil C, Bansillon V. Remifentanil and controlled hypotension; comparison with nitropruside or esmolol during tympanoplasty. Can J Anaesthesia. 2001;48:20-7.
  • Richa F, Yazigi A, Sleilaty G, Yazbeck P. Comparison between dexmedetomidine and remifentanil for controlled hypotensionduring tympanoplasty. Eur J Anaesthesiology. 2008;25:369-74.
  • Shirgoska B, Netkovski J, Zafirova B. The influence of remifentanil and remifentanil-plus- sevoflurane-controlled hypotension on mean arterial pressure and heart rate in children. Prilozi. 2012;33:171-4.
  • Hamerschmidt R, Mocellin M, Gasperin AC, Faria JL, Trevizan G, Wiemes GR et al. Local anesthesia for cochlear implant surgery: a possible alternative. Braz J Otorhinolaryngol. 2010;76:561-4.
  • Hamid R.D, Saswata R, Aaron G. Benson, Christopher R, Timothy B. McDonald, Tina L. Transcanal cochlear implantation under monitored anesthesia care. Otol Neurotol. 2005;26:674–7.
  • Hamerschmidt R, Moreira ATR, Wiemes GRM, Tenório SB, Tâmbara EM. Cochlear implant surgery with local anesthesia and sedation: comparison with general anesthesia. Otol Neurotol. 2013;34:75-8.
  • Battmer R, Laszig R, Lehnhardt E. Electrically elicited stapedius reflex in cochlear implant patients. Ear Hear. 1990;11:370-4.
  • Stephan K, Welzl-Muller K, Stiglbrunner H. Stapedius reflex threshold in cochlear implant patients. Audiology. 1988;27:227-33.
  • Gantz BJ, Brown CJ, Abbas PJ. Intraoperative measurements of electrically evoked auditory nerve compound action potential. Am J Otol. 1994;15:137-7.
  • Gordon K, Papsin BC, Harrison RV. Programming cochlear implant stimulation levels in infants and children with a combination of objective measures. Int J Audiol. 2004;43:28-4.
  • Abbas PJ, Brown CJ, Shallop JK, Firszt JB, Hughes ML, Hong SH et al. Summary of results using the nucleus CI24M implant to record the electrically evoked compound action potential. Ear Hear. 1999;20:45-59.
  • Jana JJ, Vaid N, Shanbhag J. Effect of total intravenous anaesthesia on intraoperative monitoring of Cochlear implant function in paediatric patients. Cochlear Implans Int. 2013;14:15.
  • Mark W. Crawford, Michelle C. White, Evan J. Propst, Christian Z, Sharon C, Carolyne P et al. Dose- Dependent Suppression of the Electrically Elicited Stapedius Reflex by General Anesthetics in Children Undergoing Cochlear Implant Surgery. Anesth Analg. 2009;108:1480 –7.
  • Colletti V, Carner M, Miorelli V, Guida M, Colletti L, Fiorino F.G. Cochlear implantation at under 12 months: report on 10 patients. Laryngoscope. 2005:115;445–4.
  • Peters BR, Litovsky R, Parkinson A, Lake J. Importance of age and postimplantation experience on speech perception measures in children with sequential bilateral cochlear implants. Otol Neurotol. 2007;28:649-8.
  • Holt R.F, Mario A, Neuburger H, Miyamoto RT. Age at implantation and communicative outcome in pediatric cochlear implant users: Is younger always better? International Congress Series. 2004;1273:368–3.
  • Connor CMD, Craig HK, Raudenbush SW, Heavner, Zwolan TA. The age at which young deaf children receive cochlear implants and their vocabulary and speech-production growth: is there an added value for early implantation? Ear Hear. 2006;26:628-36.
  • Mıgırov L, Kronenberg J. Bilateral, simultaneous cochlear implantation inchildren: surgical considerations. J Laryngol Otol. 2009;123:837–42.
  • Young N.M, Infant cochlear implantation and anesthetic risk. Ann Otol Rhinol Laryngol Suppl. 2002;189:49–52.
  • Rose JB, Watcha MF. Postoperative nausea and vomiting in paediatric patients. Br J Anaesth. 1999;83:104–13.
  • Rowley MP, Brown TCK. Postoperative vomiting in children. Anaesth Intensive Care. 1982;10:309–14.
  • Olutoye O, Watcha MF. Management of postoperative vomiting in pediatric patients. Int Anesthesiol Clin. 2003;41:99-118.
  • Vlastarakos PV, Candiloros D, Papacharalampous G, Tavoulari E, Kampessis G, Mochloulis G et al. Diagnostic challenges and safety considerations in cochlear implantation under the age of 12 months. Int J Pediatr Otorhinolaryngol. 2010;74:127–35.
  • Komazec Z, Lemajic-komazec S, Dankuc D, Vlaski L. Cochlear implantation-risk and complications. Med Pregl. 2008;61:27-30.
  • Yeh JS, Money KL, Gingrich K, Kim JT, Lalwani AK. Anesthetic complications in pediatric patients undergoing cochlear implantation. Laryngoscope. 2011;121:2240-4.
  • Darlong V, Khanna P, Chandralekha BDK, Pandey R, Punj J, Kumar R et al. Perioperative complications of cochlear implant surgery in children. J Anesth. 2014; doi:10.1007/s00540-014- 1878-7.
  • Coelho DH, Yeh J, Kim JT, Lalwani AK. Cochlear implantation is associated with minimal anesthetic risk in the elderly. Laryngoscope. 2009 ;119:355-8.
  • Li Y, Zhang D. Perioperative complications of 1396 patients with cochlear implantation. Journal of Clinical Otorhinolaringology. 2010;24:433-5.
  • Correspondence Address / Yazışma Adresi

Kohlear İmplant Cerrahisi ve Anestezi

Yıl 2015, Cilt: 24 Sayı: 2, 159 - 170, 05.03.2015
https://doi.org/10.17827/aktd.47056

Öz

Kohlear implant, mekanik ses enerjisini elektrik sinyallerine dönüştürüp, kohleadan seslerin algılanmasını sağlayan elektronik bir cihazdır. Kohlear implantasyon ise kohlear implantın kohleaya yerleştirilmesine verilen isimdir. Bu uygulama beraberinde anestezi ve cerrahi açısından bazı zorluklar getirmektedir. Gerek hasta popülasyonunun yaş aralığı gerek cerrahi komplikasyonlar implantasyon uygulamalarını farklı kılmaktadır. Cerrahi uygulanan yaş grubu genellikle çocuk olmakla birlikte her yaş grubuna işitme rehabilitasyonu amacıyla uygulanabilmektedir. Cerrahi sırasında immobilizasyon yanında kansız bir cerrahi saha ve fasiyal sinirin nöromonitörizasyonuna izin veren anestezi teknikleri uygulanmalıdır. Cerrahiden uyanma döneminde hastanın baş hareketlerinin az ve kontrollü olması implantın yerinden kaymasını önlemek açısından önemlidir. Yine operasyondan uyanma aşamasında fasiyal sinir muayenesi yapabilmek için kas gevşemesinin tamamen geri döndürülmesi gerekmektedir. Postoperatif dönemde vestibuler sistemde uyarılmaya bağlı olarak bulantı ve kusma beklenebilir. Bu yazıda kohlear implantasyon cerrahisinin preoperatif anestezik hazırlıkları, anestezi uygulamaları ve postoperatif komplikasyonları gözden geçirilmiştir

Kaynakça

  • Schultz B, Beger FA, Weber BP, Niclaus O, Lüllwitz E, Grouven U et al. Influence of EEG monitoring on intraoperative stapedius reflex threshold values in cochlear implantation in children. Paed Anaesthesia. 2003;13:790–6.
  • Lenarz T, Lesinski-Schiedat A, Von Der Haar-Heise S, Illg A, Bertram B, Battmer RD et al. Cochlear implantation in children under the age of two: the MHH experience with the Clarion_ cochlear implant. Ann Otol Rhinol Laryngol. 1999;108:44–9.
  • Colletti V, Carner M, Miorelli V, Guida M, Colletti L, Fiorino F.G. Cochlear implantation at under 12 months: report on 10 patients. Laryngoscope. 2005;115:445–9.
  • Waltzman SB, Roland JT Jr. Cochlear implantation in children younger than 12 months. Pediatrics. 2005;116:e487-93.
  • Trimble K, Blaser S, James AL, Papsin BC. Computed tomography and/or magnetic resonance imaging before paediatric cochlear implantation? developing an investigative strategy. Otol Neurotol. 2007;28:317-24.
  • Sennaroğlu L, Saatçi I. A new classification for cochleovestibular malformations. Laryngoscope. 2002;112:2230-41
  • Jackler RK, Luxford WM, House WF. Congenital malformations of the iner ear: a classification based on embryogenesis. Laryngoscope. 1987;97:2-14.
  • Goel L, Bennur SK, Jambhale S. Treacher-collins syndrome-a challenge for anaesthesiologists. Indian J Anaesth. 2009;53:496-500.
  • Stallmer ML, Vanaharam V, Mashour GA. Congenital cervical spine fusion and airway management: a case series of Klippel-fiel syndrome. J Clin Anesth. 2008;20:447-51.
  • Watanabe K, Hagiya K, Inomata S, Miyabe M, Tanaka M, Mizutani T. Bilateralvocal cord paralysis in a patient with chronic renal failure associated withAlport syndrome. J Anaesth 2010;24:472-3.
  • Ilhan A, Tuncer C, Komsuoglu SS, Kali S. Jervell and Lange-nielsen syndrome:neurologic and cardiologic evaluation. Pediatr Neurol. 1999;21:809-13.
  • Eckenhoff JE. Some anatomic considerations of the infant larynx influencing endotracheal anesthesia. Anesthesiology. 1951;12:401–9.
  • Taguchi N, Matsumiya N, Ishizawa Y, Dohi S, Nahito H. The relation between upper respiratory tract infection and mild hypoxemia during general anesthesia in children. Masui. 1992;41:251-4.
  • Tait AR, Malviya S, Voepel-Lewis T, Munro HM, Seiwert M, Pandit UA. Risk factors for perioperative adverse respiratory events in children with upper respiratory tract infections.Anesthesiology. 2001;95:299-306.
  • Wheeler M, Cote CJ, Todres ID. Pediatric airway. In A Practice of Anesthesia for Infants and Children (Eds CJ CoteJ,ID TodresD, GN Goudsouzian):70-90. Philadelphia, Saunders. 2001.
  • Dalal PG, Murray D, Messner AH, Feng A, McAllister J, Molter D. Pediatric laryngeal dimensions: an age-based analysis. Pediatr Anesthesiol. 2009;108:1475-9.
  • Hugo VA, Edward DM. Deliberately hypotension. In: Anesthesia (Ed RD Miller):1473. Philadelphia: Philadelphia, Churchill Livingstone, 2000.
  • Degoute CS, Ray Mj, Manchon M, Dubreil C, Bansillon V. Remifentanil and controlled hypotension; comparison with nitropruside or esmolol during tympanoplasty. Can J Anaesthesia. 2001;48:20-7.
  • Richa F, Yazigi A, Sleilaty G, Yazbeck P. Comparison between dexmedetomidine and remifentanil for controlled hypotensionduring tympanoplasty. Eur J Anaesthesiology. 2008;25:369-74.
  • Shirgoska B, Netkovski J, Zafirova B. The influence of remifentanil and remifentanil-plus- sevoflurane-controlled hypotension on mean arterial pressure and heart rate in children. Prilozi. 2012;33:171-4.
  • Hamerschmidt R, Mocellin M, Gasperin AC, Faria JL, Trevizan G, Wiemes GR et al. Local anesthesia for cochlear implant surgery: a possible alternative. Braz J Otorhinolaryngol. 2010;76:561-4.
  • Hamid R.D, Saswata R, Aaron G. Benson, Christopher R, Timothy B. McDonald, Tina L. Transcanal cochlear implantation under monitored anesthesia care. Otol Neurotol. 2005;26:674–7.
  • Hamerschmidt R, Moreira ATR, Wiemes GRM, Tenório SB, Tâmbara EM. Cochlear implant surgery with local anesthesia and sedation: comparison with general anesthesia. Otol Neurotol. 2013;34:75-8.
  • Battmer R, Laszig R, Lehnhardt E. Electrically elicited stapedius reflex in cochlear implant patients. Ear Hear. 1990;11:370-4.
  • Stephan K, Welzl-Muller K, Stiglbrunner H. Stapedius reflex threshold in cochlear implant patients. Audiology. 1988;27:227-33.
  • Gantz BJ, Brown CJ, Abbas PJ. Intraoperative measurements of electrically evoked auditory nerve compound action potential. Am J Otol. 1994;15:137-7.
  • Gordon K, Papsin BC, Harrison RV. Programming cochlear implant stimulation levels in infants and children with a combination of objective measures. Int J Audiol. 2004;43:28-4.
  • Abbas PJ, Brown CJ, Shallop JK, Firszt JB, Hughes ML, Hong SH et al. Summary of results using the nucleus CI24M implant to record the electrically evoked compound action potential. Ear Hear. 1999;20:45-59.
  • Jana JJ, Vaid N, Shanbhag J. Effect of total intravenous anaesthesia on intraoperative monitoring of Cochlear implant function in paediatric patients. Cochlear Implans Int. 2013;14:15.
  • Mark W. Crawford, Michelle C. White, Evan J. Propst, Christian Z, Sharon C, Carolyne P et al. Dose- Dependent Suppression of the Electrically Elicited Stapedius Reflex by General Anesthetics in Children Undergoing Cochlear Implant Surgery. Anesth Analg. 2009;108:1480 –7.
  • Colletti V, Carner M, Miorelli V, Guida M, Colletti L, Fiorino F.G. Cochlear implantation at under 12 months: report on 10 patients. Laryngoscope. 2005:115;445–4.
  • Peters BR, Litovsky R, Parkinson A, Lake J. Importance of age and postimplantation experience on speech perception measures in children with sequential bilateral cochlear implants. Otol Neurotol. 2007;28:649-8.
  • Holt R.F, Mario A, Neuburger H, Miyamoto RT. Age at implantation and communicative outcome in pediatric cochlear implant users: Is younger always better? International Congress Series. 2004;1273:368–3.
  • Connor CMD, Craig HK, Raudenbush SW, Heavner, Zwolan TA. The age at which young deaf children receive cochlear implants and their vocabulary and speech-production growth: is there an added value for early implantation? Ear Hear. 2006;26:628-36.
  • Mıgırov L, Kronenberg J. Bilateral, simultaneous cochlear implantation inchildren: surgical considerations. J Laryngol Otol. 2009;123:837–42.
  • Young N.M, Infant cochlear implantation and anesthetic risk. Ann Otol Rhinol Laryngol Suppl. 2002;189:49–52.
  • Rose JB, Watcha MF. Postoperative nausea and vomiting in paediatric patients. Br J Anaesth. 1999;83:104–13.
  • Rowley MP, Brown TCK. Postoperative vomiting in children. Anaesth Intensive Care. 1982;10:309–14.
  • Olutoye O, Watcha MF. Management of postoperative vomiting in pediatric patients. Int Anesthesiol Clin. 2003;41:99-118.
  • Vlastarakos PV, Candiloros D, Papacharalampous G, Tavoulari E, Kampessis G, Mochloulis G et al. Diagnostic challenges and safety considerations in cochlear implantation under the age of 12 months. Int J Pediatr Otorhinolaryngol. 2010;74:127–35.
  • Komazec Z, Lemajic-komazec S, Dankuc D, Vlaski L. Cochlear implantation-risk and complications. Med Pregl. 2008;61:27-30.
  • Yeh JS, Money KL, Gingrich K, Kim JT, Lalwani AK. Anesthetic complications in pediatric patients undergoing cochlear implantation. Laryngoscope. 2011;121:2240-4.
  • Darlong V, Khanna P, Chandralekha BDK, Pandey R, Punj J, Kumar R et al. Perioperative complications of cochlear implant surgery in children. J Anesth. 2014; doi:10.1007/s00540-014- 1878-7.
  • Coelho DH, Yeh J, Kim JT, Lalwani AK. Cochlear implantation is associated with minimal anesthetic risk in the elderly. Laryngoscope. 2009 ;119:355-8.
  • Li Y, Zhang D. Perioperative complications of 1396 patients with cochlear implantation. Journal of Clinical Otorhinolaringology. 2010;24:433-5.
  • Correspondence Address / Yazışma Adresi
Toplam 46 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Bölüm Derleme
Yazarlar

Ebru Biricik Bu kişi benim

Yayımlanma Tarihi 5 Mart 2015
Yayımlandığı Sayı Yıl 2015 Cilt: 24 Sayı: 2

Kaynak Göster

AMA Biricik E. Cochlear Implant Surgery and Anesthesia. aktd. Haziran 2015;24(2):159-170. doi:10.17827/aktd.47056