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Kohlear implant cerrahisinde anestezi yaklaşımları

Year 2019, Volume: 44 Issue: 4, 1167 - 1171, 29.12.2019
https://doi.org/10.17826/cumj.494545

Abstract

Amaç: Kohlear implantasyon (Kİ) işitmenin tekrar kazanılması için sinir liflerini uyararak seslerin algılanmasını sağlayan işitme cihazının yerleştirilmesi işlemidir ve çoğunluğunu pediatrik hastaların oluşturduğu bir hasta popülasyonuna uygulanmaktadır. Bu çalışmada Kİ operasyonu geçiren hastaların anestezi yönetimleri ve olası komplikasyonları sunulmak istenmiştir.

Gereç ve Yöntem: Bu retrospektif kesitsel çalışmada 1 Ocak 2017 ve 1 Mart 2018 tarihleri arasında kohlear implantasyon operasyonu geçiren 82 hasta değerlendirilmeye alınmıştır. Hastaların yaş, cinsiyet gibi demografik verileri, eşlik eden hastalık ve/veya sendromlar, kullanılan anestezik ilaçlar, sıvı tedavisi, operasyon süresi, operasyon sırasında ve sonrasında gelişen komplikasyonlar kaydedildi. Tüm hasta bilgileri, hastanemizde kullanılan medikal bilgi sisteminden, arşivlenen hasta dosyalarından ve anestezi kayıtlarından elde edildi.  Elde edilen veriler istatistiksel olarak değerlendirildi.

Bulgular: Toplam 81 hastanın tüm kayıtlarına ulaşıldı. Hastaların 52’ sinin erkek (%64,2), 29’ unun kadın (%35,8) olduğu tespit edildi. Yetmiş üç hastanın (%90,1) 15 yaş altında olduğu, 26 hastanın (%32,1) ailesinde de işitme kaybı olduğu ve 29’ unun (%35,8) anne ve babasının akraba olduğu tespit edildi. Anestezi ile ilişkili komplikasyonlar incelendiğinde 3 hastada (%3,7) bronkospazm ve 2 hastada (%2,5) ise postoperatif solunum yetmezliği geliştiği belirlendi. Hastaların 4’ ünde (%4,9) postoperatif enfeksiyon, 1 hastada kanama (%1,2), 2 hastada (%2,4) elektrodların yerinden çıkması ve 1 hastada sternokleidomastoid kasta spazm bildirilmiştir.

Sonuç: Kİ uygulamaları sırasında görülebilen gerek cerrahi gerek anesteziye bağlı komplikasyon oranlarının oldukça düşük olduğu tespit edilmiştir. 


References

  • Referans1. Akın İ, Şimşek G, Barmak E. Erken ve geç yaş koklear implant uygulamasında uzun dönem etkinliklerinin karşılaştırılması. Kulak Burun Bogaz Ihtis Derg 2012; 22(3): 123-128.Referans2. Goel L, Bennur SK, Jambhale S. Treacher-collins syndrome-a challenge for anaesthesiologists. Indian J Anaesth 2009; 53: 496-500.Referans3. Peker K, Ergil J, Öztürk İ. Anaesthesia Management in a Patient with Waardenburg Syndrome and Review of the Literature. Turk J Anaesthesiol Reanim 2015; 43(5): 360-362. Referans4. Yılmazer R, Yazıcı MZ, Erdim İ, Kaya HK, Özcan Dalbudak Ş, Kayhan TF. Follow-Up Results of Newborns after Hearing Screening at a Training and Research Hospital in Turkey. J Int Adv Otol 2016; 12(1): 55-60. Referans5. Ant A, Karamert R, Bayazıt YA. İşitme Kayıplarının Genetik Yönü ve Türkiye’deki Görünümü Türkiye Klinikleri J E.N.T.-Special Topics 2012; 5: 15-20.Referans6. Khabori MA, Patton MA. Consanguinity and deafness in Omani children. Int J Audiol 2008; 47: 30-33.Referans7. Joint Committee on Infant Hearing: Busa J, Harrison J, Chappell J, Yoshinaga-Itano C, Grimes A, Brookhouser PE, et al. Principles and Guidelines for Early Detecting and Intervention Programs. American Academy of Pediatrics 2007; 120: 898-921.Referans8. Pateron B, Bakhos D, LeLouarn A, et al. Local anaesthesia and conscious sedation for cochlear implantation: experience with 20 patients. J Laryngol Otol 2016; 130(2): 151-156. Referans9. Vaid N, Jana JJ, Kothadiya A, Deshpande S, Vaid S. Bilateral cochlear implantation under local anaesthesia in a young adult - A case report. Cochlear Implants Int 2016; 17(4): 207-210. Referans10. Shabashev S, Fouad Y, Huncke TK, Roland JT. Cochlear implantation under conscious sedation with local anesthesia; Safety, Efficacy, Costs, and Satisfaction. Cochlear Implants Int. 2017; 18(6): 297-303. Referans11. Wiemes GR, Hamerschmidt R, Moreira AT, de Fraga R, Tenório SB, Carvalho B. Auditory Nerve Recovery Function in Cochlear Implant Surgery with Local Anesthesia and Sedation versus General Anesthesia. Audiol Neurootol 2016; 21(3): 150-157. Referans12. Yeh JS, Mooney KL, Gingrich K, Kim JT, Lalwani AK. Anesthetic complications in pediatric patients undergoing cochlear implantation. Laryngoscope 2011; 121(10): 2240-2244. Referans13. Darlong V, Khanna P, Baidya DK, et al. Perioperative complications of cochlear implant surgery in children. J Anesth 2015; 29(1): 126-130. Referans14. Crawford MW, White MC, Propst EJ, et al. Dose-dependent suppression of the electrically elicited stapedius reflex by general anesthetics in children undergoing cochlear implant surgery. Anesth Analg 2009; 108(5): 1480-1487. Referans15. Hejazi MS, Moghaddam YJ, Pour MN, Banaii M, Abri R, Taghizadieh N. Evaluation of volatile and intravenous anesthetics, effects on the threshold of neuroresponse telemetry and the threshold of acoustically evoked stapedial reflex in children undergoing cochlear implant surgery.J Anaesthesiol Clin Pharmacol 2018; 34(2): 177-181. Referans16. Gemma M, Scola E, Baldoli C, et al. Auditory functional magnetic resonance in awake (nonsedated) and propofol-sedated children. Paediatr Anaesth 2016; 26(5): 521-530. Referans17. Hassan PF, Saleh AH. Dexmedetomidine versus Magnesium Sulfate in Anesthesia for Cochlear Implantation Surgery in Pediatric Patients. Anesth Essays Res 2017; 11(4): 1064-1069.

Anesthesia approaches in cochlear implant surgery

Year 2019, Volume: 44 Issue: 4, 1167 - 1171, 29.12.2019
https://doi.org/10.17826/cumj.494545

Abstract

Purpose: Cochlear implantation (CI) is process of inserting a hearing aid which provide perception of the voice with stimulating nerve fibers to regain hearing, and is applied to a population of patients most of whom are pediatric patients. In this study, we aimed to present anesthesia management and possible complications of patients undergoing CI operation.

Materials and Methods: In this retrospective cross-sectional study, 82 patients undergoing cochlear implantation between January 1, 2017 and March 1, 2018 were included. Demographic data such as age, gender, concomitant diseases and/or syndromes, anesthetic drugs, fluid therapy, duration of operation, complications during and after operation were recorded. All of the patients information’s were obtained from medical information system used in our hospital, archived patient files and anesthesia records. The data were evaluated statistically.    

Results: Total records of 81 patients were obtained. 52 of the patients were male (64.2%) and 29 were female (35.8%). Seventy-three patients (90.1%) were under the age of 15, 26 patients (32.1%) were found to have hearing loss in their families and 29 (35.8%) were related to their parents. When anesthesia related complications were examined, bronchospasm was detected in 3 patients (3.7%) and postoperative respiratory failure was observed in 2 patients (2.5%). Four patients (4,9%) had postoperative infection, 1 patient had bleeding (1,2%), 2 patients (2,4%) had electrodes displacement and 1 patient had spasm in sternocleidomastoid muscle.

Conclusion: It has been determined that the complication rates related to both surgical and anesthesia are very low.


References

  • Referans1. Akın İ, Şimşek G, Barmak E. Erken ve geç yaş koklear implant uygulamasında uzun dönem etkinliklerinin karşılaştırılması. Kulak Burun Bogaz Ihtis Derg 2012; 22(3): 123-128.Referans2. Goel L, Bennur SK, Jambhale S. Treacher-collins syndrome-a challenge for anaesthesiologists. Indian J Anaesth 2009; 53: 496-500.Referans3. Peker K, Ergil J, Öztürk İ. Anaesthesia Management in a Patient with Waardenburg Syndrome and Review of the Literature. Turk J Anaesthesiol Reanim 2015; 43(5): 360-362. Referans4. Yılmazer R, Yazıcı MZ, Erdim İ, Kaya HK, Özcan Dalbudak Ş, Kayhan TF. Follow-Up Results of Newborns after Hearing Screening at a Training and Research Hospital in Turkey. J Int Adv Otol 2016; 12(1): 55-60. Referans5. Ant A, Karamert R, Bayazıt YA. İşitme Kayıplarının Genetik Yönü ve Türkiye’deki Görünümü Türkiye Klinikleri J E.N.T.-Special Topics 2012; 5: 15-20.Referans6. Khabori MA, Patton MA. Consanguinity and deafness in Omani children. Int J Audiol 2008; 47: 30-33.Referans7. Joint Committee on Infant Hearing: Busa J, Harrison J, Chappell J, Yoshinaga-Itano C, Grimes A, Brookhouser PE, et al. Principles and Guidelines for Early Detecting and Intervention Programs. American Academy of Pediatrics 2007; 120: 898-921.Referans8. Pateron B, Bakhos D, LeLouarn A, et al. Local anaesthesia and conscious sedation for cochlear implantation: experience with 20 patients. J Laryngol Otol 2016; 130(2): 151-156. Referans9. Vaid N, Jana JJ, Kothadiya A, Deshpande S, Vaid S. Bilateral cochlear implantation under local anaesthesia in a young adult - A case report. Cochlear Implants Int 2016; 17(4): 207-210. Referans10. Shabashev S, Fouad Y, Huncke TK, Roland JT. Cochlear implantation under conscious sedation with local anesthesia; Safety, Efficacy, Costs, and Satisfaction. Cochlear Implants Int. 2017; 18(6): 297-303. Referans11. Wiemes GR, Hamerschmidt R, Moreira AT, de Fraga R, Tenório SB, Carvalho B. Auditory Nerve Recovery Function in Cochlear Implant Surgery with Local Anesthesia and Sedation versus General Anesthesia. Audiol Neurootol 2016; 21(3): 150-157. Referans12. Yeh JS, Mooney KL, Gingrich K, Kim JT, Lalwani AK. Anesthetic complications in pediatric patients undergoing cochlear implantation. Laryngoscope 2011; 121(10): 2240-2244. Referans13. Darlong V, Khanna P, Baidya DK, et al. Perioperative complications of cochlear implant surgery in children. J Anesth 2015; 29(1): 126-130. Referans14. Crawford MW, White MC, Propst EJ, et al. Dose-dependent suppression of the electrically elicited stapedius reflex by general anesthetics in children undergoing cochlear implant surgery. Anesth Analg 2009; 108(5): 1480-1487. Referans15. Hejazi MS, Moghaddam YJ, Pour MN, Banaii M, Abri R, Taghizadieh N. Evaluation of volatile and intravenous anesthetics, effects on the threshold of neuroresponse telemetry and the threshold of acoustically evoked stapedial reflex in children undergoing cochlear implant surgery.J Anaesthesiol Clin Pharmacol 2018; 34(2): 177-181. Referans16. Gemma M, Scola E, Baldoli C, et al. Auditory functional magnetic resonance in awake (nonsedated) and propofol-sedated children. Paediatr Anaesth 2016; 26(5): 521-530. Referans17. Hassan PF, Saleh AH. Dexmedetomidine versus Magnesium Sulfate in Anesthesia for Cochlear Implantation Surgery in Pediatric Patients. Anesth Essays Res 2017; 11(4): 1064-1069.
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Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Research
Authors

Ebru Biricik 0000-0002-3355-198X

Publication Date December 29, 2019
Acceptance Date March 10, 2019
Published in Issue Year 2019 Volume: 44 Issue: 4

Cite

MLA Biricik, Ebru. “Kohlear Implant Cerrahisinde Anestezi yaklaşımları”. Cukurova Medical Journal, vol. 44, no. 4, 2019, pp. 1167-71, doi:10.17826/cumj.494545.