Avtor/Urednik		Pegan, Boris; Ries, Mihael; Kekić, Branko; Trotić, Robert; Šindija, Branka
Naslov		First auditory brainsteam implant operation in our cochlear implantation program
Prevedeni naslov		Prva vsaditev slušnega vsadka v možgansko deblo v našem programu polžkovih vsadkov
Tip		članek
Vir		Med Razgl
Vol. in št.		Letnik 39, št. Suppl 3
Leto izdaje		2000
Obseg		str. 179-82
Jezik		eng
Abstrakt		In recent years advance of technology led us to cochlear implants that tend to replace the non-functioning cochlea. A step further is an auditory brainstem implant (ABI) where cochlear nuclei are stimulated directly. Although it enables us to bypass the eighth nerve and the possible pathology, it confronts us with many new issues. Croatian Cochlear Implantation program was started right after the Slovenian one, but kept on developing slowly due to reduced financial possibilities. The first ABI operation in Croatia was performed at our Department in January 1999. The operation was performed in a deaf 28-year-old female patient who was diagnosed a bilateral acoustic neurinoma. Diagnostic procedure incorporated standard audiologic battery for sensorineural hearing loss, CT and MRI. The left side was operated on 4 years ago in other clinic using the suboccipital approach. The auditory brainstem implant surgery was performed on the "second side" using the same approach. It was an uneventful operation with good anatomy and no serious postoperative complications. The patient is now performing exceptionally well, with up to 50% of words recognition in the opened set and 85% in the closed set, both without lip-reading. The authors present this rare and successful case one and a half year after the surgery, and show their experience in rehabilitation and good tolerance of the implanted device.
Izvleček		Napredek tehnologije v zadnjih letih je privedel do polžkovih vsadkov, ki zamenjujejo nefunkcionalnega polža. Korak dlje so slušni vsadki v možgansko deblo, kjer se kohlearna jedra neposredno stimulirajo. Čeprav to omogoča obiti 8. možganski živec z morebitnimi bolezenskimi spremembami, nas sooča z mnogimi novimi vprašanji. Hrvaški program polžkovih vsadkov se je začel neposredno po slovenskem, vendar se je zaradi skromnih finančnih razmer razvijal počasi. Prvo operacijo slušnega vsadka v možgansko deblo smo izvedli na našem oddelku v januarju 1999, Operirali smo gluho 28-letno bolnico z obojestranskim akustičnim nevrinomom. Diagnostični postopek je vključeval standardne avdiološke teste za zaznavno gluhost, računalniško tomografijo in magnetno resonanco. Levo stran so operirali na drugi kliniki pred štirimi leti s subokcipitalnim pristopom. Slušni vsadek v možgansko deblo, smo vsadili na drugo stran z enakim pristopom. Operacija je potekala brez zapletov z ugodnimi anatomskimi razmerami in brez resnih zapletov po njej. Bolničino stanje je sedaj izredno ugodno, prepoznava do 50% v odprtem in do 85% v zaprtem nizu, oboje brez odgledovanja. Avtorji predstavljajo ta redek in uspešen primer leto in pol po operaciji ter opisujejo svoje izkušnje z rehabilitacijo in dobrim prenašanjem vsadka.
Deskriptorji		COCHLEAR IMPLANT BRAIN STEM DEAFNESS NEUROMA, ACOUSTIC ADULT COCHLEAR NUCLEUS TREATMENT OUTCOME