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https://codas.org.br/article/doi/10.1590/2317-1782/20242023220pt
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Percepção auditiva da fala após o reimplante coclear

Speech perception in patients submitted to cochlear reimplantation

Lucas Bevilacqua Alves da Costa; Leticia Cristina Vicente; Leandra Tabanez do Nascimento Silva; Kátia Freitas Alvarenga; Manoel Henrique Salgado; Orozimbo Alves Costa; Rubens Brito

http://dx.doi.org/10.1590/2317-1782/20242023220pt CoDAS, vol.36, n4, e20230220, 2024
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Resumo

Objetivo: Analisar o desempenho da percepção auditiva da fala (PF) após cirurgia de substituição do implante coclear (IC) e identificar associações com a idade, tempos de uso dos dispositivos, privação e recuperação. Método: O estudo retrospectivo analisou os prontuários de 1990 a 2016 e considerou como referência o maior escore da capacidade auditiva identificada ao longo do uso do primeiro IC. Foram coletados dados epidemiológicos; etiologia; causas da substituição e marca dos dispositivos; classificação etária; idades no primeiro e segundo implante; tempos de utilização, privação e de recuperação da capacidade auditiva. Os dados foram avaliados por meio de testes estatísticos não paramétricos (IC=95%; p<0.05). Resultados: Foram avaliados 68 participantes (31 adultos e 37 crianças), sendo 52,9% do sexo feminino e as principais etiologias da perda auditiva foram: idiopática (48,5%), infecciosa (33,8%) e outras causas não infecciosas (17,6%). A idade média verificada na implantação do primeiro e do segundo IC, foram: 102±143,4 e 178,9±173,4 meses. Os tempos médios de uso do primeiro IC, privação, recuperação e uso do segundo IC, foram respectivamente: (76,1±63,3); (2,8±2,4); (6,5±7,1); (75,6±48,3) meses. A substituição foi motivada principalmente pela parada abrupta de funcionamento (77,9%) e 85,3% dos participantes recuperaram a PF, que esteve significativamente associada à idade no primeiro IC, e os tempos de utilização dos dispositivos (p<0.05). Conclusão: A maior parte dos indivíduos submetidos ao reimplante conseguem recuperar e/ou continuar o desenvolvimento das habilidades auditivas. A idade mais jovem e o tempo de uso dos dispositivos são fatores que influenciam na capacidade de recuperação da PF em reimplantados.

Palavras-chave

Implante Coclear; Falha de Prótese; Percepção Auditiva; Revisão; Reoperação

Abstract

Purpose: To analyze the performance of auditory speech perception (PF) after cochlear implant (CI) replacement surgery and associations with age, times of use of the first CI, deprivation, recovery and use of the second device. Methods: The retrospective study analyzed the medical records of 68 participants reimplanted from 1990 to 2016, and evaluated with PF performance tests, considering as a reference, the greater auditory capacity identified during the use of the first CI. Also analyzed were: Etiology of hearing loss; the reasons for the reimplantation; device brands; age range; sex; affected ear; age at first implant; time of use of the first CI, deprivation, recovery and use of the second device. The analyzes followed with the Chi-Square and Spearman, Mann-Whitney and Kruskal-Wallis tests (CI=95%; p≤0.05; Software SPSS®.v22). Results: Most were children with hearing loss due to idiopathic causes and meningitis. Abrupt stoppage of operation was the most common cause for device replacement. Most cases recovered and maintained or continued to progress in PF after reimplantation. Adults have the worst recovery capacity when compared to children and adolescents. The PF capacity showed a significant association (p≤0.05) with: age at first implant; time of use of the first and second CI. Conclusion: Periodic programming and replacement of the device when indicated are fundamental for the maintenance of auditory functions. Being young and having longer use of implants represent advantages for the development of speech perception skills. 

Keywords

Cochlear Implant; Equipment Failures; Auditory Perception; Review; Reoperation

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Submetido em:
01/09/2023

Aceito em:
08/01/2024

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