Title Retromeatalni pristup za kohlearnu implantaciju Title (english) Retrometal approach for cochlear implantation Author Jelena Bošnjak Mentor Krsto Dawidowsky (mentor)Committee member Srećko Branica (predsjednik povjerenstva)Committee member Mihael Ries (član povjerenstva)Committee member Krsto Dawidowsky (član povjerenstva)Granter University of Zagreb Defense date and country 2023-07-13, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Kohlearni implantat ili umjetna pužnica elektronski je uređaj koji omogućava osjet sluha osobama s teško ili potpuno oštećenom pužnicom. Umjetna pužnica sastoji se od vanjskog i unutarnjeg dijela. Sama elektroda uređaja kirurški se ugrađuje u kohleu. Teoretski, svaka osoba s teškom senzoričkom nagluhosti ili gluhoćom uz urednu funkciju slušnog živca može biti kandidat za kohlearnu implantaciju, no najbitniju skupinu kandidata čine gluha ili teško nagluha novorođenčad zbog posebne koristi od rane dijagnostike i intervencije, koja im omogućuje pravodoban razvitak sluha i uključenje u redovno školovanje. Stoga se u Hrvatskoj od 2002. godine provodi Sveobuhvatni probir novorođenčadi na oštećenje sluha metodom evocirane otoakustičke emisije. Sami se kriteriji za ugradnju umjetne pužnice proširuju usporedno s razvitkom tehnologije. Preoperacijska obrada sastoji se od detaljne anamneze, fizikalnog pregleda, audiološke obrade prilagođene dobi te radioloških pretraga. Najstarija kirurška tehnika za kohlearnu implantaciju, koja se koristi i danas, zahvat je koji iziskuje mastoidektomiju. Iako u potpunosti odgovara zahtjevima kohlearne implantacije, ova je tehnika povezana s učestalijim ozljedama nervusa facijalisa i chorde tympani. Od kirurških tehnika bez mastoidektomije najčešće se spominju Veria, suprameatalni i endomeatalni pristup. Paralelno s razvitkom spomenutih pristupa zagrebački otokirurški tim s Klinike za bolesti uha, nosa i grla i kirurgiju glave i vrata KBC Zagreb razvija vlastitu operacijsku tehniku koja ne iziskuje mastoidektomiju - retromeatalni pristup za kohlearnu implantaciju. Komplikacije vezane uz zahvat dijele se na velike i male. Općenito, smatra se da je stopa ozbiljnih komplikacija niska te je zahvat ugradnje umjetne pužnice siguran. Uz primjerenu rehabilitaciju, koja je za samog pacijenta najzahtjevniji dio, kohlearna implantacija dovodi do značajnog porasta kvalitete života u pedijatrijskoj, ali i odrasloj populaciji.
Abstract (english) A cochlear implant is an electronic device that enables the sense of hearing to people with a severely or completely damaged cochlea. The cochlear implant consists of an outer and an inner part. The electrode of the device is surgically implanted in the cochlea. Any person with severe sensorineural hearing loss or deafness with normal-functioning auditory nerve can potentially be a candidate for cochlear implantation, but the most important group of candidates are deaf or severe hearing-impaired newborns due to the special benefit of early diagnosis and intervention, which enables the development of hearing in a timely manner and inclusion in the regular education system. Therefore, in Croatia, since 2002, comprehensive screening of newborns for hearing impairment has been carried out using the evoked otoacoustic emission method. The criteria for cochlear implantation are expanding with the development of technology. Preoperative assessment consists of a detailed medical history, physical examination, age-adjusted audiological assessment, and radiological imaging. The oldest surgical technique for cochlear implantation, which is still used today, requires a mastoidectomy. Although it fully meets the requirements of cochlear implantation, it is associated with more frequent facial nerve and chorda tympani injuries. The most used surgical techniques without mastoidectomy are the Veria, suprameatal and endomeatal approaches. In parallel with the development of the mentioned approaches, the Zagreb otosurgical team from the Clinic for Ear, Nose and Throat Diseases and Head and Neck Surgery of KBC Zagreb has developed its own surgical technique that does not require mastoidectomy - a retromeatal approach for cochlear implantation. Complications related to the procedure are divided into major and minor. In general, the rate of serious complications is low, and cochlear implant surgery is considered a safe procedure. With adequate rehabilitation, which is the most demanding part for the patient, cochlear implantation significantly increases the quality of life in both pediatric and adult populations.
Keywords
kohlearna implantacija
oštećenje sluha
retromeatalni pristup
Keywords (english)
cochlear implantation
hearing loss
retromeatal approach
Language croatian URN:NBN urn:nbn:hr:105:948334 Study programme Title: Medicine Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2023-10-23 11:07:36
