Biomedical subjects

Simon C Parisier

Publications and source records attributed to Simon C Parisier.

4 recordsLinked to original sources

PubMed2003

Cochlear implantation in children with otitis media.

OBJECTIVE: To describe the outcome of cochlear implantation in a cohort of pediatric patients with a history of otitis media. STUDY DESIGN: Retrospective chart review and follow-up phone survey. METHODS: The medical records of patients younger than 48 months of age who underwent cochlear implantation were reviewed for demographics, complications, and history of otitis media and bilateral myringotomy and ventilation tubes. A follow-up phone survey was performed to determine the long-term natural history of otitis media. RESULTS: The records of 126 profoundly deaf pediatric patients were reviewed. Seventy-two percent had a history of at least one episode of otitis media, 31% had a history of greater than three episodes, and 2% had a history of chronic serous otitis media. Twenty-three percent underwent bilateral myringotomy and tubes in the distant past, 6 to 8 weeks before implantation, at the time of implantation, or after implantation. A phone survey was successfully completed for 76 patients with a mean follow-up period of 46 months. There was a significant decrease in the incidence of otitis media after the cochlear implantation in the majority of patients with a history of otitis media with and without a history of bilateral myringotomy and tubes. CONCLUSIONS: Placement of ventilation tubes either before or at the time of cochlear implantation seems to adequately prevent infectious disease-related complications in otitis-prone children. Therefore, implantation should not be delayed, and subsequent episodes of otitis media can be managed by conventional therapy.

Child, Preschool↗

PubMed2003

Preliminary results with the use of AlloDerm in chronic otitis media.

OBJECTIVES/HYPOTHESIS: AlloDerm, an acellular dermal graft, has been used successfully as a material for soft tissue implantation. The authors report their experience with the use of AlloDerm in the reconstruction of the tympanic membrane. STUDY DESIGN: Case review study. METHODS: Charts were reviewed for all patients who underwent tympanoplasty with and without mastoidectomy between June 1999 and June 2002 in whom AlloDerm was used as a grafting material. There were 24 patients, 17 with simple perforations (8 revisions) and 7 with chronic otitis media with cholesteatoma (6 revisions). Success was defined as closure of the tympanic membrane perforation. RESULTS: Closure of the perforation using AlloDerm was achieved in 87.5% of the patients (ie, in all but three patients). Another patient developed serous otitis media and required a myringotomy tube in the postoperative period. CONCLUSIONS: The success rate for AlloDerm in tympanoplasty was similar to that of temporalis fascia in the authors' experience. AlloDerm can provide a suitable grafting material when fascia is not available or when the size of the defect precludes the use of fascia.

Biocompatible Materials↗

PubMed2003

Facial nerve paralysis following cochlear implant surgery.

OBJECTIVES: Facial nerve paralysis is a rare but devastating complication of cochlear implant surgery. The aims of the study were to define the incidence of facial nerve paralysis in our series and understand possible mechanisms of injury. STUDY DESIGN: Retrospective chart review and case reports. METHODS: Charts were reviewed of all 705 patients implanted between 1980 and 2002 at the authors' institutions to identify those with postoperative facial nerve weakness and determine incidence. For patients with facial nerve weakness, onset, degree, and timing of paralysis were noted; clinical findings were correlated to operative report findings. The method of treatment was noted, and the final facial nerve function outcome was recorded. RESULTS: Five patients (one child and four adults) were found to have postoperative facial nerve weakness, for an incidence of 0.71%. This complication was delayed in all cases, ranging from 18 hours to 19 days postoperatively. All patients were treated with steroids or steroids combined with antiviral medication, and all ultimately recovered normal facial function. CONCLUSIONS: In the study series, the incidence of facial nerve paralysis following cochlear implant surgery was 0.71%. Possible mechanisms of injury included heating injury and viral reactivation. All patients presented with a delayed facial nerve paralysis and did recover normal facial nerve function.

Adult↗

PubMed2003

Cochlear implants: growing pains.

OBJECTIVES/HYPOTHESIS: The objective was to make familiar the problems faced in the application of cochlear implants to the half-million to a million severe to profoundly deaf individuals who are potential beneficiaries of this technology. STUDY DESIGN: Observations accumulated during 23 years as Medical Director of the Manhattan Eye Ear Throat Hospital Cochlear Implant Center. METHODS: The author reviewed insights gained while directing the Cochlear Implant Center since the early 1980s at Manhattan Eye, Ear and Throat Hospital (New York, NY). RESULTS: The rapid application of cochlear implant technology for patients with severe to profound hearing losses is creating critical problems. It is being hampered by inadequate reimbursement. There is a critical shortage of cochlear implant-trained audiologists, who are an essential keystone in the application of this technology. These audiologists are required to provide lifelong audiological services to patients who have received cochlear implants. At the same time, they must evaluate the exponentially growing number of new candidates. CONCLUSION: The restoration of hearing with cochlear implants provides an enormous educational and societal benefit. However, the existing health care delivery system limits the application of cochlear implant technology. University audiological training programs must expand their curricula to include cochlear implant-related courses. The existing rehabilitation audiologist delivery system could be applied to provide long-term, community-based cochlear implant services.

Audiology↗