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Biomedical subjects

A Daneshi

Publications and source records attributed to A Daneshi.

5 recordsLinked to original sources

Cochlear implantation in prelingually deaf persons with additional disability.

OBJECTIVES: We aimed to identify the frequency with which the following conditions were present as a second disability in cochlear-implanted, prelingually deaf persons: mild and moderate mental retardation; learning disability; attention deficit/hyperactivity disorder; cerebral palsy; congenital blindness; and autism. We also aimed to document the development of auditory perception in patients having one of these additional disabilities. STUDY DESIGN: A retrospective study was designed to pursue the above aims. METHODS: We examined the records of 398 cochlear-implanted, prelingually deaf patients who had received a cochlear implant at least one year previously. Patients were selected who showed a delay in motor, cognitive or emotional development. The selected cases were referred for psychological evaluation in order to identify patients with additional disabilities. We then compared these patients' auditory perception prior to and one year following cochlear implantation. RESULTS: A total of 60 (15 per cent) cochlear-implanted, prelingually deaf patients were diagnosed with additional disabilities. These were classified as: mild mental retardation in eight cases (13.33 per cent); moderate mental retardation in five (8.33 per cent); learning disability in 20 (33.33 per cent); attention deficit/hyperactivity disorder in 15 (25 per cent); cerebral palsy in five (8.33); congenital blindness in three (5 per cent); and autism in four (6.66 per cent). All patients showed significant development in speech perception, except for autistic and congenitally deaf-blind patients. CONCLUSION: Although cochlear implantation is not contraindicated in prelingually deaf persons with additional disabilities, congenitally deaf-blind and autistic patients showed limited development in auditory perception as a main outcome of cochlear implantation. These patients require unique rehabilitation in order to achieve more auditory development.

Adolescent↗

Cochlear implantation in children with Waardenburg syndrome.

Waardenburg syndrome is an autosomal-dominant trait resulting from mutations occurring in different genes. It is often characterized by varying degrees of: congenital hearing loss; dystopia canthorum; synophrys; broad nasal root; depigmentation of hair (white forelock), skin or both; and heterochromic or hypochromic irides. A retrospective case study was done to assess speech perception, speech production, general intelligence and educational setting in six profoundly hearing-impaired children with Waardenburg syndrome (four with type I, one with type II and one with type III) ranging in age from two years to 14 years, seven months (mean = six years, six months). None of the patients had malformation of the cochlea and were implanted using Nucleus 22/24 and Med-el combi40+. Five out of the six cases were of average intelligence and one had a borderline intelligence quotient. The follow-up period ranged from one year, 10 months to six years, six months (mean = three years, six months) after implantation. The evaluation of auditory perception in patients was accomplished using the Persian Auditory Perception Test for the Hearing-Impaired, a Persian Spondee words test and the Categories of Auditory Performance Index. The Speech Intelligibility Rating test was used to evaluate speech production ability. All the patients' speech perception and speech intelligibility capabilities improved considerably after receiving the implants, and they were able to be placed in regular educational settings. Patients used their cochlear-implant devices whenever awake, implying that they benefitted from the devices. We suggest that any further expansion of cochlear-implantation criteria in children include those with Waardenburg syndrome.

Adolescent↗

Positional envelope as a response parameter in caloric testing.

Bithermal caloric testing was carried out in 57 normal subjects and 374 patients presenting with subjective complaints of vertigo over a 4-year period from December 1984 to December 1988. Responses were quantitatively assessed using a DEC PDP 11/73 laboratory minicomputer. Patients were classified as normal and abnormal according to caloric responses based on standard methods of calculating unilateral hypoexcitability and directional preponderance using the maximum slow component velocity. Results obtained from the slow component velocity for unilateral hypoexcitability and directional preponderance were compared to the same values obtained from the overall positional envelope calculated by an integration of the slow component velocity vs. time curve. Although duration of nystagmus varies extensively in normal subjects and has not proven clinically useful in identifying abnormalities, the integral of response amplitude over time gives a more complete description of the vestibular response. However, when compared to the maximum slow component velocity in abnormal patients, the positional envelope identified only 94 of the total 119 abnormalities (79%). Therefore, maximum slow component velocity is the more sensitive response parameter in identifying vestibular pathology.

Algorithms↗