(精编)【体外膜肺ECMO精品课件】 ENT Updates for the General Pediatric Office教学课件.pptVIP

(精编)【体外膜肺ECMO精品课件】 ENT Updates for the General Pediatric Office教学课件.ppt

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演示文稿演讲PPT学习教学课件医学文件教学培训课件

* * * Change in Indiana state government over Deaf/Hard of Hearing educational services: new Center to coordinate rather than just ISD; political issues Good to know background; New technology last few years exciting— significant area of advances occur in hearing rehab/research in our specialty among all areas New ages, much change * * * * Mention: Australian data: early implantation * * * * Complications Anesthesia: pertinent for all ENT operations Current anesthesia fatality rate 1:250,000 for healthy individuals 1yr For perspective: activities with same risk of death as anesthesia: 40 hours automobile driving [2,000 miles] 40 hrs bicycle riding 24 hrs commercial airline flying 7 hrs downhill skiing; 30 minutes rock climbing 340 trips in passenger elevator Emerging Issues Earlier implantation: prior to 1year Bilateral implantation Why? Psychoacoustic literature Diminished function with only unilateral aiding of bilateral HL Improvement in speech intelligibility 3 binaural mechanisms Head shadow effect, Binaural squelch, Summation Sound localization, listening in noisy environment Adult studies support, growing peds literature Sequential vs simultaneous implantation Risk/benefit ratio; insurance approval Possible future alternative TX in future: stem cell,new implants---save one cochlea? CI Outcomes in Children: Key Findings Large individual differences; each child unique No preimplant predictors of outcome Abilities emerge after implantation Nature of early experience— Earlier implantation= better CI performance, better auditory/verbal communication Implant must be worn every day, all day Environment with robust auditory input necessary for maximal CI results CI Outcomes in Children: Language Children with CIs Outperform their Profoundly Deaf Peers Who Use Hearing Aids? Faster rates of language learning and higher overall language achievement levels in CI pts vs unimplanted Deaf children Literacy: Tomblin Geers reading levels CI pts approaches hea

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