Beneficios y desventajas de implante coclear según resultados audiológicos y habilidades comunicativas
Fecha
2018
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
: El carcinoma diferenciado de tiroides (CDT) comprende 1% de todos los carcinomas y es la neoplasia maligna endócrina más común. El estándar de oro en diagnóstico de nódulo tiroideo, además de ecografía, es el estudio histopatológico, pero la punción aspiración con aguja fina (PAAF) es simple, segura y tiene altas tasas de especificidad y sensibilidad. Es importante establecer el grado de concordancia entre ambos métodos, para tomar decisiones terapéuticas adecuadas. Objetivo: Determinar la correlación entre el estudio citológico e histopatológico en diagnóstico de CDT. Metodología: El estudio es tipo descriptivo, correlacional, no experimental y de corte transversal; incluyó 237 pacientes con sospecha de cáncer de tiroides (CT) de consulta externa de Endocrinología del hospital “Teodoro Maldonado Carbo” en Guayaquil periodo enero 2016 a diciembre 2017. Resultados: El diagnóstico con PAAF, según el Sistema Bethesda (SB) encontró 144 pacientes con CDT, correspondiendo a la categoría IV 14,8%, V 13,5% y VI 32,5% del total. El carcinoma papilar representó 96% del total y el carcinoma folicular solo 4%. El examen histopatológico reportó 204 pacientes (86,1%) con CDT. La evaluación de los métodos diagnósticos demostró una sensibilidad del 67,2%, especificidad 78,8%, fiabilidad 69%. VPP 95%, VPN 27%. Conclusión: El estudio citológico con el SB es el método aceptable para predecir que un paciente tiene CT, pero es cuestionable para predecir que no lo tiene. El estudio citológico, mediante la PAAF, si tiene concordancia diagnóstica con el estudio histopatológico en el CDT.
Severe-deep sensorineural hearing loss affects the cognitive, emotional, linguistic development of children and adults, causing limitations in their communication. The relevance of early detection and cochlear implantation for the benefit of speech development and linguistic competence is highlighted, since the cochlear implant is the first effective treatment for severe and profound hearing loss. Objective: To analyze the benefits and disadvantages of the cochlear implant according to audiological results and communication skills. Methodology: It was an observational, analytical, cross-sectional type that included 43 patients with severe and profound sensorineural hearing loss implanted in the otorhinolaryngology technical unit of the “Teodoro Maldonado Carbo” specialties hospital. Results: We studied 43 patients between children (40%) and adults (60%) with severe and profound hearing loss who received a cochlear implant. They succeeded in improving the tonal audiometry in the annual free field corresponding to 100% (81% is located in the range of mild hearing loss, considering that patients with cochlear implants need more than 15dB, unlike a normal-hearing implant, and 19% presented normal audiometry), and in communicative skills, skills 63% and 21% were able to reach category 6 and 5 respectively according to the Early Speech Perception (ESP) Ann Geers test. Conclusions: Among the main benefits mas the improvement in auditory skills, comprehensive language, adaptive behavior, expressive language, thus improving their social integration and improvement in quality of life.
Severe-deep sensorineural hearing loss affects the cognitive, emotional, linguistic development of children and adults, causing limitations in their communication. The relevance of early detection and cochlear implantation for the benefit of speech development and linguistic competence is highlighted, since the cochlear implant is the first effective treatment for severe and profound hearing loss. Objective: To analyze the benefits and disadvantages of the cochlear implant according to audiological results and communication skills. Methodology: It was an observational, analytical, cross-sectional type that included 43 patients with severe and profound sensorineural hearing loss implanted in the otorhinolaryngology technical unit of the “Teodoro Maldonado Carbo” specialties hospital. Results: We studied 43 patients between children (40%) and adults (60%) with severe and profound hearing loss who received a cochlear implant. They succeeded in improving the tonal audiometry in the annual free field corresponding to 100% (81% is located in the range of mild hearing loss, considering that patients with cochlear implants need more than 15dB, unlike a normal-hearing implant, and 19% presented normal audiometry), and in communicative skills, skills 63% and 21% were able to reach category 6 and 5 respectively according to the Early Speech Perception (ESP) Ann Geers test. Conclusions: Among the main benefits mas the improvement in auditory skills, comprehensive language, adaptive behavior, expressive language, thus improving their social integration and improvement in quality of life.
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Neoplasmas de la tiroides, Punción aspiración con aguja fina, Citología, Histopatología, Hospital de Especialidades Dr. Teodoro Maldonado Carbo, Cantón Guayaquil, Ecuador