A cochlear implant is a neuroprosthetic, electrical device that is developed for the treatment of patients who have sensory hearing loss. It directly stimulates the hearing nerve by bypassing the injured or damaged sensory receptors, the hair cells. This implant is directly placed in the inner ear. It is an electronic device which is proved to be very useful in patients with sensorineural hearing loss. This implant consists of a speech processor (externally present), which takes up the sound; transforms it into digital signals, and then internal components take it to convert it into electrical energy, which stimulates auditory nerves, and the brain perceives it and hears it as a sound. This is one of the most successful surgeries, which happens very frequently nowadays. Although, many complications are mostly associated with this implant. This paper deals with the preoperative, operative, and postoperative complications associated with cochlear implant surgery. That includes tinnitus, Meniere's disease, unilateral hearing loss, musical ear syndrome, infections; flap necrosis, facial nerve palsy, improper electrode placement, magnet displacement; failure and reimplantation, cholesteatoma, and pneumocephalus. These are just a few of the complications; there are much more complications which are associated with cochlear implants.
Unroofed coronary sinus syndrome (UCSS), also named coronary sinus (CS) septal defect, is a rare type of atrial septal defect (ASD) with the incidence less than 1% of the total number of ASDs. It is caused by incomplete formation of left atrial venous folds during embryonic development. There is communication between the CS and left atrium (LA) due to the presence of a left superior vena cava (LSVC) along with an incomplete or complete loss of the CS roof draining into the LA. It usually presents as mild breathlessness on exertion and the appearance of murmurs on auscultation. A case that is diagnosed as an unroofed CS (UCS) related to a continuous LSVC terminating into the CS, which further terminates into LA, along with a large patent ductus arteriosus (PDA) is a rare presentation.
Ellis-Van Creveld syndrome (EVCS) is an abnormal genetic condition of the EVC2 gene located on chromosome 4. In this case, the person presents with bone growth abnormalities, thus having a short stature, short arms and legs (more commonly the forearm and lower leg), a narrow chest with short ribs, polydactyly, spoon-shaped or malformed nails, abnormalities in dentition, and congenital heart defects like atrial septal defects and ventricular septal defects. In this case report, we present a 4.5-year-old female child who presented with cough and cyanosis as signs and tachypnea, tachycardia, facial oedema, cold, and clubbing as symptoms with polydactyly and short stature focuses on a rare presentation of a syndromic disease known as EVCS.
Peripheral vascular disease in association with renal artery stenosis is an important association which predicts the severity of the disease. An increase in the number of vessels affected by peripheral vascular disease increases the chances of renal artery stenosis. In our case, the patient had primarily presented with anginal chest pain with complaints of claudication which on further investigation was diagnosed to be a triple vessel coronary artery disease along with bilateral subclavian and bilateral renal stenosis. On detailed history taking, risk factors like hypertension and chronic smoking was found to be present in our case which predisposed to peripheral artery disease secondary to atherosclerosis which was diagnosed on further investigations. Although the association of renal artery stenosis is not very rare in cases of severe peripheral vascular diseases, the presence of a triple vessel coronary artery disease in synchrony is what makes it unique. Take away lesson from this case report is importance of early diagnosis of dyslipidemia causing atherosclerosis and its complications. Multiple atherosclerotic lesions in synchrony i.e, bilateral renal artery stenosis with bilateral subclavian artery stenosis with coronary artery triple vessel atherosclerotic disease like in our case and its severity should create awareness among health care individuals and early treatment measures including lifestyle modifications should be considered to avoid such drastic events.
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