Teleprogramação dos sistemas de implante coclear

Abstract

Objectives: To verify the effectiveness of teleprogramming in CI users comparing the audiological results of the IC and the programming parameters in remote and live conditions; to verify the quality of remote transmission and the understanding of the guidance given by the audiologists remotely. Patients and methods: We conducted a randomized controlled trial, with crossover, in which the remote intervention (distance) was compared to the live intervention. The end point was the realization of the free field audiometry, speech perception tests, and questionnaire and VAS scale for analysis of satisfaction with the sections. The selection criteria were: age between 18 and 59 years, of both genders; CI users of Cochlear ® device, internal unit Nucleus ® 24 or Freedom ® with speech processor Freedom ® SP, and experience with CI of at least 12 months. Exclusion criteria were: difficulty in understanding the questionnaire completed at baseline and visual disability which makes impossible the realization of lip reading. Participants performed two programming sessions on the same day: a live programming (LP) and a remote programming (RP). The same audiologists conducted the two programming sessions and the order of realization of the sessions was randomized. The minimum (T) and maximum (C) stimulation levels of five electrodes (1, 6, 11, 16, 22) were established. Tests were applied for speech perception using 65dBSNR (closed-set sentences, open-set without noise and speech-in-noise with signal-to noise 0dB and 10db, and monosyllables). The patients were also submitted to free field audiometry from 250 to 8000Hz frequencies, visual analog scale (VAS) and questionnaire after the fittings sections. The results were compared using the Wilcoxon Test. Results: The study included a total of 20 CI users, with average time of use of 43 months. Statistically significant difference was found in the T levels for the electrodes 22 and 16 (p<0.05), which indicates that levels were higher in RP. Statistically significant difference was found in the C levels for the electrodes 11 and 6 (p<0.05), which indicates that levels were higher in LP. There were no statistically significant differences between the speech perception tests and thresholds obtained with maps of LP and RP (p> 0.05). The VAS scale showed a statistically significant difference, with the highest scores to LP (p = 0.018). In the questionnaire, there was a statistically significant difference in the questions about quality and communication during the sessions, showing that LP allowed less difficulty of understanding and communication. Conclusion: Teleprogramming is feasible and effective when compared to live programming. Although there were some differences in stimulation levels

Investigação da eficácia da teleconsulta na programação do implante coclear

“…As diferenças dos limiares audiométricos e do LDV confrontados entre os grupos controle e experimental foram equivalentes (p>0,05), indicando que a programação via teleconsulta não alterou a audibilidade para os sons fracos, medidos em campo livre. A literatura também reporta que a programação via teleconsulta não alterou os limiares audiométricos em campo livre medidos intrasujeito (Ramos et al, 2009, Hughes et al, 2012, Samuel et al, 2014 ou intra-grupos (McElveen Jr et al, 2010).…”

“…Destaca-se que 13 participantes do grupo controle (5,6,9,11,12,14,22,25,27,29,31, 35 e 36) e oito participantes do grupo experimental (1,6,7,12,21,24 (Samuel et al, 2014) e dissílabos (Ramos et al 2009), materiais com estrutura consoante/vogal/consoante (McElveen Jr et al, 2010, Rushbrooke, 2012, listas de palavras Manchester Junior Words (MJW) e sentenças (Rushbrooke, 2012, Samuel et al, 2014. Em nenhum destes casos foi observada diferença estatística no desempenho de usuários que realizaram programação do IC via teleconsulta síncrona.…”