Colombia at GICCA 2015: Age and unilateral hearing loss - is it always a barrier for implants?

Research by Colombian experts suggests implants will be around for a good while, their range of features increasing every day in tackling the problems faced by persons with hearing loss.

Colombia will boast a very healthy delegation of experts at the VI Iberoamerican Conference on Cochlear Implants and Related Sciences (GICCA), a representation made up of leading professionals on the domestic and international scenes, among them José Antonio Rivas, Jaime Hernández, Alejandro Rivas, Juan Manuel García, August Peñaranda, and Adriana Rivas.

The first Colombian to take part in the Iberoamerican Group on Cochlear Implants and Related Sciences (GICCA), the organiser and manager of the Congress, was the renowned otorhinolaryngologist and neurotologist, José Antonio Rivas Correa, member of the founding group and current general manager of the José A. Rivas Clinic. "Our aim initially was to form a group which would bring together all those professionals interested in the study, scientific development, and technology related to cochlear implants, middle-ear implants, and other hearing aid systems; this was how we joined forces and set up GICCA, working since then to outline objectives oriented towards the consolidation of an Iberoamerican scientific community for the exchange of knowledge and experiences in the subject, the promotion of research, and a permanent communication channel between all members," says Rivas Correa.

Every year GICCA gathers together the top hearing professionals willing to answer the call to present their studies, all products of rigorous research related to hearing loss. "These studies analyse subjects such as individual aspects of hearing health and hearing loss through genetic, congenital or acquired causes; but also of interest is the debate surrounding hearing disability from the angle of collective hearing health in terms of the scope and impact of family, educational, occupational and social integration for the hearing impaired. The congress covers the innovative treatment areas contributing to the renovation of clinical, medical imaging, and hearing diagnostics, as well as for medical, surgical, and rehabilitation therapies," the expert adds.

Contributions to GICCA

The participation in this year's congress of the Rivas Clinic involves a wide range of presentations of research into cochlear implants, osseointegrated implants, audiological benefits from different kinds of hearing aids, user profiles for both implantable and non-implantable hearing aids, audiological evaluations, and quality of life.

The team has also deemed it important to publish results showing hearing and quality of life benefits in implanted users for whom osseointegrated auditory implants provide highly recommended options in hearing loss rehab for conductive or mixed hearing loss cases, when air conduction amplification is contraindicated, or when anatomical conditions rule out the use of conventional amplification.

For Rivas Correa, the increase in the number of elderly adults being given cochlear implants means exploring the biopsychosocial needs of this patient group. "In this case it is fundamental to identify the benefits achieved in the rehab process for elderly adult deaf patients, so we are going to release the results of a study which allowed us to identify the audiological advantages, the acquisition of hearing abilities, satisfaction, and quality of life within this collective."

When it comes to osseointegrated implants, we must underline that these are now established as widespread for hearing rehabilitation in conductive, mixed, and unilateral hearing loss. Clinical success means achievement and maintenance of implant stability. In general, clinical studies have identified a variable waiting period before the processor can be switched on, so waits of three to four months in adults, and six to eight months in children, are recommended. "The key reason for this waiting period is the achievement of optimum osseointegration; nevertheless, the question remains as to whether it is safe to shorten the processor charge time. A simple, non-invasive method for measuring the stability of the implant is Resonance Frequency Analysis (RFA), which measures implant stability according to the integration of the bone-implant combination. We at the Rivas Clinic carried out a prospective study among implanted patients using an osseointegrated hearing system in patients, measuring the stability of their implants and analysing results to take the following variables into account: age, weight, body mass index, and the presence of comorbidities and the implant stability quotient," explains José Antonio Rivas.

Hearing loss and visual disorders are the most frequent causes of disability in the adult population, and these have a big impact on people's independence, psychosocial wellbeing, and quality of life. Failures are currently being shown up in getting the best use from devices in the rehab process for those who have access to them. This means identifying outcomes and factors in use profiles for hearing aids so that information can translate into a focus on effectiveness, efficiency, improvement of quality, and consistence in rehabilitation programmes. "Recommending options for rehabilitation in unilateral deafness is a challenge for our team and, not infrequently, a dilemma for patients. The debate is definitely growing, and it is mostly modelled on the needs and preferences of users, and also on the options in available hearing devices and continuing technological evolution. We at the Clinic carried out an intra-subject study in patients with profound unilateral sensorineural hearing loss, users of cochlear implants, or bone conduction implant users, trying them out with deep insertion hearing aids (contralateral routing of signals system). A group of unilaterally deaf patients - without hearing aid - was included, and the audiological results were taken with and without noise, as well as measurements of perceived satisfaction and quality of life. This study allowed us to evaluate and compare effectiveness between treatment alternatives in patients with unilateral deafness, among them patients with cochlear implants, bone conduction systems, hearing aids, or no hearing device," explains Rivas.