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Santa Teresa Hospital performs an unprecedented surgery in the Serrana region to restore the patient’s hearing

A 45-year-old man with sudden, profound, one-sided deafness received a prosthesis developed in Austria.

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Romulo Barroso – Special Memoirs

Santa Teresa Hospital promoted on Saturday (08/07) an unprecedented operation in the Serrana area: the implantation of a prosthesis fixed in the bone of one ear. The procedure aims to restore hearing to a patient who developed sudden, one-sided, profound deafness two years ago. With this equipment, which was developed 10 years ago in Austria, the promise is that you will hear normally again within 30 days.

The surgery was led by otolaryngologist Dennis Rangel, who specializes in ear surgeries and deafness. The medical team also had five other specialists, such as anesthesiologists, speech therapists and other professionals in the field. Petropolitan Denis graduated from UFF (Federal University of Fluminense) and majored from University of São Paulo (University of São Paulo) and UFRJ (Federal University of Rio de Janeiro). He has been doing this procedure for a long time, but this is the first time the surgery has been performed in Petropolis. According to him, HST provides a microscope, which is a necessary equipment for ear surgeries.

“Ear surgeries in general, we need a microscope, which turns out to be important for these surgeries because the ear is a very small structure. A microscope that gets bigger, increases what we need (visualization),” says the doctor.

Deep sudden deafness

The operated patient is a 45-year-old male with a good health history, no comorbidities, and an active life. Two years ago, he suddenly lost hearing in his right ear. According to an otolaryngologist, sudden deafness occurs when hearing does not return within the first 72 hours of the condition.

He underwent examinations such as CT scans and MRI scans to investigate the cause of the hearing loss, which did not determine the cause. Therefore, the most likely hypothesis in this type of case is that he had damage to the auditory nerve.

“He developed a sudden, profound deafness about two years ago, unrelated to the pandemic, and he has no history of coronavirus. Initially, when this happens (because the cause of the deafness is not determined by these tests), we go to the viral aetiology: He probably had some infection.” Viral that caused neuroinflammation, that is, an infectious inflammatory process in nerve deafness, and this leads to deafness that can be deep, severe, moderate or mild. It recovers, “the doctor explains.

In such cases, there are drug treatments that attempt to reverse the situation. But if the deafness persists for more than three weeks, total hearing loss is marked – which in his case was unilateral, only in the right ear. According to Dennis Rangel, one-sided loss is the most common.

Due to the prolonged period of deafness, the patient no longer believes that they can hear normally again. During this period, he also tried to use traditional hearing aids, but to no avail. About three months ago, he sought out Doctor Dennis Rangel on the recommendation of a friend. Once he heard the patient’s report on the condition and the impact of the problem on his life, the specialist began to study the possibility of implanting this prosthesis.

“This is the point I would like to change, especially in the Serrana area. We have forms of auditory rehabilitation in cases of severe or profound deafness in patients who do not benefit from hearing aids. This patient, specifically, has unilateral deafness, or in other words, He suffers from profound deafness on one side and the other side is fine.But having one-sided deafness threatens a lot of the quality of life, because we cannot identify the source of the sound, we cannot know where the sound is coming from and it also harms our ability to understand what people are saying, and to be clear in the presence of noise he says. Dennis Rangel cites practical problems, such as the inability to identify the source of a horn sound, to others such as the inability to speak while looking straight ahead, and turning your face to better understand other people nearby.

the operation

The procedure that took place on Saturday is the implantation of a bone-fixed prosthesis, also called an osteoanchored prosthesis. This prosthesis was created in Austria in 2013 and is called “Bonebridge”. It is placed under the ear and then an external device with a microphone is placed within 30 days. He should return to hearing immediately.

Dennis Rangel explains that one way to hear sounds is through a solid medium, i.e. the sound that produces vibrations in the ear bones.

“The prosthesis is two components, and it has a component that is under the skin and attached to the ear bone, which is what we will surgically implant. It has an external part, which is what the patient will manipulate, and that will cause a magnet to be held through the skin. So when the patient removes that external unit, He won’t even notice that he has a prosthesis, and when he wants to activate the prosthesis, he will simply take this outdoor unit and attach it through magnets, because this part under the skin is able to get magnetism to stick this outdoor unit on.This outdoor unit has a microphone that basically picks up sound And from there it can be transmitted to this inner unit and this inner unit will allow us to have vibrations in the bones of the ear. And when the sound propagates through the solid medium, basically through the bone it can transmit auditory information to the cochlea, and in this way the patient can hear,” Rangel explained. .

The surgery is quick, about an hour and the patient does not need to be hospitalized. Within 30 days, after the swelling subsides, the outdoor unit will be placed. At that time, frequency tests will be carried out to make the prosthesis comfortable for the patient.

“We were able to activate it in about 30 days and the patient starts hearing with his or her hearing aid and can use it with peace of mind. It’s a prosthesis that can change the covers of the external units, it’s a prosthesis that has a specific cover that can dive into a beach, a pool, a waterfall and stick works well with the skin, and can increase or decrease magnetism, for example if a patient gains or loses weight,” says Dennis Rangel.

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