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Publicaciones científicas más recientes (desde 2010)

Autores: Manrique, Raquel; et al.
ISSN 0196-0202  Vol. 38  Nº 1  2017  págs. e57 - e68
OBJECTIVES:: The objectives of this study were to evaluate the effect of reimplanting a cochlear implant electrode in animal normal-hearing cochlea to propose measures that may prevent cochlear injury and, given its close phylogenetic proximity to humans, to evaluate the macaque as a model for electroacoustic stimulation. DESIGN:: Simultaneous, bilateral surgical procedures in a group of 5 normal-hearing specimens (Macaca fascicularis) took place in a total of 10 ears. Periodic bilateral auditory testing (distortion product otoacoustic emissions and auditory brainstem evoked responses [ABR]) took place during a 6-month follow-up period. Subsequently, unilateral explantation and reimplantation was performed. Auditory follow-up continued up to 12 months, after which animals were sacrificed and both temporal bones extracted for histological analysis. RESULTS:: Implantation and reimplantation surgeries were performed without complications in 9 of 10 cases. Full insertion depth was achieved at reimplantation in four of five ears. Auditory evaluation: Statistically significant differences between implanted and reimplanted were observed for the frequencies 2000 and 11,000 Hz, the remaining frequencies showed no differences for distortion product otoacoustic emission. Before the procedure, average thresholds with click-stimuli ABR of the five animals were 40 dB SPL (implanted group) and 40 dB SPL (reimplanted group). One week after first implantation, average thresholds were 55 dB SPL and 60 dB, respectively. After 12 months of follow-up, the average thresholds were 72.5 dB SPL (implanted group) and 65 dB SPL (reimplanted group). Hearing loss appeared during the first weeks after the first implantation and no deterioration was observed thereafter. Differences for ABR under click stimulus were not significant between the two ear groups. Similar results were observed with tone-burst ABR. A 15 dB shift was observed for the implanted group preoperatively versus 1-week post surgery and an additional 17.5 dB shift was seen after 12-month follow-up. For the reimplanted group, a 20 dB shift was observed within the first week post reimplantation surgery and an additional 5 dB after 6 months follow-up. Statistical analysis revealed significant differences between the implanted and reimplanted ear groups for frequencies 4000 Hz (p = 0.034), 12000 Hz (p = 0.031), and 16,000 Hz (p = 0.031). The histological analysis revealed that the electrode insertion was minimally traumatic for the cochlea, mainly indicating rupture of the basilar membrane in the transition area between the basal turn and the first cochlear turn only in Mf1 left ear. CONCLUSIONS:: With application of minimally traumatic surgical techniques, it is possible to maintain high rates of hearing preservation after implantation and even after reimplantation. Partial impairment of auditory thresholds may occur during the first weeks after surgery, which remains stable. Considering the tonotopic distribution of the cochlea, we found a correlation between the histological lesions sites and the auditory findings, suggesting that a rupture of the basilar membrane may impact hearing levels. The macaque was observed to be a functionally and anatomically an excellent animal model for cochlear implantation
Autores: Huarte, Alicia; Martínez, Marta; Manrique, Raquel; et al.
ISSN 0001-6519  Vol. 68  Nº 2  2016  págs. 92 - 97
Introducción El objetivo de este trabajo es conocer el impacto que el implante coclear (IC) tiene en la vida laboral de las personas implantadas, a través de una primera versión de un cuestionario elaborado en el programa de implantes cocleares de la Clínica Universidad de Navarra. Se pretende demostrar que el IC está teniendo un impacto significativo en la vida laboral de estos pacientes. Material y métodos Se estudia una población de 60 pacientes de 48 años de edad media, con hipoacusia neurosensorial profunda bilateral tratada con un IC, a la que se le presenta un cuestionario elaborado para evaluar su calidad de vida laboral con carácter retrospectivo. Resultados El 94,23% de los pacientes que completaron el cuestionario están actualmente satisfechos con su trabajo. El 93,05% se sienten más motivados para ir a trabajar tras su IC. Un 79,31% se consideran más competentes tras la cirugía y activación del dispositivo. Un 67,23% de los pacientes han mejorado sus relaciones interpersonales en el ámbito de trabajo tras la implantación coclear. Conclusiones El IC proporciona una ayuda positiva en la esfera profesional al igual que en las destrezas sociales al beneficiar la capacidad de comunicación de los pacientes implantados. El desarrollo de herramientas para evaluar el grado de satisfacción laboral de los pacientes tratados con un IC es de gran interés.
Autores: Manrique, Raquel; Calavia D; Huarte, Alicia; et al.
ISSN 1420-3030  Vol. 21.  Nº Supl 1  2016  págs. 29-35
The study aim was to determine the benefit of cochlear implantation and hearing aids in older adults diagnosed with hearing loss and to evaluate the index of depression, anxiety and quality of life after such treatments. A retrospective cohort comprised 117 patients older than 65 years and diagnosed with moderate to profound hearing loss who were included and classified into 2 groups (treated vs. non-treated). A battery of tests including auditory (pure-tone average, disyllabic words in quiet at 65 dB SPL) and findings from a series of questions relevant to quality of life were compared between both groups. Auditory outcomes for disyllabic words were 58.21% for the cochlear implant-treated group and 82.8% for the hearing aid-treated group. There was a positive effect on anxiety, depression, health status and quality of life in the cochlear implant group versus the profound hearing loss control group. We conclude that older adults with moderate to profound hearing loss gain benefit from hearing aids or cochlear implants not only in terms of improved hearing function, but also in terms of positive effects on anxiety, depression, health status and quality of life.
Autores: Senn; Colletti, V; Lenarz T; et al.
ISSN 1467-0100  Vol. 17  Nº 4  2016  págs. 163-171
Autores: Sanhueza IA; Manrique, Raquel; Huarte, Alicia; et al.
ISSN 1308-7649  Vol. 12  Nº 1  2016  págs. 16-22.
Bimodal stimulation provides better results than any monaural hearing mode, regardless of whether it involves the use of a hearing aid alone or a cochlear implant alone.
Autores: Hontanilla B; Cabello, Álvaro; et al.
ISSN 0266-4356  Vol. 54  Nº 4  2015  págs. 466-68
Autores: Manrique, Raquel; Huarte, Alicia; Manrique, Manuel Jesús;
ISSN 0937-4477  Vol. 273  Nº 3  2015  págs. 621 - 629
The objective of this study was to review cochlear reimplantation outcomes in the tertiary hospital and analyze whether facts such as type of failure, surgical findings, or etiology of deafness have an influence. A retrospective study including 38 patients who underwent cochlear implant revision surgery in a tertiary center is performed. Auditory outcomes (pure tone audiometry, % disyllabic words) along with etiology of deafness, type of complication, issues with insertion, and cochlear findings are included. Complication rate is 2.7 %. Technical failure rate is 57.9 % (50 % hard failure and 50 % soft failure), and medical failure (device infection or extrusion, migration, wound, or flap complication) is seen in 42.1 % of the cases. Management of cochlear implant complications and revision surgery is increasing due to a growing number of implantees. Cases that require explantation and reimplantation of the cochlear implant are safe procedures, where the depth of insertion and speech perception results are equal or higher in most cases. Nevertheless, there must be an increasing effort on using minimally traumatic electrode arrays and surgical techniques to improve currently obtained results.
Autores: Ramos Macías, Á.; Falcón González, J. C.; Manrique, Manuel Jesús; et al.
ISSN 1420-3030  Vol. 20  Nº Supl. 1  2015  págs. 60 - 66
Tinnitus is an incapacitating condition commonly affecting cochlear implant (CI) candidates. The aim of this clinical study is to assess the long-term effects of CI treatment in patients with severe-to-profound, sensorineural, unilateral hearing loss (UHL) and incapacitating tinnitus. We performed a prospective Cochlear¿ company-sponsored multicentre study in five Spanish centres. Sixteen patients with UHL and incapacitating tinnitus, which was indicated by a Tinnitus Handicap Inventory (THI) score >58%, received a Nucleus® CI in their deaf ear. The study design includes repeated within-subject measures on hearing, tinnitus, hyperacusis and quality of life up to 12 months after initial CI fitting. In addition to hearing loss and tinnitus, all patients suffered from hyperacusis. Most patients had a sudden hearing loss and received a CI within 2 years after their hearing loss. Preliminary 6-month, post-CI activation data of 13 subjects showed that the majority of patients perceived a subjective benefit from CI treatment, which was assessed using the THI, a Visual Analogue Scale of tinnitus loudness/annoyance and the Speech, Spatial and Qualities of Hearing Scale. Preliminary 12-month data of 7 subjects showed that most patients also perceived a degree of relief from their hyperacusis. One patient showed no improvements in any of the applied scales, which could be explained by partial insertion of the electrode due to obstruction of the cochlea by otosclerosis. In conclusion, CI can successfully be used in the treatment of UHL patients with accompanying severe tinnitus and hyperacusis. Implantation resulted in hearing benefits and a durable relief from tinnitus and hyperacusis in the majority of patients. These findings support the hypothesis that pathophysiological mechanisms after peripheral sensorineural hearing loss are at least partly reversible when hearing is restored with a CI.
Autores: Huarte, Alicia; Manrique, Manuel Jesús;
ISSN 1420-3030  Vol. 19  Nº Supl. 1  2015  págs. 36 - 39
Objectives: To determine whether individuals older than 60 years of age suffering from profound, bilateral, sensorineural hearing loss and unable to use hearing aids can benefit from a cochlear implant in order to improve hearing performance. Additionally, to evaluate how they manage the external components of their implanted system. Materials and Methods: The records of 68 cochlear implant users over 60 years of age were reviewed. They had undergone tonal and speech audiometry evaluations of hearing before and after implantation. A subset of 27 elderly patients were asked to respond to a specially designed questionnaire regarding the use of the external components of the implanted system. Results: Patients over 60 years of age benefit from cochlear implants. The earlier the implantation, the better the results tend to be. Certain limitations when using the external components of the implanted system were evident among the elderly. Conclusions: People >60 years of age suffering from profound, bilateral, sensorineural hearing loss show improved hearing performance following cochlear implantation. Using the implanted system includes some limitations that should be studied and overcome.
Autores: Gónzalez Navarro, M.; Manrique, Raquel; Manrique, Manuel Jesús; et al.
ISSN 0001-6489  Vol. 135  Nº 12  2015  págs. 1245 - 1252
CONCLUSION: Patients with cochlear implants should be treated no differently than non-implanted patients with similar symptomatology. OBJECTIVES: To describe the spectrum of symptomatology, treatment, and long-term follow-up of patients with cochlear implant and vestibular complaints. METHODS: This retrospective study included 25 patients with late onset vestibular complaints (more than 1 month post-implantation). Each patient underwent an extensive interrogatory and physical exam with ancillary test to complete a diagnosis. Treatment was given according to this and all patients followed a vestibular rehabilitation program. RESULTS: The total population was 72% male and 28% female, median age was 58 years; minimal follow-up was 9 months (mean = 51, median = 34). Cochleostomy was performed in eight cases and round window insertion was performed in 19 (two patients were removed from each group in the analysis due to their bilateral implantation under a different approach). The mean time from implant to vestibular symptoms was 53 months, median = 32; a Kaplan Meier graphic showed the round window approach has faster onset of symptoms with statistical significance (p = 0.020). The most common complaint was instability in all patients and after both surgical approaches. No difference in symptoms was found with a Kruskall Wallis test except for vertigo spells (more common in the round window approach). In 12 patients the symptomatology was attributed to the implanted side. In the long-term follow-up a relatively high number of patients (20/25) recovered with standard treatment, suggesting the presence of the implant is not associated with poor recovery prognosis.
Autores: Cardier, M; Zulueta-Santos, Cristina; Manrique, Raquel; et al.
ISSN 1420-3030  Vol. 20  Nº Supl 1  2015  págs. 48 - 52
This article presents an analysis of the impact of functional neuroimaging studies (positron emission tomography, PET) in asymmetric hearing loss based on the clinical expertise obtained from a group of 21 patients. In these patients, PET studies are performed at rest and after auditory stimulation in order to measure the increase in brain activity in the ipsi- and contralateral cortex, providing supporting evidence to recommend a specific treatment and the side to implant. In conclusion, PET is a useful tool for selected cases in which information on the metabolic status of the auditory pathway can drive the decision regarding the treatment of the most appropriate ear. However, in view of our small sample, further research is needed to confirm our results in this topic
Autores: Manrique, Manuel Jesús; Zubicaray J; Ruiz Erenchun; et al.
ISSN 1137-6627  Vol. 38  Nº 2  2015  págs. 289 - 296
La colocación de un implante coclear es una medida útil para paliar la hipoacusia neurosensorial de grado severo-profundo en aquellos casos en los que el beneficio del audífono es escaso. Desde su inicio hace 30 años los resultados auditivos han mejorado gracias a los progresivas mejoras que se han adoptado en distintos ámbitos: su diseño, estrategia, técnica quirúrgica¿Dados los buenos resultados en este periodo, las indicaciones también han variado. El objetivo de este trabajo es revisar los criterios establecidos y emergentes de indicación de implante coclear, estableciendo de manera consensuada, entre los centros sanitarios de la Comunidad Foral de Navarra, unos criterios actualizados para la indicación del mismo en dicha área territorial, de forma que pueden servir de referencia en situaciones clínicas diferenciadas.
Autores: Manrique, Manuel Jesús; Piciafuocco, S.; Manrique, Raquel; et al.
ISSN 1531-7129  Vol. 35  Nº 4  2014  págs. 619 - 628
HYPOTHESIS: Evaluate, based on morphologic and histologic parameters, the atraumaticity of 2 electrode arrays implanted in 10 human temporal bones. BACKGROUND: Atraumatic surgery and electrode arrays are current topics in otologic surgery. The preservation of cochlear anatomy and its functions is a priority and morphologic evaluation of the surgical trauma is essential to continue improving in this field. METHODS: Ten preserved human temporal bones (TB) without anatomic alterations were used in this study. They were divided into 2 groups of 5, and atraumatic surgery was performed to insert HiFocus 1J (group A) and HiFocus Helix (group B) electrode arrays. Anatomic comparisons were performed using computed tomography and histologic analysis. RESULTS: Group A: the mean length for the cochlear longitudinal axis was 10.30 mm, and the cochlear transversal axis was 7.2 mm. Scala tympani insertion was achieved in 4/5 TB studied, with a mean depth and angle of insertion of 19.2 mm and 325.5°, respectively. Lateral location of the electrode array was achieved in all specimens. No significant correlation was observed between these dimensions and depth of insertion. Group B: the mean length for the cochlear longitudinal axis was 9.52 mm, and cochlear transversal axis was 6.38 mm. Scala tympani insertion was achieved in 4/5 TB studied, with a mean depth and angle of insertion of 17.5 mm and 352°, respectively. Modiolar location of the electrode array was achieved in all specimens. A positive correlation was established between the linear and angular insertion depths (p = 0.044). CONCLUSION: In summary, it is safe to state that neither electrode array shows significant insertion trauma.
Autores: Manrique, Manuel Jesús; Manrique, Raquel; et al.
ISSN 1531-7129  Vol. 35  Nº 2  2014  págs. 216 - 220
OBJECTIVE: To describe the surgical technique under local or general anesthesia of 5 cases that have undergone this procedure and the audiologic results obtained with this new device. PATIENTS: Four patients with mixed hearing loss and 1 patient with single-sided deafness. INTERVENTION: Therapeutic. MAIN OUTCOME MEASURES: The surgery was planned beforehand with a 3D reconstruction of a CT scan. The procedure was documented and timed in every case. Air and bone conductive pure tone audiometry and disyllabic words discrimination were tested after and before the procedure. Results were statistically analyzed. RESULTS: All patients tolerated well the procedure. Four patients were intervened under local anesthesia and 1 under general anesthesia because of an associated procedure. All patients showed statistically significant difference between the presurgery and postsurgery audiologic tests. CONCLUSION: Implantation of the Bonebridge with local or general anesthesia is a safe and feasible procedure, with audiometric results that can come close with the ones provided by BAHD users.
Autores: Manrique, Manuel Jesús; Huarte, Alicia;
ISSN 0001-6519  Vol. 64  Nº 1  2013  págs. 55 - 67
Un programa de implantes cocleares (IC) reúne a una serie de profesionales, que durante las fases de selección, cirugía, programación, rehabilitación y seguimiento, desarrollan una serie de tareas enfocadas a promover una atención integral al paciente implantado. El objetivo de esta publicación es describir con detalle cuales son las tareas a realizar en cada una de las fases descritas en un programa de IC, los materiales y equipos necesarios, y el papel que juegan los profesionales implicados. Así mismo, se plantearán una serie de recomendaciones sobre cómo desarrollar de forma paulatina un programa de IC, con el fin de facilitar su progresión desde los casos más sencillos a los más complejos.
Autores: Manrique, Raquel; Manrique, Manuel Jesús;
ISSN 0001-6519  Vol. 64  Nº 1  2013  págs. 22 - 30
Introducción La aticoexposición-antroexclusión (AE-AE) simple o ampliada, es una técnica a la demanda para el tratamiento del colesteatoma. Las tasas de recurrencia/recidiva descritas con diferentes técnicas quirúrgicas son variables. El objetivo de este estudio es describir la técnica quirúrgica, sus indicaciones y analizar los resultados a largo plazo. Material y métodos Se incluyen 42 pacientes intervenidos de AE-AE en un centro terciario con un seguimiento de 6 meses-7 años. Esta técnica expone completamente el ático fresando la pared superior del conducto auditivo externo y excluye el antro y mastoides cerrando el additus con injertos de cartílago. Se indica en pacientes con colesteatoma localizado en la caja timpánica sin sobrepasar el additus o en caso de hacerlo estar encapsulado sin erosionar la cápsula laberíntica. El seguimiento es clínico y radiológico (TC de peñascos y RM con secuencias de difusión desde 2009). Resultados El 4,8% de los casos presentó una recidiva, los cuales fueron rescatados en un segundo tiempo quirúrgico. En el seguimiento la tasa de otorrea (2/42), otitis serosa (2/42) u otras complicaciones fue baja, no contraindicando las actividades acuáticas. La AE-AE no modificó el tipo de reconstrucción osicular respecto a otras técnicas. Conclusiones La AE-AE es una técnica abierta. Pretende eliminar totalmente la lesión y reducir la recidiva de colesteatoma, facilitando una normalización en los baños y una disminución de revisiones posquirúrgicas. La RM en secuencias de difusión es una técnica fiable en el despistaje y seguimiento, especialmente para el control de los espacios mastoideos tras la AE-AE.
Autores: Lenarz, T.; James, C.; Cuda, D.; et al.
ISSN 1499-2027  Vol. 52  Nº 12  2013  págs. 838 - 848
Objectives: To investigate the preservation of residual hearing in subjects who received the Nucleus Hybrid L24 cochlear implant. To investigate the performance benefits up to one year post-implantation in terms of speech recognition, sound quality, and quality of life. Design: Prospective, with sequential enrolment and within-subject comparisons. Post-operative performance using a Freedom Hybrid sound processor was compared with that of pre-operative hearing aids. Study sample: Sixty-six adult hearing-impaired subjects with bilateral severe-to-profound high frequency hearing loss. Results: Group median increase in air-conduction thresholds in the implanted ear for test frequencies 125¿1000 Hz was < 15 dB across the population; both immediately and one year post-operatively. Eighty-eight percent of subjects used the Hybrid processor at one year post-op. Sixty-five percent of subjects had significant gain in speech recognition in quiet, and 73% in noise (¿ 20 percentage points/2 dB SNR). Mean SSQ subscale scores were significantly improved (+ 1.2, + 1.3, + 1.8 points, p < 0.001), as was mean HUI3 score (+ 0.117, p < 0.01). Combining residual hearing with CI gave 22¿26 %age points mean benefit in speech recognition scores over CI alone (p < 0.01). Conclusions: Useful residual hearing was conserved in 88% of subjects. Speech perception was significantly improved over preoperative hearing aids, as was sound quality and quality of life.
Autores: Manrique, Raquel; Picciafuoco, S.; Cervera, Francisco Javier; et al.
ISSN 0937-4477  Vol. 270   Nº 1  2013  págs. 45 - 52
The purpose of this study is to determine if surgical approach to the inner ear is feasible without generating a hearing loss in an animal model. Five Macaca fascicularis were used as experimental animals and followed up for 27 months. Mastoidectomy, posterior tympanotomy and promontorial cochleostomy were performed on four specimens and one specimen was kept as control animal. Before and after drilling and exposing the endosteal layer and the membranous labyrinth, otoacustic emissions (dPOAE) and auditory brainstem responses (ABR) were used to test hearing. In vivo experimental studies prove it is reliable to expose the membranous labyrinth without causing hearing loss. dPOAE were present after 3, 6, 12, 24 and 26 months of follow-up. Regarding the ABR results from the four M. fascicularis in which a cochleostomy has been carried out, auditory thresholds are within the 20-30 dB interval at 27 months of follow-up. Experimental studies support clinical experiences indicating it is feasible to surgically approach the membranous labyrinth of the cochlea without damaging its hearing function.
Autores:  et al.
ISSN 1531-7129  Vol. 34  Nº 8  2013  págs. 1373 - 1379
Objective: Quantify the improvement and impact of the active middle ear implants (AMEIs) on a moderate-to-severe mixed hearing loss population. Study Design: Retrospective study on the indications and results obtained by individuals implanted with the AMEI. SettingS: Tertiary referral center. Patients: Thirteen adult patients with moderate-to-severe hearing loss were evaluated. Air and bone conductive pure tone audiometry and disyllabic word discrimination was performed before and after surgery. The follow-up period was from 5 to 64 months. INTERVENTION: Surgical implantation of the AMEI. MAIN OUTCOME MEASUREMENT: Auditory performance analyzed using pure tone and speech audiometry with AMEI off and on. Results: The average auditory gain in the frequency range 0.5 of 6 kHz was 44.07 dB. The average AC audiometric performance after activating the device is significantly better than the preoperative BC performance in 10 of 13 patients, with an average gain of 11.3 dB. Speech audiometry performance using disyllabic words showed a significant improvement. The detection threshold reduced significantly, from 65 to 24 dB (p = 0.012) with the AMEI. The speech recognition score at 65 dB SPL also showed a significant improvement from 28% to 90% post surgery (p = 0.004). The maximum speech recognition score also improved post surgery, from 56% to 93% with the AMEI (p = 0.023). Conclusion: The AMEI is considered an appropriate device to be used by patients with BC losses up to 70 dB, provided that hearing levels are present in all frequencies between 0.5 and 4 KHz, and the speech recognition percentage is above 60% in the ear chosen for implantation.
Autores: Morera, C.; Cavalle, L.; Manrique, Manuel Jesús; et al.
ISSN 0001-6489  Vol. 132  Nº 10  2012  págs. 1084 - 1094
Conclusion: The use of a hearing aid (HA) in combination with a cochlear implant (CI) significantly improved performance for speech perception in quiet, in noise, and for localization compared with monaural conditions. No significant differences in functional performance were observed following optimization of HA fitting. Objectives: To evaluate the binaural benefits derived from using a contralateral HA in conjunction with a CI in subjects with significant functional hearing in the nonimplanted ear and the effects of HA fitting optimization. Methods: Fifteen adult CI users, intra-subject controls, were enrolled in a prospective repeated-measure multicenter study. Evaluation of performance for speech understanding, localization, and subjective impressions was conducted before and following HA fitting optimization for CI alone, HA alone, and CI + HA. Results: For speech testing in quiet, bimodal scores were significantly better than for HA alone and CI alone conditions (p < 0.01). For speech and noise (S0N0) at 0 degrees azimuth the scores were significantly better in the bimodal condition than for CI alone (p = 0.01), indicating binaural summation. When noise was presented to the HA side (S0NHA) bimodal scores were significantly better than for CI alone (p < 0.01 and p < 0.05, respectively), suggesting a significant binaural squelch effect. Sound localization ability was significantly improved in the bimodal condition compared with the CI alone condition (p = 0.002).
Autores: Cervera, Francisco Javier; Manrique, Manuel Jesús;
Revista: FIAPAS
ISSN 1135-3511  Vol. 141  2012  págs. 1 - 7
Autores: Ramsden, J. D.; Gordon, K.; Aschendorff, A.; et al.
ISSN 1531-7129  Vol. 33  Nº 4  2012  págs. 561 - 565
This is a consensus statement on pediatric cochlear implantation by the European Bilateral Pediatric Cochlear Implant Forum.The consensus statement was determined by review of current scientific literature to identify areas of scientific and clinical agreement of current understanding of bilateral cochlear implantation.The statement is "Currently we feel that the infant or child with unambiguous cochlear implant candidacy should receive bilateral cochlear implants simultaneously as soon as possible after definitive diagnosis of deafness to permit optimal auditory development; an atraumatic surgical technique designed to preserve cochlear function, minimize cochlear damage, and allow easy, possibly repeated re-implantation is recommended."
Autores: Sennaroglu, L.; Colletti, V.; Manrique, Manuel Jesús; et al.
Revista: Otology & Neurotology
ISSN 1531-7129  Vol. 32  Nº 2  2011  págs. 187 - 191
Autores: Manrique, Raquel; Picciaffuoco, S.; Gracia, Javier; et al.
Revista: International Journal of Pediatric Otorhinolaryngology
ISSN 0165-5876  Vol. 75  Nº Supl. 1  2011  págs. 85
Autores: Manrique, Manuel Jesús; Manrique, Raquel; et al.
Revista: International Journal of Pediatric Otorhinolaryngology
ISSN 0165-5876  Vol. 75  Nº Supl.1  2011  págs. 27 - 28
Autores: Huarte, Alicia; Manrique, Raquel; et al.
ISSN 1420-3030  Vol. 16  Nº Supl. 1  2011  págs. 13 - 15
Autores: Eza Nuñez, P; Manrique, Manuel Jesús; Pérez-Fernandez, Nicolás;
ISSN 0035-1334  Vol. 131  Nº 3  2010  págs. 199 - 206
Objective: The objective of this study was to identify patients with otosclerosis and to characterize its clinical presentation among patients examined at our hospital with vertigo as the primary and most distressing symptom. Study Design: Retrospective chart review. Setting: Tertiary medical center. Patients: This study involved 40 patients suffering from dizziness and diagnosed with otosclerosis. Methods: At inclusion, the clinical status, as well as auditory (pure tone hearing level and speech audiometry, impedancemetry) and vestibular function (bedside, nystagmography, caloric test and rotator chair testing) were assessed. The results were analyzed using parametric and non-parametric tests, and the chi2 test. Results: The clinical presentation was diverse: 12 patients with Menière's syndrome (30%); 11 patients with spontaneous recurrent vertigo without hearing fluctuation (27.5%); 13 patients with positional vertigo (32.5%); 3 patients with chronic unrelapsing imbalance (7.5%); and 1 patient with acute unilateral vestibulopathy (2.5%). There was a lag between the detection of hearing loss and the beginning of vertigo attacks or imbalance in all patients. When measured through bone conduction, hearing loss was significantly different in patients with Menière's disease, spontaneous recurrent vertigo and positional vertigo. Conclusions: Dizziness, although frequent in patients with otosclerosis is rarely a cause for specific clinical assessment. There is a lag between the patient's perception of hearing loss and the initiation of vestibular symptoms, and it is not associated with any specific clinical disorder Otosclerosis can be found as any one of the most common vestibular disorders and in general, vestibular function tests reveal a more severe vestibular dysfunction than in the idiopathic forms. Level Of Evidence: 2A.
Autores: Peters, B. R.; Wyss, J.; Manrique, Manuel Jesús;
ISSN 0023-852X  Vol. 120  Nº Supl. S2  2010  págs. S17 - S44
Objectives/Hypothesis: The goal of this study is to ascertain worldwide experience with bilateral cochlear implantation (BCI) with regard to patient demographics, trends in provision of BCI to adult and child patient populations, differences and similarities in BCI candidacy criteria, diagnostic requirements, and treatment approaches among clinicians in high-volume cochlear implant centers. Study Design: Retrospective/prospective. Methods: An electronic survey consisting of 59 mainly multiple-choice questions was developed for online completion. It examined the implant experience and clinical opinion of expert cochlear implant (CI) centers worldwide on the indications, motivations, and contraindications for adult and pediatric, simultaneous and sequential BCI candidacy. Centers were chosen to complete the survey based on their known reputation as a center of excellence. Patient demographics were queried for two time periods to elucidate trends: 2006 and prior, and for the year 2007. Results: Seventy-one percent (25/35) of the CI clinics approached completed the survey. Collectively, these 25 clinics represent experience with approximately 23,200 CI users globally, representing 15% of the total estimated CI population worldwide. The total number of BCI surgeries reflected in their experience (2,880) represents 36% of the estimated number worldwide as of December 2007. Cumulatively to the end of 2007, 70% of all BCI surgeries have occurred in children, with the 3- to 10-year-old age group having the highest representation (33% of all BCIs), followed in order by adults (30%), children under 3 years of age (26%), and children between 11 and 18 years of age (11%). Seventy-two percent of all BCI surgeries were performed sequentially (70% of children, 76% of adults). Children <3 years of age represent the only age group of all patients in which simultaneous surgeries predominate (58% simultaneous). For all other age groups, sequential surgeries far outnumber simultaneous (3¿10 years, 84% sequential; 11¿18 years, 94% sequential; adults, 76% sequential). Prior to January 2007, 68% of BCIs were performed in children. This increased to 79% for the year 2007 (P < .001). With regard to children only, a change is apparent over time in terms of the age group making up the majority of pediatric BCI surgeries performed. Prior to 2007, children 3 to 10 years of age made up 50% of the children undergoing BCI, whereas those <3 years made up only 33%. In 2007 this shifted more toward the younger age group (47% for those <3 years and 40% for 3¿10-year-olds; P < .001). United States clinics had a higher proportion of adult BCI patients (59% children, 41% adults) than the non-United States clinics (78% children, 22% adults; P < .001). The majority of responders do not hold to a minimum or maximum age by which they limit BCI. Conclusions: Worldwide experience with BCI is now quite extensive and provides a useful base for evaluating clinical outcomes across patient categories and for providing further support during the patient/parent counseling process.
Autores: Battmer, R.-D.; Dillier, N.; Lai, W. K.; et al.
ISSN 1499-2027  Vol. 49  Nº 9  2010  págs. 657 - 666
Current cochlear implants can operate at high pulse rates. The effect of increasing pulse rate on speech performance is not yet clear. Habituation to low rates may affect the outcome. This paper presents the results of three subsequent studies using different experimental paradigms, applying the Nucleus CI24RE device, and conducted by ten European implant teams. Pulse rate per channel varied from 500 to 3500 pulses per second with ACE and from 1200 to 3500 pps with CIS strategy. The results showed that the first rate presented had little effect on the finally preferred rate. Lower rates were preferred. The effect of pulse rate on word scores of post-linguistic implantees was small; high rates tended to give lower scores. However, there were no significant differences between the word scores across subjects if collected at the individually preferred pulse rate. High pulse rates were preferred when the post-implantation threshold was low.
Autores: Manrique, Manuel Jesús; Manrique, Raquel; Bejarano, Bartolomé;
Libro:  Audiología. Ponencia oficial de la Sociedad Española de Otorrinolaringología y patología Cervico-Facial
2014  págs. 415 - 418
Autores: Manrique, Manuel Jesús; Manrique, Raquel;
Libro:  Libro blanco sobre la presbiacusia
2013  págs. 81 - 85
Autores: Manrique, Manuel Jesús; Manrique, Raquel;
Libro:  Atlas of otologic surgery and magic otology. The international team approach based on pathogenesis
Vol. 2  2012  págs. 1253 - 1258