The recently held annual SACIG congress was a success story in more than one way. I was fortunate to participate in the pre-congress workshops organised by Southern ENT/Cochlear and MEDEL.
The Advanced Mapping course 2022
During the Advanced Mapping course 2022, hosted by Southern ENT, I presented on Vestibular function and CI: towards a consensus on screening and referral. It was a great programme compiled by Mirisa Snyman, General Manager of Southern ENT, the sole distributor of Cochlear Nucleus, Baha and Osia and Hanno Breedt, Surgical Support Audiologist: Implantable Hearing Devices. I was joined by Dr Christine Rogers, Senior Lecturer, Audiology from the University of Cape Town (UCT) joined me for some of the presentations. I discussed the impact of cochlear implantation on vestibular function, explaining the anatomy of the vestibular system and some of the special vestibular investigations that may be ordered. Some of the crucial points highlighted were:
- The high prevalence of vestibular deficits in children with sensorineural hearing loss (SNHL).
- The fact that vestibular deficits are one of the most common causes of device failure in children
- In all patients, bilateral vestibulopathy should be avoided in simultaneous or sequential cochlear implantation. Bilateral vestibulopathy carries a poor prognosis, responding only in 50% to vestibular rehabilitation
It is of great significance that myself, Dr Christine Rogers, Sherene Labuschagne, mapping audiologist and in her absence Ruhee Hoosain, mapping audiologist that forms the vestibular subcommittee of SACIG, were able to discuss a proposed screening protocol with the audience for adult patients. This proposed protocol will be uniformly implemented and tested throughout South Africa, Namibia, Botswana and Zimbabwe at all the cochlear implant programs in the following year. The next step would be to establish a screening protocol for children. The article, Cochlear Implants and Children with Vestibular Impairments by Sharon L Cushing and Blake C Papsin, which appeared as open access in the Seminars of Hearing, was made available by the non-profit company Cape Hearing implants (CHi) to earn CPD points. All SACIG members have until the end of September 2022 to submit the answers and earn 3 CPD points which were applied for. To access the Article and Questions, visit: https://capehearingimplants.co.za/cpd-points-article-and-questionnaire/
The Electric Acoustic Stimulation (EAS) Structure & Hearing preservation workshop
The second workshop, hosted by MEDEL, focused on Electric Acoustic Stimulation (EAS) Structure & Hearing preservation. This was hosted at the famous Grootte Schuur Hospital. During this hands-on workshop, I presented vestibular preservation surgery, focussing on the latest data. I also briefly discussed the vestibular implant, which is still experimental but showing immense possibilities in treating patients with bilateral vestibulopathy.
The international faculty comprised Professor Wolfgang-Dieter Baumgartner, a specialist in ENT and acting senior physician at the University Clinic Vienna at the Vienna General Hospital. He was joined by Dr Anandhan Dhanasingh and Prem Ranjan from MEDEL. In their excellent talks, they highlighted the concept and possibility of hearing preservation with cochlear implantation in patients with residual hearing. Prof Baumgartner focussed on the surgical technique to preserve residual hearing. This technique is referred to as “soft surgery”. He performed an outstanding surgical demonstration on a cadaver bone specimen. Dr Anandan Dhanasingh, MBA and Head of Translational Science Communication research and development at MEDEL, gave exciting lectures on anatomy and explained why different length electrodes are so crucial as cochlear size is different in everyone. He discussed the radiological features of normal cochleas as well as malformed cochleas. In the malformed cochleas due to congenital development, MEDEL has developed different electrodes to cope with the anatomical challenges in these patients. Finally, Mr Prem Ranjan, Master in Audiology and Speech-Language Pathology and Senior Product Manager, MEDEL, discussed the history, principles, indications and long-term outcomes of EAS surgery. Participants were then allowed to practise insertions with dummy electrodes under the guidance of the International faculty, myself and Dr Ian Butler, ENT surgeon from Port Elizabeth or Gqeberha as it is nowadays called. Dr Tashneem Harris, ENT surgeon from Groote Schuur hospital and implant surgeon, did a fantastic job organising the local events and seeing things run smoothly.
I want to thank everyone, even if not mentioned by name, for contributing to the pre-SACIG course and workshop. Your efforts are appreciated. I am sure that our efforts will translate into better outcomes for all our patients.
