%0 Journal Article %J Acta Otorhinolaryngol Ital %D 2016 %T Achieving early functional auditory access in paediatric cochlear implantation. %A Orzan, E %A Muzzi, E %A Marchi, R %A Falzone, C %A Battelino, S %A Ciciriello, E %X

Cochlear implantation (CI) is a viable option for providing access to auditory stimulation in severe-to-profound hearing loss/impairment of cochlear origin. It has been demonstrated that CI is safe and effective for deaf children. Younger age at activation after CI is linked with better outcomes. It is important to study variables and issues that can interfere with an early fitting and access to sound after CI. They range from patient characteristics, family compliance and support, to technical, medical or organisational problems. A SWOT analysis and a subsequent TOWS matrix was conducted to discuss issues and propose recommendations to be considered when operating an early switch on of the CI.

%B Acta Otorhinolaryngol Ital %V 36 %P 45-50 %8 2016 Feb %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/27054390?dopt=Abstract %R 10.14639/0392-100X-1075 %0 Journal Article %J Acta Otorhinolaryngol Ital %D 2016 %T Achieving effective hearing aid fitting within one month after identification of childhood permanent hearing impairment. %A Bastanza, G %A Gallus, R %A De Carlini, M %A Picciotti, P M %A Muzzi, E %A Ciciriello, E %A Orzan, E %A Conti, G %X

Diagnosis of child permanent hearing impairment (PHI) can be made with extreme timeliness compared to the past thanks to improvements in PHI identification through newborn hearing screening programmes. It now becomes essential to provide an effective amplification as quickly as possible in order to restore auditory function and favour speech and language development. The early fitting of hearing aids and possible later cochlear implantation indeed prompts the development of central auditory pathways, connections with secondary sensory brain areas, as well as with motor and articulatory cortex. The aim of this paper is to report the results of a strategic analysis that involves identification of strengths, weaknesses, opportunities and threats regarding the process of achieving early amplification in all cases of significant childhood PHI. The analysis is focused on the Italian situation and is part of the Italian Ministry of Health project CCM 2013 "Preventing Communication Disorders: a Regional Program for Early Identification, Intervention and Care of Hearing Impaired Children".

%B Acta Otorhinolaryngol Ital %V 36 %P 38-44 %8 2016 Feb %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/27054389?dopt=Abstract %R 10.14639/0392-100X-1077 %0 Journal Article %J Acta Otorhinolaryngol Ital %D 2016 %T Empowering the family during the first months after identification of permanent hearing impairment in children. %A Ciciriello, E %A Bolzonello, P %A Marchi, R %A Falzone, C %A Muzzi, E %A Orzan, E %X

The latest international guidelines highlight the importance of involving the family in the diagnostic and rehabilitation process of children affected by permanent hearing impairment. This emphasises how meaningful this approach is for the development of the deaf child. So far, there is very little evidence about this approach in Italy, and there are still some barriers to its practical management. The aim of this paper is to report the results of a strategic analysis, which identifies the strengths, weaknesses, opportunities and threats of the family empowerment process during early auditory diagnosis and rehabilitation. The audiology programme should have the goal to offer information and support to families in order to achieve a conscious decision about the use and type of auditory prosthesis and rehabilitation choice within three months after audiologic diagnosis. Within the framework of the Ministry of Health project CCM 2013 "Preventing Communication Disorders: a Regional Program for Early Identification, Intervention and Care of Hearing Impaired Children", a group of professionals identified three main recommendations that can be useful to foster the natural communicative development of the child by strengthening the therapeutic alliance and empowerment of the family. The recommendations obtained with this analysis can help to develop new Italian guidelines with the aim to foster natural communicative development of the child by strengthening the therapeutic alliance and empowerment of the family.

%B Acta Otorhinolaryngol Ital %V 36 %P 64-70 %8 2016 Feb %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/27054393?dopt=Abstract %R 10.14639/0392-100X-1071 %0 Journal Article %J Acta Otorhinolaryngol Ital %D 2016 %T Improving regional universal newborn hearing screening programmes in Italy. %A Molini, E %A Cristi, M C %A Lapenna, R %A Calzolaro, L %A Muzzi, E %A Ciciriello, E %A Della Volpe, A %A Orzan, E %A Ricci, G %X

The Universal Newborn Hearing Screening (UNHS) programme aims at achieving early detection of hearing impairment. Subsequent diagnosis and intervention should follow promptly. Within the framework of the Ministry of Health project CCM 2013 "Preventing Communication Disorders: a Regional Program for early Identification, Intervention and Care of Hearing Impaired Children", the limitations and strengths of current UNHS programs in Italy have been analysed by a group of professionals working in tertiary centres involved in regional UNHS programmes, using SWOT analysis and a subsequent TOWS matrix. Coverage and lost-to-follow up rates are issues related to UNHS programmes. Recommendations to improve the effectiveness of the UNHS programme have been identified. The need for homogeneous policies, high-quality information and dissemination of knowledge for operators and families of hearing-impaired children emerged from the discussion.

%B Acta Otorhinolaryngol Ital %V 36 %P 10-4 %8 2016 Feb %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/27054385?dopt=Abstract %R 10.14639/0392-100X-1072 %0 Journal Article %J Int J Pediatr Otorhinolaryngol %D 2015 %T Life-threatening unilateral hearing impairments. Review of the literature on the association between inner ear malformations and meningitis. %A Muzzi, E %A Battelino, S %A Gregori, M %A Pellegrin, A %A Orzan, E %X

BACKGROUND: Bacterial meningitis is a life threatening disease that can be triggered by a CSF leak through an inner ear malformation. Early identification of the specific type of cochleovestibular dysplasia and the associated risk of meningitis is of vital importance.

OBJECTIVES: The objective of this review is to collect and discuss available data on the association between inner ear malformations and meningitis in children.

METHODS: Electronic databases were crosschecked for obtaining relevant papers published in the last 20 years, and further cases were identified by hand searching through the references. Demographic data were extracted from full texts, together with information on the severity of hearing impairment, the type of inner ear anomaly, the site of cerebrospinal fluid leak, the number of recurrent meningitis episodes.

RESULTS: Sixty-seven cases of meningitis related to inner ear malformation have been identified among 45 papers. Mean age at presentation is 3.60±3.00 (range 0.1-14) years. Average diagnostic delay from the first episode of meningitis is 3.44±3.41 (range 0.00-10.00) years. The number of meningitis episodes that occurred before the correct diagnosis and definitive surgical treatment is 3.27±1.81 (range 1.00-10.00). Unilateral hearing impairment affects 70% of patients. Six patients had normal hearing at presentation. Two children are dead from inner-ear-malformation-related meningitis among reviewed reports.

CONCLUSION: A high number of paediatric patients carrying inner ear malformations, especially when associated with unilateral hearing impairment, could be at risk to develop recurrent bacterial meningitis. Universal newborn hearing screening programs should prompt a diagnostic work-up even in the case of unilateral hearing impairment, in order to prevent inner ear malformation-related meningitis.

%B Int J Pediatr Otorhinolaryngol %V 79 %P 1969-74 %8 2015 Dec %G eng %N 12 %1 http://www.ncbi.nlm.nih.gov/pubmed/26453271?dopt=Abstract %R 10.1016/j.ijporl.2015.09.028