Hospital Statistics 2015-16

PUBLICATIONS

REHABILITATION UNIT OF AUDIOLOGY AND SPEECH THEARPY

This unit provides comprehensive diagnostic and rehabilitative services in various speech and hearing disorders which include diagnostic audiology services, hearing therapy & hearing aid fitting & rehabilitation & speech therapy & training.

The unit is equipped with state of the art equipment and houses facilities for diagnostic audiometry, tympanometry, evoked response testing, hearing aid calibration, ear mould lab, play therapy, stroboscopy & computer aided speech analysis with VAGHMI & vocal-2, speech analysis with software.

Consultations with clinical experts in the unit are available every working day morning. All patients seen in the unit should however have had a previous consultation with the ENT medical staff. The unit has developed expertise in detection & evaluation of pediatric hearing impairment & with its rehabilitation & therapy. The facilities for cochlear implant programming, behavioral assessment and Neural response telemetry are available in the cochlear implant lab. The speech therapy services provide therapy for stammering, misarticulation, voice disorder, post laryngectomy, aphonia, cleft palate, and patients with hearing impairment.

RESEARCH

Funded Projects:
Completed:
• Prevalence of hypothyroidism following treatment of head-neck cancer and its impact on quality of life
Department of Science and Technology 2010 (completed Dec 2010) Rs.12 lacs app. (PI: Dr. Alok Thakar)

Ongoing:

• Effects of Long term macrolide with intranasal corticosteroids spray v/s monotherapy with intranasal corticosteroid spray in patients of chronic rhinosinusitis. Investigator: Prof. R.C. Deka. Co-Investigators: Dr. Rakesh Kumar, Dr. C. Venkatakarthikeyan
Funding agency: ICMR
Funds: Rs. 2395780
Duration: 3 years (August; 2010 to 2013)

• Phase II/III randomized placebo controlled clinical trial of curcumin in resectable stage III and IV Oral Squamous Cell Cancer. Department of Biotechnology. 43 lakhs (PI: Dr. Alok Thakar)

• Feasibility studies for developing an indigenous, low pressure, indwelling, microbial resistant tracheoesophageal prosthesis (TEP) for voice rehabilitation of laryngectomy patient. Ministry of Social Justice and Welfare 2009-2011(ongoing). Rs. 1 lac (PI: Dr. Alok Thakar)

• Immunochemical characterisation of juvenile nasopharyngeal angiofibroma (JNA) and radiological and histological evaluation of vidian canal involvement in JNA. Indian Council of Medical Research, Manpower Development Plan (A Thakar- Guide/Supervisor) Rs.25,000

Collaborative Projects
 

• Congenital cytomegalovirus infection and hearing loss in rural indian population
Indian Council of Medical Research . PI- Dr. Lalit Dar (Microbiology), Co-investigator: DR. Alok Thakar
• Deregulated initiation of translation in oral carcinogenesis. Department of Science and Technology PI- Dr. Jatinder Kaur ( Biochemistry). Co-investigator: Dr. Alok Thakar
• A stereological study of age related morphological and neurochemical changes in the human cochlear nucleus . Indian Council of Medical Research. PI- Prof T S Roy (Anatomy), Co-PI- A Thakar
• A randomized, double masked, active controlled phase iii study of efficacy, safety and tolerability of repeated doses of intravitreal vegf trap-eye in subjects with neovascular age-related macular degeneration (amd) . Bayer Schering Pharma. PI- Prof S P Garg (Ophthalmology)
Departmental Projects:
Completed:
• Study of profile of patients with external nasal deformity requiring septorhinoplasty and its surgical outcome
• Oncological adequacy and functional outcome following TLM surgical resection for early laryngeal and hypopharyngeal malignancies
• Role of 18-FDG PET CT in detection of unknown primary tumors of head and neck with cervical lymph node metastasis.
• Study of effect of cricoid split with or without rib grafting in cases of subglottic stenosis
• Effect of per-cochleostomy dexamethasone steroid injection into inner ear in randomly selected patients undergoing cochlear implant surgery on intracochlear electrodes impedance and its impact on outcome results

Ongoing:
 

• Immunohistochemical characterization of Juvenile nasopharyngeal Angiofibroma, radiological and histological evaluation of JNA in vidian canal
• Evaluation of NRT based mapping in post lingual deafened cochlear implantees and its correlation with conventional behavioral test based mapping in the same patient
• Comparative study of outcomes of Tympanoplasty using titanium and hydroxyapatite prosthesis
• Evaluation of injury pattern and non surgical treatment in traumatic facial palsy and surgical treatment in any etiology of facial nerve palsy
• Clinical, radiological profile and role of sialoendoscopy in patients with salivary gland obstructive pathology
• Podoplanin expression and its clinical significance in oral cancer patients
• Assessment of site directed surgical treatment by nasal, palatal, retroglossal advancement in cases with OSAS
• Role of r TMS therapy in chronic tinnitus
• Voice analysis before and after vocal cord fat injection in unilateral cord palsy
• Clinicopathological study of antral mucosal changes in cases of b/l ethmoidal polypi
 

Patient Care

COCHLEAR IMPLANT PROGRAM (an overview)

The cochlear implantation (CI) program was started in All India Institute of Medical Sciences in 1996 under the chairmanship of Prof.RC Deka and the first adult patient was successfully operated upon in February in 1997. Soon, the department started the Children Program in 1998. Till now (Feb 2012), we have performed 414 cochlear implant surgeries in adults and children. Prof. RC Deka has also done the country’s first bilateral Cochlear implant successfully in an adult patient. The department has provided support in starting cochlear implant program in R.R. Hospital, Central Railway Hospital in New Delhi and also PGIMER in Chandigarh.

What is a cochlear implant?

A cochlear implant is an electronic device that restores partial hearing to the deaf. It is the only treatment option available for patients with bilateral profound sensorineural hearing loss, if there is no benefit with hearing aids.

How does a cochlear implant work?
Cochlear implant is surgically implanted in the ear and activated by a device worn behind the ear. It converts sound to electrical impulses. These impulses are then transmitted via hearing nerve to the brain. The device bypasses damaged parts of the auditory system (hair cells of cochlea) and directly stimulates the nerve of hearing, allowing individuals who are profoundly hearing impaired to perceive sound.

What are the components of Cochlear Implant?

Cochlear implants have two parts -

a. external (outside) parts that include a microphone, a speech processor, and a transmitter.

b. internal (surgically implanted) parts - a receiver-stimulating system fixed to the skull bone behind the ear and electrodes which are inserted into the cochlea.

The microphone picks up sounds and sends them to the speech processor. The speech processor analyzes and digitizes the sound signals and sends them to a transmitter worn on the side of head just behind the ear. The transmitter sends the coded signals to an implanted receiver. The receiver in turn delivers them to the array of electrodes that stimulate the fibers of the auditory nerve directly. The auditory nerve transmits this information to the brain where it is interpreted as meaningful sound and thus the implanted person starts learning language and speech communication skills.

Cochlear Implant surgery in AIIMS

An implant team consisting of otolaryngologist, audiologist, radiologist, pediatric neurologist, clinical psychologist and speech therapist does the clinical and other laboratory assessment before planning for surgery. Implant surgery is performed under general anesthesia and lasts from two to three hours. The procedure requires a stay in the hospital for 7 to 10 days.

Postoperative rehabilitation

The postoperative rehabilitation will be done by the rehabilitation team consisting of otolaryngologist, audiologist and speech therapist. Parents’ participation in the training is of paramount importance and one of the parents has to learn the therapy to train the child at home. When the surgical wound is well healed (usually 3 to 4 weeks after surgery) the cochlear implant is activated (switch-on) and a MAP is created using computer based software. The subsequent mapping sessions are individually tailored as per the progress made by the patient. The short and long term goals are set for listening and then language and speech. The therapist teaches the child to listen to the sound that is received from the cochlear implant and helps them in developing effective spoken communication, leading to development of language and speech.

When my child/ the patient start hearing and speaking?

Cochlear implants do not restore normal hearing, and benefits vary from one individual to another. The implantees are expected to hear and/or recognize sounds/speech and learn language through the auditory input with the help of cochlear implant. In children, 4-5 years of intensive training is needed Click here for further detail