ABSTRACTBackground: cochlear implants are electronic devices that convert sound energy into electrical signals to stimulate ganglion cells and cochlear nerve fibers. These devices are indicated for patients with severe to profound sensorineural hearing losses who receive little or no benefit from hearing aids. The implant basically takes over the function of the cochlear hair cells. The implant consists of external components (microphone, speech processor and transmitting coil) and internal components (receiver stimulator and electrode array). The implant is inserted via a trans mastoid facial recess approach to the round window and scala tympani.Objectives: to determine the effectiveness and safety of non fixation method in cochlear implantation.Methods: a prospective study carried out from September 2009 to September 2012 in Gazi Hariri Hospital. Eighty patients with congenital severe –profound sensorineural hearing loss prepared for cochlear implantation involved in the study and divided into 2 groups. Group A includes 40 patients in whom the internal device was fixed to the skull by nylon suture materials through small burr holes on both sides of the well. Group B includes 40 patients in whom the internal device placed in a tight sub pericranial pocket without nylon fixation to the skull. All patients followed postoperatively for 6 months observing wound healing and local complications (hematoma, infection, wound dehiscence, device extrusion and migration).Results: mean age 4.2 years and male-female ratio was 1.3:1.Group A: 1 patient (2.5%) developed minor wound infection treated conservatively. Three patients (7.5%) developedsevere wound infection with wound breakdown and device extrusion despite the use of antibiotics and local rotational flaps, the device was explanted in those 3 patients. Two patients (5%) developed hematoma without history of trauma and treated conservatively. One patient (2.5%) had device migration without affection of its function.Group B: 2 patients developed minor wound infection treated conservatively. One patient (2.5%) had severe wound infection ends up with wound dehiscence and device extrusion despite the use of antibiotics and local rotational flaps. Explantation of the device was done for this patient. Hematoma occurred in one patient (2.5%) without history of trauma and treated conservatively. Another one patient (2.5%) developed device migration without impairment of its function.Conclusion: creation of sub pericranial pocket without internal device fixation by nylon materials is an effective and reliable method in cochlear implantation without compromising the patient safety or device performance.Key words: cochlear implantation, non- fixation, sub pericranial pocket
Paul Auster's City of Glass is here singled out as representative of the writer's The New
York Trilogy. All throughout his novelistic career, Auster has been working on a pseudothesis
that adheres to a certain aesthetic of disappearance. The study engages this Austerian
aesthetic apropos of certain theoretical stretches such as the Emersonian "Not Me", the
Thoreauvian "interval" or "nowhere", the Deleuzian "nomadic trajectory", the Derridian
"grammè" or "specter", and the Baudrillardian "disappearance". The city of the novel's titling
is here seen as the trope of all that which has already disappeared, and hence it is seen as the
space (mise en scène) where the perfect crime of the murder of the real is to be thoro
Edward Albee, as a playwright, indicates that art should be useful and have a message. Therefore, his work foregrounds and critically examines issues concerning the Neurosis of Blackness and psychological trauma. Albee uses cruelty of racism in reflecting psychological trauma and emotional abuse of American black identity in his plays. Race, social inequality, and gender still sustain to engender controversy audience consciously. Racial discrimination is one of the major issues that affect the American Society. Albee challenges and exposes the presumptive dreams of equality of American society and institutional racism. Therefore, one of the main problems of the twentieth century in America is skin color. It
... Show MoreThe current research aims at finding out how to properly and correctly manage waste and solid waste and reduce the difficulties faced by all countries. However, it is becoming increasingly acute in developed cities because their economies are growing rapidly. It is necessary to identify the modern methods used in developed countries in managing wastes. The use of modern waste management techniques is a coordinated effort by international agencies within the borders responsible for them. The problem of the study can be identified in the lack of clarity of environmental management procedures in place. The importance of the research contributes to providing greater capacity to the administrative and technical leadership in the municipality
... Show MoreIn this paper, a mathematical model for the oxidative desulfurization of kerosene had been developed. The mathematical model and simulation process is a very important process due to it provides a better understanding of a real process. The mathematical model in this study was based on experimental results which were taken from literature to calculate the optimal kinetic parameters where simulation and optimization were conducted using gPROMS software. The optimal kinetic parameters were Activation energy 18.63958 kJ/mol, Pre-exponential factor 2201.34 (wt)-0.76636. min-1 and the reaction order 1.76636. These optimal kinetic parameters were used to find the optimal reaction conditions which
... Show MoreThe current study was designed to investigate the presence of aflatoxin M1 in 25 samples of pasteurized canned milk which collected randomly from some Iraqi local markets using ELISA technique. Aflatoxin M1 was present in 21 samples, the concentration of aflatoxin M1 ranged from (0.25-50 ppb). UV radiation (365nm wave length) was used for detoxification of aflatoxin M1 (sample with highest concentration /50 ppb of aflatoxin M1 in two different volumes ((25 & 50 ml)) for two different time (15 & 30 min) and 30, 60, 90 cm distance between lamp and milk layer were used for this purpose). Results showed that distance between lamp and milk layer was the most effective parameter in reduction of aflatoxin M1, and whenever the distance increase the
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