Intraoperative assessment of electrode function and position is essential for cochlear implant outcomes. Electrophysiological measures and radiographic imaging modalities have been used for this purpose. This study was conducted to determine the relative utility of X-ray, impedance measurements and ECAP for cochlear implant function.A retrospective review was conducted for 132 children (age range from 5 to 13 years old) who underwent cochlear implantation. 3 months after switch on, aided free field (FF) and Ling Six Sounds were compared between patients who had intraoperative ECAP and those who had not intraoperative ECAP (but with normally located electrode array as confirmed by plain X-ray).Only 4 cases (3%) had abnormal impedance measurements that became normal after reinsertion of the same electrode array. 3 cases (2.3%) showed malposition of the electrode array on plain radiograph. They underwent immediate revision. 11 cases (8.3%) had absent intraoperative ECAP response for all electrodes, and 4 cases (3%) had absent intraoperative ECAP response for basal electrodes. These devices were not explanted at the time of surgery. 3 months after switch on, FF and the ling 6 sounds were tested for all patients. No statistical significant differences were found between cases with normal intraoperative ECAP and those who gave no response in ECAP.From the study we can conclude that plain X-ray is the guideline for backup use. Results of plain X-ray impacted surgical decision making and led to the use of the backup device. In patients with correct electrode placement in normally developed cochlea as detected by X-ray, it is not recommended to use the backup even if there is no intraoperative ECAP. Also, it is recommended to follow how those children performed after 1 or 2 years to see if making the decision of using or not a backup device based in electrophysiology measures vs X-ray made a difference.
Therapy with involvement of animals presently attracts considerable attention as a new modern method of facilitating and supporting treatment of a wide scale of diseases. In contrast to increased interest in investigating and proving the positive effects of animal therapy on people, only little attention is paid to the animals involved. Stress affects the well-being, health and performance of all live beings. It is inevitable to have sufficient knowledge of the physiological forms of animal behaviour, understand the animal's body language and be able to recognize symptoms of stress, discomfort, fear and fatigue in order to prevent the risk of potentially compromising animal welfare. Suitable methods of selection, training, care and control of animals together with appropriate professional education of therapists can increase considerably the quality of therapeutic programmes, identify the animals unsuitable for such activities and look for alternative ways of their management and other forms of their involvement.