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1.
  • Abul-Kasim, Kasim, et al. (författare)
  • Low-dose computed tomography of the paranasal sinuses: radiation doses and reliability analysis.
  • 2011
  • Ingår i: American Journal of Otolaryngology. - : Elsevier BV. - 1532-818X .- 0196-0709. ; 32, s. 47-51
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: The study aimed to (1) optimize the radiation doses of computed tomography (CT) of paranasal sinuses, (2) compare the radiation doses of different CT protocols with that of plain radiography, and (3) evaluate the reliability of low-dose CT in the detection of pathology and characterization of the detected pathology. MATERIALS AND METHODS: A head phantom was examined with different scan parameters to define a cutoff value to which the radiation dose can be reduced without negative impact on image quality. Kruskal-Wallis test and Wilcoxon W test were performed to compare the effective doses of the plain radiography in 30 patients with that of 3 different CT protocols in a total of 90 patients. The interobserver and intraobserver agreement in the detection of pathologic findings and in characterization of the pathology was estimated by calculating kappa value. RESULTS: The effective doses of plain radiography and low-dose CT were 0.098 and 0.045 mSv, respectively (P < .001). The effective dose of standard CT of sinuses (0.371 mSv) was 3.8 times higher than that of plain radiography and 8.2 times higher than that of low-dose CT (P < .001). The interobserver and intraobserver agreement on CT with regard to detection of pathology and pathology characterization was almost perfect (kappa values 0.81-1) compared to fair (kappa values 0.38-0.39) in plain radiography. CONCLUSIONS: The here proposed low-dose CT means significant dose reduction and is a reliable method in the investigation of the paranasal sinuses.
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  • Kammerlind, Ann-Sofi C., et al. (författare)
  • Recovery after acute unilateral vestibular loss and predictors for remaining symptoms
  • 2011
  • Ingår i: American Journal of Otolaryngology. - : WB Saunders. - 0196-0709 .- 1532-818X. ; 32:5, s. 366-375
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: The aims of this study were to follow recovery during the first 6 months after acute unilateral vestibular loss (AUVL) and to determine predictors for self-rated remaining symptoms. Materials and methods: Forty-two subjects were included less than 10 days after AUVL. Static and dynamic clinical balance tests, visual analogue scales, University of California Los Angeles Dizziness Questionnaire, Dizziness Beliefs Scale, European Quality of Life questionnaire, Dizziness Handicap Inventory, and Hospital Anxiety and Depression Scale were performed at inclusion and at 7 follow-ups over 6 months. Subjects rated their symptoms on visual analogue scales daily at home. Videonystagmography was performed in the acute stage and after 10 weeks. Results: Decrease of symptoms and improvement of balance function were larger during the first compared with the latter part of the follow-up period. Visual analogue scale ratings for balance problems were higher than those for dizziness. A prediction model was created based on the results of 4 tests in the acute stage: standing on foam with eyes closed, standing on 1 leg with eyes open, visual analogue scale rating of vertigo at rest, and European Quality of Life questionnaire rating of health-related quality of life. The prediction model identified subjects at risk of having remaining symptoms after 6 months with a sensitivity of 86% and a specificity of 79%. Conclusions: Recovery mainly takes place during the first weeks after AUVL. Subjects rate more balance problems than dizziness. Self-rated remaining symptoms after 6 months may be predicted by clinical balance tests and subjective ratings in the acute stage.
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  • Ledin, Torbjörn, et al. (författare)
  • Chronic toxic encephalopathy investigated using dynamic posturography
  • 1991
  • Ingår i: American Journal of Otolaryngology. - 0196-0709 .- 1532-818X. ; 12:2, s. 96-100
  • Tidskriftsartikel (refereegranskat)abstract
    • Seven male patients previously exposed to industrial solvents and diagnosed with chronic toxic encephalopathy (aged 38 to 69 years; mean age, 56 years) were investigated by dynamic posturography and compared with healthy, age-matched male control patients. Dynamic posturography comprises two phases: a sensory organization (SO) phase, in which the support surface and visual surround are either stable or referenced to the patient's sway, with eyes open or closed, and a movement coordination (MC) phase, in which the platform makes active movements. In SO testing, the patient group showed significantly impaired equilibrium performance compared with the control group in most test conditions. The MC test revealed no differences between groups. A relationship was found between the equilibrium score resulting from SO testing with stable support and visual surround and the sway area of the confidence ellipse elicited 3 years previously by static posturography with eyes open. We conclude that patients with chronic toxic encephalopathy have impaired equilibrium, as demonstrated by dynamic posturography testing.
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  • Melhus, Åsa, et al. (författare)
  • Experimental recurrent otitis media induced by Haemophilus influenzae : protection and serum antibodies
  • 1995
  • Ingår i: American Journal of Otolaryngology. - : Elsevier BV. - 0196-0709 .- 1532-818X. ; 16:6, s. 383-390
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: To study whether acute otitis media caused by encapsulated or nontypeable Haemophilus influenzae confers cross-reactive protective immunity in an animal model system and to explore the possible involvement of various humoral specific antibodies in protection. MATERIALS AND METHODS: Rats were intrabullarly challenged with H influenzae type b and two different nontypeable H influenzae strains. One month after the initial infection, the animals were rechallenged ipsilaterally or contralaterally with either a homologous or heterologous strain, and the susceptibility to reinfection was investigated by otomicroscopy. RESULTS: The animals challenged and rechallenged with the type b strain were well-protected ipsilaterally and contralaterally, while the protection after homologous rechallenge with a nontypeable strain was partial in the ipsilateral ear and very poor in the contralateral ear. Middle ears previously infected with a nontypeable strain remained fully susceptible to infections with heterologous strains, but there was an indication of cross-protection in the animal groups where the first episode of acute otitis media was caused by type b and the second by a nontypeable strain. Using the Western blot technique and an enzyme linked immunosorbant assay, the serological response to different outer membrane proteins, especially protein D, of H influenzae during and after middle ear infection were investigated. The serological response from the type b infected animals were generally more distinct, while the antibody levels against protein D were lower in these groups compared with the groups infected with nontypeable strains. CONCLUSIONS: These data indicate that H influenzae type-b-induced experimental otitis media results in a better protection than a nontypeable-induced, and H influenzae b confers a cross protection.
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  • Möller, Claes, 1950-, et al. (författare)
  • Vestibular and audiologic functions in gentamicin-treated Menière's disease
  • 1988
  • Ingår i: American Journal of Otolaryngology. - : Lippincott Williams & Wilkins. - 0196-0709 .- 1532-818X .- 0192-9763. ; 9:5, s. 383-391
  • Tidskriftsartikel (refereegranskat)abstract
    • Fifteen patients with disabling Meniere's disease were treated with local intratympanic administration of gentamicin once daily. They had suffered from frequent attacks of vertigo and vomiting, the hearing in the affected ears was decreased permanently, and spontaneous nystagmus was observed. The number of treatment days ranged between 3 and 11. Follow-up time was 1 to 6 years. For evaluation of the treatment, audiologic and vestibular examinations were used, including the broad frequency-band rotatory test (0.4-4.5 Hz). Fourteen patients were free from vertigo after treatment. In 5 patients, there was an increased hearing loss, and in 10 it remained unchanged. Tinnitus and fullness sensations were diminished. After treatment, all ears were unresponsive to caloric stimulation. The clinical examination and rotatory testing in light with sinusoidal stimulation revealed good central compensation of the vestibular loss. However, with pseudorandomized oscillations in darkness, the broad frequency-band rotatory test quantified the loss of peripheral vestibular function and was able to detect the side of the lesion in eight of nine patients.
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