| 1. |
- Andersson, Gerhard, et al.
(författare)
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Evaluation of quality of life and symptoms after translabyrinthine acoustic neuroma surgery
- 1997
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Ingår i: The American journal of otology. - 0192-9763. ; 18:4, s. 421-426
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:This study aimed to describe the consequences of acoustic neuroma surgery in terms of symptoms and quality of life.STUDY DESIGN:This study was a retrospective case review.SETTING:The surgery was conducted in Uppsala, Sweden.PATIENTS:A consecutive sample of acoustic neuroma patients operated on between 1988 and 1994.INTERVENTION:All patients had been operated on with the translabyrinthine technique.MAIN OUTCOME MEASURES:A questionnaire was constructed including questions about the surgery and symptoms. The House and Brackmann scale was used for grading facial function and the Brackmann and Bars scale was used for self-assessment of facial function.RESULTS:Follow-up data were collected by a postal questionnaire sent out and returned by 141 patients, which yielded a 90% response rate. Normal to moderately impaired facial function (House I-III) was evident in 85.2% of patients, although residual facial problems were reported. Most considered hearing to be worse after surgery (80%), and tinnitus was found in 60% of the sample. Balance problems (45%), dizziness (19%), and headache/pain (22%) were also reported. Work ability was affected in 23%, and 37% reported a continued need for medical consultations, mainly because of facial problems and pain. Most (89%) were pleased with the preoperative information.CONCLUSIONS:This study showed that few patients with acoustic neuroma had experienced negative social consequences after surgery. Although not linked to the operation, residual symptoms were reported that may necessitate further rehabilitation.
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| 2. |
- Andersson, Gerhard, et al.
(författare)
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Tinnitus and translabyrinthine acoustic neuroma surgery
- 1997
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Ingår i: Audiology & neuro-otology. - : S. Karger AG. - 1420-3030 .- 1421-9700. ; 2:6, s. 403-409
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this investigation was to study the effects of translabyrinthine acoustic neuroma surgery on tinnitus in a consecutive sample of patients operated on between 1988 and 1994 in Uppsala (Sweden). A postal questionnaire was returned by 141 patients, yielding a 90% response rate without reminder. The results showed that tinnitus was experienced by 70% of the patients before surgery and 60% after surgery. In general, low degrees of tinnitus distress were found, which was confirmed by the questionnaire results. Ratings of tinnitus distress after surgery, using the Klockhoff and Lindblom grading system, showed that 48% had tinnitus of grade I, 46% of grade II, and 6% of grade III. Pre- and postsurgery grading of distress did not change significantly. There was a 35% risk for developing tinnitus when no preoperative tinnitus was present and a 15% chance that tinnitus disappears when present preoperatively.
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| 3. |
- Danckwardt-Lillieström, Niklas, et al.
(författare)
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"Endolymphatic sacitis" in a case of active Menière's disease : an ultrastructural histopathologic investigation
- 1997
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Ingår i: Annals of Otology, Rhinology and Laryngology. - 0003-4894 .- 1943-572X. ; 106:3, s. 190-198
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Tidskriftsartikel (refereegranskat)abstract
- An ultrastructural analysis of an entire intraosseous endolymphatic sac (ES) from a patient with active, well-documented Menière's disease was performed for the first time. The results were compared with those obtained from ES biopsy material from patients with acoustic neuromas. The ES was small in size and showed signs of focal inflammation with intraepithelial invasion by mononuclear cells. At these places the normal fine structure, including the vascular anatomy, was altered. The possible relationship between these changes and Meniere's disease is discussed.
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| 4. |
- Danckwardt-Lillieström, Niklas, et al.
(författare)
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Steriocilia-like structures in the endolymphatic sac in Ménière's disease and acoustic neuroma
- 1998
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Ingår i: Journal for Oto-Rhino-Laryngology. - 0301-1569 .- 1423-0275. ; 60:4, s. 190-197
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Tidskriftsartikel (refereegranskat)abstract
- The vestibular aqueduct was surgically removed in 3 patients undergoing labyrinthectomy due to severe Ménière's disease (MD). Stereocilia-like structures were found in the luminal contents of the endolymphatic sac (ES) in all of these patients. The ES from 18 patients with acoustic neuroma were used as controls. In 1 of these, numerous stereocilia-like structures were found in the ES and in 3 additional patients, a few isolated cilia-like structures were disclosed. The findings may suggest an ongoing hair cell degeneration in the inner ear that is more advanced in patients with MD. The data also suggest that the endolymphatic duct is patent and that a longitudinal flow of endolymph also occurs in patients with MD.
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| 5. |
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| 6. |
- Edfeldt, Lennart, et al.
(författare)
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Surgical treatment of adult cholesteatoma : long-term follow-up using total reconstruction procedure without staging
- 2013
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Ingår i: Acta Oto-Laryngologica. - : Informa UK Limited. - 0001-6489 .- 1651-2251. ; 133:1, s. 28-34
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Tidskriftsartikel (refereegranskat)abstract
- Conclusions:A total of 330 cases of adult cholesteatoma were operated with canal-wall down (CWD) and total reconstruction procedure (TRP) without staging. Independent of preoperative middle ear conditions, cholesteatoma extent and localization, long-term improvement of hearing with a low incidence of residual and recurrent disease were achieved.Objectives:To evaluate long-term surgical and hearing results using a well-defined surgical technique without staging in adult cholesteatoma.Methods:The same CWD surgical technique, including obliteration of the mastoid cavity, reconstruction of the canal wall, and ossiculoplasty with autologous bone, was used by three senior surgeons (1982-2004). Preoperative and postoperative pure tone average (PTA) for air conduction (AC), bone conduction (BC), and air-bone gap (ABG) were assessed and compared 1, 3, and 6 years after surgery. Various prognostic factors with potential influence on long-term hearing outcome were evaluated.Results:Recurrence of AC occurred in 10%, residual disease in 3%. Six years after surgery all patients except one had a dry ear and over 92% of all cases were water resistant. Three patients developed complete deafness. Long-lasting improvement and/or preservation of hearing, with maintenance of PTA-ABG closure in 68% of all cases within 20 dB, were obtained. Sixty-four (19%) ossicular revisions were performed.
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| 7. |
- Edfeldt, Lennart, et al.
(författare)
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Surgical treatment of paediatric cholesteatoma : Long-term follow up in comparison with adults
- 2012
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Ingår i: International Journal of Pediatric Otorhinolaryngology. - : Elsevier BV. - 0165-5876 .- 1872-8464. ; 76:8, s. 1091-1097
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This study was designed to analyse long-term results after surgery of acquired (ACH) and congenital cholesteatoma (CCH) of the middle ear in children and compare these with adults.Methods: Computer-based analysis of consecutively operated paediatric patients for ACH and CCH in a tertiary referral centre was made in 57 cases under the age of 12 operated 1983-2004 by three surgeons using identical technique. A canal wall down and total reconstruction procedure (TRP) with obliteration of the mastoid cavity, canal wall reconstruction, ossiculoplasty with consistent use of autologous bone and an "aeration enhancement procedure" (AEP) with silicon sheet in selected cases were used. Pre- and post-operative PTA (0.5-3 kHz) and pure-tone average air-bone gap (PTA-ABG) together with surgical parameters were assessed 1, 3 and 6 years following surgery.Results: Results showed stable hearing over 6 years with low incidence of persistent and recurrent disease comparable with results from adult patients. In nearly half of the cases, silastic sheeting was used. In 21 cases, stapes was eroded. Bone conduction thresholds levels remained unaffected 6 years after surgery. No deaf ears, postoperative facial dysfunction or other lesions related to surgery were observed. Six years after surgery every evaluated ear was found to be water-resistant and infection-free.Conclusion: Our results suggest that one-stage eradication of ACH and CCH in children using total reconstruction procedure (TRP) provide long-term improvement or preservation of hearing, with a low incidence of persistent or recurrent disease. No difference in surgical outcome between children and adults was found.
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