| 1. |
- Lundman, Lars, et al.
(författare)
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Otosclerosis revision surgery in Sweden : hearing outcome, predictive factors and complications
- 2020
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Ingår i: European Archives of Oto-Rhino-Laryngology. - : SPRINGER. - 0937-4477 .- 1434-4726. ; 277:1, s. 19-29
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To describe the procedures and investigate the hearing outcomes and complications after revision surgery for patients with otosclerosis in Sweden and compare these with previously published reports and to investigate factors that may predict the outcomes of revision surgery.Methods: A total of 254 patients from the Swedish Quality Register for otosclerosis surgery who underwent surgery at 21 clinics were identified as having undergone revision surgery for otosclerosis from 2003 to 2013. Clinical records and audio-grams from each of these patients were collected and analyzed.Results: Improvement in hearing by 20 dB or more and closure of air-bone gap (<= 20 dB) was achieved in 43% and 69% of patients after a first revision operation and in 46% and 70% of patients after a second revision operation. Most patients who underwent surgery because of dizziness were relieved of their dizziness. Postoperative deafness occurred in 2.3% of patients. Prior successful otosclerosis surgery predicted successful revision surgery, especially after a second revision operation. Fixation of the incus or malleus and finding of no obvious reason for the conductive hearing loss predicted a worse hearing outcome.Conclusions: The hearing results after revision surgery in Sweden is somewhat inferior to those of previously published results involving large centers. Postoperative deafness may be as much as fivefold more common after revision surgery than after primary surgery. Meticulous reading of previous charts and honest counseling regarding the risks and expectations is mandatory before planning revision surgery for otosclerosis.
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| 2. |
- Pauli, Nina, et al.
(författare)
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Are there differences in revision stapes surgery outcomes between university and county clinics? A study from the quality register for otosclerosis surgery in Sweden
- 2023
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Ingår i: European Archives of Oto-Rhino-Laryngology. - : Springer Science and Business Media LLC. - 0937-4477 .- 1434-4726. ; 280:5, s. 2247-2255
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Tidskriftsartikel (refereegranskat)abstract
- Purpose The aim of the study was to investigate hearing outcomes in stapes revision surgery with regard to the type of clinic (university clinic or county clinic). Furthermore, the aim was to investigate the risk of complications with a focus on tinnitus, hearing deterioration, and taste disturbance 1 year after surgery. Methods The study is based on data from the Swedish Quality Register for Otosclerosis Surgery (SQOS). Two study protocols were completed by the surgeon, and a questionnaire was distributed to the patients 1 year after surgery. A total of 156 revisions were available for analysis with both preoperative and postoperative audiometry data. Results Seventy-five percent of the patients reported better to much better hearing 1 year after revision surgery. An air bone gap <= 20 dB postoperatively was seen in 77% of the patients. Four percent had hearing deterioration >= 20 dB PTA(4) AC. Eleven percent had worsened or newly developed tinnitus, 5% had taste disturbance, and 3% had dizziness 1 year after surgery. Preoperative and postoperative hearing did not differ between patients operated on in university vs. county clinics. Conclusions Revision surgery in otosclerosis is a challenge for otologists, but no differences in hearing outcomes between university and county clinics were found in this nationwide study. The risk of hearing deterioration and deafness is higher than in primary stapes surgery, and revision surgery should be recommended primarily in cases with a large air-bone gap and moderate to severe preoperative hearing loss.
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| 3. |
- Pauli, Nina, et al.
(författare)
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Tinnitus in immigrants attending Swedish language education classes
- 2022
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Ingår i: Laryngoscope Investigative Otolaryngology. - : Wiley. - 2378-8038. ; 7:2, s. 614-620
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Tidskriftsartikel (refereegranskat)abstract
- Objectives The aim of this study was to investigate the prevalence of tinnitus in immigrants attending Swedish language education classes in comparison with data from the general population and tinnitus's relation to hearing in this specific population. Methods The study was based on prospectively collected data regarding hearing and health status in newcomers attending language classes. The examination consisted of pure tone audiometry, an otoscopic examination, and a study-specific questionnaire including questions from the Swedish National Health Survey. Data from the Swedish general population were retrieved from the National Health Survey. Grading of hearing according to the World Health Organization was applied. Results A total of 188 study participants were included in the study. Tinnitus was reported by 38% of the immigrants, and severe tinnitus was reported by 8%. Corresponding percentages from the general population were 17% and 3%. High-frequency hearing loss (PTA(h3) > 25 worse ear) was found to be a significant predictor for tinnitus (p = 0.032, odds ratio (OR): 2.74 [95% confidence interval (CI): 1.40-5.35]). Additionally, self-reported general health significantly predicted tinnitus, with an increased risk of tinnitus relating to worse general health (p < .001, OR: 2.43 [95% CI: 1.66-3.57]). Conclusion Severe tinnitus was more than three times as common in the immigrant participants compared to the Swedish population. High-frequency hearing loss and self-reported worse general health were predictors for tinnitus. Level of Evidence 1b
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| 4. |
- Redfors, Ylva Dahlin, et al.
(författare)
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A validation study of the Swedish version of the Glasgow hearing aid benefit profile evaluated in otosclerosis subjects
- 2022
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Ingår i: Laryngoscope Investigative Otolaryngology. - : Wiley. - 2378-8038. ; 7:3, s. 807-815
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Tidskriftsartikel (refereegranskat)abstract
- Objectives The aim of this study was to translate the Glasgow Benefit Hearing Aid Profile (GHABP) to Swedish, and to analyze its validity and reliability in patients undergoing rehabilitation with surgery or hearing aids. Methods The GHABP was translated to Swedish following published guidelines. One version of the questionnaire was adapted to fit the surgical intervention. A modification was made to the questionnaire by removing the answer option "not applicable" (N/A) since it was found confusing by the subjects. A prospective multicenter cohort study was performed to validate the questionnaire. One hundred and twenty-three individuals diagnosed with otosclerosis were included in the study prior to the intervention. The individuals were divided into three groups based on the intervention and previous hearing aid experience. Pure tone audiometry was performed 1 month prior and 1 year after the intervention. The Swedish version of the GHABP was completed by the individuals prior to the intervention, as well as 6 and 12 months after the intervention. Validity and reliability were assessed. Results The Swedish versions of the GHABP were well accepted by the included individuals. The questionnaires showed good psychometric properties, with comparable results for the two different interventions and three separate intervention groups. Initial disability was more pronounced in more challenging listening situations. Disability was reduced after the intervention. The "Use," "Benefit," and "Satisfaction" domains demonstrated beneficial results; however, a ceiling effect was noted in the same domains. The reliability was overall very high. Conclusion The Swedish version of the GHABP had good psychometric properties, with high validity and reliability. The same outcomes were found for the hearing aid and surgery groups. A ceiling effect was observed that can affect the questionnaire's ability to distinguish between subjects and measures over time. Level of evidence 2c
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| 5. |
- Redfors, Ylva Dahlin, et al.
(författare)
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Hearing-aid use and benefit : a long-term follow-up in patients undergoing surgery for otosclerosis
- 2013
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Ingår i: International Journal of Audiology. - : Informa Healthcare. - 1499-2027 .- 1708-8186. ; 52:3, s. 194-199
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aims of the study were to assess hearing-aid uptake in patients with otosclerosis 28-30 years after stapedectomy and to evaluate hearing-aid benefit to users.Design: A retrospective study was performed; it included a review of medical records and follow-up 28-30 years after surgery, including audiometry, clinical examination, structured interview, and a validated questionnaire, IOI-HA.Study sample: Sixty-five patients, who had undergone stapedectomy at a tertiary referral center in 1977-79. Results: In 95% of the subjects there was a theoretical need for hearing-aid amplification at follow-up; 46% of the subjects had no hearing aids, while 26% had unilateral and 28% bilateral hearing aids. Hearing sensitivity in the best ear predicted hearing-aid uptake. Of the subjects with a hearing aid, 94% were everyday users and 54% were full-time users (> 8 hours/day). The subjects reported a high level of satisfaction (mean 4.5) and benefit (mean 4.2), but also residual activity limitations (mean 3.1).Conclusions: The study shows that there is an unmet need for long-term hearing rehabilitation among patients previously undergoing surgery for otosclerosis. The patients who were using hearing aids were generally very satisfied with their hearing aids, but they still reported residual activity limitations.
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| 6. |
- Redfors, Ylva Dahlin, et al.
(författare)
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Hearing-related, health-related quality of life in patients who have undergone otosclerosis surgery : a long-term follow-up study
- 2015
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Ingår i: International Journal of Audiology. - : Informa UK Limited. - 1499-2027 .- 1708-8186. ; 54:2, s. 63-69
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aims of the study were to assess health-related quality of life and hearing-related disability in subjects with otosclerosis 30 years after surgery.Design: An observational study was performed. Medical records were reviewed, a clinical examination as well as audiometric assessments were performed. Generic health-related quality of life was assessed by the SF-36v2 and hearing disability by a shortened version of SSQ (speech spatial and qualities of hearing scale).Study sample: Sixty-fi ve individuals, who had undergone stapedectomy in 1977-79 at a tertiary referral center.Results: Generic health-related quality of life according to SF-36 subscale scores was comparable to that of an age- and sex-matched reference population. The SF-36 mental component summary score (MCS) was, however, significantly better than that of the reference population. The mental and physical summary component scores correlated significantly to hearing disability measured by the SSQ but not to hearing impairment. Hearing disability was displayed in all SSQ sub-scores, especially in more complex listening situations and in the localization of sounds.Conclusions: This study shows that individuals with otosclerosis, 30 years after surgery, have a good generic health-related quality of life, despite moderate to severe hearing loss and significant hearing disabilities.
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| 7. |
- Redfors, Ylva Dahlin, et al.
(författare)
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Otosclerosis : anatomy and pathology in the temporal bone assessed by multi-slice and cone-beam CT
- 2012
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Ingår i: Otology and Neurotology. - Philadelphia, USA : Lippincott Williams & Wilkins. - 1531-7129 .- 1537-4505. ; 33:6, s. 922-927
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To assess the use of cone beam computed tomography (CBCT) compared with multi-slice computed tomography (MSCT) in otosclerosis, with special emphasis on middle-and inner-ear anatomy.Study Design: Prospective study.Patients: Twenty patients who underwent a stapedectomy 30 years ago were selected on the basis of bone conduction threshold values. Their mean age was 65 years (range, 48-76 yr).Intervention: All patients underwent CBCT and MSCT with a slice thickness of 0.5 to 0.6 mm.Main Outcome Measures: Sixteen middle-and inner-ear anatomic structures and stapedial prostheses were analyzed by visual grading analysis. To assess critical reproduction and thereby the clinical applicability of CBCT, a dichotomization was made. Assessment of otosclerotic foci was performed using a grading system dividing the lesions in; 1) sole fenestral lesions, 2) retrofenestral lesions with or without fenestral lesions and 3) severe retrofenestral lesions.Results: The 16 anatomic structures were clearly reproduced by both imaging techniques. However, there was an interobserver variation in judging the superiority of 1 method in favor of the other. Otosclerotic lesions were diagnosed in 80/95% using MSCT and 50/85% using CBCT (evaluators 1 and 2, respectively). Retrofenestral lesions were diagnosed in 5 of 10 of ears with severe-to-profound hearing loss, whereas no retrofenestral lesions were diagnosed in the 10 ears with mild-to-moderate hearing loss. The stapedial prostheses were adequately or very well reproduced by both methods.Conclusion: CBCT is a new imaging technique with a considerably lower radiation dose than conventional MSCT. Our study indicates that CBCT is suitable and, in many ways, equivalent to MSCT, for temporal bone imaging in otosclerosis.
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| 8. |
- Redfors, Ylva Dahlin
(författare)
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Otosclerosis; clinical long term-perspectives
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis has assessed medical, technical and health-related aspects of otosclerosis from a long-term perspective. A retrospective clinical study was performed where 65 subjects who had previously undergone stapedectomy (1977-1979) were assessed. Twenty-eight - Thirty years later a follow-up was conducted. In Paper I, hearing thresholds were studied. Thirty years after surgery the mean hearing impairment was comparable with the preoperative level. The hearing deterioration was mainly caused by sensorineural hearing loss which was significantly worse compared to an age and sex matched control population (ISO 7029). In Paper II, hearing aid use and satisfaction were analyzed. Almost all subjects (95%) would have benefitted from hearing aid rehabilitation, however only 54 % had been fitted with hearing aids. Subjects who had received hearing aids were generally everyday users (94 %) and were very satisfied with their hearing aids. In Paper III, hearing disability and health-related quality of life was assessed. The subjects experienced hearing problems, especially in complex listening situations and in localization of sounds. Health-related quality of life showed results comparable to that of the reference population. In Paper IV, 20 of the subjects were analyzed by multi-slice and cone-beam CT (MSCT, CBCT) to assess the applicability of CBCT in the assessment of otosclerosis. The study showed that CBCT was valid in the assessments and in many ways was equivalent to MSCT.
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| 9. |
- Redfors, Ylva Dahlin, et al.
(författare)
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Otosclerosis: Thirty-Year Follow-Up After Surgery
- 2011
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Ingår i: ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY. - : Sage Publications. - 0003-4894 .- 1943-572X. ; 120:9, s. 608-614
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The aims of this study were to evaluate the hearing outcomes 28 to 30 years after stapedectomy in patients with surgically confirmed otosclerosis, and to evaluate inner ear involvement. METHODS: A retrospective clinical study was performed. Sixty-five consecutive patients who underwent stapedectomy at a tertiary referral center between 1977 and 1979 were included in the study. Medical records, including preoperative and postoperative audiograms, were reviewed, and a long-term follow-up clinical examination and pure tone audiometry were performed. The hearing outcome was compared with that of a reference population (ISO 7029) in terms of age and gender. RESULTS: Thirty years after stapedectomy, 66% of the patients' ears studied showed a moderate to profound hearing loss. The deterioration was mainly caused by a sensory hearing loss. The hearing loss was significantly greater than that in the reference population for both air and bone conduction thresholds at the early and late stages of the disease. A large majority of the patients (88%) had bilateral otosclerosis. CONCLUSIONS: Patients with otosclerosis have a sensorineural hearing loss that cannot be explained by age. Otosclerosis should be regarded as a middle and inner ear disease. Almost all patients with otosclerosis are in need of ongoing audiological rehabilitation and hearing aids.
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| 10. |
- Redfors, Ylva Dahlin, et al.
(författare)
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Psychometric properties of the Swedish version of the Glasgow Benefit Inventory in otosclerosis subjects
- 2019
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Ingår i: Laryngoscope Investigative Otolaryngology. - : Wiley. - 2378-8038. ; 4:6, s. 673-677
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Tidskriftsartikel (refereegranskat)abstract
- Objective To evaluate the psychometric properties of the Swedish version of the Glasgow Benefit Inventory (GBI). Methods A prospective multicenter cohort study was conducted. A total of 123 otosclerosis subjects were included in the study. The subjects were divided in three groups based on the following interventions: (a) stapedotomy without any prior hearing-aid rehabilitation (n = 60); (b) hearing-aid rehabilitation without any prior stapedotomy (n = 33); and (c) stapedotomy with prior hearing-aid rehabilitation (n = 30). Pre- and post-operative pure tone audiometry were measured. The Swedish version of the GBI was completed by the subjects 6 months after the intervention. Test-retest reliability and internal consistency, factor analysis, construct validity, and criterion validity, was assessed. Results The Swedish version of the GBI was well accepted by the subjects. It showed good psychometric properties with an overall high reliability. Factor analysis resulted in a 5-factor solution explaining 66.6% of the variance where factors 1 and 2 represented the general health domain. Conclusions Overall, the Swedish version of the GBI showed good psychometric properties. Based on the factor analyses, there is the possibility that the general health domain should be divided in two separate domains: general health and psychosocial health. Level of Evidence 2c.
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