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- Pauli, Nina, et al.
(författare)
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High frequency hearing 25 years after transmyringeal ventilation tube treatment
- 2023
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Ingår i: International Journal of Pediatric Otorhinolaryngology. - : Elsevier BV. - 0165-5876. ; 167
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The main aim of the study was to compare hearing outcome between a healthy control group and patients treated with transmyringeal ventilation tubes, 25 years after primary surgery. Another aim was to analyse the relation between ventilation tube treatment in childhood and the occurrence of persistent middle ear pathology 25 years later.Methods: In 1996, children treated with transmyringeal ventilation tubes were recruited for a prospective study on the outcome of ventilation tube treatment. In 2006, a healthy control group were recruited and examined together with the original participants (case group). All participants in the 2006 follow-up were eligible for this study. A clinical ear microscopy examination including eardrum pathology grading and high frequency audi-ometry (10-16 kHz) was carried out.Results: A total of 52 participants were available for analysis. Hearing outcome was worse in the treatment group (n = 29) compared to the control group (n = 29), both in regard to standard frequency range hearing, (0.5-4 kHz), and high frequency hearing (HPTA3 10-16 kHz). Almost half the case group (48%) had eardrum retraction to some extent, compared to 10% in the control group. No case of cholesteatoma was found in this study and eardrum perforation was rare (<2%).Conclusion: In the long term, high frequency hearing (HPTA3 10-16 kHz) was more often affected in the patients with transmyringeal ventilation tube treatment during childhood compared with the healthy controls. Middle ear pathology of greater clinical significance was rare.
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- Svanborg, Eva, et al.
(författare)
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Palatal Sensory Function Worsens in Untreated Snorers but not in CPAP-Treated Patients With Sleep Apnea, Indicating Vibration-Induced Nervous Lesions
- 2020
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Ingår i: Chest. - : Elsevier. - 0012-3692 .- 1931-3543. ; 157:5, s. 1296-1303
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Tidskriftsartikel (refereegranskat)abstract
- Background: Signs of both motor and sensory nervous lesions have previously been shown in the upper airway of patients with OSA and habitual snorers. Snoring per se may damage all upper airway neurons over time, thereby causing progression to manifest sleep apnea. To test this hypothesis, nonsnoring subjects, untreated snorers, and CPAP-treated patients underwent repeated sensory testing of the soft palate in a prospective long-term study. Methods: Cold detection threshold (CDT) testing at the soft palate and lip with a thermode and nocturnal respiratory recordings were performed in 2008 to 2009 with retesting 6 to 7 years later. Results: In 25 untreated snorers, palatal CDT worsened from a median (25th-75th percentile range) 4.2°C (3.2-5.9) to 11.0°C (7.0-17.4) (P < .001). The apnea-hypopnea index increased from a median 7.0 to 14.0 events/h (P < .05). There was no significant correlation between changes in CDT and the apnea-hypopnea index. In 21 nonsnoring control subjects, palatal CDT increased from a median 3.2°C to 5.6°C (P < .005). In 19 CPAP-treated patients, palatal CDT did not significantly change; eight patients had improved values. CDTs worsened significantly more in the snorers group than in the control subjects (P < .05) and the CPAP-treated patients (P < .001). There was no significant difference between control subjects and CPAP-treated patients. Conclusions: CDT worsened considerably over time in untreated snorers, significantly more than in nonsnoring control subjects and CPAP-treated patients. Untreated snorers therefore risk developing poor sensitivity in the upper airway. In contrast, efficient treatment of OSA seems to protect the sensory innervation, as the CPAP-treated group maintained their sensitivity to cold and, in some cases, the sensitivity even improved.
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- Svanborg, E., et al.
(författare)
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Snoring causes OSA : sensory nervous lesions in the palate worsen over time in untreated snorers but not in CPAP-treated patients
- 2018
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Ingår i: Journal of Sleep Research. - : John Wiley & Sons. - 0962-1105 .- 1365-2869. ; 27:1, SI, s. 399-399
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Tidskriftsartikel (refereegranskat)abstract
- Objectives/Introduction: Previous studies have shown that there are signs of both motor and sensory nervous lesions in the upper airway of patients with obstructive apnea (OSA) and, to a lesser extent, of habitual snorers.Hypothesis: Snoring per se may damage upper airway neurons overtime, thereby causing the progression to manifest sleep apnea. To prove this, non‐snoring subjects, untreated snorers and CPAP‐treated OSA‐patients underwent repeated sensory testing in the upper airwayin a long‐time study.Methods: Cold detection threshold (CDT) testing, a routine neurophysiological method to study sensory function, was performed at the soft palate and the lip. 64 subjects were initially tested in 2008 for their ability to perceive the sensation of cold and retested 6 ‐7 years later. 20 were non‐snoring controls, 24 untreated snorers and 20 had received CPAP. CDT‐testing was performed using the method of limits by a Medoc TSA 2001 equipment with an intra‐oral thermod.Results: In untreated snorers AHI increased from average 9–12. Eight previously normal subjects had developed OSA (AHI/ODI >5). CDT:s worsened from 5.0°C to 14.5°C (p = 0.001). Three subjects had completely lost their cold sensitivity in the palate, whereas it was normal and unchanged on their lips. In non‐snorers there were no significant changes in AHI (mean values 2.0). Cold detection thresholds increased slightly from average 3.1°C to 6.0°C (p = 0.003). In the CPAP‐treated patients the CDT:s did not significantly change (from 5.1°C 2008 to 7.1°C in 2015).Conclusions: CDT:s worsened much more in the untreated snorers than in the other two groups (p = 0.03). This group therefore risks developing poor sensitivity in the upper airway in a couple of years of habitual snoring. This could contribute to sleep apnea, since also the snorers′ respiratory disturbance had increased. In contrast, it seems that efficient treatment of OSA protects the sensory innervation, since the CPAP‐treated group maintained their sensitivity to cold.Disclosure: Nothing to disclose.
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