| 1. |
- Tano, Liselott, et al.
(författare)
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A daily nasal spray with saline prevents symptoms of rhinitis
- 2004
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Ingår i: Acta Oto-Laryngologica. - Oslo : Taylor & Francis. - 0001-6489 .- 1651-2251. ; 124:9, s. 1059-1062
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To ascertain whether a daily nasal spray with physiological saline could prevent symptoms of common cold in a population of otherwise healthy adults.Material and Methods: This was study involving 10 weeks of daily use of a nasal saline spray and 10 weeks of only recording symptoms. Young adults eligible for military service at an army barrack in Boden, Sweden were invited to participate in the study and 108 healthy conscripts aged approximate to 20 years agreed to do so. Data were recorded by the participants in a diary at home. In the diary the participants noted symptoms such as rhinitis, blocked nose, cough, fever and sore throat (pharyngeal pain). They also recorded inability to perform their duties due to the symptoms, and any medication or antibiotics necessitated by upper respiratory tract infection.Results: A total of 69 subjects completed the 20-week diary period. For 60 of them, compliance during the spray period exceeded 60% and their data were used in the statistical calculations. During the spray period the number of days with nasal secretion and/or blocked nose (mean 6.4 days) was significantly (p= 0.027) lower than that during the observation period (mean 11 days). Furthermore, the participants had a mean of 0.7 episodes of upper respiratory tract infection during the spray period, compared with 1.0 episodes during the observation period (p= 0.05).Conclusion: A daily nasal spray with saline can prevent nasal symptoms of common cold in a population of otherwise healthy adults.
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| 2. |
- Agerhäll, Martin, et al.
(författare)
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High prevalence of pharyngeal bacterial pathogens among healthy adolescents and young adults
- 2021
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Ingår i: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS). - : John Wiley & Sons. - 0903-4641 .- 1600-0463. ; 129:12, s. 711-716
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Tidskriftsartikel (refereegranskat)abstract
- The pharyngeal mucosa can be colonized with bacteria that have potential to cause pharyngotonsillitis. By the use of culturing techniques and PCR, we aimed to assess the prevalence of bacterial pharyngeal pathogens among healthy adolescents and young adults. We performed a cross-sectional study in a community-based cohort of 217 healthy individuals between 16 and 25 years of age. Samples were analyzed for Group A streptococci (GAS), Group C/G streptococci (SDSE), Fusobacterium necrophorum, and Arcanobacterium haemolyticum. Compared to culturing, the PCR method resulted in more frequent detection, albeit in most cases with low levels of DNA, of GAS (20/217 vs. 5/217; p < 0.01) and F. necrophorum (20/217 vs. 8/217; p < 0.01). Culturing and PCR yielded similar rates of SDSE detection (14/217 vs. 12/217; p = 0.73). Arcanobacterium haemolyticum was rarely detected (3/217), and only by PCR. Overall, in 25.3% (55/217) of these healthy adolescents and young adults at least one of these pathogens was detected, a rate that is higher than previously described. Further studies are needed before clinical adoption of PCR-based detection methods for pharyngeal bacterial pathogens, as our findings suggest a high incidence of asymptomatic carriage among adolescents and young adults without throat infections.
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| 3. |
- Agerhäll, Martin, et al.
(författare)
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High rate of early recurrence of peritonsillar abscess among adolescents and young adults
- 2023
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Ingår i: Acta Oto-Laryngologica. - : Taylor & Francis. - 0001-6489 .- 1651-2251. ; 143:7, s. 602-605
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Tidskriftsartikel (refereegranskat)abstract
- Background: Peritonsillar abscess (PTA) can be treated with aspiration or incision for drainage, but a subsequent PTA can occur if tonsillectomy is not performed. Better understanding is needed of when tonsillectomy should be performed to avoid PTA recurrence.Objective: This study investigated the recurrence rate of PTA following aspiration or incision for drainage and evaluated the risk factors for recurrence.Methods: The medical records of 292 patients treated for PTA were reviewed. Recurrence of PTA and elective or quinsy tonsillectomy were the primary endpoints. A Cox proportional hazards regression model for PTA recurrence was constructed with sex, age, and PTA history as predictors.Results: Young age was the only significant predictor of PTA recurrence. Patients aged 15 to 24 years had a 30-day recurrence rate of 15.5% and a total recurrence rate of 26.6%. The total recurrence rate among patients over 30 years of age was significantly less at 4.0% (Fisher’s exact test, p <.05).Conclusion and Significance: Based on our results, tonsillectomy should be considered for PTA in patients between 15 and– 25 years of age and, to effectively avoid future recurrence of PTA, should be performed urgently.
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| 4. |
- Dapefrid, Anna, et al.
(författare)
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Prevalence of Fusobacterium necrophorum in tonsils from patients with chronic tonsillitis
- 2017
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Ingår i: Acta Oto-Laryngologica. - : Informa UK Limited. - 0001-6489 .- 1651-2251. ; 137:3, s. 297-301
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Tidskriftsartikel (refereegranskat)abstract
- Conclusion: There was a high prevalence of Fusobacterium necrophorum (FN) in patients with chronic tonsillitis in the age group 15-23 years. This indicates that FN might play an important role in the pathogenesis of chronic tonsillitis in this age group, which is also the age group in which chronic or recurrent tonsillitis is most common.Objectives: The role of FN in patients with acute and chronic tonsillitis is unclear. Thus, this study investigated the occurrence of FN in tonsils of patients with chronic tonsillitis. The aim of the study was to determine the prevalence of FN in patients that underwent tonsillectomy due to chronic tonsillitis. This study also investigated if FN was found at different areas in the tonsils.Method: One hundred and twenty-six consecutive patients undergoing tonsillectomy due to chronic tonsillitis were included from the ENT clinics at Sunderby Hospital and Gallivare Hospital, Sweden. Both children and adults were included to encompass various age groups (age =2-57 years). Culture swabs were taken from three different levels of the tonsils - the surface, the crypts, and the inner core of the tonsils. Selective agar plates for detecting FN were used for culture. Culture was also made for detecting -hemolytic streptococci, Haemophilus influenzae, and Arcanobacterium.Results: FN was the most common pathogen (19%). The highest prevalence of FN was found in the age group 15-23 years (in 34% of the patients). FN was detected both at the surface and in the core of the tonsils. Furthermore, in the few patients where FN was not detected in all three areas, FN was always detected at the tonsillar surface, in spite of being an anaerobic bacterium. Streptococci group G and C also occurred most frequently (30%) in the same age group as FN (15-23 years), whereas Streptococci group A was more evenly spread among the age groups.
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| 5. |
- Granström, Brith, 1962-
(författare)
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Life after treatment for head and neck cancer
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Treatment for head and neck cancer (HNC) is often multimodal, including surgery, radiotherapy, and chemotherapy. The anatomic location of HNC and its treatments often affect vital functions such as swallowing and speech, but also physical appearance, leading to a risk for social withdrawal and nutritional difficulties that can affect the patient’s quality of life.Aims: The general aims of this thesis were to describe the physical and social consequences for patients treated for HNC and to identify supportive needs in regaining a new everyday life including intimate relationships, return to work, and nutritional recovery.Methods: Paper I (n = 131), objectives: to determine how patients with HNC experience changes in intimate relationships and to identify factors interfering with such relations. A semi-structured interview study was carried out on patients after treatment, and the analysis was inspired by the guidelines in constructive Grounded Theory. Paper II (n = 295), objective: to describe the frequency of patients’ returning to work after treatment for oropharyngeal cancer and to identify predictors and physical barriers (with a focus on pain, swallowing and speech difficulties, and physical appearance), that might interfere with the return-to-work process. A cross-sectional study using questionnaires was carried out 15 months after the diagnosis. Data were obtained from the Swedish Head and Neck Cancer Register. Paper III (n = 197), objective: to assess nutritional aspects and body weight in patients with HNC. A nutrition impact symptom-specific questionnaire for HNC was used to assess symptoms interfering with oral intake as well as interfering with body weight during the first year post-treatment. Paper IV (n = 21), objective: to examine how patients with HNC perceive life one year after treatment and how they experience health care. A semi-structured interview study was performed with an interview guide developed using concepts from the literature and clinical experience, and a thematic analysis approach was used.Results: In Paper I most patients reported no major changes in intimate relationships at the end of treatment. In resuming intimate relationships, facilitating factors were stable relationships before treatment, engagement from others, and being open regarding the cancer, while detrimental factors were patronization and dis-engagement. This was summarised as “being open versus not sharing the cancer journey”. In Paper II, 15 months after diagnosis 84% of the patients who were working at the time for diagnosis had returned to work. Factors negatively associated with return to work were swallowing difficulties, problems talking on the telephone, and changed physical appearance. In Paper III, the post-treatment weight loss was related to the degree of symptoms and interference with oral intake, which also increased the risk for a body weight loss of ≥10% at 12 months after the end of treatment. In Paper IV, the patients were still suffering from side effects one year after treatment and from fear of recurrence, but they tried to live as they did before the cancer diagnosis. Even if most contacts with health care were experienced positively, patients lacked regular follow-ups regarding rehabilitation and contact with their contact nurse.Conclusions: In Paper I, when resuming intimate relationships, the challenges were related to whether the patients were open or not about the disease. In Paper II, some remaining physical barriers were identified. A positive result from the study that can be reported to future patients is the high number of patients returning to work after treatment. In Paper III, both nutritional and clinical factors were shown to affect body weight, and a holistic approach is needed when addressing the patients’ nutritional needs. In Paper IV, despite the sequelae from treatment, the patients sought to live as they did before the diagnosis. This may disguise continuing needs, and by meeting the patients with engagement, the contact nurse-patient relation may uncover these needs and proper individualized support and rehabilitation can be offered.
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| 6. |
- Granström, Brith, et al.
(författare)
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Perceptions of life and experiences of health care support among individuals one year after head and neck cancer treatment - An interview study
- 2023
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Ingår i: European Journal of Oncology Nursing. - : Elsevier. - 1462-3889 .- 1532-2122. ; 66
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To examine how individuals treated for head and neck cancer perceive life one year after the end of treatment and how they experience supportive efforts from health care.Methods: A semi-structured intervies study of 21 patients was performed one year after the end of treatment. The patients gave their views concerning physical, psychological, and return-to-work issues, and their experiences concerning rehabilitative efforts from health care and particularly the contact nurse were captured. A thematic analysis was conducted.Results: One year after treatment the patients were still suffering from side effects and from fear of recurrence, but they strived to live as they did before the cancer diagnosis, such as having returned to work and resuming leisure activities. Moreover, the rehabilitative efforts from health care had ended. Having access to a contact nurse, also known as a clinical nurse specialist, was positive, however, the participants lacked regular long-term follow-ups with the contact nurse regarding rehabilitation needs. Improvement possibilities were seen in clarifying the role of the contact nurse and that the contact nurse should show engagement and make the initial contact with the patients.Conclusion: Desptite the sequelae from treatment, the patients strived to live as before their diagnosis. By regular, engaged, and long-term follow-ups by the contact nurse, remaining needs may be uncovered, and appropiate individualized support and rehabilitation can be offered.
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| 7. |
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| 8. |
- Granström, Brith, et al.
(författare)
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Return to work after oropharyngeal cancer treatment-Highlighting a growing working-age population
- 2020
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Ingår i: Head and Neck-Journal for the Sciences and Specialties of the Head and Neck. - : Wiley. - 1043-3074 .- 1097-0347. ; 42:8, s. 1893-1901
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Tidskriftsartikel (refereegranskat)abstract
- Background To describe the frequency of patients returning to work after treatment for oropharyngeal cancer and to identify predictors and physical barriers that might interfere with the return to work process. Methods Cross-sectional study including 295 patients. Data were collected regarding work/sick leave situation at 1 month before diagnosis and 15 months after diagnosis. The situation before diagnosis was retrospectively recalled by the patients. Two subscales and two single items from the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-H&N35 were used. Data were analyzed with multivariate logistic regression. Results Fifteen months after diagnosis, 212 patients (72%) were working. To be working 15 months after diagnosis was associated with working before diagnosis. Swallowing difficulties, problems talking on the telephone, and physical appearance were negatively associated with returning to work. Conclusions The large number of individuals returning to work is encouraging for patients diagnosed with oropharyngeal cancer.
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| 9. |
- Hultin, Magnus, 1968-, et al.
(författare)
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Design of a program for complementary education of International Medical Graduates in Sweden : to include Swedish or not
- 2019
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Ingår i: AMEE 2019 : an International Association for Medical Education. - : AMEE. ; , s. 1390-1390
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Konferensbidrag (refereegranskat)abstract
- Background: International medical graduates (IMGs) can either select to take a proficiency test to become licensed to practice in Sweden or to take a 1-2-year complimentary medical education (CME) to qualify for internship. Both paths test the participant for proficiency according to the national Swedish standards for becoming a licensed physician and are given in Swedish. The national standards include medical knowledge, interprofessional skills, communication with patient, relatives and other personnel, and scientific scholarship. A prerequisite for the CME is a passing grade in a Swedish language level 3 course at an accredited adult education center. A recurring observation was that both those failing the proficiency test for IMGs and those taking previous CME was lacking in Swedish proficiency.Summary of Work: A programmatic approach was taken to implement systematic training in Swedish applied in medicine at this two-year CME that is mainly based on distance training using videoconference systems. During the first year the language training corresponds to 50% of the curriculum. Research questions: Did the students at the new CME perceive the education in Swedish as valuable and did the students pass the examinations? Design: Cross-sectional study based on the course evaluations and the results of the examinations from the first semester.Summary of Results: 28 students were admitted to the program and 22 remained with the course for the finals of the first semester. The majority had increased their proficiency in Swedish as measured in vocabulary and correct use of words, but the grammar had not improved. Half of the students failed the summative assessment and three of the students also failed the majority of the formative assessments. The participants scored the relevance and the value of the Swedish training as high.Discussion and Conclusions: The students appreciate the training in Swedish while also having difficulties to pass the tests. A more comprehensive study is warranted to study how to best deliver language training to IMGs.Take-home Messages: Medical education for IMGs needs to take language proficiency into account.
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| 10. |
- Johansson, Ulrica, et al.
(författare)
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The effect of perioperative betamethasone on post-operative nausea, vomiting and pain in children undergoing tonsillar surgery
- 2010
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Ingår i: British Journal of Anaesthetic and Recovery Nursing. - 1742-6456. ; 11:2, s. 24-29
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To investigate if a single dose of betamethasone given perioperatively could reduce common post-operative problems such as vomiting, nausea and pain in children undergoing tonsillar surgery.Background: Post-operative nausea and vomiting (PONV) are common problems after surgery caused by several perioperative factors, such as post-operative pain. Prophylactic treatment of PONV can be effective in improving recovery after surgery. Studies have shown that the use of a single dose of dexamethasone during tonsillectomies in children was efficient against PONV. Dexamethasone is not available in Sweden for intravenous administration; betamethasone was thought to be an alternative.Method: The study was a retrospective cohort study including 69 children who underwent tonsillar surgery. A single dose of betamethasone perioperatively was introduced to a group of 32 children, to reduce PONV while 37 children did not receive betamethasone. Data were received from the medical records and from a post-operative questionnaire.Results: No significant differences for children undergoing tonsillar surgery regarding the prevalence of PONV between the betamethasone group and the non-betamethasone group were found. This was maybe due to a comparatively low dose of betamethasone. However, the given dose was sufficient to significantly reduce post-operative pain.
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| 11. |
- Levin, Mikael, et al.
(författare)
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Vem väljer en elbil? : De svenska hushållens val av elbilar och laddhybrider
- 2024
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Ingår i: Sammanställning av referat från Transportforum 2024. - Linköping : Statens väg- och transportforskningsinstitut. ; , s. 305-305
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Antalet nyregistrerade laddbara bilar (elbilar och laddhybrider) har under de senaste åren ökat kraftigt. Ursprungligen var det främst företag som skaffade laddbara bilar, men vi kan nu se att privatpersoner väljer en laddbar bil i allt större utsträckning. Privatpersoner tycks även välja en renodlad elbil i större utsträckning än företagen och privatleasing har blivit en populär ägandeform för laddbara bilar. För att få en bättre förståelse för vilka hushåll det är som har valt en laddbar bil har Trafikanalys undersökt vilka hushåll som har valt att köpa eller privatleasa en laddbar bil, och vi jämför åren 2016 med 2020. Fokus i studien ligger på socioekonomiska förklaringsfaktorer. Studien utgår ifrån SCB:s hushållsdata som har matchats med fordonsregistret. Det ger oss data över vilka sorters hushåll som köpt, leasat och äger vilka bilar. Vi har därigenom kunnat identifiera de hushåll som valt en laddbar bil. Genom deskriptiv analys och logistisk regression för val av fordonstyp, identifierar och beskriver vi de förutsättningar och de faktorer som kan förklara vilka hushåll som valt en laddbar bil. Analysen bidrar därmed till det rådande kunskapsläget som huvudsakligen baseras på olika former av enkät- eller intervjustudier med ett begränsat urval av personer utan koppling till faktiskt val av biltyp. Antalet hushåll intresserade av laddbara bilar har också ökat över tid, liksom antalet hushåll som faktiskt väljer laddbara bilar. Exempelvis har en större andel laddbara bilar nyregistrerats av hushåll med en större inkomstspridning 2020 jämfört med 2016. Boende i flerbostadshus valde också en laddbar bil i större utsträckning 2020 än de gjorde 2016. Dessutom har privatleasing av laddbara fordon ökat kraftigt och blivit vanligare för laddbara bilar än ej laddbara bilar. Vi har även kunnat se en större spridning i såväl ålder, inkomst och boendeform bland de hushåll som valt att privatleasa en bil istället för att köpa den.
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| 12. |
- Musk, G. C., et al.
(författare)
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Reactions to Gudair® vaccination identified in sheep used for biomedical research
- 2019
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Ingår i: Australian Veterinary Journal. - : John Wiley & Sons. - 0005-0423 .- 1751-0813. ; 97:3, s. 56-60
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Tidskriftsartikel (refereegranskat)abstract
- Case report: We report Gudair (R) vaccination (against ovine Johne's disease, Mycobacterium avium subsp. paratuberculosis) site reactions in sheep used as a surgical model in biomedical research and discuss the actual and potential impact these lesions may have on surgical procedures, particularly in otology. Nine female Merino-cross sheep (Ovis aries) were enrolled in a project designed to investigate the healing capabilities of the malleus bone in the middle ear. The sheep were 12-18 months of age. Eight sheep had lesions near the base of the right ear that were discovered when surgery was performed. The size of the lesions varied and all lesions had a thick capsule containing various amount of caseous material. Two lesions had a draining tract where purulent material was apparent at the lowest point. The prescapular lymph nodes were not palpable in any of the sheep. Aerobic growth of various organisms was reported from four sheep lesions when the purulent material was transferred to a broth media. Histopathological examination revealed intralesional Mycobacteria and focal caseous necrosis or granulomatous dermatitis and cellulitis in seven of the eight lesions. Mild necrotising to granulomatous dermatitis and cellulitis was described in the lesion where organisms were not found. Conclusions: The lesions were confirmed at the end of the study to be associated with the vaccination and did not cause any known adverse effects on the research. However, it is important to acknowledge the risk of contamination these lesions could have on a sterile surgical site.
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| 13. |
- Niklasson, Anders, et al.
(författare)
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An Optimal Partial Ossicular Prosthesis Should Connect Both to the Tympanic Membrane and Malleus : A Temporal Bone Study Using Laser Doppler Vibrometry
- 2018
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Ingår i: Otology and Neurotology. - 1531-7129 .- 1537-4505. ; 39:3, s. 333-339
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Tidskriftsartikel (refereegranskat)abstract
- Objective:To compare stapes vibrations in different partial ossicular replacement prosthesis (PORP) applications.Methods: Stapedial vibrations were measured on fresh frozen human temporal bones with laser Doppler vibrometry. Eight different types of common ossiculoplasty methods were compared regarding recovery of stapes vibrations in relation with the normal ossicular chain. The PORPs were divided into three groups: 1) PORPs with the lateral contact only with the tympanic membrane, 2) PORPs with lateral contact only to the malleus handle, and 3) PORPs with lateral contact with both the malleus handle and the tympanic membrane.Results: The PORPs with lateral contact only to the malleus handle performed better than the PORPs with lateral contact to the tympanic membrane only at 2 kHZ, but the best recovery was found in the group with contact both to the malleus handle and the tympanic membrane.Conclusion: The best sound transmission might be achieved by placing a PORP in contact with both the tympanic membrane and the handle of the malleus.
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| 14. |
- Niklasson, Anders, 1967-
(författare)
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Malleus fracture : experimental and clinical aspects
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Patients with malleus fractures are described as rare in the literature. The cause of these fractures are most commonly trauma and digital manipulation of the ear canal, while in some cases the causes are unknown. At our clinic we record one new case every year, which leads to an incidence of approximately 40-50 new cases every year in Sweden. Different treatments have been proposed for this condition. However, since the condition is rare, no consensus has been reached regarding the best treatment. Additionally, it remains unclear whether malleus fractures can heal.Aim: To get a deeper understanding of how malleus fractures occur, how they should be treated surgically, and if the malleus shows any sign of bone healing.Materials and methods: Paper I. We carried out both a retrospective study of the medical records of nine Swedish patients with isolated malleus fractures, and a literature review of this condition. Symptoms, clinical findings and patients’ history were collected.Paper II. Ossiculoplasty on human temporal bones was performed in the presence of a malleus fracture. We developed a surgical model from freshly frozen human temporal bones, and we performed Laser Doppler vibrometry (LDV) measurements on this model both before and after ossiculoplasty.Paper III. We performed ossiculoplasties with different types of partial ossicular replacement prostheses (PORP) on human temporal bones and we measured the results with LDV.Paper IV. We performed an in vivo animal study on Merino sheep, in which we produced isolated malleus fractures. We then compared the bone healing of these fractures with that of the nasal bone and the mandible. Bone healing was detected with micro-CT.Results: Paper I. The most common cause of isolated malleus fractures was found to be a so-called “digital” trauma, which occurred when the patients had removed a finger from the wet ear canal after bath. The hearing loss was occasionally accompanied by tinnitus and transient pain. Pneumatic otoscopy and tympanometry showed a hypermobile tympanic membrane, while audiometry showed a conductive hearing loss that increased towards higher frequencies.Paper II. Our LDV measurements indicated that fixation of an isolated malleus with bone cement may give the best results after surgery.Paper III. The best LDV measurements were obtained when ossiculoplasty was done using a PORP in lateral contact with both the tympanic membrane and the malleus handle.Paper IV. In our animal study we found no signs of bone healing at micro-CT four weeks after producing the malleus fractures. In contrast, both the nasal bone and the mandible showed bone healing. This indicates that the bone healing properties of the ossicles probably differ from those of other bones in the body.Conclusion: Digital trauma is the major cause of isolated malleus fractures. Pneumatic otoscopy and tympanometry showed a hypermobile tympanic membrane, while audiometry showed a conductive hearing loss increasing towards the higher frequencies. We developed a method to employ freshly frozen human temporal bones and we used LDV for detecting optimal results. This method allows to evaluate and develop otosurgery, aimed to restore hearing after an interrupted ossicular chain. The animal study indicates that malleus fractures will not heal spontaneously.
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| 15. |
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| 16. |
- Niklasson, Anders, et al.
(författare)
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Ossiculoplasty on Isolated Malleus Fractures : A Human Temporal Bone Study Using Laser Doppler Vibrometry
- 2016
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Ingår i: Otology and Neurotology. - 1531-7129 .- 1537-4505. ; 37:7, s. 895-901
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Tidskriftsartikel (refereegranskat)abstract
- Hypothesis: In the literature several surgical methods have been reported that aim to improve hearing in patients with isolated malleus fractures; however, it is still not clear which method gives the best results.Background: In this study, laser Doppler vibrometry (LDV) was used to compare the outcome of different surgical methods on malleus fractures in fresh frozen human temporal bones.Methods: Fractured malleus shafts of defrosted human temporal bones were repaired with bone cement, with a malleus prosthesis from cortical bone, or with a partial ossicular replacement prosthesis (PORP) from cortical bone, and LDV measurements were obtained for analysis.Results: The best result was achieved with the bone cement only, applied directly at the site of the fracture. The malleus prosthesis and the PORP gave similar results.Conclusion: All three surgical methods gave good results, but when the distal end of the fractured malleus can be attached close to the proximal end, the technique using only cement tends to be the best option. If the parts are too far apart, a malleus prosthesis or a PORP would be good options.
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| 17. |
- Niklasson, Anders, et al.
(författare)
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Self-inflicted negative pressure of the external ear canal : a common cause of isolated malleus fractures
- 2010
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Ingår i: Acta Oto-Laryngologica. - : Taylor & Francis. - 0001-6489 .- 1651-2251. ; 130:3, s. 410-416
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Tidskriftsartikel (refereegranskat)abstract
- We report the investigation of the cause of isolated malleus fractures based on four recent patients at our clinic and five patients reported to us by Swedish otosurgeons. In recent years we have treated four patients with isolated malleus fractures. Colleagues in the Swedish Society of Otosurgeons were encouraged to send us reports on patients with diagnosed isolated malleus fractures, resulting in five more cases. A literature review focusing on the cause and management of this injury was also conducted. Eight of nine patients in the Swedish material had the same history. The patients had inserted a finger into the external auditory canal (most often after a bath) and then pulled it out. Immediately afterwards they experienced a short pain and a hearing loss. An audiogram revealed a conductive hearing loss. After exploration of the middle ear, the most common operation performed was ossiculoplasty. In the present material the most common cause of isolated malleus fractures was a sudden negative pressure in the external auditory canal created by a quick outward movement of a finger in the external ear canal. Since this fracture appears to be infrequent, it can easily be missed at otomicroscopic examination. Tympanometry and pneumatic otomicroscopy are helpful diagnostic tools.
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| 18. |
- Niklasson, Anders, et al.
(författare)
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The Gelfoam® plug : an alternative treatment for small eardrum perforations
- 2011
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Ingår i: The Laryngoscope. - : John Wiley & Sons. - 0023-852X .- 1531-4995. ; 121:4, s. 782-784
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To examine if a Gelfoam® plug in combination with surgical removal of the perforation edges could be an alternative to the widely accepted fat plug treatment for smaller ear drum perforations.MATERIALS AND METHODS: A prospective study of 17 consecutive patients with persistent small ear drum perforations considered for myringoplasty. The perforations were central perforations 2 to 4 mm in diameter. Patient ages ranged from 6 to 83 years, and the operation was performed under general anesthesia with mask ventilation in children and under topical local anesthesia in adults. A Gelfoam® plug was inserted into the perforation after surgical removal of the perforation edges. The follow-up time was more than 3 months.RESULTS: The closure rate of the ear drum was 83% (15/18). Pure tone average (PTA) was 19 dB preoperatively and 16 dB postoperatively.CONCLUSIONS: We show for the first time in humans that a Gelfoam® plug in combination with surgical removal of the perforation edges seems to result in about the same closure rate as the fat plug technique in persistent small ear drum perforations. Moreover, the method using Gelfoam® is simpler and faster than the fat plug technique. We suggest that randomized studies comparing the Gelfoam® plug technique with the fat plug technique should be performed.
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| 19. |
- Nilsson, Gunnar, et al.
(författare)
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KUL fyller i kunskapsluckor
- 2018
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Ingår i: Läkartidningen. - : Sveriges läkarförbund. - 0023-7205 .- 1652-7518. ; 115:30-32
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 20. |
- Rönnblom, Anton, et al.
(författare)
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A New, Promising Experimental Ossicular Prosthesis : A Human Temporal Bone Study With Laser Doppler Vibrometry
- 2020
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Ingår i: Otology and Neurotology. - : Lippincott Williams & Wilkins. - 1531-7129 .- 1537-4505. ; 41:4, s. 537-544
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Tidskriftsartikel (refereegranskat)abstract
- Objective: We compared the sound transmission using different types of total ossicular replacement prostheses (TORP); we then studied the performance of a new TORP that we designed inspired by the columella, the single ossicle found in birds.Methods: Stapedial vibrations were measured on nine freshly frozen human temporal bones with laser Doppler vibrometry. We then compared the performances of eight common TORP positions or designs as well as the new silver prototype of bird-type prosthesis, designed also according to our digital holography patterns of the human tympanic membrane (TM).Results: The TORPs placed in lateral contact with both the TM and the malleus handle outperformed, at most frequencies, those placed only in contact with the TM.The new bird-type prosthesis performed equally well or better than all other prostheses.Conclusion: If the malleus handle can be retained when placing a TORP, the best sound transmission can be achieved by placing the TORP in contact with both the distal part of the malleus handle and the TM. The good performance of our bird-type prosthesis suggests that there is still room for future improvement of prosthesis design to further optimize hearing outcomes after surgery.
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| 21. |
- Rönnblom, Anton, et al.
(författare)
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Forces Required for Isolated Malleus Shaft Fractures
- 2021
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Ingår i: Otology and Neurotology. - : Wolters Kluwer. - 1531-7129 .- 1537-4505. ; 42:10, s. 1515-1520
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND HYPOTHESIS: Isolated malleus shaft fractures are rare cases. A commonly reported cause is a finger pulled out from a wet outer ear canal after a shower or bath. The objective was to investigate experimentally the mechanism and forces needed to establish an isolated malleus shaft fracture.METHODS: Ten fresh-frozen human temporal bones were adapted to allow visual inspection of the structures involved while negative pressure trauma was applied. Thirty malleus bones were broken and the required forces were measured. Measurements from 60 adult test subjects were used to create mathematical and physical models to calculate and measure the forces necessary for generating trauma. To calculate the maximum muscle force developed by the tensor tympani muscle, the muscle area and fiber type composition were determined.RESULTS: The temporal bone experiments showed that applied negative pressure in a wet ear canal could not fracture the malleus shaft with only passive counterforce from supporting structures, although the forces exceeded what was required for a malleus shaft fracture. When adding calculated counteracting forces from the tensor tympani muscles, which consisted of 87% type II fibers, we estimate that a sufficient force is generated to cause a malleus fracture.CONCLUSION: The combination of a negative pressure created by a finger pulling outward in a wet ear canal and a simultaneous counteracting reflexive force by the tensor tympani muscle were found to be sufficient to cause an isolated malleus fracture with an intact tympanic membrane.
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| 22. |
- Rönnblom, Anton, 1981-
(författare)
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Middle ear mechanics : using temporal bone experiments to improve clinical methods
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- BackgroundThe middle ear transmits and amplifies sound vibrations from the tympanic membrane via three ossicles to the inner ear. Moreover, it contains two muscles, the stapedius muscle (SM) which protects the inner ear from loud noise, and the tensor tympani (TT) whose function is still debated. The majority of hearing loss caused by disruption of the ossicular chain is a result of chronic otitis media and cholesteatoma. Variations in pathology, surgical skill and individual healing conditions make objective evaluation of ossicular replacement prosthesis in vivo difficult. Prosthesis development and the investigation of trauma mechanisms are affected by the same challenges. With few changes postmortem, the temporal bone (TB) is suitable for studies of middle ear mechanics and allows a controlled environment. Equally important, it allows theories to be tested without patient risk. In this thesis we used human TBs to find factors associated with optimal sound transfer in the two types of ossicular replacement prostheses. Furthermore, we investigated the mechanism and forces involved in rare cases of isolated malleus fractures. We also investigated the morphology, fibre phenotype composition and vascularization of the human middle ear muscles in order to better understand their roles.Materials and MethodsLaser Doppler vibrometry (LDV) is an established method of measuring sound transfer in human TBs. We have further developed a surgical model that allows testing of a wide range of prostheses and their placements. In Paper I beneficial factors in partial ossicular replacement prostheses (PORPs) were tested. In Paper II we evaluated different types of total ossicular replacement prostheses (TORPs) including an experimental prosthesis inspired by the single ossicle system of birds. In Paper III the negative pressure trauma typically associated with isolated malleus fractures, produced by a finger being withdrawn from a wet ear canal after a shower or bath, was simulated in TBs. Based on measurement from control persons the forces involved were calculated and measured in models developed for this purpose. The force of the TT was estimated by comparing its cross-sectional area and fibre composition with those reported in published references. In Paper IV we used immunohistochemical, enzyme histochemical, biochemical and morphometric techniques on TT, SM and human orofacial and limb muscle control samples.ResultsOf the prostheses, PORPs and TORPs with lateral contact with both the tympanic membrane and the malleus handle performed best, and TORPs with distal malleus contact proved superior. Our experimental bird-type prosthesis was the most stable in such placement and performed equally to or better than other prostheses. In Paper III the application of negative pressure via the ear canal did not fracture the malleus shaft, with only a passive counterforce from support structures, although the force exceeded that required for a malleus shaft fracture. We estimate that when adding calculated counteracting forces from the TT muscle, sufficient force is generated to cause a malleus fracture. Both human middle ear muscles are predominated by fast type 2 fibres, and have rich capillarization and nerve innervation compared with limb muscles. Muscle spindles were found in the TT but not the SM.ConclusionsWhere possible, an ossicular replacement prosthesis should be placed to allow distal contact with both the TM and the malleus handle. The sound transfer capabilities combined with the stable placement of our experimental prostheses suggest room for improvement. The combination of a negative pressure created by a finger being withdrawn from a wet ear canal and a simultaneous counteracting reflexive force by the TT muscle was found to be sufficient to cause an isolated malleus fracture. The finding of muscle spindles in TT, but not in SM, suggests a difference in regulatory control; furthermore, it indicates that the TT can be activated by a sudden stretch reflex as described in the malleus fracture trauma. The human middle ear muscles have a highly specialized muscle morphology, which is more similar to orofacial than to limb muscles. The fibre phenotype composition suggests capability for fine-tuned, fast, strong and relatively sustainable contractions. Based on fibre type patterns the TT is among the fastest muscles in the human body.
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| 23. |
- Rönnblom, Anton, 1981-, et al.
(författare)
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Unique fiber phenotype composition and metabolic properties of the stapedius and tensor tympani muscles in the human middle ear
- 2023
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Ingår i: Journal of Anatomy. - : John Wiley & Sons. - 0021-8782 .- 1469-7580. ; 243:1, s. 39-50
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Tidskriftsartikel (refereegranskat)abstract
- The middle ear muscles have vital roles, yet their precise function in hearing and protection remains unclear. To better understand the function of these muscles in humans, the morphology, fiber composition, and metabolic properties of nine tensor tympani and eight stapedius muscles were analyzed with immunohistochemical, enzyme-histochemical, biochemical, and morphometric techniques. Human orofacial, jaw, extraocular, and limb muscles were used as references. The immunohistochemical analysis showed that the stapedius and tensor tympani muscles were markedly dominated by fibers expressing fast contracting myosin heavy chain MyHC-2A and MyHC-2X (79 ± 6% vs. 86 ± 9%, respectively, p = 0.04). In fact, the middle ear muscles had one of the highest proportions of MyHC-2 fibers ever reported for human muscles. Interestingly, the biochemical analysis revealed a MyHC isoform of unknown identity in both the stapedius and tensor tympani muscles. Muscle fibers containing two or more MyHC isoforms were relatively frequently observed in both muscles. A proportion of these hybrid fibers expressed a developmental MyHC isoform that is normally absent in adult human limb muscles. The middle ear muscles differed from orofacial, jaw, and limb muscles by having significantly smaller fibers (220 vs. 360 μm2, respectively) and significantly higher variability in fiber size, capillarization per fiber area, mitochondrial oxidative activity, and density of nerve fascicles. Muscle spindles were observed in the tensor tympani muscle but not in the stapedius muscle. We conclude that the middle ear muscles have a highly specialized muscle morphology, fiber composition, and metabolic properties that generally showed more similarities to orofacial than jaw and limb muscles. Although the muscle fiber characteristics in the tensor tympani and stapedius muscles suggest a capacity for fast, fine-tuned, and sustainable contractions, their difference in proprioceptive control reflects different functions in hearing and protection of the inner ear.
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| 24. |
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| 25. |
- Sterner, Freja, et al.
(författare)
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Carcinomas of the minor salivary glands of the oral cavity : a population-based study from the Swedish Head and Neck Cancer Register for 2008–2018
- 2023
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Ingår i: Acta Oto-Laryngologica. - : Taylor & Francis. - 0001-6489 .- 1651-2251. ; 143:4, s. 346-351
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Tidskriftsartikel (refereegranskat)abstract
- Background and objectives: Carcinomas of the minor salivary glands are rare with a heterogeneous pathology. This study explored the demographics, histology, treatment and survival in the Swedish population over 11 years.Material and methods: Cases of salivary gland carcinomas in the oral cavity were extracted from the ‘Swedish Head and Neck Cancer Register’ (2008–2018). Statistical analyses with cross tabulation, age grouping, chi-square, the Kaplan–Meier method and log-rank tests were performed.Results: Three hundred thirty cases were included (62% female; mean age 60 years; 83% were WHO Performance Status 0). The carcinomas were mostly stage I (57%), and the most common site was the palate with 165 tumours (50%). The most common histology was mucoepidermoid carcinoma (30%), followed by polymorphous low-grade adenocarcinoma (25%) and adenoid cystic carcinoma (24%). The distribution of histology differed between age groups. The five-year predicted overall survival rate was 83%. Most patients (89%) were treated with primary surgery.Conclusion and significance: The demographics, histology, and survival of minor salivary gland carcinomas in the oral cavity in the Swedish population correspond well with previously published material. The demographics and histology differ from carcinomas of the major salivary glands in the same population.
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| 26. |
- Tano, Krister, et al.
(författare)
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Alloiococcus otitidis--otitis media pathogen or normal bacterial flora?
- 2008
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Ingår i: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS). - 0903-4641 .- 1600-0463. ; 116:9, s. 785-90
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Tidskriftsartikel (refereegranskat)abstract
- During the last decade a new potential otitis media pathogen, Alloiococcus otitidis, has been studied. It is still not clear whether this bacterium really is a pathogen, although it has been found in a high percentage of middle ear effusions in children. The present study aimed to investigate the presence of A. otitidis in the nasopharynx and outer ear canals, and to develop a culture method that would make it possible to isolate A. otitidis from these locations. Nasopharyngeal samples (n = 129) from children below 6 years were investigated by conventional culture on blood agar plates with 6% saline and rabbit antisera against A. otitidis, and by a PCR method. In the same way, we investigated 10 samples from vestibulum nasi of healthy persons, 68 samples from outer ear canals of patients with acute or chronic ear problems, and 24 samples from outer ear canals of healthy persons. In a rat model of acute otitis media, we instilled living A. otitidis into rat middle ears through the tympanic bulla and evaluated the outcome clinically by otomicroscopy at days 3, 6 and 14. Of the 129 nasopharyngeal cultures, 9 were positive for A. otitidis by PCR, but none by the culture method. Of the 68 samples from patients with running ears, 4 were positive for A. otitidis by PCR, but none by the culture method. Of the 24 healthy ear canals, 7 were positive for A. otitidis by PCR and 3 of them also by the culture method. No A. otitidis could be found from the vestibulum nasi. The rat experiment showed that the reactions in the middle ears were mild; we could not provoke a purulent acute otitis media in any of the rats. There was a 7% prevalence of A. otitidis in children below 6 years. The highest prevalence (29%) was found in outer ear canals of healthy persons, which strongly suggests that A. otitidis is part of the normal bacterial flora of the outer ear canal. The doubtful pathogenicity is also confirmed by the fact that--in the rat model--A. otitidis elicited only a mild response in the middle ear. It was possible to isolate A. otitidis using a blood agar plate with 6% saline.
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| 27. |
- Tano, Krister, et al.
(författare)
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Patient experiences of living with superior semicircular canal dehiscence syndrome
- 2023
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Ingår i: Third mobile window syndrome of the inner ear. - Cham : Springer. - 9783031165856 - 9783031165887 - 9783031165863 ; , s. 463-476
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Bokkapitel (refereegranskat)abstract
- The symptoms of SCDS can be divided into symptoms mainly related to the cochlear part of the inner ear and those mainly related to the vestibular part. However, cognitive and emotional functions can also be affected, causing fatigue and depression for example. Cochlear hyperacusis seems to be one of the most disturbing symptoms, but conductive hyperacusis can also be extremely tiring in the long run, particularly when the patients can hear their internal body sounds at a disturbingly loud volume. Balance problems accentuated during physical exercise represent another characteristic symptom of SCDS, emanating from the vestibular part of the inner ear.
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| 28. |
- Vestin Fredriksson, Malin, et al.
(författare)
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Clinical Manifestations and Symptoms of Maxillary Sinusitis of Odontogenic Origin Demonstrated by Cone Beam Computed Tomography
- 2019
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Ingår i: Journal of General Practice. - : OMICS Publishing Group. - 2329-9126. ; 7:1
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To compare the symptomatology of patients with maxillary sinusitis of dental origin (MSDO) with sinusitis due to upper respiratory tract infection (URTI) with a special focus on time to correct diagnosis. To define the accuracy of cone beam computed tomography (CBCT) in detecting the dental origin of the sinusitis.Methods: Retrospective review of the otolaryngology specialist care, primary health care and dental health care medical records of patients with maxillary sinusitis who has been referred for radiology. All patients were examined by CBCT, which has a better resolution regarding bony structures than low-dose computed tomography. To the best of our knowledge there is no previous study on this topic based on CBCT as diagnostic method.Results: Sixty-one patients were included in the study; of these, 25 had MSDO and 36 had URTI sinusitis. The MSDO patients more frequently reported foul odour and foul taste than patients with URTI sinusitis. The URTI sinusitis patients more frequently reported symptoms such as facial pain, facial congestion and cold-related symptoms. Both the time from the onset of symptoms to the first medical visit and the subsequent time to a correct diagnosis were significantly longer in the MSDO group. The accuracy of CBCT for detecting dental pathology as the underlying cause of sinusitis was 97%.Conclusion: The present study verifies that maxillary sinusitis of dental origin differs from viral-induced rhinosinusitis concerning symptomatology and clinical findings. Certain findings and symptoms could serve as valuable indicators of an underlying dental pathology, because although MSDO is well known, the present study shows that these patients are often misdiagnosed and the correct diagnose and treatment is often delayed several months. Consequently, better assessment is important. The suspicion of MSDO should be raised for patients with unilateral sinusitis presenting little pain, foul odour or foul taste and a long time course. These patients should be referred for radiology, preferably CBCT, to rule out odontogenic cause. CBCT is easy to perform for sinusitis examinations and has advances to common CT, especially regarding detection of pathology in bony structures as the periapical area. Because of this CBCT is a reliable tool in order to detect maxillary sinusitis of dental origin.
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| 29. |
- Vestin Fredriksson, Malin, 1977-, et al.
(författare)
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Construction and evaluation of a modular anthropomorphic phantom of the skull with an exchangeable specimen jar to optimize the radiological examination of temporal bone pathology
- 2024
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Ingår i: Recent Progress in Materials. - : Lidsen Publishing. - 2689-5846. ; 06:03
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Tidskriftsartikel (refereegranskat)abstract
- To develop a modular anthropomorphic phantom to evaluate the performance of radiological techniques for detecting pathologies in the temporal bone region. A phantom was constructed using a human skull, temporal bone specimen, and 3D-printed contour of a human skull. The human skull was embedded in tissue-equivalent plastic, with a cavity to hold the plastic jars containing the exchangeable freshly frozen human temporal bones. Subsequently, stepwise introduction and examination of different clinicopathological scenarios were conducted. Radiological images were nearly identical to those acquired from patients using computed tomography (CT) and cone beam computed tomography (CBCT). The radiological attenuation of polyurethane plastic (PUR) and alginate were similar to those of the soft tissues of living human patients. The mean Hounsfield unit values of the CT slices representing tissue at the brain and temporal bone level were 184 and 171 in the phantom and patient groups, respectively. The modular phantom developed in this study can evaluate radiological techniques and diagnostic possibilities without exposing patients to radiation. To our knowledge, no such modular phantom has been reported in the literature or made available commercially.
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| 30. |
- Vestin Fredriksson, Malin, 1977-
(författare)
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Radiological evaluation of maxillary sinusitis and temporal bone structures
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: In the field of otorhinolaryngology, the paranasal sinuses and the middle and inner ear present a clinical challenge. Radiological methods offer a stable foundation for diagnostics and preoperative decisions in this context. While many studies have explored the prevalence of maxillary sinusitis of dental origin (MSDO), the use of MSDO detected on cone beam computed tomography (CBCT) scans, rather than conventional computed tomography (CT), is a relatively new approach to detect MSDO. CBCT, with its higher ability to assess bony details, is becoming a valuable tool in detecting MSDO. Photon-counting Computed Tomography (PCCT), a cutting-edge diagnostic imaging method, enables radiological examinations with high spatial resolution at a low radiation dose compared with conventional CT. However, the question of how much the dose can be reduced while maintaining still diagnostic value in radiological examinations remains unanswered.Aims: This thesis aimed to further develop the use of radiology in the ear, nose and throat (ENT) medical field, which could impact how we interpret radiological findings to obtain useful clinical information. The objectives for this thesis were as follows: 1) to investigate the proportion of MSDO among patients with suspected sinusitis referred for radiological examination; 2) to compare the symptomatology of MSDO with sinusitis due to upper respiratory tract infection (URTI); 3) to develop a modular anthropomorphic phantom that could be used to evaluate the performance of radiological techniques in detecting pathology in the temporal bone (TB) region; and 4) to investigate whether the diagnostic quality of TB imaging is maintained even at significantly lower radiation doses using PCCT compared to conventional energy integrated computed tomography (EICT).Material and methods: Paper I was a retrospective study in which our research team reviewed 303 CBCT sinus examinations and analysed the data to determine the prevalence of MSDO among patients with suspected sinusitis who had been referred for radiological examination.A retrospective study was conducted in Paper II, in which the medical records from 61 patients with maxillary sinusitis confirmed via CBCT were thoroughly reviewed. Two independent observers reviewed all cases; when the observers disagreed, the examinations were re-reviewed to reach a consensus, ensuring the reliability of the findings. For comparison, the patients were divided into MSDO and URTI sinusitis groups. Information including self-reported symptoms, clinical findings, and time between first medical contact to correct diagnosis were collected and compared between the groups, providing a comprehensive understanding of the differences between the two conditions.In Paper III, a modular anthropomorphic phantom was constructed. 'To evaluate anatomical structures and image quality, the phantom was used in paper IV to scan 10 human TB specimens using PCCT and conventional CT systems.Results: In paper I, we found that the prevalence of unilateral MSDO was 40 %. Maxillary sinus mucosal swelling adjacent to periapical destruction was found in 91 % of the studied patients.In paper II, we found that the MSDO patients reported a foul odour and foul taste more often, and the time from their first symptom to the correct diagnosis was significantly longer. The URTI sinusitis patients reported toothache, bilateral facial pain, and symptoms associated with a cold more often than the MSDO patients. The accuracy of CBCT for detecting MSDO was 97%.In paper III, we found that the radiological attenuation of the polyurethane (PUR) plastic and alginate plastic used for the phantom was similar to those of the soft tissues of a living human. The mean Hounsfield unit (HU) values of the CT slices representing tissue at the TB and brain level were comparable in the phantom and patient groups.In paper IV, we found that reviewers preferred PCCT scans for the majority of structures being evaluated and for overall image quality. This was true even at a radiation dose below 15 % of that in the clinical EICT protocol.Conclusion: The close relationship between dental infections and unilateral sinusitis should not be overlooked. MSDO differs from URTI sinusitis regarding symptoms and clinical findings, and should be suspected in patients with unilateral symptoms presenting little pain and experiencing a foul odour and/or foul taste. CBCT is a reliable method of detecting MSDO. The modular phantom developed in the third study can be used to evaluate examination methods in a set-up corresponding to a living human without exposing patients to radiation. Finally, PCCT was found to be superior to EICT in terms of image quality.
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| 31. |
- Vestin Fredriksson, Malin, et al.
(författare)
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When Maxillary Sinusitis Does Not Heal : Findings on CBCT Scans of the Sinuses With a Particular Focus on the Occurrence of Odontogenic Causes of Maxillary Sinusitis
- 2017
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Ingår i: Laryngoscope Investigative Otolaryngology (LIO). - : John Wiley & Sons. - 2378-8038. ; 2:6, s. 442-446
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: This study sought to investigate the proportion of patients with suspected sinusitis referred for radiological examination who have radiologically verified sinusitis of odontogenic origin and to describe this type of sinusitis. Study Design: This investigation is a retrospective study. Methods: A total of 303 sinus examinations involving cone beam computed tomography (CBCT) performed at Sunderby Hospital, Lulea, Sweden in 2012 were independently reviewed by two radiologists. The number of cases of maxillary sinusitis and the correlation between maxillary sinusitis and odontogenic infections were determined. Results: Overall, 24% of the verified cases of sinusitis were odontogenic. An odontogenic origin was identified in 40% of unilateral maxillary sinusitis cases but only 6% of bilateral maxillary sinusitis cases (p=0.0015). Forty-nine out of 54 patients with periapical destruction had adjacent mucosal swelling in the maxillary sinus, but only 15 of these patients satisfied the criteria for sinusitis. Conclusion: The present study confirms the close relationship between odontogenic infections and unilateral maxillary sinusitis.
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| 32. |
- Öhman, Jenny, et al.
(författare)
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Patients' experiences of living with superior canal dehiscence syndrome
- 2018
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Ingår i: International Journal of Audiology. - : Taylor & Francis. - 1499-2027 .- 1708-8186. ; 57:11, s. 825-830
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The study investigated how the symptoms of superior canal dehiscence syndrome (SCDS) affected patients in their daily life, and how patients coped with the disease.Design: This was a qualitative study; semi-structured interviews were performed and analysed according to the systematic text condensation method.Study sample: Twelve of 13 identified patients with SCDS in the county of Norrbotten, Sweden, were included in the study.Results: Five main categories were created based on the patients' experiences of living with SCDS: (1) Experiencing strange symptoms: One "new" symptom was identified - mental fatigue. (2) A restricted life socially, physically and at work: All patients experienced some extent of limitation in their daily life. (3) To accept and to protect oneself: All patients had developed strategies to protect their ears from noise. (4) Misunderstood in health care: The diagnosis was sometimes delayed several years due to lack of knowledge among healthcare workers. (5) Carefully considering treatment (surgery): Symptoms were weighed against the risk of side effects.Conclusions: SCDS was rendered an invisible disability. In the present study, we identified mental fatigue as a symptom not previously considered in the literature.
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