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| 2. |
- Atturo, Francesca, et al.
(författare)
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Is the Human Round Window Really Round? : An Anatomic Study With Surgical Implications
- 2014
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Ingår i: Otology and Neurotology. - 1531-7129 .- 1537-4505. ; 35:8, s. 1354-1360
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Tidskriftsartikel (refereegranskat)abstract
- Hypothesis: Human round window (RW) presents anatomic variations that may influence surgical approach. Background: The true shape of the human RW has been divisive since its first description in 1772 by Antonio Scarpa. Introduction of novel surgical strategies in recent years have raised its significance. Here, the human RW size and shape variations were documented in microdissected human temporal bones. Methods: An archival collection of human microdissected temporal bones was analyzed. RW rim could be delineated and photographed from the labyrinthine aspect and its topography assessed. Results: Human RW is seldom round but ovoid or orthogonal, skewed, and nonplanar (saddlelike). Membrane is fan shaped or conical with an anteroinferior and a posterosuperior part. The mean longest diameter was 1.90 mm, and the smallest one is 1.54 mm. The mean diameter from the crista fenestra was 1.31 mm. The mean area of the RW was 2.08 mm(2), which varied between 0.99 and 3.20 mm(2). The crista fenestrae of the anterior component form a "doorstep" that may limit the entry to the scala tympani from the RW niche. Conclusion: The alternate anatomic features of the human RW may influence its surgical access and designs of implants aimed at targeting this region.
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| 3. |
- Axelsson, Sara, et al.
(författare)
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Prednisolone in Bell's Palsy Related to Treatment Start and Age
- 2011
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Ingår i: Otology and Neurotology. - 1531-7129 .- 1537-4505. ; 32:1, s. 141-146
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate if treatment start and age are related to the outcome in Bell's palsy patients treated with prednisolone. Study Design: Prospective, randomized, double-blind, placebo-controlled, multicenter trial. Setting: Sixteen otorhinolaryngologic centers in Sweden and 1 in Finland. Patients: Data were collected from the Scandinavian Bell's palsy study. A total of 829 patients were treated within 72 hours of onset of palsy. Follow-up was 12 months. Intervention: Patients were randomly assigned to treatment with placebo plus placebo (n = 206), prednisolone plus placebo (n = 210), valacyclovir plus placebo (n = 207), or prednisolone plus valacyclovir (n = 206). Main Outcome Measures: Facial function was assessed with the Sunnybrook grading system, and complete recovery was defined as Sunnybrook = 100. Time from onset of palsy to treatment start was registered. Results: Patients treated with prednisolone within 24 hours and 25 to 48 hours had significantly higher complete recovery rates, 66% (103/156) and 76% (128/168), than patients given no prednisolone, 51% (77/152) and 58% (102/177) (p = 0.008 and p = 0.0003, respectively). For patients treated within 49 to 72 hours of palsy onset, there were no significant differences. Patients aged 40 years or older had significantly higher complete recovery rates if treated with prednisolone, whereas patients aged younger than 40 years did not differ with respect to prednisolone treatment. However, synkinesis was significantly less in patients younger than 40 years given prednisolone (p = 0.002). Conclusion: Treatment with prednisolone within 48 hours of onset of palsy resulted in significantly higher complete recovery rates and less synkinesis compared with no prednisolone.
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| 4. |
- Berglin, Cecilia Engmér, et al.
(författare)
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Magnetic Resonance Imaging of the Middle and Inner Ear After Intratympanic Injection of a Gadolinium-Containing Gel
- 2014
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Ingår i: Otology and Neurotology. - 1531-7129 .- 1537-4505. ; 35:3, s. 526-532
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:To investigate the distribution and elimination of a gadolinium containing high viscosity formulation of sodium hyaluronan (HYA gel) after injection to the middle ear.MATERIALS AND METHODS:The T1 contrast agent gadolinium-diethylenetriamine pentaacetic acid-bis methylamine (Gd-DTPA-BMA) was added to HYA gel and delivered to the middle ear of 13 albino guinea pigs by 3 different ways of injection. Magnetic resonance imaging was performed with a 4.7 T MRI system using a T1-weighted 3-dimentional rapid acquisition with relaxation enhancement sequence.RESULTS:An injection technique where the Gd-DTPA-BMA-containing HYA gel was delivered to the middle ear through a percutaneous injection through the auditory bulla after a small incision had been made in the tympanic membrane gave the best filling of the middle ear, covering the cochlea and the region of the round window niche for 24 hours in a majority of the ears studied. Ears injected without an incision in the tympanic membrane showed an immediate uptake of Gd-DTPA-BMA in the inner ear as a sign of rupture of the round window membrane.CONCLUSION:A percutaneous injection of a HYA gel into the tympanic bulla is distributed in a predictable way and gives a good filling of the middle ear cavity. The HYA gel remains in close vicinity to the RWM for more than 24 hours. Injection should be performed after an incision of the tympanic membrane has been made to prevent rupture of the round window membrane.
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| 5. |
- Boisvert, Isabelle, et al.
(författare)
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Choice of Ear for Cochlear Implantation in Adults With Monaural Sound-Deprivation and Unilateral Hearing Aid
- 2012
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Ingår i: Otology and Neurotology. - : Lippincott, Williams and Wilkins. - 1531-7129 .- 1537-4505. ; 33:4, s. 572-579
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To identify whether speech recognition outcomes are influenced by the choice of ear for cochlear implantation in adults with bilateral hearing loss who use a hearing aid in 1 ear but have long-term auditory deprivation in the other. less thanbrgreater than less thanbrgreater thanStudy Design: Retrospective matched cohort study. Speech recognition results were examined in 30 adults with monaural sound deprivation. Fifteen received the implant in the sound-deprived ear and 15 in the aided ear. less thanbrgreater than less thanbrgreater thanSetting: Tertiary referral centers with active cochlear implant programs. less thanbrgreater than less thanbrgreater thanPatients: Adults with bilateral hearing loss and a minimum of 15 years of monaural sound deprivation who received a cochlear implant after meeting the traditional implantation criteria of the referral centers. less thanbrgreater than less thanbrgreater thanIntervention: Cochlear implantation with devices approved by the U.S. Food and Drug Administration. less thanbrgreater than less thanbrgreater thanMain Outcome Measure(s): Paired comparisons of postoperative monosyllabic word recognition scores obtained with the implant alone and in the usual listening condition (CI alone or bimodal). less thanbrgreater than less thanbrgreater thanResults: With the cochlear implant alone, individuals who received the implant in a sound-deprived ear obtained poorer scores than individuals who received the implant in the aided ear. There was no significant difference, however, in speech recognition results for the 2 groups when tested in their usual listening condition. In particular, poorer speech recognition scores were obtained with the cochlear implant alone by individuals using bimodal hearing. less thanbrgreater than less thanbrgreater thanConclusion: Similar clinical outcomes of cochlear implantation can be achieved by adults with a long-term monaural sound deprivation when comparing the usual listening condition, irrespective of whether the implant is in the sound-deprived or in the aided ear.
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| 6. |
- Eeg-Olofsson, Måns, 1967, et al.
(författare)
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Implications for contralateral bone-conducted transmission as measured by cochlear vibrations.
- 2011
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Ingår i: Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. - : LWW. - 1537-4505 .- 1531-7129. ; 32:2, s. 192-8
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Tidskriftsartikel (refereegranskat)abstract
- The velocity response at the contralateral cochlea from bone-conducted (BC) stimulation depends on the stimulation position.
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| 7. |
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| 8. |
- Gunther, Mattias, et al.
(författare)
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Surgical Treatment of Patients With Facial Neuromas : A Report of 26 Consecutive Operations
- 2010
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Ingår i: Otology and Neurotology. - 1531-7129 .- 1537-4505. ; 31:9, s. 1493-1497
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To analyze surgical treatment and outcome in patients with facial neuromas at a tertiary referral hospital. Study Design: A chart review of 26 patients treated between 1971 and 2006, with questionnaire follow-up ranging from 2 to 19 years. All patients except one were operated with radical tumor removal approaches. Results: Approximately 54% of the patients presented with symptoms related to the VIIth cranial nerve (facial palsy and facial spasm), 58% with symptoms related to the VIIIth cranial nerve (hearing deficit, tinnitus, and vertigo), and 8% related to the Vth cranial nerve (facial pain and facial sensory deficit). Approximately 39% presented with no facial symptoms. Twenty-one patients received a facial nerve graft from the greater auricular nerve or the sural nerve; 1 patient had an accessory-facial anastomosis. One patient had a subtotal tumor removal preserving the facial nerve. Three patients were not grafted. Most tumors (88%) affect the geniculate ganglion. Approximately 82% of the grafted patients regained a House-Brackmann facial nerve function (HB) grade III; 14% regained HB grades IV to V. No serious morbidity or mortality was reported. No recurrences have been reported where a total tumor removal was performed. Conclusion: Surgical removal of facial neuroma is a safe procedure with a low complication rate and a low recurrence rate. First symptoms are diverse and are predominantly derived from the facial and vestibulocochlear nerve. Facial nerve grafting is reliable, giving the patient an acceptable facial nerve function (HB III).
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| 9. |
- Hendrickx, Jan-Jaap, et al.
(författare)
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Familial aggregation of pure tone hearing thresholds in an aging European population
- 2013
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Ingår i: Otology and Neurotology. - : Lippincott Williams & Wilkins. - 1531-7129 .- 1537-4505. ; 34:5, s. 838-844
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate the familial correlations and intraclass correlation of age-related hearing impairment (ARHI) in specific frequencies. In addition, heritability estimates were calculated.STUDY DESIGN: Multicenter survey in 8 European centers.SUBJECTS: One hundred ninety-eight families consisting of 952 family members, screened by otologic examination and structured interviews. Subjects with general conditions, known to affect hearing thresholds or known otologic cause were excluded from the study.RESULTS: We detected familial correlation coefficients of 0.36, 0.37, 0.36, and 0.30 for 0.25, 0.5, 1, and 2 kHz, respectively, and correlation coefficients of 0.20 and 0.18 for 4 and 8 kHz, respectively. Variance components analyses showed that the proportion of the total variance attributable to family differences was between 0.32 and 0.40 for 0.25, 0.5, 1, and 2 kHz and below 0.20 for 4 and 8 kHz. When testing for homogeneity between sib pair types, we observed a larger familial correlation between female than male subjects. Heritability estimates ranged between 0.79 and 0.36 across the frequencies.DISCUSSION: Our results indicate that there is a substantial shared familial effect in ARHI. We found that familial aggregation of ARHI is markedly higher in the low frequencies and that there is a trend toward higher familial aggregation in female compared with male subjects.
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| 10. |
- Knutsson, Johan, et al.
(författare)
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Structural Tympanic Membrane Changes in Secretory Otitis Media and Cholesteatoma
- 2011
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Ingår i: Otology and Neurotology. - 1531-7129 .- 1537-4505. ; 32:4, s. 596-601
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Tidskriftsartikel (refereegranskat)abstract
- Background: Otitis media may predispose for retraction pathologic abnormality later in life. A weakening of the collagen fiber bundles in the lamina propria of the tympanic membrane (TM) is a prerequisite for the formation of a retraction pocket. Various collagen types have different tensile strength. The collagen-type distribution in the TM during otitis media and cholesteatoma has not been reported before. Materials and Methods: The collagen contents of TM biopsies from child patients with longstanding secretory otitis media without retraction pockets were compared with pars tensa cholesteatomas using immunohistochemical staining for collagen Types I to IV. The histology was also investigated using transmission electron microscopy. Results: The outer epithelium was in some biopsies thickened with evidence of edema. The biopsies showed an intact lamina propria with positive immunohistochemical staining for collagen Types I to III and showed normal collagen fiber bundles on electron microscopy. The outer epithelium of the cholesteatomas showed marked thickness variations and signs of edema. There was a presence of normal collagen fiber bundles in smaller parts of all cholesteatomas, positive for collagen Types I to II. In other parts, only scattered collagen fibers were found. Conclusion: Tympanic membrane biopsies from patients with longstanding secretory otitis media may show a thickening of the outer epithelium. Collagen Types I to III are present in the lamina propria, and no ultrastructural changes of the collagen fiber bundles are observed. Collagen is found in cholesteatomas in the remnants of the lamina propria, with positive staining for collagen Types I and II, whereas Type III seems to be lacking.
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