| 1. |
- 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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| 2. |
- 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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| 3. |
- 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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| 4. |
- 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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