| 11. |
- Marsk, Elin, et al.
(författare)
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Early Deterioration in Bell's Palsy : Prognosis and Effect of Prednisolone
- 2010
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Ingår i: Otology and Neurotology. - 1531-7129 .- 1537-4505. ; 31:9, s. 1503-1507
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To assess if early deterioration is a negative prognostic factor in Bell's palsy and if prednisolone treatment reduces early progression and enhances recovery. Study Design: Data extracted from the randomized, double-blind, placebo-controlled multicenter, Scandinavian Bell's palsy study. Setting: Sixteen tertiary referral centers in Sweden and one in Finland. Patients: A total of 829 patients aged 18 to 75 years with Bell's palsy. Intervention: The study design was factorial; 416 patients were given prednisolone, whereas 413 did not receive the drug. Data were analyzed with a modified intention-to-treat principle and the last-observation-carried-forward method. Main Outcome Measures: Facial function was assessed within 72 hours before treatment start, at Days 11 to 17, and at 12 months. Sunnybrook was used as the main facial grading system with complete recovery defined as Sunnybrook 100. Results: In 236 (28%) of 829 patients, the palsy deteriorated from baseline to the first follow-up at Days 11 to 17. Complete recovery at 12 months was 45% among subjects with early deterioration compared with 73% in patients with no initial deterioration (p < 0.0001). In the early deterioration group, complete recovery at 12 months was 62% in patients treated with prednisolone and 31% in those not treated (p G 0.0001). Conclusion: Early deterioration in Bell's palsy is a negative prognostic factor for complete recovery at 12 months. Prednisolone given within 72 hours may reduce early progression and improve the outcome of palsy.
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| 12. |
- 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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| 13. |
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| 14. |
- Stamatiou, Georgios, 1975-, et al.
(författare)
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A Comprehensive Network and Pathway Analysis of Human Deafness Genes
- 2013
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Ingår i: Otology and Neurotology. - : Lippincott Williams & Wilkins. - 1531-7129 .- 1537-4505. ; 34:5, s. 961-970
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To perform comprehensive network and pathway analyses of the genes known to cause genetic hearing loss.Study Design: In silico analysis of deafness genes using ingenuity pathway analysis (IPA).Methods: Genes relevant for hearing and deafness were identified through PubMed literature searches and the Hereditary Hearing Loss Homepage. The genes were assembled into 3 groups: 63 genes that cause nonsyndromic deafness, 107 genes that cause nonsyndromic or syndromic sensorineural deafness, and 112 genes associated with otic capsule development and malformations. Each group of genes was analyzed using IPA to discover the most interconnected, that is, "nodal" molecules, within the most statistically significant networks (p < 10(-45)).Results: The number of networks that met our criterion for significance was 1 for Group 1 and 2 for Groups 2 and 3. Nodal molecules of these networks were as follows: transforming growth factor beta1 (TGFB1) for Group 1, MAPK3/MAPK1 MAP kinase (ERK 1/2) and the G protein coupled receptors (GPCR) for Group 2, and TGFB1 and hepatocyte nuclear factor 4 alpha (HNF4A) for Group 3. The nodal molecules included not only those known to be associated with deafness (GPCR), or with predisposition to otosclerosis (TGFB1), but also novel genes that have not been described in the cochlea (HNF4A) and signaling kinases (ERK 1/2).Conclusion: A number of molecules that are likely to be key mediators of genetic hearing loss were identified through three different network and pathway analyses. The molecules included new candidate genes for deafness. Therapies targeting these molecules may be useful to treat deafness.
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| 15. |
- Stenfeldt, Karin, et al.
(författare)
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Collagen Type II Is Produced in Healing Pars Tensa of Perforated Tympanic Membranes : An Experimental Study in the Rat
- 2013
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Ingår i: Otology and Neurotology. - : Wolters Kluwer. - 1531-7129 .- 1537-4505. ; 34:7, s. E88-E92
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Tidskriftsartikel (refereegranskat)abstract
- Hypothesis: Type II collagen is synthesized in the tympanic membrane during healing of a perforation. The time course and appearance of Type II collagen regrowth in the newly healed tympanic membrane is the subject of the present study. Background: The arrangement of Type II collagen fibers in the tympanic membrane gives it a unique tensile strength important for sound conduction. Healing after tympanic membrane perforation can cause the tympanic membrane to lose its characteristic. At what phase Type II collagen in tympanic membrane is replaced during healing of a perforation has previously not been studied. Methods: Rat tympanic membranes were perforated, and the animals were sacrificed 9 to 16 days after perforation. Tympanic membranes were stained with a Type II collagen antibody. Results: At Day 9, a majority of the tympanic membranes had healed. Keratinizing epithelium and connective tissue had formed, but there was no Type II collagen. At Day 10, all tympanic membranes had healed, and staining for Type II collagen appeared. After Day 10, staining was more intense. Newly formed collagen did not show the parallel bundle arrangement seen in normal tympanic membranes but was more scattered in the tissue. Conclusion: Type II collagen was seen in tympanic membranes only after closure of the perforation. The fiber arrangement after healing was disturbed, which presumably has an impact on the function of the tympanic membrane. Understanding the formation of Type II collagen in the healing of tympanic membrane perforations could enable further research toward treating tympanic membrane perforations.
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| 16. |
- Stenfelt, Stefan
(författare)
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Transcranial Attenuation of Bone-Conducted Sound When Stimulation Is at the Mastoid and at the Bone Conduction Hearing Aid Position
- 2012
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Ingår i: Otology and Neurotology. - : Lippincott, Williams and Wilkins. - 1531-7129 .- 1537-4505. ; 33:2, s. 105-114
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Tidskriftsartikel (refereegranskat)abstract
- Hypothesis: The transcranial attenuation of bone-conducted (BC) sound depends on the stimulation position and the stimulation frequency. less thanbrgreater than less thanbrgreater thanBackground: Subjective transcranial attenuation of BC sound has previously only been measured at a few audiometric frequencies and with the stimulation at the mastoid. The results reported are on average of 5 to 10 dB with large intersubject variability and inconsistent with results obtained using vibration measurements of the cochlea. less thanbrgreater than less thanbrgreater thanMethods: Pure tone hearing thresholds were measured in 28 unilateral deaf subjects at 31 frequencies between 0.25 and 8 kHz. The stimulation was provided at 4 positions: ipsilateral and contralateral mastoid, and ipsilateral and contralateral position for a bone conduction hearing aid. less thanbrgreater than less thanbrgreater thanResults: With stimulation at the mastoid, the median transcranial attenuation is 3 to 5 dB at frequencies up to 0.5 kHz; between 0.5 and 1.8 kHz, it is close to 0 dB. The attenuation increases at higher frequencies; it is close to 10 dB at 3 to 5 kHz and becomes slightly less at the highest frequencies measured (4 dB at 8 kHz). When measured at the bone conduction hearing aid position, the median transcranial attenuation is 2 to 3 dB lower than at the mastoid. The intersubject variability is large at each frequency (around 40 dB), but there are small differences in general trends of the transcranial attenuation between individuals. less thanbrgreater than less thanbrgreater thanConclusion: The median transcranial attenuation depends on stimulation position and frequency. However, the variability is great, both between individuals and within subjects for adjacent frequencies.
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| 17. |
- Taghavi, Hamidreza, 1981, et al.
(författare)
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A vibration investigation of a flat surface contact to skull bone for direct bone conduction transmission in sheep skulls in vivo.
- 2013
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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. - 1537-4505 .- 1531-7129. ; 34:4, s. 690-8
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Tidskriftsartikel (refereegranskat)abstract
- Hypothesis: Bone conduction implant (BCI) attached with a flat surface contact will offer efficient and linear vibration transmission over time. Background: Despite that percutaneous bone conduction devices (PBCD) are successful in treating patients with conductive hearing loss, there are some drawbacks related to the need of a permanent skin penetration. The BCI system is designed as an alternative to the PBCD because it leaves the skin intact. Methods: BCI dummy implants were installed in 3 sheep skulls in vivo to study the vibration transmission characteristics over time. Mechanical point impedances and vibration transfer response functions of the BCI implants were measured at the time of surgery and after a healing period of 8 months. Results: In 1 sheep both implants healed without complications. In the other 2 sheep, the implants were either partially loose or lost to follow up. In the sheep with stable implants, it was found by the resonance frequency shift of the mechanical point impedance that a firmer integration between the implant and bone tissue as seen in osseointegrated surfaces developed over time. It was also shown that the transcranial vibration transmission remains stable and linear. Providing bone chips in the contact between the implant and the bone did not enhance vibration transmission. The surgical procedure for installing the BCI dummy implants was uneventful. Conclusion: The mechanical point impedances and vibration transfer response functions indicate that the BCI implants integrate and that transmission conditions remain stable over time.
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| 18. |
- Taghavi, Hamidreza, 1981, et al.
(författare)
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Feedback Analysis in Percutaneous Bone-Conduction Device and Bone-Conduction Implant on a Dry Cranium
- 2012
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Ingår i: Otology and Neurotology. - 1531-7129 .- 1537-4505. ; 33:3, s. 413-420
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Tidskriftsartikel (refereegranskat)abstract
- Hypothesis: The bone-conduction implant (BCI) can use a higher gain setting without having feedback problems compared with a percutaneous bone-conduction device (PBCD). Background: The conventional PBCD, today, is a common treatment for patients with conductive hearing loss and single-sided deafness. However, there are minor drawbacks reported related to the percutaneous implant and specifically poor high-frequency gain. The BCI system is designed as an alternative to the percutaneous system because it leaves the skin intact and is less prone to fall into feedback oscillations, thus allowing more high-frequency gain. Methods: Loop gains of the Baha Classic 300 and the BCI were measured in the frequency range of 100 to 10,000 Hz attached to a Skull simulator and a dry cranium. The Baha and the BCI positions were investigated. The devices were adjusted to full-on gain. Results: It was found that the gain headroom using the BCI was generally 0 to 10 dB better at higher frequencies than using the Baha for a given mechanical output. More specifically, if the mechanical output of the devices were normalized at the cochlear level the improvement in gain headroom with the BCI versus the Baha were in the range of 10 to 30 dB. Conclusion: Using a BCI, significantly higher gain setting can be used without feedback problems as compared with using a PBCD.
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| 19. |
- Zarenoe, Ramesh, et al.
(författare)
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Corticosteroid Treatment of Idiopathic Sudden Sensorineural Hearing Loss: Randomized Triple-Blind Placebo-Controlled Trial
- 2012
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Ingår i: Otology and Neurotology. - : Lippincott, Williams and Wilkins. - 1531-7129 .- 1537-4505. ; 33:4, s. 523-531
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To compare the effect of Prednisolone and placebo on the recovery of unilateral idiopathic sudden sensorineural hearing loss. less thanbrgreater than less thanbrgreater thanStudy Design: Prospective, randomized, triple-blind, placebo-controlled multicenter trial. less thanbrgreater than less thanbrgreater thanSetting: Four tertiary and 10 secondary referral centers. less thanbrgreater than less thanbrgreater thanPatients: Of 103 patients randomly assigned, 93 were included in the modified intention-to-treat analysis. The patients, aged 18 to 80 years, were seeking care within 1 week after onset of acute unilateral sensorineural hearing loss with a mean decrease of 30 dB or greater in the 3 most affected contiguous frequencies. less thanbrgreater than less thanbrgreater thanIntervention: Patients were randomly assigned in permuted blocks of 10 to receive Prednisolone or placebo in tapering doses from 60 mg for 3 days and, thereafter, 10 mg less each day until Day 8. If complete recovery, no more medication given, otherwise medication continued at 10 mg per day until Day 30. Final follow-up was after 3 months with audiogram; 47 patients received Prednisolone and 46 placebo. less thanbrgreater than less thanbrgreater thanMain Outcome Measure: The primary endpoint was efficacy of treatment on recovery at Day 90. Secondary endpoints were prognostic factors for hearing recovery. Analyses were by modified intention-to-treat and per protocol. less thanbrgreater than less thanbrgreater thanResults: Hearing improvement for 47 Prednisolone-treated patients was 25.5 +/- 27.1 dB compared to 26.4 +/- 26.2 dB for 46 placebo-treated patients at Day 8 and 39 +/- 20.1 dB versus 35.1 +/- 38.3 dB after 3 months. Vertigo had significant negative effect on hearing improvement and inflammatory signs in the laboratory workup-a positive prognostic effect, irrespective of treatment. less thanbrgreater than less thanbrgreater thanConclusion: Prednisolone in customary dosage does not seem to influence recovery of idiopathic sudden sensorineural hearing loss.
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| 20. |
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