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Round window vibroplasty in chronic ear surgery: Comparison with conventional hearing rehabilitation
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
2013 (English)In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 138, no 8, 814-825 p.Article in journal (Refereed) Published
Abstract [en]

Conclusion:

Functional hearing results with round window vibroplasty in chronically disabled middle ears were comparable and, at high frequencies, superior to the results achieved with previously used conventional hearing aids even after extended surgery. Soft tissue transfer appears to be more important than floating mass transducer (FMT) alignment with the round window membrane (RWM) for efficient coupling or sonoinversion.

Objectives:

To evaluate the functional hearing results of an active middle ear implant (AMEI) to the round window niche (RWN). The results were compared with previously used conventional hearing aids. The position of the FMT was determined by cone-beam computed tomography (CBCT).

Study design:

Prospective cohort study

Setting:

Tertiary referral center

Material and Methods:

Seven patients with severe middle ear disease were implanted with an AMEI with round window application. The postoperative hearing outcome was compared with preoperative hearing using unaided and conventionally aided conditions. The results were correlated with the physical/geometric relation of the FMT to the RWM as determined with CBCT.

Results:

Dislocation of the FMT was not observed. One patient was re-implanted due to accidental damage to the electrode. In all patients, the pertinent functional hearing results were achieved and were comparable to previous rehabilitation results.

Place, publisher, year, edition, pages
2013. Vol. 138, no 8, 814-825 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-198120DOI: 10.3109/00016489.2013.780294ISI: 000321791700004OAI: oai:DiVA.org:uu-198120DiVA: diva2:615259
Available from: 2013-04-09 Created: 2013-04-09 Last updated: 2017-12-06Bibliographically approved
In thesis
1. Middle Ear Cholesteatoma: Surgical Treatment, Follow-up and Hearing Restoration
Open this publication in new window or tab >>Middle Ear Cholesteatoma: Surgical Treatment, Follow-up and Hearing Restoration
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Although middle-ear cholesteatoma is a major topic in otological research, its etiology and pathogenesis remain unclear. Pediatric cholesteatoma is considered more aggressive than adult cholesteatoma, as it has a higher rate of growth, is more often infected and exhibits wider extension. Higher incidence of residual and recurrent disease after surgical treatment of pediatric cholesteatoma has been observed in most studies. In this study, the results are presented from a canal wall down (CWD) obliteration technique used in 330 adult patients (Paper I) with cholesteatoma, evaluated at 1, 3 and 6 years following surgery. Additionally, results are offered from 57 pediatric patients (Paper II) using identical surgical technique and compared with adults. The surgical and hearing outcomes in both groups showed a low incidence of residual and recurrent disease and a high rate of ear water resistance without infection. The results were unrelated to the severity and extension of disease, as well as to age and previous surgery. No differences were found in outcomes between adult and pediatric cholesteatoma patients.

The thesis also describes the use of diffusion-weighted magnetic resonance imaging (DW-MRI) (Paper III) in follow-up examinations of adult cholesteatoma patients undergoing surgical treatment. Non-echo planar diffusion-weighted imaging (Non-EPI DW-MRI)increased the accuracy of clinical examinations. It is concluded that the use of non-EPI DW-MRI should be mandatory in clinical follow-ups after cholesteatoma surgery. In Paper IV a relatively new mode of hearing rehabilitation was investigated, with an active middle ear implant (AMEI), in patients with chronically disabled ears. Functional hearing results were compared with the previous use of conventional hearing aids before and after AMEI implantation. Moreover, the consequences of positioning of the implant in the middle ear were evaluated using cone beam computed tomography (CBCT), a modification of conventional computed tomography. The hearing results, assessed with AMEI, were found to be less dependent on the precise positioning of the floating mass transducer(FMT) against the round window membrane (RWM) than was anticipated. Further, the hearing results were noted to be comparable with those with conventional hearing aids and even superior at high frequencies.

 

 

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2013. 48 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 905
National Category
Medical and Health Sciences
Research subject
Oto-Rhino-Laryngology
Identifiers
urn:nbn:se:uu:diva-198121 (URN)978-91-554-8672-3 (ISBN)
Public defence
2013-06-12, Enghoffsalen, ingång 50, Akademiska Sjukhuset, Uppsala, 13:15 (Swedish)
Opponent
Supervisors
Available from: 2013-05-22 Created: 2013-04-09 Last updated: 2013-08-30Bibliographically approved

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Edfeldt, LennartRask-Andersen, Helge

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