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  • 1.
    Liu, Wei
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Kinnefors, Anders
    Boström, Marja
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Edin, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Rask-Andersen, Helge
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Distribution of pejvakin in human spiral ganglion: an immunohistochemical study2013In: Cochlear Implants International, ISSN 1467-0100, E-ISSN 1754-7628, Vol. 14, no 4, p. 225-231Article in journal (Refereed)
    Abstract [en]

    Up to 10% of permanent hearing impairments in children originate from lesions in the neuronal auditory pathway. This form of auditory neuron injury called auditory neuropathy features a preservation of outer hair cell integrity but an impaired inner hair cell function and/or neuronal transmission. DFNB59 gene encodes the protein pejvakin (PJVK) and its mutations cause autosomal recessive auditory neuropathy as well as other forms of sensorineural hearing loss. The finding of distinct forms of hearing anomalies was based on studies of consanguineous families from different ethnic groups as well as studies in mice with PJVK gene mutations. In the present immunohistochemical study, the distribution of pejvakin protein in surgically obtained human cochleae was for the first time investigated. The human cochleae had normal hearing thresholds before the operation. The expression of pejvakin was located in the cell bodies of all spiral ganglion neurons rather than the nerve fibers that were labeled with Tuj 1 antibody. As Tuj 1 antibody stained the cytoplasm of Type 1 cells, pejvakin antibody labeled both type 1 and type 2 cells. The nuclei of the neurons were also PJVK-positive. No labeling was seen in the structures within the organ of Corti and the stria vascularis. In the previous study, PJVK had been detected in the hair cells, the spiral ganglion, the cochlear nuclei, the superior olivary nucleus, and the inferior colliculus in mouse. Our study demonstrated for the first time the expression of PJVK in human spiral ganglion neurons. Its functional role in neural signal propagation and synchrony needs further elucidation.

  • 2.
    Lundin, Karin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Näsvall, Andreas
    Köbler, Susanne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Linde, Göran
    Rask-Andersen, Helge
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Cochlear implantation in the elderly2013In: Cochlear Implants International, ISSN 1467-0100, E-ISSN 1754-7628, Vol. 14, no 2, p. 92-97Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES:

    To analyse complications and outcome of cochlear implant (CI) treatment in seniors receiving CIs during a 10-year period.

    METHODS:

    A total of 28 patients, 79 years or older (mean age 81.6 years), were evaluated and compared with a younger group of 76 patients, 20-60 years old (mean age 48.9 years). A retrospective study of the patients' records was performed. Data on per- and post-operative complications, pre- and post-operative speech perception, estimated cognitive skills, and social situation was extracted. A subjective score was assessed and correlated with post-operative performance.

    RESULTS:

    No severe per- or post-operative surgical complications were noted. Speech perception improved significantly after surgery (P < 0.001). The younger age group showed better results post-operatively for monosyllabic words (P < 0.01) compared with the older group with no difference seen for bi-syllabic words. In both the groups, there were no significant differences between patients living with or without social support.

    DISCUSSION:

    CI surgery for patients 79 years or older was well tolerated. Patients benefited greatly from the device with improved hearing. CI should not be denied older individuals who are otherwise in good health. Non-use in the elderly was associated with post-operative vertigo and tinnitus, severe disease and limited social support.

  • 3.
    Lundin, Karin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Stillesjö, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Nyberg, Gunnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurosurgery.
    Rask-Andersen, Helge
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Experiences from Auditory Brainstem Implantation (ABI) in four Paediatric Patients2016In: Cochlear Implants International, ISSN 1467-0100, E-ISSN 1754-7628Article in journal (Refereed)
  • 4.
    Lundin, Karin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Stillesjö, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Rask-Andersen, Helge
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Prognostic Value of Electrically Evoked Auditory Brainstem Responses in Cochlear Implantation2015In: Cochlear Implants International, ISSN 1467-0100, E-ISSN 1754-7628, Vol. 16, no 5, p. 254-261Article in journal (Refereed)
    Abstract [en]

    Objectives

    The aim of this study was to investigate whether electrical auditory brainstem responses (eABRs) obtained during cochlear implantation (CI) can predict CI outcomes. We also aimed to assess whether eABR can be used to select patients for auditory brainstem implantation (ABI).

    Methods

    This was a retrospective study. The latencies and quality of the eABR waveforms from adult patients implanted with CI in Uppsala from 2011 to 2013 (n = 74) and four children with severe cochlear abnormalities were analyzed. Speech perception was assessed through postoperative monosyllabic word (MS-word) recognition. A score was constructed for each patient based on wave II, III, and V patency.

    Results

    eABR latencies increased towards base stimulation of the cochlea. Wave V for the mid- and low-frequency regions was the most robust. Significant latency shifts occurred in wave V from the low- to high-frequency regions (**P < 0.01) and from the mid- to high-frequency regions (**P < 0.01). No correlations were found between waveform score, wave V–III interval, wave V latency, and MS-word scores. A negative eABR always predicted a negative outcome. Among the patients with negative outcomes, 75% had eABRs.

    Discussion

    Implant electrical stimulation and brain stem recordings can be used (eABRs wave V) to predict a negative functional outcome. Low-frequency waves V were observed in all patients with successful CI outcomes. Patients for whom eABR waveforms were completely absent had unsuccessful CI outcomes.

  • 5. Lundin, Karin
    et al.
    Stillesjö, Fredrik
    Rask-Andersen, Helge
    Prognostic value of electrically evoked auditory brainstem responsesin cochlear implantation2015In: Cochlear Implants International, ISSN 1467-0100, E-ISSN 1754-7628, Vol. 16, no 5, p. 254-261-Article in journal (Refereed)
  • 6.
    Rask-Andersen, Helge
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Erixon, Elsa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Kinnefors, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Löwenheim, Hubert
    Schrott-Fischer, Anneliese
    Liu, Wei
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Anatomy of the human cochlea: implications for cochlear implantation2011In: Cochlear Implants International, ISSN 1467-0100, E-ISSN 1754-7628, Vol. 12, no Suppl 1, p. S8-S13Article in journal (Refereed)
    Abstract [en]

    Since the classical description by Retzius in 1884, many extensive studies of the micro-anatomy of the human cochlea have been presented. The human cochlea is one of the most difficult tissues to study due to the bony capsule and its delicate contents. Most preparations suffer from post-mortem changes caused by the delay between demise and fixation. For over a decade, we have analyzed human inner-ear tissue obtained at surgery using transmission electron microscopy, scanning electron microscopy, in vitro culture, and immunohistochemistry. These studies show the value of these techniques for fine structural and molecular analyses. Modern cochlear implant surgery requires that ear surgeons are familiar with the intricate anatomy of the human cochlea and its variations. The classical technique to insert electrode arrays through a drilled cochleostomy has been abandoned by some surgeons today. Instead a round-window approach can be used as originally implemented by William House for short electrodes. This so-called 'hook' region of the cochlea presents extensive anatomical variations that can be difficult to foresee on pre-operative computed tomography. CI depends on the functional status of remaining spiral ganglion neurons. These cells are more or less preserved in CI patients but how the conservation influences the outcome of CI is debatable. Notwithstanding their preservation is crucial and more information should be attained about their deterioration and how it can be prevented. Better understanding of structure, function, and regenerative capability is needed to comprehend the nature of electrical stimulation of the peripheral and central nervous system to improve the design of future implant systems.

  • 7.
    Schart-Moren, Nadine
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Hallin, Karin
    Agrawal, Sumit K
    Ladak, Hanif M
    Eriksson, Per-Olof
    Li, Hao
    Rask-Andersen, Helge
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Peri-operative electrically evoked auditory brainstem response assessment of facial nerve/cochlea interaction at cochlear implantation2018In: Cochlear Implants International, ISSN 1467-0100, E-ISSN 1754-7628, Vol. 19, no 6, p. 324-329Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Dehiscence between the cochlear otic capsule and the facial nerve canal is a rare and relatively newly described pathology. In cochlear implantation (CI), this dehiscence may lead to adverse electric facial nerve stimulation (FNS) already at low levels, rendering its use impossible. Here, we describe an assessment technique to foresee this complication.

    METHODS: Pre- and postoperative computed tomography (CT) scans and intraoperative electrically evoked auditory brainstem response (e-ABR) measurements were analyzed in two patients with cochlear-facial dehiscence (CFD).

    RESULTS: Because of the relatively low resolution, the confirmation of CFD with a clinical CT was difficult. The e-ABR displayed a large potential with 6 and 7.5 ms latency, respectively, which did not occur otherwise.

    DISCUSSION: Potential strategies to resolve and manage FNS are described.

    CONCLUSION: Prediction of FNS by assessing the distance between the labyrinthine portion of the facial nerve and the cochlea is difficult using conventional CT scans. A large evoked late myogenic potential at low stimulation levels during intraoperative e-ABR measurement may foresee FNS at CI activation.

  • 8. Sennaroğlu, Levent
    et al.
    Colletti, Vittorio
    Lenarz, Thomas
    Manrique, Manuel
    Laszig, Roland
    Rask-Andersen, Helge
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
    Göksu, Nebil
    Offeciers, Erwin
    Saeed, Shakeel
    Behr, Robert
    Bayazıt, Yıldırım
    Casselman, Jan
    Freeman, Simon
    Kileny, Paul
    Lee, Daniel J
    Shannon, Robert V
    Kameswaran, Mohan
    Hagr, Abdulrahman
    Zarowski, Andrzej
    Schwartz, Mark S
    Bilginer, Burçak
    Kishore, Ameet
    Sennaroğlu, Gonca
    Yücel, Esra
    Saraç, Sarp
    Ataş, Ahmet
    Colletti, Lilian
    O'Driscoll, Martin
    Moon, In Seok
    Gärtner, Lutz
    Huarte, Alicia
    Nyberg, Gunnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Mocan, Burçe Özgen
    Atay, Gamze
    Bajin, Münir Demir
    Çınar, Betül Çicek
    Batuk, Merve Özbal
    Yaralı, Mehmet
    Aydınlı, Fatma Esen
    Aslan, Filiz
    Kirazlı, Meltem Cigdem
    Özkan, Hilal Burcu
    Hans, J M
    Kosaner, Julie
    Polak, Marek
    Consensus statement: Long-term results of ABI in children with complex inner ear malformations and decision making between CI and ABI2016In: Cochlear Implants International, ISSN 1467-0100, E-ISSN 1754-7628, Vol. 17, no 4, p. 163-171Article in journal (Refereed)
1 - 8 of 8
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