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  • 101.
    Hägg, Mary
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Hudiksvall Hosp, Speech & Swallowing Ctr, Dept Otorhinolaryngol, Hudiksvall, Sweden.
    Tibbling, L.
    Linkoping Univ, Dept Otorhinolaryngol, Linkoping, Sweden.
    Effect of IQoro® training on impaired postural control and oropharyngeal motor function in patients with dysphagia after stroke2018Inngår i: International Journal of Stroke, ISSN 1747-4930, E-ISSN 1747-4949, Vol. 13, s. 60-60Artikkel i tidsskrift (Annet vitenskapelig)
  • 102.
    Hägg, Mary
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Hudiksvall Hosp, Dept Otorhinolaryngol, Speech & Swallowing Ctr, SE-82481 Hudiksvall, Sweden..
    Tibbling, Lita
    Linkoping Univ, Dept Surg, S-58183 Linkoping, Sweden..
    Effect of IQoro (R) training on impaired postural control and oropharyngeal motor function in patients with dysphagia after stroke2016Inngår i: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 136, nr 7, s. 742-748Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Conclusion All patients with dysphagia after stroke have impaired postural control. IQoro (R) screen (IQS) training gives a significant and lasting improvement of postural control running parallel with significant improvement of oropharyngeal motor dysfunction (OPMD). Objectives The present investigation aimed at studying the frequency of impaired postural control in patients with stroke-related dysphagia and if IQS training has any effect on impaired postural control in parallel with effect on OPMD. Method A prospective clinical study was carried out with 26 adult patients with stroke-related dysphagia. The training effect was compared between patients consecutively investigated at two different time periods, the first period with 15 patients included in the study more than half a year after stroke, the second period with 11 patients included within 1 month after stroke. Postural control tests and different oropharyngeal motor tests were performed before and after 3 months of oropharyngeal sensorimotor training with an IQS, and at a late follow-up (median 59 weeks after end of training). Result All patients had impaired postural control at baseline. Significant improvement in postural control and OPMD was observed after the completion of IQS training in both intervention groups. The improvements were still present at the late follow-up.

  • 103.
    Hägg, Mary
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg. Hudiksvall Hosp, Speech & Swallowing Ctr, Dept Otorhinolaryngol, SE-82481 Hudiksvall, Sweden..
    Tibbling, Lita
    Linkoping Univ, Dept Otorhinolaryngol, Linkoping, Sweden..
    Effect of oral IQoro(R) and palatal plate training in post-stroke, four-quadrant facial dysfunction and dysphagia: A comparison study2015Inngår i: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 135, nr 9, s. 962-968Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Conclusion: Training with either a palatal plate (PP) or an oral IQoro(R) screen (IQS) in patients with longstanding facial dysfunction and dysphagia after stroke can significantly improve facial activity (FA) in all four facial quadrants as well as swallowing capacity (SC). Improvements remained at late follow-up. The training modalities did not significantly differ in ameliorating facial dysfunction and dysphagia in these patients. However, IQS training has practical and economic advantages over PP training. Objectives: This study compared PP and oral IQS training in terms of (i) effect on four-quadrant facial dysfunction and dysphagia after a first-ever stroke, and (ii) whether the training effect persisted at late follow-up. Methods: Patients were included during two periods; 13 patients in 2005-2008 trained with a PP, while 18 patients in 2009-2012 trained with an IQS. Four-quadrant facial dysfunction was assessed with an FA test and swallowing dysfunction with a SC test: before and after a 3-month training period and at late follow-up. FA and SC significantly improved (p < 0.001) in both groups. FA test scores after training and at late follow-up did not differ significantly between the groups, irrespective of whether the interval between stroke incidence and the start of training was long or short.

  • 104.
    Hägg, Mary
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg.
    Tibbling, Lita
    Franzen, Thomas
    Effect of IQoro(R) training in hiatal hernia patients with misdirected swallowing and esophageal retention symptoms2015Inngår i: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 135, nr 7, s. 635-639Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Conclusion: Misdirected swallowing can be triggered by esophageal retention and hiatal incompetence. The results show that oral IQoro(R) screen (IQS) training improves misdirected swallowing, hoarseness, cough, esophageal retention, and globus symptoms in patients with hiatal hernia. Objectives: The present study investigated whether muscle training with an IQS influences symptoms of misdirected swallowing and esophageal retention in patients with hiatal hernia. Methods: A total of 28 adult patients with hiatal hernia suffering from misdirected swallowing and esophageal retention symptoms for more than 1 year before entry to the study were evaluated before and after training with an IQS. The patients had to fill out a questionnaire regarding symptoms of misdirected swallowing, hoarseness, cough, esophageal retention, and suprasternal globus, which were scored from 0-3, and a VAS on the ability to swallow food. The effect of IQS traction on diaphragmatic hiatus (DH) pressure was recorded in 12 patients with hiatal hernia using high resolution manometry (HRM). Results: Upon entry into the study, misdirected swallowing, globus sensation, and esophageal retention symptoms were present in all 28 patients, hoarseness in 79%, and cough in 86%. Significant improvement was found for all symptoms after oral IQS training (p < 0.001). Traction with an IQS resulted in a 65 mmHg increase in the mean HRM pressure of the DH.

  • 105. Irander, K.
    et al.
    Borres, Magnus P.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Ghafouri, B.
    The effects of physical exercise and smoking habits on the expression of SPLUNC1 in nasal lavage fluids from allergic rhinitis subjects2014Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 78, nr 4, s. 618-622Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: Palate lung nasal epithelial clone (PLUNC) is a family of proteins, which are proposed to participate in the innate immune defense against infections in the upper aero-digestive tract. The aim of this study was to investigate the expression of SPLUNC1 in allergic rhinitis subjects with considerations taken to the mucosa( function and smoking habits. Methods: The participants, recruited from a cohort followed from infancy, were re-examined at the age of 18 years regarding allergy development. Based on medical histories and skin prick tests the participants were classified into groups with persistent allergic rhinitis (n = 18), intermittent allergic rhinitis (n = 8) and healthy controls (n = 13). Seven subjects (3, 2 and 2 in each group, respectively) reported smoking habits. The SPLUNC1 levels in nasal lavage fluids were analyzed by Western blot. Changes in the volume of the proper nasal cavity before and after physical exercise (Vol2(increase)) were analyzed by acoustic rhinometiy. Results: Compared to the control group the SPLUNC1 level was significantly lower in the persistent allergy group (3.8 +/- 3.4 OD vs. 1.3 +/- 1.5 OD; p = 0.02), but not in the intermittent allergy group without current exposure to allergens (3.6 +/- 4.7 OD). No differences were found in Vol2(increase) between any of the allergy groups and controls. In smokers Vol2(increase) was significantly reduced (p < 0.01) and the SPLUNC1 levels were lower compared to non-smokers. A significant correlation was found between SPLUNC1 and vol2(increase) (p<0.01; r = 0.53) in non-smokers. Conclusions: Current allergen exposure has an impact on SPLUNC1 expression in nasal lavage fluid, why allergy ought to be considered in study populations where analyses of SPLUNC1 levels are included in the reports. The normal nasal decongestion after exercise was not affected by allergy in contrast to smoking habits. The correlation between SPLUNC1 levels and Vol2(increase) in non-smokers may indicate involvement of SPLUNC1 in the regulation of the normal function of the nasal mucosa. Complementary studies are needed to confirm the smoke-related reduction of SPLUNC1 expression and to analyze the possible participation of SPLUNC1 in the nasal mucosa regulation.

  • 106. J, Sundman
    et al.
    J, Bring
    Friberg, Danielle
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Poor interexaminer agreement on Friedman tongue position.2017Inngår i: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 137, nr 5, s. 554-556Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Conclusion: The Friedman tongue position demonstrated only a slight inter-examiner agreement among 15 medical doctors, indicating that the method is difficult to perform and could be an uncertain method to select patients for uvulopalatopharyngoplasty.

    Objective: The Friedman staging system is a clinical tool for selecting patients with obstructive sleep apnea who are appropriate for uvulopalatopharyngoplasty. The objective of this study was to evaluate the staging system by determining the inter-examiner agreement of one of its key components, the Friedman tongue position.

    Methods: Eleven residents and four specialists in Otorhinolaryngology were recruited from a course in surgical management of obstructive sleep apnea. They examined each other’s tongue positions, resulting in a total of 210 evaluations. Cohen’s kappa analysis was performed to assess the inter-examiner agreement. The range of kappa is usually between 0–1, where 0 is complete disagreement and 1 is complete agreement.

    Results: The median kappa was 0.36 (1st and 3rd quartile, 0.23 and 0.42), corresponding to only a slight agreement.

  • 107. J, Sundquist
    et al.
    X, Li
    Friberg, Danielle
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    K, Hemminki
    K, Sundquist
    Obstructive sleep apnea syndrome in siblings: an 8-year Swedish follow-up study.2008Inngår i: Sleep, ISSN 0161-8105, E-ISSN 1550-9109, Vol. 31, nr 6, s. 817-823Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background:

    Understanding the genetic transmission of obstructive sleep apnea syndrome (OSAS) will help clinicians identify patients at risk and offer opportunities for intervention and treatment at specialist clinics.

    Objective:

    To estimate familial risk of hospitalization for OSAS in the adult population of Sweden, and to determine if there are any differences by age and sex.

    Design, setting, and participants:

    Using the MigMed database at the Karolinska Institute, we divided the population of Sweden into sibling groups based on a shared mother and father and ascertained the presence or absence of a primary hospital diagnosis of OSAS in each individual during the follow-up period, 1997 to 2004. Individuals were categorized as having or not having a sibling with OSAS, based on the presence or absence of the disorder in at least 1 of their siblings. Standardized incidence ratios (SIRs) with 95% confidence intervals (CIs) were estimated for men and women with a sibling with OSAS, compared with men and women in the reference group (SIR = 1).

    Results:

    After accounting for socioeconomic status, age, geographic region, and period of diagnosis, men with at least 1 sibling who had OSAS had a SIR of 3.42 (95% CI, 2.18–5.36); the corresponding SIR in women was 3.25 (95% CI, 1.84–5.65).

    Conclusions:

    Our results indicate that physicians should consider family history of OSAS when deciding whether to refer a patient for further sleep examinations.

  • 108.
    Jakobsson, Rebecka
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Logopedi.
    Bedömning av konversationsförmåga vid afasi: En svensk anpassning av Aura Kagans bedömningsmaterial för delaktighet och stöd i samtal hos personer med afasi och deras konversationspartners2010Independent thesis Advanced level (degree of Master (One Year)), 20 poäng / 30 hpOppgave
    Abstract [sv]

    Vid afasi påverkas förmågan att samtala och interagera med andra människor i varierande grad. Omgivningen kan utgöra en stor skillnad för hur personen med afasi lyckas interagera med hjälp av olika slags stöd, t ex med skrivet material som förstärkning till samtalsinnehållet. Aura Kagan har inom ramen för samtalsmodellen SCA (Supported Conversation for Adults with Aphasia) utformat ett bedömningsmaterial för konversationsförmåga hos personer med afasi och deras konversationspartners. Detta bedömningsmaterial har i den här studien använts som utgångspunkt för utformningen av ett svenskt bedömningsmaterial för konversationsförmåga som är ämnat att användas vid vårdinrättningar som rehabiliterar personer med afasi. Sex logopeder använde det framtagna materialet för att bedöma konversationsförmågan dels hos tio personer med varierande karaktär och svårighetsgrad av afasi, dels hos deras konversationspartners. Samtalen videoinspelades. Ytterligare två logopeder använde samma bedömningsmaterial för att bedöma konversationsförmågan i de inspelade samtalen. Bedömningsmaterialet hade hög interbedömarreliabilitet (Intraclass correlation coefficients = 0,69-0,87, p ≤ 0,02) och mycket hög intern reliabilitet (Cronbachs α = 0,93-0,95). Medverkande logopeder intervjuades om bedömningsmaterialets användarvänlighet. I den kvalitativa analysen av intervjuerna framkom förslag på förbättringar, t ex reducering av delfrågor och anpassning av skattningsskalor. I en anpassad form skulle det framtagna materialet kunna ha stor klinisk betydelse och öka förekomsten av funktionella afasibedömningar av konversationsförmåga i Sverige.

  • 109.
    Johansson, M. L.
    et al.
    Oticon Med AB, Askim, Sweden.;Univ Gothenburg, Dept Biomat, Inst Clin Sci, Sahlgrenska Acad, Gothenburg, Sweden..
    Stokroos, R. J.
    Maastricht Univ, Dept Otorhinolaryngol & Head & Neck Surg, Med Ctr, Maastricht, Netherlands..
    Banga, R.
    Queen Elizabeth Hosp, Birmingham, W Midlands, England..
    Hol, M. K.
    Radboud Univ Nijmegen, Dept Otorhinolaryngol, Med Ctr, Nijmegen, Netherlands..
    Mylanus, E. A.
    Radboud Univ Nijmegen, Dept Otorhinolaryngol, Med Ctr, Nijmegen, Netherlands..
    Jones, H. Savage
    Midland Reg Hosp, Tullamore, Ireland..
    Tysome, J. R.
    Cambridge Univ Teaching Hosp NHS Trust, Dept Skull Base Surg, Addenbrookes Hosp, Cambridge, England..
    Vannucchi, P.
    Univ Florence, Careggi Hosp, Dept Surg Sci & Translat Med, Unit Audiol, Florence, Italy..
    Hof, J. R.
    Maastricht Univ, Dept Otorhinolaryngol & Head & Neck Surg, Med Ctr, Maastricht, Netherlands..
    Brunings, J. W.
    Maastricht Univ, Dept Otorhinolaryngol & Head & Neck Surg, Med Ctr, Maastricht, Netherlands..
    van Tongeren, J.
    Maastricht Univ, Dept Otorhinolaryngol & Head & Neck Surg, Med Ctr, Maastricht, Netherlands..
    Lutgert, R. W.
    Isala Klin, Zwolle, Netherlands..
    Banerjee, A.
    James Cook Univ Hosp, Dept Otolaryngol, Middlesbrough, Cleveland, England..
    Windfuhr, J. P.
    Kliniken Maria Hilf, Dept Otolaryngol Head & Neck Surg, Monchengladbach, Germany..
    Caruso, A.
    Grp Otol, Piacenza, Italy..
    Giannuzzi, A. L.
    Grp Otol, Piacenza, Italy..
    Bordin, S.
    Venice Int Otolaryngol Network, Venice, Italy..
    Hanif, J.
    Norfolk & Norwich Univ Hosp NHS Trust, Norwich, Norfolk, England..
    Schart-Moren, Nadine
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Singam, S.
    Torbay Hosp, Dept ENT & Audiol, Torquay, Devon, England..
    Jonhede, S.
    Oticon Med AB, Askim, Sweden..
    Holmberg, M.
    Oticon Med AB, Askim, Sweden..
    Cremers, C. W.
    Radboud Univ Nijmegen, Dept Otorhinolaryngol, Med Ctr, Nijmegen, Netherlands..
    Hultcrantz, M.
    Karolinska Univ Hosp, Dept Otorhinolaryngol, Stockholm, Sweden..
    Short-term results from seventy-six patients receiving a bone-anchored hearing implant installed with a novel minimally invasive surgery technique2017Inngår i: Clinical Otolaryngology, ISSN 1749-4478, E-ISSN 1365-2273, Vol. 42, nr 5, s. 1043-1048Artikkel i tidsskrift (Annet vitenskapelig)
  • 110.
    Johansson, Sara
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Logopedi.
    Walker Westerlund, Sofia
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Logopedi.
    Hur påverkas stammande personers talflyt av förstärkt hörselåterkoppling?2010Independent thesis Advanced level (degree of Master (One Year)), 20 poäng / 30 hpOppgave
    Abstract [sv]

    I denna studie undersöktes effekten av förstärkt hörselåterkoppling (enhanced auditoryfeedback, EAF) på observerbar stamning och upplevd känsla av talflyt hos vuxna personer som stammar. Så vitt vi vet finns inga tidigare studier av effekten av förstärkt hörselåterkoppling vid stamning. Mycket forskning finns dock på andra typer av hörselåterkoppling, som exempelvis frekvensförändrad hörselåterkoppling (frequencyaltered feedback, FAF), där man sett positiv effekt på talflytet hos personer som stammar. Deltagargruppen bestod av 14 personer i åldrarna 20-43 år, som stammade. Deltagarna fick läsa högt under olika förhållanden av hörselåterkoppling, de olika förhållandena som testades var förstärkt hörselåterkoppling och FAF mot normal hörselåterkoppling. Testtillfällena spelades in och procent stammade stavelser (%SS) räknades för en objektiv bedömning av talflytet. Deltagarna fick också skatta hur de upplevde talflytet under de olika förhållandena. Såväl observerbar stamning som skattning av upplevt talflyt visade en positiv tendens vid både förstärkt hörselåterkoppling och FAF. Förändringen var statistiskt signifikant för observerbar stamning vid FAF (p = 0,002), och för skattningen av upplevt talflyt vid både förstärkthörselåterkoppling (p = 0,0053) och FAF (p = 0,021). Att förändringen i observerbarstamning vid förstärkt hörselåterkoppling inte var statistiskt signifikant (p = 0,117) kanbero på relativt låg power hos studien, särskilt som två deltagare inte uppvisade någon stamning alls i testsituationen. De positiva resultaten gällande skattningen samt de positiva tendenserna i observerbar stamning (%SS) i denna studie motiverar fortsatt forskning om förstärkt hörselåterkoppling vid stamning.

  • 111.
    Jonsson, Eva Lindell
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Biomolecular markers in head and neck cancer2017Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Head and neck cancer is a heterogeneous group of tumours, of which certain subgroups such as cancer of the mobile tongue frequently are associated with a relatively poor prognosis due to the high risk of regional failure and mortality rates that haven’t improved in a significant way over the last 3 decades, despite advancements in both diagnostics and treatment.

    Today we lack means to assess the biological aggressiveness of each individual tumour, which varies largely. Treatment comprises of surgery with additional radiotherapy and medical therapies in more advanced tumours.

    The focus in this thesis is on molecular biomarker expression in head and neck cancer and especially in association with radiotherapy. Increased knowledge paves the way to a more individualized cancer treatment aiming for better outcome and less overtreatment and sequelae.

    The aims of this thesis was:

    • To map the effects of radiotherapy in both tumour and adjacent tissue for the possible markers hyaluronan, EGFR and mast cells.
    • To investigate whether the expression of hyaluronan in the epithelium and connective tissue stroma and EGFR in the tumour correlates with the risk for developing cervical metastasis in N0 patients, and to find out whether the 3-year tumour-specific survival rates correlates with the expression of HA in the epithelium and EGFR in the tumour.
    • To establish an animal model for radiation-induced mucositis and to use that model to examine the pattern of invading inflammatory cells.
    • To investigate whether the expression of podoplanin in tongue cancer correlates with the risk for cervical metastasis and to determine whether the total amount of lymph vessels in the diagnostic biopsy has any impact on the clinical outcome.
    • To investigate the differences in the metabolome of tongue cancer cell lines with different radiosensitivity.

    The most important findings of this thesis were:

    • The expression of EGFR and hyaluronan hade the same pattern of expression in both tumour and adjacent tissues before radiotherapy. The expression of EGFR was increased in the epithelium of the adjacent tissue close to the tumour after radiotherapy.
    • The intensity of the staining of hyaluronan was correlated to the 3-year survival rates in patients with tongue cancer.
    • An experimental model for radiation-induced oral mucositis in rat was established and in this model a temporal pattern of macrophage invasion with two different subtypes of macrophages was found.
    • There were no correlation between the expression of podoplanin in the tumour tissue and the cervical metastasis rate in patients with tongue cancer, but the younger patients were more likely to have a higher expression of podoplanin in their tumour than elder patients.
    • Tongue cancer cell lines with different radiosensitivity respond to irradiation with different patterns of metabolic expressions. 
    Delarbeid
    1. Effect of radiotherapy on expression of hyaluronan and EGFR and presence of mast cells in squamous cell carcinoma of the head and neck.
    Åpne denne publikasjonen i ny fane eller vindu >>Effect of radiotherapy on expression of hyaluronan and EGFR and presence of mast cells in squamous cell carcinoma of the head and neck.
    2012 (engelsk)Inngår i: Oncology Letters, ISSN 1792-1074, E-ISSN 1792-1082, Vol. 4, nr 6Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Head and neck squamous cell carcinoma is a common form of cancer, and despite improvements in treatment during the last decades, survival rates have not significantly increased. There is therefore a need to better understand how these tumours and the adjacent tissues react to radiotherapy, the most common type of treatment for this group of tumours. In order to improve this understanding, the expression of hyaluronan (HA) and epidermal growth factor receptor (EGFR) and the presence of mast cells were mapped before and after radiotherapy using immunohistochemistry. The results showed HA and EGFR to have similar expression patterns in tumour tissue and histologically normal squamous epithelium prior to radiotherapy. Following radiotherapy, EGFR increased in histologically normal epithelium. An increased number of mast cells were also observed as a result of radiotherapy. No expression of EGFR was observed in the connective tissue either prior to or following radiotherapy.

    Emneord
    Age; Body mass index; Cytokine; Human; Proximity extension assay (PEA); Cerebrospinal fluid
    HSV kategori
    Identifikatorer
    urn:nbn:se:uu:diva-269490 (URN)10.3892/ol.2012.907 (DOI)23205115 (PubMedID)
    Tilgjengelig fra: 2015-12-16 Laget: 2015-12-16 Sist oppdatert: 2017-12-01
    2. The Micromorphological Course of Irradiation-Induced Oral Mucositis in Rat.
    Åpne denne publikasjonen i ny fane eller vindu >>The Micromorphological Course of Irradiation-Induced Oral Mucositis in Rat.
    2015 (engelsk)Inngår i: Journal of Clinical & Experimental Oncology, ISSN 2324-9110Artikkel i tidsskrift (Fagfellevurdert) Published
    HSV kategori
    Forskningsprogram
    Oto-rhino-laryngologi; Onkologi
    Identifikatorer
    urn:nbn:se:uu:diva-316200 (URN)10.4172/2324-9110.1000145 (DOI)
    Tilgjengelig fra: 2017-02-27 Laget: 2017-02-27 Sist oppdatert: 2017-02-27
    3. High expression of podoplanin in squamous cell carcinoma of the tongue occurs predominantly in patients≤ 40 years but does not correlate with tumour spread
    Åpne denne publikasjonen i ny fane eller vindu >>High expression of podoplanin in squamous cell carcinoma of the tongue occurs predominantly in patients≤ 40 years but does not correlate with tumour spread
    Vise andre…
    2016 (engelsk)Inngår i: The journal of pathology. Clinical research, ISSN 2056-4538, nr 1, s. 3-8Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    More than 30% of patients with squamous cell carcinoma (SCC) of the mobile tongue have clinically undetectable lymph node metastasis. Tumour cells can spread as single cells or collectively. A protein known to play a role in both processes is podoplanin, which is expressed in endothelial cells not only in lymph vessels but also in some aggressive tumours with high invasive and metastatic potential. Here we studied samples from 129 patients with primary SCC of the tongue for expression of podoplanin using immunohistochemistry. mRNA levels were analysed in another 27 cases of tongue SCC with adjacent clinically tumour-free tongue tissue and 14 tongue samples from healthy donors. Higher levels of podoplanin were seen in tumours compared to both normal tongue and clinically normal tongue in the tumour vicinity. No association was found between levels of podoplanin, presence of lymph node metastases or other clinical factors. Patients aged 40 or less were more likely to express high levels of podoplanin protein compared to older patients (p = 0.027). We conclude that levels of podoplanin in primary tongue SCCs are not associated with lymph node metastases. However, tongue SCCs arising in young patients (< 40 years of age) are more likely to express high levels of podoplanin than tongue SCCs that arise in the more elderly. The data suggest that podoplanin has a distinctive role in young patients, who are known to have a poor prognosis: these patients may, therefore, benefit from podoplanin inhibitory therapies.

    HSV kategori
    Identifikatorer
    urn:nbn:se:uu:diva-316241 (URN)10.1002/cjp2.28 (DOI)000410840100001 ()27499910 (PubMedID)
    Tilgjengelig fra: 2017-02-27 Laget: 2017-02-27 Sist oppdatert: 2017-12-08bibliografisk kontrollert
    4. Immunohistochemical analysis of EGFR and hyaluronan in tongue cancer and the development of regional recurrence in patients initially diagnosed N0
    Åpne denne publikasjonen i ny fane eller vindu >>Immunohistochemical analysis of EGFR and hyaluronan in tongue cancer and the development of regional recurrence in patients initially diagnosed N0
    2017 (engelsk)Inngår i: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 137, nr 8, s. 877-882Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Objective: To investigate whether the extent of expression of hyaluronan (HA) and epidermal growth factor receptor (EGFR) in squamous cell carcinoma of the mobile tongue can predict the risk of cervical metastasis and survival. Study design: Retrospective histopathologic study. Methods: Surgical specimens from 64 patients who had undergone surgery for squamous cell carcinoma of the mobile tongue were assessed using immunohistochemistry to investigate the expression of HA and EGFR in the primary tumours, and the data were then correlated to cervical metastasis and survival. Results: There was a significant correlation between the intensity of HA staining and patient survival (p .024), and a weak correlation between the staining proportion of EGFR and the risk for regional recurrence (AUC 66). Conclusions: This study indicates that immunoscoring using HA could be used to provide prognostic tools for tongue cancer, and that it might be of interest to study the prognostic properties of EGFR further concerning the risk for regional recurrence after the primary treatment.

    sted, utgiver, år, opplag, sider
    Taylor & Francis, 2017
    Emneord
    Epidermal growth factor receptor expression, immunoscoring, oral tongue squamous cell carcinoma, prognostic factors, biomarkers
    HSV kategori
    Identifikatorer
    urn:nbn:se:uu:diva-316243 (URN)10.1080/00016489.2017.1292049 (DOI)000404684100016 ()28355940 (PubMedID)
    Tilgjengelig fra: 2017-02-27 Laget: 2017-02-27 Sist oppdatert: 2017-10-19bibliografisk kontrollert
    5. Metabolic profiling of head and neck cancer cell lines with different radiosensitivity using mass spectroscopy provides new insights on the mechanism of radiation response.
    Åpne denne publikasjonen i ny fane eller vindu >>Metabolic profiling of head and neck cancer cell lines with different radiosensitivity using mass spectroscopy provides new insights on the mechanism of radiation response.
    Vise andre…
    (engelsk)Manuskript (preprint) (Annet vitenskapelig)
    HSV kategori
    Identifikatorer
    urn:nbn:se:uu:diva-316244 (URN)
    Tilgjengelig fra: 2017-02-27 Laget: 2017-02-27 Sist oppdatert: 2017-02-27
  • 112.
    Jonsson, Eva Lindell
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Nylander, Karin
    Umea Univ, Dept Med Biosci, Umea, Sweden.
    Hallén, Lars
    Umea Univ, Dept Clin Sci, Umea, Sweden.
    Laurell, Göran
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Immunohistochemical analysis of EGFR and hyaluronan in tongue cancer and the development of regional recurrence in patients initially diagnosed N02017Inngår i: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 137, nr 8, s. 877-882Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To investigate whether the extent of expression of hyaluronan (HA) and epidermal growth factor receptor (EGFR) in squamous cell carcinoma of the mobile tongue can predict the risk of cervical metastasis and survival. Study design: Retrospective histopathologic study. Methods: Surgical specimens from 64 patients who had undergone surgery for squamous cell carcinoma of the mobile tongue were assessed using immunohistochemistry to investigate the expression of HA and EGFR in the primary tumours, and the data were then correlated to cervical metastasis and survival. Results: There was a significant correlation between the intensity of HA staining and patient survival (p .024), and a weak correlation between the staining proportion of EGFR and the risk for regional recurrence (AUC 66). Conclusions: This study indicates that immunoscoring using HA could be used to provide prognostic tools for tongue cancer, and that it might be of interest to study the prognostic properties of EGFR further concerning the risk for regional recurrence after the primary treatment.

  • 113.
    Jonsson, Lars
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Engström, Mats
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Bell’s palsy guidelines for adults2014Konferansepaper (Annet vitenskapelig)
  • 114.
    Jüris, Linda
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Hyperacusis: Clinical Studies and Effect of Cognitive Behaviour Therapy2013Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Hyperacusis is a type of decreased sound tolerance where the individual has decreased loudness discomfort levels (LDL), normal hearing thresholds and is sensitive to ordinary environmental sounds. Persons with hyperacusis frequently seek help at audiological departments as they are often affected by other audiological problems. Regrettably, there is neither a consensus-based diagnostic procedure nor an evidence-based treatment for hyperacusis.

    The principal aim of this thesis was to gain knowledge about the clinical condition hyperacusis. The specific aim of Paper I was to compare hyperacusis measurement tools in order to determine the most valid measures for assessing hyperacusis. Items from a constructed clinical interview were compared with the LDL test, the Hyperacusis Questionnaire (HQ) and the Hospital Anxiety and Depression Scale (HADS). LDLs were significantly correlated with the anxiety subscale of the HADS. A third of the 62 investigated patients scored below the previously recommended cut-off for the HQ. The results suggest that HQ and HADS in combination with a clinical interview are useful as part of the assessment procedure in patients with hyperacusis.

    The aim of Paper II was to further investigate the patient group with respect to individual characteristics, psychiatric morbidity and personality traits. It was shown that anxiety disorders and anxiety-related personality traits were over-represented, which suggests common or cooperating mechanisms. Avoidance behaviour proved to be very common in the patient group, as was being unable to work due to hyperacusis.

    In Paper III it was investigated in a randomized controlled trial whether Cognitive Behaviour Therapy (CBT) could be helpful for patients with hyperacusis. The effect of CBT for hyperacusis was assessed with measures of LDLs, symptoms of hyperacusis and of anxiety and depression, fear of (re)injury due to exposure to sounds, and quality of life, compared to a waiting list control group. There were significant group effects for a majority of the measures with moderate and strong effect sizes within- and between groups. After assessment the waiting list group was also given CBT, and was then reassessed with similar effects. The results were maintained for 12 months, concluding CBT to be potentially helpful for these patients.

     

    Delarbeid
    1. The Hyperacusis Questionnaire, loudness discomfort levels, and the Hospital Anxiety and Depression Scale: A cross-sectional study
    Åpne denne publikasjonen i ny fane eller vindu >>The Hyperacusis Questionnaire, loudness discomfort levels, and the Hospital Anxiety and Depression Scale: A cross-sectional study
    2013 (engelsk)Inngår i: Hearing, Balance and Communication, ISSN 2169-5717, Vol. 11, nr 2, s. 72-79Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Objective: 

    The aim of this study was to compare hyperacusis measurement tools often used in audiological practice in order to determine the most valid measure for assessing hyperacusis. Another aim was to examine the mean value for the Hyperacusis Questionnaire (HQ) in this patient group. 

    Design: 

    This was a cross-sectional study to compare the HQ with loudness discomfort levels (LDL), the Hospital Anxiety and Depression Scale (HADS), and items from a clinical interview dealing with hyperacusis symptoms. Sixty-two patients between the ages of 18 and 61 years were evaluated. All patients were diagnosed with hyperacusis. 

    Results: 

    There were significant negative correlations between the HQ and nearly all LDL scores for the right ear, but no significant correlations could be found for the left ear. LDLs were significantly correlated with the anxiety subscale of the HADS while there were no significant correlations between the HQ and either of the HADS scales. Of the 62 patients, 41 scored above and 21 scored below the previously recommended cut-off for the HQ. 

    Conclusion: 

    We suggest that clinicians should use the HQ and HADS in combination with a clinical interview to diagnose hyperacusis, and propose that the cut-off for the Swedish version of the HQ should be lowered.

    Emneord
    Hyperacusis, assessment
    HSV kategori
    Forskningsprogram
    Psykiatri; Oto-rhino-laryngologi
    Identifikatorer
    urn:nbn:se:uu:diva-206736 (URN)10.3109/21695717.2013.780409 (DOI)
    Tilgjengelig fra: 2013-09-03 Laget: 2013-09-03 Sist oppdatert: 2014-01-23bibliografisk kontrollert
    2. Psychiatric Comorbidity and Personality Traits in Patients with Hyperacusis.
    Åpne denne publikasjonen i ny fane eller vindu >>Psychiatric Comorbidity and Personality Traits in Patients with Hyperacusis.
    2013 (engelsk)Inngår i: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 52, nr 4, s. 230-235Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Objective: Hyperacusis, defined as unusual intolerance of ordinary environmental sounds, is a common problem. In spite of this, there is limited understanding of the underlying mechanisms. We hypothesized that individuals withhyperacusis would be prone to suffer from psychiatric disorders, related in particular to anxiety. Therefore, psychiatric morbidity and personality traits were investigated, along with different sociodemographic and clinical characteristics. Design: Patientswere assessed with a clinical interview related to symptoms of hyperacusis, the Mini-international neuropsychiatric interview (MINI), and the Swedish Universities scales ofPersonality (SSP) to study psychiatric disorders and personality traits. Study sample: A group of 62 Swedish patients with hyperacusis between 18 and 61 years (mean 40.2, SD 12.2) was included. Results: Altogether 56% of the patients had at least onepsychiatric disorder, and 47% had an anxiety disorder. Also, personality traits related to neuroticism were over-represented. A majority, 79%, suffered from comorbid tinnitus, and a similar proportion used measures to avoid noisy environments. Conclusions: The over-representation of anxiety disorders and anxiety-relatedpersonality traits in patients with hyperacusis suggests common or cooperating mechanisms. Cognitive behavioural treatment strategies, proven efficient in treating anxiety, may be indicated and are suggested for further studies.

    HSV kategori
    Identifikatorer
    urn:nbn:se:uu:diva-190576 (URN)10.3109/14992027.2012.743043 (DOI)000316810100003 ()
    Tilgjengelig fra: 2013-01-08 Laget: 2013-01-08 Sist oppdatert: 2017-12-06bibliografisk kontrollert
    3. Cognitive Behaviour Therapy for Hyperacusis: A Randomized Controlled Trial
    Åpne denne publikasjonen i ny fane eller vindu >>Cognitive Behaviour Therapy for Hyperacusis: A Randomized Controlled Trial
    2014 (engelsk)Inngår i: Behaviour Research and Therapy, ISSN 0005-7967, E-ISSN 1873-622X, Vol. 54, s. 30-37Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Hyperacusis, defined as unusual intolerance to ordinary environmental sounds, is a common problem for which there are no controlled trials on psychological treatment. Given the avoidance strategies present in hyperacusis, and similarities with problems such as tinnitus and chronic pain, cognitive behaviour therapy (CBT) is hypothesized to be helpful for patients with hyperacusis. In this randomized controlled study of 60 patients with hyperacusis, CBT was compared with a waiting list control group using the Loudness Discomfort Level test (LDL), the Hyperacusis Questionnaire, the Hospital Anxiety and Depression Scales, the Quality of Life Inventory and an adapted version of the Tampa Scale of Kinesiophobia. There were significant between-group effects in favour of the CBT group on all measures except for the HADS anxiety scale. Between-group effect sizes were moderate to high, with Cohen's d = 0.67 and 0.69 per ear, respectively, for the primary measure LDL, and ranging from d = 0.32 to 1.36 for the secondary measures. The differences between groups ceased to exist when the waiting list group was treated later with CBT, and the treatment results were largely maintained after 12 months. In conclusion, CBT is a promising treatment for hyperacusis, although more research is necessary.

    Emneord
    Hyperacusis, RCT, CBT
    HSV kategori
    Forskningsprogram
    Psykiatri
    Identifikatorer
    urn:nbn:se:uu:diva-207210 (URN)10.1016/j.brat.2014.01.001 (DOI)000334009000005 ()
    Tilgjengelig fra: 2013-09-10 Laget: 2013-09-10 Sist oppdatert: 2017-12-06bibliografisk kontrollert
  • 115.
    Jüris, Linda
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Andersson, Gerhard
    Linköpings Universitet.
    Larsen, Hans Christian
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Ekselius, Lisa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Cognitive Behaviour Therapy for Hyperacusis: A Randomized Controlled Trial2014Inngår i: Behaviour Research and Therapy, ISSN 0005-7967, E-ISSN 1873-622X, Vol. 54, s. 30-37Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Hyperacusis, defined as unusual intolerance to ordinary environmental sounds, is a common problem for which there are no controlled trials on psychological treatment. Given the avoidance strategies present in hyperacusis, and similarities with problems such as tinnitus and chronic pain, cognitive behaviour therapy (CBT) is hypothesized to be helpful for patients with hyperacusis. In this randomized controlled study of 60 patients with hyperacusis, CBT was compared with a waiting list control group using the Loudness Discomfort Level test (LDL), the Hyperacusis Questionnaire, the Hospital Anxiety and Depression Scales, the Quality of Life Inventory and an adapted version of the Tampa Scale of Kinesiophobia. There were significant between-group effects in favour of the CBT group on all measures except for the HADS anxiety scale. Between-group effect sizes were moderate to high, with Cohen's d = 0.67 and 0.69 per ear, respectively, for the primary measure LDL, and ranging from d = 0.32 to 1.36 for the secondary measures. The differences between groups ceased to exist when the waiting list group was treated later with CBT, and the treatment results were largely maintained after 12 months. In conclusion, CBT is a promising treatment for hyperacusis, although more research is necessary.

  • 116. K, Lundkvist
    et al.
    A, Januszkiewicz
    Friberg, Danielle
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Uvulopalatopharyngoplasty in 158 OSAS patients failing non-surgical treatment2009Inngår i: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Conclusions: Uvulopalatopharyngoplasty (UPPP) in patients with obstructive sleep apnoea syndrome (OSAS) who had failed treatment with continuous positive airway pressure (CPAP) and mandibular retaining device (MRD) was effective and safe. The satisfaction rate was high. We recommend UPPP in selected OSAS patients, especially younger patients. Objectives: To evaluate the efficacy and complication rate of UPPP. Patients and methods: This was a non-randomized prospective study of 139 men and 19 women, median age 45 years (range 20–75), median body mass index (BMI) 29 (range 20–48), who underwent UPPP. One year follow-up comprised ambulant sleep apnoea recordings and questionnaires with the Epworth Sleepiness Scale (ESS). Results: In all, 76% of the patients underwent sleep recordings preoperatively and postoperatively. The oxygen desaturation index (ODI4) decreased from median 23 (range 6–100) to 8 (range 0–60), p<0.001. Criteria of success (>50% reduction and ODI<20), was 64%. The ESS value decreased from median 12 (range 0–21) to 6 (0–22), p<0.001. In all, 88% of the patients were satisfied. Four of 158 patients (2.5%) had serious postoperative complications. There was neither sequel of complications nor mortality.

  • 117. K, Lundkvist
    et al.
    Friberg, Danielle
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Pharyngeal disturbances in OSAS patients before and 1 year after UPPP2010Inngår i: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, s. 1399-1405Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Conclusions: The results indicate that conservative uvulopalatopharyngoplasty with tonsillectomy (UPPP) did not change the degree of pharyngeal disturbances in patients with obstructive sleep apnea syndrome (OSAS). Objectives: To investigate if the symptom scores of pharyngeal disturbances in OSAS patients were changed 1 year after UPPP, by using a questionnaire pre- and postoperatively, and to compare with healthy non-snoring controls. Methods: Fifty men and eight women, median age 46 years (range 25–75), median body mass index (BMI) 28 kg/m2 (20–38), and median preoperative oxygen desaturation index 16 (7–100) were included as they had all failed non-surgical treatment and wanted pharyngeal surgery. The questionnaire consisted of 10 questions with 4 degrees of disturbances; the maximum score was 30 and was evaluated before and 1 year after surgery. Fifteen age-, gender- and BMI-matched controls responded to the same questionnaire. Results: Responses to the questionnaire were provided pre- and postoperatively by 47 of 58 patients (81%). Their median score was unchanged from 5 (range 0–17) to 5 (0–19), compared with controls 1 (0–3). Analyses of separate questions showed a significant decrease in the score for ‘globus sensation’ and ‘swelling’ postoperatively.

  • 118. K, Lundkvist
    et al.
    K, Sundquist
    X, Li
    Friberg, Danielle
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Familial risk of sleep-disordered breathing2012Inngår i: Sleep Medicine, ISSN 1389-9457, E-ISSN 1878-5506, Vol. 13, nr 6, s. 668-673Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective

    To estimate the incidence of hospitalization for paediatric obstructive sleep apnoea syndrome (OSAS) or sleep-disordered breathing (SDB) caused by adenotonsillar or tonsillar hypertrophy without infection in children with a parent affected by OSAS.

    Patients and methods

    Using the MigMed database at Lund University, hospital data on all children aged 0–18 years in Sweden between 1997 and 2007 (total of 3 million individuals) were used to identify all first hospital admissions for OSAS or either adenotonsillar or tonsillar hypertrophy. Next, individuals were categorized as either having or not having a parent affected by OSAS. Standardized incidence ratios (SIRs) with 95% confidence intervals (CIs) were estimated for boys and girls with a parent affected by OSAS. Children with OSAS or adenotonsillar or tonsillar hypertrophy without a parent affected by OSAS acted as the reference group (SIR = 1).

    Results

    After accounting for socio-economic status, age, and geographic region, the SIRs of OSAS in boys and girls with a parent affected by OSAS were 3.09 (95% CI 1.83–4.90) and 4.46 (95% CI 2.68–6.98), respectively. The SIRs of adenotonsillar or tonsillar hypertrophy in boys and girls with a parent affected by OSAS were 1.82 (95% CI 1.54–2.14) and 1.56 (95% CI 1.30–1.87), respectively.

    Conclusion

    This study indicates familial clustering of sleep-disordered breathing, which is important information for clinicians.

  • 119. Kallioinen, Petter
    et al.
    Olofsson, Jonas
    Nakeva von Mentzer, Cecilia
    Department of Behavioral Sciences and Learning, Swedish Institute for Disability Research, Linkoping University, Linkoping, Sweden.
    Lindgren, Magnus
    Ors, Marianne
    Sahlén, Birgitta
    Lyxell, Björn
    Engström, Elisabet
    Uhlén, Inger
    Semantic Processing in Deaf and Hard-of-Hearing Children: Large N400 Mismatch Effects in Brain Responses, Despite Poor Semantic Ability2016Inngår i: Frontiers in Psychology, ISSN 1664-1078, E-ISSN 1664-1078, Vol. 7, artikkel-id 1146Artikkel i tidsskrift (Fagfellevurdert)
  • 120.
    Karlsson, Ragnhild
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Logopedi.
    Madeleine, Sundberg
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Logopedi.
    Avvikande lateralisering av motortrösklar hos vuxna som stammar: En TMS-studie2011Independent thesis Advanced level (degree of Master (One Year)), 20 poäng / 30 hpOppgave
    Abstract [sv]

    Stamning är en komplex motorisk talstörning, vars neurologisk bakgrund fortfarande inte är klarlagd. En växande mängd studier ger dock stöd för att stamning kan vara orsakat av strukturella avvikelser i den vänstra hemisfären. En studie (Sommer et al., 2003) som använde transkraniell magnetstimulering (TMS) för att undersöka kortikal inhibition hos personer som stammar (PsS) fann som ett bi-fynd att den stammande gruppen hade signifikant högre motortrösklar (MT) för vänster hemisfärs handmotorarea, det vill säga att det krävdes starkare stimulering för att väcka en muskelrespons i den kontralaterala handen. Resultat har dock inte uppmärksammats av senare forskning, och behöver verifieras. Den aktuella studien syftade till att undersöka om PsS tenderar att ha förhöjda MT, samt om det finns avvikande hemisfärsskilnader i MT hos PsS. MT mättes från båda hemisfärernas handmotorareor hos 15 PsS och 15 matchade kontollförsökspersoner med flytande tal. Resultatet visade på signifikant avvikande lateralisering av MT (p = 0,005) hos PsS; tvärtemot gruppen med flytande tal visade den stammande gruppen tendens till lägst MT i höger hemisfär, med 6 av 15 stammande som hade starkare högersidig lateralisering än någon i kontrollgruppen. Samstämmigt med resultaten från Sommer et al. (2003) var MT för vänster hemisfär signifikant högre i den stammande gruppen jämfört med kontrollgruppen (p = 0,049). Däremot fanns ingen tendens till avvikande MT i höger hemisfär (p = 0,92). Den förhöjda vänstersidiga MT kan vara relaterad till strukturella avvikelser i vänster hemisfär hos PsS.

  • 121. Katagiri, Yoshiaki
    et al.
    Takumida, Masaya
    Hirakawa, Katsuhiro
    Anniko, Matti
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Long-term administration of vasopressin can cause Meniere's disease in mice2014Inngår i: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 134, nr 10, s. 990-1004Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Conclusion: A new murine model of Meniere's disease has been developed, based on long-term administration of vasopressin. Induction of vestibular dysfunction in the present animal model can cause additional stress, by reducing inner ear blood flow. Latanoprost, a selective agonist for the FP prostanoid receptor, may become a new remedy for Meniere's disease. Objective: The purpose of this study was to develop a more suitable animal model, with a closer resemblance to the pathophysiological process in Meniere's disease. Methods: Adult CBA/J or ICR mice were treated by subcutaneous injection of vasopressin for 5 days up to 8 weeks. Morphological analyses were performed of the cochlea, vestibular end organs and endolymphatic sac. The effect of latanoprost on the development of endolymphatic hydrops was also examined. Results: All experimental animals showed mild to moderate endolymphatic hydrops, increasing in severity as the vasopressin treatment was prolonged. Animals treated with vasopressin for 8 weeks showed severe endolymphatic hydrops with partial loss of outer hair cells and spiral ganglion cells. These animals also had a reversible vestibular dysfunction following intratympanic injection of epinephrine. Latanoprost inhibited the development of endolymphatic hydrops caused by vasopressin.

  • 122.
    Knutsson, Johan
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Västerås. Vasteras Hosp, Dept Otorhinolaryngol, Vasteras, Sweden.
    Kahlin, Annika
    Vasteras Hosp, Dept Otorhinolaryngol, Vasteras, Sweden..
    von Unge, Magnus
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Västerås. Vasteras Hosp, Dept Otorhinolaryngol, Vasteras, Sweden.; Akershus Univ Hosp, Dept Otorhinolaryngol, Oslo, Norway.;Univ Oslo, Oslo, Norway..
    Clinical and audiological short-term and long-term outcomes of fat graft myringoplasty2017Inngår i: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 137, nr 9, s. 940-944Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Introduction: Results of fat graft myringoplasty are often reported with only short-term follow-up. Audiological results are less commonly reported, as well as long-term follow-up results. Materials and methods: One hundred consecutive patients scheduled for fat graft myringoplasty were included in a prospective cohort study. Clinical and audiological outcomes were assessed at six weeks and one year postoperatively. Results: Perforation sizes ranged from 0.5 to 4 mm. The six-week follow-up showed a total perforation closure rate of 72.9% with a statistically significant (p = .03) higher rate for the pediatric age group (83.0%). 64.4% of all patients were healed at one-year follow-up. Statistical analyses for background factors did not reveal any significant difference in healing rates with regard to patient sex or location or cause of the perforation. The mean preoperative air-conduction (AC) threshold was 25dB with an air-bone gap of 12 dB. At the one-year follow-up the mean air conduction threshold for healed ears was improved to 16.6 dB, still 54.2% of them had a type B tympanogram. Conclusions: Children had a higher perforation closure rate at six-week follow-up than adult patients. Recurrent tympanic membrane perforations were common after initially successful fat graft myringoplasties. Long-term hearing was improved after successful fat graft myringoplasty, resulting in a mean AC threshold of 16.6 dB.

  • 123.
    Knutsson, Johan
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Västerås. Vastmanland Cty Hosp, Dept Otorhinolaryngol, Vasteras, Sweden.;Orebro Univ Hosp, Dept Otolaryngol, Orebro, Sweden..
    Priwin, Claudia
    Sophiahemmet Univ, Dept Otorhinolaryngol, Stockholm, Sweden..
    Hessen-Soderman, Anne-Charlotte
    Cityakuten, Dept Otorhinolaryngol, Stockholm, Sweden.;Karolinska Inst, Div Clin Sci Intervent & Technol, Stockholm, Sweden..
    Rosenblad, Andreas
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Västerås.
    von Unge, Magnus
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Västerås. Vastmanland Cty Hosp, Dept Otorhinolaryngol, Vasteras, Sweden.;Akershus Univ Hosp, Dept Otorhinolaryngol, Campus Ahus, Oslo, Norway.;Univ Oslo, Campus Ahus, Oslo, Norway..
    A randomized study of four different types of tympanostomy ventilation tubes: Full-term follow-up2018Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 107, s. 140-144Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To evaluate the impact of tympanostomy ventilation tube material (silicone vs fluoroplastic) and shape (short vs long) regarding time to extrusion, occurrence of otorrhea, occlusion, tube removal and occurrence of persistent perforation.

    Methods and material: Four different types of ventilation tubes were used; Long Armstrong tubes, Donaldson tubes, Shepard tubes and straight tubes, representing four specific combinations of VT material (silicone or fluoroplastic) and shape (short, double flanged or long, single flanged). Four hundred children scheduled for bilateral tube insertion were included in a randomized trial. The patients received one type of tube in the right ear and another type in the left ear. The incidence of tube extrusion and complications were monitored post-operatively every third month by an otolaryngologist.

    Results: Twenty-two children were excluded during surgery. Out of the studied 378 children the mean age was 35.3 months. 63.8% were boys. Short tubes extruded earlier than long tubes; hazard ratio (HR) 4.84 (95% CI 3.50-6.69, p < 0.001). Long Armstrong tubes were least prone to extrude. Silicone tubes resulted in significantly longer time to first infection in a VT ear, HR 1.68 (95% CI 1.03-2.76, p = 0.039). Donaldson tubes rendered the longest mean time to first infection (p = 0.025). Infections did not affect tube extrusion rates significantly (p = 0.879). No significant differences were found regarding tube occlusion, tube extraction or persistent perforation.

    Conclusions: Long tubes are less prone to extrude early. Long Armstrong tubes have the least propensity to extrude early. Silicone tubes render significantly longer time to first infection. Donaldson tubes result in least infections. Infection does not affect extrusion rates significantly.

  • 124.
    Kämpfe Nordström, Charlotta
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Danckwardt-Lillieström, Niklas
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Laurell, Göran
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Liu, Wei
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Rask-Andersen, Helge
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    The Human Endolymphatic Sac and Inner Ear Immunity: Macrophage Interaction and Molecular Expression2019Inngår i: Frontiers in Immunology, ISSN 1664-3224, E-ISSN 1664-3224, Vol. 9, artikkel-id 3181Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The endolymphatic sac (ES) is endowed with a multitude of white blood cells that may trap and process antigens that reach the inner ear from nearby infection-prone areas, it thus serves as an immunologic defense organ. The human ES, and unexpectedly the rest of the inner ear, has been recently shown to contain numerous resident macrophages. In this paper, we describe ES macrophages using super-resolution structured fluorescence microscopy (SR-SIM) and speculate on these macrophages' roles in human inner ear defense.

    Material and Methods: After ethical permission was obtained, human vestibular aqueducts were collected during trans-labyrinthine surgery for acoustic neuroma removal. Tissues were placed in fixative before being decalcified, rapidly frozen, and cryostat sectioned. Antibodies against IBA1, cytokine fractalkine (CX3CL1), toll-like receptor 4 (TLR4), cluster of differentiation (CD) 68, CD11b, CD4, CD8, and the major histocompatibility complex type II (MHCII) were used for immunohistochemistry.

    Results: A large number of IBA1-positive cells with different morphologies were found to reside in the ES; the cells populated surrounding connective tissue and the epithelium. Macrophages interacted with other cells, showed migrant behavior, and expressed immune cell markers, all of which suggest their active role in the innate and adaptive inner ear defense and tolerance.

    Discussion: High-resolution immunohistochemistry shows that antigens reaching the ear may be trapped and processed by an immune cell machinery located in the ES. Thereby inflammatory activity may be evaded near the vulnerable inner ear sensory structures. We speculate on the immune defensive link between the ES and the rest of the inner ear.

  • 125.
    Kämpfe Nordström, Charlotta
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Laurell, Göran
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Rask-Andersen, Helge
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    The Human Vestibular Aqueduct: Anatomical Characteristics and Enlargement Criteria2016Inngår i: Otology and Neurotology, ISSN 1531-7129, E-ISSN 1537-4505, Vol. 37, nr 10, s. 1637-1645Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Hypothesis: The human vestibular aqueduct (VA) shows great anatomical variations, and imaging can be difficult, so we need more data on the normal anatomy of the VA for better radiologic evaluation of large vestibular aqueduct syndrome (LVAS). Background: The normal anatomy of the human VA was analyzed in micro-dissected human temporal bones. Methods: The study is based on two sets of human temporal bones. One set of 32 human temporal bones was selected from a collection of 50 micro-dissected specimens. The outline of the intraosseous portion of the VA was drawn and digitized, and dimensions were assessed. The other set of 20 plastic molds were randomly selected from a collection of 324 specimens, and the VA dimensions were assessed. Results: Measurements from this study are presented in means, standard deviations, and ranges. The results from these measurements are considered normal and compared with previously published data. The variations in the normal anatomy of the VA are presented and discussed. Conclusion: The VA courses sagittal in the human skull. Therefore, we recommend the lateral projection (reformatted) to demonstrate the VA in LVAS patients. We advocate assessing: 1) the width (or height) of the external aperture (EA), 2) the width at the half distance between the EA and the common crus (CC), and if possible 3) the width of the proximal portion of the VA. Based on the measurements, our criteria for enlargement are 2.0mm or greater, 1.5mm or greater, and more than 1mm at these sites.

  • 126.
    Laurell, Göran
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Pharmacological intervention in the field of ototoxicity2019Inngår i: HNO (Berlin. Print), ISSN 0017-6192, E-ISSN 1433-0458, Vol. 67, nr 6, s. 434-439Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Modern research on ototoxicity goes back to the 1940s, when streptomycin was introduced into clinical practice. Today, aminoglycoside antibiotics and platinum-based chemotherapy, mainly cisplatin, are the most important drugs that damage the inner ear and cause hearing loss. The mode of drug administration as well as drug characteristics influence the likelihood that adequate monitoring of drug pharmacokinetics can be performed. It is not possible to predict the individual risk of treatment with an ototoxic drug, but identification of high-risk treatment protocols is important. There are many studies ongoing with the aim of discovering and developing drugs to treat different types of inner ear disorders. The mechanisms of ototoxicity and subsequent loss of hearing function have been mapped in various experimental models and have provided us with useful information for developing protective treatment. When an ototoxic lesion is established, restoration of hearing function becomes more difficult. For both aminoglycoside antibiotics and cisplatin, alarge number of otoprotectors have been suggested. Systemic co-administration of an otoprotector would be the easiest approach to avoid ototoxicity in patients but it may negatively affect the intended pharmacotherapeutic aim of the ototoxic drug. New pharmacological formulations are being developed for local otoprotective treatment. This short review focuses on results from clinical reports on otoprotection in patients treated with aminoglycoside antibiotics and cisplatin. So far there is limited evidence for the safe management of otoprotection in patients. Further high-quality studies are needed to provide reliable data on the safety and effectiveness of pharmacological interventions to reduce drug-induced hearing loss.

  • 127.
    Laytragoon-Lewin, Nongnit
    et al.
    Linkoping Univ, Dept Clin & Expt Med, Linkoping, Sweden;Ryhov Hosp, Div Med Diagnost, Forsjorningsvagen 8, SE-55185 Jonkoping, Sweden.
    Cederblad, Lena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Experimentell och klinisk onkologi.
    Andersson, Bengt-Åke
    Linkoping Univ, Dept Clin & Expt Med, Linkoping, Sweden;Ryhov Hosp, Div Med Diagnost, Forsjorningsvagen 8, SE-55185 Jonkoping, Sweden.
    Olin, Mattias
    Ryhov Hosp, Dept Oncol, Jonkoping, Sweden.
    Nilsson, Mats
    Ryhov Hosp, Futurum, Jonkoping, Sweden.
    Rutqvist, Lars-Erik
    Karolinska Univ Hosp, Swedish Match AB, Stockholm, Sweden.
    Lundgren, Jan
    Karolinska Univ Hosp, Dept ENT, Stockholm, Sweden.
    Engström, Mats
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Tytor, Wieslaw
    Linkoping Univ Hosp, Dept ENT, Linkoping, Sweden.
    Löfgren, Sture
    Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Lewin, Freddi
    Ryhov Hosp, Dept Oncol, Jonkoping, Sweden.
    Single Nucleotide Polymorphism and Cancer Risk, Tumour Recurrence, or Survival of Head and Neck Cancer Patients2017Inngår i: Oncology, ISSN 0030-2414, E-ISSN 1423-0232, Vol. 92, s. 161-169Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: This paper aims at studying the influence of single-nucleotide polymorphisms (SNPs) on cancer risk, tumor recurrence, and survival in head and neck (H&N) cancer patients. Methods: A total of 45 SNPs in 41 genes were investigated. A total of 174 Caucasian H&N cancer patients and 245 healthy blood donors were enrolled in the study. Results: Ten SNPs were associated with H&N cancer risk, but the identified SNPs differed among males and females. Some of the SNPs were related to immune response genes. The immune response gene SNPs were also related to survival. In particular, we noted that the tumor necrosis factor alpha (TNFα) rs1800629 could have an influence on cancer risk, tumor recurrence as well as survival. Conclusion: Genetic variation of the TNFα rs1800629 might be useful as a biomarker in clinical decision-making since it was found to be related to cancer risk, tumor recurrence, and survival of H&N cancer patients.

  • 128.
    Lidian, Adnan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Necrosis of the upper lip, lateral nasal cartilage and forehead skin after embolization of a HHT patient2018Inngår i: Angiogenesis, ISSN 0969-6970, E-ISSN 1573-7209, Vol. 21, nr 1, s. 145-145Artikkel i tidsskrift (Annet vitenskapelig)
  • 129.
    Lindblom, Ulrika
    et al.
    Lund Univ, Dept Clin Sci Oncol & Radiat Phys, S-22100 Lund, Sweden.;Kirkenes Hosp, Dept Otorhinolaryngol, Kirkenes, Norway..
    Nilsson, Per
    Lund Univ, Skane Univ Hosp, Dept Clin Sci Oncol & Radiat Phys, S-22100 Lund, Sweden..
    Garskog, Ola
    Umea Univ, Dept Clin Sci, Otorhinolaryngol, SE-90187 Umea, Sweden..
    Kjellen, Elisabeth
    Lund Univ, Skane Univ Hosp, Dept Clin Sci Oncol & Radiat Phys, S-22100 Lund, Sweden..
    Laurell, Göran
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar. Umea Univ, Dept Clin Sci, Otorhinolaryngol, SE-90187 Umea, Sweden..
    Wahlberg, Peter
    Lund Univ, Skane Univ Hosp, Dept Clin Sci, Otorhinolaryngol, S-22100 Lund, Sweden..
    Zackrisson, Bjorn
    Umea Univ, Dept Radiat Sci, Oncol, SE-90187 Umea, Sweden..
    Jaghagen, Eva Levring
    Umea Univ, Dept Odontol Oral & Maxillofacial Radiol, SE-90187 Umea, Sweden..
    Aspiration as a late complication after accelerated versus conventional radiotherapy in patients with head and neck cancer2016Inngår i: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 136, nr 3, s. 304-311Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Conclusion Neck dissection after radiotherapy increased the risk of aspiration as a late effect in a sub-sample of patients treated for head and neck cancer in the ARTSCAN study. Patients treated with accelerated fractionation (AF) developed aspiration, with or without coughing, more frequently than patients treated with conventional fractionation (CF). Objectives A long-term follow-up study was conducted to determine the frequency of aspiration as a late effect in patients with head and neck cancer treated with AF or CF. Method One-hundred and eight patients were recruited from two centres of the Swedish multi-centre study, ARTSCAN, where AF and CF were compared. Patients with positive lymph nodes were treated with neck dissection after completing radiotherapy. The follow-up was performed at a median of 65 months after initiation of radiotherapy and included an ENT and a videofluoroscopic examination. Results Aspiration was found in 51/108 (47%) and silent aspiration in 34/96 (35%) patients. Neck dissection (n = 47 patients) was significantly associated with both aspiration and silent aspiration. Aspiration was more common among patients treated with AF (34/61; 56%) compared to CF (17/47; 36%; p = 0.053). Silent aspiration was also more common after AF (24/54; 44%) than after CF (10/42; 24%; p = 0.052).

  • 130.
    Lindell Jonsson, Eva
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Erngren, Ida
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Farmaceutiska fakulteten, Institutionen för läkemedelskemi, Analytisk farmaceutisk kemi.
    Engskog, Mikael
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Farmaceutiska fakulteten, Institutionen för läkemedelskemi, Analytisk farmaceutisk kemi.
    Haglöf, Jakob
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Farmaceutiska fakulteten, Institutionen för läkemedelskemi, Analytisk farmaceutisk kemi.
    Arvidsson, Torbjörn
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Farmaceutiska fakulteten, Institutionen för läkemedelskemi, Analytisk farmaceutisk kemi. Medical Product Agency.
    Hedeland, Mikael
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Farmaceutiska fakulteten, Institutionen för läkemedelskemi, Analytisk farmaceutisk kemi.
    Pettersson, Curt
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Farmaceutiska fakulteten, Institutionen för läkemedelskemi, Analytisk farmaceutisk kemi.
    Laurell, Göran
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Nestor, Marika
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Medicinsk strålningsvetenskap.
    Exploring Radiation Response in Two Head and Neck Squamous Carcinoma Cell Lines Through Metabolic Profiling2019Inngår i: Frontiers in Oncology, ISSN 2234-943X, E-ISSN 2234-943X, Vol. 9, artikkel-id 825Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Head and neck squamous cell carcinoma (HNSCC) is the sixth most common form of cancer worldwide. Radiotherapy, with or without surgery, represents the major approach to curative treatment. However, not all tumors are equally sensitive to irradiation. It is therefore of interest to apply newer system biology approaches (e.g., metabolic profiling) in squamous cancer cells with different radiosensitivities in order to provide new insights on the mechanisms of radiation response. In this study, two cultured HNSCC cell lines from the same donor, UM-SCC-74A and UM-SCC-74B, were first genotyped using Short Tandem Repeat (STR), and assessed for radiation response by the means of clonogenic survival and growth inhibition assays. Thereafter, cells were cultured, irradiated and collected for subsequent metabolic profiling analyses using liquid chromatography-mass spectrometry (LC-MS). STR verified the similarity of UM-SCC-74A and UM-SCC-74B cells, and three independent assays proved UM-SCC-74B to be clearly more radioresistant than UM-SCC-74A. The LC-MS metabolic profiling demonstrated significant differences in the intracellular metabolome of the two cell lines before irradiation, as well as significant alterations after irradiation. The most important differences between the two cell lines before irradiation were connected to nicotinic acid and nicotinamide metabolism and purine metabolism. In the more radiosensitive UM-SCC-74A cells, the most significant alterations after irradiation were linked to tryptophan metabolism. In the more radioresistant UM-SCC-74B cells, the major alterations after irradiation were connected to nicotinic acid and nicotinamide metabolism, purine metabolism, the methionine cycle as well as the serine, and glycine metabolism. The data suggest that the more radioresistant cell line UM-SCC-74B altered the metabolism to control redox-status, manage DNA-repair, and change DNA methylation after irradiation. This provides new insights on the mechanisms of radiation response, which may aid future identification of biomarkers associated with radioresistance of cancer cells.

  • 131.
    Lindell Jonsson, Eva
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Erngren, Ida
    Engskog, Mikael
    Haglöf, Jakob
    Pettersson, Curt
    Laurell, Göran
    Nestor, Marika
    Metabolic profiling of head and neck cancer cell lines with different radiosensitivity using mass spectroscopy provides new insights on the mechanism of radiation response.Manuskript (preprint) (Annet vitenskapelig)
  • 132.
    Lindell Jonsson, Eva
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Laurell, Göran
    Eriksson, Per-Olof
    Saadat, Mohammad
    The Micromorphological Course of Irradiation-Induced Oral Mucositis in Rat.2015Inngår i: Journal of Clinical & Experimental Oncology, ISSN 2324-9110Artikkel i tidsskrift (Fagfellevurdert)
  • 133.
    Lindgren, Linnéa
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Logopedi.
    Törneke, Kajsa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Logopedi.
    Samtal vid middagsbordet i en trespråkig familj: Språkval i ett flerspråkigt sammanhang2010Independent thesis Advanced level (degree of Master (One Year)), 20 poäng / 30 hpOppgave
    Abstract [sv]

    Logopeder som träffar barn med språkstörning arbetar i hög grad med barnets hela familj. Specifik kunskap krävs då barnet och familjen är två- eller flerspråkiga. I denna fallstudie beskrivs språkanvändningen i en trespråkig familj som bor i Sverige. Den flamländsktalande modern och svensktalande fadern talade sina respektive modersmål med dottern Betty enligt språkstrategin one parent – one language (OPOL). Föräldrarna talade engelska sinsemellan. Data samlades in via videoinspelning, föräldraskattning och intervjuer. I den kvantitativa delen av studien undersöktes främst vilka språk som användes mellan familjemedlemmarna och i vilken grad kodväxling förekom. Den kvalitativa delen av studien fokuserade på föräldrarnas reflektioner om familjens trespråkighet ur ett individ-, familje- och samhällsperspektiv. Resultaten visade att föräldrarna följde sin språkstrategi väl och att kodväxling främst skedde föräldrarna emellan. Dottern följde strategin väl till fadern men till modern fanns betydande inslag av svenska. Tre teman som sammanfattar föräldrarnas reflektioner om flerspråkighet kunde urskiljas. Dessa var engelskans särställning i samhället, flamländska som minoritetsspråk samt språk som mått på integrering. Den logopediska relevansen diskuterades utifrån värdet av observationer på flerspråkiga barns interaktion med sina föräldrar vid bedömning, utökning av anamnes för flerspråkiga samt om logopeder bör rekommendera språkstrategier till flerspråkiga familjer.

  • 134.
    Liu, Wei
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Atturo, Francesca
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Aldaya, Robair
    Santi, Peter
    Cureoglu, Sebahattin
    Obwegeser, Sabrina
    Glueckert, Rudolf
    Pfaller, Kristian
    Schrott-Fischer, Annelies
    Rask-Andersen, Helge
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Macromolecular organization and fine structure of the human basilar membrane - RELEVANCE for cochlear implantation2015Inngår i: Cell and Tissue Research, ISSN 0302-766X, E-ISSN 1432-0878, Vol. 360, nr 2, s. 245-262Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Introduction Cochlear micromechanics and frequency tuning depend on the macromolecular organization of the basilar membrane (BM), which is still unclear in man. Novel techniques in cochlear implantation (CI) motivate further analyses of the BM. Materials and methods Normal cochleae from patients undergoing removal of life-threatening petro-clival meningioma and an autopsy specimen from a normal human were used. Laser-confocal microscopy, high resolution scanning (SEM) and transmission electronmicroscopy (TEM) were carried out in combination. In addition, one human temporal bone was decellularized and investigated by SEM. Results The human BM consisted in four separate layers: (1) epithelial basement membrane positive for laminin-beta 2 andcollagen IV, (2) BM Bproper boolean AND composed of radial fibers expressing collagen II and XI, (3) layer of collagen IV and (4) tympanic covering layer (TCL) expressing collagen IV, fibronectin and integrin. BM thickness varied both radially and longitudinally (mean 0.55-1.16 mu m). BM was thinnest near the OHC region and laterally. Conclusions There are several important similarities and differences between the morphology of the BM in humans and animals. Unlike in animals, it does not contain a distinct pars tecta (arcuate) and pectinata. Its width increases and thickness decreases as it travels apically in the cochlea. Findings show that the human BM is thinnest and probably most vibration-sensitive at the outer pillar feet/Deiter cells at the OHCs. The inner pillar and IHCs seem situated on a fairly rigid part of the BM. The gradient design of the BM suggests that its vulnerability increases apical wards when performing hearing preservation CI surgery.

  • 135.
    Liu, Wei
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Kämpfe Nordström, Charlotta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Danckwardt-Lillieström, Niklas
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Rask-Andersen, Helge
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Human Inner Ear Immune Activity: A Super-Resolution Immunohistochemistry Study2019Inngår i: Frontiers in Neurology, ISSN 1664-2295, E-ISSN 1664-2295, Vol. 10, artikkel-id 728Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Like the brain, the human inner ear was long thought to be devoid of immune activity. Only the endolymphatic sac (ES) was known to be endowed with white blood cells that could process antigens and serve as an immunologic defense organ for the entire inner ear. Unexpectedly, the cochlear and vestibular organs, including the eighth cranial nerve, were recently shown to contain macrophages whose functions and implication in ear disease are somewhat undefined. Here, we review recent inner ear findings in man and extend the analyses to the vestibular nerve using super-resolution structured illumination microscopy (SR-SIM).

    Materials and Methods: Human ESs and cochleae were collected during surgery to treat patients with vestibular schwannoma and life-threatening petro-clival meningioma compressing the brainstem. The ESs and cochleae were placed in fixative, decalcified, and rapidly frozen and cryostat sectioned. Antibodies against ionized calcium-binding adaptor molecule 1-expressing cells (IBA1 cells), laminin beta 2 and type IV collagen TUJ1, cytokine fractalkine (CX3CL1), toll-like receptor 4 (TLR4), CD68, CD11b, CD4, CD8, the major histocompatibility complex type II (MHCII), and the microglial marker TEME119 were used.

    Results: IBA1-positive cells were present in the ESs, the cochlea, central and peripheral axons of the cochlear nerve, and the vestibular nerve trunk. IBA1 cells were found in the cochlear lateral wall, spiral limbus, and spiral ganglion. Notable variants of IBA1 cells adhered to neurons with "synapse-like" specializations and cytoplasmic projections. Slender IBA1 cells occasionally protracted into the basal lamina of the Schwann cells and had intimate contact with surrounding axons.

    Discussion: The human eighth nerve may be under the control of a well-developed macrophage cell system. A small number of CD4+ and CD8+ cells were found in the ES and occasionally in the cochlea, mostly located in the peripheral region of Rosenthal's canal. A neuro-immunologic axis may exist in the human inner ear that could play a role in the protection of the auditory nerve. The implication of the macrophage system during disease, surgical interventions, and cell-based transplantation should be further explored.

  • 136.
    Liu, Wei
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Li, Hao
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Edin, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Brännström, Johan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Vaskulärbiologi.
    Glueckert, Rudolf
    Med Univ Innsbruck, Innsbruck, Austria.
    Schrott-Fischer, Annelies
    Med Univ Innsbruck, Innsbruck, Austria.
    Molnar, Matyas
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Pacholsky, Dirk
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Pfaller, Kristian
    Med Univ Innsbruck, Innsbruck, Austria.
    Rask-Andersen, Helge
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Molecular composition and distribution of gap junctions in the sensory epithelium of the human cochlea a super-resolution structured illumination microscopy (SR-SIM) study2017Inngår i: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 122, nr 3, s. 160-170Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Mutations in the GJB2 gene, which encodes the Connexin26 (Cx26) protein, are the most common cause of childhood hearing loss in American and European populations. The cochlea contains a gap junction (GJ) network in the sensory epithelium and two connective tissue networks in the lateral wall and spiral limbus. The syncytia contain the GJ proteins beta 2 (GJB2/Cx26) and beta 6 (GJB6/Cx30). Our knowledge of their expression in humans is insufficient due to the limited availability of tissue. Here, we sought to establish the molecular arrangement of GJs in the epithelial network of the human cochlea using surgically obtained samples. Methods: We analyzed Cx26 and Cx30 expression in GJ networks in well-preserved adult human auditory sensory epithelium using confocal, electron, and super -resolution structured illumination microscopy (SR-SIM). Results: Cx30 plaques (<5 mu m) dominated, while Cx26 plaques were subtle and appeared as 'mini junctions' (2-300 nm). 3-D volume rendering of Z-stacks and orthogonal projections from single optical sections suggested that the GJs are homomeric/homotypic and consist of assemblies of identical GJs composed of either Cx26 or Cx30. Occasionally, the two protein types were co-expressed, suggesting functional cooperation. Conclusions: Establishing the molecular composition and distribution of the GJ networks in the human cochlea may increase our understanding of the pathophysiology of Cx-related hearing loss. This information may also assist in developing future strategies to treat genetic hearing loss.

  • 137.
    Liu, Wei
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Schrott-Fischer, Annelies
    Med Univ Innsbruck, Dept Otolaryngol, Innsbruck, Austria..
    Glueckert, Rudolf
    Med Univ Innsbruck, Dept Otolaryngol, Innsbruck, Austria..
    Benav, Heval
    MED EL GmbH, R&D, Innsbruck, Austria..
    Rask-Andersen, Helge
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    The Human "Cochlear Battery" - Claudin-11 Barrier and Ion Transport Proteins in the Lateral Wall of the Cochlea2017Inngår i: Frontiers in Molecular Neuroscience, ISSN 1662-5099, Vol. 10, artikkel-id 239Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The cochlea produces an electric field potential essential for hair cell transduction and hearing. This biological "battery" is situated in the lateral wall of the cochlea and contains molecular machinery that secretes and recycles K+ ions. Its functioning depends on junctional proteins that restrict the para-cellular escape of ions. The tight junction protein Claudin-11 has been found to be one of the major constituents of this barrier that maintains ion gradients (Gow et al., 2004; Kitajiri et al., 2004a). We are the first to elucidate the human Claudin-11 framework and the associated ion transport machinery using super-resolution fluorescence illumination microscopy (SR-SIM). Methods: Archival cochleae obtained during meningioma surgery were used for SR-SIM together with transmission electron microscopy after ethical consent. Results: Claudin-11-expressing cells formed parallel tight junction lamellae that insulated the epithelial syncytium of the stria vascularis and extended to the suprastrial region. Intercellular gap junctions were found between the barrier cells and fibrocytes. Conclusion: Transmission electron microscopy, confocal microscopy and SR-SIM revealed exclusive cell specialization in the various subdomains of the lateral wall of the human cochlea. The Claudin-11-expressing cells exhibited both conductor and isolator characteristics, and these micro-porous separators may selectively mediate the movement of charged units to the intrastrial space in a manner that is analogous to a conventional electrochemical "battery." The function and relevance of this battery for the development of inner ear disease are discussed.

  • 138.
    Loizou, Christos
    et al.
    Umea Univ, Dept Clin Sci, Div Otorhinolaryngol, SE-90185 Umea, Sweden..
    Laurell, Göran
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar. Umea Univ, Dept Clin Sci, Div Otorhinolaryngol, SE-90185 Umea, Sweden..
    Arvidsson, Andreas
    Umea Univ, Dept Clin Sci, Div Otorhinolaryngol, SE-90185 Umea, Sweden..
    Lindquist, David
    Umea Univ, Dept Radiat Sci, Div Oncol, SE-90185 Umea, Sweden..
    Nylander, Karin
    Umea Univ, Dept Med Biosci, Div Pathol, SE-90185 Umea, Sweden..
    Olofsson, Katarina
    Umea Univ, Dept Clin Sci, Div Otorhinolaryngol, SE-90185 Umea, Sweden..
    Recurrent respiratory papillomatosis in northern Sweden: Clinical characteristics and practical guidance2015Inngår i: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 135, nr 10, s. 1058-1064Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Conclusion: Recurrent respiratory papillomatosis (RRP) patients with high surgical treatment frequency (>= 1/year, HF) were significantly younger and had a more widespread laryngeal disease compared to a low frequency treated group (< 1 treatment/year, LF). This study confirms the existence of a clinical RRP group, not primarily related to HPV sub-type, but more care-intensive and in need of more vigilant follow-up. Objectives: RRP is associated with high morbidity due to its influence on breathing and voice. The purpose of this study was to characterize RRP patients in northern Sweden and investigate possible predictor factors affecting therapeutic needs. Method: Patients from the regional referral area (northern Sweden) were categorized for age, disease duration, juvenile or adult onset, profile of disease development, number of surgical sessions in relation to disease duration, laryngeal deposition of papilloma, gender, and HPV sub-types, in order to identify patients with increased need for frequent surgical treatment. Results: The median age of the RRP patients (n = 48) was 44.5 years; 34 (71%) were males and 14 (29%) females, most were infected with HPV 6. Patients with high surgical treatment frequency/year were significantly younger and showed more widespread papillomatous vegetation in the larynx, compared to the low frequency treated group.

  • 139.
    Loizou, Christos
    et al.
    Umea Univ, Div Otorhinolaryngol, Dept Clin Sci, S-90185 Umea, Sweden..
    Laurell, Göran
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar. Umea Univ, Div Otorhinolaryngol, Dept Clin Sci, S-90185 Umea, Sweden..
    Lindquist, David
    Umea Univ, Div Oncol, Dept Radiat Sci, S-90185 Umea, Sweden..
    Ofverman, Charlotte
    Umea Univ, Div Oncol, Dept Radiat Sci, S-90185 Umea, Sweden..
    Stefansson, Kristina
    Umea Univ, Div Oncol, Dept Radiat Sci, S-90185 Umea, Sweden..
    Nylander, Karin
    Umea Univ, Div Pathol, Dept Med Biosci, S-90185 Umea, Sweden..
    Olofsson, Katarina
    Umea Univ, Div Otorhinolaryngol, Dept Clin Sci, S-90185 Umea, Sweden..
    Incidence of tonsillar cancer in northern Sweden: Impact of human papilloma virus2015Inngår i: Oncology Letters, ISSN 1792-1074, E-ISSN 1792-1082, Vol. 10, nr 6, s. 3565-3572Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The incidence rate of tonsillar cancer is increasing worldwide. The current study identifies a parallel increase in the incidence of tonsillar cancer, human papilloma virus (HPV) and p16 expression among a population from northern Sweden, a sparsely populated area, confirming the strong association between p16 and HPV infection in tonsillar tissue. Data from the Swedish Cancer Registry was assessed to identify cases of tonsillar cancer in the northern territorial area of Sweden. HPV DNA was extracted from paraffin embedded diagnostic biopsies and detected by polymerase chain reaction using general primers Gp5+/6+ and CpI/IIG. Expression of p16 was identified by immunochemistry. Patients were grouped into urban or rural residence categories. A total of 214 cases were identified, comprising 155 (72.4%) men and 59 (27.6%) women, and 65 of these patients, who presented between 2000 and 2012, were analyzed. The overall median age for the analyzed patients was 58 years; 48 (74%) were males (median age, 57.5 years) and 17 (26%) were females (median age, 65 years). Of the 65 specimens, 59 (91%) were positive for HPV, and 62 (95%) expressed p16. The incidence of tonsillar cancer in the cohort demonstrated a 2-fold increase between 1990 and 2013; specifically, a 2.7-fold increase was observed in men whilst the female group exhibited only a small increase. These findings demonstrate a strong association between p16 expression and HPV infection in tonsillar malignancies. The incidence of HPV-positive tonsillar cancer has increased in recent years, even in sparsely populated regions, as demonstrated in northern Sweden.

  • 140.
    Lundin, Karin
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Behr, Robert
    Univ Marburg, Acad Hosp, Klinikum Fulda gAG, Fulda, Germany.
    Rask-Andersen, Helge
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Re-implantation of an auditory brainstem implant (ABI) in a child: A case report2017Inngår i: Acta oto-laryngologica case reports, E-ISSN 2377-2484, Vol. 2, nr 1, s. 119-124Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The study aimed at describing a case of auditory brainstem implant (ABI) paediatric re-implantation performed at the Akademiska University Hospital, Sweden. The patient was a boy with Goldenhar syndrome with absent vestibular-cochlear nerves and was first implanted with an ABI in 2009 at the age of two years. A technical device failure in 2015 led to a re-implantation at the age of nine years. The ABI was successfully re-implanted although the implant was closely attached to the surrounding tissue and difficult to remove. The intraoperative electrical auditory brainstem measures (eABRs) gave unclear responses after re-implantation. After 12 months, the patient's hearing thresholds was not as good as it was after the primary implant, but it is still developing. The child is a full-time user. ABI re-implantation is possible even after many years, although there is a risk that the implant might be fixed to the brainstem and difficult to remove.

  • 141.
    Lundin, Karin
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Stillesjö, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Nyberg, Gunnar
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Rask-Andersen, Helge
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Self-Reported Benefit, Sound Perception, and Quality-of-Life in Patients with Auditory Brainstem Implants (ABIs)2016Inngår i: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 136, nr 1, s. 62-67Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    CONCLUSION:

    The majority of the patients used their auditory brainstem implants (ABIs) all the time, reporting that he/she would make the decision to receive an implant again if the decision were reconsidered. The findings support that the ABI is a valuable treatment in patients with type 2 neurofibromatosis (NF2) and in children with congenital inner ear and nerve anomalies or cochlear ossification.

    OBJECTIVE:

    To evaluate the patients who underwent ABI implantation in Uppsala during 1993-2013. This study analyzed patients' implant use, perception of environmental sounds, perceived benefit from the implant, and quality-of-life (QoL).

    METHOD:

    The NF2-patients (n = 20) comprised the majority of the patients, and there were a few non-NF2 pediatric patients (n = 4). The exclusion criteria included deceased patients (n = 4) and patients with no hearing sensations from the implant, or those with an inactivated ABI (n = 2). The data were collected from a questionnaire survey.

    RESULTS:

    Eleven adult patients and two pediatric patients answered the questionnaires. Eight of the adult patients used their implants 'always'. The two children always used their implants. Hearing problems had the largest negative effect on the QoL. The non-users and the users scored equally on the NFTI-QoL.

  • 142.
    Lundin, Karin
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Stillesjö, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Rask-Andersen, Helge
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Experiences and Results from Cochlear Implantation in Patients with Long Duration of Deafness2014Inngår i: Audiology & Neurotology Extra, ISSN 1664-5537, Vol. 4, nr 2, s. 46-55Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective:

    The aim of the present study was to gauge factors that influence the outcome of cochlear implants (CI) in patients who have been deaf for an extended period.

    Patients and Methods:

    Twelve adult cases (13 ears) were operated on at the CI unit in Uppsala during the period of 2002-2013. These patients had a deafness duration ranging between 20 and 72 years in the implanted ear and severe to profound hearing loss or deafness in the other ear. Data concerning pre- and postoperative speech perception, deafness duration, hearing/deafness duration in the contralateral ear, age at implantation, intraoperative electrophysiological measurements, cause of deafness, and user status were collected.

    Results:

    Eleven of 12 patients (13 ears) benefitted from CI treatment.

    Conclusion:

    The overall hearing experience, deafness duration, and age at onset of deafness are important issues to consider prior to CI.

  • 143.
    Lundin, Karin
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Stillesjö, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Rask-Andersen, Helge
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Prognostic Value of Electrically Evoked Auditory Brainstem Responses in Cochlear Implantation2015Inngår i: Cochlear Implants International, ISSN 1467-0100, E-ISSN 1754-7628, Vol. 16, nr 5, s. 254-261Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 144. Lundin, Karin
    et al.
    Stillesjö, Fredrik
    Rask-Andersen, Helge
    Prognostic value of electrically evoked auditory brainstem responsesin cochlear implantation2015Inngår i: Cochlear Implants International, ISSN 1467-0100, E-ISSN 1754-7628, Vol. 16, nr 5, s. 254-261-Artikkel i tidsskrift (Fagfellevurdert)
  • 145.
    Lundman, Lars
    et al.
    Cent Hosp Karlstad, Dept Otolaryngol, S-65185 Karlstad, Sweden.
    Strömbäck, Karin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Björsne, Andreas
    Hearing Org Habilitat & Hlth, Gothenburg, Region Vastra G, Sweden.
    Grendin, Joakim
    Ostersund Hosp, Ostersund, Sweden.
    Dahlin-Redfors, Ylva
    Univ Gothenburg, Sahlgrenska Univ Hosp, Dept Otorhinolaryngol, Inst Clin Sci, Gothenburg, Sweden.
    Otosclerosis revision surgery in Sweden: hearing outcome, predictive factors and complications2020Inngår i: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 277, nr 1, s. 19-29Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: To describe the procedures and investigate the hearing outcomes and complications after revision surgery for patients with otosclerosis in Sweden and compare these with previously published reports and to investigate factors that may predict the outcomes of revision surgery.

    Methods: A total of 254 patients from the Swedish Quality Register for otosclerosis surgery who underwent surgery at 21 clinics were identified as having undergone revision surgery for otosclerosis from 2003 to 2013. Clinical records and audio-grams from each of these patients were collected and analyzed.

    Results: Improvement in hearing by 20 dB or more and closure of air-bone gap (<= 20 dB) was achieved in 43% and 69% of patients after a first revision operation and in 46% and 70% of patients after a second revision operation. Most patients who underwent surgery because of dizziness were relieved of their dizziness. Postoperative deafness occurred in 2.3% of patients. Prior successful otosclerosis surgery predicted successful revision surgery, especially after a second revision operation. Fixation of the incus or malleus and finding of no obvious reason for the conductive hearing loss predicted a worse hearing outcome.

    Conclusions: The hearing results after revision surgery in Sweden is somewhat inferior to those of previously published results involving large centers. Postoperative deafness may be as much as fivefold more common after revision surgery than after primary surgery. Meticulous reading of previous charts and honest counseling regarding the risks and expectations is mandatory before planning revision surgery for otosclerosis.

  • 146.
    Löfstrand Tideström, Britta
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper.
    Hultcrantz, Elisabeth
    Development of craniofacial and dental arch morphology in relation to sleep  disordered breathing from 4 to 12 years: Effects of adenotonsillar surgery2010Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 74, nr 2, s. 137-143Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: To study the development of craniofacial and dental arch morphology in children with sleep disordered breathing in relation to adenotonsillar surgery. SUBJECTS AND METHODS: From a community-based cohort of 644 children, 393 answered questionnaires at age 4, 6 and 12 years. Out of this group, 25 children who were snoring regularly at age 4 could be followed up to age 12 together with 24 controls not snoring at age 4, 6 and 12 years. Study casts were obtained from cases and controls and lateral cephalograms from the cases. Analysis regarding facial features and dento-alveolar development was performed. RESULTS: Children snoring regularly at age 4 showed reduced transversal width of the maxilla and more frequently had anterior open bite and lateral cross-bite than the controls. These conditions persisted for most cases at age 6, by which time 18/25 had been operated for snoring. In most of the cases, surgery cured the snoring temporarily, but their width of the maxilla was still smaller by age 12-even when nasal breathing was attained. At age 12, the frequency of lateral cross-bite was much reduced and anterior open bite was resolved, both in cases and controls. The children who snored regularly at age 12 operated or not operated, showed a long face anatomy and were oral breathers (this applied even to those who were operated). The seven cases who were not operated and the five who were still snoring in spite of surgery at age 12, did not have reduced maxillary width as compared to the controls. CONCLUSION: Dento-facial development in snoring children is not changed by adenotonsillar surgery regardless of symptom relief. If snoring persists or relapses orthodontic maxillar widening and/or functional training should be considered. Collaboration between otorhinolaryngologist, orthodontists and speech and language pathologists is strongly recommended.

  • 147.
    Löfstrand Tideström, Britta
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper.
    Thilander, Birgit
    Ahlqvist-Rastad, Jane
    Jakobsson, Olafur
    Hultcrantz, Elisabeth
    Breathing obstruction in relation to craniofacial and dental arch morphology in 4-year-old children1999Inngår i: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 21, nr 4, s. 323-332Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The prevalence of breathing obstruction was determined in a cohort of 4-year-old children. Craniofacial morphology was studied in obstructed children and compared with data from a control group of 4-year-old children with ideal occlusion. Dental arch morphology was compared in obstructed and non-obstructed children in the group. Parents of 95.5 per cent of the study base of 644 children answered a questionnaire concerning their child's nocturnal behaviour and related questions. The 48 children who, based on parental report, snored every night or stopped breathing when snoring (the 'snoring group'), showed a higher rate of disturbed sleep, mouth-breathing, and a history of throat infections as compared with the rest of the cohort. These children were examined by both an orthodontist and an otorhinolaryngologist and, when indicated, they were also monitored in a sleep laboratory. Twenty-eight of the children were diagnosed as having a breathing obstruction (4.3 per cent of the cohort) and six children (0.9 per cent) had sleep apnoea (mean apnoea-hypopnoea index of 17.3), using the same definition as that for adults. Cephalometric values among the obstructed children differed from those of a Swedish sample of the same age with ideal occlusion. Thy had a smaller cranial base angle and a lower ratio of posterior/anterior total face height. Small, but not significant differences were seen for NSL-ML and NL-ML. Compared with 48 asymptomatic children from the same cohort, the obstructed children had a narrower maxilla, a deeper palatal height, and a shorter lower dental arch. In addition, the prevalence of lateral crossbite was significantly higher among the obstructed children.

  • 148.
    Menjivar Dominguez, Jennifer
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Logopedi.
    Yläneva, Karolina
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Logopedi.
    A case study of aided story telling: Comparing the Step-by-Step™ with the How Was School Today Prototype2010Independent thesis Advanced level (degree of Master (One Year)), 20 poäng / 30 hpOppgave
    Abstract [en]

    The main purpose of this study was to compare how the Step-by-Step™ (S-b-S) and the newly developed How Was School Today (HWST) prototype can support participation in narrative activities for a 10-year-old boy with complex communication needs (CCN) when he interacts with two typically developed peers. The researchers wanted to find out how the use of the different communication aids affected interaction. The S-b-S is a low technology communication device with a voice recording function. The HWST prototype is a simulation of the HWST system, which is a high technology system that automatically collects information and creates stories about what the user has done in school. The researchers focused on different aspects of gaze and questions as vital communicative practices for the boy‟s involvement in the interaction, and hence, thestory telling activity. The data was analysed mainly qualitatively with conversation analysis (CA). A descriptive quantitative analysis was also developed. The results indicate that the HWST prototype provides a framework for establishment of joint orientation towards the prototype and questions about it. The S-b-S on the other hand creates a context in which it is easier to establish eye contact. There is an uneven distribution of questions with a much higher frequency in the session where the HWST prototype was used. There are not many studies on narrative ability in children with CCN together with peers. Future research on shared stories in natural environments is suggested.

  • 149.
    Moritz, Elin
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Logopedi.
    Jerremalm, Helena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Logopedi.
    Kan du försöka ännu mer att träffa rätt knappar?: En undersökning av deklarativ och procedurell inlärnings- och minnesförmåga hos barn mellan 10 och 12 år.2009Independent thesis Advanced level (degree of Master (One Year)), 20 poäng / 30 hpOppgave
    Abstract [sv]

    Enligt den deklarativa/procedurella modellen av språket (DP-modellen), utvecklad av M. T. Ullman, antas de neurala system som underligger det deklarativa minnet också understödja det mentala lexikonet, medan de neurala system som underligger det procedurella minnet antas understödja den mentala grammatiken. Det huvudsakliga syftet med denna studie var att skapa referensdata för två datorbaserade test som avsåg att pröva icke-språklig deklarativ och procedurell inlärnings- och minnesförmåga. Ytterligare ett syfte var att undersöka huruvida könsskillnader i testresultat kunde påvisas, eftersom tidigare forskning har funnit att kvinnor tenderar att ha en fördel när det gäller deklarativt minne. Studien ämnade även utforska om stöd för DP-modellen kunde erhållas, genom att undersöka om resultaten på två språkliga test som prövade passivt ordförråd och grammatisk förståelse korrelerade med resultaten på det icke-språkliga deklarativa respektive procedurella testet. I studien deltog 31 barn som var mellan tio och tolv år gamla. Resultaten från båda de datorbaserade testen indikerade att inlärning skett. Däremot kunde inga signifikanta skillnader i resultat mellan flickor och pojkar påvisas. Inte heller erhölls några signifikanta resultat som kunde ge stöd för DP-modellen. Flera av resultaten gick dock i förväntad riktning, och i framtida studier med fler deltagare och ett reviderat upplägg, är det möjligt att signifikanta resultat skulle kunna påvisas.

  • 150.
    Morén, Staffan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Unilateral Cleft Lip and Palate: Speech, Voice and Nasal Function in Adults2018Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Cleft lip and palate (CLP) is the most common craniofacial malformation. Even after repair of the cleft there may be persistent symptoms affecting speech, voice, nasal breathing, dentition, appearance and quality of life. The aims of the thesis were to: (I) investigate subjective nasal function and nasal airway at clinical examination, (II) evaluate speech by perceptual evaluation, (III) assess voice quality by perceptual evaluation and acoustic analysis and (IV) compare ratings of speech by naïve listeners, speech-language pathologists (SLPs) and patients.

    All consecutive patients with complete  unilateral CLP, born 1960-1987, and treated at Uppsala University Hospital were invited. A total of 83 (76%) (I) and 73 (67%) (II, III, IV) of the 109 eligible patients and non-cleft controls (n=63) participated. Patients had been treated in childhood with one- or two-stage palate closure. The participants underwent clinical examination, recording of speech and filled in questionnaires.

    The results showed that: (I) Patients earlier treated for UCLP suffer from more nasal symptoms than controls. However, nasal symptoms were not associated with clinical findings or method of palate closure. (II) Seven patients (10%) presented with hypernasality, 12 (16%) had audible nasal emission and/or nasal turbulence, five (7%) had consonant production errors, one (2%) had glottal reinforcements/substitutions, and one had reduced intelligibility. Controls had no quantifiable problems with speech. (III) Among patients, the mean values for the 12 perceptual voice variables on a visual analogue scale (0 = no abnormality, 100 = maximal abnormality) ranged between 1 and 22 and the mean for all was 6 mm. Voice variables were similar between patients and controls except “vocal fry”; this and total mean of all the perceptual voice variables were slightly lower among patients (p = 0.009 and p = 0.018 ). No clear association was found between velopharyngeal insufficiency and dysphonia. (IV). There were positive correlations between speech ratings by naïve listeners and SLPs (r =0.44 to 0.69, p always < 0.001, Spearman). The correlations between ratings of any of these groups and the patients’ self-ratings were weaker (r < 0.40). The patients were less satisfied with their speech and rated themselves to have more speech abnormalities than controls (p < 0.001). There were no statistically significant differences in any of the variables regarding speech, voice or nose between patients treated with one-stage and two-stage palate closure in any of the studies.

    This thesis shows that adults treated for unilateral CLP have more nasal symptoms and cleft related speech abnormalities compared to the controls, however the prevalence of speech abnormalities are relatively low. Voice quality is not affected. Speech quality is rated differently by naïve listeners, SLPs and patients.

    Delarbeid
    1. Nasal symptoms and clinical findings in adult patients treated for unilateral cleft lip and palate
    Åpne denne publikasjonen i ny fane eller vindu >>Nasal symptoms and clinical findings in adult patients treated for unilateral cleft lip and palate
    2013 (engelsk)Inngår i: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery, ISSN 2000-656X, E-ISSN 2000-6764, Vol. 47, nr 5, s. 383-389Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    The aim of the study was to investigate self-experienced nasal symptoms among adults treated for UCLP and the association to clinical findings, and to evaluate whether palate closure in one-stage or two-stages affected the symptoms or clinical findings. All people with UCLP born between 1960-1987, treated at Uppsala University Hospital, were considered for participation in this cross-sectional population study with long-term follow-up. Eighty-three patients (76% participation rate) participated, a mean of 37 years after the first operation. Fifty-two patients were treated with one-stage palate closure and 31 with two-stage palate closure. An age-matched group of 67 non-cleft controls completed the same study protocol, which included a questionnaire regarding nasal symptoms, nasal inspection, anterior rhinoscopy, and nasal endoscopy. Patients reported a higher frequency of nasal symptoms compared with the control group, e.g., nasal obstruction (81% compared with 60%) and mouth breathing (20% compared with 5%). Patients also rated their nasal symptoms as having a more negative impact on their daily life and physical activities than controls. Nasal examination revealed higher frequencies of nasal deformities among patients. No positive correlation was found between nasal symptoms and severity of findings at nasal examination. No differences were identified between patients treated with one-stage and two-stage palate closure regarding symptoms or nasal findings. Adult patients treated for UCLP suffer from more nasal symptoms than controls. However, symptoms are not associated with findings at clinical nasal examination or method of palate closure.

    Emneord
    Unilateral cleft lip and palate, nasal function, nasal obstruction, olfactory function, clinical examination, adult, surgical protocols
    HSV kategori
    Identifikatorer
    urn:nbn:se:uu:diva-209465 (URN)10.3109/2000656X.2013.771583 (DOI)000324533400009 ()
    Tilgjengelig fra: 2013-10-24 Laget: 2013-10-21 Sist oppdatert: 2018-01-26bibliografisk kontrollert
    2. Speech in Adults Treated for Unilateral Cleft Lip and Palate: Long-Term Follow-Up After One- or Two-Stage Palate Repair
    Åpne denne publikasjonen i ny fane eller vindu >>Speech in Adults Treated for Unilateral Cleft Lip and Palate: Long-Term Follow-Up After One- or Two-Stage Palate Repair
    Vise andre…
    2017 (engelsk)Inngår i: The Cleft Palate-Craniofacial Journal, ISSN 1055-6656, E-ISSN 1545-1569, Vol. 54, nr 6, s. 639-649Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    OBJECTIVE: To evaluate speech in adults treated for unilateral cleft lip and palate with one-stage or two-stage palate closure and compare the speech of the patients with that of a noncleft control group.

    DESIGN: Cross-sectional study with long-term follow-up.

    PARTICIPANTS/SETTING: All unilateral cleft lip and palate patients born from 1960 to 1987 and treated at Uppsala University Hospital, Sweden, were invited (n = 109). Participation rate was 67% (n = 73) at a mean of 35 years after primary surgery. Forty-seven had been treated according to one-stage palate closure and 26 according to two-stage palate closure. Pharyngeal flap surgery had been performed in 11 of the 73 patients (15%). The noncleft control group consisted of 63 age-matched volunteers.

    MAIN OUTCOME MEASURE(S): Speech-language pathologists rated perceptual speech characteristics from blinded audio recordings.

    RESULTS: Among patients, seven (10%) presented with hypernasality, 12 (16%) had audible nasal emission and/or nasal turbulence, five (7%) had consonant production errors, one (2%) had glottal reinforcements/substitutions, and one (2%) had reduced intelligibility. Controls had no audible signs of velopharyngeal insufficiency and no quantifiable problems with the other speech production variables. No significant differences were identified between patients treated with one-stage and two-stage palate closure for any of the variables.

    CONCLUSIONS: The prevalence of speech outcome indicative of velopharyngeal insufficiency among adult patients treated for unilateral cleft lip and palate was low but higher compared with individuals without cleft. Whether palatal closure is performed in one or two stages does not seem to affect the speech outcome at a mean age of 35 years.

    Emneord
    adult, cross-sectional, long-term, one-stage repair, speech outcome, two-stage repair, unilateral cleft lip and palate
    HSV kategori
    Identifikatorer
    urn:nbn:se:uu:diva-317289 (URN)10.1597/15-037 (DOI)000413110600003 ()28140670 (PubMedID)
    Tilgjengelig fra: 2017-03-13 Laget: 2017-03-13 Sist oppdatert: 2018-01-26bibliografisk kontrollert
    3. Voice quality in adults treated for unilateral cleft lip and palate: Long-Term Follow-Up After One- or Two-Stage Palate Repair
    Åpne denne publikasjonen i ny fane eller vindu >>Voice quality in adults treated for unilateral cleft lip and palate: Long-Term Follow-Up After One- or Two-Stage Palate Repair
    2018 (engelsk)Inngår i: The Cleft Palate-Craniofacial Journal, ISSN 1055-6656, E-ISSN 1545-1569, Vol. 55, nr 8, s. 1103-1114Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Objectives: The aim of the current study was to assess voice quality among adults treated for unilateral cleft lip and palate (UCLP), after 1- or 2-stage palate closure, and compare it to a noncleft control group.

    Study Design: Cross-sectional study in UCLP patients with long-term follow-up and noncleft controls.

    Participants: UCLP patients born 1960-1987, treated at Uppsala University Hospital, Sweden, were examined (n = 73) at a mean of 35 years after primary surgery. Forty-seven patients (64%) had been treated with 1-stage palate closure and 26 with 2-stage closure (36%). The noncleft control group consisted of 63 age-matched volunteers.

    Main Outcome Measure(s): Ratings of perceptual voice characteristics from blinded voice recordings with Swedish Voice Evaluation Approach (SVEA) method. Acoustic voice analysis including pitch and spectral measures.

    Results: Among the patients, the mean values for the 12 evaluated variables on a VAS scale (0 = no abnormality, 100 = maximal abnormality) ranged between 1 and 22 and the mean for all was 6 mm. Voice variables were similar between patients and controls except the total mean of all the perceptual voice variables, as well as “vocal fry”—both slightly lower among patients (P = .018 and P = .009). There was no difference in any variable between patients treated with 1-stage and 2-stage palate closure. No clear relationship was found between VPI and dysphonia.

    Conclusion: The voice characteristics among adults treated for UCLP in childhood are not different from those of individuals without cleft.

    Emneord
    unilateral cleft lip and palate, adult, long-term, voice, palate repair
    HSV kategori
    Forskningsprogram
    Oto-rhino-laryngologi
    Identifikatorer
    urn:nbn:se:uu:diva-340092 (URN)10.1177/1055665618764521 (DOI)000445004200007 ()29561718 (PubMedID)
    Tilgjengelig fra: 2018-01-26 Laget: 2018-01-26 Sist oppdatert: 2019-06-19bibliografisk kontrollert
    4. Speech in Adults Treated for Unilateral Cleft Lip and Palate as Rated by Naïve Listeners, Speech-Language Pathologists and Patients
    Åpne denne publikasjonen i ny fane eller vindu >>Speech in Adults Treated for Unilateral Cleft Lip and Palate as Rated by Naïve Listeners, Speech-Language Pathologists and Patients
    Vise andre…
    (engelsk)Manuskript (preprint) (Annet vitenskapelig)
    Abstract [en]

    Introduction

    Speech may be affected in patients with cleft lip and palate (CLP). Professional listeners, naïve listeners and patients perceive speech differently. The aim of the study was to evaluate speech among adults treated for unilateral CLP as rated by naïve listeners, speech language pathologists (SLPs) and patients.

    Methods All patients with complete unilateral CLP (UCLP) treated at Uppsala University Hospital, Uppsala, Sweden, between 1960 and 1987 were invited. A total of 73 of 109 patients (67%) participated with a mean time of 35 years since initiation of treatment. The non-cleft control group consisted of 55 volunteers. All participants filled out a questionnaire for self-rating of speech and their speech was audio-recorded digitally. Fourteen naïve listeners and four SLPs rated the speech individually from blinded recordings.

    Results

    There were more speech abnormalities among patients compared to controls according to the ratings of naïve listeners and SLPs[Office1] . The patients were less satisfied with their speech and rated themselves to have more speech abnormalities than controls (p < 0.001, Mann Whitney U test). There were positive correlations between the speech ratings by naïve listeners and SLPs (r = 0.44 to 0.69, p always < 0.001, Spearman). The correlations between ratings of any of these groups and the patients’ self-ratings were weaker  (r < 0.40, Spearman).

    Conclusion

    In general, adult patients treated for UCLP during childhood consider their speech as fairly good. However, they were less satisfied than non-cleft controls. The agreement between ratings by naïve listeners and SLPs were good while the agreement between these ratings and self-assessment of speech varied widely. When assessing treatment outcomes in adult patients treated for UCLP, differences in perception of speech abnormalities by professionals, laymen and patients should be taken into account.  

    Emneord
    Adult, Humans, Speech, Cleft Lip-Palate, Nonsyndromic Self-Assessment, Statistics, Nonparametric Control Groups, Hospitals, University, Speech-Language Pathology, Auditory Perception, Treatment Outcome
    HSV kategori
    Forskningsprogram
    Oto-rhino-laryngologi
    Identifikatorer
    urn:nbn:se:uu:diva-340124 (URN)
    Tilgjengelig fra: 2018-01-26 Laget: 2018-01-26 Sist oppdatert: 2018-01-26
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