Fully implantable, self-powered hearing aids with no external unit could significantly increase the life quality of patients suffering severe hearing loss. This highly demanding concept, however, requires a strongly miniaturized device which is fully implantable in the middle/inner ear and includes the following components: frequency selective microphone or accelerometer, energy harvesting device, speech processor, and cochlear multielectrode. Here we demonstrate a low volume, piezoelectric micro-electromechanical system (MEMS) cantilever array which is sensitive, even in the lower part of the voice frequency range (300–700 Hz). The test array consisting of 16 cantilevers has been fabricated by standard bulk micromachining using a Si-on-Insulator (SOI) wafer and aluminum nitride (AlN) as a complementary metal-oxide-semiconductor (CMOS) and biocompatible piezoelectric material. The low frequency and low device footprint are ensured by Archimedean spiral geometry and Si seismic mass. Experimentally detected resonance frequencies were validated by an analytical model. The generated open circuit voltage (3–10 mV) is sufficient for the direct analog conversion of the signals for cochlear multielectrode implants.
Background: Effective and selective oral rinses are required in the daily medical and dental practice. Currently mouthwashes used have substantial side effects. Objectives: Our aim was to evaluate the efficacy of chlorine dioxide-containing mouthwashes in comparison with other previously established mouth rinses in healthy adults using oral hygiene indices. Methods: This work was registered in PROSPERO (CRD42018099059) and carried out using multiple databases and reported according to the PRISMA statement. The search terms used were “chlorine dioxide” AND “oral”, and only randomised controlled trials (RCTs) were included. The primary outcome was the alteration of the plaque index (PI), while the secondary outcomes were the gingival index (GI) and bacterial counts. For the risk of bias assessment, the Cochrane Risk of Bias Tool was used. Statistical analysis for data heterogeneity was performed by Q-value and I2-tests. Results: 364 articles were found in the databases. After the selection process, only five RCTs were eligible for meta-analysis. Data heterogeneity was low. There were no statistical differences in effectiveness between chlorine dioxide and other effective mouth rinses in PI (0.720±0.119 vs 0.745±0.131; 95%; confidence intervals (CIs): 0.487-0.952 vs 0.489-1.001, respectively) and GI (0.712±0.130 vs 0.745±0.131; 95% CIs: 0.457–0.967 vs 0.489– 1.001, respectively) and also in bacterial counts. Conclusion: Chlorine dioxide reduces both plaque and gingival indices and bacterial counts in the oral cavity similar to other routinely used oral rinses, however, the evidence supporting this outcome is very limited. Therefore, further large scale RCTs are needed to decrease the risk of bias.
Background: Endoscopic type I tympanoplasty was originally introduced in the 1990s, and the extensive spread of this practice can be easily observed. The conventional technique performed involves the repair of a tympanic membrane perforation, and is defined as microscopic type I tympanoplasty.Objective of Review: The aim of this study was the comparison of postoperative outcomes of both the endoscopic and the microscopic type I tympanoplasty.Type of Review: We conducted a meta‐analysis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐analysis (PRISMA) guidelines.Search Strategy: A systematic literature search was performed in the databases of PubMed, Embase, Cochrane Library, Clarivate Analytics‐Web of Science, ClinicalTrials.gov, World Health Organization Library, and Scopus by inserting, ‘myringoplasty OR (tympanoplasty AND perforation)’ into the search query. We applied only a ‘human’ filter. We excluded non‐English studies. Additional records were identified by checking the references of relevant studies.Evaluation Method: Comparative studies were included in our analysis. We calculated the pooled odds ratio (OR) with 95% confidence interval (CI) for dichotomous outcomes and weighted mean difference (WMD) with a 95% CI for continuous outcomes. Additionally, we assessed the risk of bias and estimated the quality of evidence for each outcome.Results: Our systematic search yielded 16 studies (involving 1179 interventions), eligible for analysis. The pooled graft uptake rate (OR: 1.21, CI: 0.82‐1.77; I2 = 0.0%), the postoperative hearing results (WMD = −1.13; 95% CI: −2.72‐0.45; I2 = 78.1%) and the operation time (WMD = −21.11; 95% CI: −42.60‐0.38; I2 = 99.3%), were all comparable amongst the two techniques. In contrast, the endoscopic type I tympanoplasty outperforms when regarding the pooled canaloplasty rate (OR = 7.96; 95% CI: 4.30‐14.76; I2 = 0.0%, P = 1.000) and features an increase in desirable cosmetic results (OR = 19.29; 95% CI: 11.37‐32.73; I2 = 0.0%, P = 0.839), when compared with the microscopic approach.Conclusions: Based on our meta‐analysis, the surgical outcomes of endoscopic type I tympanoplasty in terms of graft uptake rate, postoperative hearing results and operation time were comparable to the microscopic type I tympanoplasty. In regards to cosmetics, an increase in desirable results was achieved in the endoscopic group, particularly the incidence of canaloplasty which proved to be significantly lower.
6 January 2015 in European Archives of Oto-Rhino-Laryngology
Herpes zoster (HZ) causes considerable pain and distress, and γ-Aminobutyric acid (GABA) and its derivatives are assumed to control this, but the available data are inconsistent. This meta-analysis and systematic review aimed to assess the effectiveness of GABA derivatives in the prevention of acute herpetic pain. The metaanalysis was conducted following the PRISMA guidelines using PICO format, registered in PROSPERO number CRD42018095758. PubMed, Web of Science, Ovid, Scopus, and EMBASE databases were searched. Records were included if they were randomized controlled trials of patients undergoing HZ infection, investigating the effect of GABA derivatives versus placebo in the treatment of HZ pain. Eligible trials were evaluated for the risk of bias. Then data were extracted and analysed. The number of patients with observed presence of pain after treatment was used to calculate odds ratio in a random effect model with the DerSimonian-Laird estimator. The I2 statistic was analysed for heterogeneity. The potential risk of bias was measured using Egger’s regression test. The meta-analysis included three randomized controlled trials with a total of 297 patients. The incidence of acute HZ pain events for GABA group was significantly lower compared to placebo group,18/148 vs 44/149, respectively (OR = 0.36; 95% CI = 0.14 to 0.93; Z = 2.11; P = 0.035), Egger’s test yielded P = 0.308. In conclusion, the present meta-analysis demonstrates that GABA derivatives reduce the incidence of acute herpetic pain. However, additional, well-designed randomized clinical trials are needed to determine their dose- and time-dependency regarding this symptom.
29 March 2024 in The Journal of International Advanced Otology
BACKGROUND: The purpose of this study was to examine the quality of life (QoL) and hearing thresholds of patients who underwent 2 types of stapes surgery. METHODS: A retrospective cohort study was performed comparing stapedotomy with NiTiBOND prostheses (n=20) and stapedectomy with autogenous cortical bone columella (n=20), applying the Glasgow Benefit Inventory (GBI) and the Hearing Handicap Inventory for Adults outcome measures with hearing thresholds. Univariate comparative statistical methods were applied. RESULTS: The stapedotomy cohort had significantly better values of Social Support Score of the GBI as compared to the stapedectomy cohort (P=.016). No statistically significant difference was detected between the groups in the pre- and postoperative audiological results and the further QoL measures. CONCLUSION: Apart from the excellent postoperative audiological results of the different types of stapes surgeries, stapedotomy with NiTiBOND prostheses seems to be superior as regards QoL over stapedectomy applying autogenous cortical bone columella. Cite this article as: Révész P, Kopjár E, Szakács Z, et al. Comparing the quality of life and hearing thresholds following stapedectomy versus laser stapedotomy with NiTiBOND piston. J Int Adv Otol. 2024;20(2):142-146.