Objectives: The aim of this study was to evaluate the hearing benefit, advantages, and disadvantages in a series of patients using a new, nonimplantable, pressure-free, adhesive bone conduction hearing aid. Methods: Twelve patients were included in the study at the ear, nose, and throat department of the Medical University of Vienna. All patients suffered from conductive hearing loss for at least 3 months. A sound field audiometry, Freiburg monosyllables word test and Oldenburg sentence test were carried out. Additionally, sound quality (SSQ12) and quality of life (AQoL-8D) were assessed using questionnaires. Results: Analysis revealed an average aided threshold of 30.8 dB HL (±7.1 SD) and an unaided threshold of 45.1 dB HL (±7.0 SD), resulting in a statistically significant (p < 0.001) average functional gain. Additionally, participants experienced about 30% gain in word recognition scores at 65 dB sound pressure level, speech reception threshold in quiet was 56.8 dB (±6.1) and improved to 44.5 dB (±6.4) in the aided condition. Both, the SSQ12 and the AQoL-8D showed a statistically significant improvement when comparing the scores at the beginning of the study to the answers after 2 weeks of device usage (SSQ12 (p < 0.002) and AQoL-8D (p = 0.002)). Neither skin irritations nor pain were reported during the study period. Conclusion: In conclusion, this new, adhesive bone conduction hearing aid has a high patient satisfaction rate while causing no skin irritation or pain.
9 May 2018 in European Archives of Oto-Rhino-Laryngology
Recently, p16 has been included in the TNM guideline for oropharyngeal carcinomas. The role of HPV and p16 in hypopharyngeal and laryngeal carcinomas has not yet been established sufficiently.
Introduction: Temporal bone paragangliomas are rare tumors with high vascularization and usually benign entity. A variety of modalities, including gross total resection, subtotal resection, conventional or stereotactic radiotherapy including gamma-knife, embolization, and wait-and-scan strategy can be considered. The aim of this study was to compare long-term outcomes of different primary treatment modalities in temporal bone paragangliomas. Materials and Methods: Patients with temporal bone paragangliomas treated between 1976 and 2018 at a tertiary referral center were retrospectively analyzed in this study. Collected patient data of 42 years were analyzed and long-term results including interdisciplinary management were assessed. Patient outcomes were compared within the different therapy modalities according to tumor control rate and complications. Clinical characteristics, radiological imaging, tumor extent and location (according to Fisch classification), symptoms, and follow-up were evaluated and a descriptive analysis for each treatment modality was performed. Tumor recurrence or growth progression and respective cranial nerve function before and after therapy were described. Results: A total of 59 patients were treated with a single or combined treatment modality and clinical follow-up was 7 (13) years (median, interquartile range). Of the included patients 45 (76%) were female and 14 (24%) male (ratio 3:1) with a patient age range from 18 to 83 years. Total resection was performed on 31 patients, while 14 patients underwent subtotal resection. Eleven patients were treated with conventional primary radiotherapy or gamma-knife radiosurgery. Pulsatile tinnitus (n = 17, 29%) and hearing impairment (n = 16, 27%) were the most common symptoms in our patient group. Permanent lower cranial nerve deficits were observed only in patients with large tumors (Fisch C and D, n = 14, 24%). Among the 45 patients who were treated surgically, 88% of patients with Fisch A and B paragangliomas had no recurrent disease, while no tumor growth was perceived in 83% of patients with Fisch C and D paragangliomas. Conclusion: In conclusion, we propose surgery as a treatment option for patients with small tumors, due to a high control rate and less cranial nerve deficits compared to larger tumors. Although patients with Fisch C and D temporal bone paraganglioma can be treated surgically, only subtotal resections are possible in many cases. Additionally, frequent occurrence of cranial nerve deficits in those patients and tumor growth progression in long-term follow-up examinations make a combination of the therapy modalities or a primary radiotherapy more suitable in larger tumors.
Objectives: The main aim of this study was to compare the average daily wearing time of a conventional bone conduction device with a pressure-free, adhesive bone conduction device. Further, audiologic and quality-of-life outcome parameters were evaluated. Methods: An academic, prospective, randomized cross-over trial was performed at a single center. Thirteen subjects between 12 and 63 years with conductive hearing loss were included. Average daily wearing time and subjective observations were assessed in a diary. Sound field audiometry, Freiburg monosyllables word test, and Oldenburg sentence test in quiet and in noise were carried out after 2 weeks of habituation to each device. AQoL-8D and SSQ-12 questionnaires were completed at baseline and after a 2-week test interval. Results: Median wearing time of the devices was 8.1 hours (5.8–10.2 interquartile range) for the adhesive and 4.3 hours (2.7–7.1) for the conventional bone conduction device, the difference was statistically significant (p = 0.033). There were no statistically significant differences in sound field audiometry, Freiburg monosyllables word test, and Oldenburg sentence test when comparing the two devices. AQoL-8D and SSQ-12 showed a significant improvement with the devices in comparison with baseline, with no significant difference between devices in the total scores. Ten subjects reported pain using the conventional device, two subjects reported skin irritations using the adhesive device. Conclusion: For patients with mixed or conductive hearing loss, the adhesive device is a valuable alternative with a significantly longer daily wearing time.
Simultaneous translabyrinthine tumor resection and cochlear implantation is a promising treatment method with hearing rehabilitation for sporadic vestibular schwannomas. Size of vestibular schwanomma, distance to modiolus, residual hearing and promontory stimulation electrical brainstem response audiometry are important preoperative predictive factors for determining a positive post tumour resection electrically evoked auditory brain stem response. The presence of an electrically evoked auditory brain stem response with an intracochlear test electrode after tumour resection was used to determine whether a patient received a cochlear implant Positive electrically evoked auditory brain stem responses measured with an intracochlear test electrode after tumour resection seem to correlate well with auditory perception with a cochlear implant.