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Αλέξανδρος Γ. Σφακιανάκης

Monday, August 23, 2021

Reimplantation of an Extruding Cochlear Implant

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Ear Nose Throat J. 2021 Aug 23:1455613211039042. doi: 10.1177/01455613211039042. Online ahead of print.

ABSTRACT

Cochlear implants have successfully improved hearing in severe and profoundly deaf patients in addition to improving their quality of life. Implant extrusion and wound infection of a cochlear implant are one of the most common postoperative complications, although it does not occur frequently (1.5%-5% of cases).1,2 We present a case of an extruding coch lear implant with dehiscence that was successfully reimplanted, a procedure of which there have been few previous reports in the literature.

PMID:34420408 | DOI:10.1177/01455613211039042

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Long-term audiological benefit with an active transcutaneous bone-conduction device: a retrospective cohort analysis

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Eur Arch Otorhinolaryngol. 2021 Aug 23. doi: 10.1007/s00405-021-07031-w. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate long-term audiological, surgical and safety outcomes of a complex patient cohort treated with an active transcutaneous bone-conduction device (tBCD).

METHODS: This retrospective, monocentric cohort analysis involves 31 adults with conductive (CHL) and mixed hearing loss (MHL). For outcome analysis, study results were divided into short-term follow-up data (< 12 months) and long-term follow-up data (> 12 months).

RESULTS: 31 patients with a total person-time of 90.4 years and an average number of 3.2 ± 1.5 preoperatively performed surgeries on the implanted side were investigated. Mean BCD-aided PTA4 thresholds were significantly lower than unaided PTA4AC before surgery (64.7 ± 16.1 dB HL; CHL 50.6 ± 10.6 dB HL; MHL 72.8 ± 12.8 dB HL) and did not change between short-te rm (42.3 ± 13.1 dB HL; CHL 35.8 ± 6.8 dB HL; MHL 45.2 ± 14.3 dB HL) and long-term (43.4 ± 10.0 dB HL; CHL 35.8 ± 4.3 dB HL; MHL 48.1 ± 9.6 dB HL) follow-up periods. Speech intelligibility in the Freiburg monosyllables test at 65 dB improved significantly, from 16.3 ± 21.5% (CHL 26.8 ± 19.0%; MHL 8.7 ± 20.5%) in the unaided condition to 82.7 ± 15.5% (CHL 90.0 ± 12.2%; MHL 79.4 ± 16.3%) in the short-term and 85.5 ± 13.2% (CHL 93.8 ± 7.9%; MHL 79.5 ± 13.3%) BCD-aided in the long-term follow-up periods. Ten minor procedure-related and 6 implant-related (5 minor, 1 major) AEs occurred over the total follow-up period.

CONCLUSION: The device provides satisfactory audiological and speech benefit over long-term follow-up periods, up to 7 years. Explant rates were very low, while the overall rate of manageable AEs was high in this complex patient cohort. The device is considered a safe and effective option in the long-term hearing rehabilitation of patients with CHL and M HL.

PMID:34424382 | DOI:10.1007/s00405-021-07031-w

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Dehiscence or thinning of bone overlying the superior semicircular canal in idiopathic intracranial hypertension

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Eur Arch Otorhinolaryngol. 2021 Aug 23. doi: 10.1007/s00405-021-07020-z. Online ahead of print.

ABSTRACT

STUDY DESIGN: Retrospective cohort.

OBJECTIVES: The objective of the study is to evaluate a relationship between idiopathic intracranial hypertension (IIH) and superior semicircular canal dehiscence (SSCD) of bone overlying the superior semicircular canal (SSC).

MATERIALS AND METHODS: A total of 57 (114 ears) individuals, 20 of whom were controls and 37 of whom were IIH, were included in the study. Individuals were evaluated with 0.8 mm slice thickness computed tomography (CT) images for SSC bony roof thickness and SSCD. Thickness of the bony roof over the SSC was graded from Grade 1 to Grade 4. Grade 3 was defined as pre-dehiscence and Grade 4 as dehiscence.

RESULTS: Bony roof thickness was 1.25 mm in the control group and 0.76 mm in the IIH group. When bony roof thickness was compared between the groups, it was f ound to be significantly thinner in the IIH group (p = 0.012). In the IIH group, while dehiscence was detected in 25 of 74 ears, no dehiscence was detected in 49 ears. In the control group, while dehiscence was detected in 5 ears, no dehiscence was detected in 35 ears. The difference is statistically significant (p = 0.015). The correlation between bony roof thickness and cerebrospinal fluid (CSF) pressure in the IIH group was not statistically significant (p = 0.343; rho = 0.110). The correlation between bony roof thickness and age in the IIH group was not statistically significant (p = 0.082; rho = - 0.164).

CONCLUSION: Increased CSF pressure in patients with IIH may cause chronic, progressive, and irreversible damage to the bone of the SSC and, according to our study, the rate of SSCD was found to be high in IIH patients.

PMID:34424380 | DOI:10.1007/s00405-021-07020-z

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Interactive live-stream surgery contributes to surgical education in the context of contact restrictions

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Eur Arch Otorhinolaryngol. 2021 Aug 23. doi: 10.1007/s00405-021-06994-0. Online ahead of print.

ABSTRACT

BACKGROUND: Attendance teaching is the predominant teaching method at universities but needs to be questioned in the context of digital transformation. This study establishes and evaluates a method to accomplish electronic learning to supplement traditional attendance courses.

MATERIALS AND METHODS: Surgery was transmitted in real-time conditions via an online live stream from the surgical theater. Visualization was transferred from a fully digital surgical microscope, an endoscope or an environmental camera in high definition quality. Students were able to participate at home from their personal computer. After following the surgery, they participated in an online-evaluation.

RESULTS: A total of 65 students participated in the live stream. The majority of students (61.54%) indicated a significant subjective increase in knowledge after participation. The majority of students (53.85%) indicated that live surgeries should be offered as a permanent component in addition to classroom teaching. Likewise, a broader offer was desired by many students (63.08%).

CONCLUSIONS: Live streaming of surgery is a promising approach as an alternative or supplement to traditional attendance teaching. An expansion of digital teaching can be explicitly supported on the basis of this study.

PMID:34424381 | DOI:10.1007/s00405-021-06994-0

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Cervical Subarachnoid Drain for the Treatment of Cerebrospinal Fluid Leak: 2-Dimensional Operative Video

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Oper Neurosurg (Hagerstown). 2021 Aug 23:opab292. doi: 10.1093/ons/opab292. Online ahead of print.

ABSTRACT

Cerebrospinal fluid (CSF) leak is a common phenomenon encountered by the neurosurgeon. It is most commonly come across after a neurosurgical procedure, but it can be seen idiopathically. Treatment usually ranges from conservative management through cerebrospinal fluid diversion to direct surgical repair. Continuous CSF drainage provides a path for diversion and allowing the site of the dural injury to heal effectively.1 Cervical subarachnoid drain is a safe and effective alternative when lumbar access is contraindicated or not achievable.2 Here we present a case of a 22-yr-old female with progressive symptomatic positional headaches due to a CSF leak from a prior deformity surgery treated with a cervical subarachnoid drain after a failed attempt at a direct repair. This 2-dimensional video illustrates the technique used for the placemen t of a cervical subarachnoid drain for the treatment of symptomatic CSF leak. Patient consented to the procedure and for the publication of their image.

PMID:34424330 | DOI:10.1093/ons/opab292

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Sunday, August 22, 2021

Improving speech characteristics of young adults with congenital dysarthria: An exploratory study comparing articulation training and the Beatalk method

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Publication date: Available online 20 August 2021

Source: Journal of Communication Disorders

Author(s): Michal Icht

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Contralateral hearing loss in children with a unilateral enlarged vestibular aqueduct

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Publication date: November 2021

Source: International Journal of Pediatric Otorhinolaryngology, Volume 150

Author(s): E.A. van Beeck Calkoen, R.J.E. Pennings, J. Smits, S. Pegge, L.J.C. Rotteveel, P. Merkus, B.M. Verbist, E. Sanchez, E.F. Hensen

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