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Teunissen EM, Aukema TW, Banga R, Eeg-Olofsson M, Hol MKS, Hougaard DD, Tysome JR, Johansson ML, Svensson S, Powell HRF. Evaluation of Clinical Performance of Ponto Implantation Using a Minimally Invasive Surgical Technique-A Prospective Multicenter Study. Otol Neurotol 2024; 45:1037-1044. [PMID: 39186326 DOI: 10.1097/mao.0000000000004315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2024]
Abstract
OBJECTIVE To investigate the clinical outcomes of bone-anchored hearing implant surgery using the MONO procedure. STUDY DESIGN Multicenter, multinational, single-arm, prospective trial with a 12-month follow-up. SETTING Seven European university hospitals from the United Kingdom, Sweden, Denmark, and The Netherlands. PATIENTS Fifty-one adult patients requiring surgical intervention for bone conduction hearing. INTERVENTION Bone-anchored hearing implant surgery using the MONO procedure. MAIN OUTCOME MEASURES The primary endpoint assessed implant usability 3 months after surgery. Implant status, soft tissue reactions, pain and numbness, postoperative events, and sound processor usage were assessed at all follow-up visits. Hearing-related quality of life was evaluated using the Glasgow Benefit Inventory (GBI). RESULTS At 3 months, 94.2% of the implant/abutment complexes provided reliable anchorage for sound processor usage. No severe intraoperative complications occurred. Sixty-nine percent of surgeries were performed under local anesthesia, with surgery lasting 10 minutes on average. Four implants were lost due to trauma (n = 2), spontaneous loss of osseointegration (n = 1), or incomplete insertion (n = 1). Adverse soft tissue reactions occurred in 2.6% of visits, with a maximum Holgers grade of 3 (n = 1) and grade 2 (n = 5) across patients. Hearing-related quality of life at 3 months improved in 96% of patients. CONCLUSION The MONO procedure provides a safe and efficient surgical technique for inserting bone-anchored hearing implants with few and minor intra- and postoperative complications.
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Affiliation(s)
- Emma M Teunissen
- Department of Otorhinolaryngology-Head and Neck Surgery, Donders Center for Neuroscience, Radboud University Medical Center, Radboud University, Nijmegen
| | | | - Rupan Banga
- Department of Otorhinolaryngology, Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom
| | | | | | - Dan D Hougaard
- Department of Otolaryngology, Head & Neck Surgery & Audiology, Aalborg University Hospital, Aalborg, Denmark
| | - James R Tysome
- Department of Otorhinolaryngology, Addenbrooke's Hospital, Cambridge, United Kingdom
| | | | | | - Harry R F Powell
- Department of Otorhinolaryngology, St Thomas' Hearing Implant Centre, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
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Kisser U, Stelter K, Lill C. Total versus subtotal tonsillectomy for recurrent tonsillitis: 5-year follow up of a prospective randomized noninferiority clinical trial. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08987-1. [PMID: 39322860 DOI: 10.1007/s00405-024-08987-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 09/10/2024] [Indexed: 09/27/2024]
Abstract
PURPOSE In long-term follow-up, it remains uncertain whether tonsillectomy, a procedure associated with significant comorbidity, can be substituted with partial tonsillectomy in patients with recurrent tonsillitis. This paper is to present the 5-year follow-up data of our previous study titled "Total versus subtotal tonsillectomy for recurrent tonsillitis-a prospective randomized noninferiority clinical trial." MATERIALS AND METHODS The underlying study was performed as single-blinded prospective noninferiority procedure in patients with recurrent chronic tonsil infection, where one side was removed completely (tonsillectomy) and the other side partially (intracapsular/partial tonsillectomy). Five years after surgery, we collected data on the frequency of tonsillitis in the first, second, third, fourth, and fifth year post-surgery. We obtained assessments from patients, their ENT physicians, and general practitioners separately. To assess the impact of surgical therapy on overall quality of life, we employed the Glasgow Benefit Inventory (GBI). RESULTS Out of the 111 patients initially included in the years 2015-2018, 79 were eligible for the 5-year follow-up, representing a 71% follow-up rate. The mean follow-up time was 60 months. Notably, during the first 12 months post-surgery, no cases of bacterial inflammation were observed in the remaining tonsillar tissue following partial tonsillectomy, suggesting noninferiority compared to total tonsillectomy. This effect remained consistent over the 5-year study period. GBI results indicate that both total and partial tonsillectomy positively impact the physical and mental health of patients with recurrent tonsillitis. CONCLUSION Considering that partial tonsillectomy is associated with less pain and reduced postoperative bleeding, it may emerge as a potential replacement for total tonsillectomy as the standard method in the future.
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Affiliation(s)
- Ulrich Kisser
- Department of Otorhinolaryngology, Head and Neck Surgery, University Clinic Halle, Halle, Germany
| | - Klaus Stelter
- ENT, Head and Neck Surgery, ENT Center Mangfall-Inn, Rosenheim, Germany
| | - Claudia Lill
- Department of Otorhinolaryngology, Head and Neck Surgery, Evangelical Hospital, Hans-Sachs-Gasse 10-12, 1180, Vienna, Austria.
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3
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Taha HI, Elgendy MS, Ezz MR, Tolba K, El Safty M, Azzawi MADA, Katamesh BE, Albazee E. Septoplasty versus non-surgical management for deviated nasal septum: a systematic review and meta-analysis of randomized controlled trials. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08937-x. [PMID: 39230606 DOI: 10.1007/s00405-024-08937-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2024] [Accepted: 08/19/2024] [Indexed: 09/05/2024]
Abstract
PURPOSE This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to evaluate the efficacy and safety of septoplasty versus non-surgical management for patients experiencing nasal obstruction due to deviated nasal septum (DNS). METHODS We conducted a comprehensive search of PubMed, Scopus, Embase, Web of Science, Cochrane Library, Clinicaltrials.gov, ICTRP, and ISRCTN for relevant RCTs. The primary outcomes included the Nasal Obstruction Symptom Evaluation (NOSE) scale, Sino-Nasal Outcome Test (SNOT-22), Peak Nasal Inspiratory Flow (PNIF), surgical complications, and quality of life. Data were synthesized using RevMan 5.4 and STATA 18, with effect estimates presented as mean differences (MD) or risk ratios (RR) with 95% confidence intervals (CI). The study protocol was registered with PROSPERO (ID: CRD42024538373). RESULTS Our search identified 537 studies, of which 3 RCTs involving 721 participants met the inclusion criteria. The meta-analysis revealed that septoplasty significantly improved NOSE and SNOT-22 scores compared to non-surgical interventions at 6 and 12 months of follow-up, despite no notable differences at 3 months post-treatment. No significant difference was observed regarding nasal flow assessed by PNIF. The rate of complications was low, ranging from 0.31% (revision rate) to 4.12% (bleeding and infection rates). Additionally, our qualitative synthesis showed an improvement in the quality of life at 6 and 12 months in the septoplasty group compared with the non-surgical group. CONCLUSIONS This systematic review and meta-analysis of 721 patients revealed the efficacy of septoplasty, with or without turbinate surgery, in improving nasal obstruction symptoms at 6 and 12 months. Additionally, septoplasty consists of a relatively low rate of complications such as bleeding, infection, and septal perforation. Furthermore, a low revision rate was found. Septoplasty improved the quality of life, especially after 6 and 12 months. However, our findings should be interpreted with caution, and further research is needed to consolidate our results.
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Affiliation(s)
- Hosam I Taha
- Faculty of Medicine, Tanta University, Tanta, Egypt
| | | | | | - Khalid Tolba
- Faculty of Medicine, Tanta University, Tanta, Egypt
| | | | | | - Basant E Katamesh
- Faculty of Medicine, Tanta University, Tanta, Egypt
- Research Scholar, Mayo Clinic, Rochester, MN, USA
| | - Ebraheem Albazee
- Kuwait Institute for Medical Specializations (KIMS), Kuwait City, Kuwait.
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Arana-Fernández B, Santamaría-Gadea A, Mariño-Sánchez F, Rojas-Lechuga MJ, Alobid I. Septal Perforation Quality of Life questionnaire (SEPEQOL): validation of a new instrument to assess patients undergoing endoscopic repair of a nasal septal perforation. Head Face Med 2024; 20:46. [PMID: 39223541 PMCID: PMC11368029 DOI: 10.1186/s13005-024-00451-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2024] [Accepted: 08/28/2024] [Indexed: 09/04/2024] Open
Abstract
PURPOSE Nasoseptal perforations (NSP) are a clinically heterogeneous group of disorders with a wide range of available treatments. Patient-reported outcome measures (PROMs) can provide valuable insights for assessing clinical and surgical outcomes. This study aims to develop and validate a novel-specific questionnaire for patients with NSP. METHODS A multi-centre prospective observational study was conducted at two tertiary referral hospitals. "Septal Perforation Quality of Life" (SEPEQOL) was developed by a committee of experts. The psychometric properties, including reproducibility, reliability, validity, and responsiveness, were assessed. RESULTS The study included 96 symptomatic NSP patients and 30 healthy controls. SEPEQOL internal consistency was satisfactory [Cronbach´s α = 0.7843; 95% confidence interval (CI), 0.702-0.856]. Test-retest reliability was excellent, demonstrated by the absolute intraclass correlation (ICC = 0.974; 95% CI, 0.935-0.989, P-value < 0.001) and Bland-Altman plot (line bias = 1.6 ± 4.57; 95% CI -0.54-3.74, P-value < 0.001). The mean total SEPEQOL score was higher before surgery (25.16 ± 1.65) compared to 6-months after the procedure (13.72 ± 11.39), with a mean difference of 12.19 [standard deviation (SD) 10.76], P-value < 0.001. CONCLUSIONS SEPEQOL is reliable, consistent, valid, and sensitive to change over time. SEPEQOL assesses the impact of health-related quality of life on NSP and its management in clinical practice. Moreover, it is easy to apply in clinical settings with minimal burden.
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Affiliation(s)
- Beatriz Arana-Fernández
- Rhinology and Skull Base Surgery Unit, Otorhinolaryngology Department, La Paz University Hospital, Madrid, Spain
| | - Alfonso Santamaría-Gadea
- Rhinology and Skull Base Surgery Unit, Otorhinolaryngology Department, Ramón y Cajal University Hospital, Madrid, 28034, Spain.
| | - Franklin Mariño-Sánchez
- Rhinology and Skull Base Surgery Unit, Otorhinolaryngology Department, Ramón y Cajal University Hospital, Madrid, 28034, Spain
| | - María Jesús Rojas-Lechuga
- Rhinology and Skull Base Surgery Unit, Otorhrinolaryngology Department, Hospital Clinic, Barcelona, Spain
| | - Isam Alobid
- Rhinology and Skull Base Surgery Unit, Otorhinolaryngology Department, Hospital Clinic, IDIBAPS Ciberes, Universitat de Barcelona, Barcelona, Spain
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Rutenkröger M, Wandke S, Gempt J, Dührsen L, Scheer M, Strauss C, Führes H. German translation and cross-cultural adaptation of the Vestibular Schwannoma Quality of Life Index (VSQOL). J Patient Rep Outcomes 2024; 8:95. [PMID: 39136861 PMCID: PMC11322465 DOI: 10.1186/s41687-024-00778-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 07/16/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND Vestibular schwannomas (VSs) are benign tumors of the vestibulocochlear nerve that often cause significant neurological and functional impairment. Patient-reported outcomes, including quality of life (QoL), are essential for understanding the overall impact of VS and its treatment. This study aimed to translate and culturally adapt the Vestibular Schwannoma Quality of Life (VSQOL) Index into German to expand its relevance to German-speaking populations. METHODS We used a qualitative approach including translation and cognitive interviews with 10 patients who underwent VS surgery. The translation process followed the TRAPD protocol to ensure linguistic and conceptual accuracy. Cognitive interviews assessed the comprehensibility and relevance of the translated questionnaire. RESULTS The translation showed remarkable consistency between translators, with minor discrepancies resolved by consensus. Cognitive interviews provided valuable insights that led to refinements in item wording. Participants emphasized the importance of an additional item on physician referrals, reflecting differences in health care systems between the United States and Germany. CONCLUSIONS The German VSQOL provides a comprehensive tool for assessing QoL in patients with VS that integrates patient-centered dimensions. A Validation study is underway to establish its reliability and validity.
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Affiliation(s)
- Mareike Rutenkröger
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Svenja Wandke
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- II. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jens Gempt
- Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lasse Dührsen
- Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maximilian Scheer
- Department of Neurosurgery, University Hospital Halle, Halle (Saale), Germany
| | - Christian Strauss
- Department of Neurosurgery, University Hospital Halle, Halle (Saale), Germany
| | - Hannah Führes
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Szmulewicz DJ, Galli R, Tarnutzer AA. Patient-Related Outcome Measures for Oculomotor Symptoms in the Cerebellar Ataxias: Insights from Non-Cerebellar Disorders. CEREBELLUM (LONDON, ENGLAND) 2024; 23:1435-1448. [PMID: 38214833 PMCID: PMC11269357 DOI: 10.1007/s12311-024-01656-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/05/2024] [Indexed: 01/13/2024]
Abstract
In patients with cerebellar ataxia (CA), symptoms related to oculomotor dysfunction significantly affect quality of life (QoL). This study aimed to analyze the literature on patient-related outcome measures (PROMs) assessing QoL impacts of vestibular and cerebellar oculomotor abnormalities in patients with CA to identify the strengths and limitations of existing scales and highlight any areas of unmet need. A systematic review was conducted (Medline, Embase) of English-language original articles reporting on QoL measures in patients with vertigo, dizziness or CA. Pre-specified parameters were retrieved, including diseases studied, scales applied and conclusions drawn. Our search yielded 3671 articles of which 467 studies (n = 111,606 participants) were deemed relevant. The most frequently studied disease entities were (a) non-specific dizziness/gait imbalance (114 studies; 54,581 participants), (b) vestibular schwannomas (66; 15,360), and (c) vestibular disorders not further specified (66; 10,259). The Dizziness Handicap Inventory (DHI) was the most frequently used PROM to assess QoL (n = 91,851), followed by the Penn Acoustic Neuroma Quality-of-Life Scale (n = 12,027) and the Activities-Specific Balance Confidence Scale (n = 2'471). QoL-scores capturing symptoms related to oculomotor abnormalities in CA were rare, focused on visual impairments (e.g., National-Eye-Institute Visual Function Questionnaire, Oscillopsia Functional Impact, oscillopsia severity score) and were unvalidated. The DHI remains the most widely used and versatile scale for evaluating dizziness. A lack of well-established PROMs for assessing the impact of oculomotor-related symptoms on QoL in CA was noted, emphasizing the need for developing and validating a new QoL-score dedicated to the oculomotor domain for individuals with CA.
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Affiliation(s)
- David J Szmulewicz
- Balance Disorders and Ataxia Service, Royal Victoria Eye and Ear Hospital, Melbourne, VIC, Australia
- The Bionics Institute, Melbourne, VIC, Australia
- University of Melbourne AU, Melbourne, VIC, Australia
| | - Rocco Galli
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Alexander A Tarnutzer
- Faculty of Medicine, University of Zurich, Zurich, Switzerland.
- Department of Neurology, Cantonal Hospital of Baden, Baden, Switzerland.
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Imagawa N, Motegi M, Kondo Y, Shimazaki T, Yamauchi T, Suka M. Generic and Hearing-Specific Quality of Life in Older Adult Cochlear Implant Users. Cureus 2024; 16:e66042. [PMID: 39224740 PMCID: PMC11366783 DOI: 10.7759/cureus.66042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2024] [Indexed: 09/04/2024] Open
Abstract
Background This study aimed to evaluate the quality of life (QOL) of older adults using cochlear implants (CIs) by focusing on how individual characteristics and speech perception are related to generic QOL ratings and utilizing the Health Utilities Index Mark III (HUI3) for assessment. Methodology A cross-sectional study was conducted with 19 participants aged ≥60 years, who were within one to five years post-implant activation. Data were obtained through self-administered questionnaires, including the HUI3 for generic QOL assessment and disease-specific indexes. Speech perception tests and chart reviews provided personal characteristic data. Statistical analysis was performed using the Mann-Whitney U-test, one-way analysis of variance, and Pearson's correlation coefficient. Results In total, 18 patients responded to the study. This study revealed that the generic QOL in older adult CI users was lower than that in the general older adult population. There was no significant association between QOL and variables such as sex, duration of implant usage, or age. However, a longer duration of hearing loss before receiving an implant was associated with higher generic QOL scores. Additionally, a strong correlation was observed between the hearing-related QOL score and utility scores. Conclusions Longer pre-implantation hearing loss correlated with better post-implantation QOL. Additionally, a reduced QOL, specifically within the hearing attribute, a subdomain of the HUI3, was associated with a lower overall generic QOL. The results suggest that generic QOL cannot be evaluated based on hearing ability alone and that cochlear implantation does not completely improve generic QOL. This study represents an important first step in understanding the QOL of older adult CI users from a variety of backgrounds.
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Affiliation(s)
- Norie Imagawa
- Department of Health and Welfare, Prefectural University of Hiroshima, Hiroshima, JPN
| | - Masaomi Motegi
- Department of Otolaryngology-Head and Neck Surgery, Gunma University Graduate School of Medicine, Gunma, JPN
| | - Yuiko Kondo
- Department of Otorhinolaryngology, Jikei University Hospital School of Medicine, Tokyo, JPN
| | - Takashi Shimazaki
- Department of Public Health and Environmental Medicine, Jikei University School of Medicine, Tokyo, JPN
| | - Takashi Yamauchi
- Department of Public Health and Environmental Medicine, Jikei University School of Medicine, Tokyo, JPN
| | - Machi Suka
- Department of Public Health and Environmental Medicine, Jikei University School of Medicine, Tokyo, JPN
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Zheng YP, He XF, Zhang YF, Geng LX, Zhang HM, Wan H, He X. Five-blade scratcher for treating severe rhinophyma: A retrospective study. World J Clin Cases 2024; 12:4180-4190. [PMID: 39015915 PMCID: PMC11235531 DOI: 10.12998/wjcc.v12.i20.4180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 05/21/2024] [Accepted: 05/23/2024] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND Rhinophyma, a late-stage subtype of rosacea, is characterized by excessive sebaceous glands and connective tissue proliferation. Patients may experience respiratory disturbances and psychological distress that significantly affect their quality of life when excessive nasal hyperplasia obstructs the external nasal valves. Surgery is the treatment of choice for rhinophyma. However, excessive bleeding, scarring, pigmentation, and high recurrence rates frequently characterize current surgical methods. AIM To evaluate the clinical effectiveness and recurrence rates after treating severe rhinophyma with the five-blade scratcher. METHODS This study retrospectively analyzed the clinical records of 28 patients with severe rhinophyma rosacea. The Global Flushing Severity Score (GFSS), Clinician Erythema Assessment (CEA), Rhinophyma Severity Index (RHISI), Glasgow Benefit Inventory (GBI), and satisfaction scores were used to assess the recovery of patients at 6 months and 5 years, with the recurrence rate calculated at 5 years postoperatively. In addition, the levels of pro-inflammatory factors (TNF-α, IL-1β, and IL-6) in the serum of patients before and after surgery were detected by ELISA. RESULTS The GFSS, CEA, and RHISI scores at 6 months and 5 years postoperatively were significantly lower than those preoperatively (P < 0.001 for both periods). Five-blade scratcher treatment greatly benefits patients as demonstrated by the GBI and patient satisfaction. A small number of patients (7/28, 25%) reported recurrence after surgical treatment for rhinophyma in our department that was not more serious than before treatment. The expression of pro-inflammatory factors (TNF-α, IL-1β, and IL-6) in the patient's serum was significantly reduced after surgery of five-blade scratcher. CONCLUSION The five-blade scratcher treatment demonstrates notable advantages, including simplicity, safety, efficacy, and cost-effectiveness, coupled with reduced bleeding, minimized scarring, lower recurrence rates, reduced the level of pro-inflammatory factors and improved patient satisfaction. Consequently, this therapeutic modality exhibits a viable option for individuals afflicted with severe rhinophyma.
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Affiliation(s)
- Yu-Ping Zheng
- Department of Dermatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Xu-Feng He
- Department of Dermatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Yan-Feng Zhang
- Department of Dermatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Lan-Xin Geng
- Department of Dermatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Hui-Min Zhang
- Department of Dermatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Hua Wan
- Department of Galactophore, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Xiang He
- Department of Dermatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
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Kaya İ, Şahin FF, Tanrıverdi H, Eroğlu S, Kirazli T. Comparison of endoscopic and microscopic stapedotomy in the same patients: a prospective randomized controlled trial. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08823-6. [PMID: 39001920 DOI: 10.1007/s00405-024-08823-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 07/01/2024] [Indexed: 07/15/2024]
Abstract
PURPOSE This study aimed to conduct a comparative analysis of audiological and postoperative clinical outcomes between the endoscopic and microscopic stapedotomy approaches. METHODS This study employed a randomized, controlled design. Twenty-seven patients with bilateral otosclerosis underwent stapedotomy in both ears, with randomized allocation of the surgical technique (endoscopic vs. microscopic) for the first operated ear. Air-bone gap (ABG) and ABG gain were measured at least 12 months postoperatively. Postoperative outcomes including pain (Visual Analog Scale-VAS), dizziness, early-term (day 1) and late-term (6 months) dysgeusia were evaluated. The Glasgow Benefit Inventory (GBI) assessed health-related quality of life at one month postoperatively, and operative time was measured. RESULTS This study compared endoscopic (n = 27 ears) and microscopic (n = 27 ears) stapedotomy for otosclerosis. Both groups achieved similar hearing improvement with no significant differences in pre-operative and post-operative bone/air conduction thresholds, ABG, and ABG gain (all p > 0.05). The endoscopic stapedotomy group demonstrated reduced postoperative pain (lower VAS scores, p < 0.001), lower early dysgeusia (3.7% vs. 33.3%, p = 0.005), shorter operative time (47.3 vs. 75.4 min, p < 0.001) and improved patient-reported outcomes (higher GBI score, p = 0.014) when compared to microscopic stapedotomy group. No significant differences were observed in postoperative dizziness or late-term dysgeusia between groups. CONCLUSION This study found similar hearing improvement with both endoscopic and microscopic stapedotomy for otosclerosis. However, the endoscopic approach showed advantages in reduced postoperative pain, early dysgeusia, and operative time, with improved patient-reported quality of life. These findings suggest endoscopic stapedotomy as a valuable alternative to the conventional microscopic approach.
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Affiliation(s)
- İsa Kaya
- Department of Otorhinolaryngology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Fetih Furkan Şahin
- Department of Otorhinolaryngology, Kızıltepe State Hospital, Mardin, Turkey.
| | - Hasan Tanrıverdi
- Department of Otorhinolaryngology, Şırnak State Hospital, Şırnak, Turkey
| | - Süleyman Eroğlu
- Department of Otorhinolaryngology, Ege University Faculty of Medicine, Izmir, Turkey
| | - Tayfun Kirazli
- Department of Otorhinolaryngology, Ege University Faculty of Medicine, Izmir, Turkey
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Jafari A, Simmonds JC, Mitchell MB, Banks CG, Lehmann A, Paz-Lansberg M, Yoon MK, Metson R. A New Patient-reported Outcomes Measure for Surgically Treated Epiphora: Tearing Assessment and Rating Scale-12 (TEARS-12). Am J Rhinol Allergy 2024; 38:211-217. [PMID: 38623636 DOI: 10.1177/19458924241241871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
BACKGROUND No widely accepted, validated instrument currently exists to measure clinical outcomes in patients who undergo dacryocystorhinostomy (DCR) for treatment of epiphora. OBJECTIVE To develop a patient-reported outcome measure applicable to this population. METHODS Psychometric evaluations, consultation with experts, and review of the literature informed item generation of a 12-question questionnaire to incorporate the most relevant symptoms experienced by patients with nasolacrimal duct obstruction. This questionnaire, known as the Tearing Assessment and Rating Scale-12 (TEARS-12), was administered to 32 patients before and after intervention, in the form of endoscopic DCR. Statistical analysis was performed to measure internal consistency, responsiveness, and test-retest reliability. RESULTS Pre-operative and post-operative TEARS-12 scores (28.2 [standard error (SE) 3.19] vs 11.8 [SE 3.25], respectively, P = 0.001) demonstrated improved patient outcome within 6 weeks following endoscopic DCR. Cronbach's alpha for the questionnaire was 0.90, indicating high overall reliability. Additionally, each question demonstrated internal reliability, with a corrected item-total correlation greater than 0.30. The intraclass correlation between the two pre-operative scores was 0.858 (P < 0.001), indicating high test-retest reliability. CONCLUSION TEARS-12 is a statistically valid, easy-to-administer instrument to measure clinical outcomes in patients who undergo endoscopic DCR.
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Affiliation(s)
- Aria Jafari
- Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, WA, USA
| | | | - Margaret B Mitchell
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA, USA
- Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA, USA
| | - Catherine G Banks
- Department of Otolaryngology, University of New South Wales, Sydney, Australia
| | - Ashton Lehmann
- Department of Otolaryngology, Geisinger Medical Center, Danville, PA, USA
| | | | - Michael K Yoon
- Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA, USA
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Ralph Metson
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA, USA
- Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA, USA
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Alasmi A, Saleh S, Anderson I, Abdelsamad Y, Hagr A. Validation of the Arabic language version of the Audio Processor Satisfaction Questionnaire (APSQ) for hearing implant users. PLoS One 2024; 19:e0303301. [PMID: 38857266 PMCID: PMC11164331 DOI: 10.1371/journal.pone.0303301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 04/23/2024] [Indexed: 06/12/2024] Open
Abstract
OBJECTIVE Audio processors (AP) are the external components of hearing implants. User satisfaction with the performance and comfort of their AP is a critical factor in ensuring daily use, which leads to improved hearing outcomes. The aim of this study was to construct and validate an Arabic language translation of the APSQ for use among Arabic-speaking clinicians and patients. DESIGN The original APSQ was translated into the Arabic language using cross-cultural adaptation measures. The final questionnaire was administered to CI users in electronic form. STUDY SAMPLE 117 CI users (64 female) participated. A total of 179 ears were assessed. RESULTS High levels of satisfaction with audio processors were observed among CI users. Item and scale analyses indicate that this version of the APSQ measure a homogeneous and valid construct. CONCLUSION The Arabic version of the APSQ captures user satisfaction with hearing implant audio processors.
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Affiliation(s)
- Abdulaziz Alasmi
- King Abdullah Ear Specialist Center (KAESC), King Abdulaziz University Hospital, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Shaza Saleh
- King Abdullah Ear Specialist Center (KAESC), King Abdulaziz University Hospital, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Ilona Anderson
- Clinical Research Department, MED-EL GmbH, Innsbruck, Austria
| | | | - Abdulrahman Hagr
- King Abdullah Ear Specialist Center (KAESC), King Abdulaziz University Hospital, King Saud University Medical City, Riyadh, Saudi Arabia
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Marangi GF, Faiola A, Cimmino AA, Savani L, Mirra C, Gratteri M, Giuffrè MT, Segreto F, Cogliandro A, Persichetti P. Relevance of Self-Consciousness of Appearance on Patient Satisfaction in Primary Rhinoplasty: a 12-Month Follow-up Prospective Study. Aesthetic Plast Surg 2024; 48:2269-2277. [PMID: 38200126 DOI: 10.1007/s00266-023-03803-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 12/07/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Rhinoplasty procedure has a strong impact on patient quality of life. Plastic surgery patients show a degree of appearance-related distress higher than general population, especially patients undergoing rhinoplasty. Relationship between patient-reported outcome after rhinoplasty and self-consciousness of appearance needs further studies. The aim of this study is to investigate this correlation, considering the surgeon external evaluation as well. MATERIALS AND METHODS A total of 50 consecutive patients underwent primary cosmetofunctional rhinoseptoplasty. Appearance-related distress and surgical outcome were assessed by DAS59 (Derriford Appearance Scale 59) and SCHNOS (Standardised Cosmesis and Health Nasal Outcomes Survey), administered before and after surgery. Follow-up period was 12 months. Third-party clinical outcome was evaluated by three plastic surgeons by a scale ranging from 1 (poor outcome) to 5 (excellent outcome). RESULTS A first division in Group 1 (satisfied) and Group 2 (unsatisfied) was done. DAS59 mean score in Group 1 showed to be statistically lower than Group 2 (p value < 0.05). Spearman's test showed a large strong positive correlation between preoperative and postoperative DAS59 and SCHNOS-C score variations (Delta 0-12 months) (r = 0.7514, p<0.001), as well as between DAS59 and SCHNOS-O (r = 0.5117, p<0.001) and between SCHNOS-C and SCHNOS-O (r = 0.6928, p<0.001). CONCLUSION Rhinoseptoplasty has a significant impact on the patient self-consciousness of appearance, in both negative and positive terms. We emphasize the surgeon's burden, who need to carefully assess and address the patient's expectations during the first evaluation. This distinction is crucial since unrealistic expectations may lead to dissatisfaction even after a properly performed procedure. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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Affiliation(s)
- Giovanni Francesco Marangi
- Department of Plastic, Reconstructive and Aesthetic Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, 00128, Rome, Italy
| | - Angelo Faiola
- Department of Plastic, Reconstructive and Aesthetic Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, 00128, Rome, Italy
| | - Andrea Aniello Cimmino
- Department of Plastic, Reconstructive and Aesthetic Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, 00128, Rome, Italy.
| | - Luca Savani
- Department of Plastic, Reconstructive and Aesthetic Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, 00128, Rome, Italy
| | - Carlo Mirra
- Department of Plastic, Reconstructive and Aesthetic Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, 00128, Rome, Italy
| | - Marco Gratteri
- Department of Plastic, Reconstructive and Aesthetic Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, 00128, Rome, Italy
| | - Maria Teresa Giuffrè
- Department of Plastic, Reconstructive and Aesthetic Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, 00128, Rome, Italy
| | - Francesco Segreto
- Department of Plastic, Reconstructive and Aesthetic Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, 00128, Rome, Italy
| | - Annalisa Cogliandro
- Department of Plastic, Reconstructive and Aesthetic Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, 00128, Rome, Italy
| | - Paolo Persichetti
- Department of Plastic, Reconstructive and Aesthetic Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, 00128, Rome, Italy
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Fuentes-López E, Galaz-Mella J, Ayala S, De la Fuente C, Luna-Monsalve M, Nieman C, Marcotti A. Association between the home-to-healthcare center distance and hearing aid abandonment among older adults. Front Public Health 2024; 12:1364000. [PMID: 38873313 PMCID: PMC11169842 DOI: 10.3389/fpubh.2024.1364000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 05/01/2024] [Indexed: 06/15/2024] Open
Abstract
Background Access to audiology services for older adults residing in sparsely populated regions is often limited compared to those in central urban areas. The geographic accessibility to follow-up care, particularly the influence of distance, may contribute to an increased risk of hearing aid abandonment. Objective To assess the association between the home-to-healthcare-calibration-center distance and hearing aid abandonment among older adults fitted in the Chilean public health system. Methods 455 patients who received hearing aids from two public hospitals in two regions were considered. Univariate and multivariate Poisson regression models with robust variance estimation were used to analyze the association between the geographical distance and hearing aid abandonment, accounting for confounding effects. Results Approximately 18% of the sample abandoned the hearing aid, and around 50% reported using the hearing aid every day. A twofold increase in distance between home and the hearing center yielded a 35% (RR = 1.35; 95% CI: 1.04-1.74; p = 0.022) increased risk of hearing aid abandonment. Also, those in the second quintile had a 2.17 times the risk of abandoning the hearing aid compared to the first quintile (up to 2.3 km). Under the assumption that patients reside within the first quintile of distance, a potential reduction of 45% in the incidence of hearing aid abandonment would be observed. The observed risk remained consistent across different statistical models to assess sensitivity. Conclusion A higher distance between the residence and the healthcare center increases hearing aid abandonment risk. The association may be explained by barriers in purchasing supplies required to maintain the device (batteries, cleaning elements, potential repairs, or maintenance).
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Affiliation(s)
- Eduardo Fuentes-López
- Departamento de Fonoaudiología, Escuela de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Javier Galaz-Mella
- Faculty of Rehabilitation Sciences, School of Speech Therapy, Exercise and Rehabilitation Sciences Institute, Universidad Andres Bello, Santiago, Chile
| | - Salvador Ayala
- Escuela de Odontología, Facultad de Odontología y Ciencias de la Rehabilitación, Universidad San Sebastián, Santiago, Chile
| | - Carlos De la Fuente
- Exercise and Rehabilitation Sciences Institute, Postgraduate, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
| | - Manuel Luna-Monsalve
- Escuela de Fonoaudiología, Facultad de Odontología y Ciencias de la Rehabilitación, Universidad San Sebastián, Santiago, Chile
| | - Carrie Nieman
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, United States
- Cochlear Center for Hearing & Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Anthony Marcotti
- Escuela de Fonoaudiología, Facultad de Odontología y Ciencias de la Rehabilitación, Universidad San Sebastián, Santiago, Chile
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Derks LSM, Smit AL, Thomeer HGXM, Topsakal V, Grolman W, Stokroos RJ, Wegner I. Quality of life, hearing results, patient satisfaction and postoperative complications of day-case versus inpatient unilateral cochlear implantation in adults: a randomized controlled, equivalence trial. Eur Arch Otorhinolaryngol 2024; 281:2313-2325. [PMID: 38180606 PMCID: PMC11023990 DOI: 10.1007/s00405-023-08352-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 11/13/2023] [Indexed: 01/06/2024]
Abstract
OBJECTIVE To investigate the hypothesis that day-case cochlear implantation is associated with equal quality of life, hearing benefits and complications rates, compared to inpatient cochlear implantation. STUDY DESIGN A single-center, non-blinded, randomized controlled, equivalence trial in a tertiary referral center. METHODS Thirty adult patients with post-lingual bilateral sensorineural hearing loss eligible for unilateral cochlear implantation surgery were randomly assigned to either the day-case or inpatient treatment group. The effect on general quality of life, patient satisfaction, (subjective) hearing improvement, postoperative complications and causes of crossover and/or readmission were assessed using questionnaires, auditory evaluations and patients' charts over a follow-up period of 1 year. RESULTS Overall quality of life measured by the HUI3 was equal between the day-case (n = 14) and inpatient group (n = 14). The overall patients' satisfaction showed a slight favor towards an inpatient approach. There was no significant difference in the subjective and objective hearing improvement between both treatment groups. During the 1-year follow-up period no major complications occurred. Minor complications occurred intraoperatively in three day-case patients resulting in three out of nine admissions of day-case patients. Other causes of admission of day-case patients were nausea and vomiting (n = 1), drowsiness (n = 1), late scheduled surgery (n = 2), social reasons (n = 1), or due to an unclear reason (n = 1). No patients required readmission. CONCLUSION We found equal outcomes of QoL, patient satisfaction, objective, and subjective hearing outcomes between day-case and inpatient unilateral cochlear implantation. Nine out of 14 day-case patients were admitted for at least one night postoperatively (crossover). No major complications occurred in both groups. A day-case approach seems feasible when using specific patient selection, surgical planning and the preoperative provision of patient information into account. Besides this, the familiarity with a day-case approach of both patient and the surgical team can increase the feasibility of day-case surgery. LEVEL OF EVIDENCE: 1
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Affiliation(s)
- Laura S M Derks
- Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, G05.129, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Adriana L Smit
- Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, G05.129, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Hans G X M Thomeer
- Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, G05.129, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Vedat Topsakal
- University Department Otorhinolaryngology, Head & Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
- Faculty of Medicine and Health Sciences, Antwerp University, Antwerp, Belgium
| | - Wilko Grolman
- Jean Causse Ear Clinic, Traverse de Béziers, Colombiers, France
| | - Robert J Stokroos
- Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, G05.129, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Inge Wegner
- Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Groningen, Groningen, The Netherlands
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15
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Thomas M, Scheer M, Rampp S, Strauss C, Schönfeld R, Leplow B. Psychological factors and long-term tinnitus handicap in vestibular schwannoma patients after retrosigmoid microsurgery - a cross-sectional study. Int J Audiol 2024:1-8. [PMID: 38613519 DOI: 10.1080/14992027.2024.2339351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 04/01/2024] [Indexed: 04/15/2024]
Abstract
OBJECTIVE This study aimed to investigate the connection between psychological factors and postoperative tinnitus in vestibular schwannoma (VS) patients following retrosigmoid microsurgery. DESIGN Cross-sectional study. STUDY SAMPLE Ninety-three VS patients participated, completing questionnaires on demographics, tinnitus severity (THI-12), personality traits (TIPI-G), dizziness impact (DHI), perceived health benefits (GBI), somatisation tendencies (SOMS-2), and psychological distress (HADS-D). Our analysis involved Mann-Whitney U-tests, Spearman's rank-order correlations, and false discovery rate correction. RESULTS Most participants reported postoperative tinnitus (77/93), with 41 experiencing it preoperatively. Emotional stability correlated negatively with tinnitus presence, while tinnitus severity was associated with emotional distress. Preoperative somatisation tendencies were also positively linked to tinnitus severity. Postoperative Tinnitus was further linked to reduced perceived health benefits and increased anxiety and depression levels. Notably, age and gender showed no significant associations. CONCLUSION This study uncovers the interplay between postoperative tinnitus and psychological factors in VS patients, highlighting emotional and cognitive dimensions. Tailored psychological interventions addressing tinnitus's psychosomatic impact may enhance patients quality of life.
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Affiliation(s)
- M Thomas
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Scheer
- Department of Neurosurgery, University Hospital Halle, Halle, Germany
| | - S Rampp
- Department of Neurosurgery, University Hospital Halle, Halle, Germany
- Department of Neurosurgery, University Hospital Erlangen, Erlangen, Germany
- Department of Neuroradiology, University Hospital Erlangen, Erlangen, Germany
| | - C Strauss
- Department of Neurosurgery, University Hospital Halle, Halle, Germany
| | - R Schönfeld
- Department of Psychology, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
| | - B Leplow
- Department of Psychology, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany
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16
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Dahlin Redfors Y, Björsne A, Finizia C. Psychometric properties of the Swedish version of the international outcome inventory - alternative interventions (IOI-AI) - ear surgery (IOI-AI op). Int J Audiol 2024:1-8. [PMID: 38587069 DOI: 10.1080/14992027.2024.2332774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 03/11/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVE The aims of this study were to adapt the Swedish version of the International Outcome Inventory for Hearing Aids (IOI-HA) to the International Outcome Inventory for Alternative Interventions (IOI-AI) in the context of ear surgery (IOI-AIop) and to test the psychometric properties. DESIGN The validated Swedish questionnaire IOI-HA was adapted to the IOI-AIop by omitting the question about hearing aid use and changing the term "hearing aid" to "surgery" in the remaining items. The validity, component structure and reliability of the IOI-AIop were assessed. STUDY SAMPLE Subjects diagnosed with otosclerosis and undergoing stapedotomy were included in the study (n = 162). RESULTS High mean scores were noted for all items. Ceiling effects were noted, most pronounced for the satisfaction item. Principal component analysis (PCA) yielded a two-component structure explaining 77.5% of the variance. The test-retest reliability measured by intra class correlation coefficient was >0.9, and the internal consistency coefficient measured by Cronbach's alfa was >0.8. CONCLUSION The IOI-AIop showed good psychometric properties. However, ceiling effects were observed. The two-component solution was in line with previous factor analyses of the IOI-HA and the IOI-AI. The comprehensive IOI-AIop is recommended as a useful tool to evaluate patient perspectives after ear surgery.
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Affiliation(s)
- Ylva Dahlin Redfors
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Otorhinolaryngology, Head and Neck Surgery, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Andreas Björsne
- Department of Otorhinolaryngology, Head and Neck Surgery, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
- Unit of Audiology, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
- Hearing Organization, Habilitation & Health, Region Västra Götaland, Gothenburg, Sweden
| | - Caterina Finizia
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Otorhinolaryngology, Head and Neck Surgery, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
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17
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Brewer DM, Bernstein CM, Calandrillo D, Muscato N, Introcaso K, Bosworth C, Olson A, Vovos R, Stillitano G, Sydlowski S. Teledelivery of Aural Rehabilitation to Improve Cochlear Implant Outcomes. Laryngoscope 2024; 134:1861-1867. [PMID: 37688797 DOI: 10.1002/lary.31031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/16/2023] [Accepted: 08/14/2023] [Indexed: 09/11/2023]
Abstract
OBJECTIVE(S) This randomized controlled study evaluated the effectiveness of a Telehealth Aural Rehabilitation (TeleAR) training protocol to improve outcomes for adult cochlear implant (CI) users. METHODS This was a multisite clinical study with participants randomized to either an AR treatment or active control group. The AR protocol consisted of auditory training (words, sentences, and speech tracking), informational counseling, and communication strategies. The control group participants engaged in cognitive stimulation activities (crosswords, sudoku, etc.). Each group completed 6 weekly 90-min individual treatment sessions delivered remotely. Twenty postlingually deafened adult CI users participated. Assessments were completed pretreatment and 1 week and 2 months posttreatment. RESULTS Repeated-measures ANOVA and planned contrasts were used to compare group performance on AzBio Sentences, Hearing Handicap Inventory (HHI), Client Oriented Scale of Improvement (COSI), and Glasgow Benefit Inventory (GBI). The two groups were statistically equivalent on all outcome measures at pre-assessment. There was a statistically significant main effect of time for all measures. Improvement over time was observed for participants in both groups, with greater improvement seen for the AR than the CT group on all outcome measures. The AR group showed medium to large effect sizes on all measures over time, suggesting clinically significant outcomes. CONCLUSION This randomized controlled study provides evidence of improved speech recognition and psychosocial outcomes following 6 weeks of TeleAR intervention. For adult post-lingually deafened CI users, including those >3 months post-activation, AR treatment can leverage neuroplasticity to maximize outcomes. LEVEL OF EVIDENCE 2 Laryngoscope, 134:1861-1867, 2024.
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Affiliation(s)
- Diane Majerus Brewer
- Department of Speech, Language and Hearing Sciences, George Washington University, Washington, DC, U.S.A
| | - Claire Marcus Bernstein
- Department of Hearing, Speech, and Language Sciences, Gallaudet University, Washington, DC, U.S.A
| | - Dominique Calandrillo
- Department of Hearing, Speech, and Language Sciences, Gallaudet University, Washington, DC, U.S.A
| | - Nancy Muscato
- Department of Communication Sciences and Disorders, University of South Florida, Tampa, Florida, U.S.A
| | - Kailey Introcaso
- Department of Communication Sciences and Disorders, University of South Florida, Tampa, Florida, U.S.A
| | - Cassandra Bosworth
- Audiology and Speech Pathology in Department of Otolaryngology, Columbia University Irving Medical Center, New York City, New York, U.S.A
| | - Anne Olson
- Communication Sciences and Disorders, University of Kentucky College of Health Sciences, Lexington, Kentucky, U.S.A
| | - Rachel Vovos
- The Cleveland Clinic, Hearing Implant Program, Cleveland, Ohio, U.S.A
| | - Gina Stillitano
- The Cleveland Clinic, Hearing Implant Program, Cleveland, Ohio, U.S.A
| | - Sarah Sydlowski
- The Cleveland Clinic, Hearing Implant Program, Cleveland, Ohio, U.S.A
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18
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Aliyeva A, Yagız O, Ceylan ME. Otoplasty in Adults: Psychological Impacts on Quality of Life. Indian J Otolaryngol Head Neck Surg 2024; 76:1481-1490. [PMID: 38566726 PMCID: PMC10982276 DOI: 10.1007/s12070-023-04296-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 10/15/2023] [Indexed: 04/04/2024] Open
Abstract
Psychological distress, emotional trauma, and behavioral problems related to prominent ears can cause complicated situations in children and adults. This study aimed to investigate the changes in the psychological impact on quality of life after Otoplasty. The study used several measures, including the Glasgow Benefit Inventory, Social Appearance Anxiety Scale (SAAS), Body Image Scale (BIS), Rosenberg Self-Esteem Scale (RSES), and Visual Analogue Score (VAS), which were completed before and six months after the surgery. The GBI questionnaire was used to detect the health-related quality of life changes after Otoplasty, as it is a reliable, valid, and responsive measure. Six months after the surgery, BIS total scores, VAS scores, and SAAS scores decreased significantly, while RSES scores were not significantly different. These results suggest that Otoplasty can significantly impact adult patients' psychological well-being and quality of life and that the surgery should be considered regardless of age.
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Affiliation(s)
- Aynur Aliyeva
- The Diviont of the Otorhinolaryngology-Head and Neck Surgery, Cincinnati Children’s Hospital, Cincinnati, OH USA
- Neuroscience Doctoral Program, Yeditepe University, Istanbul, Turkey
| | - Ozlem Yagız
- The Department of Otorhinolaryngology, Head and Neck Surgery, University of Health Sciences Izmir Tepecik Research and Training Hospital, Izmir, Turkey
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Wazen JJ, Kim CS, Ortega C, King T, Schwartz SR, Zeitler DM. Benefits of unilateral cochlear implantation in adults with asymmetric hearing loss: Audiologic and patient-related outcome measures. Am J Otolaryngol 2024; 45:104138. [PMID: 38101137 DOI: 10.1016/j.amjoto.2023.104138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/03/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE To investigate the benefits of cochlear implantation in adults with single-sided deafness (SSD) and asymmetric hearing loss (AHL). STUDY DESIGN Prospective within-subjects repeated-measures. SETTING Two tertiary cochlear implant centers. PATIENTS Fourteen adults with severe-to-profound sensorineural hearing loss in the worse hearing ear and up to moderate SNHL in the better hearing ear. INTERVENTION Cochlear implantation in the worse hearing ear. MAIN OUTCOME MEASURES Consonant-nucleus-consonant (CNC) test, AzBio sentence test in noise, and lateralization testing were conducted preoperatively and at 3-, 6-, and 12-months post-activation. Patient-related outcomes were measured using the Speech, Spatial, and Qualities of Hearing Scale and Glasgow Benefit Inventory. Tinnitus Handicap Inventory was administered to subjects with tinnitus. RESULTS Mean length of hearing loss in the worse hearing ear was 3.5 years. The mean CNC change scores from baseline were 54.8, 55.9, and 58.9 percentage points at 3-, 6-, and 12-months (p < 0.001). AzBio sentence test in noise demonstrated improved scores in all spatial configurations, although statistically significant in S0N0 (speech front, noise front) only. Lateralization testing showed significant improvement of 22.9, 24.5, and 24.0 percentage points at 3-, 6-, and 12 months post-activation (p = 0.002). All patient-related outcome measures revealed significant improvement. CONCLUSION This study demonstrates improved speech perception in noise, sound lateralization, quality of life, and reduction in tinnitus perception in adults with SSD/AHL who undergo cochlear implantation. Our results add to the growing body of evidence that cochlear implant should be offered to this population.
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Affiliation(s)
- Jack J Wazen
- First Physicians Group Silverstein Institute, 1901 Floyd Street, Sarasota, FL 34239, United States of America
| | - Christine S Kim
- First Physicians Group Silverstein Institute, 1901 Floyd Street, Sarasota, FL 34239, United States of America.
| | - Carmelo Ortega
- First Physicians Group Silverstein Institute, 1901 Floyd Street, Sarasota, FL 34239, United States of America
| | - Tonya King
- Sarasota Memorial Hospital Research Institute, 1700 South Tamiami Trail, Sarasota, FL 34239, United States of America
| | - Seth R Schwartz
- Virginia Mason Medical Center, 1100 Ninth Avenue, Seattle, WA 98101, United States of America
| | - Daniel M Zeitler
- Virginia Mason Medical Center, 1100 Ninth Avenue, Seattle, WA 98101, United States of America
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Gutierrez JA, Shannon CM, Nguyen SA, Meyer TA, Lambert PR. Comparison of Quality of Life Outcomes for Percutaneous Versus Transcutaneous Implantable Hearing Devices: A Systematic Review and Meta-analysis. Otol Neurotol 2024; 45:e129-e136. [PMID: 38270194 DOI: 10.1097/mao.0000000000004111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
OBJECTIVE To compare quality of life (QOL) outcomes of percutaneous and transcutaneous bone conduction devices (pBCD and tBCD, respectively). DATABASES REVIEWED Pubmed, Scopus, CINAHL. METHODS A systematic review was performed searching for English language articles from inception to March 15, 2023. Studies reporting QOL outcomes measured using a validated tool following implantation of either pBCDs or tBCDs were considered for inclusion. QOL outcomes included scores for Glasgow Benefit Inventory, Glasgow Children's Benefit Inventory, Abbreviated Profile of Hearing Aid Benefit, and the Speech, Spatial, and Qualities of Hearing Scale. A meta-analysis of continuous measures was performed. RESULTS A total of 52 articles with 1,469 patients were included. Six hundred eighty-nine patients were implanted with pBCDs, and the remaining 780 were implanted with tBCDs. Average Glasgow Benefit Inventory scores for the tBCD group (33.0, 95% confidence interval [22.7-43.3]) were significantly higher than the pBCD group (30.9 [25.2-36.6]) (Δ2.1 [1.4-2.8], p < 0.0001). Mean Glasgow Children's Benefit Inventory scores (Δ3.9 [2.0-5.8], p = 0.0001) and mean gain in Abbreviated Profile of Hearing Aid Benefit scores (Δ5.6 [4.8-6.4], p < 0.0001) were significantly higher among patients implanted with tBCDs than those implanted with pBCDs. Patients implanted with tBCDs also had significantly higher gains on the Speech (Δ1.1 [0.9-1.3], p < 0.0001), Spatial (Δ0.8 [0.7-0.9], p < 0.0001), and Qualities of Hearing (Δ1.2 [1.1-1.3], p < 0.0001) portions of the Speech, Spatial, and Qualities of Hearing Scale than those implanted with pBCDs. CONCLUSIONS Patients implanted with transcutaneous devices had better QOL outcomes than those implanted with percutaneous devices.
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Affiliation(s)
- Jorge A Gutierrez
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC
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21
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Lindeboom JJ, Labbé N, Strijbos RM, van den Elsen-Hutten M, van Huffelen W, Teunissen EM, Hol MKS, Bom SJH. Long-Term Results of the Linear Incision Technique With Tissue Reduction Versus Tissue Preservation for Inserting Bone-Anchored Hearing Implants: The Ongoing Optimization in Bone Implant Surgery. Otol Neurotol 2024; 45:285-294. [PMID: 38361296 DOI: 10.1097/mao.0000000000004101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
OBJECTIVE To compare the long-term outcomes of the linear incision technique with tissue reduction (LIT-TR) and the linear incision technique with tissue preservation (LIT-TP) for inserting bone-anchored hearing implants (BAHIs). STUDY DESIGN Single-center retrospective cohort study. SETTING Large general teaching hospital. PATIENTS A total of 231 adult patients were included between August 2005 and October 2020, with a minimum follow-up time of 6 months. INTERVENTION The test group received a BAHI using the LIT-TP (N = 147). The control group underwent surgery using the LIT-TR (N = 84). MAIN OUTCOME MEASURES Soft tissue reactions, skin thickening, postoperative complications (e.g., wound dehiscence), and implant loss were compared between the test and control group. Furthermore, Cochlear Bone Anchored Solutions AB (Mölnlycke, Sweden) and Oticon Medical AB (Askim, Sweden) implants/abutments within the LIT-TP cohort were compared. Validated questionnaires were used to quantify patients' health-related quality of life (HRQoL). RESULTS Significantly more cases with wound dehiscence and adverse soft tissue reactions (Holgers ≥2) were observed in the LIT-TR cohort (p < 0.001). However, the LIT-TP cohort showed significantly more cases with skin thickening (requiring treatment) within the first 2 years after implantation. There were no differences in implant loss rates, overall soft tissue reactions (Holgers >1), and overall HRQoL between the two patient groups. Significant improvement in the patients' HRQoL after implementation of a BAHI was found in both techniques. The Ponto Wide implant/abutment showed less frequent skin thickening (requiring treatment) and fewer soft tissue reactions compared with the BIA400 implant/abutment. CONCLUSION This large-scale study demonstrates that the LIT-TP shows excellent long-term outcomes, including a low incidence of implant failure.
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Affiliation(s)
| | - Nilou Labbé
- Department of Otorhinolaryngology, Deventer Hospital
| | | | | | | | - Emma M Teunissen
- Department of Otorhinolaryngology, Donders Center for Neurosciences, Radboud University Medical Center, Nijmegen
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22
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Doran MA, Ayintap E, Aytogan H. Evaluation of the relationship between tear meniscus changes and quality of life outcomes after external dacryocystorhinostomy. Int Ophthalmol 2024; 44:105. [PMID: 38378968 DOI: 10.1007/s10792-024-03038-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/12/2024] [Indexed: 02/22/2024]
Abstract
PURPOSE This study aims to investigate the effects of external dacryocystorhinostomy (DCR) surgery on tear meniscus parameters and assess its relationship with improvements in quality of life (QoL) in patients with nasolacrimal duct obstruction (NLDO). METHODS This prospective study included 30 patients diagnosed with NLDO who underwent external DCR surgery. Tear meniscus (TM) parameters, including height, depth and area, were measured using anterior segment optical coherence tomography. Lacrimal symptom questionnaire (LacQ), Munk scores and Glasgow benefit inventories (GBI) were collected. Statistical analysis was performed to evaluate the correlation between tear meniscus changes and improvements in QoL. RESULTS TM height, depth and area decreased from preoperative median measurements (0.09 mm2, 0.37 mm, 0.56 mm) to postoperative median measurements (0.03 mm2, 0.21 mm, 0.30 mm) (p < 0.001). Lacrimal symptom scores and Munk scores showed a significant improvement at 3-month postoperatively (p < 0.001). The GBI scores also demonstrated a significant improvement, indicating a positive impact on the patients' QoL. (p < 0.001). A statistically significant correlation was found between the change in TM parameters and LacQ lacrimal symptom scores. CONCLUSION External DCR surgery leads to significant improvements in tear meniscus parameters and quality of life outcomes in patients with NLDO. The decreased in TM height and TM area indicates improved tear film dynamics and decreased tear volume, which positively impact the patients' ocular comfort and overall well-being. This study highlights the importance of tear meniscus evaluation as a potential market for assessing the success of DCR surgery and its impact on patients' QoL.
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Affiliation(s)
- Mehmet Ali Doran
- Department of Ophthalmology, Republic of Turkey Health Sciences University Izmir Tepecik Training and Research Hospital, Izmir, Turkey.
| | - Emre Ayintap
- Department of Ophthalmology, Republic of Turkey Health Sciences University Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Hasan Aytogan
- Department of Ophthalmology, Republic of Turkey Health Sciences University Izmir Tepecik Training and Research Hospital, Izmir, Turkey
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23
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Anwar Z, McLeod NMH, Van den Bosch P, Cairns M. A review of the use of patient reported outcome measures (PROMS) in temporomandibular joint (TMJ) surgery. J Craniomaxillofac Surg 2024; 52:181-187. [PMID: 38143160 DOI: 10.1016/j.jcms.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 10/09/2023] [Accepted: 11/23/2023] [Indexed: 12/26/2023] Open
Abstract
Temporomandibular joint (TMJ) surgery accounts for a significant number of patient episodes in oral and maxillofacial surgery, and treatment effectiveness is commonly assessed using measures of pain and mouth opening. Patient-reported outcome measures (PROMs) enable assessment of the patient's perspective and perception of the diseases and treatment outcomes. The purpose of this review was to assess the use of PROMs in TMJ surgery. A review of 3 databases (PubMed, OVID, Trip) was carried out to assess the use of PROMs when reporting on TMJ surgical interventions. Studies were limited to the English language, involving humans and at least one surgical intervention of the TMJ. A total of 214 articles met the inclusion and exclusion criteria, of which only 28 used 18 PROMs among them. Half of these PROMs were single-question visual analogue scales or Likert scales on quality of life and disability. The Oral Health Impact Profile and the Helkimo Clinical Dysfunction Index were the second most used (n = 3). PROMs were used most in studies on internal derangement (n = 9) and in cohort study designs (n = 26), but this was not statistically significant. In the majority of research on TMJ surgery, no PROMs are used, and when one is, there is a tendency to use weaker single-question PROMs as opposed to multi-question PROMs to assess outcomes. With the increasing importance of PROMs for assessing patients' perception of treatment outcomes, further research is needed to establish valid and reproducible PROMs for TMJ surgery.
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Affiliation(s)
- Zuhair Anwar
- Department of Oral and Maxillofacial Surgery, Barts Health NHS trust, UK.
| | - Niall M H McLeod
- Department of Oral & Maxillofacial Surgery, University Hospitals Coventry and Warwickshire, UK; Department of Oral and Maxillofacial Surgery, Barts Health NHS trust, UK.
| | - Peter Van den Bosch
- Department of Oral and Maxillofacial Surgery, Manchester Foundation Trust, UK.
| | - Mark Cairns
- Department of Oral and Maxillofacial Surgery, Barts Health NHS trust, UK.
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24
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Koro E, Lundgren E, Smeds H, Werner M. Long-Term Follow-Up in Active Transcutaneous Bone Conduction Implants. Otol Neurotol 2024; 45:58-64. [PMID: 38085764 DOI: 10.1097/mao.0000000000004057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
OBJECTIVE To evaluate long-term outcomes of active transcutaneous bone conduction implants (atBCIs) regarding safety, hearing, and quality of life. STUDY DESIGN A clinical study with retrospective medical record analysis combined with prospective audiometry and quality of life questionnaires. SETTING Three secondary to tertiary care hospitals. PATIENTS All subjects operated with an atBCI in three regions in Sweden were asked for informed consent. Indications for atBCI were single-sided deafness (SSD) and conductive or mixed hearing loss (CMHL). INTERVENTION Evaluation of atBCI. MAIN OUTCOME MEASURES Pure tone and speech audiometry and Glasgow Benefit Inventory (GBI). RESULT Thirty-three subjects were included and 29 completed all parts. The total follow-up time was 124.1 subject-years. Nineteen subjects had CMHL and in this group, pure tone averages (PTA4) were 56.6 dB HL unaided and 29.6 dB HL aided, comparable with a functional gain of 26.0 dB. Effective gain (EG) was -12.7 dB. With bilateral hearing, Word Recognition Scores (WRS) in noise were 36.5% unaided and 59.1% aided. Fourteen subjects had SSD or asymmetric hearing loss (AHL) and in this group, PTA4 were >100 dB HL unaided and 32.1 dB HL aided with the contralateral ear blocked. EG was -9.1 dB. With bilateral hearing, WRSs were 53.2% unaided and 67.9% aided. The means of the total GBI scores were 31.7 for CMHL and 23.6 for SSD/AHL. CONCLUSION Few complications occurred during the study. The atBCI is concluded to provide a safe and effective long-term hearing rehabilitation.
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Affiliation(s)
- Eleonor Koro
- Department of Clinical Sciences, Otorhinolaryngology, University of Umeå, Umeå, Sweden
| | - Elenor Lundgren
- Department of Clinical Sciences, Otorhinolaryngology, University of Umeå, Umeå, Sweden
| | - Henrik Smeds
- Department of Clinical Science, Intervention and Technology, Division of ENT Diseases, Karolinska Institute, Stockholm, Sweden
| | - Mimmi Werner
- Department of Clinical Sciences, Otorhinolaryngology, University of Umeå, Umeå, Sweden
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25
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Gong AJ, Garg T, Khalil A, Gowda PC, Mathai SC, Rowan NR, Merlo CA, Weiss CR. Health-Related Quality of Life Outcome Measures in Individuals With Hereditary Hemorrhagic Telangiectasia: A Scoping Review. Am J Rhinol Allergy 2024; 38:60-76. [PMID: 37855028 DOI: 10.1177/19458924231207123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
BACKGROUND Studies evaluating health-related quality of life (HRQOL) in patients with hereditary hemorrhagic telangiectasia (HHT) have expanded rapidly in the past decade. These studies have evaluated QOL aspects ranging from the general QOL for patients living with HHT to intervention-specific outcomes. However, few tools have been fully validated across the spectrum of disease manifestations and interventions in HHT. OBJECTIVE In this scoping review, we aim to map the literature on HHT-QOL metrics, identify gaps, inform future QOL research, and facilitate future metric development. METHODS We analyzed articles in English that assessed at least 1 measure of general HRQOL, including physical health, mental health, social health, or intervention-specific QOL in patients with HHT. Searches across 2 bibliographic databases (PubMed and Scopus) yielded 186 articles after duplicates were removed. Sixty-three studies met eligibility criteria: 22 prospective studies (34.9%), 20 retrospective studies (31.7%), 12 cross-sectional studies (17.5%), 6 randomized controlled trials or secondary analyses of a randomized controlled trials (9.5%), 2 qualitative studies (3.2%), and 1 case-control study (1.6%). Two additional studies-1 prospective and 1 cross-sectional study-were identified at the October 2022 14th International HHT Conference and included, making a total of 65 studies. RESULTS The 65 eligible studies used 30 QOL instruments. Twenty studies characterized baseline HRQOL, and 45 studies evaluated QOL before and after treatment. Of those 45 studies, 37 evaluated HRQOL before and after therapies targeting epistaxis and nasal symptoms, 4 targeted therapies for liver arteriovenous malformations and high-output heart failure, 3 evaluated therapies for both epistaxis and gastrointestinal bleeding, and 1 evaluated treatment targeting gastrointestinal bleeding alone. CONCLUSIONS Comparison of results across studies remains challenging given the heterogeneity in outcomes measures. Further development of HHT-specific patient-reported outcomes instruments that capture the global illness experience of HHT is needed.
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Affiliation(s)
- Anna J Gong
- Division of Interventional Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Tushar Garg
- Division of Interventional Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Adham Khalil
- Division of Interventional Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Prateek C Gowda
- Division of Interventional Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Stephen C Mathai
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nicholas R Rowan
- Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Christian A Merlo
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Clifford R Weiss
- Division of Interventional Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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26
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Houborg HI, Klug TE. Evaluation of Guidelines For Tonsillectomy in Adults With Recurrent Acute Tonsillitis. Ann Otol Rhinol Laryngol 2023; 132:1573-1583. [PMID: 37183925 DOI: 10.1177/00034894231173481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
OBJECTIVES The criteria for selecting patients with recurrent acute tonsillitis (RT) for tonsillectomy remain unsettled and different guidelines are used internationally. We aimed to evaluate currently used guidelines for tonsillectomy in adults with RT and identify the best predictive parameters for improved throat-related quality of life (TR-QOL) after surgery. METHODS About 66 RT patients undergoing tonsillectomy was prospectively included and categorized into 3 groups based on which guideline(s) they met: Group 1: patients not meeting any of the Danish/Paradise/Scottish Intercollegiate Guideline Network (SIGN) guidelines. Group 2: patients meeting the Danish guidelines. Group 3: patients meeting the Paradise and/or the SIGN guidelines. TR-QOL was assessed using the Tonsillectomy Outcome Inventory 14 (TOI-14) before and 6 months after tonsillectomy as well as the Glasgow Benefit Inventory (GBI). Predictive parameters for improved TR-QOL were investigated using multiple linear regression. RESULTS About 61 (92%) patients completed the questionnaires. Patients in all groups had significant TR-QOL improvements (Group 1 (n = 20): ΔTOI-14 31.1; GBI 29.4; Group 2 (n = 31): ΔTOI-14 32.0; GBI 36.4; Group 3 (n = 10): ΔTOI-14 45.6; GBI 39.7) and satisfaction rates were high (94%-100%). Preoperative TOI-14 score was the best predictor for improved TR-QOL (P < .001, R2 = .80), followed by the number of tonsillitis episodes with physician verification within the previous 12 months (P = .002, R2 = .25). CONCLUSIONS Patients in all groups experienced massive TR-QOL improvements suggesting that currently used guidelines may be too restrictive. Preoperative TOI-14 score was the best parameter for predicting TR-QOL improvement, and this tool may be useful in the selection of adults with RT for tonsillectomy.
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Affiliation(s)
- Hannah Inez Houborg
- Department of Otorhinolaryngology, Head and Neck Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Tejs Ehlers Klug
- Department of Otorhinolaryngology, Head and Neck Surgery, Aarhus University Hospital, Aarhus, Denmark
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27
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Taylor CM, Marino MJ, Bansberg SF. Septal Perforation Repair Quality of Life Outcomes Using the Revised 15-item Glasgow Benefit Inventory. Ann Otol Rhinol Laryngol 2023; 132:1550-1556. [PMID: 37157824 DOI: 10.1177/00034894231170938] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
BACKGROUND The 18-item Glasgow Benefit Inventory (GBI) has been widely used to measure patient general health response to otorhinolaryngologic and facial plastic interventions. The GBI was recently reorganized into 15 questions with 5 sub-scale factors (GBI-5F) to improve its utility. Application of the GBI-5F to septal perforation treatments may improve our understanding of quality of life outcomes. METHODOLOGY/PRINCIPAL The GBI was given to patients seen from August 2018 through October 2021 who were at least 6 months postoperative attempted perforation surgical closure using bilateral nasal mucosal flaps with an interposition graft. Original GBI and GBI-5F scores were computed and subgroup analysis performed in this retrospective medical record review. RESULTS Of the 98 patients (mean age 45.5 years) who met study criteria, 65 were female. Mean perforation length was 12.9, and height 9.7 mm. The mean postoperative time to GBI completion was 12.7 months. Highest GBI-5F scores were noted in the Quality of Life factor, followed by Self-confidence and Social Involvement. Females reported significantly higher scores than men. Total GBI scores were similar to those recorded for other rhinologic procedures. CONCLUSIONS The GBI-5F provides measurable insight into patient quality of life benefit following septal perforation repair.
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Affiliation(s)
- Cullen M Taylor
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Phoenix, AZ, USA
| | - Michael J Marino
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Phoenix, AZ, USA
| | - Stephen F Bansberg
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Phoenix, AZ, USA
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28
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Fuentes-López E, Fuente A, Luna-Monsalve M, Cañete OM. Social determinants of health associated with attitudes towards hearing loss and hearing aids in older adults fitted in a Latin American country: validation of the ALHQ questionnaire into Spanish. Int J Audiol 2023; 62:927-937. [PMID: 35834435 DOI: 10.1080/14992027.2022.2097133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 06/28/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE This study aimed to evaluate the association between certain social determinants of health (i.e. educational level, income, and social support) and attitudes towards hearing loss and hearing aids among older adults with hearing loss fitted in a Latin American country. DESIGN Older adults were asked about their attitudes towards hearing loss and hearing aids, years of formal education, income, social support, perception of having a hearing disability, and social pressure when using the hearing aid. To do so, we adapted the Attitudes towards Loss of Hearing Questionnaire (S-ALHQ) into Spanish. All the questionnaires were conducted as structured interview. STUDY SAMPLE Two hundred fifty-two older hearing aids users were recruited from a public hospital in Chile. RESULTS The S-ALHQ showed adequate validity, along with good reliability. The multivariate models showed that educational level and social support were the social determinants of health negatively associated with the attitudes. Aided hearing disability and social pressure to use hearing aids were the co-variables associated with S-ALHQ scores. CONCLUSIONS The study showed a significant relationship between specific social determinants of health and attitudes towards hearing loss and hearing aids. These attitudes should be considered when implementing rehabilitation programs for older adults with hearing loss.
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Affiliation(s)
- Eduardo Fuentes-López
- Carrera de Fonoaudiología, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Adrian Fuente
- École d'orthophonie et d'audiologie, Faculté de médecine, Université de Montréal, Montréal, Canada
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, Canada
| | - Manuel Luna-Monsalve
- Escuela de Fonoaudiología, Facultad de Ciencias de la Salud, Universidad San Sebastián, Santiago, Chile
| | - Oscar M Cañete
- Research Unit for ORL - Head and Neck Surgery and Audiology, Odense University Hospital and University of Southern Denmark, Odense, Denmark
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29
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McIlveen EC, Edwards J, Vella M, McKinlay L, Hancock C, Quasim T, Moug SJ. Patient-reported impact of emergency laparotomy on employment and health status 1 year after surgery. Langenbecks Arch Surg 2023; 408:378. [PMID: 37749405 DOI: 10.1007/s00423-023-03104-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 09/09/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND Whilst there has been significant improvement in mortality outcomes after emergency laparotomy, there is little information on longer term outcomes in the year after discharge. The main aim of the study was to assess the impact that an emergency laparotomy has on patients' and employment and health status 1 year after surgery. METHODS This study was a questionnaire study conducted in a single centre district general hospital of patients who had undergone an emergency laparotomy between October 2015 and December 2016. Patients were included according to the National Emergency Laparotomy Audit criteria. At screening, patients who were alive at 1 year and had the capacity to consent were approached between January and December 2017. Patients underwent a researcher-led telephone interview using a semi-structured questionnaire to assess the impact of emergency laparotomy on overall, general and physical health (Glasgow Benefit Inventory) as well as employment status. The symptoms that patients experienced and their impact were also recorded. RESULTS Forty-two patients responded to and completed the questionnaire. Just over one-third of patients experienced a deterioration in their general or physical health and 21% of patients experienced a change in employment. Factors which significantly impacted on health status were stoma issues, postoperative morbidity and a change in employment (p < 0.05). The main symptoms which patients identified as being troublesome were altered bowel habit and stoma issues with a resultant social and psychological impact. CONCLUSIONS One-third of patients experienced a deterioration in their psychosocial and physical health status as well as a change in employment during the first-year postsurgery. Larger research studies are required to define the impact of emergency laparotomy on patients in the longer term and more research is needed to improve perioperative rehabilitation in the postoperative period to ensure optimal functional gain after technically successful surgery.
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Affiliation(s)
- Erin C McIlveen
- Department of General Surgery, Royal Alexandra Hospital, Corsebar Road, Paisley, PA2 9PN, UK.
| | - Jennifer Edwards
- Department of Anaesthetics, Royal Alexandra Hospital, Paisley, UK
| | - Mark Vella
- Department of General Surgery, Royal Alexandra Hospital, Corsebar Road, Paisley, PA2 9PN, UK
| | - Laura McKinlay
- Department of General Surgery, Royal Alexandra Hospital, Corsebar Road, Paisley, PA2 9PN, UK
| | - Claire Hancock
- Department of General Surgery, Royal Alexandra Hospital, Corsebar Road, Paisley, PA2 9PN, UK
| | - Tara Quasim
- University Department of Anaesthetics and Critical Care, Glasgow Royal Infirmary, Glasgow, UK
| | - Susan J Moug
- Department of General Surgery, Royal Alexandra Hospital, Corsebar Road, Paisley, PA2 9PN, UK
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Wang XY, Ren LJ, Xie YZ, Fu YY, Zhu YY, Li CL, Zhang TY. The Effects of BCDs in Unilateral Conductive Hearing Loss: A Systematic Review. J Clin Med 2023; 12:5901. [PMID: 37762842 PMCID: PMC10532261 DOI: 10.3390/jcm12185901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/21/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
Bone conduction devices (BCDs) are widely used in the treatment of conductive hearing loss (CHL), but their applications on unilateral CHL (UCHL) patients remain controversial. To evaluate the effects of BCDs in UCHL, a systematic search was undertaken until May 2023 following the PRISMA guidelines. Among the 391 references, 21 studies met the inclusion criteria and were ultimately selected for review. Data on hearing thresholds, speech recognition, sound localization, and subjective questionnaire outcomes were collected and summarized. Moderate hearing threshold improvements were found in UCHL patients aided with BCDs. Their speech recognition abilities improved significantly. However, sound localization results showed wide individual variations. According to subjective questionnaires, BCDs had an overall positive influence on the daily life of UCHL patients, although several unfavorable experiences were reported by some of them. We concluded that the positive audiological benefits and subjective questionnaire results have made BCDs a credible intervention for UCHL patients. Before final implantations, UCHL patients should first go through a period of time when they were fitted with non-implantable BCDs as a trial.
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Affiliation(s)
- Xin-Yue Wang
- Department of Facial Plastic Reconstructive Surgery, ENT Institute, Eye and ENT Hospital, Fudan University, Shanghai 200031, China; (X.-Y.W.); (L.-J.R.); (Y.-Z.X.); (Y.-Y.F.); (Y.-Y.Z.)
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China
| | - Liu-Jie Ren
- Department of Facial Plastic Reconstructive Surgery, ENT Institute, Eye and ENT Hospital, Fudan University, Shanghai 200031, China; (X.-Y.W.); (L.-J.R.); (Y.-Z.X.); (Y.-Y.F.); (Y.-Y.Z.)
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China
| | - You-Zhou Xie
- Department of Facial Plastic Reconstructive Surgery, ENT Institute, Eye and ENT Hospital, Fudan University, Shanghai 200031, China; (X.-Y.W.); (L.-J.R.); (Y.-Z.X.); (Y.-Y.F.); (Y.-Y.Z.)
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China
| | - Yao-Yao Fu
- Department of Facial Plastic Reconstructive Surgery, ENT Institute, Eye and ENT Hospital, Fudan University, Shanghai 200031, China; (X.-Y.W.); (L.-J.R.); (Y.-Z.X.); (Y.-Y.F.); (Y.-Y.Z.)
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China
| | - Ya-Ying Zhu
- Department of Facial Plastic Reconstructive Surgery, ENT Institute, Eye and ENT Hospital, Fudan University, Shanghai 200031, China; (X.-Y.W.); (L.-J.R.); (Y.-Z.X.); (Y.-Y.F.); (Y.-Y.Z.)
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China
| | - Chen-Long Li
- Department of Facial Plastic Reconstructive Surgery, ENT Institute, Eye and ENT Hospital, Fudan University, Shanghai 200031, China; (X.-Y.W.); (L.-J.R.); (Y.-Z.X.); (Y.-Y.F.); (Y.-Y.Z.)
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China
| | - Tian-Yu Zhang
- Department of Facial Plastic Reconstructive Surgery, ENT Institute, Eye and ENT Hospital, Fudan University, Shanghai 200031, China; (X.-Y.W.); (L.-J.R.); (Y.-Z.X.); (Y.-Y.F.); (Y.-Y.Z.)
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China
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31
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Young A, Fechtner L, Brennan C, Rende S, Wazen J. Clinical performance, audiological outcomes, and quality of life of the Cochlear Osia ® system. Am J Otolaryngol 2023; 44:103951. [PMID: 37329694 DOI: 10.1016/j.amjoto.2023.103951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 06/04/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVE The Cochlear Osseointegrated Steady-State Implant Bone Anchored Hearing Device (Osia) is a surgically implanted titanium apparatus that utilizes a piezoelectric actuator under the skin to address conductive and mixed hearing loss as well as single-sided deafness. The purpose of this study is to examine the clinical, audiologic, and quality-of-life outcomes in patients who underwent Osia implantation. METHODS This is a retrospective study analyzing 30 adult patients (age 27-86) with conductive healing loss (CHL), mixed hearing loss (MHL), or single-sided deafness (SSD) who were implanted with the Osia device from January 2020 to April 2023 at a single institution by the senior author. Preoperative speech score testing (CNC, AzBio in quiet, AzBio in noise) were performed in all subjects while unaided, wearing conventional air conduction hearing aids, and wearing a softband BAHA. These preoperative speech scores were then compared to post-implantation speech scores using paired t-test analysis to assess for degree of speech improvement. In order to analyze quality of life after Osia implantation, each patient filled out the Glasgow Benefit Inventory (GBI) survey. The GBI is a series of 18 questions answered using a five-point Likert scale that addresses the changes in general health status, physical health status, psychosocial health status, and social support after a medical intervention. RESULTS CHL, MHL, and SSD patients had significant improvement in hearing and speech recognition scores after Osia implantation compared to preoperative unaided hearing: CNC (14 % vs 80 %, p < 0.0001), AzBio in Quiet (26 % vs 94 %, p < 0.0001), and AzBio in Noise (36 % vs 87 %, p = 0.0001). Preoperative speech scores using the softband BAHA were accurate predictors of post-implantation speech scores and can serve to determine surgical candidacy for the Osia. Post-implantation Glasgow Benefit Inventory patient surveys demonstrated significant improvement in quality of life with patients scoring an average increase of +54.1 points in heath satisfaction. CONCLUSION Adult patients with CHL, MHL, and SSD can receive significant improvement in speech recognition scores after implantation with the Osia device. This translates to improved quality of life, which was confirmed on the post-implantation Glasgow Benefit Inventory patient surveys.
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Affiliation(s)
- Allen Young
- Silverstein Institute-First Physicians Group of Sarasota, 1901 Floyd Street, Sarasota, FL 34239, United States of America.
| | - Linnea Fechtner
- Grand Valley ENT and Facial Plastics Surgeons, 2373 G Road, Suite 270, Grand Junction, CO 81505, United States of America
| | - Carolyn Brennan
- Silverstein Institute-First Physicians Group of Sarasota, 1901 Floyd Street, Sarasota, FL 34239, United States of America
| | - Sharon Rende
- Silverstein Institute-First Physicians Group of Sarasota, 1901 Floyd Street, Sarasota, FL 34239, United States of America
| | - Jack Wazen
- Silverstein Institute-First Physicians Group of Sarasota, 1901 Floyd Street, Sarasota, FL 34239, United States of America
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Portelli D, Ciodaro F, Loteta S, Alberti G, Bruno R. Audiological assessment with Matrix sentence test of percutaneous vs transcutaneous bone-anchored hearing aids: a pilot study. Eur Arch Otorhinolaryngol 2023; 280:4065-4072. [PMID: 36933021 DOI: 10.1007/s00405-023-07918-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 03/06/2023] [Indexed: 03/19/2023]
Abstract
PURPOSE The study evaluated if there were differences between two types of bone-anchored hearing aids (BAHA), percutaneous vs transcutaneous implants in terms of audiological and psychosocial outcomes. METHODS Eleven patients were enrolled. Inclusion criteria were: patients with conductive or mixed hearing loss in the implanted ear with a bone conduction pure-tone average (BC PTA) of the hearing threshold at 500, 1000, 2000, and 3000 Hz ≤ 55 dB HL, aged > 5 years. Patients were assigned to two groups: percutaneous implant (BAHA Connect) and transcutaneous implant (BAHA Attract). Pure-tone audiometry, speech audiometry, free-field pure-tone and speech audiometry with the hearing aid, and Matrix sentence test were performed. The Satisfaction with Amplification in Daily Life (SADL) questionnaire, the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire, and the Glasgow Benefit Inventory (GBI) were used to assess the psychosocial and audiological benefits provided by the implant, and the variation in the quality of life after the surgery. RESULTS No differences were found comparing the data of Matrix SRT. APHAB and GBI questionnaires did not show a statistically significant difference comparing each subscale and the global score. The comparison of scores obtained from the SADL questionnaire demonstrated a difference in the "Personal Image" subscale with a better score for the transcutaneous implant. Furthermore, the Global Score of the SADL questionnaire was statistically different between groups. Other subscales did not show any significant difference. A Spearman's ρ correlation test was used to evaluate if the age could influence the SRT results; no correlation was found between age and SRT. Furthermore, the same test was used to confirm a negative correlation between SRT and the global benefit of the APHAB questionnaire. CONCLUSION The current research confirms the absence of statistically significant differences comparing percutaneous and transcutaneous implants. The Matrix sentence test has shown the comparability of the two implants in the speech-in-noise intelligibility. Actually, the choice of the implant type can be done according to the patient's personal needs, the surgeon's experience, and the patient anatomy.
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Affiliation(s)
- Daniele Portelli
- Unit of Otorhinolaryngology, Department of Adult and Development Age Human Pathology "Gaetano Barresi", Policlinico "G. Martino", University of Messina, Via Consolare Valeria 1, 98125, Messina, ME, Italy.
| | - Francesco Ciodaro
- Unit of Otorhinolaryngology, Department of Adult and Development Age Human Pathology "Gaetano Barresi", Policlinico "G. Martino", University of Messina, Via Consolare Valeria 1, 98125, Messina, ME, Italy
| | - Sabrina Loteta
- Unit of Otorhinolaryngology, Department of Adult and Development Age Human Pathology "Gaetano Barresi", Policlinico "G. Martino", University of Messina, Via Consolare Valeria 1, 98125, Messina, ME, Italy
| | - Giuseppe Alberti
- Unit of Otorhinolaryngology, Department of Adult and Development Age Human Pathology "Gaetano Barresi", Policlinico "G. Martino", University of Messina, Via Consolare Valeria 1, 98125, Messina, ME, Italy
| | - Rocco Bruno
- Unit of Otorhinolaryngology, Department of Adult and Development Age Human Pathology "Gaetano Barresi", Policlinico "G. Martino", University of Messina, Via Consolare Valeria 1, 98125, Messina, ME, Italy
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Cantone E, Torrisi A, D’Ecclesia A, Massimilla EA, Motta G, Motta G. QoL Following Dacryocystorhinostomy: Linguistic Adaptation of Italian Version of GBI. Indian J Otolaryngol Head Neck Surg 2023; 75:1660-1664. [PMID: 37636772 PMCID: PMC10447665 DOI: 10.1007/s12070-023-03638-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 02/23/2023] [Indexed: 08/29/2023] Open
Abstract
The Glasgow Benefit Inventory (GBI) is a generic patient recorded outcome measure assessing the quality of life of patients undergoing ear nose and troth surgery. Although largely used in the clinical practice, it has never been adapted and validated in the Italian language. The aim of the study was to translate the original GBI from English to Italian and to examine its reliability for use in the Italian adult population of patients undergoing endonasal endoscopic dacryocystorhinostomy. After translation and back-translation of the original English we evaluated the reliability of GBI for use in 79 Italian adults undergoing dacryocystorhinostomies. Reliability of GBI-IT was examined by the internal consistency of the scale (using the Cronbach's alpha coefficient), and by the test-retest analysis. The GBI-IT showed adequate internal consistency (Cronbach's alpha = 0.85 for the total scale). The total GBI-IT score showed a strong correlation in retests (CCC 0.87). In conclusion, our study showed that the GBI-IT has satisfactory internal consistency and reliability and is equivalent to the original English version. In addition, it can be considered a valuable measure for both clinical and research uses.
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Affiliation(s)
- Elena Cantone
- Department of Neuroscience, Reproductive and Odontostomatological Sciences-ENT Section, University of Naples Federico II, 80131 Naples, Italy
- Head and Neck Department-ENT Section, AOU Federico II, 80131 Naples, Italy
| | - Aldo Torrisi
- Department of Neuroscience, Reproductive and Odontostomatological Sciences-ENT Section, University of Naples Federico II, 80131 Naples, Italy
- Head and Neck Department-ENT Section, AOU Federico II, 80131 Naples, Italy
| | - Aurelio D’Ecclesia
- ENT Operative Unit, IRCCS “Casa Sollievo Della Sofferenza”, San Giovanni Rotondo, Italy
| | - Eva Aurora Massimilla
- Head and Neck Surgery Unit, Department of Mental and Physical Health and Preventive Medicine, Università Degli Studi Della Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Giovanni Motta
- Head and Neck Surgery Unit, Department of Mental and Physical Health and Preventive Medicine, Università Degli Studi Della Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Gaetano Motta
- Head and Neck Surgery Unit, Department of Mental and Physical Health and Preventive Medicine, Università Degli Studi Della Campania Luigi Vanvitelli, 80131 Naples, Italy
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Alkholaiwi F. Quality of Life of Patients With Nasal Obstruction Who Underwent Septoplasty: Assessed With the Glasgow Benefit Inventory. Cureus 2023; 15:e45523. [PMID: 37868415 PMCID: PMC10585188 DOI: 10.7759/cureus.45523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2023] [Indexed: 10/24/2023] Open
Abstract
BACKGROUND Septoplasty is considered the definitive treatment for symptomatic patients with deviated nasal septum. Although septoplasty is a commonly successful performed surgery, it has also been found to affect patients' quality of life (QoL). The Glasgow Benefit Inventory (GBI) scale is a validated questionnaire used to assess satisfaction after treatment. OBJECTIVE The present study was conducted with the aim to assess the outcome of septoplasty using the GBI scale. METHODS A retrospective study was conducted among patients with chronic nasal obstruction in Dr. Sulaiman Alhabib Hospital, Riyadh, Saudi Arabia, to assess the outcome of septoplasty using the GBI. All patients who met the eligibility criteria were subjected to a detailed otorhinolaryngology, head and neck examination, including nasal endoscopy prior to septoplasty, followed by the distribution of a previously validated questionnaire translated into Arabic. Statistical analysis was performed using R version 3.6.3 software. Counts and percentages were used to summarize the distribution of categorical variables. RESULTS A total of 75 patients were enrolled in the study initially, among which 42 patients met the eligibility criteria; 65% were male and 35% were female. Most respondents reported improvement in the total GBI score (92.5%, n = 40). A similar improvement was observed in the general subscale domain (92.5%, n = 40) as compared to the social support domain (66.7%, n = 28) and physical health domain (66.7%, n = 28), which showed less improvement. CONCLUSION We found a positive change in the QoL among the patients after septoplasty using a validated and reliable instrument.
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Affiliation(s)
- Feras Alkholaiwi
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, SAU
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Bekele Okuba T, Lystad RP, Boisvert I, McMaugh A, Moore RC, Walsan R, Mitchell RJ. Cochlear implantation impact on health service utilisation and social outcomes: a systematic review. BMC Health Serv Res 2023; 23:929. [PMID: 37649056 PMCID: PMC10468908 DOI: 10.1186/s12913-023-09900-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 08/10/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Hearing loss can have a negative impact on individuals' health and engagement with social activities. Integrated approaches that tackle barriers and social outcomes could mitigate some of these effects for cochlear implants (CI) users. This review aims to synthesise the evidence of the impact of a CI on adults' health service utilisation and social outcomes. METHODS Five databases (MEDLINE, Scopus, ERIC, CINAHL and PsychINFO) were searched from 1st January 2000 to 16 January 2023 and May 2023. Articles that reported on health service utilisation or social outcomes post-CI in adults aged ≥ 18 years were included. Health service utilisation includes hospital admissions, emergency department (ED) presentations, general practitioner (GP) visits, CI revision surgery and pharmaceutical use. Social outcomes include education, autonomy, social participation, training, disability, social housing, social welfare benefits, occupation, employment, income level, anxiety, depression, quality of life (QoL), communication and cognition. Searched articles were screened in two stages ̶̶̶ by going through the title and abstract then full text. Information extracted from the included studies was narratively synthesised. RESULTS There were 44 studies included in this review, with 20 (45.5%) cohort studies, 18 (40.9%) cross-sectional and six (13.6%) qualitative studies. Nine studies (20.5%) reported on health service utilisation and 35 (79.5%) on social outcomes. Five out of nine studies showed benefits of CI in improving adults' health service utilisation including reduced use of prescription medication, reduced number of surgical and audiological visits. Most of the studies 27 (77.1%) revealed improvements for at least one social outcome, such as work or employment 18 (85.7%), social participation 14 (93.3%), autonomy 8 (88.9%), education (all nine studies), perceived hearing disability (five out of six studies) and income (all three studies) post-CI. None of the included studies had a low risk of bias. CONCLUSIONS This review identified beneficial impacts of CI in improving adults' health service utilisation and social outcomes. Improvement in hearing enhanced social interactions and working lives. There is a need for large scale, well-designed epidemiological studies examining health and social outcomes post-CI.
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Affiliation(s)
- Tolesa Bekele Okuba
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
| | - Reidar P Lystad
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Isabelle Boisvert
- Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Anne McMaugh
- Macquarie School of Education, Faculty of Arts, Macquarie University, Sydney, Australia
| | | | - Ramya Walsan
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Rebecca J Mitchell
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
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Nijmeijer HGB, Huinck WJ, Kramer SE, Donders ART, van der Wilt GJ, Mylanus EAM. Changes on clinical and participatory outcomes in people with severe-to-profound hearing loss after cochlear implantation: protocol of a multicentre prospective observational cohort study - Societal Merit of Intervention on Hearing Loss Evaluation (SMILE). BMJ Open 2023; 13:e072689. [PMID: 37369408 PMCID: PMC10410821 DOI: 10.1136/bmjopen-2023-072689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
INTRODUCTION Cochlear implantation (CI) is a (cost-)effective intervention for people with severe or profound hearing loss. Since its introduction experience increased and the technology evolved, leading to better results and relaxation of CI eligibility criteria. Meanwhile, with national healthcare costs increasing there is a need for evidence of healthcare technology's value. This protocol describes a study to investigate clinical and participatory outcomes after CI for the currently (expanded) eligible hearing impaired population. The study adds to the current evidence base through its multicentre design, long-term follow-up and use of participatory outcomes alongside standard clinical outcomes. METHODS This multicentre prospective observational cohort study will include at least 156 adult patients with severe-to-profound hearing loss, approximately evenly divided into two groups (1, ages 18-65 years and 2, age >65 years). The measurements consist of audiometry, cognition tests, listening effort tests and multiple generic and disease specific questionnaires. Questionnaires will be administered twice before CI, soon after inclusion at CI referral and shortly before CI surgery, with an annual follow-up of 3 years after CI. The Impact on Participation and Autonomy questionnaire will be used to assess participation. Generalised models (linear, logistic, Poisson) will be used. Mixed effects models will be used to investigate changes over time while exploring differences in subgroups and the influence of covariates. ETHICS AND DISSEMINATION The study has received ethical approval from the Medical Ethical Committee of all participating centres. The results could provide valuable insights into changes in participatory outcomes of people with severe-to-profound hearing loss after CI. Results will be disseminated through peer-reviewed journals, scientific conferences and professional and patient organisation meetings. TRIAL REGISTRATION NUMBER NCT05525221.
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Affiliation(s)
- Hugo G B Nijmeijer
- Department of Otorhinolaryngology, Radboudumc, Nijmegen, Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
| | - Wendy J Huinck
- Department of Otorhinolaryngology, Radboudumc, Nijmegen, Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
| | - Sophia E Kramer
- Otolaryngology-Head and Neck Surgery, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, Netherlands
| | | | - Gert Jan van der Wilt
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
- Department for Health Evidence, Radboudumc, Nijmegen, Netherlands
| | - Emmanuel A M Mylanus
- Department of Otorhinolaryngology, Radboudumc, Nijmegen, Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
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Zaramo TZ, Zelko I, Ragland D, Tunyi J, Kaur MN, Bajestani N, Lee CN, Chung KC, Mitchell KAS. Can we do better at measuring patient-reported outcomes after cranioplasty? A systematic review. Neurosurg Rev 2023; 46:109. [PMID: 37148399 PMCID: PMC10163856 DOI: 10.1007/s10143-023-02006-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/23/2023] [Accepted: 04/23/2023] [Indexed: 05/08/2023]
Abstract
Measuring quality of life (QOL) after cranioplasty is increasingly evident as a necessary component of patient-centered care. For data to be useful in clinical decision-making and approval of new therapies, studies must utilize valid and reliable instruments. Our objective was to critically appraise studies evaluating QOL in adult cranioplasty patients and determine validity and relevance of the patient-reported outcome measures (PROMs) used. Electronic databases of PubMed, Embase, CINAHL, and PsychINFO were used to identify PROMs measuring QOL in adult patients with cranioplasty. The methodological approach, cranioplasty outcomes, and domains measured by the PROMs were extracted and summarized descriptively. A content analysis of the identified PROMs was completed to identify the concepts measured. From 2236 articles identified, 17 articles containing eight QOL PROMs met the inclusion criteria. None of the PROMs was specifically validated or developed for adults undergoing cranioplasty. The QOL domains included physical health, psychological health, social health, and general QOL. These four domains encompassed 216 total items among the PROMs. Appearance was only assessed in two PROMs. To our knowledge, there are currently no validated PROMs that comprehensively measure appearance, facial function, and adverse effects in adults undergoing cranioplasty. There is an urgent need to develop PROMs to measure QOL outcomes rigorously and comprehensively in this patient population to inform clinical care, research, and quality improvement initiatives. Findings from this systematic review will be used to derive an outcome instrument containing important concepts related to QOL in patients who undergo cranioplasty.
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Affiliation(s)
- Taborah Z Zaramo
- Department of Plastic & Reconstructive Surgery, The Ohio State University Wexner College of Medicine, Columbus, OH, USA
| | - Ian Zelko
- Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Dashaun Ragland
- Department of Plastic & Reconstructive Surgery, The Ohio State University Wexner College of Medicine, Columbus, OH, USA
| | - Jude Tunyi
- Department of Plastic & Reconstructive Surgery, The Ohio State University Wexner College of Medicine, Columbus, OH, USA
| | - Manraj N Kaur
- Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Nojan Bajestani
- Department of Plastic & Reconstructive Surgery, The Ohio State University Wexner College of Medicine, Columbus, OH, USA
| | - Clara N Lee
- Department of Plastic & Reconstructive Surgery, The Ohio State University Wexner College of Medicine, Columbus, OH, USA
| | - Kevin C Chung
- Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Kerry-Ann S Mitchell
- Department of Plastic & Reconstructive Surgery, The Ohio State University Wexner College of Medicine, Columbus, OH, USA.
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Pisani D, Gioacchini FM, Chiarella G, Astorina A, Ricciardiello F, Scarpa A, Re M, Viola P. Vestibular Impairment in Patients with Vestibular Schwannoma: A Journey through the Pitfalls of Current Literature. Audiol Res 2023; 13:285-303. [PMID: 37102775 PMCID: PMC10135541 DOI: 10.3390/audiolres13020025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/17/2023] [Accepted: 04/06/2023] [Indexed: 04/28/2023] Open
Abstract
Vestibular Schwannoma is the most common tumour of Ponto Cerebellar Angle and is capable of strongly impacting the patient's quality of life. In recent decades, the proposals for the management of the disease have multiplied, just as the diagnostic capacity has improved. While in the past, the primary objective was the preservation of the facial function, and subsequently also of the auditory function, the attention to the vestibular symptomatology, which appears to be one of the main indicators of deterioration of quality of life, is still unsatisfactory. Many authors have tried to provide guidance on the best possible management strategy, but a universally recognized guideline is still lacking. This article offers an overview of the disease and the proposals which have advanced in the last twenty years, evaluating their qualities and defects in a critical reading.
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Affiliation(s)
- Davide Pisani
- Unit of Audiology, Regional Centre of Cochlear Implants and ENT Diseases, Department of Experimental and Clinical Medicine, Magna Graecia University, 88100 Catanzaro, Italy
| | - Federico Maria Gioacchini
- Ear, Nose, and Throat Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Via Conca 71, 60020 Ancona, Italy
| | - Giuseppe Chiarella
- Unit of Audiology, Regional Centre of Cochlear Implants and ENT Diseases, Department of Experimental and Clinical Medicine, Magna Graecia University, 88100 Catanzaro, Italy
| | - Alessia Astorina
- Unit of Audiology, Regional Centre of Cochlear Implants and ENT Diseases, Department of Experimental and Clinical Medicine, Magna Graecia University, 88100 Catanzaro, Italy
| | | | - Alfonso Scarpa
- Department of Medicine and Surgery, University of Salerno, 84084 Salerno, Italy
| | - Massimo Re
- Ear, Nose, and Throat Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Via Conca 71, 60020 Ancona, Italy
| | - Pasquale Viola
- Unit of Audiology, Regional Centre of Cochlear Implants and ENT Diseases, Department of Experimental and Clinical Medicine, Magna Graecia University, 88100 Catanzaro, Italy
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van der Weijden FN, Hernández EM, Rossell Perry PE, van Essen LH. The influence of music lessons on the socio-emotional wellbeing of children with cleft lip and/or palate. Br Dent J 2023:10.1038/s41415-023-5570-x. [PMID: 36882490 DOI: 10.1038/s41415-023-5570-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 11/08/2022] [Indexed: 03/09/2023]
Abstract
Introduction There is a dearth of psychological interventions for patients with cleft lip and/or palate (CL/P).Objective To evaluate the influence of music lessons on the socio-emotional wellbeing of children with CL/P.Setting This study was conducted at Asociación San Lucas (Moyobamba, Peru), which has a multidisciplinary programme for children with CL/P. Recorder lessons are offered to all patients aged 6-8 years. From age eight, the children can switch to flute, clarinet, violin, viola or cello.Materials and methods The Glasgow Benefit Inventory (GBI), a post-intervention questionnaire, was administered to all 26 children participating in the music programme.Results Mean GBI scores per question ranged from 59.62 (SD: 31.68) to 92.31 (SD: 23.21), showing an overall positive effect of the music lessons on the patients' socio-emotional wellbeing. Playing a musical instrument gave the children satisfaction and self-confidence. The children lost much of their shame, became less shy, and participated more in social activities. In a non-significant numerical trend, boys, flute/clarinet players and orchestra players had higher mean GBI scores than, respectively, girls, string players and children who did not play in the orchestra.Conclusions Quantitative and qualitative analysis indicated a positive influence of music lessons on the patients' socio-emotional wellbeing.
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Affiliation(s)
- Fawn N van der Weijden
- Department of Orthodontics, Academic Centre of Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands.
| | - Edgar M Hernández
- Faculty of Medicine Alberto Hurtado, University Peruana Cayetano Heredia, Lima, Peru
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Robinette K, Sims J, Pang B, Babu S. Transcutaneous versus percutaneous bone-anchored hearing aids: A quality of life comparison. Am J Otolaryngol 2023; 44:103758. [PMID: 36610247 DOI: 10.1016/j.amjoto.2022.103758] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 12/18/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE To determine whether patients have improved quality of life outcomes with percutaneous bone conduction implant (p-BCI) versus transcutaneous bone conduction implant (t-BCI). MATERIALS & METHODS Retrospective chart review of patients who have undergone placement of a BCI in the Ascension St John Providence Health System from 2013 to 2018. Patient satisfaction of t-BCI and p-BCI was measured using a questionnaire that incorporated the Glasgow Benefit Inventory (GBI) and BAHA, aesthetic, hygiene & use (BAHU) survey. Key outcome variables were separated into 2 categories: (1) evaluation of wound healing and implant-associated complications, and (2) quality of life improvements. RESULTS Comparative analysis of the 27 p-BCI patients and 10 t-BCI patients showed overall positive benefit with no statistically significant difference on quality of life improvement between the two groups. Total complication rates for p-BCI (48.1 %) vs t-BCI (10 %) was marginally significant (p = 0.056). Rate of revision for p-BCI versus t-BCI was 14.8 % vs 0 %, respectively. CONCLUSION This study provides a much-needed comparative insight in patient's experience with these two devices. Understanding which device is preferable in the patient's view will offer helpful information for guiding proper implant selection.
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Affiliation(s)
- Kyle Robinette
- Otolaryngology - Head & Neck Surgery, Valley Children's Hospital, CA, Pediatric Otolaryngology, United States of America
| | - Jake Sims
- Otolaryngology - Head & Neck Surgery Residency, Beaumont Hospital, Royal Oak and Farmington Hills, MI, Michigan State University College of Osteopathic Medicine, United States of America.
| | - Bo Pang
- Otolaryngology - Head & Neck Surgery, Hawaii ENT Consultants, United States of America
| | - Seilesh Babu
- Otolaryngology - Head & Neck Surgery, Michigan Ear Institute, Otology/Neurotology, Ascension Providence Park Hospital, Associate Professor Wayne State University, United States of America
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Sakr AA, Magdy EA, Melek LN, Mohamed SS. Evaluation of patients' quality of life using novel "Multidisciplinary Salivary Gland Society" questionnaire in minimally invasive management of obstructive sialadenitis. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 135:e59-e67. [PMID: 36089488 DOI: 10.1016/j.oooo.2022.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/07/2022] [Accepted: 07/11/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVE The introduction of minimally invasive surgical procedures has significantly reduced the rate of major salivary gland removal. This study aimed to assess these procedures in relieving patients' complaints and their impact on quality of life using the newly introduced Multidisciplinary Salivary Gland Society questionnaire. STUDY DESIGN Between January 2021 and October 2021, a case series was treated with minimally invasive surgical procedures. Data such as stone size, number and location, surgical approach, symptoms relief, and improvement of quality of life were collected and analyzed. Thirty-six patients were included (22 males and 14 females); 28 had stones in the submandibular gland and 8 in the parotid gland with largest stone diameter ranging from 0.2 to 2.8 cm. The approach was selected according to stone size and location, so 17 patients were treated with sialendoscopy (alone or using a combined approach), and 19 patients were treated without sialendoscopy using a transoral approach. RESULTS After a 6-month follow-up, the questionnaire scores showed a statistically significant difference in comparison to preoperative ones. CONCLUSIONS Minimally invasive surgical procedures present an excellent option for sialolithotomy, after which the relief of symptoms, restoration of gland function, and a significant improvement in quality of life are achieved.
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Affiliation(s)
- Aya A Sakr
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Alexandria University, Egypt.
| | - Emad A Magdy
- Department of Otorhinolaryngology-Head & Neck Surgery, Faculty of Medicine, Alexandria University Main Hospital, Egypt
| | - Lydia N Melek
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Alexandria University, Egypt
| | - Sherif S Mohamed
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Alexandria University, Egypt
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Treatment of Advanced Male Genital Lymphedema With a Complete Functional Lymphatic System Pedicled Transfer. Urology 2023:S0090-4295(23)00157-7. [PMID: 36809836 DOI: 10.1016/j.urology.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/01/2023] [Accepted: 02/05/2023] [Indexed: 02/21/2023]
Abstract
OBJECTIVE To evaluate the functional efficacy of the superficial circumflex iliac artery perforator (SCIP) -lymphatic pedicled flap in the treatment of advanced male genital lymphedema. METHODS From February 2018 to January 2022, we treated 26 male patients with scrotal and penoscrotal advanced lymphedema using reconstructive lymphatic surgery. Isolated scrotal involvement was seen in 15 patients, and 11 patients had penoscrotal involvement. Excision of genital lymphedematous fibrotic tissue was followed by reconstruction utilizing the SCIP-lymphatic flap. Patient characteristics, intraoperative data, and postoperative results were evaluated. RESULTS The mean patient age was 39 ± 4.6, and the mean follow-up time was 44.9 months. the SCIP-lymphatic flap was used to reconstruct partial (n = 11) or total (n = 15) scrotum and used to reconstruct total penile skin in 9 cases and partial in 2 cases. The flap survival rate was 100%. Cellulitis rates were dramatically reduced after reconstruction (P value <.001). The mean genital lymphedema score (GLS) after surgery was 0.05, which was significantly lower than the preoperative 1, 6.2 (P < .001). The median Glasgow Benefit Inventory (GBI) total score was +41, all 26 patients (100%) showed a degree of quality of life improvement. CONCLUSION The pedicled SCIP lymphatic transfer approach in advanced male genital lymphedema can provide a durable complete functional lymphatic system that improves the appearance and genital lymphatic drainage. This leads to an improvement in quality of life as well as in sexual functions.
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Wendrich AW, van Heteren JAA, Peters JPM, Cattani G, Stokroos RJ, Versnel H, Smit AL. Choice of treatment evaluated after trial periods with bone conduction devices and contralateral routing of sound systems in patients with single-sided deafness. Laryngoscope Investig Otolaryngol 2023; 8:192-200. [PMID: 36846432 PMCID: PMC9948587 DOI: 10.1002/lio2.1002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 11/14/2022] [Accepted: 12/15/2022] [Indexed: 12/29/2022] Open
Abstract
Objectives Patients with single-sided deafness (SSD) may experience difficulties with speech perception in noise, sound localization, have tinnitus and experience a reduced quality of life (QoL). contralateral routing of sound hearing aids (CROS) or bone conduction devices (BCD) may partly improve subjective speech communication and QoL in SSD patients. A trial period with these devices can help in making a well-informed choice of treatment. Our aim was to evaluate factors influencing the choice of treatment made after a BCD and CROS trial period in adult SSD patients. Methods Patients were randomized in the: "first BCD, then CROS" or "first CROS, then BCD" trial period group. After the BCD on headband and CROS were tested for 6 weeks each, patients choose for BCD, CROS or no treatment. Primary outcome was the distribution of choice of treatment. Secondary outcomes included the association between the choice of treatment and patient characteristics, reasons for treatment acceptance or rejection, device usage during the trial periods, and disease-specific QoL outcomes. Results Of 91 patients randomized, 84 completed both trial periods and made their choice of treatment: 25 (30%) BCD, 34 (40%) CROS, and 25 (30%) no treatment. No characteristics were found to be related to choice of treatment. Top three reasons for acceptance or rejection were: device (dis)comfort, sound quality and (dis)advantage of subjective hearing. Average daily device use during the trial periods was higher for CROS than for BCD. Choice of treatment was significantly related with both duration of device usage and greater improvement of QoL after the corresponding trial period. Conclusion The majority of SSD patients preferred BCD or CROS over no treatment. Evaluating device usage, discussing treatment (dis)advantages and disease-specific QoL outcomes after trial periods are to be considered during patient counseling and could facilitate whether to choose one of these treatments. Level of evidence 1B.
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Affiliation(s)
- Anne W. Wendrich
- Department of Otorhinolaryngology and Head & Neck SurgeryUniversity Medical Center UtrechtUtrechtNetherlands
- UMC Utrecht Brain CenterUniversity Medical Center UtrechtUtrechtNetherlands
| | - Jan A. A. van Heteren
- Department of Otorhinolaryngology and Head & Neck SurgeryUniversity Medical Center UtrechtUtrechtNetherlands
- UMC Utrecht Brain CenterUniversity Medical Center UtrechtUtrechtNetherlands
| | - Jeroen P. M. Peters
- Department of Otorhinolaryngology and Head & Neck SurgeryUniversity Medical Center UtrechtUtrechtNetherlands
- UMC Utrecht Brain CenterUniversity Medical Center UtrechtUtrechtNetherlands
| | - Guido Cattani
- Department of Otorhinolaryngology and Head & Neck SurgeryUniversity Medical Center UtrechtUtrechtNetherlands
- Adelante Center of Expertise in rehabilitation and AudiologyHoensbroekNetherlands
| | - Robert J. Stokroos
- Department of Otorhinolaryngology and Head & Neck SurgeryUniversity Medical Center UtrechtUtrechtNetherlands
- UMC Utrecht Brain CenterUniversity Medical Center UtrechtUtrechtNetherlands
| | - Huib Versnel
- Department of Otorhinolaryngology and Head & Neck SurgeryUniversity Medical Center UtrechtUtrechtNetherlands
- UMC Utrecht Brain CenterUniversity Medical Center UtrechtUtrechtNetherlands
| | - Adriana L. Smit
- Department of Otorhinolaryngology and Head & Neck SurgeryUniversity Medical Center UtrechtUtrechtNetherlands
- UMC Utrecht Brain CenterUniversity Medical Center UtrechtUtrechtNetherlands
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Bruchhage KL, Lupatsii M, Möllenkolk F, Leffers D, Kurabi A, Jürgens T, Graspeuntner S, Hollfelder D, Leichtle A. Hearing rehabilitation and microbial shift after middle ear surgery with Vibrant Soundbridge in patients with chronic otitis media. Eur Arch Otorhinolaryngol 2023; 280:3107-3118. [PMID: 36662266 DOI: 10.1007/s00405-022-07795-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 12/08/2022] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Patients with otitis media (OM) encounter significant functional hearing impairment with conductive, or a combined hearing loss and long-term sequelae involving impaired speech/language development in children, reduced academic achievement and irreversible disorders of middle and inner ear requiring a long time therapy and/or multiple surgeries. In its persistent chronic form, Otitis media (COM) can often only be treated by undergoing ear surgery for hearing restoration. The persistent inflammatory reaction plays a major role, often caused by multi-resistant pathogens in the ear. Herein, we present outcomes of patients implanted with currently the only FDA approved active Middle Ear Implant Vibrant Soundbridge (VSB), suffering from persistent COM. METHODS The study enrolled 42 patients, treated by performing middle ear (ME) surgery to different extents and implanted with the VSB to various structures in the ME. Included were 17 children and 25 adults that had recurrent and/or persisting OM and significant hearing loss. Preoperative and postoperative patients' audiometric data were evaluated and the benefit with VSB assessed using the Glasgow Benefit Inventory for adults and pediatric cohorts. The microbial spectrum of pathogens was assessed before and after surgery, exploring the colonization of the otopathogens, as well as the intestinal microbiome from individually burdened patients. RESULTS The mean functional gain is 29.7 dB HL (range from 10 to 56.2 dB HL) with a significant improvement in speech intelligibility in quiet. Following VSB implantation, no significant differences in coupling were observed at low complication rates. Postoperatively patients showed significantly increased benefit with VSB compared to the untreated situation, including less otorrhea, pain, medical visits, and medication intake, with no recurrent OM and significant bacterial shift in otopathogens. The analysis of the intestinal microbiome displayed a high abundance of bacterial strains that might be linked to chronic and persistent inflammation. CONCLUSIONS Functional ear surgery including rehabilitation with a VSB in patients suffering from COM present to be safe and effective. The successful acceptance accompanied by the improved audiological performance resulted in significant benefit with VSB, with a shift in the ear pathogens and altered microbiome and thus is a great opportunity to be treated.
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Affiliation(s)
- Karl-Ludwig Bruchhage
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Mariia Lupatsii
- Department of Infectious Diseases and Microbiology, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Friederike Möllenkolk
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - David Leffers
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Arwa Kurabi
- Division of Otolaryngology, Department of Surgery, UCSD School of Medicine, La Jolla, San Diego, USA
| | - Tim Jürgens
- Institute of Acoustics, University of Applied Sciences Lübeck, Lübeck, Germany
| | - Simon Graspeuntner
- Department of Infectious Diseases and Microbiology, University Hospital Schleswig-Holstein, Lübeck, Germany.,German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany
| | - Daniela Hollfelder
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Anke Leichtle
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Schleswig-Holstein, Lübeck, Germany.
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Kubba H, Whitmer WM, Browning GG. Measuring benefit from non-surgical interventions in otolaryngology for different conditions, using the revised 5-factor Glasgow Benefit Inventory. Clin Otolaryngol 2023; 48:25-31. [PMID: 36240049 PMCID: PMC10092363 DOI: 10.1111/coa.13992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 09/25/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVES The Glasgow Benefit Inventory (GBI) has been extensively used to report the benefit from otolaryngological surgery. Benefit from non-surgical management has not been reported, despite this being the outcome of most otolaryngology and audiology consultations. DESIGN GBI responses from 4543 adults from the Scottish ENT Outcome Study were categorised by diagnosis. Benefit scores for different interventions within diagnostic categories for which surgery was not a potential management are reported using the revised 5-factor Glasgow Benefit Inventory (GBI-5F; 15 questions and 5 factors). SETTING Adult otolaryngology outpatient clinics in six university hospitals. PARTICIPANTS Adults seen with conditions that had no surgical option and given non-surgical management. RESULTS Overall, 80% of participants managed in Scottish Ear Nose and Throat Outcome Study (SENTOS) did not have surgery. A total of 1373 (30%) participants with various diagnoses were given reassurance and advice with no active intervention. There was no change in their GBI-5F total or factor scores, suggesting that they did not come to harm from their lack of active intervention. Hearing aids for bilateral sensorineural hearing loss gave greater benefit than reassurance in all factors, though individuals with a conductive impairment reported greater benefit in the Quality of life factor than those with a sensorineural impairment. Hearing aids and maskers produced benefit in the Support factor for patients with tinnitus. Epley's manoeuvre for benign paroxysmal positional vertigo gave benefit in the total score and the Quality of life factor compared with reassurance. Systemic medication for laryngo-pharyngeal reflux and topical medication for otitis externa gave no greater benefit in any factor or the total score compared with reassurance. CONCLUSION The GBI-5F and its five factors give useful information for reporting the benefit of non-surgical interventions in adult otolaryngology and audiology clinics.
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Affiliation(s)
- Haytham Kubba
- Hearing Sciences - Scottish Section, University of Nottingham, Glasgow Royal Infirmary, Glasgow, UK
| | - William M Whitmer
- Hearing Sciences - Scottish Section, University of Nottingham, Glasgow Royal Infirmary, Glasgow, UK
| | - George G Browning
- Hearing Sciences - Scottish Section, University of Nottingham, Glasgow Royal Infirmary, Glasgow, UK
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Ceuleers D, Baudonck N, Keppler H, Kestens K, Dhooge I, Degeest S. Development of the hearing-related quality of life questionnaire for auditory-visual, cognitive and psychosocial functioning (hAVICOP). JOURNAL OF COMMUNICATION DISORDERS 2023; 101:106291. [PMID: 36508852 DOI: 10.1016/j.jcomdis.2022.106291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 11/18/2022] [Accepted: 11/27/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION There is a need for a validated and standardized self-assessment instrument to assess the subjective effect of hearing aid (HA) use and/or cochlear implantation (CI) on different aspects of functioning in daily life. The aim of this study was to develop a new holistic Patient Reported Outcome Measure (PROM) to assess hearing-related quality of life. The new PROM is titled the hearing-related quality of life questionnaire for Auditory-VIsual, COgnitive and Psychosocial functioning (hAVICOP). METHODS A conceptual framework was set up and test items were prepared per domain. Preliminary testing involved a semi-structured interview-based assessment in normal-hearing and hearing-impaired adults and an expert panel. For the further psychometric evaluation, a new sample of 15 adult HA users, 20 adult CI users and 20 normal-hearing adults filled in the refined version of the hAVICOP, the Speech, Spatial and Qualities of Hearing Scale, the Nijmegen Cochlear Implant Questionnaire and the TNO-AZL Questionnaire for Adult's Health-Related Quality of Life. Based on these results, a factor analysis was conducted and internal consistency, discriminant validity and concurrent construct validity were determined. RESULTS The final version of the hAVICOP consists of three domains for hearing-related quality of life: (1) auditory-visual functioning, (2) cognitive functioning, and (3) psychosocial functioning. A sufficient internal consistency was found, and discriminant validity and concurrent construct validity were good. CONCLUSIONS A new PROM to assess hearing-related quality of life was developed, named the hAVICOP. In the future the validity and reliability should be examined further.
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Affiliation(s)
- Dorien Ceuleers
- Department of Head and Skin, Ghent University, Ghent, Belgium.
| | - Nele Baudonck
- Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium
| | - Hannah Keppler
- Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium; Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Katrien Kestens
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Ingeborg Dhooge
- Department of Head and Skin, Ghent University, Ghent, Belgium; Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium
| | - Sofie Degeest
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
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Derks LSM, Borgstein I, Kamalski DMA, Thomeer HGXM, Tange RA, Grolman W, Stokroos RJ, Wegner I. Hearing Results, Quality of Life, Patient Satisfaction, and Postoperative Complications of Day-case Versus Inpatient Stapes Surgery for Otosclerosis in Adults: A Randomized Controlled Trial. OTOLOGY & NEUROTOLOGY OPEN 2022; 2:e019. [PMID: 38516577 PMCID: PMC10950158 DOI: 10.1097/ono.0000000000000019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 09/18/2022] [Indexed: 03/23/2024]
Abstract
Objective To investigate the effect of day-case stapes surgery on hearing results, quality of life, patient satisfaction, and complications rates, compared with inpatient stapes surgery. Study Design A single-center, nonblinded, randomized controlled trial in a tertiary referral center. Methods One hundred twelve adult patients planned for primary or revision stapes surgery were randomly assigned to either the day-case or inpatient treatment group. The effect on hearing outcomes (primarily), hearing benefits, quality of life, patient satisfaction, postoperative complications, and causes of crossover or readmission (secondarily) were assessed using auditory evaluations, questionnaires, and patients' charts over a follow-up period of 1 year. Results Audiometric measurements and postoperative success rates were not different between the inpatient and day-case group. There were no statistically significant differences between both groups regarding the overall quality of life (QoL) (HUI3), disease-specific QoL (GHSI), change in postoperative health status (GBI), and postoperative complications rate. We found a high patient satisfaction toward the day-case approach. Six patients allocated to the inpatient group requested same-day discharge. Of the day-case patients, there was a crossover rate to inpatient care of 38% (20 patients), mainly due to postoperative nausea and vomiting (25%), vertigo (20%), or dizziness (40%). Conclusion We found no significant differences in outcomes of audiometric measurements, QoL, patient satisfaction and postoperative complications following day-case, and inpatient stapes surgery. Therefore, stapes surgery in a day-case setting seems to be a feasible approach in terms of postoperative outcome, safety, and desirability when taking patient selection and surgical planning into account. Besides this, the familiarity with a day-case approach of both patient and the surgical team, will increase the acceptance and feasibility of day-case stapes surgery.
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Affiliation(s)
- Laura S. M. Derks
- Department of Otorhinolaryngology—Head and Neck Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Isabelle Borgstein
- Department of Otorhinolaryngology—Head and Neck Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Digna M. A. Kamalski
- Department of Otorhinolaryngology—Head and Neck Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Hans G. X. M. Thomeer
- Department of Otorhinolaryngology—Head and Neck Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Rinze A. Tange
- Department of Otorhinolaryngology—Head and Neck Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Wilko Grolman
- Causse Ear Clinic, Traverse de Béziers, Colombiers, France
| | - Robert J. Stokroos
- Department of Otorhinolaryngology—Head and Neck Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Inge Wegner
- Department of Otorhinolaryngology—Head and Neck Surgery, University Medical Center Groningen, Groningen, the Netherlands
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Green FR, Sanders MI, Davies P, Mirza S, Sinha S. Quality of life outcomes after transnasal endoscopic pituitary surgery using the Glasgow Benefit Inventory. Br J Neurosurg 2022; 36:720-727. [PMID: 35938178 DOI: 10.1080/02688697.2022.2106352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
PURPOSE This study assesses postoperative quality-of-life outcomes via the Glasgow Benefit Inventory (GBI) in patients undergoing transnasal endoscopic pituitary surgery for pituitary adenoma. METHODS This was a retrospective cohort study in a UK tertiary referral centre. 145 patients who had undergone transnasal endoscopic pituitary surgery for pituitary adenoma over a 6-year period at one institution completed the GBI with at least 3 months' follow up. Patients with prior radiotherapy were excluded. The GBI is a patient-reported outcome measure that assesses post-intervention outcomes in three domains: 'general' functioning, 'social support' and 'physical' functioning. Pre- and post-operative visual loss scores were additionally assessed via a 1-5 Likert scale. GBI scores were assessed alongside these visual loss scores, clinical and surgical parameters and demographics. RESULTS Mean age was 59.5 years (range 20-87 years) and mean follow up was 36 months. A total of 46 of 145 (31.7%) patients had secreting tumours. The most common primary symptom was visual loss. Mean total score for all patients was positive (+8.4); with 'general' domain score the most positive (+10.5). All patient groups had overall positive, 'general' and 'social support' domain scores. Patients with Cushing's disease reported significantly higher mean total scores (+29.6) than all other groups. Acromegaly (+7.9) and non-functioning adenoma (NFA) groups (+5.2) reported lower mean total scores. 'Physical' domain mean scores were negative for acromegaly and NFA groups. There was statistical significance between a pre- to post-operative improvement in visual score and mean total GBI score (p = 0.02) and mean 'general' domain GBI score (p = 0.02). CONCLUSIONS These findings can aid preoperative counselling of patients undergoing this surgery. Those with NFA and no anticipated improvement to visual loss symptoms may be advised of possible worsened physical outcomes and of the option to delay the surgery until symptoms are present.
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Affiliation(s)
- Frederick R Green
- Ear, Nose and Throat Department, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | - Matthew I Sanders
- Neurosurgery Department, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | - Paul Davies
- Ear, Nose and Throat Department, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | - Showkat Mirza
- Ear, Nose and Throat Department, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | - Saurabh Sinha
- Neurosurgery Department, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
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Parikh KP, Motiwala M, Beer-Furlan A, Michael LM, Rangarajan SV, Choby GW, Kshettry VR, Saleh S, Mukherjee D, Kirsch C, McKean E, Sorenson JM. Skull Base Registries: A Roadmap. J Neurol Surg B Skull Base 2022; 83:561-578. [PMID: 36393883 PMCID: PMC9653294 DOI: 10.1055/a-1934-9191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 08/29/2022] [Indexed: 01/17/2023] Open
Abstract
Hospitals, payors, and patients increasingly expect us to report our outcomes in more detail and to justify our treatment decisions and costs. Although there are many stakeholders in surgical outcomes, physicians must take the lead role in defining how outcomes are assessed. Skull base lesions interact with surrounding anatomy to produce a complex spectrum of presentations and surgical challenges, requiring a wide variety of surgical approaches. Moreover, many skull base lesions are relatively rare. These factors and others often preclude the use of prospective randomized clinical trials, thus necessitating alternate methods of scientific inquiry. In this paper, we propose a roadmap for implementing a skull base registry, along with expected benefits and challenges.
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Affiliation(s)
- Kara P. Parikh
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis, Tennessee, United States
| | - Mustafa Motiwala
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis, Tennessee, United States
| | - Andre Beer-Furlan
- Department of Neurosurgery, Moffitt Cancer Center, Tampa, Florida, United States
| | - L. Madison Michael
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis, Tennessee, United States
| | - Sanjeet V. Rangarajan
- Department of Otolaryngology-Head and Neck Surgery, The University of Tennessee Health Science Center College of Medicine Memphis, Memphis, Tennessee, United States
| | - Garret W. Choby
- Department of Otorhinolaryngology, Mayo Clinic Rochester, Rochester, Minnesota, United States
| | - Varun R. Kshettry
- Brain Tumor and Neuro-Oncology Center Cleveland Clinic, Cleveland, Ohio, United States
| | - Sara Saleh
- Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, United States
| | - Debraj Mukherjee
- Department of Neurosurgery, Johns Hopkins Medical Institutions Campus, Baltimore, Maryland, United States
| | - Claudia Kirsch
- Yale University School of Medicine Department of Radiology and Biomedical Imaging, New Haven, Connecticut, United States
- Department of Clinical Dentistry, University of Sheffield, Sheffield, South Yorkshire, England
- Mount Sinai Biomedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States
| | - Erin McKean
- Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, United States
- Department of Otolaryngology–Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, United States
| | - Jeffrey M. Sorenson
- Department of Neurosurgery, University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee, United States
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Tomasoni M, Borsetto D, Deretti A, Arcuri M, Sordi A, Zorzi S, Redaelli de Zinis LO, Piazza C, Deganello A, Sorrentino T. Exploratory tympanotomy in conductive hearing loss with normal pre-operative investigations. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2022; 42:569-581. [PMID: 36654524 PMCID: PMC9853104 DOI: 10.14639/0392-100x-n1933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 07/06/2022] [Indexed: 01/18/2023]
Abstract
Objective To investigate whether patients with conductive hearing loss (CHL) and normal preoperative investigations may benefit from exploratory tympanotomy (ET) and tailored treatment performed according to intraoperative findings. Methods Patients treated with ET for CHL with normal pre-operative otoscopy, tympanometry and CT scan from 2011 to 2019 were reviewed. Data regarding demographics, audiometry, intraoperative findings and surgery were collected and analysed to assess if they can predict post-operative air bone gap (ABG) closure and patient satisfaction. Results Forty-eight cases were included. Mean ABG significantly reduced (p < 0.001) from preoperative (38.4 dB) to postoperative (14.8 dB). Post-operative ABG closure within 10 dB was observed in 20 cases (41.7%). Overall satisfaction was reported in 60% of cases. Stapes fixation was the most common diagnosis (47.9%) and significantly associated with lower post-operative ABG and higher satisfaction. Conclusions In CHL with normal pre-operative investigations, ET represents the mainstay of treatment, even if audiological outcomes may widely vary. Intraoperative finding of stapes fixation (thus stapedotomy) ensures the best audiological and satisfaction outcomes.
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Affiliation(s)
- Michele Tomasoni
- Department of Otolaryngology-Head and Neck Surgery, ASST Spedali Civili, University of Brescia, Brescia, Italy,Correspondence Michele Tomasoni Department of Otorhinolaryngology-Head and Neck Surgery, University of Brescia, piazzale Spedali Civili 1, 25123 Brescia, Italy E-mail:
| | - Daniele Borsetto
- Department of ENT Surgery, Cambridge University Hospitals, Cambridge, UK
| | - Alessandra Deretti
- Department of Otolaryngology-Head and Neck Surgery, ASST Spedali Civili, University of Brescia, Brescia, Italy
| | - Mara Arcuri
- Department of Otolaryngology-Head and Neck Surgery, ASST Spedali Civili, University of Brescia, Brescia, Italy
| | - Alessandra Sordi
- Department of Otolaryngology-Head and Neck Surgery, ASST Spedali Civili, University of Brescia, Brescia, Italy
| | - Silvia Zorzi
- Department of Otolaryngology-Head and Neck Surgery, ASST Spedali Civili, University of Brescia, Brescia, Italy
| | - Luca Oscar Redaelli de Zinis
- Department of Otolaryngology-Head and Neck Surgery, ASST Spedali Civili, University of Brescia, Brescia, Italy, Department of Pediatric Otolaryngology-Head Neck Surgery, Children Hospital ASST Spedali Civili, University of Brescia, Brescia, Italy
| | - Cesare Piazza
- Department of Otolaryngology-Head and Neck Surgery, ASST Spedali Civili, University of Brescia, Brescia, Italy
| | - Alberto Deganello
- Department of Otolaryngology-Head and Neck Surgery, ASST Spedali Civili, University of Brescia, Brescia, Italy
| | - Tommaso Sorrentino
- Department of Otolaryngology-Head and Neck Surgery, ASST Spedali Civili, University of Brescia, Brescia, Italy
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