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Schoovaerts M, Ourak M, Borghesan G, Putzeys T, Poorten EV, Verhaert N. OCT-based intra-cochlear imaging and 3D reconstruction: ex vivo validation of a robotic platform. Int J Comput Assist Radiol Surg 2024:10.1007/s11548-024-03081-7. [PMID: 38436923 DOI: 10.1007/s11548-024-03081-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 02/15/2024] [Indexed: 03/05/2024]
Abstract
PURPOSE The small size of the cochlea, and its location deeply embedded in thick temporal bone, poses a challenge for intra-cochlear guidance and diagnostics. Current radiological imaging techniques are not able to visualize the cochlear microstructures in detail. Rotational optical coherence tomography (OCT) fibers show great potential for intra-cochlear guidance. The generated images could be used to map, and study, the tiny cochlear microstructures relevant for hearing. METHODS This work describes the design of a rotational OCT probe with an outer diameter of 0.9 mm. It further discusses a robotic system, which features a remote center of motion mechanism, dedicated to the probe's positioning, fine manipulation and stable insertion into the cochlear micro-spaces. Furthermore, the necessary calibration steps for 3D reconstruction are described, followed by a detailed quantitative analysis, comparing the 3D reconstructions using a synthetic, 2:1 scaled scala tympani model with a reconstruction from micro-CT, serving as the ground truth. Finally, the potential of the system is demonstrated by scanning a single ex vivo cadaveric human cochlea. RESULTS The study investigates five insertions in the same 2:1 scaled tympani model, along with their corresponding 3D reconstruction. The comparison with micro-CT results in an average root-mean-square error of 74.2 µm, a signed distance error of 38.1 µm and a standard deviation of 63.6 µm. The average F-score of the reconstructions, using a distance threshold of 100 and 74.2 µm, resulted in 83.0% and 71.8%, respectively. Insertion in the cadaveric human cochlea showed the challenges for straight insertion, i.e., navigating the hook region. CONCLUSION Overall, the system shows great potential for intra-cochlear guidance and diagnostics, due to the system's capability for precise and stable insertion into the basal turn in the scala tympani. The system, combined with the calibration procedure, results in detailed and precise 3D reconstructions.
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Affiliation(s)
- Maarten Schoovaerts
- Department of Mechanical Engineering, KU Leuven, Celestijnenlaan 300, 3001, Leuven, Belgium.
- Department of Neurosciences, KU Leuven, Herestraat 49, 3001, Leuven, Belgium.
| | - Mouloud Ourak
- Department of Mechanical Engineering, KU Leuven, Celestijnenlaan 300, 3001, Leuven, Belgium
| | - Gianni Borghesan
- Department of Mechanical Engineering, KU Leuven, Celestijnenlaan 300, 3001, Leuven, Belgium
- Flanders Make, KU Leuven, Celestijnenlaan 300, 3001, Leuven, Belgium
| | - Tristan Putzeys
- Department of Neurosciences, KU Leuven, Herestraat 49, 3001, Leuven, Belgium
- Department of Physics and Astronomy, KU Leuven, Celestijnenlaan 200, 3001, Leuven, Belgium
| | | | - Nicolas Verhaert
- Department of Neurosciences, KU Leuven, Herestraat 49, 3001, Leuven, Belgium
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Leuven, Herestraat 49, 3001, Leuven, Belgium
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Geerardyn A, Zhu M, Verhaert N, Quesnel AM. Intracochlear Trauma and Local Ossification Patterns Differ Between Straight and Precurved Cochlear Implant Electrodes. Otol Neurotol 2024; 45:245-255. [PMID: 38270168 PMCID: PMC10922381 DOI: 10.1097/mao.0000000000004102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
HYPOTHESIS Trauma to the osseous spiral lamina (OSL) or spiral ligament (SL) during cochlear implant (CI) insertion segregates with electrode type and induces localized intracochlear ossification and fibrosis. BACKGROUND The goal of atraumatic CI insertion is to preserve intracochlear structures, limit reactive intracochlear tissue formation, and preserve residual hearing. Previous qualitative studies hypothesized a localized effect of trauma on intracochlear tissue formation; however, quantitative studies failed to confirm this. METHODS Insertional trauma beyond the immediate insertion site was histologically assessed in 21 human temporal bones with a CI. Three-dimensional reconstructions were generated and virtually resectioned perpendicular to the cochlear spiral at high resolution. The cochlear volume occupied by ossification or fibrosis was determined at the midpoint of the trauma and compared with regions proximal and distal to this point. RESULTS Seven cases, all implanted with precurved electrodes, showed an OSL fracture beyond the immediate insertion site. Significantly more intracochlear ossification was observed at the midpoint of the OSL fracture, compared with the -26 to -18 degrees proximal and 28 to 56 degrees distal to the center. No such pattern was observed for fibrosis. In the 12 cases with a perforation of the SL (9 straight and 3 precurved electrodes), no localized pattern of ossification or fibrosis was observed around these perforations. CONCLUSION OSL fractures were observed exclusively with precurved electrodes in this study and may serve as a nidus for localized intracochlear ossification. Perforation of the SL, in contrast, predominantly occurred with straight electrodes and was not associated with localized ossification.
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Affiliation(s)
| | - MengYu Zhu
- Otopathology Laboratory, Massachusetts Eye and Ear, Boston, Massachusetts, USA
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Geerardyn A, Zhu M, Klabbers T, Huinck W, Mylanus E, Nadol JB, Verhaert N, Quesnel AM. Human Histology after Structure Preservation Cochlear Implantation via Round Window Insertion. Laryngoscope 2024; 134:945-953. [PMID: 37493203 DOI: 10.1002/lary.30900] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 06/22/2023] [Accepted: 07/05/2023] [Indexed: 07/27/2023]
Abstract
OBJECTIVES Current surgical techniques aim to preserve intracochlear structures during cochlear implant (CI) insertion to maintain residual cochlear function. The optimal technique to minimize damage, however, is still under debate. The aim of this study is to histologically compare insertional trauma and intracochlear tissue formation in humans with a CI implanted via different insertion techniques. METHODS One recent temporal bone from a donor who underwent implantation of a full-length CI (576°) via round window (RW) insertion was compared with nine cases implanted via cochleostomy (CO) or extended round window (ERW) approach. Insertional trauma was assessed on H&E-stained histological sections. 3D reconstructions were generated and virtually re-sectioned to measure intracochlear volumes of fibrosis and neo-ossification. RESULTS The RW insertion case showed electrode translocation via the spiral ligament. 2/9 CO/ERW cases showed no insertional trauma. The total volume of the cochlea occupied by fibro-osseous tissue was 10.8% in the RW case compared with a mean of 30.6% (range 8.7%-44.8%, N = 9) in the CO/ERW cases. The difference in tissue formation in the basal 5 mm of scala tympani, however, was even more pronounced when the RW case (12.3%) was compared with the cases with a CO/ERW approach (mean of 93.8%, range 81% to 100%, N = 9). CONCLUSIONS Full-length CI insertions via the RW can be minimally traumatic at the cochlear base without inducing extensive fibro-osseous tissue formation locally. The current study further supports the hypothesis that drilling of the cochleostomy with damage to the endosteum incites a local tissue reaction. LEVEL OF EVIDENCE 4: Case-control study Laryngoscope, 134:945-953, 2024.
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Affiliation(s)
- Alexander Geerardyn
- Department of Otolaryngology-Head & Neck Surgery, Harvard Medical School, Boston, Massachusetts, U.S.A
- Otopathology Laboratory, Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A
- ExpORL, Department of Neurosciences, Katholieke Universiteit Leuven, Leuven, Belgium
| | - MengYu Zhu
- Otopathology Laboratory, Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A
| | - Tim Klabbers
- Department of Otorhinolaryngology, Radboudumc, Nijmegen, the Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands
| | - Wendy Huinck
- Department of Otorhinolaryngology, Radboudumc, Nijmegen, the Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands
| | - Emmanuel Mylanus
- Department of Otorhinolaryngology, Radboudumc, Nijmegen, the Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands
| | - Joseph B Nadol
- Department of Otolaryngology-Head & Neck Surgery, Harvard Medical School, Boston, Massachusetts, U.S.A
- Otopathology Laboratory, Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A
| | - Nicolas Verhaert
- ExpORL, Department of Neurosciences, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Alicia M Quesnel
- Department of Otolaryngology-Head & Neck Surgery, Harvard Medical School, Boston, Massachusetts, U.S.A
- Otopathology Laboratory, Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A
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Loos E, Stultiens JJA, Volpe B, Vermorken BL, Van Boxel SCJ, Devocht EMJ, van Hoof M, Postma AA, Guinand N, Pérez-Fornos A, Van Rompaey V, Denys S, Desloovere C, Verhaert N, van de Berg R. Optimizing vestibular implant electrode positioning using fluoroscopy and intraoperative CT imaging. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-023-08428-5. [PMID: 38180608 DOI: 10.1007/s00405-023-08428-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 12/18/2023] [Indexed: 01/06/2024]
Abstract
PURPOSE Vestibular implant electrode positioning close to the afferent nerve fibers is considered to be key for effective and selective electrical stimulation. However, accurate positioning of vestibular implant electrodes inside the semicircular canal ampullae is challenging due to the inability to visualize the target during the surgical procedure. This study investigates the accuracy of a new surgical protocol with real-time fluoroscopy and intraoperative CT imaging, which facilitates electrode positioning during vestibular implant surgery. METHODS Single-center case-controlled cohort study with a historic control group at a tertiary referral center. Patients were implanted with a vestibulocochlear implant, using a combination of intraoperative fluoroscopy and cone beam CT imaging. The control group consisted of five patients who were previously implanted with the former implant prototype, without the use of intraoperative imaging. Electrode positioning was analyzed postoperatively with a high-resolution CT scan using 3D slicer software. The result was defined as accurate if the electrode position was within 1.5 mm of the center of the ampulla. RESULTS With the new imaging protocol, all electrodes could be positioned within a 1.5 mm range of the center of the ampulla. The accuracy was significantly higher in the study group with intraoperative imaging (21/21 electrodes) compared to the control group without intraoperative imaging (10/15 electrodes), (p = 0.008). CONCLUSION The combined use of intraoperative fluoroscopy and CT imaging during vestibular implantation can improve the accuracy of electrode positioning. This might lead to better vestibular implant performance.
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Affiliation(s)
- Elke Loos
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Health Medicine and Life Sciences, School for Mental Health and Neuroscience (MHeNS), Maastricht University Medical Center, Maastricht, The Netherlands.
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium.
- Department of Neurosciences, Research Group Experimental Oto-Rhino-Laryngology (ExpORL), KU Leuven, University of Leuven, Herestraat 49, 3000, Leuven, Belgium.
| | - Joost J A Stultiens
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Health Medicine and Life Sciences, School for Mental Health and Neuroscience (MHeNS), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Benjamin Volpe
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Health Medicine and Life Sciences, School for Mental Health and Neuroscience (MHeNS), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Bernd L Vermorken
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Health Medicine and Life Sciences, School for Mental Health and Neuroscience (MHeNS), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Stan C J Van Boxel
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Health Medicine and Life Sciences, School for Mental Health and Neuroscience (MHeNS), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Elke M J Devocht
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Health Medicine and Life Sciences, School for Mental Health and Neuroscience (MHeNS), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Marc van Hoof
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Health Medicine and Life Sciences, School for Mental Health and Neuroscience (MHeNS), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Alinda A Postma
- Department of Radiology and Nuclear Medicine, Faculty of Health Medicine and Life Sciences, School for Mental Health and Neuroscience (MHeNS), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Nils Guinand
- Service of Otorhinolaryngology Head and Neck Surgery, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland
| | - Angelica Pérez-Fornos
- Service of Otorhinolaryngology Head and Neck Surgery, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland
| | - Vincent Van Rompaey
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Sam Denys
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Neurosciences, Research Group Experimental Oto-Rhino-Laryngology (ExpORL), KU Leuven, University of Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Christian Desloovere
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Neurosciences, Research Group Experimental Oto-Rhino-Laryngology (ExpORL), KU Leuven, University of Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Nicolas Verhaert
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Neurosciences, Research Group Experimental Oto-Rhino-Laryngology (ExpORL), KU Leuven, University of Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Raymond van de Berg
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Health Medicine and Life Sciences, School for Mental Health and Neuroscience (MHeNS), Maastricht University Medical Center, Maastricht, The Netherlands
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Moyaert J, Gilles A, Mertens G, Lammers MJW, Gommeren H, Janssens de Varebeke S, Fransen E, Verhaert N, Denys S, van de Berg R, Pennings R, Vanderveken O, Van Rompaey V. Interaural and sex differences in the natural evolution of hearing levels in pre-symptomatic and symptomatic carriers of the p.Pro51Ser variant in the COCH gene. Sci Rep 2024; 14:184. [PMID: 38167558 PMCID: PMC10762206 DOI: 10.1038/s41598-023-50583-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024] Open
Abstract
Hearing impairment constitutes a significant health problem in developed countries. If hearing loss is slowly progressive, the first signs may not be noticed in time, or remain untreated until the moment the auditory dysfunction becomes more apparent. The present study will focus on DFNA9, an autosomal dominant disorder caused by pathogenic variants in the COCH gene. Although several cross-sectional studies on this topic have been conducted, a crucial need for longitudinal research has been reported by many authors. Longitudinal trajectories of individual hearing thresholds were established as function of age and superimposed lowess curves were generated for 101 female and male carriers of the p.Pro51Ser variant. The average number of times patients have been tested was 2.49 years with a minimum of 1 year and a maximum of 4 years. In addition, interaural and sex differences were studied, as they could modify the natural evolution of the hearing function. The current study demonstrates that, both in female carriers and male carriers, the first signs of hearing decline, i.e. hearing thresholds of 20 dB HL, become apparent as early as the 3rd decade in the highest frequencies. In addition, a rapid progression of SNHL occurs between 40 and 50 years of age. Differences between male and female carriers in the progression of hearing loss are most obvious between the age of 50 and 65 years. Furthermore, interaural discrepancies also manifest from the age of 50 years onwards. High-quality prospective data on the long-term natural evolution of hearing levels offer the opportunity to identify different disease stages in each cochlea and different types of evolution. This will provide more insights in the window of opportunity for future therapeutic intervention trials.
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Affiliation(s)
- Julie Moyaert
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium.
| | - Annick Gilles
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Griet Mertens
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Marc J W Lammers
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Hanne Gommeren
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | | | - Erik Fransen
- Centre of Medical Genetics, University of Antwerp, Antwerp, Belgium
| | - Nicolas Verhaert
- Department of Neurosciences, Research Group Experimental Otorhinolaryngology (ExpORL), KU Leuven, Leuven, Belgium
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospitals of Leuven, Leuven, Belgium
| | - Sam Denys
- Department of Neurosciences, Research Group Experimental Otorhinolaryngology (ExpORL), KU Leuven, Leuven, Belgium
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospitals of Leuven, Leuven, Belgium
| | - Raymond van de Berg
- Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Health Medicine and Life Sciences, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Ronald Pennings
- Department of Otorhinolaryngology and Head and Neck Surgery, Radboud UMC, Nijmegen, The Netherlands
| | - Olivier Vanderveken
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Vincent Van Rompaey
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
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Wils I, Geerardyn A, Putzeys T, Denis K, Verhaert N. Lumped element models of sound conduction in the human ear: A systematic review. J Acoust Soc Am 2023; 154:1696-1709. [PMID: 37712750 DOI: 10.1121/10.0020841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 08/16/2023] [Indexed: 09/16/2023]
Abstract
Lumped element models facilitate investigating the fundamental mechanisms of human ear sound conduction. This systematic review aims to guide researchers to the optimal model for the investigated parameters. For this purpose, the literature was reviewed up to 12 July 2023, according to the PRISMA guidelines. Seven models are included via database searching, and another 19 via cross-referencing. The quality of the models is assessed by comparing the predicted middle ear transfer function, the tympanic membrane impedance, the energy reflectance, and the intracochlear pressures (ICPs) (scala vestibuli, scala tympani, and differential) with experimental data. Regarding air conduction (AC), the models characterize the pathway from the outer to the inner ear and accurately predict all six aforementioned parameters. This contrasts with the few existing bone conduction (BC) models that simulate only a part of the ear. In addition, these models excel at predicting one observable parameter, namely, ICP. Thus, a model that simulates BC from the coupling site to the inner ear is still lacking and would increase insights into the human ear sound conduction. Last, this review provides insights and recommendations to determine the appropriate model for AC and BC implants, which is highly relevant for future clinical applications.
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Affiliation(s)
- Irina Wils
- Department of Neurosciences, KU Leuven, B-3000 Leuven, Belgium
| | | | - Tristan Putzeys
- Department of Neurosciences, KU Leuven, B-3000 Leuven, Belgium
| | - Kathleen Denis
- Department of Mechanical Engineering, KU Leuven, B-3000 Leuven, Belgium
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Geerardyn A, De Voecht K, Wouters J, Verhaert N. Electro-vibrational stimulation results in improved speech perception in noise for cochlear implant users with bilateral residual hearing. Sci Rep 2023; 13:11251. [PMID: 37438474 DOI: 10.1038/s41598-023-38468-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 07/08/2023] [Indexed: 07/14/2023] Open
Abstract
A cochlear implant is a neuroprosthetic device that can restore speech perception for people with severe to profound hearing loss. Because of recent evolutions, a growing number of people with a cochlear implant have useful residual acoustic hearing. While combined electro-acoustic stimulation has been shown to improve speech perception for this group of people, some studies report limited adoption rates. Here, we present electro-vibrational stimulation as an alternative combined stimulation strategy that similarly targets the full cochlear reserve. This novel strategy combines the electrical stimulation by the cochlear implant with low-frequency bone conduction stimulation. In a first evaluation of electro-vibrational stimulation, speech perception in noise was assessed in 9 subjects with a CI and symmetrical residual hearing. We demonstrate a statistically significant and clinically relevant improvement for speech perception in noise of 1.9 dB signal-to-noise ratio. This effect was observed with a first prototype that provides vibrational stimulation to both ears with limited transcranial attenuation. Future integration of electro-vibrational stimulation into one single implantable device could ultimately allow cochlear implant users to benefit from their low-frequency residual hearing without the need for an additional insert earphone.
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Affiliation(s)
- Alexander Geerardyn
- ExpORL, Department of Neurosciences, KU Leuven, Leuven, Belgium
- Department of Neurosciences, Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Katleen De Voecht
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Jan Wouters
- ExpORL, Department of Neurosciences, KU Leuven, Leuven, Belgium
- Department of Neurosciences, Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | - Nicolas Verhaert
- ExpORL, Department of Neurosciences, KU Leuven, Leuven, Belgium.
- Department of Neurosciences, Leuven Brain Institute, KU Leuven, Leuven, Belgium.
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.
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Wellens J, Deschaume O, Putzeys T, Eyley S, Thielemans W, Verhaert N, Bartic C. Sulfobetaine-based ultrathin coatings as effective antifouling layers for implantable neuroprosthetic devices. Biosens Bioelectron 2023; 226:115121. [PMID: 36774733 DOI: 10.1016/j.bios.2023.115121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/30/2023] [Accepted: 02/02/2023] [Indexed: 02/05/2023]
Abstract
Foreign body response (FBR), inflammation, and fibrotic encapsulation of neural implants remain major problems affecting the impedance of the electrode-tissue interface and altering the device performance. Adhesion of proteins and cells (e.g., pro-inflammatory macrophages, and fibroblasts) triggers the FBR cascade and can be diminished by applying antifouling coatings onto the implanted devices. In this paper, we report the deposition and characterization of a thin (±6 nm) sulfobetaine-based coating onto microfabricated platinum electrodes and cochlear implant (CI) electrode arrays. We found that this coating has stable cell and protein-repellent properties, for at least 31 days in vitro, not affected by electrical stimulation protocols. Additionally, its effect on the electrochemical properties relevant to stimulation (i.e., impedance, charge injection capacity) was negligible. When applied to clinical CI electrode arrays, the film was successful at inhibiting fibroblast adhesion on both the silicone packaging and the platinum/iridium electrodes. In vitro, in fibroblast cultures, coated CI electrode arrays maintained impedance values up to five times lower compared to non-coated devices. Our studies demonstrate that such thin sulfobetaine containing layers are stable and prevent protein and cell adhesion in vitro and are compatible for use on CI electrode arrays. Future in vivo studies should be conducted to investigate its ability to mitigate biofouling, fibrosis, and the resulting impedance changes upon long-term implantation in vivo.
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Affiliation(s)
- Jolan Wellens
- Laboratory for Soft Matter and Biophysics, Dept. Physics and Astronomy, KU Leuven, Celestijnenlaan 200D, 3001, Leuven, Belgium
| | - Olivier Deschaume
- Laboratory for Soft Matter and Biophysics, Dept. Physics and Astronomy, KU Leuven, Celestijnenlaan 200D, 3001, Leuven, Belgium
| | - Tristan Putzeys
- Laboratory for Soft Matter and Biophysics, Dept. Physics and Astronomy, KU Leuven, Celestijnenlaan 200D, 3001, Leuven, Belgium; Experimental Oto-rhino-laryngology Research Group, Dept. Neuroscience, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Samuel Eyley
- Sustainable Materials Lab, Department of Chemical Engineering, KU Leuven, Campus Kulak Kortrijk, Etienne Sabbelaan 53, 8500, Kortrijk, Belgium
| | - Wim Thielemans
- Sustainable Materials Lab, Department of Chemical Engineering, KU Leuven, Campus Kulak Kortrijk, Etienne Sabbelaan 53, 8500, Kortrijk, Belgium
| | - Nicolas Verhaert
- Experimental Oto-rhino-laryngology Research Group, Dept. Neuroscience, KU Leuven, Herestraat 49, 3000, Leuven, Belgium; Department of Otorhinolaryngology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Carmen Bartic
- Laboratory for Soft Matter and Biophysics, Dept. Physics and Astronomy, KU Leuven, Celestijnenlaan 200D, 3001, Leuven, Belgium.
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9
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Starovoyt A, Shaheen E, Putzeys T, Kerckhofs G, Politis C, Wouters J, Verhaert N. Anatomically and mechanically accurate scala tympani model for electrode insertion studies. Hear Res 2023; 430:108707. [PMID: 36773540 DOI: 10.1016/j.heares.2023.108707] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/25/2022] [Accepted: 01/24/2023] [Indexed: 01/26/2023]
Abstract
The risk of insertion trauma in cochlear implantation is determined by the interplay between individual cochlear anatomy and electrode insertion mechanics. Whereas patient anatomy cannot be changed, new surgical techniques, devices for cochlear monitoring, drugs, and electrode array designs are continuously being developed and tested, to optimize the insertion mechanics and prevent trauma. Preclinical testing of these developments is a crucial step in feasibility testing and optimization for clinical application. Human cadaveric specimens allow for the best simulation of an intraoperative setting. However, their availability is limited and it is not possible to conduct repeated, controlled experiments on the same sample. A variety of artificial cochlear models have been developed for electrode insertion studies, but none of them were both anatomically and mechanically representative for surgical insertion into an individual cochlea. In this study, we developed anatomically representative models of the scala tympani for surgical insertion through the round window, based on microCT images of individual human cochleae. The models were produced in transparent material using commonly-available 3D printing technology at a desired scale. The anatomical and mechanical accuracy of the produced models was validated by comparison with human cadaveric cochleae. Mechanical evaluation was performed by recording insertion forces, counting the number of inserted electrodes and grading tactile feedback during manual insertion of a straight electrode by experienced cochlear implant surgeons. Our results demonstrated that the developed models were highly representative for the anatomy of the original cochleae and for the insertion mechanics in human cadaveric cochleae. The individual anatomy of the produced models had a significant impact on the insertion mechanics. The described models have a promising potential to accelerate preclinical development and testing of atraumatic insertion techniques, reducing the need for human cadaveric material. In addition, realistic models of the cochlea can be used for surgical training and preoperative planning of patient-tailored cochlear implantation surgery.
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Affiliation(s)
- Anastasiya Starovoyt
- Research Group Experimental Oto-Rhino-Laryngology, Department of Neurosciences, KU Leuven, University of Leuven, Leuven, Belgium; Leuven Brain Institute, Department of Neurosciences, KU Leuven, 3000 Leuven, Belgium
| | - Eman Shaheen
- OMFS IMPATH Research Group, Department of Imaging and Pathology, KU Leuven, University of Leuven, Leuven, Belgium; Department of Oral and Maxillofacial Surgery, UZ Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Tristan Putzeys
- Research Group Experimental Oto-Rhino-Laryngology, Department of Neurosciences, KU Leuven, University of Leuven, Leuven, Belgium; Leuven Brain Institute, Department of Neurosciences, KU Leuven, 3000 Leuven, Belgium; Laboratory for Soft Matter and Biophysics, Department of Physics and Astronomy, KU Leuven, University of Leuven, Leuven, Belgium
| | - Greet Kerckhofs
- Biomechanics lab, Institute of Mechanics, Materials, and Civil Engineering, UCLouvain, Louvain-la-Neuve, Belgium; Department of Materials Engineering, KU Leuven, University of Leuven, Leuven, Belgium; IREC, Institute of Experimental and Clinical Research, UCLouvain, Woluwé-Saint-Lambert, Belgium; Prometheus, Division of Skeletal Tissue Engineering, KU Leuven, University of Leuven, Leuven, Belgium
| | - Constantinus Politis
- OMFS IMPATH Research Group, Department of Imaging and Pathology, KU Leuven, University of Leuven, Leuven, Belgium; Department of Oral and Maxillofacial Surgery, UZ Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Jan Wouters
- Research Group Experimental Oto-Rhino-Laryngology, Department of Neurosciences, KU Leuven, University of Leuven, Leuven, Belgium; Leuven Brain Institute, Department of Neurosciences, KU Leuven, 3000 Leuven, Belgium
| | - Nicolas Verhaert
- Research Group Experimental Oto-Rhino-Laryngology, Department of Neurosciences, KU Leuven, University of Leuven, Leuven, Belgium; Leuven Brain Institute, Department of Neurosciences, KU Leuven, 3000 Leuven, Belgium; Department of Otorhinolaryngology, Head and Neck Surgery, UZ Leuven, University Hospitals of Leuven, Leuven, Belgium.
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10
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Geerardyn A, Zhu M, Wu P, O'Malley J, Nadol JB, Liberman MC, Nakajima HH, Verhaert N, Quesnel AM. Three-dimensional quantification of fibrosis and ossification after cochlear implantation via virtual re-sectioning: Potential implications for residual hearing. Hear Res 2023; 428:108681. [PMID: 36584546 PMCID: PMC10942756 DOI: 10.1016/j.heares.2022.108681] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/13/2022] [Accepted: 12/18/2022] [Indexed: 12/24/2022]
Abstract
Hearing preservation may be achieved initially in the majority of patients after cochlear implantation, however, a significant proportion of these patients experience delayed hearing loss months or years later. A prior histological report in a case of delayed hearing loss suggested a potential cochlear mechanical origin of this hearing loss due to tissue fibrosis, and older case series highlight the frequent findings of post-implantation fibrosis and neoosteogenesis though without a focus on the impact on residual hearing. Here we present the largest series (N = 20) of 3-dimensionally reconstructed cochleae based on digitally scanned histologic sections from patients who were implanted during their lifetime. All patients were implanted with multichannel electrodes via a cochleostomy or an extended round window insertion. A quantified analysis of intracochlear tissue formation was carried out via virtual re-sectioning orthogonal to the cochlear spiral. Intracochlear tissue formation was present in every case. On average 33% (SD 14%) of the total cochlear volume was occupied by new tissue formation, consisting of 26% (SD 12%) fibrous and 7% (SD 6%) bony tissue. The round window was completely covered by fibro-osseous tissue in 85% of cases and was associated with an obstruction of the cochlear aqueduct in 100%. The basal part of the basilar membrane was at least partially abutted by the electrode or new tissue formation in every case, while the apical region, corresponding with a characteristic frequency of < 500 Hz, appeared normal in 89%. This quantitative analysis shows that after cochlear implantation via extended round window or cochleostomy, intracochlear fibrosis and neoossification are present in all cases at anatomical locations that could impact normal inner ear mechanics.
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Affiliation(s)
- A Geerardyn
- Department of Otolaryngology - Head & Neck Surgery, Harvard Medical School, Boston, MA, USA; Otopathology Laboratory, Massachusetts Eye and Ear, Boston, MA, USA; ExpORL, Department of Neurosciences, Katholieke Universiteit Leuven, Leuven, Belgium
| | - M Zhu
- Otopathology Laboratory, Massachusetts Eye and Ear, Boston, MA, USA
| | - P Wu
- Department of Otolaryngology - Head & Neck Surgery, Harvard Medical School, Boston, MA, USA; Eaton Peabody Laboratories, Massachusetts Eye and Ear, Boston, MA, USA
| | - J O'Malley
- Otopathology Laboratory, Massachusetts Eye and Ear, Boston, MA, USA
| | - J B Nadol
- Department of Otolaryngology - Head & Neck Surgery, Harvard Medical School, Boston, MA, USA; Otopathology Laboratory, Massachusetts Eye and Ear, Boston, MA, USA
| | - M C Liberman
- Department of Otolaryngology - Head & Neck Surgery, Harvard Medical School, Boston, MA, USA; Otopathology Laboratory, Massachusetts Eye and Ear, Boston, MA, USA; Eaton Peabody Laboratories, Massachusetts Eye and Ear, Boston, MA, USA
| | - H H Nakajima
- Department of Otolaryngology - Head & Neck Surgery, Harvard Medical School, Boston, MA, USA; Eaton Peabody Laboratories, Massachusetts Eye and Ear, Boston, MA, USA
| | - N Verhaert
- ExpORL, Department of Neurosciences, Katholieke Universiteit Leuven, Leuven, Belgium
| | - A M Quesnel
- Department of Otolaryngology - Head & Neck Surgery, Harvard Medical School, Boston, MA, USA; Otopathology Laboratory, Massachusetts Eye and Ear, Boston, MA, USA.
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11
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Van den Borre E, Wouters J, Verhaert N, Boon E, van Wieringen A. Measures of Speech Understanding in Noise for Young Children with a Cochlear Implant in Mainstream and Special Education. Trends Hear 2023; 27:23312165231179586. [PMID: 37282565 DOI: 10.1177/23312165231179586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
The use of two types of speech-in-noise (SPIN) assessment, namely digits-in-noise self-tests and open-set, monosyllabic word tests, to assess the SPIN understanding performance of children with cochlear implants (CI) in mainstream and special education, was investigated. The tests' feasibility and reliability and the influence of specific cognitive abilities on their results were studied. The results of 30 children with CIs in mainstream and special education were compared to those of 60 normal-hearing children in elementary school. Results indicate that the digit triplet test (DTT) was feasible for all children tested in this study, as seen by the familiarity of all the digits, the high stability of the test results (<3 dB SNR), and a small measurement error (≤2 dB SNR). Remembering full triplets did not form a problem and results did not show systematic attention loss. For children with CIs, the performance on the DTT was strongly related to the performance on the open-set monosyllabic word-in-noise task. However, small but significant differences were observed in the performance of children with CIs in mainstream and special education on the monosyllabic word test. Both tests showed little influence of cognitive abilities, making them both useful in situations where the bottom-up auditory aspect of SPIN performance needs to be investigated or in situations where sentence-in-noise tests are too challenging.
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Affiliation(s)
- Elien Van den Borre
- Department of Neurosciences, Research Group ExpORL, KU Leuven, Leuven, Belgium
| | - Jan Wouters
- Department of Neurosciences, Research Group ExpORL, KU Leuven, Leuven, Belgium
| | - Nicolas Verhaert
- Department of Neurosciences, Research Group ExpORL, KU Leuven, Leuven, Belgium
- Department of Neurosciences, Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Department of Otorhinolaryngology, Head and Neck Surgery, UZ Leuven, University Hospitals of Leuven, Leuven, Belgium
| | - Ellen Boon
- Department of Otorhinolaryngology, Head and Neck Surgery, UZ Leuven, University Hospitals of Leuven, Leuven, Belgium
| | - Astrid van Wieringen
- Department of Neurosciences, Research Group ExpORL, KU Leuven, Leuven, Belgium
- Department of Special Needs Education, University of Oslo, Oslo, Norway
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12
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Starovoyt A, Quirk BC, Putzeys T, Kerckhofs G, Nuyts J, Wouters J, McLaughlin RA, Verhaert N. An optically-guided cochlear implant sheath for real-time monitoring of electrode insertion into the human cochlea. Sci Rep 2022; 12:19234. [PMID: 36357503 PMCID: PMC9649659 DOI: 10.1038/s41598-022-23653-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 11/03/2022] [Indexed: 11/12/2022] Open
Abstract
In cochlear implant surgery, insertion of perimodiolar electrode arrays into the scala tympani can be complicated by trauma or even accidental translocation of the electrode array within the cochlea. In patients with partial hearing loss, cochlear trauma can not only negatively affect implant performance, but also reduce residual hearing function. These events have been related to suboptimal positioning of the cochlear implant electrode array with respect to critical cochlear walls of the scala tympani (modiolar wall, osseous spiral lamina and basilar membrane). Currently, the position of the electrode array in relation to these walls cannot be assessed during the insertion and the surgeon depends on tactile feedback, which is unreliable and often comes too late. This study presents an image-guided cochlear implant device with an integrated, fiber-optic imaging probe that provides real-time feedback using optical coherence tomography during insertion into the human cochlea. This novel device enables the surgeon to accurately detect and identify the cochlear walls ahead and to adjust the insertion trajectory, avoiding collision and trauma. The functionality of this prototype has been demonstrated in a series of insertion experiments, conducted by experienced cochlear implant surgeons on fresh-frozen human cadaveric cochleae.
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Affiliation(s)
- Anastasiya Starovoyt
- grid.5596.f0000 0001 0668 7884Department of Neurosciences, ExpORL, KU Leuven, 3000 Leuven, Belgium ,grid.5596.f0000 0001 0668 7884Department of Neurosciences, Leuven Brain Institute, KU Leuven, 3000 Leuven, Belgium
| | - Bryden C. Quirk
- grid.1010.00000 0004 1936 7304Australian Research Council Centre of Excellence for Nanoscale BioPhotonics, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA 5005 Australia ,grid.1010.00000 0004 1936 7304Institute for Photonics and Advanced Sensing, The University of Adelaide, Adelaide, SA 5005 Australia
| | - Tristan Putzeys
- grid.5596.f0000 0001 0668 7884Department of Neurosciences, ExpORL, KU Leuven, 3000 Leuven, Belgium ,grid.5596.f0000 0001 0668 7884Department of Neurosciences, Leuven Brain Institute, KU Leuven, 3000 Leuven, Belgium ,grid.5596.f0000 0001 0668 7884Laboratory for Soft Matter and Biophysics, Department of Physics and Astronomy, KU Leuven, 3000 Leuven, Belgium
| | - Greet Kerckhofs
- grid.7942.80000 0001 2294 713XBiomechanics Laboratory, Institute of Mechanics, Materials, and Civil Engineering, UCLouvain, 1348 Louvain-La-Neuve, Belgium ,grid.5596.f0000 0001 0668 7884Department of Materials Science and Engineering, KU Leuven, 3000 Leuven, Belgium ,grid.7942.80000 0001 2294 713XInstitute of Experimental and Clinical Research, UCLouvain, 1200 Woluwé-Saint-Lambert, Belgium ,grid.5596.f0000 0001 0668 7884Prometheus, Division of Skeletal Tissue Engineering, KU Leuven, 3000 Leuven, Belgium
| | - Johan Nuyts
- grid.5596.f0000 0001 0668 7884Department of Imaging and Pathology, Division of Nuclear Medicine, KU Leuven, 3000 Leuven, Belgium ,Nuclear Medicine and Molecular Imaging, Medical Imaging Research Center, 3000 Leuven, Belgium
| | - Jan Wouters
- grid.5596.f0000 0001 0668 7884Department of Neurosciences, ExpORL, KU Leuven, 3000 Leuven, Belgium ,grid.5596.f0000 0001 0668 7884Department of Neurosciences, Leuven Brain Institute, KU Leuven, 3000 Leuven, Belgium
| | - Robert A. McLaughlin
- grid.1010.00000 0004 1936 7304Australian Research Council Centre of Excellence for Nanoscale BioPhotonics, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA 5005 Australia ,grid.1010.00000 0004 1936 7304Institute for Photonics and Advanced Sensing, The University of Adelaide, Adelaide, SA 5005 Australia ,grid.1012.20000 0004 1936 7910School of Engineering, University of Western Australia, Perth, WA 6009 Australia
| | - Nicolas Verhaert
- grid.5596.f0000 0001 0668 7884Department of Neurosciences, ExpORL, KU Leuven, 3000 Leuven, Belgium ,grid.5596.f0000 0001 0668 7884Department of Neurosciences, Leuven Brain Institute, KU Leuven, 3000 Leuven, Belgium ,grid.410569.f0000 0004 0626 3338Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals of Leuven, 3000 Leuven, Belgium
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13
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Pollet N, Mennes T, Denys S, Loos E, Verhaert N, Vander Poorten V, Hens G. Otomicroscopic and functional outcomes after cleft palate repair via Sommerlad intravelar veloplasty vs. modified Veau-Wardill-Kilner push-back. Int J Pediatr Otorhinolaryngol 2022; 162:111283. [PMID: 35998528 DOI: 10.1016/j.ijporl.2022.111283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 07/18/2022] [Accepted: 08/11/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE We aim to compare the modified Veau-Wardill-Kilner push-back technique (VWK) and the Sommerlad intravelar veloplasty (Sommerlad IVVP) in terms of middle ear outcomes and oronasal fistulae frequency in three years old children. METHODS For this retrospective cohort study, data were collected and anonymized from consecutive patients with cleft palate (with or without cleft lip) who underwent surgery in our hospital between January 2008 and December 2018. Patients with syndromic diagnoses and patients who underwent surgical treatment elsewhere were excluded. We collected data from 101 children (202 ears) regarding middle ear complications at the age of three, including acute otitis media, middle ear effusion, tympanic membrane retraction, tympanic membrane perforation, tympanic membrane atelectasis and chronic otitis media with cholesteatoma. In addition, the presence of oronasal fistulae and the number of ventilation tubes received by the age of three were recorded. RESULTS The odds of children having a normal middle ear evaluation were 3.07 (95% Confidence interval (95%CI): [1.52, 6.12]; p < 0.05) times higher when children received Sommerlad IVVP compared to modified VWK. With 40.7% compared to 26.7%, a significantly higher incidence of middle ear effusion was present in the modified VWK group compared to Sommerlad IVVP (X2(1) = 4.38, p < 0.05). Furthermore, this group needed significantly more ventilation tube reinsertions (X2(2) = 12.22, p < 0.05) and was found to have a significantly higher incidence of oronasal fistula (53.5% vs. 17.2%, X2(1) = 14.75, p < 0.05). The latter was significantly associated with a higher need for ventilation tube reinsertion (X2(1) = 7.34, p < 0.05). CONCLUSION This study shows superior middle ear outcomes and fewer oronasal fistulae after Sommerlad IVVP compared to modified Veau-Wardill-Kilner push-back at the age of three.
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Affiliation(s)
- Naomi Pollet
- Otorhinolaryngology, Head & Neck Surgery, University Hospitals Leuven, Herestraat 49, B-3000, Leuven, Belgium.
| | - Tillo Mennes
- Otorhinolaryngology, Head & Neck Surgery, University Hospitals Leuven, Herestraat 49, B-3000, Leuven, Belgium.
| | - Sam Denys
- Otorhinolaryngology, Head & Neck Surgery, University Hospitals Leuven, Herestraat 49, B-3000, Leuven, Belgium; Department of Neurosciences, KU Leuven, Herestraat 49, B-3000, Leuven, Belgium.
| | - Elke Loos
- Otorhinolaryngology, Head & Neck Surgery, University Hospitals Leuven, Herestraat 49, B-3000, Leuven, Belgium; Department of Neurosciences, KU Leuven, Herestraat 49, B-3000, Leuven, Belgium.
| | - Nicolas Verhaert
- Otorhinolaryngology, Head & Neck Surgery, University Hospitals Leuven, Herestraat 49, B-3000, Leuven, Belgium; Department of Neurosciences, KU Leuven, Herestraat 49, B-3000, Leuven, Belgium.
| | - Vincent Vander Poorten
- Otorhinolaryngology, Head & Neck Surgery, University Hospitals Leuven, Herestraat 49, B-3000, Leuven, Belgium; Department of Oncology, KU Leuven, Herestraat 49, B-3000, Leuven, Belgium.
| | - Greet Hens
- Otorhinolaryngology, Head & Neck Surgery, University Hospitals Leuven, Herestraat 49, B-3000, Leuven, Belgium; Department of Neurosciences, KU Leuven, Herestraat 49, B-3000, Leuven, Belgium.
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14
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Denys S, Cima RFF, Fuller TE, Ceresa AS, Blockmans L, Vlaeyen JWS, Verhaert N. Fear influences phantom sound percepts in an anechoic room. Front Psychol 2022; 13:974718. [PMID: 36225679 PMCID: PMC9549870 DOI: 10.3389/fpsyg.2022.974718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 09/05/2022] [Indexed: 11/29/2022] Open
Abstract
Aims and hypotheses In an environment of absolute silence, researchers have found many of their participants to perceive phantom sounds (tinnitus). With this between-subject experiment, we aimed to elaborate on these research findings, and specifically investigated whether–in line with the fear-avoidance model of tinnitus perception and reactivity–fear or level of perceived threat influences the incidence and perceptual qualities of phantom sound percepts in an anechoic room. We investigated the potential role of individual differences in anxiety, negative affect, noise sensitivity and subclinical hearing loss. We hypothesized that participants who experience a higher level of threat would direct their attention more to the auditory system, leading to the perception of tinnitus-like sounds, which would otherwise be subaudible, and that under conditions of increased threat, narrowing of attention would lead to perceptual distortions. Methods In total, N = 78 normal-hearing volunteers participated in this study. In general, the study sample consisted of young, mostly female, university students. Their hearing was evaluated using gold-standard pure tone audiometry and a speech-in-noise self-test (Digit Triplet Test), which is a sensitive screening test to identify subclinical hearing loss. Prior to a four-minute stay in an anechoic room, we randomized participants block design-wise in a threat (N = 37) and no-threat condition (N = 41). Participants in the threat condition were deceived about their hearing and were led to believe that staying in the room would potentially harm their hearing temporarily. Participants were asked whether they perceived sounds during their stay in the room and rated the perceptual qualities of sound percepts (loudness and unpleasantness). They were also asked to fill-out standardized questionnaires measuring anxiety (State–Trait Anxiety Inventory), affect (Positive and Negative Affect Schedule) and noise sensitivity (Weinstein Noise Sensitivity Scale). The internal consistency of the questionnaires used was verified in our study sample and ranged between α = 0.61 and α = 0.90. Results In line with incidence rates reported in the literature, 74% of our participants reported having heard tinnitus-like sounds in the anechoic room. Speech-in-noise identification ability was comparable for both groups of participants. The experimental manipulation of threat was proven to be effective, as indicated by significantly higher scores on a Threat Manipulation Checklist among participants in the threat condition as compared to those in the no-threat condition (p < 0.01). Nevertheless, participants in the threat condition were as likely to report tinnitus percepts as participants in the no-threat condition (p = 1), and tinnitus percepts were not rated as being louder (p = 0.76) or more unpleasant (p = 0.64) as a function of level of threat. For participants who did experience tinnitus percepts, a higher level of threat was associated with a higher degree of experienced unpleasantness (p < 0.01). These associations were absent in those who did not experience tinnitus. Higher negative affect was only slightly associated with higher ratings of tinnitus unpleasantness (p < 0.01). Conclusion Whereas our threat manipulation was successful in elevating the level of fear, it did not contribute to a higher percentage of participants perceiving tinnitus-like sounds in the threat condition. However, higher levels of perceived threat were related to a higher degree of perceived tinnitus unpleasantness. The findings of our study are drawn from a rather homogenous participant pool in terms of age, gender, and educational background, challenging conclusions that are applicable for the general population. Participants generally obtained normophoric scores on independent variables of interest: they were low anxious, low noise-sensitive, and there was little evidence for the presence of subclinical hearing loss. Possibly, there was insufficient variation in scores to find effects.
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Affiliation(s)
- Sam Denys
- Research Group Experimental Otorhinolaryngology (ExpORL), Department of Neurosciences, University of Leuven, Leuven, Belgium
- Department of Otorhinolaryngology–Head and Neck Surgery, University Hospitals of Leuven, Leuven, Belgium
- Multidisciplinary University Center for Speech-Language Pathology and Audiology, University Hospitals of Leuven, Leuven, Belgium
- *Correspondence: Sam Denys,
| | - Rilana F. F. Cima
- Research Group Health Psychology, Department of Behavior, Health and Psychopathology, University of Leuven, Leuven, Belgium
- Department of Clinical Psychological Science, Maastricht University, Maastricht, Netherlands
- Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, Netherlands
| | - Thomas E. Fuller
- Department of Clinical Psychological Science, Maastricht University, Maastricht, Netherlands
- Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, Netherlands
- Medtronic, Maastricht, Netherlands
| | | | - Lauren Blockmans
- Research Group Experimental Otorhinolaryngology (ExpORL), Department of Neurosciences, University of Leuven, Leuven, Belgium
| | - Johan W. S. Vlaeyen
- Research Group Health Psychology, Department of Behavior, Health and Psychopathology, University of Leuven, Leuven, Belgium
| | - Nicolas Verhaert
- Research Group Experimental Otorhinolaryngology (ExpORL), Department of Neurosciences, University of Leuven, Leuven, Belgium
- Department of Otorhinolaryngology–Head and Neck Surgery, University Hospitals of Leuven, Leuven, Belgium
- Multidisciplinary University Center for Speech-Language Pathology and Audiology, University Hospitals of Leuven, Leuven, Belgium
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15
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Putzeys T, Borgers C, Fierens G, Walraevens J, Van Wieringen A, Verhaert N. Intracochlear pressure as an objective measure for perceived loudness with bone conduction implants. Hear Res 2022; 422:108550. [PMID: 35689853 DOI: 10.1016/j.heares.2022.108550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 05/25/2022] [Accepted: 05/28/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND The generally accepted method to assess the functionality of novel bone conduction implants in a preclinical stage is to experimentally measure the vibratory response of the cochlear promontory. Yet, bone conduction of sound is a complex propagation phenomenon, depending on both frequency and amplitude, involving different conduction pathways. OBJECTIVES The aim of this study is to validate the use of intracochlear sound pressure (ICP) as an objective indicator for perceived loudness for bone conduction stimulation. It is investigated whether a correlation exists between intracochlear sound pressure measurements in cadaveric temporal bones and clinically obtained results using the outcome of a loudness balancing experiment. METHODS Ten normal hearing subjects were asked to balance the perceived loudness between air conducted (AC) sound and bone conducted (BC) sound by changing the AC stimulus. Mean balanced thresholds were calculated and used as stimulation levels in a cadaver trial (N = 4) where intracochlear sound pressure was measured during AC and BC stimulation to assess the correlation with the measured clinical data. The intracochlear pressure was measured at the relatively low stimulation amplitude of 80 dBHL using a lock-in amplification technique. RESULTS Applying AC and BC stimulation at equal perceived loudness on cadaveric heads yield a similar differential intracochlear pressure, with differences between AC and BC falling within the range of variability of normal hearing test subjects. CONCLUSION Comparing the perceived loudness at 80 dB HL for both AC and BC validates intracochlear pressure as an objective indicator of the cochlear drive. The measurement setup is more time-intensive than measuring the vibratory response of the cochlear promontory, yet it provides direct information on the level of the cochlear scalae.
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Affiliation(s)
- Tristan Putzeys
- KU Leuven - University of Leuven, Department of Neurosciences, ExpORL, B-3000 Leuven, Belgium; KU Leuven - University of Leuven, Department of Physics and Astronomy, Laboratory for Soft Matter and Biophysics, Heverlee, Belgium.
| | - Charlotte Borgers
- KU Leuven - University of Leuven, Department of Neurosciences, ExpORL, B-3000 Leuven, Belgium
| | - Guy Fierens
- KU Leuven - University of Leuven, Department of Neurosciences, ExpORL, B-3000 Leuven, Belgium; KU Leuven - University of Leuven, Department of Physics and Astronomy, Laboratory for Soft Matter and Biophysics, Heverlee, Belgium; Cochlear Technology Centre, Mechelen, Belgium
| | | | - Astrid Van Wieringen
- KU Leuven - University of Leuven, Department of Neurosciences, ExpORL, B-3000 Leuven, Belgium
| | - Nicolas Verhaert
- KU Leuven - University of Leuven, Department of Neurosciences, ExpORL, B-3000 Leuven, Belgium; University Hospitals Leuven, Department of Otorhinolaryngology, Head and Neck Surgery, Leuven, Belgium
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Vermeersch G, Laenen L, Lens G, van der Elst KCM, Thal DR, Jentjens S, Demaerel P, Van Nieuwenhuyse T, Wollants E, Boeckx N, Verhaert N, Dubois B, Kuppeveld FJM, Woei-A-Jin FJSHS. Antiviral treatment with fluoxetine for rituximab-associated chronic echovirus 13 meningoencephalitis and myofasciitis. Eur J Neurol 2022; 29:3117-3123. [PMID: 35763378 DOI: 10.1111/ene.15478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/23/2022] [Accepted: 06/04/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND & PURPOSE Enterovirus infections pose a serious threat for patients with humoral deficiencies and may be lethal, while the efficacy of proposed treatment options, such as corticosteroids, intravenous immunoglobulins and fluoxetine remain debated. METHODS We investigated viral clearance in a patient with rituximab-induced B-cell depletion and chronic echovirus 13 (E13) meningoencephalitis/myofasciitis in response to intravenous immunoglobulins and fluoxetine using sequential semi-quantitative E13 viral load measurements by real-time reverse transcription polymerase chain reaction. Fluoxetine concentrations in plasma and cerebrospinal fluid were determined by liquid chromatography-mass spectrometry. RESULTS Intravenous immunoglobulins appeared ineffective in this case of E13 infection, whereas virus clearance in cerebrospinal fluid was obtained after 167 days of oral fluoxetine. Since treatment with corticosteroids resulted in a flare of symptoms, rechallenge with viral load measurements was not attempted. CONCLUSION In this report of a patient with rituximab-associated chronic echovirus 13 meningoencephalitis viral clearance in response to single treatment options is assessed for the first time. Our observations further support the in vivo efficacy of fluoxetine against enteroviral infections. More research is needed to establish its efficacy in different enterovirus strains.
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Affiliation(s)
- Gaël Vermeersch
- Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium
| | - Lies Laenen
- Department of Laboratory Medicine, National Reference Centre for Enteroviruses, University Hospitals Leuven, Leuven, Belgium
| | - Géraldine Lens
- Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium.,Department of Nuclear Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Kim C M van der Elst
- Department of Clinical Pharmacy, Division Laboratories, Pharmacy and Biomedical Genetics, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Dietmar Rudolf Thal
- Department of Pathology, University Hospitals Leuven, and Laboratory of Neuropathology, Department of Imaging and Pathology, Leuven Brain Institute, Leuven, Belgium
| | - Sander Jentjens
- Department of Nuclear Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Philippe Demaerel
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium
| | | | - Elke Wollants
- Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical and Epidemiological Virology, Rega Institute, KU, Leuven, Belgium
| | - Nancy Boeckx
- Clinical Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Nicolas Verhaert
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Benedicte Dubois
- Department of Neurology, University Hospitals Leuven, Leuven Brain Institute, Leuven, Belgium
| | - Frank J M Kuppeveld
- Department of Biomolecular Health Sciences, Division of Infectious Diseases and Immunology, Section of Virology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - F J S H Sherida Woei-A-Jin
- Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium
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17
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Parys QA, Van Bulck P, Loos E, Verhaert N. Inner Ear Pharmacotherapy for Residual Hearing Preservation in Cochlear Implant Surgery: A Systematic Review. Biomolecules 2022; 12:biom12040529. [PMID: 35454118 PMCID: PMC9032072 DOI: 10.3390/biom12040529] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 03/25/2022] [Accepted: 03/28/2022] [Indexed: 02/05/2023] Open
Abstract
Cochlear implantation initiates an inflammatory cascade in which both acute insertion trauma and chronic foreign body reaction lead to intracochlear fibrosis and loss of residual hearing. Several strategies have been proposed to attenuate the local reactive process after implantation, including intracochlear drug delivery. The present study gives an overview of what is being investigated in the field of inner ear therapeutics and cochlear implant surgery. The aim is to evaluate its potential benefit in clinical practice. A systematic search was conducted in PubMed, Embase, and Cochrane Library databases identifying comparative prospective studies examining the effect of direct inner ear drug application on mechanical cochlear trauma. Both animal and human studies were considered and all studies were assessed for quality according to the validated risk of bias tools. Intracochlear administration of drugs is a feasible method to reduce the local inflammatory reaction following cochlear implantation. In animal studies, corticosteroid use had a significant effect on outcome measures including auditory brainstem response, impedance, and histological changes. This effect was, however, only durable with prolonged drug delivery. Significant differences in outcome were predominantly seen in studies where the cochlear damage was extensive. Six additional reports assessing non-steroidal agents were found. Overall, evidence of anti-inflammatory effects in humans is still scarce.
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Affiliation(s)
- Quentin-Alexandre Parys
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, 3000 Leuven, Belgium; (Q.-A.P.); (P.V.B.); (E.L.)
| | - Pauline Van Bulck
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, 3000 Leuven, Belgium; (Q.-A.P.); (P.V.B.); (E.L.)
| | - Elke Loos
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, 3000 Leuven, Belgium; (Q.-A.P.); (P.V.B.); (E.L.)
- Department of Neurosciences, Research Group Experimental Oto-Rhino-Laryngology (ExpORL), KU Leuven, University of Leuven, 3000 Leuven, Belgium
| | - Nicolas Verhaert
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, 3000 Leuven, Belgium; (Q.-A.P.); (P.V.B.); (E.L.)
- Department of Neurosciences, Research Group Experimental Oto-Rhino-Laryngology (ExpORL), KU Leuven, University of Leuven, 3000 Leuven, Belgium
- Correspondence:
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18
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Roggeman Q, Denys S, Pietermans L, Willaert A, Desloovere C, Verhaert N. Impact of delay of elective otologic surgical interventions during the COVID-19 pandemic. B-ENT 2021. [DOI: 10.5152/b-ent.2021.21471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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19
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D'hondt C, Verhaert N, Wouters J. Directional Response of a subcutaneous hearing implant microphone. Hear Res 2021; 421:108412. [PMID: 34969577 DOI: 10.1016/j.heares.2021.108412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 10/26/2021] [Accepted: 12/06/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Christiane D'hondt
- KU Leuven, University of Leuven, Department of Neurosciences, Research Group ExpORL, Onderwijs en Navorsing 2, Herestraat 49, bus 721, 3000, Leuven, Belgium; Cochlear Technology Centre Belgium, Schaliënhoevedreef 20i, 2800, Mechelen, Belgium.
| | - Nicolas Verhaert
- KU Leuven, University of Leuven, Department of Neurosciences, Research Group ExpORL, Onderwijs en Navorsing 2, Herestraat 49, bus 721, 3000, Leuven, Belgium; University Hospitals Leuven, Department of Otolaryngology, Head and Neck Surgery, Herestraat 49, 3000 Leuven, Belgium.
| | - Jan Wouters
- KU Leuven, University of Leuven, Department of Neurosciences, Research Group ExpORL, Onderwijs en Navorsing 2, Herestraat 49, bus 721, 3000, Leuven, Belgium.
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20
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Schoisswohl S, Langguth B, Schecklmann M, Bernal-Robledano A, Boecking B, Cederroth CR, Chalanouli D, Cima R, Denys S, Dettling-Papargyris J, Escalera-Balsera A, Espinosa-Sanchez JM, Gallego-Martinez A, Giannopoulou E, Hidalgo-Lopez L, Hummel M, Kikidis D, Koller M, Lopez-Escamez JA, Marcrum SC, Markatos N, Martin-Lagos J, Martinez-Martinez M, Martinez-Martinez M, Ferron MM, Mazurek B, Mueller-Locatelli N, Neff P, Oppel K, Perez-Carpena P, Robles-Bolivar P, Rose M, Schiele T, Schiller A, Simoes J, Stark S, Staudinger S, Stege A, Verhaert N, Schlee W. Unification of Treatments and Interventions for Tinnitus Patients (UNITI): a study protocol for a multi-center randomized clinical trial. Trials 2021; 22:875. [PMID: 34863270 PMCID: PMC8642746 DOI: 10.1186/s13063-021-05835-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 11/15/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Tinnitus represents a relatively common condition in the global population accompanied by various comorbidities and severe burden in many cases. Nevertheless, there is currently no general treatment or cure, presumable due to the heterogeneity of tinnitus with its wide variety of etiologies and tinnitus phenotypes. Hence, most treatment studies merely demonstrated improvement in a subgroup of tinnitus patients. The majority of studies are characterized by small sample sizes, unstandardized treatments and assessments, or applications of interventions targeting only a single organ level. Combinatory treatment approaches, potentially targeting multiple systems as well as treatment personalization, might provide remedy and enhance treatment responses. The aim of the present study is to systematically examine established tinnitus therapies both alone and in combination in a large sample of tinnitus patients. Further, it wants to provide the basis for personalized treatment approaches by evaluating a specific decision support system developed as part of an EU-funded collaborative project (Unification of treatments and interventions for tinnitus patients; UNITI project). METHODS/STUDY DESIGN This is a multi-center parallel-arm randomized clinical trial conducted at five different clinical sites over the EU. The effect of four different tinnitus therapy approaches (sound therapy, structured counseling, hearing aids, cognitive behavioral therapy) applied over a time period of 12 weeks as a single or rather a combinatory treatment in a total number of 500 chronic tinnitus patients will be investigated. Assessments and interventions are harmonized over the involved clinical sites. The primary outcome measure focuses on the domain tinnitus distress assessed via the Tinnitus Handicap Inventory. DISCUSSION Results and conclusions from the current study might not only provide an essential contribution to combinatory and personalized treatment approaches in tinnitus but could also provide more profound insights in the heterogeneity of tinnitus, representing an important step towards a cure for tinnitus. TRIAL REGISTRATION ClinicalTrials.gov NCT04663828 . Registered on 11 December 2020.
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Affiliation(s)
- Stefan Schoisswohl
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitaetsstraße 84, 93053, Regensburg, Germany.
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitaetsstraße 84, 93053, Regensburg, Germany
| | - Martin Schecklmann
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitaetsstraße 84, 93053, Regensburg, Germany
| | - Alberto Bernal-Robledano
- Department of Otolaryngology, Instituto de Investigacion Biosanitaria Ibs.GRANADA, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Benjamin Boecking
- Tinnitus Center, Charité- Universitätsmedizin Berlin, corporate member of Freie Universität Berlin und Humboldt Universität Berlin, Berlin, Germany
| | | | | | - Rilana Cima
- Department of Health Psychology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Sam Denys
- Department of Neurosciences, Research group Experimental Oto-Rhino-Laryngology, University of Leuven, Leuven, Belgium.,Department of Otorhinolaryngology - Head and Neck surgery, University Hospitals Leuven, Leuven, Belgium.,Multidisciplinary University Center for Speech-Language Pathology and Audiology, University Hospitals Leuven, Leuven, Belgium
| | | | - Alba Escalera-Balsera
- Otology & Neurotology Group CTS 495, Department of Genomic Medicine, GENYO, Center for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, Spain
| | - Juan Manuel Espinosa-Sanchez
- Department of Otolaryngology, Instituto de Investigacion Biosanitaria Ibs.GRANADA, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Otology & Neurotology Group CTS 495, Department of Genomic Medicine, GENYO, Center for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, Spain
| | - Alvaro Gallego-Martinez
- Otology & Neurotology Group CTS 495, Department of Genomic Medicine, GENYO, Center for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, Spain
| | | | - Leyre Hidalgo-Lopez
- Department of Mental Health, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Michael Hummel
- Central Biobank Charité, Charité- Universitätsmedizin Berlin, corporate member of Freie Universität Berlin und Humboldt Universität Berlin, Berlin, Germany
| | - Dimitris Kikidis
- Department of Otolaryngology, Head and Neck Surgery, National and Kapodistrian University of Athens, Hippocrateion General Hospital, Athens, Greece
| | - Michael Koller
- Center for Clinical Studies, University Hospital Regensburg, Regensburg, Germany
| | - Jose A Lopez-Escamez
- Department of Otolaryngology, Instituto de Investigacion Biosanitaria Ibs.GRANADA, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Otology & Neurotology Group CTS 495, Department of Genomic Medicine, GENYO, Center for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, Spain.,Department of Surgery, Division of Otolaryngology, Universidad de Granada, Granada, Spain
| | - Steven C Marcrum
- Department of Otolaryngology, University Hospital Regensburg, Regensburg, Germany
| | - Nikolaos Markatos
- Department of Otolaryngology, Head and Neck Surgery, National and Kapodistrian University of Athens, Hippocrateion General Hospital, Athens, Greece
| | - Juan Martin-Lagos
- Department of Otolaryngology, Instituto de Investigacion Biosanitaria ibs. GRANADA, Hospital Universitario Clinico San Cecilio, Granada, Spain
| | - Maria Martinez-Martinez
- Department of Otolaryngology, Instituto de Investigacion Biosanitaria Ibs.GRANADA, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Otology & Neurotology Group CTS 495, Department of Genomic Medicine, GENYO, Center for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, Spain
| | - Marta Martinez-Martinez
- Department of Otolaryngology, Instituto de Investigacion Biosanitaria Ibs.GRANADA, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Department of Otolaryngology, Instituto de Investigacion Biosanitaria ibs. GRANADA, Hospital Universitario Clinico San Cecilio, Granada, Spain
| | - Maria Mata Ferron
- Department of Otolaryngology, Instituto de Investigacion Biosanitaria Ibs.GRANADA, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Otology & Neurotology Group CTS 495, Department of Genomic Medicine, GENYO, Center for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, Spain
| | - Birgit Mazurek
- Tinnitus Center, Charité- Universitätsmedizin Berlin, corporate member of Freie Universität Berlin und Humboldt Universität Berlin, Berlin, Germany
| | - Nicolas Mueller-Locatelli
- Department of Otolaryngology, Instituto de Investigacion Biosanitaria ibs. GRANADA, Hospital Universitario Clinico San Cecilio, Granada, Spain
| | - Patrick Neff
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitaetsstraße 84, 93053, Regensburg, Germany.,Center for Cognitive Neuroscience and Department of Psychology, University of Salzburg, Salzburg, Austria
| | - Kevin Oppel
- Terzo-Institute for Applied Hearing Research, ISMA, Sonneberg, Germany
| | - Patricia Perez-Carpena
- Department of Otolaryngology, Instituto de Investigacion Biosanitaria Ibs.GRANADA, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Otology & Neurotology Group CTS 495, Department of Genomic Medicine, GENYO, Center for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, Spain
| | - Paula Robles-Bolivar
- Otology & Neurotology Group CTS 495, Department of Genomic Medicine, GENYO, Center for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, Spain
| | - Matthias Rose
- Department of Psychosomatic and Psychotherapy, Charité- Universitätsmedizin Berlin, corporate member of Freie Universität Berlin und Humboldt Universität Berlin, Berlin, Germany
| | - Tabea Schiele
- Tinnitus Center, Charité- Universitätsmedizin Berlin, corporate member of Freie Universität Berlin und Humboldt Universität Berlin, Berlin, Germany
| | - Axel Schiller
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitaetsstraße 84, 93053, Regensburg, Germany
| | - Jorge Simoes
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitaetsstraße 84, 93053, Regensburg, Germany
| | - Sabine Stark
- Tinnitus Center, Charité- Universitätsmedizin Berlin, corporate member of Freie Universität Berlin und Humboldt Universität Berlin, Berlin, Germany
| | - Susanne Staudinger
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitaetsstraße 84, 93053, Regensburg, Germany
| | - Alexandra Stege
- Central Biobank Charité, Charité- Universitätsmedizin Berlin, corporate member of Freie Universität Berlin und Humboldt Universität Berlin, Berlin, Germany
| | - Nicolas Verhaert
- Department of Neurosciences, Research group Experimental Oto-Rhino-Laryngology, University of Leuven, Leuven, Belgium.,Department of Otorhinolaryngology - Head and Neck surgery, University Hospitals Leuven, Leuven, Belgium.,Multidisciplinary University Center for Speech-Language Pathology and Audiology, University Hospitals Leuven, Leuven, Belgium
| | - Winfried Schlee
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitaetsstraße 84, 93053, Regensburg, Germany
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21
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Geerardyn A, Willaert A, Decallonne B, Desloovere C, Verhaert N. Prevalence of Otological Disease in Turner Syndrome: A Systematic Review. Otol Neurotol 2021; 42:953-958. [PMID: 33625195 DOI: 10.1097/mao.0000000000003118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Girls and women with Turner syndrome (TS) present with multiple ear and hearing problems, ranging from external morphologic abnormalities to sensorineural or conductive hearing loss. The exact pathophysiology behind these otological diseases is not yet completely understood. The aim of this study is to provide a systematic review on the prevalence of otological disease in TS. METHODS We conducted a systematic review according to the PRISMA guidelines. A database search was performed in PubMed, Embase, Web of Science, and Cochrane library. RESULTS The prevalence of otological disease as external ear deformities (20-62%), recurrent otitis media (24-48%), and hearing loss (36-84%) is high in TS. The auditory phenotype in TS is complex and seems to be dynamic with CHL due to middle ear disease at young age and sensorineural hearing loss later in life. CONCLUSION This systematic review of the literature confirms that otological disease is definitely part of the widely variable phenotype in Turner patients. Strong evidence is lacking on the exact prevalence numbers, emphasizing the need for more prospective data gathering. Growing insights in its pathophysiology will help in the understanding and management of hearing problems in TS across lifespan.
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Affiliation(s)
- Alexander Geerardyn
- Department of Otorhinolaryngology, Head and Neck Surgery
- Department Neurosciences, ExpORL, KU Leuven, University of Leuven, Leuven, Belgium
| | | | - Brigitte Decallonne
- Department of Endocrinology, University Hospitals Leuven
- Department of Chronic Diseases and Metabolism
| | - Christian Desloovere
- Department of Otorhinolaryngology, Head and Neck Surgery
- Department Neurosciences, ExpORL, KU Leuven, University of Leuven, Leuven, Belgium
| | - Nicolas Verhaert
- Department of Otorhinolaryngology, Head and Neck Surgery
- Department Neurosciences, ExpORL, KU Leuven, University of Leuven, Leuven, Belgium
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22
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Fierens G, Standaert N, Peeters R, Glorieux C, Verhaert N. Safety of active auditory implants in magnetic resonance imaging. J Otol 2021; 16:185-198. [PMID: 34220987 PMCID: PMC8241703 DOI: 10.1016/j.joto.2020.12.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/19/2020] [Accepted: 12/17/2020] [Indexed: 11/23/2022] Open
Abstract
Magnetic resonance imaging (MRI) has become the gold standard for the diagnosis of many pathologies. Using MRI in patients with auditory implants can however raise concerns due to mutual interactions between the implant and imaging device, resulting in potential patient risks. Several implant manufacturers have been working towards more MRI safe devices. Older devices are however often labelled for more stringent conditions, possibly creating confusion with patients and professionals. With this myriad of different devices that are implanted in patients for lifetimes of at least 20 years, it is crucial that both patients and professionals have a clear understanding of the safety of their devices. This work aims at providing an exhaustive overview on the MRI safety of active auditory implants. The available industry standards that are followed by manufacturers are outlined and an overview of the latest scientific developments focusing on the last five years is provided. In addition, based on the analysis of the adverse events reported to the Food and Drug Administration (FDA) and in literature within the past ten years, a systematic review of the most commonly occurring issues for patients with auditory implants in the MRI environment is provided. Results indicate that despite the release of more MRI conditional active hearing implants on the market, adverse events still occur. An extensive overview is provided on the MRI safety of active auditory implants, aiming to increase the understanding of the topic for healthcare professionals and contribute to safer scanning conditions for patients.
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Affiliation(s)
- Guy Fierens
- Laboratory of Soft Matter and Biophysics, Department of Physics and Astronomy, KU Leuven, Celestijnenlaan 200D, B-3001, Heverlee, Belgium
- Cochlear Technology Centre, Schaliënhoevedreef 20I, B-2800, Mechelen, Belgium
- KU Leuven, Department of Neurosciences, Research Group Experimental Otorhinolaryngology, Herestraat 49, B-3000, Leuven, Belgium
| | - Nina Standaert
- University Hospitals Leuven, Department of Otorhinolaryngology, Herestraat 49, B-3000, Leuven, Belgium
| | - Ronald Peeters
- University Hospitals Leuven, Department of Radiology, Herestraat 49, B-3000, Leuven, Belgium
| | - Christ Glorieux
- Laboratory of Soft Matter and Biophysics, Department of Physics and Astronomy, KU Leuven, Celestijnenlaan 200D, B-3001, Heverlee, Belgium
| | - Nicolas Verhaert
- KU Leuven, Department of Neurosciences, Research Group Experimental Otorhinolaryngology, Herestraat 49, B-3000, Leuven, Belgium
- University Hospitals Leuven, Department of Otorhinolaryngology, Herestraat 49, B-3000, Leuven, Belgium
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23
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Schlee W, Schoisswohl S, Staudinger S, Schiller A, Lehner A, Langguth B, Schecklmann M, Simoes J, Neff P, Marcrum SC, Spiliopoulou M, Niemann U, Schleicher M, Unnikrishnan V, Puga C, Mulansky L, Pryss R, Vogel C, Allgaier J, Giannopoulou E, Birki K, Liakou K, Cima R, Vlaeyen JWS, Verhaert N, Ranson S, Mazurek B, Brueggemann P, Boecking B, Amarjargal N, Specht S, Stege A, Hummel M, Rose M, Oppel K, Dettling-Papargyris J, Lopez-Escamez JA, Amanat S, Gallego-Martinez A, Escalera-Balsera A, Espinosa-Sanchez JM, Garcia-Valdecasas J, Mata-Ferron M, Martin-Lagos J, Martinez-Martinez M, Martinez-Martinez MJ, Müller-Locatelli N, Perez-Carpena P, Alcazar-Beltran J, Hidalgo-Lopez L, Vellidou E, Sarafidis M, Katrakazas P, Kostaridou V, Koutsouris D, Manta R, Paraskevopoulos E, Haritou M, Elgoyhen AB, Goedhart H, Koller M, Shekhawat GS, Crump H, Hannemann R, Holfelder M, Oberholzer T, Vontas A, Trochidis I, Moumtzi V, Cederroth CR, Koloutsou K, Spanoudakis G, Basdekis I, Gallus S, Lugo A, Stival C, Borroni E, Markatos N, Bibas A, Kikidis D. Towards a unification of treatments and interventions for tinnitus patients: The EU research and innovation action UNITI. Prog Brain Res 2021; 260:441-451. [PMID: 33637231 DOI: 10.1016/bs.pbr.2020.12.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Tinnitus is the perception of a phantom sound and the patient's reaction to it. Although much progress has been made, tinnitus remains a scientific and clinical enigma of high prevalence and high economic burden, with an estimated prevalence of 10%-20% among the adult population. The EU is funding a new collaborative project entitled "Unification of Treatments and Interventions for Tinnitus Patients" (UNITI, grant no. 848261) under its Horizon 2020 framework. The main goal of the UNITI project is to set the ground for a predictive computational model based on existing and longitudinal data attempting to address the question of which treatment or combination of treatments is optimal for a specific patient group based on certain parameters. Clinical, epidemiological, genetic and audiological data, including signals reflecting ear-brain communication, as well as patients' medical history, will be analyzed making use of existing databases. Predictive factors for different patient groups will be extracted and their prognostic relevance validated through a Randomized Clinical Trial (RCT) in which different patient groups will undergo a combination of tinnitus therapies targeting both auditory and central nervous systems. From a scientific point of view, the UNITI project can be summarized into the following research goals: (1) Analysis of existing data: Results of existing clinical studies will be analyzed to identify subgroups of patients with specific treatment responses and to identify systematic differences between the patient groups at the participating clinical centers. (2) Genetic and blood biomarker analysis: High throughput Whole Exome Sequencing (WES) will be performed in well-characterized chronic tinnitus cases, together with Proximity Extension Assays (PEA) for the identification of blood biomarkers for tinnitus. (3) RCT: A total of 500 patients will be recruited at five clinical centers across Europe comparing single treatments against combinational treatments. The four main treatments are Cognitive Behavioral Therapy (CBT), hearing aids, sound stimulation, and structured counseling. The consortium will also make use of e/m-health applications for the treatment and assessment of tinnitus. (4) Decision Support System: An innovative Decision Support System will be implemented, integrating all available parameters (epidemiological, clinical, audiometry, genetics, socioeconomic and medical history) to suggest specific examinations and the optimal intervention strategy based on the collected data. (5) Financial estimation analysis: A cost-effectiveness analysis for the respective interventions will be calculated to investigate the economic effects of the interventions based on quality-adjusted life years. In this paper, we will present the UNITI project, the scientific questions that it aims to address, the research consortium, and the organizational structure.
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Affiliation(s)
- Winfried Schlee
- Department of Psychiatry and Psychotherapy, Bezirksklinikum, University of Regensburg, Regensburg, Germany.
| | - Stefan Schoisswohl
- Department of Psychiatry and Psychotherapy, Bezirksklinikum, University of Regensburg, Regensburg, Germany
| | - Susanne Staudinger
- Department of Psychiatry and Psychotherapy, Bezirksklinikum, University of Regensburg, Regensburg, Germany
| | - Axel Schiller
- Department of Psychiatry and Psychotherapy, Bezirksklinikum, University of Regensburg, Regensburg, Germany
| | - Astrid Lehner
- Department of Psychiatry and Psychotherapy, Bezirksklinikum, University of Regensburg, Regensburg, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, Bezirksklinikum, University of Regensburg, Regensburg, Germany
| | - Martin Schecklmann
- Department of Psychiatry and Psychotherapy, Bezirksklinikum, University of Regensburg, Regensburg, Germany
| | - Jorge Simoes
- Department of Psychiatry and Psychotherapy, Bezirksklinikum, University of Regensburg, Regensburg, Germany
| | - Patrick Neff
- Department of Psychiatry and Psychotherapy, Bezirksklinikum, University of Regensburg, Regensburg, Germany
| | - Steven C Marcrum
- Ear, Nose, Throat Department, University Hospital Regensburg, Regensburg, DE, Germany
| | - Myra Spiliopoulou
- Department of Informatics, Knowledge Management and Discovery Lab, Otto-von-Guericke-University Magdeburg, Magdeburg, DE, Germany
| | - Uli Niemann
- Department of Informatics, Knowledge Management and Discovery Lab, Otto-von-Guericke-University Magdeburg, Magdeburg, DE, Germany
| | - Miro Schleicher
- Department of Informatics, Knowledge Management and Discovery Lab, Otto-von-Guericke-University Magdeburg, Magdeburg, DE, Germany
| | - Vishnu Unnikrishnan
- Department of Informatics, Knowledge Management and Discovery Lab, Otto-von-Guericke-University Magdeburg, Magdeburg, DE, Germany
| | - Clara Puga
- Department of Informatics, Knowledge Management and Discovery Lab, Otto-von-Guericke-University Magdeburg, Magdeburg, DE, Germany
| | - Lena Mulansky
- University Hospital Wuerzburg, Institute for Clinical Epidemiology and Biometry (IKE-B), Wuerzburg, DE, Germany
| | - Ruediger Pryss
- University Hospital Wuerzburg, Institute for Clinical Epidemiology and Biometry (IKE-B), Wuerzburg, DE, Germany
| | - Carsten Vogel
- University Hospital Wuerzburg, Institute for Clinical Epidemiology and Biometry (IKE-B), Wuerzburg, DE, Germany
| | - Johannes Allgaier
- University Hospital Wuerzburg, Institute for Clinical Epidemiology and Biometry (IKE-B), Wuerzburg, DE, Germany
| | - Efi Giannopoulou
- ZEINCRO Egeszegugyi Szolgaltato Korlatolt Felelossegu Tarsasag, Budakalasz, HU, Hungary
| | - Katalin Birki
- ZEINCRO Egeszegugyi Szolgaltato Korlatolt Felelossegu Tarsasag, Budakalasz, HU, Hungary
| | - Klairi Liakou
- ZEINCRO Egeszegugyi Szolgaltato Korlatolt Felelossegu Tarsasag, Budakalasz, HU, Hungary
| | - Rilana Cima
- Department of Health Psychology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Johan W S Vlaeyen
- Department of Health Psychology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Nicolas Verhaert
- Department of Health Psychology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Saskia Ranson
- Adelante Tinnitus Expertise Centre, Maastricht, NL, The Netherlands
| | - Birgit Mazurek
- Tinnitus Center, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Petra Brueggemann
- Tinnitus Center, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Benjamin Boecking
- Tinnitus Center, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Nyamaa Amarjargal
- Tinnitus Center, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Sandy Specht
- Tinnitus Center, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Alexandra Stege
- Tinnitus Center, Charité-Universitätsmedizin Berlin, Berlin, Germany; Charité University Hospital Berlin, Centrale Biobank Charité (ZeBanC), Berlin, DE, Germany
| | - Michael Hummel
- Tinnitus Center, Charité-Universitätsmedizin Berlin, Berlin, Germany; Charité University Hospital Berlin, Centrale Biobank Charité (ZeBanC), Berlin, DE, Germany
| | - Matthias Rose
- Charité University Hospital Berlin, Dept of Psychosomatic and Psychotherapy, Berlin, DE, Germany
| | - Kevin Oppel
- Terzo-Institut für angewandte Gehörforschung, Berlin, DE, Germany
| | | | - Jose Antonio Lopez-Escamez
- Otology & Neurotology Group CTS 495, Department of Genomic Medicine, GENYO. Centre for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, ES, Spain; Department of Otolaryngology, Instituto de Investigación Biosanitaria Ibs. Granada, Hospital Universitario Virgen de las Nieves, Granada, ES, Spain; Department of Surgery, Division of Otolaryngology, Universidad de Granada, Granada, ES, Spain
| | - Sana Amanat
- Otology & Neurotology Group CTS 495, Department of Genomic Medicine, GENYO. Centre for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, ES, Spain
| | - Alvaro Gallego-Martinez
- Otology & Neurotology Group CTS 495, Department of Genomic Medicine, GENYO. Centre for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, ES, Spain
| | - Alba Escalera-Balsera
- Otology & Neurotology Group CTS 495, Department of Genomic Medicine, GENYO. Centre for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, ES, Spain
| | - Juan Manuel Espinosa-Sanchez
- Otology & Neurotology Group CTS 495, Department of Genomic Medicine, GENYO. Centre for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, PTS Granada, Granada, ES, Spain; Department of Otolaryngology, Instituto de Investigación Biosanitaria Ibs. Granada, Hospital Universitario Virgen de las Nieves, Granada, ES, Spain
| | - Juan Garcia-Valdecasas
- Department of Otolaryngology, Instituto de Investigación Biosanitaria Ibs. Granada, Hospital Universitario Virgen de las Nieves, Granada, ES, Spain
| | - Maria Mata-Ferron
- Department of Otolaryngology, Instituto de Investigación Biosanitaria Ibs. Granada, Hospital Universitario Virgen de las Nieves, Granada, ES, Spain
| | - Juan Martin-Lagos
- Department of Otolaryngology, Instituto de Investigacion Biosanitaria ibs. Granada, Hospital Universitario Clinico San Cecilio, Granada, ES, Spain
| | - Maria Martinez-Martinez
- Department of Otolaryngology, Instituto de Investigacion Biosanitaria ibs. Granada, Hospital Universitario Clinico San Cecilio, Granada, ES, Spain
| | - María Jesús Martinez-Martinez
- Department of Otolaryngology, Instituto de Investigación Biosanitaria Ibs. Granada, Hospital Universitario Virgen de las Nieves, Granada, ES, Spain
| | - Nicolas Müller-Locatelli
- Department of Otolaryngology, Instituto de Investigacion Biosanitaria ibs. Granada, Hospital Universitario Clinico San Cecilio, Granada, ES, Spain
| | - Patricia Perez-Carpena
- Department of Otolaryngology, Instituto de Investigacion Biosanitaria ibs. Granada, Hospital Universitario Clinico San Cecilio, Granada, ES, Spain
| | - Jorge Alcazar-Beltran
- Department of Mental Health, Hospital Universitario Virgen de las Nieves, Granada, ES, Spain
| | - Leyre Hidalgo-Lopez
- Department of Mental Health, Hospital Universitario Virgen de las Nieves, Granada, ES, Spain
| | | | - Michalis Sarafidis
- Institute of Communication and Computer Systems (ICCS), Athens, GR, Greece
| | | | | | | | - Rano Manta
- Institute of Communication and Computer Systems (ICCS), Athens, GR, Greece
| | | | - Maria Haritou
- Institute of Communication and Computer Systems (ICCS), Athens, GR, Greece
| | - Ana Belén Elgoyhen
- Instituto de Investigaciones en Ingeniería Genética y Biología Molecular, "Dr. Héctor N. Torres" (INGEBI), Buenos Aires, AR, Argentina
| | | | - Michael Koller
- Center for Clinical Studies, University Hospital Regensburg, Regensburg, DE, Germany
| | - Giriraj Singh Shekhawat
- College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia; Ear Institute, University College London, London, United Kingdom; Tinnitus Research Initiative, Regensburg, Germany
| | - Holger Crump
- Patient Organisation "Hast Du Töne" Bergisch-Gladbach, Bergisch-Gladbach, DE, Germany
| | | | | | | | | | | | | | | | | | | | | | - Silvano Gallus
- Laboratory of Lifestyle Epidemiology, Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Alessandra Lugo
- Laboratory of Lifestyle Epidemiology, Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Chiara Stival
- Laboratory of Lifestyle Epidemiology, Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Elisa Borroni
- Laboratory of Lifestyle Epidemiology, Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Nikolaos Markatos
- National and Kapodistrian University of Athens, Hippocrateion Hospital, Department of Otolaryngology, Athens, GR, Greece
| | - Athanasios Bibas
- National and Kapodistrian University of Athens, Hippocrateion Hospital, Department of Otolaryngology, Athens, GR, Greece
| | - Dimitris Kikidis
- National and Kapodistrian University of Athens, Hippocrateion Hospital, Department of Otolaryngology, Athens, GR, Greece
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Wackers G, Cornelis P, Putzeys T, Peeters M, Tack J, Troost F, Doll T, Verhaert N, Wagner P. Electropolymerized Receptor Coatings for the Quantitative Detection of Histamine with a Catheter-Based, Diagnostic Sensor. ACS Sens 2021; 6:100-110. [PMID: 33337133 DOI: 10.1021/acssensors.0c01844] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
In this article, we report on the development of a catheter-based, biomimetic sensor as a step toward a minimally invasive diagnostic instrument in the context of functional bowel disorders. Histamine is a key mediator in allergic and inflammatory processes in the small intestines; however, it is a challenge to determine histamine levels at the duodenal mucosa, and classical bioreceptors are unsuitable for use in the digestive medium of bowel fluid. Therefore, we have developed molecularly imprinted polypyrrole coatings for impedimetric sensing electrodes, which enable the quantification of histamine in nondiluted, human bowel fluid in a broad concentration range from 25 nM to 1 μM. The electrodes show negligible cross-sensitivity to histidine as a competitor molecule and, for comparison, we also evaluated the response of nonimprinted and taurine-imprinted polypyrrole to histamine. Furthermore, using equivalent-circuit modeling, we found that the molecular recognition of histamine by polypyrrole primarily increases the resistive component of the electrode-liquid interface while capacitive effects are negligible. The sensor, integrated into a catheter, measures differentially to correct for nonspecific adsorption effects in the complex matrix of bowel fluids, and a single triggering frequency is sufficient to determine histamine concentrations. Together, these features are beneficial for real-time diagnostic tests.
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Affiliation(s)
- Gideon Wackers
- Laboratory for Soft Matter and Biophysics, KU Leuven, Celestijnenlaan 200D, Leuven B-3001, Belgium
| | - Peter Cornelis
- Laboratory for Soft Matter and Biophysics, KU Leuven, Celestijnenlaan 200D, Leuven B-3001, Belgium
| | - Tristan Putzeys
- Laboratory for Soft Matter and Biophysics, KU Leuven, Celestijnenlaan 200D, Leuven B-3001, Belgium
- Research Group Experimental Oto-rhino-laryngology, KU Leuven, O&N II, Herestraat 49, Leuven B-3001, Belgium
| | - Marloes Peeters
- School of Engineering, Newcastle University, Newcastle upon Tyne NE1 7RU, U.K
| | - Jan Tack
- Translational Research in Gastrointestinal Disorders TARGID, KU Leuven, O&N I, Herestraat 49, Leuven B-3000, Belgium
| | - Freddy Troost
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Universiteitsingel 40, ER Maastricht NL-6229, The Netherlands
| | - Theodor Doll
- Institute of AudioNeuroTechnology VIANNA, Hannover Medical School, Stadtfelddamm 34, Hannover D-30625, Germany
| | - Nicolas Verhaert
- Research Group Experimental Oto-rhino-laryngology, KU Leuven, O&N II, Herestraat 49, Leuven B-3001, Belgium
| | - Patrick Wagner
- Laboratory for Soft Matter and Biophysics, KU Leuven, Celestijnenlaan 200D, Leuven B-3001, Belgium
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25
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Loos E, Verhaert N, Darrouzet V, Godey B, Linder T, Vincent C, Lavieille JP, Schmerber S, Lescanne E, Trabalzini F, De Foer B, Van Havenbergh T, Somers T. Intratemporal facial nerve schwannomas: multicenter experience of 80 cases. Eur Arch Otorhinolaryngol 2020; 277:2209-2217. [PMID: 32279104 DOI: 10.1007/s00405-020-05960-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 04/01/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To provide more data on the clinical presentation and natural evolution of facial nerve schwannomas and to provide guidance for therapeutic decision making. METHODS A retrospective case review of eighty patients diagnosed with a facial nerve schwannoma between 1990 and 2018 in ten tertiary referral centers in Europe was performed. Patients' demographics, symptomatology, audiometry, anatomical site (segments involved), size and whenever possible volume measurement were registered. RESULTS At presentation, transient or persistent facial palsy was the most common symptom, followed by hearing loss. The schwannoma involved more than one segment in the majority of the patients with the geniculate ganglion being most commonly involved. Initial treatment consisted of a wait and scan approach in 67.5%, surgery in 30% and radiation therapy in 2.5% of the patients. Tympanic segment schwannomas caused mainly conductive hearing loss and were more prone to develop facial palsy at follow-up. Internal auditory canal or cerebellopontine angle schwannomas presented with significantly more sensorineural hearing loss. CONCLUSIONS Although modern imaging has improved diagnosis of this tumor, choosing the best treatment modality remains a real challenge. Based on the literature review and current findings, more insights into the clinical course and the management of facial nerve schwannomas are provided.
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Affiliation(s)
- Elke Loos
- Department of ENT-HNS, European Institute for Otorhinolaryngology-Head and Neck Surgery and Skull Base Surgery, Sint Augustinus Hospital, GZA, Oosterveldlaan 24, 2600, Antwerp, Belgium
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Nicolas Verhaert
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Vincent Darrouzet
- Department of Otolaryngology, Skull Base Surgery, CHU de Bordeaux, Université de Bordeaux, 33000, Bordeaux, France
| | - Benoit Godey
- Department of ENT-HNS, University Hospital of Rennes, Rennes, France
| | - Thomas Linder
- Department of ENT-HNS, Cantonal Hospital Luzern, Luzern, Switzerland
| | - Christophe Vincent
- CHU Lille, Otologie et Otoneurologie, Université de Lille, Inserm U1008, Controlled Drug Delivery Systems and Biomaterials, Lille, France
| | - Jean Pierre Lavieille
- APHM, Hôpital de La Conception, Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, 147 Boulevard Baille, 13005, Marseille, France
| | | | - Emmanuel Lescanne
- Department of ENT, Head and Neck Surgery, Regional Hospital University Centre of Tours, 2, Boulevard Tonnellé, 37044, Tours Cedex 9, France
| | - Franco Trabalzini
- Department of ENT-HNS, Azienda Ospedaliero Universitaria Meyer, Firenze, Italy
| | - Bert De Foer
- Department of Radiology, Sint Augustinus Hospital, GZA, Oosterveldlaan 24, 2610, Antwerp, Belgium
| | | | - Thomas Somers
- Department of ENT-HNS, European Institute for Otorhinolaryngology-Head and Neck Surgery and Skull Base Surgery, Sint Augustinus Hospital, GZA, Oosterveldlaan 24, 2600, Antwerp, Belgium.
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26
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Deun LV, De Voecht K, Desloovere C, Verhaert N. Safety and efficacy of the Bonebridge bone conduction implant: a comparative study. B-ENT 2020. [DOI: 10.5152/b-ent.2020.19123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Fierens G, Verhaert N, Benoudiba F, Bellin MF, Ducreux D, Papon JF, Nevoux J. Stability of the standard incus coupling of the Carina middle ear actuator after 1.5T MRI. PLoS One 2020; 15:e0231213. [PMID: 32271819 PMCID: PMC7144975 DOI: 10.1371/journal.pone.0231213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 03/18/2020] [Indexed: 11/18/2022] Open
Abstract
Limited data is available concerning the safety of active middle ear implants (AMEI) during Magnetic Resonance Imaging (MRI). Measurements in temporal bones are the gold standard for preclinical assessment of device safety. In this study the coupling stability of an actuator as used in a fully implantable AMEI was determined in temporal bones. Eleven temporal bones were implanted with the actuator according to the manufacturer’s surgical guidelines. The actuator was coupled on the incus short process as recommended for sensorineural hearing loss. Temporal bones were exposed 10 times to the MRI magnetic field by entering the MRI suite in a clinically relevant way. Computed Tomography (CT) images were acquired before and after the experiment to investigate the risk of actuator dislocation. Based on the electrical impedance of the actuator, the loading of the actuator to the incus was confirmed. Relative actuator displacement was determined on the CT images by comparing the initial with the final actuator position in 3D space. Impedance curves were analyzed after each exposure to check the loading of the actuator to the ossicles. Analysis of CT images with a 0.30.6 mm in-plane resolution indicate no actuator displacement. The maximum detected change in impedance for all actuators was 8.43 Ω at the actuator’s resonance frequency. Impedance curves measured when the actuator was retracted from the short process after the experiment still indicate the presence of a clear resonance peak. No actuator displacement or dislocation could be detected in the analysis of CT images and the measured impedance curves. Impedance curves obtained when the actuator was retracted from the incus short process still show a clear resonance peak, indicating the device is still functional after the MRI exposures.
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Affiliation(s)
- Guy Fierens
- ExpORL Research group, Department of Neurosciences, KU Leuven - University of Leuven, Leuven, Belgium
| | - Nicolas Verhaert
- ExpORL Research group, Department of Neurosciences, KU Leuven - University of Leuven, Leuven, Belgium.,Department of Otolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Farida Benoudiba
- AP-HP, Hôpital Bicêtre, Service de Neuroradiologie, Le Kremlin-Bicêtre, France
| | - Marie-France Bellin
- Université Paris-Saclay, Faculté de Médecine Université Paris-Sud, Le Kremlin-Bicêtre, France.,AP-HP, Hôpital Bicêtre, Service de Radiologie Générale, Le Kremlin-Bicêtre, France
| | - Dennis Ducreux
- AP-HP, Hôpital Bicêtre, Service de Neuroradiologie, Le Kremlin-Bicêtre, France.,Université Paris-Saclay, Faculté de Médecine Université Paris-Sud, Le Kremlin-Bicêtre, France
| | - Jean-François Papon
- Université Paris-Saclay, Faculté de Médecine Université Paris-Sud, Le Kremlin-Bicêtre, France.,AP-HP, Hôpital Bicêtre, Service d'Oto-Rhino-Laryngologie, Le Kremlin-Bicêtre, France
| | - Jérôme Nevoux
- Université Paris-Saclay, Faculté de Médecine Université Paris-Sud, Le Kremlin-Bicêtre, France.,AP-HP, Hôpital Bicêtre, Service d'Oto-Rhino-Laryngologie, Le Kremlin-Bicêtre, France
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Wackers G, Putzeys T, Peeters M, Van de Cauter L, Cornelis P, Wübbenhorst M, Tack J, Troost F, Verhaert N, Doll T, Wagner P. Towards a catheter-based impedimetric sensor for the assessment of intestinal histamine levels in IBS patients. Biosens Bioelectron 2020; 158:112152. [PMID: 32275205 DOI: 10.1016/j.bios.2020.112152] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 03/09/2020] [Accepted: 03/12/2020] [Indexed: 12/18/2022]
Abstract
In this work, we report on the development of a catheter-based sensor designed for measuring the concentration of histamine in the human duodenum. Certain gut disorders, such as the irritable bowel syndrome (IBS), are associated with elevated levels of intestinal histamine due to chronic immune activation. As it is still impossible to determine histamine concentrations in vivo, a nasointestinal catheter with histamine-sensing capabilities has the potential to become a valuable diagnostic instrument. Regarding the sensing principle, we selected impedance spectroscopy using voltages that are compatible with intra-body applications with molecularly imprinted polymers (MIPs) as recognition elements. MIPs are synthetic receptors that offer the advantages of robustness, high specificity and selectivity for histamine as a target. In this specific case, the MIPs were synthesized from acryclic acid monomers, which guarantees a uniform binding capacity within the pH range of intestinal fluid. We have validated the catheter sensor on human intestinal liquids spiked with histamine in a testing setup that mimics the environment inside the duodenum. The dose-response curves show an analytical range between 5 and 200 nM of histamine, corresponding to physiologically normal conditions while higher concentrations correlate with disease. The key output signal of the sensor is the resistive component of the MIP-functionalized titanium electrodes as derived from the equivalent-circuit modelling of full-range impedance spectra. Future applications could be catheters tailored to cardiovascular, urological, gastrointestinal, and neurovascular applications. This, in combination with the versatility of the MIPs, will make this sensor platform a versatile diagnostic tool.
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Affiliation(s)
- Gideon Wackers
- KU Leuven, Laboratory for Soft Matter and Biophysics, Celestijnenlaan 200 D, B-3001, Leuven, Belgium.
| | - Tristan Putzeys
- KU Leuven, Laboratory for Soft Matter and Biophysics, Celestijnenlaan 200 D, B-3001, Leuven, Belgium; KU Leuven, Research Group Experimental Oto-rhino-laryngology, O&N II, Herestraat 49, B-3001, Leuven, Belgium
| | - Marloes Peeters
- Newcastle University, School of Engineering, Newcastle NE1 7RU, United Kingdom
| | - Lori Van de Cauter
- KU Leuven, Laboratory for Soft Matter and Biophysics, Celestijnenlaan 200 D, B-3001, Leuven, Belgium
| | - Peter Cornelis
- KU Leuven, Laboratory for Soft Matter and Biophysics, Celestijnenlaan 200 D, B-3001, Leuven, Belgium
| | - Michael Wübbenhorst
- KU Leuven, Laboratory for Soft Matter and Biophysics, Celestijnenlaan 200 D, B-3001, Leuven, Belgium
| | - Jan Tack
- KU Leuven, Translational Research in Gastrointestinal Disorders, O&N I, Herestraat 49, B-3001, Leuven, Belgium
| | - Freddy Troost
- Food Innovation and Health, Centre for Healthy Eating and Food Innovation, Maastricht University, NUTRIM School of Nutrition and Translational Research in Metabolism, Universiteitssingel 40, NL-6229 ER, Maastricht, the Netherlands
| | - Nicolas Verhaert
- KU Leuven, Research Group Experimental Oto-rhino-laryngology, O&N II, Herestraat 49, B-3001, Leuven, Belgium
| | - Theodor Doll
- Hannover Medical School, Institute of AudioNeuroTechnology VIANNA, Stadtfelddamm 34, D-30625, Hannover, Germany
| | - Patrick Wagner
- KU Leuven, Laboratory for Soft Matter and Biophysics, Celestijnenlaan 200 D, B-3001, Leuven, Belgium
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Vanderauwera J, Hellemans E, Verhaert N. Research Insights on Neural Effects of Auditory Deprivation and Restoration in Unilateral Hearing Loss: A Systematic Review. J Clin Med 2020; 9:E812. [PMID: 32192018 PMCID: PMC7141286 DOI: 10.3390/jcm9030812] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 03/05/2020] [Accepted: 03/13/2020] [Indexed: 12/25/2022] Open
Abstract
Neuroplasticity following bilateral deafness and auditory restoration has been repeatedly investigated. In clinical practice, however, a significant number of patients present a severe-to-profound unilateral hearing loss (UHL). To date, less is known about the neuroplasticity following monaural hearing deprivation and auditory input restoration. This article provides an overview of the current research insights on the impact of UHL on the brain and the effect of auditory input restoration with a cochlear implant (CI). An exhaustive systematic review of the literature was performed selecting 38 studies that apply different neural analyses techniques. The main results show that the hearing ear becomes functionally dominant after monaural deprivation, reshaping the lateralization of the neural network for auditory processing, a process that can be considered to influence auditory restoration. Furthermore, animal models predict that the onset time of UHL impacts auditory restoration. Hence, the results seem to advocate for early restoration of UHL, although further research is required to disambiguate the effects of duration and onset of UHL on auditory restoration and on structural neuroplasticity following UHL deprivation and restoration. Ongoing developments on CI devices compatible with Magnetic Resonance Imaging (MRI) examinations will provide a unique opportunity to investigate structural and functional neuroplasticity following CI restoration more directly.
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Affiliation(s)
- Jolijn Vanderauwera
- Psychological Sciences Research Institute, Université Catholique de Louvain, 1348 Louvain-la-Neuve, Belgium;
- Institute of Neuroscience, Université Catholique de Louvain, 1348 Louvain-la-Neuve, Belgium
| | - Elisabeth Hellemans
- Department of Otolaryngology, Head and Neck Surgery, University Hospitals Leuven, 3000 Leuven, Belgium;
| | - Nicolas Verhaert
- Department of Otolaryngology, Head and Neck Surgery, University Hospitals Leuven, 3000 Leuven, Belgium;
- KU Leuven, Research Group ExpORL, Department of Neurosciences, 3000 Leuven, Belgium
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D’hondt C, Wouters J, Verhaert N. Alteration of the relative vibration of the round window membrane after implantation of a direct acoustic cochlear implant. Int J Audiol 2019; 59:341-347. [DOI: 10.1080/14992027.2019.1705405] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Christiane D’hondt
- Research and Development, Cochlear Technology Centre Belgium, Mechelen, Belgium
- Research Group ExpORL, Department of Neurosciences, KU Leuven, University of Leuven, Leuven, Belgium
| | - Jan Wouters
- Research Group ExpORL, Department of Neurosciences, KU Leuven, University of Leuven, Leuven, Belgium
| | - Nicolas Verhaert
- Research Group ExpORL, Department of Neurosciences, KU Leuven, University of Leuven, Leuven, Belgium
- Department of Otolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
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Willaert A, Van Eynde C, Verhaert N, Desloovere C, Vander Poorten V, Devriendt K, Swillen A, Hens G. Vestibular dysfunction is a manifestation of 22q11.2 deletion syndrome. Am J Med Genet A 2019; 179:448-454. [DOI: 10.1002/ajmg.a.7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 10/08/2018] [Accepted: 10/27/2018] [Indexed: 01/14/2023]
Affiliation(s)
- Annelore Willaert
- Department of Otorhinolaryngology‐Head and Neck SurgeryUniversity Hospitals Leuven Leuven Belgium
- Department of NeurosciencesKU Leuven – University of Leuven, ExpORL Leuven Belgium
| | - Charlotte Van Eynde
- Department of Otorhinolaryngology‐Head and Neck SurgeryUniversity Hospitals Leuven Leuven Belgium
| | - Nicolas Verhaert
- Department of Otorhinolaryngology‐Head and Neck SurgeryUniversity Hospitals Leuven Leuven Belgium
- Department of NeurosciencesKU Leuven – University of Leuven, ExpORL Leuven Belgium
| | - Christian Desloovere
- Department of Otorhinolaryngology‐Head and Neck SurgeryUniversity Hospitals Leuven Leuven Belgium
| | - Vincent Vander Poorten
- Department of Otorhinolaryngology‐Head and Neck SurgeryUniversity Hospitals Leuven Leuven Belgium
| | - Koenraad Devriendt
- Department of Human Genetics, University of Leuven, Centre for Human GeneticsUniversity Hospitals Leuven Leuven Belgium
| | - Ann Swillen
- Department of Human Genetics, University of Leuven, Centre for Human GeneticsUniversity Hospitals Leuven Leuven Belgium
| | - Greet Hens
- Department of Otorhinolaryngology‐Head and Neck SurgeryUniversity Hospitals Leuven Leuven Belgium
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Deprez H, Gransier R, Hofmann M, Wouters J, Verhaert N. Development and validation of a method to record electrophysiological responses in direct acoustic cochlear implant subjects. Hear Res 2018; 370:217-231. [PMID: 30213516 DOI: 10.1016/j.heares.2018.08.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 07/30/2018] [Accepted: 08/14/2018] [Indexed: 11/25/2022]
Abstract
Acoustic hearing implants, such as direct acoustic cochlear implants (DACIs), can be used to treat profound mixed hearing loss. Electrophysiological responses in DACI subjects are of interest to confirm auditory processing intra-operatively, and to assist DACI fitting postoperatively. We present two related studies, focusing on DACI artifacts and electrophysiological measurements in DACI subjects, respectively. In the first study we aimed to characterize DACI artifacts, to study the feasibility of measuring frequency-specific electrophysiological responses in DACI subjects. Measurements of DACI artifacts were collected in a cadaveric head to disentangle possible DACI artifact sources and compared to a constructed DACI artifact template. It is shown that for moderate stimulation levels, DACI artifacts are mainly dominated by the artifact from the radio frequency (RF) communication signal, that can be modeled if the RF encoding protocol is known. In a second study, the feasibility of measuring intra-operative responses, without applying the RF artifact models, in DACI subjects is investigated. Auditory steady-state and brainstem responses were measured intra-operatively in three DACI subjects, immediately after implantation, to confirm proper DACI functioning and coupling to the inner ear. Intra-operative responses could be measured in two of the three tested subjects. Absence of intra-operative responses in the third subject can possibly be explained by the hearing loss, attenuation of intra-operative responses, the difference between electrophysiological and behavioral threshold, and a temporary threshold shift due to the DACI surgery. In conclusion, RF artifacts can be modeled, such that electrophysiological responses to frequency-specific stimuli could possibly be measured in DACI subjects, and intra-operative responses in DACI subjects can be obtained.
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Affiliation(s)
- Hanne Deprez
- ExpORL, Dept. of Neurosciences, KU Leuven, Herestraat 49, 3000, Leuven, Belgium.
| | - Robin Gransier
- ExpORL, Dept. of Neurosciences, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Michael Hofmann
- ExpORL, Dept. of Neurosciences, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Jan Wouters
- ExpORL, Dept. of Neurosciences, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Nicolas Verhaert
- ExpORL, Dept. of Neurosciences, KU Leuven, Herestraat 49, 3000, Leuven, Belgium; University Hospitals Leuven, Department of Otolaryngology, Head and Neck Surgery, 3000, Leuven, Belgium
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Verhaert N, Borgers C, De Voecht K, Boon E, Desloovere C. A Role for Acoustic Stimulation in Advanced Otosclerosis: Direct Acoustic Cochlear Implant versus Cochlear Implant. Audiol Neurootol 2018; 23:89-97. [DOI: 10.1159/000491990] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 07/06/2018] [Indexed: 11/19/2022] Open
Abstract
Recent findings support the efficacy of the direct acoustic cochlear implant (DACI) in patients with advanced otosclerosis whose rehabilitation is very challenging. Standard treatment consists of stapes surgery combined with hearing aids or a cochlear implant (CI). CI surgery, however, is often challenging depending on the grade of otosclerosis. This study aims to compare speech perception scores in quiet and noise of 6 DACI and 12 CI patients with advanced otosclerosis at 3 and 12 months after fitting. Preoperative computed tomographic scans of all patients were scored by experts using an existing otosclerosis grading system (stages 1–3). Speech perception in quiet was significantly better for DACI compared to CI users at 3 months after fitting. At 12 months, no difference was found between DACI and CI patients. Speech perception scores in noise were significantly better in the DACI group. In summary, a DACI system seems to provide an effective treatment option as the acoustic component can be preserved in patients with advanced otosclerosis.
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Abstract
Development of electrophysiological means to assess the medial olivocochlear (MOC) system in humans is important to further our understanding of the function of that system and for the refinement and validation of psychoacoustical and otoacoustic emission methods which are thought to probe the MOC. Based on measurements in anesthetized animals it has been hypothesized that the MOC-reflex (MOCR) can enhance the response to signals in noise, and several lines of evidence support such a role in humans. A difficulty in these studies is the isolation of efferent effects. Efferent activation can be triggered by acoustic stimulation of the contralateral or ipsilateral ear, but ipsilateral stimulation is thought to be more effective. However, ipsilateral stimulation complicates interpretation of effects since these sounds can affect the perception of other ipsilateral sounds by mechanisms not involving olivocochlear efferents. We assessed the ipsilaterally evoked MOCR in human using a transtympanic procedure to record mass-potentials from the cochlear promontory or the niche of the round window. Averaged compound action potential (CAP) responses to masked probe tones of 4 kHz with and without a precursor (designed to activate the MOCR but not the stapedius reflex) were extracted with a polarity alternating paradigm. The masker was either a simultaneous narrow band noise masker or a short (20-ms) tonal ON- or OFF-frequency forward masker. The subjects were screened for normal hearing (audiogram, tympanogram, threshold stapedius reflex) and psychoacoustically tested for the presence of a precursor effect. We observed a clear reduction of CAP amplitude by the precursor, for different masking conditions. Even without an MOCR, this is expected because the precursor will affect the response to subsequent stimuli via neural adaptation. To determine whether the precursor also activated the efferent system, we measured the CAP over a range of masker levels, with or without precursor, and for different types of masker. The results show CAP reduction consistent with the type of gain reduction caused by the MOCR. These results generally support psychoacoustical paradigms designed to probe the efferent system as indeed activating the MOCR system, but not all observations are consistent with this mechanism.
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Affiliation(s)
- Eric Verschooten
- Laboratory of Auditory Neurophysiology, Department of Neurosciences, University of LeuvenLeuven, Belgium
| | - Elizabeth A Strickland
- Department of Speech, Language, and Hearing Sciences, Purdue UniversityWest Lafayette, IN, United States
| | - Nicolas Verhaert
- ExpORL Research Group, Department of Neurosciences, University of LeuvenLeuven, Belgium
| | - Philip X Joris
- Laboratory of Auditory Neurophysiology, Department of Neurosciences, University of LeuvenLeuven, Belgium
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Delrue S, Verhaert N, Dinther JV, Zarowski A, Somers T, Desloovere C, Offeciers E. Surgical Management and Hearing Outcome of Traumatic Ossicular Injuries. J Int Adv Otol 2016; 12:231-236. [DOI: 10.5152/iao.2016.2868] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Loos E, Verhaert N, Willaert A, Devriendt K, Swillen A, Hermans R, Op de Beeck K, Hens G. Malformations of the middle and inner ear on CT imaging in 22q11 deletion syndrome. Am J Med Genet A 2016; 170:2975-2983. [DOI: 10.1002/ajmg.a.37872] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Accepted: 07/08/2016] [Indexed: 11/11/2022]
Affiliation(s)
- Elke Loos
- Department of Otorhinolaryngology-Head and Neck Surgery; University Hospitals Leuven; Leuven Belgium
| | - Nicolas Verhaert
- Department of Otorhinolaryngology-Head and Neck Surgery; University Hospitals Leuven; Leuven Belgium
- Department of Neurosciences, ExpORL, KU Leuven; University of Leuven; Leuven Belgium
| | - Annelore Willaert
- Department of Otorhinolaryngology-Head and Neck Surgery; University Hospitals Leuven; Leuven Belgium
| | | | - Ann Swillen
- Centre for Human Genetics; University Hospitals Leuven; Leuven Belgium
| | - Robert Hermans
- Department of Radiology; University Hospitals Leuven; Leuven Belgium
| | - Katya Op de Beeck
- Department of Radiology; University Hospitals Leuven; Leuven Belgium
| | - Greet Hens
- Department of Otorhinolaryngology-Head and Neck Surgery; University Hospitals Leuven; Leuven Belgium
- Department of Neurosciences, ExpORL, KU Leuven; University of Leuven; Leuven Belgium
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Van Eynde C, Swillen A, Lambeens E, Verhaert N, Desloovere C, Luts H, Poorten VV, Devriendt K, Hens G. Prevalence and Nature of Hearing Loss in 22q11.2 Deletion Syndrome. J Speech Lang Hear Res 2016; 59:583-589. [PMID: 27249537 DOI: 10.1044/2015_jslhr-h-15-0098] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Accepted: 11/18/2015] [Indexed: 06/05/2023]
Abstract
PURPOSE The purpose of this study was to clarify the prevalence, type, severity, and age-dependency of hearing loss in 22q11.2 deletion syndrome. METHOD Extensive audiological measurements were conducted in 40 persons with proven 22q11.2 deletion (aged 6-36 years). Besides air and bone conduction thresholds in the frequency range between 0.125 and 8.000 kHz, high-frequency thresholds up to 16.000 kHz were determined and tympanometry, acoustic reflex (AR) measurement, and distortion product otoacoustic emission (DPOAE) testing were performed. RESULTS Hearing loss was identified in 59% of the tested ears and was mainly conductive in nature. In addition, a high-frequency sensorineural hearing loss with down-sloping curve was found in the majority of patients. Aberrant tympanometric results were recorded in 39% of the ears. In 85% of ears with a Type A or C tympanometric peak, ARs were absent. A DPOAE response in at least 6 frequencies was present in only 23% of the ears with a hearing threshold ≤30 dB HL. In patients above 14 years of age, there was a significantly lower percentage of measurable DPOAEs. CONCLUSION Hearing loss in 22q11.2 deletion syndrome is highly prevalent and both conductive and high-frequency sensorineural in nature. The age-dependent absence of DPOAEs in 22q11.2 deletion syndrome suggests cochlear damage underlying the high-frequency hearing loss.
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Dierickx C, Jacquemin L, Boon E, Dierckx A, Debruyne F, Wouters J, Desloovere C, Verhaert N. Predictive factors of speech understanding in adults with cochlear implants. B-ENT 2016; 12:219-226. [PMID: 29727127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
OBJECTIVE The aim of this study was to analyse the factors that influenced speech recognition scores in quiet conditions and speech reception threshold levels (SRT) in fixed noise conditions, after cochlear implant (CI) surgery in adults with postlinguistic deafness. STUDY DESIGN Combined retrospective and prospective study in a tertiary referral centre. METHODS We included 66 patients that received implants between 2002 and 2013. We retrospectively collected speech recognition scores and 14 demographic, audiological, and technical factors, including gender, age at implantation, aetiology, hearing loss progression, preoperative Pure Tone Average (PTA), hearing loss onset age and duration, duration and use of hearing aids (HAs); implantation in the best or worst ear; implantation on the right or left side; use of HA after implantation; and the duration and type of CI. We prospectively tested a subgroup of 21 patients for SRT in fixed noise. RESULTS The hearing loss duration significantly affected speech recognition scores in quiet conditions (H (4) = 10.567, p =0.032) and SRTs in fixed noise conditions (rs = 0.466, p = 0.033). The PTA of the better ear significantly affected only the SRT in fixed noise conditions (rs = 0.57 1, p = 0.007). CONCLUSION The duration of hearing loss and the PTA of the best ear had significant effects on the outcomes of speech recognition and SRT in quiet and fixed noise conditions, respectively. These findings are important for counselling CI candidates. Further studies in larger study populations are warranted.
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Van Eynde C, Denys S, Desloovere C, Wouters J, Verhaert N. Speech-in-noise testing as a marker for noise-induced hearing loss and tinnitus. B-ENT 2016; Suppl 26:185-191. [PMID: 29461742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
Speech-in-noise testing as a marker for noise-induced hearing loss and tinnitus. Noise-induced hearing loss and tinnitus are auditory complaints that often co-occur. Often, there is no immediate indication of changes in the pure tone audiogram. Patients can still have clinically normal hearing thresholds while clearly experiencing reduced speech comprehension. This might be explained by the process of neurodegeneration of the innervated dendrites of the auditory nerve fibres and secondary degeneration of spiral ganglion neurons. Subsequent maladaptive neuronal plasticity of the central auditory system can induce tinnitus. Standard hearing testing is no longer sufficient in these patients. Therefore more complex tasks, such as speech-in-noise tests, might be valuable extensions to the standard hearing tests. We carried out a prospective investigation of the influence of tinnitus upon speech comprehension in noise and the effectiveness of speech-in-noise testing, using the Flemish version of the digit triplet test (DTT). Thirty-seven patients with mild noise-induced hearing loss, tinnitus complaints and clinically normal pure tone thresholds completed the DTT and filled in two tinnitus enquiries. A statistically significant (p=0.026) correlation between the averaged high PTA, 2,z and the averaged SRT across ears on the DTT was found. There also seems to be a slight influence of tinnitus onset on the SRT score.
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Sabbe A, Verhaert N, Joossen I, Lammens A, Debruyne F. Otosclerosis: Shift in bone conduction after stapedotomy. B-ENT 2015; 11:183-189. [PMID: 26601550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
OBJECTIVES To analyze changes in bone conduction (BC) thresholds before and after stapedotomy in patients with clinical otosclerosis with a focus on the Carhart notch, which is defined as a significant loss of BC at a certain audiometric frequency. METHODOLOGY Retrospective case review of pure tone audiometry (PTA) in 213 patients who underwent a stapedotomy at a tertiary referral center between 2004 and 2011. The patients were grouped by age and the frequency of the Carhart notch. The non-operated ear was also evaluated. RESULTS The Carhart notch was present on pre-operative audiometry in 158 (74%) patients at 0.5 (n = 18, 8.45%), 1 (n = 25, 11.70%), or 2 kHz (n = 115, 54.0%). We measured a mean postoperative improvement in BC of 7.5, 8.4, and 8.8 dB HL. Pre-operatively, 55 (25.8%) patients did not exhibit a typical notch configuration. The mean gain in BC, defined on PTA according to the AAO-HNS criteria (0.5, 1, 2 and 3, or 4 kHz), was 1.8 dB HL after stapedotomy. CONCLUSION The Carhart notch was not solely related to the 2 kHz frequency. The greatest gain in BC after stapedotomy for otosclerosis occurred at the notch frequency.
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Lenarz T, Verhaert N, Desloovere C, Desmet J, D'hondt C, González JCF, Kludt E, Macías AR, Skarżyński H, Van de Heyning P, Vyncke C, Wasowski A. A Comparative Study on Speech in Noise Understanding with a Direct Acoustic Cochlear Implant in Subjects with Severe to Profound Mixed Hearing Loss. Audiol Neurootol 2014; 19:164-74. [DOI: 10.1159/000358004] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Accepted: 12/13/2013] [Indexed: 11/19/2022] Open
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Lammens F, Verhaert N, Devriendt K, Debruyne F, Desloovere C. Aetiology of congenital hearing loss: a cohort review of 569 subjects. Int J Pediatr Otorhinolaryngol 2013; 77:1385-91. [PMID: 23835162 DOI: 10.1016/j.ijporl.2013.06.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2013] [Revised: 05/31/2013] [Accepted: 06/02/2013] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Newborn hearing screening was implemented in Flanders about fifteen years ago. The aim of this study was to determine the aetiology of hearing loss detected by the Flemish screening programme. METHODS From 1997 to 2011, 569 neonates were referred to our tertiary referral centre after failed neonatal screening with Auditory Brainstem Responses. In case hearing loss (HL) was confirmed, further diagnostic testing was launched. A retrospective chart review was performed analysing the degree of HL, risk factor and aetiology. RESULTS Metabolic disorders (0.5%), infectious diseases (35.8%), congenital malformations (6.1%) and genetic abnormalities (19.8%), whether or not syndromic, were retained. In 35% of the subjects no obvious aetiology could be determined in the current study. CONCLUSION In contrast to the literature findings, this series shows a genetic syndromic cause in 80% of the genetic bilateral HL cases. On the other hand connexin positive diagnoses were mostly underrepresented in this study, showing the need for better screening.
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Affiliation(s)
- F Lammens
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals of Leuven, Leuven, Belgium.
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Verhaert N, Moyaert N, Godderis L, Debruyne F, Desloovere C, Luts H. Noise exposure of care providers during otosurgical procedures. B-ENT 2013; 9:3-8. [PMID: 23641584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
OBJECTIVE To monitor the noise exposure of care providers during otological surgery due to drilling and suction in the operating room. METHODS A clinical study monitoring different standard otosurgical procedures was conducted; cochlear implantation (CI), mastotympanoplasty, and mastoidectomy alone. Noise exposure to the surgeon and assistant were monitored with wireless personal noise dosimetry and stationary sound monitoring. Both maximum peak level in dBC (Lpeak) and time-average sound pressure level in dBA (equivalent level or Leq) were measured during drilling episodes. Frequency analysis in one third octaves covering the frequency bands 6.3 Hz to 20 k Hz was performed using a sound analyzing program. RESULTS When averaged over the entire procedure, the sound pressure level was highest for the surgeon and the assistant with values of 76.0 dBA and 72.5 dBA, respectively, during CI. Lpeak was 135.9 dBC. Leq for the stationary sound measurement was 74.2 dBA. During cortical bone work using a cutting burr, 84.6 dBA was measured. Mean values of L95% (estimation of the background noise) were between 55.8 dBA and 61.2 dBA. Frequency analysis showed the highest sound pressure level for all procedures was between 2.5 kHz and 3.15 kHz. CONCLUSION This is the first study to use personal sound dosimetry to monitor noise exposure during otosurgical drilling. In accordance with other studies, the results presented show sound levels below international occupational noise level regulations. However, the measured noise exposure during drilling could have negative effects on care providers based on unfavorable acoustical comfort.
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Affiliation(s)
- N Verhaert
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium.
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Desloovere C, Verhaert N, Van Kerschaver E, Debruyne F. Fifteen years of early hearing screening in Flanders: impact on language and education. B-ENT 2013; Suppl 21:81-90. [PMID: 24383226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVES To assess the impact of fifteen years of universal neonatal hearing screening in Flanders on language development and the educational setting. METHODOLOGY An analysis of the database of Kind en Gezin from 1997 to 2012 and a long-term evaluation of the children referred to our centre after failed neonatal hearing screening. The CELF and PPVT language tests were performed. RESULTS Between 1997 and August 2012, bilateral hearing loss was confirmed in 2393 children in Flanders, of whom 11.4% were referred to our tertiary centre. The educational setting and language development of 84 children older than 5 years was evaluated and 54% of them had additional disabilities. Of the children without additional disabilities, 84% attended mainstream schools; 42% of children with additional disabilities entered mainstream education with additional support. There was a significant correlation between the number of additional disabilities and the education level (p < 0.001) and between the degree of hearing loss and educational placement (p < 0.001). Data on language development were available for 76% of the children and a significant correlation could be demonstrated only between the results of the PPVT language and the number of additional handicaps (p < 0.008). CONCLUSIONS The majority of children receiving early treatment after neonatal hearing screening enter mainstream education. The number of additional disabilities has a significant effect on education level and language development.
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Affiliation(s)
- C Desloovere
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Belgium.
| | - N Verhaert
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Belgium
| | | | - F Debruyne
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Belgium
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Royackers L, Rector E, Verhaert N, Desloovere C. Long-term audiological follow-up of children with congenital cytomegalovirus. B-ENT 2013; Suppl 21:57-64. [PMID: 24383224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVE To evaluate the audiological outcome of children with congenital cytomegalovirus infection. METHODOLOGY In a prospective study, the hearing of 98 congenitally cytomegalovirus-infected children born between January 2003 and July 2009 was systematically evaluated until the age of six using the Flemish CMV protocol. Symptomatic children with hearing loss at birth were treated with ganciclovir, if parents consented. RESULTS Seventy children passed initial screening, 28 had unilateral or bilateral hearing loss. In the normal hearing group, one asymptomatic and two symptomatic children developed late-onset hearing loss. Eight children in the group with hearing loss at birth received ganciclovir. Nine symptomatic and 11 asymptomatic children did not receive ganciclovir. In the treated group, 37.5% of the children had stable hearing loss, and 37.5% had progressive and/or fluctuating hearing loss. First progression or fluctuation always occurred after the age of one year. The hearing threshold improved in 25.0%. The improvement took place during or shortly after treatment. Hearing loss remained stable in 33.3% of the untreated symptomatic children, while progression or fluctuation occurred in 55.5%. In the asymptomatic group, hearing loss was most commonly stable (63.6%). The first change in the hearing threshold was almost always detected before the age of one year in both untreated groups. CONCLUSIONS Hearing loss caused by congenital cytomegalovirus infection cannot be defined unequivocally either with respect to the level of hearing loss or its evolution over time. Treating symptomatic children with ganciclovir leads to a better prognosis during the first year of life, after which progression or fluctuation again becomes more likely. However, overall, progression is more common in the untreated symptomatic group. Asymptomatic children with SNHL are more likely to have a stable hearing status.
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Affiliation(s)
- L Royackers
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium.
| | - E Rector
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
| | - N Verhaert
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
| | - C Desloovere
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
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Lammens F, Verhaert N, Desloovere C. Syndromic disorders in congenital hearing loss. B-ENT 2013; Suppl 21:45-50. [PMID: 24383222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVES To investigate the aetiology of congenital hearing loss detected by the universal neonatal hearing screening programme (Algo) that was introduced in Flanders 15 years ago, and, more specifically, to investigate genetic causes. METHODOLOGY Diagnostic work-up of all children with confirmed hearing loss after referral by the Algo screening programme and screening at the neonatal intensive care unit (NICU) of our university hospital. RESULTS A hearing loss was confirmed in 505 of the 569 neonates (18% from NICU) referred between 1997 and 2011. After further examination, a genetic origin was identified in 84 (17%) of 100 children with a syndromic hearing loss. The most frequent syndromes are discussed. CONCLUSION A higher percentage of syndromic hearing loss was found than in the literature. This could be explained by the good cooperation with the human genetics department and the proportion of children retrieved from the neonatal intensive care unit.
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Affiliation(s)
- F Lammens
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals of Leuven, Leuven, Belgium
| | - N Verhaert
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals of Leuven, Leuven, Belgium
| | - C Desloovere
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals of Leuven, Leuven, Belgium
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Verhaert N, Lazard DS, Gnansia D, Bébéar JP, Romanet P, Meyer B, Péan V, Mollard D, Truy E. Speech performance and sound localization abilities in Neurelec Digisonic® SP binaural cochlear implant users. Audiol Neurootol 2012; 17:256-66. [PMID: 22584289 DOI: 10.1159/000338472] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2011] [Accepted: 03/12/2012] [Indexed: 11/19/2022] Open
Abstract
In this prospective study the outcome of the Digisonic® SP Binaural cochlear implant (CI), a device enabling electric stimulation of both cochleae by a single receiver, was evaluated in 14 postlingually deafened adults after 12 months of use. Speech perception was tested using French disyllabic words in quiet and in speech-shaped noise at +10 dB signal-to-noise ratio. Horizontal sound localization in quiet was tested using pink noise coming from 5 loudspeakers, from -90 to +90° along the azimuth. Speech scores in quiet were 76% (±19.5 SD) in the bilateral condition, 62% (±24 SD) for the better ear alone and 43.5% (±27 SD) for the poorer ear alone. Speech scores in noise were 60% (±27.5 SD), 46% (±28 SD) and 28% (±25 SD), respectively, in the same conditions. Statistical analysis showed a significant advantage of the bilateral use in quiet and in noise (p < 0.05 compared to the better ear). Significant spatial perception benefits such as summation effect (p < 0.05), head shadow effect (p < 0.0001) and squelch effect (p < 0.0005) were noted. Sound localization accuracy improved significantly when using the device in the bilateral condition with an average root mean square of 35°. Compared with published outcomes of usual bilateral cochlear implantation, this device could be a valuable alternative to two CIs. Prospective controlled trials, comparing the Digisonic SP Binaural CI with a standard bilateral cochlear implantation are mandatory to evaluate their respective advantages and cost-effectiveness.
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Affiliation(s)
- Nicolas Verhaert
- Département d'ORL, de Chirurgie Cervico-Maxillo-Faciale, et d'Audiophonologie, Hospices Civils de Lyon, Hôpital Edouard Herriot, Lyon, France.
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Verhaert N, Vander Poorten V, Delaere P, Bex M, Debruyne F. Levothyroxine replacement therapy after thyroid surgery. B-ENT 2006; 2:129-33. [PMID: 17067083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Abstract
INTRODUCTION AND AIM New entities, such as 'subclinical' over- and undersubstitution, are easily diagnosed after thyroid surgery due to improved testing methods, and the incidence of thyroidectomy with lifelong hormone substitution is increasing. Thus, there is a need to review conventional replacement therapy after thyroid surgery. We investigated the adequacy of our thyroid hormone replacement therapy for three months after total-, subtotal-, and hemithyroidectomy using an upper reference limit of thyrotropin (TSH) of 4.6 mU/L. MATERIALS AND METHODS Eighty-seven patients undergoing thyroidectomy for benign thyroid pathology participated. Levothyroxine (L-T4) treatment began five days after surgery. Preoperatively euthyroid patients received 150 microg L-T4 daily following total thyroidectomy, 100 microg L-T4 after subtotal thyroidectomy, and 50 microg L-T4 after hemithyroidectomy. Preoperatively hyperthyroid patients received 100 microg L-T4 following total thyroidectomy and 50 microg L-T4 following subtotal thyroidectomy. An average of six weeks after surgery, thyrotropin (TSH) was measured (reference limits 0.15-4.60 mU/L), and necessary dose adjustments were made. RESULTS Of the patients who were preoperatively euthyroid, 45% with total thyroidectomy, 42% with subtotal thyroidectomy, and 17% with hemithyroidectomy required L-T4 dose adjustments. Of the patients who were preoperatively hyperthyroid, 60% of those with total thyroidectomy and all of those with subtotal thyroidectomy required L-T4 dose adjustments. CONCLUSIONS To avoid over- and undersubstitution after thyroidectomy, an optimal replacement therapy dose is necessary. A small majority of our preoperatively euthyroid patients received adequate therapy. Endocrinological follow-up six weeks after surgery revealed the need for L-T4 dose adjustments, especially in preoperatively hyperthyroid patients. When the extent of resection was similar for hyperthyroid and euthyroid patients, the same initial dose of L-T4 was justified.
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Affiliation(s)
- N Verhaert
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
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