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Rak K, Kaulitz S, Voelker J, Müller-Graff T, Engert J, Spahn B, Hackenberg S, Grasso P, Hagen R. [Online training for hearing implant surgery : A new approach to otological training. German version]. HNO 2024; 72:317-324. [PMID: 38530381 PMCID: PMC11045577 DOI: 10.1007/s00106-024-01451-w] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2024] [Indexed: 03/28/2024]
Abstract
OBJECTIVE Education in microsurgery of the ear includes staged training to allow for mastering of the complex microsurgical procedures, particularly in the context of middle ear reconstruction and cochlear implantation. Traditional surgical training includes temporal bone preparations by cadaver dissection and supervised operating room practice. As these on-site trainings are limited, there is a need to broaden education facilities in an on-line format. Therefore, a first basic on-line training for otosurgery was developed. MATERIALS AND METHODS The system consists of an artificial temporal bone model together with a set of basic surgical instruments and implant dummies. As an essential part of the training kit, a high-resolution camera set is included that allows for connection to a video streaming platform and enables remote supervision of the trainees' surgical steps by experienced otological surgeons. In addition, a pre-learning platform covering temporal bone anatomy and instrumentation and pre-recorded lectures and instructional videos has been developed to allow trainees to review and reinforce their understanding before hands-on practice. RESULTS Over the three courses held to date, 28 participants with varying levels of prior surgical experience took part in this otological surgical training program. The immediate feedback of the participants was evaluated by means of a questionnaire. On this basis, the high value of the program became apparent and specific areas could by identified where further refinements could lead to an even more robust training experience. CONCLUSION The presented program of an otosurgical online training allows for basal education in practical exercises on a remote system. In this way, trainees who have no direct access to on-site instruction facilities in ear surgery now have the chance to start their otosurgical training in an educational setting adapted to modern technologies.
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Affiliation(s)
- Kristen Rak
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland.
| | - Stefan Kaulitz
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Johannes Voelker
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Tassilo Müller-Graff
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Jonas Engert
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Björn Spahn
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Stephan Hackenberg
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Peter Grasso
- MED-EL Elektromedizinische Geräte Gesellschaft m.b.H., Innsbruck, Österreich
| | - Rudolf Hagen
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
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Müller-Graff FT, Spahn B, Herrmann DP, Kurz A, Voelker J, Hagen R, Rak K. [Comprehensive literature review on the application of the otological-surgical planning software OTOPLAN® for cochlear implantation. German version]. HNO 2024:10.1007/s00106-024-01461-8. [PMID: 38587661 DOI: 10.1007/s00106-024-01461-8] [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] [Accepted: 11/28/2023] [Indexed: 04/09/2024]
Abstract
BACKGROUND The size of the human cochlear, measured by the diameter of the basal turn, varies between 7 and 11 mm. For hearing rehabilitation with cochlear implants (CI), the size of the cochlear influences the individual frequency map and the choice of electrode length. OTOPLAN® (CAScination AG [Bern, Switzerland] in cooperation with MED-EL [Innsbruck, Austria]) is a software tool with CE marking for clinical applications in CI treatment which allows for precise pre-planning based on cochlear size. This literature review aims to analyze all published data on the application of OTOPLAN®. MATERIALS AND METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were applied to identify relevant studies published in the PubMed search engine between January 2015 and February 2023 using the search terms "otoplan" [title/abstract] OR "anatomy-based fitting" [title/abstract] OR "otological software tool" [title/abstract] OR "computed tomography-based software AND cochlear" [title/abstract]. RESULTS The systematic review of the literature identified 32 studies on clinical use of OTOPLAN® in CI treatment. Most studies were reported from Germany (7 out of 32), followed by Italy (5), Saudi Arabia (4), the USA (4), and Belgium (3); 2 studies each were from Austria and China, and 1 study from France, India, Norway, South Korea, and Switzerland. In the majority of studies (22), OTOPLAN® was used to assess cochlear size, followed by visualizing the electrode position using postoperative images (5), three-dimensional segmentation of temporal bone structures (4), planning the electrode insertion trajectory (3), creating a patient-specific frequency map (3), planning of a safe drilling path through the facial recess (3), and measuring of temporal bone structures (1). CONCLUSION To date, OTOPLAN® is the only DICOM viewer with CE marking in the CI field that can process pre-, intra-, and postoperative images in the abovementioned applications.
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Affiliation(s)
- Franz-Tassilo Müller-Graff
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland.
| | - Björn Spahn
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - David P Herrmann
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Anja Kurz
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Johannes Voelker
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Rudolf Hagen
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Kristen Rak
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
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Andries E, Lorens A, Skarżyński PH, Skarżyński H, Calvino M, Gavilán J, Lassaletta L, Tavora-Vieira D, Acharya A, Kurz A, Hagen R, Anderson I, Koinig K, Abdelsamad Y, Van de Heyning P, Van Rompaey V, Mertens G. Holistic assessment of cochlear implant outcomes using the international classification of functioning disability and health model: data analysis of a longitudinal prospective multicenter study. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08600-5. [PMID: 38573516 DOI: 10.1007/s00405-024-08600-5] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 03/05/2024] [Indexed: 04/05/2024]
Abstract
PURPOSE To study outcome after cochlear implantation using the Cochlear Implant (CI) outcome assessment protocol based on the International Classification of Functioning, Disability and Health (ICF) model (CI-ICF). METHODS Raw data of a prospective, longitudinal, multicenter study was analyzed. Seventy-two CI candidates were assessed preoperatively and six months postoperatively using the CI-ICF protocol. Following tools were used: (1) Work Rehabilitation Questionnaire (WORQ), (2) Abbreviated Profile of Hearing Aid Benefit (APHAB), (3) Audio Processor Satisfaction Questionnaire (APSQ), (4) Speech, Spatial, and Qualities of Hearing Scale (SSQ12), (5) Hearing Implant Sound Quality Index (HISQUI19), (6) Nijmegen CI Questionnaire (NCIQ) (7) pure tone audiometry, (8) speech audiometry, (9) sound localization. RESULTS There was a significant improvement of speech discrimination in quiet (p = 0.015; p < 0.001) and in noise (p = 0.041; p < 0.001), sound detection (p < 0.001), tinnitus (p = 0.026), listening (p < 0.001), communicating with-receiving-spoken messages (p < 0.001), conversation (p < 0.001), family relationships (p < 0.001), community life (p = 0.019), NCIQ total score and all subdomain scores (p < 0.001). Subjective sound localization significantly improved (p < 0.001), while psychometric sound localization did not. There was no significant subjective deterioration of vestibular functioning and no substantial change in sound aversiveness. CI users reported a high level of implant satisfaction postoperatively. CONCLUSION This study highlights the positive impact of cochlear implantation on auditory performance, communication, and subjective well-being. The CI-ICF protocol provides a holistic and comprehensive view of the evolution of CI outcomes.
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Affiliation(s)
- Ellen Andries
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), Antwerp, Belgium.
- Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp (UA), Antwerp, Belgium.
| | - Artur Lorens
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Kajetany, Warsaw, Poland
| | - Piotr Henryk Skarżyński
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Kajetany, Warsaw, Poland
- Center of Hearing and Speech 'Medincus', Kajetany, Poland
- Department of Teleaudiology and Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing, Kajetany, Warsaw, Poland
- Institute of Sensory Organs, Kajetany, Poland
| | - Henryk Skarżyński
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Kajetany, Warsaw, Poland
| | - Miryam Calvino
- Department of Otolaryngology, La Paz University Hospital, IdiPAZ Institute for Health Research, Madrid, Spain
- Biomedical Research Networking Centre On Rare Diseases (CIBERER-U761), Institute of Health Carlos III, Madrid, Spain
| | - Javier Gavilán
- Department of Otolaryngology, La Paz University Hospital, IdiPAZ Institute for Health Research, Madrid, Spain
| | - Luis Lassaletta
- Department of Otolaryngology, La Paz University Hospital, IdiPAZ Institute for Health Research, Madrid, Spain
- Biomedical Research Networking Centre On Rare Diseases (CIBERER-U761), Institute of Health Carlos III, Madrid, Spain
| | - Dayse Tavora-Vieira
- Department of Otolaryngology, Head & Neck Surgery, Fiona Stanley Fremantle Hospital Group, Perth, Australia
- Medical School, Division of Surgery, The University of Western Australia, Perth, Australia
- Faculty of Health Sciences, School of Allied Health, Curtin University, Perth, Australia
| | - Aanand Acharya
- Department of Otolaryngology, Head & Neck Surgery, Fiona Stanley Fremantle Hospital Group, Perth, Australia
| | - Anja Kurz
- Comprehensive Hearing Center, Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Rudolf Hagen
- Comprehensive Hearing Center, Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Ilona Anderson
- Clinical Research Department, MED-EL GmbH, Innsbruck, Austria
| | - Karin Koinig
- Clinical Research Department, MED-EL GmbH, Innsbruck, Austria
| | | | - Paul Van de Heyning
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), Antwerp, Belgium
- Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp (UA), Antwerp, Belgium
| | - Vincent Van Rompaey
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), Antwerp, Belgium
- Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp (UA), Antwerp, Belgium
| | - Griet Mertens
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), Antwerp, Belgium
- Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp (UA), Antwerp, Belgium
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Spahn B, Ilgen L, Neun T, Müller-Graff FT, Schendzielorz P, Hagen R, Althoff D, Zabler S, Rak K. Dependence of Cochlear Duct Length Measurement on the Resolution of the Imaging Dataset. Otol Neurotol 2024; 45:e234-e240. [PMID: 38238926 DOI: 10.1097/mao.0000000000004088] [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: 02/17/2024]
Abstract
HYPOTHESIS Measurements of the cochlear duct length (CDL) are dependent on the resolution of the imaging dataset. BACKGROUND Previous research has shown highly precise cochlear measurements using 3D-curved multiplanar reconstruction (MPR) and flat-panel volume computed tomography (fpVCT). Thus far, however, there has been no systematic evaluation of the imaging dataset resolution required for optimal CDL measurement. Therefore, the aim of this study was to evaluate the dependence of CDL measurement on the resolution of the imaging dataset to establish a benchmark for future CDL measurements. METHODS fpVCT scans of 10 human petrous bone specimens were performed. CDL was measured using 3D-curved MPR with secondary reconstruction of the fpVCT scans (fpVCT SECO ) and increasing resolution from 466 to 99 μm. In addition, intraobserver variability was evaluated. A best-fit function for calculation of the CDL was developed to provide a valid tool when there are no measurements done with high-resolution imaging datasets. RESULTS Comparison of different imaging resolution settings showed significant differences for CDL measurement in most of the tested groups ( p < 0.05), except for the two groups with the highest resolution. Imaging datasets with a resolution lower than 200 μm showed lower intraobserver variability than the other resolution settings, although there were no clinically unacceptable errors with respect to the Bland-Altman plots. The developed best-fit function showed high accuracy for CDL calculation using resolution imaging datasets of 300 μm or lower. CONCLUSION 3D-curved MPR in fpVCT with a resolution of the imaging dataset of 200 μm or higher revealed the most precise CDL measurement. There was no benefit of using a resolution higher than 200 μm with regard to the accuracy of the CDL measurement.
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Affiliation(s)
- Bjoern Spahn
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center
| | - Lukas Ilgen
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center
| | - Tilmann Neun
- Institute for Diagnostic and Interventional Neuroradiology, University of Wuerzburg
| | - Franz-Tassilo Müller-Graff
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center
| | - Philipp Schendzielorz
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center
| | - Rudolf Hagen
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center
| | - Daniel Althoff
- Fraunhofer Development Center for X-ray Technology, Wuerzburg
| | - Simon Zabler
- Deggendorf Institute of Technology, Faculty of Applied Computer Science, Deggendorf, Germany
| | - Kristen Rak
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center
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Engert J, Backhaus J, Henig L, Spahn B, Voelker J, Ickrath P, Scherzad A, Rak K, Hagen R, König S, Hackenberg S, Kaulitz S. [Repetitio est mater studiorum-implementation of ENT cases in case-based e-learning]. HNO 2024; 72:166-172. [PMID: 38180480 PMCID: PMC10879404 DOI: 10.1007/s00106-023-01409-4] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND German university otorhinolaryngology has a need for digital teaching content. Case-based e‑learning represents a digital teaching methodology. The data on student use of case-based e‑learning in university teaching of ENT medicine are limited. OBJECTIVE The aim of this work was to determine the extent to which voluntary case-based e‑learning is used by otolaryngology students and what influence the quality of the e‑learning has on motivation to use e‑learning and on the interest in otolaryngology. MATERIALS AND METHODS Fifteen voluntary e‑learning cases were created based on the content of the ENT lecture in the winter semester 2022/2023. Subsequently, a descriptive evaluation of the usage statistics of the cases of 157 students was conducted. Likewise, an evaluation of the quality of the e‑learning as well as the motivation to complete it and the interest in otorhinolaryngology was carried out using a voluntary questionnaire. RESULTS Voluntary case-based e‑learning was used to varying degrees by 66% of the students. The quality of e‑learning correlated significantly with the motivation and the interest in otolaryngology. CONCLUSION The teaching content of otorhinolaryngology can be implemented sufficiently in case-based e‑learning and is characterized by satisfactory student acceptance. Integration should be accomplished in a high-quality manner to increase motivation and interest in otorhinolaryngology.
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Affiliation(s)
- Jonas Engert
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland.
| | - Joy Backhaus
- Institut für Medizinische Lehre und Ausbildungsforschung, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - Linda Henig
- Institut für Medizinische Lehre und Ausbildungsforschung, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - Bjoern Spahn
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Johannes Voelker
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Pascal Ickrath
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Agmal Scherzad
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Kristen Rak
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Rudolf Hagen
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Sarah König
- Institut für Medizinische Lehre und Ausbildungsforschung, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - Stephan Hackenberg
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Stefan Kaulitz
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
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Krafft E, Kaulitz S, Voelker J, Engert J, Spahn B, Hagen R, Rak K. [Initial assessment of ENT emergencies-a feasibility study]. HNO 2024:10.1007/s00106-024-01434-x. [PMID: 38386035 DOI: 10.1007/s00106-024-01434-x] [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] [Accepted: 01/17/2024] [Indexed: 02/23/2024]
Abstract
In Germany, an increased volume of patient cases in the emergency department has been observed for several years, many of which do not represent hospital emergencies. To improve the triage and management of patient flows, the Structured Initial Medical Assessment (Strukturierte medizinische Ersteinschätzung in Deutschland, SmED) triage system was developed. This certified medical product is intended to assess both the urgency of everyday complaints and their adequate medical care in a targeted, faster, and safer manner. It supports medical professionals in triage by suggesting courses of action, whereby the ultimate responsibility remains with the professionals themselves. For otorhinolaryngology, a content review was carried out with regard to plausibility and patient safety in the head and neck region on the basis of nine specific emergencies. The cases were simulated by nine otorhinolaryngologists and triaged on the basis of the SmED by medical staff and medical students by assigning a care level and timepoint (urgency). The majority of cases were correctly assigned. The SmED initial assessment system is a good tool for assessing urgent clinical pictures in ear, nose, and throat (ENT) medicine. The long-term goal of the initial assessment is to relieve the capacities of outpatient departments. In order to achieve this and to shorten patient waiting times, it would be necessary to refer patients quickly to otorhinolaryngology. It is therefore necessary to ensure that patients are referred to an ENT on-call service via the online tool.
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Affiliation(s)
- Eva Krafft
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Stefan Kaulitz
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Johannes Voelker
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Jonas Engert
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Björn Spahn
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Rudolf Hagen
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Kristen Rak
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland.
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Hagen R. [Obituary for Prof. Dr. Klaus Terrahe : 04.01.1935-25.11.2023]. HNO 2024; 72:69-71. [PMID: 38180479 DOI: 10.1007/s00106-023-01415-6] [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] [Subscribe] [Scholar Register] [Accepted: 12/20/2023] [Indexed: 01/06/2024]
Affiliation(s)
- Rudolf Hagen
- , Anne-Frank-Straße 39, 97082, Würzburg, Deutschland.
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Spahn B, Koestler C, Herrmann D, Voelker J, Engert J, Kurz A, Hagen R, Cebulla M, Rak K. The Stapes Head Coupler-A Flexible and Safe Option for Vibroplasty. Otol Neurotol 2024; 45:11-17. [PMID: 38085759 DOI: 10.1097/mao.0000000000004060] [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: 12/18/2023]
Abstract
OBJECTIVE To investigate the surgical approach and the audiological outcome of a stapes head coupler in active middle ear implant surgery. STUDY DESIGN Retrospective data analysis. SETTING Tertiary referral center with a large active middle ear implant program. PATIENTS Twelve patients with active middle ear implant surgery. INTERVENTIONS Therapeutic surgical approach for hearing rehabilitation in human subjects. MAIN OUTCOME MEASURES Auditory brainstem response, sound field thresholds, vibrogram, speech perception in the Freiburger monosyllabic word test. RESULTS The stapes head was attached safely in different coupling situations. Audiological outcomes were similar to the audiological performance of established vibroplasty couplers presented in the literature. CONCLUSION The stapes head coupler is a new and safe tool for vibroplasty with a good audiological outcome.
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Affiliation(s)
- Bjoern Spahn
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Wuerzburg, Germany
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Kraus F, Gehrke S, Ehrmann-Müller D, Hofer F, Shehata-Dieler W, Hagen R, Scherzad A. Comparison of three different image enhancement systems for detection of laryngeal lesions. J Laryngol Otol 2024; 138:105-111. [PMID: 37211357 PMCID: PMC10772018 DOI: 10.1017/s0022215123000981] [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: 11/18/2022] [Revised: 02/08/2023] [Accepted: 04/25/2023] [Indexed: 05/23/2023]
Abstract
OBJECTIVE Image enhancement systems are important diagnostic tools in the detection of laryngeal pathologies. This study aimed to compare three different image enhancement systems: professional image enhancement technology, Image1 S and narrow-band imaging. METHOD Using the three systems, 100 patients with laryngeal lesions were investigated using a flexible and a 30° rigid endoscope. The lesions were diagnosed by three experts and classified using the Ni classification. The findings were compared. RESULTS Lesions classified as 'benign' were histopathologically confirmed in 50 per cent of patients, malignant lesions were confirmed in 41 per cent and recurrent respiratory papillomatosis were confirmed in 9 per cent. There was no significant difference between the experts' assessments of each image enhancement system. CONCLUSION The three systems give comparable results in the detection of laryngeal lesions. With two additional systems, more users can perform image-enhanced endoscopy, resulting in a broadly available tool that can help to improve oncological assessment.
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Affiliation(s)
- Fabian Kraus
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Würzburg, Würzburg, Germany
| | - Sven Gehrke
- School of Economics and Business Administration, University of Jena, Jena, Germany
| | - Desiree Ehrmann-Müller
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Würzburg, Würzburg, Germany
| | - Frank Hofer
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Bundeswehr Hospital Ulm, Ulm, Germany
| | - Wafaa Shehata-Dieler
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Würzburg, Würzburg, Germany
| | - Rudolf Hagen
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Würzburg, Würzburg, Germany
| | - Agmal Scherzad
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Würzburg, Würzburg, Germany
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Sparber-Sauer M, Dietzschold M, Schönstein A, Heinz A, Vokuhl C, Pajtler KW, Harrabi S, Lin YL, Kalle TV, Hagen R, Ladenstein R, Kazanowska B, Ljungman G, Klingebiel T, Ebinger M, Koscielniak E, Münter M, Timmermann B. Radiotherapy and long-term sequelae in pediatric patients with parameningeal rhabdomyosarcoma: Results of two Cooperative Weichteilsarkom Studiengruppe (CWS) trials and one registry. Pediatr Blood Cancer 2024; 71:e30742. [PMID: 37880926 DOI: 10.1002/pbc.30742] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/14/2023] [Accepted: 10/14/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND Parameningeal location of rhabdomyosarcoma (PM RMS) is known to be an unfavorable prognostic factor. Scarce data are available on radiotherapy (RT) concepts with regard to outcome. METHODS Treatment and outcome of 395 children with PM RMS registered within two Cooperative Weichteilsarkom Studiengruppe (CWS) trials and one registry (1995-2021) were evaluated. RESULTS Patients were IRS group II (n = 15) and III (n = 380) and received systemic treatment according to the enrolled protocols: I2VA (n = 172), VAIA/CEVAIE (n = 223). Delayed resection was performed in 88/395 (22%) patients, and RT was additionally given in 79/88 (90%) resected patients. RT was the predominant local treatment in 355/395 (90%) patients: hyperfractionated accelerated photon (HART; n = 77), conventionally fractionated photon (n = 91) or proton beam (n = 126), brachytherapy (n = 4), heavy ions (n = 1), not available (n = 56). In the subgroup of RT as only local treatment (n = 278), no intracranial tumor extension and complete remission at end of treatment were significant positive prognostic factors. No significant difference on tumor outcome was seen between different radiotherapy concepts. Long-term toxicity with mostly endocrinological and visual deficiencies was reported in 161/279 (58%) surviving patients with a lower trend after proton beam RT (48%) when compared to HART or conventionally fractionated photon RT (71% and 72%, respectively). Ten-year event-free and overall survival in the overall group were 62% (±5, 95% confidence interval [CI]) and 67% (±5, 95% CI); in the RT-only group 67% (±6, 95% CI) and 71% (±6, 95% CI), respectively. CONCLUSION CWS data confirm the recent RT concept in PM RMS. Long-term sequelae as endocrinological and visual deficiencies need to be addressed.
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Affiliation(s)
- Monika Sparber-Sauer
- Klinikum der Landeshauptstadt Stuttgart gKAöR, Olgahospital, Stuttgart Cancer Center, Zentrum für Kinder-, Jugend- und Frauenmedizin, Pädiatrie 5 (Pädiatrische Onkologie, Hämatologie, Immunologie), Stuttgart, Germany
- University of Medicine Tübingen, Tübingen, Germany
| | | | - Anton Schönstein
- Network Aging Research, Heidelberg University, Heidelberg, Germany
| | - Amadeus Heinz
- Klinikum der Landeshauptstadt Stuttgart gKAöR, Olgahospital, Stuttgart Cancer Center, Zentrum für Kinder-, Jugend- und Frauenmedizin, Pädiatrie 5 (Pädiatrische Onkologie, Hämatologie, Immunologie), Stuttgart, Germany
| | - Christian Vokuhl
- Department of Pathology, Section of Pediatric Pathology, University Hospital Bonn, Bonn, Germany
| | - Kristian W Pajtler
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg University, Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg University, Heidelberg, Germany
- Department of Pediatric Oncology, Hematology, and Immunology, Heidelberg University Hospital, Heidelberg, Germany
| | - Semi Harrabi
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
- Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany
- National Center for Tumor diseases (NCT), Heidelberg, Germany
- Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Radiation Oncology, Heidelberg Ion-Beam Therapy Center (HIT), Heidelberg University Hospital, Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Yi-Lan Lin
- Department of Particle Therapy, University Hospital Essen, West German Proton Therapy Centre Essen (WPE), West German Cancer Centre (WTZ), West German, Germany
| | - Thekla von Kalle
- Klinikum Stuttgart - Olgahospital, Stuttgart Cancer Center, Zentrum für Kinder-, Jugend- und Frauenmedizin, Olgahospital, Institute of Radiology, Stuttgart, Germany
| | - Rudolf Hagen
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Wuerzburg, Wuerzburg, Germany
| | | | - Bernarda Kazanowska
- Department of Pediatric Hematology/Oncology and BMT, Wroclaw Medical University, Wroclaw, Poland
| | - Gustaf Ljungman
- Department of Women's and Children's Health, Pediatric Oncology, University of Uppsala, Uppsala, Sweden
| | - Thomas Klingebiel
- Department for Children and Adolescents, University Hospital, Goethe University Frankfurt, Frankfurt, Germany
| | - Martin Ebinger
- Department of Pediatric Hematology and Oncology, University Children's Hospital, Tuebingen, Germany
| | - Ewa Koscielniak
- Klinikum der Landeshauptstadt Stuttgart gKAöR, Olgahospital, Stuttgart Cancer Center, Zentrum für Kinder-, Jugend- und Frauenmedizin, Pädiatrie 5 (Pädiatrische Onkologie, Hämatologie, Immunologie), Stuttgart, Germany
- University of Medicine Tübingen, Tübingen, Germany
| | - Marc Münter
- Klinikum Stuttgart, Institute of Radiotherapy, Stuttgart, Germany
| | - Beate Timmermann
- Department of Particle Therapy, University Hospital Essen, West German Proton Therapy Centre Essen (WPE), West German Cancer Centre (WTZ), West German, Germany
- German Cancer Consortium (DKTK), Essen, Germany
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Bassler MC, Knoblich M, Gerhard-Hartmann E, Mukherjee A, Youssef A, Hagen R, Haug L, Goncalves M, Scherzad A, Stöth M, Ostertag E, Steinke M, Brecht M, Hackenberg S, Meyer TJ. Differentiation of Salivary Gland and Salivary Gland Tumor Tissue via Raman Imaging Combined with Multivariate Data Analysis. Diagnostics (Basel) 2023; 14:92. [PMID: 38201401 PMCID: PMC10795677 DOI: 10.3390/diagnostics14010092] [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: 11/06/2023] [Revised: 12/10/2023] [Accepted: 12/29/2023] [Indexed: 01/12/2024] Open
Abstract
Salivary gland tumors (SGTs) are a relevant, highly diverse subgroup of head and neck tumors whose entity determination can be difficult. Confocal Raman imaging in combination with multivariate data analysis may possibly support their correct classification. For the analysis of the translational potential of Raman imaging in SGT determination, a multi-stage evaluation process is necessary. By measuring a sample set of Warthin tumor, pleomorphic adenoma and non-tumor salivary gland tissue, Raman data were obtained and a thorough Raman band analysis was performed. This evaluation revealed highly overlapping Raman patterns with only minor spectral differences. Consequently, a principal component analysis (PCA) was calculated and further combined with a discriminant analysis (DA) to enable the best possible distinction. The PCA-DA model was characterized by accuracy, sensitivity, selectivity and precision values above 90% and validated by predicting model-unknown Raman spectra, of which 93% were classified correctly. Thus, we state our PCA-DA to be suitable for parotid tumor and non-salivary salivary gland tissue discrimination and prediction. For evaluation of the translational potential, further validation steps are necessary.
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Affiliation(s)
- Miriam C. Bassler
- Process Analysis and Technology (PA&T), School of Life Science, Reutlingen University, Alteburgstr. 150, 72762 Reutlingen, Germany; (M.C.B.); (M.K.); (A.M.); (E.O.)
- Institute of Physical and Theoretical Chemistry, Faculty of Science, University of Tübingen, Auf der Morgenstelle 18, 72076 Tübingen, Germany
| | - Mona Knoblich
- Process Analysis and Technology (PA&T), School of Life Science, Reutlingen University, Alteburgstr. 150, 72762 Reutlingen, Germany; (M.C.B.); (M.K.); (A.M.); (E.O.)
- Institute of Physical and Theoretical Chemistry, Faculty of Science, University of Tübingen, Auf der Morgenstelle 18, 72076 Tübingen, Germany
| | - Elena Gerhard-Hartmann
- Institute of Pathology, University of Würzburg, Josef-Schneider-Str. 2, 97080 Würzburg, Germany; (E.G.-H.); (A.Y.); (L.H.)
| | - Ashutosh Mukherjee
- Process Analysis and Technology (PA&T), School of Life Science, Reutlingen University, Alteburgstr. 150, 72762 Reutlingen, Germany; (M.C.B.); (M.K.); (A.M.); (E.O.)
- Institute of Physical and Theoretical Chemistry, Faculty of Science, University of Tübingen, Auf der Morgenstelle 18, 72076 Tübingen, Germany
| | - Almoatazbellah Youssef
- Institute of Pathology, University of Würzburg, Josef-Schneider-Str. 2, 97080 Würzburg, Germany; (E.G.-H.); (A.Y.); (L.H.)
| | - Rudolf Hagen
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic & Reconstructive Head and Neck Surgery, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080 Würzburg, Germany; (R.H.); (M.G.); (A.S.); (M.S.); (S.H.)
| | - Lukas Haug
- Institute of Pathology, University of Würzburg, Josef-Schneider-Str. 2, 97080 Würzburg, Germany; (E.G.-H.); (A.Y.); (L.H.)
| | - Miguel Goncalves
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic & Reconstructive Head and Neck Surgery, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080 Würzburg, Germany; (R.H.); (M.G.); (A.S.); (M.S.); (S.H.)
| | - Agmal Scherzad
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic & Reconstructive Head and Neck Surgery, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080 Würzburg, Germany; (R.H.); (M.G.); (A.S.); (M.S.); (S.H.)
| | - Manuel Stöth
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic & Reconstructive Head and Neck Surgery, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080 Würzburg, Germany; (R.H.); (M.G.); (A.S.); (M.S.); (S.H.)
| | - Edwin Ostertag
- Process Analysis and Technology (PA&T), School of Life Science, Reutlingen University, Alteburgstr. 150, 72762 Reutlingen, Germany; (M.C.B.); (M.K.); (A.M.); (E.O.)
| | - Maria Steinke
- Chair of Tissue Engineering and Regenerative Medicine, University Hospital Würzburg, Röntgenring 11, 97070 Würzburg, Germany;
- Fraunhofer Institute for Silicate Research ISC, Röntgenring 11, 97070 Würzburg, Germany
| | - Marc Brecht
- Process Analysis and Technology (PA&T), School of Life Science, Reutlingen University, Alteburgstr. 150, 72762 Reutlingen, Germany; (M.C.B.); (M.K.); (A.M.); (E.O.)
- Institute of Physical and Theoretical Chemistry, Faculty of Science, University of Tübingen, Auf der Morgenstelle 18, 72076 Tübingen, Germany
| | - Stephan Hackenberg
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic & Reconstructive Head and Neck Surgery, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080 Würzburg, Germany; (R.H.); (M.G.); (A.S.); (M.S.); (S.H.)
| | - Till Jasper Meyer
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic & Reconstructive Head and Neck Surgery, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080 Würzburg, Germany; (R.H.); (M.G.); (A.S.); (M.S.); (S.H.)
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12
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Zhi Y, Higuchi T, Hackenberg S, Hagen R, Stöth M, Scherzad A, Buck AK, Werner RA, Serfling SE. [ 18F]FDG PET/CT can trigger relevant oncological management changes leading to favorable outcome in iodine-negative thyroid cancer patients. Endocrine 2023:10.1007/s12020-023-03645-8. [PMID: 38133766 DOI: 10.1007/s12020-023-03645-8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND In patients with iodine-negative thyroid cancer (TC), current guidelines endorse an [18F]FDG PET/CT to identify dedifferentiated sites of disease. We aimed to determine the rate of oncological management changes triggered by such a molecular imaging approach, along with the impact on outcome. METHODS 42 consecutive patients with negative findings on [131I] whole body scan were scheduled for [18F]FDG PET/CT and treatment based on PET results were initiated. To determine the impact on oncological management, we compared the therapeutic plan prior to and after molecular imaging. Based on imaging follow-up, the rate of controlled disease (CD, defined as stable disease, complete or partial response) was also recorded, thereby allowing to assess whether [18F]FDG-triggered management changes can also lead to favorable outcome. RESULTS We observed no alterations of the treatment plan in 9/42 (21.4%) subjects (active surveillance in 9/9 [100%]). Oncological management was changed in the remaining 33/42 (78.6%; systemic treatment in 9/33 [27.3%] and non-systemic treatment in 24/33 [72.7%]). Among patients receiving non-systemic therapy, the following changes were noted: surgery in 20/24 (83.3%) and radiation therapy in 4/24 (16.7%). In the systemic group, tyrosine kinase inhibitor (TKI) was prescribed in 8/9 (88.9%), while radioiodine therapy based on a TKI-mediated redifferentiation approach was conducted in 1/9 (11.1%). In 26 subjects with available follow-up, rate of CD was 22/26 (84.6%) and among those, 15/22 (68.1%) had experienced previous management changes based on PET/CT findings. CONCLUSIONS In subjects with iodine-negative TC, [18F]FDG PET/CT triggered relevant management changes along with disease control in the vast majority of patients. As such, in dedifferentiated TC, [18F]FDG PET/CT may serve as a relevant management tool and therapeutic decision-aid in the clinic.
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Affiliation(s)
- Yingjun Zhi
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Takahiro Higuchi
- Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
- Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Stephan Hackenberg
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Würzburg, Germany
- Department of Otorhinolaryngology - Head and Neck Surgery, RWTH Aachen University, Aachen, Germany
| | - Rudolf Hagen
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Manuel Stöth
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Agmal Scherzad
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Andreas K Buck
- Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Rudolf A Werner
- Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
- Johns Hopkins School of Medicine, The Russell H Morgan Department of Radiology and Radiological Science, Baltimore, MD, USA
| | - Sebastian E Serfling
- Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany.
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13
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Breitsprecher TM, Baumgartner WD, Brown K, Dazert S, Doyle U, Dhanasingh A, Großmann W, Hagen R, Van de Heyning P, Mlynski R, Neudert M, Rajan G, Rak K, Van Rompaey V, Schmutzhard J, Volkenstein S, Völter C, Wimmer W, Zernotti M, Weiss NM. Effect of Cochlear Implant Electrode Insertion Depth on Speech Perception Outcomes: A Systematic Review. Otol Neurotol Open 2023; 3:e045. [PMID: 38516541 PMCID: PMC10950166 DOI: 10.1097/ono.0000000000000045] [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] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 10/29/2023] [Indexed: 03/23/2024]
Abstract
Objective The suitable electrode array choice is broadly discussed in cochlear implantation surgery. Whether to use a shorter electrode length under the aim of structure preservation versus choosing a longer array to achieve a greater cochlear coverage is a matter of debate. The aim of this review is to identify the impact of the insertion depth of a cochlear implant (CI) electrode array on CI users' speech perception outcomes. Databases Reviewed PubMed was searched for English-language articles that were published in a peer-reviewed journal from 1997 to 2022. Methods A systematic electronic search of the literature was carried out using PubMed to find relevant literature on the impact of insertion depth on speech perception. The review was conducted according to the preferred reporting items for systematic reviews and meta-analyses guidelines of reporting. Studies in both, children and adults with pre- or postlingual hearing loss, implanted with a CI were included in this study. Articles written in languages other than English, literature reviews, meta-analyses, animal studies, histopathological studies, or studies pertaining exclusively to imaging modalities without reporting correlations between insertion depth and speech outcomes were excluded. The risk of bias was determined using the "Risk of Bias in Nonrandomized Studies of Interventions" tool. Articles were extracted by 2 authors independently using predefined search terms. The titles and abstracts were screened manually to identify studies that potentially meet the inclusion criteria. The extracted information included: the study population, type of hearing loss, outcomes reported, devices used, speech perception outcomes, insertion depth (linear insertion depth and/or the angular insertion depth), and correlation between insertion depth and the speech perception outcomes. Results A total of 215 relevant studies were assessed for eligibility. Twenty-three studies met the inclusion criteria and were analyzed further. Seven studies found no significant correlation between insertion depth and speech perception outcomes. Fifteen found either a significant positive correlation or a positive effect between insertion depth and speech perception. Only 1 study found a significant negative correlation between insertion depth and speech perception outcomes. Conclusion Although most studies reported a positive effect of insertion depth on speech perception outcomes, one-third of the identified studies reported no correlation. Thus, the insertion depth must be considered as a contributing factor to speech perception rather than as a major decisive criterion. Registration This review has been registered in PROSPERO, the international prospective register of systematic reviews (CRD42021257547), available at https://www.crd.york.ac.uk/PROSPERO/.
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Affiliation(s)
- Tabita M. Breitsprecher
- Department of Otorhinolaryngology-Head and Neck Surgery, Ruhr-University Bochum, St. Elisabeth-Hospital Bochum, Bochum, Germany
| | - Wolf-Dieter Baumgartner
- Universitätsklinik für Hals-, Nasen- und Ohrenkrankheiten, Medizinische Universität Wien, Wien, Austria
| | - Kevin Brown
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Stefan Dazert
- Department of Otorhinolaryngology-Head and Neck Surgery, Ruhr-University Bochum, St. Elisabeth-Hospital Bochum, Bochum, Germany
| | - Una Doyle
- MED-EL Elektromedizinische Geraete Gesellschaft m.b.H., Innsbruck, Austria
| | - Anandhan Dhanasingh
- MED-EL Elektromedizinische Geraete Gesellschaft m.b.H., Innsbruck, Austria
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Wilma Großmann
- Department of Otorhinolaryngology, Head and Neck Surgery, “Otto Körner,” Rostock University Medical Center, Rostock, Germany
| | - Rudolf Hagen
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Comprehensive Hearing Center, University of Würzburg, Würzburg, Germany
| | - Paul Van de Heyning
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Otorhinolaryngology and Head & Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Robert Mlynski
- Department of Otorhinolaryngology, Head and Neck Surgery, “Otto Körner,” Rostock University Medical Center, Rostock, Germany
| | - Marcus Neudert
- Department of Otorhinolaryngology Head and Neck Surgery, Technische Universität Dresden (oder TU Dresden), Faculty of Medicine (and University Hospital) Carl Gustav Carus, Dresden, Germany
| | - Gunesh Rajan
- Otolaryngology, Head and Neck Surgery, Medical School, University of Western Australia, Perth, Australia
- Faculty of Health Sciences and Medicine, University of Lucerne, Luzern, Switzerland
| | - Kristen Rak
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Comprehensive Hearing Center, University of Würzburg, Würzburg, Germany
| | - Vincent Van Rompaey
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Otorhinolaryngology and Head & Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Joachim Schmutzhard
- Department of Otorhinolaryngology-Head and Neck Surgery, Medical University Innsbruck, Innsbruck, Austria
| | - Stefan Volkenstein
- Department of Otorhinolaryngology, Head and Neck Surgery, Ruhr-University Bochum, Johannes Wesling Klinikum Minden, Bochum, Germany
| | - Christiane Völter
- Department of Otorhinolaryngology-Head and Neck Surgery, Ruhr-University Bochum, St. Elisabeth-Hospital Bochum, Bochum, Germany
| | - Wilhelm Wimmer
- Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Technical University of Munich (TUM), Munich, Germany
- Department of Otorhinolaryngology, TUM School of Medicine, Klinikum Rechts der Isar, Munich, Germany
| | - Mario Zernotti
- Division of Otolaryngology and Head and Neck Surgery, Sanatorio Allende, Catholic University of Córdoba and National University of Córdoba, Córdoba, Argentina
| | - Nora M. Weiss
- Department of Otorhinolaryngology-Head and Neck Surgery, Ruhr-University Bochum, St. Elisabeth-Hospital Bochum, Bochum, Germany
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Otorhinolaryngology and Head & Neck Surgery, Antwerp University Hospital, Edegem, Belgium
- Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Technical University of Munich (TUM), Munich, Germany
- Department of Otorhinolaryngology, TUM School of Medicine, Klinikum Rechts der Isar, Munich, Germany
- International Graduate School of Neuroscience, Ruhr-University Bochum, Bochum, Germany
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Stöth M, Meyer T, Gehrke T, Hagen R, Scheich M, Hackenberg S, Scherzad A. Discontinuation of anti‑programmed cell death protein 1 immune checkpoint inhibition after complete remission in head and neck squamous cell carcinoma: A case report and literature review. Oncol Lett 2023; 26:489. [PMID: 37818135 PMCID: PMC10561138 DOI: 10.3892/ol.2023.14076] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 07/07/2023] [Indexed: 10/12/2023] Open
Abstract
Programmed cell death protein 1 (PD-1) inhibition plays a central role in the current treatment of recurrent or metastatic head and neck squamous cell carcinoma (R/M-HNSCC). Some patients achieve a durable response, and even complete remission (CR) is possible, though it occurs rarely. In cases of durable CR, there are no guidelines regarding a possible discontinuation of immunotherapy. Since clinical experience on this issue is limited, the present study reported on a case of a durable CR following discontinuation of PD-1 inhibition in R/M-HNSCC and additionally presented an overview on the current literature. The present study reported on a case of CR of recurrent oropharyngeal cancer after four cycles of PD-1 monotherapy with Nivolumab. The therapy was discontinued after overall 46 cycles. Even after 3 more years of follow-up, there was no sign of tumor recurrence. Overall, according to reports from the literature, CR seems to be an indicator for durable disease control after therapy discontinuation. Since data on therapy termination is rare, decisions about when to stop successful immunotherapy in R/M-HNSCC have to be made individually for each patient.
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Affiliation(s)
- Manuel Stöth
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, D-97080 Würzburg, Germany
| | - Till Meyer
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, D-97080 Würzburg, Germany
| | - Thomas Gehrke
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, D-97080 Würzburg, Germany
| | - Rudolf Hagen
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, D-97080 Würzburg, Germany
| | - Matthias Scheich
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, D-97080 Würzburg, Germany
| | - Stephan Hackenberg
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital, Rhine-Westphalia Technical University of Aachen, D-52074 Aachen, Germany
| | - Agmal Scherzad
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, D-97080 Würzburg, Germany
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15
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Engert J, Bauer D, Spahn B, Müller-Graff FT, Voelker J, Neun T, Althoff D, Hagen R, Hackenberg S, Rak K. Computed tomographic 3D analysis of the cochlear aqueduct-potential and limitations of clinical imaging. Acta Otolaryngol 2023; 143:931-935. [PMID: 38127466 DOI: 10.1080/00016489.2023.2294921] [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: 11/17/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023]
Abstract
Background: The cochlear aqueduct (CA), which connects the scala tympani and the subarachnoid space, and its accompanying structures appear to have a significant relevance during cochlear implantation and an accurate visualization in clinical imaging is of great interest. Aims and Objective: This study aims to determine which potential and limitations clinically available imaging modalities have in the visualization of the CA. Methods: Micro-CT, flat-panel volume computed tomography with and without secondary reconstruction (fpVCT, fpVCTseco) and multislice computed tomography (MSCT) of 10 temporal bone specimen were used for 3D analysis of the CA. Results: FpVCTseco proved superior in visualizing the associated structures and lateral portions of the CA, which merge into the basal turn of the cochlea. All clinical imaging modalities proved equal in analyzing the length, total volume of the CA and its area of the medial orifice. Conclusion: The choice of the most accurate clinical imaging modality to evaluate the CA and its associated structures depends on the clinical or scientific question. Furthermore, this study should provide a basis for further investigations analyzing the CA.
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Affiliation(s)
- Jonas Engert
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Wuerzburg, Germany
| | - Daniel Bauer
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Wuerzburg, Germany
| | - Bjoern Spahn
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Wuerzburg, Germany
| | - Franz-Tassilo Müller-Graff
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Wuerzburg, Germany
| | - Johannes Voelker
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Wuerzburg, Germany
| | - Tilmann Neun
- Institute for Diagnostic and Interventional Neuroradiology, University of Wuerzburg, Wuerzburg, Germany
| | - Daniel Althoff
- Fraunhofer Development Center for X-ray Technology, Wuerzburg, Germany
| | - Rudolf Hagen
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Wuerzburg, Germany
| | - Stephan Hackenberg
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Wuerzburg, Germany
| | - Kristen Rak
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Wuerzburg, Germany
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Zhi Y, Gerhard-Hartmann E, Hartrampf PE, Weich A, Higuchi T, Bley TA, Hackenberg S, Hagen R, Rosenwald A, Scherzad A, Remde H, Fassnacht M, Werner RA, Serfling SE. Somatostatin Receptor-Directed PET/CT Can Differentiate Between Different Subtypes of Head and Neck Paragangliomas. Clin Nucl Med 2023; 48:923-927. [PMID: 37756444 PMCID: PMC10581414 DOI: 10.1097/rlu.0000000000004870] [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: 06/06/2023] [Revised: 08/01/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND Given their neuroendocrine origin, head and neck paragangliomas (HNPGLs) can be imaged with somatostatin receptor (SSTR)-directed PET/CT. We aimed to determine whether the in vivo PET signal can differentiate between varying HNPGL subtypes. PATIENTS AND METHODS Fourteen patients with HNPGL received pretherapeutic SSTR-PET/CTs using 68 Ga-DOTATOC. Six (42.9%) patients had a jugular paraganglioma (PGL-J), 5 (35.7%) were diagnosed with carotid paraganglioma (PGL-Cs), and the remaining 3 patients (21.4%) had PGL-C with pathogenic SDHx germline variants (PGL-C-SDH). A visual and quantitative assessment of the primary tumor on SSTR-PET was performed, including SUV max and target-to-background ratio (TBR). Quantitative values were then compared between subgroups of patients affected with different HNPGL entities. RESULTS On visual assessment, all primary HNPGLs could be identified on SSTR-PET/CT. Quantification of HNPGL revealed substantially elevated SUV max in PGL-J (101.7 ± 58.5) when compared with PGL-C-SDH (13.4 ± 5.6, P < 0.05), but not when compared with PGL-C (66.7 ± 27.3, P = 0.4; PGL-C vs PGL-C-SDH, P = 0.2). TBR of PGL-J (202.9 ± 82.2), however, further differentiated between PGL-C (95.7 ± 45.4, P < 0.05) and PGL-C-SDH (20.4 ± 12.2, P < 0.01; PGL-C vs PGL-C-SDH, P = 0.3). Moreover, whole-body readout revealed metastases in 2/3 (66.7%) of PGL-C-SDH patients, with a single SSTR-expressing skeletal lesion in one subject and bipulmonary lesions in the other patient. CONCLUSIONS In patients with HNPGL, SSTR-PET/CT identified the primary and metastatic disease and provides substantially elevated TBR, indicating excellent image contrast. PET-based quantification can also differentiate between varying HNPGL subtypes.
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Affiliation(s)
- Yingjun Zhi
- From the Department of Otorhinolaryngology, Plastic, Aesthetic, and Reconstructive Head and Neck Surgery, University Hospital Würzburg
| | - Elena Gerhard-Hartmann
- Institute of Pathology and Comprehensive Cancer Center Mainfranken, Julius-Maximilian University Würzburg
| | | | - Alexander Weich
- Division of Gastroenterology, Department of Internal Medicine II
- NET-Zentrum Würzburg, ENETS Center of Excellence, University Hospital Würzburg, Würzburg, Germany
| | - Takahiro Higuchi
- Department of Nuclear Medicine
- Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Thorsten A. Bley
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg
| | - Stephan Hackenberg
- Department of Otorhinolaryngology–Head and Neck Surgery, RWTH Aachen University, Aachen
| | - Rudolf Hagen
- From the Department of Otorhinolaryngology, Plastic, Aesthetic, and Reconstructive Head and Neck Surgery, University Hospital Würzburg
| | - Andreas Rosenwald
- Institute of Pathology and Comprehensive Cancer Center Mainfranken, Julius-Maximilian University Würzburg
| | - Agmal Scherzad
- From the Department of Otorhinolaryngology, Plastic, Aesthetic, and Reconstructive Head and Neck Surgery, University Hospital Würzburg
| | - Hanna Remde
- Division of Endocrinology, Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
| | - Martin Fassnacht
- Division of Endocrinology, Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany
| | - Rudolf A. Werner
- Department of Nuclear Medicine
- NET-Zentrum Würzburg, ENETS Center of Excellence, University Hospital Würzburg, Würzburg, Germany
- Johns Hopkins School of Medicine, The Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD
| | - Sebastian E. Serfling
- Department of Nuclear Medicine
- NET-Zentrum Würzburg, ENETS Center of Excellence, University Hospital Würzburg, Würzburg, Germany
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17
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Matthies C, Zeller L, Kurz A, Rak K, Hagen R, Shehata-Dieler W. Electrically evoked auditory responses: A classification for brainstem implant placement in Neurofibromatosis Type 2. Clin Neurophysiol 2023; 155:16-28. [PMID: 37659342 DOI: 10.1016/j.clinph.2023.08.005] [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: 11/23/2022] [Revised: 08/04/2023] [Accepted: 08/08/2023] [Indexed: 09/04/2023]
Abstract
OBJECTIVE In auditory brainstem implant (ABI) surgery, array placement may be optimized by electrophysiological information of adequate brainstem activation gained from electrically evoked auditory brainstem responses (EABR). This study aims 1) to characterize in detail the EABR from ABI implantation, 2) to introduce an EABR Classification Scheme, and 3) to analyze data for their correlation with individual patients' findings. METHODS Out of a continuous series of 54 patients who received an ABI between 2005 and 2019, 23 Neurofibromatosis Type 2 patients with complete documentation of 154 recordings were selected for offline analysis and for development and evaluation of a new EABR Classification Scheme comprising Class A: three vertex positive peaks, Class B:two peaks, Class C: a combination of one peak and a second melted double peak, Class D: one sole vertex positive peak and Class E: no peaks. RESULTS All 23 subjects showed EABR at final ABI position and experienced auditory sensations at first activation. The most frequent morphology consisted of two peaks, Classes B and C. Identified mean latencies were for P1 0.42 ms (±0.095), P2 1.42 ms (±0.244) and P3 2.41 ms (±0.329). Peak latencies correlated positively with tumor extensions (p < 0.005). CONCLUSIONS This study provides clear instructions on optimal EABR performance and evaluation. SIGNIFICANCE The new EABR Classification Scheme relies on a fast "online" identification of vertex positive peaks at the estimated post-artifact phase. The variability in EABR morphology provides an individual snapshot of the actual structural and functional status of the brainstem.
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Affiliation(s)
- Cordula Matthies
- Department of Neurosurgery, Würzburg University Hospital, Würzburg, Germany.
| | - Laura Zeller
- Department of Neurosurgery, Würzburg University Hospital, Würzburg, Germany
| | - Anja Kurz
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Würzburg University Hospital, Würzburg, Germany
| | - Kristen Rak
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Würzburg University Hospital, Würzburg, Germany
| | - Rudolf Hagen
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Würzburg University Hospital, Würzburg, Germany
| | - Wafaa Shehata-Dieler
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Würzburg University Hospital, Würzburg, Germany
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18
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Moratin H, Thöle A, Lang J, Ehret Kasemo T, Stöth M, Hagen R, Scherzad A, Hackenberg S. Ag- but Not ZnO-Nanoparticles Disturb the Airway Epithelial Barrier at Subtoxic Concentrations. Pharmaceutics 2023; 15:2506. [PMID: 37896266 PMCID: PMC10610507 DOI: 10.3390/pharmaceutics15102506] [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: 09/26/2023] [Revised: 10/18/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023] Open
Abstract
Inhalation is considered to be the most relevant source of human exposure to nanoparticles (NPs); however, only a few investigations have addressed the influence of exposing the respiratory mucosal barrier to subcytotoxic doses. In the nasal respiratory epithelium, cells of the mucosa represent one of the first contact points of the human organism with airborne NPs. Disruption of the epithelial barrier by harmful materials can lead to inflammation in addition to potential intrinsic toxicity of the particles. The aim of this study was to investigate whether subtoxic concentrations of zinc oxide (ZnO)- and silver (Ag)-NPs have an influence on upper airway barrier integrity. Nasal epithelial cells from 17 donors were cultured at the air-liquid interface and exposed to ZnO- and Ag-NPs. Barrier function, quantified by transepithelial electrical resistance (TEER), decreased after treatment with 10 µg/mL Ag-NPs, but FITC-dextran permeability remained stable and no change in mRNA levels of tight junction proteins and E-cadherin was detected by real-time quantitative PCR (RT-qPCR). The results indicate that subtoxic concentrations of Ag-NPs may already induce damage of the upper airway epithelial barrier in vitro. The lack of similar disruption by ZnO-NPs of similar size suggests a specific effect by Ag-NPs.
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Affiliation(s)
- Helena Moratin
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Wuerzburg, Josef-Schneider-Strasse 11, 97080 Wuerzburg, Germany (S.H.)
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19
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Zhi Y, Werner RA, Schirbel A, Higuchi T, Buck AK, Kosmala A, Bley TA, Hagen R, Hackenberg S, Rosenwald A, Scherzad A, Gerhard-Hartmann E, Serfling SE. Diagnostic efficacy of C-X-C motif chemokine receptor 4-directed PET/CT in newly diagnosed head and neck squamous cell carcinoma - a head-to-head comparison with [ 18F]FDG. Am J Nucl Med Mol Imaging 2023; 13:208-216. [PMID: 38023816 PMCID: PMC10656626] [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] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 09/10/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND The aim of this study was to determine the read-out capabilities of the novel C-X-C motif chemokine receptor 4 (CXCR4)-targeting radiotracer [68Ga]Ga-PentixaFor compared to the reference radiotracer [18F]FDG in untreated individuals with head and neck squamous cell carcinoma (HNSCC). MATERIAL AND METHODS 12 patients with histologically confirmed HNSCC were scheduled for [18F]FDG and [68Ga]Ga-PentixaFor PET/CT. Maximum standardized uptake values (SUVmax) and target-to-background ratios (TBR) were applied with vena cava superior serving as reference. In addition, we compared [68Ga]Ga-PentixaFor-PET findings with immunohistochemical (IHC) results of CXCR4 expression. RESULTS On visual assessment, [18F]FDG identified more sites of disease, with increased detection rates for both the primary tumor ([18F]FDG, 12/12 [100%] vs. [68Ga]Ga-PentixaFor, 10/12 [83%]) and LN metastases ([18F]FDG, 9/12 [75%] vs. [68Ga]Ga-PentixaFor, 8/12 [67%]). Indicative for improved image contrast using [18F]FDG, quantification showed a higher TBR for the latter radiotracer, when compared to [68Ga]Ga-PentixaFor for all lesions ([18F]FDG, 11.7 ± 8.5 vs. [68Ga]Ga-PentixaFor, 4.3 ± 1.3; P=0.03), primary tumors ([18F]FDG, 13.6 ± 8.7 vs. [68Ga]Ga-PentixaFor, 4.4 ± 1.4; P<0.01), and LN lesions ([18F]FDG, 9.3 ± 10.6 vs. [68Ga]Ga-PentixaFor, 4.7 ± 1.5; P=0.3). IHC showed variable CXCR4 expression in the primary and LN, along with no associations between ex-vivo CXCR4 upregulation and [68Ga]Ga-PentixaFor-based TBR (R=0.33, P=0.39) or SUVmax (R=0.44, P=0.2). Of note, IHC also revealed heterogeneous expression of CXCR4 in immune cells in the tumor microenvironment and in germinal centers, indicative for inflammatory reactions. CONCLUSIONS In HNSCC, [18F]FDG demonstrated superior diagnostic performance relative to [68Ga]Ga-PentixaFor, in particular for assessment of the primary. Based on the IHC analyses, these findings may be explained by CXCR4 upregulation not only by tumor but also by immune cells in the tumor microenvironment.
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Affiliation(s)
- Yingjun Zhi
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital WürzburgWürzburg 97080, Germany
| | - Rudolf A Werner
- Department of Nuclear Medicine, University Hospital WürzburgWürzburg 97080, Germany
- Division of Nuclear Medicine, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of MedicineBaltimore, MD 21205, USA
| | - Andreas Schirbel
- Department of Nuclear Medicine, University Hospital WürzburgWürzburg 97080, Germany
| | - Takahiro Higuchi
- Department of Nuclear Medicine, University Hospital WürzburgWürzburg 97080, Germany
- Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityOkayama 700-8530, Japan
| | - Andreas K Buck
- Department of Nuclear Medicine, University Hospital WürzburgWürzburg 97080, Germany
| | - Aleksander Kosmala
- Department of Nuclear Medicine, University Hospital WürzburgWürzburg 97080, Germany
| | - Thorsten A Bley
- Department of Diagnostic and Interventional Radiology, University Hospital WürzburgWürzburg 97080, Germany
| | - Rudolf Hagen
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital WürzburgWürzburg 97080, Germany
| | - Stephan Hackenberg
- Department of Otorhinolaryngology - Head and Neck Surgery, RWTH Aachen UniversityAachen 52074, Germany
| | - Andreas Rosenwald
- Department of Pathology and Comprehensive Cancer Center Mainfranken, Julius-Maximilian University of WürzburgWürzburg 97080, Germany
| | - Agmal Scherzad
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital WürzburgWürzburg 97080, Germany
| | - Elena Gerhard-Hartmann
- Department of Pathology and Comprehensive Cancer Center Mainfranken, Julius-Maximilian University of WürzburgWürzburg 97080, Germany
| | - Sebastian E Serfling
- Department of Nuclear Medicine, University Hospital WürzburgWürzburg 97080, Germany
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Engert J, Doll J, Vona B, Ehret Kasemo T, Spahn B, Hagen R, Rak K, Voelker J. mRNA Abundance of Neurogenic Factors Correlates with Hearing Capacity in Auditory Brainstem Nuclei of the Rat. Life (Basel) 2023; 13:1858. [PMID: 37763262 PMCID: PMC10532994 DOI: 10.3390/life13091858] [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: 08/07/2023] [Revised: 08/30/2023] [Accepted: 08/31/2023] [Indexed: 09/29/2023] Open
Abstract
Neural stem cells (NSCs) have previously been described up to the adult stage in the rat cochlear nucleus (CN). A decreasing neurogenic potential was observed with critical changes around hearing onset. A better understanding of molecular factors affecting NSCs and neurogenesis is of interest as they represent potential targets to treat the cause of neurologically based hearing disorders. The role of genes affecting NSC development and neurogenesis in CN over time on hearing capacity has remained unclear. This study investigated the mRNA abundance of genes influencing NSCs and neurogenesis in rats' CN over time. The CN of rats on postnatal days 6, 12, and 24 were examined. Real-time quantitative polymerase chain reaction arrays were used to compare mRNA levels of 84 genes relevant to NSCs and neurogenesis. Age- and hearing-specific patterns of changes in mRNA abundance of neurogenically relevant genes were detected in the rat CN. Additionally, crucial neurogenic factors with significant and relevant influence on neurogenesis were identified. The results of this work should contribute to a better understanding of the molecular mechanisms underlying the neurogenesis of the auditory pathway.
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Affiliation(s)
- Jonas Engert
- Department of Otorhinolaryngology, University Hospital Wuerzburg, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Josef-Schneider-Strasse 11, 97080 Wuerzburg, Germany; (T.E.K.); (B.S.); (R.H.); (K.R.); (J.V.)
| | - Julia Doll
- Institute of Pathology, University of Wuerzburg, Josef-Schneider-Strasse 2, 97080 Wuerzburg, Germany;
| | - Barbara Vona
- Institute for Auditory Neuroscience and InnerEarLab, University Medical Center Göttingen, Robert-Koch-Strasse 40, 37075 Göttingen, Germany;
- Institute of Human Genetics, University Medical Center Göttingen, Heinrich-Düker-Weg 12, 37073 Göttingen, Germany
| | - Totta Ehret Kasemo
- Department of Otorhinolaryngology, University Hospital Wuerzburg, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Josef-Schneider-Strasse 11, 97080 Wuerzburg, Germany; (T.E.K.); (B.S.); (R.H.); (K.R.); (J.V.)
| | - Bjoern Spahn
- Department of Otorhinolaryngology, University Hospital Wuerzburg, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Josef-Schneider-Strasse 11, 97080 Wuerzburg, Germany; (T.E.K.); (B.S.); (R.H.); (K.R.); (J.V.)
| | - Rudolf Hagen
- Department of Otorhinolaryngology, University Hospital Wuerzburg, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Josef-Schneider-Strasse 11, 97080 Wuerzburg, Germany; (T.E.K.); (B.S.); (R.H.); (K.R.); (J.V.)
| | - Kristen Rak
- Department of Otorhinolaryngology, University Hospital Wuerzburg, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Josef-Schneider-Strasse 11, 97080 Wuerzburg, Germany; (T.E.K.); (B.S.); (R.H.); (K.R.); (J.V.)
| | - Johannes Voelker
- Department of Otorhinolaryngology, University Hospital Wuerzburg, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Josef-Schneider-Strasse 11, 97080 Wuerzburg, Germany; (T.E.K.); (B.S.); (R.H.); (K.R.); (J.V.)
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21
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Scherzad A, Stöth M, Meyer TJ, Haug L, Gehrke T, Schilling B, Meierjohann S, Scheich M, Hagen R, Gesierich A, Hackenberg S. Multimodal treatment and immune checkpoint inhibition in sinonasal mucosal melanoma: real-world data of a retrospective, single-center study. Eur Arch Otorhinolaryngol 2023; 280:4215-4223. [PMID: 37272953 PMCID: PMC10382337 DOI: 10.1007/s00405-023-08015-8] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 05/08/2023] [Indexed: 06/06/2023]
Abstract
PURPOSE Local failure and distant metastases occur frequently in sinonasal mucosal melanoma (SNMM). Response rates to chemotherapy are low and targetable mutations are rarely detected. However, there is increasing data indicating efficacy of immune checkpoint inhibition (ICI). The aim of this retrospective monocenter study was to assess the mutational landscape and to evaluate the outcome of surgical treatment and ICI in SNMM in a real-world setting. METHODS Thirty-eight SNMM patients being treated between 1999 and 2020 at our institution were retrospectively reviewed. Survival curves were generated according to Kaplan-Meier and compared by the log-rank test. RESULTS Local failure was seen in 60% of patients treated in a curative intent. Overall, 24% of all patients suffered from regional and 66% from distant metastases. Next generation sequencing revealed mutations of BRAF, NRAS and KRAS. One out of three patients treated with a primary ICI showed a complete response (CR) and two showed progressive disease. Eleven patients received ICI as a palliative treatment. CR could be observed in three patients and stable disease in one patient. In the whole study population, the 5-year overall survival rate (OS) was 26%. OS was better for patients who received ICI during the course of disease. CONCLUSIONS Recurrences and distant metastases are frequent in SNMM. Durable CR could be observed after primary and palliative ICI. Therefore, ICI in a palliative, adjuvant or even neoadjuvant setting might play a promising role in SNMM therapy while targetable mutations are rarely detected.
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Affiliation(s)
- Agmal Scherzad
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Manuel Stöth
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany.
| | - Till J Meyer
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Lukas Haug
- Institute of Pathology, University of Würzburg, 97080, Würzburg, Germany
| | - Thomas Gehrke
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Bastian Schilling
- Department of Dermatology, Venerology and Allergology, University Hospital Würzburg, 97080, Würzburg, Germany
| | - Svenja Meierjohann
- Institute of Pathology, University of Würzburg, 97080, Würzburg, Germany
- Comprehensive Cancer Center Mainfranken, University Hospital Würzburg, Würzburg, Germany
| | - Matthias Scheich
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Rudolf Hagen
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Germany
| | - Anja Gesierich
- Department of Dermatology, Venerology and Allergology, University Hospital Würzburg, 97080, Würzburg, Germany
| | - Stephan Hackenberg
- Department of Otorhinolaryngology-Head and Neck Surgery, RWTH Aachen University Hospital, 52074, Aachen, Germany
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22
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Kraus F, Wech T, Köstler H, Hagen R, Scherzad A. Do Disinfectant Solutions during Gargling Reach the Pharynx? Folia Phoniatr Logop 2023; 76:102-108. [PMID: 37544306 DOI: 10.1159/000533135] [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: 03/06/2023] [Accepted: 07/05/2023] [Indexed: 08/08/2023] Open
Abstract
INTRODUCTION In times of COVID-19, gargling disinfectant is commonly used. Disinfectant solutions seem to decrease the infection's symptoms. For disinfection, several techniques are reported. So far, there are no data about the regions in the upper airways achieved by gargled fluid. METHODS Ten healthy volunteers without any dysphagia were investigated with a high-sensitivity flexible endoscopic evaluation of swallowing (hsFEES®) during and after gargling colored water. One volunteer repeated the gargling process in fast and real-time MRI. RESULTS In all cases, no color accumulation was detected on the posterior pharyngeal wall, epi- or hypopharynx during gargling. The MRI scans confirmed the results. CONCLUSIONS hsFEES® and fast MRI provide an insight into the gargling pattern. Data show that during gargling, the fluid covers the soft tissue in the oral cavity and the anterior part of the soft palate, but not the posterior pharyngeal wall nor the epi- and hypopharynx.
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Affiliation(s)
- Fabian Kraus
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Würzburg, Würzburg, Germany
| | - Tobias Wech
- Department of Diagnostic and Interventional Radiology, University of Würzburg, Würzburg, Germany
| | - Herbert Köstler
- Department of Diagnostic and Interventional Radiology, University of Würzburg, Würzburg, Germany
| | - Rudolf Hagen
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Würzburg, Würzburg, Germany
| | - Agmal Scherzad
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Würzburg, Würzburg, Germany
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23
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Kurz A, Herrmann D, Hagen R, Rak K. Using Anatomy-Based Fitting to Reduce Frequency-to-Place Mismatch in Experienced Bilateral Cochlear Implant Users: A Promising Concept. J Pers Med 2023; 13:1109. [PMID: 37511722 PMCID: PMC10381201 DOI: 10.3390/jpm13071109] [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] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 06/28/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023] Open
Abstract
Fitting cochlear implant (CI) users can be challenging. Anatomy-based fitting (ABF) maps may have the potential to lead to better objective and subjective outcomes than conventional clinically based fitting (CBF) methods. ABF maps were created via information derived from exact electrode contact positions, which were determined via post-operative high-resolution flat panel volume computer tomography and clinical fitting software. The outcome measures were speech understanding in quiet and noise and self-perceived sound quality with the CBF map and with the ABF map. Participants were 10 experienced bilateral CI users. The ABF map provided better speech understanding in quiet and noisy environments compared to the CBF map. Additionally, two approaches of reducing the frequency-to-place mismatch revealed that participants are more likely to accept the ABF map if their electrode array is inserted deep enough to stimulate the apical region of their cochlea. This suggests an Angular Insertion Depth of the most apical contact of around 720°-620°. Participants had better speech understanding in quiet and noise with the ABF map. The maps' self-perceived sound quality was similar. ABF mapping may be an effective tool for compensating the frequency-to-place mismatch in experienced bilateral CI users.
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Affiliation(s)
- Anja Kurz
- Department of Otorhinolaryngology, Head & Neck Surgery, Comprehensive Hearing Center, University of Würzburg, Josef-Schneider-Str. 11, 97080 Würzburg, Germany
| | - David Herrmann
- Department of Otorhinolaryngology, Head & Neck Surgery, Comprehensive Hearing Center, University of Würzburg, Josef-Schneider-Str. 11, 97080 Würzburg, Germany
| | - Rudolf Hagen
- Department of Otorhinolaryngology, Head & Neck Surgery, Comprehensive Hearing Center, University of Würzburg, Josef-Schneider-Str. 11, 97080 Würzburg, Germany
| | - Kristen Rak
- Department of Otorhinolaryngology, Head & Neck Surgery, Comprehensive Hearing Center, University of Würzburg, Josef-Schneider-Str. 11, 97080 Würzburg, Germany
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24
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Engert J, Spahn B, Bieniussa L, Hagen R, Rak K, Voelker J. Neurogenic Stem Cell Niche in the Auditory Thalamus: In Vitro Evidence of Neural Stem Cells in the Rat Medial Geniculate Body. Life (Basel) 2023; 13:life13051188. [PMID: 37240833 DOI: 10.3390/life13051188] [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: 04/10/2023] [Revised: 05/09/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023] Open
Abstract
The medial geniculate body (MGB) is a nucleus of the diencephalon representing a relevant segment of the auditory pathway and is part of the metathalamus. It receives afferent information via the inferior brachium of the inferior colliculus and transmits efferent fibers via acoustic radiations to the auditory cortex. Neural stem cells (NSCs) have been detected in certain areas along the auditory pathway. They are of great importance as the induction of an adult stem cell niche might open a regenerative approach to a causal treatment of hearing disorders. Up to now, the existence of NSCs in the MGB has not been determined. Therefore, this study investigated whether the MGB has a neural stem cell potential. For this purpose, cells were extracted from the MGB of PND 8 Sprague-Dawley rats and cultured in a free-floating cell culture assay, which showed mitotic activity and positive staining for stem cell and progenitor markers. In differentiation assays, the markers β-III-tubulin, GFAP, and MBP demonstrated the capacity of single cells to differentiate into neuronal and glial cells. In conclusion, cells from the MGB exhibited the cardinal features of NSCs: self-renewal, the formation of progenitor cells, and differentiation into all neuronal lineage cells. These findings may contribute to a better understanding of the development of the auditory pathway.
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Affiliation(s)
- Jonas Engert
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Wuerzburg, Josef-Schneider-Strasse 11, 97080 Wuerzburg, Germany
| | - Bjoern Spahn
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Wuerzburg, Josef-Schneider-Strasse 11, 97080 Wuerzburg, Germany
| | - Linda Bieniussa
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Wuerzburg, Josef-Schneider-Strasse 11, 97080 Wuerzburg, Germany
| | - Rudolf Hagen
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Wuerzburg, Josef-Schneider-Strasse 11, 97080 Wuerzburg, Germany
| | - Kristen Rak
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Wuerzburg, Josef-Schneider-Strasse 11, 97080 Wuerzburg, Germany
| | - Johannes Voelker
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Wuerzburg, Josef-Schneider-Strasse 11, 97080 Wuerzburg, Germany
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25
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Müller-Graff FT, Voelker J, Kurz A, Hagen R, Neun T, Rak K. Accuracy of radiological prediction of electrode position with otological planning software and implications of high-resolution imaging. Cochlear Implants Int 2023; 24:144-154. [PMID: 36617441 DOI: 10.1080/14670100.2022.2159128] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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] [Indexed: 01/10/2023]
Abstract
OBJECTIVES In cochlear implantation, preoperative prediction of electrode position has recently gained increasing attention. Currently, planning is usually done by multislice CT (MSCT). However, flat-panel volume CT (fpVCT) and its secondary reconstructions (fpVCTSECO) allow for more precise visualization of the cochlea. Combined with a newly developed otological planning software, the position of every single contact can be effectively predicted. In this study it was investigated how accurately radiological prediction forecasts the postoperative electrode localization and whether higher image resolution is advantageous. METHODS Utilizing otological planning software (OTOPLAN®) and different clinical imaging modalities (MSCT, fpVCT and fpVCTSECO) the electrode localization [angular insertion depth (AID)] and respective contact frequencies were predicted preoperatively and examined postoperatively. Furthermore, inter-electrode-distance (IED) and inter-electrode-frequency difference (IEFD) were evaluated postoperatively. RESULTS Measurements revealed a preoperative overestimation of AID. Corresponding frequencies were also miscalculated. Determination of IED and IEFD revealed discrepancies at the transition from the basal to the middle turn and round window to the basal turn. All predictions and discrepancies were lowest when using fpVCTSECO. CONCLUSION The postoperative electrode position can be predicted quite accurately using otological planning software. However, because of several potential misjudgments, high-resolution imaging, such as offered by fpVCTSECO, should be used pre- and postoperatively.
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Affiliation(s)
- Franz-Tassilo Müller-Graff
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Wuerzburg, Germany
| | - Johannes Voelker
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Wuerzburg, Germany
| | - Anja Kurz
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Wuerzburg, Germany
| | - Rudolf Hagen
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Wuerzburg, Germany
| | - Tilmann Neun
- Institute for Diagnostic and Interventional Neuroradiology, University of Wuerzburg, Wuerzburg, Germany
| | - Kristen Rak
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Wuerzburg, Germany
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26
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Rak K, Köstler C, Geiger U, Kaulitz S, Herrmann D, Shehata-Dieler W, Hagen R, Cebulla M. Application of an Intraoperative Auditory Brainstem Response Measurement System in Active Middle Ear Implant Revision Surgery. Otol Neurotol 2023; 44:483-492. [PMID: 37026817 DOI: 10.1097/mao.0000000000003851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
OBJECTIVE To investigate the benefit of intraoperative auditory brainstem response (ABR) measurements in revision active middle ear implant surgery. STUDY DESIGN Retrospective data analysis. SETTING Tertiary referral center with a large active middle ear implant program. MAIN OUTCOME MEASURES Intraoperative ABR thresholds, audiogram, sound field thresholds, speech understanding in the Freiburger monosyllabic word test. PATIENTS Fourteen patients with active middle ear implant revision surgery. RESULTS The application of the ABR measurement resulted in improved sound field thresholds and enhanced speech understanding. Analysis revealed a significant correlation of intraoperative gain in ABR threshold with the postoperative gain in sound field thresholds. CONCLUSION ABR monitoring can be a useful tool to provide information intraoperatively about the coupling efficiency of the FMT. Especially in revision surgeries, this might help to improve postoperative hearing success.
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Affiliation(s)
- Kristen Rak
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Wuerzburg, Germany
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27
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Meyer TJ, Tekin N, Hense P, Ehret-Kasemo T, Lodes N, Stöth M, Ickrath P, Gehrke T, Hagen R, Dembski S, Peer M, Steinke MR, Scherzad A, Hackenberg S. Evaluation of the cytotoxic and genotoxic potential of printer toner particles in a 3D air-liquid interface, primary cell-based nasal tissue model. Toxicol Lett 2023; 379:1-10. [PMID: 36907250 DOI: 10.1016/j.toxlet.2023.03.004] [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: 11/22/2022] [Revised: 03/03/2023] [Accepted: 03/08/2023] [Indexed: 03/12/2023]
Abstract
Printer toner particles (TPs) are a common, potentially hazardous substance, with an unclear toxicological impact on the respiratory mucosa. Most of the airways surface is covered by a ciliated respiratory mucosa, therefore appropriate tissue models of the respiratory epithelium with a high in vivo correlation are necessary for in vitro evaluation of airborne pollutants toxicology and the impact on the functional integrity. The aim of this study is the evaluation of TPs toxicology in a human primary cell-based air-liquid-interface (ALI) model of respiratory mucosa. The TPs were analyzed and characterized by scanning electron microscopy, pyrolysis and X-ray fluorescence spectrometry. ALI models of 10 patients were created using the epithelial cells and fibroblasts derived from nasal mucosa samples. TPs were applied to the ALI models via a modified Vitrocell® cloud and submerged in the dosing 0.89 - 892.96 µg/ cm2. Particle exposure and intracellular distribution were evaluated by electron microscopy. The MTT assay and the comet assay were used to investigate cytotoxicity and genotoxicity, respectively. The used TPs showed an average particle size of 3 - 8 µm. Mainly carbon, hydrogen, silicon, nitrogen, tin, benzene and benzene derivates were detected as chemical ingredients. By histomorphology and electron microscopy we observed the development of a highly functional, pseudostratified epithelium with a continuous layer of cilia. Using electron microscopy, TPs could be detected on the cilia surface and also intracellularly. Cytotoxicity was detected from 9 µg/ cm2 and higher, but no genotoxicity after ALI and submerged exposure. The ALI with primary nasal cells represents a highly functional model of the respiratory epithelium in terms of histomorphology and mucociliary differentiation. The toxicological results indicate a weak TP-concentration-dependent cytotoxicity. AVAILABILITY OF DATA AND MATERIALS: The datasets used and analysed during the current study are available from the corresponding author on reasonable request.
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Affiliation(s)
- Till Jasper Meyer
- University Hospital Würzburg, Department of Oto-Rhino-Laryngology, Plastic, Aesthetic & Reconstructive Head and Neck Surgery, Josef-Schneider-Straße 11, 97080 Würzburg, Germany.
| | - Nursen Tekin
- University Hospital Würzburg, Department of Oto-Rhino-Laryngology, Plastic, Aesthetic & Reconstructive Head and Neck Surgery, Josef-Schneider-Straße 11, 97080 Würzburg, Germany
| | - Peter Hense
- Bochum University of Applied Sciences, Department Civil and Environmental Engineering, Am Hochschulcampus 1, 44801 Bochum, Germany
| | - Totta Ehret-Kasemo
- University Hospital Würzburg, Department of Oto-Rhino-Laryngology, Plastic, Aesthetic & Reconstructive Head and Neck Surgery, Josef-Schneider-Straße 11, 97080 Würzburg, Germany
| | - Nina Lodes
- University Hospital Würzburg, Chair of Tissue Engineering and Regenerative Medicine, Röntgenring 11, 97070 Würzburg, Germany
| | - Manuel Stöth
- University Hospital Würzburg, Department of Oto-Rhino-Laryngology, Plastic, Aesthetic & Reconstructive Head and Neck Surgery, Josef-Schneider-Straße 11, 97080 Würzburg, Germany
| | - Pascal Ickrath
- University Hospital Würzburg, Department of Oto-Rhino-Laryngology, Plastic, Aesthetic & Reconstructive Head and Neck Surgery, Josef-Schneider-Straße 11, 97080 Würzburg, Germany
| | - Thomas Gehrke
- University Hospital Würzburg, Department of Oto-Rhino-Laryngology, Plastic, Aesthetic & Reconstructive Head and Neck Surgery, Josef-Schneider-Straße 11, 97080 Würzburg, Germany
| | - Rudolf Hagen
- University Hospital Würzburg, Department of Oto-Rhino-Laryngology, Plastic, Aesthetic & Reconstructive Head and Neck Surgery, Josef-Schneider-Straße 11, 97080 Würzburg, Germany
| | - Sofia Dembski
- University Hospital Würzburg, Chair of Tissue Engineering and Regenerative Medicine, Röntgenring 11, 97070 Würzburg, Germany; Fraunhofer Institute for Silicate Research ISC, Neunerplatz 2, 97082 Würzburg, Germany
| | - Michael Peer
- Fraunhofer Institute for Environmental, Safety, and Energy Technology UMSICHT, Institute Branch Sulzbach-Rosenberg, An der Maxhütte 1, 92237 Sulzbach-Rosenberg, Germany
| | - Maria R Steinke
- University Hospital Würzburg, Chair of Tissue Engineering and Regenerative Medicine, Röntgenring 11, 97070 Würzburg, Germany; Fraunhofer Institute for Silicate Research ISC, Neunerplatz 2, 97082 Würzburg, Germany
| | - Agmal Scherzad
- University Hospital Würzburg, Department of Oto-Rhino-Laryngology, Plastic, Aesthetic & Reconstructive Head and Neck Surgery, Josef-Schneider-Straße 11, 97080 Würzburg, Germany
| | - Stephan Hackenberg
- RWTH Aachen University Hospital, Department of Otorhinolaryngology - Head and Neck Surgery, Pauwelsstraße 30, 52074 Aachen, Germany
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Sprinzl GM, Magele A, Schoerg P, Hagen R, Rak K, Kurz A, Van de Heyning P, Calvino M, Lassaletta L, Gavilán J. A Novel Representation of Audiological and Subjective Findings for Acoustical, Bone Conduction and Direct Drive Hearing Solutions. J Pers Med 2023; 13:jpm13030462. [PMID: 36983644 PMCID: PMC10058515 DOI: 10.3390/jpm13030462] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/15/2022] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
Abstract
Background: The benefit of hearing rehabilitation is often measured using audiological tests or subjective questionnaires/interviews. It is important to consider both aspects in order to evaluate the overall benefits. Currently, there is no standardized method for reporting combined audiological and patient reported subjective outcome measures in clinical practice. Therefore, this study focuses on showing the patient’s audiological, as well as subjective outcomes in one graph using data from an existing study. Method: The present paper illustrated a graph presenting data on four quadrants with audiological and subjective findings. These quadrants represented speech comprehension in quiet (unaided vs. aided) as WRS% at 65 dB SPL, speech recognition in noise (unaided vs. aided) as SRT dB SNR, sound field threshold (unaided vs. aided) as PTA4 in dB HL, wearing time and patient satisfaction questionnaire results. Results: As an example, the HEARRING graph in this paper represented audiological and subjective datasets on a single patient level or a cohort of patients for an active bone conduction hearing implant solution. The graph offered the option to follow the user’s performance in time. Conclusion: The HEARRING graph allowed representation of a combination of audiological measures with patient reported outcomes in one single graph, indicating the overall benefit of the intervention. In addition, the correlation and consistency between some results (e.g., aided threshold and aided WRS) can be better visualized. Those users who lacked performance benefits on one or more parameters and called for further insight could be visually identified.
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Affiliation(s)
- Georg Mathias Sprinzl
- Department of Otorhinolaryngology, Head & Neck Surgery, University Clinic St. Poelten, Dunant-Platz 1, 3100 St. Pölten, Austria
- Karl Landsteiner Institute of Implantable Hearing Devices, 3100 St. Pölten, Austria
- Correspondence: ; Tel.: +43-2742-9004-11500
| | - Astrid Magele
- Department of Otorhinolaryngology, Head & Neck Surgery, University Clinic St. Poelten, Dunant-Platz 1, 3100 St. Pölten, Austria
- Karl Landsteiner Institute of Implantable Hearing Devices, 3100 St. Pölten, Austria
| | - Philipp Schoerg
- Department of Otorhinolaryngology, Head & Neck Surgery, University Clinic St. Poelten, Dunant-Platz 1, 3100 St. Pölten, Austria
- Karl Landsteiner Institute of Implantable Hearing Devices, 3100 St. Pölten, Austria
| | - Rudolf Hagen
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Str. 11, 97080 Würzburg, Germany
| | - Kristen Rak
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Str. 11, 97080 Würzburg, Germany
| | - Anja Kurz
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Str. 11, 97080 Würzburg, Germany
| | - Paul Van de Heyning
- ENT Department, Antwerp University Hospital, Wilrijkstraat 10, 2650 Antwerp, Belgium
| | - Miryam Calvino
- Department of Otolaryngology, La Paz University Hospital, 28046 Madrid, Spain
| | - Luis Lassaletta
- Department of Otolaryngology, La Paz University Hospital, 28046 Madrid, Spain
| | - Javier Gavilán
- Department of Otolaryngology, La Paz University Hospital, 28046 Madrid, Spain
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Fei P, Shehata-Dieler W, Huestegge L, Hagen R, Kühn H. Longitudinal Development of Verbal and Nonverbal Intelligence After Cochlear Implantation According to Wechsler Tests in German-speaking Children: A Preliminary Study. Ear Hear 2023; 44:264-275. [PMID: 36163636 DOI: 10.1097/aud.0000000000001278] [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: 10/14/2022]
Abstract
OBJECTIVES Intelligence as a construct of cognitive abilities is the basis of knowledge and skill acquisition and the main predictor of academic achievement. As a broad construct, it is usually divided into subdomains, such as nonverbal and verbal intelligence. Verbal intelligence is one domain of intelligence but is not synonymous with specific linguistic abilities like grammar proficiency. We aim to address the general expectation that early cochlear implantation enables children who are hard of hearing to develop comprehensively, including with respect to verbal intelligence. The primary purpose of this study is to trace the longitudinal development of verbal and nonverbal intelligence in children with cochlear implants (CIs). DESIGN Sixteen children with congenital hearing loss who received unilateral or bilateral implants and completed at least two intelligence assessments around the age of school entrance were included in the study. The first assessment was performed around 3 years after CI fitting (chronological age range: 3.93 to 7.03 years). The second assessment was performed approximately 2 years after the first assessment. To analyze verbal and nonverbal IQ in conjunction and across children at different ages, we used corresponding standardized and normalized tests from the same test family (Wechsler Preschool and Primary Scale of Intelligence and/or Wechsler Intelligence Scale for Children). RESULTS Regarding longitudinal development, both verbal and nonverbal IQ increased, but verbal IQ increased more substantially over time. At the time of the second measurement, verbal and nonverbal IQ were on a comparable level. Nevertheless, we also observed strong inter-individual differences. The duration between both assessments was significantly associated with verbal IQ at the second measurement time point and thus with verbal IQ gain over time. Education mode (regular vs. special kindergarten/school) was significantly correlated with nonverbal IQ at the second assessment time point. CONCLUSIONS The results, despite the small sample size, clearly suggest that children with CIs can achieve intellectual abilities comparable to those of their normal-hearing peers by around the third year after initial CI fitting, and they continue to improve over the following 2 years. We recommend further research focusing on verbal IQ assessed around the age of school entrance to be used as a predictor for further development and for the establishment of an individual educational program.
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Affiliation(s)
- Peipei Fei
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Wuerzburg, Germany
| | - Wafaa Shehata-Dieler
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Wuerzburg, Germany
| | - Lynn Huestegge
- Department of Psychology, University of Wuerzburg, Wuerzburg, Germany
| | - Rudolf Hagen
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Wuerzburg, Germany
| | - Heike Kühn
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Wuerzburg, Germany
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30
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Wilhelm C, Radeloff K, Scherzad A, Scheich M, Hagen R. [COVID-19: Collateral damage in head and neck oncology and preventive measures for future pandemics]. Laryngorhinootologie 2023; 102:104-110. [PMID: 36750111 DOI: 10.1055/a-2007-2002] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
The start of the COVID-19 pandemic led to enormous challenges for global healthcare, as capacities and resources had to be made available quickly for the treatment of COVID-19 patients. As a result, restrictions had to be accepted, especially in the care of oncological patients. The collateral damage of these limitations inevitably also affects patients with head and neck cancer. This review article summarizes the development of tumor incidences during the pandemic, internationally developed guidelines for the care of patients with head and neck cancer and studies on the delay in oncological therapies and mortality. In addition, the effects on the mental health of the patients, the psychosocial consequences and ethical issues are examined. In perspective, preventive measures for such negative collateral effects in future pandemics are discussed using the example of a concept for application software (app)-based digital care for patients with head and neck cancer.
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Affiliation(s)
- Christian Wilhelm
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Würzburg, Germany
| | - Katrin Radeloff
- Universitätsklinik für Hals-Nasen-Ohrenheilkunde, Evangelisches Krankenhaus Oldenburg, Oldenburg, Germany
| | - Agmal Scherzad
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Würzburg, Germany
| | - Matthias Scheich
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Würzburg, Germany
| | - Rudolf Hagen
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Würzburg, Germany
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Ickrath P, Sprügel L, Beyersdorf N, Haug L, Scherzad A, Hagen R, Hackenberg S. Aspergillus fumigatus-Specific T Cells in Patients with Chronic Rhinosinusitis. Int Arch Allergy Immunol 2023; 184:502-512. [PMID: 36652922 DOI: 10.1159/000528394] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 11/24/2022] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION Aspergillus fumigatus belongs to the saprophytic fungi, and its spores form a significant part of the daily load of fungal spores inhaled as particles in aerosols. A. fumigatus is a possible T-cell activator. Its contribution to the pathogenesis of chronic rhinosinusitis (CRS) is controversially discussed. The aim of this study was to detect and characterize A. fumigatus-specific CD4+ and CD8+ T cells in patients with CRS with (CRSwNP) and without (CRSsNP) nasal polyps. METHODS Tissue and blood samples were collected from patients who underwent paranasal sinus surgery due to CRSwNP or CRSsNP. Afterward, purified CD4+ and CD8+ cells were cultured together with antigen-presenting cells. A peptide mix derived from A. fumigatus antigen was added to the cultures. After 6 days, multicolor flow cytometry was performed, and proliferation was measured using the marker Ki-67. Cytokine secretion was quantified from the supernatant of the cell culture. RESULTS Significant differences in the proliferation of nasal CD4+ T cells to A. fumigatus antigen were observed for cells from patients with CRSwNP in comparison to CRSsNP, while no differences were found between nasal and peripheral blood T cells. The activation of tissue-derived CD4+ T cells was associated with significantly higher concentrations of IL-4, IL-5, and IL-17a in the cell culture from patients with CRSwNP in comparison to CRSsNP and/or healthy controls. CONCLUSION Our findings indicate that patients with CRSwNP harbor a higher proportion of A. fumigatus-reactive CD4+ T cells in the nasal mucosa than patients with CRSsNP. A. fumigatus-reactive CD4+ T cells of CRSwNP patients secreted TH2 cytokines and IL-17. Our findings suggest a role for A. fumigatus in the pathogenesis of CRSwNP and provide a rationale for targeted therapies.
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Affiliation(s)
- Pascal Ickrath
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Würzburg, Würzburg, Germany
| | - Lisa Sprügel
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Würzburg, Würzburg, Germany
| | - Niklas Beyersdorf
- Institute for Virology and Immunobiology, University of Würzburg, Würzburg, Germany
| | - Lukas Haug
- Institute of Pathology, University of Würzburg, Würzburg, Germany
| | - Agmal Scherzad
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Würzburg, Würzburg, Germany
| | - Rudolf Hagen
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Würzburg, Würzburg, Germany
| | - Stephan Hackenberg
- Department of Otorhinolaryngology - Head and Neck Surgery, RWTH Aachen University Hospital, Aachen, Germany
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Tecle NE, Hackenberg S, Scheich M, Scherzad A, Hagen R, Gehrke T. Surgical management of lateral neck abscesses in children: a retrospective analysis of 100 cases. Eur J Pediatr 2023; 182:431-438. [PMID: 36378330 PMCID: PMC9829626 DOI: 10.1007/s00431-022-04676-5] [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] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 10/09/2022] [Accepted: 10/22/2022] [Indexed: 11/16/2022]
Abstract
UNLABELLED Cervical abscesses are relatively common infections in pediatric patients. There is an ongoing debate about the necessity and time point of surgical drainage. The identification of a focus of infection might play an important role in facilitating a therapeutic decision. In a retrospective study, 100 pediatric patients aged 1-18 years who underwent incision and drainage of a lateral cervical abscess at our institution were analyzed. Patients were divided into two groups based on whether a focus of infection could be identified or not. Data collection included patient characteristics, microbiological results, antibiotic regimen, and clinical course. A focus of infection was found in 29% (29/100) of the patients, most frequently in the tonsils. A causative microorganism was found in 75% (75/100) of all patients, with Staphylococcus aureus and Streptococcus pyogenes being the most common pathogens. All patients received an empiric antibiotic therapy in addition to surgery. Antibiotic medication was changed in 31% in both groups (9/29 with a focus of infection and 22/71 without a focus of infection) during therapy. Children without an identified focus of infection generally were younger and had more comorbidities reducing immune response while also showing differences in the pathogens involved. There were no complications associated to surgery or antibiotic therapy in any of the patients involved. CONCLUSION Children with an identified focus of infection show several differences compared to those with isolated lateral abscesses, especially regarding the microorganisms involved. But the focus of infection seems not to have an impact on patient's outcome. WHAT IS KNOWN • Neck abscesses are a relatively common disease in the pediatric population and may cause serious complications. • Therapy in general consists of intravenous antibiotics with or without surgery. WHAT IS NEW • The focus identification has no impact on patient's outcome. • Children with an identified focus of infection show several differences compared to those with isolated lateral abscesses, especially regarding their medical history, age, and the microorganisms involved.
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Affiliation(s)
- Nyat-Eyob Tecle
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital of Würzburg, Würzburg, Germany.
| | - Stephan Hackenberg
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital of Würzburg, Würzburg, Germany ,Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - Matthias Scheich
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital of Würzburg, Würzburg, Germany
| | - Agmal Scherzad
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital of Würzburg, Würzburg, Germany
| | - Rudolf Hagen
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital of Würzburg, Würzburg, Germany
| | - Thomas Gehrke
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital of Würzburg, Würzburg, Germany
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Hagen R, Rak K, Kurz A, Baumgartner WD, Gavilán J, van de Heyning P. The Online HEARRING Counselling 1.0 Platform Provides Clinicians with Comprehensive Information on Hearing Device Solutions for Conductive, Mixed, and Sensorineural Hearing Loss. J Pers Med 2022; 12:jpm12122027. [PMID: 36556248 PMCID: PMC9781436 DOI: 10.3390/jpm12122027] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 10/27/2022] [Accepted: 11/21/2022] [Indexed: 12/13/2022] Open
Abstract
A platform to help clinicians ensure that hearing device candidates are informed about the benefits and drawbacks of their recommended treatment option would be of clinical counselling benefit because it could help each candidate form realistic expectations about life with their treatment option. Following the World Café approach, 54 participants (surgeons, audiologist, and researchers) generated lists of the benefits and drawbacks of each treatment option for single-sided deafness (SSD) and bone conduction (BC) solutions. They then prioritized the benefits and drawbacks. After the World Café, literature research was performed on each topic to check if the statements (on benefits and drawbacks) are supported by quality peer-reviewed publications. Each participant was surveyed to ensure a collective agreement was reached. The HEARRING Counselling 1.0 Platform was developed. Thus far, sections for SSD and BC solutions have been completed. Initial feedback has been highly positive. The platform will be expanded to cover middle ear implant solutions and cochlear implants. A plan is in place to ensure the information continues to be timely. The HEARRING Counselling 1.0 helps clinicians provide comprehensive information to candidates about their treatment option and thereby helps establish that candidates have realistic expectations about the benefits and drawbacks of device use.
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Affiliation(s)
- Rudolf Hagen
- The Comprehensive Hearing Center, Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Josef-Schneider-Straße 11, 97080 Würzburg, Germany
- Correspondence: ; Tel.: +49-931-201-21701
| | - Kristen Rak
- The Comprehensive Hearing Center, Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Josef-Schneider-Straße 11, 97080 Würzburg, Germany
| | - Anja Kurz
- The Comprehensive Hearing Center, Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Wuerzburg, Josef-Schneider-Straße 11, 97080 Würzburg, Germany
| | | | - Javier Gavilán
- Department of Otolaryngology, IdiPAZ Research Institute, La Paz University Hospital, Paseo de la Castellana, 262, 28046 Madrid, Spain
| | - Paul van de Heyning
- ENT Department, Antwerp University Hospital, Wilrijkstraat 10, 2650 Antwerp, Belgium
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Abstract
OBJECTIVE To evaluate a new methodological approach of applying anatomy-based fitting (ABF) in experienced cochlear implant (CI) users. PARTICIPANTS Three experienced unilateral and bilateral CI users with postlingual hearing loss. INTERVENTION Postoperative imaging, via a high-volume Dyna computed tomography, and exact electrode measurement positions were integrated into the clinical fitting software following a new procedure, which adapted individual frequency bandwidths within the audio processor. MAIN OUTCOME MEASURES Speech perception in quiet and noise, clinical mapping, and self-perceived level of auditory benefit were assessed. RESULTS For each CI user, ABF mapping provided better speech perception in quiet and in noise compared with the original clinical fitting mapping. In addition, ABF mapping was accepted in CI users despite unequal bilateral array insertion depths and lengths; however, acceptance was only established if the point of first electrode contact was less than 230 Hz. CONCLUSIONS ABF mapping increased the acceptance in CI users with longer electrode arrays and in bilateral CI users who were unsatisfied with their device experience. A larger prospective, randomized investigation is currently underway to assess longitudinal outcomes with ABF mapping.
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Affiliation(s)
- Anja Kurz
- Department of Otolaryngology, University Hospital Würzburg, Comprehensive Hearing Center, Würzburg, Germany
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Meyer T, Hackenberg S, Herrmann M, Gehrke T, Steber M, Hagen R, Kleinsasser N, Scherzad A. Head and neck squamous cancer cells enhance the differentiation of human mesenchymal stem cells to adipogenic and osteogenic linages in vitro. Oncol Lett 2022; 24:450. [DOI: 10.3892/ol.2022.13570] [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] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 08/09/2022] [Indexed: 11/07/2022] Open
Affiliation(s)
- Till Meyer
- Department of Oto‑Rhino‑Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, D‑97080 Würzburg, Germany
| | - Stephan Hackenberg
- Department of Oto‑Rhino‑Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, D‑97080 Würzburg, Germany
| | - Marietta Herrmann
- IZKF Research Group Tissue Regeneration in Musculoskeletal Diseases, University Hospital Würzburg, D‑97070 Würzburg, Germany
| | - Thomas Gehrke
- Department of Oto‑Rhino‑Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, D‑97080 Würzburg, Germany
| | - Magdalena Steber
- Department of Oto‑Rhino‑Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, D‑97080 Würzburg, Germany
| | - Rudolf Hagen
- Department of Oto‑Rhino‑Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, D‑97080 Würzburg, Germany
| | - Norbert Kleinsasser
- Department of Oto‑Rhino‑Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, D‑97080 Würzburg, Germany
| | - Agmal Scherzad
- Department of Oto‑Rhino‑Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, D‑97080 Würzburg, Germany
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Topsakal V, Agrawal S, Atlas M, Baumgartner WD, Brown K, Bruce IA, Dazert S, Hagen R, Lassaletta L, Mlynski R, Raine CH, Rajan GP, Schmutzhard J, Sprinzl GM, Staecker H, Usami SI, Van Rompaey V, Zernotti M, van de Heyning P. Minimally Traumatic Cochlear Implant Surgery: Expert Opinion in 2010 and 2020. J Pers Med 2022; 12:jpm12101551. [PMID: 36294690 PMCID: PMC9605439 DOI: 10.3390/jpm12101551] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/14/2022] [Accepted: 09/17/2022] [Indexed: 12/03/2022] Open
Abstract
This study aimed to discover expert opinion on the surgical techniques and materials most likely to achieve maximum postoperative residual hearing preservation in cochlear implant (CI) surgery and to determine how these opinions have changed since 2010. A previously published questionnaire used in a study published in 2010 was adapted and expanded. The questionnaire was distributed to an international group of experienced CI surgeons. Present results were compared, via descriptive statistics, to those from the 2010 survey. Eighteen surgeons completed the questionnaire. Respondents clearly favored the following: round window insertion, slow array insertion, and the peri- and postoperative use of systematic antibiotics. Insertion depth was regarded as important, and electrode arrays less likely to induce trauma were preferred. The usefulness of dedicated soft-surgery training was also recognized. A lack of agreement was found on whether the middle ear cavity should be flushed with a non-aminoglycoside antibiotic solution or whether a sheath or insertion tube should be used to avoid contaminating the array with blood or bone dust. In conclusion, this paper demonstrates how beliefs about CI soft surgery have changed since 2010 and shows areas of current consensus and disagreement.
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Affiliation(s)
- Vedat Topsakal
- Department of Otorhinolaryngology, Head and Neck Surgery, Brussels Health Campus, University Hospital Brussels (UZ Brussel), Vrije Universiteit Brussel (VUB), 1090 Jette, Belgium
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), University of Antwerp, 2610 Edegem, Belgium
- Correspondence: ; Tel.: +32-2477-6882; Fax: +32-2477-6880
| | - Sumit Agrawal
- London Canada Health Sciences Centre, Department of Otolaryngology–Head & Neck Surgery, Western University, London, ON N6G 2M3, Canada
| | - Marcus Atlas
- Ear Science Institute Australia, Subiaco, WA 6008, Australia
| | | | - Kevin Brown
- UNC Ear & Hearing Center at Chapel Hill School of Medicine, Chapel Hill, NC 27599, USA
| | - Iain A. Bruce
- Royal Manchester Children’s Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M13 9WL, UK
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M15 6JA, UK
| | - Stefan Dazert
- St. Elisabeth Hospital, Ruhr University Bochum, 44787 Bochum, Germany
| | - Rudolf Hagen
- Würzburg ENT University Hospital, 97080 Würzburg, Germany
| | | | - Robert Mlynski
- Department of Otorhinolaryngology, Head and Neck Surgery “Otto Körner”, Rostock University Medical Center, 18057 Rostock, Germany
| | - Christopher H. Raine
- Bradford Royal Infirmary Yorkshire Auditory Implant Service, Bradford BD9 6RJ, UK
| | | | - Joachim Schmutzhard
- Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | | | - Hinrich Staecker
- Department of Otolaryngology-Head & Neck Surgery, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Shin-ichi Usami
- Department of Hearing Implant Sciences, Shinshu University School of Medicine, Matsumoto 390-8621, Japan
| | - Vincent Van Rompaey
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), University of Antwerp, 2610 Edegem, Belgium
| | | | - Paul van de Heyning
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), University of Antwerp, 2610 Edegem, Belgium
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Kurz A, Rak K, Hagen R. Improved performance with automatic sound management 3 in the MED-EL SONNET 2 cochlear implant audio processor. PLoS One 2022; 17:e0274446. [PMID: 36108069 PMCID: PMC9477286 DOI: 10.1371/journal.pone.0274446] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 08/29/2022] [Indexed: 12/02/2022] Open
Abstract
Objectives The SONNET 2 audio processor features ambient noise reduction (ANR), transient-noise reduction (TNR), and adaptive intelligence (AI). The primary aim of this study was to evaluate if using these features improves speech perception in noise, subjective listening effort, and sound quality. Design In this prospective longitudinal study, twenty adult SONNET users were fitted with the SONNET 2 audio processor, configured either as a default SONNET (no ANR/TNR/AI), with mild ANR/TNR, with strong ANR/TNR, with mild AI, and with strong AI. Speech perception in noise was assessed in speech and stationary noise from the front (S0N0); speech, stationary noise, and transient noise from the front (S0N0T0); and speech from the front in spatially-distributed stationary noise (S0N±45N±135). Listening effort, subjective sound quality, and device/setup preference were assessed. Results In the S0N0 setup, speech perception in noise was significantly better with the SONNET 2 when using ANR/TNR in the mild setup than with the SONNET or the SONNET 2 in the default SONNET configuration. In the S0N±45N±135 setup, speech understanding was significantly better in all four SONNET 2 configurations than with the SONNET or the SONNET 2 in the default SONNET configuration (a 1.26–2.55 dB SRT80 benefit). Subjects tolerated consistently lower signal-to-noise values with the SONNET 2 configurations using ANR/TNR than with the default SONNET configuration in all listening effort categories. All SONNET 2 configurations using ANR/TNR were preferred and better rated in speech in stationary and/or transient noise compared to the default SONNET configuration. Sound quality and pleasantness were better in those SONNET 2 configurations. Subjects strongly preferred the SONNET 2 configurations over the SONNET configuration. Conclusions The new front-end features implemented in the SONNET 2 audio processor objectively improve speech perception in noise. Subjects preferred the SONNET 2, over the SONNET, in the presence of stationary and transient noise.
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Affiliation(s)
- Anja Kurz
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Comprehensive Hearing Center, University Hospital of Würzburg, Würzburg, Germany
- * E-mail:
| | - Kristen Rak
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Comprehensive Hearing Center, University Hospital of Würzburg, Würzburg, Germany
| | - Rudolf Hagen
- Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, Comprehensive Hearing Center, University Hospital of Würzburg, Würzburg, Germany
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Windfuhr JP, Sittel C, Deitmer T, Jungehülsing M, Grundmann T, Hagen R, Baumann I, Hackenberg S. [Statement on hospitalization of children after otorhinolaryngologic interventions in Germany : Position paper from the Pediatric Otorhinolaryngology Working Group of the German Society of Otorhinolaryngology, Head and Neck Surgery]. HNO 2022; 70:791-794. [PMID: 36083469 PMCID: PMC9581825 DOI: 10.1007/s00106-022-01215-4] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2022] [Indexed: 11/24/2022]
Abstract
The inpatient care of children after ENT surgery is organized heterogeneously across Germany. In this statement, the working group on Pediatric ENT comments a national survey on the status quo of child care after ENT interventions in German hospitals. The statement should serve as a basis for further interdisciplinary discussion.
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Affiliation(s)
| | | | - Thomas Deitmer
- Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie, Bonn, Deutschland
| | | | | | | | | | - Stephan Hackenberg
- Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie, Universitätsklinikum RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.
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Herrmann DP, Müller-Graff FT, Kaulitz S, Cebulla M, Kurz A, Hagen R, Neun T, Rak K. Application of intentional facial nerve stimulation during cochlear implantation as an electrophysiological tool to estimate the intracochlear electrode position. Sci Rep 2022; 12:13426. [PMID: 35927465 PMCID: PMC9352782 DOI: 10.1038/s41598-022-17732-9] [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: 08/20/2021] [Accepted: 07/29/2022] [Indexed: 11/17/2022] Open
Abstract
This proof of concept describes the use of evoked electromyographic (EMG) activation of the facial nerve for intraoperative monitoring of the electrode insertion during cochlear implantation (CI). Intraoperative EMG measurements from the facial nerve were conducted in nine patients undergoing CI implantation. Electric current pulses were emitted from contacts on the CI array during and immediately after electrode insertion. For control, the results of EMG measurements were compared to postoperative flat panel volume computed tomography scans with secondary reconstruction (fpVCTSECO). During insertion, the EMG response evoked by the electrical stimulation from the CI was growing with the stimulating contact approaching the facial nerve and declined with increasing distance. After full insertion, contacts on the apical half of the CI array stimulated higher EMG responses compared with those on the basal half. Comparison with postoperative imaging demonstrated that electrode contacts stimulating high EMG responses had the shortest distances to the facial nerve. It could be demonstrated that electrically evoked EMG activation of the facial nerve can be used to monitor the progress during CI electrode insertion and to control the intracochlear electrode position after full insertion.
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Affiliation(s)
- David P Herrmann
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Wuerzburg, Germany
| | - Franz-Tassilo Müller-Graff
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Wuerzburg, Germany
| | - Stefan Kaulitz
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Wuerzburg, Germany
| | - Mario Cebulla
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Wuerzburg, Germany
| | - Anja Kurz
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Wuerzburg, Germany
| | - Rudolf Hagen
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Wuerzburg, Germany
| | - Tilmann Neun
- Department of Diagnostic and Interventional Neuroradiology, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Wuerzburg, Germany
| | - Kristen Rak
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Str. 11, 97080, Wuerzburg, Germany.
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Scheunemann CWD, Taeger J, Brecht SV, Neun T, Hagen R, Lueth TC, Rak KJ. Concept and first Implementation of an intracochlearly navigated Electrode Array for Cochlear Implantation. Annu Int Conf IEEE Eng Med Biol Soc 2022; 2022:2560-2564. [PMID: 36085908 DOI: 10.1109/embc48229.2022.9871850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Cochlear implants (CI) are an established treatment for people with deafness or severe hearing loss. To restore patients' hearing an electrode array (EA) of the CI is inserted into the cochlea to stimulate the auditory nerve. Thereby, the exact positioning and gentle insertion of the EA is crucial for optimal hearing perception outcome. Currently, only microscopic vision is available for entering the cochlea, but the critical intracochlear process during EA insertion is like a "black box" and the surgeon has to rely on haptic feedback. Methods for visualizing the insertion process during surgery are inaccurate or not suitable for routine use due to radiation exposure. To address this problem, we developed a computer-assisted and image-guided cochlear implantation system with an exact real-time visualization of the EA position during the insertion process. The system is based on an electromagnetic tracking system that measures the position and orientation of a sensor integrated into the tip of a EA prototype and visualizes it in presurgical image data. A first experiment with our system showed that a EA prototype could be inserted into a cochlea of a human temporal bone and placed with an accuracy of [Formula: see text]. A maximum insertion angle of 120° was achieved.
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Moratin H, Böhm S, Hagen R, Scherzad A, Hackenberg S. Influence of Wound Fluid on the Transdifferentiation of Human Mesenchymal Bone Marrow Stem Cells into Cancer-Associated Fibroblasts. Cells Tissues Organs 2022; 212:304-316. [PMID: 35661080 DOI: 10.1159/000525342] [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: 04/23/2022] [Accepted: 06/01/2022] [Indexed: 07/26/2023] Open
Abstract
Cancer-associated fibroblasts (CAF) in the tumor microenvironment have a decisive influence on tumor growth and metastatic behavior. The cellular origins as well as the stimuli leading to CAF formation are heterogenous, impeding a precise characterization. Aim of this study was to analyze the influence of cytokines secreted in the process of wound healing, tumor cell-associated paracrine-secreted factors, and direct cell-cell contact on the expression of the CAF-associated markers fibroblast activation protein (FAP), α-smooth muscle actin (α-SMA), thrombospondin-1 (THBS1), and tenascin-c (TNC) by RT-PCR in mesenchymal stem cells (MSC). Cells developed different morphological characteristics after incubation with wound fluid (WF). Moreover, expression of FAP and α-SMA in MSC was significantly reduced after WF compared to tumor-conditioned medium and in co-culture with tumor cells; THBS1 and TNC were not significantly altered after any of the different incubation methods. There were no alterations of expression patterns of FAP and α-SMA in the immunohistochemical analysis. Differ-ences in the cytokine composition of the media were found in the dot blot. The heterogeneity of the results emphasizes the complexity of the interactions of tumor cells and cells of the microenvironment, particularly through the addition of human-derived WF.
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Affiliation(s)
- Helena Moratin
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Wuerzburg, Wuerzburg, Germany
| | - Sonja Böhm
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Wuerzburg, Wuerzburg, Germany
| | - Rudolf Hagen
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Wuerzburg, Wuerzburg, Germany
| | - Agmal Scherzad
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Wuerzburg, Wuerzburg, Germany
| | - Stephan Hackenberg
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, RWTH Aachen University, Aachen, Germany
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Bieniussa L, Kahraman B, Skornicka J, Schulte A, Voelker J, Jablonka S, Hagen R, Rak K. Pegylated Insulin-Like Growth Factor 1 attenuates Hair Cell Loss and promotes Presynaptic Maintenance of Medial Olivocochlear Cholinergic Fibers in the Cochlea of the Progressive Motor Neuropathy Mouse. Front Neurol 2022; 13:885026. [PMID: 35720065 PMCID: PMC9203726 DOI: 10.3389/fneur.2022.885026] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
The progressive motor neuropathy (PMN) mouse is a model of an inherited motor neuropathy disease with progressive neurodegeneration. Axon degeneration associates with homozygous mutations of the TBCE gene encoding the tubulin chaperone E protein. TBCE is responsible for the correct dimerization of alpha and beta-tubulin. Strikingly, the PMN mouse also develops a progressive hearing loss after normal hearing onset, characterized by degeneration of the auditory nerve and outer hair cell (OHC) loss. However, the development of this neuronal and cochlear pathology is not fully understood yet. Previous studies with pegylated insulin-like growth factor 1 (peg-IGF-1) treatment in this mouse model have been shown to expand lifespan, weight, muscle strength, and motor coordination. Accordingly, peg-IGF-1 was evaluated for an otoprotective effect. We investigated the effect of peg-IGF-1 on the auditory system by treatment starting at postnatal day 15 (p15). Histological analysis revealed positive effects on OHC synapses of medial olivocochlear (MOC) neuronal fibers and a short-term attenuation of OHC loss. Peg-IGF-1 was able to conditionally restore the disorganization of OHC synapses and maintain the provision of cholinergic acetyltransferase in presynapses. To assess auditory function, frequency-specific auditory brainstem responses and distortion product otoacoustic emissions were recorded in animals on p21 and p28. However, despite the positive effect on MOC fibers and OHC, no restoration of hearing could be achieved. The present work demonstrates that the synaptic pathology of efferent MOC fibers in PMN mice represents a particular form of “efferent auditory neuropathy.” Peg-IGF-1 showed an otoprotective effect by preventing the degeneration of OHCs and efferent synapses. However, enhanced efforts are needed to optimize the treatment to obtain detectable improvements in hearing performances.
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Affiliation(s)
- Linda Bieniussa
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Baran Kahraman
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Johannes Skornicka
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Annemarie Schulte
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany
| | - Johannes Voelker
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Sibylle Jablonka
- Institute of Clinical Neurobiology, University of Würzburg, Würzburg, Germany
| | - Rudolf Hagen
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Kristen Rak
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Würzburg, Germany
- *Correspondence: Kristen Rak
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Cebulla M, Herrmann DP, Hagen R, Rak K. Intraoperative Auditory Brainstem Response Measurements via the Vibrant Soundbridge Active Middle Ear Implant: Comparison of Two Methods. Am J Audiol 2022; 31:261-267. [PMID: 35472299 DOI: 10.1044/2022_aja-21-00208] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The Vibrant Soundbridge (VSB) active middle ear implant can be used to treat adults and children with hearing loss. Intraoperative measurements based on auditory brainstem response (ABR) allow the determination of the implant's performance. Two methods for stimulus presentation during ABR measurements via VSB will be compared. METHOD ABRs were measured in patients implanted with a VSB using a standard ABR system. The stimulus was transmitted directly to the VSB using a new transmission unit (AcoustiAP, MED-EL) and for comparison via a standard audio processor coupled to a wireless streaming device. The study included 10 subjects with mild-to-profound sensorineural, conductive, or mixed hearing loss. RESULTS As opposed to the wireless method, the AcoustiAP transmits the ABR stimulus without additional signal processing. Therefore, only minor distortions of the transmitted signal are to be expected. There was no significant difference between the performance of the two methods (mean wave V amplitudes 313 [75.2] vs. 301 [88.2] nVpp). In addition, the new system allowed for a more stable connection to the implant system. CONCLUSION The AcoustiAP is a valuable tool for performing ABR measurements in patients during VSB implantation using standard equipment, as it allows for easier and more controlled measurements of the coupling efficiency of the implant.
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Affiliation(s)
- Mario Cebulla
- Department of Otorhinolaryngology, Plastic, Aesthetic, and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Germany
| | - David P. Herrmann
- Department of Otorhinolaryngology, Plastic, Aesthetic, and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Germany
| | - Rudolf Hagen
- Department of Otorhinolaryngology, Plastic, Aesthetic, and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Germany
| | - Kristen Rak
- Department of Otorhinolaryngology, Plastic, Aesthetic, and Reconstructive Head and Neck Surgery, University Hospital Würzburg, Germany
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Van de Heyning P, Gavilán J, Godey B, Hagen R, Hagr A, Kameswaran M, Li Y, Manoj M, Mlynski R, O’Driscoll M, Pillsbury H, Raine CH, Rajan G, Schmutzhard J, Staecker H. Worldwide Variation in Cochlear Implant Candidacy. J Int Adv Otol 2022; 18:196-202. [PMID: 35608486 PMCID: PMC10682809 DOI: 10.5152/iao.2022.21470] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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: 08/03/2021] [Accepted: 03/28/2022] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND The aim of this study was to find out how candidacy criteria have evolved differently across the globe. METHODS Candidacy criteria and outcome measurements applied in 19 HEARRING clinics were analyzed. RESULTS Candidacy criteria vary between clinics. Overall, both bilateral implantation and cochlear implantation in patients with single-sided deafness are becoming more frequent. CONCLUSION Standardized outcome measurement instruments need to be applied to provide access to the hearing world to all patients with hearing loss who would benefit from cochlear implantation.
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Affiliation(s)
| | - Javier Gavilán
- Madrid Hospital La Paz Paseo de la Castellana, Madrid, Spain
| | - Benoît Godey
- CHU - Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - Rudolf Hagen
- Würzburg ENT University Hospital, Würzburg, Germany
| | - Abdulrahman Hagr
- King Abdullah Ear Specialist Center, ENT Department, Riyadh, Saudi Arabia
| | | | - Yongxin Li
- Capital Medical University, Beijing Tongren Hospital, Beijing Shi, China
| | - Manikoth Manoj
- Calicut ENT Super Speciality Institute and Research Center, Kerala, India
| | | | - Martin O’Driscoll
- Central Manchester University Hospitals Ellen Wilkinson Building, Manchester, United Kingdom
| | - Harold Pillsbury
- UNC Ear & Hearing Center at Chapel Hill School of Medicine, North Carolina, USA
| | - Christopher H. Raine
- Bradford Royal Infirmary Yorkshire Auditory Implant Center, Bradford, United Kingdom
| | - Gunesh Rajan
- Luzern HNO-klinik Kantonspital Luzerner, Luzern, Switzerland
| | | | - Hinrich Staecker
- Kansas University Center for Hearing and Balance Disorders, Kansas City, USA
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Van de Heyning P, Roland P, Lassaletta L, Agrawal S, Atlas M, Baumgartner WD, Brown K, Caversaccio M, Dazert S, Gstoettner W, Hagen R, Hagr A, Jablonski GE, Kameswaran M, Kuzovkov V, Leinung M, Li Y, Loth A, Magele A, Mlynski R, Mueller J, Parnes L, Radeloff A, Raine C, Rajan G, Schmutzhard J, Skarzynski H, Skarzynski PH, Sprinzl G, Staecker H, Stöver T, Tavora-Viera D, Topsakal V, Usami SI, Van Rompaey V, Weiss NM, Wimmer W, Zernotti M, Gavilan J. Suitable Electrode Choice for Robotic-Assisted Cochlear Implant Surgery: A Systematic Literature Review of Manual Electrode Insertion Adverse Events. Front Surg 2022; 9:823219. [PMID: 35402479 PMCID: PMC8987358 DOI: 10.3389/fsurg.2022.823219] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 11/26/2021] [Accepted: 02/09/2022] [Indexed: 12/05/2022] Open
Abstract
Background and Objective The cochlear implant (CI) electrode insertion process is a key step in CI surgery. One of the aims of advances in robotic-assisted CI surgery (RACIS) is to realize better cochlear structure preservation and to precisely control insertion. The aim of this literature review is to gain insight into electrode selection for RACIS by acquiring a thorough knowledge of electrode insertion and related complications from classic CI surgery involving a manual electrode insertion process. Methods A systematic electronic search of the literature was carried out using PubMed, Scopus, Cochrane, and Web of Science to find relevant literature on electrode tip fold over (ETFO), electrode scalar deviation (ESD), and electrode migration (EM) from both pre-shaped and straight electrode types. Results A total of 82 studies that include 8,603 ears implanted with a CI, i.e., pre-shaped (4,869) and straight electrodes (3,734), were evaluated. The rate of ETFO (25 studies, 2,335 ears), ESD (39 studies, 3,073 ears), and EM (18 studies, 3,195 ears) was determined. An incidence rate (±95% CI) of 5.38% (4.4–6.6%) of ETFO, 28.6% (26.6–30.6%) of ESD, and 0.53% (0.2–1.1%) of EM is associated with pre-shaped electrodes, whereas with straight electrodes it was 0.51% (0.1–1.3%), 11% (9.2–13.0%), and 3.2% (2.5–3.95%), respectively. The differences between the pre-shaped and straight electrode types are highly significant (p < 0.001). Laboratory experiments show evidence that robotic insertions of electrodes are less traumatic than manual insertions. The influence of round window (RW) vs. cochleostomy (Coch) was not assessed. Conclusion Considering the current electrode designs available and the reported incidence of insertion complications, the use of straight electrodes in RACIS and conventional CI surgery (and manual insertion) appears to be less traumatic to intracochlear structures compared with pre-shaped electrodes. However, EM of straight electrodes should be anticipated. RACIS has the potential to reduce these complications.
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Affiliation(s)
- Paul Van de Heyning
- Department of Otorhinolaryngology Head and Neck Surgery, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
- Department of Translational Neurosciences, University of Antwerp, Antwerp, Belgium
- *Correspondence: Paul Van de Heyning
| | - Peter Roland
- Department of Otolaryngology, Head & Neck Surgery, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Luis Lassaletta
- Hospital Universitario La Paz, Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Sumit Agrawal
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, ON, Canada
| | - Marcus Atlas
- Ear Sciences Institute Australia, Lions Hearing Clinic, Perth, WA, Australia
| | | | - Kevin Brown
- UNC Ear and Hearing Center at Chapel Hill School of Medicine, Chapel Hill, NC, United States
| | - Marco Caversaccio
- Department for ENT, Head and Neck Surgery, Bern University Hospital, Bern, Switzerland
| | - Stefan Dazert
- Department of Otorhinolaryngology-Head and Neck Surgery, Ruhr-University Bochum, St. Elisabeth University Hospital Bochum, Bochum, Germany
| | | | - Rudolf Hagen
- Würzburg ENT University Hospital, Würzburg, Germany
| | - Abdulrahman Hagr
- King Abdullah Ear Specialist Center, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Greg Eigner Jablonski
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Otorhinolaryngology & Head and Neck Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | | | - Vladislav Kuzovkov
- St. Petersburg ENT and Speech Research Institute, St. Petersburg, Russia
| | - Martin Leinung
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Yongxin Li
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Otolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing, China
| | - Andreas Loth
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Astrid Magele
- Ear, Nose and Throat Department, University Clinic St. Poelten, Karl Landsteiner Private University, St. Poelten, Austria
| | - Robert Mlynski
- Department of Otorhinolaryngology, Head and Neck Surgery, “Otto Körner” Rostock University Medical Center, Rostock, Germany
| | - Joachim Mueller
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Ludwig-Maximilians-Universitat Munchen, Munchen, Germany
| | - Lorne Parnes
- Department of Otolaryngology-Head and Neck Surgery, Western University, London, ON, Canada
| | - Andreas Radeloff
- Division of Oto-Rhino-Laryngology, Evangelisches Krankenhaus Oldenburg, Research Center of Neurosensory Sciences, University Oldenburg, Oldenburg, Germany
| | - Chris Raine
- Bradford Royal Infirmary Yorkshire Auditory Implant Center, Bradford, United Kingdom
| | - Gunesh Rajan
- Department of Otolaryngology, Head and Neck Surgery, Luzerner Kantonsspital, Luzern, Medical Sciences Department of Health Sciences and Medicine. University of Lucerne, Luzern, Switzerland. Otolaryngology, Head & Neck Surgery, Medical School University of Western Australia, Perth, WA, Australia
| | - Joachim Schmutzhard
- Department of Otorhinolaryngology, Medical University of Innsbruck, Innsbruck, Austria
| | - Henryk Skarzynski
- Department of Teleaudiology and Screening, World Hearing Center of the Institute of Physiology and Pathology of Hearing, Kajetany, Poland
| | - Piotr H. Skarzynski
- Department of Teleaudiology and Screening, World Hearing Center of the Institute of Physiology and Pathology of Hearing, Kajetany, Poland
| | - Georg Sprinzl
- Ear, Nose and Throat Department, University Clinic St. Poelten, Karl Landsteiner Private University, St. Poelten, Austria
| | - Hinrich Staecker
- Kansas University Center for Hearing and Balance Disorders, Kansas City, KS, United States
| | - Timo Stöver
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Frankfurt, Frankfurt am Main, Germany
| | | | - Vedat Topsakal
- Department of ENT HNS, University Hospital Brussels, Brussels, Belgium
| | - Shin-Ichi Usami
- Department of Hearing Implant Sciences, Shinshu University School of Medicine, Nagano, Japan
| | - Vincent Van Rompaey
- Department of Otorhinolaryngology Head and Neck Surgery, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
- Department of Translational Neurosciences, University of Antwerp, Antwerp, Belgium
| | - Nora M. Weiss
- Department of Otorhinolaryngology-Head and Neck Surgery, Ruhr-University Bochum, St. Elisabeth University Hospital Bochum, Bochum, Germany
| | - Wilhelm Wimmer
- Department for ENT, Head and Neck Surgery, Bern University Hospital, Bern, Switzerland
| | - Mario Zernotti
- Catholic University of Córdoba and National University of Córdoba, Córdoba, Argentina
| | - Javier Gavilan
- Hospital Universitario La Paz, Institute for Health Research (IdiPAZ), Madrid, Spain
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Bieniussa L, Jain I, Bosch Grau M, Juergens L, Hagen R, Janke C, Rak K. Microtubule and auditory function - an underestimated connection. Semin Cell Dev Biol 2022; 137:74-86. [PMID: 35144861 DOI: 10.1016/j.semcdb.2022.02.004] [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: 07/01/2021] [Revised: 02/01/2022] [Accepted: 02/03/2022] [Indexed: 10/19/2022]
Abstract
The organ of Corti, located in the cochlea within the inner ear is the receptor organ for hearing. It converts auditory signals into neuronal action potentials that are transmitted to the brain for further processing. The mature organ of Corti consists of a variety of highly differentiated sensory cells that fulfil unique tasks in the processing of auditory signals. The actin and microtubule cytoskeleton play essential function in hearing, however so far, more attention has been paid to the role of actin. Microtubules play important roles in maintaining cellular structure and intracellular transport in virtually all eukaryotic cells. Their functions are controlled by interactions with a large variety of microtubule-associated proteins (MAPs) and molecular motors. Current advances show that tubulin posttranslational modifications, as well as tubulin isotypes could play key roles in modulating microtubule properties and functions in cells. These mechanisms could have various effects on the stability and functions of microtubules in the highly specialised cells of the cochlea. Here, we review the current understanding of the role of microtubule-regulating mechanisms in the function of the cochlea and their implications for hearing, which highlights the importance of microtubules in the field of hearing research.
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Affiliation(s)
- Linda Bieniussa
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Würzburg, Germany
| | - Ipsa Jain
- Institute of Stem cell Biology and Regenerative Medicine, Bangalore, India
| | - Montserrat Bosch Grau
- Genetics and Physiology of Hearing Laboratory, Institute Pasteur, 75015 Paris, France
| | - Lukas Juergens
- Department of Ophthalmology, University of Duesseldorf, Germany
| | - Rudolf Hagen
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Würzburg, Germany
| | - Carsten Janke
- Institut Curie, Université PSL, CNRS UMR3348, Orsay, France; Université Paris-Saclay, CNRS UMR3348, Orsay, France
| | - Kristen Rak
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Würzburg, Germany.
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Noyalet L, Ilgen L, Bürklein M, Shehata-Dieler W, Taeger J, Hagen R, Neun T, Zabler S, Althoff D, Rak K. Vestibular Aqueduct Morphology and Meniere's Disease—Development of the “Vestibular Aqueduct Score” by 3D Analysis. Front Surg 2022; 9:747517. [PMID: 35187054 PMCID: PMC8854222 DOI: 10.3389/fsurg.2022.747517] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 07/26/2021] [Accepted: 01/03/2022] [Indexed: 11/13/2022] Open
Abstract
Improved radiological examinations with newly developed 3D models may increase understanding of Meniere's disease (MD). The morphology and course of the vestibular aqueduct (VA) in the temporal bone might be related to the severity of MD. The presented study explored, if the VA of MD and non-MD patients can be grouped relative to its angle to the semicircular canals (SCC) and length using a 3D model. Scans of temporal bone specimens (TBS) were performed using micro-CT and micro flat panel volume computed tomography (mfpVCT). Furthermore, scans were carried out in patients and TBS by computed tomography (CT). The angle between the VA and the three SCC, as well as the length of the VA were measured. From these data, a 3D model was constructed to develop the vestibular aqueduct score (VAS). Using different imaging modalities it was demonstrated that angle measurements of the VA are reliable and can be effectively used for detailed diagnostic investigation. To test the clinical relevance, the VAS was applied on MD and on non-MD patients. Length and angle values from MD patients differed from non-MD patients. In MD patients, significantly higher numbers of VAs could be assigned to a distinct group of the VAS. In addition, it was tested, whether the outcome of a treatment option for MD can be correlated to the VAS.
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Affiliation(s)
- Laurent Noyalet
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Würzburg, Würzburg, Germany
| | - Lukas Ilgen
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Würzburg, Würzburg, Germany
| | - Miriam Bürklein
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Würzburg, Würzburg, Germany
| | - Wafaa Shehata-Dieler
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Würzburg, Würzburg, Germany
| | - Johannes Taeger
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Würzburg, Würzburg, Germany
| | - Rudolf Hagen
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Würzburg, Würzburg, Germany
| | - Tilmann Neun
- Institute for Diagnostic and Interventional Neuroradiology, University of Würzburg, Würzburg, Germany
| | - Simon Zabler
- Department of X-ray Microscopy, University of Würzburg, Würzburg, Germany
| | - Daniel Althoff
- Fraunhofer Development Center for X-ray Technology, Würzburg, Germany
| | - Kristen Rak
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Würzburg, Würzburg, Germany
- *Correspondence: Kristen Rak
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Voelker J, Voelker C, Engert J, Goemann N, Hagen R, Rak K. Spontaneous Calcium Oscillations through Differentiation: A Calcium Imaging Analysis of Rat Cochlear Nucleus Neural Stem Cells. Cells 2021; 10:2802. [PMID: 34685782 PMCID: PMC8534573 DOI: 10.3390/cells10102802] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 09/14/2021] [Accepted: 10/14/2021] [Indexed: 11/28/2022] Open
Abstract
Causal therapies for the auditory-pathway and inner-ear diseases are still not yet available for clinical application. Regenerative medicine approaches are discussed and examined as possible therapy options. Neural stem cells could play a role in the regeneration of the auditory pathway. In recent years, neural stem and progenitor cells have been identified in the cochlear nucleus, the second nucleus of the auditory pathway. The current investigation aimed to analyze cell maturation concerning cellular calcium activity. Cochlear nuclei from PND9 CD rats were microscopically dissected and propagated as neurospheres in free-floating cultures in stem-cell medium (Neurobasal, B27, GlutaMAX, EGF, bFGF). After 30 days, the dissociation and plating of these cells took place under withdrawal of the growth factors and the addition of retinoic acid, which induces neural cell differentiation. Calcium imaging analysis with BAPTA-1/Oregon Green was carried out at different times during the differentiation phase. In addition, the influence of different voltage-dependent calcium channels was analyzed through the targeted application of inhibitors of the L-, N-, R- and T-type calcium channels. For this purpose, comparative examinations were performed on CN NSCs, and primary CN neurons. As the cells differentiated, a significant increase in spontaneous neuronal calcium activity was demonstrated. In the differentiation stage, specific frequencies of the spontaneous calcium oscillations were measured in different regions of the individual cells. Initially, the highest frequency of spontaneous calcium oscillations was ascertainable in the maturing somata. Over time, these were overtaken by calcium oscillations in the axons and dendrites. Additionally, in the area of the growth cones, an increasing activity was determined. By inhibiting voltage-dependent calcium channels, their expression and function in the differentiation process were confirmed. A comparable pattern of maturation of these channels was found in CN NSCs and primary CN neurons. The present results show that neural stem cells of the rat cochlear nucleus differentiated not only morphologically but also functionally. Spontaneous calcium activities are of great relevance in terms of neurogenesis and integration into existing neuronal structures. These functional aspects of neurogenesis within the auditory pathway could serve as future targets for the exogenous control of neuronal regeneration.
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Affiliation(s)
- Johannes Voelker
- Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, Department of Oto-Rhino-Laryngology, University of Wuerzburg Josef-Schneider-Strasse 11, D-97080 Wuerzburg, Germany; (C.V.); (J.E.); (N.G.); (R.H.); (K.R.)
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Taeger J, Müller-Graff FT, Ilgen L, Schendzielorz P, Hagen R, Neun T, Rak K. Cochlear Duct Length Measurements in Computed Tomography and Magnetic Resonance Imaging Using Newly Developed Techniques. OTO Open 2021; 5:2473974X211045312. [PMID: 34595367 PMCID: PMC8477698 DOI: 10.1177/2473974x211045312] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 02/07/2021] [Accepted: 08/15/2021] [Indexed: 11/16/2022] Open
Abstract
Objective Growing interest in measuring the cochlear duct length (CDL) has emerged, since it can influence the selection of cochlear implant electrodes. Currently the measurements are performed with ionized radiation imaging. Only a few studies have explored CDL measurements in magnetic resonance imaging (MRI). Therefore, the presented study aims to fill this gap by estimating CDL in MRI and comparing it with multislice computed tomography (CT). Study Design Retrospective data analyses of 42 cochleae. Setting Tertiary care medical center. Methods Diameter (A value) and width (B value) of the cochlea were measured in HOROS software. The CDL and the 2-turn length were determined by the elliptic circular approximation (ECA). In addition, the CDL, the 2-turn length, and the angular length were determined via HOROS software by the multiplanar reconstruction (MPR) method. Results CDL values were significantly shorter in MRI by MPR (d = 1.38 mm, P < .001) but not by ECA. Similar 2-turn length measurements were significantly lower in MRI by MPR (d = 1.67 mm) and ECA (d = 1.19 mm, both P < .001). In contrast, angular length was significantly higher in MRI (d = 26.79°, P < .001). When the values were set in relation to the frequencies of the cochlea, no clinically relevant differences were estimated (58 Hz at 28-mm CDL). Conclusion In the presented study, CDL was investigated in CT and MRI by using different approaches. Since no clinically relevant differences were found, diagnostics with radiation may be omitted prior to cochlear implantation; thus, a concept of radiation-free cochlear implantation could be established.
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Affiliation(s)
- Johannes Taeger
- Department of Oto-rhino-laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Wuerzburg, Germany
| | - Franz Tassilo Müller-Graff
- Department of Oto-rhino-laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Wuerzburg, Germany
| | - Lukas Ilgen
- Department of Oto-rhino-laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Wuerzburg, Germany
| | - Phillip Schendzielorz
- Department of Oto-rhino-laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Wuerzburg, Germany
| | - Rudolf Hagen
- Department of Oto-rhino-laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Wuerzburg, Germany
| | - Tilman Neun
- Department of Diagnostic and Interventional Neuroradiology, University of Wuerzburg, Wuerzburg, Germany
| | - Kristen Rak
- Department of Oto-rhino-laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Wuerzburg, Germany
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Meyer TJ, Gerhard-Hartmann E, Lodes N, Scherzad A, Hagen R, Steinke M, Hackenberg S. Pilot study on the value of Raman spectroscopy in the entity assignment of salivary gland tumors. PLoS One 2021; 16:e0257470. [PMID: 34529739 PMCID: PMC8445432 DOI: 10.1371/journal.pone.0257470] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 09/01/2021] [Indexed: 11/18/2022] Open
Abstract
Background The entity assignment of salivary gland tumors (SGT) based on histomorphology can be challenging. Raman spectroscopy has been applied to analyze differences in the molecular composition of tissues. The aim of this study was to evaluate the suitability of RS for entity assignment in SGT. Methods Raman data were collected in deparaffinized sections of pleomorphic adenomas (PA) and adenoid cystic carcinomas (ACC). Multivariate data and chemometric analysis were completed using the Unscrambler software. Results The Raman spectra detected in ACC samples were mostly assigned to nucleic acids, lipids, and amides. In a principal component-based linear discriminant analysis (LDA) 18 of 20 tumor samples were classified correctly. Conclusion In this proof of concept study, we show that a reliable SGT diagnosis based on LDA algorithm appears possible, despite variations in the entity-specific mean spectra. However, a standardized workflow for tissue sample preparation, measurement setup, and chemometric algorithms is essential to get reliable results.
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Affiliation(s)
- Till Jasper Meyer
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic & Reconstructive Head and Neck Surgery, University Hospital Würzburg, Würzburg, Germany
- * E-mail:
| | | | - Nina Lodes
- Chair of Tissue Engineering and Regenerative Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Agmal Scherzad
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic & Reconstructive Head and Neck Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Rudolf Hagen
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic & Reconstructive Head and Neck Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Maria Steinke
- Chair of Tissue Engineering and Regenerative Medicine, University Hospital Würzburg, Würzburg, Germany
- Fraunhofer Institute for Silicate Research ISC, Würzburg, Germany
| | - Stephan Hackenberg
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic & Reconstructive Head and Neck Surgery, University Hospital Würzburg, Würzburg, Germany
- Department of Otorhinolaryngology – Head and Neck Surgery, RWTH Aachen University Hospital, Aachen, Germany
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