[Prevalence, Risk Factors and Diagnostics of Hearing Impairment in Preterm Infants]. / Prävalenz, Risikofaktoren und Diagnostik von Hörstörungen bei Frühgeborenen.

Introduction: The preterm birth is clearly associated with increased risk of developing congenital hearing impairment. Therefore, special attention must be paid to the postnatal control of auditory function in all preterm infants. The present work investigates if the latest scientific findings regarding prevalence, clinical diagnostics, therapy and risk factors of hearing impairment in premature infants are regularly implemented in daily practice. Methods: At the department of phoniatrics and pediatric audiology of the University Hospital of Magdeburg, the treatment data of 126 preterm children born between 2006 and 2011 were evaluated retrospectively. The additional analysis of all records available at the screening center (n=67 640) covering this period enables drawing conclusions on the total number and prevalence of hearing impairment in preterm infants in Saxony-Anhalt. Results: Almost all premature babies, like mature newborns, underwent postnatal hearing screening of both ears. The data analysis shows that the practical implementation often does not comply with the guideline of the G-BA (Gemeinsamer Bundesausschuss) in all details. For example, the recommended screening method for preterm infants (AABR) or the screening and treatment timing are not always applied in accordance with the guidelines of the G-BA. Discussion: Assessment of the practical implementation of universal newborn hearing screening was planned at the time of the introduction of the hearing screening program by the G-BA. As a part of this investigation, the practical care of vulnerable groups such as preterm infants must be given special attention. Based on the collected data, the diagnostics and therapy should be unified. Regardless of the maternity clinic where the infants were born, there should be the same opportunity for early diagnosis and thus for prognostically better treatment of congenital hearing impairment. Rapid postnatal fitting with hearing aid can stimulate the maturation of the central auditory system and potentially help to avoid problems of hearing and speech development.

[What should the (abdominal) surgeon know about ORL/ENT aspects in general (abdominal) surgery]. / Was sollte der (Viszeral-)Chirurg von der HNO wissen - HNO-ärztliche Aspekte in der (Viszeral-)Chirurgie.

The separation of laryngology and rhinology from the medical field and of otology from the surgical field in the 1850s led to the development of an independent field: the ear, nose and throat diseases, head and neck surgery. Therefore, oto-rhino-laryngology (ORL) has its roots in surgery. Concerning this and considering common anatomic circumstances, ORL medical aspects should be relevant to the surgeon. This concerns traumatological cases, the problem of difficult intubation and the common treatment of a series of illnesses of the upper aerodigestive tract, in particular problems of the major tumour surgery.

[Otitis media with effusion : frequency, diagnosis, and therapy in early childhood]. / Seromukotympanon : Häufigkeit, Diagnose und Therapie im frühen Kindesalter.

BACKGROUND: Otitis media with effusion (OME) as the most common cause of hearing loss in childhood plays an important role in the follow-up after failed newborn hearing screening (NHS). The introduction of the NHS allows OME to be diagnosed and treated in the first months of life. MATERIAL AND METHODS: In 715 children referred to the Department of Phoniatrics and Pedaudiology of the Ear, Nose, Throat University Hospital of Magdeburg during the period 2006-2010, the prevalence and therapy process of OME during follow-up could be determined. RESULTS: OME was diagnosed in 16 % of the patients. Spontaneous resolution was observed in 37 % of the cases, while 46 % of the children were treated surgically. A substantially increased risk for persistent OME was observed in children with craniofacial dysmorphia or cleft palate. CONCLUSION: Using NHS, OME can be diagnosed and treated early, thus, preventing potential problems in the linguistic, social and intellectual development of children.

[An anatomic facsimile model with origin inner ear structures for temporal bone preparations]. / Die Realisierung von anatomischen Felsenbeinfaksimilemodellen mit cochleären Hohlraumstrukturen.

BACKGROUND: Microsurgical dissection exercises are essential in otosurgery training. Human temporal bone specimens are rarely available for necessary extensive preparation steps up to the cochlea. This requires the development of new Anatomical Facsimile Models (AFM) of the temporal bone with its diffizil internal structures. MATERIAL AND METHODS: The construction of AFM was realized by rapid prototyping technologies. Data for processing come from high resolution CT-scans. RESULTS: With the production of AFM true to the original structures of the temporal bone by rapid prototyping methods it was possible to reproduce the very small cavity structures of the inner ear (cochlea, semicircular canals). All cavity structures of the temporal bone, including the middle ear, are constructed without solid support material. This allows the introduction of Cochlea-Implant electrodes into the cochlea. CONCLUSION: The use of modern rapid prototyping technologies enables us to produce any number of identical models of an original specimen. The preparation steps and the material properties correspond to those of the original temporal bone. Therefore AFM are excellent preparation models.

Visualization of inner ear dysplasias in patients with sensorineural hearing loss.

PURPOSE: We evaluated a data acquisition and post-processing protocol for inner ear (IE) assessment by MR imaging in patients, suffering from various labyrinth malformations. MATERIAL AND METHODS: MR IE studies of 158 consecutive patients (316 IEs) suffering from sensorineural hearing loss without evidence of an acoustic neurinoma were reviewed for pathologies of the IE and internal acoustic meatus. High-resolution MR data of all abnormal IE studies (n=45) were post-processed to previously standardized 3D volume rendered (VR) reconstructions. RESULTS: In 9 patients (5.7%) the following IE dysplasias were detected: malformation of the cochlea (6 IEs), vestibulum (4 IEs), semicircular canals (12 IEs) and vestibular aqueduct/endolymphatic sac (10 IEs). One patient showed evidence of an aplasia of the vestibulocochlear nerve. In 4 patients multiple IE dysplasias were encountered. Comprehensive 3D visualization of all labyrinthine dysplasias was achieved by the use of two VR reconstructions. The overall time for bilateral IE assessment amounted to 30-35 min. CONCLUSION: The imaging protocol allows for rapid and comprehensive visualization of various IE dysplasias, based on a limited number of VR reconstructions.

[Histological studies of tympanic membrane rim defects in chronic otitis media mesotympanalis]. / Histologische Untersuchungen des Trommelfelldefektrandes bei der chronischen Otitis media mesotympanalis.

In the present study we investigated resected tympanic membranes taken during tympanoplasty. Tissue from 111 patients with chronic otitis media was analyzed after being embedded in paraffin and stained with hematoxylin and eosin. In 67 patients (60%) the tympanic membrane epidermis did not extend beyond the margin of the perforation rim, so that no epithelial migration was observed on the inner side of the tympanic membrane. In 27 specimens (24%) we found an epithelial migration on the inner side of the tympanic membrane, but this did not extend to the margins of the excised tissue. In 17 tissue specimens (16%) epithelial migration extended to the margins of the resected tissue. Clinically, these patients were found to have non-functioning Eustachian tubes. The size of the tympanic membrane perforation was not found to impact on epithelial migration. However, there was a correlation between the extent of the epithelial migration seen in the specimens and the occurrence of a permanent tympanic membrane perforation after tympanoplasty. Of 17 patients with these findings, 4 (23%) had consistent reperforations. The tympanic membrane rims of these patients were completely covered with squamous epithelium. Patients with no or only little epithelial migration to the inner side of the tympanic membrane were found to have a significantly lower postoperative rate of recurrent infection and drum reperforation.

[Acceptance and hearing aid use by patients of retirement age (in the Magdeburg clinical area)]. / Akzeptanz und Tragegewohnheiten von Hörgeräten bei Patienten im Rentenalter (im Versorgungsbereich Magdeburg).

Providing patients with hearing aids in the former German Democratic Republic was carried out in audiological centers by otolaryngologists and authorized audiologic-phonatric assistants. The available selection of hearing aids was limited. A randomized group of 119 patients rehabilitated with hearing aids was examined. The current study includes persons older than 65 years. In 78.4% of the patients treated, the quality of life was improved with the hearing aids. In contrast, the other patients reported the aids to be useless. Nearly 90% of all patients had no problems in managing their hearing aids. About 75% of the patients used the hearing aid the whole day. In addition to the hearing aid prescribed, 33 patients also have had to read lips and only a combination of both allows these patients to have adequate communication. Patients reported that 80% of the hearing aids worked well or were rarely out of order. Further, 68% of the people questioned reported a positive attitude of their fellow citizens. Only 6% mentioned that the use of hearing aids to treat presbycusis disturbed social communications. Since hearing loss can be progressive and to avoid interference in early rehabilitation, frequent follow-ups by otorhinolaryngologists are required. The evaluation of patients with hearing disorders requires the collaboration of physicians and hearing aid acousticians in order to give patients the most information and understanding of their deafness.