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2.
Acta Otolaryngol ; 135(12): 1277-85, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26223816

RESUMO

CONCLUSION: Bone conduction implants are useful in patients with conductive and mixed hearing loss for whom conventional surgery or hearing aids are no longer an option. They may also be used in patients affected by single-sided deafness. OBJECTIVES: To establish a consensus on the quality standards required for centers willing to create a bone conduction implant program. METHOD: To ensure a consistently high level of service and to provide patients with the best possible solution the members of the HEARRING network have established a set of quality standards for bone conduction implants. These standards constitute a realistic minimum attainable by all implant clinics and should be employed alongside current best practice guidelines. RESULTS: Fifteen items are thoroughly analyzed. They include team structure, accommodation and clinical facilities, selection criteria, evaluation process, complete preoperative and surgical information, postoperative fitting and assessment, follow-up, device failure, clinical management, transfer of care and patient complaints.


Assuntos
Condução Óssea/fisiologia , Consenso , Perda Auditiva Condutiva-Neurossensorial Mista/cirurgia , Próteses e Implantes/normas , Ajuste de Prótese/métodos , Percepção da Fala/fisiologia , Seguimentos , Perda Auditiva Condutiva-Neurossensorial Mista/fisiopatologia , Humanos , Desenho de Prótese , Fatores de Tempo
3.
Otol Neurotol ; 34(5): 838-44, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23739559

RESUMO

OBJECTIVE: To investigate the familial correlations and intraclass correlation of age-related hearing impairment (ARHI) in specific frequencies. In addition, heritability estimates were calculated. STUDY DESIGN: Multicenter survey in 8 European centers. SUBJECTS: One hundred ninety-eight families consisting of 952 family members, screened by otologic examination and structured interviews. Subjects with general conditions, known to affect hearing thresholds or known otologic cause were excluded from the study. RESULTS: We detected familial correlation coefficients of 0.36, 0.37, 0.36, and 0.30 for 0.25, 0.5, 1, and 2 kHz, respectively, and correlation coefficients of 0.20 and 0.18 for 4 and 8 kHz, respectively. Variance components analyses showed that the proportion of the total variance attributable to family differences was between 0.32 and 0.40 for 0.25, 0.5, 1, and 2 kHz and below 0.20 for 4 and 8 kHz. When testing for homogeneity between sib pair types, we observed a larger familial correlation between female than male subjects. Heritability estimates ranged between 0.79 and 0.36 across the frequencies. DISCUSSION: Our results indicate that there is a substantial shared familial effect in ARHI. We found that familial aggregation of ARHI is markedly higher in the low frequencies and that there is a trend toward higher familial aggregation in female compared with male subjects.


Assuntos
Audiometria de Tons Puros/estatística & dados numéricos , Limiar Auditivo/fisiologia , Perda Auditiva/epidemiologia , Fatores Etários , Idoso , Análise de Variância , Europa (Continente)/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
4.
Neuroimage ; 52(2): 470-80, 2010 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-20417285

RESUMO

Tinnitus is an auditory phantom percept with a tone, hissing, or buzzing sound in the absence of any objective physical sound source. About 6% to 25% of the affected people report interference with their lives as tinnitus causes a considerable amount of distress. However, the underlying neurophysiological mechanism for the development of tinnitus-related distress remains not well understood. Hence we focus on the cortical and subcortical source differences in resting-state EEG between tinnitus patients with different grades of distress using continuous scalp EEG recordings and Low Resolution Electromagnetic Tomography (LORETA). Results show more synchronized alpha activity in the tinnitus patients with a serious amount of distress with peaks localized to various emotion-related areas. These areas include subcallosal anterior cingulate cortex, the insula, parahippocampal area and amygdala. In addition, less alpha synchronized activity was found in the posterior cingulate cortex, precuneus and DLPFC. A comparison between the tinnitus group with distress and the Nova Tech EEG (NTE) normative database demonstrated increased synchronized alpha and beta activity and less synchronized delta and theta activity in the dorsal anterior cingulate cortex in tinnitus patients with distress. It is interesting that the areas found show some overlap with the emotional component of the pain matrix and the distress related areas in asthmatic dyspnea. Unpleasantness of pain activates the anterior cingulate and prefrontal cortices, amygdala, and insula. As such, it might be that distress is related to alpha and beta activity in the dorsal anterior cingulate cortex, the amount of distress perceived to an alpha network consisting of the amygdala-anterior cingulate cortex-insula-parahippocampal area.


Assuntos
Encéfalo/fisiopatologia , Zumbido/fisiopatologia , Zumbido/psicologia , Adaptação Psicológica/fisiologia , Ritmo alfa , Mapeamento Encefálico , Bases de Dados como Assunto , Eletroencefalografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Periodicidade , Análise de Regressão , Processamento de Sinais Assistido por Computador , Estresse Psicológico/etiologia , Estresse Psicológico/fisiopatologia , Zumbido/complicações , Tomografia
5.
Otol Neurotol ; 30(8): 1101-10, 2009 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-19672201

RESUMO

INTRODUCTION: The Common Otology Database (COD) is a joint effort by an international group of otologists to organize audit with a standardized reporting method in middle ear surgery. The first results on hearing outcome of the COD are presented in this article. OBJECTIVE: The primary objective was to confirm the validity of the benchmark group by comparing hearing outcome results with previously reported results. The secondary objective was to describe the population, technical aspects, and hearing outcomes of stapes surgery. STUDY DESIGN: Nonrandomized prospective multicenter audit. SETTING: Twenty tertiary-referral otologic centers. PATIENTS AND INTERVENTION: Primary and revision stapes operations in patients with otosclerosis. MAIN OUTCOME MEASURES: Air-bone gap (ABG), bone-conduction (BC) thresholds, and air-conduction (AC) thresholds were evaluated at 3 and 12 months according to the guidelines of the Committee on Hearing and Equilibrium for the evaluation of conductive hearing loss. Raw data were displayed in an Amsterdam Hearing Evaluation Plot. RESULTS: In primary stapes surgeries, the postoperative ABG was closed to 10 dB or less in 63.6% and to 20 dB or less in 92.6% (median, 8.75 dB). In revision stapes surgeries, the postoperative ABG was closed to 10 dB in 41.2% and to 20 dB in 76.5% of cases (median, 11.25 dB). The overall mean postoperative ABG at 12 months was 10.38 dB compared with 28.75 dB preoperatively. Using laser to perform the fenestration results in a less pronounced BC improvement when compared with procedures without laser assistance. No statistically significant difference in ABG pure-tone average at 3 months could be demonstrated between the different prosthesis types. CONCLUSION: Results of hearing outcome are similar to previous, primarily retrospective, single-center studies. Our data confirm the effectiveness of stapes surgery in patients with otosclerosis.


Assuntos
Bases de Dados Factuais , Otolaringologia/estatística & dados numéricos , Otosclerose/cirurgia , Cirurgia do Estribo , Adulto , Audiometria , Estudos de Viabilidade , Feminino , Fenestração do Labirinto , Seguimentos , Audição/fisiologia , Humanos , Terapia a Laser/estatística & dados numéricos , Masculino , Auditoria Médica , Pessoa de Meia-Idade , Estudos Prospectivos , Padrões de Referência , Reprodutibilidade dos Testes , Resultado do Tratamento
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