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Cor W. R. J. Cremers - One of the best experts on this subject based on the ideXlab platform.
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congenital stapes ankylosis associated with another ossicular chain anomaly surgical results in 30 ears
Archives of Otolaryngology-head & Neck Surgery, 2011Co-Authors: Henricus G X M Thomeer, Henricus P M Kunst, Cor W. R. J. CremersAbstract:Objective To describe the audiometric results after stapes surgery in a consecutive series of patients with stapes footplate ankylosis combined with another ossicular middle ear anomaly. Study Design A retrospective analysis of charts collected between 1986 and 2001. Setting A tertiary referral center. Patients A total of 25 patients (30 ears) underwent exploratory tympanotomies and ossicular reconstruction. Main Outcome Measure Audiometric results. Results Overall, a mean gain in Air Conduction of 18 dB (from 49 dB to 31 dB) and a mean postoperative Air-bone gap (ABG) of 20 dB (mean preoperative ABG, 40 dB) were observed. The ABG closure was 20 dB or less in 70% of cases, which is in agreement with the few results reported in the literature. Moreover, the audiometric results remained stable. In the group of ears with a syndrome, the mean gain of Air Conduction was only 19 dB, which was comparable to that observed among nonsyndromic ears. Conclusions Surgery for congenital stapes footplate ankylosis with a concomitant ossicular chain anomaly can provide worthwhile hearing improvement. The ABG closure was 20 dB or less in 21 of 30 ears (70%). Most ears had some sensorineural impAirment (10-20 dB), which influenced the final hearing level after surgery. Over recent decades, the technique of the malleostapedotomy procedure has been improved. Preoperative assessment is mandatory for syndromal diagnoses, which might be important for patient counseling and prognosis.
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congenital stapes ankylosis associated with another ossicular chain anomaly surgical results in 30 ears
Archives of Otolaryngology-head & Neck Surgery, 2011Co-Authors: Henricus G X M Thomeer, Henricus P M Kunst, Cor W. R. J. CremersAbstract:OBJECTIVE: To describe the audiometric results after stapes surgery in a consecutive series of patients with stapes footplate ankylosis combined with another ossicular middle ear anomaly. STUDY DESIGN: A retrospective analysis of charts collected between 1986 and 2001. SETTING: A tertiary referral center. PATIENTS: A total of 25 patients (30 ears) underwent exploratory tympanotomies and ossicular reconstruction. MAIN OUTCOME MEASURE: Audiometric results. RESULTS: Overall, a mean gain in Air Conduction of 18 dB (from 49 dB to 31 dB) and a mean postoperative Air-bone gap (ABG) of 20 dB (mean preoperative ABG, 40 dB) were observed. The ABG closure was 20 dB or less in 70% of cases, which is in agreement with the few results reported in the literature. Moreover, the audiometric results remained stable. In the group of ears with a syndrome, the mean gain of Air Conduction was only 19 dB, which was comparable to that observed among nonsyndromic ears. CONCLUSIONS: Surgery for congenital stapes footplate ankylosis with a concomitant ossicular chain anomaly can provide worthwhile hearing improvement. The ABG closure was 20 dB or less in 21 of 30 ears (70%). Most ears had some sensorineural impAirment (10-20 dB), which influenced the final hearing level after surgery. Over recent decades, the technique of the malleostapedotomy procedure has been improved. Preoperative assessment is mandatory for syndromal diagnoses, which might be important for patient counseling and prognosis.
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Long-term Results of Bone-Anchored Hearing Aid Recipients Who Had Previously Used Air-Conduction Hearing Aids
Archives of Otolaryngology–Head & Neck Surgery, 2005Co-Authors: Myrthe K.s. Hol, Emmanuel A. M. Mylanus, Ad F.m. Snik, Cor W. R. J. CremersAbstract:OBJECTIVE: To study the long-term results (use, care, satisfaction, ear infections, and audiometry) of the application of a bone-anchored hearing aid (BAHA) to patients with conventional indications who had previously used Air-Conduction hearing aids. DESIGN: Follow-up study (mean duration, 9 years). SETTING: Tertiary referral center. PATIENTS: The study population comprised 27 patients with conductive or mixed hearing loss and who had participated in a previous study (N = 34). Seven could not be included anymore as a result of death, Alzheimer disease, or problems related to the implant. Everyone filled out the questionnAire, and 23 patients underwent audiometric evaluation. MAIN OUTCOME MEASURES: The patients filled out the adapted Nijmegen questionnAire. Aided free-field thresholds were measured as well as scores for speech in noise and in quiet. Results were compared with those obtained in the initial study. RESULTS: All 27 patients were still using their BAHA and appreciated it with regard to speech recognition in quiet, sound comfort, and improvements in ear infections. The audiometric results showed that most patients tested had stable bone-Conduction thresholds over the years (after correction for age). Despite the treatment with BAHA, a significant deterioration in the cochlear hearing was observed in the other patients in the ear under study (their best hearing ear). CONCLUSIONS: Positive patient outcome measures emphasized the importance of BAHA application to patients with conventional indications. The audiometric data showed fAirly stable cochlear function but not for all patients. This underlines that conservative treatment should be chosen (fitting of bone-Conduction devices).
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hearing gain after stapedotomy partial platinectomy or total stapedectomy for otosclerosis
Annals of Otology Rhinology and Laryngology, 1991Co-Authors: Cor W. R. J. Cremers, Jan M H Beusen, Patrick L M HuygenAbstract:The differences in hearing gain 1 year after stapedectomy, partial platinectomy, or total stapedectomy for otosclerosis were studied separately at 0.5, 1, 2, 4, and 8 kHz with the data available from 311 consecutive primary operations performed between 1980 and 1982 in the University of Nijmegen Department of Otorhinolaryngology. Three groups of patients were matched for age, sex, clinical type of otosclerosis, and type of 0.6-mm all-Teflon piston. The hearing gain for Air Conduction was significantly better by an average of 7.4 dB for all frequencies combined after either stapedotomy or partial platinectomy compared to total stapedectomy.
Henricus G X M Thomeer - One of the best experts on this subject based on the ideXlab platform.
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congenital stapes ankylosis associated with another ossicular chain anomaly surgical results in 30 ears
Archives of Otolaryngology-head & Neck Surgery, 2011Co-Authors: Henricus G X M Thomeer, Henricus P M Kunst, Cor W. R. J. CremersAbstract:OBJECTIVE: To describe the audiometric results after stapes surgery in a consecutive series of patients with stapes footplate ankylosis combined with another ossicular middle ear anomaly. STUDY DESIGN: A retrospective analysis of charts collected between 1986 and 2001. SETTING: A tertiary referral center. PATIENTS: A total of 25 patients (30 ears) underwent exploratory tympanotomies and ossicular reconstruction. MAIN OUTCOME MEASURE: Audiometric results. RESULTS: Overall, a mean gain in Air Conduction of 18 dB (from 49 dB to 31 dB) and a mean postoperative Air-bone gap (ABG) of 20 dB (mean preoperative ABG, 40 dB) were observed. The ABG closure was 20 dB or less in 70% of cases, which is in agreement with the few results reported in the literature. Moreover, the audiometric results remained stable. In the group of ears with a syndrome, the mean gain of Air Conduction was only 19 dB, which was comparable to that observed among nonsyndromic ears. CONCLUSIONS: Surgery for congenital stapes footplate ankylosis with a concomitant ossicular chain anomaly can provide worthwhile hearing improvement. The ABG closure was 20 dB or less in 21 of 30 ears (70%). Most ears had some sensorineural impAirment (10-20 dB), which influenced the final hearing level after surgery. Over recent decades, the technique of the malleostapedotomy procedure has been improved. Preoperative assessment is mandatory for syndromal diagnoses, which might be important for patient counseling and prognosis.
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congenital stapes ankylosis associated with another ossicular chain anomaly surgical results in 30 ears
Archives of Otolaryngology-head & Neck Surgery, 2011Co-Authors: Henricus G X M Thomeer, Henricus P M Kunst, Cor W. R. J. CremersAbstract:Objective To describe the audiometric results after stapes surgery in a consecutive series of patients with stapes footplate ankylosis combined with another ossicular middle ear anomaly. Study Design A retrospective analysis of charts collected between 1986 and 2001. Setting A tertiary referral center. Patients A total of 25 patients (30 ears) underwent exploratory tympanotomies and ossicular reconstruction. Main Outcome Measure Audiometric results. Results Overall, a mean gain in Air Conduction of 18 dB (from 49 dB to 31 dB) and a mean postoperative Air-bone gap (ABG) of 20 dB (mean preoperative ABG, 40 dB) were observed. The ABG closure was 20 dB or less in 70% of cases, which is in agreement with the few results reported in the literature. Moreover, the audiometric results remained stable. In the group of ears with a syndrome, the mean gain of Air Conduction was only 19 dB, which was comparable to that observed among nonsyndromic ears. Conclusions Surgery for congenital stapes footplate ankylosis with a concomitant ossicular chain anomaly can provide worthwhile hearing improvement. The ABG closure was 20 dB or less in 21 of 30 ears (70%). Most ears had some sensorineural impAirment (10-20 dB), which influenced the final hearing level after surgery. Over recent decades, the technique of the malleostapedotomy procedure has been improved. Preoperative assessment is mandatory for syndromal diagnoses, which might be important for patient counseling and prognosis.
Henricus P M Kunst - One of the best experts on this subject based on the ideXlab platform.
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congenital stapes ankylosis associated with another ossicular chain anomaly surgical results in 30 ears
Archives of Otolaryngology-head & Neck Surgery, 2011Co-Authors: Henricus G X M Thomeer, Henricus P M Kunst, Cor W. R. J. CremersAbstract:OBJECTIVE: To describe the audiometric results after stapes surgery in a consecutive series of patients with stapes footplate ankylosis combined with another ossicular middle ear anomaly. STUDY DESIGN: A retrospective analysis of charts collected between 1986 and 2001. SETTING: A tertiary referral center. PATIENTS: A total of 25 patients (30 ears) underwent exploratory tympanotomies and ossicular reconstruction. MAIN OUTCOME MEASURE: Audiometric results. RESULTS: Overall, a mean gain in Air Conduction of 18 dB (from 49 dB to 31 dB) and a mean postoperative Air-bone gap (ABG) of 20 dB (mean preoperative ABG, 40 dB) were observed. The ABG closure was 20 dB or less in 70% of cases, which is in agreement with the few results reported in the literature. Moreover, the audiometric results remained stable. In the group of ears with a syndrome, the mean gain of Air Conduction was only 19 dB, which was comparable to that observed among nonsyndromic ears. CONCLUSIONS: Surgery for congenital stapes footplate ankylosis with a concomitant ossicular chain anomaly can provide worthwhile hearing improvement. The ABG closure was 20 dB or less in 21 of 30 ears (70%). Most ears had some sensorineural impAirment (10-20 dB), which influenced the final hearing level after surgery. Over recent decades, the technique of the malleostapedotomy procedure has been improved. Preoperative assessment is mandatory for syndromal diagnoses, which might be important for patient counseling and prognosis.
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congenital stapes ankylosis associated with another ossicular chain anomaly surgical results in 30 ears
Archives of Otolaryngology-head & Neck Surgery, 2011Co-Authors: Henricus G X M Thomeer, Henricus P M Kunst, Cor W. R. J. CremersAbstract:Objective To describe the audiometric results after stapes surgery in a consecutive series of patients with stapes footplate ankylosis combined with another ossicular middle ear anomaly. Study Design A retrospective analysis of charts collected between 1986 and 2001. Setting A tertiary referral center. Patients A total of 25 patients (30 ears) underwent exploratory tympanotomies and ossicular reconstruction. Main Outcome Measure Audiometric results. Results Overall, a mean gain in Air Conduction of 18 dB (from 49 dB to 31 dB) and a mean postoperative Air-bone gap (ABG) of 20 dB (mean preoperative ABG, 40 dB) were observed. The ABG closure was 20 dB or less in 70% of cases, which is in agreement with the few results reported in the literature. Moreover, the audiometric results remained stable. In the group of ears with a syndrome, the mean gain of Air Conduction was only 19 dB, which was comparable to that observed among nonsyndromic ears. Conclusions Surgery for congenital stapes footplate ankylosis with a concomitant ossicular chain anomaly can provide worthwhile hearing improvement. The ABG closure was 20 dB or less in 21 of 30 ears (70%). Most ears had some sensorineural impAirment (10-20 dB), which influenced the final hearing level after surgery. Over recent decades, the technique of the malleostapedotomy procedure has been improved. Preoperative assessment is mandatory for syndromal diagnoses, which might be important for patient counseling and prognosis.
Rinze A Tange - One of the best experts on this subject based on the ideXlab platform.
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retrospective analysis of early postoperative hearing results obtained after stapedotomy with implantation of a new titanium stapes prosthesis
Otology & Neurotology, 2003Co-Authors: C L Zuur, Robert Lindeboom, A J De Bruijn, Rinze A TangeAbstract:Objective: To evaluate the early postoperative hearing results of a new titanium stapes prosthesis (K-Piston) implanted in patients with otosclerosis. Study design: A retrospective analysis of preoperative and early postoperative hearing thresholds. Setting: One tertiary referral and teaching hospital. Patients: Eighteen men and 40 women, mean age 47 years, with otosclerosis. Intervention: Primary stapedotomy. Main Outcome Measure: Main outcome measures were the mean gains in bone-Conduction and Air-Conduction pure-tone thresholds. and pure-tone averages for different frequency combinations. Success and failure of the individual cases were presented using Amsterdam Hearing Evaluation Plots. Results: The overall postoperative Air-bone gap for the frequency combination 0.5-1-2-4 kHz was 8.4 (standard deviation: 5.2) dB. In 79% of the patients the postoperative Air-bone gap was less than 10 dB. Air-Conduction improved even in higher frequencies, while the Carhart effect was not seen in most cases. In three patients a deterioration of bone-Conduction was observed ranging from I I to 16 dB sound pressure level (SPL), and in four patients the gain in Air-Conduction was insufficient (3-29 dB SPL) to close the preoperative Air-bone gap to within 20 dB. Conclusion: The new low-weight, full-titanium stapes prosthesis with its slight rough surface and its good mechanical stability and biocompatibility can safely and successfully restore the function of the middle car when implanted in patients with otosclerosis
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retrospective analysis of early postoperative hearing results obtained after stapedotomy with implantation of a new titanium stapes prosthesis
Otology & Neurotology, 2003Co-Authors: C L Zuur, Robert Lindeboom, A J De Bruijn, Rinze A TangeAbstract:Objective: To evaluate the early postoperative hearing results of a new titanium stapes prosthesis (K-Piston) implanted in patients with otosclerosis. Study design: A retrospective analysis of preoperative and early postoperative hearing thresholds. Setting: One tertiary referral and teaching hospital. Patients: Eighteen men and 40 women, mean age 47 years, with otosclerosis. Intervention: Primary stapedotomy. Main Outcome Measure: Main outcome measures were the mean gains in bone-Conduction and Air-Conduction pure-tone thresholds, and pure-tone averages for different frequency combinations. Success and failure of the individual cases were presented using Amsterdam Hearing Evaluation Plots. Results: The overall postoperative Air-bone gap for the frequency combination 0.5-1-2-4 kHz was 8.4 (standard deviation: 5.2) dB. In 79% of the patients the postoperative Air-bone gap was less than 10 dB. Air-Conduction improved even in higher frequencies, while the Carhart effect was not seen in most cases. In three patients a deterioration of bone-Conduction was observed ranging from 11 to 16 dB sound pressure level (SPL), and in four patients the gain in Air-Conduction was insufficient (3-29 dB SPL) to close the preoperative Air-bone gap to within 20 dB. Conclusion: The new low-weight, full-titanium stapes prosthesis with its slight rough surface and its good mechanical stability and biocompatibility can safely and successfully restore the function of the middle ear when implanted in patients with otosclerosis.
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efficacy of evaluation of audiometric results after stapes surgery in otosclerosis i the effects of using different audiologic parameters and criteria on success rates
Otolaryngology-Head and Neck Surgery, 2001Co-Authors: Arthur J G De Bruijn, Rinze A Tange, Wouter A DreschlerAbstract:The Committee on Hearing and Equilibrium of the American Academy of Otolaryngology-Head and Neck Surgery proposed guidelines to provide more uniformity in reporting hearing results after middle ear surgery. One of the proposals was to include the hearing thresholds at 0.5, 1, 2, and 3 kHz in a 4-frequency pure-tone average (PTA) and to use post-operative bone-Conduction (BC) levels rather than preoperative BC levels in describing postoperative Air-bone gaps (ABGs). The hearing results of 451 stapes operations were evaluated to analyze to what extent the choice of different audiologic criteria affects success rates. It appeared that choice of PTA significantly affects postoperative gain in Air-Conduction thresholds and ABG levels. If one takes the improvements in speech-reception thresholds as the gold standard, the gain in Air-Conduction correlates best with a gain in speech-reception threshold if a higher frequency, such as 3 or 4 kHz, is included in a 4-frequency PTA. Also, choice of preoperative or postoperative BC in computing postoperative ABGs had a significant effect on the mean postoperative ABG levels, showing more favorable results with the use of preoperative BC thresholds.
John J Rosowski - One of the best experts on this subject based on the ideXlab platform.
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a lumped element model of the chinchilla middle ear
Journal of the Acoustical Society of America, 2019Co-Authors: Peter Bowers, John J RosowskiAbstract:An Air-Conduction circuit model was developed for the chinchilla middle ear and cochlea. The lumped-element model is based on the classic Zwislocki model of the same structures in human. Model parameters were fit to various measurements of chinchilla middle-ear transfer functions and impedances, using a combination of error-minimization-driven computer-automated and manual fitting methods. The measurements used to fit the model comprise a newer, more-extensive data set than previously used, and include measurements of stapes velocity and inner-ear sound pressure within the vestibule and the scala tympani near the round window. The model is in agreement with studies of the effects of middle-ear cavity holes in experiments that require access to the middle-ear Air space. The structure of the model allows easy addition of other sources of auditory stimulation, e.g., the multiple sources of bone-conducted sound—the long-term goal for the model's development—and mechanical stimulation of the ossicles and round window.An Air-Conduction circuit model was developed for the chinchilla middle ear and cochlea. The lumped-element model is based on the classic Zwislocki model of the same structures in human. Model parameters were fit to various measurements of chinchilla middle-ear transfer functions and impedances, using a combination of error-minimization-driven computer-automated and manual fitting methods. The measurements used to fit the model comprise a newer, more-extensive data set than previously used, and include measurements of stapes velocity and inner-ear sound pressure within the vestibule and the scala tympani near the round window. The model is in agreement with studies of the effects of middle-ear cavity holes in experiments that require access to the middle-ear Air space. The structure of the model allows easy addition of other sources of auditory stimulation, e.g., the multiple sources of bone-conducted sound—the long-term goal for the model's development—and mechanical stimulation of the ossicles and round...
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comparison of umbo velocity in Air and bone Conduction
Hearing Research, 2012Co-Authors: Christof Roosli, David Chhan, Christopher F Halpin, John J RosowskiAbstract:Abstract This study investigates the ossicular motion produced by bone-conducted (BC) sound in live human ears. Laser Doppler Vibrometry was used to measure Air Conduction (AC)- and BC-induced umbo velocity ( V U ) in both ears of 10 subjects, 20 ears total. Sound pressure in the ear canal ( P EC ) was measured simultaneously. For Air Conduction, V U at standard hearing threshold level was calculated. For BC, Δ V was defined as the difference between V U and the tympanic ring velocity (an estimate of the skull velocity measured in the ear canal). Δ V and P E C at BC standard hearing threshold were calculated. Δ V at standard BC threshold was significantly smaller than V U at standard AC threshold between 500 Hz and 2000 Hz. Ear canal pressure at BC threshold tended to be smaller than for AC below 3000 Hz (with significant differences at 1000 Hz and 2000 Hz). Our results are most consistent with inertia of the ossicles and cochlear fluid driving BC hearing below 500 Hz, but with other mechanisms playing a significant role at higher frequencies. Sound radiated into the external ear canal might contribute to BC hearing at 3000 Hz and above.