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Thomas Zahnert - One of the best experts on this subject based on the ideXlab platform.
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Aktueller Stand der Lebensqualitätsmessung bei Patienten mit chronischer Otitis media und Schallleitungsschwerhörigkeit
HNO, 2018Co-Authors: S. Lailach, Thomas Zahnert, I. Baumann, M NeudertAbstract:The evaluation of results after Middle Ear Reconstruction has been mainly based on functional parameters. In clinical practice as well as in otological resEarch, the pure tone audiogram represents the gold standard in the assessment of the postoperative outcome. In order to assess the patient’s subjective outcome, outcome analyzes focus increasingly on the health-related quality of life (HRQOL). However, the evaluation of HRQOL requires reliable and validated measuring instruments. A modest number of validated questionnaires for determination of the disease-specific HRQOL in patients with chronic otitis media and/or conductive hEaring loss are currently available. Three of seven available questionnaires were developed and validated in the German-speaking countries, the Zurich Chronic Middle Ear Inventory 21 (ZCMEI-21), the Chronic Otitis Media Outcome Test 15 (COMOT-15) and the Stapesplasty Outcome Test 25 (SPOT-25). In this review, all seven available disease-specific measuring instruments as well as the generic questionnaires, which were used in previous clinical trials, are explained and current findings of quality-of-life resEarch in patients with chronic otitis media and/or conductive hEaring loss are presented. Die Ergebnisbewertung nach Rekonstruktion des Mittelohrs erfolgt bisher vorwiegend anhand funktioneller Parameter. Sowohl im klinischen Alltag als auch in der otologischen Forschung stellt das Reintonaudiogramm den Goldstandard in der Beurteilung des postoperativen Ergebnisses dar. Um das subjektive Therapieergebnis durch den Patienten zu bewerten, rückt die gesundheitsbezogene Lebensqualität (HRQOL) zunehmend in den Mittelpunkt von Ergebnisanalysen, wobei zur Bewertung der HRQOL validierte Messinstrumente erforderlich sind. Die Anzahl derzeit verfügbarer validierter Fragebögen zur Bestimmung der krankheitsspezifischen HRQOL bei chronischer Otitis media und/oder Schallleitungsschwerhörigkeit ist überschaubar. Mit dem Zurich Chronic Middle Ear Inventory 21 (ZCMEI-21), dem Chronic Otitis media Outcome Test 15 (COMOT-15) und dem Stapesplasty Outcome Test 25 (SPOT-25) wurden 3 von 7 gegenwärtig verfügbaren Messinstrumenten im deutschen Sprachraum entwickelt und validiert. In dieser Übersichtsarbeit werden die 7 derzeit verfügbaren krankheitsspezifischen Messinstrumente sowie die in bisherigen klinischen Untersuchungen verwendeten generischen Fragebögen vorgestellt und die aktuellen Erkenntnisse aus der Lebensqualitätsforschung bei Patienten mit chronischer Otitis media und/oder Schallleitungsschwerhörigkeit dargelegt.
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Aktueller Stand der Lebensqualitätsmessung bei Patienten mit chronischer Otitis media und Schallleitungsschwerhörigkeit
HNO, 2018Co-Authors: S. Lailach, Thomas Zahnert, I. Baumann, M NeudertAbstract:Die Ergebnisbewertung nach Rekonstruktion des Mittelohrs erfolgt bisher vorwiegend anhand funktioneller Parameter. Sowohl im klinischen Alltag als auch in der otologischen Forschung stellt das Reintonaudiogramm den Goldstandard in der Beurteilung des postoperativen Ergebnisses dar. Um das subjektive Therapieergebnis durch den Patienten zu bewerten, rückt die gesundheitsbezogene Lebensqualität (HRQOL) zunehmend in den Mittelpunkt von Ergebnisanalysen, wobei zur Bewertung der HRQOL validierte Messinstrumente erforderlich sind. Die Anzahl derzeit verfügbarer validierter Fragebögen zur Bestimmung der krankheitsspezifischen HRQOL bei chronischer Otitis media und/oder Schallleitungsschwerhörigkeit ist überschaubar. Mit dem Zurich Chronic Middle Ear Inventory 21 (ZCMEI-21), dem Chronic Otitis media Outcome Test 15 (COMOT-15) und dem Stapesplasty Outcome Test 25 (SPOT-25) wurden 3 von 7 gegenwärtig verfügbaren Messinstrumenten im deutschen Sprachraum entwickelt und validiert. In dieser Übersichtsarbeit werden die 7 derzeit verfügbaren krankheitsspezifischen Messinstrumente sowie die in bisherigen klinischen Untersuchungen verwendeten generischen Fragebögen vorgestellt und die aktuellen Erkenntnisse aus der Lebensqualitätsforschung bei Patienten mit chronischer Otitis media und/oder Schallleitungsschwerhörigkeit dargelegt. The evaluation of results after Middle Ear Reconstruction has been mainly based on functional parameters. In clinical practice as well as in otological resEarch, the pure tone audiogram represents the gold standard in the assessment of the postoperative outcome. In order to assess the patient’s subjective outcome, outcome analyzes focus increasingly on the health-related quality of life (HRQOL). However, the evaluation of HRQOL requires reliable and validated measuring instruments. A modest number of validated questionnaires for determination of the disease-specific HRQOL in patients with chronic otitis media and/or conductive hEaring loss are currently available. Three of seven available questionnaires were developed and validated in the German-speaking countries, the Zurich Chronic Middle Ear Inventory 21 (ZCMEI-21), the Chronic Otitis Media Outcome Test 15 (COMOT-15) and the Stapesplasty Outcome Test 25 (SPOT-25). In this review, all seven available disease-specific measuring instruments as well as the generic questionnaires, which were used in previous clinical trials, are explained and current findings of quality-of-life resEarch in patients with chronic otitis media and/or conductive hEaring loss are presented.
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Middle Ear Reconstruction with a flexible prosthesis
Current Directions in Biomedical Engineering, 2017Co-Authors: T Stoppe, Thomas Zahnert, Matthias Bornitz, Nikoloz Lasurashvili, Kirsten Sauer, Thomas BeleitesAbstract:AbstractThe Middle Ear plays a crucial role in the quality of hEaring. This complex construct performs different tasks like the protection against large air pressure input, the transmission of sound and its adaption to the inner Ear impedance. Traumas, erosion by chronic otitis media or cholesteatoma, as well as other degenerative or damaging diseases, are reasons for a necessary Reconstruction of specific Middle Ear structures. The Reconstruction of the ossicular chain is very often performed by using rigid ossicular replacement prostheses made out of titanium, ceramics or bone. Tilting and dislocation of these passive implants are some of the known complications after Middle Ear surgery. They are related to loads at the implant coupling points in response to a tension change in the Middle Ear. The healing process, scar tension and ventilation problems are possible causes.To increase the sound transmission quality of total Reconstructions and safety in case of pressure dependent movement of the tympanic membrane, a novel flexible total ossicular replacement prosthesis (TORP) with a silicone coated ball joint prototype was developed and investigated. Besides measurements of first Middle Ear transfer functions of temporal bones, the mechanical properties of the flexible TORP were examined with stress relaxation investigations.The novel silicone coated ball and socket joint TORP provides a sound transfer equivalent to the intact human Middle Ear at normal pressure and negative pressure in the Middle Ear. Together with the low stiffness values at an anatomically typical deflection of about 500 μm the prevention of a stiffening of the stapes annular ligament could be approved. Thus, improved acoustic transmission quality and Reconstruction stability in comparison to common rigid titanium TORP could be determined. Nevertheless, further design improvements should be accomplished. The demonstrated flexible TORP can solve some common problems in Middle Ear Reconstruction.
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Impact of Prosthesis Length on Tympanic Membrane's and Annular Ligament's Stiffness and the Resulting Middle Ear Sound Transmission.
Otology & neurotology : official publication of the American Otological Society American Neurotology Society [and] European Academy of Otology and Neu, 2016Co-Authors: M Neudert, Thomas Beleites, Matthias Bornitz, Nikoloz Lasurashvili, Uwe Schmidt, Thomas ZahnertAbstract:Hypothesis:Prosthesis’ length creates tension in ossicular Reconstructions, which directly effects the Middle Ear sound transmission.Background:Relatively long prostheses are often used to stabilize the Middle Ear Reconstruction to prevent dislocation. Thereby, tension on the flexible components suc
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Clinical investigation of flat panel CT following Middle Ear Reconstruction: a study of 107 patients
European Radiology, 2014Co-Authors: K. Zaoui, J. Kromeier, Thomas Beleites, M Neudert, Roland Laszig, Thomas Zahnert, C. OffergeldAbstract:Objectives After Middle Ear Reconstruction using partial or total ossicular replacement prostheses (PORP/TORP), an air–bone gap (ABG) may persist because of prosthesis displacement or malposition. So far, CT of the temporal bone has played the main role in the diagnosis of reasons for postoperative insufficient ABG improvement. Recent experimental and clinical studies have evaluated flat panel CT (fpCT) as an alternative imaging technique that provides images with high isovolumetric resolution, fewer metal-induced artefacts and lower irradiation doses. Methods One hundred and seven consecutive patients with chronic otitis media with or without cholesteatoma underwent Reconstruction by PORP ( n = 52) or TORP ( n = 55). All subjects underwent preoperative and postoperative audiometric testing and postoperative fpCT. Results Statistical evaluation of all 107 patients as well as the sole sub-assembly groups (PORP or TORP) showed a highly significant correlation between hEaring improvement and fpCT-determined prosthesis position. FpCT enables detailed postoperative information on patients with Middle Ear Reconstruction. Conclusions FpCT is a new imaging technique that provides immediate feedback on surgical results after reconstructive Middle Ear surgery. Specific parameters evaluated by fpCT may serve as a predictive tool for estimated postoperative hEaring improvement. Therefore this imaging technique is suitable for postoperative quality control in reconstructive Middle Ear surgery. Key Points • Flat panel CT offers advantages with regard to artefacts and radiation dose . • FpCT provides higher isovolumetric resolution of temporal bone and Middle Ear implants . • FpCT allows prediction of the postoperative hEaring outcome in patients . • FpCT is an important tool for immediate postoperative quality control . • FpCT improves postoperative management of patients with complications following ossicular replacement
M Neudert - One of the best experts on this subject based on the ideXlab platform.
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Aktueller Stand der Lebensqualitätsmessung bei Patienten mit chronischer Otitis media und Schallleitungsschwerhörigkeit
HNO, 2018Co-Authors: S. Lailach, Thomas Zahnert, I. Baumann, M NeudertAbstract:Die Ergebnisbewertung nach Rekonstruktion des Mittelohrs erfolgt bisher vorwiegend anhand funktioneller Parameter. Sowohl im klinischen Alltag als auch in der otologischen Forschung stellt das Reintonaudiogramm den Goldstandard in der Beurteilung des postoperativen Ergebnisses dar. Um das subjektive Therapieergebnis durch den Patienten zu bewerten, rückt die gesundheitsbezogene Lebensqualität (HRQOL) zunehmend in den Mittelpunkt von Ergebnisanalysen, wobei zur Bewertung der HRQOL validierte Messinstrumente erforderlich sind. Die Anzahl derzeit verfügbarer validierter Fragebögen zur Bestimmung der krankheitsspezifischen HRQOL bei chronischer Otitis media und/oder Schallleitungsschwerhörigkeit ist überschaubar. Mit dem Zurich Chronic Middle Ear Inventory 21 (ZCMEI-21), dem Chronic Otitis media Outcome Test 15 (COMOT-15) und dem Stapesplasty Outcome Test 25 (SPOT-25) wurden 3 von 7 gegenwärtig verfügbaren Messinstrumenten im deutschen Sprachraum entwickelt und validiert. In dieser Übersichtsarbeit werden die 7 derzeit verfügbaren krankheitsspezifischen Messinstrumente sowie die in bisherigen klinischen Untersuchungen verwendeten generischen Fragebögen vorgestellt und die aktuellen Erkenntnisse aus der Lebensqualitätsforschung bei Patienten mit chronischer Otitis media und/oder Schallleitungsschwerhörigkeit dargelegt. The evaluation of results after Middle Ear Reconstruction has been mainly based on functional parameters. In clinical practice as well as in otological resEarch, the pure tone audiogram represents the gold standard in the assessment of the postoperative outcome. In order to assess the patient’s subjective outcome, outcome analyzes focus increasingly on the health-related quality of life (HRQOL). However, the evaluation of HRQOL requires reliable and validated measuring instruments. A modest number of validated questionnaires for determination of the disease-specific HRQOL in patients with chronic otitis media and/or conductive hEaring loss are currently available. Three of seven available questionnaires were developed and validated in the German-speaking countries, the Zurich Chronic Middle Ear Inventory 21 (ZCMEI-21), the Chronic Otitis Media Outcome Test 15 (COMOT-15) and the Stapesplasty Outcome Test 25 (SPOT-25). In this review, all seven available disease-specific measuring instruments as well as the generic questionnaires, which were used in previous clinical trials, are explained and current findings of quality-of-life resEarch in patients with chronic otitis media and/or conductive hEaring loss are presented.
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Aktueller Stand der Lebensqualitätsmessung bei Patienten mit chronischer Otitis media und Schallleitungsschwerhörigkeit
HNO, 2018Co-Authors: S. Lailach, Thomas Zahnert, I. Baumann, M NeudertAbstract:The evaluation of results after Middle Ear Reconstruction has been mainly based on functional parameters. In clinical practice as well as in otological resEarch, the pure tone audiogram represents the gold standard in the assessment of the postoperative outcome. In order to assess the patient’s subjective outcome, outcome analyzes focus increasingly on the health-related quality of life (HRQOL). However, the evaluation of HRQOL requires reliable and validated measuring instruments. A modest number of validated questionnaires for determination of the disease-specific HRQOL in patients with chronic otitis media and/or conductive hEaring loss are currently available. Three of seven available questionnaires were developed and validated in the German-speaking countries, the Zurich Chronic Middle Ear Inventory 21 (ZCMEI-21), the Chronic Otitis Media Outcome Test 15 (COMOT-15) and the Stapesplasty Outcome Test 25 (SPOT-25). In this review, all seven available disease-specific measuring instruments as well as the generic questionnaires, which were used in previous clinical trials, are explained and current findings of quality-of-life resEarch in patients with chronic otitis media and/or conductive hEaring loss are presented. Die Ergebnisbewertung nach Rekonstruktion des Mittelohrs erfolgt bisher vorwiegend anhand funktioneller Parameter. Sowohl im klinischen Alltag als auch in der otologischen Forschung stellt das Reintonaudiogramm den Goldstandard in der Beurteilung des postoperativen Ergebnisses dar. Um das subjektive Therapieergebnis durch den Patienten zu bewerten, rückt die gesundheitsbezogene Lebensqualität (HRQOL) zunehmend in den Mittelpunkt von Ergebnisanalysen, wobei zur Bewertung der HRQOL validierte Messinstrumente erforderlich sind. Die Anzahl derzeit verfügbarer validierter Fragebögen zur Bestimmung der krankheitsspezifischen HRQOL bei chronischer Otitis media und/oder Schallleitungsschwerhörigkeit ist überschaubar. Mit dem Zurich Chronic Middle Ear Inventory 21 (ZCMEI-21), dem Chronic Otitis media Outcome Test 15 (COMOT-15) und dem Stapesplasty Outcome Test 25 (SPOT-25) wurden 3 von 7 gegenwärtig verfügbaren Messinstrumenten im deutschen Sprachraum entwickelt und validiert. In dieser Übersichtsarbeit werden die 7 derzeit verfügbaren krankheitsspezifischen Messinstrumente sowie die in bisherigen klinischen Untersuchungen verwendeten generischen Fragebögen vorgestellt und die aktuellen Erkenntnisse aus der Lebensqualitätsforschung bei Patienten mit chronischer Otitis media und/oder Schallleitungsschwerhörigkeit dargelegt.
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Impact of Prosthesis Length on Tympanic Membrane's and Annular Ligament's Stiffness and the Resulting Middle Ear Sound Transmission.
Otology & neurotology : official publication of the American Otological Society American Neurotology Society [and] European Academy of Otology and Neu, 2016Co-Authors: M Neudert, Thomas Beleites, Matthias Bornitz, Nikoloz Lasurashvili, Uwe Schmidt, Thomas ZahnertAbstract:Hypothesis:Prosthesis’ length creates tension in ossicular Reconstructions, which directly effects the Middle Ear sound transmission.Background:Relatively long prostheses are often used to stabilize the Middle Ear Reconstruction to prevent dislocation. Thereby, tension on the flexible components suc
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Clinical investigation of flat panel CT following Middle Ear Reconstruction: a study of 107 patients
European Radiology, 2014Co-Authors: K. Zaoui, J. Kromeier, Thomas Beleites, M Neudert, Roland Laszig, Thomas Zahnert, C. OffergeldAbstract:Objectives After Middle Ear Reconstruction using partial or total ossicular replacement prostheses (PORP/TORP), an air–bone gap (ABG) may persist because of prosthesis displacement or malposition. So far, CT of the temporal bone has played the main role in the diagnosis of reasons for postoperative insufficient ABG improvement. Recent experimental and clinical studies have evaluated flat panel CT (fpCT) as an alternative imaging technique that provides images with high isovolumetric resolution, fewer metal-induced artefacts and lower irradiation doses. Methods One hundred and seven consecutive patients with chronic otitis media with or without cholesteatoma underwent Reconstruction by PORP ( n = 52) or TORP ( n = 55). All subjects underwent preoperative and postoperative audiometric testing and postoperative fpCT. Results Statistical evaluation of all 107 patients as well as the sole sub-assembly groups (PORP or TORP) showed a highly significant correlation between hEaring improvement and fpCT-determined prosthesis position. FpCT enables detailed postoperative information on patients with Middle Ear Reconstruction. Conclusions FpCT is a new imaging technique that provides immediate feedback on surgical results after reconstructive Middle Ear surgery. Specific parameters evaluated by fpCT may serve as a predictive tool for estimated postoperative hEaring improvement. Therefore this imaging technique is suitable for postoperative quality control in reconstructive Middle Ear surgery. Key Points • Flat panel CT offers advantages with regard to artefacts and radiation dose . • FpCT provides higher isovolumetric resolution of temporal bone and Middle Ear implants . • FpCT allows prediction of the postoperative hEaring outcome in patients . • FpCT is an important tool for immediate postoperative quality control . • FpCT improves postoperative management of patients with complications following ossicular replacement
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Clinical investigation of flat panel CT following Middle Ear Reconstruction: a study of 107 patients.
European radiology, 2013Co-Authors: K. Zaoui, J. Kromeier, Thomas Beleites, M Neudert, Roland Laszig, Thomas Zahnert, C. OffergeldAbstract:After Middle Ear Reconstruction using partial or total ossicular replacement prostheses (PORP/TORP), an air–bone gap (ABG) may persist because of prosthesis displacement or malposition. So far, CT of the temporal bone has played the main role in the diagnosis of reasons for postoperative insufficient ABG improvement. Recent experimental and clinical studies have evaluated flat panel CT (fpCT) as an alternative imaging technique that provides images with high isovolumetric resolution, fewer metal-induced artefacts and lower irradiation doses. One hundred and seven consecutive patients with chronic otitis media with or without cholesteatoma underwent Reconstruction by PORP (n = 52) or TORP (n = 55). All subjects underwent preoperative and postoperative audiometric testing and postoperative fpCT. Statistical evaluation of all 107 patients as well as the sole sub-assembly groups (PORP or TORP) showed a highly significant correlation between hEaring improvement and fpCT-determined prosthesis position. FpCT enables detailed postoperative information on patients with Middle Ear Reconstruction. FpCT is a new imaging technique that provides immediate feedback on surgical results after reconstructive Middle Ear surgery. Specific parameters evaluated by fpCT may serve as a predictive tool for estimated postoperative hEaring improvement. Therefore this imaging technique is suitable for postoperative quality control in reconstructive Middle Ear surgery. • Flat panel CT offers advantages with regard to artefacts and radiation dose. • FpCT provides higher isovolumetric resolution of temporal bone and Middle Ear implants. • FpCT allows prediction of the postoperative hEaring outcome in patients. • FpCT is an important tool for immediate postoperative quality control. • FpCT improves postoperative management of patients with complications following ossicular replacement
Daniel J Lee - One of the best experts on this subject based on the ideXlab platform.
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development of a temporal bone model for transcanal endoscopic Ear surgery
Otolaryngology-Head and Neck Surgery, 2015Co-Authors: Matthew M Dedmon, Elliott D Kozin, Daniel J LeeAbstract:Transcanal endoscopic Ear surgery (TEES) is being increasingly used in chronic Ear disease for cholesteatoma removal and Middle Ear Reconstruction, reducing the need for a postauricular incision an...
Richard L. Goode - One of the best experts on this subject based on the ideXlab platform.
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Effect of absence of malleus on ossiculoplasty in human temporal bones
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2008Co-Authors: Yoshitaka Shimizu, Richard L. GoodeAbstract:OBJECTIVE: We evaluated the effect of malleus presence or absence on Middle Ear sound transmission after Middle Ear Reconstruction in a temporal bone model.STUDY DESIGN: Human cadaveric temporal bone study.METHODS: The velocity of the stapes footplate was measured using a laser Doppler vibrometer. After baseline measurements in eight intact temporal bones, reconstructed Middle Ear transmission with and without the malleus was analyzed. Furthermore, to assess the influence of interposed cartilage, cartilage pieces of three different diameters were inserted and the three test conditions compared.RESULTS: Reconstruction without a malleus tended to be slightly worse at 0.6 to 3.0 kHz. However, these differences were not statistically significant. In the cartilage experiments, the large-diameter cartilage was the worst at 0.25 kHz and 0.5 kHz but was better than the medium-diameter cartilages at 3.0 kHz and 4.0 kHz (P < 0.05).CONCLUSION: Absence of the malleus impaired Middle Ear sound transmission slightly in...
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Acoustic Effect of Malleus Head Removal and Tensor Tympani Muscle Section on Middle Ear Reconstruction
The Laryngoscope, 1997Co-Authors: Masanori Asai, Joseph B. Roberson, Richard L. GoodeAbstract:In the Reconstruction of Ears with a missing incus, an incus replacement prosthesis (IRP) is commonly used to connect malleus and stapes. In some cases, it is necessary to resect the malleus head and/or section the tensor tympani muscle (TTM) tendon. The acoustic effects of these maneuvers have not been well studied. We performed experiments in a temporal bone model to measure the effect of these maneuvers on Middle Ear sound transmission. Measurements of umbo and stapes displacement were made before and after malleus head removal and TTM section plus incus replacement with an IRP. After malleus head removal, there was a peak gain in stapes displacement of 6 dB below 0.5 kHz and 8 dB above 2.5 kHz. TTM section had a similar but lesser effect. A clinical example is described.
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Experimental models of ossiculoplasty.
Otolaryngologic clinics of North America, 1994Co-Authors: Richard L. Goode, Shinsei NishiharaAbstract:Measurement of the acoustic properties of Middle Ear prostheses in an appropriate model prior to insertion in humans should be part of the routine of the prosthesis development and testing process, but it is not. This article describes a human temporal bone model suitable for such testing and discusses the results of several commonly used prostheses evaluated in the model. By comparing existing and new experimental prostheses in such a model, we should be better able to develop prostheses capable of providing improved hEaring results following Middle Ear Reconstruction.
Thomas Beleites - One of the best experts on this subject based on the ideXlab platform.
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Middle Ear Reconstruction with a flexible prosthesis
Current Directions in Biomedical Engineering, 2017Co-Authors: T Stoppe, Thomas Zahnert, Matthias Bornitz, Nikoloz Lasurashvili, Kirsten Sauer, Thomas BeleitesAbstract:AbstractThe Middle Ear plays a crucial role in the quality of hEaring. This complex construct performs different tasks like the protection against large air pressure input, the transmission of sound and its adaption to the inner Ear impedance. Traumas, erosion by chronic otitis media or cholesteatoma, as well as other degenerative or damaging diseases, are reasons for a necessary Reconstruction of specific Middle Ear structures. The Reconstruction of the ossicular chain is very often performed by using rigid ossicular replacement prostheses made out of titanium, ceramics or bone. Tilting and dislocation of these passive implants are some of the known complications after Middle Ear surgery. They are related to loads at the implant coupling points in response to a tension change in the Middle Ear. The healing process, scar tension and ventilation problems are possible causes.To increase the sound transmission quality of total Reconstructions and safety in case of pressure dependent movement of the tympanic membrane, a novel flexible total ossicular replacement prosthesis (TORP) with a silicone coated ball joint prototype was developed and investigated. Besides measurements of first Middle Ear transfer functions of temporal bones, the mechanical properties of the flexible TORP were examined with stress relaxation investigations.The novel silicone coated ball and socket joint TORP provides a sound transfer equivalent to the intact human Middle Ear at normal pressure and negative pressure in the Middle Ear. Together with the low stiffness values at an anatomically typical deflection of about 500 μm the prevention of a stiffening of the stapes annular ligament could be approved. Thus, improved acoustic transmission quality and Reconstruction stability in comparison to common rigid titanium TORP could be determined. Nevertheless, further design improvements should be accomplished. The demonstrated flexible TORP can solve some common problems in Middle Ear Reconstruction.
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Impact of Prosthesis Length on Tympanic Membrane's and Annular Ligament's Stiffness and the Resulting Middle Ear Sound Transmission.
Otology & neurotology : official publication of the American Otological Society American Neurotology Society [and] European Academy of Otology and Neu, 2016Co-Authors: M Neudert, Thomas Beleites, Matthias Bornitz, Nikoloz Lasurashvili, Uwe Schmidt, Thomas ZahnertAbstract:Hypothesis:Prosthesis’ length creates tension in ossicular Reconstructions, which directly effects the Middle Ear sound transmission.Background:Relatively long prostheses are often used to stabilize the Middle Ear Reconstruction to prevent dislocation. Thereby, tension on the flexible components suc
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Clinical investigation of flat panel CT following Middle Ear Reconstruction: a study of 107 patients
European Radiology, 2014Co-Authors: K. Zaoui, J. Kromeier, Thomas Beleites, M Neudert, Roland Laszig, Thomas Zahnert, C. OffergeldAbstract:Objectives After Middle Ear Reconstruction using partial or total ossicular replacement prostheses (PORP/TORP), an air–bone gap (ABG) may persist because of prosthesis displacement or malposition. So far, CT of the temporal bone has played the main role in the diagnosis of reasons for postoperative insufficient ABG improvement. Recent experimental and clinical studies have evaluated flat panel CT (fpCT) as an alternative imaging technique that provides images with high isovolumetric resolution, fewer metal-induced artefacts and lower irradiation doses. Methods One hundred and seven consecutive patients with chronic otitis media with or without cholesteatoma underwent Reconstruction by PORP ( n = 52) or TORP ( n = 55). All subjects underwent preoperative and postoperative audiometric testing and postoperative fpCT. Results Statistical evaluation of all 107 patients as well as the sole sub-assembly groups (PORP or TORP) showed a highly significant correlation between hEaring improvement and fpCT-determined prosthesis position. FpCT enables detailed postoperative information on patients with Middle Ear Reconstruction. Conclusions FpCT is a new imaging technique that provides immediate feedback on surgical results after reconstructive Middle Ear surgery. Specific parameters evaluated by fpCT may serve as a predictive tool for estimated postoperative hEaring improvement. Therefore this imaging technique is suitable for postoperative quality control in reconstructive Middle Ear surgery. Key Points • Flat panel CT offers advantages with regard to artefacts and radiation dose . • FpCT provides higher isovolumetric resolution of temporal bone and Middle Ear implants . • FpCT allows prediction of the postoperative hEaring outcome in patients . • FpCT is an important tool for immediate postoperative quality control . • FpCT improves postoperative management of patients with complications following ossicular replacement
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Clinical investigation of flat panel CT following Middle Ear Reconstruction: a study of 107 patients.
European radiology, 2013Co-Authors: K. Zaoui, J. Kromeier, Thomas Beleites, M Neudert, Roland Laszig, Thomas Zahnert, C. OffergeldAbstract:After Middle Ear Reconstruction using partial or total ossicular replacement prostheses (PORP/TORP), an air–bone gap (ABG) may persist because of prosthesis displacement or malposition. So far, CT of the temporal bone has played the main role in the diagnosis of reasons for postoperative insufficient ABG improvement. Recent experimental and clinical studies have evaluated flat panel CT (fpCT) as an alternative imaging technique that provides images with high isovolumetric resolution, fewer metal-induced artefacts and lower irradiation doses. One hundred and seven consecutive patients with chronic otitis media with or without cholesteatoma underwent Reconstruction by PORP (n = 52) or TORP (n = 55). All subjects underwent preoperative and postoperative audiometric testing and postoperative fpCT. Statistical evaluation of all 107 patients as well as the sole sub-assembly groups (PORP or TORP) showed a highly significant correlation between hEaring improvement and fpCT-determined prosthesis position. FpCT enables detailed postoperative information on patients with Middle Ear Reconstruction. FpCT is a new imaging technique that provides immediate feedback on surgical results after reconstructive Middle Ear surgery. Specific parameters evaluated by fpCT may serve as a predictive tool for estimated postoperative hEaring improvement. Therefore this imaging technique is suitable for postoperative quality control in reconstructive Middle Ear surgery. • Flat panel CT offers advantages with regard to artefacts and radiation dose. • FpCT provides higher isovolumetric resolution of temporal bone and Middle Ear implants. • FpCT allows prediction of the postoperative hEaring outcome in patients. • FpCT is an important tool for immediate postoperative quality control. • FpCT improves postoperative management of patients with complications following ossicular replacement