The Experts below are selected from a list of 321 Experts worldwide ranked by ideXlab platform
Wilko Grolman - One of the best experts on this subject based on the ideXlab platform.
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Day-case Stapes Surgery: Day-case versus inpatient Stapes Surgery for otosclerosis: a randomized controlled trial
BMC Ear Nose and Throat Disorders, 2016Co-Authors: Laura S. M. Derks, Inge Wegner, Rinze A. Tange, Digna M. A. Kamalski, Wilko GrolmanAbstract:Background Otosclerosis is characterized by bony deposits in the otic capsule, resulting in Stapes fixation and progressive hearing loss. It can be treated effectively by surgically removing (part of) the Stapes and replacing it with a prosthesis. Increasingly, Stapes Surgery is performed as a day-case procedure. The major drive towards day-case Surgery has been out of economic considerations. However, it is also increasingly an explicit patient request and leads to shorter waiting times for Surgery, a reduced risk of infection and most likely positively influences the patient’s quality of life as a result of rapid discharge and rehabilitation. Even though Stapes Surgery seems well suited to a day-case approach, given the low complication rates and early recovery, evidence is scarce and of low quality. Methods and design A single-center unblinded randomized controlled trial was designed to (primarily) investigate the effect of hearing outcomes of day-case Stapes Surgery compared to inpatient Stapes Surgery and (secondarily) investigate the effect of both methods on quality of life, tinnitus, vertigo and cost-effectiveness. One hundred and twelve adult otosclerosis patients who are eligible for Stapes Surgery will be randomly assigned to either the day-case or inpatient treatment group. The primary and secondary outcome measures will be assessed using pure-tone audiometry (at approximately 2 months and 1 year follow-up), questionnaires (at 3 months and 1 year follow-up) and costs diaries (weekly the first month after which once a month until 1 year follow-up). Discussion/conclusion This trial allows for a comparison between day-case and inpatient Stapes Surgery to investigate the hypothesis that day-case Stapes Surgery is associated with a higher quality of life and higher cost-effectiveness, while maintaining equal hearing results, compared to inpatient Stapes Surgery. Trial registration Netherlands Trial Register ( www.trialregister.nl ): NTR4133 , registration date 21^st August 2013.
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Day-case Stapes Surgery: Day-case versus inpatient Stapes Surgery for otosclerosis: a randomized controlled trial
BMC ear nose and throat disorders, 2016Co-Authors: Laura S. M. Derks, Inge Wegner, Rinze A. Tange, Digna M. A. Kamalski, Wilko GrolmanAbstract:Otosclerosis is characterized by bony deposits in the otic capsule, resulting in Stapes fixation and progressive hearing loss. It can be treated effectively by surgically removing (part of) the Stapes and replacing it with a prosthesis. Increasingly, Stapes Surgery is performed as a day-case procedure. The major drive towards day-case Surgery has been out of economic considerations. However, it is also increasingly an explicit patient request and leads to shorter waiting times for Surgery, a reduced risk of infection and most likely positively influences the patient’s quality of life as a result of rapid discharge and rehabilitation. Even though Stapes Surgery seems well suited to a day-case approach, given the low complication rates and early recovery, evidence is scarce and of low quality. A single-center unblinded randomized controlled trial was designed to (primarily) investigate the effect of hearing outcomes of day-case Stapes Surgery compared to inpatient Stapes Surgery and (secondarily) investigate the effect of both methods on quality of life, tinnitus, vertigo and cost-effectiveness. One hundred and twelve adult otosclerosis patients who are eligible for Stapes Surgery will be randomly assigned to either the day-case or inpatient treatment group. The primary and secondary outcome measures will be assessed using pure-tone audiometry (at approximately 2 months and 1 year follow-up), questionnaires (at 3 months and 1 year follow-up) and costs diaries (weekly the first month after which once a month until 1 year follow-up). This trial allows for a comparison between day-case and inpatient Stapes Surgery to investigate the hypothesis that day-case Stapes Surgery is associated with a higher quality of life and higher cost-effectiveness, while maintaining equal hearing results, compared to inpatient Stapes Surgery. Netherlands Trial Register ( www.trialregister.nl ): NTR4133 , registration date 21st August 2013.
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Primary Stapes Surgery in patients with otosclerosis: prediction of postoperative outcome.
Archives of otolaryngology--head & neck surgery, 2011Co-Authors: Arnold J. N. Bittermann, Rinze A. Tange, Maroeska M. Rovers, Robert Vincent, Wouter A. Dreschler, Wilko GrolmanAbstract:Objectives To evaluate the audiometric results of primary Stapes Surgery in patients with otosclerosis and to determine predictors of a postoperative air-bone gap (ABG) of 10 dB or less and a postoperative gain in air conduction (AC) exceeding 20 dB. Design Retrospective cohort study. Setting Tertiary referral center in Utrecht, the Netherlands. Patients Nine hundred thirty-nine patients with otosclerosis who underwent primary Stapes Surgery between January 1, 1982, and March 1, 2009. Intervention Primary Stapes Surgery. Main Outcome Measures Preoperative and postoperative audiometric results were compared. Logistic regression analyses were performed to evaluate which factors (ie, sex, age at Surgery, bilateral otosclerosis, and preoperative 4-frequency [0.5, 1, 2, and 4 kHz] ABG, AC, or bone conduction) independently contributed to the prediction of a postoperative ABG of 10 dB or less and a postoperative gain in AC exceeding 20 dB. Results A total of 72.1% of patients had a postoperative ABG of 10 dB or less, and 93.8% of patients had a postoperative ABG of 20 dB or less. Age at Surgery and preoperative ABG and AC were independent prognostic determinants. A patient older than 40 years with a preoperative ABG of 30 dB or less has a 77.6% chance of achieving a postoperative ABG of 10 dB or less. A patient with a preoperative AC exceeding 50 dB and a preoperative ABG exceeding 30 dB has an 86.2% chance of achieving a postoperative gain in AC exceeding 20 dB. Conclusions Following primary Stapes Surgery, a postoperative ABG of 10 dB or less and a postoperative gain in AC exceeding 20 dB may be predicted with accuracies of 62.1% and 80.1%, respectively. Clinicians can use this information to inform patients more explicitly about expected postoperative audiometric results.
Laura S. M. Derks - One of the best experts on this subject based on the ideXlab platform.
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Day-case Stapes Surgery: Day-case versus inpatient Stapes Surgery for otosclerosis: a randomized controlled trial
BMC Ear Nose and Throat Disorders, 2016Co-Authors: Laura S. M. Derks, Inge Wegner, Rinze A. Tange, Digna M. A. Kamalski, Wilko GrolmanAbstract:Background Otosclerosis is characterized by bony deposits in the otic capsule, resulting in Stapes fixation and progressive hearing loss. It can be treated effectively by surgically removing (part of) the Stapes and replacing it with a prosthesis. Increasingly, Stapes Surgery is performed as a day-case procedure. The major drive towards day-case Surgery has been out of economic considerations. However, it is also increasingly an explicit patient request and leads to shorter waiting times for Surgery, a reduced risk of infection and most likely positively influences the patient’s quality of life as a result of rapid discharge and rehabilitation. Even though Stapes Surgery seems well suited to a day-case approach, given the low complication rates and early recovery, evidence is scarce and of low quality. Methods and design A single-center unblinded randomized controlled trial was designed to (primarily) investigate the effect of hearing outcomes of day-case Stapes Surgery compared to inpatient Stapes Surgery and (secondarily) investigate the effect of both methods on quality of life, tinnitus, vertigo and cost-effectiveness. One hundred and twelve adult otosclerosis patients who are eligible for Stapes Surgery will be randomly assigned to either the day-case or inpatient treatment group. The primary and secondary outcome measures will be assessed using pure-tone audiometry (at approximately 2 months and 1 year follow-up), questionnaires (at 3 months and 1 year follow-up) and costs diaries (weekly the first month after which once a month until 1 year follow-up). Discussion/conclusion This trial allows for a comparison between day-case and inpatient Stapes Surgery to investigate the hypothesis that day-case Stapes Surgery is associated with a higher quality of life and higher cost-effectiveness, while maintaining equal hearing results, compared to inpatient Stapes Surgery. Trial registration Netherlands Trial Register ( www.trialregister.nl ): NTR4133 , registration date 21^st August 2013.
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Day-case Stapes Surgery: Day-case versus inpatient Stapes Surgery for otosclerosis: a randomized controlled trial
BMC ear nose and throat disorders, 2016Co-Authors: Laura S. M. Derks, Inge Wegner, Rinze A. Tange, Digna M. A. Kamalski, Wilko GrolmanAbstract:Otosclerosis is characterized by bony deposits in the otic capsule, resulting in Stapes fixation and progressive hearing loss. It can be treated effectively by surgically removing (part of) the Stapes and replacing it with a prosthesis. Increasingly, Stapes Surgery is performed as a day-case procedure. The major drive towards day-case Surgery has been out of economic considerations. However, it is also increasingly an explicit patient request and leads to shorter waiting times for Surgery, a reduced risk of infection and most likely positively influences the patient’s quality of life as a result of rapid discharge and rehabilitation. Even though Stapes Surgery seems well suited to a day-case approach, given the low complication rates and early recovery, evidence is scarce and of low quality. A single-center unblinded randomized controlled trial was designed to (primarily) investigate the effect of hearing outcomes of day-case Stapes Surgery compared to inpatient Stapes Surgery and (secondarily) investigate the effect of both methods on quality of life, tinnitus, vertigo and cost-effectiveness. One hundred and twelve adult otosclerosis patients who are eligible for Stapes Surgery will be randomly assigned to either the day-case or inpatient treatment group. The primary and secondary outcome measures will be assessed using pure-tone audiometry (at approximately 2 months and 1 year follow-up), questionnaires (at 3 months and 1 year follow-up) and costs diaries (weekly the first month after which once a month until 1 year follow-up). This trial allows for a comparison between day-case and inpatient Stapes Surgery to investigate the hypothesis that day-case Stapes Surgery is associated with a higher quality of life and higher cost-effectiveness, while maintaining equal hearing results, compared to inpatient Stapes Surgery. Netherlands Trial Register ( www.trialregister.nl ): NTR4133 , registration date 21st August 2013.
Timo P. Hirvonen - One of the best experts on this subject based on the ideXlab platform.
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Simultaneous bilateral Stapes Surgery after follow-up of 13 years
Acta oto-laryngologica, 2020Co-Authors: Topi Jutila, Ville Sivonen, Timo P. HirvonenAbstract:Eighteen patients underwent simultaneous bilateral Stapes Surgery in 2003–2006. We evaluated the long-term outcomes in this patient group, and assessed their hearing in noise and binaural hearing. ...
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Immediate postoperative nystagmus and vestibular symptoms after Stapes Surgery.
Acta oto-laryngologica, 2013Co-Authors: Timo P. Hirvonen, Heikki AaltoAbstract:Abstract Conclusion: Vestibular disturbance is frequent, but mild even immediately after Stapes Surgery. Vestibular symptoms improved or disappeared quickly, and they did not correlate with nystagmus. Outpatient Stapes Surgery performed under local anaesthesia is a feasible approach. Objective: Vestibular symptoms are common and may prevent outpatient Surgery. The time course of vestibular disturbance is unclear, and we aimed to evaluate it immediately after the operation in the recovery room. Methods: Twenty patients with otosclerosis undergoing stapedotomy were prospectively included in the study. Postoperative symptoms were collected and nystagmus was recorded with video-oculography (VOG) on average 29 min after the Surgery. Results: None of the patients had spontaneous nystagmus with gaze fixation. Nine patients (45%) had slow spontaneous horizontal nystagmus (mean slow phase velocity of 1.1°/s) in the primary position without gaze fixation. In seven of these, the nystagmus obeyed Alexander's law. Nin...
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Simultaneous bilateral Stapes Surgery.
Acta oto-laryngologica, 2008Co-Authors: Juuso Kujala, Heikki Aalto, Hans Ramsay, Timo P. HirvonenAbstract:Conclusions. The patients recovered from the Surgery as after unilateral Surgery. The success rate for hearing improvement was good both subjectively and objectively, and this was also displayed in the quality of life. According to our study, simultaneous bilateral Stapes Surgery can be performed safely in selected patients with bilateral conductive hearing loss. Objectives. Otosclerosis is bilateral in the majority of patients. In this study we evaluated the outcome of simultaneous bilateral Stapes Surgery. Subjects and methods. Eighteen patients suffering from bilateral otosclerosis or osteogenesis imperfecta were prospectively included. After operation, hearing and vestibular function were followed by audiometry and visual feedback posturography (VFP). Patients estimated their hearing gain, the intensity of vestibular symptoms and quality of life score with a questionnaire during the follow-up period of 1 year. Results. The mean improvement in pure-tone average (PTA) air conduction (PTA-AC) was 18 dB (...
Rinze A. Tange - One of the best experts on this subject based on the ideXlab platform.
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Day-case Stapes Surgery: Day-case versus inpatient Stapes Surgery for otosclerosis: a randomized controlled trial
BMC Ear Nose and Throat Disorders, 2016Co-Authors: Laura S. M. Derks, Inge Wegner, Rinze A. Tange, Digna M. A. Kamalski, Wilko GrolmanAbstract:Background Otosclerosis is characterized by bony deposits in the otic capsule, resulting in Stapes fixation and progressive hearing loss. It can be treated effectively by surgically removing (part of) the Stapes and replacing it with a prosthesis. Increasingly, Stapes Surgery is performed as a day-case procedure. The major drive towards day-case Surgery has been out of economic considerations. However, it is also increasingly an explicit patient request and leads to shorter waiting times for Surgery, a reduced risk of infection and most likely positively influences the patient’s quality of life as a result of rapid discharge and rehabilitation. Even though Stapes Surgery seems well suited to a day-case approach, given the low complication rates and early recovery, evidence is scarce and of low quality. Methods and design A single-center unblinded randomized controlled trial was designed to (primarily) investigate the effect of hearing outcomes of day-case Stapes Surgery compared to inpatient Stapes Surgery and (secondarily) investigate the effect of both methods on quality of life, tinnitus, vertigo and cost-effectiveness. One hundred and twelve adult otosclerosis patients who are eligible for Stapes Surgery will be randomly assigned to either the day-case or inpatient treatment group. The primary and secondary outcome measures will be assessed using pure-tone audiometry (at approximately 2 months and 1 year follow-up), questionnaires (at 3 months and 1 year follow-up) and costs diaries (weekly the first month after which once a month until 1 year follow-up). Discussion/conclusion This trial allows for a comparison between day-case and inpatient Stapes Surgery to investigate the hypothesis that day-case Stapes Surgery is associated with a higher quality of life and higher cost-effectiveness, while maintaining equal hearing results, compared to inpatient Stapes Surgery. Trial registration Netherlands Trial Register ( www.trialregister.nl ): NTR4133 , registration date 21^st August 2013.
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Day-case Stapes Surgery: Day-case versus inpatient Stapes Surgery for otosclerosis: a randomized controlled trial
BMC ear nose and throat disorders, 2016Co-Authors: Laura S. M. Derks, Inge Wegner, Rinze A. Tange, Digna M. A. Kamalski, Wilko GrolmanAbstract:Otosclerosis is characterized by bony deposits in the otic capsule, resulting in Stapes fixation and progressive hearing loss. It can be treated effectively by surgically removing (part of) the Stapes and replacing it with a prosthesis. Increasingly, Stapes Surgery is performed as a day-case procedure. The major drive towards day-case Surgery has been out of economic considerations. However, it is also increasingly an explicit patient request and leads to shorter waiting times for Surgery, a reduced risk of infection and most likely positively influences the patient’s quality of life as a result of rapid discharge and rehabilitation. Even though Stapes Surgery seems well suited to a day-case approach, given the low complication rates and early recovery, evidence is scarce and of low quality. A single-center unblinded randomized controlled trial was designed to (primarily) investigate the effect of hearing outcomes of day-case Stapes Surgery compared to inpatient Stapes Surgery and (secondarily) investigate the effect of both methods on quality of life, tinnitus, vertigo and cost-effectiveness. One hundred and twelve adult otosclerosis patients who are eligible for Stapes Surgery will be randomly assigned to either the day-case or inpatient treatment group. The primary and secondary outcome measures will be assessed using pure-tone audiometry (at approximately 2 months and 1 year follow-up), questionnaires (at 3 months and 1 year follow-up) and costs diaries (weekly the first month after which once a month until 1 year follow-up). This trial allows for a comparison between day-case and inpatient Stapes Surgery to investigate the hypothesis that day-case Stapes Surgery is associated with a higher quality of life and higher cost-effectiveness, while maintaining equal hearing results, compared to inpatient Stapes Surgery. Netherlands Trial Register ( www.trialregister.nl ): NTR4133 , registration date 21st August 2013.
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Primary Stapes Surgery in patients with otosclerosis: prediction of postoperative outcome.
Archives of otolaryngology--head & neck surgery, 2011Co-Authors: Arnold J. N. Bittermann, Rinze A. Tange, Maroeska M. Rovers, Robert Vincent, Wouter A. Dreschler, Wilko GrolmanAbstract:Objectives To evaluate the audiometric results of primary Stapes Surgery in patients with otosclerosis and to determine predictors of a postoperative air-bone gap (ABG) of 10 dB or less and a postoperative gain in air conduction (AC) exceeding 20 dB. Design Retrospective cohort study. Setting Tertiary referral center in Utrecht, the Netherlands. Patients Nine hundred thirty-nine patients with otosclerosis who underwent primary Stapes Surgery between January 1, 1982, and March 1, 2009. Intervention Primary Stapes Surgery. Main Outcome Measures Preoperative and postoperative audiometric results were compared. Logistic regression analyses were performed to evaluate which factors (ie, sex, age at Surgery, bilateral otosclerosis, and preoperative 4-frequency [0.5, 1, 2, and 4 kHz] ABG, AC, or bone conduction) independently contributed to the prediction of a postoperative ABG of 10 dB or less and a postoperative gain in AC exceeding 20 dB. Results A total of 72.1% of patients had a postoperative ABG of 10 dB or less, and 93.8% of patients had a postoperative ABG of 20 dB or less. Age at Surgery and preoperative ABG and AC were independent prognostic determinants. A patient older than 40 years with a preoperative ABG of 30 dB or less has a 77.6% chance of achieving a postoperative ABG of 10 dB or less. A patient with a preoperative AC exceeding 50 dB and a preoperative ABG exceeding 30 dB has an 86.2% chance of achieving a postoperative gain in AC exceeding 20 dB. Conclusions Following primary Stapes Surgery, a postoperative ABG of 10 dB or less and a postoperative gain in AC exceeding 20 dB may be predicted with accuracies of 62.1% and 80.1%, respectively. Clinicians can use this information to inform patients more explicitly about expected postoperative audiometric results.
Peter Hegyi - One of the best experts on this subject based on the ideXlab platform.
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endoscopic versus microscopic Stapes Surgery outcomes a meta analysis and systematic review
Laryngoscope, 2020Co-Authors: Alexandros Koukkoullis, Istvan Toth, Noemi Gede, Zsolt Szakacs, Peter Hegyi, Gabor Varga, Istvan Pap, Kinga HarmatAbstract:OBJECTIVE Compare intraoperative and postoperative outcomes of endoscopic and microscopic Stapes Surgery to provide objective evidence on whether the former is a better alternative than the latter. METHODS We performed a systematic review and meta-analysis for studies that compared endoscopic Stapes Surgery with microscopic Stapes Surgery. Only studies that met predetermined criteria were selected and assessed for bias and quality. Primary outcomes were postoperative air-bone gap (ABG) and chorda tympani nerve injury. Secondary outcomes were average operating time, tympanic membrane (TM) perforation, and postoperative taste disturbance, pain, and dizziness. We calculated pooled odds ratios (ORs) with 95% confidence intervals (CIs) for dichotomous outcomes and weighted mean difference (WMD) with 95% CI for continuous outcomes. A confidence interval starting above 1.0 was considered as statistically significant. I2 and χ2 tests were used to quantify statistical heterogeneity. We used funnel plots to look for publication bias and performed a sensitivity analysis. RESULTS Six nonrandomized cohort studies were eligible. The primary outcomes were ABG 20 dB: OR = 2.51 (95% CI: 0.77 to 8.22), and chorda tympani injury: OR = 3.51 (95% CI: 1.55 to 7.93). Secondary outcomes were taste: OR = 2.36 (95% CI: 1.01 to 5.51), average operation time: WMD = 0.14 (95% CI: -11.69 to 11.98), TM perforation: OR = 1.70 (95% CI: 0.44 to 6.58); pain: OR = 0.84 (95% CI: 0.36 to 1.96), and dizziness: OR = 2.15 (95% CI: 0.94 to 4.89). CONCLUSIONS Endoscopic Stapes Surgery is a valid alternative to the microscope. LEVEL OF EVIDENCE 2a Laryngoscope, 130: 2019-2027, 2020.