Laryngo-rhino-otologie最新文献

ADHEAR is a non-invasive, passive bone conduction hearing aid. It is a pressure-free device, which overcomes the skin problems and irritations of conventional devices. Patients with otosclerosis and stapes fixation with normal inner ear represent an audiological homogenous group. We tested the ADHEAR benefit for this group.Thirty-one patients with maximal conductive hearing loss were tested preoperatively with and without ADHEAR. Pure tone and speech recognition tests, Freiburger mono- and multisyllables, were performed. The performance was evaluated at four sound pressure levels (35, 50, 65, and 80 dB). Intraoperative findings confirmed otosclerosis in 28 cases.The free-field PTA4 (pure tone average at 500 Hz, 1, 2, 4 kHz) in patients with otosclerosis improved with ADHEAR by 8.1 (±7.14) dB. Multisyllable understanding without ADHEAR at 65 dB was 69.6%, and 87.3% with ADHEAR (p = 0.002). Monosyllable understanding without ADHEAR at 65 dB was 37.9%, and 61.2% with ADHEAR (p = 0.00008).ADHEAR in patients with otosclerosis improved their speech understanding significantly in most testsituations. Because of its size at the speech-relevant sound pressure levels of 50 and 65 dB, the gain is clinically relevant. In difficult and easy situations we observed ceiling and floor effects. Thus, ADHEAR appears to be at least temporarily a good rehabilitation alternative.

Multiple sclerosis (MS) is an disease of the central nervous system, which is reflected in impaired transmission of impulses due to damage to the myelin layer. In addition to the visual evoked potentials, the vestibular evoked myogenic potentials (VEMPs) are increasingly considered for diagnosis. Due to a low signal-to-noise ratio, several hundred stimulus responses are usually averaged in order to determine the amplitude and latencies from these curves. However, this averaging procedure also filters out information that, if taken into account, could provide further insights into the course of the disease.16 young patients with MS and an EDSS score of 1.4 ± 0.6 were compared with 92 healthy subjects of the same age. Amplitude, latency, AR and five new parameters from the analysis were used as parameters from the tactile evoked oVEMPs.The total n10 amplitude and the n10 amplitude on the left side showed relevant differences tough not reaching statistical significance. In contrast, the n10 amplitude on the right side and the LSD parameter were not significantly different. All n10 latencies and the AR as well as all parameters from the novelty analysis were significantly different.On the one hand, the present study confirms already known changes in the registration of oVEMPs in patients with MS compared to healthy subjects and, on the other hand, the new parameters have the potential to better describe the current state of the disease and to provide detailed information about the current state of myelination or the site of pathophysiological processes within the CNS.

Septal perforations can severely diminish quality of life. Where surgical closure is impossible, due to size, location or contraindications, septum obturators offer an alternative. Defect anatomy can be assessed two ways: analog via silicone impression, or digitally using preoperative CT scans. This study compares these two methods.Retrospective analysis of 500 patients with symptomatic septal perforations was carried out, including defect size and location, type of closure and closure rate in surgical closures. 19 patients qualified for comparison of defect size and shape determined by conventional impression with CT-based data. For high precision comparison, silicone impressions were converted into plaster models, then digitally scanned, and CT data was converted into 3D models.The analysis of the NSD in the 19 patients and the comparison of the results from analog silicone impressions and preoperative CT scans revealed deviations of less than 10% in 8 out of 19 cases and less than 20% in 13 out of 19 cases. The deviations tended to be smaller in cases of larger defects. Larger deviations were observed when there were longer time intervals between the impression and the CT scan.Measurements of NSD based on CT data yield similar results to those obtained from silicone impressions, particularly when the CT scans are performed in close temporal proximity and in cases of larger defects. Further clinical studies should investigate whether iSOs created from CT data result in comparable clinical patient acceptance.

Background: The growing prominence of Artificial Intelligence (AI) in medicine introduces both transformative possibilities and potential challenges. Our study focuses on the current status and perceptions of AI in Head and Neck Surgery (HNS), examining its utilization, benefits, ethical concerns, and protective measures.

Objectives: The study aims to illuminate the existing landscape of AI in HNS in Germany.

Materials and methods: Conducted through a questionnaire, key aspects include its current usage, potential applications (e.g., diagnosis, surgical planning), anticipated benefits (e.g., improved patient care ), and significant ethical concerns (e.g., miscalculations by AI, data privacy).

Results: The survey reveals limited AI adoption in HNS, with substantial potential for improvement. Ethical considerations, especially miscalculations by AI and data privacy, emerge as central issues. The survey emphasizes the crucial role of physician control and the need for legal oversight to address concerns related to AI integration. While AI's presence in HNS is modest, the study identifies opportunities for enhancement. Ethical guidelines and practitioner-centric control are vital for discussions surrounding AI integration.

Conclusions: This research underscores the significance of ethical considerations and practitioner control in the context of AI in surgical practices. It highlights the demand for targeted training to empower practitioners in navigating the complexities of AI technologies in healthcare, ensuring responsible and patient-centric implementation.