Pub Date : 2024-07-01Epub Date: 2024-03-27DOI: 10.1007/s00106-024-01426-x
Svenja Buth, Izet Baljić, Alexander Mewes, Matthias Hey
Background: Binaural hearing enables better speech comprehension in noisy environments and is necessary for acoustic spatial orientation. This study investigates speech discrimination in noise with separated signal sources and measures sound localization. The aim was to study characteristics and reproducibility of two selected measurement techniques which seem to be suitable for description of the aforementioned aspects of binaural hearing.
Materials and methods: Speech reception thresholds (SRT) in noise and test-retest reliability were collected from 55 normal-hearing adults for a spatial setup of loudspeakers with angles of ± 45° and ± 90° using the Oldenburg sentence test. The investigations of sound localization were conducted in a semicircle and fullcircle setup (7 and 12 equidistant loudspeakers).
Results: SRT (S-45N45: -14.1 dB SNR; S45N-45: -16.4 dB SNR; S0N90: -13.1 dB SNR; S0N-90: -13.4 dB SNR) and test-retest reliability (4 to 6 dB SNR) were collected for speech intelligibility in noise with separated signals. The procedural learning effect for this setup could only be mitigated with 120 training sentences. Significantly smaller SRT values, resulting in better speech discrimination, were found for the test situation of the right compared to the left ear. RMS values could be gathered for sound localization in the semicircle (1,9°) as well as in the fullcircle setup (11,1°). Better results were obtained in the retest of the fullcircle setup.
Conclusion: When using the Oldenburg sentence test in noise with spatially separated signals, it is mandatory to perform a training session of 120 sentences in order to minimize the procedural learning effect. Ear-specific SRT values for speech discrimination in noise with separated signal sources are required, which is probably due to the right-ear advantage. A training is recommended for sound localization in the fullcircle setup.
背景:双耳听力能让人在嘈杂环境中更好地理解语音,也是声学空间定位的必要条件。本研究调查了噪声中信号源分离的语音辨别能力,并对声音定位进行了测量。目的是研究两种选定测量技术的特点和可重复性,这两种技术似乎适合描述双耳听力的上述方面:通过奥登堡句子测试,对 55 名听力正常的成年人进行了噪声中的言语接收阈值(SRT)和测试-再测试可靠性的收集,扬声器的空间设置角度为± 45°和± 90°。声音定位的调查在半圆和全圆设置(7 个和 12 个等距扬声器)中进行:结果:通过分离信号收集了噪声中语音清晰度的 SRT(S-45N45:-14.1 dB SNR;S45N-45:-16.4 dB SNR;S0N90:-13.1 dB SNR;S0N-90:-13.4 dB SNR)和测试重复可靠性(4 至 6 dB SNR)。这种设置的程序学习效应只能通过 120 个训练句子来缓解。与左耳相比,右耳的 SRT 值明显较小,因此语音辨别能力更强。在半圆形(1.9°)和全圆形(11.1°)设置下,均方根值可用于声音定位。全圆设置的复测结果更好:结论:在噪声中使用空间分离信号进行奥尔登堡句子测试时,必须进行 120 个句子的训练,以尽量减少程序学习效应。在信号源分离的噪声中进行语音辨别时,需要使用特定耳朵的 SRT 值,这可能是由于右耳的优势。建议在全圆设置中进行声音定位训练。
{"title":"[Speech discrimination with separated signal sources and sound localization with speech stimuli : Learning effects and reproducibility].","authors":"Svenja Buth, Izet Baljić, Alexander Mewes, Matthias Hey","doi":"10.1007/s00106-024-01426-x","DOIUrl":"10.1007/s00106-024-01426-x","url":null,"abstract":"<p><strong>Background: </strong>Binaural hearing enables better speech comprehension in noisy environments and is necessary for acoustic spatial orientation. This study investigates speech discrimination in noise with separated signal sources and measures sound localization. The aim was to study characteristics and reproducibility of two selected measurement techniques which seem to be suitable for description of the aforementioned aspects of binaural hearing.</p><p><strong>Materials and methods: </strong>Speech reception thresholds (SRT) in noise and test-retest reliability were collected from 55 normal-hearing adults for a spatial setup of loudspeakers with angles of ± 45° and ± 90° using the Oldenburg sentence test. The investigations of sound localization were conducted in a semicircle and fullcircle setup (7 and 12 equidistant loudspeakers).</p><p><strong>Results: </strong>SRT (S<sub>-45</sub>N<sub>45</sub>: -14.1 dB SNR; S<sub>45</sub>N<sub>-45</sub>: -16.4 dB SNR; S<sub>0</sub>N<sub>90</sub>: -13.1 dB SNR; S<sub>0</sub>N<sub>-90</sub>: -13.4 dB SNR) and test-retest reliability (4 to 6 dB SNR) were collected for speech intelligibility in noise with separated signals. The procedural learning effect for this setup could only be mitigated with 120 training sentences. Significantly smaller SRT values, resulting in better speech discrimination, were found for the test situation of the right compared to the left ear. RMS values could be gathered for sound localization in the semicircle (1,9°) as well as in the fullcircle setup (11,1°). Better results were obtained in the retest of the fullcircle setup.</p><p><strong>Conclusion: </strong>When using the Oldenburg sentence test in noise with spatially separated signals, it is mandatory to perform a training session of 120 sentences in order to minimize the procedural learning effect. Ear-specific SRT values for speech discrimination in noise with separated signal sources are required, which is probably due to the right-ear advantage. A training is recommended for sound localization in the fullcircle setup.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11192817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-02-26DOI: 10.1007/s00106-024-01431-0
F Klimek, U Förster-Ruhrmann, J Hagemann, M Cuevas, M Gröger, L Klimek
The prevalence of analgesic intolerance syndrome (AIS), internationally known as NSAID-exacerbated respiratory disease (NERD), is reported to be 0.5-5.7% in the general population. The disease often begins with nasal symptoms, which are later joined by chronic rhinosinusitis with nasal polyposis (CRSwNP), asthma, and respiratory hypersensitivity reactions following use of nonsteroidal anti-inflammatory drugs (NSAIDs). In the setting of chronic respiratory disease, the type 2 inflammatory endotype is predominant in approximately 80% of patients with CRSwNP, rendering biologics directed against interleukin (IL)-4, IL‑5, IL-13, and IgE of high clinical interest, particularly in patients with severe CRSwNP and NERD. NERD is often associated with CRSwNP and asthma. Patients with CRSwNP and NERD have been treated, among other therapies, with aspirin therapy after desensitization (ATAD). With the approval of monoclonal antibodies for CRSwNP and asthma, the question arises as to what extent ATAD, which is associated with undesirable side effects, is still useful in the treatment of CRSwNP. In this manuscript, the use of ATAD in CRSwNP patients is discussed from different medical and socioeconomic points of view, both alternatively to or in combination with monoclonal antibodies. Accordingly, both ATAD and biologics continue to play a supporting role in modern treatment of CRSwNP in NERD patients, and should be used judiciously to complement each other.
{"title":"[Does aspirin therapy after desensitization still have a role in treatment of chronic rhinosinusitis with nasal polyposis in the era of biologics?]","authors":"F Klimek, U Förster-Ruhrmann, J Hagemann, M Cuevas, M Gröger, L Klimek","doi":"10.1007/s00106-024-01431-0","DOIUrl":"10.1007/s00106-024-01431-0","url":null,"abstract":"<p><p>The prevalence of analgesic intolerance syndrome (AIS), internationally known as NSAID-exacerbated respiratory disease (NERD), is reported to be 0.5-5.7% in the general population. The disease often begins with nasal symptoms, which are later joined by chronic rhinosinusitis with nasal polyposis (CRSwNP), asthma, and respiratory hypersensitivity reactions following use of nonsteroidal anti-inflammatory drugs (NSAIDs). In the setting of chronic respiratory disease, the type 2 inflammatory endotype is predominant in approximately 80% of patients with CRSwNP, rendering biologics directed against interleukin (IL)-4, IL‑5, IL-13, and IgE of high clinical interest, particularly in patients with severe CRSwNP and NERD. NERD is often associated with CRSwNP and asthma. Patients with CRSwNP and NERD have been treated, among other therapies, with aspirin therapy after desensitization (ATAD). With the approval of monoclonal antibodies for CRSwNP and asthma, the question arises as to what extent ATAD, which is associated with undesirable side effects, is still useful in the treatment of CRSwNP. In this manuscript, the use of ATAD in CRSwNP patients is discussed from different medical and socioeconomic points of view, both alternatively to or in combination with monoclonal antibodies. Accordingly, both ATAD and biologics continue to play a supporting role in modern treatment of CRSwNP in NERD patients, and should be used judiciously to complement each other.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139974714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-03-11DOI: 10.1007/s00106-024-01433-y
Anna-Rebekka Staufenberg, Hanna K Frankenberger, Ulrike Förster-Ruhrmann, Franziska C Spahn, Ludger Klimek, Kai Fruth, Clemens Stihl, Christoph Matthias, Moritz Gröger, Jan Hagemann
Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a type‑2 inflammatory disease of the upper airways, with severe impairment of quality of life. Persons affected by NSAID-exacerbated respiratory disease (NERD) usually present with highly dynamic recurrence of polyps and disease despite prior treatment with sinus surgeries, oral corticosteroids, and aspirin desensitization (ATAD). Biologic therapy has fundamentally changed the choice of therapeutic concept; however, limited data exist on subgroups such as NERD patients. The aim of the current article is to report on a multicenter retrospective study on add-on therapy with dupilumab, omalizumab, and mepolizumab in patients with NERD.
Methods: This is a retrospective cohort study of patients (NERD+, status after ATAD) in three reference centers in Germany (Munich, Mainz, Berlin). Subjective and objective parameters were collected at 4, 8, and 12 months after biologic therapy initiation in accordance with current EPOS/EUFOREA (European Position Paper on Rhinosinusitis and Nasal Polyps/European Forum for Research and Education in Allergy and Airway Diseases) guidelines. Biologic agents were chosen depending on availability and patient characteristics.
Results: Treatment was commenced in 122 patients meeting the criteria for CRSwNP and NERD. The endoscopic polyp score, SNOT-22 questionnaire score, visual analogue scoring of total symptoms/severity of disease, and sense of smell (psychophysical testing with Sniffin'Sticks/Brief Smell Identification Test, B‑SIT; Sensonics, Inc., Haddon Heights, NJ, USA) improved significantly after 4 and 12 months of add-on therapy (p < 0.0001). All three biologic agents significantly improved one or more disease parameter. Adverse events were not life threatening but led to change of biologic agent in 4 cases. Patients rated biologic therapy significantly better than ATAD, with improved long-term disease control.
Conclusion: Add-on biologic therapy is effective, safe, and widely accepted among CRSwNP + NERD patients. Future studies might allow for personalized algorithms with sequential surgery, ATAD, and/or biologic therapy.
{"title":"[Biologic therapy in patients with severe NSAID-exacerbated respiratory disease and previous aspirin desensitization : Results of a multicentric study].","authors":"Anna-Rebekka Staufenberg, Hanna K Frankenberger, Ulrike Förster-Ruhrmann, Franziska C Spahn, Ludger Klimek, Kai Fruth, Clemens Stihl, Christoph Matthias, Moritz Gröger, Jan Hagemann","doi":"10.1007/s00106-024-01433-y","DOIUrl":"10.1007/s00106-024-01433-y","url":null,"abstract":"<p><strong>Background: </strong>Chronic rhinosinusitis with nasal polyps (CRSwNP) is a type‑2 inflammatory disease of the upper airways, with severe impairment of quality of life. Persons affected by NSAID-exacerbated respiratory disease (NERD) usually present with highly dynamic recurrence of polyps and disease despite prior treatment with sinus surgeries, oral corticosteroids, and aspirin desensitization (ATAD). Biologic therapy has fundamentally changed the choice of therapeutic concept; however, limited data exist on subgroups such as NERD patients. The aim of the current article is to report on a multicenter retrospective study on add-on therapy with dupilumab, omalizumab, and mepolizumab in patients with NERD.</p><p><strong>Methods: </strong>This is a retrospective cohort study of patients (NERD+, status after ATAD) in three reference centers in Germany (Munich, Mainz, Berlin). Subjective and objective parameters were collected at 4, 8, and 12 months after biologic therapy initiation in accordance with current EPOS/EUFOREA (European Position Paper on Rhinosinusitis and Nasal Polyps/European Forum for Research and Education in Allergy and Airway Diseases) guidelines. Biologic agents were chosen depending on availability and patient characteristics.</p><p><strong>Results: </strong>Treatment was commenced in 122 patients meeting the criteria for CRSwNP and NERD. The endoscopic polyp score, SNOT-22 questionnaire score, visual analogue scoring of total symptoms/severity of disease, and sense of smell (psychophysical testing with Sniffin'Sticks/Brief Smell Identification Test, B‑SIT; Sensonics, Inc., Haddon Heights, NJ, USA) improved significantly after 4 and 12 months of add-on therapy (p < 0.0001). All three biologic agents significantly improved one or more disease parameter. Adverse events were not life threatening but led to change of biologic agent in 4 cases. Patients rated biologic therapy significantly better than ATAD, with improved long-term disease control.</p><p><strong>Conclusion: </strong>Add-on biologic therapy is effective, safe, and widely accepted among CRSwNP + NERD patients. Future studies might allow for personalized algorithms with sequential surgery, ATAD, and/or biologic therapy.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11192825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140102896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-05-18DOI: 10.1007/s00106-024-01487-y
H M Appel, R Lochbaum, T K Hoffmann, J Hahn
Background: In patients with severe, uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP), dupilumab 300 mg every 2 weeks can completely resolve nasal polys, sinus disease, and symptoms. In this case, patients ask for de-escalation. Although trials have demonstrated recurrence after stopping the biologic at 24 weeks, reducing the dose of dupilumab to once every 4 weeks did not result in deterioration of control. An extension of the treatment intervals would, however, diverge from the approval text, and is currently not recommended.
Methods: The course of 29 patients with severe CRSwNP, type‑2 inflammation-associated comorbidities, and an indication for biologic was retrospectively analyzed. After resolution of CRSwNP and symptoms under biweekly dupilumab 300 mg, the dupilumab interval had been prolonged individually, initially up to 4 weeks, thereafter up to 6 weeks, if applicable. Control was assessed via quality of life (22-item sinonasal outcome test, SNOT-22), nasal polyp score, and smell identification test (Sniffin' Sticks; Burghart Messtechnik, Holm, Germany).
Results: All patients showed an excellent improvement within the first 3 months. The dupilumab application interval was extended to 4 weeks after 7-31 months (median 13 months) and to 6 weeks (n = 9) after 17-35 months (median 23 months). No recurrent polyps or symptoms were subsequently observed.
Conclusion: In case of maximal regression of polyps and discomfort, extension of dupilumab injection intervals to 4 and potentially 6 weeks is possible without clinical worsening. Further studies on de-escalation or termination of biologic treatment when CRSwNP control is achieved are essential.
{"title":"[Chronic rhinosinusitis with nasal polyps-extension of dupilumab treatment intervals].","authors":"H M Appel, R Lochbaum, T K Hoffmann, J Hahn","doi":"10.1007/s00106-024-01487-y","DOIUrl":"10.1007/s00106-024-01487-y","url":null,"abstract":"<p><strong>Background: </strong>In patients with severe, uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP), dupilumab 300 mg every 2 weeks can completely resolve nasal polys, sinus disease, and symptoms. In this case, patients ask for de-escalation. Although trials have demonstrated recurrence after stopping the biologic at 24 weeks, reducing the dose of dupilumab to once every 4 weeks did not result in deterioration of control. An extension of the treatment intervals would, however, diverge from the approval text, and is currently not recommended.</p><p><strong>Methods: </strong>The course of 29 patients with severe CRSwNP, type‑2 inflammation-associated comorbidities, and an indication for biologic was retrospectively analyzed. After resolution of CRSwNP and symptoms under biweekly dupilumab 300 mg, the dupilumab interval had been prolonged individually, initially up to 4 weeks, thereafter up to 6 weeks, if applicable. Control was assessed via quality of life (22-item sinonasal outcome test, SNOT-22), nasal polyp score, and smell identification test (Sniffin' Sticks; Burghart Messtechnik, Holm, Germany).</p><p><strong>Results: </strong>All patients showed an excellent improvement within the first 3 months. The dupilumab application interval was extended to 4 weeks after 7-31 months (median 13 months) and to 6 weeks (n = 9) after 17-35 months (median 23 months). No recurrent polyps or symptoms were subsequently observed.</p><p><strong>Conclusion: </strong>In case of maximal regression of polyps and discomfort, extension of dupilumab injection intervals to 4 and potentially 6 weeks is possible without clinical worsening. Further studies on de-escalation or termination of biologic treatment when CRSwNP control is achieved are essential.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11192668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-06-21DOI: 10.1007/s00106-024-01497-w
Heidi Olze
{"title":"[Allergology-current status of rhinologic research].","authors":"Heidi Olze","doi":"10.1007/s00106-024-01497-w","DOIUrl":"https://doi.org/10.1007/s00106-024-01497-w","url":null,"abstract":"","PeriodicalId":55052,"journal":{"name":"Hno","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-05-03DOI: 10.1007/s00106-024-01479-y
J Strauss, R Lochbaum, T K Hoffmann, B Mayer, H Appel, J Hahn
Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a multifactorial inflammatory disease, the treatment of which has undergone significant changes in recent years. In addition to surgical approaches, topical and systemic steroids, and adaptive acetylsalicylic acid (ASA) desensitization, three specific antibodies have complemented the therapeutic portfolio since 2019.
Methods: A retrospective evaluation of all patients who presented as outpatients for the first time due to CRSwNP in 2007 and 2008 (collective A) and 2017 and 2018 (collective B) was performed, up to and including June 2023.
Results: The clinical courses of 463 patients (mean age 49.1 years, range 5-82 years; 65.9% male) were included in the analysis. Conservative treatment with nasal corticosteroids started before initial presentation was more frequent in collective B (collective A 43.9% vs. collective B 72.2%). In 278 of the 463 patients (60%; A: 62%, B: 58%), at least one operation on the nasal sinuses had been performed after initial presentation; in 101 of these patients (36.3%) recurrent polyposis (within mean follow-up of 2.4 years) required further treatment. The indication for ASA provocation/desensitization was applied less frequently in collective B, also due to a high discontinuation rate (at least 38%) of the maintenance therapy. Of the total cohort, 16 patients (3.5%; A: n = 8, B: n = 8) were meanwhile switched to antibody therapy at recurrence.
Conclusion: A step-by-step guideline-orientated approach is recommended in the treatment of CRSwNP. Systemic antibodies as an add-on to nasal corticosteroids are a relatively new therapeutic option for treatment-refractory CRSwNP, which reduces the indication for ASA desensitization, which is associated with a relatively high incidence of side effects and poor compliance.
{"title":"[Chronic rhinosinusitis with nasal polyposis : A retrospective analysis of therapeutic approaches in 463 patients].","authors":"J Strauss, R Lochbaum, T K Hoffmann, B Mayer, H Appel, J Hahn","doi":"10.1007/s00106-024-01479-y","DOIUrl":"10.1007/s00106-024-01479-y","url":null,"abstract":"<p><strong>Background: </strong>Chronic rhinosinusitis with nasal polyps (CRSwNP) is a multifactorial inflammatory disease, the treatment of which has undergone significant changes in recent years. In addition to surgical approaches, topical and systemic steroids, and adaptive acetylsalicylic acid (ASA) desensitization, three specific antibodies have complemented the therapeutic portfolio since 2019.</p><p><strong>Methods: </strong>A retrospective evaluation of all patients who presented as outpatients for the first time due to CRSwNP in 2007 and 2008 (collective A) and 2017 and 2018 (collective B) was performed, up to and including June 2023.</p><p><strong>Results: </strong>The clinical courses of 463 patients (mean age 49.1 years, range 5-82 years; 65.9% male) were included in the analysis. Conservative treatment with nasal corticosteroids started before initial presentation was more frequent in collective B (collective A 43.9% vs. collective B 72.2%). In 278 of the 463 patients (60%; A: 62%, B: 58%), at least one operation on the nasal sinuses had been performed after initial presentation; in 101 of these patients (36.3%) recurrent polyposis (within mean follow-up of 2.4 years) required further treatment. The indication for ASA provocation/desensitization was applied less frequently in collective B, also due to a high discontinuation rate (at least 38%) of the maintenance therapy. Of the total cohort, 16 patients (3.5%; A: n = 8, B: n = 8) were meanwhile switched to antibody therapy at recurrence.</p><p><strong>Conclusion: </strong>A step-by-step guideline-orientated approach is recommended in the treatment of CRSwNP. Systemic antibodies as an add-on to nasal corticosteroids are a relatively new therapeutic option for treatment-refractory CRSwNP, which reduces the indication for ASA desensitization, which is associated with a relatively high incidence of side effects and poor compliance.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11192687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-04-29DOI: 10.1007/s00106-024-01473-4
Petra Brueggemann, Georgios Kastellis, Gerhard Hesse, Birgit Mazurek
Chronic tinnitus is a common symptom of the auditory system. A causal therapy does not yet exist. The recommended treatment includes expert counseling, psychotherapeutic interventions, particularly cognitive behavioral therapy, and measures to improve hearing. The treatment modules are multimodal and can be combined individually. Depending on the severity of the different disease dimensions (tinnitus and comorbidities), a rehabilitative approach may be useful for maintaining health and occupational ability. In addition to a thorough and well-founded diagnosis and counseling, specific cognitive behavioral therapy and non-specific psychotherapeutic interventions (mindfulness/relaxation) on an individual or group basis, physiotherapy, and exercise, as well as auditory rehabilitation measures (hearing aids, auditory therapy) in the context of multimodal therapy approaches are necessary.
{"title":"[Rational timepoint of medical rehabilitation in chronic tinnitus : Applying for rehabilitation options for a chronic course].","authors":"Petra Brueggemann, Georgios Kastellis, Gerhard Hesse, Birgit Mazurek","doi":"10.1007/s00106-024-01473-4","DOIUrl":"10.1007/s00106-024-01473-4","url":null,"abstract":"<p><p>Chronic tinnitus is a common symptom of the auditory system. A causal therapy does not yet exist. The recommended treatment includes expert counseling, psychotherapeutic interventions, particularly cognitive behavioral therapy, and measures to improve hearing. The treatment modules are multimodal and can be combined individually. Depending on the severity of the different disease dimensions (tinnitus and comorbidities), a rehabilitative approach may be useful for maintaining health and occupational ability. In addition to a thorough and well-founded diagnosis and counseling, specific cognitive behavioral therapy and non-specific psychotherapeutic interventions (mindfulness/relaxation) on an individual or group basis, physiotherapy, and exercise, as well as auditory rehabilitation measures (hearing aids, auditory therapy) in the context of multimodal therapy approaches are necessary.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140857011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.1007/s00106-024-01496-x
Marie-Nicole Theodoraki, Matthias Brand
Scuba diving and other modes of device-supported diving are popular activities that can be especially demanding and hazardous for people with preexisting physical conditions. Due to the high ambient pressure, the temperature differences, and potential unpredictable events, which have manifold effects on the organism, diving carries a high risk of life-threatening disease. A special risk is present if the body does not readily equalize air pressure changes. Therefore, prior to diving, all divers should undergo detailed education regarding the physical principles of the sport as well as specific physical examination. Consultation of an otolaryngologist is of exceptional relevance because many otorhinolaryngologic diseases can lead to (usually temporary) unfitness to dive. The role of the modern otorhinolaryngologist trained in diving medicine is to correctly advise the patient and restore fitness for diving via conservative or invasive methods.
{"title":"[The otolaryngologist's role in evaluating diving fitness].","authors":"Marie-Nicole Theodoraki, Matthias Brand","doi":"10.1007/s00106-024-01496-x","DOIUrl":"https://doi.org/10.1007/s00106-024-01496-x","url":null,"abstract":"<p><p>Scuba diving and other modes of device-supported diving are popular activities that can be especially demanding and hazardous for people with preexisting physical conditions. Due to the high ambient pressure, the temperature differences, and potential unpredictable events, which have manifold effects on the organism, diving carries a high risk of life-threatening disease. A special risk is present if the body does not readily equalize air pressure changes. Therefore, prior to diving, all divers should undergo detailed education regarding the physical principles of the sport as well as specific physical examination. Consultation of an otolaryngologist is of exceptional relevance because many otorhinolaryngologic diseases can lead to (usually temporary) unfitness to dive. The role of the modern otorhinolaryngologist trained in diving medicine is to correctly advise the patient and restore fitness for diving via conservative or invasive methods.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141478014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-11DOI: 10.1007/s00106-024-01489-w
Cynthia Glaubitz, Rainer Beck, Tim Liebscher, Antje Aschendorff, Kerstin Kreibohm-Strauß, Dominique Kronesser, Yvonne Seebens, Barbara Streicher, Stefanie Kröger
Background: Very early bilateral cochlear implant (CI) provision is today's established standard for children. Therefore, the assessment of preverbal and verbal performance in very early stages of development is becoming increasingly important. Performance data from cohorts of children were evaluated and presented based on diagnostic assessment using chronological age (CA) and hearing age (HA).
Methods: The present study, as part of a retrospective multicentre study, included 4 cohorts (N = 72-233) of children with bilateral CI without additional disabilities. Their results in the German parent questionnaires Elternfragebögen zur Früherkennung von Risikokindern(ELFRA‑1 and ELFRA-2) subdivided for CA and HA were statistically analysed. The data were also analysed in terms of mono-/bilingualism and age at CI provision.
Results: Overall, verbal performance in relation to CA was lower than in relation to HA. Preverbal skills were largely CA appropriate. Children with bi-/multilingual language acquisition performed significantly lower. Verbal performance in ELFRA‑2 referenced to CA was negatively correlated with age at CI provision.
Conclusion: In the case of early CI provision, CA should be the preferred reference mark in preverbal and verbal assessment in order to obtain exact individual performance levels and avoid bias in results. The percentiles determined are of limited use as generally valid reference values to which the individual performance of bilaterally implanted children could be compared. Further multicentre studies should be initiated.
背景:早期双侧人工耳蜗(CI)植入是当今儿童的既定标准。因此,对儿童早期发育阶段的前语言和语言表达能力进行评估变得越来越重要。本研究根据使用实足年龄(CA)和听力年龄(HA)进行的诊断评估,评估并展示了一组儿童的表现数据:本研究是一项回顾性多中心研究的一部分,包括 4 组(N = 72-233)无其他残疾的双侧 CI 儿童。对他们在德国家长问卷 Elternfragebögen zur Früherkennung von Risikokindern(ELFRA-1 和 ELFRA-2)中的结果进行了统计分析。此外,还从单语/双语和提供 CI 的年龄角度对数据进行了分析:总体而言,与 CA 相关的口头表达能力低于与 HA 相关的口头表达能力。前语言技能在很大程度上与 CA 相适应。学习双语/多语的儿童的表现明显较差。ELFRA-2中与CA相关的言语表现与提供CI的年龄呈负相关:结论:在早期使用 CI 的情况下,CA 应作为言前和言语评估的首选参考指标,以获得准确的个人表现水平,避免结果出现偏差。所确定的百分位数作为普遍有效的参考值,在比较双侧植入儿童的个人表现方面作用有限。应进一步开展多中心研究。
{"title":"[Early language performance in the ELFRA questionnaire : Analysis of multicentre data from children with bilateral cochlear implants].","authors":"Cynthia Glaubitz, Rainer Beck, Tim Liebscher, Antje Aschendorff, Kerstin Kreibohm-Strauß, Dominique Kronesser, Yvonne Seebens, Barbara Streicher, Stefanie Kröger","doi":"10.1007/s00106-024-01489-w","DOIUrl":"https://doi.org/10.1007/s00106-024-01489-w","url":null,"abstract":"<p><strong>Background: </strong>Very early bilateral cochlear implant (CI) provision is today's established standard for children. Therefore, the assessment of preverbal and verbal performance in very early stages of development is becoming increasingly important. Performance data from cohorts of children were evaluated and presented based on diagnostic assessment using chronological age (CA) and hearing age (HA).</p><p><strong>Methods: </strong>The present study, as part of a retrospective multicentre study, included 4 cohorts (N = 72-233) of children with bilateral CI without additional disabilities. Their results in the German parent questionnaires Elternfragebögen zur Früherkennung von Risikokindern(ELFRA‑1 and ELFRA-2) subdivided for CA and HA were statistically analysed. The data were also analysed in terms of mono-/bilingualism and age at CI provision.</p><p><strong>Results: </strong>Overall, verbal performance in relation to CA was lower than in relation to HA. Preverbal skills were largely CA appropriate. Children with bi-/multilingual language acquisition performed significantly lower. Verbal performance in ELFRA‑2 referenced to CA was negatively correlated with age at CI provision.</p><p><strong>Conclusion: </strong>In the case of early CI provision, CA should be the preferred reference mark in preverbal and verbal assessment in order to obtain exact individual performance levels and avoid bias in results. The percentiles determined are of limited use as generally valid reference values to which the individual performance of bilaterally implanted children could be compared. Further multicentre studies should be initiated.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141302132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}