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Lein A, Baumgartner WD, Riss D, Gstöttner W, Landegger LD, Liu DT, Thurner T, Vyskocil E, Brkic FF. Early Results With the New Active Bone-Conduction Hearing Implant: A Systematic Review and Meta-Analysis. Otolaryngol Head Neck Surg 2024. [PMID: 38529662 DOI: 10.1002/ohn.728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 12/12/2023] [Accepted: 02/02/2024] [Indexed: 03/27/2024]
Abstract
OBJECTIVE The bone conduction implant (BCI) 602 is a new transcutaneous BCI with smaller dimensions. However, limited patient numbers restrict the statistical power and generalizability of the current studies. The present systematic review and meta-analysis summarize early audiological and medical outcomes of adult and pediatric patients implanted with the BCI 602 due to mixed or conductive hearing loss. DATA SOURCE Following the Preferred Reporting items for Systematic Reviews and Meta-analyses guidelines, 108 studies were reviewed, and 6 (5.6%) were included in the meta-analysis. REVIEW METHOD The data on study and patient characteristics, surgical outcomes, and audiological test results were extracted from each article. Meta-analysis employed the fixed-effect and random-effects models to analyze the mean differences (MDs) between pre- and postoperative performances. RESULTS In total, 116 patients were evaluated, including 64 (55%) adult and 52 (45%) pediatric patients. No intraoperative adverse events were reported, while postoperative complications were reported in 2 (3.1%) adult and 2 (3.8%) pediatric patients. Studies consistently showed significant improvements in audiological outcomes, quality of life, and sound localization in the aided condition. In the meta-analysis, we observed a significant difference in the unaided compared to the aided condition in sound field thresholds (n = 112; MD, -27.05 dB; P < 0.01), signal-to-noise ratio (n = 96; MD, -6.35 dB; P < 0.01), and word recognition scores (n = 96; MD, 68.89%; P < 0.01). CONCLUSION The implantation of the BCI 602 was associated with minimal surgical complications and excellent audiological outcomes for both the pediatric and the adult cohort. Therefore, our analysis indicates a high level of safety and reliability. Further research should focus on direct comparisons with other BCIs and long-term functional outcomes.
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Affiliation(s)
- Alexander Lein
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Wolf-Dieter Baumgartner
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Dominik Riss
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Wolfgang Gstöttner
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Lukas D Landegger
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - David T Liu
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Thomas Thurner
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Erich Vyskocil
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Faris F Brkic
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
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Baumgartner WD, Gstöttner W, Brkic FF. Letter to the Editor regarding "A comparative study of audiological outcomes and compliance between the Osia system and other bone conduction hearing implants" by Kim et al. European Archives of Otorhinolaryngology 2023 May; 280(5):2217-2224. Eur Arch Otorhinolaryngol 2023; 280:5143-5144. [PMID: 37432470 DOI: 10.1007/s00405-023-08116-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 07/03/2023] [Indexed: 07/12/2023]
Affiliation(s)
- Wolf-Dieter Baumgartner
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Wolfgang Gstöttner
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Faris F Brkic
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
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Baumgartner WD, Gstöttner W, Brkic FF. Correction: Letter to the Editor regarding "A comparative study of audiological outcomes and compliance between the Osia system and other bone conduction hearing implants" by Kim et al. European Archives of Otorhinolaryngology 2023 May; 280(5):2217-2224. Eur Arch Otorhinolaryngol 2023; 280:5145. [PMID: 37548706 DOI: 10.1007/s00405-023-08166-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Affiliation(s)
- Wolf-Dieter Baumgartner
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Wolfgang Gstöttner
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Faris F Brkic
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
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Brkic FF, Baumgartner WD, Schlott M, Liu DT, Thurner T, Riss D, Gstöttner W, Vyskocil E. Experience With the New Active Transcutaneous Bone-Conduction Implant With Smaller Dimensions. Otolaryngol Head Neck Surg 2023; 169:615-621. [PMID: 36939484 DOI: 10.1002/ohn.269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/13/2022] [Accepted: 12/29/2022] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Recently, the Bonebridge 602 implant was introduced. Its smaller dimensions facilitate implantation even in surgically demanding cases. However, in extreme anatomical conditions, implant lifts are still required. We intended to report on the medical and audiological outcomes of all patients implanted with the implant with a secondary focus on the safety, efficacy, and feasibility of the use of 1-mm lifts. STUDY DESIGN Retrospective cohort study. SETTING Tertiary academic center. METHODS We retrospectively analyzed all patients implanted with the Bonebridge 602. Patient demographics and surgically-specific data were collected from the medical charts. Furthermore, audiological results were assessed. Outcomes were compared between implantations with versus without lifts. RESULTS Twenty-one devices were implanted during the study period. Satisfactory audiological results were observed, while no intra- or postoperative adverse events occurred. The majority of patients were daily users at the end of the observation period (n = 20/21, 95.2%), and one patient (n = 1/21, 4.8%) was a nonuser after 6 months of use because of subjective dissatisfaction. Due to anatomical considerations, 1-mm lifts were used in 4 implantations (19.0%). The application of lifts did not result in prolonged surgical times, complications, or shorter time of use, nor did it negatively affect audiometric results. CONCLUSION Implantations with the new and smaller Bonebridge were associated with gratifying medical and audiological outcomes. Still, in extreme anatomical conditions, 1-mm lifts are necessary. Nonetheless, surgical placement with the help of lifts seems safe, effective, and feasible, and is a viable option in cases with challenging anatomies due to previous surgeries or anomalies.
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Affiliation(s)
- Faris F Brkic
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Wolf-Dieter Baumgartner
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Melina Schlott
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - David T Liu
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Thomas Thurner
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Dominik Riss
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Wolfgang Gstöttner
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Erich Vyskocil
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
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Auinger AB, Riss D, Baumgartner WD, Arnoldner C, Gstöttner W. Robot-assisted cochlear implant surgery in a patient with partial ossification of the basal cochlear turn: a technical note. Clin Otolaryngol 2022; 47:504-507. [PMID: 35286758 PMCID: PMC9314985 DOI: 10.1111/coa.13930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 01/14/2022] [Accepted: 01/30/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Alice Barbara Auinger
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Dominik Riss
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Wolf-Dieter Baumgartner
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Christoph Arnoldner
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Wolfgang Gstöttner
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
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Kornauth C, Pemovska T, Vladimer GI, Bayer G, Bergmann M, Eder S, Eichner R, Erl M, Esterbauer H, Exner R, Felsleitner-Hauer V, Forte M, Gaiger A, Geissler K, Greinix HT, Gstöttner W, Hacker M, Hartmann BL, Hauswirth AW, Heinemann T, Heintel D, Hoda MA, Hopfinger G, Jaeger U, Kazianka L, Kenner L, Kiesewetter B, Krall N, Krajnik G, Kubicek S, Le T, Lubowitzki S, Mayerhoefer ME, Menschel E, Merkel O, Miura K, Müllauer L, Neumeister P, Noesslinger T, Ocko K, Öhler L, Panny M, Pichler A, Porpaczy E, Prager GW, Raderer M, Ristl R, Ruckser R, Salamon J, Schiefer AI, Schmolke AS, Schwarzinger I, Selzer E, Sillaber C, Skrabs C, Sperr WR, Srndic I, Thalhammer R, Valent P, van der Kouwe E, Vanura K, Vogt S, Waldstein C, Wolf D, Zielinski CC, Zojer N, Simonitsch-Klupp I, Superti-Furga G, Snijder B, Staber PB. Functional Precision Medicine Provides Clinical Benefit in Advanced Aggressive Hematologic Cancers and Identifies Exceptional Responders. Cancer Discov 2022; 12:372-387. [PMID: 34635570 PMCID: PMC9762339 DOI: 10.1158/2159-8290.cd-21-0538] [Citation(s) in RCA: 61] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 07/22/2021] [Accepted: 09/24/2021] [Indexed: 01/07/2023]
Abstract
Personalized medicine aims to match the right drug with the right patient by using specific features of the individual patient's tumor. However, current strategies of personalized therapy matching provide treatment opportunities for less than 10% of patients with cancer. A promising method may be drug profiling of patient biopsy specimens with single-cell resolution to directly quantify drug effects. We prospectively tested an image-based single-cell functional precision medicine (scFPM) approach to guide treatments in 143 patients with advanced aggressive hematologic cancers. Fifty-six patients (39%) were treated according to scFPM results. At a median follow-up of 23.9 months, 30 patients (54%) demonstrated a clinical benefit of more than 1.3-fold enhanced progression-free survival compared with their previous therapy. Twelve patients (40% of responders) experienced exceptional responses lasting three times longer than expected for their respective disease. We conclude that therapy matching by scFPM is clinically feasible and effective in advanced aggressive hematologic cancers. SIGNIFICANCE: This is the first precision medicine trial using a functional assay to instruct n-of-one therapies in oncology. It illustrates that for patients lacking standard therapies, high-content assay-based scFPM can have a significant value in clinical therapy guidance based on functional dependencies of each patient's cancer.See related commentary by Letai, p. 290.This article is highlighted in the In This Issue feature, p. 275.
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Affiliation(s)
- Christoph Kornauth
- Department of Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria
- Comprehensive Cancer Center Vienna, Medical University of Vienna and Vienna General Hospital, Vienna, Austria
| | - Tea Pemovska
- Department of Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Gregory I Vladimer
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
- Exscientia GmbH, Vienna, Austria
| | - Günther Bayer
- Department of Pathology, Medical University of Vienna, Vienna, Austria
| | - Michael Bergmann
- Department of Surgery, Medical University of Vienna, Vienna, Austria
| | - Sandra Eder
- Department of Internal Medicine and Hematology/Oncology, Klinikum Klagenfurt, Klagenfurt, Austria
| | - Ruth Eichner
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Martin Erl
- Abteilung für Innere Medizin, Krankenhaus der Barmherzigen Brüder Salzburg, Salzburg, Austria
| | - Harald Esterbauer
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Ruth Exner
- Department of Surgery, Medical University of Vienna, Vienna, Austria
| | | | - Maurizio Forte
- Department of Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria
| | - Alexander Gaiger
- Department of Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria
- Comprehensive Cancer Center Vienna, Medical University of Vienna and Vienna General Hospital, Vienna, Austria
| | - Klaus Geissler
- Medical School, Sigmund Freud University, Vienna, Austria
| | - Hildegard T Greinix
- Department of Internal Medicine, Division of Hematology, Medical University of Graz, Graz, Austria
| | - Wolfgang Gstöttner
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Marcus Hacker
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | | | - Alexander W Hauswirth
- Department of Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria
| | - Tim Heinemann
- Department of Biology, Institute of Molecular Systems Biology, ETH Zürich, Zürich, Switzerland
| | - Daniel Heintel
- Division of Medicine I, Klinik Ottakring, Vienna, Austria
| | - Mir Alireza Hoda
- Department of Thoracic Surgery, Medical University of Vienna, Vienna, Austria
| | - Georg Hopfinger
- Third Medical Department, Centre for Oncology and Haematology, Klinik Favoriten, Vienna, Austria
| | - Ulrich Jaeger
- Department of Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria
- Comprehensive Cancer Center Vienna, Medical University of Vienna and Vienna General Hospital, Vienna, Austria
| | - Lukas Kazianka
- Department of Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria
| | - Lukas Kenner
- Department of Pathology, Medical University of Vienna, Vienna, Austria
| | - Barbara Kiesewetter
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria
| | - Nikolaus Krall
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
- Exscientia GmbH, Vienna, Austria
| | - Gerhard Krajnik
- Department of Medicine I, Universitätsklinikum St. Pölten, St. Pölten, Austria
| | - Stefan Kubicek
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Trang Le
- Department of Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria
| | - Simone Lubowitzki
- Department of Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria
| | - Marius E Mayerhoefer
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Elisabeth Menschel
- Third Medical Department, Hematology & Oncology, Hanusch Hospital, Vienna, Austria
| | - Olaf Merkel
- Department of Pathology, Medical University of Vienna, Vienna, Austria
| | - Katsuhiro Miura
- Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Leonhard Müllauer
- Department of Pathology, Medical University of Vienna, Vienna, Austria
| | - Peter Neumeister
- Department of Internal Medicine, Division of Hematology, Medical University of Graz, Graz, Austria
| | - Thomas Noesslinger
- Third Medical Department, Hematology & Oncology, Hanusch Hospital, Vienna, Austria
| | - Katharina Ocko
- Pharmacy Department, Vienna General Hospital, Vienna, Austria
| | - Leopold Öhler
- Internal Medicine I, Department of Oncology, St. Josef Hospital, Vienna, Austria
| | - Michael Panny
- Third Medical Department, Hematology & Oncology, Hanusch Hospital, Vienna, Austria
| | - Alexander Pichler
- Department of Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria
| | - Edit Porpaczy
- Department of Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria
| | - Gerald W Prager
- Comprehensive Cancer Center Vienna, Medical University of Vienna and Vienna General Hospital, Vienna, Austria
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria
| | - Markus Raderer
- Comprehensive Cancer Center Vienna, Medical University of Vienna and Vienna General Hospital, Vienna, Austria
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria
| | - Robin Ristl
- Section for Medical Statistics, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | | | - Julius Salamon
- Department of Medicine, Landesklinikum Waidhofen a.d. Ybbs, Waidhofen-Ybbs, Austria
| | - Ana-Iris Schiefer
- Department of Pathology, Medical University of Vienna, Vienna, Austria
| | - Ann-Sofie Schmolke
- Department of Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria
| | - Ilse Schwarzinger
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Edgar Selzer
- Department of Radiation Oncology, Medical University of Vienna, Vienna, Austria
| | - Christian Sillaber
- Department of Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria
| | - Cathrin Skrabs
- Department of Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria
| | - Wolfgang R Sperr
- Department of Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria
- Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria
| | - Ismet Srndic
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Renate Thalhammer
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Peter Valent
- Department of Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria
- Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria
| | - Emiel van der Kouwe
- Department of Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria
| | - Katrina Vanura
- Department of Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria
| | - Stefan Vogt
- Department of Medicine and Oncology, LKH Wiener Neustadt, Wiener Neustadt, Austria
| | - Cora Waldstein
- Department of Radiation Oncology, Medical University of Vienna, Vienna, Austria
| | - Dominik Wolf
- Department of Internal Medicine V, Department of Hematology and Oncology, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Niklas Zojer
- Division of Medicine I, Klinik Ottakring, Vienna, Austria
| | | | - Giulio Superti-Furga
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
- Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Berend Snijder
- Department of Biology, Institute of Molecular Systems Biology, ETH Zürich, Zürich, Switzerland
| | - Philipp B Staber
- Department of Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria.
- Comprehensive Cancer Center Vienna, Medical University of Vienna and Vienna General Hospital, Vienna, Austria
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Brkic FF, Baumgartner WD, Riss D, Thurner T, Liu DT, Gstöttner W, Vyskocil E. Progressive Sensorineural Hearing Loss in Vibrant Soundbridge Users Requiring Cochlear Implantation. J Pers Med 2022; 12:jpm12020191. [PMID: 35207679 PMCID: PMC8878649 DOI: 10.3390/jpm12020191] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 01/22/2022] [Accepted: 01/25/2022] [Indexed: 02/04/2023] Open
Abstract
Less than 20% of patients with sensorineural hearing loss (HL) provided with the Vibrant Soundbridge (VSB) experience a progressive HL and warrant cochlear implantation (CI). The aim of this study was to identify possible predictors of progressive HL prior to VSB implantation. This retrospective study included all consecutive ears with sensorineural HL provided with the VSB between 1998 and 2016. The patient cohort was divided in a study group comprising patients who underwent CI (CI group) after years of VSB usage and those who did not require VSB replacement during the observational time (control group). Pre- and postoperative pure-tone audiometry thresholds were compared among the two groups. Fifteen out of 81 VSB devices (18.5%) required a CI. The CI group had higher preoperative air-conduction (AC) thresholds than the control group (64.3 ± 8.9 dB vs. 56.3 ± 12.9 dB; p = 0.007) at the time of the VSB implantation. On average, the CI group was significantly younger (39.1 ± 12.3 years vs. 52.6 ± 16.2 years; p = 0.003). In conclusion, VSB users with higher preoperative AC thresholds and younger age at the time of VSB implantation might be at risk for progressive HL within the upcoming eight years and need a further CI surgery. Preoperative counseling is particularly advisable in this patient group.
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Brkic FF, Riss D, Arnoldner C, Liepins R, Gstöttner W, Baumgartner WD, Vyskocil E. Safety and Efficacy of Implantation of the Bonebridge Active Transcutaneous Bone-Conduction Device Using Implant Lifts. J Am Acad Audiol 2021; 32:290-294. [PMID: 34062601 DOI: 10.1055/s-0041-1723038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Implant lifts were recently introduced to facilitate implantation of the Bonebridge and to reduce the risk of uncovering the sigmoid sinus and/or dura. PURPOSE The current study analyzed medical, technical, and audiological outcomes of implantation with the Bonebridge implant using lifts. RESEARCH DESIGN This was a retrospective study on all consecutive patients implanted with a bone-conduction hearing implant at a tertiary medical referral center between March 2012 and October 2018. Outcome measures were complications, explantations, and revisions and the mean time of implant use. Audiological results were assessed as well. Outcomes were evaluated for devices implanted with BCI Lifts and compared with those implanted without lifts. RESULTS In the study period, 13 out of a total of 54 implantations were conducted using one or two 1- to 4-mm BCI Lifts. During the follow-up period, two complications occurred and both in patients implanted without lifts (2/41; 4.9%). All patients in the lifts group were using the implant at the end of observation period. No statistically significant difference was observed in functional hearing gain or word-recognition improvement at 65 dB between two groups. CONCLUSIONS The use of BCI Lifts in Bonebridge implantations was not associated with adverse events during the observation period. The clinical follow-up revealed no complications in implantations requiring lifts. Furthermore, the functional hearing gain and the word-recognition improvement did not differ from those of devices implanted without lifts. Data indicate safety and efficacy for Bonebridge implantations using lifts.
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Affiliation(s)
- Faris F Brkic
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Dominik Riss
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Christoph Arnoldner
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Rudolfs Liepins
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Wolfgang Gstöttner
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Wolf-Dieter Baumgartner
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Erich Vyskocil
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
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Berger M, Bastl K, Bastl M, Dirr L, Hutter HP, Moshammer H, Gstöttner W. Impact of air pollution on symptom severity during the birch, grass and ragweed pollen period in Vienna, Austria: Importance of O 3 in 2010-2018. Environ Pollut 2020; 263:114526. [PMID: 32283467 DOI: 10.1016/j.envpol.2020.114526] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 04/01/2020] [Accepted: 04/01/2020] [Indexed: 06/11/2023]
Abstract
Air pollution is a threat to the general population, especially to pollen allergy sufferers in urban environments. Different air quality parameters have hitherto been examined which add to the burden of pollen allergy sufferers. Parameters such as NO2, SO2, PM10, PM2.5, and O3 are supposed to have additional impact, not only on health in general (increase in asthma, allergy sensitization frequency), but also on pollen grains (increase of allergenicity). However, it remains unknown if those air quality parameters increase symptom severity during the pollen season. We selected the birch, grass, and ragweed pollen seasons as different time periods throughout the year and analyzed the relationship of symptom data to pollen, air quality, and meteorological data (temperature, relative humidity) for the metropolis of Vienna (Austria). A linear regression model was computed based on different symptom data, and both pollen and air quality data were tested simultaneously. Ozone was positively and significantly associated with symptom scores in all three seasons, whereas this was only rarely the case with other pollutants. Therefore, only ozone was selected for further analysis in a model including meteorological parameters. In this model, effect estimates of ozone were attenuated but remained significant for the grass pollen season. The lack of significance in the other seasons may be attributed to the less numerous symptom data entries and the shorter duration of the pollen seasons for birch and ragweed. All other air quality parameters usually showed lower concentrations during the pollen seasons and displayed little variation. This might explain the lack of a clear signal. Our results suggest that today's allergic population is already affected by air quality (rising O3 levels). Air quality should be considered as well in pollen information and pollen allergy studies in general because of its increasing importance in the light of global warming.
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Affiliation(s)
- Markus Berger
- Paracelsus Medizinische Privatuniversität, Strubergasse 21, 5020 Salzburg, Austria; Research Group Aerobiology and Pollen Information, Department of Oto-Rhino-Laryngology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
| | - Katharina Bastl
- Research Group Aerobiology and Pollen Information, Department of Oto-Rhino-Laryngology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
| | - Maximilian Bastl
- Research Group Aerobiology and Pollen Information, Department of Oto-Rhino-Laryngology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
| | - Lukas Dirr
- Research Group Aerobiology and Pollen Information, Department of Oto-Rhino-Laryngology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
| | - Hans-Peter Hutter
- Department of Environmental Health, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria.
| | - Hanns Moshammer
- Department of Environmental Health, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria.
| | - Wolfgang Gstöttner
- Research Group Aerobiology and Pollen Information, Department of Oto-Rhino-Laryngology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
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10
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Van de Heyning P, Atlas M, Baumgartner WD, Caversaccio M, Gavilan J, Godey B, Gstöttner W, Hagen R, Yongxin L, Karltorp E, Kameswaran M, Kuzovkov V, Lassaletta L, Manoj M, Parnes L, Pillsbury H, Raine C, Rajan G, Schmutzhard J, Skarzynski H, Staecker H, Usami SI, Zernotti M. The reliability of hearing implants: report on the type and incidence of cochlear implant failures. Cochlear Implants Int 2020; 21:228-237. [PMID: 32156201 DOI: 10.1080/14670100.2020.1735678] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objectives: This study presents the data collected through a database on the type and incidence of cochlear implant device failures and major complications and quantifies the risk of failures across time based on the Association for the Advancement of Medical Instrumentation (AAMI) CI86:2017 standard. Methods: Information on reliability of MED-EL cochlear implants was collected from the MED-EL complaint database between 2003 and2013. Explants were categorized and device reliability was calculated according to the AAMI CI86:2017 standard principles. Results: Data were collected for 11662 devices (5462 children, 6200 adults). The mean duration of follow up was 46.16 months. The total failure rate for all devices and all subjects was 2.41%. Medical related explants (MRE) were significantly worse for children than for adults with the ceramic implants, C40+ (p = 0.008) and PULSAR (p = 0.020). Device failure explants (DFE) were significantly worse for children than for adults with all four devices in the study, the C40+ (p < 0.001), PULSAR (p < 0.001), SONATA (p < 0.001), and CONCERTO (p = 0.023). The mean annual failure rate for all subjects and devices was 0.63% (1.03% for children, 0.28% for adults). The mean annual failure rate was 0.90% for the C40+; 0.57% for the PULSAR; 0.46% for the SONATA; and 0.39% for the CONCERTO. Conclusions: Compared to adults, children had significantly worse MRE and DFE due to a higher risk of head trauma and more vulnerable skull anatomy. Further, the authors conclude that the AAMI standard will ensure a more comprehensive and transparent evaluation of cochlear implant reliability in the future.
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Affiliation(s)
| | - Marcus Atlas
- Ear Science Centre, School of Surgery, The University of Western Australia, Nedlands, Australia.,Ear Science Institute Australia Implant Centre, Subiaco, Australia
| | - Wolf-Dieter Baumgartner
- Medizinische Universität Wien, Universitätsklinik für Hals-, Nasen- und Ohrenkrankheiten, Vienna, Austria
| | - Marco Caversaccio
- Universitätsklinik für HNO, Kopf- und Halschirurgie, Inselspital Bern, Bern, Switzerland
| | - Javier Gavilan
- Hospital Universitario La Paz, Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Benoit Godey
- Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - Wolfgang Gstöttner
- Medizinische Universität Wien, Universitätsklinik für Hals-, Nasen- und Ohrenkrankheiten, Vienna, Austria
| | - Rudolph Hagen
- Klinik und Poliklinik für Hals-, Nasen und Ohren- Krankheiten, Universität Würzburg, Würzburg, Germany
| | - Li Yongxin
- Capital Medical University, Beijing Tongren Hospital, Beijing, People's Republic of China
| | - Eva Karltorp
- Karolinska University Hospital, Karolinska vägen, 171 76 Solna, Sweden
| | - Mohan Kameswaran
- Madras ENT Research Foundation (MERF), No-1, 1st Cross Street, Off. II Main Road, Raja Annamalai Puram Chennai, Tamil Nadu 600028, India
| | - Vlad Kuzovkov
- St. Petersburg ENT and Speech Research Institute, St. Petersburg, Russia
| | - Luis Lassaletta
- Hospital Universitario La Paz, Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Manikoth Manoj
- ENT Super Speciality Institute and Research Center, East Hill, Kozhikode, Kerala 673005, India
| | | | - Harold Pillsbury
- UNC Ear & Hearing Center at Chapel Hill School of Medicine, 170 Manning Dr #7070 Chapel Hill, NC 27514, USA
| | | | - Gunesh Rajan
- Otolaryngology, Head & Neck Surgery Unit, School of Surgery, University of Western Australia, Fremantle Hospital, Fremantle, Australia
| | - Joachim Schmutzhard
- Universitätsklinik für Hals- Nasen- Ohrenheilkunde Innsbruck, Innsbruck, Austria
| | - Henryk Skarzynski
- Institute of Physiology and Pathology of Hearing, Warsaw, Poland.,World Hearing Center, Nadarzyn, Poland.,Institute of Sensory Organs, Nadarzyn, Poland
| | - Hinrich Staecker
- Kansas University Center for Hearing and Balance Disorders, 3901 Rainbow Blvd, Kansas City, KS 66160, USA
| | - Shin-Ichi Usami
- Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
| | - Mario Zernotti
- Instituto de ORL, Av Ambrosio Olmos 754, Córdoba, Argentina
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11
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Kadletz L, Taucher K, Janik S, Grasl S, Grasl MC, Gstöttner W, Erovic BM. Cross-sectional study on the occurrence of Frey's syndrome following superficial parotidectomy or extracapsular dissection. J Craniomaxillofac Surg 2020; 48:199-202. [PMID: 32033873 DOI: 10.1016/j.jcms.2020.01.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 11/13/2019] [Accepted: 01/06/2020] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Most studies that examine postoperative outcomes after parotidectomy in patients with benign parotid gland tumors are based on retrospective chart reviews. Data about long-term results in patients with parotid gland surgery with patient contact are still sparsely published. METHODS During the period of 1960-2005, a total of 127 patients underwent either extracapsular dissection (ECD) or superficial parotidectomy (SP) and were available for interview. Patients were questioned about their postoperative outcome after parotid gland surgery. RESULTS The mean follow-up was 21.5 years. A total of 42 and 85 patients underwent ECD and SP, respectively. No significant differences were observed in the rates of permanent facial paralysis (SP 1.2% vs. ECD 7.1%; p = 0.1053) or recurrence (SP 4.7% vs. ECD 11.9%; p = 0.1557), and Frey's syndrome was diagnosed only after SP (10.6% vs. 0% after ECD, p = 0.0293). Frey's syndrome was detected more often compared to retrospective chart analysis. CONCLUSION We conclude that Frey's syndrome is underdiagnosed after SP without standardized follow-up examinations. Long-term follow-up should be applied to detect and treat gustatory sweating.
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Affiliation(s)
- Lorenz Kadletz
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Vienna, Austria.
| | - Klaus Taucher
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Stefan Janik
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Stefan Grasl
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Matthäus C Grasl
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Wolfgang Gstöttner
- Department of Otorhinolaryngology and Head and Neck Surgery, Medical University of Vienna, Vienna, Austria
| | - Boban M Erovic
- Institute of Head and Neck Surgery, Evangelical Hospital, Vienna, Austria.
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12
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Brkic FF, Riss D, Scheuba K, Arnoldner C, Gstöttner W, Baumgartner WD, Vyskocil E. Medical, Technical and Audiological Outcomes of Hearing Rehabilitation with the Bonebridge Transcutaneous Bone-Conduction Implant: A Single-Center Experience. J Clin Med 2019; 8:jcm8101614. [PMID: 31623414 PMCID: PMC6832994 DOI: 10.3390/jcm8101614] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 09/25/2019] [Accepted: 09/29/2019] [Indexed: 12/05/2022] Open
Abstract
Bone-conduction implants are a standard therapeutic option for patients with conductive, unilateral, or mixed hearing loss who either do not tolerate conventional hearing aids or can benefit from surgery. The aim of this study was to evaluate long-term medical and technical outcomes, and audiological results with the Bonebridge transcutaneous bone-conduction implant. This retrospective study included all patients implanted with a bone-conduction hearing implant at a tertiary medical referral center between March 2012 and October 2018. Medical and technical outcomes included the mean length of implant usage, medical and technical complications (skin and wound infection, lack of benefit, technical failure), explantations and revisions, coupling approaches, implant failure rate, implant survival and the implant loss for added follow-up years. Auditory results were measured by functional hearing gain and the Freiburger monosyllabic test at 65 dB sound pressure level. Sixty-four patients were included in the study; five of these were implanted bilaterally (69 devices). Five unilaterally implanted patients were lost to follow-up. The mean follow-up was 27.1 months (range: 0.2 months–6.3 years). The mean implant usage was 25.9 months (range: 0.2 months–6.3 years). Fifty-seven implants (89.1%) were in use at the end of the follow-up period. Complications occurred in six ears (9.4%). Five implants (7.8%) were explanted without reimplantation. Device failure occurred in one implant (1.6%), which was possibly caused by recurrent head trauma. The rate of implant loss due to technical device failure (damage to device) was 1 per 72 follow-up years. The mean improvement on the Freiburger monosyllabic test (52.1%, p = 0.0001), and in functional hearing gain across frequencies (26.5 dB, p = 0.0001) was significant. This single-center follow-up reveals the medical and technical reliability of a transcutaneous bone-conduction implant for hearing rehabilitation because complication and revision rates were low. The majority of patients still used the device at the end of the observation period. Implantation resulted in favorable hearing outcomes in comparison to that of unaided conditions. Cautious patient selection mainly regarding co-morbidities, the history of chronic otologic diseases and proper surgical technique seems to be crucial in reducing complications.
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Affiliation(s)
- Faris F Brkic
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
| | - Dominik Riss
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
| | - Katharina Scheuba
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
| | - Christoph Arnoldner
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
| | - Wolfgang Gstöttner
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
| | - Wolf-Dieter Baumgartner
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
| | - Erich Vyskocil
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
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13
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van de Heyning P, Arauz SL, Atlas M, Baumgartner WD, Caversaccio M, Chester-Browne R, Estienne P, Gavilan J, Godey B, Gstöttner W, Han D, Hagen R, Kompis M, Kuzovkov V, Lassaletta L, Lefevre F, Li Y, Müller J, Parnes L, Kleine Punte A, Raine C, Rajan G, Rivas A, Rivas JA, Royle N, Sprinzl G, Stephan K, Walkowiak A, Yanov Y, Zimmermann K, Zorowka P, Skarzynski H. Electrically evoked compound action potentials are different depending on the site of cochlear stimulation. Cochlear Implants Int 2016; 17:251-262. [DOI: 10.1080/14670100.2016.1240427] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | | | - Marcus Atlas
- Ear Science Centre, School of Surgery, The University of Western Australia, Nedlands, Australia
- Ear Science Institute Australia Implant Centre, Subiaco, Australia
| | - Wolf-Dieter Baumgartner
- Medizinische Universität Wien, Universitätsklinik für Hals-, Nasen- und Ohrenkrankheiten, Vienna, Austria
| | - Marco Caversaccio
- Universitätsklinik für HNO, Kopf- und Halschirurgie, Inselspital Bern, Bern, Switzerland
| | - Ronel Chester-Browne
- Ear Science Centre, School of Surgery, The University of Western Australia, Nedlands, Australia
- Ear Science Institute Australia Implant Centre, Subiaco, Australia
| | | | - Javier Gavilan
- Hospital Universitario La Paz, Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Benoit Godey
- Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - Wolfgang Gstöttner
- Medizinische Universität Wien, Universitätsklinik für Hals-, Nasen- und Ohrenkrankheiten, Vienna, Austria
| | - Demin Han
- Capital Medical University, Beijing Tongren Hospital, Beijing, China
| | - Rudolph Hagen
- Klinik und Poliklinik für Hals-, Nasen und Ohren- Krankheiten, Universität Würzburg, Würzburg, Germany
| | - Martin Kompis
- Universitätsklinik für HNO, Kopf- und Halschirurgie, Inselspital Bern, Bern, Switzerland
| | - Vlad Kuzovkov
- St. Petersburg ENT and Speech Research Institute, St. Petersburg, Russia
| | - Luis Lassaletta
- Hospital Universitario La Paz, Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Franc Lefevre
- Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - Yongxin Li
- Capital Medical University, Beijing Tongren Hospital, Beijing, China
| | - Joachim Müller
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Klinikum der Universität München, München, Germany
| | | | | | | | - Gunesh Rajan
- Otolaryngology, Head & Neck Surgery Unit, School of Surgery, University of Western Australia, Fremantle Hospital, Fremantle, Australia
| | - Adriana Rivas
- Clinica Rivas, Centro Medico Otologico, Bogota, Colombia
| | | | - Nicola Royle
- Bradford Royal Infirmary, Bradford, United Kingdom
| | - Georg Sprinzl
- Universitätsklinik für Hals- Nasen- Ohrenheilkunde Innsbruck, Innsbruck, Austria
| | - Kurt Stephan
- Universitätsklinik für Hör-, Stimm- und Sprachstörungen Innsbruck, Innsbruck, Austria
| | - Adam Walkowiak
- Institute of Physiology and Pathology of Hearing, Warsaw, Poland
- World Hearing Center, Nadarzyn, Poland
- Institute of Sensory Organs, Nadarzyn, Poland
| | - Yuri Yanov
- St. Petersburg ENT and Speech Research Institute, St. Petersburg, Russia
| | | | - Patrick Zorowka
- Universitätsklinik für Hör-, Stimm- und Sprachstörungen Innsbruck, Innsbruck, Austria
| | - Henryk Skarzynski
- Institute of Physiology and Pathology of Hearing, Warsaw, Poland
- World Hearing Center, Nadarzyn, Poland
- Institute of Sensory Organs, Nadarzyn, Poland
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14
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Wagenblast J, Adunka O, Gstöttner W, Arnoldner C, Riedl N, Diensthuber M, Stöver T, Hambek M. AdOnco database - six years' experience with the documentation of clinical and scientific data on patients with head and neck cancer. In Vivo 2010; 24:603-606. [PMID: 20668332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
PURPOSE To report the experience with AdOnco, a computerized database for head and neck cancer patients. PATIENTS AND METHODS AdOnco is a Filemaker Pro 6.0 based database integrated into the local network of the host ENT department. It is used by the physicians as a clinical and scientific documentation system to store and retrieve information about all patients with head and neck cancer referred to the host oncology center. This study reviews the achievements to date of AdOnco and, as an example of its enormous data evaluation potential, presents survival curves of patients with laryngeal cancer undergoing laser resection. RESULTS Over a period of six years, the data of 881 patients with head and neck cancer were entered into the AdOnco database. CONCLUSION AdOnco has proven to be a useful patient database and documentation system which has become an integral and essential part of daily clinical routine and also a valuable research tool.
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Affiliation(s)
- Jens Wagenblast
- ENT Department, Goethe University Medical School, Frankfurt am Main, Germany.
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15
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Wagenblast J, Arnoldner C, Gstöttner W, Bisdas S, Mörtel S, May A, Hambek M. Does dexamethasone inhibit the antineoplastic effect of cisplatin and docetaxel in head and neck cancer cells? Anticancer Res 2010; 30:123-127. [PMID: 20150626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND/AIM Comedication with glucocorticoids such as dexamethasone is frequently given to head and neck cancer patients treated with chemotherapy. However, an increasing body of evidence suggests that dexamethasone may induce resistance to antineoplastic agents. The present study was the first to investigate the effect of dexamethasone on the antiproliferative activity of cisplatin and docetaxel in vitro in squamous cell carcinoma of the head and neck (SCCHN) cell lines. MATERIALS AND METHODS The cytotoxic effect of cisplatin and docetaxel on eight SCCHN cell lines was determined for each drug alone or with increasing concentrations of dexamethasone. Cell growth inhibition and viability were measured quantitatively after 24, 48, 72 hours of treatment using water-soluble-tetrazolium-test and lactate dehydrogenase assays. Absolute tumor cell numbers were determined by cell counting in a Rosenthal chamber. RESULTS Cisplatin and docetaxel alone inhibited the growth of all eight SCCHN cell lines significantly (p=0.012). The antiproliferative activity of both agents was not decreased by the addition of dexamethasone in any of the cell lines (p>0.05). CONCLUSION Dexamethasone does not interfere with the cytotoxic action of cisplatin or docetaxel in the investigated SCCHN cell lines.
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Affiliation(s)
- Jens Wagenblast
- ENT Department, University Hospital, Theodor-Stern-Kai 7, 60590 Frankfurt/Main, Germany.
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16
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Bredberg G, Lindström B, Baumgartner WD, Farhadi M, Goldberg T, Gstöttner W, Pillsbury H, Skarzynski H, Sorri M, Heyning PVD, Zaghis A, Graham J, Williams G, D'Haese P. Open-set speech perception in adult cochlear implant users with ossified cochleae. Cochlear Implants Int 2009; 4:55-72. [PMID: 18792138 DOI: 10.1179/cim.2003.4.2.55] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
This study describes open-set speech recognition in cochlear implant subjects with ossified cochleae and compares it to a control group with open cochleae. Twenty-one postlingually deafened adults with a Med-El Combi 40/40+GB split- electrode implant were matched to patients using a Med-El cochlear implant with a standard electrode. Speech recognition was assessed over an 18-month period. Split- electrode patients improved significantly over time, but their scores were significantly lower and increased significantly slower than those of controls. Of 14 patients with a duration of deafness less than 20 years, average sentence test scores were 50%, and average monosyllabic word test scores were 31%. This study provides evidence that cochlear implantation is beneficial to patients with ossified cochleae, but early implantation is advisable.
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Affiliation(s)
- G Bredberg
- Cochlear Implant Clinic M43, Huddinge University Hospital, Stockholm, Sweden.
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17
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Wagenblast J, Baghi M, Arnoldner C, Bisdas S, Gstöttner W, May A, Knecht R, Hambek M. Effects of combination treatment of bortezomib and dexamethasone in SCCHN cell lines depend on tumor cell specificity. Oncol Rep 2008; 20:1207-1211. [PMID: 18949423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
Bortezomib has recently become the new treatment standard for relapsed or refractory multiple myeloma. We previously demonstrated that bortezomib also had a significant growth-inhibiting and apoptotic effect on squamous cell carcinoma of the head and neck (SCCHN) cells in vitro. Preclinical evidence has provided a rationale for combining bortezomib with dexamethasone in multiple myeloma, suggesting that the therapeutic effects of the two agents might be additive. These findings are in contrast with the results achieved in solid tumor models where the addition of dexamethasone reduced the efficacy of other antineoplastic drugs. In the present study, we investigated the effect of dexamethasone in combination with bortezomib in SCCHN cell lines for the first time. The antiproliferative effect of bortezomib alone or in combination with increasing concentrations of dexamethasone was investigated in four SCCHN cell lines. Cell growth inhibition and viability were measured quantitatively using WST and LDH assays. Bortezomib alone inhibited the growth of all four SCCHN cell lines significantly (p<0.047). The addition of dexamethasone leads to a clear tumor cell decline and showed a trend in enhancing the growth-inhibitory effect of bortezomib although the difference failed to reach statistical significance (p>0.05). Our first results show that dexamethasone increased the cytotoxic activity of bortezomib in most SCCHN cell lines investigated. These findings might be dependent on molecular factors such as the degree of tumor cell differentiation and proliferation rate. Therefore, further studies will be required to elucidate these molecular factors to substantiate our findings from a cancer biological point of view.
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Affiliation(s)
- Jens Wagenblast
- ENT Department, Goethe University Medical School, Frankfurt am Main, Germany.
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18
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Wagenblast J, Baghi M, Helbig M, Arnoldner C, Bisdas S, Gstöttner W, Hambek M, May A. Craniofacial reconstructions with bone-anchored epithesis in head and neck cancer patients--a valid way back to self-perception and social reintegration. Anticancer Res 2008; 28:2349-2352. [PMID: 18751417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND Patients with advanced head and neck cancer often require radical and mutilating surgery resulting in severe impairment of their aesthetic self-perception and social life. Cosmetically satisfying results associated with high aesthetic self-perception and social reintegration are possible with bone-anchored epithesis representing a serious alternative to craniofacial reconstructive techniques using regional and free tissue transfer. PATIENTS AND METHODS Five head and neck cancer patients treated in our Ear, Nose and Throat Department in the years 2003-2004 were evaluated after epithesial reconstruction. RESULTS Three out of the five patients scored self-perception after epithesial reconstruction as "very good", while social integration was scored as "very good" by three and as "satisfactory" by two patients. Daily getting along was scored as "very good" by four and as satisfactory by one patient. One patient had a very good acceptance of the epithesis as a part of the body and for four patients it was satisfactory. CONCLUSION For the first time, the high degree of satisfaction in head and neck cancer patients receiving epithesial reconstruction in the maxillofacial region is demonstrated.
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Affiliation(s)
- Jens Wagenblast
- Department of ENT-Surgery, Medical School, Goethe University, 60590 Frankfurt am Main, Germany.
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19
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Wagenblast J, Baghi M, Arnoldner C, Bisdas S, Gstöttner W, Ackermann H, May A, Knecht R, Hambek M. Effect of bortezomib and cetuximab in EGF-stimulated HNSCC. Anticancer Res 2008; 28:2239-2243. [PMID: 18751401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND Proteasome inhibition has been shown to be effective in multiple myeloma and solid tumor models. In this in vitro study, the antitumor effect of bortezomib (Velcade) in combination with cetuximab was investigated in epidermal growth factor (EGF)-stimulated head and neck squamous cell carcinoma cell lines (HNSCC). MATERIALS AND METHODS Dose escalation studies were performed with five EGF-stimulated squamous cell carcinoma cell lines using bortezomib alone or in combination with cetuximab. Growth inhibitory and cell decline effects were measured quantitatively using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazoliumbromide (MTT) and lactate dehydrogenase (LDH) assay. RESULTS Bortezomib alone showed no significant antiproliferative activity in any EGF-stimulated HNSCC cell line (p > 0.05), whereas the combination of bortezomib and cetuximab had highly significant antitumoral activity (p < 0.043). CONCLUSION Our results indicate that cetuximab increases the cytotoxic activity of bortezomib in EGF-stimulated HNSCC cell lines. A combination treatment of HNSCC with bortezomib and cetuximab may allow a therapeutical regimen to be developed that is less toxic than the conventional drugs used for these tumors.
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Affiliation(s)
- Jens Wagenblast
- ENT Department, Medical School, Goethe University, 60590 Frankfurt am Main, Germany.
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20
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Abstract
Megadolichobasilar anomaly, a dilatant arteriopathy of the basilar artery attributable to chronic arterial hypertension, can cause cranial nerve compression syndromes of the cerebellopontine angle or infarcts of the vertebrobasilar circulation. In this paper, we report on a patient with known megadolichobasilar anomaly and a partially thrombosed fusiform aneurysm of the basilar artery, who presented with acute-onset vertigo and subsequent deafness due to thromboembolic occlusion of the labyrinthine artery. Because of the vascular origin of the patient's symptoms, his vertigo disappeared over time while the deafness persisted.
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Affiliation(s)
- M H Unkelbach
- Zentrum der Hals-Nasen-Ohrenheilkunde, Klinikum der Johann-Wolfgang-Goethe-Universität Frankfurt am Main, -, Deutschland.
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Wagenblast J, Hambek M, Baghi M, Gstöttner W, Strebhardt K, Ackermann H, Knecht R. Antiproliferative activity of bortezomib alone and in combination with cisplatin or docetaxel in head and neck squamous cell carcinoma cell lines. J Cancer Res Clin Oncol 2007; 134:323-30. [PMID: 17701215 DOI: 10.1007/s00432-007-0287-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2007] [Accepted: 07/17/2007] [Indexed: 10/23/2022]
Abstract
PURPOSE Proteasome inhibition has been shown to be effective in multiple myeloma and solid tumor models. In this in vitro study, we investigated the antitumor effect of bortezomib (Velcade((R))) in squamous cell carcinoma of the head and neck (SCCHN) cell lines and examined the interaction of the drug with docetaxel (TAX) and cisplatin (CDDP). METHODS Dose escalation studies were performed with eight squamous cell carcinoma cell lines using bortezomib alone or in combination with TAX or CDDP. Growth inhibitory and proapoptotic effects were measured quantitatively using cytohistology and western blot analysis. RESULTS Bortezomib alone showed a significant antiproliferative activity in all SCCHN cell lines (P = 0.012), and the activity was further enhanced by the addition of TAX or CDDP (P </= 0.036). When the combination of bortezomib and CDDP was used, the dose of the latter could be reduced to yield the same antiproliferative effect as the cytotoxic drug alone (P < 0.012). CONCLUSIONS Our results indicate that bortezomib increases the cytotoxic activity of TAX and CDDP in SCCHN cell lines. In vivo and in the clinical setting, the addition of bortezomib may allow to reduce the doses of TAX or CDDP to decrease the systemic toxicity of these drugs.
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Affiliation(s)
- Jens Wagenblast
- ENT Department, Medical School, Goethe University, Frankfurt am Main, Germany
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22
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Hambek M, Werner C, Baghi M, Gstöttner W, Knecht R. Enhancement of docetaxel efficacy in head and neck cancer treatment by G0 cell stimulation. Eur J Cancer 2007; 43:1502-7. [PMID: 17524637 DOI: 10.1016/j.ejca.2005.09.037] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2005] [Accepted: 09/02/2005] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Docetaxel has recently taken part in new chemotherapy regimens with promising activity especially in the first line therapy (induction chemotherapy) of head and neck cancer (SCCHN). Nevertheless a major problem concerning the response of SCCHN to chemotherapy is the high percentage of resting cells (G0-phase cells) being resistant to chemotherapy. To overcome this phenomenon we have investigated the capacity of several cytokines to switch on cells into division cycle and progress to the chemosensitive phases (S, M-phase). METHODS Il-6, Serotonin, G-CSF and EGF were used to stimulate G0-phase squamous cell cancer cells (Detroit 562, A431, UM-SCC 10B) for reentry in the cell cycle to enhance the response to docetaxel. The proportion of G0-phase cells was detected through multicolor FACS analysis and Ki67 staining. RESULTS Cell cycle reentering was most effective after combination treatment with Serotonin+EGF. The proportion of G0 phase cells was significantly reduced after stimulation with Serotonin+EGF (p<0.05). Corresponding to cell cycle reentry the cytotoxic effect of docetaxel was significantly (p<0.04) enhanced in the prestimulated cells compared to the control (docetaxel monotreatment). CONCLUSIONS Our investigations demonstrate for the first time that sensitizing G0 phase squamous cell carcinoma cells for docetaxel treatment is possible by prestimulation with target cytokines. Considering that up to 95% of tumor cells are in the resting (G0) phase of the cell cycle at the initiation of chemotherapy, prestimulation with EGF and serotonin could contribute to a synchronization of cancer cells. This would clearly enhance the cytotoxic effect.
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Affiliation(s)
- Markus Hambek
- ENT-Center, University Clinic Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt / Main, Germany.
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23
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Helbig M, Helbig S, Knecht R, Kahla-Witzsch HA, Gstöttner W. [Quality management: reduced waiting time and enhanced efficiency in a university ear, nose, and throat outpatient department]. HNO 2007; 55:29-35. [PMID: 16622694 DOI: 10.1007/s00106-006-1400-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The introduction of Diagnosis-Related Groups, which standardize payment for each clinical service, entails keeping the inpatient treatment as short as possible. Thus outpatient treatment is gaining in importance. To cope with this change, organizational and structural modifications of clinic routine are necessary. METHODS In the ear, nose, and throat outpatient clinic of Johann Wolfgang Goethe University in Frankfurt, Germany, a hotline was established that allows patients to make appointments and get advice based on quality management guidelines according to DIN EN ISO 9001:2000. The development of this project is described here step by step, from planning to inclusion in the daily clinic routine. RESULTS Patient visits became more effective despite increasing demand. This resulted in high satisfaction of patients and clinic personnel alike. CONCLUSION This model may contribute considerably to coping with the increasing demand for clinic appointments and to optimal use of a clinic's human resources.
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Affiliation(s)
- M Helbig
- Zentrum für HNO-Heilkunde des Universitätsklinikums Frankfurt/Main, Theodor-Stern-Kai 7, 60590, Frankfurt/Main.
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24
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Helbig M, Kahla-Witzsch HA, Helbig S, Knecht R, Gstöttner W. [Quality assessment according to DIN EN ISO 9001:2000: certification in a university ENT department]. HNO 2007; 54:922-8. [PMID: 17041776 DOI: 10.1007/s00106-006-1467-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND In 2003, our department inaugurated a quality management system. The certification according to DIN EN ISO 9001:2000 as required by the hospital management was achieved in August 2005. The aims were optimization of internal operating schedules and standardization of procedures according to logistic interfaces with external structures. METHODS Since 2000, the implementation of an internal quality management system is required by German law and threatened by penalty in case of non-implementation. Beside a basic audit and optimization of all organizational procedures, all core processes were determined and the approvals checked. These aims involve both the quality of operational procedures, in and outpatient treatment, research, study and teaching and aspects of service such as quickness of scheduling and forwarding of reports as well as economic aspects and efficiency. The department of "quality management", whose main tasks are the professional guidance and the training of the quality management representatives, plays an important role. RESULTS Realization of the new regulations and restructuring resulted in an increase in effectiveness and an improvement in operational procedures. In particular, patients and staff have benefited from the reorganized and modified sequence of operations. CONCLUSION Implementation of a quality management system in different hospital departments is recommended.
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Affiliation(s)
- M Helbig
- Zentrum für Hals-Nasen-Ohren-Heilkunde des Klinikums der Johann-Wolfgang-Goethe-Universität, Theodor-Stern-Kai 7, 60590 , Frankfurt/Main, Deutschland.
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25
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Baumgartner WD, Jappel A, Morera C, Gstöttner W, Müller J, Kiefer J, Van De Heyning P, Anderson I, Nielsen SB. Outcomes in adults implanted with the FLEXsoft electrode. Acta Otolaryngol 2007; 127:579-86. [PMID: 17503226 DOI: 10.1080/00016480600987784] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
CONCLUSION Achieving deep insertions, as well as good speech perception results, the FLEXsoft electrode array allows for some preservation in subjects with measurable low frequency hearing, even after a period of time. This opens the door for future research in electrode design, hearing preservation research and drug delivery systems. OBJECTIVES The FLEXsoft electrode is designed to be atraumatic to the structures of the cochlea during deep insertion of a cochlear implant electrode. This paper reports on the surgical and functional outcomes in implantations with the FLEXsoft electrode array. PATIENTS AND METHODS Twenty-three adult subjects received a FLEXsoft electrode array and were assessed on speech perception tests (monosyllables, sentences in quiet and in noise), a subjective questionnaire (Nijmegen Cochlear Implant Questionnaire) and a pure-tone audiogram. Results at 1, 3, 6 and 12 months post first fitting were compared to scores from the preoperative interval. RESULTS Surgery was uneventful in all cases, the surgical handling was satisfactory and correct position of the electrode was achieved in all cases. Hearing could be preserved (as determined by the audiogram) in half of the subjects who had measurable audiograms preoperatively at the 1 month test interval, and in a quarter of subjects after 12 months of device use, despite deep insertion of the electrode. Speech perception scores showed significant improvement over time, as did quality of life scores, and were comparable to results with the standard electrode array as used in the COMBI 40+ and PULSARCI100.
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Kiefer J, Ye Q, Tillein J, Adunka O, Arnold W, Gstöttner W. Protecting the cochlea during stapes surgery: is there a role for corticosteroids? Adv Otorhinolaryngol 2007; 65:300-307. [PMID: 17245062 DOI: 10.1159/000098849] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
The aim of the present study was to evaluate possible protective effects of corticosteroids on the inner ear after surgical trauma and to exclude any ototoxicity. A corticosteroid (triamcinolone, Volon A) was topically applied to the inner ear of guinea pigs, either by extracochlear application with permeation and diffusion through the round window membrane or by intracochlear application with direct infusion into the inner ear via a cochleostomy. Threshold and input/output functions of compound action potentials (CAPs) were determined before and after application of the corticosteroid. We found that extracochlear application of the corticosteroid induced insignificant mild shifts of mean CAP thresholds, but significantly increased mean maximal amplitudes of input/output function after the 14th day following application of the steroid. No detrimental effects on cochlear function were noted in the extracochlear group, indicating absence of ototoxicity with the concentrations used. In the intracochlear group, CAP thresholds and amplitudes of input/ output function recovered from partial hearing loss due to cochleostomy between 7 and 14 days after application of the steroid, whereas in controls without steroid application, no such recovery of hearing was detected. These results suggest that topical application of triamcinolone has no ototoxic effect and that it leads to increased recovery of cochlear functions after trauma in the guinea pig inner ear.
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Affiliation(s)
- Jan Kiefer
- Klinik für Hals-Nasen-Ohrenheilkunde, Klinikum rechts der Isar, Technische niversität München, Munich, Germany
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Abstract
OBJECTIVE/HYPOTHESIS The objective of this controlled animal study was to evaluate the effects of intrascalar blood on hearing. MATERIAL AND METHODS Eight guinea pigs underwent intrascalar administration of their own blood in one ear and control solution in the contralateral ear. Solutions were applied through cochleostomy to the scala tympani. Compound action potential (CAP) thresholds were determined before administration and at different intervals for 2 months thereafter. RESULTS Immediate deterioration of thresholds was seen mainly in the high-frequency range, averaging 27 dB and 20 dB in the study and control groups, respectively. At day 3, threshold shifts recovered in the control group but remained in the low-frequency range in the study group. An extensive recovery was seen in both groups. However, permanent threshold shifts persisted. There was an enhanced shift of thresholds of up to 7 dB in the study group. CONCLUSIONS Even small amounts of intrascalar blood seem to cause transient and permanent detrimental effects on cochlear function. In procedures involving opening of the otic capsule-like stapes surgery and cochlear implantation with hearing preservation-minimizing surgical blood admixture to intracochlear compartments seems therefore fundamental.
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Affiliation(s)
- Andreas Radeloff
- Department of Otolaryngology-Head and Neck Surgery, JW Goethe-University, Frankfurt am Main, Germany.
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28
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Hambek M, Werner C, Baghi M, Gstöttner W, Knecht R. Prestimulation of head and neck cancer cells with growth factors enhances treatment efficacy. Anticancer Res 2006; 26:1091-5. [PMID: 16619511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
OBJECTIVES In recent years, new chemotherapy regimens with promising activity, especially in first-line therapy (induction chemotherapy) of head and neck cancer (SCCHN), have been developed. Nevertheless, a major problem concerning the response of SCCHN to chemotherapy is the high percentage of resting cells (G0-phase cells) being resistant to chemotherapy. To overcome this phenomenon, the capacity of several cytokines to switch on cells into the division cycle and progress to the chemosensitive phases (S-, M-phases) was investigated. MATERIALS AND METHODS Interleukin-6, serotonin, granulocyte colony stimulating factor (G-CSF) and epidermal growth factor (EGF) were used to stimulate G0-phase squamous cell cancer cells (Detroit 562, A431, UM-SCC 10B) for re-entry into the cell cycle to enhance the response to cisplatin. The proportion of G0-phase cells was detected through multicolor FACS analysis and Ki-67 staining. RESULTS Cell cycle re-entry was most effective after combination treatment with serotonin + EGF. The proportion of G0-phase cells was significantly reduced after stimulation with serotonin + EGF (p < 0.05). Corresponding to cell cycle re-entry, the cytotoxic effect of cisplatin was significantly (p < 0.04) enhanced in the prestimulated compared to the control cells (cisplatin mono-treatment). CONCLUSION Our investigations demonstrated for the first time that sensitizing G0-phase squamous cell carcinoma cells for chemotherapy is possible by prestimulation with target cytokines. Considering that up to 95% of tumor cells are in the resting (G0) phase of the cell cycle at the initiation of chemotherapy, prestimulation with EGF and serotonin could contribute to a synchronization of cancer cells. This would clearly enhance the cytotoxic effect.
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Affiliation(s)
- Markus Hambek
- ENT-Center, University Clinic Frankfurt, 60590 Frankfurt/Main, Germany
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29
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Abstract
Tumorous lesions in the region of the inner ear and cerebellopontine angle are very rare and can be classified into benign and malignant disease forms. This contribution presents and explains the CT and MRI characteristics of these tumors.High-resolution computed tomography (HRCT) in the axial projection is applied for evaluation in the high-resolution bone window. The coronary slices can be reconstructed from the axial datasets or in individual cases examined in the coronary plane.HRCT excellently demonstrates osseous lesions and in individual cases - e.g., exostoses - it can simply suffice to perform HRCT of the temporal bone, while HRCT is also excellent for detecting osseous lesions to determine whether the tumor is benign or malignant.MRI, on the other hand, excellently shows the extent of tumor spread because of its superb soft tissue contrast. Consequently, HRCT and MRI images of the inner ear and cerebellopontine angle provide meaningful information for visualization and classification of tumorous lesions. The two methods should not be considered as competing but rather as complementary and among other aspects exert considerable influence on the therapeutic approach.
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Affiliation(s)
- C Czerny
- Klinik für Radiodiagnostik, Medizinische Universität, Wien, Osterreich.
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30
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Bisdas S, Baghi M, Hübner F, Müller C, Vorbüchner M, Smolarz A, Knecht R, Gstöttner W, Vogl TJ. Wertigkeit der Protonen MR-Spektroskopie von extrakraniellen Kopf- und Hals-Tumoren: in vivo Studie. ROFO-FORTSCHR RONTG 2006. [DOI: 10.1055/s-2006-940592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Hambek M, Baghi M, Strebhardt K, Strebhard K, Baumann H, Gstöttner W, Knecht R. Reduction of cisplatin dosage by ZD 1839. Anticancer Res 2005; 25:3985-8. [PMID: 16309188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Cisplatin (CDDP) is the main chemotherapeutic drug in the treatment of recurrent or metastatic squamous cell carcinoma of the head and neck (SCCHN), but its nephrotoxicity often limits the treatment. ZD 1839 is an orally-applicable, selective EGFR tyrosine kinase inhibitor. This investigation explored whether the cisplatin dose can be reduced by the additional application of ZD 1839. Four different SCCHN cell lines were treated with descending doses of CDDP alone or in combination with ZD 1839. Proliferation was measured by the MTT assay; tumor cell toxicity was measured by using the lactate dehydrogenase approach. ZD 1839 augments CDDP-dependent antiproliferative effects. By adding ZD 1839 to the treatment regimen, the CDDP dose could be reduced by up to 25% of the CDDP IC50 dose without compromising the antiproliferative effect. Adding ZD 1839 to CDDP may therefore enable CDDP treatment at a lower dose without compromising antiproliferative effects.
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Affiliation(s)
- Markus Hambek
- Department of Otorhonolaryngology, School of Medicine, J. W. Goethe University, 60590 Frankfurt, Germany
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Hambek M, Werner C, Baghi M, Gstöttner W, Knecht R. WITHDRAWN: Enhancement of docetaxel efficacy in head and neck cancer treatment by G0 cell stimulation. Eur J Cancer 2005. [DOI: 10.1016/j.ejca.2005.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
BACKGROUND The aim of the present paper is to evaluate the clinical parameters in patients implanted for combined, ipsilateral electric-acoustic stimulation of the auditory system. METHODS A total of 18 patients with residual deep frequency hearing were implanted with a Combi 40+cochlear implant (MED-EL, Austria). Insertion depths ranged from 18 to 22 mm (360 degrees ). A modified surgical technique should contribute to hearing preservation in low frequency regions of the cochlea. Pure-tone audiometric thresholds were measured pre- and postoperatively. A speech audiometric evaluation was performed on two subjects. RESULTS Utilizing adapted surgical procedures, the preservation of low frequency hearing was accomplished in 16 of 18 subjects (88.9%). Seven (38.9%) patients had complete and nine (50.0%) partial preservation of residual hearing. The speech discrimination scores of two patients documented an increase in sentence intelligibility when compared with only the cochlear implant. CONCLUSIONS Hearing preservation in cochlear implant surgery is possible. Insertions of 360 degrees provide a full functioning cochlear implant to stimulate sufficient neural structures for above average discrimination scores with the implant alone. A synergistic effect of the electric and the acoustic stimulation modes leads to high discrimination scores in background noise.
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Affiliation(s)
- W Gstöttner
- HNO-Universitätsklinik, Klinikum der J.-W.-Goethe-Universität, Frankfurt am Main.
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Hambek M, Baghi M, Baumaun H, Strebhardt K, Strebhard K, Adunka O, Gstöttner W, Knecht R. Iressa (ZD 1839) inhibits phosphorylation of three different downstream signal transducers in head and neck cancer (SCCHN). Anticancer Res 2005; 25:1871-5. [PMID: 16158919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Proliferation of squamous cell carcinoma of the head and neck (SCCHN) depends on epidermal growth factor receptor (EGFR) expression. The EGFR activates different signal pathways leading to gene transcription in the nucleus due to cell cycle progression and proliferation of tumor cells. AKT, STAT3 and MAPK play central roles in these pathways. However, they are not only regulated by the EGFR. We therefore investigated whether a specific inhibitor of the EGFR tyrosine kinase (ZD 1839 or Iressa) is able to inhibit phosphorylation of these three signals at the same time. Western blot analysis of pretreated SCCHN cells revealed that ZD 1839 greatly reduces the amount of phosphorylated AKT, STAT3 as well as MAPK Surprisingly, this effect was not dose-dependent between the concentration range of 5.15 to 41.2 microM/ml. We conclude that Iressa has a high potency to inhibit nuclear gene transcription responsible for cell cycle progression. Furthermore, dose reduction of Iressa in the case of toxicity may not severely influence the response to treatment.
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Affiliation(s)
- Markus Hambek
- Department of Otorhinolaryngology, School of Medicine, J. W. Goethe University, 60590 Frankfurt, Germany
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36
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Aladwan A, Mack M, Gstöttner W, Vogl TJ. Duplication of internal carotid artery: a rare case of tympanic mass. Eur Radiol 2005; 15:2525-7. [PMID: 15776246 DOI: 10.1007/s00330-004-2507-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2004] [Accepted: 08/26/2004] [Indexed: 10/25/2022]
Abstract
We report a case of a 30-year-old female patient evaluated for a right retrotympanic polyp found at otoscopy. During biopsy, a severe hemorrhage occurred. During computed tomography and angiography, the diagnosis of a duplication of internal carotid artery was made.
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Affiliation(s)
- Abdelhamid Aladwan
- Department of Diagnostic and Interventional Radiology, University of Frankfurt/Main, Frankfurt/Main, Germany
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37
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Abstract
BACKGROUND Our aim was to design and develop a computer database system for head and neck cancer patients for clinical and scientific use. METHODS A relational database based on Filemaker Pro 6.0 was developed and integrated into our local network. Its precise and easy to handle interface should allow a quick overview of the patient's oncological data. An automatically generated letter was integrated to enhance patient care. For evaluation purposes, statistical analysis functions were incorporated. RESULTS Over a 7 month period, about 300 patient records were available through the local network. The automated letter function and the well organized display resulted in more efficient patient care. Additionally, the quality of the information presented to referring physicians increased. Statistical analysis provided by the database was reliable and easy to export. CONCLUSIONS We developed an oncology database for clinical and scientific use and integrated it into our patient documentation system. The combination of clinical and scientific features proved to be very effective in daily patient care routine and research.
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Affiliation(s)
- O Adunka
- HNO-Universitätsklinik der Johann-Wolfgang-Goethe-Universität Frankfurt am Main.
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38
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Knecht R, Peters S, Hambek M, Solbach C, Baghi M, Gstöttner W, Hambek M. EGFR-antibody-supplemented TPF chemotherapy. Preclinical investigations to a novel approach for head and neck cancer induction treatment. Adv Otorhinolaryngol 2004; 62:81-91. [PMID: 15608420 DOI: 10.1159/000082475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Recent studies on polychemotherapy of head and neck cancer showed an improved remission rate on adding taxanes to the standard cytotoxic drugs cisplatin and 5-fluorouracil (5-FU). Moreover, for enhancing the response rate of chemotherapy today, a series of biological response modifiers are of interest, including modulators of the epidermal growth factor receptor (EGFR). Therefore we investigated whether the addition of monoclonal antibodies against the EGFR could enhance the response rate of cisplatin, 5-FU and docetaxel. Squamous cell cancer lines were transplanted into nude mice. After tumors had begun to grow, they were treated either with cisplatin, 5-FU or docetaxel alone or in combination with escalating doses of a humanized monoclonal anti-EGFR antibody.
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Affiliation(s)
- Rainald Knecht
- Department of Otorhinolaryngology, School of Medicine, JW Goethe University, Frankfurt, Germany.
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Hambek M, Baghi M, Strebhardt K, Strebhard K, May A, Adunka O, Gstöttner W, Knecht R. STAT 3 activation in head and neck squamous cell carcinomas is controlled by the EGFR. Anticancer Res 2004; 24:3881-6. [PMID: 15736426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Proliferation of squamous cell carcinoma of the head and neck (SCCHN) depends on epidermal growth factor receptor (EGFR) expression. As STAT 3 activation as well contributes to the cell growth in SCCHN, the interaction of STAT 3 and the EGFR is of great interest when considering treatment options through inhibition of STAT 3. We, therefore, evaluated the influence of blocking or activating the EGFR in human SCCHN cell lines and in vivo tumors on STAT 3 activation. We compared the effects on STAT 3 activation with the regulation of MAP Kinase under these conditions. We found that STAT 3 can be strongly inhibited via EGFR blocking in vitro as well as in vivo. However, the influence of EGFR regulation on the MAP Kinase pathway seemed to be very slight. These findings provide evidence that STAT 3 signal activity in head and neck carcinomas, which is partially responsible for proliferative activity, can be controlled via the EGFR.
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Affiliation(s)
- Markus Hambek
- Department of Otorhinolaryngology, School of Medicine, J. W. Goethe University, 60590 Frankfurt, Germany
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40
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Adunka O, Kiefer J, Unkelbach MH, Radeloff A, Lehnert T, Gstöttner W. Evaluation eines Elektrodendesigns für die kombinierte elektrisch-akustische Stimulation. Laryngorhinootologie 2004; 83:653-8. [PMID: 15476137 DOI: 10.1055/s-2004-825675] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND The objective of this study was to assess the intracochlear position and the extent of trauma to cochlear structures using the C40(+) M electrode (MED-EL, Innsbruck, Austria), which was especially designed for the combined electric acoustic stimulation. METHODS Five human temporal bones were implanted using a standard cochlear implant procedure featuring mastoidectomy, posterior tympanotomy, and promontory cochleostomy. For the cochleostomy, an inferior approach with preservation of the endosteum of the cochlea was used to contribute to hearing preservation in the in vivo condition. RESULTS All insertions of the new electrode array were performed into the scala tympani of the cochlea. The average insertion depth was 288 degrees. Apically, 4 of the 5 implantations were completely atraumatic. One bone showed a rupture of the basilar membrane only at the tip of the electrode. However, 4 of the 5 arrays produced severe trauma to basal cochlear structures. Two pathomechanisms, the direct traumatization through drilling of the cochleostomy or the indirect traumatization via buckling of the array could be distinguished. CONCLUSIONS Due to the reduced contact spacing and its flexible body, the C40(+) M electrode is suitable for cochlear implantations with hearing preservation and combined electric and acoustic stimulation of the auditory system. Modifications of the surgical pathway to the cochlea should help to minimize the risk of basal cochlear trauma.
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Affiliation(s)
- O Adunka
- HNO Universitätsklinik, J.-W.-Goethe-Universität Frankfurt am Main, Frankfurt am Main.
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41
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Knecht R, Tesch H, Baghi M, Hambek M, Zamboglou N, Gstöttner W. Response rate and outcome of a novel first line therapy for advanced head and neck carcinomas: Chemo-radiochemotherapy (CRC). J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.5559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- R. Knecht
- University Clinic, Frankfurt, Germany
| | - H. Tesch
- University Clinic, Frankfurt, Germany
| | - M. Baghi
- University Clinic, Frankfurt, Germany
| | - M. Hambek
- University Clinic, Frankfurt, Germany
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Peters S, Hambek M, Gstöttner W, Knecht R. [Tissue microarrays. Value of immunohistochemical proliferation markers for serial investigations of head and neck cancer]. HNO 2004; 52:409-12. [PMID: 15138646 DOI: 10.1007/s00106-003-0914-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Tissue microarrays (TMAs) are still seldom used in oncological research, especially that involving otorhinolaryngology, although the benefit of this method has often been reported. METHODS We prepared ten different tumor probes from patients with head and neck cancer for immunohistochemistry and performed ki67 and proliferating cell nuclear antigen (PCNA) staining on the usual paraffin sections as well as on TMAs consisting of the same tissue. RESULTS AND CONCLUSIONS We conclude that investigation by means of TMA makes oncological research, and especially the screening of tumor probes, much more efficient since a high correlation ( r>0.7, P<0.0001) between both methods was found.
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Affiliation(s)
- S Peters
- Zentrum für Hals-Nasen-Ohren-Heilkunde, Kopf- und Halschirurgie, Johann-Wolfgang-Goethe-Universität, Frankfurt am Main.
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Kiefer J, Ye Q, Tillein J, Gstöttner W. Die topische Anwendung von Kortikosteroiden in der Chirurgie des Innenohres. Laryngorhinootologie 2004. [DOI: 10.1055/s-2004-823312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Knecht R, Baghi M, Hambek M, Gstöttner W. Ansprechrate einer neuen Induktionschemotherapie (TPF) bei fortgeschrittenen Karzinomen des Pharynx und Larynx. Laryngorhinootologie 2004. [DOI: 10.1055/s-2004-823550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Baghi M, Mack M, Gstöttner W, Knecht R. Diagnostische Signifikanz der Magnetresonanztomographie mit Sinerem zur Erkennung von Lymphknotenmetastasen bei Kopf- und Halstumoren. Laryngorhinootologie 2004. [DOI: 10.1055/s-2004-823246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Unkelbach MH, Adunka O, Radeloff A, Kiefer J, Gstöttner W. Reduktion des Insertionstraumas mit einer neuen Cochlea Implantat Elektrode. Laryngorhinootologie 2004. [DOI: 10.1055/s-2004-823240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Hambek M, Adunka OF, Gstöttner W, Knecht R. Klinisch-wissenschaftliches Datenbanksystem zur Erfassung und Auswertung onkologischer Daten im Kopf-Hals Bereich. Laryngorhinootologie 2004. [DOI: 10.1055/s-2004-823619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Adunka OF, Kiefer J, Unkelbach M, Gstöttner W. Evaluation des Elektrodeninsertionstraumas nach Insertionen via Rundfenstermembran. Laryngorhinootologie 2004. [DOI: 10.1055/s-2004-823206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Peters S, Hambek M, Gstöttner W, Knecht R. Wirkung des EGFR-Antikörpers EMD 72000 und seines (Fab`)2-Fragmentes auf die Zellproliferation in vitro. Laryngorhinootologie 2004. [DOI: 10.1055/s-2004-823522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Gstöttner W, Adunka OF, Kiefer J, Pok SM, Peters S. Cochlea Implantation mit Tieftonrestgehörerhalt. Laryngorhinootologie 2004. [DOI: 10.1055/s-2004-823216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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