showing 28 related works from this author
Obstructive Sleep Apnea in Patients with Head and Neck Cancer—More than Just a Comorbidity?
2021
Obstructive sleep apnea is the most common type of sleep-disordered breathing with growing prevalence. Its presence has been associated with poor quality of life and serious comorbidities. There is increasing evidence for coexisting obstructive sleep apnea in patients suffering from head and neck cancer, a condition that ranks among the top ten most common types of cancer worldwide. Routinely, patients with head and neck cancer are treated with surgery, radiation therapy, chemotherapy, immunotherapy or a combination of these, all possibly interfering with the anatomy of the oral cavity, pharynx or larynx. Thus, cancer treatment might worsen already existing obstructive sleep apnea or trigge…
Influence of different approaches to the cerebellopontine angle on the function of the intermediate nerve
2007
Object Surgery in the cerebellopontine angle (CPA) is a standard procedure at many centers. Outcome is focused mainly on preservation of hearing and facial function postoperatively. The nonmotor part of the facial nerve, the intermediate nerve, is nearly neglected nowadays. Methods A retrospective study was designed, including a questionnaire that was sent to 178 patients who had undergone surgery between 2000 and 2004. Data were obtained in 156 cases. The questionnaire was divided into five parts assessing the presence of increased tearing, reduced tearing, salivation disturbances, increased nasal secretions, and abnormalities in taste. Finally, a self-assessment of patient symptoms was a…
Intratympanic gentamicin treatment after endolymphatic sac surgery.
2005
Interval treatment with up to three intratympanic gentamicin injections once weekly effectively controlled vertigo while preserving hearing in patients with Ménière's disease and recurrent or resistant vertigo after saccotomy.Recurrent or resistant incapacitating vertigo may occur after endolymphatic sac surgery (saccotomy) in patients with Ménière's disease. In these patients, revision saccotomy, vestibular nerve section or labyrinthectomy are the established treatment options. We advocate a once-weekly application of intratympanic gentamicin (12 mg) as an effective alternative in this group of patients.Five patients (age range 39-65 years) with definite Ménière's disease according to the …
Bilateral taste disorders in patients with Ramsay Hunt syndrome and Bell palsy
2018
OBJECTIVE Ramsay Hunt syndrome (RHS) and Bell palsy (BP) are typically known as facial nerve motor syndromes and are primarily unilateral. The aim of this study was to challenge this assertion, because both conditions are also known to be associated with viruses that typically affect several nerves. METHODS Ten participants with RHS, 12 with BP, all clinically unilateral, and 12 healthy controls were prospectively enrolled. Electrogustometric thresholds were measured bilaterally in the areas of the chorda tympani, the glossopharyngeal, and the major petrosal nerve. Also bilaterally, the taste function was tested using chemogustometry with different tastant concentrations. Again bilaterally,…
Steroid and vasoactive treatment for acute deafness after attempted hearing preservation acoustic neuroma surgery.
2004
<i>Objective:</i> To investigate whether intravenous steroid and vasoactive therapy in the acute postoperative period improves hearing outcome in patients who develop acute deafness after attempted hearing preservation surgery for acoustic neuroma (AN) through a retrosigmoid or a middle cranial fossa approach. <i>Study Design and Setting:</i> Retrospective controlled study in a tertiary care center. Thirty-six patients who had developed acute deafness after hearing preservation surgery for treatment of an AN were reviewed. Preoperative AAOHNS hearing class was A in 2, B in 2 and D in 32 patients. Twenty-seven patients were treated with prednisolone, hydroxyethyl star…
DPOAE‐Grams in Patients with Acute Tonal Tinnitus
2005
To investigate cochlear outer hair cell function in patients with acute tonal tinnitus and normal or near-normal hearing threshold.Prospective controlled study in an academic tertiary health center. Distortion products of otoacoustic emissions (DPOAE)-grams of 32 ears with acute tonal tinnitus and normal hearing or minimal hearing loss were compared with those of 17 healthy nontinnitus ears.Tinnitus ears exhibited relatively increased amplitudes of DPOAE at high frequencies (4-6.3 kHz) when compared with the group of healthy ears and relatively decreased DPOAE amplitudes at middle frequencies (1650-2400 Hz). Statistically significant ( P0.01) increased mean values of DPOAE amplitudes were o…
Intensity of Respiratory Cortical Arousals Is a Distinct Pathophysiologic Feature and Is Associated with Disease Severity in Obstructive Sleep Apnea …
2021
Background: We investigated whether the number, duration and intensity of respiratory arousals (RA) on C3-electroencephalographic (EEG) recordings correlate with polysomnography (PSG)-related disease severity in obstructive sleep apnea (OSA) patients. We also investigated if every patient might have an individual RA microstructure pattern, independent from OSA-severity. Methods: PSG recordings of 20 OSA patients (9 female
Intratympanic Dexamethasone/Hyaluronic Acid Mix as an Adjunct to Intravenous Steroid and Vasoactive Treatment in Patients With Severe Idiopathic Sudd…
2011
To evaluate differences in effectiveness (hearing recovery rates) between idiopathic sudden sensorineural hearing loss (ISSNHL) patients treated with intravenous therapy alone and patients treated with a combination of intravenous and intratympanic therapy.Retrospective case review.Tertiary referral hospital center.Ninety-four patients with moderate ISSNHL treated with an intravenous steroid and vasoactive regimen (duration of therapy, 9 ± 2.76 d) and 76 patients with severe ISSNHL treated with a combination regimen of intravenous and intratympanic therapy (duration of therapy, 10 ± 2.71 d) were reviewed. In the latter patients' group, a series of 3 intratympanic injections of a dexamethaso…
Transient evoked otoacoustic emissions in vestibular neuritis.
2007
Objectives: Partial or total degeneration of the vestibulocochlear anastomosis at its takeoff from the saccular ganglion and regenerating efferent neural buds under the cochlear outer hair cells (OHCs) have been found in the temporal bones of human patients with a history of vestibular neuritis (VN). We sought to test whether VN has any functional impact on the ipsilateral OHCs by means of transient evoked otoacoustic emission (TEOAE) testing. Methods: We retrospectively analyzed prospectively collected TEOAE data of 28 patients (19 female, 9 male; age range, 21 to 60 years; median age, 42.5 years). The pure tone air conduction hearing thresholds at each standard audiometric frequency (0.12…
Comparison of electronystagmography results with dynamic posturography findings in patients with vestibular schwannoma.
2007
Condition-5-score (C5S) and condition-6-score (C6S) of computerized dynamic platform posturography (CDPP) can detect the presence of a functional deficit of the lateral semicircular canal (and the superior vestibular nerve), irrespective of the central vestibular compensatory status, in vestibular schwannoma (VS) patients.To test whether CDPP findings differ between VS patients with and without asymmetry on caloric and/or rotational ENG studies.This was a retrospective review of 216 consecutive patients with VS. C5S and C6S of CDPP (Equitest) were compared among patients with normal caloric and rotational studies, patients with asymmetry on caloric studies and normal rotational studies, and…
Radiofrequency tissue volume reduction for treatment of auricle keloids
2010
Objectives/Hypothesis: Keloids are often refractive to treatment, and recurrences occur quite frequently. Radiofrequency tissue volume reduction (RFTVR) is a surgical technology that induces extensive fibrosis at the target tissues. Methods: We applied RFTVR in 14 patients (19 auricles, 5 patients treated bilaterally; 9 female, 5 male; range, 10–66 years) with keloids of the auricle. Keloids were located at the earlobe in 4 patients (5 auricles), helix in 9 patients (12 auricles), and at both earlobe and helix in 1 patient (2 auricles). In 6 patients (8 auricles) RFTVR was the sole treatment modality applied, and in 7 patients (10 auricles) intralesional steroid injection was also performed…
Malignant and benign sinonasal paragangliomas
2013
Objectives/Hypothesis To report on the clinical course and management of sinonasal paragangliomas (PGLs). Study Design and Methods Retrospective chart review of six patients with PGLs of the nasal cavity and paranasal sinuses. Results Three patients had tumors with malignant clinical behavior with cerebral metastases or infiltration of brain and local recurrence, despite surgery and/or radiotherapy, while three patients demonstrated a benign course. Conclusion Sinonasal paragangliomas are frequently malignant. If malignant, they are very aggressive, with rapid local spread as well as high metastatic potential despite surgical resection; and they have a poor prognosis. Malignancy cannot be d…
Influence of nerve of origin and tumor size of vestibular schwannoma on dynamic posturography findings.
2006
Condition 5-score (C5S) and vestibular ratio (VER) correlate, but condition-6-score (C6S) and mean overall balance score (MOBS) do not, with the size of an inferior vestibular nerve (IVN) vestibular schwannoma (VS). In IVN VS patients the visual system plays a major role in the maintenance of postural stability.To test whether the size of a superior vestibular nerve (SVN) or IVN VS, as measured on MRI scans, correlates with computerized dynamic platform posturography (CDPP) findings and whether CDPP findings could preoperatively predict the nerve of origin of the VS.This was a retrospective study. Seventy-five consecutive VS patients were evaluated. C5S, C6S, VER, and MOBS were evaluated. S…
Increased amplitudes of distortion product otoacoustic emissions in patients with unilateral acoustic neuroma.
2004
We present a case series of 4 patients with a unilateral acoustic neuroma and increased amplitudes of the distortion products of otoacoustic emissions (DPOAEs) at the low- and middle- frequency bandwidth on the involved side compared to the uninvolved side despite a 28-dB hearing level (HL) worse (compared to the uninvolved side) pure-tone hearing threshold average for standard audiometric frequencies between 1 and 6 kHz at the involved side. In 3 of these patients, 2 with an inferior vestibular nerve origin of the acoustic neuroma and one in whom the nerve of origin could not be unequivocally defined, the tumor was extending extrameatally. One patient had a purely intrameatal acoustic neur…
Diagnosis and therapy of vestibular schwannoma.
2009
MRI studies are of paramount importance for diagnosis and follow-up measurements during conservative and postinterventional management of vestibular schwannomas (VS). MRI findings that convey important information for hearing-preservation VS surgery are: length of tumor-cochlear nerve contact, involvement of the internal auditory canal, incomplete filling of internal auditory canal, tumor size less than 15 mm and the intralabyrinthine signal intensity on 3DFT-CISS gradient-echo images. Functional neuro-otologic studies of facial nerve function, hearing and vestibular/balance function provide a valuable means of assessment of the actual impairment of the functional status of the VS patient. …
Intratympanic Dexamethasone and Hyaluronic Acid in Patients with Low-Frequency and Ménière's-Associated Sudden Sensorineural Hearing Loss
2005
Steroids are widely used for the treatment of cochleovestibular disorders. Direct steroid application in the middle ear cavity, when combined with a round window membrane permeability-modulating substance, increases the level of the steroid reaching the target cells. We measured hearing in patients with idiopathic isolated low-frequency sensorineural hearing loss and in patients with sudden sensorineural hearing loss and a history of Ménière's disease. Contradictory reports about effectiveness of intratympanic steroid therapy on vertigo control and hearing improvement in patients with Ménière's disease exist in the literature.Eighteen patients with isolated low-frequency idiopathic sudden s…
[Treatment of sensorineural hearing loss in acute viral otitis media with intratympanic dexamethasone and hyaluronic acid in comparison with intraven…
2006
Background: Intratympanic dexamethasone with hyaluronic acid has shown to be an effective treatment of the inner ear damage in sudden hearing loss and Meniere's disease. It is not known yet if the same applies to the toxic inner ear damage in acute viral otitis media. Patients: Retrospectively, 26 patients who suffered from acute viral otitis media with sensorineural hearing loss were examined with regard to the improvement of their inner ear hearing loss. Twelve patients were treated with intravenous therapy only, consisting of hydroxyethylstarch, pentoxifylline and prednisolone. Fourteen patients additionally received intratympanic injections, consisting of dexamethasone and hyaluronic ac…
Influence of nerve branch of origin and extracanalicular extension of the tumor on hearing after middle fossa removal of vestibular schwannoma
2007
Neither nerve branch of origin nor extracanalicular (up to 1 cm) extension of a vestibular schwannoma (VS) influence the postoperative hearing outcome in patients operated via a middle cranial fossa (MCF) approach.To test whether the nerve branch of tumor origin and an extracanalicular, up to 1 cm, tumor extension influences hearing outcome after MCF VS surgery.This was a retrospective case review of 50 patients with postoperative pure-tone audiogram (PTA) performed later than 90 days after surgery. Twenty patients had a superior vestibular nerve (SVN) tumor and 27 patients had an inferior vestibular nerve (IVN) tumor. In three patients the nerve branch of origin of the VS could not be uneq…
The VEGF/VEGF-R Axis in Sporadic Vestibular Schwannomas Correlates with Irradiation and Disease Recurrence
2012
<b><i>Background/Aims:</i></b> The molecular mechanisms downstream of mutated neurofibromatosis type 2 (NF2) gene resulting in the growth and development of vestibular schwannoma (VS) are controversial. Several lines of evidence suggest the involvement of the vascular endothelial growth factor (VEGF) pathway in VS development. Given that recent studies of VEGF blockade in patients with NF2-associated VS showed positive effects on VS growth control, we initiated this comprehensive study of the VEGF pathway in sporadic VS. <b><i>Methods:</i></b> A tissue microarray analysis of 182 sporadic VS was conducted. The expression of VEGF and its recepto…
Fascin upregulation in primary head and neck squamous cell carcinoma is associated with lymphatic metastasis
2014
Fascin is an actin-bundling protein that is associated with cellular motility and cancer-cell invasion. The present study aimed to examine the expression of fascin in head and neck squamous cell carcinoma (HNSCC) and its potential use as a biomarker. In a prospective study with a median follow-up time of 48.8 months, tumor tissues, adjacent healthy tissues and cervical lymph node metastases were collected from 25 patients and analyzed by immunohistochemistry. The specimens were scored according to the intensity of fascin staining and the percentage of tumor cells stained using a semi-quantitative scoring approach; the data were analyzed and correlated with clinical follow-up observations. A…
Obstructive Sleep Apnea and the Brain
2018
Quality of Life in Sporadic Vestibular Schwannoma: A Review
2009
Quality of life (QoL) measures are increasingly used as outcome measures in the assessment of different treatment options in clinical practice and as endpoints in clinical trials. Methods and questionnaires currently used for QoL assessment in vestibular schwannoma (VS) patients, studies evaluating QoL before and after treatment, studies on patients managed conservatively and studies evaluating facial-nerve-function-related QoL in VS patients are reviewed. Current methodological controversial issues in QoL studies on VS patients include the lack of a planned prospective comparison between QoL values before and after treatment, a need for the inclusion of additional questions along with stan…
Proteomic identification of the heterogeneous nuclear ribonucleoprotein K as irradiation responsive protein related to migration
2014
Abstract Irradiation resistance is a major obstacle of head and neck squamous cell carcinoma (HNSCC) therapy, limiting treatment success and patient survival. The aim of our experiments was to identify irradiation-regulated proteins as potential drug targets. Two established HNSCC cell lines (HNSCCUM-01T and HNSCCUM-02T) were treated with a single 8 Gy (Gray) fraction of irradiation. Changes in cellular protein expression were studied after 24 h by means of 2D-electrophoresis and MALDI–TOF-mass spectrometry. Ninety-four differentially expressed proteins were identified. The expression levels of four proteins were regulated similarly in both cell lines after irradiation treatment, i.e., GRP7…
Dynamic posturography findings predict balance status in vestibular schwannoma patients.
2007
OBJECTIVE To test whether condition 5 score (C5S) and condition 6 score (C6S) of the sensory organization test of computerized dynamic platform posturography (CDPP) differ between vestibular schwannoma (VS) patients with and without vestibular symptoms. STUDY DESIGN Retrospective review of prospectively collected data. SETTING Tertiary academic referral center. PATIENTS Two hundred and sixteen consecutive patients with a histological diagnosis of a VS (103 women; 113 men; age range, 18-78 years; median, 54 years) who had been preoperatively evaluated by CDPP. A hundred and twelve patients had a history of vertigo, dizziness, and/or imbalance, and 104 patients had neither present nor past ve…
The Drainage System of the Paranasal Sinuses: A Review with Possible Implications for Balloon Catheter Dilation
2011
Background Intersinus connections and accessory ostia of the maxillary sinus are well known to rhinologic surgeons but are less known for the remaining paranasal sinuses. Probing and dilatation of the natural ostia of diseased sinuses is being popularized currently by the clinical value of balloon catheter dilation (BCD). Although short-term high success rates with treatment of the dilated ostia/duct have been reported with this technique, the potential impact of fractures of adjacent bony septae on accessory sinus ostia, on mucosally lined surfaces, and on intersinus drainage pathways still has not been considered. The aim of this study was to review the literature on accessory sinus ostia…
Cochlear origin of early hearing loss in vestibular schwannoma.
2007
Objective: To test whether early hearing loss (HL) is cochlear in origin in patients with vestibular schwannoma (VS). Study Design: Retrospective case review in an academic tertiary referral center. Methods: A group of 19 VS patients with normal/symmetrical hearing and a group of 20 VS patients with mild HL (threshold at any tested frequency better than 45 dB HL) on the tumor ear side. Differences of the amplitudes of the distortion products of otoacoustic emissions (DPOAEs) between the tumor ear and the nontumor ear were studied at frequencies of 1, 1.4, 2, 2.8, and 4 kHz. The Wilcoxon test was used to compare the ears for both groups and to test for possible differences in tumor size betw…
Corticoperipheral neuromuscular disconnection in obstructive sleep apnoea.
2020
Abstract The roles of central nervous mechanisms and cortical output in obstructive sleep apnoea remain unclear. We addressed corticomuscular coupling between cortical sensorimotor areas and lower facial motor units as a mechanistic pathway and as a possible surrogate marker of corticoperipheral motor control in obstructive sleep apnoea. In this exploratory cross-sectional retrospective study, we analysed EEG (C3 and C4 leads) and chin EMG from polysomnography recordings in 86 participants (22 females; age range: 26–81 years): 27 with mild (respiratory disturbance index = 5–15 events/h), 21 with moderate (15–30 events/h) and 23 with severe obstructive sleep apnoea (>30 events/h) and 15 cont…
The Apnea-Hypopnea Index Underestimates Systemic Inflammation in Women with Sleep-Disordered Breathing.
2018
Evidence suggests that sleep-related respiratory and related metabolic compromise may vary between females and males with sleep-disordered breathing (SDB). Our purpose was to elucidate possible gender differences in sleep-associated respiratory and inflammatory parameters in patients with SDB.A consecutive number of SDB patients (46 females and 167 males) who underwent polysomnography were retrospectively reviewed. Fibrinogen and C-reactive protein (CRP) concentration, apnea index (ApnI), hypopnea index (HypI), apnea-hypopnea index (AHI), average and minimal SpOApnI and AHI were significantly higher in males. Correlation analysis revealed striking gender differences: only in females, CRP co…