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  • 1.
    Alm, Fredrik
    et al.
    Örebro University, School of Health Sciences. Department of Anaesthesia and Intensive Care.
    Ericsson, Elisabeth
    Örebro University, School of Health Sciences.
    Pain and pain management after pediatric tonsil surgery2017Conference paper (Refereed)
  • 2.
    Alm, Fredrik
    et al.
    Örebro University, School of Health Sciences. Department of Anaesthesia and Intensive Care.
    Ericsson, Elisabeth
    Örebro University, School of Health Sciences.
    Vilka faktorer påverkar den postoperativa smärtan i samband med tonsillkirurgi?2017Conference paper (Other academic)
  • 3.
    Alm, Fredrik
    et al.
    Örebro University, School of Health Sciences. Department of Anaesthesia and Intensive Care.
    Jaensson, Maria
    Örebro University, School of Health Sciences.
    Lundeberg, Stefan
    Pain Treatment Service, Astrid Lindgren Children's Hospital, Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden.
    Ericsson, Elisabeth
    Örebro University, School of Health Sciences.
    Adherence to Swedish guidelines for pain treatment in relation to pediatric tonsil surgery: A survey of the multidisciplinary team2017In: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 101, p. 123-131Article in journal (Refereed)
    Abstract [en]

    Background: Pain management in children after tonsil surgery is essential, and optimal pain treatment has been discussed for many years. Data from the National Tonsil Register in Sweden (NTRS) and a national mapping system have demonstrated the need for national pain treatment guidelines for pediatric tonsil surgery. As a result, Swedish national guidelines, together with updated patient information on the website tonsilloperation.se, were developed and implemented in 2013.

    Objectives The objective of this study was to evaluate the professionals’ opinions of and adherence to pain treatment guidelines for pediatric tonsil surgery patients in a two-year follow-up.

    Method: This descriptive cross-sectional study was based on data from an inter-professional questionnaire, which was validated by an expert group using a content validity index (S-CVI 0.93). The questionnaire was sent to all Swedish ear, nose and throat (ENT) departments (n=49) that the NTRS identified as performing tonsil surgery on children younger than 18 years of age. In each clinic, we asked for responses from staff in each of the following professions: ENT physicians, anesthesia physicians, registered nurse anesthetists, and registered nurses in the ENT departments.

    Results: Respondents from 48 ENT departments participated, and 139/163 (85%) completed questionnaires were returned. The guidelines were reported as being clear, ensuring patient safety and providing optimal pharmacological treatment. Treatment was given according to the guidelines: Half of the departments gave pre- or intraoperative treatment with clonidine, betamethasone and high-dose paracetamol (acetaminophen). A multimodal pain approach (paracetamol and COX inhibitors) after hospital discharge was prescribed by all departments after tonsillectomy and, more extensively, after tonsillotomy. One-third of the departments prescribed paracetamol with a higher normal dose for the first three postoperative days. Half of the departments prescribed rescue analgesics, clonidine or opioids after tonsillectomy. None of the departments prescribed codeine or tramadol, drugs that are discouraged in the guidelines. The majority of the departments used the website tonsilloperation.se to provide information to the patients and their caregivers.

    Conclusion: The respondents' opinions of and the ENT departments adherence to the Swedish national guidelines were considered to be good. The national implementation process in Sweden has impacted the manner in which ENT departments treat pain after tonsil surgery.

  • 4.
    Alm, Fredrik
    et al.
    Örebro University, School of Health Sciences.
    Jaensson, Maria
    Örebro University, School of Health Sciences.
    Lundeberg, Stefan
    Astrid Lindgrens Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
    Hemlin, Claes
    Sollentuna Specialist Clinic, Stockholm, Sweden.
    Hessén-Söderman, Anne-Charlotte
    Department of Otorhinolaryngology, Aleris Sabbatsberg, Stockholm, Sweden; Division of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
    Nerfeldt, Pia
    Karolinska University Hospital, Huddinge, Sweden.
    Odhagen, Erik
    Department of Otorhinolaryngology, Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Sunnergren, Ola
    Department of Otorhinolaryngology, Ryhov County Hospital, Jönköping, Sweden; Futurum-The Academy for health and care, County Council, Jönköping, Sweden.
    Stalfors, Joacim
    Sahlgrenska Universitety Hospital, Göteborg, Sweden.
    Ericsson, Elisabeth
    Örebro University, School of Health Sciences.
    Adherence to Swedish Guidelines for Pain Treatment in Tonsil Surgery in Pediatric Patients2016Conference paper (Refereed)
    Abstract [en]

    Objective: As shown by data from the National Tonsil Surgery Register in Sweden, tonsil surgery often causes severe pain that lasts for many days. The register data demonstrate the necessity for better evidence-based pain treatment guidelines for tonsil surgery. The guidelines, introduced in 2013, consist of both pharmacological and non-pharmacological recommendations. In the guidelines, a multimodal analgesic approach and combination of analgesics are recommended to provide effective pain treatment with limited side effects. Two national multi-professional education days on pain, pharmacology and the guidelines were offered. Web-based information about pharmacological treatment (www.tonsililloperation.se) was designed for patients and next-of-kin. The current aims were to describe adherence to the Swedish guidelines for pain treatment in tonsil surgery in pediatric patients < 18 years

    Method: An inter-professional questionnaire was developed, including questions linked to the relevant guidelines. The questions came from a national mapping before the guidelines were designed. The items were discussed by an expert group, and content validity was evaluated using the content validity index.ENT-and anesthesia physicians and nurses from all 50 ENT clinics in Sweden were enrolled.

    Results: Most clinics had received the guidelines, but there was a discrepancy between the professions. More than half had perused the literature review performed before the guidelines were designed, and attended themulti-professional education day. Pre- and perioperative treatment usually included paracetamol, clonidine and betamethasone. A multimodal pain approach after discharge from hospital (tonsillectomy and tonsillotomy) was used, combining paracetamol with cox-inhibitors. Most clinics used paracetamol, with a higher dose for the first 3 days (healthy children and acceptable nutrition), and a reduced dose from day 4.In case of inadequate analgesia after tonsillectomy, oral clonidine or opioids were used. Several clinics followed the recommendation to use clonidine as first choice and secondly an opioid. No respondents prescribed codeine compared to 80% at the mapping before the guidelines were designed. The guidelines were experienced as clear, safe and sufficient. The web-based information was used by most of the clinics to improve quality of care and provide facilitating tools for patients, relatives and caregivers.

    Conclusion: Swedish guidelines for tonsil surgery provide practical evidence-based pain treatment recommendations. To achieve a change, multi-professional education is necessary. This needs to be repeated for a wider spread.

    Future research should include evaluation through pain diaries and questionnaires to next-of-kin and children. There should be matching of data from the quality registers at each clinic, with pain variables such as unplanned health care contacts due to pain, number of days with analgesics, and return to normal diet

  • 5.
    Alm, Fredrik
    et al.
    Örebro University, School of Health Sciences.
    Lundeberg, Stefan
    Ericsson, Elisabeth
    Örebro University, School of Health Sciences.
    Pain and pain management at home after tonsil surgery2019Conference paper (Refereed)
  • 6.
    Alm, Fredrik
    et al.
    Örebro University, School of Health Sciences. Department of Anaesthesia and Intensive Care.
    Lundeberg, Stefan
    Pain Treatment Service, Department of Physiology and Pharmacology, Karolinska Institute, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
    Ericsson, Elisabeth
    Örebro University, School of Health Sciences.
    Postoperative pain, pain management, and recovery at home after pediatric tonsil surgery2021In: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 278, p. 451-461Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To explore the severity and duration of postoperative pain, the management of analgesics, and postoperative recovery in children undergoing tonsil surgery.

    METHOD: Participants included 299 children aged 4-17 years undergoing tonsillotomy ± adenoidectomy (TT ± A) or tonsillectomy ± adenoidectomy (TE ± A). Data were collected up to 12 days. The child rated pain on the Face Pain Scale-Revised (FPS-R) and recovery using the Postoperative Recovery in Children (PRiC) questionnaire. Caregivers assessed their child's pain, anxiety, and nausea on a numeric analog scale and kept a log of analgesic administration.

    RESULTS: High pain levels (FPS-R ≥ 4) were reported in all surgical and age groups (TT ± A age 4-11, TE ± A age 4-11, TE ± A age 12-17), but there were variations in pain intensity and duration within and between groups. The TE ± A group scored more days with moderate to very excruciating pain and lower recovery than the TT ± A group, with the worst outcomes reported by older TE ± A children. The majority of the children used paracetamol + COX-inhibitors at home, but regular administration of analgesics was lacking, particularly during late evening and at night. Few were received rescue medication (opioid or clonidine) despite severe pain. Physical symptoms and daily life activities were affected during the recovery period. There was moderate agreement between child and the caregiver's pain assessment scores.

    CONCLUSION: Children reported a troublesome recovery with significant postoperative pain, particularly older children undergoing tonsillectomy. Pain treatment at home was suboptimal and lacked regular analgesic administration. Patient information needs to be improved regarding the importance of regular administration of analgesics and rescue medication.

  • 7.
    Alm, Fredrik
    et al.
    Örebro University, School of Health Sciences.
    Stalfors, Joacim
    Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; Sheikh Khalifa Medical City, Ajman, United Arab Emirates.
    Nerfeldt, Pia
    Karolinska University Hospital, Huddinge, Sweden.
    Ericsson, Elisabeth
    Örebro University, School of Health Sciences.
    Patient reported outcome of pain after tonsil surgery: An analysis of 32,225 children from the National Tonsil Surgery Register in Sweden 2009-20162017Conference paper (Refereed)
    Abstract [en]

    Tonsil surgery is common surgical procedure in children and cause significant pain under postoperative recovery. The objective of this register study was to explore factors affecting pain after pediatric tonsil surgery, using patient-reported outcomes from questionnaires in the National Tonsil Surgery Registry in Sweden, 30 days after surgery. A total of 32,225 tonsil surgeries on children (aged 1-18 years) during January 2009- November 2016 were included; 13,904 tonsillectomies with or without adenoidectomy (TE±A) and 18,321 tonsillotomies with or without adenoidectomy (TT±A). In surgery cases of indication obstruction, the TT±A stopped taking painkillers and returned to normal eating habits sooner, and had less contact with health care services due to pain, compared to TE±A. After TE±A, the indication infection group had more days on analgesics and more contacts with health care services due to pain, compared to the indication obstruction group. TE±A with cold-dissection technique resulted in fewer days on painkillers compared to warm-technique, and reduced the number of contacts with health care services due to pain. Older children were affected by more days of morbidity than the younger ones, but there was no gender difference after adjustment for age, dissection technique and hemostasis technique. Implementation of national guidelines for pain treatment (2013) and patient information on the website tonsilloperation.se seems to have increased the days on analgesics after surgery. Pain after tonsil surgery depends on the surgical procedure and technique, as well as factors such as the patient’s age and surgical indication. More studies including pain interventions are needed to improve the care of tonsillectomy patients.

  • 8.
    Alm, Fredrik
    et al.
    Örebro University, School of Health Sciences. Department of Anaesthesia and Intensive Care.
    Stalfors, Joacim
    Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Sheikh Khalifa Medical City, Ajman, United Arab Emirates.
    Nerfeldt, Pia
    Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden; Division of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden.
    Ericsson, Elisabeth
    Örebro University, School of Health Sciences.
    Patient reported pain-related outcome measures after tonsil surgery: an analysis of 32,225 children from the National Tonsil Surgery Register in Sweden 2009–20162017In: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 274, no 10, p. 3711-3722Article in journal (Refereed)
    Abstract [en]

    The objective of this study was to describe factors affecting pain after pediatric tonsil surgery, using patient reported pain-related outcome measures (pain-PROMs) from the National Tonsil Surgery Register in Sweden. In total, 32,225 tonsil surgeries on children (1 to\18 years) during 2009–2016 were included; 13,904 tonsillectomies with or without adenoidectomy (TE ± A), and 18,321 tonsillotomies with or without adenoidectomy (TT ± A). Adjustments were made for variables included in the register to compensate for contributable factors in the analysis. When compared to TE ± A for surgical indication obstruction, TT ± A resulted in lower pain-PROMs, shorter use of postoperative analgesics, earlier return to regular food intake, and lower risk for contact with health care services due to pain. Children who underwent TE ± A because of obstruction problems stopped taking painkillers and returned to normal eating habits sooner, compared to children who underwent TE ± A for infectious indications. In both indication groups, TE ± A performed with hot rather than cold technique (dissection and haemostasis) generally resulted in higher pain-PROMs. Older children reported more days on analgesics and a later return to regular food intake after TE ± A than younger ones. No clinically relevant difference between sexes was found. Between 2012 and 2016 (pre-and post-implementation of Swedish national guidelines for pain treatment), the mean duration of postoperative analgesic use had increased. In conclusion, TE ± A caused considerably higher ratings of pain-related outcome measures, compared to TT ± A. For TE ± A, cold surgical techniques (dissection and haemostasis) were superior to hot techniques in terms of pain-PROMs. Older children reported higher pain-PROMs after TE ± A than younger ones.

  • 9.
    Andersson, Maria
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Fredriksson, Valeria
    Svenska audionomers inställning gentemot kompetensutvecklingsprogram2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Sammanfattning:

    Audionomyrket har utvecklats från ett assisterande till ett självständigt yrke. Framsteg inom forskning berörande audiologi ställer höga krav på audionomens kompetensutveckling. Internationellt har det undersökts hur kompetensutveckling kan förbättras, genom bildandet av frivilliga eller obligatoriska kompetensutvecklingsprogram, för att ge en säker patientvård och en tillfredsställande yrkesutveckling. I Sverige ansvarar varje audionom enskilt för sin kompetensutveckling. Det finns i dagsläget inga studier som undersöker svenska audionomers inställning till att införa liknande kompetensutvecklingsprogram som finns internationellt, vilket är motivet bakom studien. Syftet är att undersöka svenska audionomers inställning kring frivilliga samt obligatoriska kompetensutvecklingsprogram med tillhörande gransknings-process för att vidareutveckla audionomprofessionen och hålla samtliga yrkesverksamma ajour med ny vetenskap. En kvantitativ metod i form av en webbenkät tillämpades för att nå ut till ett stort omfång yrkesverksamma audionomer över hela Sverige. Studiens resultat visar att ett stort antal yrkesverksamma audionomer är positivt inställda till det frivilliga samt obligatoriska kompetensutvecklingsprogrammet med tillhörande granskningsprocess. En förändrad form av kompetensutvecklingssystem än den nuvarande är därmed eftersträvad av majoriteten. Studiens resultat har tagit fasta på att kompetensutvecklingsprogram bör inriktas mot både de tvärvetenskapliga områden som professionen bygger på och audionomens specialiseringsområden. Audionomerna anser att tiden motsvarande en till åtta timmar per månad är tillräcklig för kompetensutvecklande aktiviteter. Audionomerna har en stor medvetenhet om vikten av att utveckla den professionella kompetensen. Hindrande faktorer som ekonomi, hög patientgenomströmning, tidsbrist, etc. minskar audionomernas möjlighet till deltagande av kompetensutvecklande aktiviteter. De yttre omständigheterna bidrar till att yrkesverksamma audionomer i hög grad önskar en förändrad form av kompetensutvecklings-system än den nuvarande.

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    Svenska audionomers inställning gentemot kompetensutvecklingsprogram
  • 10. Andersson, Morgan
    et al.
    Värendh, Maria
    Undersökningstekniker öron, näsa & hals2019Book (Other academic)
  • 11.
    Andersson, Susanne
    et al.
    Örebro University, School of Health and Medical Sciences.
    Eriksson, Angelica
    Ljudmiljön på två särboenden för äldre: En pilotstudie2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Download full text (pdf)
    Ljudmiljön på två särboenden för äldre: En pilotstudie
  • 12.
    Arancibia, Elisabeth
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Eriksson, Emma
    ”Det klickar i mitt öra…” Objektiv tinnitus orsakad av palatal myoklonus: En forskningsöversikt2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Tinnitus är idag vanligt förekommande och kan klassificeras som antingen subjektiv eller objektiv. Subjektiv tinnitus hörs endast av den drabbade individen, medan objektiv tinnitus kommer från verkliga ljud som kan mätas eller höras av andra. Palatal myoklonus innebär muskelryckningar i palatala muskler och räknas bland muskulära orsaker till objektiv tinnitus.

    Syfte: Syftet med denna studie är att belysa objektiv tinnitus orsakad av essentiell palatal myoklonus med avseende på symptombild, diagnostik samt behandling och utfall.

    Metod: En forskningsöversikt har genomförts för att besvara studiens syfte.

    Resultat: Resultatet visar att symptombilden vid essentiell palatal myoklonus främst är objektiv klickande tinnitus, vilken i vissa fall varit mycket svår för individen att hantera och i majoriteten av fallen haft en negativ inverkan på de drabbade individernas livskvalitet. De diagnostiska metoder som används är i många fall mätningar som görs i syfte att utesluta påverkan från andra organ, i synnerhet någon form av neurologisk patologi. Nasal endoskopi, audiologiska utredningar och magnetkameraröntgen är några av de mätmetoder som använts för att ställa korrekt diagnos. Bland behandlingsmetoder nämns främst injektion av botulinumtoxin A i muskler kring mjuka gommen samt farmakologiska behandlingsmetoder, men även ett par mer sällsynta behandlingsmetoder beskrivs såsom radiofrekvensablation av palatala muskler och kirurgisk blockering av örontrumpeten.

    Slutsats: En tidig, korrekt diagnos för den drabbade individen är angelägen då denna objektiva tinnitus kan vara enormt påfrestande. Det föreligger ett behov av kontrollerade studier på ett större antal individer för att fastställa reproducerbarheten i de behandlingsmetoder som idag finns att tillgå.

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    ”Det klickar i mitt öra…” Objektiv tinnitus orsakad av palatal myoklonus
  • 13.
    Asp, Filip
    et al.
    Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Department of Cochlear Implants M43, Karolinska University Hospital, Stockholm, Sweden.
    Mäki-Torkko, Elina
    Örebro University, School of Medical Sciences. Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; Department of ENT-Head Neck Surgery, County Council of Östergötland, Linköping, Sweden; Swedish Institute for Disability Research, Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.
    Karltorp, Eva
    Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Department of Cochlear Implants M43, Karolinska University Hospital, Stockholm, Sweden.
    Harder, Henrik
    Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; Department of ENT-Head Neck Surgery, County Council of Östergötland, Linköping, Sweden.
    Hergils, Leif
    Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; Department of ENT-Head Neck Surgery, County Council of Östergötland, Linköping, Sweden.
    Eskilsson, Gunnar
    Department of Cochlear Implants, M43, Karolinska University Hospital, Stockholm, Sweden.
    Stenfelt, Stefan
    Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; Swedish Institute for Disability Research, Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.
    A longitudinal study of the bilateral benefit in children with bilateral cochlear implants2015In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 54, no 2, p. 77-88Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To study the development of the bilateral benefit in children using bilateral cochlear implants by measurements of speech recognition and sound localization.

    DESIGN: Bilateral and unilateral speech recognition in quiet, in multi-source noise, and horizontal sound localization was measured at three occasions during a two-year period, without controlling for age or implant experience. Longitudinal and cross-sectional analyses were performed. Results were compared to cross-sectional data from children with normal hearing.

    STUDY SAMPLE: Seventy-eight children aged 5.1-11.9 years, with a mean bilateral cochlear implant experience of 3.3 years and a mean age of 7.8 years, at inclusion in the study. Thirty children with normal hearing aged 4.8-9.0 years provided normative data.

    RESULTS: For children with cochlear implants, bilateral and unilateral speech recognition in quiet was comparable whereas a bilateral benefit for speech recognition in noise and sound localization was found at all three test occasions. Absolute performance was lower than in children with normal hearing. Early bilateral implantation facilitated sound localization.

    CONCLUSIONS: A bilateral benefit for speech recognition in noise and sound localization continues to exist over time for children with bilateral cochlear implants, but no relative improvement is found after three years of bilateral cochlear implant experience.

  • 14.
    Axelsson, Arvid
    et al.
    Örebro University, School of Health and Medical Sciences.
    Hammar, Magnus
    Örebro University, School of Health and Medical Sciences.
    Träning av frekvensdiskriminering - är det meningsfullt?2009Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Denna experimentella studie syftar till att undersöka huruvida en eventuell träningseffekt i 

    frekvensdiskrimination kvarstår efter en tids träningsuppehåll. Tidigare forskning har visat 

    tydliga samband mellan frekvensdiskriminering och talutveckling, kortikal signalbehandling 

    och dyslexi. Det har klargjorts genom tidigare studier att förmågan att diskriminera frekvenser 

    är möjligt att träna upp. Därmed är träning i frekvensdiskrimination en lämplig del i en 

    behandlingsmetod med syfte att utveckla den auditiva perceptionen. Denna studie undersöker 

    de praktiska förutsättningarna till denna behandlingsmetod genom att utreda varaktigheten av 

    den eventuella träningseffekten 14 dagar efter träningen. 24 normalhörande personer deltog i 

    studien där försökspersonernas förmåga att frekvensdiskriminera undersöktes med hjälp av ett 

    egenutvecklat mjukvaruprogram. Först uppmättes försökspersonernas förmåga när de var 

    otränade (mätning 1). Sedan genomfördes ett träningspass som följdes av en mätning 

    (mätning 2). Efter 14 dagar genomfördes ytterligare en mätning för att undersöka den 

    bestående effekten (mätning 3). 

    Resultatet visade (när tre outliers exkluderats) en signifikant skillnad mellan mätning 1 och 2 

    (p=0,034) vilket innebär att en omedelbar träningseffekt erhölls. Ingen signifikant skillnad 

    kunde påvisas mellan mätning 2 och 3 (p=0,952) men en signifikant skillnad erhölls mellan 

    mätning 1 och 3 (p=0,031) vilket påvisar att den omedelbara träningseffekten kvarstod efter 

    de gångna 14 dagarna. 

    Download full text (pdf)
    FULLTEXT01
  • 15.
    Axelsson, Lars
    et al.
    Department of Otorhinolaryngology, University of Gothenburg Sahlgrenska Academy, Goteborg, Sweden; Department of Otorhinolaryngology - Head and Neck Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Holmberg, Erik
    Regional Cancer Center in Western Sweden, Gothenburg, Sweden; Department of Oncology, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden.
    Nyman, Jan
    Department of Oncology, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden.
    Högmo, Anders
    Department of Otorhinolaryngology - Head and Neck Surgery, Karolinska University Hospital, Stockholm, Sweden.
    Sjödin, Helena
    Department of Oncology, Karolinska University Hospital, Stockholm, Sweden.
    Gebre-Medhin, Maria
    Department of Oncology, Lund University Hospital, Lund, Skåne, Sweden.
    Von Beckerath, Mathias
    Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Otorhinolaryngology - Head and Neck Surgery.
    Ekberg, Tomas
    Department of Otorhinolaryngology - Head and Neck Surgery, Uppsala University Hospital, Uppsala, Sweden.
    Farnebo, Lisa
    Department of Otorhinolaryngology - Head and Neck Surgery, Linköping University Hospital, Linköping, Sweden.
    Talani, Charbel
    Department of Oncology, Linköping University Hospital, Linkoping, Sweden.
    Spak, Lena Norberg
    Department of Otorhinolaryngology - Head and Neck Surgery, Norrlands University Hospital, Umeå, Sweden.
    Notstam, Isak
    Department of Otorhinolaryngology, County Hospital Sundsvall-Harnösand, Sundsvall, Sweden.
    Hammerlid, Eva
    Department of Otorhinolaryngology, University of Gothenburg Sahlgrenska Academy, Goteborg, Sweden; Department of Otorhinolaryngology - Head and Neck Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Swedish National Multicenter Study on Head and Neck Cancer of Unknown Primary: Prognostic Factors and Impact of Treatment on Survival2021In: International Archives of Otorhinolaryngology, ISSN 1809-9777, E-ISSN 1809-4864, Vol. 25, no 3, p. 433-442Article in journal (Refereed)
    Abstract [en]

    Introduction: Head and neck cancer of unknown primary (HNCUP) is a rare condition whose prognostic factors that are significant for survival vary between studies. No randomized treatment study has been performed thus far, and the optimal treatment is not established.

    Objective: The present study aimed to explore various prognostic factors and compare the two main treatments for HNCUP: neck dissection and (chemo) radiation vs primary (chemo) radiation.

    Methods: A national multicenter study was performed with data from the Swedish Head and Neck Cancer Register (SweHNCR) and from the patients' medical records from 2008 to 2012.

    Results: Two-hundred and sixty HNCUP patients were included. The tumors were HPVpositive in 80%. The overall 5-year survival rate of patients treated with curative intent was 71%. Age (p < 0.001), performance status (p = 0.036), and N stage (p = 0.046) were significant factors for overall survival according to the multivariable analysis. Treatment with neck dissection and (chemo) radiation (122 patients) gave an overall 5-year survival of 73%, and treatment with primary (chemo) radiation (87 patients) gave an overall 5-year survival of 71%, with no significant difference in overall or disease-free survival between the 2 groups.

    Conclusions: Age, performance status, and N stage were significant prognostic factors. Treatment with neck dissection and ( chemo) radiation and primary (chemo).

  • 16.
    Backlund, Ann-Christin
    Örebro University, School of Health and Medical Sciences.
    Grad av nöjdhet och ökad livskvalitet hos uni- respektive bilaterala hörapparatanvändare2009Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
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  • 17.
    Balisani, Safia
    Örebro University, School of Health and Medical Sciences.
    Audionomens möjligheter till kompetens- och kunskapsutveckling2009Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 18.
    Barzinjy, Vian B.
    et al.
    Department of Medical Microbiology, College of Medicine, Hawler Medical University, Erbil, Iraq.
    Dabbagh, Rasool
    Department of Medical Microbiology, College of Medicine, Hawler Medical University, Erbil, Iraq.
    Saber, Amanj
    Department of Surgery, College of Medicine, Hawler Medical University, Erbil, Iraq.
    Fungal and Other Microorganisms Involved in Otomycosis in Hawler Area2009In: Middle East Journal of Internal Medicine, ISSN 1837-9052, Vol. 2, no 1, p. 7-10Article in journal (Refereed)
    Abstract [en]

    Background: Patients with clinical manifestations suggestive of otitis externa.

    Objective: To study the prevalence of mycotic infection in these patients.

    Methods: Ear swabs were taken from these patients and both direct examination and culture were done.

    Results: The most common pathogenic fungal isolates were Candida species (8.4%) and Aspergillus niger (4.2%). Conclusion: Besides Aspergillus and Candida species isolated in these patients, many bacteria were also seen. Dry climate, wearing head clothes, presence of middle ear infection, wearing hearing aids and swimming were predisposing factors for this infection.

  • 19.
    Basic, Vladimir T.
    et al.
    Department of Clinical Medicine, Örebro University, Örebro, Sweden.
    Tadele, Elsa
    Department of Clinical Medicine, Örebro University, Örebro, Sweden; Medical University of Giessen, Molecular Biology and Medicine of the Lung program, Giessen, Germany.
    Jacobsen, Annette
    Department of Clinical Medicine, Örebro University, Örebro, Sweden; School of Biomedical Sciences, Charles Sturt University, Wagga Wagga, Australia.
    Sirsjö, Allan
    Department of Clinical Medicine, Örebro University, Örebro, Sweden.
    Abdel-Halim, Samy M.
    Division of Respiratory Medicine and Allergology, Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden.
    Chronic cigarette smoke exposureimpairs skeletal muscle regenerative capacity in murineCOPD/emphysema model.Manuscript (preprint) (Other academic)
    Abstract [en]

    Background: Cigarette smoke (CS) is a well established risk factor in the development of COPD and irreversible airflow limitation. In contrast, the extent to which CS exposure contributes to development of peripheral skeletal muscle dysfunction and wasting remains largely unknown. Decline in skeletal muscle regenerative capacity has been previously reported in COPD patients.

    Methods: To investigate effects of chronic CS exposure on skeletal muscle regenerative capacity, 129/SvJ mice were exposed to CS for 6 months. The expression levels of myogenin, Jarid2, Znf496, Notch1, Pax7, Fgf1 and Myh3, which are known to regulate skeletal muscle myogenesis, were studied. Additionally, number of fibers with central nuclei, myonuclei number and mean fiber cross-sectional area were assessed.

    Results: Compared to controls, skeletal muscles from CS-exposed mice exhibited significantly decreased expression of Jarid2, coupled with enhanced expression of Znf496, Notch1, Pax7, Fgf1 and Myh3. Expression of myogenin, a marker of terminally differentiated myofibers, was reduced. Furthermore, reduced muscle fiber crosssectional area, increased number of fibers with central nuclei and reduced myonuclei number were also observed in CS-exposed animals.

    Conclusions: Taken together, current results provide evidence linking chronic CS exposure and an ongoing damage/repair process as well as impaired regenerative capacity in skeletal muscles of CS-exposed mice.

  • 20.
    Bejerot, Susanne
    et al.
    Örebro University, School of Medical Sciences. Department of Psychiatry, School of Medical Sciences, Örebro University, Örebro, Sweden; University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Hesselmark, Eva
    Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet, Solna, Sweden; Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden.
    The Cunningham Panel is an unreliable biological measure2019In: Translational Psychiatry, E-ISSN 2158-3188, Vol. 9, no 1, article id 49Article in journal (Refereed)
  • 21.
    Benatti, Alice
    et al.
    Operative Unit of Otolaryngology and Otosurgery, Padua University, Padua, Italy.
    Castiglione, Alessandro
    Department of Neurosciences, Padua University, Padua, Italy.
    Trevisi, Patrizia
    Department of Neurosciences, Padua University, Padua, Italy.
    Bovo, Roberto
    Operative Unit of Otolaryngology and Otosurgery, Padua University, Padua, Italy.
    Rosignoli, Monica
    ENT Department, Audiology Service, Ferrara University, Ferrara, Italy.
    Manara, Renzo
    Neuroradiology, Padua University, Padua, Italy.
    Martini, Alessandro
    Department of Neurosciences, Operative Unit of Otolaryngology and Otosurgery, Padua University, Padua, Italy.
    Endocochlear inflammation in cochlear implant users: Case report and literature review2013In: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 77, no 6, p. 885-893Article, review/survey (Refereed)
    Abstract [en]

    Objectives: Cochlear implantation is a relatively safe procedure with a low complication rate. The overall rate of complications among cochlear implant patients ranges from 6% to 20%. Major complications are those that are life-threatening or require surgery, whereas minor complications are those that can be medically treated. Nonetheless, certain complications, even if highly rare, may require specific investigations and treatments. Among these rare complications are those with endocochlear involvement, such as cochleitis or labyrinthitis, with fibrosis or ossification that could lead to explantation. The aims of the present study were to report a particular case of post-operative cochleitis and to review the rate of complications after cochlear implantation, emphasising those conditions with proven endocochlear involvement.

    Methods: We refer to the case of an eight-year-old Italian boy affected by the sudden onset of headache, ipsilateral otalgia and facial paresis, who presented to our clinic for inexplicable worsening of the performance of his implant and his residual hearing, six years after surgery. A complete investigation including (clinical history, routine, autoimmune and serological blood tests, electrophysiological measurements from the cochlear implant and neuroimaging) was performed and is herein described. Additionally, a comprehensive review of the literature was conducted using internet search engines; 274 papers were selected, 88 of which were best suited to our purposes.

    Results: In our case, the progression of the symptoms and the performance decrement required explantation, followed by a complete recovery. Reviewing the literature revealed only three reports concerning cases of proven endocochlear phlogosis that required revision surgery. Wound swelling/infection and vertigo remain the two most common complications of cochlear implantation. Failure of the device is the third most frequent complication (10.06% of all complications and 1.53% of cochlear implantations). Other rare conditions (such as granulating labyrinthitis with cochlear fibrosis, ossification and erosion, silicone allergy and the formation of a biofilm around the internal device) are possible and unpredictable. Although rare (approximately 1%), such cases may require explantation.

    Conclusions: Despite efforts by both surgeons and manufacturers, device-related and surgical complications still occur. These and other rare conditions demand specific management, and their frequency may be underestimated. Further studies are needed to assess more realistic rates of complications and devise more efficient strategies for early diagnosis and treatment.

  • 22.
    Bergemalm, Per-Olof
    Örebro University, Department of Nursing and Caring Sciences.
    Progress of sensorineural hearing loss after closed head injury: presence of autoantibodies2004In: Audiological Medicine, ISSN 1651-386X, E-ISSN 1651-3835, Vol. 2, no 2, p. 92-99Article in journal (Refereed)
    Abstract [en]

    Sensorineural hearing impairment is a common sequel to closed head injury (CHI). In most cases, the impairment subsides within the first post‐traumatic year; in some cases the impairment is permanent and in other cases there will be progress. In most cases the reason for progress is unknown. Substantial research has been carried out to ascertain the aetiology of sudden sensorineural hearing loss (SNHL) and Menière's disease. A number of studies have demonstrated the presence of antibodies against HSP 70 antigen in patients' sera. In accordance with this finding, autoimmunity as an aetiological factor for progressive SNHL has been proposed. There are reports indicating that trauma is a possible mechanism for eliciting an autoimmune response, and the aim of the present study is to study this mechanism. The question of sympathetic cochleolabyrinthitis is highlighted. Sera from 35 subjects with a history of closed head injury three to 13 years prior to the investigation were obtained for Western blot immunoassay in an attempt to identify HSP 70 antibodies. Twenty‐seven of the subjects demonstrated progress of a sensorineural hearing impairment after CHI. Two of 35, both with progress of a SNHL, demonstrated presence of anti‐HSP 70 antibodies. Therefore, a significant role of an HSP 70 related autoimmune mechanism for SNHL progress post CHI could not be confirmed in the present study. Nevertheless, the possible role of autoantibodies in individual cases cannot be ruled out, neither can the presence of other transitory autoimmune reactions after CHI. No conclusive evidence of sympathetic cochleolabyrinthitis was found.

  • 23.
    Bergemalm, Per-Olof
    Örebro University, Department of Nursing and Caring Sciences.
    Progressive hearing loss after closed head injury: a predictable outcome?2003In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 123, no 7, p. 836-845Article in journal (Refereed)
    Abstract [en]

    Objectives-To evaluate the prevalence of progression of closed head injury (CHI)-induced hearing impairment, defined as greater than or equal to 15 dB HL deterioration at 1 or more frequencies, and to identify risk factors in patient history and initial status that could predict progression.

    Material and Methods-A total of 600 patients with major CHI were admitted to 2 Swedish medical centres during a 14-year period. The type of injury was established by means of CT and the severity of head injury was measured using the Swedish Reaction Level Scale (RLS). In 62 of these patients, pure-tone audiometry was performed soon after the injury. Forty-three patients agreed to participate in the present investigation, which was carried out 2-13 years after the injury. Each participant was evaluated using pure-tone audiometry and an itemized anamnesis was obtained.

    Results-There was a higher prevalence of hearing impairments in the study group compared to a control group. Thirty-two subjects (74%) showed a progression of greater than or equal to 15 dB, which was significantly greater than the spontaneous progression in the control group. Age and temporal bone fracture were risk factors for progression but not brain contusion only or RLS. There was an association between early pure-tone average (PTA) and progression as well as regression, i.e. the poorer the initial PTA the greater the progression as well as regression, indicating increased instability in the auditory system. Examination of patient histories did not reveal any single risk factors for progression. A serendipitous finding was a higher prevalence of reported memory shortcomings among those with post-traumatic tinnitus.

    Conclusion-Especially for those with fracture of the temporal bone the present results stress the importance of audiometric evaluation and follow-up, from both rehabilitation and medicolegal perspectives

  • 24.
    Bergemalm, Per-Olof
    et al.
    Örebro University, Department of Nursing and Caring Sciences.
    Lyxell, Björn
    Appearances are deceptive?: Long-term cognitive and central auditory sequelae from closed head injury2005In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 44, no 1, p. 39-49Article in journal (Refereed)
    Abstract [en]

    The purpose of the present study was to examine possible signs of long-term cognitive and/or central auditory sequelae seven to eleven years after a closed head injury (CHI) of sufficient severity to cause scull fracture and/or brain contusion. Another purpose was that this investigation should be carried out in a group of recovered trauma victims with, to the individual, no known or minimal sequelae. A computer-based set of five cognitive tests and three central auditory tests were used in a group of formerly brain-injured patients who considered themselves as well recovered. Most of the participants did not report any signs of cognitive or auditory impairment. Tests of working memory capacity, verbal information processing speed, phonological processing and verbal inference-making ability were used. Auditory brain response (ABR), distorted speech audiometry (interrupted speech), and phase audiometry were used to test central auditory function. The initial severity of brain damage, i.e. status when the patient arrived at the emergency ward, was estimated with Swedish Reaction Level Scale (RLS). Cognitive shortcomings after CHI were demonstrated in a high percentage (59%, 13/22) of the cases seven to eleven years after the injury. Central auditory processing disorders (APD) were also demonstrated in a fairly high percentage (58%, 11/19) of the subjects. None of the correlations between RLS and the results on cognitive and central auditory tests reached statistical significance. However, there was a correlation between cognitive performance and the results on the central auditory tests used in this investigation. Eighty percent (8/10) of those participants with pathologies on ABR and/or phase audiometry and/or IS also failed on one or more of the cognitive tasks, compared to 44% (4/9) among those with no signs of APD. It is possible, many years after CHI, to observe cognitive shortcomings and APD in a relatively high percentage of CHI cases that are subjectively considered to be fairly well recovered. The cognitive tasks used in the study have proved to be a sensitive method to discover cognitive impairments. Long-term cognitive sequelae and APD could not be predicted from RLS scores.

  • 25.
    Bergemalm, P-O
    Örebro University Hospital.
    Interrupted speech and MRI findings after traumatic head injury: A long-term follow-up2013In: Hearing, Balance and Communication, ISSN 2169-5725, Vol. 11, no 2, p. 80-86Article in journal (Refereed)
  • 26.
    Berglund, Malin
    et al.
    Department of Otorhinolaryngology, NU Hospital Group, Trollhättan, Sweden; Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Olaison, Sara
    Department of Otorhinolaryngology, Örebro University Hospital, Örebro, Sweden.
    Bonnard, Åsa
    Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden; Division of CLINTEC, Department of Otorhinolaryngology, Karolinska Institute, Stockholm, Sweden.
    Fransson, Mattias
    Department of Otorhinolaryngology, Lund University Hospital, Lund, Sweden.
    Hultcrantz, Malou
    Division of CLINTEC, Department of Otorhinolaryngology, Karolinska Institute, Stockholm, Sweden.
    Florentzson, Rut
    Department of Otorhinolaryngology, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Dahlin, Christer
    Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Oral & Maxillofacial Surgery, NU Hospital Group, Trollhättan, Sweden.
    Eriksson, Per Olof
    Department of Surgical Sciences, Otorhinolaryngology, Uppsala University Hospital, Uppsala, Sweden.
    Westman, Eva
    Department of Clinical Sciences, Otorhinolaryngology, Umeå University, site Sundsvall, Umeå, Sweden.
    Hearing outcome after myringoplasty in Sweden: A nationwide registry-based cohort study2020In: Clinical Otolaryngology, ISSN 1749-4478, E-ISSN 1365-2273, Vol. 45, no 3, p. 357-363Article in journal (Refereed)
    Abstract [en]

    Objectives: To present hearing results after successful primary myringoplasty surgeries registered in the Swedish Quality Registry for Myringoplasty and to evaluate the chance of hearing improvement and the risk of hearing loss.

    Design: A retrospective nationwide cohort study based on prospectively collected registry data between 2002 and 2012.

    Settings: Registry data from secondary and tertiary hospitals performing myringoplasty.

    Participants: Patients with healed tympanic membrane after primary myringoplasty surgery performed from 2002 to 2012 in Sweden.

    Main outcome measures: Postoperative hearing results, hearing gain and air-bone gap (ABG).

    Results: In 2226 myringoplasties, air conduction audiograms were recorded, and the average preoperative pure tone average (PTA(4)) of the group was 28.5 dB, which improved postoperatively to 19.6 dB with an average of 8.8 dB improvement. Bone conduction was measured for 1476 procedures. Closure of the ABG to 10 dB or less was achieved in 51% of the ears and to less than 20 dB in 89% of the ears. Sixty-one percent of patients with preoperatively deteriorated hearing experienced improved hearing, but 3% of all patients experienced deteriorated hearing. After the surgery, 93% of the patients were satisfied.

    Conclusions: Hearing results after successful myringoplasty surgery are often favourable, but although the tympanic membrane is healed, hearing improvement is not guaranteed, and hearing deterioration can also occur.

  • 27.
    Bergman, Pia
    et al.
    Department of Otorhinolaryngology, Jönköping County hospital, Jönköping, Sweden; Division of Neuro and Inflammation Science, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; Department of Otorhinolaryngology in Linköping, Anaesthetics, Operations and Specialty Surgery Center, Region Östergötland, Linköping, Sweden.
    Lyxell, Björn
    Department of Special Needs Education, Oslo University, Oslo, Norway; Linnaeus Centre HEAD, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.
    Harder, Henrik
    Department of Otorhinolaryngology in Linköping, Anaesthetics, Operations and Specialty Surgery Center, Region Östergötland, Linköping, Sweden.
    Mäki-Torkko, Elina
    Örebro University, School of Medical Sciences. Division of Neuro and Inflammation Science, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; Department of Otorhinolaryngology in Linköping, Anaesthetics, Operations and Specialty Surgery Center, Region Östergötland, Linköping, Sweden; Linnaeus Centre HEAD, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.
    The outcome of unilateral cochlear implantation in adults: Speech recognition, health-related quality of life and level of anxiety and depression: a one- and three-year follow up study2020In: International Archives of Otorhinolaryngology, ISSN 1809-9777, E-ISSN 1809-4864, Vol. 24, no 3, p. 338-346Article in journal (Refereed)
    Abstract [en]

    Introduction: Hearing impairment is a common disease worldwide, with a comprehensive impact, and cochlear implantation (CI) is an intervention for profound hearing impairment.

    Objective: To study the outcome one and three years after unilateral CI on hearing, health-related quality of life and level of depression and anxiety, and the correlation between the outcomes. Second, to study whether age, gender, etiology, operated side, residual hearing or cognitive performance can predict the outcome.

    Methods: A prospective longitudinal study including adults with profound postlingual hearing impairment, with respect to hearing (speech recognition), health-related quality of life (Health Utilities Index 3) and level of depression and anxiety (Hospital Anxiety and Depression scale), pre-CI, and one and three years post-CI. The total sample was composed of 40 participants (40% of men), with a mean age of 71 years.

    Results: Speech recognition and the overall health-related quality of life improved one year post-CI (p ¼ 0.000), without correlation (ρ¼ 0.27), and with no difference three years post-CI. The hearing attribute (in the health-related quality of life instrument) improved one and three years post-CI (p ¼ 0.000). The level of anxiety did not change one and three years post-CI. The level of depression improved one year post-CI (p ¼ 0.036), and deteriorated three years post-CI (p ¼ 0.031). Age, etiology, operated side, residual hearing and cognitive performance did not predict the outcome, but the female gender did significantly improve speech recognition compared with men (p ¼ 0.009).

    Conclusion: The CI significantly improved speech recognition, health-related quality of life and level of depression one year post-CI without mutual correlation, and women performed significantly better than men. There were no further improvements three years post-CI, apart from the hearing attribute.

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    The Outcome of Unilateral Cochlear Implantation in Adults: Speech Recognition, Health-Related Quality of Life and Level of Anxiety and Depression: a One- and Three-Year Follow-Up Study
  • 28.
    Bjessbo, Sofia
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Lindström Stolt, Jessica
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    BAHA versus CROS: En sammanställning av en experimentell studie om hörhjälpmedel för personer med ensidig dövhet2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 29.
    Bogren, Sandra
    et al.
    Örebro University, School of Health and Medical Sciences.
    Nilsson, Kristine
    Dikotiska lyssningstester:  En mätmetod i testbatteriet för utredning av centrala auditiva störningar2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
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  • 30.
    Boisvert, Isabelle
    et al.
    Centre for Language Sciences, Macquarie University, Sydney NSW, Australia; HEARing Cooperative Research Centre, Melbourne VIC, Australia; Linnaeus Centre HEAD, Swedish Institute for Disability Research, Linnaeus University, Växjö, Sweden.
    Lyxell, Björn
    Linnaeus Centre HEAD, Swedish Institute for Disability Research, Linnaeus University, Växjö, Sweden; Department of Behavioural Sciences and Learning, Division of Technical Audiology, Linköping University, Linköping, Sweden.
    Mäki-Torkko, Elina
    Örebro University, School of Medical Sciences. Linnaeus Centre HEAD, Swedish Institute for Disability Research, Linnaeus University, Växjö, Sweden; Department of Clinical and Experimental Medicine, Division of Technical Audiology, Linkoping University, Linkoping, Sweden; Department of ENT-Head Neck Surgery UHL, County Council of Östergötland, Linköping, Sweden.
    McMahon, Catherine M.
    Centre for Language Sciences, Macquarie University, Sydney NSW, Australia; HEARing Cooperative Research Centre, Melbourne VIC, Australia.
    Dowell, Richard C.
    HEARing Cooperative Research Centre, Melbourne VIC, Australia; Department of Audiology and Speech Pathology, University of Melbourne, Melbourne, Australia; Department of Audiology, Royal Victorian Eye and Ear Hospital, Melbourne VIC, Australia.
    Choice of ear for cochlear implantation in adults with monaural sound-deprivation and unilateral hearing aid2012In: Otology and Neurotology, ISSN 1531-7129, E-ISSN 1537-4505, Vol. 33, no 4, p. 572-579Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To identify whether speech recognition outcomes are influenced by the choice of ear for cochlear implantation in adults with bilateral hearing loss who use a hearing aid in 1 ear but have long-term auditory deprivation in the other.

    STUDY DESIGN: Retrospective matched cohort study. Speech recognition results were examined in 30 adults with monaural sound deprivation. Fifteen received the implant in the sound-deprived ear and 15 in the aided ear.

    SETTING: Tertiary referral centers with active cochlear implant programs.

    PATIENTS: Adults with bilateral hearing loss and a minimum of 15 years of monaural sound deprivation who received a cochlear implant after meeting the traditional implantation criteria of the referral centers.

    INTERVENTION: Cochlear implantation with devices approved by the U.S. Food and Drug Administration.

    MAIN OUTCOME MEASURE(S): Paired comparisons of postoperative monosyllabic word recognition scores obtained with the implant alone and in the usual listening condition (CI alone or bimodal).

    RESULTS: With the cochlear implant alone, individuals who received the implant in a sound-deprived ear obtained poorer scores than individuals who received the implant in the aided ear. There was no significant difference, however, in speech recognition results for the 2 groups when tested in their usual listening condition. In particular, poorer speech recognition scores were obtained with the cochlear implant alone by individuals using bimodal hearing.

    CONCLUSION: Similar clinical outcomes of cochlear implantation can be achieved by adults with a long-term monaural sound deprivation when comparing the usual listening condition, irrespective of whether the implant is in the sound-deprived or in the aided ear.

  • 31.
    Borg, Erik
    et al.
    Audiol Res Ctr, Örebro University Hospital, Örebro, Sweden.
    Borg, Birgitta
    Audiol Res Ctr, Örebro University Hospital, Örebro, Sweden.
    New perspectives on counselling in audiological habilitation/rehabilitation2015In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 54, no 1, p. 11-19Article in journal (Refereed)
    Abstract [en]

    Objective: To develop and apply a pedagogical method focusing on Empowerment, Empathy, Competence, and Counselling: the EC programme, and to present an initial evaluation. Design: The EC programme was gradually developed within a study circle framework and in dialogue with study circle leaders and participants (clients) with hearing impairment (HI). An evaluation was carried out with the study circle leaders. Study sample : Seventeen upper secondary school students with HI took part in the development of the programme. Eighteen study circle leaders responded to a questionnaire. Results: The EC programme developed consisted of films, CD, and DVD productions to increase insight into one's own hearing ability, to demonstrate for others what HI means, strategies to evaluate situations, and help to act constructively in social situations. The study circle leaders found most of the course material appropriate and easy to use, as a whole or in parts. The leaders' evaluations indicated that the clients had increased their knowledge about how the HI affected themselves and others. The clients had improved their self-confidence and their empathic view of others. Conclusion: The EC programme can be used in its entirety or in part. Participation may lead to increased empowerment, empathy, competence and counselling ability.

  • 32.
    Bovo, Roberto
    et al.
    University of Ferrara, Ferrara, Italy.
    Castiglione, Alessandro
    University of Ferrara, Ferrara, Italy.
    Ciorba, A.
    University of Ferrara, Ferrara, Italy.
    Borrelli, M.
    University of Ferrara, Ferrara, Italy.
    Martini, A.
    University of Ferrara, Ferrara, Italy.
    Hearing impairment in the Sturge-Weber syndrome2009In: European Journal of Clinical Investigation, ISSN 0014-2972, E-ISSN 1365-2362, Vol. 39, no 9, p. 837-838Article in journal (Refereed)
  • 33.
    Bovo, Roberto
    et al.
    Audiology Department, University Hospital of Ferrara, Ferrara, Italy.
    Ciorba, Andrea
    Audiology Department, University Hospital of Ferrara, Ferrara, Italy.
    Castiglione, Alessandro
    Audiology Department, University Hospital of Ferrara, Ferrara, Italy.
    Martini, Alessandro
    Audiology Department, University Hospital of Ferrara, Ferrara, Italy.
    Cavernous hemangioma of the external ear: case report and literature review2010In: B-ENT, ISSN 1781-782X, Vol. 6, no 2, p. 127-130Article, review/survey (Refereed)
    Abstract [en]

    Objectives: To describethe occurrence of a cavernous hemangioma of the external auditory meatus extending to the middle ear and the retroauricolar region in an adult patient, and to review the relevant literature.

    Methods: Case report. We report the clinical presentation, imaging studies and surgical procedures used in the study.

    Results:  The angiographic study showed that the blood supply of the mass originated from the posterior auricular artery. Via a retroauricular approach, this artery was isolated and ligated in order to control the intra-operative bleeding. A canal wall up mastoidectomy with posterior tympanotomy and a tympano-canaloplasty were performed, permitting a complete excision. At 36 months of follow-up, no clinical and radiological signs of recurrence were detected.

    Conclusion: Surgical removal is the treatment of choice, with rare recurrence of the hemangiomas. Pre-operative evaluation is based on computed tomography (CT scan), but should be followed by magnetic resonance angiography (MR-angio) or intra-arterial digital subtraction angiography (IA-DSA), especially in case of wider lesions.

  • 34.
    Bovo, Roberto
    et al.
    Audiology Department, University of Ferrara, Ferrara, Italy.
    Ciorba, Andrea
    Audiology Department, University of Ferrara, Ferrara, Italy.
    Trevisi, Patrizia
    Audiology Department, University of Ferrara, Ferrara, Italy.
    Aimoni, Claudia
    Audiology Department, University of Ferrara, Ferrara, Italy.
    Cappiello, Lucia
    Audiology Department, University of Ferrara, Ferrara, Italy.
    Castiglione, Alessandro
    Audiology Department, University of Ferrara, Ferrara, Italy.
    Govoni, Marcello
    Reumatology Department, University of Ferrara, Ferrara, Italy.
    Martini, Alessandro
    Audiology Department, University of Ferrara, Ferrara, Italy.
    Cochlear implant in Cogan syndrome2011In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 131, no 5, p. 494-497Article in journal (Refereed)
    Abstract [en]

    Conclusions: Despite the need for special fitting strategies, improvements in speech discrimination tests support the use of cochlear implantation (CI) for patients with Cogan syndrome. Adequate preimplant counselling is mandatory, to prevent high expectations and to stress the necessity for bilateral implantation.

    Objective: In 60% of patients with Cogan syndrome, CI remains the only treatment option. Literature data agree that once the electrode array is properly inserted, functional outcomes are very good. Nevertheless, results may deteriorate due to progressive cochlear ossification. A few studies have documented the outcomes of CI in these patients, but none have reported the long-term results.

    Methods: This was a retrospective study describing the outcomes of 3 implanted patients with Cogan syndrome – among 300 adult patients who received a cochlear implant, 3 had become deaf due to Cogan syndrome.

    Results: In one patient the cochlear ossification advanced and the speech perception abilities worsened from the highest category to identification of words in closed set. The second patient complained of an abrupt reduction of loudness at 18 months post-implant, which required an increased electrical stimulation. The third patient reached the identification category probably due to auditory dyssynchrony, as an atypical consequence of the syndrome.

  • 35. Brigger, M.T.
    et al.
    Hultcrantz, Elisabeth
    Ericsson, Elisabeth
    Örebro University, School of Health Sciences.
    Lowe, D.
    Gysin, C.
    Dulguerov, P.
    Comments to ORL 2013;75:175–181 (DOI: 10.1159/000342319)2013In: Journal for Oto-Rhino-Laryngology, ISSN 0301-1569, E-ISSN 1423-0275, Vol. 75, no 3, p. 182-183Article in journal (Other academic)
  • 36. Brigger, M.T.
    et al.
    Hultcrantz, Elisabeth
    Ericsson, Elisabeth
    Örebro University, School of Health Sciences.
    Lowe, D.
    Sarny, S.
    Comments to ORL 2013;75:166–173 (DOI: 10.1159/000342317)2013In: Journal for Oto-Rhino-Laryngology, ISSN 0301-1569, E-ISSN 1423-0275, Vol. 75, no 3, p. 174-174Article in journal (Other academic)
  • 37. Brigger, M.T.
    et al.
    Hultcrantz, Elisabeth
    Ericsson, Elisabeth
    Örebro University, School of Health Sciences.
    Lowe, D.
    Windfuhr, J.P.
    Sarny, S.
    Comments to ORL 2013;75:144–151 (DOI: 10.1159/000343706)2013In: Journal for Oto-Rhino-Laryngology, ISSN 0301-1569, E-ISSN 1423-0275, Vol. 75, no 3, p. 152-154Article in journal (Other academic)
  • 38. Brigger, M.T.
    et al.
    Hultcrantz, Elisabeth
    Ericsson, Elisabeth
    Örebro University, School of Health Sciences.
    Lowe, D.
    Windfuhr, J.P.
    Sarny, S.
    Comments to ORL 2013;75:193–202 (DOI: 10.1159/000342329)2013In: Journal for Oto-Rhino-Laryngology, ISSN 0301-1569, E-ISSN 1423-0275, Vol. 75, no 3, p. 203-204Article in journal (Other academic)
  • 39. Brigger, M.T.
    et al.
    Hultcrantz, Elisabeth
    Ericsson, Elisabeth
    Örebro University, School of Health Sciences.
    Windfuhr, J.P.
    Gysin, C.
    Dulguerov, P.
    Sarny, S.
    Comments to ORL 2013;75:136–141 (DOI: 10.1159/000342315)2013In: Journal for Oto-Rhino-Laryngology, ISSN 0301-1569, E-ISSN 1423-0275, Vol. 75, no 3, p. 142-143Article in journal (Other academic)
  • 40.
    Busi, Micol
    et al.
    Department of Medical & Surgical Disciplines of Communication and Behavior, University Hospital of Ferrara, Ferrara, Italy.
    Rosignoli, Monica
    ENT & Audiology Department, University Hospital of Ferrara, Ferrara, Italy.
    Castiglione, Alessandro
    Department of Neurosciences, Complex Operative Unit of Otorhinolaryngology and Otosurgery, University Hospital of Padua, Padua, Italy.
    Minazzi, Federica
    ENT & Audiology Department, University Hospital of Ferrara, Ferrara, Italy.
    Trevisi, Patrizia
    Department of Neurosciences, Complex Operative Unit of Otorhinolaryngology and Otosurgery, University Hospital of Padua, Padua, Italy.
    Aimoni, Claudia
    ENT & Audiology Department, University Hospital of Ferrara, Ferrara, Italy.
    Calzolari, Ferdinando
    Neuroradiology Service, University Hospital of Udine, Udine, Italy.
    Granieri, Enrico
    Neurological Clinic, University Hospital of Ferrara, Ferrara, Italy.
    Martini, Alessandro
    Department of Neurosciences, Complex Operative Unit of Otorhinolaryngology and Otosurgery, University Hospital of Padua, Padua, Italy.
    Cochlear Implant Outcomes and Genetic Mutations in Children with Ear and Brain Anomalies2015In: Biomedical Research International, ISSN 2314-6133, Vol. 2015, article id 696281Article in journal (Refereed)
    Abstract [en]

    Background: Specific clinical conditions could compromise cochlear implantation outcomes and drastically reduce the chance of an acceptable development of perceptual and linguistic capabilities. These conditions should certainly include the presence of inner ear malformations or brain abnormalities. The aims of this work were to study the diagnostic value of high resolution computed tomography (HRCT) and magnetic resonance imaging (MRI) in children with sensorineural hearing loss who were candidates for cochlear implants and to analyse the anatomic abnormalities of the ear and brain in patients who underwent cochlear implantation. We also analysed the effects of ear malformations and brain anomalies on the CI outcomes, speculating on their potential role in the management of language developmental disorders.

    Methods: The present study is a retrospective observational review of cochlear implant outcomes among hearing-impaired children who presented ear and/or brain anomalies at neuroimaging investigations with MRI and HRCT. Furthermore, genetic results from molecular genetic investigations (GJB2/GJB6 and, additionally, in selected cases, SLC26A4 or mitochondrial-DNA mutations) on this study group were herein described. Longitudinal and cross-sectional analysis was conducted using statistical tests.

    Results: Between January 1, 1996 and April 1, 2012, at the ENT-Audiology Department of the University Hospital of Ferrara, 620 cochlear implantations were performed. There were 426 implanted children at the time of the present study (who were <18 years). Among these, 143 patients (64 females and 79 males) presented ear and/or brain anomalies/lesions/malformations at neuroimaging investigations with MRI and HRCT. The age of the main study group (143 implanted children) ranged from 9 months and 16 years (average = 4.4; median = 3.0).

    Conclusions: Good outcomes with cochlear implants are possible in patients who present with inner ear or brain abnormalities, even if central nervous system anomalies represent a negative prognostic factor that is made worse by the concomitant presence of cochlear malformations. Common cavity and stenosis of the internal auditory canal (less than 2 mm) are negative prognostic factors even if brain lesions are absent.

  • 41.
    Bäckström, Matilda
    et al.
    Örebro University, School of Health and Medical Sciences.
    Eriksson, Birgitta
    Örebro University, School of Health and Medical Sciences.
    Auditiv deprivering: i ett audionom perspektiv2008Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Studien riktar sig främst till audionomer, och andra med intresse av hörselrehabilitering.

    Auditiv deprivering kan visa sig som en med tiden försämrad taluppfattning i örat som inte fått adekvat stimulering. Vad som karaktäriserar dem som drabbas är inte klarlagt. Inte heller vet man exakt orsak eller tidsförlopp. Genom att hörapparatanpassa det drabbade örat har effekten kunnat reduceras och i vissa fall har fullständig återhämtning konstaterats.

    Litteraturstudiens syfte var att belysa fenomenet och aspekter som bör beaktas i audionomens arbete med insatser av både förebyggande och rehabiliterande karaktär. Metoden var att granska artiklar framtagna genom systematisk och manuell sökning, i databaser tillgängliga genom Örebro universi¬tet.

    Resultatet visar att personer med hörselnedsättning av såväl sensorineural som konduktiv art drabbas. Hörselnedsättningens grad kan troligen påverka, liksom symmetrin mellan öronen. Den initiala taluppfattningen i örat som drabbas kan variera. Detta arbete visar också att en sensitiv metod för att konstatera effekten är den som i Sverige heter maximal taluppfattning, men objektiva mätmetoder välkomnas. Audionomens ställningstagande i val av en eller två hörapparater berörs, med utgångspunkt av auditiv deprivering och binaural interference. Resultat och diskussion lyfter viktiga aspekter att beakta för audionomen i det rehabiliterande arbetet.

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  • 42.
    Båsjö, Sara
    et al.
    Örebro University, School of Health Sciences. Swedish Institute for Disability Research, Örebro University Hospital, Örebro, Sweden; HEAD Graduate School, Linköping University, Linköping, Sweden.
    Möller, Claes
    Örebro University, School of Health Sciences. Swedish Institute for Disability Research, Örebro University Hospital, Örebro, Sweden.
    Widén, Stephen
    Örebro University, School of Health Sciences. Swedish Institute for Disability Research, Örebro University Hospital, Örebro, Sweden.
    Jutengran, Göran
    School of Health Sciences, University of Borås, Borås, Sweden.
    Kähäri, Kim
    Division of Audiology, Sahlgrenska Academy, Göteborg University, Göteborg, Sweden.
    Hearing thresholds, tinnitus, and headphone listening habits in nine-year-old children2016In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 55, no 10, p. 587-596Article in journal (Refereed)
    Abstract [en]

    Objective: Investigate hearing function and headphone listening habits in nine-year-old Swedish children. Design: A cross-sectional study was conducted and included otoscopy, tympanometry, pure-tone audiometry, and spontaneous otoacoustic emissions (SOAE). A questionnaire was used to evaluate headphone listening habits, tinnitus, and hyperacusis. Study sample: A total of 415 children aged nine years.

    Results: The prevalence of a hearing threshold 20 dB HL at one or several frequencies was 53%, and the hearing thresholds at 6 and 8 kHz were higher than those at the low and mid frequencies. SOAEs were observed in 35% of the children, and the prevalence of tinnitus was 5.3%. No significant relationship between SOAE and tinnitus was found. Pure-tone audiometry showed poorer hearing thresholds in children with tinnitus and in children who regularly listened with headphones.

    Conclusion: The present study of hearing, listening habits, and tinnitus in nine-year old children is, to our knowledge, the largest study so far. The main findings were that hearing thresholds in the right ear were poorer in children who used headphones than in children not using them, which could be interpreted as headphone listening may have negative consequences to children’s hearing. Children with tinnitus showed poorer hearing thresholds compared to children without tinnitus.

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  • 43.
    Carlsson, Ellinor
    et al.
    Örebro University, School of Health and Medical Sciences.
    Norén, Linda
    Örebro University, School of Health and Medical Sciences.
    Finns det samband mellan psykologiska symptom och sömnsvårigheter hos personer med hörselnedsättning?2009Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
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    Finns det samband
  • 44.
    Carlsson, Per-Inge
    et al.
    Örebro University, Department of Nursing and Caring Sciences.
    Borg, Erik
    Grip, Lars
    Dahl, Niklas
    Bondeson, Marie-Louise
    Variabillity in noise susceptibility in a Swedish population: the role of 35delG mutation in the Connexin 26 (GJB2) gene2004In: Audiological Medicine, ISSN 1651-386X, E-ISSN 1651-3835, Vol. 2, no 2, p. 123-130Article in journal (Refereed)
    Abstract [en]

    Although it seems that genetic factors can influence individual susceptibility to noise, still very little is known about the genes or the mechanisms involved. The connexin 26 (Cx26) (GJB2) gene is of particular interest to study in relation to noise, since the gene encodes the gap junction protein Cx26. Noise has a metabolic and mechanical effect on the inner ear and may, therefore, interfere with gap junction channels. In order to investigate whether abnormally high susceptibility to noise induced hearing loss (NIHL) in humans is associated with the common 35delG mutation in the Cx26 gene, 1200 noise‐exposed workers were investigated in Sweden. Using a selection procedure based on audiometric analysis, noise exposure data and questionnaires, noise‐exposed workers were divided into two categories: noise susceptible and noise resistant. There was a correspondence in noise susceptibility between this noise‐exposed population and the international reference ISO Standard 1999. Blood samples were drawn from 245 highly selected male subjects (103 noise susceptible, 112 noise resistant and 30 randomized cases), and genomic DNA was analysed with respect to the Cx26 35delG mutation. The incidence of 35delG carriers among this cohort was determined by multiplex, allele‐specific PCR. Two of the 245 subjects (0.8% ‐ [95% confidence interval 0.1–2.9]) were found to be heterozygous carriers of the 35delG mutation, while the remaining 243 subjects were all non‐carriers. Both the heterozygous carriers were found in the noise susceptible group. Statistical evaluation of the results demonstrated no significant difference in carrier incidence between the noise susceptible and noise resistant individuals in our Swedish noise‐exposed population. In conclusion, there was no support for a major role of Cx26 35delG mutation in explaining the variability in noise susceptibility in this Swedish population.

  • 45.
    Carlsson, Per-Inge
    et al.
    Department of Otorhinolaryngology, Central Hospital, Karlstad, Sweden; Audiological Research Centre, Örebro University Hospital, Örebro, Sweden.
    Karltorp, Eva
    Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden.
    Carlsson-Hansén, Eva
    Department of Audiology, Örebro University Hospital, Örebro, Sweden.
    Åhlman, Henrik
    Centre for Inherited Metabolic Diseases, Karolinska University Hospital, Stockholm, Sweden.
    Möller, Claes
    Audiological Research Centre, Örebro University Hospital, Örebro, Sweden; Department of Otorhinolaryngology Karolinska University Hospital, Stockholm, Sweden.
    von Döbeln, Ulrika
    Centre for Inherited Metabolic Diseases, Karolinska University Hospital, Stockholm, Sweden.
    GJB2 (Connexin 26) gene mutations among hearing-impaired persons in a Swedish cohort2012In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 132, no 12, p. 1301-1305Article in journal (Refereed)
    Abstract [en]

    Conclusion: The most common mutation in the Swedish population was Connexin 26 (C×26) 35delG, which indicates that the percentage of Swedish persons with C×26 mutations and polymorphisms in the GJB2 gene among non-syndromic hearing-impaired (HI) persons is comparable to the rest of Europe. The results strongly support a Swedish policy to offer all children with diagnosed hearing impairment genetic tests for the C×26 35delG mutation.

    Objectives: The aim of the present study was to search for mutations in the GBJ2 gene among Swedish persons with non-syndromic hearing impairment to further clarify how common these mutations are in Sweden, one of the northernmost countries in Europe.

    Methods: Seventy-nine patients with non-syndromic hearing impairment participated in the study. For 87% of the participants, a pure tone audiogram showed a severe or profound hearing impairment. Dried blood spots on filter paper, taken at 3-5 days of age in the Swedish nationwide neonatal screening programme for congenital disorders and saved in a biobank, were used for the molecular genetic analyses.

    Results: The total number of subjects with one or two pathologic mutations or a mutation of unknown consequence found in the GJB2 gene was 28 of 79 (35%). Nineteen (19) persons (24%) were homozygotes for the 35delG mutation.

  • 46.
    Castiglione, Alessandro
    University of Padua, Padua, Italy.
    Aging, cognitive decline and hearing loss: outcomes of auditory rehabilitation in older adults 20162016Doctoral thesis, monograph (Other academic)
  • 47.
    Castiglione, Alessandro
    et al.
    Department of Neurosciences and Complex Operative Unit of Otolaryngology, University Hospital of Padua, Padua, Italy.
    Benatti, Alice
    Department of Neurosciences and Complex Operative Unit of Otolaryngology, University Hospital of Padua, Padua, Italy.
    Velardita, Carmelita
    Department of Neurosciences and Complex Operative Unit of Otolaryngology, University Hospital of Padua, Padua, Italy.
    Favaro, Diego
    Department of Neurosciences and Complex Operative Unit of Otolaryngology, University Hospital of Padua, Padua, Italy.
    Padoan, Elisa
    Department of Neurosciences and Complex Operative Unit of Otolaryngology, University Hospital of Padua, Padua, Italy.
    Severi, Daniele
    Department of Neurosciences and Complex Operative Unit of Otolaryngology, University Hospital of Padua, Padua, Italy.
    Pagliaro, Michela
    Department of Neurosciences and Complex Operative Unit of Otolaryngology, University Hospital of Padua, Padua, Italy.
    Bovo, Roberto
    Department of Neurosciences and Complex Operative Unit of Otolaryngology, University Hospital of Padua, Padua, Italy.
    Vallesi, Antonino
    Department of Neurosciences and Center for Cognitive Neuroscience, University of Padua, Padua, Italy.
    Gabelli, Carlo
    Regional Center for the Study and Treatment of the Aging Brain, Department of Internal Medicine, University of Padua, Padua, Italy.
    Martini, Alessandro
    Department of Neurosciences and Complex Operative Unit of Otolaryngology, University Hospital of Padua, Padua, Italy; Department of Neurosciences and Center for Cognitive Neuroscience, University of Padua, Padua, Italy.
    Aging, Cognitive Decline and Hearing Loss: Effects of Auditory Rehabilitation and Training with Hearing Aids and Cochlear Implants on Cognitive Function and Depression among Older Adults2016In: Audiology & neuro-otology, ISSN 1420-3030, E-ISSN 1421-9700, Vol. 21, no Sup. 1, p. 21-28Article in journal (Refereed)
    Abstract [en]

    A growing interest in cognitive effects associated with speech and hearing processes is spreading throughout the scientific community essentially guided by evidence that central and peripheral hearing loss is associated with cognitive decline. For the present research, 125 participants older than 65 years of age (105 with hearing impairment and 20 with normal hearing) were enrolled, divided into 6 groups according to their degree of hearing loss and assessed to determine the effects of the treatment applied. Patients in our research program routinely undergo an extensive audiological and cognitive evaluation protocol providing results from the Digit Span test, Stroop color-word test, Montreal Cognitive Assessment and Geriatric Depression Scale, before and after rehabilitation. Data analysis was performed for a cross-sectional and longitudinal study of the outcomes for the different treatment groups. Each group demonstrated improvement after auditory rehabilitation or training on short- and long-term memory tasks, level of depression and cognitive status scores. Auditory rehabilitation by cochlear implants or hearing aids is effective also among older adults (median age of 74 years) with different degrees of hearing loss, and enables positive improvements in terms of social isolation, depression and cognitive performance. 

  • 48.
    Castiglione, Alessandro
    et al.
    Department of Neurosciences-Complex Operative Unit of Otorhinolaryngology and Otosurgery, University Hospital of Padua, Padua, Italy.
    Ciorba, Andrea
    ENT & Audiology Department, University Hospital of Ferrara, Ferrara, Italy.
    Aimoni, Claudia
    ENT & Audiology Department, University Hospital of Ferrara, Ferrara, Italy.
    Orioli, Elisa
    Centre for Haemostasis & Thrombosis, Haematology Section, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
    Zeri, Giulia
    Centre for Haemostasis & Thrombosis, Haematology Section, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
    Vigliano, Marco
    Centre for Haemostasis & Thrombosis, Haematology Section, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
    Gemmati, Donato
    Centre for Haemostasis & Thrombosis, Haematology Section, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
    Sudden sensorineural hearing loss and polymorphisms in iron homeostasis genes: new insights from a case-control study2015In: BioMed Research International, ISSN 2314-6133, E-ISSN 2314-6141, article id 834736Article in journal (Refereed)
    Abstract [en]

    Background: Even if various pathophysiological events have been proposed as explanations, the putative cause of sudden hearing loss remains unclear.

    Objectives: To investigate and to reveal associations (if any) between the main iron-related gene variants and idiopathic sudden sensorineural hearing loss.

    Study Design: Case-control study.

    Materials and Methods: A total of 200 sudden sensorineural hearing loss patients (median age 63.65 years; range 10–92) were compared with 400 healthy control subjects. The following genetic variants were investigated: the polymorphism c.−8CG in the promoter of the ferroportin gene (FPN1; SLC40A1), the two isoforms C1 and C2 (p.P570S) of the transferrin protein (TF), the amino acidic substitutions p.H63D and p.C282Y in the hereditary hemochromatosis protein (HFE), and the polymorphism c.–582AG in the promoter of the HEPC gene, which encodes the protein hepcidin (HAMP).

    Results: The homozygous genotype c.−8GG of the SLC40A1 gene revealed an OR for ISSNHL risk of 4.27 (CI 95%, 2.65–6.89; ), being overrepresented among cases.

    Conclusions: Our study indicates that the homozygous genotype FPN1 −8GG was significantly associated with increased risk of developing sudden hearing loss. These findings suggest new research should be conducted in the field of iron homeostasis in the inner ear.

  • 49.
    Castiglione, Alessandro
    et al.
    Department of Neurosciences, Operative Unit of Otolaryngology and Otosurgery, University of Padua, Padua, Italy.
    Melchionda, Salvatore
    Unit of Medical Genetics, IRCCS, "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Italy..
    Carella, Massimo
    Unit of Medical Genetics, IRCCS, "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Italy.
    Trevisi, Patrizia
    Department of Neurosciences, Operative Unit of Otolaryngology and Otosurgery, University of Padua, Padua, Italy.
    Bovo, Roberto
    Department of Neurosciences, Operative Unit of Otolaryngology and Otosurgery, University of Padua, Padua, Italy.
    Manara, Renzo
    Neuroradiologic Unit, University of Padua, Padua, Italy.
    Martini, Alessandro
    Department of Neurosciences, Operative Unit of Otolaryngology and Otosurgery, University of Padua, Padua, Italy.
    EYA1-related disorders: two clinical cases and a literature review2014In: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 78, no 8, p. 1201-1210Article, review/survey (Refereed)
    Abstract [en]

    Objectives: To delineate the diagnostic and rehabilitative aspects of syndromes that have overlapping features, we present the cases of two unrelated Caucasian males affected by hearing impairment, preauricular pits and cervical fistulae. Specific findings that are helpful in the diagnosis and management of EYA1-related disorders are highlighted.

    Methods: Genetic, otologic, imaging, eye and renal evaluations were conducted to achieve a detailed and comprehensive assessment, leading to the most accurate diagnosis and appropriate treatment. A literature review was also carried out.

    Results: Diagnostic criteria indicated that the two patients were affected by BOS1 (Branchio-Otic Syndrome 1). We also identified a novel sporadic missense mutation in the EYA1 gene: p.G533R (c.1597G>A, NM_000503.4), a highly conserved, heterozygotic amino acid substitution. In the other case, we identified the p.X593QextX6 (c.1777T>A, NM_000503.4) substitution. Both variants lead to isoform 1 (EYA1B and EYA1C) which is composed of 592 amino acids. Clinical and in silico evidence suggests a pathogenic role for the new mutations. Imaging evaluation revealed a complex pathology, characterized by external, inner and middle ear malformations, without renal anomalies.

    Conclusions: Our results demonstrate the importance of considering the imaging evaluation and the complete DNA sequencing of the EYA1 gene for the differential diagnosis of deafness and related branchio-oto-renal disorders.

  • 50.
    Castiglione, Alessandro
    et al.
    Örebro University, School of Medical Sciences. Örebro University Hospital. Audiology Department, Örebro University Hospital, Örebro, Sweden.
    Möller, Claes
    Örebro University, School of Health Sciences.
    Usher Syndrome2022In: Audiology Research, ISSN 2039-4330, E-ISSN 2039-4349, Vol. 12, no 1, p. 42-65Article, review/survey (Refereed)
    Abstract [en]

    Usher syndrome (USH) is the most common genetic condition responsible for combined loss of hearing and vision. Balance disorders and bilateral vestibular areflexia are also observed in some cases. The syndrome was first described by Albrecht von Graefe in 1858, but later named by Charles Usher, who presented a large number of cases with hearing loss and retinopathy in 1914. USH has been grouped into three main clinical types: 1, 2, and 3, which are caused by mutations in different genes and are further divided into different subtypes. To date, nine causative genes have been identified and confirmed as responsible for the syndrome when mutated: MYO7A, USH1C, CDH23, PCDH15, and USH1G (SANS) for Usher type 1; USH2A, ADGRV1, and WHRN for Usher type 2; CLRN1 for Usher type 3. USH is inherited in an autosomal recessive pattern. Digenic, bi-allelic, and polygenic forms have also been reported, in addition to dominant or nonsyndromic forms of genetic mutations. This narrative review reports the causative forms, diagnosis, prognosis, epidemiology, rehabilitation, research, and new treatments of USH.

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