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Rekonstruktionen von trachealen Stenosen stellen eine chirurgische Herausforderung dar und sind aufgrund individueller Probleme nicht immer zufriedenstellend möglich.Häufig verbleiben ein Tracheostoma mit einer als Platzhalter eingesetzten Trachealkanüle oder ein Montgomery®-T-Röhrchen.In einem kasuistischen Beitrag wird die Versorgung von laryngotrachealen Stenosen einerseits mit einer angefertigten Epithese und andrerseits mit einer Montgomerykanüle verglichen. Die Probleme,die sich bei beiden Patienten ergaben,lagen in den anatomischen Variationen der Trachea ober-und unterhalb des Tracheostomas.Im ersten Fall handelte es sich um eine laryngeale Stenose nach Suizidversuch, wofür eine Epithese verwendet wurde. Die Besonderheit dieser Kanüle lag darin, dass das Lumen oberhalb des Tracheostomas kleiner war als unterhalb des Tracheostomas. Erst hierdurch wurde eine ausreichende Stimmfunktion bei suffizienter Atmung möglich. Im zweiten Fall handelte es sich um einen Patienten mit einer Kehlkopfpapillomatose, die wegen häufig stenosierenden Rezidiven behandelt wurde. Hier kam oberhalb des Tracheotomas eine modifizierte gekürzte Montgomerykanüle zum Einsatz,unterhalb des Tracheostomas wurde die Luftzufuhr mit einer Trachealkanüle gesichert. Vorteil dieser Art der Versorgung war, dass sie problemlos häufig gewechselt werden konnte. Schwierigkeiten in der Schienung subglottischer Stenosen mit herkömmlichen Produkten liegen in der unterschiedlichen Angulation des supra- und substomalen Anteils sowie in unterschiedlichen Lumina. Zur Lösung dieses Problems bietet sich die kombinierte Versorgung des kranialen Bereichs mit einem modfizierten T-Röhrchen und zusätzlicher Sprechkanüle an oder die individuell gefertigte Schienung mit einer vom Epithetiker hergestellten Tracheal-"Epithese".Der Erstautor gibt keinen Interessenkonflikt an.

Item does not contain fulltext, OBJECTIVE: To confirm the clinical efficacy and safety of a direct acoustic cochlear implant. STUDY DESIGN: Prospective multicenter study. SETTING: The study was performed at 3 university hospitals in Europe (Germany, The Netherlands, and Switzerland). PATIENTS: Fifteen patients with severe-to-profound mixed hearing loss because of otosclerosis or previous failed stapes surgery. INTERVENTION: Implantation with a Codacs direct acoustic cochlear implant investigational device (ID) combined with a stapedotomy with a conventional stapes prosthesis MAIN OUTCOME MEASURES: Preoperative and postoperative (3 months after activation of the investigational direct acoustic cochlear implant) audiometric evaluation measuring conventional pure tone and speech audiometry, tympanometry, aided thresholds in sound field and hearing difficulty by the Abbreviated Profile of Hearing Aid Benefit questionnaire. RESULTS: The preoperative and postoperative air and bone conduction thresholds did not change significantly by the implantation with the investigational Direct Acoustic Cochlear Implant. The mean sound field thresholds (0.25-8 kHz) improved significantly by 48 dB. The word recognition scores (WRS) at 50, 65, and 80 dB SPL improved significantly by 30.4%, 75%, and 78.2%, respectively, after implantation with the investigational direct acoustic cochlear implant compared with the preoperative unaided condition. The difficulty in hearing, measured by the Abbreviated Profile of Hearing Aid Benefit, decreased by 27% after implantation with the investigational direct acoustic cochlear implant. CONCLUSION: Patients with moderate-to-severe mixed hearing loss because of otosclerosis can benefit substantially using the Codacs investigational device.

Item does not contain fulltext, OBJECTIVE: To confirm the clinical efficacy and safety of a direct acoustic cochlear implant. STUDY DESIGN: Prospective multicenter study. SETTING: The study was performed at 3 university hospitals in Europe (Germany, The Netherlands, and Switzerland). PATIENTS: Fifteen patients with severe-to-profound mixed hearing loss because of otosclerosis or previous failed stapes surgery. INTERVENTION: Implantation with a Codacs direct acoustic cochlear implant investigational device (ID) combined with a stapedotomy with a conventional stapes prosthesis MAIN OUTCOME MEASURES: Preoperative and postoperative (3 months after activation of the investigational direct acoustic cochlear implant) audiometric evaluation measuring conventional pure tone and speech audiometry, tympanometry, aided thresholds in sound field and hearing difficulty by the Abbreviated Profile of Hearing Aid Benefit questionnaire. RESULTS: The preoperative and postoperative air and bone conduction thresholds did not change significantly by the implantation with the investigational Direct Acoustic Cochlear Implant. The mean sound field thresholds (0.25-8 kHz) improved significantly by 48 dB. The word recognition scores (WRS) at 50, 65, and 80 dB SPL improved significantly by 30.4%, 75%, and 78.2%, respectively, after implantation with the investigational direct acoustic cochlear implant compared with the preoperative unaided condition. The difficulty in hearing, measured by the Abbreviated Profile of Hearing Aid Benefit, decreased by 27% after implantation with the investigational direct acoustic cochlear implant. CONCLUSION: Patients with moderate-to-severe mixed hearing loss because of otosclerosis can benefit substantially using the Codacs investigational device.

Item does not contain fulltext, OBJECTIVE: To confirm the clinical efficacy and safety of a direct acoustic cochlear implant. STUDY DESIGN: Prospective multicenter study. SETTING: The study was performed at 3 university hospitals in Europe (Germany, The Netherlands, and Switzerland). PATIENTS: Fifteen patients with severe-to-profound mixed hearing loss because of otosclerosis or previous failed stapes surgery. INTERVENTION: Implantation with a Codacs direct acoustic cochlear implant investigational device (ID) combined with a stapedotomy with a conventional stapes prosthesis MAIN OUTCOME MEASURES: Preoperative and postoperative (3 months after activation of the investigational direct acoustic cochlear implant) audiometric evaluation measuring conventional pure tone and speech audiometry, tympanometry, aided thresholds in sound field and hearing difficulty by the Abbreviated Profile of Hearing Aid Benefit questionnaire. RESULTS: The preoperative and postoperative air and bone conduction thresholds did not change significantly by the implantation with the investigational Direct Acoustic Cochlear Implant. The mean sound field thresholds (0.25-8 kHz) improved significantly by 48 dB. The word recognition scores (WRS) at 50, 65, and 80 dB SPL improved significantly by 30.4%, 75%, and 78.2%, respectively, after implantation with the investigational direct acoustic cochlear implant compared with the preoperative unaided condition. The difficulty in hearing, measured by the Abbreviated Profile of Hearing Aid Benefit, decreased by 27% after implantation with the investigational direct acoustic cochlear implant. CONCLUSION: Patients with moderate-to-severe mixed hearing loss because of otosclerosis can benefit substantially using the Codacs investigational device.