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Copyright of HNO is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study evaluated the use of landline and mobile phones in an international sample of cochlear implant users. A custom-designed survey was mailed to cochlear implant users from four different countries. A link to the survey was posted on the MED-EL website, with responses from a further six countries. Results from 196 surveys show that there is a significant shift from pre-operative non-use of a telephone to use of a telephone post-operatively. Seventy-one percent of MED-EL cochlear implant users are able to use a landline telephone to some extent and 54% are able to use a mobile phone to some extent. Talking to familiar speakers about familiar topics is the easiest listening condition on the telephone, and it is easier to recognize a voice using the landline. Many respondents found it difficult to make a call without some assistance. Most respondents could manage to call someone in an emergency, even on a mobile phone. Data obtained should provide useful information in the counselling and rehabilitation of cochlear implant recipients and candidates. [ABSTRACT FROM AUTHOR]

Copyright of Archives of Oto-rhino-laryngology is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Investigation of long-term safety and performance of an active, transcutaneous bone conduction implant in adults and children up to 36 months post-implantation., Study Design: Prospective, single-subject repeated-measures design., Setting: Otolaryngology departments of eight German and Austrian hospitals.∗†‡§||¶#∗∗†† Affiliations listed above that did not participate in the study.‡‡§§||||¶¶., Patients: Fifty seven German-speaking patients (49 adults and eight children) suffering from conductive or mixed hearing loss, with an upper bone conduction threshold limit of 45 dB HL at frequencies between 500 and 3000 Hz., Intervention: Implantation of the Bonebridge transcutaneous bone conduction hearing implant (tBCI)., Main Outcome Measures: Patients' audiometric pure tone averages (PTA4) (0.5, 1, 2, 4 kHz) thresholds (air conduction, bone conduction, and sound field) and speech perception (word recognition scores [WRS] and speech reception thresholds [SRT50%]) were tested preoperatively and up to 36 months postoperatively. Patients were also monitored for adverse events and administered quality-of-life questionnaires., Results: Speech perception (WRS: pre-op: 17.60%, initial activation [IA]: 74.23%, 3M: 83.65%, 12M: 83.46%, 24M: 84.23%, 36M: 84.42%; SRT50%: pre-op: 65.56 dB SPL, IA: 47.67 dB SPL, 3M: 42.61 dB SPL, 12M: 41.11 dB SPL, 24M: 41.74 dB SPL, 36M: 42.43 dB SPL) and sound field thresholds (pre-op: 57.66 dB HL, IA: 33.82 dB HL, 3M: 29.86 dB HL, 12M: 28.40 dB HL, 24M: 28.22 dB HL, 36M: 28.52 dB HL) improved significantly at all aided postoperative visits. Air and bone conduction thresholds showed no significant changes, confirming preservation of patients' residual unaided hearing. All adverse events were resolved by the end of the study., Conclusions: Safety and performance of the tBCI was demonstrated in children and adults 36 months postoperatively., Competing Interests: The authors disclose no conflicts of interest., (Copyright © 2021, Otology & Neurotology, Inc.)

Objective: To investigate the safety and efficacy of a new bone conduction hearing implant in children, during a 3-month follow-up period., Study Design: Prospective, single-subject repeated-measures design in which each subject serves as his/her own control., Setting: Otolaryngology departments of four Austrian hospitals., Patients: Twelve German-speaking children aged 5 to 17 suffering from conductive or mixed hearing loss, with an upper bone conduction threshold limit of 45 dB HL at frequencies between 500 and 4000 Hz., Intervention: Implantation of the Bonebridge transcutaneous bone conduction hearing implant (tBCI)., Main Outcome Measures: The subjects' audiometric thresholds (air conduction, bone conduction, and sound field at frequencies 500 Hz to 8 kHz) and speech perception (word recognition scores [WRS] and 50% word intelligibility in sentences [SRT50%]) were tested preoperatively and at 1 and 3 months postoperatively. The patients were also monitored for adverse events and they or their parents filled out questionnaires to analyze satisfaction levels., Results: Speech perception as measured by WRS and SRT50% improved on average approximately 67.6% and 27.5 dB, respectively, 3 months after implantation. Aided thresholds also improved postoperatively, showing statistical significance at all tested frequencies. Air conduction and bone conduction thresholds showed no significant changes, confirming that subjects' residual unaided hearing was not damaged by the treatment. Only minor adverse events were reported and resolved by the end of the study., Conclusion: Safety and efficacy of the new bone conduction implant was demonstrated in children followed up to 3 months postoperatively.

Conclusions: The round window (RW) approach in the use of the Vibrant Soundbridge(®) (VSB) is a safe and effective treatment of conductive and mixed hearing losses for a period of more than 3 years of device use., Objective: To investigate the long-term safety and efficacy as well as user satisfaction of patients with conductive and mixed hearing losses implanted with the VSB using RW vibroplasty., Methods: Twelve patients with conductive and mixed hearing losses were evaluated after 40 months of daily VSB use. Safety was assessed by evaluating reports of postoperative medical and surgical complications as well as by changes in bone conduction hearing thresholds. Efficacy outcome measures included aided and unaided hearing thresholds, speech recognition in quiet and in noise and subjective benefit questionnaires., Results: The safety results revealed no significant medical complications. One subject experienced sudden hearing loss after 18-24 months of device use, but still continues to wear the device to her satisfaction. With regard to efficacy, there were no significant changes from short- to long-term results in aided word understanding, functional gain or speech recognition threshold, suggesting that the outcomes are stable over time. Subjective questionnaires revealed either the same or better results compared with the short-term data.

Background/aims: The Vibrant Soundbridge (VSB) is an active middle ear implant, 'direct-drive' hearing system for the treatment of hearing loss. Recently, the VSB has been applied to conductive and mixed hearing losses. The aim of this study is to evaluate aided benefit, speech recognition in quiet and noise, subjective benefits, changes in residual hearing, and medical and surgical complications in adults with conductive or mixed hearing losses implanted with the VSB using Round Window (RW) Vibroplasty., Methods: Twelve German-speaking adults participated in a single-subject, repeated measures study design comparing their performance using the VSB with their own unaided preoperative performance. Hearing performance and changes in residual hearing were assessed using routine audiometric measures, sound field thresholds, and word and sentence recognition in quiet and in noise. Subjective benefits, including subjective hearing performance, device satisfaction, and quality of life were evaluated using the Abbreviated Profile of Hearing Aid Benefit, the Hearing Device Satisfaction Scale, and the Glasgow Benefit Inventory, respectively., Results: Aided hearing thresholds, word recognition at conversational levels, and sentence recognition in quiet and noise were significantly improved without significant changes in residual cochlear hearing and without major medical and surgical complications. One subject required repositioning surgery to improve transducer coupling with the RW membrane. Subjective benefit and device satisfaction were good, as were overall and general quality of life., Conclusion: The VSB, implanted using RW vibroplasty, is a safe and effective treatment for adults with conductive and mixed hearing losses who may have few, if any, other options., (Copyright (c) 2010 S. Karger AG, Basel.)

Background/aims: To evaluate gain at threshold level and speech recognition performance of 54 subjects with mild-to-severe symmetrical sensorineural hearing loss (SNHL) that received the active middle ear implant system Vibrant Soundbridge (VSB)., Methods: Pre- and postoperative assessments of hearing thresholds and monosyllabic word discrimination were performed in a homogeneous group of 54 adults who received a VSB system (VORP 502/AP 404) in an active middle ear implant (AMEI) program in a tertiary referral hospital. All subjects included in this study had mild-to-severe, predominately sloping SNHL. Gain at threshold level and speech recognition results were assessed for unaided and aided conditions using the patient's walk-in hearing aid (HA) and the VSB in a retrospective study design., Results: A comparison of pre- and postoperative unaided air conduction thresholds revealed a mean decrease in pure tone averages of 3.9 dB (0.25-8 kHz). Gain at threshold level (unaided thresholds minus AMEI-aided thresholds) was, on average, 20.9 dB at 0.5 kHz, 20.5 dB at 1 kHz, 23.8 dB at 2 kHz, 30.2 dB at 3 kHz, 36.1 dB at 4 kHz, 37.6 dB at 6 kHz and 37.9 dB at 8 kHz. Monosyllabic word discrimination at 65 dB SPL improved from a mean of 30% in the unaided condition to 44% for the HA-aided condition (p<0.05), with a further increase to 57% for the VSB-aided condition (p<0.05, compared to the HA)., Conclusion: The AMEI system VSB can be considered as an effective rehabilitation alternative in subjects with mild-to-severe SNHL and unsatisfying benefit from conventional hearing aids., (Copyright (c) 2010 S. Karger AG, Basel.)

Based on a variety of experimental and clinical studies the diagnostic significance of transient evoked otoacoustic emissions (TEOAEs) is well established. This is also due to the availability of commercial hardware and software which is optimized for the recording of click-evoked OAEs. In cases with distortion product otoacoustic emissions (DPOAEs) the significance for clinical purposes is not yet clear. This study presents results obtained in normal hearing subjects and patients with sensorineural hearing losses (214 ears). The study focuses on three problems: 1. Incidence of DPOAEs in different groups of hearing loss. 2. Level of DPOAEs at various frequencies in each group of hearing loss. 3. Frequency-specific relationships between hearing loss and DPOAEs. Recording of DPOAEs was performed with the ILO92 system and standard configuration (primary tone level, 70 dB SPL). In normal hearing ears DPOAEs were observed at all frequencies above 1 kHz. In cases with moderate hearing loss the detection rate decreased to about 80%. With further increases in hearing loss the detection rate and level of DPOAEs decreased. At frequencies below 1500 Hz even in normal hearing subjects, the level of DPOAEs only slightly exceeded the noise level. The upper limit of hearing loss for which DPOAEs could be observed depended on frequency. In the low-frequency range DPOAEs were absent in ears with a sensorineural hearing loss greater than 35-45 dB; at frequencies between 4 and 6 kHz DPOAEs were observed even in ears with a hearing loss 65 dB.(ABSTRACT TRUNCATED AT 250 WORDS)

Knowledge of the different clinical manifestations of inflammation caused by specific infectious agents of the external ear canal and the auricle makes a successful empirical therapy possible. Initial therapy should always consist of local treatment modalities including repeated cleansing of the aural canal and insertion of a cotton wick carrying local medication. Major advancement of systemic therapy of bacterial external otitis has been obtained by the availability of the new Gyrase-inhibitors (Fluoroquinolones). These antibiotic drugs possess--given orally--strong activity against the entire spectrum of etiologic bacteria and are effective in the difficult to treat malignant external otitis. In systemic therapy of Zoster oticus the antiviral substance Aciclovir can improve otalgia and auricular eruptions. Early Aciclovir treatment is advised in cases of Ramsay Hunt Syndrome to minimize permanent nerve damage.

In 16 patients with recurrences of squamous cell cancer of the upper aerodigestive system a combination-chemotherapy was performed in three cycles. On the 1st day of each cycle 20 mg/m2 methotrexate and 15 mg bleomycin, on the 2nd day 60 mg/m2 cis-diamminedichloroplatinum and from day 3 until day 8 15 mg bleomycin was given daily. Only half the patients received all 3 planned cycles. The overall response rate for complete or partial remission (more than 50% tumor-shrinkage) was 37% (1 complete, 5 partial remissions). Median duration of remissions was 2.6 months (1-6 months). Life quality (modified Karnowsky Index) was improved in 5 patients, tumor pain could be reduced in 7 patients. The median survival time was 4.3 months. The results are compared to those of other authors.

Twenty-four (48%) out of a group of 50 patients treated with one to three single doses of cisplatin compound (cis-DDP), at a dosage of 60 mg/m2 body surface, were found to have deterioration of post-treatment pure tone audiometric threshold levels. Statistical analysis of pre- and post-treatment hearing losses by means of the paired t-test, however, did not show any significant hearing loss associated with cis-DDP-toxicity, nor could hearing loss following treatment be correlated to ages of the patients, pre-treatment hearing impairments, specific frequencies, or the number of treatment courses given. In contrast, cochlear damage was studied in the guinea pig model by daily administration of high cumulative doses of cis-DDP, and was found to be dose-dependent and selectively restricted to the outer hair cells of the inner ear and corresponding nerve fibers. Hair cell degeneration was most severe in the basal turn of the cochlea, and progressed in an apical direction so that the cells in the first row were the most affected.

Results of a combined therapy, consisting of preoperative chemotherapy, radical resection and postoperative irradiation, of 51 locally advanced, previously untreated, resectable squamous cancers of the head and neck are reported. The overall response rate to chemotherapy was 58.5% (with 33% complete remissions) and higher in carcinomas of the oral cavity and hypopharynx than of the supraglottis and oropharynx. Three year survival was 53% for the entire group, 75% for hypopharyngeal, 58% for oral, 50% for supraglottic and 32% for oropharyngeal lesions, in responders to chemotherapy statistically significant higher than in non responders and only 18% in the fifteen patients who developed recurrences.

This is a short review of our concepts of the operative closure of small, medium sized and large septal perforations. We describe the details of our personal technique of the closure of medium sized supra- and retrocolummellar perforations with a vestibulum skin-mucoperichondrium-cartilage-flap.

Twenty-one patients with advanced previously untreated squamous cell carcinoma of the oral cavity, oro- and hypopharynx and supraglottic region were treated with combined cis-platinum-methotrexate-bleomycin chemotherapy. Methotrexate (20 mg/m2) was given on day 1, after prehydration cis-diaminodichloroplatinum (60 mg/m2) was given with mannitol diuresis on day 2. From day 3 until day 8 15 mg bleomycin was given daily in a 6-h infusion. Three courses were given every 3 weeks. After clinical evaluation for tumor response all patients were operated and underwent postoperative radiotherapy. After induction chemotherapy eight patients (39%) had a complete, five (24%) a partial (shrinkage of measurable disease more than 50%), and seven (33%) a minor response (more than 25% but less than 50% tumor shrinkage). The neoplasms of the oral cavity and the pharynx responded better than the laryngeal primaries. Exophytic tumors responded better to chemotherapy than the endophytic tumors. Histopathologic examination in serial sections demonstrates in all cases--even after clinically complete response--some small rests of tumor in local fibrotic tissue often underneath a regrown mucosal epithelium.

Morphological and audiological early and late results after reconstruction of the ossicular chain with Plastipore prosthesis (TORP's and PORP's) were compared with those achieved by using autogenous or allogenic ossicles. In particular 32 tympanoplasties with TORP's were compared with 25 cases of columella and 29 PORP cases with 75 interpositions. Only Plastipore prostheses were extruded, up to now in 11.4% of cases. The final extrusion rate will be even higher since perforations of the fascia graft or the drum over the head of the prostheses as signs of imminent extrusions were noted in 9.8% of tympanoplasties at the end of the 2-year follow-up period. However, only in one third of tympanoplasties cartilage had been interposed between the head of the prosthesis and the fascia graft or drum. Audiological results, early as well as late ones, using the mean postoperative air-bone gap as criterion of success, showed no statistically significant differences between the compared groups. Only the comparison of the mean air-bone gaps in late results versus the preoperative values seemed to favour the PORP group over the interposition group. In some PORP cases, however, greater reduction of the air-bone gap was caused by postoperative deterioration of the bone conduction threshold level. In addition, hearing gains were more lasting in the interposition than in the PORP group. Because of the high extrusion rate and the fact that the audiological results were not significantly better than in the compared groups we will cease using PORP's and will employ TORP's only with careful interposition of cartilage and then only in selected cases with good tubal function.

In 22 patients with T3-4, N0-3, Mo squamous cell cancer of the head and neck (classification UICC 1979), who were treated with induction chemotherapy before surgical resection and postoperative radiotherapy, a comparative histopathologic examination of the prechemotherapy biopsy specimens and serial sections of the surgical specimens was performed. Chemotherapy consisted of 3 cycles every 3 weeks. On the first day of each cycle methotrexate (20 mg/m2) and 15 bleomycin, on the second day cis-diamminodichloroplatinum (60 mg/m2) and from day 3-8 15 mg bleomycin was given daily in a 6 hour infusion. Histopathologic grading of the prechemotherapy biopsies separated well from moderately well and from low differentiated squamous cell carcinoma. In addition the type of tumor growth - solid organoid or diffus reticular - and the mode of invasion were examined. The surgical specimens showed characteristic morphologic changes dependent on the quantity of the remaining tumor. Many tumor residues consisted of solid organoid well-differentiated carcinoma only. After good tumor response to chemotherapy tumor nests typically showed central cystic changes, which resembled pseudoglandular squamous cell carcinoma in cases with tendency towards keratinization or adenoid "basalioma", rarely solid "basalioma", if no tendency towards keratinization was found. Very small tumor nests in abundant local fibrotic tissue merely consisted of undifferentiated cells with absence of differentiated cells. In cases with tendency towards keratinization undifferentiated cells sometimes built one layer - complete or incomplete - around big foci of keratinization. The type of tumor growth - solid organoid or diffuse reticular - and the grade of differentiation showed marked accentuation after chemotherapy.