70 results on '"M. Lenarz"'
Search Results
2. [A Rare Differential Diagnosis of Headache]
- Author
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A, Reichelt, A, Coordes, S, Niehues, and M, Lenarz
- Subjects
Adult ,Diagnosis, Differential ,Visual Analog Scale ,Headache Disorders ,Calcinosis ,Frontal Sinus ,Humans ,Female ,Radionuclide Imaging ,Tomography, X-Ray Computed ,Fibrosis ,Magnetic Resonance Imaging ,Fibrous Dysplasia, Monostotic - Published
- 2016
3. [Seldom Differential Diagnosis of Rotary Vertigo with Nausea]
- Author
-
L M, Jahreiß, A, Coordes, P, Seyedahmadi, A H, Nave, and M, Lenarz
- Subjects
Male ,Medulla Oblongata ,Brain Stem Infarctions ,Electronystagmography ,Nausea ,Middle Aged ,Nystagmus, Pathologic ,Diagnosis, Differential ,Diffusion Magnetic Resonance Imaging ,Pons ,Vertigo ,Audiometry, Pure-Tone ,Humans ,Follow-Up Studies - Published
- 2016
4. [Tonsillectomy in adults: Length of hospital stay has no influence on the frequency of postoperative hemorrhage]
- Author
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A, Coordes, J, Soudry, V M, Hofmann, and M, Lenarz
- Subjects
Adult ,Male ,Postoperative Care ,Adolescent ,Incidence ,Comorbidity ,Length of Stay ,Middle Aged ,Postoperative Hemorrhage ,Tonsillitis ,Young Adult ,Age Distribution ,Treatment Outcome ,Risk Factors ,Germany ,Humans ,Female ,Sex Distribution ,Aged ,Retrospective Studies ,Tonsillectomy - Abstract
Tonsillectomies (TE) in Germany are traditionally performed during inpatient hospital stays. Socioeconomic changes in the healthcare system have resulted in shorter hospital stays.The aim of the study was to investigate whether a shorter hospital stay of 2 days leads to increased postoperative bleeding after TE. Factors affecting the duration of hospitalization were also studied.The relevant data of all patients (≥ 14 years) undergoing TE in the ENT Clinic of the Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, between 2011 and 2013 were recorded anonymously. Risk factors for bleeding after TE were analyzed. Additionally, patients who had a hospital stay of 2 days (since 2013) were compared with patients hospitalized for ≥ 3 days, and the influence of various risk factors on the length of hospital stay was analyzed.During the study period 2011-2013, 376 procedures were performed and data from 213 patients was collected for analysis. Median patient age was 26 years (range 14-73 years). The rate of primary hemorrhage (up to 24 hours after TE) was 2% and the rate of secondary bleeding (later than 24 hours) was 24%. In 7% of patients with postoperative haemorrhage (primary and secondary) surgical hemostasis was performed. Male gender was associated with a significantly higher haemorrhage rate. Shortening postdischarge surveillance to only 2 days did not affect the postoperative bleeding rate.The duration of stationary monitoring following TE should not only be based on the rate of secondary bleeding, but also on patient comfort and safety. A shortening of postoperative monitoring to only 2 days had no effect on the haemorrhage frequency after TE and can therefore, be considered for adults who do not live alone and are within a reasonable distance to a hospital.
- Published
- 2015
5. Periphere Fazialisparese bei einem Tumor im Epitympanon
- Author
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Annekatrin Coordes, M. Lenarz, and S.M. Niehues
- Subjects
Plastic surgery ,medicine.medical_specialty ,Otorhinolaryngology ,business.industry ,Head and neck surgery ,Medicine ,business ,Surgery - Published
- 2013
6. Zentral-auditorische Implantate
- Author
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Thomas Lenarz, Hubert H. Lim, G. Joseph, M. Lenarz, and G. Reuter
- Subjects
Inferior colliculus ,medicine.medical_specialty ,Speech perception ,Hearing loss ,business.industry ,medicine.medical_treatment ,Acoustic neuroma ,Audiology ,medicine.disease ,Cochlear nucleus ,Otorhinolaryngology ,Cochlear implant ,otorhinolaryngologic diseases ,medicine ,medicine.symptom ,Neurofibromatosis type 2 ,business ,Auditory brainstem implant - Abstract
Deaf patients with severe sensory hearing loss can benefit from a cochlear implant (CI), which stimulates the auditory nerve fibers. However, patients who do not have an intact auditory nerve cannot benefit from a CI. The majority of these patients are neurofibromatosis type 2 (NF2) patients who developed neural deafness due to growth or surgical removal of a bilateral acoustic neuroma. The only current solution is the auditory brainstem implant (ABI), which stimulates the surface of the cochlear nucleus in the brainstem. Although the ABI provides improvement in environmental awareness and lip-reading capabilities, only a few NF2 patients have achieved some limited open set speech perception. In the search for alternative procedures our research group in collaboration with Cochlear Ltd. (Australia) developed a human prototype auditory midbrain implant (AMI), which is designed to electrically stimulate the inferior colliculus (IC). The IC has the potential as a new target for an auditory prosthesis as it provides access to neural projections necessary for speech perception as well as a systematic map of spectral information. In this paper the present status of research and development in the field of central auditory prostheses is presented with respect to technology, surgical technique and hearing results as well as the background concepts of ABI and AMI.
- Published
- 2009
7. [Cancer stem cell phenotypes and miRNA: therapeutic targets in head and neck squamous cell carcinoma]
- Author
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A, Coordes, S, Zhifeng, V, Sangvatanakul, X, Qian, M, Lenarz, A M, Kaufmann, and A E, Albers
- Subjects
MicroRNAs ,Epithelial-Mesenchymal Transition ,Models, Genetic ,Head and Neck Neoplasms ,Squamous Cell Carcinoma of Head and Neck ,Gene Targeting ,Carcinoma, Squamous Cell ,Neoplastic Stem Cells ,Animals ,Humans ,Antineoplastic Agents ,Molecular Targeted Therapy ,Neoplasm Proteins - Abstract
Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer worldwide. HNSCC is caused by persistent high-risk human papillomavirus (HR-HPV) infection or excessive consumption of alcohol or tobacco. The persistently low survival rates result from local recurrences and metastases, which are probably caused by so-called tumor stem cells (TSCs). The epithelial-mesenchymal transition (EMT) or transformation is a key event in metastasis initiation and is being increasingly associated with TSCs.This review describes new therapeutic targets in HNSCC, focusing on the TSC hypothesis and EMT regulation.TSCs and EMT are regulated directly and indirectly via transcription factors and microRNAs (miRNAs). These miRNAs regulate multiple cellular processes and may serve as new therapeutic targets, whose modulation could increase the effectiveness of HNSCC treatments. Post-transcriptionally, miRNAs regulate transcription factors associated with EMT (ZEB1/2, EZH2, Bmi-1), tumor suppressors (p53), TSC markers (ALDH, CD44, EpCAM, p63) and both epithelial (E-cadherin) and mesenchymal markers (vimentin).Alterations in HNSSC TSC miRNA expression before and after chemotherapy could potentially serve as a therapeutic control. In the long term, knowledge of a patient's individual protein expression pattern may permit application of specific chemotherapy. Such individualized therapy might prohibit the development of metastases and potentially unresectable recurrences with a high resistance to radiation and chemotherapy, thus improving the prognosis in HNSCC patients.
- Published
- 2014
8. [Role of miRNA in malignoma of the head and neck]
- Author
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A, Coordes, M, Lenarz, A M, Kaufmann, and A E, Albers
- Subjects
Genetic Markers ,Epithelial-Mesenchymal Transition ,Exons ,Oncogene Proteins, Viral ,Prognosis ,Introns ,Gene Expression Regulation, Neoplastic ,MicroRNAs ,Otorhinolaryngologic Neoplasms ,Cell Transformation, Neoplastic ,Early Diagnosis ,Phenotype ,Carcinoma, Squamous Cell ,Disease Progression ,Neoplastic Stem Cells ,Humans ,Neoplasm Recurrence, Local - Abstract
Despite optimized therapeutic strategies, the long-term survival of head and neck squamous cell carcinomas (HNSCC) has improved in recent years only slightly. Most studies on the tumor cell genome focus on protein-coding genes (exons). Data on changes within the non-coding sequences (introns) are limited. miRNAs (microRNA, miR) are small non-coding single-stranded RNAs that control gene expression at the posttranscriptional level by interacting with the mRNA. miRNA functions include many biological processes and control up to 50 % of human genes. They can have oncogenic or tumor suppressive functions. Altered expression patterns of miRNAs are involved in carcinogenesis and tumor progression even in HNSCC, or those processes (increased resistance to radiation or chemotherapy) that could be responsible for the poor long-term prognosis by forming metastases and inoperable local recurrences. Therefore, we here present miRNA groups, which are involved in these processes and may serve as new potential therapeutic treatment targets. miRNAs may also serve as biomarkers for early diagnosis, evaluation and monitoring of treatment and tumor recurrence. Alterations in miRNA expression before and after chemotherapy are therefore of high interest. In the long run, this knowledge could lead to more effective therapies with improved therapeutic outcome of HNSCC.
- Published
- 2014
9. [Peripheral facial nerve palsy caused by a tumor in the epitympanum]
- Author
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A, Coordes, S M, Niehues, and M, Lenarz
- Subjects
Diagnosis, Differential ,Male ,Radiography ,Treatment Outcome ,Tympanic Membrane ,Facial Paralysis ,Humans ,Middle Aged ,Ear Neoplasms - Published
- 2013
10. [Surgical intervention for idiopathic hearing loss]
- Author
-
M, Lenarz
- Subjects
Treatment Outcome ,Tympanoplasty ,Myringoplasty ,Humans ,Minimally Invasive Surgical Procedures ,Hearing Loss ,Combined Modality Therapy - Published
- 2013
11. [Central auditory prosthesis]
- Author
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T, Lenarz, H, Lim, G, Joseph, G, Reuter, and M, Lenarz
- Subjects
Equipment Failure Analysis ,Deep Brain Stimulation ,Humans ,Prostheses and Implants ,Deafness ,Prosthesis Design - Abstract
Deaf patients with severe sensory hearing loss can benefit from a cochlear implant (CI), which stimulates the auditory nerve fibers. However, patients who do not have an intact auditory nerve cannot benefit from a CI. The majority of these patients are neurofibromatosis type 2 (NF2) patients who developed neural deafness due to growth or surgical removal of a bilateral acoustic neuroma. The only current solution is the auditory brainstem implant (ABI), which stimulates the surface of the cochlear nucleus in the brainstem. Although the ABI provides improvement in environmental awareness and lip-reading capabilities, only a few NF2 patients have achieved some limited open set speech perception. In the search for alternative procedures our research group in collaboration with Cochlear Ltd. (Australia) developed a human prototype auditory midbrain implant (AMI), which is designed to electrically stimulate the inferior colliculus (IC). The IC has the potential as a new target for an auditory prosthesis as it provides access to neural projections necessary for speech perception as well as a systematic map of spectral information. In this paper the present status of research and development in the field of central auditory prostheses is presented with respect to technology, surgical technique and hearing results as well as the background concepts of ABI and AMI.
- Published
- 2009
12. Restoring hearing with an auditory midbrain implant in humans – current evidence from cortical event-related potentials
- Author
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Wido Nager, H. H. Lim, M. Lenarz, Thomas F. Münte, Thomas Lenarz, and Reinhard Dengler
- Subjects
medicine.medical_specialty ,Event-related potential ,medicine ,Neurology (clinical) ,Implant ,Audiology ,Current (fluid) ,Psychology ,Neuroscience ,Auditory midbrain - Published
- 2008
13. [Image-guided minimal-invasive cochlear implantation--experiments on cadavers]
- Author
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O, Majdani, S H, Bartling, M, Leinung, T, Stöver, M, Lenarz, C, Dullin, and Th, Lenarz
- Subjects
Surgery, Computer-Assisted ,Calibration ,Humans ,Minimally Invasive Surgical Procedures ,Equipment Design ,Cone-Beam Computed Tomography ,Cochlear Implantation ,Software ,Electrodes, Implanted ,Petrous Bone - Abstract
The accuracy of navigation systems can be improved significantly by using high-resolution flat panel-based Volume Computed Tomography (fpVCT) so that new surgical therapeutic concepts become feasible. A navigation-guided minimally-invasive cochleostomy places highest requirements on the accuracy of intraoperative navigation.A flat-panel Volume Computed Tomograph (fpVCT) was used to scan four human temporal bones. The isometric voxel size was 200 microm. The preoperative planning was used to define an optimized drilling channel from the mastoid surface to the round window niche and the scala tympani providing a safety margin to critical anatomical structures such as facial nerve, chorda tympani, sigmoid sinus and posterior wall of auditory canal. The canal was drilled hand-operated with a navigated drill following the previously planned trajectory. Afterwards the drilled canal was imaged by fpVCT. Conventional dissection including mastoidectomy and posterior tympanotomy assured correct localization of the cochleostomy.Path planning took an average of 54 minutes (range 35-85 minutes). Installation took an average of 16 minutes (range 14-19 minutes). The drilling procedure itself took an average of 7.75 min (range 5-12 minutes.) The RMSE-values varied between 0.1 and 0.2 mm (Table 1). All four specimens showed a cochleostomy located at the scala tympani anterior inferior to the round window. The chorda tympani was damaged in one specimen--this was preoperatively planned as a narrow facial recess was encountered. The time needed for planning and system-installation could be reduced continuously.This feasibility study demonstrates that using current image-guided surgery technology in combination with fpVCT allows drilling of a minimally invasive channel to the cochlea with loco typico cochleostomy. The necessary accuracy of intraoperative navigation can be achieved by use of fpVCT (technical accuracy between 0.1 and 0.2 mm). Our results demonstrate the feasibility of a navigation-guided minimally-invasive cochleostomy loco typico. While we are enthused by this preliminary work, we recognize the barriers which exist in translation to clinical application. These include surgical issues (e.g. control of unexpected bleeding) and electrode issues (e.g. development of insertion tools).
- Published
- 2007
14. Auditory Midbrain Implant (AMI) – Physiologie und Histologie von akuten und chronischen Implantationen
- Author
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G. Reuter, A. Stan, G. Paasche, T. Lenarz, M. Lenarz, and U. Reich
- Published
- 2005
15. Das auditorische Midbrain Implant (AMI) – eine Alternative zum auditorischen Hirnstammimplantat
- Author
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T. Lenarz, G. Reuter, J. Patrick, H. Lim, and M. Lenarz
- Published
- 2005
16. Operative Intervention beim idiopathischen Hörsturz
- Author
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M. Lenarz
- Subjects
Plastic surgery ,medicine.medical_specialty ,Otorhinolaryngology ,business.industry ,Hearing loss ,Intervention (counseling) ,General surgery ,Head and neck surgery ,Medicine ,medicine.symptom ,business - Published
- 2013
17. Caring Is the Essence of Practice
- Author
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Dorothea M. Lenarz
- Subjects
General Medicine ,General Nursing - Published
- 1971
18. Caring is the essence of practice
- Author
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D M, Lenarz
- Subjects
Male ,Mental Disorders ,Humans ,Nurse-Patient Relations - Published
- 1971
19. Medial and mediolateral orbital decompression in intractable Graves' Orbitopathy.
- Author
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Seibel I, Hofmann VM, Sönmez H, Schönfeld S, Jumah MD, Lenarz M, and Coordes A
- Subjects
- Adult, Aged, Diplopia etiology, Female, Graves Ophthalmopathy complications, Graves Ophthalmopathy diagnostic imaging, Graves Ophthalmopathy physiopathology, Humans, Intraocular Pressure, Male, Middle Aged, Otorhinolaryngologic Surgical Procedures methods, Retrospective Studies, Tomography, X-Ray Computed, Visual Fields, Decompression, Surgical methods, Graves Ophthalmopathy surgery, Orbit surgery
- Abstract
Objective: Graves' Orbitopathy (GO) has well established treatment guidelines; however, its management is still controversial. The aim was to evaluate the results of medial and mediolateral orbital decompression (OD) in intractable GO., Methods: Retrospective chart review of all patients with advanced stages of GO, who underwent medial (1-wall) or mediolateral (2-wall) OD between May 2012 and November 2014 in our institution. Ophthalmologic examinations included visual acuity, Hertel exophthalmometry (proptosis), intraocular pressure (IOP), visual field (30:2) and diplopia. Follow-up was performed 1 week, 3 months and 1 year postoperatively. Additionally, a questionnaire was used to investigate subjective benefits., Results: The study included 34 eyes of 20 patients. In our study, GO patients who underwent mediolateral OD had significantly higher IOP preoperatively (p<0.05) and lower visual acuity, proptosis and visual field compared with patients who underwent medial OD. After 1- and 2-wall OD, visual acuity, proptosis, visual field and IOP in upgaze improved significantly. Using a questionnaire, the patients reported significant improvements in impaired vision, eye pain and pressure, vitality and social life. 94% of all patients reported they would repeat the operation. After 2-wall OD, the surgical scar had little effect., Conclusion: With GO patients in advanced stages, both medial (1-wall) and mediolateral (2-wall) OD procedures are convincing therapeutic options. In more advanced GO stages with high IOP, 2-wall OD should be prioritized, as mediolateral OD had superior long-term functional outcomes., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)
- Published
- 2017
- Full Text
- View/download PDF
20. Active middle ear implant coupled bilaterally to the round window despite bilateral implanted stapes prostheses.
- Author
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Coordes A, Jahreiss L, Schönfeld U, and Lenarz M
- Subjects
- Audiometry, Pure-Tone, Female, Humans, Middle Aged, Otosclerosis surgery, Postoperative Complications surgery, Cholesteatoma, Middle Ear surgery, Hearing Loss, Bilateral surgery, Hearing Loss, Mixed Conductive-Sensorineural surgery, Hearing Loss, Sensorineural surgery, Ossicular Prosthesis, Round Window, Ear surgery, Stapes Surgery
- Abstract
After stapes surgery, patients with mixed or moderate hearing loss have limited possibilities for hearing improvement. We are reporting on a patient who underwent stapedotomy bilaterally 20 years ago and had sensorineural and mixed hearing loss. Recurrent otitis externa prevented the use of hearing aids. This patient was treated bilaterally with the Vibrant Soundbridge (Med-El, Innsbruck, Austria) successively. The Schuknecht piston stapes prostheses remained in situ. The Floating Mass Transducer (FMT; Med-El) was coupled to the round window (RW) and provided good acoustic reinforcement bilaterally. In conclusion, for patients with otosclerosis and stapes surgery, the FMT-RW coupling (Bess AG, Berlin, DE) is a safe procedure with good acoustic amplification. Laryngoscope, 2016 127:500-503, 2017., (© 2016 The American Laryngological, Rhinological and Otological Society, Inc.)
- Published
- 2017
- Full Text
- View/download PDF
21. Gender-specific risk factors in post-tonsillectomy hemorrhage.
- Author
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Coordes A, Soudry J, Hofmann VM, and Lenarz M
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Alcohol Drinking adverse effects, Berlin, Child, Child, Preschool, Female, Glucocorticoids adverse effects, Humans, Male, Middle Aged, Multivariate Analysis, Retrospective Studies, Risk Factors, Smoking adverse effects, Surveys and Questionnaires, Postoperative Hemorrhage etiology, Sex Factors, Tonsillectomy adverse effects
- Abstract
There are gender-specific differences in the frequency and course of different diseases. Specifically, some studies have shown an increased risk of post-tonsillectomy hemorrhage (PTH). The aim of the study was to investigate gender-specific risk factors for hemorrhage after tonsillectomy (TE)/abscess-TE. We anonymously reviewed and recorded the relevant data of all patients (≥14 years) who underwent a TE/abscess-TE between 2011 and 2013 in the ENT Clinic of the Charité Universitätsmedizin Berlin, Campus Benjamin Franklin. A patient survey was used to complete missing data. We analyzed gender-specific risk factors for PTH. During the study period, 460 operations were performed and the data of 250 patients were analyzed (213 TE and 37 abscess-TE). The median patient age was 27 years (ranging from 14 to 83 years). The rate of primary PTH (<24 h after TE/abscess-TE) was 3 %, and the rate of secondary PTH (>24 h) was 23 %. A significantly higher PTH rate was associated with males (p = 0.037), which was still apparent in ages 21-30 after sub-classification. Multivariate analysis calculated diagnosis, regular alcohol consumption and administration of glucocorticoids to be independent risk factors associated with gender. In conclusion, the PTH rate is gender-specific, and male patients are at higher risk, especially in young adulthood. Therefore, doctors should advise male patients of the increased risk of bleeding and stress the importance of compliance. Also, close postoperative follow-up is desirable.
- Published
- 2016
- Full Text
- View/download PDF
22. Meta-analysis of survival in patients with HNSCC discriminates risk depending on combined HPV and p16 status.
- Author
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Coordes A, Lenz K, Qian X, Lenarz M, Kaufmann AM, and Albers AE
- Subjects
- Carcinoma, Squamous Cell genetics, Carcinoma, Squamous Cell pathology, Carcinoma, Squamous Cell virology, Disease-Free Survival, Female, Head and Neck Neoplasms complications, Head and Neck Neoplasms genetics, Head and Neck Neoplasms virology, Humans, Male, Papillomaviridae, Papillomavirus Infections virology, Prognosis, Publication Bias, Risk, Carcinoma, Squamous Cell mortality, Genes, p16, Head and Neck Neoplasms mortality, Papillomavirus Infections complications
- Abstract
Data indicate a better prognosis for human papillomavirus (HPV)-associated head and neck squamous cell carcinoma (HNSCC). HPV and p16 detection are established markers for HPV-related HNSCC. Both are accepted as survival-independent predictors. Previous studies investigating the survival in HNSCC patients depending on HPV(+/-) and p16(+/-) status consistently found discordant results with p16(-)/HPV(+) and p16(+)/HPV(-). However, no meta-analysis regarding the survival according to combined HPV/p16 status has been performed yet. The objective of this study was to discriminate the impact of combined HPV(+/-) and p16(+/-) status on survival. Data sources were identification and review of publications assessing survival of the distinct subgroups with both p16 and HPV investigated in HNSCC until February, 2015. A meta-analysis was performed to classify survival and clinical outcomes. 18 out of 397 articles (4424 patients) were eligible for the meta-analysis. The percent proportion of the subgroups was 25 % for HPV(+)/p16(+), 61.2 % for HPV(-)/p16(-), 7.1 % for HPV(-)/p16(+) and 6.8 % for HPV(+)/P16(-). The meta-analysis showed a significantly improved 5-year overall survival (OS), 5-year disease-free survival and their corresponding hazard ratio for HPV(+)/p16(+) HNSCC in comparison to HPV(-)/p16(-), HPV(+)/p16(-) and HPV(-)/p16(+). The 5-year OS of the HPV(-)/p16(+) subgroup was intermediate while HPV(+)/p16(-) and HPV(-)/p16(-) HNSCC had the shortest survival. With current therapeutic strategies, survival of patients with HNSCC is better if associated with HPV(+)/p16(+) or HPV(-)/p16(+). Clinical trials are needed to confirm the distinct survival pattern and to investigate possible differences in survival for HPV(+)/p16(-) and HPV(-)/p16(+) HNSCC. To further differentiate p16(+) HNSCC, HPV testing may be advisable.
- Published
- 2016
- Full Text
- View/download PDF
23. [A Rare Differential Diagnosis of Headache].
- Author
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Reichelt A, Coordes A, Niehues S, and Lenarz M
- Subjects
- Adult, Calcinosis pathology, Diagnosis, Differential, Female, Fibrosis, Fibrous Dysplasia, Monostotic pathology, Headache Disorders classification, Humans, Magnetic Resonance Imaging, Radionuclide Imaging, Tomography, X-Ray Computed, Visual Analog Scale, Calcinosis diagnosis, Calcinosis surgery, Fibrous Dysplasia, Monostotic diagnosis, Fibrous Dysplasia, Monostotic surgery, Frontal Sinus pathology, Frontal Sinus surgery, Headache Disorders diagnosis, Headache Disorders etiology
- Published
- 2016
- Full Text
- View/download PDF
24. Incidence and long-term survival of patients with de novo head and neck carcinoma after liver transplantation.
- Author
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Coordes A, Albers AE, Lenarz M, Seehofer D, Puhl G, Pascher A, Neuhaus R, Neuhaus P, Pratschke J, and Andreou A
- Subjects
- Adolescent, Adult, Carcinoma, Squamous Cell therapy, Female, Follow-Up Studies, Head and Neck Neoplasms therapy, Humans, Incidence, Male, Middle Aged, Prospective Studies, Squamous Cell Carcinoma of Head and Neck, Survival Rate, Young Adult, Carcinoma, Squamous Cell etiology, Carcinoma, Squamous Cell mortality, Head and Neck Neoplasms etiology, Head and Neck Neoplasms mortality, Liver Transplantation adverse effects
- Abstract
Background: Liver transplant recipients have an increased risk of developing de novo malignancies., Methods: We conducted a prospective evaluation of clinicopathological data and predictors for overall survival (OS) in patients with head and neck squamous cell carcinoma (HNSCC) after liver transplantation (1988 to 2010)., Results: Thirty-three of 2040 patients who underwent liver transplantation (1.6%) developed de novo HNSCC. The incidence of HNSCC in liver transplant recipients with end-stage alcoholic liver disease (26) was 5%. After a median follow-up of 9 years, 1-year, 3-year, and 5-year OS rates were 74%, 47%, and 34%, respectively. Tumor size, cervical lymph node metastases, tumor site, and therapy (surgery only vs surgery and adjuvant radiotherapy [RT]/chemoradiotherapy [CRT] vs RT/CRT only; p < .0001) were significantly associated with OS in univariate analysis. However, surgery only predicted OS independently in multivariate analysis., Conclusion: Early diagnosis and surgical treatment of de novo HNSCC are crucial to the outcome. HNSCC risk should be taken into close consideration during posttransplantation follow-up examinations, especially among patients with a positive history of smoking and alcohol consumption., (© 2015 Wiley Periodicals, Inc.)
- Published
- 2016
- Full Text
- View/download PDF
25. [Seldom Differential Diagnosis of Rotary Vertigo with Nausea].
- Author
-
Jahreiß LM, Coordes A, Seyedahmadi P, Nave AH, and Lenarz M
- Subjects
- Audiometry, Pure-Tone, Diagnosis, Differential, Diffusion Magnetic Resonance Imaging, Electronystagmography, Follow-Up Studies, Humans, Male, Medulla Oblongata blood supply, Medulla Oblongata pathology, Middle Aged, Nystagmus, Pathologic etiology, Pons blood supply, Pons pathology, Brain Stem Infarctions diagnosis, Nausea etiology, Vertigo etiology
- Published
- 2016
- Full Text
- View/download PDF
26. [Tonsillectomy in adults: Length of hospital stay has no influence on the frequency of postoperative hemorrhage].
- Author
-
Coordes A, Soudry J, Hofmann VM, and Lenarz M
- Subjects
- Adolescent, Adult, Age Distribution, Aged, Comorbidity, Female, Germany epidemiology, Humans, Incidence, Male, Middle Aged, Retrospective Studies, Risk Factors, Sex Distribution, Treatment Outcome, Young Adult, Length of Stay statistics & numerical data, Postoperative Care statistics & numerical data, Postoperative Hemorrhage epidemiology, Tonsillectomy statistics & numerical data, Tonsillitis epidemiology, Tonsillitis surgery
- Abstract
Background: Tonsillectomies (TE) in Germany are traditionally performed during inpatient hospital stays. Socioeconomic changes in the healthcare system have resulted in shorter hospital stays., Objectives: The aim of the study was to investigate whether a shorter hospital stay of 2 days leads to increased postoperative bleeding after TE. Factors affecting the duration of hospitalization were also studied., Materials and Methods: The relevant data of all patients (≥ 14 years) undergoing TE in the ENT Clinic of the Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, between 2011 and 2013 were recorded anonymously. Risk factors for bleeding after TE were analyzed. Additionally, patients who had a hospital stay of 2 days (since 2013) were compared with patients hospitalized for ≥ 3 days, and the influence of various risk factors on the length of hospital stay was analyzed., Results: During the study period 2011-2013, 376 procedures were performed and data from 213 patients was collected for analysis. Median patient age was 26 years (range 14-73 years). The rate of primary hemorrhage (up to 24 hours after TE) was 2% and the rate of secondary bleeding (later than 24 hours) was 24%. In 7% of patients with postoperative haemorrhage (primary and secondary) surgical hemostasis was performed. Male gender was associated with a significantly higher haemorrhage rate. Shortening postdischarge surveillance to only 2 days did not affect the postoperative bleeding rate., Conclusion: The duration of stationary monitoring following TE should not only be based on the rate of secondary bleeding, but also on patient comfort and safety. A shortening of postoperative monitoring to only 2 days had no effect on the haemorrhage frequency after TE and can therefore, be considered for adults who do not live alone and are within a reasonable distance to a hospital.
- Published
- 2015
- Full Text
- View/download PDF
27. Biology and immunology of cancer stem(-like) cells in head and neck cancer.
- Author
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Qian X, Ma C, Nie X, Lu J, Lenarz M, Kaufmann AM, and Albers AE
- Subjects
- Carcinoma, Squamous Cell immunology, Carcinoma, Squamous Cell therapy, Carcinoma, Squamous Cell virology, Head and Neck Neoplasms immunology, Head and Neck Neoplasms therapy, Head and Neck Neoplasms virology, Humans, Immune Tolerance, Immunotherapy, Neoplasm Metastasis, Neoplastic Stem Cells drug effects, Neoplastic Stem Cells pathology, Neoplastic Stem Cells radiation effects, Squamous Cell Carcinoma of Head and Neck, Tumor Escape, Carcinoma, Squamous Cell pathology, Head and Neck Neoplasms pathology, Neoplastic Stem Cells immunology
- Abstract
Immunological approaches against tumors including head and neck squamous cell carcinoma (HNSCC) have been investigated for about 50 years. Such immunotherapeutic treatments are still not sufficiently effective for therapy of HNSCC. Despite the existence of immunosurveillance tumor cells may escape from the host immune system by a variety of mechanisms. Recent findings have indicated that cancer stem(-like) cells (CSCs) in HNSCC have the ability to reconstitute the heterogeneity of the bulk tumor and contribute to immunosuppression and resistance to current therapies. With regard to the CSC model, future immunotherapy possibly in combination with other modes of treatment should target this subpopulation specifically to reduce local recurrence and metastasis. In this review, we will summarize recent research findings on immunological features of CSCs and the potential of immune targeting of CSCs., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)
- Published
- 2015
- Full Text
- View/download PDF
28. Positron Emission Tomography Imaging Reveals Auditory and Frontal Cortical Regions Involved with Speech Perception and Loudness Adaptation.
- Author
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Berding G, Wilke F, Rode T, Haense C, Joseph G, Meyer GJ, Mamach M, Lenarz M, Geworski L, Bengel FM, Lenarz T, and Lim HH
- Subjects
- Acoustic Stimulation, Adaptation, Physiological, Adult, Aged, Auditory Cortex pathology, Auditory Cortex surgery, Brain Mapping, Brain Stem pathology, Brain Stem surgery, Cochlea pathology, Cochlea surgery, Cochlear Implantation, Cochlear Implants, Electrodes, Female, Frontal Lobe pathology, Frontal Lobe surgery, Hearing Loss, Bilateral pathology, Hearing Loss, Bilateral surgery, Humans, Male, Middle Aged, Positron-Emission Tomography, Recovery of Function, Speech, Auditory Cortex physiopathology, Brain Stem physiopathology, Cochlea physiopathology, Frontal Lobe physiopathology, Hearing Loss, Bilateral physiopathology, Speech Perception physiology
- Abstract
Considerable progress has been made in the treatment of hearing loss with auditory implants. However, there are still many implanted patients that experience hearing deficiencies, such as limited speech understanding or vanishing perception with continuous stimulation (i.e., abnormal loudness adaptation). The present study aims to identify specific patterns of cerebral cortex activity involved with such deficiencies. We performed O-15-water positron emission tomography (PET) in patients implanted with electrodes within the cochlea, brainstem, or midbrain to investigate the pattern of cortical activation in response to speech or continuous multi-tone stimuli directly inputted into the implant processor that then delivered electrical patterns through those electrodes. Statistical parametric mapping was performed on a single subject basis. Better speech understanding was correlated with a larger extent of bilateral auditory cortex activation. In contrast to speech, the continuous multi-tone stimulus elicited mainly unilateral auditory cortical activity in which greater loudness adaptation corresponded to weaker activation and even deactivation. Interestingly, greater loudness adaptation was correlated with stronger activity within the ventral prefrontal cortex, which could be up-regulated to suppress the irrelevant or aberrant signals into the auditory cortex. The ability to detect these specific cortical patterns and differences across patients and stimuli demonstrates the potential for using PET to diagnose auditory function or dysfunction in implant patients, which in turn could guide the development of appropriate stimulation strategies for improving hearing rehabilitation. Beyond hearing restoration, our study also reveals a potential role of the frontal cortex in suppressing irrelevant or aberrant activity within the auditory cortex, and thus may be relevant for understanding and treating tinnitus.
- Published
- 2015
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29. [Cancer stem cell phenotypes and miRNA: therapeutic targets in head and neck squamous cell carcinoma].
- Author
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Coordes A, Zhifeng S, Sangvatanakul V, Qian X, Lenarz M, Kaufmann AM, and Albers AE
- Subjects
- Animals, Antineoplastic Agents therapeutic use, Carcinoma, Squamous Cell drug therapy, Epithelial-Mesenchymal Transition drug effects, Gene Targeting methods, Head and Neck Neoplasms drug therapy, Humans, Models, Genetic, Neoplastic Stem Cells drug effects, Squamous Cell Carcinoma of Head and Neck, Carcinoma, Squamous Cell genetics, Epithelial-Mesenchymal Transition genetics, Head and Neck Neoplasms genetics, MicroRNAs genetics, Molecular Targeted Therapy methods, Neoplasm Proteins genetics, Neoplastic Stem Cells metabolism
- Abstract
Background: Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer worldwide. HNSCC is caused by persistent high-risk human papillomavirus (HR-HPV) infection or excessive consumption of alcohol or tobacco. The persistently low survival rates result from local recurrences and metastases, which are probably caused by so-called tumor stem cells (TSCs). The epithelial-mesenchymal transition (EMT) or transformation is a key event in metastasis initiation and is being increasingly associated with TSCs., Objectives: This review describes new therapeutic targets in HNSCC, focusing on the TSC hypothesis and EMT regulation., Materials and Methods, Results: TSCs and EMT are regulated directly and indirectly via transcription factors and microRNAs (miRNAs). These miRNAs regulate multiple cellular processes and may serve as new therapeutic targets, whose modulation could increase the effectiveness of HNSCC treatments. Post-transcriptionally, miRNAs regulate transcription factors associated with EMT (ZEB1/2, EZH2, Bmi-1), tumor suppressors (p53), TSC markers (ALDH, CD44, EpCAM, p63) and both epithelial (E-cadherin) and mesenchymal markers (vimentin)., Conclusion: Alterations in HNSSC TSC miRNA expression before and after chemotherapy could potentially serve as a therapeutic control. In the long term, knowledge of a patient's individual protein expression pattern may permit application of specific chemotherapy. Such individualized therapy might prohibit the development of metastases and potentially unresectable recurrences with a high resistance to radiation and chemotherapy, thus improving the prognosis in HNSCC patients.
- Published
- 2014
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30. Safety and efficacy of Nasya/Prevalin in reducing symptoms of allergic rhinitis.
- Author
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Stoelzel K, Bothe G, Chong PW, and Lenarz M
- Subjects
- Administration, Intranasal, Adult, Antigens, Dermatophagoides, Bentonite, Double-Blind Method, Female, Gels, Glycerol, Humans, Male, Middle Aged, Nasal Provocation Tests, Phosphates, Plant Oils, Polysaccharides, Bacterial, Treatment Outcome, Young Adult, Nasal Sprays, Rhinitis, Allergic prevention & control
- Abstract
Background: Nasya/Prevalin is a natural, drug-free nasal spray for treatment and prevention of allergic rhinitis. Because of its thixotropic property, it forms a barrier on the nasal mucosa, preventing allergen contact. This study assesses the clinical efficacy and safety of Nasya/Prevalin in a nasal provocation test with house dust mite allergens., Methodology/principal: In this randomised, double-blind, placebo-controlled trial, 20 subjects suffering from allergic rhinitis because of house dust mite allergens received a single dose of Nasya/Prevalin or saline spray before allergen challenge. Total nasal symptom score and total ocular symptom score were assessed 15, 30, 60, 75, 90, 120 and 240 min after challenge. Further, the appearance of the mucosa was examined by rhinoscopy., Results: A single treatment with Nasya/Prevalin led to a significant reduction of TNSS at 60, 75 and 90 min after dust mite allergen challenge as compared with placebo (pVCAS = 0.021, pVCAS = 0.035, pVCAS = 0.036, respectively). Mucosa changes assessed by the rhinoscopic score (on swelling, secretion and colour) were significantly worse in the placebo group compared with the Nasya/Prevalin group (P = 0.033). Nasya/Prevalin was well tolerated, and the safety was comparable with placebo., Conclusions: Treatment with Nasya/Prevalin was effective in preventing allergic reactions induced by dust mite allergen challenge., (© 2013 John Wiley & Sons Ltd.)
- Published
- 2014
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31. [Role of miRNA in malignoma of the head and neck].
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Coordes A, Lenarz M, Kaufmann AM, and Albers AE
- Subjects
- Carcinoma, Squamous Cell diagnosis, Cell Transformation, Neoplastic genetics, Disease Progression, Early Diagnosis, Epithelial-Mesenchymal Transition genetics, Exons genetics, Gene Expression Regulation, Neoplastic genetics, Genetic Markers genetics, Humans, Introns genetics, Neoplasm Recurrence, Local diagnosis, Neoplasm Recurrence, Local genetics, Neoplasm Recurrence, Local therapy, Neoplastic Stem Cells metabolism, Oncogene Proteins, Viral genetics, Otorhinolaryngologic Neoplasms diagnosis, Otorhinolaryngologic Neoplasms therapy, Phenotype, Prognosis, Carcinoma, Squamous Cell genetics, MicroRNAs genetics, Otorhinolaryngologic Neoplasms genetics
- Abstract
Despite optimized therapeutic strategies, the long-term survival of head and neck squamous cell carcinomas (HNSCC) has improved in recent years only slightly. Most studies on the tumor cell genome focus on protein-coding genes (exons). Data on changes within the non-coding sequences (introns) are limited. miRNAs (microRNA, miR) are small non-coding single-stranded RNAs that control gene expression at the posttranscriptional level by interacting with the mRNA. miRNA functions include many biological processes and control up to 50 % of human genes. They can have oncogenic or tumor suppressive functions. Altered expression patterns of miRNAs are involved in carcinogenesis and tumor progression even in HNSCC, or those processes (increased resistance to radiation or chemotherapy) that could be responsible for the poor long-term prognosis by forming metastases and inoperable local recurrences. Therefore, we here present miRNA groups, which are involved in these processes and may serve as new potential therapeutic treatment targets. miRNAs may also serve as biomarkers for early diagnosis, evaluation and monitoring of treatment and tumor recurrence. Alterations in miRNA expression before and after chemotherapy are therefore of high interest. In the long run, this knowledge could lead to more effective therapies with improved therapeutic outcome of HNSCC., (© Georg Thieme Verlag KG Stuttgart · New York.)
- Published
- 2014
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32. [Peripheral facial nerve palsy caused by a tumor in the epitympanum].
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Coordes A, Niehues SM, and Lenarz M
- Subjects
- Diagnosis, Differential, Ear Neoplasms surgery, Facial Paralysis diagnosis, Facial Paralysis surgery, Humans, Male, Middle Aged, Radiography, Treatment Outcome, Tympanic Membrane surgery, Ear Neoplasms complications, Ear Neoplasms diagnosis, Facial Paralysis etiology, Tympanic Membrane diagnostic imaging, Tympanic Membrane pathology
- Published
- 2014
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33. Inhibition of pan-class I phosphatidyl-inositol-3-kinase by NVP-BKM120 effectively blocks proliferation and induces cell death in diffuse large B-cell lymphoma.
- Author
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Zang C, Eucker J, Liu H, Coordes A, Lenarz M, Possinger K, and Scholz CW
- Subjects
- Autophagy drug effects, Blotting, Western, Cell Cycle drug effects, Cell Line, Tumor, Cell Survival drug effects, Class I Phosphatidylinositol 3-Kinases metabolism, Dose-Response Relationship, Drug, Flow Cytometry, Humans, Lymphoma, Large B-Cell, Diffuse metabolism, Lymphoma, Large B-Cell, Diffuse pathology, Myeloid Cell Leukemia Sequence 1 Protein genetics, Myeloid Cell Leukemia Sequence 1 Protein metabolism, Protein Biosynthesis drug effects, Proto-Oncogene Proteins c-akt metabolism, Signal Transduction drug effects, TOR Serine-Threonine Kinases metabolism, Tumor Cells, Cultured, bcl-X Protein genetics, bcl-X Protein metabolism, Aminopyridines pharmacology, Apoptosis drug effects, Cell Proliferation drug effects, Class I Phosphatidylinositol 3-Kinases antagonists & inhibitors, Morpholines pharmacology
- Abstract
Diffuse large B-cell lymphoma (DLBCL) is the most frequent aggressive lymphoma, with a great demand for novel treatments for relapsing and refractory disease. Constitutive activation of the phosphatidyl-inositol-3-kinase (PI3K)/Akt/mammalian target of rapamycin (mTOR) signaling pathway is often detected in this lymphoma. Inhibition of this signaling cascade with the pan-class I PI3K inhibitor NVP-BKM120 decreased cell proliferation and increased apoptotic cell death. DLBCL proliferation was further decreased if NVP-BKM120-induced autophagy was blocked. Treatment with NVP-BKM120 was associated with an increase of the pro-apoptotic BH3-only proteins Puma and Bim and down-regulation of the anti-apoptotic Bcl-xL and Mcl-1. Translation of Bcl-xL and Mcl-1 is facilitated by cap-dependent mRNA translation, a process that was partially inhibited by NVP-BKM120. Overall, we demonstrated here the potential of NVP-BKM120 for the treatment of DLBCL.
- Published
- 2014
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34. Neural representation in the auditory midbrain of the envelope of vocalizations based on a peripheral ear model.
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Rode T, Hartmann T, Hubka P, Scheper V, Lenarz M, Lenarz T, Kral A, and Lim HH
- Subjects
- Acoustic Stimulation, Animals, Female, Guinea Pigs, Male, Auditory Pathways physiology, Auditory Perception physiology, Evoked Potentials, Auditory physiology, Inferior Colliculi physiology, Mesencephalon physiology, Neurons physiology
- Abstract
The auditory midbrain implant (AMI) consists of a single shank array (20 sites) for stimulation along the tonotopic axis of the central nucleus of the inferior colliculus (ICC) and has been safely implanted in deaf patients who cannot benefit from a cochlear implant (CI). The AMI improves lip-reading abilities and environmental awareness in the implanted patients. However, the AMI cannot achieve the high levels of speech perception possible with the CI. It appears the AMI can transmit sufficient spectral cues but with limited temporal cues required for speech understanding. Currently, the AMI uses a CI-based strategy, which was originally designed to stimulate each frequency region along the cochlea with amplitude-modulated pulse trains matching the envelope of the bandpass-filtered sound components. However, it is unclear if this type of stimulation with only a single site within each frequency lamina of the ICC can elicit sufficient temporal cues for speech perception. At least speech understanding in quiet is still possible with envelope cues as low as 50 Hz. Therefore, we investigated how ICC neurons follow the bandpass-filtered envelope structure of natural stimuli in ketamine-anesthetized guinea pigs. We identified a subset of ICC neurons that could closely follow the envelope structure (up to ~100 Hz) of a diverse set of species-specific calls, which was revealed by using a peripheral ear model to estimate the true bandpass-filtered envelopes observed by the brain. Although previous studies have suggested a complex neural transformation from the auditory nerve to the ICC, our data suggest that the brain maintains a robust temporal code in a subset of ICC neurons matching the envelope structure of natural stimuli. Clinically, these findings suggest that a CI-based strategy may still be effective for the AMI if the appropriate neurons are entrained to the envelope of the acoustic stimulus and can transmit sufficient temporal cues to higher centers.
- Published
- 2013
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35. [Sudden hearing loss - intratympanic dexamethasone: injection or perfusion?].
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Lenarz M and Löwenheim H
- Subjects
- Female, Humans, Male, Anti-Inflammatory Agents administration & dosage, Dexamethasone administration & dosage, Ear, Middle, Hearing Loss, Sudden drug therapy
- Published
- 2013
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36. RORγt⁺ innate lymphoid cells acquire a proinflammatory program upon engagement of the activating receptor NKp44.
- Author
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Glatzer T, Killig M, Meisig J, Ommert I, Luetke-Eversloh M, Babic M, Paclik D, Blüthgen N, Seidl R, Seifarth C, Gröne J, Lenarz M, Stölzel K, Fugmann D, Porgador A, Hauser A, Karlas A, and Romagnani C
- Subjects
- Cells, Cultured, Cellular Microenvironment, Homeostasis, Humans, Immunity, Innate, Inflammation Mediators metabolism, Mucous Membrane immunology, Natural Cytotoxicity Triggering Receptor 2 immunology, Nuclear Receptor Subfamily 1, Group F, Member 3 metabolism, Palatine Tonsil cytology, Palatine Tonsil immunology, Receptor Cross-Talk, Signal Transduction, Tumor Necrosis Factor-alpha metabolism, Interleukin-22, Interleukins metabolism, Lymphocytes immunology, Natural Cytotoxicity Triggering Receptor 2 metabolism
- Abstract
RORγt⁺ innate lymphoid cells (ILCs) are crucial players of innate immune responses and represent a major source of interleukin-22 (IL-22), which has an important role in mucosal homeostasis. The signals required by RORγt⁺ ILCs to express IL-22 and other cytokines have been elucidated only partially. Here we showed that RORγt⁺ ILCs can directly sense the environment by the engagement of the activating receptor NKp44. NKp44 triggering in RORγt⁺ ILCs selectively activated a coordinated proinflammatory program, including tumor necrosis factor (TNF), whereas cytokine stimulation preferentially induced IL-22 expression. However, combined engagement of NKp44 and cytokine receptors resulted in a strong synergistic effect. These data support the concept that NKp44⁺ RORγt⁺ ILCs can be activated without cytokines and are able to switch between IL-22 or TNF production, depending on the triggering stimulus., (Copyright © 2013 Elsevier Inc. All rights reserved.)
- Published
- 2013
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37. [Surgical intervention for idiopathic hearing loss].
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Lenarz M
- Subjects
- Combined Modality Therapy, Hearing Loss diagnosis, Humans, Treatment Outcome, Hearing Loss surgery, Minimally Invasive Surgical Procedures methods, Myringoplasty methods, Tympanoplasty methods
- Published
- 2013
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- View/download PDF
38. Frequency representation within the human brain: stability versus plasticity.
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Lim HH, Lenarz M, Joseph G, and Lenarz T
- Subjects
- Adult, Electric Stimulation, Electrodes, Humans, Prostheses and Implants, Brain physiology, Neuronal Plasticity
- Abstract
A topographical representation for frequency has been identified throughout the auditory brain in animals but with limited evidence in humans. Using a midbrain implant, we identified an ordering of pitch percepts for electrical stimulation of sites across the human inferior colliculus (IC) that was consistent with the IC tonotopy shown in animals. Low pitches were perceived by the subject for stimulation of superficial IC sites while higher pitches were perceived for stimulation of deeper sites. Interestingly, this pitch ordering was not initially observed for stimulation across the IC, possibly due to central changes caused by prior hearing loss. Daily implant stimulation for about 4 months altered the pitch percepts from being predominantly low to exhibiting the expected ordering across the stimulated IC. A presumably normal tonotopic representation may have been maintained within the IC or accessible through IC stimulation that helped form this pitch ordering perceived in higher centers.
- Published
- 2013
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39. Alterations in early auditory evoked potentials and brainstem transmission time associated with tinnitus residual inhibition induced by auditory electrical stimulation.
- Author
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Mahmoudian S, Lenarz M, Esser KH, Salamat B, Alaeddini F, Dengler R, Farhadi M, and Lenarz T
- Subjects
- Adolescent, Adult, Aged, Auditory Pathways physiopathology, Cochlear Nerve physiopathology, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Perceptual Masking physiology, Tinnitus diagnosis, Young Adult, Brain Stem physiopathology, Electric Stimulation Therapy, Evoked Potentials, Auditory, Brain Stem physiology, Neural Inhibition physiology, Reaction Time physiology, Synaptic Transmission physiology, Tinnitus physiopathology, Tinnitus therapy
- Abstract
Introduction: Residual inhibition (RI) is the temporary inhibition of tinnitus by use of masking stimuli when the device is turned off., Objective: The main aim of this study was to evaluate the effects of RI induced by auditory electrical stimulation (AES) in the primary auditory pathways using early auditory-evoked potentials (AEPs) in subjective idiopathic tinnitus (SIT) subjects., Materials and Methods: A randomized placebo-controlled study was conducted on forty-four tinnitus subjects. All enrolled subjects based on the responses to AES, were divided into two groups of RI and Non-RI (NRI). The results of the electrocochleography (ECochG), auditory brain stem response (ABR) and brain stem transmission time (BTT) were determined and compared pre- and post-AES in the studied groups., Results: The mean differences in the compound action potential (CAP) amplitudes and III/V and I/V amplitude ratios were significantly different between the RI, NRI and PES controls. BTT was significantly decreased associated with RI., Conclusion: The observed changes in AEP associated with RI suggested some peripheral and central auditory alterations. Synchronized discharges of the auditory nerve fibers and inhibition of the abnormal activity of the cochlear nerve by AES may play important roles associated with RI. Further comprehensive studies are required to determine the mechanisms of RI more precisely.
- Published
- 2013
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40. Coactivation of different neurons within an isofrequency lamina of the inferior colliculus elicits enhanced auditory cortical activation.
- Author
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Calixto R, Lenarz M, Neuheiser A, Scheper V, Lenarz T, and Lim HH
- Subjects
- Animals, Electric Stimulation methods, Guinea Pigs, Male, Acoustic Stimulation methods, Action Potentials physiology, Auditory Cortex physiology, Inferior Colliculi physiology, Neurons physiology
- Abstract
The phenomenal success of the cochlear implant (CI) is attributed to its ability to provide sufficient temporal and spectral cues for speech understanding. Unfortunately, the CI is ineffective for those without a functional auditory nerve or an implantable cochlea required for CI implementation. As an alternative, our group developed and implanted in deaf patients a new auditory midbrain implant (AMI) to stimulate the central nucleus of the inferior colliculus (ICC). Although the AMI can provide frequency cues, it appears to insufficiently transmit temporal cues for speech understanding. The three-dimensional ICC consists of two-dimensional isofrequency laminae. The single-shank AMI only stimulates one site in any given ICC lamina and does not exhibit enhanced activity (i.e., louder percepts or lower thresholds) for repeated pulses on the same site with intervals <2-5 ms, as occurs for CI pulse or acoustic click stimulation. This enhanced activation, related to short-term temporal integration, is important for tracking the rapid temporal fluctuations of a speech signal. Therefore, we investigated the effects of coactivation of different regions within an ICC lamina on primary auditory cortex activity in ketamine-anesthetized guinea pigs. Interestingly, our findings reveal an enhancement mechanism for integrating converging inputs from an ICC lamina on a fast scale (<6-ms window) that is compromised when stimulating just a single ICC location. Coactivation of two ICC regions also reduces the strong and long-term (>100 ms) suppressive effects induced by repeated stimulation of just a single location. Improving AMI performance may require at least two shanks implanted along the tonotopic gradient of the ICC that enables coactivation of multiple regions along an ICC lamina with the appropriate interstimulus delays.
- Published
- 2012
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41. Long-term performance of cochlear implants in postlingually deafened adults.
- Author
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Lenarz M, Sönmez H, Joseph G, Büchner A, and Lenarz T
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Female, Humans, Longitudinal Studies, Male, Middle Aged, Retrospective Studies, Time Factors, Young Adult, Cochlear Implants, Deafness surgery
- Abstract
Objective: To evaluate the stability of long-term hearing performance after cochlear implantation (CI) in postlingually deafened adults and to explore the boundaries and limitations of the present test batteries for adult CI patients., Study Design: Case series with chart review., Setting: Tertiary referral center., Subjects and Methods: A cohort of 1005 postlingually deafened adult cochlear implantees, who received their implants after age 18 years, was unilaterally implanted and had no inner ear malformations or cochlear ossification. Hearing performance with cochlear implant was evaluated with the help of 5 standard German speech tests., Results: The average performance improved significantly during the first 6 months in all tests (learning phase) and afterward entered a plateau phase in which no statistically significant improvements or deteriorations were observed for more than 20 years of follow-up. For each test, the average performance of the cohort, the ceiling effect, and the average results for high and low performers are presented., Conclusions: In this study, postlingually deafened adults required about 6 months to learn how to process the artificial signals delivered by the cochlear implant. After this learning phase, the hearing performance entered a stable plateau phase for more than 20 years. This stability reveals the long-term reliability of the technology and the biological stability of the electrode-nerve interface over years. In this study, the authors also evaluated the "ceiling effect" with 5 standard German speech tests, used for evaluation of postlingually deafened adult CI patients.
- Published
- 2012
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42. Cochlear implant performance in geriatric patients.
- Author
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Lenarz M, Sönmez H, Joseph G, Büchner A, and Lenarz T
- Subjects
- Adolescent, Adult, Age Factors, Aged, Analysis of Variance, Auditory Perception physiology, Cohort Studies, Female, Geriatric Assessment, Germany, Hearing Loss, Bilateral diagnosis, Hearing Loss, Bilateral surgery, Hearing Tests methods, Humans, Male, Middle Aged, Quality of Life, Retrospective Studies, Risk Assessment, Speech Reception Threshold Test, Treatment Outcome, Young Adult, Aging physiology, Cochlear Implantation methods, Cochlear Implants, Speech Perception physiology
- Abstract
Objectives/hypothesis: To evaluate the hearing performance with cochlear implants (CIs) in patients who were 70 years or older at the time of implantation (geriatric patients) and compare it with the performance in younger adults., Study Design: Individual, retrospective, cohort study., Methods: A cohort of 1,005 postlingually deafened adults was selected for this study. According to their age at the time of cochlear implantation, patients were divided into four age groups: group 1, 18 to 39 years; group 2, 40 to 59 years; group 3, 60 to 69 years; and group 4, 70 years and older). The test battery was composed of four standard German speech tests: Freiburger Monosyllabic Test, Speech Tracking Test, and Hochmair-Schulz-Moser (HSM) Sentence Test in quiet and in 10 dB noise., Results: Geriatric patients showed a similar learning curve as the younger adults in the first 2 years after implantation. The direct comparison of speech perception in the Freiburger Monosyllabic Test, Speech Tracking Test, and HSM Test in quiet revealed no differences between the average performance of the geriatric patients and younger adults. However, in the HSM Test in noise, the performance of the geriatric group was significantly lower than the younger adults., Conclusions: Geriatric CI patients have a similar learning curve to younger adults, and in speech tests in quiet they show a comparable performance. However, their performance is significantly lower in noisy surroundings. This may be due to the central presbycusis in patients older than 70 years and should be taken into account in postoperative fitting of these patients. Further prospective studies are required to evaluate the role of special rehabilitation methods and cognitive training to improve the speech perception in noise in geriatric CI patients., (Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.)
- Published
- 2012
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- View/download PDF
43. Effect of gender on the hearing performance of adult cochlear implant patients.
- Author
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Lenarz M, Sönmez H, Joseph G, Büchner A, and Lenarz T
- Subjects
- Adult, Deafness physiopathology, Female, Follow-Up Studies, Humans, Male, Prosthesis Design, Retrospective Studies, Sex Distribution, Sex Factors, Speech Reception Threshold Test, Cochlear Implants, Deafness rehabilitation, Hearing physiology, Speech Perception physiology
- Abstract
Objectives/hypothesis: To evaluate the role of gender on the hearing performance of postlingually deafened adult patients with cochlear implants., Study Design: Individual retrospective cohort study., Methods: There were 638 postlingually deafened adults (280 men and 358 women) selected for a retrospective evaluation of their hearing performance with cochlear implants. Both genders underwent the same surgical and rehabilitative procedures and benefited from the latest technological advances available. There was no significant difference in the age, duration of deafness, and preoperative hearing performance between the genders. The test battery was composed of the Freiburger Monosyllabic Test, Speech Tracking, and the Hochmair-Schulz-Moser (HSM) sentence test in quiet and in 10-dB noise. The results of 5 years of follow-up are presented here., Results: Genders showed a similar performance in Freiburger Monosyllabic Test and Speech Tracking Test. However, in the HSM test in noise, men performed slightly better than women in all of the follow-up sessions, which was statistically significant at 2 and 4 years after implantation., Conclusions: Although normal-hearing women use more predictive cognitive strategies in speech comprehension and are supposed to have a more efficient declarative memory system, this may not necessarily lead to a better adaptation to the altered auditory information delivered by a cochlear implant. Our study showed that in more complex listening situations such as speech tests in noise, men tend to perform slightly better than women. Gender may have an influence on the hearing performance of postlingually deafened adults with cochlear implants., (Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.)
- Published
- 2012
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44. Effect of technological advances on cochlear implant performance in adults.
- Author
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Lenarz M, Joseph G, Sönmez H, Büchner A, and Lenarz T
- Subjects
- Adult, Age Factors, Aged, Cochlear Implantation adverse effects, Cohort Studies, Deafness diagnosis, Follow-Up Studies, Forecasting, Humans, Longitudinal Studies, Male, Middle Aged, Prosthesis Failure, Retrospective Studies, Risk Assessment, Speech Reception Threshold Test, Time Factors, Treatment Outcome, Biomedical Technology trends, Cochlear Implantation methods, Cochlear Implants, Deafness surgery, Prosthesis Design, Quality Improvement, Speech Perception physiology
- Abstract
Objectives/hypothesis: To evaluate the effect of technological advances in the past 20 years on the hearing performance of a large cohort of adult cochlear implant (CI) patients., Study Design: Individual, retrospective, cohort study., Methods: According to technological developments in electrode design and speech-processing strategies, we defined five virtual intervals on the time scale between 1984 and 2008. A cohort of 1,005 postlingually deafened adults was selected for this study, and their hearing performance with a CI was evaluated retrospectively according to these five technological intervals. The test battery was composed of four standard German speech tests: Freiburger monosyllabic test, speech tracking test, Hochmair-Schulz-Moser (HSM) sentence test in quiet, and HSM sentence test in 10 dB noise., Results: The direct comparison of the speech perception in postlingually deafened adults, who were implanted during different technological periods, reveals an obvious improvement in the speech perception in patients who benefited from the recent electrode designs and speech-processing strategies. The major influence of technological advances on CI performance seems to be on speech perception in noise., Conclusions: Better speech perception in noisy surroundings is strong proof for demonstrating the success rate of new electrode designs and speech-processing strategies. Standard (internationally comparable) speech tests in noise should become an obligatory part of the postoperative test battery for adult CI patients., (Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.)
- Published
- 2011
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45. Preoperative prediction of vestibular schwannoma's nerve of origin with posturography and electronystagmography.
- Author
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Borgmann H, Lenarz T, and Lenarz M
- Subjects
- Adult, Aged, Humans, Middle Aged, Neuroma, Acoustic physiopathology, Nystagmus, Physiologic, Posture, Retrospective Studies, Vestibular Nerve physiopathology, Electrodiagnosis methods, Neuroma, Acoustic pathology, Vestibular Nerve pathology
- Abstract
Conclusion: Chances of hearing preservation are better in patients with vestibular schwannoma (VS) from the superior vestibular nerve (SVN) than from the inferior vestibular nerve (IVN). Pathologic posturography and electronystagmography (ENG) findings are more common in schwannomas from the SVN compared with tumors from the IVN. In this way, computerized dynamic platform posturography (CDPP) and ENG contribute to predict the nerve of origin of VS and can be used indirectly as a prognostic factor for hearing preservation., Objectives: To test whether preoperative CDPP or ENG results contribute to predict the nerve of origin in VS and also to evaluate the influence of the nerve of origin on hearing preservation., Methods: Eighty-nine patients with VS originating from the IVN and 22 patients with VS from the SVN were included. Hearing loss due to surgery was calculated on postoperative and preoperative audiograms. Caloric response was measured by ENG and condition 5 and 6 score were recorded by CDPP before surgery., Results: Hearing loss due to surgery was significantly lower in patients with tumors from the SVN than from the IVN (p = 0.011). Pathologic results in preoperative ENG (p < 0.0001) and CDPP (p = 0.025) were significantly more frequent in subjects with SVN than with IVN schwannomas.
- Published
- 2011
- Full Text
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46. Effects of pulse phase duration and location of stimulation within the inferior colliculus on auditory cortical evoked potentials in a guinea pig model.
- Author
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Neuheiser A, Lenarz M, Reuter G, Calixto R, Nolte I, Lenarz T, and Lim HH
- Subjects
- Animals, Cochlear Implants, Guinea Pigs, Male, Models, Animal, Reaction Time physiology, Electric Stimulation, Evoked Potentials, Auditory physiology, Inferior Colliculi physiology
- Abstract
The auditory midbrain implant (AMI), which consists of a single shank array designed for stimulation within the central nucleus of the inferior colliculus (ICC), has been developed for deaf patients who cannot benefit from a cochlear implant. Currently, performance levels in clinical trials for the AMI are far from those achieved by the cochlear implant and vary dramatically across patients, in part due to stimulation location effects. As an initial step towards improving the AMI, we investigated how stimulation of different regions along the isofrequency domain of the ICC as well as varying pulse phase durations and levels affected auditory cortical activity in anesthetized guinea pigs. This study was motivated by the need to determine in which region to implant the single shank array within a three-dimensional ICC structure and what stimulus parameters to use in patients. Our findings indicate that complex and unfavorable cortical activation properties are elicited by stimulation of caudal-dorsal ICC regions with the AMI array. Our results also confirm the existence of different functional regions along the isofrequency domain of the ICC (i.e., a caudal-dorsal and a rostral-ventral region), which has been traditionally unclassified. Based on our study as well as previous animal and human AMI findings, we may need to deliver more complex stimuli than currently used in the AMI patients to effectively activate the caudal ICC or ensure that the single shank AMI is only implanted into a rostral-ventral ICC region in future patients.
- Published
- 2010
- Full Text
- View/download PDF
47. Artifacts caused by cochlear implants with non-removable magnets in 3T MRI: phantom and cadaveric studies.
- Author
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Majdani O, Rau TS, Götz F, Zimmerling M, Lenarz M, Lenarz T, Labadie R, and Leinung M
- Subjects
- Cadaver, Humans, Prosthesis Design, Reproducibility of Results, Artifacts, Cochlear Implants, Imaging, Three-Dimensional, Magnetic Resonance Imaging methods, Magnetics instrumentation, Phantoms, Imaging
- Abstract
The aim of this study was to evaluate artifacts produced by cochlear implants (CI) during 3.0 Tesla (T) magnetic resonance imaging of the brain using different sequences on phantom and cadaveric specimens. A phantom and three cadaveric specimens with CIs were imaged using a 3.0 T clinical scanner. Artifacts were analyzed quantitatively and according to the sequence used. Different brain regions were evaluated for image distortion and limitation of diagnostic significance. In cadaver studies, all sequences generated signal-void areas around the implant. In T2-weighted sequences, additional periodic shadowing was discovered. Anatomical structures of the brain on the contralateral side of the CI were for the most part undistorted. At 3T, artifacts around CIs with non-removable magnets compromise image quality of the nearby brain regions and diagnosis of brain lesions is limited. In the contralateral hemisphere, diagnostic accuracy is only marginally limited.
- Published
- 2009
- Full Text
- View/download PDF
48. Auditory midbrain implant: a review.
- Author
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Lim HH, Lenarz M, and Lenarz T
- Subjects
- Adult, Aged, Animals, Auditory Pathways physiopathology, Auditory Threshold, Comprehension, Cues, Deafness physiopathology, Deafness rehabilitation, Deep Brain Stimulation, Female, Humans, Inferior Colliculi physiopathology, Lipreading, Male, Prosthesis Design, Signal Processing, Computer-Assisted, Speech Perception, Time Perception, Treatment Outcome, Auditory Brain Stem Implants adverse effects, Correction of Hearing Impairment, Deafness surgery, Inferior Colliculi surgery, Persons With Hearing Impairments rehabilitation, Prosthesis Implantation adverse effects
- Abstract
The auditory midbrain implant (AMI) is a new hearing prosthesis designed for stimulation of the inferior colliculus in deaf patients who cannot sufficiently benefit from cochlear implants. The authors have begun clinical trials in which five patients have been implanted with a single shank AMI array (20 electrodes). The goal of this review is to summarize the development and research that has led to the translation of the AMI from a concept into the first patients. This study presents the rationale and design concept for the AMI as well a summary of the animal safety and feasibility studies that were required for clinical approval. The authors also present the initial surgical, psychophysical, and speech results from the first three implanted patients. Overall, the results have been encouraging in terms of the safety and functionality of the implant. All patients obtain improvements in hearing capabilities on a daily basis. However, performance varies dramatically across patients depending on the implant location within the midbrain with the best performer still not able to achieve open set speech perception without lip-reading cues. Stimulation of the auditory midbrain provides a wide range of level, spectral, and temporal cues, all of which are important for speech understanding, but they do not appear to sufficiently fuse together to enable open set speech perception with the currently used stimulation strategies. Finally, several issues and hypotheses for why current patients obtain limited speech perception along with several feasible solutions for improving AMI implementation are presented.
- Published
- 2009
- Full Text
- View/download PDF
49. The influence of the coupling of actuation drivers of implantable hearing systems on the mechanics of the middle ear.
- Author
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Stieve M, Winter M, Battmer R, Lenarz M, and Lenarz T
- Subjects
- Acoustic Impedance Tests, Deafness therapy, Ear, Middle physiology, Humans, Preoperative Care, Treatment Outcome, Cochlear Implantation instrumentation, Cochlear Implantation methods, Cochlear Implants, Deafness surgery, Ear, Middle surgery, Transducers
- Abstract
We used multifrequency tympanometry to provide middle ear mechanics after implantation of different implantable hearing aids. A total of 34 patients were included in the investigation; 19 of them were fitted with the Otologics system and 15 with the MED-EL Vibrant Soundbridge system. With the Otologics recipients, measurements were made preoperatively and both two months and at least 12 months postoperatively. Measurements involving the MED-EL patients were taken at least 12 months postoperatively. For all measurements, the non-implanted contralateral side was used as a control. Preoperatively, the resonance frequency of the Otologics patients was 904.3 +/- 218.2 Hz for the implanted side and 907.1 +/- 161.8 Hz for the non-implanted side. Postoperatively, a significant increase (p < 0.01) compared with the preoperative value and the control side was observed after two months: 1111.3 +/- 234.7 Hz, as opposed to 823.8 +/- 274.5 Hz on the contralateral side. After 12 months, the resonance point was restored to approximately the preoperatively measured values: 975 +/- 55.3 Hz (implanted side) and 901.3 +/- 207.1 (control side). The resonance frequency in the Symphonix patients, as measured after at least 12 months (on average, 35 months), was 1006.3 +/- 269.5 Hz on the non-implanted side and 900.1 +/- 249.3 Hz on the implanted side. It is apparent that the resonance frequency on the implanted side was higher than on the control side, although the difference was not significant (p = 0.496). Monitoring following the implantation of active hearing systems is therefore recommended in order that conclusions can be drawn regarding the adequacy of the coupling of the actuation driver to the ossicular chain.
- Published
- 2009
- Full Text
- View/download PDF
50. [Central auditory prosthesis].
- Author
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Lenarz T, Lim H, Joseph G, Reuter G, and Lenarz M
- Subjects
- Equipment Failure Analysis, Humans, Prosthesis Design, Deafness rehabilitation, Deep Brain Stimulation instrumentation, Deep Brain Stimulation methods, Prostheses and Implants
- Abstract
Deaf patients with severe sensory hearing loss can benefit from a cochlear implant (CI), which stimulates the auditory nerve fibers. However, patients who do not have an intact auditory nerve cannot benefit from a CI. The majority of these patients are neurofibromatosis type 2 (NF2) patients who developed neural deafness due to growth or surgical removal of a bilateral acoustic neuroma. The only current solution is the auditory brainstem implant (ABI), which stimulates the surface of the cochlear nucleus in the brainstem. Although the ABI provides improvement in environmental awareness and lip-reading capabilities, only a few NF2 patients have achieved some limited open set speech perception. In the search for alternative procedures our research group in collaboration with Cochlear Ltd. (Australia) developed a human prototype auditory midbrain implant (AMI), which is designed to electrically stimulate the inferior colliculus (IC). The IC has the potential as a new target for an auditory prosthesis as it provides access to neural projections necessary for speech perception as well as a systematic map of spectral information. In this paper the present status of research and development in the field of central auditory prostheses is presented with respect to technology, surgical technique and hearing results as well as the background concepts of ABI and AMI.
- Published
- 2009
- Full Text
- View/download PDF
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