10 results on '"Robert A Feijen"'
Search Results
2. Prospective evaluation of multidimensional health‐related quality of life after endoscopic endonasal surgery for pituitary adenomas using the endoscopic endonasal sinus and skull base surgery questionnaire
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Gonneke E. Joustra, Ellen tenDam, Karin M. Vermeulen, Astrid G. W. Korsten‐Meijer, Auke P. A. Appelman, and Robert A. Feijen
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anterior skull base ,endoscopic endonasal sinus and Skull Base surgery questionnaire (EES‐Q) ,endoscopic skull base surgery ,patient reported outcome measure ,quality of life ,Otorhinolaryngology ,RF1-547 ,Surgery ,RD1-811 - Abstract
Abstract Objective Social functioning is an important factor in the evaluation of postoperative health‐related quality of life (HRQoL) for pituitary adenoma patients. In a prospective cohort study multidimensional HRQoL of non‐functioning (NFA) and functioning (FA) pituitary adenoma patients were evaluated following endoscopic endonasal surgery using the endoscopic endonasal sinus and skull base surgery questionnaire (EES‐Q). Methods Prospectively, 101 patients were included. The EES‐Q was completed preoperatively and postoperatively (2 weeks, 3 months, 1 year). Sinonasal complaints were completed daily during the first week postoperatively. Preoperative and postoperative scores were compared. A generalized estimating equation (uni‐ and multivariate) analysis was performed to identify significant HRQoL changes related to selected covariates. Results Two weeks postoperatively, physical (p
- Published
- 2023
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3. The effect of three‐dimensional visualisation on performance in endoscopic sinus surgery: A clinical training study using surgical navigation for movement analysis in a randomised crossover design
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Robert A. Feijen, Ellen Ten Dam, Astrid G. W. Korsten-Meijer, Bernard F. A. M. van der Laan, Herman M. Helder, Man, Biomaterials and Microbes (MBM), and Damage and Repair in Cancer Development and Cancer Treatment (DARE)
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Adult ,Male ,medicine.medical_specialty ,anterior skull base ,Endoscope ,Endoscopic endonasal surgery ,IMPACT ,NEUROENDOSCOPY ,Otolaryngology ,Young Adult ,03 medical and health sciences ,Imaging, Three-Dimensional ,0302 clinical medicine ,LAPAROSCOPY ,Paranasal Sinuses ,Humans ,Medicine ,030223 otorhinolaryngology ,Laparoscopy ,Nose ,Cross-Over Studies ,SKULL BASE SURGERY ,medicine.diagnostic_test ,undergraduate education ,business.industry ,imaging ,Endoscopy ,Original Articles ,HIGH-DEFINITION ,Crossover study ,ENDONASAL ,Visualization ,Endoscopic sinus surgery ,VISION ,medicine.anatomical_structure ,Surgery, Computer-Assisted ,Otorhinolaryngology ,Education, Medical, Graduate ,030220 oncology & carcinogenesis ,technology ,Physical therapy ,Original Article ,Female ,business ,endoscopic sinus surgery ,SYSTEM - Abstract
Objectives: Endoscopic imaging techniques and endoscopic endonasal surgery (EES) expertise have evolved rapidly. Only few studies have assessed the effect of three-dimensional (3D) endoscopy on endoscopic sinus surgery (ESS). The present study aimed to objectively and subjectively assess the additional value of 3D high-definition (HD) endoscopy in ESS. Design: A randomized crossover study of endoscopic surgery performance, using five ESS tasks of varying complexity, performed on Thiel embalmed human specimens. Setting: Simulated surgical environment. Participants: Thirty participants, inexperienced in ESS. Main outcome measures: Performance was assessed using video imaging, surgical navigation and questionnaires. Main outcome measures were as follows: efficiency (defined by time to task completion), distance covered inside the nose, average velocity towards target, accuracy (measured by error rate), and subjective assessment of endoscope characteristics. Results: During ESS tasks, both efficiency and accuracy did not differ significantly between 2D HD and 3D HD endoscopy. Subjectively, imaging characteristics of the 3D HD endoscope were rated significantly better. Conclusions: ESS performance of inexperienced participants was not significantly improved by the use of 3D HD endoscopy during ESS tasks, although imaging characteristics of the 3D HD endoscope were rated significantly better. Surgical field characteristics and surgical techniques are likely to influence any additional value of 3D HD endoscopy.
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- 2020
4. Detection by fluorescence of pituitary neuroendocrine tumour (PitNET) tissue during endoscopic transsphenoidal surgery using bevacizumab-800CW (DEPARTURE trial)
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Robert A. Feijen, Rob A Vergeer, Gerrit van den Berg, André P van Beek, Astrid G. W. Korsten-Meijer, Iris Schmidt, Mark R. Postma, J. Marc C. van Dijk, Wilfred F. A. den Dunnen, Jos M. A. Kuijlen, Wouter B. Nagengast, Schelto Kruijff, Guided Treatment in Optimal Selected Cancer Patients (GUTS), Movement Disorder (MD), Molecular Neuroscience and Ageing Research (MOLAR), and Center for Liver, Digestive and Metabolic Diseases (CLDM)
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Vascular Endothelial Growth Factor A ,EXPRESSION ,Fluorescence-lifetime imaging microscopy ,Pituitary disorder ,Bevacizumab ,medicine.medical_treatment ,pituitary disorders ,INVASION ,In vivo ,ADENOMAS ,medicine ,Humans ,Pituitary Neoplasms ,neurosurgery ,Transsphenoidal surgery ,medicine.diagnostic_test ,business.industry ,Endoscopy ,General Medicine ,Interim analysis ,Diabetes and Endocrinology ,Neuroendocrine Tumors ,CAVERNOUS SINUS SPACE ,Medicine ,Feasibility Studies ,Nuclear medicine ,business ,Ex vivo ,medicine.drug - Abstract
IntroductionAchieving gross total resection and endocrine remission in pituitary neuroendocrine tumours (PitNET) can be challenging, especially in PitNETs with cavernous sinus (CS) invasion, defined as a Knosp grade of 3 or 4. A potential target to identify PitNET tissue is vascular endothelial growth factor A (VEGF-A), which expression is known to be significantly higher in PitNETs with CS invasion.Methods and analysisThe aim of this non-randomised, non-blinded, single centre, feasibility and dose-finding phase 1 trial is to determine the feasibility of intraoperative fluorescence imaging detection of PitNET tissue during endoscopic transsphenoidal surgery using the VEGF-A targeting optical agent bevacizumab-800CW (4, 5, 10 or 25 mg). Nine to fifteen patients with a PitNET with a Knosp grade of 3 or 4 will be included. Secondary objectives are: (1) To identify the optimal tracer dose for imaging of PitNET tissue during transsphenoidal surgery for further development in a phase 2 fluorescence molecular endoscopy trial. (2) To quantify fluorescence intensity in vivo and ex vivo with multidiameter single-fibre reflectance, single-fibre fluorescence (MDSFR/SFF) spectroscopy. (3) To correlate and validate both the in vivo and ex vivo measured fluorescence signals with histopathological analysis and immunohistochemical staining. (4) To assess the (sub)cellular location of bevacizumab-800CW by ex vivo fluorescence microscopy. Intraoperative, three imaging moments are defined to detect the fluorescent signal. The tumour-to-background ratios are defined by intraoperative fluorescence in vivo measurements including MDSFR/SFF spectroscopy data and by ex vivo back-table fluorescence imaging. After inclusion of three patients in each dose group, an interim analysis will be performed to define the optimal dose.Ethics and disseminationApproval was obtained from the Medical Ethics Review Board of the University Medical Centre Groningen. Results will be disseminated through national and international journals. The participants and relevant patient support groups will be informed about the results.Trial registration numberNCT04212793
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- 2021
5. Evaluation of the psychometric properties of the endoscopic endonasal sinus and skull base surgery questionnaire (EES-Q) in a prospective cohort study
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Ellen Ten Dam, Astrid G. W. Korsten-Meijer, Robert A. Feijen, Bernard F. A. M. van der Laan, Jos M. A. Kuijlen, Paul F M Krabbe, Eelco W. Hoving, Man, Biomaterials and Microbes (MBM), Damage and Repair in Cancer Development and Cancer Treatment (DARE), Value, Affordability and Sustainability (VALUE), and Methods in Medicines evaluation & Outcomes research (M2O)
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Male ,Rhinology ,medicine.medical_specialty ,anterior skull base ,Psychometrics ,Endoscopic endonasal surgery ,Tertiary referral hospital ,outcomes ,ANTERIOR ,PATIENT ,VALIDATION ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,QUALITY-OF-LIFE ,Surveys and Questionnaires ,Paranasal Sinus Diseases ,medicine ,Humans ,rhinology ,Prospective Studies ,030223 otorhinolaryngology ,Prospective cohort study ,Sinus (anatomy) ,Netherlands ,Skull Base ,business.industry ,Reproducibility of Results ,Construct validity ,Endoscopy ,Middle Aged ,anterior skull base surgery ,medicine.anatomical_structure ,Otorhinolaryngology ,quality of life ,030220 oncology & carcinogenesis ,Skull base surgery ,Physical therapy ,Female ,Sino-Nasal Outcome Test ,business ,endoscopic sinus surgery - Abstract
OBJECTIVES: The patients' perspective on health has become increasingly important when assessing treatment outcomes. Recently, the Endoscopic Endonasal Sinus and Skull Base Surgery Questionnaire (EES-Q) was developed to determine the impact of endoscopic endonasal surgery on health-related quality of life (HRQoL). The aim of this study was to evaluate the test-retest reliability, construct validity, and responsiveness of the EES-Q.DESIGN: Prospective cohort study.SETTING: University Medical Center Groningen, tertiary referral hospital, the Netherlands.PARTICIPANTS: One hundred patients who underwent endoscopic endonasal surgery because of sinus or anterior skull base pathology.MAIN OUTCOME MEASURES: Test-retest reliability, construct validity and responsiveness.RESULTS: The EES-Q domains exhibited good test-retest reliability (ICC > 0.90). Construct validity was corroborated by significant positive and negative correlations between the EES-Q and the SNOT-22 and postoperative health status (p < 0.01) respectively. The correlation between the social EES-Q domain and the ability to move and perform usual activities (EQ-5D-3L) was significant positive (p < 0.01). In patients with paranasal sinus pathology, the EES-Q was responsive to clinical change (Cohen's d = 0.6).CONCLUSION: The EES-Q is a reliable and acceptable responsive disease-specific HRQoL instrument. The expected construct validity of the EES-Q is supported by the results in this study. Inconveniences in social functioning had the greatest negative impact on postoperative health status rating. This reflects the importance of a multidimensional HRQoL assessment after EES. The results indicate that the EES-Q is a promising disease-specific tool for the HRQoL assessment after endoscopic endonasal sinus or anterior skull base surgery. This article is protected by copyright. All rights reserved.
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- 2019
6. Development of the Endoscopic Endonasal Sinus and Skull Base Surgery Questionnaire
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Jos M. A. Kuijlen, Astrid G. W. Korsten-Meijer, Paul F M Krabbe, Ellen Ten Dam, Minke J C van den Berge, Robert A. Feijen, Eelco W. Hoving, Karin M. Vermeulen, and Bernard F. A. M. van der Laan
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medicine.medical_specialty ,Endoscopic endonasal surgery ,business.industry ,Varimax rotation ,Construct validity ,Exploratory factor analysis ,Surgery ,Test (assessment) ,03 medical and health sciences ,0302 clinical medicine ,Otorhinolaryngology ,Quality of life ,Cronbach's alpha ,medicine ,Physical therapy ,Immunology and Allergy ,030223 otorhinolaryngology ,business ,Prospective cohort study ,030217 neurology & neurosurgery - Abstract
Background The patients’ perspective of health outcomes has become important input for assessing treatment effects. However, existing endoscopic endonasal surgery (EES) instruments are not fully aligned with the concept of health-related quality of life (HRQoL). A prospective cohort study was therefore conducted to develop a suitable quality-of-life tool to assess nasal morbidity after EES: the Endoscopic Endonasal Sinus and Skull Base Surgery Questionnaire (EES-Q). Methods The study included 300 patients: 207 with sinus pathology and 93 with anterior skull base pathology. The EES-Q was administered prior to surgery and postoperatively (2 weeks, 3 months, and 1 year). Psychometric instrument properties were tested and relevant health domains were formulated. Seventy-two items were generated by the conventional psychometric approach. An exploratory factor analysis was used to test construct validity. The optimal number of factors to retain was determined by using the eigenvalues-greater-than-1 rule and scree plot. Orthogonal varimax rotation was used to enhance interpretability. Internal consistency was assessed using the Cronbach α. Results The factor analysis yielded a 3-factor solution, representing physical, psychological, and social functioning. The final version of the instrument consisted of 30 items with a high internal consistency (>0.80) for all 3 HRQoL domains. Conclusions The EES-Q is a comprehensive, multidimensional, disease-specific instrument. A distinguishing characteristic is that, apart from the physical and psychological domains, the EES-Q also encompasses a social domain. Understanding different HRQoL aspects in patients undergoing EES may help caregivers restore, improve, or preserve the patient's health through individualized care, which depends on identifying their specific needs.
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- 2017
7. Development of the Endoscopic Endonasal Sinus and Skull Base Surgery Questionnaire
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Ellen, Ten Dam, Robert A, Feijen, Minke J C, van den Berge, Eelco W, Hoving, Jos M, Kuijlen, Bernard F A M, van der Laan, Karin M, Vermeulen, Paul F M, Krabbe, and Astrid G W, Korsten-Meijer
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Adult ,Male ,Skull Base ,Surveys and Questionnaires ,Nasal Surgical Procedures ,Paranasal Sinuses ,Quality of Life ,Humans ,Endoscopy ,Female ,Middle Aged ,Aged - Abstract
The patients' perspective of health outcomes has become important input for assessing treatment effects. However, existing endoscopic endonasal surgery (EES) instruments are not fully aligned with the concept of health-related quality of life (HRQoL). A prospective cohort study was therefore conducted to develop a suitable quality-of-life tool to assess nasal morbidity after EES: the Endoscopic Endonasal Sinus and Skull Base Surgery Questionnaire (EES-Q).The study included 300 patients: 207 with sinus pathology and 93 with anterior skull base pathology. The EES-Q was administered prior to surgery and postoperatively (2 weeks, 3 months, and 1 year). Psychometric instrument properties were tested and relevant health domains were formulated. Seventy-two items were generated by the conventional psychometric approach. An exploratory factor analysis was used to test construct validity. The optimal number of factors to retain was determined by using the eigenvalues-greater-than-1 rule and scree plot. Orthogonal varimax rotation was used to enhance interpretability. Internal consistency was assessed using the Cronbach α.The factor analysis yielded a 3-factor solution, representing physical, psychological, and social functioning. The final version of the instrument consisted of 30 items with a high internal consistency (0.80) for all 3 HRQoL domains.The EES-Q is a comprehensive, multidimensional, disease-specific instrument. A distinguishing characteristic is that, apart from the physical and psychological domains, the EES-Q also encompasses a social domain. Understanding different HRQoL aspects in patients undergoing EES may help caregivers restore, improve, or preserve the patient's health through individualized care, which depends on identifying their specific needs.
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- 2017
8. Calculating nasoseptal flap dimensions: a cadaveric study using cone beam computed tomography
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Wicher J. van der Meer, Astrid G. W. Korsten-Meijer, Robert A. Feijen, Peter O. Gerrits, Ellen Ten Dam, Bernard F. A. M. van der Laan, Rutger H. Schepers, Damage and Repair in Cancer Development and Cancer Treatment (DARE), Man, Biomaterials and Microbes (MBM), and Personalized Healthcare Technology (PHT)
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ENDOSCOPIC RECONSTRUCTION ,Male ,Cone beam computed tomography ,Sphenoid Sinus ,MODELS ,ANTERIOR ,Surgical Flaps ,Vascularity ,Imaging, Three-Dimensional ,stomatognathic system ,Cadaver ,QUALITY-OF-LIFE ,Nasal septum ,medicine ,Skull base reconstruction ,Humans ,HEAD ,Nasoseptal flap ,Sinus (anatomy) ,NECK ,Aged ,Nasal Septum ,Aged, 80 and over ,Skull Base ,Frontal sinus ,SKULL BASE SURGERY ,business.industry ,Dissection ,General Medicine ,Anatomy ,DEFECTS ,Cone-Beam Computed Tomography ,MAXILLOFACIAL SURGERY ,Skull ,medicine.anatomical_structure ,Otorhinolaryngology ,Preoperative planning ,Three-dimensional imaging ,Frontal Sinus ,Female ,medicine.symptom ,Cadaveric spasm ,business ,CT - Abstract
We hypothesize that three-dimensional imaging using cone beam computed tomography (CBCT) is suitable for calculating nasoseptal flap (NSF) dimensions. To evaluate our hypothesis, we compared CBCT NSF dimensions with anatomical dissections. The NSF reach and vascularity were studied. In an anatomical study (n = 10), CBCT NSF length and surface were calculated and compared with anatomical dissections. The NSF position was evaluated by placing the NSF from the anterior sphenoid sinus wall and from the sella along the skull base towards the frontal sinus. To visualize the NSF vascularity in CBCT, the external carotic arteries were perfused with colored Iomeron. Correlations between CBCT NSFs and anatomical dissections were strongly positive (r > 0.70). The CBCT NSF surface was 19.8 cm(2) [16.6-22.3] and the left and right CBCT NSF lengths were 78.3 mm [73.2-89.5] and 77.7 mm [72.2-88.4] respectively. Covering of the anterior skull base was possible by positioning the NSF anterior to the sphenoid sinus. If the NSF was positioned from the sella along the skull base towards the frontal sinus, the NSF reached partially into the anterior ethmoidal sinuses. CBCT is a valuable technique for calculating NSF dimensions. CBCT to demonstrate septum vascularity in cadavers proved to be less suitable. The NSF reach for covering the anterior skull base depends on positioning. This study encourages preoperative planning of a customized NSF, in an attempt to spare septal mucosa. In the concept of minimal invasive surgery, accompanied by providing customized care, this can benefit the patients' postoperative complaints.
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- 2014
9. Nasoseptal Flap for Skull Base Reconstruction using Cone Beam Computed Tomography: A Cadaveric Study
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Robert A. Feijen, Peter O. Gerrits, W.J. Van Der Meer, Astrid G. W. Korsten-Meijer, Ellen Ten Dam, Bfam Van Der Laan, and Rutger H. Schepers
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Cone beam computed tomography ,Skull ,medicine.anatomical_structure ,business.industry ,Medicine ,Neurology (clinical) ,Base (exponentiation) ,Nuclear medicine ,business ,Cadaveric spasm - Published
- 2014
10. Cochlear aqueduct flow resistance is not constant during evoked inner ear pressure change in the guinea pig
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Hero P. Wit, Frans W. J. Albers, Robert A. Feijen, and Faculteit Medische Wetenschappen/UMCG
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PERILYMPHATIC FLUID ,DYNAMICS ,hydrops ,Materials science ,Endolymph ,TRANSMISSION ,Guinea Pigs ,Aqueduct ,Perilymph ,Models, Biological ,meniere ,Cochlear Aqueduct ,round window ,MANIPULATION ,medicine ,otorhinolaryngologic diseases ,Pressure ,micropressure system ,Animals ,Inner ear ,skin and connective tissue diseases ,Cochlea ,Round window ,endolymph ,Internal pressure ,Anatomy ,Sensory Systems ,MENIERES-DISEASE ,ANATOMY ,medicine.anatomical_structure ,Round Window, Ear ,Ear, Inner ,Cochlear aqueduct ,sense organs - Abstract
Inner ear fluid pressure was measured during 6.25 mHz square wave middle ear pressure manipulation, with a perforated tympanic membrane. After a negative-going middle ear pressure change the calculated flow resistance of the inner ear pressure release routes (mainly the cochlear aqueduct) was approximately constant, with a value of 12 Pa s/nl (averaged over two ears), when values for the inner ear window compliance are taken from the literature. After a positive-going middle ear pressure change the calculated flow resistance changed with round window position and with the pressure difference across the cochlear aqueduct. It reached an average maximum value of 114 Pa s/nl. The change of flow resistance during inner ear pressure variation can be explained by a permeability change of the cochlear aqueduct, caused by a change of structures filling the aqueduct and its entrance in scala tympani. (C) 2002 Elsevier Science B.V. All rights reserved.
- Published
- 2003
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