@article{HackenbergMeyerHaefneretal.2022, author = {Hackenberg, Stephan and Meyer, Till Jasper and H{\"a}fner, Johannes and Scheich, Matthias and St{\"o}th, Manuel and Al-Tinawi, Fadi and Neun, Tilmann and Mlynski, Robert and Hagen, Rudolf and Scherzad, Agmal}, title = {Surgical management of tympanojugular paragangliomas using the flexible CO\(_2\) laser}, series = {European Archives of Oto-Rhino-Laryngology}, volume = {279}, journal = {European Archives of Oto-Rhino-Laryngology}, number = {12}, doi = {10.1007/s00405-022-07416-5}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-324164}, pages = {5623-5630}, year = {2022}, abstract = {Purpose Surgery is a standard therapy for tympanojugular paragangliomas (TJP). Maintaining the quality of life (QoL) requires functional preservation. The flexible CO\(_2\) laser allows contact-free tumor removal. This retrospective study compares the postoperative functional outcomes of TJP surgery with and without the flexible CO\(_2\) laser. Methods Between 2005 and 2019, 51 patients with TJP were surgically treated at a tertiary hospital. Until 2012, 17 patients received conventional surgery. Thereafter, the flexible laser was used in 34 patients. Tumor extend, pre- and postoperative cranial nerve function, and complications were compared between the groups. Results The cohort consisted of 33 class A and B tumors and 18 class C and D tumors. Preoperative embolization was performed in 17 cases. Class C/D TJP were usually removed via an infratemporal fossa type A approach. Gross total tumor removal was achieved in 14/18 class C/D tumors. 3/51 patients suffered from long-term partial or complete facial palsy. No differences in post-therapeutic cranial nerve function or complications were noted between the conventional and laser group. One recurrence was observed after complete tumor resection. Conclusion The flexible CO\(_2\) laser was shown to be a safe and effective alternative to conventional bipolar cauterization, which is appreciated by the surgeon in these highly vascularized tumors. Both techniques allowed a high tumor control rate and good long-term results also from a functional point of view.}, language = {en} } @article{MertensAndriesKurzetal.2022, author = {Mertens, Griet and Andries, Ellen and Kurz, Anja and Tȧvora-Vieira, Dayse and Calvino, Miryam and Amann, Edda and Anderson, Ilona and Lorens, Artur}, title = {Towards a consensus on an ICF-based classification system for horizontal sound-source localization}, series = {Journal of Personalized Medicine}, volume = {12}, journal = {Journal of Personalized Medicine}, number = {12}, issn = {2075-4426}, doi = {10.3390/jpm12121971}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-297319}, year = {2022}, abstract = {The study aimed to develop a consensus classification system for the reporting of sound localization testing results, especially in the field of cochlear implantation. Against the background of an overview of the wide variations present in localization testing procedures and reporting metrics, a novel classification system was proposed to report localization errors according to the widely accepted International Classification of Functioning, Disability and Health (ICF) framework. The obtained HEARRING_LOC_ICF scale includes the ICF graded scale: 0 (no impairment), 1 (mild impairment), 2 (moderate impairment), 3 (severe impairment), and 4 (complete impairment). Improvement of comparability of localization results across institutes, localization testing setups, and listeners was demonstrated by applying the classification system retrospectively to data obtained from cohorts of normal-hearing and cochlear implant listeners at our institutes. The application of our classification system will help to facilitate multi-center studies, as well as allowing better meta-analyses of data, resulting in improved evidence-based practice in the field.}, language = {en} } @article{TopsakalAgrawalAtlasetal.2022, author = {Topsakal, Vedat and Agrawal, Sumit and Atlas, Marcus and Baumgartner, Wolf-Dieter and Brown, Kevin and Bruce, Iain A. and Dazert, Stefan and Hagen, Rudolf and Lassaletta, Luis and Mlynski, Robert and Raine, Christopher H. and Rajan, Gunesh P. and Schmutzhard, Joachim and Sprinzl, Georg Mathias and Staecker, Hinrich and Usami, Shin-ichi and Van Rompaey, Vincent and Zernotti, Mario and Heyning, Paul van de}, title = {Minimally traumatic cochlear implant surgery: expert opinion in 2010 and 2020}, series = {Journal of Personalized Medicine}, volume = {12}, journal = {Journal of Personalized Medicine}, number = {10}, issn = {2075-4426}, doi = {10.3390/jpm12101551}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-288196}, year = {2022}, abstract = {This study aimed to discover expert opinion on the surgical techniques and materials most likely to achieve maximum postoperative residual hearing preservation in cochlear implant (CI) surgery and to determine how these opinions have changed since 2010. A previously published questionnaire used in a study published in 2010 was adapted and expanded. The questionnaire was distributed to an international group of experienced CI surgeons. Present results were compared, via descriptive statistics, to those from the 2010 survey. Eighteen surgeons completed the questionnaire. Respondents clearly favored the following: round window insertion, slow array insertion, and the peri- and postoperative use of systematic antibiotics. Insertion depth was regarded as important, and electrode arrays less likely to induce trauma were preferred. The usefulness of dedicated soft-surgery training was also recognized. A lack of agreement was found on whether the middle ear cavity should be flushed with a non-aminoglycoside antibiotic solution or whether a sheath or insertion tube should be used to avoid contaminating the array with blood or bone dust. In conclusion, this paper demonstrates how beliefs about CI soft surgery have changed since 2010 and shows areas of current consensus and disagreement.}, language = {en} } @article{NoyaletIlgenBuerkleinetal.2022, author = {Noyalet, Laurent and Ilgen, Lukas and B{\"u}rklein, Miriam and Shehata-Dieler, Wafaa and Taeger, Johannes and Hagen, Rudolf and Neun, Tilmann and Zabler, Simon and Althoff, Daniel and Rak, Kristen}, title = {Vestibular aqueduct morphology and Meniere's disease - development of the vestibular aqueduct score by 3D analysis}, series = {Frontiers in Surgery}, volume = {9}, journal = {Frontiers in Surgery}, issn = {2296-875X}, doi = {10.3389/fsurg.2022.747517}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-312893}, year = {2022}, abstract = {Improved radiological examinations with newly developed 3D models may increase understanding of Meniere's disease (MD). The morphology and course of the vestibular aqueduct (VA) in the temporal bone might be related to the severity of MD. The presented study explored, if the VA of MD and non-MD patients can be grouped relative to its angle to the semicircular canals (SCC) and length using a 3D model. Scans of temporal bone specimens (TBS) were performed using micro-CT and micro flat panel volume computed tomography (mfpVCT). Furthermore, scans were carried out in patients and TBS by computed tomography (CT). The angle between the VA and the three SCC, as well as the length of the VA were measured. From these data, a 3D model was constructed to develop the vestibular aqueduct score (VAS). Using different imaging modalities it was demonstrated that angle measurements of the VA are reliable and can be effectively used for detailed diagnostic investigation. To test the clinical relevance, the VAS was applied on MD and on non-MD patients. Length and angle values from MD patients differed from non-MD patients. In MD patients, significantly higher numbers of VAs could be assigned to a distinct group of the VAS. In addition, it was tested, whether the outcome of a treatment option for MD can be correlated to the VAS.}, language = {en} } @article{BieniussaKahramanSkornickaetal.2022, author = {Bieniussa, Linda and Kahraman, Baran and Skornicka, Johannes and Schulte, Annemarie and Voelker, Johannes and Jablonka, Sibylle and Hagen, Rudolf and Rak, Kristen}, title = {Pegylated insulin-like growth factor 1 attenuates hair cell loss and promotes presynaptic maintenance of medial olivocochlear cholinergic fibers in the cochlea of the progressive motor neuropathy mouse}, series = {Frontiers in Neurology}, volume = {13}, journal = {Frontiers in Neurology}, issn = {1664-2295}, doi = {10.3389/fneur.2022.885026}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-276669}, year = {2022}, abstract = {The progressive motor neuropathy (PMN) mouse is a model of an inherited motor neuropathy disease with progressive neurodegeneration. Axon degeneration associates with homozygous mutations of the TBCE gene encoding the tubulin chaperone E protein. TBCE is responsible for the correct dimerization of alpha and beta-tubulin. Strikingly, the PMN mouse also develops a progressive hearing loss after normal hearing onset, characterized by degeneration of the auditory nerve and outer hair cell (OHC) loss. However, the development of this neuronal and cochlear pathology is not fully understood yet. Previous studies with pegylated insulin-like growth factor 1 (peg-IGF-1) treatment in this mouse model have been shown to expand lifespan, weight, muscle strength, and motor coordination. Accordingly, peg-IGF-1 was evaluated for an otoprotective effect. We investigated the effect of peg-IGF-1 on the auditory system by treatment starting at postnatal day 15 (p15). Histological analysis revealed positive effects on OHC synapses of medial olivocochlear (MOC) neuronal fibers and a short-term attenuation of OHC loss. Peg-IGF-1 was able to conditionally restore the disorganization of OHC synapses and maintain the provision of cholinergic acetyltransferase in presynapses. To assess auditory function, frequency-specific auditory brainstem responses and distortion product otoacoustic emissions were recorded in animals on p21 and p28. However, despite the positive effect on MOC fibers and OHC, no restoration of hearing could be achieved. The present work demonstrates that the synaptic pathology of efferent MOC fibers in PMN mice represents a particular form of "efferent auditory neuropathy." Peg-IGF-1 showed an otoprotective effect by preventing the degeneration of OHCs and efferent synapses. However, enhanced efforts are needed to optimize the treatment to obtain detectable improvements in hearing performances.}, language = {en} } @article{HerrmannMuellerGraffKaulitzetal.2022, author = {Herrmann, David P. and M{\"u}ller-Graff, Franz-Tassilo and Kaulitz, Stefan and Cebulla, Mario and Kurz, Anja and Hagen, Rudolf and Neun, Tilmann and Rak, Kristen}, title = {Application of intentional facial nerve stimulation during cochlear implantation as an electrophysiological tool to estimate the intracochlear electrode position}, series = {Scientific Reports}, volume = {12}, journal = {Scientific Reports}, number = {1}, doi = {10.1038/s41598-022-17732-9}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-300197}, year = {2022}, abstract = {This proof of concept describes the use of evoked electromyographic (EMG) activation of the facial nerve for intraoperative monitoring of the electrode insertion during cochlear implantation (CI). Intraoperative EMG measurements from the facial nerve were conducted in nine patients undergoing CI implantation. Electric current pulses were emitted from contacts on the CI array during and immediately after electrode insertion. For control, the results of EMG measurements were compared to postoperative flat panel volume computed tomography scans with secondary reconstruction (fpVCT\(_{SECO}\)). During insertion, the EMG response evoked by the electrical stimulation from the CI was growing with the stimulating contact approaching the facial nerve and declined with increasing distance. After full insertion, contacts on the apical half of the CI array stimulated higher EMG responses compared with those on the basal half. Comparison with postoperative imaging demonstrated that electrode contacts stimulating high EMG responses had the shortest distances to the facial nerve. It could be demonstrated that electrically evoked EMG activation of the facial nerve can be used to monitor the progress during CI electrode insertion and to control the intracochlear electrode position after full insertion.}, language = {en} } @phdthesis{Engert2022, author = {Engert, Jonas}, title = {Untersuchung neuronaler Stammzellen des Colliculus inferior der Ratte im zeitlichen Verlauf}, doi = {10.25972/OPUS-28264}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-282642}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2022}, abstract = {Neural stem cells (NSCs) have been recently identified in the inferior colliculus (IC). These cells are of particular interest, as no casual therapeutic options for impaired neural structures exist. This research project aims to evaluate the neurogenic potential in the rat IC from early postnatal days until adulthood. The IC of rats from postnatal day 6 up to 48 was examined by neurosphere assays and histological sections. In free-floating IC cell cultures, neurospheres formed from animals from early postnatal to adulthood. The amount of generated neurospheres decreased in older ages and increased with the number of cell line passages. Cells in the neurospheres and the histological sections stained positively with NSC markers (Doublecortin, Sox-2, Musashi-1, Nestin, and Atoh1). Dissociated single cells from the neurospheres differentiated and were stained positively for the neural lineage markers β-III-tubulin, glial fibrillary acidic protein, and myelin basic protein. In addition, NSC markers (Doublecortin, Sox-2, CDK5R1, and Ascl-1) were investigated by qRT-PCR. In conclusion, a neurogenic potential in the rat IC was detected and evaluated from early postnatal days until adulthood. The identification of NSCs in the rat IC and their age-specific characteristics contribute to a better understanding of the development and the plasticity of the auditory pathway and might be activated for therapeutic use.}, subject = {Colliculus inferior}, language = {de} } @phdthesis{Kretzer2022, author = {Kretzer, Katharina}, title = {Einfluss der Form elektrischer Impulse auf die intracochle{\"a}re neuronale Antwort bei Cochlea-Implantat-Tr{\"a}gern: triphasische Pulse mit anodischer und kathodischer zweiter Phase}, doi = {10.25972/OPUS-28165}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-281650}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2022}, abstract = {Vorliegende Arbeit besch{\"a}ftigte sich mit der Verbesserung von Defiziten der elektrischen Stimulation durch Cochlea Implantate (CI) mit alternativen Pulsformen. Dabei wurde mit elektrophysiologischen und psychophysikalischen Methoden untersucht, wie sich die Pulsformen auf die Effektivit{\"a}t der Stimulation auswirken. Es wurden pr{\"a}zisions-triphasische Pulse (pTP) mit anodischer und kathodischer zweiter Phase anhand der Daten von elf Probanden untersucht. Im Rahmen der objektiven elektrophysiologischen Messung wurde mit den unterschiedlichen Formen des pTP an drei unterschiedlichen Kontaktpositionen auf den CI-Elektrodentr{\"a}gern stimuliert, und die St{\"a}rke der jeweils evozierten neuronalen Antwort aufgezeichnet. Der subjektive psychophysikalische Test diente dazu, die pulsformspezifischen H{\"o}rschwellen zu bestimmen und wurde an zwei unterschiedlichen Kontakten auf den CI-Elektrodentr{\"a}gern durchgef{\"u}hrt. Dabei erzielten pTP, welche eine symmetrisch-triphasische Pulsform aufwiesen, geringere neuronale Antwortst{\"a}rken und h{\"o}here H{\"o}rschwellen als die pTP, die einer biphasischen Pulsform glichen. Diejenigen pTP, die biphasischen Pulsen mit anodischer erster Phase glichen, erzielten dabei die h{\"o}chsten neuronalen Antwortst{\"a}rken und die niedrigsten H{\"o}rschwellen.}, subject = {Cochlear-Implantat}, language = {de} } @phdthesis{DerouetgebSchenkelberger2022, author = {Derouet [geb. Schenkelberger], Freya Kwen-Kwes}, title = {Entwicklung optimierter Ankopplungsbedingungen von aktiven Mittelohrimplantaten am runden Fenster}, doi = {10.25972/OPUS-27807}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-278079}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2022}, abstract = {Seit Mitte der 90er-Jahre gewinnen aktive Mittelohrimplantate wie die Vibrant sound bridge (VSB) zunehmend an Bedeutung. Sie k{\"o}nnen zur Rehabilitation von Schallleitungs- und Schallempfindungsst{\"o}rungen, sowie kombinierter H{\"o}rst{\"o}rungen indiziert sein. Die Vibrant sound bridge stellt eine Alternative f{\"u}r Patienten dar, bei denen aus verschiedenen Gr{\"u}nden eine Unvertr{\"a}glichkeit gegen{\"u}ber herk{\"o}mmlichen H{\"o}rger{\"a}ten besteht. Bei der Implantation des Floating mass transducers (FMT) am runden Fenster zeigte sich in der Klinik neben einer hohen Revisionsrate von bis zu 15,6 \% eine hohe Varianz der audiologischen Ergebnisse, was auf eine unkontrollierte und mangelnde Ankopplung des Floating mass transducers an das runde Fenster zur{\"u}ckzuf{\"u}hren ist. Erste Ergebnisse der kontrollierten Ankopplung am runden Fenster mit einem Kamin zeigten vielversprechende Ergebnisse. Die suffiziente Fixation des Kamins an der Rundfensternische stellt eine Herausforderung dar. Es bedarf eines Haftvermittlers, der eine suffiziente Verbindung zwischen dem Titankamin und dem darunter befindlichen Knochen am runden Fenster herstellt. Ziel der Dissertation war die Findung einer geeigneten Haftkomponente zur Fixation des Kamins am runden Fenster. Es wurden der Calciumphosphatzement HydroSet® (Fa. Stryker) und der Glasionomerzement Ketac™ Cem (Fa. ESPE 3M™ Deutschland) untersucht. In Anlehnung an DIN 13990-2 wurden nach Einwirkung physikalischen Stresses in Form von Temperatur und Feuchtigkeit die Scherhaftfestigkeit der Titanzylinder an humanen Felsenbeinknochen gemessen. Es zeigte sich eine schwach signifikant bessere Haftung f{\"u}r das Calciumphosphatzement HydroSet®, bei insgesamt geringer Scherhaftfestigkeit beider Zemente im Vergleich mit anderen zahnheilkundlichen Adh{\"a}siven der Literatur.}, language = {de} } @phdthesis{Wagner2022, author = {Wagner, Martin}, title = {Zyto- und Gentoxizit{\"a}t von Zinkoxid-Nanopartikeln in humanen mesenchymalen Stammzellen nach repetitiver Exposition und im Langzeitversuch}, doi = {10.25972/OPUS-27572}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-275726}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2022}, abstract = {Zinkoxid-Nanopartikel (ZnO-NP) finden in vielen Produkten des t{\"a}glichen Verbrauchs Verwendung. Daten {\"u}ber die toxikologischen Eigenschaften von ZnO-NP werden kontrovers diskutiert. Die menschliche Haut ist in Bezug auf die ZnO-NP Exposition das wichtigste Kontakt-Organ. Intakte Haut stellt eine suffiziente Barriere gegen{\"u}ber NP dar. Bei defekter Haut ist ein Kontakt zu den proliferierenden Stammzellen m{\"o}glich, sodass diese als wichtiges toxikologische Ziel f{\"u}r NP darstellen. Das Ziel dieser Dissertation war die Bewertung der genotoxischen und zytotoxischen Effekte an humanen mesenchymalen Stammzellen (hMSC) durch niedrig dosierte ZnO-NP nach 24 st{\"u}ndiger Exposition, repetitiven Expositionen und im Langzeitversuch bis zu 6 Wochen. Zytotoxische Wirkungen von ZnO-NP wurden mit 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazoliumbromid-Test (MTT) gemessen. Dar{\"u}ber hinaus wurde die Genotoxizit{\"a}t durch den Comet-Assay bewertet. Zur Langzeitbeobachtung bis zu 6 Wochen wurde die Transmissionselektronenmikroskopie (TEM) verwendet. Zytotoxizit{\"a}t nach 24-st{\"u}ndiger ZnO-NP-Exposition war ab einer Konzentration von 50 µg/ml nachweisbar. Genotoxizit{\"a}t konnten bereits bei Konzentrationen von 1 und 10 µg/ml ZnO-NP beschrieben werden. Wiederholte Exposition verst{\"a}rkte die Zyto-, aber nicht die Genotoxizit{\"a}t. Eine intrazellul{\"a}re NP-Akkumulation mit Penetration der Zellorganelle wurde bei einer Exposition bis zu 6 Wochen beobachtet. Die Ergebnisse deuten auf zytotoxische und genotoxisches Effekte von ZnO-NP hin. Bereits geringe Dosen von ZnO-NP k{\"o}nnen bei wiederholter Exposition toxische Wirkungen hervorrufen sowie eine langfristige Zellakkumulation. Diese Daten sollten bei der Verwendung von ZnO-NP an gesch{\"a}digter Haut ber{\"u}cksichtigt werden.}, subject = {nanoparticle}, language = {de} }