@article{ZahnertLoewenheimBeutneretal.2016,
  author    = {Zahnert, Thomas and L{\"o}wenheim, Hubert and Beutner, Dirk and Hagen, Rudolf and Ernst, Arneborg and Pau, Hans-Wilhelm and Zehlicke, Thorsten and K{\"u}hne, Hilke and Friese, Natascha and Tropitzsch, Anke and L{\"u}ers, Jan-Christoffer and Mlynski, Robert and Todt, Ingo and H{\"u}ttenbrink, Karl-Bernd},
  title     = {Multicenter Clinical Trial of Vibroplasty Couplers to Treat Mixed/Conductive Hearing Loss: First Results},
  series = {Audiology and Neurotology},
  volume    = {21},
  journal   = {Audiology and Neurotology},
  number    = {4},
  issn      = {1420-3030},
  doi       = {10.1159/000444616},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-199129},
  pages     = {212-222},
  year      = {2016},
  abstract  = {Objective: To evaluate the safety and effectiveness of round window (RW), oval window (OW), CliP and Bell couplers for use with an active middle ear implant. Methods: This is a multicenter, long-term, prospective trial with consecutive enrollment, involving 6 university hospitals in Germany. Bone conduction, air conduction, implant-aided warble-tone thresholds and Freiburger monosyllable word recognition scores were compared with unaided preimplantation results in 28 moderate-to-profound hearing-impaired patients after 12 months of follow-up. All patients had previously undergone failed reconstruction surgeries (up to 5 or more). In a subset of patients, additional speech tests at 12 months postoperatively were used to compare the aided with the unaided condition after implantation with the processor switched off. An established quality-of-life questionnaire for hearing aids was used to determine patient satisfaction. Results: Postoperative bone conduction remained stable. Mean functional gain for all couplers was 37 dB HL (RW = 42 dB, OW = 35 dB, Bell = 38 dB, CliP = 27 dB). The mean postoperative Freiburger monosyllable score was 71\% at 65 dB SPL. The postimplantation mean SRT<sub>50</sub> (speech reception in quiet for 50\% understanding of words in sentences) improved on average by 23 dB over unaided testing and signal-to-noise ratios also improved in all patients. The International Outcome Inventory for Hearing Aids (IOI-HA)quality-of-life questionnaire was scored very positively by all patients. Conclusion: A significant improvement was seen with all couplers, and patients were satisfied with the device at 12 months postoperatively. These results demonstrate that an active implant is an advantage in achieving good hearing benefit in patients with prior failed reconstruction surgery.},
  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{SchravenDalhoffWildensteinetal.2014,
  author    = {Schraven, Sebastian P. and Dalhoff, Ernst and Wildenstein, Daniela and Hagen, Rudolf and Gummer, Anthony W. and Mlynski, Robert},
  title     = {Alternative Fixation of an Active Middle Ear Implant at the Short Incus Process},
  series = {Audiology and Neurotology},
  volume    = {19},
  journal   = {Audiology and Neurotology},
  number    = {1},
  issn      = {1420-3030},
  doi       = {10.1159/000354981},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-196823},
  pages     = {1-11},
  year      = {2014},
  abstract  = {Introduction: Since 1996, the preferred approach for positioning the active middle-ear implant Vibrant Soundbridge© is a mastoidectomy and a posterior tympanotomy. With this device, placement of the floating mass transducer (FMT) on the long incus process is the standard method for treatment of mild-to-severe sensorineural hearing loss in the case of normal middle-ear anatomy. The aim of this study was to determine the vibrational effectiveness of FMT placement at the short incus process. Materials and Methods: An extended antrotomy and a posterior tympanotomy were performed in 5 fresh human temporal bones. As a control for normal middle-ear function, the tympanic membrane was stimulated acoustically and the vibration of the stapes footplate and the round-window (RW) membrane were (sequentially) measured by laser Doppler vibrometry. Vibration responses for coupling of an FMT to the long incus process (standard coupling) were compared to those for coupling to the short incus process. Results: Apart from narrow frequency bands near 3 and 9 kHz for the stapes footplate and RW membrane, respectively, the velocity responses presented no significant differences between standard coupling of the FMT and coupling to the short incus process. Conclusion: Coupling the FMT to the short incus process may be a viable alternative in cases where the surgical approach is limited to an extended antrotomy. A reliable technique for attachment to the short incus process has yet to be developed.},
  language  = {en}
}
@article{SbieraDexneitReichardtetal.2011,
  author    = {Sbiera, Silviu and Dexneit, Thomas and Reichardt, Sybille D. and Michel, Kai D. and van den Brandt, Jens and Schmull, Sebastian and Kraus, Luitgard and Beyer, Melanie and Mlynski, Robert and Wortmann, Sebastian and Allolio, Bruno and Reichardt, Holger M. and Fassnacht, Martin},
  title     = {Influence of Short-Term Glucocorticoid Therapy on Regulatory T Cells \(In\) \(Vivo\)},
  series = {PLoS One},
  volume    = {6},
  journal   = {PLoS One},
  number    = {9},
  doi       = {10.1371/journal.pone.0024345},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-140822},
  pages     = {e24345},
  year      = {2011},
  abstract  = {Background: Pre- and early clinical studies on patients with autoimmune diseases suggested that induction of regulatory T(T(reg)) cells may contribute to the immunosuppressive effects of glucocorticoids(GCs). Objective: We readdressed the influence of GC therapy on T(reg) cells in immunocompetent human subjects and naive mice. Methods: Mice were treated with increasing doses of intravenous dexamethasone followed by oral taper, and T(reg) cells in spleen and blood were analyzed by FACS. Sixteen patients with sudden hearing loss but without an inflammatory disease received high-dose intravenous prednisolone followed by stepwise dose reduction to low oral prednisolone. Peripheral blood T(reg) cells were analyzed prior and after a 14 day GC therapy based on different markers. Results: Repeated GC administration to mice for three days dose-dependently decreased the absolute numbers of T(reg) cells in blood (100 mg dexamethasone/kg body weight: 2.8 +/- 1.8 x 10(4) cells/ml vs. 33 +/- 11 x 10(4) in control mice) and spleen (dexamethasone: 2.8 +/- 1.9 x 10(5)/spleen vs. 95 +/- 22 x 10(5)/spleen in control mice), which slowly recovered after 14 days taper in spleen but not in blood. The relative frequency of FOXP3(+) T(reg) cells amongst the CD4(+) T cells also decreased in a dose dependent manner with the effect being more pronounced in blood than in spleen. The suppressive capacity of T(reg) cells was unaltered by GC treatment in vitro. In immunocompetent humans, GCs induced mild T cell lymphocytosis. However, it did not change the relative frequency of circulating T(reg) cells in a relevant manner, although there was some variation depending on the definition of the T(reg) cells (FOXP3(+): 4.0 +/- 1.5\% vs 3.4 +/- 1.5\%*; AITR(+): 0.660.4 vs 0.5 +/- 0.3\%, CD127(low): 4.0 +/- 1.3 vs 5.0 +/- 3.0\%* and CTLA4+: 13.8 +/- 11.5 vs 15.6 +/- 12.5\%; * p < 0.05). Conclusion: Short-term GC therapy does not induce the hitherto supposed increase in circulating T(reg) cell frequency, neither in immunocompetent humans nor in mice. Thus, it is questionable that the clinical efficacy of GCs is achieved by modulating T(reg) cell numbers.},
  language  = {en}
}
@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{FassnachtSbieraDexneitetal.2011,
  author    = {Fassnacht, Martin and Sbiera, Silviu and Dexneit, Thomas and Reichardt, Sybille D. and Michel, Kai D. and van den Brandt, Jens and Schmull, Sebastian and Kraus, Luitgard and Beyer, Melanie and Mlynski, Robert and Wortmann, Sebastian and Allolio, Bruno and Reichardt, Holger M.},
  title     = {Influence of Short-Term Glucocorticoid Therapy on Regulatory T Cells In Vivo},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-74749},
  year      = {2011},
  abstract  = {Background: Pre- and early clinical studies on patients with autoimmune diseases suggested that induction of regulatory T(Treg) cells may contribute to the immunosuppressive effects of glucocorticoids(GCs). Objective: We readdressed the influence of GC therapy on Treg cells in immunocompetent human subjects and na{\i}¨ve mice. Methods: Mice were treated with increasing doses of intravenous dexamethasone followed by oral taper, and Treg cells in spleen and blood were analyzed by FACS. Sixteen patients with sudden hearing loss but without an inflammatory disease received high-dose intravenous prednisolone followed by stepwise dose reduction to low oral prednisolone. Peripheral blood Treg cells were analyzed prior and after a 14 day GC therapy based on different markers. Results: Repeated GC administration to mice for three days dose-dependently decreased the absolute numbers of Treg cells in blood (100 mg dexamethasone/kg body weight: 2.861.86104 cells/ml vs. 336116104 in control mice) and spleen (dexamethasone: 2.861.96105/spleen vs. 956226105/spleen in control mice), which slowly recovered after 14 days taper in spleen but not in blood. The relative frequency of FOXP3+ Treg cells amongst the CD4+ T cells also decreased in a dose dependent manner with the effect being more pronounced in blood than in spleen. The suppressive capacity of Treg cells was unaltered by GC treatment in vitro. In immunocompetent humans, GCs induced mild T cell lymphocytosis. However, it did not change the relative frequency of circulating Treg cells in a relevant manner, although there was some variation depending on the definition of the Treg cells (FOXP3+: 4.061.5\% vs 3.461.5\%*; AITR+: 0.660.4 vs 0.560.3\%, CD127low: 4.061.3 vs 5.063.0\%* and CTLA4+: 13.8611.5 vs 15.6612.5\%; * p,0.05). Conclusion: Short-term GC therapy does not induce the hitherto supposed increase in circulating Treg cell frequency, neither in immunocompetent humans nor in mice. Thus, it is questionable that the clinical efficacy of GCs is achieved by modulating Treg cell numbers.},
  subject      = {Medizin},
  language  = {en}
}