TY  - JOUR
A1  - Topsakal, Vedat
A1  - Agrawal, Sumit
A1  - Atlas, Marcus
A1  - Baumgartner, Wolf-Dieter
A1  - Brown, Kevin
A1  - Bruce, Iain A.
A1  - Dazert, Stefan
A1  - Hagen, Rudolf
A1  - Lassaletta, Luis
A1  - Mlynski, Robert
A1  - Raine, Christopher H.
A1  - Rajan, Gunesh P.
A1  - Schmutzhard, Joachim
A1  - Sprinzl, Georg Mathias
A1  - Staecker, Hinrich
A1  - Usami, Shin-ichi
A1  - Van Rompaey, Vincent
A1  - Zernotti, Mario
A1  - Heyning, Paul van de
T1  - Minimally traumatic cochlear implant surgery: expert opinion in 2010 and 2020
JF  - Journal of Personalized Medicine
N2  - 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.
KW  - electric acoustic stimulation (EAS)
KW  - cochlear implants
KW  - atraumatic surgery
KW  - hearing preservation
KW  - partial deafness treatment
Y1  - 2022
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-288196
SN  - 2075-4426
VL  - 12
IS  - 10
ER  - 
TY  - JOUR
A1  - Gugel, Isabel
A1  - Grimm, Florian
A1  - Hartjen, Philip
A1  - Breun, Maria
A1  - Zipfel, Julian
A1  - Liebsch, Marina
A1  - Löwenheim, Hubert
A1  - Ernemann, Ulrike
A1  - Kluwe, Lan
A1  - Mautner, Victor-Felix
A1  - Tatagiba, Marcos
A1  - Schuhmann, Martin Ulrich
T1  - Risk stratification for immediate postoperative hearing loss by preoperative BAER (brainstem auditory evoked response) and audiometry in NF2-associated vestibular schwannomas
JF  - Cancers
N2  - Both brainstem auditory evoked potentials (BAEP) and audiometry play a crucial role in neuro-oncological treatment decisions in Neurofibromatosis Type 2 associated (NF2) vestibular schwannoma (VS) as hearing preservation is the major goal. In this study, we investigated the risk of immediate postoperative hearing deterioration (>15 dB and/or 15% loss in pure-tone average [PTA]/ speech discrimination score [SDS] in a cohort of 100 operated VS (ears) in 72 NF2 patients by retrospective analysis of pre- and postoperative hearing data (PTA, SDS, American Association of Otolaryngology–Head and Neck Surgery [AAO-HNS], and brainstem auditory evoked potential [BAEP] class) taking into account relevant influencing factors, particularly preoperative audiometry and BAEP status and the extent of resection. Immediately after surgery, the hearing was preserved in 73% of ears and approximately ~60% of ears kept their hearing classes. Preoperative BAEP (p = 0.015) and resection amount (p = 0.048) significantly influenced postoperative hearing outcome. The prediction model for postoperative hearing deterioration/loss between preoperative BAEP and AAO-HNS class showed increased risk by increasing BAEP class. Twenty-one tumors/ears were identified with large BAEP and AAO-HNS class discrepancies (≥2 points) and were associated with a high (48–100%) risk of deafness after surgery in ears with preoperative available hearing. Overall, the results were heterogeneous but the better both BAEP and audiometry class before surgery, the higher the chance of hearing maintenance afterwards. Large resection amounts (e.g., 100% risk in near-total resections) exhibit a significant (p < 0.05) higher risk compared to smaller amounts (e.g., 10/20% in laser-coagulated/partially resected tumors). Our results emphasized the indispensable role of both hearing monitoring in form of audiometry and neurophysiology (BAEP) in the pre-and perioperative monitoring of NF2-associated VS. Both BAEP and audiometry are good prognostic markers for the postoperative hearing outcome. The extent of resection should be strictly guided by and adjusted to the intraoperative neurophysiological monitoring.
KW  - hearing preservation
KW  - neurofibromatosis type 2
KW  - vestibular schwannoma
KW  - audiometry
KW  - brainstem auditory evoked potentials
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-234165
SN  - 2072-6694
VL  - 13
IS  - 6
ER  -