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Hearing Disorders: HELP
Articles by Per Caye Thomasen
Based on 28 articles published since 2010
(Why 28 articles?)
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Between 2010 and 2020, P. Cayé-Thomasen wrote the following 28 articles about Hearing Disorders.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Review [Bone-anchored hearing aids and active middle ear implants]. 2019

Ryberg, Alexander Christian / West, Niels / Sass, Hjalte Christian Reeberg / Cayé-Thomasen, Per. ·alexanderryberg@gmail.com. ·Ugeskr Laeger · Pubmed #31735200.

ABSTRACT: This review is concerned with hearing implants, which are used in patients with hearing loss, who cannot be treated successfully with a conventional hearing aid. Among these implants, bone-anchored hearing systems (BAHS) can be used for conductive or mixed hearing loss, while active middle ear implants primarily are reserved for sensorineural hearing loss. For BAHS, active transcutaneous implants may replace percutaneous implants as a future first choice.

2 Review [Cochlear implantation in children]. 2018

West, Niels / Cayé-Thomasen, Per / Bille, Michael. ·westniels@gmail.com. ·Ugeskr Laeger · Pubmed #30259842.

ABSTRACT: Children with severe hearing impairment or deafness are preferably recognised and treated with a cochlear implant (CI) before the age of one year, as early stimulation of the auditory sense is essential for the development of spoken language. Today, children with deafness are offered a bilateral CI, as it allows for improved speech perception in noise and sound localisation. However, the indications for cochlear implantation have been extended to include children with asymmetric hearing loss, in order to avoid the development of aural preference syndrome, which may limit the effect of a CI later.

3 Clinical Trial Significant regional differences in Denmark in outcome after cochlear implants in children. 2012

Percy-Smith, Lone / Busch, Georg W / Sandahl, Minna / Nissen, Lena / Josvassen, Jane Lignel / Bille, Michael / Lange, Theis / Cayé-Thomasen, Per. ·Implant Centre, Department of Audiology, Rigshospitalet, Denmark. loper@geh.regionh.dk ·Dan Med J · Pubmed #22549489.

ABSTRACT: INTRODUCTION: The objectives of the present study were to study regional differences in outcome for a paediatric cochlear implant (CI) population after the introduction of universal neonatal hearing screening (UNHS) and bilateral implantation in Denmark. MATERIAL AND METHODS: Data relate to 94 subjects. A test battery consisting of eight different tests/assessments was performed in order to report the level of audition, speech, language and self-esteem. For data analyses of any associations between the regions, Fisher's exact test was used. Potential rater variability within either of the centres was assessed using logistic regression models. RESULTS: The levels of audition were comparable between the group from West Denmark (West) and the group from East Denmark (East). In contrast, all tests of speech and language revealed a statistically significant difference between East and West. In all tests, West subjects scored significantly lower than East subjects. West children received more hours of speech therapy, more learning support assistance, and more parents used signing. Furthermore, the parents from West were significantly less involved in the auditory rehabilitation of their children than parents from East. CONCLUSION: The results were remarkable and call for a thorough evaluation of both the quality and organization of the paediatric CI population with particular concern for the paediatric CI population of West Denmark. FUNDING: The Oticon foundation financially supported this study. Trial registration was not relevant as the study is designed as a prospective case series. TRIAL REGISTRATION: not relevant.

4 Article Association of SLC26A4 mutations, morphology, and hearing in pendred syndrome and NSEVA. 2019

Mey, Kristianna / Muhamad, Ali A / Tranebjaerg, Lisbeth / Rendtorff, Nanna D / Rasmussen, Stig H / Bille, Michael / Cayé-Thomasen, Per. ·Department of Otorhinolaryngology, Head and Neck Surgery and Audiology Rigshospitalet/Gentofte, Hellerup. · the Department of Neuroradiology, Rigshospitalet. · the Department of Clinical Genetics, Rigshospitalet/The Kennedy Center. · the Institute of Clinical Medicine. · the Big Data Team, Municipality of Copenhagen. · Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. ·Laryngoscope · Pubmed #31633822.

ABSTRACT: OBJECTIVE: To investigate the relations of monoallelic (M1), biallelic (M2), or the absence of mutations (M0) in SLC26A4 to inner ear morphology and hearing levels in individuals with Pendred syndrome (PS) or nonsyndromic enlarged vestibular aqueduct (NSEVA) associated with hearing loss. METHODS: In a cohort of 139 PS/NSEVA individuals, 115 persons from 95 unrelated families had full genetic sequencing of SLC26A4, and 113 had retrievable images for re-assessment of inner ear morphology. The association between the number of mutant alleles in SLC26A4, inner ear morphology (including endolymphatic sac size and protein content on magnetic resonance imaging), and hearing level (pure tone average) was explored. RESULTS: Biallelic SLC26A4 mutations (M2) occurred in three-quarters of the cohort and was invariably associated with poor hearing; in 87%, it was associated with incomplete partition type II of the cochlea as well as enlarged endolymphatic sac and vestibular aqueduct. M1 or M0 individuals exhibited a greater variability in inner ear morphology. Endolymphatic sac size and presence of "high-protein" sac contents were significantly higher in M2 individuals compared to M1 and M0 individuals. CONCLUSION: The number of SLC26A4 mutations is associated with severity and variability of inner ear morphology and hearing level in individuals with PS or NSEVA. M2 individuals have poorer hearing and present largely incomplete partition type II of the cochleas with enlarged endolymphatic sacs, whereas individuals with M1 and no detectable SLC26A4 mutations have less severe hearing loss and more diverse inner ear morphology. LEVEL OF EVIDENCE: 4. Laryngoscope, 129:2574-2579, 2019.

5 Article Surgery of the lateral skull base: a 50-year endeavour. 2019

Zanoletti, E / Mazzoni, A / Martini, A / Abbritti, R V / Albertini, R / Alexandre, E / Baro, V / Bartolini, S / Bernardeschi, D / Bivona, R / Bonali, M / Borghesi, I / Borsetto, D / Bovo, R / Breun, M / Calbucci, F / Carlson, M L / Caruso, A / Cayé-Thomasen, P / Cazzador, D / Champagne, P-O / Colangeli, R / Conte, G / D'Avella, D / Danesi, G / Deantonio, L / Denaro, L / Di Berardino, F / Draghi, R / Ebner, F H / Favaretto, N / Ferri, G / Fioravanti, A / Froelich, S / Giannuzzi, A / Girasoli, L / Grossardt, B R / Guidi, M / Hagen, R / Hanakita, S / Hardy, D G / Iglesias, V C / Jefferies, S / Jia, H / Kalamarides, M / Kanaan, I N / Krengli, M / Landi, A / Lauda, L / Lepera, D / Lieber, S / Lloyd, S L K / Lovato, A / Maccarrone, F / Macfarlane, R / Magnan, J / Magnoni, L / Marchioni, D / Marinelli, J P / Marioni, G / Mastronardi, V / Matthies, C / Moffat, D A / Munari, S / Nardone, M / Pareschi, R / Pavone, C / Piccirillo, E / Piras, G / Presutti, L / Restivo, G / Reznitsky, M / Roca, E / Russo, A / Sanna, M / Sartori, L / Scheich, M / Shehata-Dieler, W / Soloperto, D / Sorrentino, F / Sterkers, O / Taibah, A / Tatagiba, M / Tealdo, G / Vlad, D / Wu, H / Zanetti, D. ·Department of Neuroscience DNS, Otolaryngology Section, Padova University, Padova, Italy. · Department of Neurosurgery, Lariboisière Hospital, University of Paris Diderot, Paris, France. · Gruppo Otologico, Piacenza-Rome, Italy. · Academic Neurosurgery, Department of Neuroscience DNS, University of Padova Medical School, Padova, Italy. · Neurosurgery, Bellaria Hospital, Bologna, Italy. · AP-HP, Groupe Hôspital-Universitaire Pitié-Salpêtrière, Neuro-Sensory Surgical Department and NF2 Rare Disease Centre, Paris, France. · Sorbonne Université, Paris, France. · ENT and Skull-Base Surgery Department, Department of Neurosciences, Ospedale Papa Giovanni XXIII, Bergamo, Italy. · Otolaryngology-Head and Neck Surgery Department, University Hospital of Modena, Italy. · Neurosurgery, Maria Cecilia Hospital, Cotignola (RA), Italy. · Department of Neurosurgery, Julius Maximilians University Hospital Würzburg, Bavaria, Germany. · Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN, USA. · Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA. · The Department of Otorhinolaryngology, Head & Neck Surgery and Audiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. · Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. · Department of Neuroscience DNS, Section of Human Anatomy, Padova University, Padova, Italy. · Department of Neuroradiology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy. · Department of Radiation Oncology, University Hospital Maggiore della Carità, Novara, Italy. · Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy. · Unit of Audiology, Department of Clinical Sciences and Community Health, University of Milano, Italy. · Department of Surgery, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy. · Department of Neurosurgery, Eberhard Karls University Tübingen, Germany. · Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA. · Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, "Julius-Maximilians" University Hospital of Würzburg, Bavaria, Germany. · Department of Neurosurgery, Cambridge University Hospital, Cambridge, UK. · Oncology Department, Cambridge University Hospital, Cambridge, UK. · Department of Otolaryngology Head and Neck Surgery, Shanghai Ninh People's Hospital, Shanghai Jiatong University School of Medicine, China. · Department of Neurosciences, King Faisal Specialist Hospital & Research Center, Alfaisal University, College of Medicine, Riyadh, KSA. · ENT & Skull-Base Department, Ospedale Nuovo di Legnano, Legnano (MI), Italy. · Department of Neuro-Otology and Skull-Base Surgery Manchester Royal Infirmary, Manchester, UK. · Department of Neuroscience DNS, Audiology Unit, Padova University, Treviso, Italy. · University Aix-Marseille, France. · Otolaryngology-Head and Neck Surgery Department, University Hospital of Verona, Italy. · Mayo Clinic School of Medicine, Rochester, MN, USA. · Department of Neuro-otology and Skull Base Surgery, Cambridge University Hospital, Cambridge, UK. · ENT Department, Treviglio (BG), Italy. ·Acta Otorhinolaryngol Ital · Pubmed #31130732.

ABSTRACT: -- No abstract --

6 Article The Natural History of Hearing Loss in Pendred Syndrome and Non-Syndromic Enlarged Vestibular Aqueduct. 2019

Mey, Kristianna / Bille, Michael / Rye Rasmussen, Stig Hebbelstrup / Tranebjærg, Lisbeth / Cayé-Thomasen, Per. ·Department of Otorhinolaryngology, Head & Neck Surgery and Audiology, Rigshospitalet/Gentofte, Hellerup. · Big Data Team, Municipality of Copenhagen. · Department of Clinical Genetics, Rigshospitalet/The Kennedy Centre. · Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. · Faculty of Health Sciences and Medicine, University of Copenhagen. ·Otol Neurotol · Pubmed #30741891.

ABSTRACT: INTRODUCTION: The aim was to investigate the progress of hearing loss over time in a cohort of pendred syndrome and non-syndromic enlarged vestibular aqueduct (PS/NSEVA) with one or two confirmed pathogenic variations in SLC26A4. STUDY DESIGN: Retrospective cohort study. SUBJECTS AND METHODS: At our tertiary referral center, a retrospective search of all patients with enlarged vestibular aqueduct, hearing loss and SLC26A4 mutations yielded 103 individuals by March 2017, 96 of whom had records of hearing levels; both an early audiometry and the latest between 3 and 668 months follow-up. Pure-tone average (PTA; average of thresholds at 0.5, 1, 2 and 4 kHz) was calculated for both ears at time 1 and time 2. Neonatal screening results were retrieved. RESULTS: Eighty-seven (87) individuals had biallelic (M2) and 16 had monoallelic alterations (M1) in their SLC26A4. On average, the PTA progressed to 80 dB HL by the age of 6 years for the entire cohort, and 3.2 years for the biallelic (M2) affected individuals. 25% of the cohort was screened in the neonatal screening program; of these 42% had "passed" at least monaurally. Audiometric profiles related to age show faster deterioration in high frequencies than in low frequencies. CONCLUSION: In patients with PS/NSEVA and SLC26A4 mutations, the average hearing loss progresses to 80 dB HL by the age of 6 years. For biallelic (M2) affected individuals it was 3.2 years. Although hearing levels reached severe to profound during childhood, almost 1/2 had passed neonatal hearing screening, at least monaurally, emphasizing the need for close follow-up.

7 Article Language outcome in children with congenital hearing impairment: The influence of etiology. 2019

Dieleman, Eveline / Percy-Smith, Lone / Caye-Thomasen, Per. ·Department of Otorhinolaryngology, Head and Neck Surgery, and Audiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark. Electronic address: eveline_dieleman@hotmail.com. · Patientforening Decibel, Rygårdsallé 43, 2900, Hellerup, Denmark. · Department of Otorhinolaryngology, Head and Neck Surgery, and Audiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark. ·Int J Pediatr Otorhinolaryngol · Pubmed #30579085.

ABSTRACT: OBJECTIVES: To investigate the possible association between the etiology of hearing impairment (HI) and language outcome in children with congenital HI after an early medical-technical intervention and three years of AVT. METHODS: A retrospective, two-center study was conducted of 53 patients who were divided in four categories of etiology (degeneratio labyrinthi acustici (DLA) congenita hereditaria, DLA congenita non specificata, DLA congenita postinfectiosa and auditory neuropathy). Language outcome was assessed by examining receptive vocabulary (Peabody Picture Vocabulary Test, PPVT-4), receptive language (Reynell test) and productive language (the Danish 'Viborgmaterialet'). All tests were conducted 1, 2 and 3 years after the children received their hearing device. Test scores were calculated from the child's chronological age. Analysis of possible associations was performed using Fisher's exact test and McNemar's test was conducted to examine possible differences between each year of testing for every speech-language test. Subsequently, univariate analyses were performed to search for other possible covariates associated with language outcome. RESULTS: No significant associations were found between the etiology of the HI and the language outcome of children with HI after 1 year of AVT (PPVT, p = 0,234; Reynell, p = 0,845; Viborgmaterialet, p = 0,667), neither after 2 years of AVT (PPVT, p = 0,228; Reynell, p = 0,172; Viborgmaterialet, p = 0,659) nor after 3 years of AVT (PPVT, p = 0,102; Reynell, p = 0,512 Viborgmaterialet, p = 0,580). Some significant associations were found between language outcome and the type of hearing device and between language outcome and additional disabilities, however no strong evidence was found. CONCLUSION: Most children with congenital HI developed a comparable level of speech and language regardless of the etiology of their HI. This study highlights the interest of further research using objective assessments techniques in a larger and more homogeneous population. If the findings from this study will be confirmed in future studies, this will have a clinical and societal impact regarding the diagnostics of HI.

8 Article Audiovestibular Loss of Function Correlates in Vestibular Schwannomas. 2018

West, Niels / Møller, Martin Nue / Hansen, Søren / Cayé-Thomasen, Per. ·Department of Otorhinolaryngology, Head and Neck Surgery, Rigshospitalet, Copenhagen, Denmark. · University of Copenhagen, School of Health and Medical Sciences, Copenhagen, Denmark. ·J Int Adv Otol · Pubmed #30100546.

ABSTRACT: OBJECTIVES: The aim of the present study was to investigate the relationships between tumor size, hearing, and vestibular outcomes in patients with vestibular schwannomas (VSs). MATERIALS AND METHODS: Adult patients (n=124) with unilateral extrameatal VS prior to surgery were included in the study. This was a retrospective cohort study of preoperative audiovestibular investigations including audiometry, discrimination test, caloric test, cervical vestibular evoked myogenic potential (c-VEMP), and ocular vestibular evoked myogenic potential (o-VEMP). RESULTS: The difference between lesioned and non-lesioned ear was significant for all audiovestibular outcomes. The mean caloric deficit was 74%. No tumor sided o-VEMPs were elicited. Caloric deficit correlated with hearing loss measured with pure tone average and discrimination score. c-VEMP deficit was significantly associated with severe hearing loss and larger tumors. CONCLUSION: The presence of VS leads to a significant deterioration of audiovestibular function in all objective measures. Caloric test and o-VEMPS are sensitive though unspecific measures of VSs. Increasing tumor size is not directly associated with hearing loss and only somewhat to vestibular deficit. However, audiovestibular findings are correlated.

9 Article Differences and similarities in early vocabulary development between children with hearing aids and children with cochlear implant enrolled in 3-year auditory verbal intervention. 2018

Percy-Smith, Lone / Hallstrøm, Maria / Josvassen, Jane Lignel / Mikkelsen, Jeanette Hølledig / Nissen, Lena / Dieleman, Eveline / Cayé-Thomasen, Per. ·Patientforening Decibel, Rygårdsallé 43, 2900, Hellerup, Denmark; East Danish CI Center, Department of Otolaryngology, Head and Neck Surgery, Rigshospitalet, F 2071, Copenhagen University Hospital, Blegdamsvej 9, DK 2100, Copenhagen, Denmark. Electronic address: Lone@decibel.dk. · Patientforening Decibel, Rygårdsallé 43, 2900, Hellerup, Denmark. · Vestdansk CI-Center / Audiologisk Klinik, Aarhus Universitetshospital, Peter Sabroes Gade 6, Bygn. 14F, 8000, Aarhus C, Denmark. · Department of Otolaryngology, Head and Neck Surgery, Rigshospitalet, F 2071, Copenhagen University Hospital, Blegdamsvej 9, DK 2100, Copenhagen, Denmark. ·Int J Pediatr Otorhinolaryngol · Pubmed #29605368.

ABSTRACT: OBJECTIVE: The overall objective of this study was to evaluate the implementation of a Nordic Auditory Verbal (AV) intervention for children with all degrees and types of hearing impairment (HI) using all kinds of hearing technology. A first specific objective was to identify differences and similarities in early vocabulary development between children with cochlear implant (CI) compared with children with hearing aids (HAs)/Bone anchored hearing aids (Bahs) enrolled in a 3-year AVprogram, and to compare the group of children with HI to a control group of children with normal hearing (NH). A second specific objective was to study universal neonatal hearing screening (UNHS) using the 1-3-6 Early Hearing Detection and Intervention (EHDI) guidelines. INTRODUCTION: Effect of AV intervention for children with HI using different hearing technology is not thoroughly studied. It is relevant to question, whether children with mild to moderate HI encounter the same intensive need for AV intervention as children with congenital deafness. METHODS: A longitudinal and comparative study design was used involving two cohorts of children, i.e. 36 children with CI and 19 children with HA/Bahs. The children were the first in Denmark to receive a 3-year AV intervention by formally trained AV-practitioners. Children were tested annually with standardized speech and language tests, i.e. Peabody Picture Vocabulary test, Reynell test and a Danish test for active vocabulary, Viborgmaterialet. Categorical variables were compared using Fischer's exact test and continuous variables were compared using Wilcoxon-Mann-Whitney test, as data was not normally distributed. RESULTS: Median age of diagnosis was 6 months and median age at intervention was 13 and 12 months respectively. There was no statistically significant difference between the two groups in terms of scores according to age equivalency for the three tests. However, there was a significant difference between children with HI regardless of hearing technology and children with NH. CONCLUSION: Children with HI progressed over a three-year period, but they did not reach the same level as children with NH. The high completion rate of 98,2% of families over a three-year period indicates the relevance of AV practice in a Nordic country. Children were diagnosed later than 3 months and intervention also started later than recommended. A result that warrants further investigation.

10 Article Auditory verbal habilitation is associated with improved outcome for children with cochlear implant. 2018

Percy-Smith, Lone / Tønning, Tenna Lindbjerg / Josvassen, Jane Lignel / Mikkelsen, Jeanette Hølledig / Nissen, Lena / Dieleman, Eveline / Hallstrøm, Maria / Cayé-Thomasen, Per. ·a Patientforening Decibel , Hellerup , Denmark. · b Department of Otolaryngology, Head and Neck Surgery , Copenhagen University Hospital , Copenhagen , Denmark. · c Vestdansk CI-Center/Audiologisk Klinik , Aarhus Universitetshospital , Aarhus C , Denmark. · d Faculty of Medical Sciences , University of Groningen , Groningen , Holland. ·Cochlear Implants Int · Pubmed #29058555.

ABSTRACT: OBJECTIVES: To study the impact of (re)habilitation strategy on speech-language outcomes for early, cochlear implanted children enrolled in different intervention programmes post implant. METHODS: Data relate to a total of 130 children representing two pediatric cohorts consisting of 94 and 36 subjects, respectively. The two cohorts had different speech and language intervention following cochlear implantation, i.e. standard habilitation vs. auditory verbal (AV) intervention. Three tests of speech and language were applied covering language areas of receptive and productive vocabulary and language understanding. RESULTS: Children in AV intervention outperformed children in standard habilitation on all three tests of speech and language. When effect of intervention was adjusted with other covariates children in AV intervention still had higher odds at performing at age equivalent speech and language levels. CONCLUSION: Compared to standard intervention, AV intervention is associated with improved outcome for children with CI. Based on this finding, we recommend that all children with HI should be offered this intervention and it is, therefore, highly relevant when National boards of Health and Social Affairs recommend basing the habilitation on principles from AV practice. It should be noted, that a minority of children use spoken language with sign support. For this group it is, however, still important that educational services provide auditory skills training.

11 Article Sporadic Endolymphatic Sac Tumor-A Very Rare Cause of Hearing Loss, Tinnitus, and Dizziness. 2017

Schnack, Didde Trærup / Kiss, Katalin / Hansen, Søren / Miyazaki, Hidemi / Bech, Birgitte / Caye Thomasen, Per. ·Department of Otorhinolaryngology, Head and Neck Surgery - Audiology, Rigshospitalet, Copenhagen, Denmark. diddeschnack@gmail.com. ·J Int Adv Otol · Pubmed #28716765.

ABSTRACT: Sporadic endolymphatic sac tumor is a very rare neoplasm. It is low malignant, locally destructive and expansive, but non-metastasizing. The tumor is very rare in the sporadic form, but more often associated with Von Hippel-Lindau disease. A 65-year old man with left sided tinnitus and hearing loss for several months. Audiometry showed an asymmetrical sensory neural hearing loss on the left side up to 60 dB. The speech discrimination score was 46% and stapedial reflexes were absent. Several years earlier, he had suffered from periods of dizziness. Magnetic resonance imaging (MRI) showed a destructive and locally invasive tumor in the peripheral vestibular system expanding into the cerebellopontine angle. Paraganglioma and von Hippel-Lindau`s disease were excluded. Vestibular examination showed no function of vestibular organ left side. The tumor was resected radically by translabyrintine approach. Per-operative freeze-microscopy showed inflammation tissue, whereas subsequent microscopy showed papillary-cystic endolymphatic sac tumor. Endolymphatic sac tumor is a rare neoplasm. The tumor may present with asymmetrically sensory neural hearing loss with or without tinnitus, dizziness and facial nerve paresis. An MRI scan is the appropriate diagnostic tool final dianosis is made by the post-operative histo-pathology. Dizziness can be the first sign of a tumor in this area.

12 Article Intralabyrinthine schwannomas : Surgical management and hearing rehabilitation with cochlear implants. 2017

Plontke, S K / Rahne, T / Pfister, M / Götze, G / Heider, C / Pazaitis, N / Strauss, C / Caye-Thomasen, P / Kösling, S. ·Department of Otorhinolaryngology, Head & Neck Surgery, Martin Luther University Halle-Wittenberg, University Medicine Halle, Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany. stefan.plontke@uk-halle.de. · Department of Otorhinolaryngology, Head & Neck Surgery, Martin Luther University Halle-Wittenberg, University Medicine Halle, Ernst-Grube-Str. 40, 06120, Halle (Saale), Germany. · ENT Sarnen, Sarnen, Switzerland. · Institute of Pathology, Martin Luther University Halle-Wittenberg, University Medicine Halle, Halle (Saale), Germany. · Department of Neurosurgery, Martin Luther University Halle-Wittenberg, University Medicine Halle, Halle (Saale), Germany. · Department of Oto-rhino-laryngology, Head and Neck Surgery, and Audiology, University Hospital Rigshospitalet, Copenhagen, Denmark. · Department of Radiology, Martin Luther University Halle-Wittenberg, University Medicine Halle, Halle (Saale), Germany. ·HNO · Pubmed #28664238.

ABSTRACT: Intralabyrinthine schwannomas (ILS) are a rare differential diagnosis of sudden hearing loss and vertigo. In an own case series of 12 patients, 6 tumors showed an intracochlear, 3 an intravestibular, 1 a transmodiolar including the cerebellopontine angle (CPA), 1a transotic including the CPA, and 1 a multilocular location. The tumors were removed surgically in 9 patients, whereas 3 patients decided for a "wait-and-test-and-scan" strategy. Of the surgical patients, 3 underwent labyrinthectomy and cochlear implant (CI) surgery in a single-stage procedure; 1 patient had extended cochleostomy with CI surgery; 3 underwent partial or subtotal cochleoectomy, with partial cochlear reconstruction and CI surgery (n = 1) or implantation of electrode dummies for possible later CI after repeated MRI follow-up (n = 2); and in 2 patients, the tumors of the internal auditory canal and cerebellopontine angle exhibiting transmodiolar or transmacular growth were removed by combined translabyrinthine-transotic resection. For the intracochlear tumors, vestibular function could mostly be preserved after surgery. In all cases with CI surgery, hearing rehabilitation was successful, although speech discrimination was limited for the case with subtotal cochleoectomy. Surgical removal of intracochlear schwannomas via partial or subtotal cochleoectomy is, in principle, possible with preservation of vestibular function. In the authors' opinion, radiotherapy of ILS is only indicated in isolated cases. Cochlear implantation during or after tumor resection (i. e., as synchronous or staged surgeries) is an option for hearing rehabilitation in cartain cases and represents a therapeutic approach in contrast to a "wait-and-test-and-scan" strategy.

13 Article [Intralabyrinthine schwannomas : Surgical management and hearing rehabilitation with cochlear implants. German version]. 2017

Plontke, S K / Rahne, T / Pfister, M / Götze, G / Heider, C / Pazaitis, N / Strauss, C / Caye-Thomasen, P / Kösling, S. ·Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Hals-Chirurgie, Martin-Luther-Universität Halle-Wittenberg, Universitätsmedizin Halle, Ernst-Grube-Str. 40, 06120, Halle (Saale), Deutschland. stefan.plontke@uk-halle.de. · Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Hals-Chirurgie, Martin-Luther-Universität Halle-Wittenberg, Universitätsmedizin Halle, Ernst-Grube-Str. 40, 06120, Halle (Saale), Deutschland. · HNO Sarnen, Sarnen, Schweiz. · Institut für Pathologie, Martin-Luther-Universität Halle-Wittenberg, Universitätsmedizin Halle, Halle (Saale), Deutschland. · Klinik und Poliklinik für Neurochirurgie, Martin-Luther-Universität Halle-Wittenberg, Universitätsmedizin Halle, Halle (Saale), Deutschland. · Klinik für Oto-Rhino-Laryngologie, Kopf- und Hals- Chirurgie und Audiologie, Universitäts-Hospital Rigshospitalet, Kopenhagen, Dänemark. · Klinik für Radiologie, Martin-Luther-Universität Halle-Wittenberg, Universitätsmedizin Halle, Halle (Saale), Deutschland. ·HNO · Pubmed #28421258.

ABSTRACT: Intralabyrinthine schwannomas (ILS) are a rare differential diagnosis of sudden hearing loss and vertigo. In an own case series of 12 patients, 6 tumors showed an intracochlear, 3 an intravestibular, 1 a transmodiolar including the cerebello-pontine angle (CPA), 1 a transotic including the CPA and 1 a multilocular location. The tumors were removed surgically in 9 patients, whereas 3 patients opted for a "wait-and-test-and-scan" strategy. Of the surgical patients, 3 underwent labyrinthectomy and cochlear implant (CI) surgery in a single stage procedure; 1 patient received extended cochleostomy with CI surgery; 3 underwent partial or subtotal cochleoectomy, with partial cochlear reconstruction and CI surgery (n = 1) or implantation of electrode dummies for possible later CI following repeated MRI follow-up (n = 2); and in 2 patients, the tumors of the internal auditory canal and cerebellopontile angle exhibiting transmodiolar or transmacular growth were removed by combined translabyrinthine-transotic resection. For the intracochlear tumors, vestibular function could mostly be preserved after surgery. In all cases with CI surgery, hearing rehabilitation was successful, although speech discrimination was limited for the case with subtotal cochleoectomy. Surgical removal of intracochlear schwannomas via partial or subtotal cochleoectomy is, in principle, possible with preservation of vestibular function. In the authors' opinion, radiotherapy of ILS is only indicated in isolated cases. Provided performed early enough, cochlear implantation after surgical removal of ILS is an option for auditory rehabilitation, thus representing-in contrast to the "wait-and-test-and-scan" strategy-a therapeutic approach.

14 Article Ten-Year Follow-up on Tumor Growth and Hearing in Patients Observed With an Intracanalicular Vestibular Schwannoma. 2017

Kirchmann, Malene / Karnov, Kirstine / Hansen, Søren / Dethloff, Thomas / Stangerup, Sven-Eric / Caye-Thomasen, Per. ·Department of Oto-Rhino-Laryngology, Head and Neck Surgery, and Audiology, Copenhagen University Hospital Rigshos-pitalet, Copenhagen, Denmark. · Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. ·Neurosurgery · Pubmed #27571523.

ABSTRACT: BACKGROUND: Reports on the natural history of tumor growth and hearing in patients with a vestibular schwannoma (VS) are almost exclusively short-term data. Long-term data are needed for comparison with results of surgery and radiotherapy. OBJECTIVE: To report the long-term occurrence of tumor growth and hearing loss in 156 patients diagnosed with an intracanalicular VS and managed conservatively. METHODS: In this longitudinal cohort study, diagnostic and follow-up magnetic resonance imaging and audiometry were compared. RESULTS: After a follow-up of 9.5 years, tumor growth had occurred in 37% and growth into the cerebellopontine angle had occurred in 23% of patients. Conservative treatment failed in 15%. The pure tone average had increased from 51- to 72-dB hearing level, and the speech discrimination score (SDS) had decreased from 60% to 34%. The number of patients with good hearing (SDS > 70%) was reduced from 52% to 22%, and the number of patients with American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) class A hearing was reduced from 19% to 3%. Hearing was preserved better in patients with 100% SDS at diagnosis than in patients with even a small loss of SDS. Serviceable hearing was preserved in 34% according to AAO-HNS (class A-B) and in 58% according to the word recognition score (class I-II). Rate of hearing loss was higher in patients with growing tumors. CONCLUSION: Tumor growth occurred in only a minority of patients diagnosed with an intracanalicular VS during 10 years of observation. The risk of hearing loss is small in patients with normal discrimination at diagnosis. Serviceable hearing is preserved spontaneously in 34% according to AAO-HNS and in 58% according to the word recognition score.

15 Article Cochlear implantation in Pendred syndrome and non-syndromic enlarged vestibular aqueduct - clinical challenges, surgical results, and complications. 2016

Mey, Kristianna / Bille, Michael / Cayé-Thomasen, Per. ·a Department of Otorhinolaryngology, Head & Neck Surgery, and Audiology , East Danish Center for Cochlear Implantation, Copenhagen University Hospital Rigshospitalet/Gentofte Hospital , Copenhagen , Denmark ; · b Faculty of Health and Medical Sciences , University of Copenhagen , Copenhagen , Denmark. ·Acta Otolaryngol · Pubmed #27241825.

ABSTRACT: OBJECTIVE: To explore specific clinical issues, surgical results, and complications of 80 cochlear implantations (CI) in 55 patients with Pendred syndrome (PS) or non-syndromic enlarged vestibular aqueduct (NSEVA). BACKGROUND: Previous studies have focused either on unselected case series or on populations with mixed cochlear malformations. PS/NSEVA accounts for up to 10% of congenital SNHL, rendering this a large group of cochlear implant candidates. The abnormal inner ear anatomy of these patients may be associated with a lower surgical success rate and a higher rate of complications. STUDY DESIGN: Retrospective review of patients' medical records and CT/MRI. SETTING: Tertiary referral center. MATERIALS AND METHODS: The medical records and CT/MRI images of 55 PS/NSEVA patients receiving 80 cochlear implantations from 1982-2014 were reviewed. Demographic data, surgical results, intra-operative incidents, and post-operative complications were retrieved. RESULTS: Complications occurred in 36% of implantations; 5% hereof major complications. Gushing/oozing from the cochleostoma occurred in 10% of implantations and was related to transient, but not prolonged post-operative vertigo. CONCLUSION: Intra-operative risks of gushing/oozing and post-operative vertigo are the primary clinical issues in PS/NSEVA patients regarding CI. Nonetheless, the surgical success rate is high and the major complication rate is low; similar to studies of unselected series of CI recipients.

16 Article Objective and Subjective Outcome of a New Transcutaneous Bone Conduction Hearing Device: Half-year Follow-up of the First 12 Nordic Implantations. 2016

Eberhard, Kristine Elisabeth / Olsen, Steen Østergaard / Miyazaki, Hidemi / Bille, Michael / Caye-Thomasen, Per. ·*Faculty of Health and Medical Sciences, University of Copenhagen †Department of Oto-rhino-laryngology, Head and Neck Surgery, and Audiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark. ·Otol Neurotol · Pubmed #26859460.

ABSTRACT: OBJECTIVE: To examine the objective and subjective outcome of a new transcutaneous bone conduction hearing device. STUDY DESIGN: Prospective, consecutive case series. PATIENTS: Twelve patients were implanted. Eight patients had a conductive/mixed (con/mix) hearing loss. Four had single sided deafness. MAIN OUTCOME MEASURES: At half-year follow-up, aided and unaided sound field hearing was evaluated by 1) warble tone thresholds, 2) pure-tone average (PTA4), 3) speech discrimination score (SDS) in quiet, and 4) speech reception threshold 50% at 70 dB SPL noise level (SRT50%). Subjective outcome was evaluated by three questionnaires: 1) International Outcome Inventory for Hearing Aids, 2) Speech, Spatial and Qualities of Hearing Scale 12, and 3) a questionnaire on frequency and duration of use. RESULTS: No major complications occurred. The mean aided PTA4 was lowered by 23dB. SDS was increased by 40% at 50dB, by 34% at 65dB, and by 12% at 80 dB SPL. SRT50% in noise improved 5.2 dB. 58% of the patients used the device daily and 83% at least 5 days a week. 50% used the device ≥ 8 hours and 75% ≥ 4  hours a day. Mean International Outcome Inventory for Hearing Aids score was 3.7, corresponding to beneficial outcome. In Speech, Spatial and Qualities of Hearing Scale 12, "quality of hearing" scored especially high. The con/mix hearing loss group showed larger benefit especially in SDS, SRT50% in noise and the subjective evaluations, whereas frequency and duration of use were similar. CONCLUSION: This study on the first 12 Nordic patients implanted with a new transcutaneous bone conduction hearing device demonstrates significant objective, as well as subjective hearing benefit. Patient satisfaction was high, as was the frequency of use.

17 Article Peripheral Vestibular System Disease in Vestibular Schwannomas: A Human Temporal Bone Study. 2015

Møller, Martin Nue / Hansen, Søren / Caye-Thomasen, Per. ·*Department of Oto-Rhino-Laryngology, Head and Neck Surgery, and Audiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark †Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. ·Otol Neurotol · Pubmed #26375978.

ABSTRACT: INTRODUCTION: Dizziness is a common symptom in patients with vestibulo-cochlear schwannoma (VS), and several recent studies have identified this symptom as the single most important concerning the quality of life. Clinical and histological observations regarding hearing loss have suggested that this may be caused by both cochlear and retrocochlear mechanisms. Multiple mechanisms may also be at play in the case of dizziness, which may broaden perspectives of therapeutic approach. This study presents a systematic and detailed assessment of vestibular histopathology in temporal bones from patients with VS. METHODS: Retrospective analysis of vestibular system histopathology in temporal bones from 17 patients with unilateral VS. The material was obtained from The Copenhagen Temporal Bone Collection. RESULTS: Vestibular schwannomas were associated with atrophy of the vestibular ganglion, loss of fiber density of the peripheral vestibular nerve branches, and atrophy of the neuroepithelium of the vestibular end organs. In cases with small tumors, peripheral disease occurred only in the tissue structures innervated by the specific nerve from which the tumor originated. CONCLUSION: Vestibular schwannomas are associated with distinctive disease of the peripheral vestibular tissue structures, suggesting anterograde degeneration and that dizziness in these patients may be caused by deficient peripheral vestibular nerve fibers, neurons, and end organs. In smaller tumors, a highly localized disease occurs, which opens perspectives of differentiated clinical assessment and subsequent, targeted therapy.

18 Article A new wide-diameter bone-anchored hearing implant-prospective 1-year data on complications, implant stability, and survival. 2014

Foghsgaard, Søren / Caye-Thomasen, Per. ·*Department of Otorhinolaryngology, Head and Neck Surgery, Copenhagen University Hospital Rigshospitalet; and †Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark. ·Otol Neurotol · Pubmed #24608379.

ABSTRACT: OBJECTIVE: To investigate a new wide bone-anchored hearing implant considering initial stability, stability over time, implant loss, and skin reaction. STUDY DESIGN: Consecutive, prospective case series. SETTING: Tertiary referral center. PATIENTS: Twenty adult patients were enrolled. All operations were 1-stage, single-incision technique with subcutaneous reduction. INTERVENTION(S): Measurement of implant stability. MAIN OUTCOME MEASURE(S): Implant stability quotient (ISQ) values were recorded using resonance frequency analysis at the time of implantation and at 10 days, 6 weeks, 6 months, and 1 year after surgery. Skin and soft tissue reactions according to Holgers grading system. RESULTS: Implant stability quotient measurements revealed a significant increase in ISQ during the first 10 days after operation, and the ISQ values continued to rise throughout the 1-year observation period. No implants were lost. Skin and soft tissue reactions were rare and minor, as no reaction was seen in 93% of the follow-up examinations and no grade 4 reactions occurred. CONCLUSION: The new wide implant showed good stability at surgery. Osseointegration was fast, and implant stability increased throughout the 1-year observation period. No implants were lost. Skin and soft tissue reactions were rare and minor.

19 Article Hearing 25 years after surgical treatment of otitis media with effusion in early childhood. 2013

Khodaverdi, Mojgan / Jørgensen, Gita / Lange, Theis / Stangerup, Sven-Eric / Drozdziewizc, Dominika / Tos, Mirko / Bonding, Per / Caye-Thomasen, Per. ·Department of Oto-Rhino-Laryngology, Copenhagen University Hospital Rigshospitalet/Gentofte, Copenhagen, Denmark. ·Int J Pediatr Otorhinolaryngol · Pubmed #23218983.

ABSTRACT: OBJECTIVE: To determine the long-term hearing following surgical treatment of chronic OME in early childhood (myringotomy or ventilation tube) and to determine the impact of the occurrence and the extension of specific eardrum pathology on the hearing level. PATIENTS AND METHODS: In 1977-1978, 224 consecutive children (91 girls and 133 boys) with chronic bilateral OME were enrolled and treated by adenoidectomy, bilateral myringotomy and insertion of a ventilation tube on the right side only. In 2002, a follow-up examination included otomicroscopy and audiometry. Hearing thresholds were compared to an age- and gender-matched normative data set. For the determination of the impact of specific eardrum pathology on the hearing, multiple linear regression modelling was used in adjustment for age and concomitant eardrum pathologies. RESULTS: Long-term hearing after chronic OME and associated treatment is not different from age and gender-matched normal hearing. Treatment modality (myringotomy or ventilation tube) has no impact on the long-term hearing level. The regression analyses showed that the presence of myringosclerosis is associated with an overall hearing loss in myringotomised ears (4-5 dB), but not in tubed ears, for which only high frequencies were affected. Conversely, tensa atrophy is associated with an overall hearing loss in tubed ears (3-4 dB), but not in myringotomised ears, for which only high frequencies were affected. CONCLUSIONS: Hearing 25 years after surgical treatment of chronic OME is not different from age and gender matched normal hearing. In addition, treatment modality (myringotomy or ventilation tube) has no impact on the long-term hearing level. However, atrophy is associated with a hearing loss in tubed ears, whereas myringosclerosis is associated with a hearing loss in myringotomised ears. The hearing loss associated with pathology is of limited magnitude (up to about 5 dB PTA). Even though pathology does occur more frequently and more extensively in tubed ears, the effect on the hearing at the group level is too small to have an impact. It is important to note, that this may be due to a type 2-error (number of patients too small to show an effect).

20 Article Language understanding and vocabulary of early cochlear implanted children. 2013

Percy-Smith, Lone / Busch, Georg / Sandahl, Minna / Nissen, Lena / Josvassen, Jane Lignel / Lange, Theis / Rusch, Ea / Cayé-Thomasen, Per. ·East Danish Cochlear Implant Center, Department of Audiology, Rigshospitalet University Hospital of Copenhagen, Denmark. loper@geh.regionh.dk ·Int J Pediatr Otorhinolaryngol · Pubmed #23141802.

ABSTRACT: OBJECTIVES: The aim of the study was to identify factors associated with the level of language understanding, the level of receptive and active vocabulary, and to estimate effect-related odds ratios for cochlear implanted children's language level. METHODS: The patient material included all children born in Denmark between January 2005 and January 2011, having received a cochlear implant (CI) and with a minimum of 6 months of hearing with their CI (N=94). The participation rate was 88% (N=83). Sixty-eight (82%) of the participating children were implanted bilaterally. Mean age at implantation was 19.6 months. The mean age at test was 46.3 months and the mean age of hearing with CI was 25.9 months. The children were tested with three different tests, the PPVT-4, the Reynell receptive part and a Danish test "Viborgmaterialet" for active vocabulary. Logistic regression models were used for analysis of the potential influence of eighteen different factors upon the test outcomes. RESULTS: The majority of children did not have age equivalent language understanding and vocabulary. There was significant effect of the following factors upon the test outcomes: age at hearing aid start before implantation, age at implantation, length of hearing, communication mode, mode of implantation, amount of support teaching, residence and educational placement. Children who started HA treatment before 6 months of age, were implanted before 12 months or did not use total communication had the highest odds of having age equivalent language understanding and vocabulary. CONCLUSIONS: The majority of hearing impaired children in Denmark received hearing aids before six months of hearing and the majority was implanted before 18 months of age. Despite these medical and technical advances the vast majority did not have age equivalent language understanding and vocabulary. Data suggest that the language gap is not closed in two years after implantation.

21 Article Fractionated stereotactic radiotherapy of vestibular schwannomas accelerates hearing loss. 2012

Rasmussen, Rune / Claesson, Magnus / Stangerup, Sven-Eric / Roed, Henrik / Christensen, Ib Jarle / Cayé-Thomasen, Per / Juhler, Marianne. ·Department of Neurosurgery, Rigshospitalet, Copenhagen, Denmark. rune333@gmail.com ·Int J Radiat Oncol Biol Phys · Pubmed #22560549.

ABSTRACT: OBJECTIVE: To evaluate long-term tumor control and hearing preservation rates in patients with vestibular schwannoma treated with fractionated stereotactic radiotherapy (FSRT), comparing hearing preservation rates to an untreated control group. The relationship between radiation dose to the cochlea and hearing preservation was also investigated. METHODS AND MATERIALS: Forty-two patients receiving FSRT between 1997 and 2008 with a minimum follow-up of 2 years were included. All patients received 54 Gy in 27-30 fractions during 5.5-6.0 weeks. Clinical and audiometry data were collected prospectively. From a "wait-and-scan" group, 409 patients were selected as control subjects, matched by initial audiometric parameters. Radiation dose to the cochlea was measured using the original treatment plan and then related to changes in acoustic parameters. RESULTS: Actuarial 2-, 4-, and 10-year tumor control rates were 100%, 91.5%, and 85.0%, respectively. Twenty-one patients had serviceable hearing before FSRT, 8 of whom (38%) retained serviceable hearing at 2 years after FSRT. No patients retained serviceable hearing after 10 years. At 2 years, hearing preservation rates in the control group were 1.8 times higher compared with the group receiving FSRT (P=.007). Radiation dose to the cochlea was significantly correlated to deterioration of the speech reception threshold (P=.03) but not to discrimination loss. CONCLUSION: FSRT accelerates the naturally occurring hearing loss in patients with vestibular schwannoma. Our findings, using fractionation of radiotherapy, parallel results using single-dose radiation. The radiation dose to the cochlea is correlated to hearing loss measured as the speech reception threshold.

22 Article Cochlear ossification in patients with profound hearing loss following bacterial meningitis. 2012

Caye-Thomasen, Per / Dam, Mikkel Seidelin / Omland, Silje Haukali / Mantoni, Margit. ·Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital Rigshospitalet/Gentofte, Copenhagen, Denmark. peca@geh.regionh.dk ·Acta Otolaryngol · Pubmed #22497482.

ABSTRACT: CONCLUSION: Cochlear ossification following bacterial meningitis is related to causative pathogen, but not age at disease or time point of evaluation. However, progression may occur over time, especially in case of primary signs of ossification. OBJECTIVE: To investigate the occurrence and degree of cochlear ossification on CT and MRI in patients with bilateral profound hearing loss following bacterial meningitis, in relation to causative pathogen, age at disease, and time point of evaluation. Progression of ossification in cases that underwent more than one scan was evaluated. METHODS: In the period 1982-2008, 47 cochlear implantations were performed in 34 consecutive candidates suffering from bilateral profound hearing loss following bacterial meningitis. A retrospective review of patient files and preoperative CT and MR images was performed. RESULTS: Cochlear ossification was observed in 35% of patients and 26% of ears on CT. The corresponding values for MRI were 44 and 30% (difference not significant). Streptococcus pneumoniae infection caused ossification more frequently than Neisseria meningitidis. No difference was found between pediatric and adult cases, and the occurrence of ossification was not related to the time point of evaluation. Signs of progressive ossification were found in cases with two CT scans, especially if ossification was present at the first scan.

23 Article Factors associated with the occurrence of hearing loss after pneumococcal meningitis. 2010

Worsøe, Lise / Cayé-Thomasen, Per / Brandt, Christian Thomas / Thomsen, Jens / Østergaard, Christian. ·Department of Oto-rhino-laryngology, Head and Neck Surgery, Copenhagen University Hospital Gentofte, Hellerup, Denmark. l_worsoe@hotmail.com ·Clin Infect Dis · Pubmed #20815735.

ABSTRACT: BACKGROUND: On the basis of a nationwide registration during a 5-year period (1999-2003), the frequency and severity of hearing loss was investigated retrospectively in 343 consecutive Danish patients who survived pneumococcal meningitis, to identify important risk factors (including the pneumococcal serotype) for development of hearing loss. METHODS: Results of blood and cerebrospinal fluid (CSF) biochemistry, bacterial serotyping, follow-up audiological examinations, and medical records were collected, and disease-related risk factors for hearing loss were identified. The mean pure-tone hearing threshold levels were compared with normative data. RESULTS: Of 240 patients examined by use of audiometry, 129 (54%) had a hearing deficit, and 50 (39%) of these 129 patients were not suspected of hearing loss at discharge from hospital. Of the 240 patients, 16 (7%) had profound unilateral hearing loss, and another 16 (7%) had bilateral profound hearing loss. Significant risk factors for hearing loss were advanced age, the presence of comorbidity, severity of meningitis, a low CSF glucose level, a high CSF protein level, and a certain pneumococcal serotype (P < .05). By applying multivariate logistic regression analysis, we found that advanced age, female sex, and a certain serotype were significant risk factors, because fewer patients with serotype 6B had hearing loss than did patients with serotype 12F (P = .03), which was the most commonly occurring serotype. CONCLUSION: Hearing loss is common after pneumococcal meningitis, and audiometry should be performed on all those who survive pneumococcal meningitis. Important risk factors for hearing loss are advanced age, female sex, severity of meningitis, and bacterial serotype.

24 Article Systemic steroid reduces long-term hearing loss in experimental pneumococcal meningitis. 2010

Worsøe, Lise / Brandt, Christian Thomas / Lund, Søren Peter / Østergaard, Christian / Thomsen, Jens / Cayé-Thomasen, Per. ·Department of Oto-rhino-laryngology, Head and Neck Surgery, Copenhagen University Hospital Gentofte, Hellerup, Denmark. l_worsoe@hotmail.com ·Laryngoscope · Pubmed #20717948.

ABSTRACT: OBJECTIVES/HYPOTHESIS: Sensorineural hearing loss is a common complication of pneumococcal meningitis. Treatment with corticosteroids reduces inflammatory response and may thereby reduce hearing loss. However, both experimental studies and clinical trials investigating the effect of corticosteroids on hearing loss have generated conflicting results. The objective of the present study was to determine whether systemic steroid treatment had an effect on hearing loss and cochlear damage in a rat model of pneumococcal meningitis. STUDY DESIGN: Controlled animal study of acute bacterial meningitis. METHODS: Adult rats were randomly assigned to two experimental treatment groups: a group treated with systemic steroid (n = 13) and a control group treated with saline (n = 13). Treatment was initiated 21 hours after infection and repeated once a day for three days. Hearing loss and cochlear damage were assessed by distortion product otoacoustic emissions (DPOAE), auditory brainstem response (ABR) at 16 kHz, and spiral ganglion neuron density. RESULTS: Fifty-six days after infection, steroid treatment significantly reduced hearing loss assessed by DPOAE (P < .05; Mann-Whitney) and showed a trend toward reducing loss of viable neurons in the spiral ganglion (P = .0513; Mann-Whitney). After pooling data from day 22 with data from day 56, we found that systemic steroid treatment significantly reduced loss of spiral ganglion neurons (P = .0098; Mann-Whitney test). CONCLUSIONS: Systemic steroid treatment reduces long-term hearing loss and loss of spiral ganglion neurons in experimental pneumococcal meningitis in adult rats. The findings support a beneficial role of anti-inflammatory agents in reducing hearing loss and cochlear damage in meningitis.

25 Article Intratympanic steroid prevents long-term spiral ganglion neuron loss in experimental meningitis. 2010

Worsøe, Lise / Brandt, Christian Thomas / Lund, Søren Peter / Ostergaard, Christian / Thomsen, Jens / Cayé-Thomasen, Per. ·Department of Oto-rhino-laryngology, Head and Neck Surgery, Copenhagen University Hospital Gentofte, Hellerup, Denmark. l_worsoe@hotmail.com ·Otol Neurotol · Pubmed #20147868.

ABSTRACT: HYPOTHESIS: Intratympanic steroid treatment prevents hearing loss and cochlear damage in a rat model of pneumococcal meningitis. BACKGROUND: Sensorineural hearing loss is a long-term complication of meningitis affecting up to a third of survivors. Streptococcus pneumoniae is the bacterial species most often associated with a hearing loss. METHODS: Rats were randomly assigned to 3 treatment groups: a group treated with intratympanic betamethasone and 2 control groups treated with either intratympanic or systemic saline. Treatment was initiated 21 hours after infection and repeated once a day for 3 days. Hearing loss and cochlear damage were assessed by distortion product otoacoustic emissions, auditory brainstem response at 16 kHz, and spiral ganglion neuron density. RESULTS: Fifty-six days after infection, auditory brainstem response showed no significant differences between groups, and distortion product otoacoustic emissions showed significant hearing loss at the low frequencies in animals treated with intratympanic steroid compared with animals treated with systemic saline (p < 0.05; Mann-Whitney test). However, intratympanic steroid significantly increased the number of viable neurons in the spiral ganglion compared with both intratympanic and systemic saline (p = 0.0082 and p = 0.0089; Mann-Whitney test). Histology revealed fibrosis of the tympanic membrane and cavity in steroid-treated animals, which plausibly caused the low-frequency hearing loss. CONCLUSION: Intratympanic betamethasone treatment prevents long-term spiral ganglion neuron loss in experimental pneumococcal meningitis. This finding is clinically relevant in relation to post-meningitic hearing rehabilitation by cochlear implantation. However, the drug instillation in the middle ear induced local fibrosis and a concurrent low-frequency hearing loss.

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