Advances in Oto-Rhino-Laryngology最新文献_第10页

The Future of Cochlear Implant Design. 人工耳蜗设计的未来。

Advances in Oto-Rhino-Laryngology Pub Date : 2018-01-01 Epub Date: 2018-04-06 DOI: 10.1159/000485540

Alistair Mitchell-Innes, Shakeel R Saeed, Richard Irving

{"title":"The Future of Cochlear Implant Design.","authors":"Alistair Mitchell-Innes, Shakeel R Saeed, Richard Irving","doi":"10.1159/000485540","DOIUrl":"https://doi.org/10.1159/000485540","url":null,"abstract":"This chapter discusses the multifaceted future of cochlear implant design. Current research is focused on novel strategies relating to the electrode array, aiming to improve the neuronal health and spatial selectivity, and reduce the power consumption. Future design iterations will most likely improve the neuronal health by reducing insertion trauma, minimizing the inflammatory pathway that follows electrode insertion or through the use of neurotrophins or stem cells. Improvements in spatial selectivity and in speech recognition in difficult listening environments can be achieved through changes in the electrode/neural interface. Designing an array that brings the electrodes closer to neural tissue, or changing the method of stimulation with current steering or even optical or piezoelectric stimulation are discussed. Increasing the MRI compatibility is an important consideration, and devices allowing remote programming have a huge impact on worldwide provision. Technology exists to realize the elusive goal of a fully implantable cochlear implant, allowing continuous and invisible hearing. Ultimately, future technologies will be integrated to allow tailoring of implant design to the individual, thereby addressing the broad variability in user performance. At the same time, there is an urgent requirement for a high quality, low cost, mass-produced implant for the developing world.","PeriodicalId":39848,"journal":{"name":"Advances in Oto-Rhino-Laryngology","volume":"81 ","pages":"105-113"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000485540","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36125534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 14

Hearing Rehabilitation in Congenital Middle Ear Malformation. 先天性中耳畸形的听力康复。

Advances in Oto-Rhino-Laryngology Pub Date : 2018-01-01 Epub Date: 2018-04-06 DOI: 10.1159/000485525

Henning Frenzel

{"title":"Hearing Rehabilitation in Congenital Middle Ear Malformation.","authors":"Henning Frenzel","doi":"10.1159/000485525","DOIUrl":"https://doi.org/10.1159/000485525","url":null,"abstract":"Microtia and atresia cause significant conductive hearing loss of up to 60 dB HL. The bilateral cases suffer from severely restricted communication abilities and require immediate acoustic stimulation. There is also growing evidence that unilateral cases benefit from an early and selective stimulation of the affected side. Hearing restoration can be performed in selected cases of minor malformation by classic middle ear reconstruction. However, the majority of patients presumably benefit better from a hearing aid. There are 3 main types: active middle ear implants, active bone conduction implants and passive bone conduction implants. All implants improve speech perception, speech recognition, the signal-to-noise ratio and directional hearing. The extent varies among implants and requires further studies. Decision making on the implant type depends on the extent of malformation and hence the preoperative imaging. New scoring systems provide reliable risk stratification. Second it depends on the age of the patient. The active middle ear implants provide a selective stimulation of the affected side and are beneficial if implanted in the first years of life during the maturation period of the auditory system. In conclusion, hearing rehabilitation of congenital atresia should be performed as early as possible. This includes not only the bilateral but also the unilateral affected patients.","PeriodicalId":39848,"journal":{"name":"Advances in Oto-Rhino-Laryngology","volume":"81 ","pages":"32-42"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000485525","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36126344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 8

Hearing Preservation Cochlear Implant Surgery. 听力保护人工耳蜗手术。

Advances in Oto-Rhino-Laryngology Pub Date : 2018-01-01 Epub Date: 2018-04-06 DOI: 10.1159/000485544

Iain A Bruce, Ingo Todt

引用次数: 8

A Succinct History of Sleep Medicine. 《睡眠医学简史》

Advances in Oto-Rhino-Laryngology Pub Date : 2017-01-01 Epub Date: 2017-07-17 DOI: 10.1159/000470486

Leh-Kiong Anne Huon, Christian Guilleminault

引用次数: 7

Advances in the Diagnosis of Obstructive Sleep Apnea: Drug-Induced Sleep Endoscopy. 阻塞性睡眠呼吸暂停的诊断进展:药物性睡眠内镜。

Advances in Oto-Rhino-Laryngology Pub Date : 2017-01-01 Epub Date: 2017-07-17 DOI: 10.1159/000470816

Madeline J L Ravesloot, Linda Benoist, Peter van Maanen, Eric J Kezirian, Nico de Vries

引用次数: 5

Updated Concepts on Treatment Outcomes for Obstructive Sleep Apnea. 阻塞性睡眠呼吸暂停治疗结果的最新概念。

Advances in Oto-Rhino-Laryngology Pub Date : 2017-01-01 Epub Date: 2017-07-17 DOI: 10.1159/000470821

Victor Certal, Robson Capasso

{"title":"Updated Concepts on Treatment Outcomes for Obstructive Sleep Apnea.","authors":"Victor Certal, Robson Capasso","doi":"10.1159/000470821","DOIUrl":"https://doi.org/10.1159/000470821","url":null,"abstract":"Obstructive sleep apnea is a highly prevalent and poorly understood condition that not only leads to significant individual patient health damage, but carries a large societal cost secondary to excessive healthcare utilization, motor-vehicle accidents, and work absenteeism. While a significant fund of knowledge about its damaging effects on the cardiovascular system and neural pathways has been gathered over the past few decades, the translation to direct patient care still presents numerous challenges. With the exception of clear issues such as socially unacceptable snoring and breathing irregularities, the exact cause and effect relationship between airway narrowing, hypoxemia, and sleep fragmentation with subjective sleep-related complaints and neurocognitive symptoms is less clear. Besides better-defined clinical diagnostic criteria, the need for clear serum, saliva, or urine biomarkers to assess the physiologic burden of disease remains a work in progress, as are well-defined long-term clinically relevant outcomes of interest. Here, readers will be guided to a critical evaluation on the current main metrics of sleep study, suggested steps on diagnostic and treatment goals, and introduced to the concept of a continuum of disease.","PeriodicalId":39848,"journal":{"name":"Advances in Oto-Rhino-Laryngology","volume":"80 ","pages":"37-40"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000470821","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35194014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Advances in Oral Appliances for Obstructive Sleep Apnea. 阻塞性睡眠呼吸暂停口腔器械的研究进展。

Advances in Oto-Rhino-Laryngology Pub Date : 2017-01-01 Epub Date: 2017-07-17 DOI: 10.1159/000470865

Ofer Jacobowitz

{"title":"Advances in Oral Appliances for Obstructive Sleep Apnea.","authors":"Ofer Jacobowitz","doi":"10.1159/000470865","DOIUrl":"https://doi.org/10.1159/000470865","url":null,"abstract":"Oral appliances that advance the mandible are widely used as alternatives to positive airway pressure (PAP) devices or as primary therapy for obstructive sleep apnea (OSA) in adults. Although PAP is more efficacious at lowering the polysomnographic indices of OSA, the clinical effectiveness of PAP and oral appliances is similar, and patients are more likely to adhere to oral appliance therapy than to PAP treatment. Clinical examination is used to determine the candidacy of oral appliances and to select a particular appliance for a given patient. Endoscopic examination of the pharynx may be used to help assess the potential for efficacy. Otherwise, if available, titration of mandibular protrusion during sleep may be performed prior to appliance production in order to assess efficacy. Once a patient is fitted with a titratable oral appliance, further advancement is usually performed at home to resolve the clinical symptoms and signs of OSA. Clinical follow-up is needed to assess the outcome, side effects, and adherence, as the long-term adherence rate is approximately 50%. Recent advances in oral appliance therapy include the development of embedded temperature sensors for adherence monitoring and the production of thinner, lighter appliances via 3D printing techniques.","PeriodicalId":39848,"journal":{"name":"Advances in Oto-Rhino-Laryngology","volume":"80 ","pages":"57-65"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000470865","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35194195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Advanced Concepts in the Pathophysiology of Obstructive Sleep Apnea. 阻塞性睡眠呼吸暂停病理生理学的先进概念。

Advances in Oto-Rhino-Laryngology Pub Date : 2017-01-01 Epub Date: 2017-07-17 DOI: 10.1159/000470522

David P White

引用次数: 22

Multilevel Obstructive Sleep Apnea Surgery. 多层阻塞性睡眠呼吸暂停手术。

Advances in Oto-Rhino-Laryngology Pub Date : 2017-01-01 Epub Date: 2017-07-17 DOI: 10.1159/000470879

Hsin-Ching Lin, Edward M Weaver, Ho-Sheng Lin, Michael Friedman

{"title":"Multilevel Obstructive Sleep Apnea Surgery.","authors":"Hsin-Ching Lin, Edward M Weaver, Ho-Sheng Lin, Michael Friedman","doi":"10.1159/000470879","DOIUrl":"https://doi.org/10.1159/000470879","url":null,"abstract":"Continuous positive airway pressure (CPAP) is the primary treatment of obstructive sleep apnea/hypopnea syndrome (OSA). Most sleep physicians are in agreement that a certain number of OSA patients cannot or will not use CPAP. Although other conservative therapies, such as oral appliance, sleep hygiene, and sleep positioning, may help some of these patients, there are many who fail all conservative treatments. As sleep surgeons, we have the responsibility to screen patients for both symptoms and signs of OSA. As experts of upper airway diseases, we often view an airway clearly and help the patient understand the importance of assessment and treatment for OSA. Surgery for OSA is not a substitute for CPAP but is a salvage treatment for those who failed CPAP and other conservative therapies and therefore have no other options. Most early studies and reviews focused on the efficacy of uvulopalatopharyngoplasty, a single-level procedure for the treatment of OSA. Since OSA is usually caused by multilevel obstructions, the true focus on efficacy should be on multilevel surgical intervention. The purpose here is to provide an updated overview of multilevel surgery for OSA patients.","PeriodicalId":39848,"journal":{"name":"Advances in Oto-Rhino-Laryngology","volume":"80 ","pages":"109-115"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000470879","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35194197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 37

Updated Friedman Staging System for Obstructive Sleep Apnea. 更新的弗里德曼阻塞性睡眠呼吸暂停分期系统。

Advances in Oto-Rhino-Laryngology Pub Date : 2017-01-01 Epub Date: 2017-07-17 DOI: 10.1159/000470859

Michael Friedman, Anna M Salapatas, Lauren B Bonzelaar

引用次数: 68