PubMed Health⌕ Search

Biomedical subjects

Thomas Somers

Publications and source records attributed to Thomas Somers.

8 recordsLinked to original sources
PubMed2006

The value of diffusion-weighted MR imaging in the diagnosis of primary acquired and residual cholesteatoma: a surgical verified study of 100 patients.

Our goal was to determine the value of echo-planar diffusion-weighted MR imaging in detecting the presence of primary acquired and residual cholesteatoma. One hundred patients were evaluated by preoperative magnetic resonance (MR) imaging with diffusion-weighted MR imaging. The patient population consisted of a first group of 55 patients evaluated in order to detect the presence of a primary acquired cholesteatoma. In the second group, 45 patients were evaluated for the presence of a residual cholesteatoma 8-18 months after cholesteatoma surgery, prior to second-look surgery. Surgical findings were compared with preoperative findings on diffusion-weighted imaging (DWI). The sensitivity, specificity, positive and negative predictive values of both groups was assessed. In the group of primary surgery patients, hyperintense signal compatible with cholesteatoma was found in 89% of cases with a sensitivity, specificity, positive and negative predictive value for DWI of 81, 100, 100 and 40%, respectively. In the group of second-look surgery patients, only one of seven surgically verified residual cases was correctly diagnosed using DWI, with a sensitivity, specificity, positive and negative predictive values of 12.5, 100, 100 and 72%, respectively. These results confirm the value of DWI in detecting primary cholesteatoma, but show the poor capability of DWI in detecting small residual cholesteatoma.

Adolescent↗
PubMed2006

Stapedotomy with microdrill or carbon dioxide laser: influence on inner ear function.

OBJECTIVES: A prospective randomized audiological analysis of 336 otosclerosis operations was conducted to compare the evolution of bone conduction thresholds after primary stapedotomy with two different techniques to open the footplate: microdrill and carbon dioxide laser stapedotomy. METHODS: To monitor the inner ear function, we compared the preoperative bone conduction thresholds with the postoperative levels at day 2, week 2, week 6, and month 6. Evolution of the bone conduction was compared for the two studied groups (laser versus microdrill). RESULTS: An average bone conduction loss of 1.8 dB was measured at day 2 for the middle frequencies (0.5, 1, and 2 kHz). At 4 kHz, a bone conduction loss of 7 dB was found. The bone conduction thresholds measured in the first and second months after surgery showed a gradual recovery with overclosure as the end result. CONCLUSIONS: Our results confirm the transient depression of inner ear function in the immediate postoperative period, with recovery within the first weeks after surgery. In the studied population, no statistically significant difference was found between the two techniques that were used to make the calibrated hole (laser versus microdrill). These results demonstrate that both techniques possess the same early effect regarding inner ear function. The authors hypothesize that an early inflammatory reaction could be the cause of the transient bone conduction shift.

Adolescent↗
PubMed2005

Consensus statements on the BAHA system: where do we stand at present?

After more than 25 years of clinical experience, the BAHA (bone-anchored hearing aid) system is a well-established treatment for hearing-impaired patients with conductive or mixed hearing loss. Owing to its success, the use of the BAHA system has spread and the indications for application have gradually become broader. New indications, as well as clinical applications, were discussed during scientific roundtable meetings in 2004 by experts in the field, and the outcomes of these discussions are presented in the form of statements. The issues that were discussed concerned BAHA surgery, the fitting range of the BAHA system, the BAHA system compared to conventional devices, bilateral application, the BAHA system in children, the BAHA system in patients with single-sided deafness, and, finally, the BAHA system in patients with unilateral conductive hearing loss.

Adult↗
PubMed2002

The use of malleus allografts in ossiculoplasty.

OBJECTIVE: To assess the functional performance of remodeled malleus allografts in a malleus-footplate assembly in terms of hearing results and mid long-term stability. STUDY DESIGN: A retrospective study of 60 consecutive patients who underwent a malleus allograft ossiculoplasty from 1993 until 2000. In all cases the incus and the stapedial arch were missing as the result of cholesteatoma (49), chronic otitis (5), incus necrosis resulting from stapes prosthesis (5), and congenital ossicular malformations (1). In all cases malleus allografts were remodeled to form a malleus-stapes assembly. RESULTS: The audiometric results, using such an ossiculoplasty, revealed an overall median gain of 18.3 dB at 2 months, 22.3 dB at 6 months, and 25 dB 1 year postoperatively on Fletcher frequencies. An air-bone gap closure within 20 dB was achieved in 81% of all cases 1 year postoperatively. No cases of extrusion have been seen in our series. CONCLUSION: Our findings suggest that malleus allografts are capable of generating good and stable functional results as malleus-stapes assembly.

Adolescent↗
PubMed2002

Outcome of cochlear implantation at different ages from 0 to 6 years.

OBJECTIVE: To evaluate the outcome of cochlear implantation in young children in relation to the age at implantation. STUDY DESIGN: A retrospective longitudinal and cross-sectional analysis of pediatric cochlear implant patients. PATIENTS: All children with congenital deafness who underwent implantation before the age of 6 years (n = 48 for the longitudinal analysis and n = 70 for the cross-sectional analysis) INTERVENTIONS: All children received a multichannel cochlear implant. MAIN OUTCOME MEASURES: Categories of Auditory Performance (CAP) score and integration into the mainstream school system. RESULTS: For all children, the CAP score increased after implantation. Implantation beyond the age of 4 years hardly ever resulted in normal CAP scores or in integration into the mainstream primary school (20 to 30% of cases). Implantation between the age of 2 and 4 years always resulted in normal CAP scores after 3 years with a 66% probability of integration into the primary school. Implantation before the age of 2 years always resulted in immediate normalization of the CAP scores, with a 90% probability of integration into the mainstream kindergarten, well before entrance into the primary school. CONCLUSION: All children with congenital deafness who underwent implantation before the age of 6 years appeared to benefit from the implant. However, these data add evidence to the importance of early implantation (before the age of 2 years). Intervention before the age of 4 years seemed to be critical to avoid irreversible auditory performance losses, and intervention before the age of 2 years seemed to be critical to achieve optimal results.

Age Factors↗