Purpose
To evaluate the changes of peripapillary and subfoveal choroidal thickness (CT) after trabeculectomy.
Methods
Prospective longitudinal study included 37 eyes with open‐angle glaucoma. The ...subfoveal and peripapillary CT was measured using enhanced depth imaging spectral domain optical coherence tomography before trabeculectomy and 1 week, 3 and 6 months postoperatively. The associations between changes in the CT, intraocular pressure (IOP) and axial length were analysed.
Results
The medium subfoveal CT (IQR) increased from 182 (97) μm at baseline to 267 (107) μm 1 week, 213 (97) μm 3 months and 207 (91) μm 6 months postoperatively (p < 0.001). The peripapillary CT increased in all four quadrants at all follow‐ups (p < 0.05). The subfoveal and peripapillary choroidal thickening correlated with the magnitude of IOP reduction (p < 0.05) and axial length shortening (p < 0.01) during whole follow‐up period. There was a peripapillary CT increase of 2.9 μm per mmHg of IOP reduction (p < 0.001, CI 1.5–4.4) and 4.8 μm per mm of baseline axial length (p = 0.049, CI 0.03–9.6) 1 week postoperatively after adjustment for baseline IOP. Six months postoperatively, the decrease in axial length was the only factor associated with peripapillary choroidal thickening (p = 0.031; regression coefficient: 73.29 μm/mm, CI 7.1–139.5).
Conclusion
Intraocular pressure (IOP) reduction after trabeculectomy caused the increase in subfoveal and peripapillary CT for at least 6 months postoperatively correlating with greater IOP reduction and axial length shortening. In the long term, the decrease in axial eye length, but not IOP, was the only factor to be associated with peripapillary choroidal thickening.
Background and Objectives: Speech audiometry employs standardized materials, typically in the language spoken by the target population. Language-specific nuances, including phonological features, ...influence speech perception and recognition. The material of speech audiometry tests for the assessment of word recognition comprises lists of words that are phonemically or phonetically balanced. As auditory perception is influenced by a variety of linguistic features, it is necessary to develop test materials for the listener’s mother tongue. The objective of our study was to compose and evaluate new lists of Lithuanian words to assess speech recognition abilities. Materials and Methods: The main criteria for composing new lists of Lithuanian words included the syllable structure and frequency, the correlation between consonant and vowel phonemes, the frequency of specific vowel and consonant phonemes, word familiarity and rate. The words for the new lists were chosen from the Frequency Dictionary of Written Lithuanian according to the above criteria. Word recognition was assessed at different levels of presentations. The word list data were analyzed using a linear mixed-effect model for repeated measures. Results: Two hundred bisyllabic words were selected and organized into four lists. The results showed no statistically significant difference between the four sets of words. The interaction of the word list and presentation level was not statistically significant. Conclusions: Monaural performance functions indicated good inter-list reliability with no significant differences between the word recognition scores on the different bisyllabic word lists at each of the tested intensities. The word lists developed are equivalent, reliable and can be valuable for assessing speech recognition in a variety of conditions, including diagnosis, hearing rehabilitation and research.
: Granulomatosis with Polyangiitis (GPA) is a rare, autoimmune, multisystemic disease characterized by vasculitis and necrotizing granuloma that commonly affects the upper and lower respiratory tract ...and kidneys. Audiovestibular dysfunction in GPA diseases may have different clinical presentations. The aim of the present study was to evaluate hearing function in patients with GPA and to compare the results with a healthy control group.
: A total of 34 individuals participated in the study. The GPA group consisted of 14 participants, and the control group was composed of 20 healthy participants with no signs or symptoms of ear disease. The ages ranged from 18 to 65 years old, with a mean age of 43.8 years. The participants underwent a complete audiological evaluation using otoscopy, impedance audiometry, pure tone audiometry, speech audiometry-evaluation of speech thresholds, and speech recognition in quiet. Both ears were tested. All of the participants of the study were native Lithuanian speakers. Data were statistically analyzed using the Statistical Analysis System software SAS
Studio 3.8. A
value < 0.05 was regarded as statistically significant.
: 92.85% of patients from the GPA group reported hearing-related symptoms: hearing loss, tinnitus, and fullness in the ears. The arithmetic means of all hearing thresholds at frequencies from 125 Hz to 8000 Hz were significantly higher in the GPA group. The results revealed statistically significant differences between the two groups in the Speech Detection Threshold, Speech Recognition Threshold, Speech Discomfort level, and Word Recognition Scores.
: The frequency of hearing loss, the average hearing thresholds, and speech thresholds were higher in GPA patients than in healthy individuals. The most common type of hearing loss was sensorineural. Audiological assessments should be considered during the routine evaluation of patients with GPA disease to prevent hearing-related disabilities.
PurposeTo evaluate changes in lamina cribrosa (LC) shape, curvature, and depth after trabeculectomy.DesignProspective, observational case series.ParticipantsA total of 112 patients (118 eyes) with ...open- or closed-angle glaucoma undergoing trabeculectomy.MethodsThe optic nerve head was imaged using enhanced depth imaging spectral-domain OCT before trabeculectomy and at 6 follow-up visits throughout the first postoperative year. The anterior LC surface and Bruch’s membrane opening were marked in the serial horizontal B scans for the analysis of LC parameters using Morphology 1.0 software. Postoperative morphologic LC changes were assessed.Main Outcome MeasuresThe postoperative LC global shape index (GSI), nasal-temporal (N-T) and superior-inferior (S-I) curvatures, and mean and sectoral LC depth (LCD).ResultsThe mean LC GSI increased only during the early postoperative period (P = 0.02), resulting in a change toward the saddle-rut shape. There was a flattening of the LC curvature in N-T (P < 0.001) and S-I (P = 0.003) meridians 12 months after trabeculectomy. A shallowing of the mean and sectoral LCD from baseline was significant throughout the entire follow-up period (P < 0.001) and progressed up to postoperative month 6. Twenty-eight patients showed a deepening of the LC from baseline in at least 1 visit. Eyes with shallower LCD compared with baseline responded to intraocular pressure (IOP) reduction with greater movement anteriorly than eyes with deeper LCD (P = 0.002). Greater IOP reduction (P = 0.007), less retinal nerve fiber layer thinning over the year (P = 0.003), and more superiorly-inferiorly curved baseline LC (P = 0.001) were associated with an increase in GSI. Younger age and IOP reduction were related to LC shallowing (P < 0.001, P = 0.002) and N-T flattening (P < 0.001).ConclusionsIn most eyes, trabeculectomy resulted in long-term flattening and shallowing of the LC. However, in some eyes, LC deepened from baseline. Change in LC global shape appeared to be temporal. Reduction in IOP plays an important role in the early phase of LC change; however, in the later phase, LC remodeling may play a crucial role in view of stable IOP.
We evaluated the changes in visual field mean deviation (VF MD) and retinal nerve fibre layer (RNFL) thickness in glaucoma patients undergoing trabeculectomy. One hundred patients were examined with ...VF and spectral-domain optical coherence tomography (OCT) before trabeculectomy and 4 follow-up visits over one year. Linear mixed models were used to investigate factors associated with VF and RNFL. VF improved during the first 3 months of follow-up (2.55 ± 1.06 dB/year) and worsened at later visits (-1.14 ± 0.29 dB/year). RNFL thickness reduced by -4.21 ± 0.25 µm/year from 1st month of follow-up. Eyes with an absence of initial VF improvement (β = 0.64; 0.30-0.98), RNFL thinning (β = 0.15; 0.08-0.23), increasing intraocular pressure (IOP; β = -0.11; -0.18 to -0.03) and severe glaucoma (β = -10.82; -13.61 to -8.02) were associated with VF deterioration. Eyes with VF deterioration (β = 0.19; 0.08-0.29), increasing IOP (β = -0.09; -0.17 to -0.01), and moderate (β = -6.33; -12.17 to -0.49) or severe glaucoma (β = -19.58; -24.63 to -14.52) were associated with RNFL thinning. Changes in RNFL structure and function occur over a 1-year follow-up period after trabeculectomy. Early VF improvement is more likely to occur in patients with mild/moderate glaucoma, whereas those with severe glaucoma show greater decline over one year. Our findings indicate that progression is observable using OCT, even in late-stage glaucoma.
Tinnitus affects around 15% of the population and can be a debilitating condition for a sizeable part of them. However, effective evidence-based treatments are scarce. One recommended treatment for ...tinnitus is cognitive behavioral therapy which has been found to be effective when delivered online. However, more treatments including mindfulness-based interventions have been studied recently in an attempt to facilitate the availability of effective treatments. There are promising findings showing great effects in reducing tinnitus-induced distress and some evidence about the efficacy of such intervention delivered online. However, there is a lack of evidence on how these two treatments compare against one another. Therefore, the aim of this study will be to compare Internet-delivered cognitive behavioral therapy for tinnitus against an Internet-delivered mindfulness-based tinnitus stress reduction intervention in a three-armed randomized controlled trial with a waiting list control condition.
This study will be a randomized controlled trial seeking to recruit Lithuanian-speaking individuals suffering from chronic tinnitus. The self-report measure Tinnitus Handicap Inventory will be used. Self-referred participants will be randomized into one of three study arms: Internet-delivered cognitive behavioral therapy, Internet-delivered mindfulness-based tinnitus stress reduction intervention, or a waiting-list control group. Post-treatment measures will be taken at the end of the 8-week-long intervention (or waiting). Long-term efficacy will be measured 3 and 12 months post-treatment.
Internet-delivered interventions offer a range of benefits for delivering evidence-based treatments. This is the first randomized controlled trial to directly compare Internet-delivered CBT and MBTSR for tinnitus in a non-inferiority trial.
ClinicalTrials.gov NCT05705323. Registered on January 30, 2023.
Abstract Objective To evaluate the success rate for revision tympanoplasty using different graft materials, to compare results of primary and re-tympanoplasty using the same technique and to analyse ...the effect of potential influencing factors on closure of tympanic membrane (TM) and hearing outcome. Methods Study included all patients, who underwent tympanoplasty ( n = 617) and re-tympanoplasty ( n = 94) for chronic otitis media without cholesteatoma in the period between September 1998 and 2007. The data of all patients on preoperative disease, perforation size and localization, middle ear status, surgical approach, graft material, adjunctive procedures, pre- and postoperative morphological (otomicroscopy) and functional (hearing examination evaluating pure-tone audiogram) results were analyzed. All operations were performed using an underlay technique and either the retroauricular or transcanal approach. The temporal fascia, perichondrium or cartilage–perichondrium composite grafts were used for the reconstruction of TM. Ossiculoplasty was performed as needed. The interrelation between multiple pre-operative parameters and post-operative morphological (closure of the perforation) and functional (hearing level) outcomes was analysed. Results Successful closure rates of the TM perforation were 93.6% and 90.2% of the patients in the primary and revision tympanoplasty groups, respectively. Graft take rate and hearing results did not depend on graft material. Structural changes were found more frequently in the re-tympanoplasty group (63.4% comparing to 29.5% of primary cases). Ossiculoplasty was performed more often in revision cases (24.4% comparing to 11.4% of primary cases). Successful hearing (ABG within 20 dB) for primary tympanoplasties was achieved in 81.1%, and for retympanoplasty – in 69.5% of the cases. ( p < 0.01). There were no interrelation between any estimated parameters and the graft take rate for either primary or revision tympanoplasty. Conclusions There is no evidence of increased risk of graft failure in re-tympanoplasty cases when compared to primary tympanoplasty operations. Hearing results depend on structural changes in the middle ear (ossicular abnormalities and tympanoscerosis) which in revision cases are found more often. No differences were found between fascia, perichondrum or cartilage-perichondrium grafts in terms of graft healing and hearing results.
Cochlear implantation (CI) is the main treatment method for deaf children. CI influences not only communication, but also psychosocial outcomes in children with severe to profound hearing loss. ...Focusing on issues specific to CI (e.g., self-reliance, social relations, education) may provide a more accurate and relative view of functional status of paediatric cochlear implant users. The objectives of this study were to translate into Lithuanian and adapt an international questionnaire of the quality of life after cochlear implantation and to evaluate parental perspectives regarding CI and the child's progress after a minimum of two years after surgery.
The parental questionnaire
was used to evaluate the quality of life following cochlear implantation. The questionnaire includes 74 items covering two main domains: decision-making (26 items) and the outcomes of implantation (48 items). Quality of life is estimated according to the scores of eight sub-domains: communication, general functioning, well-being, self-reliance, social relations, education, effects of implantation, and supporting the child.
The paediatric sample consisted of 11 (39%) girls and 17 (61%) boys, whose mean age at the time of cochlear implantation was 2.41 ± 2.25 years, mean duration of the implant use 3.7 ± 1.3 years. All the grand means in the outcomes of implantation domain exceeded 3 on the 5-point scale, meaning that parents viewed the quality of life of their children as either average or better. Parents rated the sub-domains of communication (3.90 ± 0.77 points), social relations (4.05 ± 0.41), and supporting the child (3.89 ± 0.49) most positively.
According to parents, the quality of life improves after the cochlear implantation, especially in the fields of communication, social relations and supporting the child.
Darbo tikslas. Ausies trimito tuboplastika lazeriu yra perspektyvus priežastinis lėtinių vidurinės ausies ligų gydymas. Šio darbo tikslas – įvertinti ausies trimito ryklinės angos lazerinės ...tuboplastikos efektyvumą lėtiniu sekreciniu vidurinės ausies uždegimu sergančių pacientų, kurie prieš tai buvo nesėkmingai gydyti operaciniu būdu.
Metodika. Atliktos 47 endoskopinės lazerinės ausies trimito tuboplastikos bei timpanostomijos tiriamojoje ir 46 timpanostomijos operacijos kontrolinėje grupėse. Pacientų vidutinis pooperacinio stebėjimo laikas – 36 ± 15,67 mėnesiai. Prieš tyrimą buvo vertinami tiriamųjų ir kontrolinės grupės asmenų anamnezės duomenys, atliekama otoskopija, rinoskopija, laringoskopija, timpanometrija, toninė slenkstinė audiometrija, Valsalvos testas, nosiaryklės ir ausies trimito ryklinės angos videoendoskopija. Timpanostominiai vamzdeliai šalinami praėjus 6 mėnesiams po operacijos. Gydymo efektyvumas buvo vertinamas atliekant otoskopiją, timpanogramą, toninę slenkstinę audiogramą, Valsalvos testą, nosiaryklės videoendoskopiją.
Rezultatai. Vertinant operacijos rezultatų efektyvumą objektyviai, po mėnesio pasveiko 19,1 %, pagerėjo 46,9 %, nepagerėjo 34 % pacientų. Vertinant rezultatus po 12 mėnesių, pasveikusiųjų buvo 36,2 %, būklė pagerėjo 29,8 %, o nepakito 34 % pacientų. Kontrolinėje grupėje rezultatai po mėnesio buvo panašūs (pasveiko 22,7 %, pagerėjo 52,3 %, nepagerėjo 25 %; p = 0,682), tačiau po 12 mėnesių gydymo rezultatai buvo daug blogesni (pasveiko 2,3 %, pagerėjo 38,6 %, nepagerėjo 59,1 %; p = 0,001). Koreliacija tarp videoendoskopijos pokyčių (fiksuotas spindžio atsidarymas) ir teigiamų gydymo rezultatų buvo statistiškai patikima (p = 0,000).
Išvados. Ausies trimito ryklinės angos lazerinė tuboplastika yra efektyvi procedūra lėtiniu sekreciniu vidurinės ausies uždegimu sergantiems pacientams, kai endoskopiškai nustatoma ausies trimito ryklinės angos funkcinė obstrukcija.
This study aimed to validate the Lithuanian version of the Dizziness Handicap Inventory (DHI-L), investigate its reliability, and perform factor analysis.
A standard protocol of translation was ...followed for psychometric instruments. A total of 108 patients (75.9% women), mean age 51.9 years, with peripheral or central dizziness and vertigo participated in our cross-sectional study. The internal consistency was measured by Cronbach's alpha coefficient and corrected item-total correlations (CI-TCs). After a week, 65 of the recruited patients were again asked to fill out Dizziness Handicap Inventory (DHI)-L to ascertain test-retest reliability (intraclass correlation, ICC). Concurrent validation was performed using Pearson correlation between the total score and subscales of DHI-L and the eight scales of Short Form-36 Health Survey (SF-36). Finally, the factor structure of the DHI was assessed by principal component analysis (PCA).
The Cronbach's alpha coefficient was very high (0.91). CI-TCs for DHI-L total scale ranged from 0.33 to 0.67. The correlations between DHI and SF-36 were high to weak. The ICC was excellent for the total score and its subscales. Our proposed two-factor model explained 44.5% of the variance. The first factor indicated disability in daily activities and psychological effect of handicap. The second factor comprised of items that pertained to postural instability.
The DHI-L has shown good reliability and validity. Results did not support the original subscale structure of the DHI. As more studies need to be done to restructure DHI, we recommend only using the total DHI score as a measure of dizziness handicap.
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