ObjectiveReliance on webinars for continuing medical education (CME) has increased since the onset of the COVID-19 pandemic. Here, we aimed to evaluate the teaching methods used in these ...webinars.DesignRetrospective, longitudinal study.Setting20 CME-approved webinars, conducted March–December 2020 in Germany, and lasting 2.25 hours each.ParticipantsOtorhinolaryngologists pursuing CME credits.InterventionsPostwebinar participant assessments of the speaker, effects on practical work, desired scientific content, technical quality, interactions, attention and future training behaviour.ResultsOn average, 780 participants joined each webinar. The mean survey response rate was 35% (n=282). When asked how well the speaker had mastered the content, 38% responded ‘very well’, 44% responded ‘well’, 14% indicated ‘satisfactory’ and 4% chose ‘sufficient’. The frequency of webinars was considered appropriate by 92%, too high by 4% and too low by 4% of participants. The measured attention of the participants was 90%. After the COVID-19 pandemic lockdown, 68% of participants preferred online teaching. The average costs per participant were €3.50 (about $4.25 or £3.15) per webinar.ConclusionsAlthough the pandemic context likely influenced the results, we conclude that periodic ear, nose and throat webinar training during COVID-19 in 2020 was an effective alternative delivery method. We found high attention rates, high levels of participant satisfaction and low costs. Evaluations and re-evaluations will be necessary to adapt teaching concepts successfully and ensure high levels of teaching and learning efficiency.
Introduction: Several factors are known to influence speech perception in cochlear implant (CI) users. To date, the underlying mechanisms have not yet been fully clarified. Although many CI users ...achieve a high level of speech perception, a small percentage of patients does not or only slightly benefit from the CI (poor performer, PP). In a previous study, PP showed significantly poorer results on nonauditory-based cognitive and linguistic tests than CI users with a very high level of speech understanding (star performer, SP). We now investigate if PP also differs from the CI user with an average performance (average performer, AP) in cognitive and linguistic performance. Methods: Seventeen adult postlingually deafened CI users with speech perception scores in quiet of 55 (9.32) % (AP) on the German Freiburg monosyllabic speech test at 65 dB underwent neurocognitive (attention, working memory, short- and long-term memory, verbal fluency, inhibition) and linguistic testing (word retrieval, lexical decision, phonological input lexicon). The results were compared to the performance of 15 PP (speech perception score of 15 11.80 %) and 19 SP (speech perception score of 80 4.85 %). For statistical analysis, U-Test and discrimination analysis have been done. Results: Significant differences between PP and AP were observed on linguistic tests, in Rapid Automatized Naming (RAN: p = 0.0026), lexical decision (LexDec: p = 0.026), phonological input lexicon (LEMO: p = 0.0085), and understanding of incomplete words (TRT: p = 0.0024). AP also had significantly better neurocognitive results than PP in the domains of attention (M3: p = 0.009) and working memory (OSPAN: p = 0.041; RST: p = 0.015) but not in delayed recall (delayed recall: p = 0.22), verbal fluency (verbal fluency: p = 0.084), and inhibition (Flanker: p = 0.35). In contrast, no differences were found hereby between AP and SP. Based on the TRT and the RAN, AP and PP could be separated in 100%. Discussion: The results indicate that PP constitute a distinct entity of CI users that differs even in nonauditory abilities from CI users with an average speech perception, especially with regard to rapid word retrieval either due to reduced phonological abilities or limited storage. Further studies should investigate if improved word retrieval by increased phonological and semantic training results in better speech perception in these CI users.
Objectives To investigate the expression of osteoclast‐activating and differentiating factors and to study the occurrence of osteoclast precursor cells and osteoclasts in acquired human cholesteatoma ...tissue.
Methods We examined 21 cholesteatoma samples versus 18 normal auditory canal skin specimens for the expression of osteoprotegerin ligand (OPGL), osteoprotegerin (OPG), and macrophage‐colony stimulating factor (M‐CSF) using reverse transcriptase–polymerase chain reaction (RT‐PCR) and immunohistochemistry. Immunohistochemistry and computer‐assisted microscopy using markers CD4, CD11a, CD11b, CD14, CD51, CD68, and TRAP obtained the detection of osteoclast cell lineage.
Results An increased expression of the investigated cytokines M‐CSF, OPG, and OPGL was demonstrated by immunohistochemistry and RT‐PCR in cholesteatoma tissue compared with normal external meatal skin. Several CD4‐positive cells exhibited a co‐expression for OPGL within the perimatrix of cholesteatoma. The presence of osteoclast precursor cells was confirmed in all samples of cholesteatoma tissue.
Conclusions This study reveals that the number of osteoclast precursor cells is markedly increased in the perimatrix of cholesteatoma tissue. Our results support a concept described for inflammatory arthritis: the inflammation related to cholesteatoma induces bone resorption by release of OPGL from activated T‐cells and triggers osteoclastogenesis. This could be a major target for drugs to inhibit osteoclast formation and bone resorption and may be an adjunct in cholesteatoma management.
Zusammenfassung
Hintergrund
Die chronische Otitis media (COM) kann durch Symptome wie Otorrhö, Schmerzen, Hörminderung, Tinnitus oder Schwindel zu einer erheblichen Beeinträchtigung der ...gesundheitsbezogenen Lebensqualität (Health-Related Quality of Life, HRQoL) führen. In den letzten Jahren entstand ein zunehmendes Interesse an der standardisierten Erhebung der HRQoL mit erkrankungsspezifischen Fragebögen (Patient-Reported Outcome Measure, PROM). Mit validierten PROM kann die HRQoL bei der COM systematisch gemessen werden und ergänzt so (semi)objektive Ergebnisparameter wie z. B. den audiometrisch erhobenen Hörverlust. Auf Deutsch existieren 2 erkrankungsspezifische validierte PROM für die COM, der Chronic Otitis Media Outcome Test (COMOT-15) und das Zurich Chronic Middle Ear Inventory (ZCMEI-21), welche in den letzten Jahren zunehmende Verbreitung gefunden haben.
Fragestellung
Die vorliegende narrative Übersichtsarbeit zeigt den gegenwärtigen Stand der Untersuchung der HRQoL bei der COM und deren chirurgischen Therapien auf.
Ergebnisse und Schlussfolgerung
Der wichtigste Einflussfaktor auf die HRQoL bei der COM ist das Hörvermögen. Durch eine chirurgische Therapie kommt es bei der COM mit oder ohne Cholesteatom i. d. R. zu einer klinisch relevanten Verbesserung der HRQoL. Im Fall einer COM mit Cholesteatom korreliert dessen Ausdehnung allerdings nicht mit der HRQoL. Während die HRQoL in der Indikationsstellung der chirurgischen Therapie bei einer COM mit Cholesteatom sekundär ist, spielt sie eine wichtige Rolle bei relativen Operationsindikationen, beispielsweise bei einer symptomatischen offenen Mastoidhöhle („Radikalhöhle“). Insgesamt sind präoperativ sowie während der Nachsorge regelmäßig angewendete erkrankungsspezifische PROM wichtige Instrumente zur Beurteilung von Therapien der COM sowohl beim einzelnen Patienten als auch in wissenschaftlichen Studien oder im Rahmen eines Qualitätsmonitorings.
In cochlear implantation with flexible lateral wall electrodes, a cochlear coverage of 70% to 80% is assumed to yield an optimal speech perception. Therefore, fitting the cochlear implant (CI) to the ...patient's individual anatomy has gained importance in recent years. For these reasons, the optimal angular insertion depth (AID) has to be calculated before cochlear implantation. One CI manufacturer offers a software that allows to visualize the AID of different electrode arrays. Here, it is hypothesized that these preoperative AID models overestimate the postoperatively measured insertion angle. This study aims to investigate the agreement between preoperatively estimated and postoperatively measured AID.
Retrospective cross-sectional study.
Single-center tertiary referral center.
Patients undergoing cochlear implantation.
Preoperative and postoperative high-resolution computed tomography (HRCT).
The cochlear duct length was estimated by determining cochlear parameters ( A value and B value), and the AID for the chosen electrode was (i) estimated by elliptic circular approximation by the software and (ii) measured manually postoperatively by detecting the electrode contacts after insertion.
A total of 80 HRCT imaging data sets from 69 patients were analyzed. The mean preoperative AID estimation was 662.0° (standard deviation SD, 61.5°), and the mean postoperatively measured AID was 583.9° (SD, 73.6°). In all cases (100%), preoperative AID estimation significantly overestimated the postoperative determined insertion angle (mean difference, 38.1°). A correcting factor of 5% on preoperative AID estimation dissolves these differences.
The use of an electrode visualization tool may lead to shorter electrode array choices because of an overestimation of the insertion angle. Applying a correction factor of 0.95 on preoperative AID estimation is recommended.
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