Objective: To determine the benefit of sequential cochlear implantation after a long inter-implantation interval in children with bilateral deafness receiving their second implant between 5 and 18... Show moreObjective: To determine the benefit of sequential cochlear implantation after a long inter-implantation interval in children with bilateral deafness receiving their second implant between 5 and 18 years of age. Study design: Prospective cohort-study. Setting: Tertiary multicenter. Patients: 85 children with bilateral deafness and unilateral implantation receiving a contralateral cochlear implant at the age of 5 to 18 years. Method: The primary outcomes were speech recognition in quiet and noise (CVC) scores. The secondary outcomes were language outcomes and subjective hearing abilities, all measured before and 12 months after sequential bilateral cochlear implantation. Medians of the paired data were compared using the Wilcoxon signed-rank test. Univariable linear regression analyses was used to analyze associations between variables and performance outcomes. Results: A significant benefit was found for speech recognition in quiet (96% [89-98] vs 91% [85-96]; p < 0.01) and noise (65% [57-75] vs 54% [47-71]; p = 0.01) in the bilateral CI condition compared to unilateral (n = 75, excluded 10 non-users). No benefit was seen for language outcomes. The subjective sound quality score was statistically significant higher in bilateral compared to the unilateral CI condition. Pre-operative residual hearing level in the ear of the second implant, the inter-implant interval and age at time of second implantation was not significantly associated with performance scores. Conclusion: After 12 months of use, sequential bilateral cochlear implantation showed improved speech perception in quiet and noise and improved subjective sound quality outcomes in children despite a great inter-implantation interval (median of 8 years [range 1-16 years]). Show less
Objectives:An association between tinnitus distress with anxiety and depression is described in literature. A similar relationship might exist between tinnitus distress and personality traits,... Show moreObjectives:An association between tinnitus distress with anxiety and depression is described in literature. A similar relationship might exist between tinnitus distress and personality traits, especially since associations between personality traits and other chronic diseases are already revealed. In this systematic review, we aim to investigate whether personality is a risk factor for tinnitus distress. Design:We searched PubMed and EMBASE databases from inception up to December 31, 2018 for articles on the association between tinnitus distress and personality. Two researchers screened titles, abstracts, and full texts for eligibility. Directness of evidence and risk of bias were assessed. From the included studies, study characteristics and outcome data of tinnitus distress and personality traits were extracted. Results:A total of 323 unique articles were screened of which 11 cross-sectional studies were eligible for critical appraisal and were used for data extraction. Including study populations were heterogenous, and studies scored high to moderate risk of bias. Nine out of 11 articles showed an association between tinnitus distress and the personality of neuroticism. Conclusions:By limitations in the methodology of included studies, the evidence on specific personality traits as a risk factor for tinnitus distress is inconclusive. Some evidence on a positive association with neuroticism is identified. To draw conclusions about causal relations, these further studies should be of longitudinal design in a cohort setting. These studies should assess tinnitus distress using validated questionnaires with multiple personality dimensions and validated questionnaires to assess personality traits. Show less
ObjectiveThe objective of this study was to assess the attitude and behaviour of Dutch ENT surgeons and ENT residents towards Evidence Based Medicine.IntroductionEvidence Based Medicine is the... Show moreObjectiveThe objective of this study was to assess the attitude and behaviour of Dutch ENT surgeons and ENT residents towards Evidence Based Medicine.IntroductionEvidence Based Medicine is the cornerstone of modern clinical care. It is considered of crucial importance for optimal patient care and health care quality. Practicing it requires positive attitude and behaviour. Little is known about the attitude and behaviour towards Evidence Based Medicine in otorhinolaryngology.MethodsWe performed a web-based questionnaire among 607 Dutch Ear- Nose & Throat surgeons of whom 106 residents (cross-sectional study). The questionnaire consisted of 3 parts; (1) personal characteristics, (2) questions regarding Evidence Based Medicine attitude (McColl questionnaire, scale 0-100%) and (3) questions regarding Evidence Based Medicine behaviour (barriers and information seeking behaviour). Data were collected between March 26th 2018 and June 1st 2018.ResultsThe median score on the overall McColl questionnaire was 50 (IQR 35). The main barriers respondents experienced were time related. Limited time in the outpatient clinic was considered a more important barrier for residents to practice EBM compared to ENT surgeons. Respondents gut feeling and their own preference were identified as the main contributing factors in clinical decision making.ConclusionIn conclusion Dutch ENT surgeons have a moderate attitude on the McColl questionnaire. The main barriers to practice Evidence Based Medicine they experience are time related. Show less
Kraaijenga, V.J.C.; Ramakers, G.G.J.; Smulders, Y.E.; Zon, A. van; Stegeman, I.; Smit, A.L.; ... ; Grolman, W. 2017
