Endre søk
Begrens søket
12 1 - 50 of 69
RefereraExporteraLink til resultatlisten
Permanent link
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annet format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annet språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Treff pr side
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sortering
  • Standard (Relevans)
  • Forfatter A-Ø
  • Forfatter Ø-A
  • Tittel A-Ø
  • Tittel Ø-A
  • Type publikasjon A-Ø
  • Type publikasjon Ø-A
  • Eldste først
  • Nyeste først
  • Skapad (Eldste først)
  • Skapad (Nyeste først)
  • Senast uppdaterad (Eldste først)
  • Senast uppdaterad (Nyeste først)
  • Disputationsdatum (tidligste først)
  • Disputationsdatum (siste først)
  • Standard (Relevans)
  • Forfatter A-Ø
  • Forfatter Ø-A
  • Tittel A-Ø
  • Tittel Ø-A
  • Type publikasjon A-Ø
  • Type publikasjon Ø-A
  • Eldste først
  • Nyeste først
  • Skapad (Eldste først)
  • Skapad (Nyeste først)
  • Senast uppdaterad (Eldste først)
  • Senast uppdaterad (Nyeste først)
  • Disputationsdatum (tidligste først)
  • Disputationsdatum (siste først)
Merk
Maxantalet träffar du kan exportera från sökgränssnittet är 250. Vid större uttag använd dig av utsökningar.
  • 1. A, Borgström
    et al.
    P, Nerfeldt
    Friberg, Danielle
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Questionnaire OSA-18 has poor validity compared to polysomnography in pediatric obstructive sleep apnea.2013Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464Artikkel i tidsskrift (Fagfellevurdert)
  • 2.
    Alm, Fredrik
    et al.
    Örebro universitet, Institutionen för hälsovetenskaper. Department of Anaesthesia and Intensive Care, School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Jaensson, Maria
    Örebro universitet, Institutionen för hälsovetenskaper.
    Lundeberg, Stefan
    Pain Treatment Service, Astrid Lindgren Children's Hospital, Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden.
    Ericsson, Elisabeth
    Örebro universitet, Institutionen för hälsovetenskaper.
    Adherence to Swedish guidelines for pain treatment in relation to pediatric tonsil surgery: A survey of the multidisciplinary team2017Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 101, s. 123-131Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Pain management in children after tonsil surgery is essential, and optimal pain treatment has been discussed for many years. Data from the National Tonsil Register in Sweden (NTRS) and a national mapping system have demonstrated the need for national pain treatment guidelines for pediatric tonsil surgery. As a result, Swedish national guidelines, together with updated patient information on the website tonsilloperation.se, were developed and implemented in 2013.

    Objectives The objective of this study was to evaluate the professionals’ opinions of and adherence to pain treatment guidelines for pediatric tonsil surgery patients in a two-year follow-up.

    Method: This descriptive cross-sectional study was based on data from an inter-professional questionnaire, which was validated by an expert group using a content validity index (S-CVI 0.93). The questionnaire was sent to all Swedish ear, nose and throat (ENT) departments (n=49) that the NTRS identified as performing tonsil surgery on children younger than 18 years of age. In each clinic, we asked for responses from staff in each of the following professions: ENT physicians, anesthesia physicians, registered nurse anesthetists, and registered nurses in the ENT departments.

    Results: Respondents from 48 ENT departments participated, and 139/163 (85%) completed questionnaires were returned. The guidelines were reported as being clear, ensuring patient safety and providing optimal pharmacological treatment. Treatment was given according to the guidelines: Half of the departments gave pre- or intraoperative treatment with clonidine, betamethasone and high-dose paracetamol (acetaminophen). A multimodal pain approach (paracetamol and COX inhibitors) after hospital discharge was prescribed by all departments after tonsillectomy and, more extensively, after tonsillotomy. One-third of the departments prescribed paracetamol with a higher normal dose for the first three postoperative days. Half of the departments prescribed rescue analgesics, clonidine or opioids after tonsillectomy. None of the departments prescribed codeine or tramadol, drugs that are discouraged in the guidelines. The majority of the departments used the website tonsilloperation.se to provide information to the patients and their caregivers.

    Conclusion: The respondents' opinions of and the ENT departments adherence to the Swedish national guidelines were considered to be good. The national implementation process in Sweden has impacted the manner in which ENT departments treat pain after tonsil surgery.

  • 3. Anmyr, Lena
    et al.
    Larsson, Kjerstin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Forskning om funktionshinder och habilitering.
    Olsson, Mariann
    Freijd, Anders
    Strengths and difficulties in children with cochlear implants: Comparing self-reports with reports from parents and teachers2012Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 76, nr 8, s. 1107-1112Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: The aim was to explore and compare how children with cochlear implants, their parents, and their teachers perceive the children's mental health in terms of emotional and behavioral strengths and difficulties.

    Methods: The self-report, parents', and teachers' versions of the Strengths and Difficulties Questionnaire (SDQ) were used to assess the mental health of 22 children with cochlear implants. The children's assessments were then compared to the parents' and 17 teachers' assessments. The data were analyzed using the SPSS software package.

    Results: Total difficulties (p = .000), emotional symptoms (p = .000), and conduct problems (p = .007) were greater according to the children than according to parents and teachers. Younger children (9 years, n = 12) reported more emotional symptoms than older children (12 and 15 years, n = 10). Almost a quarter of the children rated themselves in a way indicating mental ill-health. Parents and teachers each indicated mental ill-health for one child.

    Conclusions: Children with cochlear implants express greater concerns about their mental health than their parents and teachers do. This is important knowledge for adults in families, schools, and health care in order to support these children and offer treatment when needed.

  • 4. Anmyr, Lena
    et al.
    Olsson, Mariann
    Freijd, Anders
    Larsson, Kjerstin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Forskning om funktionshinder och habilitering.
    Sense of coherence, social networks, and mental health among children with a cochlear implant2015Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 79, nr 4, s. 610-615Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: The aim of this study was to explore the personal and social resources of children with a cochlear implant from a child's perspective. Method: This descriptive cross-sectional study included 19 children with cochlear implants, aged 9-12 years. Data was collected, using the children's sense of coherence (CSOC) scale, the Network map, and the strengths and difficulties questionnaire (SDQ). The data was analyzed using descriptive and correlation statistics. Results: Most children had a strong sense of coherence. School life was an important arena for their social network. The mental health was comparable to normal hearing children. Still, some of the children with implants had low SOC and poor mental health. High SOC and closeness of the social network, especially in school, were associated with good mental health. Conclusion: This study shows that Swedish school-aged children with cochlear implants as a group have access to personal and social resources as strong sense of coherence and social networks. Still, there are individual children with psychosocial problems who need support and treatment.

  • 5.
    Anmyr, Lena
    et al.
    Karolinska Institutet.
    Olsson, Mariann
    Karolinska Institutet.
    Larsson, Kjerstin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Forskning om funktionshinder och habilitering.
    Freijd, Anders
    Children with hearing impairment: living with cochlear implants or with hearing aids2011Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 75, nr 6, s. 844-849Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective

    The aim of this study was to enhance knowledge about the life circumstances of children with cochlear implants or hearing aids, regarding daily functioning and attitude to the impairment.

    Methods

    Data were obtained from 36 children with cochlear implants and 38 children with hearing aids via study-specific questionnaires with fixed answer alternatives. The questions covered (1) usage of aids and related factors, (2) hearing in different everyday situations, (3) thoughts about the children's own hearing and others’ attitudes to it, and (4) choice of language. The data were analyzed using SPSS, and presented via the theoretical frame of the International Classification of Functioning, Disability and Health, Child and Youth version (ICF-CY).

    Results

    Children with CI and HA functioned equally well in daily life, but there were also certain differences. Symptoms from neck and shoulders were more common among children with hearing aids than among children with cochlear implants (p < .001). Children with hearing aids used their aids significantly less often than those with cochlear implants (p < .001). The participation variables showed that children with hearing aids had significantly more hearing problems in team sports (p = .033) and outdoor activities (p = .019), in comparison to children with cochlear implants. The two groups had similar thoughts regarding their own hearing, mostly considering it not to be a problem. They also did not generally think that other people found their hearing to be a problem.

    Conclusions

    Children with cochlear implants and children with hearing aids have, in some aspects, equally good functioning in everyday life situations. However, certain differences were found in dimensions of functioning, regarding neck and shoulder pain, usage of aids and sign language, and hearing problems in some activities.

  • 6. Borg, Erik
    et al.
    Edquist, Gertrud
    Reinholdson, Anna-Clara
    Risberg, Arne
    KTH, Skolan för datavetenskap och kommunikation (CSC), Tal, musik och hörsel, TMH.
    McAllister, Bob
    Speech and language development in a population of Swedish hearing-impaired pre-school-children, a cross-sectional study2007Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 71, nr 7, s. 1061-1077Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: There is little information on speech and language development in preschool children with mild, moderate or severe hearing impairment. The primary aim of the study is to establish a reference material for clinical use covering various aspects of speech and language functions and to relate test values to pure tone audiograms and parents' judgement of their children's hearing and language abilities. Methods: Nine speech and language tests were applied or modified, both classical tests and newly developed tests. Ninety-seven children with normal hearing and 156 with hearing impairment were tested. Hearing was 80 dB HL PTA or better in the best ear. Swedish was their strongest language. None had any additional diagnosed major handicaps. The children were 4-6 years of age. The material was divided into 10 categories of hearing impairment, 5 conductive and 5 sensorineural: unilateral; bilateral 0-20; 21-40; 41-60; 61-80 dB HL PTA. The tests, selected on the basis of a three component language model, are phoneme discrimination; rhyme matching; Peabody Picture Vocabulary Test (PPVT-III, word perception); Test for Reception of Grammar (TROG, grammar perception); prosodic phrase focus; rhyme construction; Word Finding Vocabulary Test (word production); Action Picture Test (grammar production); oral motor test. Results: Only categories with sensorineural toss showed significant differences from normal. Word production showed the most marked delay for 21-40 dB HL: 5 and 6 years p < 0.01; for 41-60 dB: 4 years p < 0.01 and 6 years p < 0.01 and 61-80 dB: 5 years p < 0.05. Phoneme discrimination 21-40 dB HL: 6 years p < 0.05; 41-60 dB: 4 years p < 0.01; 61-80 dB: 4 years p < 0.001, 5 years p < 0.001. Rhyme matching: no significant difference as compared to normal data. Word perception: sensorineural 41-60 dB HL: 6 years p < 0.05; 61-80 dB: 4 years p < 0.05; 5 years p < 0.01. Grammar perception: sensorineural 41-60 dB HL: 6 years p < 0.05; 61-80 dB: 5 years p < 0.05. Prosodic phrase focus: 41-60 dB HL: 5 years p < 0.01. Rhyme construction: 41-60 dB HL: 4 years p < 0.05. Grammar production: 61-80 dB HL: 5 years p < 0.01. Oral motor function: no differences. The Word production test showed a 1.5-2 years delay for sensorineural impairment 41-80 dB HL through 4-6 years of age. There were no differences between hearing-impaired boys and girls. Extended data for the screening test [E. Borg, A. Risberg, B. McAllister, B.M. Undemar, G. Edquist, A.C. Reinholdsson, et at., Language development in hearing-impaired children. Establishment of a reference material for a "Language test for hearing-impaired children", Int. J. Pediatr. Otorhinolaryngot. 65 (2002) 15-26] are presented. Conclusions: Reference values for expected speech and language development are presented that cover nearly 60% of the studied population. The effect of the peripheral hearing impairment is compensated for in many children with hearing impairment up to 60 dB HL. Above that degree of impairment, language delay is more pronounced, probably due to a toss of acuity. The importance of central cognitive functions, speech reading and signing for compensation of peripheral limitations is pointed out.

  • 7. Borg, Erik
    et al.
    Edquist, Gertrud
    Reinholdson, Anna-Clara
    Risberg, Arne
    McAllister, Bob
    Stockholms universitet, Humanistiska fakulteten, Institutionen för lingvistik.
    Speech and language development in a population of Swedish hearing-impaired pre-school-children, a cross-sectional study2007Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 71, nr 7, s. 1061-1077Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: There is little information on speech and language development in preschool children with mild, moderate or severe hearing impairment. The primary aim of the study is to establish a reference material for clinical use covering various aspects of speech and language functions and to relate test values to pure tone audiograms and parents' judgement of their children's hearing and language abilities. Methods: Nine speech and language tests were applied or modified, both classical tests and newly developed tests. Ninety-seven children with normal hearing and 156 with hearing impairment were tested. Hearing was 80 dB HL PTA or better in the best ear. Swedish was their strongest language. None had any additional diagnosed major handicaps. The children were 4-6 years of age. The material was divided into 10 categories of hearing impairment, 5 conductive and 5 sensorineural: unilateral; bilateral 0-20; 21-40; 41-60; 61-80 dB HL PTA. The tests, selected on the basis of a three component language model, are phoneme discrimination; rhyme matching; Peabody Picture Vocabulary Test (PPVT-III, word perception); Test for Reception of Grammar (TROG, grammar perception); prosodic phrase focus; rhyme construction; Word Finding Vocabulary Test (word production); Action Picture Test (grammar production); oral motor test. Results: Only categories with sensorineural toss showed significant differences from normal. Word production showed the most marked delay for 21-40 dB HL: 5 and 6 years p < 0.01; for 41-60 dB: 4 years p < 0.01 and 6 years p < 0.01 and 61-80 dB: 5 years p < 0.05. Phoneme discrimination 21-40 dB HL: 6 years p < 0.05; 41-60 dB: 4 years p < 0.01; 61-80 dB: 4 years p < 0.001, 5 years p < 0.001. Rhyme matching: no significant difference as compared to normal data. Word perception: sensorineural 41-60 dB HL: 6 years p < 0.05; 61-80 dB: 4 years p < 0.05; 5 years p < 0.01. Grammar perception: sensorineural 41-60 dB HL: 6 years p < 0.05; 61-80 dB: 5 years p < 0.05. Prosodic phrase focus: 41-60 dB HL: 5 years p < 0.01. Rhyme construction: 41-60 dB HL: 4 years p < 0.05. Grammar production: 61-80 dB HL: 5 years p < 0.01. Oral motor function: no differences. The Word production test showed a 1.5-2 years delay for sensorineural impairment 41-80 dB HL through 4-6 years of age. There were no differences between hearing-impaired boys and girls. Extended data for the screening test [E. Borg, A. Risberg, B. McAllister, B.M. Undemar, G. Edquist, A.C. Reinholdsson, et at., Language development in hearing-impaired children. Establishment of a reference material for a ""Language test for hearing-impaired children"", Int. J. Pediatr. Otorhinolaryngot. 65 (2002) 15-26] are presented. Conclusions: Reference values for expected speech and language development are presented that cover nearly 60% of the studied population. The effect of the peripheral hearing impairment is compensated for in many children with hearing impairment up to 60 dB HL. Above that degree of impairment, language delay is more pronounced, probably due to a toss of acuity. The importance of central cognitive functions, speech reading and signing for compensation of peripheral limitations is pointed out.

  • 8. Brown, C.
    et al.
    Magnusson, Bengt
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oto-Rhino-Laryngologi. Östergötlands Läns Landsting, RC - Rekonstruktionscentrum, ÖNH - Öron- Näsa- Halskliniken.
    On the physics of the infant feeding bottle and middle ear sequela: Ear disease in infants can be associated with bottle feeding2000Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 54, nr 1, s. 13-20Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: When using conventional feeding bottles, negative pressure is generated in the oral cavity, as well as, in the bottle when fluid is removed by sucking. The negative pressure inside the bottle causes the infant to suck excessively and the intraoral negative pressure may subsequently be transmitted to the middle ear via the eustachian tube. Methods: In seven infants, simultaneous pressure recordings were performed in the feeding vessel and the middle ear using three types of feeding bottles. Results: With conventional non-ventilated and under-ventilated bottles a negative pressure formed while the infant sucked and negative intratympanic pressure was frequently generated. Conclusions: It is suggested that this sequence of events may lead to secretory otitis and it's accompanying consequences. In contrast, a fully ventilated bottle showed positive pressure throughout the feeding procedure, which is similar to normal breast-feeding, and negative pressure changes were not recorded in the middle ear.

  • 9. Brunne, M.
    et al.
    Falk, B.
    Hellström, S.
    Magnusson, Bengt
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oto-Rhino-Laryngologi. Östergötlands Läns Landsting, RC - Rekonstruktionscentrum, ÖNH - Öron- Näsa- Halskliniken.
    Qualitative research methods in otorhinolaryngology.1999Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 51Artikkel i tidsskrift (Fagfellevurdert)
  • 10. Brunne, M.
    et al.
    Falk, B.
    Hellström, S.
    Magnusson, Bengt
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oto-Rhino-Laryngologi. Östergötlands Läns Landsting, RC - Rekonstruktionscentrum, ÖNH - Öron- Näsa- Halskliniken.
    The character and consequenses of disturbing sound sensations in retraction type middle ear disease.1999Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 51, s. 11-21Artikkel i tidsskrift (Fagfellevurdert)
  • 11. Bunne, Marie
    et al.
    Falk, Bernt
    Hellström, Sten
    Magnusson, Bengt
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oto-Rhino-Laryngologi. Östergötlands Läns Landsting, RC - Rekonstruktionscentrum, ÖNH - Öron- Näsa- Halskliniken.
    Variability of Eustachian tube function in children with secretory otitis media. Evaluations at tube insertion and at follow-up2000Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 52, nr 2, s. 131-141Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: Despite the variable clinical course of diseases related to Eustachian tube function, the variability of tubal function has been less focused than outcomes of single tests. This study aimed to compare the passive and active tubal function and its variability in children with secretory otitis media (SOM) at tube insertion and at follow-up. Method: Thirty-eight ears in 19 children aged 4-10 years (mean 7.0 years) with long-standing SOM were examined 4-6 h after tube insertion, at 4 months and at 9 months. The pressure in the middle ear and the nasopharynx were recorded while performing (1) forced opening test, (2) equalization of +100 and −100 daPa, (3) Valsalva test, and (4) sniff test. The procedure was repeated after 30 min. Relationships were analyzed by uni- and multi-variate analysis of variance. Results: From tube insertion to 4 months, the mean forced opening pressure increased from 282±128 to 355±153 daPa (P<0.01), and the mean closing pressure from 91±51 to 126±82 daPa (P<0.01). There was no further change at 9 months. Female gender, serous effusion (in contrast to mucoid), and more than three previous episodes of acute otitis media were related to higher opening and closing pressures. At tube insertion, 60% and 16% equalized +100 and −100 daPa, respectively, and 28% succeeded in performing Valsalva inflation. The sniff test was positive in 32%, indicating a closing failure. These rates did not change significantly over time. For individual ears, outcomes of all tests varied considerably when retested after 30 min; Po changed by ±12% and Pc by ±26%, and 9-29% of the ears changed from a positive to negative response, or vice versa, in the equalization, Valsalva, and sniff tests. Conclusions: The unexpected finding of weaker closing forces at the day of tube insertion and increased tubal resistance at follow-up might be ascribed to changes in the muco-adhesive forces related to the disease and tube treatment. The pronounced intra-individual variability of test outcomes indicates that tubal function is dynamic and variable in ears prone to SOM, which emphasizes that results of single tubal function tests have very low prognostic value.

  • 12.
    Edfeldt, Lennart
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Kinnefors, Anders
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Strömbäck, Karin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Köbler, Susanne
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Rask-Andersen, Helge
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Surgical treatment of paediatric cholesteatoma: Long-term follow up in comparison with adults2012Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 76, nr 8, s. 1091-1097Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: This study was designed to analyse long-term results after surgery of acquired (ACH) and congenital cholesteatoma (CCH) of the middle ear in children and compare these with adults.

    Methods: Computer-based analysis of consecutively operated paediatric patients for ACH and CCH in a tertiary referral centre was made in 57 cases under the age of 12 operated 1983-2004 by three surgeons using identical technique. A canal wall down and total reconstruction procedure (TRP) with obliteration of the mastoid cavity, canal wall reconstruction, ossiculoplasty with consistent use of autologous bone and an "aeration enhancement procedure" (AEP) with silicon sheet in selected cases were used. Pre- and post-operative PTA (0.5-3 kHz) and pure-tone average air-bone gap (PTA-ABG) together with surgical parameters were assessed 1, 3 and 6 years following surgery.

    Results: Results showed stable hearing over 6 years with low incidence of persistent and recurrent disease comparable with results from adult patients. In nearly half of the cases, silastic sheeting was used. In 21 cases, stapes was eroded. Bone conduction thresholds levels remained unaffected 6 years after surgery. No deaf ears, postoperative facial dysfunction or other lesions related to surgery were observed. Six years after surgery every evaluated ear was found to be water-resistant and infection-free.

    Conclusion: Our results suggest that one-stage eradication of ACH and CCH in children using total reconstruction procedure (TRP) provide long-term improvement or preservation of hearing, with a low incidence of persistent or recurrent disease. No difference in surgical outcome between children and adults was found.

  • 13.
    Engstrom, Elisabet
    et al.
    Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden.
    Kallioinen, Petter
    Stockholm Univ, Sweden.
    von Mentzer, Cecilia
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutet för handikappvetenskap (IHV).
    Lindgren, Magnus
    Lund Univ, Sweden.
    Ors, Marianne
    Lund Univ, Sweden; Skane Univ Hosp, Sweden.
    Sahlen, Birgitta
    Lund Univ, Sweden.
    Lyxell, Björn
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutet för handikappvetenskap (IHV).
    Uhlen, Inger
    Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden.
    Computer-assisted reading intervention for children with sensorineural hearing loss using hearing aids: Effects on auditory event-related potentials for and mismatch negativity2019Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 117, s. 17-25Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: The primary aim was to investigate whether computer-assisted reading intervention somehow can affect event-related potentials (ERP) and mismatch negativity (MMN) in hearing impaired (HI) children with hearing aids (HAs) and normal hearing (NH) children. Methods: The study included 15 HI children with sensorineural hearing loss (SNHL) using bilateral HAs and 14 NH children as a reference group; all children between the ages of 5 and 8. A multi-feature MMN-paradigm, Optimum-1, with a standard stimulus alternating with 5 different deviants was used. ERPs were recorded pre and post intervention, i.e. one month of repeatedly computer-assisted training (GraphoGame). MMN was calculated from the average ERP of each deviant minus standard. Data were based on samples within a specific time interval, 80-224 ms, and repeated measures ANOVA was used to analyze possible interactions. Results: There was a significant difference between groups before training, though, the mean obligatory responses or MMN was not statistically significantly different before versus after training, neither among the NH nor the HI children. Further, the HI children did generally achieve lower levels in GraphoGame compared to the NH children. Altogether, our findings indicate differences between the groups and that training may affect the neurophysiological processing in the brain, gaining the HI children. Both MMN and positive mismatch response (pMMR) were seen among both the HA and NH children, irrespective to deviant type. Individually, changes of the MMN and pMMR after training seem unpredictable. Conclusion: There are statistically significant differences in both the obligatory responses in ERP and the MMNs between the NH and HI groups before the computer-assisted training. Though, these differences disappear after the intervention. This suggests possible training effects regarding the central auditory processing among the HI children.

  • 14.
    Engström, Elisabet
    et al.
    Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet.
    Kallioinen, Petter
    Department of Linguistics, Stockholm University.
    Nakeva von Mentzer, Cecilia
    Department of Behavorial Sciences and Learning, Swedish Institute for Disability Research, Linköping University.
    Lindgren, Magnus
    Department of Psychology, Lund University, 221 00 Lund.
    Ors, Marianne
    Department of Clinical Neurophysiology, Skåne University Hospital, 221 85 Lund.
    Sahlén, Birgitta
    Lund University, Faculty of Medicine, Department of Clinical Sciences, Logopedics, Phoniatrics & Audiology, Lasarettsgatan 21, 22 185 Lund.
    Lyxell, Björn
    Department of Behavorial Sciences and Learning, Swedish Institute for Disability Research, Linköping University, 581 83 Linköping.
    Uhlén, Inger
    Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, 171 77 Stockholm,.
    Computer-assisted reading intervention for children with sensorineural hearing loss using hearing aids: Effects on auditory event-related potentials and mismatch negativity2019Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 117, s. 17-25Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES:

    The primary aim was to investigate whether computer-assisted reading intervention somehow can affect event-related potentials (ERP) and mismatch negativity (MMN) in hearing impaired (HI) children with hearing aids (HAs) and normal hearing (NH) children.

    METHODS:

    The study included 15 HI children with sensorineural hearing loss (SNHL) using bilateral HAs and 14 NH children as a reference group; all children between the ages of 5 and 8. A multi-feature MMN-paradigm, Optimum-1, with a standard stimulus alternating with 5 different deviants was used. ERPs were recorded pre and post intervention, i.e. one month of repeatedly computer-assisted training (GraphoGame). MMN was calculated from the average ERP of each deviant minus standard. Data were based on samples within a specific time interval, 80-224 ms, and repeated measures ANOVA was used to analyze possible interactions.

    RESULTS:

    There was a significant difference between groups before training, though, the mean obligatory responses or MMN was not statistically significantly different before versus after training, neither among the NH nor the HI children. Further, the HI children did generally achieve lower levels in GraphoGame compared to the NH children. Altogether, our findings indicate differences between the groups and that training may affect the neurophysiological processing in the brain, gaining the HI children. Both MMN and positive mismatch response (pMMR) were seen among both the HA and NH children, irrespective to deviant type. Individually, changes of the MMN and pMMR after training seem unpredictable.

    CONCLUSION:

    There are statistically significant differences in both the obligatory responses in ERP and the MMNs between the NH and HI groups before the computer-assisted training. Though, these differences disappear after the intervention. This suggests possible training effects regarding the central auditory processing among the HI children.

  • 15. Engström, Elisabet
    et al.
    Kallioinen, Petter
    Stockholms universitet, Humanistiska fakulteten, Institutionen för lingvistik.
    von Mentzer, Cecilia Nakeva
    Lindgren, Magnus
    Ors, Marianne
    Sahlén, Birgitta
    Lyxell, Björn
    Uhlén, Inger
    Computer-assisted reading intervention for children with sensorineural hearing loss using hearing aids: Effects on auditory event-related potentials for and mismatch negativity2019Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 117, s. 17-25Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: The primary aim was to investigate whether computer-assisted reading intervention somehow can affect event-related potentials (ERP) and mismatch negativity (MMN) in hearing impaired (HI) children with hearing aids (HAs) and normal hearing (NH) children.

    Methods: The study included 15 HI children with sensorineural hearing loss (SNHL) using bilateral HAs and 14 NH children as a reference group; all children between the ages of 5 and 8. A multi-feature MMN-paradigm, Optimum-1, with a standard stimulus alternating with 5 different deviants was used. ERPs were recorded pre and post intervention, i.e. one month of repeatedly computer-assisted training (GraphoGame). MMN was calculated from the average ERP of each deviant minus standard. Data were based on samples within a specific time interval, 80-224 ms, and repeated measures ANOVA was used to analyze possible interactions.

    Results: There was a significant difference between groups before training, though, the mean obligatory responses or MMN was not statistically significantly different before versus after training, neither among the NH nor the HI children. Further, the HI children did generally achieve lower levels in GraphoGame compared to the NH children. Altogether, our findings indicate differences between the groups and that training may affect the neurophysiological processing in the brain, gaining the HI children. Both MMN and positive mismatch response (pMMR) were seen among both the HA and NH children, irrespective to deviant type. Individually, changes of the MMN and pMMR after training seem unpredictable.

    Conclusion: There are statistically significant differences in both the obligatory responses in ERP and the MMNs between the NH and HI groups before the computer-assisted training. Though, these differences disappear after the intervention. This suggests possible training effects regarding the central auditory processing among the HI children.

  • 16.
    Ericsson, Elisabeth
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Brattwall, Metha
    Anesthesia and Intensive Care, Sahlgrenska University Hospital, Mölndal, Sweden.
    Lundeberg, Stefan
    Pain treatment service, Astrid Lindgren Children's Hospital, Stockholm, Sweden; Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden .
    Swedish guidelines for the treatment of pain in tonsil surgery in pediatric patients up to 18 years2015Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 79, nr 4, s. 443-450Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Surgery of the tonsils often causes severe pain lasting for many days as been shown by data from the National Tonsil Surgery Register in Sweden. Tonsillotomy is associated with fewer readmissions due to bleeding, number of days requiring analgesics and health care contacts due to pain compared to tonsillectomy. The register data demonstrate the necessity of better-evidenced based pain treatment guidelines for tonsil-surgery.

    Objectives: To develop evidenced based pain treatment guidelines for tonsil-surgery in Sweden.

    Methods: The evidence based guidelines were designed by an updated literature review and from the clinical expertise in the pediatric pain field, which thereafter were reviewed by ENT-doctors and anesthetists from each ENT-clinic in Sweden.

    Results: A multimodal pain treatment approach is advocated, including premedication and administration during anesthesia, with paracetamol (acetaminophen), clonidine and betamethasone. If not given as a premedication the combination can be administered intravenously in the initial phase of anesthesia. At the end of surgery, if no bleeding problems, cox-inhibitors can be given.After discharge from hospital, the recommendations for pain relief are paracetamol combined with cox-inhibitors (ibuprofen, diclofenac) and if needed oral clonidine in favor of opioids. When pain intensity decreases, discontinue the analgesic treatment in the following order: opioid, clonidine, paracetamol and at last ibuprofen. The need for analgesic treatment after tonsillectomy is usually 5-8 days, after tonsillotomy only 3-5 days.Parents are recommended to contact the hospital if the child has difficulties in drinking or eating adequately and/or suffers from pain despite taking the recommended medication regularly.

    Conclusions: Swedish guidelines for tonsil-surgery provide practical evidence-based pain treatment recommendations.

  • 17.
    Ericsson, Elisabeth
    et al.
    Department of Nursing Science, School of Health Sciences, Jönköping University, Jönköping; Department of clinical and experimental medicine, Division of Oto-rhino-laryngology, Linköping University, Linköping.
    Lundeborg, Inger
    Department of clinical and experimental medicin, Division of speech and language pathology, Linköping University, Linköping.
    Hultcrantz, Elisabeth
    Department of clinical and experimental medicine, Division of Oto-rhino-laryngology, Linköping University, Linköping.
    Child Behavior and quality of life before and after tonsillotomy versus tonsillectomy2009Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 73, nr 9, s. 1254-1262Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: Compare two techniques for pediatric tonsil surgery with respect to postoperative pain and morbidity and changes in sleep behavior, health related quality of life (HRQL) and benefits due to surgery.

    Methods: 67 children (4.5–5.5 years) with tonsillar hypertrophy and obstructive sleep-disordered breathing with or without recurrent tonsillitis were randomized to either regular tonsillectomy (TE) (n = 32) or intracapsular tonsillectomy/tonsillotomy (TT) (n = 35) with Radiofrequency surgical technique (ellman Int.). Before TT/TE, the parents completed a validated Quality of Life survey of pediatric obstructive sleep apnea, the OSA-18 (Obstructive Sleep Apnea-18) and a standardized assessment of their children’s behavior with the Child Behavior Checklist (CBCL). Six months after surgery, the parents repeated these measurements, and assessed the health related benefits of the surgery using the Glasgow Children’s Benefit Inventory (GCBI).

    Results: In the TT group, the children recorded less pain from the first day after surgery on wards, used fewer doses of painkillers and were pain-free 3 days earlier than the children in the TE group. Six months after surgery, there were no significant difference between TT and TE with regard to snoring and ENT-infections. The differences in the total scores and in all the individual domains between the initialOSA-18 and postsurgery scores were all significant (P < 0.0001). The improvement in the total problem score measured with CBCL was also significant (P < 0.01) and there was no difference between the TT and TE children. The improvements in all subscores of the GCBI indicated a significant health benefit of both TT and TE.

    Conclusions: TT with RF-surgery causes less pain and postoperative morbidity than regular TE and has an equal effect on snoring and recurrent infections. Pre-school children with tonsillar hypertrophy and obstructive sleep-disordered breathing all show an impact on HRQL and behavior before surgery and improve dramatically just as much after TT as after TE. Therefore TT would be considered for treatment of small children

  • 18.
    Ericsson, Elisabeth
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oto-Rhino-Laryngologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Öronkliniken US.
    Lundeborg, Inger
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Logopedi. Linköpings universitet, Hälsouniversitetet.
    Hultcrantz, Elisabeth
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oto-Rhino-Laryngologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Öronkliniken US.
    Child behavior and quality of life before and after tonsillotomy versus tonsillectomy2009Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 73, nr 9, s. 1254-1262Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: Compare two techniques for pediatric tonsil surgery with respect to postoperative pain and morbidity and changes in sleep behavior, health related quality of life (HRQL) and benefits due to surgery. Methods: 67 children (4.5-5.5 years) with tonsillar hypertrophy and obstructive sleep-disordered breathing with or without recurrent tonsillitis were randomized to either regular tonsillectomy (TE) (n = 32) or intracapsular tonsillectomy/tonsillotomy (TT) (n = 35) with Radiofrequency surgical technique (ellman Int.). Before TT/TE, the parents completed a validated Quality of Life survey of pediatric obstructive sleep apnea, the OSA-18 (Obstructive Sleep Apnea-18) and a standardized assessment of their childrens behavior with the Child Behavior Checklist (CBCL). Six months after surgery, the parents repeated these measurements, and assessed the health related benefits of the surgery using the Glasgow Childrens Benefit Inventory (GCBI). Results: In the TT group, the children recorded less pain from the first day after surgery onwards, used fewer doses of painkillers and were pain-free 3 days earlier than the children in the TE group. Six months after surgery, there were no significant difference between TT and TE with regard to snoring and ENT-infections. The differences in the total scores and in all the individual domains between the initial OSA-18 and post-surgery scores were all significant (P andlt; 0.0001). The improvement in the total problem score measured with CBCL was also significant (P andlt; 0.01) and there was no difference between the TT and TE children. The improvements in all subscores of the GCBI indicated a significant health benefit of both TT and TE. Conclusions: TT with RF-surgery causes less pain and postoperative morbidity than regular TE and has an equal effect on snoring and recurrent infections. Pre-school children with tonsillar hypertrophy and obstructive sleep-disordered breathing all show an impact on HRQL and behavior before surgery and improve dramatically just as much after TT as after TE. Therefore TT would be considered for treatment of small children.

  • 19.
    Ericsson, Elisabeth
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD. Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Lundeborg, Inger
    University, Linköping.
    Hultcrantz, Elisabeth
    University, Linköping.
    Child Behavior and quality of life before and after tonsillotomy versus tonsillectomy2009Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 73, nr 9, s. 1254-1262Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: Compare two techniques for pediatric tonsil surgery with respect to postoperative pain and morbidity and changes in sleep behavior, health related quality of life (HRQL) and benefits due to surgery.

    Methods: 67 children (4.5–5.5 years) with tonsillar hypertrophy and obstructive sleep-disordered breathing with or without recurrent tonsillitis were randomized to either regular tonsillectomy (TE) (n = 32) or intracapsular tonsillectomy/tonsillotomy (TT) (n = 35) with Radiofrequency surgical technique (ellman Int.). Before TT/TE, the parents completed a validated Quality of Life survey of pediatric obstructive sleep apnea, the OSA-18 (Obstructive Sleep Apnea-18) and a standardized assessment of their children’s behavior with the Child Behavior Checklist (CBCL). Six months after surgery, the parents repeated these measurements, and assessed the health related benefits of the surgery using the Glasgow Children’s Benefit Inventory (GCBI).

    Results: In the TT group, the children recorded less pain from the first day after surgery on wards, used fewer doses of painkillers and were pain-free 3 days earlier than the children in the TE group. Six months after surgery, there were no significant difference between TT and TE with regard to snoring and ENT-infections. The differences in the total scores and in all the individual domains between the initialOSA-18 and postsurgery scores were all significant (P < 0.0001). The improvement in the total problem score measured with CBCL was also significant (P < 0.01) and there was no difference between the TT and TE children. The improvements in all subscores of the GCBI indicated a significant health benefit of both TT and TE.

    Conclusions: TT with RF-surgery causes less pain and postoperative morbidity than regular TE and has an equal effect on snoring and recurrent infections. Pre-school children with tonsillar hypertrophy and obstructive sleep-disordered breathing all show an impact on HRQL and behavior before surgery and improve dramatically just as much after TT as after TE. Therefore TT would be considered for treatment of small children

  • 20.
    Ericsson, Elisabeth
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oto-Rhino-Laryngologi. Linköpings universitet, Hälsouniversitetet.
    Wadsby, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Barn- och ungdomspsykiatri. Linköpings universitet, Hälsouniversitetet.
    Hultcrantz, Elisabeth
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oto-Rhino-Laryngologi. Linköpings universitet, Hälsouniversitetet.
    Pre-surgical Child Behavior Ratings and Pain Management after Two Different Techniques of Tonsil Surger2006Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 70, nr 10, s. 1749-1758Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective

    The purpose of this investigation was to compare child behavior before surgery with experience of pain and anxiety in relation to two techniques of tonsil surgery, to relate previous experiences of surgery/tonsillitis with anxiety and pain, and to compare the children's, parent's and nurse's rating of pain.

    Method

    Ninety-two children (5–15 years) with sleep-disordered breathing (SDB) and with or without recurrent tonsillitis were randomized to partial tonsil resection/tonsillotomy (TT) or full tonsillectomy (TE). Measures: Parents: Child Behavior Checklist (CBCL). Children: State-Trait-Anxiety Inventory for Children (STAIC) and seven-point Faces Pain Scale (FPS). Parents/staff: seven-point Verbal Pain Rating Scale (VPRS). Pain relievers were opoids, paracetamol and diclophenac.

    Results

    These children with SDB scored significantly higher on CBCL than did normative groups, but no connection was observed between CBCL rating and experience of pain. There was no relation between pre-operative anxiety and pain. The post-operative anxiety level (STAIC) correlated with pain. The TE-group scored higher on STAIC after surgery. Previous experience of surgery or tonsillitis did not influence post-operative pain. The TE-group rated higher experience of pain despite more medication. The nurses scored pain lower than the parents/children and under-medicated.

    Conclusion

    SDB may influence children's behavior, but with no relation to post-operative pain. The surgical method predicts pain better than does the child's behavior rating. The nurses underestimated the pain experienced by the child.

  • 21.
    Ericsson, Elisabeth
    et al.
    Linköpings universitet.
    Wadsby, Marie
    Linköpings universitet.
    Hultcrantz, Elisabeth
    Linköpings universitet.
    Pre-surgical Child Behavior Ratings and Pain Management after Two Different Techniques of Tonsil Surgery2006Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 70, nr 10, s. 1749-1758Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective

    The purpose of this investigation was to compare child behavior before surgery with experience of pain and anxiety in relation to two techniques of tonsil surgery, to relate previous experiences of surgery/tonsillitis with anxiety and pain, and to compare the children's, parent's and nurse's rating of pain.

    Method

    Ninety-two children (5–15 years) with sleep-disordered breathing (SDB) and with or without recurrent tonsillitis were randomized to partial tonsil resection/tonsillotomy (TT) or full tonsillectomy (TE). Measures: Parents: Child Behavior Checklist (CBCL). Children: State-Trait-Anxiety Inventory for Children (STAIC) and seven-point Faces Pain Scale (FPS). Parents/staff: seven-point Verbal Pain Rating Scale (VPRS). Pain relievers were opoids, paracetamol and diclophenac.

    Results

    These children with SDB scored significantly higher on CBCL than did normative groups, but no connection was observed between CBCL rating and experience of pain. There was no relation between pre-operative anxiety and pain. The post-operative anxiety level (STAIC) correlated with pain. The TE-group scored higher on STAIC after surgery. Previous experience of surgery or tonsillitis did not influence post-operative pain. The TE-group rated higher experience of pain despite more medication. The nurses scored pain lower than the parents/children and under-medicated.

    Conclusion

    SDB may influence children's behavior, but with no relation to post-operative pain. The surgical method predicts pain better than does the child's behavior rating. The nurses underestimated the pain experienced by the child.

  • 22.
    Ericsson, Elisabeth
    et al.
    University of Linköping.
    Wadsby, Marie
    University of Linköping.
    Hultcrantz, Elisabeth
    University of Linköping.
    Pre-surgical Child Behavior Ratings and Pain Management after Two Different Techniques of Tonsil Surgery2006Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 70, nr 10, s. 1749-1758Artikkel i tidsskrift (Fagfellevurdert)
  • 23.
    Eriksson, Mats
    et al.
    Örebro universitet, Institutionen för hälsovetenskaper.
    Nilsson, Ulrica
    Örebro universitet, Institutionen för hälsovetenskaper.
    Bramhagen, Ann-Cathrine
    Fakulty of Health and Society, Department of Care Science, Malmö University, Malmö, Sweden.
    Idvall, Ewa
    Fakulty of Health and Society, Department of Care Science, Malmö University, Malmö, Sweden.
    Ericsson, Elisabeth
    Örebro universitet, Institutionen för hälsovetenskaper.
    Self-reported postoperative recovery in children after tonsillectomy compared to tonsillotomy2017Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 96, s. 47-54Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: Tonsil surgery is associated with significant morbidity during recovery. Patient-reported outcome measures (PROM) are the golden standard for the planning and follow-up of delivered care, which should also be an axiom for children. The current aims were to describe self-reported postoperative recovery in children after tonsil surgery, and to compare tonsillotomy and tonsillectomy in this respect.

    Methods: In total, 238 children (4–12 years old) with a history of obstructive problems and/or recurrent tonsillitis, and undergoing tonsil surgery were included. Forty-eight per cent were operated with partial tonsil resection/tonsillotomy (TT) and 52% with total tonsillectomy (TE), all in day surgery.

    Postoperative recovery was assessed on days 1, 4 and 10 using the validated self-rating instrument PRiC, Postoperative Recovery in Children. This includes 23 items covering different aspects of recovery after tonsil surgery. A higher score indicates worse status in the respective items.

    Results: Daily life activities (sleeping, eating and playing), physical symptoms (e.g., headache, stomach ache, sore throat, otalgia, dizziness, nausea, defecation, urination), and emotional aspects (sadness, frightening dreams) were affected during the recovery period.

    The TE-girls showed higher scores than the boys regarding stomach ache, defecation and dizziness.

    Children above 6 years of age reported higher values for the physical comfort variables, while the younger group showed worse emotional states.

    Postoperative recovery improved from day 1–10 in all surgical groups. The TE-group showed lower recovery compared to the TT-group (p < 0.01–0.001) in most items.

    Conclusion: The goal of postoperative management is to minimize or eliminate discomfort, facilitating the recovery process and avoiding complications. Children are able to describe their recovery, and thus, PRiC seems to be able to serve as a PROM to obtain patient-centered data after tonsil surgery. The recovery process after TT causes less postoperative morbidity and a quicker return to normal activity compared to TE.

  • 24. Flynn, Traci
    et al.
    Möller, Claes
    Örebro universitet, Hälsoakademin.
    Jönsson, Radoslava
    Lohmander, Anette
    The high prevalence of otitis media with effusion in children with cleft lip and palate as compared to children without clefts2009Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 73, nr 10, s. 1441-1446Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: Children with cleft lip and palate universally present with otitis media with effusion. This prevalence has not been systematically studied. The purpose of the present study was to examine and compare the prevalence of otitis media with effusion, hearing sensitivity, and audiometry method utilised for assessment in children with and without clefts. METHODS: Two groups of children (children with unilateral cleft lip and palate, N=22, and children without clefts, N=20) were followed prospectively and longitudinally from 1 to 5 years of age. Data were collected at four points (1, 1.5, 3, and 5 years of age). Assessments at each of the four points included: (1) otomicroscopy, (2) tympanometry, and (3) hearing assessment. RESULTS: Overall the children with unilateral cleft lip and palate demonstrated a significantly higher prevalence of otitis media with effusion (121 ears, 74.7%) than children without clefts (31 ears, 19.4%) (p<0.001). This higher prevalence was also significant at 1, 1.5, 3, and 5 years of age (p<0.001). Of those ears with otitis media with effusion, 83.1% of the ears exhibited a hearing loss (PTA >20dB), with this loss more prevalent in the cleft group (89.7% UCLP and 70.0% non-cleft). The hearing loss was significantly more pronounced in the cleft (group 35.71dB HL UCLP and 26.41dB HL non-cleft group). Children with unilateral cleft lip and palate utilised a lower age-appropriate audiometry testing method than age-matched children with no cleft at 1, 1.5, and 3 years of age. CONCLUSIONS: Children with unilateral cleft lip and palate present with a significantly higher prevalence of otitis media with effusion than children without cleft. Also, the hearing loss associated with otitis media with effusion is demonstrated in this study. Furthermore, the method of audiometry has been examined and children with unilateral cleft lip and palate had to be assessed with a lower level of method than children without cleft.

  • 25. Forséni, M.
    et al.
    Melhus, Åsa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Ryan, A. F.
    Bagger-Sjöbäck, D.
    Hultcrantz, M.
    Detection and localization of interleukin-6 in the rat middle ear during experimental acute otitis media, using mRNA in situ hybridization and immunohistochemistry2001Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 57, nr 2, s. 115-121Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: Otitis media is one of the most common diseases among children. A well-known sequela of acute, chronic, and secretory otitis media is tympanosclerosis. With the exception of surgery, there is no causal treatment available for this condition, which may cause hearing disabilities. This study aimed to describe the localization of interleukin (IL)-6 mRNA and its gene product in the rat middle ear during pneumococcal otitis media. IL-6 is known to be involved in inflammatory and bone remodeling processes. METHODS: Using an experimental model of pneumococcal acute otitis media, the expression of interleukin IL-6, was analyzed. Sprague-Dawley rats were sacrificed at different time points varying from 1 h to 6 days intervals after inoculation. The middle ears were analyzed by messenger RNA in situ hybridization, and by immunohistochemistry with cell-type specific antibodies directed against IL-6. RESULTS: Transcripts of IL-6 were observed only on day 1 post-inoculation, whereas the final gene product was observed at all intervals after inoculation. IL-6 was localized in the bony part of the bulla nearest to the mucosa, around mucosal vessels, and in the ciliae of the mucosal epithelium. The results demonstrated that IL-6 was synthesized locally as early as 1 h after bacterial middle ear challenge, and that although transcription could not be detected after 24 h, the cytokine product persisted for at least 5 days after the infection was introduced. CONCLUSIONS: IL-6 was shown to be produced early in the inflammatory process during induced pneumococcal otitis media in the rat. No production was seen after 24 h although the protein remained in the tissue for at least 5 days. IL-6 could initiate a differentiation of macrophages to osteoclasts and thereby participate in a bone remodeling process leading to tympanosclerosis development.

  • 26.
    Frölander, Hans Erik
    et al.
    Linköpings universitet, Institutet för handikappvetenskap (IHV). Örebro University; Örebro University Hospital, Sweden.
    Möller, Claes
    Linköpings universitet, Institutet för handikappvetenskap (IHV). Örebro University; Örebro University Hospital, Sweden.
    Marshall, Jan D.
    Jackson laboratory, Bar Harbor, ME, USA.
    Sundqvist, Anett
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutet för handikappvetenskap (IHV).
    Rönnåsen, Berit
    Linköpings universitet, Institutet för handikappvetenskap (IHV). Örebro University; Örebro University Hospital, Sweden.
    Falkensson, Lil
    National Resource Centre, Lund, Sweden.
    Lyxell, Björn
    Linköpings universitet, Institutet för handikappvetenskap (IHV). Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten. Östergötlands Läns Landsting, Sinnescentrum, Öron- näsa- och halskliniken US.
    Theory-of-mind in adolescents and young adults with Alström syndrome2014Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 78, nr 3, s. 530-536Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE:

    The study focuses on theory-of-mind in adolescents and young adults with Alström syndrome (ALMS). ALMS, an autosomal recessive syndrome causes juvenile blindness, sensorineural hearing loss, cardiomyopathy, endocrinological disorders and metabolic dysfunction. Theory-of-mind (ToM) refers to the ability to impute mental states to one self and to others. Clinical observations have revealed an increased occurrence of deviances in mental state understanding in ALMS. In the present study ToM will be examined and related to working memory (WM), verbal ability and sensory loss.

    METHODS:

    Twelve young individuals (16-37 years) with ALMS and 24 nondisabled individuals matched on age, gender and educational level participated. ToM was assessed by means of a multiple task that taxes the ability to understand thoughts and feelings of story characters'. WM was examined by means of a reading span task and verbal ability by means of a vocabulary test.

    RESULTS:

    The ALMS group performed at significantly lower levels in ToM tasks and displayed a higher variability in performance than the control group. Individuals with ALMS and a relatively poor level performance provided fewer correct mental state inferences in ToM tasks than ALMS individuals with relatively higher performance levels. ALMS individuals with relatively high performance levels made as many correct inferences in ToM tasks as the control group, but their inferences were more often incomplete. Vocabulary skills and educational level, but not WM-capacity predicted ToM performance. Degree of deafblindness did not have an impact on ToM. Age of onset of visual loss but not hearing loss related to ToM.

    CONCLUSIONS:

    The individuals with ALMS display a high degree of heterogeneity in terms of ToM, where some individuals reached performance levels comparable to nondisabled individuals. The results are discussed with respect to how cognitive and verbal abilities and factors related to the disability affect ToM.

  • 27.
    Frölander, Hans-Erik
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin. School of Health and Medical Sciences, Örebro; Audiological Research Centre, Örebro University Hospital, Örebro, Sweden; Research on Hearing and Deafness (HEAD) Graduate School, The Swedish Institute for Disability Research, Linköping University, Linköping, Sweden;.
    Möller, Claes
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Region Örebro län. School of Health and Medical Sciences, Örebro University, Örebro, Sweden; Audiological Research Centre, Örebro University Hospital, Örebro, Sweden; Department of Audiology, Örebro University Hospital, Örebro, Sweden; The Linnaeus Centre HEAD, The Swedish Institute for Disability Research, Linköping, Sweden.
    Marshall, Jan D.
    The Jackson laboratory, Bar Harbor ME, USA.
    Sundqvist, Annette
    Department of Behavioral Science and Learning, Linköping University, Linköping, Sweden; Linnaeus Ctr HEAD, Linköping, Sweden; The Linnaeus Centre HEAD, The Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.
    Rönnåsen, Berit
    Örebro universitet, Institutionen för hälsovetenskap och medicin. School of Health and Medical Sciences, Örebro; Audiological Research Centre, Örebro University Hospital, Örebro, Sweden; Research on Hearing and Deafness (HEAD) Graduate School, The Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.
    Falkensson, Lil
    The Swedish National Expert Team for the Diagnoses of Deafblindness, National Resource Centre, Lund, Sweden.
    Lyxell, Björn
    Department of Behavioral Science and Learning, Linköping University, Linköping, Sweden; The Linnaeus Centre HEAD, The Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.
    Theory-of-mind in adolescents and young adults with Alström Syndrome2014Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 78, nr 3, s. 530-537Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: The study focuses on theory-of-mind in adolescents and young adults with Alström syndrome (ALMS). ALMS, an autosomal recessive syndrome causes juvenile blindness, sensorineural hearing loss, cardiomyopathy, endocrinological disorders and metabolic dysfunction. Theory-of-mind (ToM) refers to the ability to impute mental states to one self and to others. Clinical observations have revealed an increased occurence of deviances in mental state understanding in ALMS. In the present study ToM will be examined and related to working memory (WM), verbal ability and sensory loss.

    Methods: Twelve young individuals (16-37 years) with ALMS and 24 nondisabled individuals matched on age, gender and educational level participated. ToM was assessed by means of a multiple task that taxes the ability to understand thoughts and feelings of story chraracters´. WM was examined by means of a reading span task and verbal ability by means of a vocabulary test.

    Results: The ALMS group performed at significantly lower levels in ToM tasks and displayed a higher variability in performance than the control group. Individuals with ALMS and a relatively poor level performance provided fewer correct mental state inferences in ToM tasks than ALMS individuals with relatively higher performance levels. ALMS individuals with relatively high performance levels made as many correct inferences in ToM tasks as the control group, but their inferences were more often incomplete. Vocabulary skills and educational level, but not WM-capacity predicted ToM performance. Degree of deafblindness did not have an impact on ToM. Age of onset of visual loss but not hearing loss related to ToM.

    Conclusions: The individuals with ALMS display a high degree of heterogeneity in terms of ToM, where some individuals reached performance levels comparable to nondisabled individuals. The results are discussed with respect to how cognitive and verbal abilities and factors related to the disability affect ToM.

  • 28.
    Gisselsson-Solen, Marie
    et al.
    Univ Lund Hosp, Dept Otorhinolaryngol Head & Neck Surg, S-22185 Lund, Sweden..
    Hermansson, Ann
    Univ Lund Hosp, Dept Otorhinolaryngol Head & Neck Surg, S-22185 Lund, Sweden..
    Melhus, Åsa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Infektionsmedicin.
    Individual-level effects of antibiotics on colonizing otitis pathogens in the nasopharynx2016Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 88, s. 17-21Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Although there is evidence of an association between antibiotic consumption and resistant bacteria on a population level, the relationship on an individual level has been less well studied, particularly in terms of nasopharyngeal colonization. We have therefore analysed this association, using data from a closely followed cohort of children taking part in a vaccination trial. Methods: 109 children with early onset of acute otitis media (AOM) were randomised to heptavalent pneumococcal conjugate vaccine (PCV7) or no vaccination. They were followed for three years with scheduled appointments as well as sick visits. Nasopharyngeal cultures were obtained at all visits. Antibiotic treatments were recorded, as were risk factors for AOM, including siblings, short breast-feeding and parental smoking. Data were entered into a Cox regression model, and the findings of Streptococcus pneumoniae and Haemophilus influenzae with reduced susceptibility to the penicillin group were related to the number of previous courses of antibiotics. Results: There was evidence of an association between the amount of previously consumed betalactams and colonization with beta-lactamasenegative ampicillin-resistant (BLNAR) H. influenzae (RR 1.21; 95% CI 1.03-1.43; p = 0.03), and also with the most commonly prescribed drug; amoxicillin (RR 1.39; 95% CI 1.09-1.76; p = 0.01). There was no evidence for an association between antibiotic consumption and betalactamase producing H. influenzae or S. pneumoniae with reduced susceptibility to penicillin. Furthermore, there was no evidence of an association between resistant bacteria and AOM risk factors or PCV7. Conclusion: In this subgroup of children, most of whom were given several courses of antibiotics in early childhood, there was evidence of an association between betalactam/amoxicillin consumption and nasopharyngeal colonization with BLNAR strains, bacteria that have increased in prevalence during the last 10-15 years, and that are notoriously difficult to treat with oral antibiotics.

  • 29.
    Gronseth, Torstein
    et al.
    Univ Oslo, Oslo, Norway.;Oslo Univ Hosp, Dept Otolaryngol Head & Neck Surg, Oslo, Norway..
    Vestby, Lene K.
    Norwegian Vet Inst, Oslo, Norway..
    Nesse, Live L.
    Norwegian Vet Inst, Oslo, Norway..
    Thoen, Even
    Norwegian Vet Inst, Oslo, Norway..
    Habimana, Olivier
    Univ Hong Kong, Sch Biol Sci, Pok Fu Lam Rd, Hong Kong, Hong Kong, Peoples R China..
    von Unge, Magnus
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Västerås. Akershus Univ Hosp, Dept Otolaryngol Head & Neck Surg, Lorenskog, Norway.;Univ Oslo, Campus Ahus, Oslo, Norway..
    Silvola, Juha T.
    Univ Oslo, Oslo, Norway.;Akershus Univ Hosp, Dept Otolaryngol Head & Neck Surg, Lorenskog, Norway.;Univ Oslo, Campus Ahus, Oslo, Norway..
    Lugol's solution eradicates Staphylococcus aureus biofilm in vitro2017Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 103, s. 58-64Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: The aim of the study was to evaluate the antibacterial efficacy of Lugol's solution, acetic acid, and boric acid against Staphylococcus aureus biofilm. Methods: The efficacy of Lugol's solution 1%, 0.1%, and 0.05%, acetic acid 5% or boric acid 4.7% for treatment of Staphylococcus aureus biofilm in vitro was tested using 30 clinical strains. Susceptibility in the planktonic state was assessed by disk diffusion test. Antiseptic effect on bacteria in biofilm was evaluated by using a,Biofilm-oriented antiseptic test (BOAT) based on metabolic activity, a biofilm bactericidal test based on culturing of surviving bacteria and confocal laser scanning microscopy combined with LIVE/DEAD staining. Results: In the planktonic state, all tested S. aureus strains were susceptible to Lugol's solution and acetic acid, while 27 out of 30 tested strains were susceptible to boric acid. In biofilm the metabolic activity was significantly reduced following exposure to Lugol's solution and 5% acetic acid, while boric acid exposure led to no significant changes in metabolic activities. In biofilm, biocidal activity was observed for Lugol's solution 1% (30/30), 0.1% (30/30), and 0.05% (26/30). Acetic acid and boric acid showed no bactericidal activity in this test. Confocal laser scanning microscopy, assessed in 4/30 strains, revealed significantly fewer viable biofilm bacteria with Lugol's solution (1% p < 0.001, 0.1% p = 0.001 or 0.05% p = 0.001), acetic acid 5% for 10 min (p = 0.001) or 30 min (p = 0.015), but not for acetic acid for 1 min or boric acid. Conclusion: Lugol's solution 1.0% and 0.1% effectively eradicated S. aureus in biofilm and could be an alternative to conventional topical antibiotics where S. aureus biofilm is suspected such as external otitis, pharyngitis and wounds. (C) 2017 Elsevier B.V. All rights reserved.

  • 30.
    Henricson, Cecilia
    et al.
    Linköpings universitet, Institutet för handikappvetenskap (IHV). Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten.
    Lyxell, Björn
    Linköpings universitet, Institutet för handikappvetenskap (IHV). Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten.
    Möller, Claes
    Örebro Universitetssjukhus, audiologiskt forskningscentrum, Örebro Universitet.
    Lidestam, Björn
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten.
    Wass, Malin
    Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutet för handikappvetenskap (IHV). Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap.
    Cognitive skills in children with Usher syndrome type 1 and cochlear implants2012Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 76, nr 10, s. 1449-1457Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Introduction: Usher syndrome is a genetic condition causing deaf-blindness and is one of the most common causes of syndromic deafness. Individuals with USH1 in Sweden born during the last 15 years have typically received cochlear implants (CI) as treatment for their congenital, profound hearing loss. Recent research in genetics indicate that the cause of deafness in individuals with Usher type 1 (USH1) could be beneficial for the outcome with cochlear implants (CI). This population has not previously been the focus of cognitive research.

    Objective: The present study aims to examine the phonological and lexical skills and working memory capacity (WMC) in children with USH1 and CI and to compare their performance with children with NH, children with hearing-impairment using hearing-aids and to children with non-USH1 deafness using CI. The participants were 7 children aged 7-16 years with USH1 and CI.

    Methods: The participants performed 10 sets of tasks measuring phonological and lexical skills and working memory capacity.

    Conclusions: The results indicate that children with USH1 and CI as a group in general have a similar level of performance on the cognitive tasks as children with hearing impairment and hearing aids. The group with USH1 and CI has a different performance profile on the tests of working memory, phonological skill and lexical skill than children with non-USH1 deafness using CI, on tasks of phonological working memory and phonological skill.

  • 31.
    Henricson, Cecilia
    et al.
    Swedish Institute for Disability Research, Linköping University.
    Wass, Malin
    Swedish Institute for Disability Research, Linköping University.
    Lidestam, Björn
    Linnaeus Centre for Research on Hearing and Deafness (HEAD).
    Möller, Claes G.
    Swedish Institute for Disability Research, Linköping University.
    Lyxell, Björn
    Department of Psychology, University of Linköping, Swedish Institute for Disability Research, Linköping University.
    Cognitive skills in children with Usher syndrome type 1 and cochlear implants2012Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 76, nr 10, s. 1449-1457Artikkel i tidsskrift (Fagfellevurdert)
  • 32.
    Henricson, Cecilia
    et al.
    Swedish Institute for Disability Research (SIDR), Örebro University, Örebro, ,Sweden; Linnaeus Centre for Research on Hearing and Deafness (HEAD), Växjö, Sweden; Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden.
    Wass, Malin
    Swedish Institute for Disability Research (SIDR), Örebro University, Örebro, ,Sweden; Linnaeus Centre for Research on Hearing and Deafness (HEAD), Växjö, Sweden; Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden.
    Lidestam, Björn
    Swedish Institute for Disability Research (SIDR), Örebro University, Örebro, ,Sweden; Linnaeus Centre for Research on Hearing and Deafness (HEAD), Växjö, Sweden; Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden.
    Möller, Claes
    Örebro universitet, Institutionen för hälsovetenskap och medicin. Swedish Institute for Disability Research (SIDR), Örebro University, Örebro, Sweden; Linnaeus Centre for Research on Hearing and Deafness (HEAD), Växjö, Sweden; Audiological Research Centre, Örebro University Hospital, Örebro, Sweden.
    Lyxell, Björn
    Swedish Institute for Disability Research (SIDR), Örebro University, Örebro, Sweden; Linnaeus Centre for Research on Hearing and Deafness (HEAD), Växjö, Sweden; Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden.
    Cognitive skills in children with Usher syndrome typ 1 and cochlear implants2012Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 76, nr 10, s. 1449-1457Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Introduction: Usher syndrome is a genetic condition causing deaf-blindness and is one of the most common causes of syndromic deafness. Individuals with USH1 in Sweden born during the last 15 years have typically received cochlear implants (CI) as treatment for their congenital, profound hearing loss. Recent research in genetics indicates that the cause of deafness in individuals with Usher type 1 (USH1) could be beneficial for the outcome with cochlear implants (CI). This population has not previously been the focus of cognitive research.

    Objective: The present study aims to examine the phonological and lexical skills and working memory capacity (WMC) in children with USH1 and CI and to compare their performance with children with NH, children with hearing-impairment using hearing-aids and to children with non-USH1 deafness using CI. The participants were 7 children aged 7-16 years with USH1 and CI.

    Methods: The participants performed 10 sets of tasks measuring phonological and lexical skills and working memory capacity.

    Conclusions: The results indicate that children with USH1 and CI as a group in general have a similar level of performance on the cognitive tasks as children with hearing impairment and hearing aids. The group with USH1 and CI has a different performance profile on the tests of working memory, phonological skill and lexical skill than children with non-USH1 deafness using CI, on tasks of phonological working memory and phonological skill.

  • 33.
    Hultcrantz, Elisabeth
    et al.
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oto-Rhino-Laryngologi. Östergötlands Läns Landsting, Rekonstruktionscentrum, Öronkliniken US. Linköpings universitet, Hälsouniversitetet.
    Linder, Arne
    ENT Department, Akademiska Sjukhuset, Uppsala, Sweden.
    Markström, Agneta
    Respiratory Unit, Department of Anesthesia and Intensive Care, Karolinska Institute, Danderyds Hospital (KIDS), Sweden.
    Long-term effects of intracapsular partial tonsillectomy (tonsillotomy) compared with full tonsillectomy2005Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 69, nr 4, s. 463-469Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To compare the long-term effects (six years after surgery) of two techniques for pediatric tonsil surgery with respect to snoring, apneas, eating difficulties, infections and general health. The two methods were intracapsular partial tonsillectomy (tonsillotomy, "TT") using CO 2-laser technique and traditional (total) blunt dissection tonsillectomy (TE). Study design: A questionnaire distributed by mail to the parents of children, who, in 1998, were included in a prospective clinical randomized study in one tertiary care ENT clinic. Method: A 10 question survey follow-up of 41 children, between 9 and 15 years of age, who originally, six years earlier had been randomized to either TT with CO2-laser (n = 21) or TE (n = 20). The main indication for the surgery was a history of sleep related breathing distress (SRBD). Before the present study, all of the children had participated in earlier follow-ups at six months and one year after surgery. Results: All the children in both groups answered the questionnaire. There were no significant differences between the answers from the two groups in any respects: the effect on snoring and apneas was equally stable for both groups. The number of children who remained free from snoring decreased from 40 after the first year to 25 after six years (11 TT, 14 TE). Snoring in the recurrent cases was not rated to be as frequent or as loud as before the surgery. Infections of the upper respiratory tract (URI) that had been treated with antibiotics occurred to the same extent in both groups. None had eating difficulties. The patients' satisfaction with the results of the surgery was high or very high in 18/21 TT and 20 TE cases, and the vast majority of the parents rated their children's present health status as improved compared with the preoperative condition. Conclusion: Tonsillotomy with CO2-laser seems to be a reliable method for tonsil surgery with substantially less primary morbidity than conventional tonsillectomy and with the same positive long-term effects after six years.

  • 34. Hultcrantz, Elisabeth
    et al.
    Linder, Arne
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Markström, Agneta
    Tonsillectomy or tonsillotomy?:  a randomized study comparing postoperative pain and long-term effects 1999Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 51, nr 3, s. 171-6Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: tonsillectomy (TE) is currently the most common treatment for children with snoring and sleep apnea. Many of these children have not had any severe throat infections. To cure such children from their obstructive problems, without influencing the immunological function of the tonsils, tonsillotomy (TT) with CO2-laser was performed in a randomized study comparing it to regular tonsillectomy, with special attention to postoperative pain and symptom recurrence. Method: 41 children 3.5–8 years-old were included — 21 ‘TT’s’ and 20 ‘TE’s’. They were all operated under the same anesthesia and followed the same postoperative scheme for analgesia. A visual analogue scale for pain measurements with faces was used for the first 24 h. After that, each day until pain-free, the parents registered the child’s pain on a three graded scale, what the child was able to eat, and the amount of analgesic drugs used. Results: all the children were cured from their breathing obstruction. The mean time used for the surgery was the same and no postoperative bleeding was seen in either group. ‘TT children’ were pain-free after 5 days and ‘TE children’ after 8 days. Eight to ten days after surgery, the TT-children had gained weight and the TE children lost weight significantly. The TE group used twice as much analgesic drugs as the TT group during the first postoperative week. The TT group was healed with normal-looking, but small tonsils after 8–10 days; the TE group often still showed edema and crusts. At the one-year follow-up 2/21among the ‘TT-children’ snored, but did not require re-surgery. Conclusion: tonsillotomy is much less painful than TE and children recover more quickly. Results with respect to breathing obstruction are almost the same for both methods at 1-year follow-up.

  • 35. Hultcrantz, Elisabeth
    et al.
    Löfstrand Tideström, Britta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper.
    The development of sleep disordered breathing from 4 to 12 years and dental arch morphology2009Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 73, nr 9, s. 1234-1241Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To track the development of sleep disordered breathing (SDB) as well as dento-facial morphology in cohort of children by having them complete a questionnaire at ages 4, 6 and 12. Clinical examination, sleep studies (at ages 4 and 12) and orthodontic evaluation were carried out on all who were reported to snore regularly and children who did not snore at all. RESULTS: Out of the original group of 615 children, 64% (393) answered the inquiry on all three occasions. Of those, 27 snored regularly and 231 did not snore at all at the age of 12. There were differences between those groups on all answers, especially prevalence of oral breathing: 78% versus 5% (p<0.001). The prevalence of OSA decreased from 3.1% at the age of 4 to 0.8% at age 12 and the severity decreased from a mean AHI 14.8 at 4 to a mean AHI of 1.95 at age 12. The minimum prevalence of snoring regularly was estimated to 4.2% at 12 years compared to 5.3% at 4, calculated for the original cohort of 644 children. The odds for a child who snored regularly at 4 or 6 years to be snoring regularly also at age 12 was 3.7 times greater than for a not snoring child in spite of surgery (OR 3.7, 95% CI 2.4-5.7). 63 children had undergone surgery due to snoring by age 12. 14 of them never snored and 17 snored regularly at the age 12. The dental arch was narrower in the children snoring regularly at 4, 6 and 12 years compared to not snoring children. Cross-bites were more common among snoring children than among non-snoring children, at 4 and 6 as well as at 12. CONCLUSION: The prevalence of regular snoring is about the same from 4 to 12 years independent of surgery, but the prevalence of OSA decreased considerably. The children snoring regularly generally have a narrower maxilla compared to children not snoring. Surgery in young children is necessary but "cures" the snoring only temporary.

  • 36.
    Hurst, David S.
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Amin, Kawa
    Sevéus, Lahja
    Venge, Per
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper.
    Mast cells and tryptase in the middle ear of children with otitis media with effusion1999Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 49, nr Suppl 1, s. S315-319Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: This is the first report of the presence of tryptase, a reflection of mast cell activity, in chronic middle ear effusion of patients in whom atopic status was characterized.

    DESIGN AND METHODS: Mediator activity of mast cells and eosinophils was measured prospectively from effusion of 33 random patients and five controls with chronic otitis media with effusion (OME). Atopy was determined by enzyme-linked immunosorbent assay testing. Middle ear biopsies from a second group of eight OME patients and four controls were fixed in plastic and stained immunohistochemically for mast cells.

    RESULTS: Sixty-one percent of patients had extensive activation of mast cells in their middle ears. Among those with elevated tryptase in their effusion, 95.6% were atopic and 94.7% also had elevated effusion eosinophilic cationic protein. Tryptase was elevated only in the effusion of atopic patients as compared with controls (P < 0.01). Mast cells were present in six of eight OME ears and absent in all four normals.

    CONCLUSION: Mast cells and its mediator tryptase, both indicators of a Th2-driven immune response, are present in the majority of ears which have chronic effusion, suggesting that the inflammation within the middle ear of most OME patients is allergic in nature.

  • 37.
    Huttunen, Kerttu
    et al.
    Univ Oulu, Fac Humanities, Logoped, Oulu, Finland;Univ Oulu, Child Language Res Ctr, Oulu, Finland;Univ Oulu, PEDEGO Res Unit, Oulu, Finland;MRC Oulu, Oulu, Finland;Oulu Univ Hosp, Dept Otorhinolaryngol Head & Neck Surg, Oulu, Finland.
    Erixon, Elsa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Lofkvist, Ulrika
    Univ Oslo, Dept Special Needs Educ, Oslo, Norway;Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden.
    Maki-Torkko, Elina
    Orebro Univ, Sch Med Sci, Orebro, Sweden;Orebro Univ Hosp, Audiol Res Ctr, Orebro, Sweden.
    The impact of permanent early-onset unilateral hearing impairment in children - A systematic review2019Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 120, s. 173-183Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Background: Decision-making on treatment and (re)habilitation needs to be based on clinical expertise and scientific evidence. Research evidence for the impact of permanent unilateral hearing impairment (UHI) on children's development has been mixed and, in some of the reports, based on fairly small, heterogeneous samples. Additionally, treatment provided has been highly variable, ranging from no action taken or watchful waiting up to single-sided cochlear implantation. Published information about the effects of treatment has also been heterogeneous. Moreover, earlier reviews and meta-analyses published on the impact of UHI on children's development have generally focused on select areas of development. Objectives: This systematic review aimed to summarize the impact of children's congenital or early onset unilateral hearing impairment on listening and auditory skills, communication, speech and language development, cognitive development, educational achievements, psycho-social development, and quality of life. Methods: Literature searches were performed to identify reports published from inception to February 16th, 2018 with the main electronic bibliographic databases in medicine, psychology, education, and speech and hearing sciences as the data sources. PubMed, CINALH, ERIC, LLBA, PsychINFO, and ISI Web of Science were searched for unilateral hearing impairment with its synonyms and consequences of congenital or early onset unilateral hearing impairment. Eligible were articles written in English, German, or Swedish on permanent unilateral hearing impairments that are congenital or with onset before three years of age. Hearing impairment had to be of at least a moderate degree with PTA >= 40 dB averaged over frequencies 0.5 to 2 or 0.5-4 kHz, hearing in the contralateral ear had to have PTA(0.5-2 kHz) or PTA(0.5-4 kHz) <= 20 dB, and consequences of unilateral hearing impairment needed to be reported in an unanimously defined population in at least one of the areas the review focused on. Four researchers independently screened 1618 abstracts and 566 full-text articles for evaluation of study eligibility. Eligible full-text articles were then reviewed to summarize the results and assess the quality of evidence. Additionally, data from 13 eligible case and multi-case studies, each having less than 10 participants, were extracted to summarize their results. Quality assessment of evidence was made adapting the Grades of Recommendations, Assessment, Development, and Evaluation (GRADE) process, and reporting of the results adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. Results: Three articles with the quality of evidence graded as very-low to low, fulfilled the eligibility criteria set. Due to the heterogeneity of the articles, only a descriptive summary could be generated from the results. Unilateral hearing impairment was reported to have a negative impact on preverbal vocalization of infants and on sound localization and speech perception both in quiet and in noise. Conclusions: No high-quality studies of consequences of early-onset UHI in children were found. Inconsistency in assessing and reporting outcomes, the relatively small number of participants, low directness of evidence, and the potential risk of confounding factors in the reviewed studies prevented any definite conclusions. Further well-designed prospective research using larger samples is warranted on this topic.

  • 38.
    Huttunen, Kerttu
    et al.
    Faculty of Humanities, Logopedics, and Child Language Research Center, University of Oulu, Finland; PEDEGO Research Unit, University of Oulu, Finland; MRC Oulu, Oulu, Finland; Oulu University Hospital, Department of Otorhinolaryngology, Head and Neck Surgery, Oulu, Finland.
    Erixon, Elsa
    Uppsala University, Department of Surgical Sciences, Section of Otorhinolaryngology and Head and Neck Surgery, Uppsala, Sweden.
    Löfkvist, Ulrika
    University of Oslo, Department of Special Needs Education, Oslo, Norway; Karolinska Institute, Department of Clinical Science, Intervention and Technology, Stockholm, Sweden.
    Mäki-Torkko, Elina
    Örebro universitet, Institutionen för medicinska vetenskaper. Audiological Research Center.
    The impact of permanent early-onset unilateral hearing impairment in children: A systematic review2019Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 120, s. 173-183Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Background: Decision-making on treatment and (re)habilitation needs to be based on clinical expertise and scientific evidence. Research evidence for the impact of permanent unilateral hearing impairment (UHI) on children's development has been mixed and, in some of the reports, based on fairly small, heterogeneous samples. Additionally, treatment provided has been highly variable, ranging from no action taken or watchful waiting up to single-sided cochlear implantation. Published information about the effects of treatment has also been heterogeneous. Moreover, earlier reviews and meta-analyses published on the impact of UHI on children's development have generally focused on select areas of development.

    Objectives: This systematic review aimed to summarize the impact of children's congenital or early onset unilateral hearing impairment on listening and auditory skills, communication, speech and language development, cognitive development, educational achievements, psycho-social development, and quality of life.

    Methods: Literature searches were performed to identify reports published from inception to February 16th, 2018 with the main electronic bibliographic databases in medicine, psychology, education, and speech and hearing sciences as the data sources. PubMed, CINALH, ERIC, LLBA, PsychINFO, and ISI Web of Science were searched for unilateral hearing impairment with its synonyms and consequences of congenital or early onset unilateral hearing impairment. Eligible were articles written in English, German, or Swedish on permanent unilateral hearing impairments that are congenital or with onset before three years of age. Hearing impairment had to be of at least a moderate degree with PTA >= 40 dB averaged over frequencies 0.5 to 2 or 0.5-4 kHz, hearing in the contralateral ear had to have PTA(0.5-2 kHz) or PTA(0.5-4 kHz) <= 20 dB, and consequences of unilateral hearing impairment needed to be reported in an unanimously defined population in at least one of the areas the review focused on.

    Four researchers independently screened 1618 abstracts and 566 full-text articles for evaluation of study eligibility. Eligible full-text articles were then reviewed to summarize the results and assess the quality of evidence. Additionally, data from 13 eligible case and multi-case studies, each having less than 10 participants, were extracted to summarize their results.

    Quality assessment of evidence was made adapting the Grades of Recommendations, Assessment, Development, and Evaluation (GRADE) process, and reporting of the results adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards.

    Results: Three articles with the quality of evidence graded as very-low to low, fulfilled the eligibility criteria set. Due to the heterogeneity of the articles, only a descriptive summary could be generated from the results. Unilateral hearing impairment was reported to have a negative impact on preverbal vocalization of infants and on sound localization and speech perception both in quiet and in noise.

    Conclusions: No high-quality studies of consequences of early-onset UHI in children were found. Inconsistency in assessing and reporting outcomes, the relatively small number of participants, low directness of evidence, and the potential risk of confounding factors in the reviewed studies prevented any definite conclusions. Further well-designed prospective research using larger samples is warranted on this topic.

  • 39. Irander, K.
    et al.
    Borres, Magnus P.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Ghafouri, B.
    The effects of physical exercise and smoking habits on the expression of SPLUNC1 in nasal lavage fluids from allergic rhinitis subjects2014Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 78, nr 4, s. 618-622Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: Palate lung nasal epithelial clone (PLUNC) is a family of proteins, which are proposed to participate in the innate immune defense against infections in the upper aero-digestive tract. The aim of this study was to investigate the expression of SPLUNC1 in allergic rhinitis subjects with considerations taken to the mucosa( function and smoking habits. Methods: The participants, recruited from a cohort followed from infancy, were re-examined at the age of 18 years regarding allergy development. Based on medical histories and skin prick tests the participants were classified into groups with persistent allergic rhinitis (n = 18), intermittent allergic rhinitis (n = 8) and healthy controls (n = 13). Seven subjects (3, 2 and 2 in each group, respectively) reported smoking habits. The SPLUNC1 levels in nasal lavage fluids were analyzed by Western blot. Changes in the volume of the proper nasal cavity before and after physical exercise (Vol2(increase)) were analyzed by acoustic rhinometiy. Results: Compared to the control group the SPLUNC1 level was significantly lower in the persistent allergy group (3.8 +/- 3.4 OD vs. 1.3 +/- 1.5 OD; p = 0.02), but not in the intermittent allergy group without current exposure to allergens (3.6 +/- 4.7 OD). No differences were found in Vol2(increase) between any of the allergy groups and controls. In smokers Vol2(increase) was significantly reduced (p < 0.01) and the SPLUNC1 levels were lower compared to non-smokers. A significant correlation was found between SPLUNC1 and vol2(increase) (p<0.01; r = 0.53) in non-smokers. Conclusions: Current allergen exposure has an impact on SPLUNC1 expression in nasal lavage fluid, why allergy ought to be considered in study populations where analyses of SPLUNC1 levels are included in the reports. The normal nasal decongestion after exercise was not affected by allergy in contrast to smoking habits. The correlation between SPLUNC1 levels and Vol2(increase) in non-smokers may indicate involvement of SPLUNC1 in the regulation of the normal function of the nasal mucosa. Complementary studies are needed to confirm the smoke-related reduction of SPLUNC1 expression and to analyze the possible participation of SPLUNC1 in the nasal mucosa regulation.

  • 40.
    Irander, Kristina
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Borres, M.P.
    Uppsala University, Sweden Thermo Fisher Science, Sweden .
    Ghafouri, Bijar
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Smärt och rehabiliteringscentrum. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Arbets- och miljömedicin.
    The effects of physical exercise and smoking habits on the expression of SPLUNC1 in nasal lavage fluids from allergic rhinitis subjects2014Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 78, nr 4, s. 618-622Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: Palate lung nasal epithelial clone (PLUNC) is a family of proteins, which are proposed to participate in the innate immune defense against infections in the upper aero-digestive tract. The aim of this study was to investigate the expression of SPLUNC1 in allergic rhinitis subjects with considerations taken to the mucosa( function and smoking habits. Methods: The participants, recruited from a cohort followed from infancy, were re-examined at the age of 18 years regarding allergy development. Based on medical histories and skin prick tests the participants were classified into groups with persistent allergic rhinitis (n = 18), intermittent allergic rhinitis (n = 8) and healthy controls (n = 13). Seven subjects (3, 2 and 2 in each group, respectively) reported smoking habits. The SPLUNC1 levels in nasal lavage fluids were analyzed by Western blot. Changes in the volume of the proper nasal cavity before and after physical exercise (Vol2(increase)) were analyzed by acoustic rhinometiy. Results: Compared to the control group the SPLUNC1 level was significantly lower in the persistent allergy group (3.8 +/- 3.4 OD vs. 1.3 +/- 1.5 OD; p = 0.02), but not in the intermittent allergy group without current exposure to allergens (3.6 +/- 4.7 OD). No differences were found in Vol2(increase) between any of the allergy groups and controls. In smokers Vol2(increase) was significantly reduced (p less than 0.01) and the SPLUNC1 levels were lower compared to non-smokers. A significant correlation was found between SPLUNC1 and vol2(increase) (pless than0.01; r = 0.53) in non-smokers. Conclusions: Current allergen exposure has an impact on SPLUNC1 expression in nasal lavage fluid, why allergy ought to be considered in study populations where analyses of SPLUNC1 levels are included in the reports. The normal nasal decongestion after exercise was not affected by allergy in contrast to smoking habits. The correlation between SPLUNC1 levels and Vol2(increase) in non-smokers may indicate involvement of SPLUNC1 in the regulation of the normal function of the nasal mucosa. Complementary studies are needed to confirm the smoke-related reduction of SPLUNC1 expression and to analyze the possible participation of SPLUNC1 in the nasal mucosa regulation.

  • 41. Johansson, Ewa
    et al.
    Hultcrantz, Elisabeth
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oto-Rhino-Laryngologi. Östergötlands Läns Landsting, RC - Rekonstruktionscentrum, ÖNH - Öron- Näsa- Halskliniken.
    Tonsillectomy - Clinical consequences twenty years after surgery?2003Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 67, nr 9, s. 981-988Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Tonsillectomy (T) is one of the most common surgical procedures performed on children. Long-term follow-up studies concerning its consequences are lacking. This study is the first study done on a group of patients that underwent T in their childhood, about 20 years ago. The investigation is a cohort study, which followed-up 18 patients who were tonsillectomized 20 years ago. It was to be determined whether these subjects suffer from more respiratory tract infections (or other infections) today, than people who are not tonsillectomized. A group of 54 age-matched subjects were selected for comparison. A questionnaire was mailed to the study population. No significant differences were found between the groups in the frequency of upper respiratory tract infection (URI). The mean number of URI's was approximately [MSOffice1]2.5 per year in both groups. The duration of the URI's was identical in each group. A high temperature was present to the same extent in each group. Absence from work, number of visits to physicians and the use of antibiotics were the same in each group. However, the prevalence of chronic disease was greater in the T-group than in the comparison group. The difference was significant with a Relative Risk of 9.41 and a Confidence Interval differing from 1 (1.13

  • 42.
    Knutsson, Johan
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Västerås. Vastmanland Cty Hosp, Dept Otorhinolaryngol, Vasteras, Sweden.;Orebro Univ Hosp, Dept Otolaryngol, Orebro, Sweden..
    Priwin, Claudia
    Sophiahemmet Univ, Dept Otorhinolaryngol, Stockholm, Sweden..
    Hessen-Soderman, Anne-Charlotte
    Cityakuten, Dept Otorhinolaryngol, Stockholm, Sweden.;Karolinska Inst, Div Clin Sci Intervent & Technol, Stockholm, Sweden..
    Rosenblad, Andreas
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Västerås.
    von Unge, Magnus
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Västerås. Vastmanland Cty Hosp, Dept Otorhinolaryngol, Vasteras, Sweden.;Akershus Univ Hosp, Dept Otorhinolaryngol, Campus Ahus, Oslo, Norway.;Univ Oslo, Campus Ahus, Oslo, Norway..
    A randomized study of four different types of tympanostomy ventilation tubes: Full-term follow-up2018Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 107, s. 140-144Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To evaluate the impact of tympanostomy ventilation tube material (silicone vs fluoroplastic) and shape (short vs long) regarding time to extrusion, occurrence of otorrhea, occlusion, tube removal and occurrence of persistent perforation.

    Methods and material: Four different types of ventilation tubes were used; Long Armstrong tubes, Donaldson tubes, Shepard tubes and straight tubes, representing four specific combinations of VT material (silicone or fluoroplastic) and shape (short, double flanged or long, single flanged). Four hundred children scheduled for bilateral tube insertion were included in a randomized trial. The patients received one type of tube in the right ear and another type in the left ear. The incidence of tube extrusion and complications were monitored post-operatively every third month by an otolaryngologist.

    Results: Twenty-two children were excluded during surgery. Out of the studied 378 children the mean age was 35.3 months. 63.8% were boys. Short tubes extruded earlier than long tubes; hazard ratio (HR) 4.84 (95% CI 3.50-6.69, p < 0.001). Long Armstrong tubes were least prone to extrude. Silicone tubes resulted in significantly longer time to first infection in a VT ear, HR 1.68 (95% CI 1.03-2.76, p = 0.039). Donaldson tubes rendered the longest mean time to first infection (p = 0.025). Infections did not affect tube extrusion rates significantly (p = 0.879). No significant differences were found regarding tube occlusion, tube extraction or persistent perforation.

    Conclusions: Long tubes are less prone to extrude early. Long Armstrong tubes have the least propensity to extrude early. Silicone tubes render significantly longer time to first infection. Donaldson tubes result in least infections. Infection does not affect extrusion rates significantly.

  • 43. Knutsson, Johan
    et al.
    Priwin, Claudia
    Sophiahemmet Högskola.
    Hessén-Söderman, Anne-Charlotte
    Rosenblad, Andreas
    von Unge, Magnus
    A randomized study of four different types of tympanostomy ventilation tubes: Full-term follow-up2018Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 107, s. 140-144, artikkel-id S0165-5876(18)30078-8Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To evaluate the impact of tympanostomy ventilation tube material (silicone vs fluoroplastic) and shape (short vs long) regarding time to extrusion, occurrence of otorrhea, occlusion, tube removal and occurrence of persistent perforation.

    METHODS AND MATERIAL: Four different types of ventilation tubes were used; Long Armstrong tubes, Donaldson tubes, Shepard tubes and straight tubes, representing four specific combinations of VT material (silicone or fluoroplastic) and shape (short, double flanged or long, single flanged). Four hundred children scheduled for bilateral tube insertion were included in a randomized trial. The patients received one type of tube in the right ear and another type in the left ear. The incidence of tube extrusion and complications were monitored postoperatively every third month by an otolaryngologist.

    RESULTS: Twenty-two children were excluded during surgery. Out of the studied 378 children the mean age was 35.3 months. 63.8% were boys. Short tubes extruded earlier than long tubes; hazard ratio (HR) 4.84 (95% CI 3.50-6.69, p < 0.001). Long Armstrong tubes were least prone to extrude. Silicone tubes resulted in significantly longer time to first infection in a VT ear, HR 1.68 (95% CI 1.03-2.76, p = 0.039). Donaldson tubes rendered the longest mean time to first infection (p = 0.025). Infections did not affect tube extrusion rates significantly (p = 0.879). No significant differences were found regarding tube occlusion, tube extraction or persistent perforation.

    CONCLUSIONS: Long tubes are less prone to extrude early. Long Armstrong tubes have the least propensity to extrude early. Silicone tubes render significantly longer time to first infection. Donaldson tubes result in least infections. Infection does not affect extrusion rates significantly.

    LEVEL OF EVIDENCE: 1b.

  • 44.
    Linder, Arne
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Öron-, näs- och halssjukdomar.
    Markström, Agneta
    Hultcrantz, Elisabeth
    Using the carbon dioxide laser for tonsillotomy in children1999Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 50, nr 1, s. 31-6Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Carbon dioxide laser tonsillotomies were performed on 33 children aged 1-12 years for the relief of obstructive symptoms due to tonsillar hyperplasia. As opposed to conventional tonsillectomy, only the protruding part of each tonsil was removed. A carbon dioxide laser delivering 20 W was used for the excision. Twenty-one children were seen in active short-term follow-up and the records of all the children were checked for possible surgery related events up to 20-33 months after surgery. Laser tonsillotomy was uniformly effective in relieving the obstruction, with good hemostasis. The tonsillar remnants healed completely within 2 weeks. No major adverse events occurred. Post-operative pain appeared slight and easily controlled. There was no gain in operating time compared with conventional tonsillectomy. The laser tonsillotomies were in most cases done in day surgery. No recurrence of obstructive problems was reported up to 20-33 months after surgery. It was concluded that tonsillotomy, using a carbon dixoide laser, is a valid treatment for obstructive symptoms caused by enlarged tonsils, which can be performed with little bleeding and post-operative pain. The improved hemostasis may enable a shift from in-patient to day surgery.

  • 45. Lofkvist, Ulrika
    et al.
    Almkvist, Ove
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen.
    Lyxell, Bjoern
    Tallberg, Ing-Mari
    Lexical and semantic ability in groups of children with cochlear implants, language impairment and autism spectrum disorder2014Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 78, nr 2, s. 253-263Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: Lexical-semantic ability was investigated among children aged 6-9 years with cochlear implants (CI) and compared to clinical groups of children with language impairment (LI) and autism spectrum disorder (ASD) as well as to age-matched children with normal hearing (NH). In addition, the influence of age at implantation on lexical-semantic ability was investigated among children with Cl. Methods: 97 children divided into four groups participated, CI (n = 34), LI (n = 12), ASD (n = 12), and NH (n = 39). A battery of tests, including picture naming, receptive vocabulary and knowledge of semantic features, was used for assessment. A semantic response analysis of the erroneous responses on the picture-naming test was also performed. Results: The group of children with Cl exhibited a naming ability comparable to that of the age-matched children with NH, and they also possessed a relevant semantic knowledge of certain words that they were unable to name correctly. Children with CI had a significantly better understanding of words compared to the children with LI and ASD, but a worse understanding than those with NH. The significant differences between groups remained after controlling for age and non-verbal cognitive ability. Conclusions: The children with Cl demonstrated lexical-semantic abilities comparable to age-matched children with NH, while children with LI and ASD had a more atypical lexical-semantic profile and poorer sizes of expressive and receptive vocabularies. Dissimilar causes of neurodevelopmental processes seemingly affected lexical-semantic abilities in different ways in the clinical groups.

  • 46.
    Lundberg, Thorbjörn
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Biagio, Leigh
    Univ Pretoria, Dept Speech Language Pathol & Audiol, ZA-0002 Pretoria, South Africa.
    Laurent, Claude
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Öron- näs- och halssjukdomar. Univ Pretoria, Dept Speech Language Pathol & Audiol, ZA-0002 Pretoria, South Africa.
    Sandström, Herbert
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Swanepoel, De Wet
    Univ Pretoria, Dept Speech Language Pathol & Audiol, ZA-0002 Pretoria, South Africa.
    Remote evaluation of video-otoscopy recordings in an unselected pediatric population with an otitis media scale2014Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 78, nr 9, s. 1489-1495Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: A recently validated image-based grading scale for acute otitis media (OMGRADE) can be used to assess tympanic membrane (TM) status. The aim of this study was to evaluate the validity and reliability of this scale for remote assessments of TM status using video-otoscopy recordings in an unselected pediatric population.

    Method: Children 2-16 years attending a South African primary health clinic were offered an ear examination by an otologist using otomicroscopy. An ear and hearing telehealth facilitator then made video-otoscopy recordings (9 – 33 seconds) of the ears and uptakes were uploaded to a secure server for remote assessments in Sweden by an otologist and general practitioner at four- and eight-weeks post onsite assessment. TM appearance was judged according to the OMGRADE scale. Concordance between onsite otomicroscopy and asynchronous assessments of video-otoscopy recordings was calculated together with intra- and inter-rater agreements.

    Results: One hundred and eighty ears were included. Concordance of TM classifications using the OMGRADE scale was found to be substantial (weighted kappa range 0,66-0,79). Intra- and inter-rater agreement (test-retest) was found to be substantial to almost perfect (weighted kappa range 0,85-0,88 and 0,69-0,72, respectively).

    Conclusion: The OMGRADE scale can be used to accurately assess the normal TM and secretory otitis media (SOM) remotely using video-otoscopy recordings in an unselected pediatric population.

  • 47.
    Lundberg, Thorbjörn
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    de Jager, Leigh Biagio
    Swanepoel, De Wet
    Laurent, Claude
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Öron- näs- och halssjukdomar. Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa.
    Diagnostic accuracy of a general practitioner with video-otoscopy collected by a health care facilitator compared to traditional otoscopy2017Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 99, s. 49-53Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: Video-otoscopy is rapidly developing as a new method to diagnose common ear disease and can be performed by trained health care facilitators as well as by clinicians. This study aimed to compare remote asynchronous assessments of video-otoscopy with otoscopy performed by a general practitioner. Method: Children, aged 2-16 years, attending a health center in Johannesburg, South Africa, were examined. An otologist performed otomicroscopy and a general practitioner performed otoscopy. Video-otoscopy was performed by a health care facilitator and video sequences were stored on a server for assessment by the same general practitioner 4 and 8 weeks later. At all examinations, a diagnosis was set and the tympanic membrane appearance was graded using the OMgrade-scale. The otologist's otomicroscopic diagnosis was set as reference standard to compare the accuracy of the two otoscopic methods. Results: Diagnostic agreement between otologist's otomicroscopic examination and the general practitioner's otoscopic examination was substantial (kappa 0.66). Agreement between onsite otomicroscopy and the general practitioners asynchronous video assessments were also substantial (kappa 0.70 and 0.80). Conclusion: Video-otoscopy performed by a health care facilitator and assessed asynchronously by a general practitioner had similar or better accuracy compared to face-to-face otoscopy performed by a general practitioner.

  • 48.
    Lundberg, Thorbjörn
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Westman, Göran
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Hellström, Sten
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Öron- näs- och halssjukdomar.
    Sandström, Herbert
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Digital imaging and telemedicine as a tool for studying inflammatory conditions in the middle ear: evaluation of image quality and agreement between examiners2008Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 72, nr 1, s. 73-79Artikkel i tidsskrift (Annet vitenskapelig)
    Abstract [en]

    Objective: To evaluate digital imaging of the tympanic membrane by telemedicine technology and study interpersonal agreement in assessing image quality.

    Methods: In an open consecutive study, 64 children aged 2-16 years who attended three rural health care centres in Northern Sweden with otalgia were examined with video endoscopic photography of their tympanic membrane in a telemedical environment. One hundred and twenty-four images were stored in a central database and Later assessed independently regarding image quality by an ENT specialist, a general practitioner and a registrar in general practice. The overall image quality was graded (0-2) regarding assessment of signs of tympanic membrane inflammation. ALL images were also assessed regarding 8 different components, four image-related components and four anatomically related components.

    Results: Overall image quality was good, with 82.3% of acceptable or excellent quality. The position and thickness of the TM were found to be the most important factors of the images to be able to assess inflammatory disease. Image quality tended to be higher later in the study as a sign of improved skills of examiners. Interpersonal agreement between examiners was acceptable. Overall grade showed k 0.56, 0.49 and 0.66 respectively, and focus, light and existence of obscuring objects were the components with the highest agreement.

    Conclusions: The image quality of video endoscopy of the tympanic membrane was good overall. Interpersonal agreement in evaluating image quality was acceptable but not excellent. The use of digital imaging of good quality in clinical studies can offer an objective clinical evaluation of the TM in retrospect by independent reviewers using strict criteria.

  • 49.
    Löfkvist, Ulrika
    et al.
    Linköpings universitet, Institutet för handikappvetenskap (IHV). Karolinska University Hospital, Stockholm, Sweden.
    Almkvist, Ove
    Stockholm University / Karolinska University Hospital, Stockholm, Sweden.
    Lyxell, Björn
    Linköpings universitet, Institutet för handikappvetenskap (IHV). Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten. Östergötlands Läns Landsting, Sinnescentrum, Öron- näsa- och halskliniken US.
    Tallberg, Ing-Mari
    Karolinska University Hospital / Karolinska Institute, Stockholm, Sweden.
    Lexical and semantic ability in groups of children with cochlear implants, language impairment and autism spectrum disorder2014Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 78, nr 2, s. 253-263Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective

    Lexical-semantic ability was investigated among children aged 6–9 years with cochlear implants (CI) and compared to clinical groups of children with language impairment (LI) and autism spectrum disorder (ASD) as well as to age-matched children with normal hearing (NH). In addition, the influence of age at implantation on lexical-semantic ability was investigated among children with CI.

    Methods

    97 children divided into four groups participated, CI (n = 34), LI (n = 12), ASD (n = 12), and NH (n = 39). A battery of tests, including picture naming, receptive vocabulary and knowledge of semantic features, was used for assessment. A semantic response analysis of the erroneous responses on the picture-naming test was also performed.

    Results

    The group of children with CI exhibited a naming ability comparable to that of the age-matched children with NH, and they also possessed a relevant semantic knowledge of certain words that they were unable to name correctly. Children with CI had a significantly better understanding of words compared to the children with LI and ASD, but a worse understanding than those with NH. The significant differences between groups remained after controlling for age and non-verbal cognitive ability.

    Conclusions

    The children with CI demonstrated lexical-semantic abilities comparable to age-matched children with NH, while children with LI and ASD had a more atypical lexical-semantic profile and poorer sizes of expressive and receptive vocabularies. Dissimilar causes of neurodevelopmental processes seemingly affected lexical-semantic abilities in different ways in the clinical groups.

  • 50.
    Löfstrand Tideström, Britta
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper.
    Hultcrantz, Elisabeth
    Development of craniofacial and dental arch morphology in relation to sleep  disordered breathing from 4 to 12 years: Effects of adenotonsillar surgery2010Inngår i: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 74, nr 2, s. 137-143Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: To study the development of craniofacial and dental arch morphology in children with sleep disordered breathing in relation to adenotonsillar surgery. SUBJECTS AND METHODS: From a community-based cohort of 644 children, 393 answered questionnaires at age 4, 6 and 12 years. Out of this group, 25 children who were snoring regularly at age 4 could be followed up to age 12 together with 24 controls not snoring at age 4, 6 and 12 years. Study casts were obtained from cases and controls and lateral cephalograms from the cases. Analysis regarding facial features and dento-alveolar development was performed. RESULTS: Children snoring regularly at age 4 showed reduced transversal width of the maxilla and more frequently had anterior open bite and lateral cross-bite than the controls. These conditions persisted for most cases at age 6, by which time 18/25 had been operated for snoring. In most of the cases, surgery cured the snoring temporarily, but their width of the maxilla was still smaller by age 12-even when nasal breathing was attained. At age 12, the frequency of lateral cross-bite was much reduced and anterior open bite was resolved, both in cases and controls. The children who snored regularly at age 12 operated or not operated, showed a long face anatomy and were oral breathers (this applied even to those who were operated). The seven cases who were not operated and the five who were still snoring in spite of surgery at age 12, did not have reduced maxillary width as compared to the controls. CONCLUSION: Dento-facial development in snoring children is not changed by adenotonsillar surgery regardless of symptom relief. If snoring persists or relapses orthodontic maxillar widening and/or functional training should be considered. Collaboration between otorhinolaryngologist, orthodontists and speech and language pathologists is strongly recommended.

12 1 - 50 of 69
RefereraExporteraLink til resultatlisten
Permanent link
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annet format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annet språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf