Martin Durisin
Research interests
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InterestsOtology, Rhinology, Hearing Loss, Hearing Disorders, Nasal Polyps, Audiology, Hearing, Head and Neck Neoplasms
Publications
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Electron microscopy changes of cochlear implant electrodes with permanently high impedances.
Cochlear implants international. 11/2011; 12(4):228-33.
Impedance measurements by means of telemetry have provided us with an objective test of cochlear implant function. Unmeasurable impedance suggests a possible defect on the corresponding channel of the electrode. However, increasing impedances could suggest inflammatory and/or proliferating processes... [more] Impedance measurements by means of telemetry have provided us with an objective test of cochlear implant function. Unmeasurable impedance suggests a possible defect on the corresponding channel of the electrode. However, increasing impedances could suggest inflammatory and/or proliferating processes along the electrode. In this report we examined correlations between high impedance, measured in vivo and in vitro findings on the electrode surfaces. We describe recurrent increases in cochlear implant electrode impedance in the same channels, which could initially be reversed by reprogramming the implant, and with anti-inflammatory treatment using cortisone and antibiotics. Subsequently, however, the impedances remained consistently high, indicating a cochlear implant defect. After the removal of the cochlear implant, the electrodes were examined using light and scanning electron microscopy. Examination of the electrodes with normal impedance values revealed, in the great majority of the electrodes, silver shining surfaces. On the other hand, electrodes with high impedances were found coated with tissue. Further analysis of these electrodes using scanning electron microscopy also demonstrated surface changes. Persistently high impedances were related to changes on the electrodes' surface and to coating with tissue in this case. These changes can result in adhesive processes and technical malfunction, leading to explantation and difficult re-implantation. Therefore, close and professional supervision of cochlear implant patients is needed.
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1.44Impact points
Outcomes and special considerations of cochlear implantation in waardenburg syndrome.
Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 04/2011; 32(6):951-5.
The objective of this study was a state-of-the-art analysis of cochlear implantation in patients with Waardenburg syndrome (WS). Twenty-five patients with WS treated with cochlear implants in our department from 1990 to 2010. The 25 patients with WS underwent 35 cochlear implantations. Hearing outco... [more] The objective of this study was a state-of-the-art analysis of cochlear implantation in patients with Waardenburg syndrome (WS). Twenty-five patients with WS treated with cochlear implants in our department from 1990 to 2010. The 25 patients with WS underwent 35 cochlear implantations. Hearing outcome was evaluated using HSM sentence test in 65 dB in quiet, Freiburg Monosyllabic Test, and categories of auditory performance for children and compared with that of a control group. Anatomic abnormalities of the inner ear were examined using magnetic resonance imaging and computed tomography of the temporal bones. The mean follow-up time was 8.3 years (range, 0.3-18.3 yr). The majority achieved favorable postimplantation performance with mean HSM scores of 75.3% (range, 22.6%-99%) and Freiburg Monosyllabic Test scores of 67.8% (range, 14%-95%). However, in 4 cases, the results were less satisfactory. The comparison with the control group did not reveal any statistical significance (p = 0.56). In 6 patients (24%), behavioral disorders caused temporary difficulties during the rehabilitation procedure. Except of isolated large vestibule in 1 patient, the radiological assessment of the 50 temporal bones did not reveal any temporal bone abnormalities. Most patients with WS performed well with cochlear implants. However, WS is related to behavioral disorders that may cause temporary rehabilitation difficulties. Finally, temporal bone malformations that could affect cochlear implantation are notcharacteristic of WS.
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1.44Impact points
Cochlear osteoneogenesis after meningitis in cochlear implant patients: a retrospective analysis.
Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 09/2010; 31(7):1072-8.
Retrospective clinical study. Academic tertiary referral center at the Medical University of Hannover. Computed tomographic findings of 126 patients (95 children and 31 adults) profoundly deafened by meningitis during a period of 20 years were evaluated. Children were defined as up to 12 years old a... [more] Retrospective clinical study. Academic tertiary referral center at the Medical University of Hannover. Computed tomographic findings of 126 patients (95 children and 31 adults) profoundly deafened by meningitis during a period of 20 years were evaluated. Children were defined as up to 12 years old at the onset of meningitis. No patients showed any relevant bilateral auditory brainstem response thresholds at the time of admission to our clinic. Patient histories, surgical findings, and imaging results were analyzed by experienced surgeons/neuroradiologists. Of 95 children, 30 (32%) displayed symptoms of labyrinthitis ossificans, whereas 11 (36%) of 31 adults showed changes of the bony structure of the cochlea. High-resolution computed tomography (HRCT) evaluation indicated that the ossification was detected more frequently if there was a larger time interval between onset of meningitis and high-resolution computed tomographic scan. Bilateral ossification at various stages was observed in 67% of children and 55% of adults with obliteration. In the comparison of cochlear ossification found in computed tomographic scans and intraoperative obliteration, HRCT showed a specificity of 73% and a sensitivity of 88%. The intraoperative evaluation revealed various stages of cochlear obliteration in 44% of children and 39% of adults. In our study, the earliest onset of labyrinthitis ossificans was found in high-resolution computed tomographic scans as early as 4 weeks after the onset of meningitis. In most cases, ossification occurred bilaterally with predominantly asymmetric involvement of both ears. The rate of osteoneogenesis increases significantly over time after meningitis. This leads to the conclusion that cochlear ossification can start very early and increase over time with unpredictable speed. Cochlear ossification typically develops bilaterally. From these results, we conclude that cochlear implantation should be performed bilaterally as soon as possible after meningitis and deafness have been diagnosed. HRCT offers good specificity but only limited sensitivity. Preoperative diagnostics should include magnetic resonance imaging to optimize preparation for cochlear implantation.
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Investigation of Balance Function Using Dynamic Posturography under Electrical-Acoustic Stimulation in Cochlear Implant Recipients
International Journal of Otolaryngology. 01/2010;
Introduction. The purpose of the present study is to investigate the effect of electrical-acoustic stimulation on vestibular function in CI patients by using the EquiTest and to help answer the question of whether electrically stimulating the inner ear using a cochlear implant influences the balance... [more] Introduction. The purpose of the present study is to investigate the effect of electrical-acoustic stimulation on vestibular function in CI patients by using the EquiTest and to help answer the question of whether electrically stimulating the inner ear using a cochlear implant influences the balance system in any way. Material and Methods. A test population (n=50) was selected at random from among the cochlear implant recipients. Dynamic posturography (using the EquiTest) was performed with the device switched off an switched on. Results. In summary, it can be said that an activated cochlear implant affects the function of the vestibular system and may, to an extent, even lead to a stabilization of balance function under the static conditions of dynamic posturography, but nevertheless also to a significant destabilization. Significant improvements in vestibular function were seen mainly in equilibrium scores under conditions 4 and 5, the composite equilibrium score, and the vestibular components as revealed by sensory analysis. Conclusions. Only under the static conditions are significantly poorer scores achieved when stimulation is applied. It may be that the explanation for any symptoms of dizziness lies precisely in the fact that they occur in supposedly noncritical situations, since, when the cochlear implant makes increased demands on the balance system, induced disturbances can be centrally suppressed.
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Investigation of Balance Function Using Dynamic Posturography under Electrical-Acoustic Stimulation in Cochlear Implant Recipients.
International journal of otolaryngology. 01/2010; 2010:978594.
Introduction. The purpose of the present study is to investigate the effect of electrical-acoustic stimulation on vestibular function in CI patients by using the EquiTest and to help answer the question of whether electrically stimulating the inner ear using a cochlear implant influences the balance... [more] Introduction. The purpose of the present study is to investigate the effect of electrical-acoustic stimulation on vestibular function in CI patients by using the EquiTest and to help answer the question of whether electrically stimulating the inner ear using a cochlear implant influences the balance system in any way. Material and Methods. A test population (n = 50) was selected at random from among the cochlear implant recipients. Dynamic posturography (using the EquiTest) was performed with the device switched off an switched on. Results. In summary, it can be said that an activated cochlear implant affects the function of the vestibular system and may, to an extent, even lead to a stabilization of balance function under the static conditions of dynamic posturography, but nevertheless also to a significant destabilization. Significant improvements in vestibular function were seen mainly in equilibrium scores under conditions 4 and 5, the composite equilibrium score, and the vestibular components as revealed by sensory analysis. Conclusions. Only under the static conditions are significantly poorer scores achieved when stimulation is applied. It may be that the explanation for any symptoms of dizziness lies precisely in the fact that they occur in supposedly noncritical situations, since, when the cochlear implant makes increased demands on the balance system, induced disturbances can be centrally suppressed.
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0.65Impact points
Audiological performance in cochlear implanted patients deafened by meningitis depending on duration of deafness.
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 04/2008; 265(4):381-8.
The objective of our study was to evaluate audiological outcome in cochlear implanted children deafened by meningitis and its correlation with duration of deafness from meningitis in a retrospective clinical study at an academic tertiary referral center. Sixty patients profoundly deafened by meningi... [more] The objective of our study was to evaluate audiological outcome in cochlear implanted children deafened by meningitis and its correlation with duration of deafness from meningitis in a retrospective clinical study at an academic tertiary referral center. Sixty patients profoundly deafened by meningitis were evaluated. Two groups of children depending on duration of deafness--group 1 defined by duration of deafness less than 6 months and group 2 defined by duration of deafness over 6 months were evaluated. The control group A (duration of deafness <6 months) and group B (duration of deafness >6 months) with similar demographics data and a non-meningitis-related cause of deafness were evaluated. Patient history, cochlear implantation and audiological findings (MAIS, MUSS and open set tests questionnaire) were investigated. Standardized diagnostic and therapeutic procedure was performed in all patients. Our results showed better auditory performance and language control in children implanted within 6 months after meningitis. Over the period of 36 months group 2 was able to catch up with the group 1 in the MUSS and MAIS tests. However, the results of the common phrases test remain significantly better in group 1 over this time period (P=0.0188). In case of meningitis, audiological and radiological assessment should be performed within 4 weeks after the onset of disease. We see a clear indication for immediate implantation in patients with profound SNHL caused by meningitis. The aim should be bilateral implantation in this population to achieve the best possible performance by implantation before obliteration occurs. Premeningetic auditory experience is an important advantage which should be used. Frequent bilateral and sometimes late obliteration should be taken into consideration in the decision-making process as well.
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0.98Impact points
Speech and music perception with the new fine structure speech coding strategy: preliminary results.
Acta oto-laryngologica. 01/2008; 127(12):1298-303.
CONCLUSIONS: Taking into account the excellent results with significant improvements in the speech tests and the very high satisfaction of the patients using the new strategy, this first implementation of a fine structure strategy could offer a new quality of hearing with cochlear implants (CIs). OB... [more] CONCLUSIONS: Taking into account the excellent results with significant improvements in the speech tests and the very high satisfaction of the patients using the new strategy, this first implementation of a fine structure strategy could offer a new quality of hearing with cochlear implants (CIs). OBJECTIVE: This study consisted of an intra-individual comparison of speech recognition, music perception and patient preference when subjects used two different speech coding strategies with a MedEl Pulsar CI: continuous interleaved sampling (CIS) and the new fine structure processing (FSP) strategy. In contrast to envelope-based strategies, the FSP strategy also delivers subtle pitch and timing differences of sound to the user and is thereby supposed to enhance speech perception in noise and increase the quality of music perception. PATIENTS AND METHODS: This was a prospective study assessing performance with two different speech coding strategies. The setting was a CI programme at an academic tertiary referral centre. Fourteen post-lingually deaf patients using a MedEl Pulsar CI with a mean CI experience of 0.98 years were supplied with the new FSP speech coding strategy. Subjects consecutively used the two different speech coding strategies. Speech and music tests were performed with the previously fitted CIS strategy, immediately after fitting with the new FSP strategy and 4, 8 and 12 weeks later. The main outcome measures were individual performance and subjective assessment of two different speech processors. RESULTS: Speech and music test scores improved statistically significantly after conversion from CIS to FSP strategy. Twelve of 14 patients preferred the new FSP speech processing strategy over the CIS strategy.
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0.66Impact points
Primary central nervous system lymphoma presenting as bilateral tumors of the internal auditory canal.
Skull base : official journal of North American Skull Base Society ... [et al.]. 12/2007; 17(6):409-12.
The increasing incidence of central nervous system (CNS) lymphoma in the general population, especially in young adults with AIDS, should alert the otolaryngologist that in future there will be an even greater incidence of this rare disease. It may be responsible for hearing loss accompanied by othe... [more] The increasing incidence of central nervous system (CNS) lymphoma in the general population, especially in young adults with AIDS, should alert the otolaryngologist that in future there will be an even greater incidence of this rare disease. It may be responsible for hearing loss accompanied by other neurological deficits. CNS lymphoma often has a rapidly progressive course. Early diagnosis and rapid therapy are crucial for a better prognosis. We report a case of primary CNS lymphoma involving both internal auditory canals that presented with sudden deafness and disequilibrium accompanied by facial and abducens nerve palsy.
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0.65Impact points
Otogenic cerebellar abscess due to purulent labyrinthitis and defect of the superior semicircular canal and its propagation through the endolymphatic sac.
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 09/2007; 264(8):955-8.
The otogenic cerebellar abscess still is one of the most dangerous complications of otitis media and implicates a high risk of mortality. Early diagnosis and therapy are decisive factors for the chances of rehabilitation. Radiologic imaging (CT/MRI) plays an important role. A broad-spectrum antibiot... [more] The otogenic cerebellar abscess still is one of the most dangerous complications of otitis media and implicates a high risk of mortality. Early diagnosis and therapy are decisive factors for the chances of rehabilitation. Radiologic imaging (CT/MRI) plays an important role. A broad-spectrum antibiotic according to antibiogram is indispensable. The type of surgical intervention depends on the cause and localization of the abscess. In this case the cerebellar abscess was a complication resulting from labyrinthitis, which was propagated through the endolymphatic duct and sac to the posterior fossa dura. Consequently, it could be cured ultimately only after petrosectomy and abscess drainage toward the mastoid cavity. It is mandatory to completely sanitize the infection surgically in order to avoid lethal complication especially in case of a delayed clinical course or recurrent symptoms of labyrinth involvement. Close interdisciplinary collaboration between ORL, neurosurgery and neuroradiology is desirable for successful therapy.
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0.65Impact points
Cavernous hemangioma of the internal auditory canal.
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 06/2007; 264(5):569-71.
Hemangiomas rarely occur in the internal auditory canal. These tumors originate from the capillary bed of the epineurium surrounding the nerve and can either compress or infiltrate the nerve. Depending on location and the nerve of origin, these lesions can cause severe and progressive sensorineural ... [more] Hemangiomas rarely occur in the internal auditory canal. These tumors originate from the capillary bed of the epineurium surrounding the nerve and can either compress or infiltrate the nerve. Depending on location and the nerve of origin, these lesions can cause severe and progressive sensorineural hearing loss, tinnitus, facial nerve palsy, or vertigo even when they are relatively small. The presence of a small contrast-enhancing tumor in the internal auditory canal accompanied by severe sensorineural hearing loss and facial nerve palsy, should raise the suspicion of a hemangioma. Early recognition and surgical intervention in these benign tumors may improve the chance of preserving the functional integrity of the facial nerve and provides better results after nerve reconstruction. Due to their relative small size, the temporal bone CT-scan may show no evidence of pathological widening of the internal auditory canal or the typical intralesional calcifications at the time of presentation. MRI with Gadolinium is the imaging method of choice and a high index of clinical suspicion is necessary for the diagnosis of these tumors. In this paper we report about a 51-year-old male presented with right-sided sensory-neural deafness and facial nerve palsy, accompanied by severe tinnitus and ipsilateral loss of vestibular function due to a cavernous hemangioma in the internal auditory canal.
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0.66Impact points
A case of multiple primary tumors of the anterior skull base.
Skull base : official journal of North American Skull Base Society ... [et al.]. 04/2007; 17(2):153-6.
We report a case of synchronous olfactory bulb meningioma and undifferentiated carcinoma of the nose and paranasal sinuses that involved and destroyed the anterior skull base and mimicked intracranial invasion by a carcinoma. The heterogeneity of tissue types in the skull base gives rise to a divers... [more] We report a case of synchronous olfactory bulb meningioma and undifferentiated carcinoma of the nose and paranasal sinuses that involved and destroyed the anterior skull base and mimicked intracranial invasion by a carcinoma. The heterogeneity of tissue types in the skull base gives rise to a diverse variety of benign and malignant neoplasms which have totally different prognoses. Synchronous development of benign and malignant primary tumors both originating from and involving the skull base at the same location is very rare and may cause confusion for both the skull base surgeon and neuroradiologist.
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0.30Impact points
[Exostosis of the internal auditory canal in a patient with myotonic dystrophy]
Laryngo- rhino- otologie. 11/2006; 85(10):755-9.
A 53-year-old patient with myotonic dystrophy presented to our clinic with progressive bilateral hearing loss. The ENT status and particularly the otological examination were without pathological signs. Pure tone audiograms showed a bilateral moderate to severe sensorineural hearing loss. Routinely ... [more] A 53-year-old patient with myotonic dystrophy presented to our clinic with progressive bilateral hearing loss. The ENT status and particularly the otological examination were without pathological signs. Pure tone audiograms showed a bilateral moderate to severe sensorineural hearing loss. Routinely performed computed tomography of the temporal bones revealed the rare picture of exostosis of the internal auditory canals and the medial surface of the petrous bones. To our knowledge, this is the first report describing exostosis of the internal auditory canal in a patient with myotonic dystrophy, although at present it remains unclear in how far there is a causal connection between these two pathologies.
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0.30Impact points
[Peripheral facial palsy as the first symptom of a metastatic bronchogenic carcinoma]
Laryngo- rhino- otologie. 08/2006; 85(7):512-6.
BACKGROUND: We present a case of a facial palsy as the initial symptom of a bronchogenic carcinoma. METHODS: Case-report. A 56-year-old patient presented with a peripheral facial palsy. The clinical picture as well as the temporal bone CT were without pathological findings. A 10-day rheologic therap... [more] BACKGROUND: We present a case of a facial palsy as the initial symptom of a bronchogenic carcinoma. METHODS: Case-report. A 56-year-old patient presented with a peripheral facial palsy. The clinical picture as well as the temporal bone CT were without pathological findings. A 10-day rheologic therapy as well as anti-viral medication were not successful. Five days after rheological therapy had been completed, the patient presented a swelling of the neck. In the computer tomography we found a bilateral thrombosis of the internal jugular vein. In addition, the clinical picture of a left-sided glossopharyngeal palsy appeared. The following thorax CT as well as the diagnostic extirpation of an enlarged cervical lymph node lead to the diagnosis of a metastasized smallcell neuro-endocrine bronchogenic carcinoma with a compression of the right primary bronchus and the vena cava superior as well as an upper inflow congestion. In the cMRT we furthermore found a metastasis in the area of the foramen stylomastoideum. The patient underwent emergency radiation and chemotherapy. RESULTS: According to the present findings, this metastasis lead to the facial palsy as the initial symptom of the bronchogenic carcinoma. CONCLUSION: Therefore, therapy resistant facial palsy should be further diagnosed in detail, especially examined by imaging procedures.
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0.30Impact points
[Embryonal rhabdomyosarcoma of the orbita]
Laryngo- rhino- otologie. 03/2006; 85(2):124-7.
A 2(1/2) year old girl was presented with an acute, painless orbital swelling without signs of local or systemic inflammation. CT and MRT scanning revealed a tumor which by open biopsy disclosed embryonal rhabdomyosarcoma. By means of this case we present the current diagnostic and therapeutic appro... [more] A 2(1/2) year old girl was presented with an acute, painless orbital swelling without signs of local or systemic inflammation. CT and MRT scanning revealed a tumor which by open biopsy disclosed embryonal rhabdomyosarcoma. By means of this case we present the current diagnostic and therapeutic approaches for childhood soft tissue sarcomas. At present our patient receives a poly-chemotherapy which has already shown a good response. For local tumor control, a complete surgical resection as well as radiotherapy may be indicated and have to be considered carefully with respect to the possible late effects. This case demonstrates that in a child with a unilateral, progressive orbital tumor, the differential diagnosis of a soft tissue sarcoma has to be ruled out.
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0.30Impact points
[The interesting case -- case no. 65].
Laryngo- rhino- otologie. 11/2004; 83(11):750-3.
Bilateral Osteomyelitis following frontal sinusitis is a rare complication in the antibiotic era. The main risk of a progredient course is mainly the formation of external subperiostal, epidural, subdural abscesses or brain abscesses with potentially life-threatening complications. This is a report ... [more] Bilateral Osteomyelitis following frontal sinusitis is a rare complication in the antibiotic era. The main risk of a progredient course is mainly the formation of external subperiostal, epidural, subdural abscesses or brain abscesses with potentially life-threatening complications. This is a report on a patient who presented in our department with progredient cephalgia and swelling in the area around the glabella and frontal sinus. Macroscopical examination revealed septum deviation to the right side and nasal polyposis of the right nasal passage. A computed tomography of the paranasal sinuses showed subtotal soft tissue obstruction of all sinuses with the exception of the sphenoidal sinus. Bilateral osteolysis of the ventral osseous borders of the frontal sinus with accompanying osteosclerosis was also observed. The therapy consisted of radical frontal sinus surgery via Unterberger approach. This case demonstrates a rare case of bilateral frontal osteomyelitis together with the necessary diagnostic and therapeutic measures. The management consisted of the removal of all osteomyelitic bone and antibiotic therapy. Differential diagnostic procedures must be carried out in order to exclude orbital and intracranial complications. Regular follow-up examinations and a CT scan of the paranasal sinuses are part of the standard therapy.
Following (2)
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Heinrich Lanfermann
Medizinische Hochschule Hannover -
Andreas Büchner
Medizinische Hochschule Hannover
