Burkard Schwab

Burkard Schwab
HELIOS Klinikum Hildesheim · ENT

Prof. Dr.

About

129
Publications
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Publications

Publications (129)
Article
Full-text available
Nowadays, several options are available to treat patients with conductive or mixed hearing loss. Whenever surgical intervention is not possible or contra-indicated, and amplification by a conventional hearing device (e.g., behind-the-ear device) is not feasible, then implantable hearing devices are an indispensable next option. Implantable bone-con...
Article
Full-text available
Purpose To review types and frequencies of adverse events (AE) associated with bone-conduction hearing implants (BCHIs) and active middle-ear implants (aMEIs) as reported in the literature. Methods Cochrane, PubMed, and EMBASE libraries were searched for primary articles in English or German language that reported on adverse events following BCHI...
Article
Zhang C et al. Physical and psychological outcomes of simple sigmoid sinus bony wall repair for pulsatile tinnitus due to sigmoid sinus wall anomalies. Eur Arch Otorhinolaryngol 2019; 276: 1327–1334 Ein pulsatiler Tinnitus (PT) aufgrund von Anomalien der sigmoiden Sinuswand (SSWA) ist eine häufige Gesundheitsstörung. In einer retrospektiven Studie...
Article
Full-text available
There is currently no standardized method for reporting audiological, surgical and subjective outcome measures in clinical trials with active middle ear implants (AMEIs). It is often difficult to compare studies due to data incompatibility and to perform meta-analyses across different centres is almost impossible. A committee of ENT and audiologica...
Article
Objective: To evaluate possible increases in bone conduction (BC) hearing thresholds in patients undergoing subtotal petrosectomy (SP) with fat obliteration and blind sac closure of the outer ear canal and subsequent round window vibroplasty. Patients and interventions: Between 1997 and 2013, 43 patients (45 ears) with combined hearing loss and...
Article
Purpose: The purpose of this study was to describe the role of explorative tympanotomy in patients with Profound Sudden Sensorineural Hearing Loss (SSNHL) without clinical evidence of perilymphatic or labyrinthine fistula and to compare intraoperative findings with the postoperative hearing outcome. Study design: Retrospective study of all patie...
Article
Full-text available
The objective of the study was to examine the impact of the surgical wound closure technique as protection of the obliterated tympanomastoid cavity on the revision surgery rate after subtotal petrosectomy (SP). This is a retrospective case series conducted in a tertiary care referral center. 199 patients (212 ears) with recurrent chronic otitis med...
Article
Objectives: In conductive, mixed hearing losses and single-sided-deafness bone-anchored hearing aids are a well-established treatment. The transcutaneous transmission across the intact skin avoids the percutaneous abutment of a bone-anchored device with the usual risk of infections and requires less care.In this study, the audiological results of...
Article
Full-text available
The new implantable hearing system Codacs™ was designed to close the treatment gap between active middle ear implants and cochlear implants in cases of severe-to-profound mixed hearing loss. The Codacs™ actuator is attached to conventional stapes prosthesis during the implantation and thereby provides acoustical stimulation through a stapedotomy to...
Article
Subtotal petrosectomy combined with obliteration of the tympanomastoid is a standard procedure to treat temporal bones in patients with radical cavity and chronic infections. Currently, patients with profound-to-severe sensorineural hearing loss are often fitted with cochlear implants. In the case of profound mixed hearing loss, active middle ear i...
Article
The principal aim of this study was to assess the safety and effectiveness of the middle ear implant Vibrant Soundbridge (VSB) in patients with moderate-to-severe sensorineural hearing loss up to a mean (± standard deviation) duration of 11.1 ± 2.1 years (min. = 8.2, max. = 13.9, n = 16) after the intervention. This was a retrospective, single-subj...
Article
Full-text available
Objective: To compare audiological outcomes in mild-to-moderate mixed hearing loss patients treated with a bone-anchored hearing aid or an active middle-ear implant. Analysis aimed to refine criteria used in preoperative selection of implant type. Design: Retrospective comparative analysis of audiological data. Follow-up time ranged between 0.55...
Article
Objective: To compare surgical methods, functional gain, and speech discrimination using two different coupling methods for an active middle ear implant. Of several couplers enabling placement of the active element at various locations, two function directly at a cochlear membrane, bypassing a missing or malformed ossicular chain. This study evalua...
Article
Objective: Implantable hearing aids have become a valid option for the therapy of various forms of hearing loss. The Codacs™ Direct Acoustic Cochlear Implant System is the first vibratory implant available for patients with severe to profound mixed hearing loss (MHL). By directly coupling sound energy into the perilymph, a very high maximum power...
Article
Full-text available
Objective: This study aimed to review current knowledge regarding implantation of the Vibrant Soundbridge floating mass transducer (FMT) at the round window (round window vibroplasty) as well as to form a consensus on steps for a reliable, stable surgical procedure. Data sources: Review of the literature and experimental observations by the auth...
Article
Mechanical stimulation of the round window (RW) of the cochlea is successfully done with the Vibrant Soundbridge (Med-El), but clinical outcomes show a substantial degree of variability. One source of variability is variation in the pre-load static force applied by the stimulator to the round window (Maier et al., 2013), in this study we investigat...
Article
Background: High-frequency jet ventilation (HFJV) through thin catheters creates more room for surgical procedures in laryngotracheal surgery, while few contraindications exist. In contrast, the anaesthesiologist has to cope with reduced monitoring and numerous contraindications. Therefore, every participating discipline has to thoroughly know the...
Article
Patients with moderate-to-severe mixed hearing losses (MHLs) are hard to provide sufficient benefit with currently available conventional hearing aids. Here, the long-term safety of a direct acoustic cochlear stimulator (DACS) and the effectiveness compared with conventional "high-performance" hearing aids were investigated. Prospective, within pat...
Article
Implanting active middle ear implants (AMEI) at the round window has become a standard procedure to restore hearing for patients with moderate inner ear or mixed hearing loss. The round window (RW)-Coupler was developed as an alternative coupling aid to fit smaller RW diameters and require less drilling in the RW niche. The question arises whether...
Article
To confirm the clinical efficacy and safety of a direct acoustic cochlear implant. Prospective multicenter study. The study was performed at 3 university hospitals in Europe (Germany, The Netherlands, and Switzerland). Fifteen patients with severe-to-profound mixed hearing loss because of otosclerosis or previous failed stapes surgery. Implantation...
Article
The Direct Acoustic Cochlea Stimulator Partial Implant (DACS PI, Phonak Acoustic Implants SA, Switzerland) is intended to stimulate the cochlea by a conventional stapedotomy piston that is crimped onto the DACS PI artificial incus. An alternative approach to the round window (RW) is successfully done with other devices, having the advantage of bein...
Article
Aim: The evolution of the auditory technology resulted in the constantly increasing use of active middle ear implants (AMEI). The results with these implants are promising, showing considerable hearing benefits for patients with sensorineural or combined hearing loss. A systematic review over the actual AMEI and surgical issues is presented. Method...
Article
Objectives/hypothesis: Most existing studies about infantile Bartter syndrome (BS) have focused on renal function, and deafness has not been closely studied. Our objective was to evaluate the treatment of hearing impairment in children with infantile BS and analyze relevant, unexplored issues. Study design: Retrospective chart review. Methods:...
Article
Full-text available
The aim of this study was to describe the outcome and possible complications of subtotal petrosectomy (SP) for Vibrant Soundbridge (VSB) device surgery in a tertiary referral center. A secondary objective was the evaluation of hearing results in a subgroup of subjects who received the VSB device. Between 2009 and early 2011, 22 adult subjects with...
Article
To date, all the Vibrant Soundbridge (VSB) applications have managed to stimulate the inner ear indirectly. Our objective was to present a new VSB application for direct inner ear stimulation. Prospective cohort study. Tertiary, referral center Three patients with previous middle ear surgery and moderate-to-severe ipsilateral, mixed hearing loss. O...
Article
A minimal tip dislocation of the middle ear transducer (MET(®), Otologics Ltd) may result in poor hearing performance. Our objective was to examine if a defined MET dislocation can be diagnosed by high-resolution computed tomography (HRCT) or digital volume tomography (DVT). A human cadaver head was sequentially implanted with different MET tips (i...
Article
To evaluate the significance of advanced post-operative haemostasis investigation in cases of recurrent, severe post-tonsillectomy bleeding. Of the 120 patients treated at our tertiary centre between 2006 and 2010 due to post-tonsillectomy haemorrhage, 22 with recurrent, severe episodes of bleeding underwent further, advanced haemostasis investigat...
Article
Aim of this study was to examine any stapes fixation-related clinical, intraoperative and high-resolution computed tomography (HRCT) findings in children undergoing stapedotomy. Detailed diagnostic assessment was performed in 12 children (18 ears) who underwent stapedotomy within the period 2005-2008. Ear malformations such as malleus-incus anomali...
Article
To present power stapes, stapedotomy, and middle ear implantation with Vibrant SoundBridge (VSB) performed in a one-step surgery as an alternative option for hearing rehabilitation in patients with osteogenesis imperfecta (OI). Retrospective case series. Tertiary referral ear center. A family with genetically proven OI Type I. Two patients, mother...
Article
Full-text available
Objectives: Previous studies have shown that both motor exercises and vestibuloocular tests reveal a difference in the balance function of deaf and normal-hearing children and adolescents. The purpose is to evaluate the influence on balance function of the hearing status. Material and Methods: A total of 80 children and adolescents between the ages...
Article
The objective of this study was to examine any anatomic limitations in implantation of the semi-implantable middle ear transducer (MET) and fully implantable Carina middle ear implants (Otologics, Boulder, CO). Retrospective case series. This study involved high-resolution computed tomography (HRCT) of the temporal bone and surgical findings in 22...
Article
To design a semi-automatic laser scalpel for tissue resection in the area of neck masses it was necessary to examine the biomechanic behavour of these tissues. The aim was to identify if and to what extent (amplitude and velocity) the tissues shift due to respiration and circulation. This is important since these movements have to be followed by th...
Article
Full-text available
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 p...
Article
Full-text available
Background. The purpose of this study was to evaluate the thermal and pressure effects using a Titan Sapphire chirped-pulse amplifier system configured to deliver ultrashort pulses of 180 femtoseconds (fs) in an inner ear model. Materials and Methods. Temperature increases and heat exchange processes in the fluid (physiological saline) were examine...
Article
Background and Aim: The aim of this study is to compare placements of the vibrational transducer on the cochlear round window membrane (RWM) with different transducer shapes and coupling methods. Derived measurements of induced displacement provide objective measurement of the cochlea. Material and Methods: Fresh frozen human temporal bones were im...
Article
Since the publications of Martin, et al. (1948) and Schiff (1959), who were the first to report on the administration of sex hormones to juvenile nasopharyngeal fibroma (JNF) patients, several authors have described the different clinical effects and histologic changes after androgen and estrogen application. Since the mechanism of action of sex st...
Conference Paper
Full-text available
In der Chirurgie insbesondere bei onkologischen Fragestellungen kommt es zu Grenzsituationen, in denen es gilt, Gewebeverbände mit hoher Genauigkeit aufzutrennen, z.B. bei Infiltration von Gefäßwänden oder Nervenstrukturen durch Tumorausläufer. Oft könnte eine physiologisch funktioneil wichtige Struktur erhalten werden, wenn ein chirurgisches Instr...
Article
The clinical feasibility test described here evaluates the basis for a laser therapy system that enables tumour tissue to be separated from nerves in a minimally invasive manner. It was first investigated whether, using an Er:YAG laser, laser-induced nerve (specifically, facial nerve) responses in the rabbit in vivo can be reliably detected with th...
Article
In order to design a semi-automatic laser scalpel for tissue resection in the neck area, it was necessary to examine the biomechanical behavior of these tissues. The aim and scope of this project was to identify if, and to what extent, the tissues shift as a result of respiration and circulation as well as to quantifying not only the amplitude and...
Article
A 28-year-old female patient with a migrant background presented for surgery with a suspected cholesteatoma in the left ear. The patient reported having had an aural discharge for several months; otoscopic examination revealed a runny ear, and discrete granulation tissue was seen. Pure-tone audiometry showed conduction hearing loss of 30-40 dB acro...
Article
This study examined the explanatory power of 3-dimensional visualization of middle ear prostheses and to introduce this method as a supplementary diagnostic tool. Various prostheses were examined in vitro. Surface rendering and perspective volume-rendering techniques were compared with axial, curviplanar, and maximum intensity projection images. On...
Article
Background: For the experimental animal study to evaluate a new ossicular chain replacement prosthesis, we developed a new technique for surgical implantation into the middle ear of rabbits. The selection of the species was based on its similarity to human middle ear anatomy and the favored, standardized, microsurgical approach to the middle ear ca...
Article
For the experimental animal study to evaluate a new ossicular chain replacement prosthesis, we developed a new technique for surgical implantation into the middle ear of rabbits. The selection of the species was based on its similarity to human middle ear anatomy and the favored, standardized, microsurgical approach to the middle ear cavity. For th...
Article
The objective of this study was to assess whether the use of the erbium: yttrium-aluminum-garnet (Er:YAG) laser has negative effects on inner ear function and to compare the short- and long-term hearing outcome of patients undergoing conventional stapedotomy versus laser stapedotomy. Retrospective review of prospectively collected audiometric data...
Article
Objective: The objective of this study was to assess whether the use of the erbium: yttrium-aluminum-garnet (Er:YAG) laser has negative effects on inner ear function and to compare the short- and long-term hearing outcome of patients undergoing conventional stapedotomy versus laser stapedotomy. Study Design: Retrospective review of prospectively co...
Article
This is a prospective study on 808 profoundly or totally deaf patients who underwent either unilateral or bilateral cochlear implantation, involving a minimally invasive surgical approach, at the Medical University of Hannover's Department of Otolaryngology between May 2001 and May 2005. Advanced Bionics, Cochlear and MED-EL devices were used, the...
Article
Intraoperative CT surgery provides the surgeon with additional information about the altered surgical site in difficult anatomical situations. The skull base and lamina papyracea may be revealed by means of intraoperative CT, which may be beneficial in endonasal sinus surgery involving difficult surgical sites, although individual ethmoid cells can...
Article
Expert appraisals of vestibular disorders and their effects on daily life are essentially based on an evaluation of the patient's subjectively described symptoms. The aim of the present study was to ascertain the extent to which dynamic posturography is able to assist in the preparation of expert's reports. 60 patients underwent a survey of their b...
Article
Hintergrund: Gutachterliche Beurteilungen von vestibulären Störungen und deren Auswirkungen auf das tägliche Leben beruhen im Wesentlichen auf einer Bewertung der subjektiven Beschwerden des Patienten. Ziel der Untersuchung sollte sein zu überprüfen, inwieweit die dynamische Posturographie in der Lage ist, gutachterliche Aussagen zu unterstützen. M...
Article
Computergestützte Nachverarbeitungstechniken von CT-Schichtbildern erlauben die nichtinvasive 3D-Bildgebung des Mittelohres zur Diagnostik und präoperativen Planung. In dieser Arbeit soll auf die verschiedenen Nachverarbeitungstechniken und die Anwendung eines 3D-Nachverarbeitungsverfahrens an einem großem Patientenkollektiv eingegangen werden. Bei...
Article
Laser applications within the tympanic cavity area are widely accepted. Commonly used systems are CO(2), argon, KTP and erbium devices. The disadvantages are heat development and/or acoustic load of the inner ear. A new laser with ultra short pulses was examined concerning its ablation characteristics and tested for possible applications in the tym...
Article
The local therapy of inner ear diseases provides a means of directly applying pharmacological substances and delivering electrical stimulation to inner ear structures. Problems relating to dosage, systemic effects and the blood-cochlear barrier are thus avoided, which is not the case with systemic therapy. The preferred access point is the membrane...
Article
Full-text available
Velopharyngeal insufficiency (VPI) has received little attention in the medical literature. The aim of the present study was to determine the extent to which VPI constitutes a problem for woodwind and brass musicians. A total of 148 musicians (professionals from a symphony orchestra and students, the latter mainly from a national youth orchestra) w...