Jacob Alexander De Ru

Jacob Alexander De Ru
Central Military Hospital · Department of Otorhinolaryngology

MD, PhD

About

125
Publications
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Introduction

Publications

Publications (125)
Article
Background: TIPIC-syndrome (Transient Perivascular Inflammation of the Carotid Artery) as a cause of a painful lump in the neck is not often described in the literature. This self-limiting perivascular inflammation of the carotid bifurcation is relatively unknown. Case: We describe a 50-year old patient, in whom a CT-scan that was performed beca...
Article
Background and context : Diffuse idiopathic skeletal hyperostosis (DISH) is characterized by growing ossifications of spinal entheses and tendons, which may cause trachea and esophagus compression when located anteriorly in the cervical spine. Purpose : Our previous systematic review on the epidemiological and clinical knowledge of dysphagia and a...
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Full-text available
Importance Tympanic membrane retraction (TMR) is a relatively common otological finding. However, no consensus on its management exists. We are looking especially for a treatment strategy in the military population who are unable to attend frequent follow-up visits, and who experience relatively more barotrauma at great heights and depths and easil...
Article
PurposeIn guideline development the evidence is more and more coming exclusively from randomized-controlled trials (RCTs), while all other evidential levels are too easily brushed aside. This adopted creed is based on the radical ideas of Archibald Cochrane. Randomize until it hurts—which should presumably be read as a stimulus to perform better re...
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Objective Seasonal allergic rhinitis (SAR) is an exaggerated immunological reaction to allergens (pollen) in the air. In a small subgroup of patients, SAR can be difficult to control with first-line therapy. Intramuscular corticosteroid injections (IMCIs) are an additional treatment in this subgroup of SAR patients. The aim of this systematic revie...
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Background Acute acoustic trauma (AAT) is an acute hearing impairment caused by intense noise-impact. The current management strategy for AAT with substantial hearing loss in the Dutch military is the combination therapy with corticosteroids and hyperbaric oxygen therapy (HBOT). In a previous study, early initiation of the combination therapy was a...
Article
To the Editor We compliment Yoo et al¹ on their impressive cohort study reviewing data on 1364 patients with Bell palsy. However, we need more data to be able to concur with some of their conclusions. Their discussion correctly expresses our view that combination therapy should be used, especially in cases of severe palsy. Unfortunately, the data a...
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This articles discusses the recently published Cochrane systematic review (CSR) on antiviral treatment for Bell’s palsy. The CSR concluded that there was no clear difference in rates of incomplete recovery between combination therapy and corticosteroids alone. The conclusions of this CSR are in our opinion misleading, illogical, and based on an ove...
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Painful neuromas are a devastating condition that is notoriously difficult to treat. The large number of techniques that have been attempted suggest that no one technique is superior. Neuromas often occur in the extremities, but iatrogenically caused pain in the head and neck area has also been described. This article describes 3 consecutive patien...
Article
Despite the use of symptomatic treatment against hay fever, a subgroup of patients is hindered tremendously during the season. Intramuscular steroid injections are not mentioned in current guidelines, or even advised against, though they were often used some decades ago. Triamcinolone intramuscular injection can be considered an additional therapy...
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Full-text available
Despite the use of symptomatic treatment against hay fever, a subgroup of patients is hindered tremendously during the season. Intramuscular steroid injections are not mentioned in current guidelines, or even advised against, though they were often used some decades ago. Triamcinolone intramuscular injection can be considered an additional therapy...
Chapter
In the last decade, a new surgical treatment modality was developed for frontal secondary headache, based on the assumption that the trigger of this pain entity is the entrapment of peripheral sensory nerves. The surgery entails a procedure, where an endoscopic approach is used to decompress the supraorbital and supratrochlear nerve branches, which...
Article
In Reply We thank Ponzetto et al for their positive feedback and their interest in our article.
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The tuning fork tests have been under attack since their first use in clinical examination. However, the tuning fork is small and fits into every white coat, and tuning fork tests for hearing are easy, accurate and inexpensive. They should be used in patients with an acute unilateral hearing loss if an electric audiometer is not available. After mo...
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Introduction Acute hearing loss can have a major impact on a patient’s life. This holds true for both acute acoustic trauma (AAT) and idiopathic sudden sensorineural hearing loss (ISSHL), two devastating conditions for which no highly effective treatment options exist. This narrative review provides the rationale and evidence for HBOT in AAT and IS...
Article
Sudden sensorineural hearing loss (SSNHL) occurs within 72 hours and is defined as hearing loss of at least 30 dB at 3 or more consecutive frequencies. Although steroids might be beneficial, an additional therapy is still warranted. Recently, several systematic reviews that assessed overlapping literature about the association of hyperbaric oxygen...
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Full-text available
Entrapment neuropathy is a known cause of neurological disorders. In the head and neck area, this pathophysiological mechanism could be a trigger for headache. Over the last few decades, injection of botulinum toxin type A in the muscles that are causing the compression as well as surgical decompression have proved to be effective treatment methods...
Article
Introduction Acute acoustic trauma (AAT) is a sensorineural hearing impairment due to exposure to an intense impulse noise which causes cochlear hypoxia. Hyperbaric oxygen therapy (HBO) could provide an adequate oxygen supply. The aim was to investigate the effectiveness of early treatment with combined HBO and corticosteroid therapy in patients wi...
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Full-text available
Idiopathic sudden sensorineural hearing loss (ISSHL) is an otolaryngologic emergency. The condition is usually defined as a sudden deafness of 30 dB or more in at least 3 contiguous frequencies that occurs in less than 3 days.¹ Pathologic causes need to be excluded. The origin is still unclear, but the main theories point to vascular or (viral) inf...
Article
Importance Endoscopic surgical decompression of the supratrochlear nerve (STN) and supraorbital nerve (SON) is a new treatment for patients with frontal chronic headache who are refractory to standard treatment options. Objective To evaluate and compare treatment outcomes of oral medication, botulinum toxin type A (BoNT/A) injections, and endoscop...
Article
BACKGROUND Intermediate nerve neuralgia (INN) is a rare and often overlooked form of primary otalgia. The pathophysiological mechanism is unknown, although one of the possible contributing factors is a neurovascular conflict at the root entry zone of the intermediate nerve. The pain can be severely debilitating, and the palette of treatment options...
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Full-text available
Objective: Balloon dilation is a new entity in the therapeutic approach of Eustachian tube dysfunction. The aim of this systematic review is to evaluate the success of balloon dilation of the tuba auditiva in reducing symptoms in adult patients with Eustachian tube dysfunction. Data sources: Embase, PubMed, and Cochrane Library. Review methods:...
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Full-text available
Rehabilitation for vestibular disease is a safe method to partially alleviate symptoms of vertigo. It was hypothesized that principles of military aviation vestibular desensitization procedures that have a success rate of more than 80% can be extrapolated to chronic vestibular disease as well. The virtual reality motion base computer-assisted rehab...
Article
Full-text available
In the last decade, a new surgical treatment modality was developed for frontal secondary headache, based on the assumption that the trigger of this pain entity is the entrapment of peripheral sensory nerves. The surgery entails a procedure, where an endoscopic approach is used to decompress the supraorbital and supratrochlear nerve branches, which...
Article
Full-text available
Hearing is an extremely complex phenomenon, involving a large number of interrelated variables that are difficult to measure in vivo. In order to investigate such process under simplified and well-controlled conditions, models of sound transmission have been developed through many decades of research. The value of modeling the hearing system is not...
Article
Objective Sudden sensorineural hearing loss in divers may be caused by either inner-ear barotrauma or inner-ear decompression sickness. There is no consensus on the best treatment option. This study aimed to evaluate the therapeutic value of hyperbaric oxygen therapy for sudden sensorineural hearing loss in divers. Method A literature review and t...
Article
Precise knowledge of the nerve supply of the corrugator supercilii muscle (CSM) is a prerequisite for performing a selective denervation of the CSM. The authors' goal was to determine the course and variability of the motor nerves of the CSM in relation to fixed orbital landmarks. The facial nerve branches toward the CSM were identified during micr...
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Full-text available
Clinical study of tympanostomy tube placement for patients with intractable Ménière's disease - Volume 129 Issue 7 - JA De Ru, W C Heerens
Article
The management of Bell's palsy has been the subject of much debate, with corticosteroids being the preferred medication. However, evidence also supports the use of antiviral drugs for severe cases and even decompression surgery in patients who, despite medical treatment, are not recovering. A literature review was conducted on the management of Bel...
Article
PROBLEM: The scientific research agenda of the Dutch Association of Otorhinolaryngology and Head & Neck Surgery claims that there is a knowledge gap with regard to the efficacy of septoplasty for a blocked nose. This assertion is based on a restrictive approach to evidence-based medicine that could result in unnecessary trials and the abolition or...
Article
Feedback is considered important to acquire clinical skills. Research evidence shows that feedback does not always improve learning and its effects may be small. In many studies, a variety of variables involved in feedback provision may mask either one of their effects. E.g., there is reason to believe that the way oral feedback is framed may affec...
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Background: Ototoxicity caused by medication can lead to debilitating symptoms such as dizziness, vertigo and postural instability. There is no current 'gold standard' treatment available. Case report: A 79-year-old male, with bilateral loss of vestibular function caused by gentamicin toxicity after surgery for prosthetic valve endocarditis, com...
Article
In this rapid systematic review, we studied the clinical question, What is the effect of hyperbaric oxygen therapy on hearing thresholds in patients who suffered a recent acute acoustic trauma? After screening for eligible titles and abstracts and extracting duplicates, 6 original research papers could be found. The general methodology of the studi...
Article
The authors are concerned that an overrestrictive approach to evidence-based medicine could lead to the neglect of valuable treatment options. We describe the need for a personalised approach to evidence-based medicine, and support this with examples from ENT practice. We concur with the point of view that evidence at all levels should be used in c...
Article
To describe the clinical characteristics of a 70-year-old female with occipital neuropathy following bone conduction device surgery. A 65-year-old woman underwent bone conduction device placement surgery on the left temporal bone. Postoperatively she progressively developed chronic pain at the implantation site. The pain led to minimal neck movemen...
Article
Objective: The chances of full recovery from a facial nerve paralysis, depending on the varying pathologies, can be determined depending on the extent of the impairment. Very often, especially in mild to moderate cases, the recovery is good. However, in clinical practice we cannot rely on overall statistics for such a devastating symptom. We need t...
Article
To study the effect of radiofrequency thermocoagulation (RFT) of the sphenopalatine ganglion (SPG) on headache and facial pain conditions following critical reevaluation of the original diagnosis. This was a retrospective study of clinical records gathered over 4 consecutive years of all 15 facial pain or headache patients who underwent RFT of the...
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To study the anatomy of the pterygopalatine fossa (PPF) using ultrahigh-resolution magnetic resonance imaging. A human cadaveric tissue block containing the pterygopalatine fossa was examined on a clinical 7-Tesla magnetic resonance imaging system. Subsequently, cryosections of the tissue block were created in a coronal plane. The cryosections were...
Article
The primary treatment of a facial nerve palsy in patients with Ramsay Hunt syndrome consists of a combination of antiviral agents and steroids. Despite this treatment there is a certain amount of patients who will not achieve full recovery or a satisfactory result. For these patients a surgical decompression might be an option. This case report des...
Article
We present a case report of a patient with a putative diagnosis of complex regional pain syndrome of the nose. We would like to bring this disorder to the attention of rhinologists. A 53-year-old man presented with a history of extreme, constant, debilitating pain in his nose that started after he underwent several extensive nasal surgeries. Examin...
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In this evidence-based case report, the authors studied the following clinical question: What is the effect of adding antiviral agents to corticosteroids in the treatment of patients with severe or complete Bell palsy? The search yielded 250 original research articles. The 6 randomized trials of these that could be used all reported low-quality dat...
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Pterygopalatine ganglion (PPG) branches, seem to be involved in the pathophysiology of facial pain. The functions of these branches, including a recently discovered orbital branch, are not completely known but could be of clinical significance. This study was designed to characterize PPG branches through immunohistochemical stain and study their an...
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This manuscript describes our past experiences with reviewers and the review procedures that are currently used in the medical sciences. We conclude that reviewers all too often are biased, whereas scientific discussion should be based on substantive comments and without prejudice. In our opinion, subjective arguments for rejection of manuscripts c...
Article
This manuscript critically appraises the Dutch Consensus Report (ZATT) on adenotonsillectomy. This consensus report states that in children with (mild) complaints of recurrent throat infections adenotonsillectomy is not indicated. However, this statement, in our opinion, is not justified. This because it is clear that patients who underwent surgery...
Article
Diffuse idiopathic skeletal hyperostosis (DISH) is a common but underdiagnosed condition relating to ossification of spinal ligaments that can cause compression of the esophagus and trachea. According to case reports, dysphagia or airway obstruction resulting from DISH is a rare occurrence. This study was intended to identify all published cases of...
Article
Cluster headache is an invalidating form of headache. Although cluster headache can be managed pharmacologically, some patients require surgical treatment with varying results. Microvascular decompression of the pterygopalatine ganglion could be an alternative to traditional surgical management in patients with cluster headache. Microvascular decom...
Article
Chronic daily headache (CDH) located in the frontal region is a common problem. We have previously described the positive results that were achieved with botulinum toxin (BTX) injections in the musculus corrugator supercilii (MCS) for this disorder. Nowadays, we offer transection of this muscle to patients following a minimum of two BTX injections,...
Article
To critically appraise the topic, questioning whether administering antiviral medication in case of Ramsay Hunt syndrome improves the restoration of facial nerve function. We reviewed the literature on this subject and calculated the odds ratios for the different treatment modalities. Our study clearly shows that antiviral medication in combination...
Article
Full-text available
To report microvascular decompression as a possible effective treatment for patients with nervus intermedius neuralgia, and to contribute to the literature regarding both this syndrome and this specific form of treatment. Case report of a patient with intermedius neuralgia. The main complaint was severe otalgia in the area innervated by the nervus...
Article
Full-text available
Based on our insights derived from literature we arrive at two more basic principles that form the cornerstones of our model: namely, the fact that the attenuation of the eardrum and the ossicular chain are at the root of the extremely large dynamic range of our auditory sense, and the fact that the bone conduction phenomenon is actually the result...
Article
Two one-year-old boys were seen by a paediatrician with symptoms of increasing breathlessness and inspiratory stridor. Upon the probable diagnosis subglottic laryngitis and toddler's asthma, respectively, they were admitted to hospital for medical treatment. Because they failed to recover sufficiently with this treatment, an ENT specialist subseque...
Article
Full-text available
Endonasal and infrazygomatic pterygopalatine ganglion (PPG) block for facial pain provides pain relief in a broader area than expected on anatomic grounds. The aim of this study was to search for neural structures in the pterygopalatine fossa (PPF) that could explain unexpected pain relief after PPG blockage. The neural PPF content was explored thr...
Article
In response to the article “Predicting Migraine Responsiveness to Botulinum Toxin Type A Injections”1 in the February issue of the Archives, we offer our thoughts on the possible pathophysiologic mechanism of botulinum toxin type A (BTX) treatment in some patients with headache.1 We agree that a selective group of patients with headache might benef...
Article
The introduction of new antibiotic, oral quinolones, seems to have led to the belief that this form of treatment suffices to 'cure' Malignant External Otitis. Indeed, the high mortality rate has decreased significantly ever since. We argue, however, that the measure of 'cure' has not been clearly determined. In our view, it is paramount that we nee...
Article
To identify the pathogens associated with complicated ear, throat and sinus infections and to link the relevant susceptibility patterns to the empirical therapy currently advised in the Dutch guidelines. Retrospective, descriptive study of consecutive cases. Tertiary referral centre. All consecutive patients with a complicated ear, nose and throat...
Chapter
Symptomencomplex dat ontstaat door een laesie van de branchiomotorische vezels van de n. facialis in hun verloop van de hersenstam naar de gelaatsspieren, met als meest kenmerkend verschijnsel een, meestal unilaterale, verlamming van de desbetreffende spieren. In 50% is er sprake van een idiopathische facialisparese (de verlamming van Bell), die wa...
Article
Chance of full recovery of facial nerve function following paralysis due to a herpes zoster infection is small. Therefore, treatment is imperative. A recently published systematic review published by the Cochrane Collaboration has caused us pause for thought. First of all, because the in our opinion incorrect conclusion that antiviral medication ma...
Article
Full-text available
Based on our insights derived from literature we arrive at two more basic principles that form the cornerstones of our model: namely, the fact that the attenuation of the eardrum and the ossicular chain are at the root of the extremely large dynamic range of our auditory sense, and the fact that the bone conduction phenomenon is actually the result...
Article
The objective was to formulate distinctive criteria to substantiate our opinion that Sluder's neuralgia and cluster headache are two different clinical entities. A systematic review was carried out of all available, original literature on Sluder's neuralgia. Pain characteristics, periodicity and associated signs and symptoms were studied and listed...
Article
To review systematically the literature for the current criteria and strategies used to diagnose acute mastoiditis in children. A comprehensive literature search was performed in PubMed, Embase, and the Cochrane Library of studies on the diagnosis of acute mastoiditis in children published between January 1980 and September 2007. The study type and...
Article
To describe our results with botulinum toxin type A injection for headache in carefully selected patients, and to present the rationale behind this therapy. Tertiary referral centre. This article describes a case series of 10 consecutive patients with frontally localised headache, whose pain worsened when pressure was applied at the orbital rim nea...
Article
It is suggested that the brain response of a food odour sensed retro-nasally is related to satiation. The extent of retro-nasal aroma release during consumption depends on the physical structure of a food, i.e. solid foods generate a longer, more pronounced retro-nasal aroma release than liquid foods. The aim of this study was to investigate if a b...
Article
For clinical communication a reliable grading scale for facial nerve function disorders is necessary. For detection of progression or improvement during follow-up, and for objective data analysis an easy categorization is needed. At this moment the House-Brackmann Grading Scale is widely used mainly because of its ease of use. This article describe...
Article
This study discusses the anatomy and surgical techniques for the prevention of Frey syndrome. By performing only a partial superficial parotidectomy, we probably preserve the connection between the auriculotemporal nerve and the facial nerve. By suturing the remainder of the parotid gland tissue and the superficial musculoaponeurotic system (SMAS)...
Article
A cervical schwannoma is a benign tumour that usually causes no other complaints than the neck mass itself. Rarely a dumb-bell shaped schwannoma is seen entering the foramen intervertebrale with expansion into the canalis vertebralis. Diagnosis and treatment of such a case are presented and discussed.