Per Cayé-Thomasen

Rigshospitalet | rigshospitalet · Department of Otorhinolaryngology and Audiology

Importance Over the past decades, the number of patients, especially in the older adult patient group, diagnosed with vestibular schwannoma (VS) has increased. Assuming that older adult patients have more comorbidities, a longer recovery period after surgery, a higher rate of surgical complications, and a higher mortality rate after VS surgery, a t...

Objective The objective of the current study was to present the results of an international working group survey identifying perceived limitations of existing facial nerve grading scales to inform the development of a novel grading scale for assessing early postoperative facial paralysis that incorporates regional scoring and is anchored in recover...

Objective To determine tinnitus prevalence and severity in a cohort of unselected first-time cochlear implant (CI) recipients whose primary motive for CI was sensorineural hearing loss (SNHL), and to evaluate the effect of CI on tinnitus after cochlear implantation. Methods Prospective longitudinal study of 45 adult CI recipients with moderate to...

Background Hearing loss and deafness are well-known sequelae from bacterial meningitis (ABM) and may result in social dysfunction and learning difficulties. Yet, the timely development of hearing loss and restitution is poorly studied, especially among adults. Hearing loss was revisited using otoacoustic emissions (OAEs) to determine the occurrence...

Objectives: This study investigated age at implantation, improvement in hearing and speech perception outcomes, as well as surgical complications in pediatric cochlear implant recipients with Pendred Syndrome (PS) or non-syndromic enlarged vestibular aqueduct (NSEVA). Design: A systematic review of the literature between 1984 and 2021 was perfor...

Purpose Falls are the leading cause of injury and premature death among community dwelling elderly but can be prevented through comprehensive balance rehabilitation which ideally targets the patient’s specific needs. In this study, we evaluate the reliability and agreement of six novel clinical measures of different balance domains which applied in...

Background Intractable benign paroxysmal positional vertigo (BPPV) may be treated by plugging the affected semicircular canal (SCC). A cochlear implant (CI) can diminish subjective symptoms of tinnitus. We present a case with intractable BPPV and incapacitating tinnitus who underwent surgery, simultaneously plugging his posterior SCC (PSCC) and imp...

Background: Tinnitus is a common symptom among individuals with a vestibular schwannoma. In recent years, cochlear implantation, often combined with tumor resection, is an increasingly used option in the management of these patients. The existing literature does not account well for the effect of treatment on tinnitus burden. Thus, this paper repo...

Objective: This study reports subjective and objective audiovestibular function in patients diagnosed with an endolymphatic sac tumor (ELST), to evaluate the clinical implication of vestibular testing in ELST patients. Study design: Retrospective cohort study. Setting: Tertiary referral center/university hospital. Patients: Five patients dia...

Background: Idiopathic sudden sensorineural hearing loss (ISSNHL) is common, and defined as a sudden decrease in sensorineural hearing sensitivity of unknown aetiology. Systemic corticosteroids are widely used, however their value remains unclear. Intratympanic injections of corticosteroids have become increasingly common in the treatment of ISSNH...

Background: Cochlear implantation requires excellent surgical skills; virtual reality simulation training is an effective method for acquiring basic competency in temporal bone surgery before progression to cadaver dissection. However, cochlear implantation virtual reality simulation training remains largely unexplored and only one simulator curre...

Cochlear implantation is considered the best treatment option for patients with severe-to-profound sensorineural hearing loss for whom conventional hearing aids are insufficient. We used a repeated measures longitudinal approach to evaluate speech recognition and patient-reported outcomes after cochlear implantation in an unbiased cohort of Danish...

The saccule is one of the vestibular sensory organs of the inner ear. It detects head movements and provides information to maintain balance and orient in space. Despite its critical role, very little is known about its neurotransmission and regulation. Multiple disease entities and medications affect balance, which is why information on neurotrans...

PurposeTo develop and gather validity evidence for a novel tool for assessment of cochlear implant (CI) surgery, including virtual reality CI surgery training.Methods Prospective study gathering validity evidence according to Messick’s framework. Four experts developed the CI Surgery Assessment Tool (CISAT). A total of 35 true novices (medical stud...

Background and objectives: Vestibular schwannomas (VS) frequently lead to ipsilateral sensorineural hearing loss (HL) as part of its natural history or as a result of treatment. Cochlear implantation represents a well-documented treatment of profound HL that cannot be treated adequately with a conventional hearing aid, thus being offered to select...

Purpose SARS-CoV-2 vaccines are a key step in fighting the pandemic. Nevertheless, their rapid development did not allow for testing among specific population subgroups such as pregnant and breastfeeding women, or elaborating specific guidelines for healthcare personnel working in high infection risk specialties, such as otolaryngology (ORL). This...

Introduction Branchiootorenal syndrome (BOR) manifests with branchial fistulae, otological anomalies and renal dysplasia. Management remains largely symptomatic. The most common consequence of BOR is mild-to-profound sensorineural, conductive or mixed hearing loss, where conventional hearing aids (HA) provide limited benefit. Cochlear implantation...

Purpose To determine the prevalence of SARS-CoV-2 at a Danish tertiary referral otorhinolaryngology clinic during the first wave of the COVID-19 pandemic among patients with suspected acute upper airway infection (UAI) and patients operated for head and neck cancer (HNC), respectively. To monitor changes in the number of patient encounters for acut...

Objective Ubiquitous throughout the literature and during patient counseling, vestibular schwannoma is often quoted to affect about 1 per 100,000 people. Yet, reports from distinct international populations suggest that the incidence is likely much higher. The objective of the current work was to systematically characterize the global incidence of...

ImportanceOtorhinolaryngology is considered one of the medical specialties with a high risk for exposure to corona disease 2019 (COVID-19). Uncontrolled transmission in a hospital department poses a risk to both healthcare workers (HCWs) and patients.Objective To monitor SARS-CoV-2 incidence, transmission, and antibody development among HCWs to ide...

Background: Vestibular dysfunction is likely the most common complication to cochlear implantation (CI) and may, in rare cases, result in persistent severe vertigo. Literature on long-term vestibular outcomes is scarce. Objective: This paper aims to evaluate vestibular dysfunction before and after cochlear implantation, the long-term vestibular out...

Objective: Although Pendred syndrome involves anatomical abnormalities in the vestibular system and patient-perceived dizziness, the literature on vestibular function is scarce. The objective was to evaluate objective vestibular function in patients with PS using the video head impulse test (VHIT) and the cervical vestibular evoked myogenic potent...

Objective: Active treatment of small- or medium-sized vestibular schwannoma during wait-and-scan management is currently recommended at most centers globally once growth is detected. The primary aim of the current study was to characterize the natural history of growing sporadic vestibular schwannoma during observation. Study design: Cohort stud...

As for other vestibular schwannomas, intralabyrinthine schwannomas commonly cause a sensorineural hearing loss, contrary to more lateral ear pathology that can cause conductive or mixed hearing loss. This case report features a patient that presented with a mixed and thus partly pseudo-conductive hearing loss due to an intracochlear schwannoma, a f...

A new generation of children with hearing impairment (HI) has emerged due to the introduction of universal neonatal hearing screening, medical-surgical/technical and educational advances. Aim: Investigation of long-term development of vocabulary and social well-being of children with HI, including children with HI and additional disability. Meth...

Patients with superior canal dehiscence syndrome (SCDS) can present with a range of auditory and/or vestibular signs and symptoms that are associated with a bony defect of the superior semicircular canal (SSC). Over the past two decades, advances in diagnostic techniques have raised the awareness of SCDS and treatment approaches have been refined t...

Purpose: SARS-CoV-2 vaccines are a key step in fighting the pandemic. Nevertheless, their rapid development did not allow for testing among specific population subgroups such as pregnant and breastfeeding women, or elaborating specific guidelines for healthcare personnel working in high infection risk specialties, such as otolaryngology (ORL). This...

In this review, we discuss the auditory brainstem implant (ABI), which is a neuroprosthetic device being an advanced hearing aid in cases of bilateral, profound or complete hearing impairment due to a non-functional or absent cochlear nerve, or an inner ear malformation precluding cochlear implantation. Originally indicated in patients with bilater...

Background: Cochlear implantation may be complicated by concurrent injury to the vestibular apparatus, potentially resulting in disabling vertigo and balance problems. Information on vestibular function before implantation as measured by the video head impulse test (VHIT) and cervical vestibular evoked myogenic potentials (cVEMPs) is scarce and li...

Objective: Cochlear implantation (CI) may have undesired effects on the vestibular apparatus. However, the literature holds no consensus on vestibular affection and the testing tools applied to test for vestibular dysfunction after cochlear implantation are inconsistent. We aimed to investigate the impact of CI on vestibular function by an extensi...

Introduction: A number of epidemiological studies have reported data on, e.g., tumor size and hearing at diagnosis for patients with a vestibular schwannoma (VS), whereas only a few have touched upon the potential significance of sex. The aim of this report is thus to present gender-specific data on incidence and age, tumor localization, tumor siz...

Objective: Cochlear implantation (CI) carries a risk of loss of vestibular function following surgery. Thus, vestibular assessment presurgery is used to identify vestibulopathy that may contraindicate implantation and guide in selecting the candidate ear. The aim of this study was to evaluate the clinical implications of preoperative vestibular as...

A cochlear implant is an electrode, which is implanted in the inner ear to establish or re-establish hearing. Based on estimates on the prevalence of undertreated bilateral profound hearing loss, the number of adult people receiving a cochlear implant is low. In addition, many people with residual acoustic hearing or people with single-sided deafne...

Background Optimal management of vestibular schwannoma(VS) is still debated and thus international consensus has not been achieved. Treatment options are observation, radiotherapy and surgery. Knowledge on the natural history of tumor growth is essential for choice of treatment modality. The aim is to present intra-/extrameatal tumor growth and man...

Introduction Hearing rehabilitation with cochlear implants has attracted increasing interest also for patients with cochleovestibular schwannoma. The authors report their experience with the surgical management of tumors with rare transmodiolar or transmacular extension and outcomes after cochlear implantation (CI). Methods This retrospective case...

Background: Although cochlear implantation (CI) is widely performed in postlingually hearing-impaired adults in the Nordic countries, the literature on hearing outcomes remains scarce. Aims/objectives: To evaluate and correlate hearing outcomes after implantation. Methods: Prospective evaluation of 40 adult first-implantation recipients pre- and...

Introduction: Hearing rehabilitation with cochlear implants has attracted increasing interest also for patients with cochleovestibular schwannoma. The authors report their experience with the surgical management of tumors with rare transmodiolar or transmacular extension and outcomes after cochlear implantation (CI). Methods: This retrospective...

Objective: This prospective longitudinal cohort study at six tertiary referral centers in Canada and Denmark describes the clinical efficiency and surgical safety of cochlear implantation with the Oticon Medical Neuro cochlear implant system, including the Neuro Zti implant, the EVO electrode array, and the Neuro One sound processor. Methods: Pa...

Introduction: The inner ear vestibular system is essential to balance function. Although hearing loss is well-described and quite common following meningitis, the literature evaluating vestibular function following meningitis is very limited. In particular, information on results of contemporary vestibular function tests, e.g., the video head impul...

PurposeE-learning provides a flexible and effective approach to learning and is increasingly used in otorhinolaryngology (ORL). We developed a national theoretical e-learning course for ORL trainees and describe our experiences with implementation as well as piloting the e-learning course.MethodsE-learning course content was developed as structured...

Objective Our objective was to investigate if the tumor microRNA (miRNA) expression profile was related to tumor growth rate. Growth-related miRNAs might be potential targets for future therapeutic intervention.Material and methodsTumor tissue was sampled during surgery of patients with a sporadic vestibular schwannoma. Tumor growth rate was determ...

Purpose Cochlear implantation (CI) in patients with sensorineural hearing loss caused by a vestibular schwannoma (VS) represents a unique subtype of hearing rehabilitation, as the outcome may be compromised by vestibulocochlear nerve injury as part of the natural VS history or due to iatrogenic trauma induced by surgical tumor removal. This paper a...

Objective: No previous studies have investigated a vestibular function test battery combining the Video Head Impulse Test (VHIT), the caloric test, and the cervical vestibular evoked myogenic potential (cVEMP) test. The objective was to investigate the sensitivity of the three vestibular tests to the presence of a vestibular schwannomas (VS), and...

Introduction: School-aged children with hearing impairment (HI) listen and learn in noisy environments. On-going monitoring of speech understanding in noise is essential to adjust clinical interventions accordingly. Methods: The aim of this study was to assess Dantale II in a paediatric population. The secondary aims were identification of diffe...

Objective: Virtual reality (VR) simulation training can improve temporal bone (TB) cadaver dissection skills and distributed, self-regulated practice is optimal for skills consolidation. Decentralized training (DT) at the trainees' own department or home offers more convenient access compared with centralized VR simulation training where the simul...

Background: Children with Pendred syndrome (PS) and non-syndromic enlarged vestibular aqueduct (NSEVA) represent a group of pre-lingual hearing-impaired individuals with rehabilitation challenges. Objective: To evaluate receptive language capabilities in a pediatric cohort with PS and NSEVA. Materials and methods: Twenty-four (24) children diagnose...

Objective: To investigate the relations of monoallelic (M1), biallelic (M2), or the absence of mutations (M0) in SLC26A4 to inner ear morphology and hearing levels in individuals with Pendred syndrome (PS) or nonsyndromic enlarged vestibular aqueduct (NSEVA) associated with hearing loss. Methods: In a cohort of 139 PS/NSEVA individuals, 115 pers...

Objective: Reports on the epidemiology of vestibular schwannoma (VS) indicate an increase in diagnosed cases, often based on selected materials over a limited period of time. This report presents prospective 40-year epidemiological data from an unselected national cohort of all patients diagnosed with a VS in Denmark since 1976. Study-design: Da...

Objective: Information on cochlear MRI signal change following vestibular schwannoma (VS) surgery by the retrolabyrinthine approach (RLA) is nonexisting, and information using the translabyrinthine approach (TLA) is scarce. We aimed to evaluate cochlear MRI fluid signal in patients with a unilateral VS, before and after surgery by the RLA or the T...

The present study was aimed at conducting parental evaluations of the Auditory Verbal Therapy approach (AVT) and to assess the relevance of this approach for children with HL and their families in Denmark. The children’s social well-being was also investigated. Questionnaires were developed to evaluate parental perceptions of AVT. A standard quest...

This review is concerned with hearing implants, which are used in patients with hearing loss, who cannot be treated successfully with a conventional hearing aid. Among these implants, bone-anchored hearing systems (BAHS) can be used for conductive or mixed hearing loss, while active middle ear implants primarily are reserved for sensorineural heari...

Disregarding the widely used division of skull base into anterior and lateral, since the skull base should be conceived as a single anatomic structure, it was to our convenience to group all those approaches that run from the antero-lateral, pure lateral and postero-lateral side of the skull base as “Surgery of the lateral skull base”. “50 years of...

Objective: To report hearing preservation results after retrolabyrinthine vestibular schwannoma surgery, using a new system for continuous near real-time monitoring of cochlear nerve function. Study design: Retrospective chart review. Setting: Tertiary referral center, University Hospital. Patients: Thirty-one consecutive patients with growi...

Abstract. Background: Salivary gland carcinomas (SDC) infrequently metastasize to the brain. Case Report: A 72-yearold male experienced left-sided hearing loss and vestibular dysfunction. Two years earlier, the patient underwent treatment for a SDC. Magnetic resonance imaging indicated a suspected vestibular schwannoma (VS); however, a perioperativ...

Introduction: The aim was to investigate the progress of hearing loss over time in a cohort of pendred syndrome and non-syndromic enlarged vestibular aqueduct (PS/NSEVA) with one or two confirmed pathogenic variations in SLC26A4. Study design: Retrospective cohort study. Subjects and methods: At our tertiary referral center, a retrospective se...

Objective This is a systematic review of the literature on the spontaneous course of hearing in patients observed with a vestibular schwannoma. Included studies are appraised using the Grading of Recommendations Assessment, Development and Evaluation system. Design PubMed, Embase, Medline, Cochrane library, and CINAHL (Cumulative Index to Nursing a...

Introduction: Outcome after cochlear implantation in adults varies and is affected by many factors. One factor is auditory training after implantation. No national guidelines for adult auditory training currently exist in Denmark. An auditory verbal skills training (AVST) rehabilitation programme was developed and applied at the East Danish Cochle...

Facial nerve schwannomas (FS) can symptomatically mimic vestibular schwannomas (VS). In addition, FS can be difficult to distinguish from VS on magnetic resonance imaging (MRI). Although disequilibrium is not uncommon in patients with FS, no previous studies have investigated the vestibular function in such patients. Three cases of FS presented ves...

Objectives To investigate the possible association between the etiology of hearing impairment (HI) and language outcome in children with congenital HI after an early medical-technical intervention and three years of AVT. Methods A retrospective, two-center study was conducted of 53 patients who were divided in four categories of etiology (degenera...

Objective: The etiology of symptoms following primary repair of superior canal dehiscence (SCD) may be due to a persistent third window. However, the extent of surgery cannot be seen on postoperative computed tomography (CT) since most repair materials are not radiopaque. We hypothesize that the extent of superior semicircular canal (SSC) occlusio...

To understand speech, the slowly varying outline, or envelope, of the acoustic stimulus is used to distinguish words. A small amount of information about the envelope is sufficient for speech recognition, but the mechanism used by the auditory system to extract the envelope is not known. Several different theories have been proposed, including enve...

Objective: To investigate the effect on final-product performance of a distributed, virtual reality (VR) simulation training program on cadaveric dissection performance and learning curves compared with standard VR simulation training during a temporal bone course. Study design: Educational interventional cohort study. Setting: The national Da...

Children with severe hearing impairment or deafness are preferably recognised and treated with a cochlear implant (CI) before the age of one year, as early stimulation of the auditory sense is essential for the development of spoken language. Today, children with deafness are offered a bilateral CI, as it allows for improved speech perception in no...

Vestibular schwannomas are benign tumours originating from the eighth cranial nerve. The incidence in Denmark is rising and is around 200 per million per year. Pure tone audiometry, discrimination score and tinnitus anamnesis determine, whether a diagnostic MRI is merited. Around one fourth of newly diagnosed patients receive surgery due to the siz...

Objectives: The aim of the present study was to investigate the relationships between tumor size, hearing, and vestibular outcomes in patients with vestibular schwannomas (VSs). Materials and methods: Adult patients (n=124) with unilateral extrameatal VS prior to surgery were included in the study. This was a retrospective cohort study of preope...

In light of missing systematic reviews in the literature, the objective of this paper is to present the contemporary knowledge on the molecular biology of vestibular schwannomas (VS), based on a systematic literature search. In addition, current and prospected medical therapy based on molecular biology is addressed. A systematic literature search w...

A new electrophysiological system for intraoperative, continuous, near-real time monitoring of cochlear nerve function through acoustic stimulation in the ear canal and recording of the evoked dorsal cochlear nucleus potentials (DNAPs) by a specially designed DNAP electrode placed directly on the brainstem is described. The system is denominated "(...

Objective The overall objective of this study was to evaluate the implementation of a Nordic Auditory Verbal (AV) intervention for children with all degrees and types of hearing impairment (HI) using all kinds of hearing technology. A first specific objective was to identify differences and similarities in early vocabulary development between child...

OBJECTIVE: To report surgical results and complications of cochlear implantation in patients with far-advanced otosclerosis (FAO). MATERIALS and METHODS: This was a retrospective chart review of surgical results in terms of electrode insertion as well as peri- and postoperative complications. Ten cochlear implantations (CIs) were performed in eight...