Search

Background: The size of the human cochlear, measured by the diameter of the basal turn, varies between 7 and 11 mm. For hearing rehabilitation with cochlear implants (CI), the size of the cochlear influences the individual frequency map and the choice of electrode length. OTOPLAN® (CAScination AG [Bern, Switzerland] in cooperation with MED-EL [Innsbruck, Austria]) is a software tool with CE marking for clinical applications in CI treatment which allows for precise pre-planning based on cochlear size. This literature review aims to analyze all published data on the application of OTOPLAN®., Materials and Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were applied to identify relevant studies published in the PubMed search engine between January 2015 and February 2023 using the search terms "otoplan" [title/abstract] OR "anatomy-based fitting" [title/abstract] OR "otological software tool" [title/abstract] OR "computed tomography-based software AND cochlear" [title/abstract]., Results: The systematic review of the literature identified 32 studies on clinical use of OTOPLAN® in CI treatment. Most studies were reported from Germany (7 out of 32), followed by Italy (5), Saudi Arabia (4), the USA (4), and Belgium (3); 2 studies each were from Austria and China, and 1 study from France, India, Norway, South Korea, and Switzerland. In the majority of studies (22), OTOPLAN® was used to assess cochlear size, followed by visualizing the electrode position using postoperative images (5), three-dimensional segmentation of temporal bone structures (4), planning the electrode insertion trajectory (3), creating a patient-specific frequency map (3), planning of a safe drilling path through the facial recess (3), and measuring of temporal bone structures (1)., Conclusion: To date, OTOPLAN® is the only DICOM viewer with CE marking in the CI field that can process pre-, intra-, and postoperative images in the abovementioned applications., (© 2024. The Author(s).)

In Germany, an increased volume of patient cases in the emergency department has been observed for several years, many of which do not represent hospital emergencies. To improve the triage and management of patient flows, the Structured Initial Medical Assessment (Strukturierte medizinische Ersteinschätzung in Deutschland, SmED) triage system was developed. This certified medical product is intended to assess both the urgency of everyday complaints and their adequate medical care in a targeted, faster, and safer manner. It supports medical professionals in triage by suggesting courses of action, whereby the ultimate responsibility remains with the professionals themselves. For otorhinolaryngology, a content review was carried out with regard to plausibility and patient safety in the head and neck region on the basis of nine specific emergencies. The cases were simulated by nine otorhinolaryngologists and triaged on the basis of the SmED by medical staff and medical students by assigning a care level and timepoint (urgency). The majority of cases were correctly assigned. The SmED initial assessment system is a good tool for assessing urgent clinical pictures in ear, nose, and throat (ENT) medicine. The long-term goal of the initial assessment is to relieve the capacities of outpatient departments. In order to achieve this and to shorten patient waiting times, it would be necessary to refer patients quickly to otorhinolaryngology. It is therefore necessary to ensure that patients are referred to an ENT on-call service via the online tool., (© 2024. The Author(s).)

Objective:  Surgical treatment with bone conduction hearing implants and epitheses for ear malformations offer the right combination of hearing rehabilitation and cosmetic reconstruction. The surgical procedure is often performed in two-stage surgical steps. This project aimed to gain experience with a procedure in which the hearing implant and the epithesis anchors are inserted simultaneously., Material and Methods:  Four ears of three patients (n f  = 1, n m  = 2) with severe ear malformations (type III, according to Weerda) received a Bonebridge and an epithesis anchor with three base posts in one operation each. Previously, the indication for the use of a bone conduction implant using the active middle ear implant (aMEI) score, according to Frenzel (2013), had been established., Results:  All patients scored 4 points each in the aMEI-score, indicating an unfavorable prognosis for successful implantation of an active middle ear implant. The treatment with a Bonebridge and an epithesis anchor was performed without complications. Postoperatively, the initial audiological fitting and the application of the magnetic abutment were performed after 4 weeks. Audiometry showed a functional gain of up to 30 dB and an improved speech comprehension. The epithesis was shaped like the contralateral ear. After treatment, patients were satisfied with the audiological and cosmetic results., Conclusions:  The simultaneous surgical procedure with a bone conduction hearing implant and epithesis anchor is a good option for the treatment of ear malformations. The aMEI-score was a helpful instrument for the indication. The procedure reduced the surgical risk and the time and effort required for treatment., Competing Interests: Wir erklären, dass wir von keinem Unternehmen Unterstützung für die eingereichte Arbeit erhalten haben und keine finanziellen Interessen haben, die für die eingereichten Arbeiten relevant sein könnten., (Thieme. All rights reserved.)