Outcome of computer-assisted surgery in patients with chronic rhinosinusitis

Abstract Objective: To compare the complication rates and outcome of computer-assisted versus non-computer-assisted functional endoscopic sinus surgery. Methods: We reviewed retrospectively the medical records of 276 patients who had undergone sinus surgery for chronic rhinosinusitis with (n=108) or without (n=168) computer assistance, from 1996 to 2004, to determine the incidence of complications and need for revision surgery. Results: The incidence of complications was 6.5 per cent in the computer-assisted group and 6.0 per cent in the non-computer-assisted group (p=1.00). In the computer-assisted group, 9.2 per cent needed revision surgery, compared with 10.7 per cent in the non-assisted group (p=0.84). Conclusions: Although our study found no significant difference in complications or revision rates, computer-assisted surgery serves as an important orientation aid during functional endoscopic sinus surger

Speech Signal Enhancement in Cocktail Party Scenarios by Deep Learning based Virtual Sensing of Head-Mounted Microphones

The cocktail party effect refers to the human sense of hearing’s ability to pay attention to a single conversation while filtering out all other background noise. To mimic this human hearing ability for people with hearing loss, scientists integrate beamforming algorithms into the signal processing path of hearing aids or implants’ audio processors. Although these algorithms’ performance strongly depends on the number and spatial arrangement of the microphones, most devices are equipped with a small number of microphones mounted close to each other on the audio processor housing. We measured and evaluated the impact of the number and spatial arrangement of hearing aid or head-mounted microphones on the performance of the established Minimum Variance Distortionless Response beamformer in cocktail party scenarios. The measurements revealed that the optimal microphone placement exploits monaural cues (pinna-effect), is close to the target signal, and creates a large distance spread due to its spatial arrangement. However, this microphone placement is impractical for hearing aid or implant users, as it includes microphone positions such as on the forehead. To overcome microphones’ placement at impractical positions, we propose a deep virtual sensing estimation of the corresponding audio signals. The results of objective measures and a subjective listening test with 20 participants showed that the virtually sensed microphone signals significantly improved the speech quality, especially in cocktail party scenarios with low signal-to-noise ratios. Subjective speech quality was assessed using a 3-alternative forced choice procedure to determine which of the presented speech mixtures was most pleasant to understand. Hearing aid and cochlear implant (CI) users might benefit from the presented approach using virtually sensed microphone signals, especially in noisy environments

Electrospinning Auricular Shaped Scaffolds for Tissue Engineering

Poly(ɛ)caprolactone scaffolds have been electrospun directly into an auricular shaped conductive mould. Bovine chondrocytes were harvested from articular cartilage and seeded onto 16 of the produced scaffolds, which received either an ethanol (group A) or a plasma treatment (group B) for sterilisation before seeding. The seeded scaffolds were cultured for 3 weeks in vitro and analysed with regard to total DNA and GAG content as well as the expression of AGG, COL1, COL2, MMP3 and MMP13. Rapid cell proliferation and GAG accumulation was observed until week 2. However, total DNA and GAG content decreased again in week 3. qPCR data shows a slight increase in the expression of anabolic genes and a slight decrease for the catabolic genes, with a significant difference between the groups A and B only for COL2 and MMP1

Computerassistierte Chirurgie der Nasennebenhöhlen und der vorderen Schädelbasis

Zusammenfassung: Endoskopische oder mikroskopische Eingriffe bei chronischen Nasennebenhöhlenentzündungen mit oder ohne Polyposis sind in der täglichen Praxis häufig. Da es sich um delikate und schwierige minimal-invasive Eingriffe bei engem Raum, Tunnelblick von 4-mm-Endoskopen und häufig leicht blutendem Gewebe bei chronisch entzündlichen Erkrankungen handelt, ist die Orientierung in diesem "Labyrinth" oft schwierig. Bei Rezidiven von Nasenpolypen oder Tumoren sind oft die normalen anatomischen Landmarken, welche dem Chirurgen als Orientierung dienen, nicht mehr vorhanden. Die Navigation zusammen mit den Bildgebungsverfahren wie CT und MRT hilft bei unübersichtlichen Verhältnissen dem Chirurgen, sich im Raum zu orientieren und die Operation umso sicherer und z.T. auch schneller durchzuführen. Zusätzlich hat die Navigation ein großes Potenzial für Ausbildungszweck

Are Smartwatches a Suitable Tool to Monitor Noise Exposure for Public Health Awareness and Otoprotection?

Introduction and Objectives: Noise-induced hearing loss (NIHL) and tinnitus are common problems that can be prevented with hearing protection measures. Sound level meters and noise dosimeters enable to monitor and identify health-threatening occupational or recreational noise, but are limited in their daily application because they are usually difficult to operate, bulky, and expensive. Smartwatches, which are becoming increasingly available and popular, could be a valuable alternative to professional systems. Therefore, the aim of this study was to evaluate the applicability of smartwatches for accurate environmental noise monitoring. Methods: The A-weighted equivalent continuous sound pressure level (LAeq) was recorded and compared between a professional sound level meter and a popular smartwatch. Noise exposure was assessed in 13 occupational and recreational settings, covering a large range of sound pressure levels between 35 and 110 dBA. To assess measurement agreement, a Bland-Altman plot, linear regression, the intra-class correlation coefficient, and descriptive statistics were used. Results: Overall, the smartwatch underestimated the sound level meter measurements by 0.5 dBA (95% confidence interval [0.2, 0.8]). The intra-class correlation coefficient showed excellent agreement between the two devices (ICC = 0.99), ranging from 0.65 (music club) to 0.99 (concert) across settings. The smartwatch’s sampling rate decreased significantly with lower sound pressure levels, which could have introduced measurement inaccuracies in dynamic acoustic environments. Conclusions: The assessment of ambient noise with the tested smartwatch is sufficiently accurate and reliable to improve awareness of hazardous noise levels in the personal environment and to conduct exploratory clinical research. For professional and legally binding measurements, we recommend specialized sound level meters or noise dosimeters. In the future, smartwatches will play an important role in monitoring personal noise exposure and will provide a widely available and cost-effective measure for otoprotection

Correction: Neural Activity During Audiovisual Speech Processing: Protocol For a Functional Neuroimaging Study.

[This corrects the article DOI: 10.2196/38407.]

Neural Activity During Audiovisual Speech Processing: Protocol For a Functional Neuroimaging Study.

BACKGROUND The field of health information management (HIM) focuses on the protection and management of health information from a variety of sources. The American Health Information Management Association (AHIMA) Council for Excellence in Education (CEE) determines the needed skills and competencies for this field. AHIMA's HIM curricula competencies are divided into several domains among the associate, undergraduate, and graduate levels. Moreover, AHIMA's career map displays career paths for HIM professionals. What is not known is whether these competencies and the career map align with industry demands. OBJECTIVE The primary aim of this study is to analyze HIM job postings on a US national job recruiting website to determine whether the job postings align with recognized HIM domains, while the secondary aim is to evaluate the AHIMA career map to determine whether it aligns with the job postings. METHODS A national job recruitment website was mined electronically (web scraping) using the search term "health information management." This cross-sectional inquiry evaluated job advertisements during a 2-week period in 2021. After the exclusion criteria, 691 job postings were analyzed. Data were evaluated with descriptive statistics and natural language processing (NLP). Soft cosine measures (SCM) were used to determine correlations between job postings and the AHIMA career map, curricular competencies, and curricular considerations. ANOVA was used to determine statistical significance. RESULTS Of all the job postings, 29% (140/691) were in the Southeast, followed by the Midwest (140/691, 20%), West (131/691,19%), Northeast (94/691, 14%), and Southwest (73/691, 11%). The educational levels requested were evenly distributed between high school diploma (219/691, 31.7%), associate degree (269/691, 38.6%), or bachelor's degree (225/691, 32.5%). A master's degree was requested in only 8% (52/691) of the postings, with 72% (42/58) preferring one and 28% (16/58) requiring one. A Registered Health Information Technologist (RHIT) credential was the most commonly requested (207/691, 29.9%) in job postings, followed by Registered Health Information Administrator (RHIA; 180/691, 26%) credential. SCM scores were significantly higher in the informatics category compared to the coding and revenue cycle (P=.006) and data analytics categories (P<.001) but not significantly different from the information governance category (P=.85). The coding and revenue cycle category had a significantly higher SCM score compared to the data analytics category (P<.001). Additionally, the information governance category was significantly higher than the data analytics category (P<.001). SCM scores were significantly different between each competency category, except there were no differences in the average SCM score between the information protection and revenue cycle management categories (P=.96) and the information protection and data structure, content, and information governance categories (P=.31). CONCLUSIONS Industry job postings primarily sought a high school diploma and associate degrees, with a master's degree a distant third. NLP analysis of job postings suggested that the correlation between the informatics category and job postings was higher than that of the coding, revenue cycle, and data analytics categories. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/38407

Endoscopic and Robotic Stapes Surgery: Review with Emphasis on Recent Surgical Refinements

Purpose of Review Stapes surgery has been established as the gold standard for surgical treatment of conductive hearing loss in otosclerosis. Excellent outcomes with very low complication rate are reported for this surgery. Recent advances to improve surgical outcome have modified the surgical technique with endoscopes, and recent studies report development of robotical assistance. This article reviews the use of endoscopes and robotical assistance for stapes surgery. Recent Findings While different robotic models have been developed, 2 models for stapes surgery have been used in the clinical setting. These can be used concomitant to an endoscope or microscope. Endoscopes are used on a regular base regarding stapes surgery with similar outcomes as microscopes. Endoscopic stapes surgery shows similar audiological results to microscopic technique with an advantage of less postoperative dysgeusia and pain. Its utility in cases of revision surgery or malformation is emphasized. Summary Endoscopic stapes surgery is used on a regular basis with excellent outcomes similar to the microscopic approach, while reducing surgical morbidity. Robotic technology is increasingly being developed in the experimental setting, and first applications are reported in its clinical use