Clinical evaluation of cholesteatoma diagnostics and outcomes of bone conduction devices
2026 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]
This thesis investigates the diagnostic accuracy of non-echo-planar diffusion-weighted magnetic resonance imaging (non-EPI DW MRI) for cholesteatoma detection in routine clinical practice. It also evaluates the audiological and patient-reported outcomes of active transcutaneous bone-conduction devices (active transcutaneous BCDs) in otologic care.The thesis focuses on cholesteatoma diagnostics and hearing rehabilitation in individuals with conductive hearing loss, mixed hearing loss, and single-sided deafness.
The first paper evaluated the diagnostic accuracy of non-EPI DW MRI for the detection of cholesteatoma in routine clinical practice. Overall, diagnostic accuracy was moderate in routine clinical practice but improved when examinations were interpreted by experienced radiologists and when standardised EAONO/JOS diagnostic criteria were applied.
The subsequent papers assessed audiological and patient-reported outcome measures following implantation of active transcutaneous BCDs. The second paper evaluated the short-term outcomes of an active transcutaneous BCD and included an assessment of postoperative complications. The results demonstrated substantial short-term improvements in audiological performance and in quality of life among individuals with conductive and mixed hearing loss, while the complications rate was low. Participants with single-sided deafness generally experienced less benefit from the active transcutaneous BCD. However, the observed outcomes were in line with those reported for alternative rehabilitation options in this population.
The third paper examined the long-term efficacy and safety of active transcutaneous BCDs. Hearing improvements and patient-reported outcomes were maintained over time, with a low incidence of adverseevents.
The fourth paper expanded the evidence base by comparing the audiological performance of two commercially available active transcutaneous BCDs in participants with conductive and mixed hearing loss. The results showed that both systems produced substantial improvements in audiological performance. However, one system achieved significantly lower aided sound-field thresholds at several frequencies, indicating more efficient sound transmission. Both devices led to significant improvements in speech recognition in noise, with comparable gains across groups.
Overall, the findings indicate that non-EPI DW MRI has limitations in routine clinical practice, but diagnostic accuracy improves when examinations are interpreted by experienced radiologists using standardised assessment criteria. Active transcutaneous BCDs represent a safe and effective rehabilitation option for individuals with conductiveand mixed hearing loss and single-sided deafness.
Place, publisher, year, edition, pages
Umeå: Umeå University, 2026. , p. 76
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 2408
Keywords [en]
Active transcutaneous bone-conduction devices, audiology, patient-reported outcome measures, non-echo-planar diffusion-weighted magnetic resonance imaging, diagnostic accuracy, cholesteatoma.
National Category
Oto-rhino-laryngology
Identifiers
URN: urn:nbn:se:umu:diva-251788ISBN: 978-91-8070-936-1 (electronic)ISBN: 978-91-8070-935-4 (print)OAI: oai:DiVA.org:umu-251788DiVA, id: diva2:2051751
Public defence
2026-05-08, Triple Helix, Samverkanshuset, Umeå, 09:00 (Swedish)
Opponent
Supervisors
Note
Link to participate via Zoom: https://umu.zoom.us/s/67288228854
2026-04-172026-04-092026-04-14Bibliographically approved
List of papers