Publications by authors named "Topi Jutila"

11 Publications

  • Page 1 of 1

Simultaneous bilateral stapes surgery after follow-up of 13 years.

Acta Otolaryngol 2021 Jan 12;141(1):39-42. Epub 2020 Oct 12.

Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

Background: Eighteen patients underwent simultaneous bilateral stapes surgery in 2003-2006.

Objectives: We evaluated the long-term outcomes in this patient group, and assessed their hearing in noise and binaural hearing.

Material And Methods: Fifteen patients returned questionnaires concerning their hearing, taste function, and balance. Thirteen patients underwent pure-tone and speech audiogram, Finnish matrix sentence test, video head impulse test, and clinical examination on average 13 years after surgery.

Results: We found no significant difference in air- and bone conduction pure-tone average, speech audiometry, and the air-bone gap between the 1-year and the late postoperative visits. One patient had bilaterally a partial loss of the vestibulo-ocular reflex of unknown cause.

Conclusions And Significance: The hearing results 13 years after simultaneous bilateral stapes surgery remained good without any significant delayed complications. Simultaneous bilateral stapes surgery is a viable treatment option in selected patients with otosclerosis.
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http://dx.doi.org/10.1080/00016489.2020.1828621DOI Listing
January 2021

Impact noise of prostate biopsy devices.

Scand J Urol 2020 Apr 5;54(2):175-178. Epub 2020 Feb 5.

Department, of Otorhinolaryngology, Helsinki University Hospital, Helsinki, Finland.

To analyse the impact noise generated by prostate biopsy devices. In a laboratory setting, repeated impact noise was recorded at distances of 50 cm and 100 cm using five brands of device on chicken meat, an apple and an empty target. In a clinical setting, the impact noise levels of prostate biopsy devices were recorded in 40 real patient cases using three brands of device. In the laboratory setting, the average SPL (sound pressure level) peak level ranged from 104.3 to 121.3 dB. The highest impact noise levels were measured with the Monopty device, ranging from 114.8 to 122.4 dB. In the clinical setting, there were no statistical differences between repeated SPL values for each specific target. Also, the noise levels were equal when the same device brand was used at 50 cm and 100 cm. The highest SPLs were recorded with the Monopty device, which ranged from 110 to 127 dB. The corresponding values for the Max-Core and Multicore were from 106 to 122.5 dB and from 108 to 116.5 dB, respectively. Biopsy devices generate high peak levels of impact noise. Personnel performing biopsies are advised to consider using hearing protection, even though the impact noise may not induce permanent hearing loss.
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http://dx.doi.org/10.1080/21681805.2020.1716068DOI Listing
April 2020

Clinical Characteristics of Troublesome Pediatric Tinnitus.

Clin Med Insights Ear Nose Throat 2017 23;10:1179550617736521. Epub 2017 Oct 23.

Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

Objectives: The frequency of tinnitus in children and adults is practically the same. However, although adults reveal their symptoms and seek for medical aid, the suffering often remains unrecognized in the young. This is due to both the inability of children to properly describe their symptoms and the lack of recognition.

Materials And Methods: Among 5768 patients entering our department with complaints of tinnitus between 2010 and 2015, there were only 112 children. A full clinical history and medical status had been determined at the time of presentation and were analyzed retrospectively.

Results: The average duration from first complain to clinical presentation was approximately 12 months. A normal hearing capability of less than 25 dB was measured in 80% of the cases. Only 23 patients presented with a hearing impairment. The causes ranged from hearing loss, previous orthodontic treatment, noise trauma, middle ear aeration, muscular neck tension, and skull base fracture. Typical co-morbidities such as sleeping disorders, concentration disorders, and hyperacusis were observed.

Conclusions: This retrospective study shows that recognition of tinnitus in the childhood is generally delayed. A better characterization of complaints and triggers, however, is a prerequisite to sensitize medical personnel and caretakers for the suffering and to avoid developmental impairments.
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http://dx.doi.org/10.1177/1179550617736521DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5656107PMC
October 2017

Head tilt is pronounced after an ipsilateral head roll in patients with vestibular schwannoma.

Eur Arch Otorhinolaryngol 2014 Jun 29;271(6):1791-6. Epub 2013 Nov 29.

Department of Otorhinolaryngology & Head and Neck Surgery, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland,

The study aimed to measure utricular function by directly quantifying head tilt in vestibular schwannoma (VS) patients using regular video-oculography (VOG) equipment with integrated head-position sensor, and to correlate the results with patients' symptoms and signs. We recorded head tilting after exclusion of visual cues (static head tilt), and after returning to the centre following lateral head rolls towards each side [subjective head vertical (SHV)]. Head tilt in 43 patients was measured preoperatively and approximately 4 months postoperatively, and compared to that of 20 healthy subjects. Symptoms were assessed with a structured questionnaire. Static head tilt in patients was significantly greater than in controls (1.0° ± 0.9°) preoperatively (1.6° ± 1.5°, p = 0.04) and postoperatively (1.7° ± 1.5°, p = 0.01). Mean SHV in patients was significantly greater than in controls (1.2° ± 1.0°) preoperatively (2.0° ± 1.9°, p = 0.03) and postoperatively (2.5° ± 1.8°, p = 0.001), increasing non-significantly after surgery (p = 0.3). Side-specific SHV after ipsilateral head rolls was significantly greater than after contralateral head rolls preoperatively (2.8° ± 3.3° vs. -0.5° ± 3.0°, p = 0.001) and postoperatively (3.3° ± 3.0° vs. 0.6° ± 3.2°, p < 0.001). The intensity of dizziness increased postoperatively (p = 0.04), but its effect on quality of life remained unchanged. In conclusion, commercial VOG equipment including a head-position sensor allows direct evaluation of head tilt in VS patients. The slight head tilt towards the ipsilateral side becomes most evident after returning from an ipsilateral head roll.
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http://dx.doi.org/10.1007/s00405-013-2836-yDOI Listing
June 2014

[Bilateral failure of the vestibular system of the inner ear underlying an equilibrium disturbance].

Duodecim 2013 ;129(14):1494-8

HUS, Korva-, nenä- ja kurkkutautien klinikka PL 220, 00029 HUS.

Bilateral vestibular failure is a fairly rare, though possible cause underlying the symptoms of a dizzy patient. A recognizable oscillopsia symptom makes the diagnosis easier, though confirmation of the diagnosis requires a more precise measurement. The prognosis for recovery is not good, and curative treatment is not available. Diagnosis is nevertheless important with regard to rehabilitation and maintaining of functional capacity.
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September 2013

[Nystagmus].

Duodecim 2013 ;129(8):807-16

HYKS, Korva.

Physiological nystagmus stabilizes gaze during head movements and pathological nystagmus reflects a disorder of the vestibulo-ocular reflex (VOR). Pathological nystagmus appears or strengthens usually during change in head position. Therefore, dizziness or nystagmus associated with head movements is not specific to benign paroxysmal positional vertigo unless it is verified in specific positional test. Peripheral nystagmus decelerates during visual fixation, accelerates when gaze is turned towards the fast phase, does not change direction, and is usually composed of several directional components unlike central nystagmus. The velocity and frequency of the slow phase of nystagmus can be measured with electronystagmography or video-oculography.
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July 2013

Cochlear implantation rarely alters horizontal vestibulo-ocular reflex in motorized head impulse test.

Otol Neurotol 2013 Jan;34(1):48-52

Department of Otorhinolaryngology and Head and Neck Surgery, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.

Objective: Determine the change in vestibular function in patients receiving a unilateral cochlear implant, and to compare these results with other signs and symptoms.

Study Design: Prospective cohort study.

Setting: Academic tertiary referral center.

Patients: Forty-four adults (mean age, 55 yr; range, 30-76 yr) receiving their first cochlear implant.

Intervention: Cochlear implantation.

Main Outcome Measures: Horizontal high-frequency vestibulo-ocular reflex (VOR) was measured using the motorized head impulse rotator preoperatively and twice (on average two and 19 months) postoperatively. VOR gain and asymmetry were calculated (mean ± standard deviation). Symptoms were assessed with a structured questionnaire.

Results: Gain on the operated side was 0.77 ± 0.26 preoperatively, 0.75 ± 0.30 in the early and 0.73 ± 0.33 in the late postoperative control, and did not change significantly. Mean asymmetry remained within 9% to 10% in all test occasions. Dizziness symptom score or dizziness-related quality of life score did not change significantly. General quality-of-life score improved significantly from that of preoperative 3.5 ± 1.2 to that of 2.6 ± 1.1 postoperatively (p = 0.01). Subjective hearing scores improved significantly from 4.9 ± 0.3 to 2.4 ± 1.0, respectively (p = 0.0000). Gain was decreased significantly in 4 patients (10%) in the early and in 2 patients (7%) in the late postoperative control.

Conclusion: Late high-frequency loss of vestibular function or vestibular symptoms is rare but possible after cochlear implantation surgery. This should be taken into account in patient counseling especially when considering bilateral cochlear implant surgery.
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http://dx.doi.org/10.1097/MAO.0b013e318277a430DOI Listing
January 2013

Recovery of the horizontal vestibulo-ocular reflex in motorized head impulse test is common after vestibular loss.

Acta Otolaryngol 2012 Jul 4;132(7):726-31. Epub 2012 Mar 4.

Department of Otorhinolaryngology, Helsinki University Central Hospital, Finland.

Conclusion: Decreased horizontal vestibulo-ocular reflex (VOR) gain measured with the motorized head impulse rotator usually recovers at least partially within a few months after sudden unilateral vestibular loss. In addition to traditional evaluation of nystagmus, head impulse test responses provide valuable information on the severity and recovery of vestibular loss.

Objectives: To quantify recovery of vestibular function with the motorized head impulse test in patients with acute unilateral peripheral vestibular loss, and to compare these results with other signs and symptoms.

Methods: We recorded prospectively the horizontal VOR with the motorized head impulse rotator in 30 patients with sudden unilateral vestibular deficit on average 3 days after the onset (early). Twenty patients were measured sequentially on average 3 months later (late). We calculated VOR gain and asymmetry (mean ± standard deviation).

Results: The early ipsilesional gain of 0.49 ± 0.21 improved highly significantly to the late gain of 0.79 ± 0.23 (p = 0.0000). The respective asymmetry improved highly significantly from 32 ± 18% to 12 ± 14% (p = 0.0002). Gain or asymmetry recovered at least partially in 80% of the patients. The late high symptom score correlated with low gain (p = 0.043) and high asymmetry (p = 0.018).
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http://dx.doi.org/10.3109/00016489.2012.656763DOI Listing
July 2012

Subjective head vertical test reveals subtle head tilt in unilateral peripheral vestibular loss.

Eur Arch Otorhinolaryngol 2011 Oct 15;268(10):1523-6. Epub 2011 Mar 15.

Department of Otolaryngology, Helsinki University Central Hospital, Haartmaninkatu 4 E, P.O. Box 220, 00029 HUS Helsinki, Finland.

Utricular dysfunction has been indirectly measured with subjective visual horizontal or vertical testing. Video-oculography equipment with integrated head position sensor allows direct evaluation of head tilt. The aim was to assess head tilt after peripheral vestibular lesion by recording tilting of the head after excluding visual cues (static test condition), and after three lateral head tilts to both sides [subjective head vertical (SHV)]. Thirty patients with unilateral, peripheral vestibular loss were measured in the acute state, and 3 months later. Twenty healthy, age- and sex-matched subjects served as controls. Mean static tilt of 2.6 ± 1.1° in patients with acute vestibular loss differed significantly from that of 1.0 ± 0.4° in healthy subjects (p = 0.004), and from that of 1.1 ± 0.5° during the follow-up visit (p = 0.008). The mean SHV of 3.4 ± 0.7° in patients with acute vestibular loss was significantly more than that of 1.2 ± 0.5° in controls (p < 0.001). The SHV towards the lesion was 4.9 ± 1.0° while returning from the lesion side and 2.0 ± 1.0° while returning from the healthy side. The SHV was definitely abnormal in 60%, moderately abnormal in 20% and normal in 20% of the patients in acute state. Abnormal SHV persisted in only 20% of the patients indicating that recovery of the peripheral utricular function is occurring within months. In summary, head tilts slightly towards acute peripheral lesion, and this tilting is reinforced, when the head is actively moved on the lesion side.
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http://dx.doi.org/10.1007/s00405-011-1560-8DOI Listing
October 2011

Signal analysis of three-dimensional nystagmus for otoneurological investigations.

Ann Biomed Eng 2011 Mar 24;39(3):973-82. Epub 2010 Nov 24.

Department of Computer Sciences, University of Tampere, Tampere, Finland.

Three-dimensional signal analysis can be applied to eye movements called nystagmus in order to study otoneurological patients suffering from vertigo and other balance problems. We developed an analysis and modeling algorithm for three-dimensional nystagmus measured by a video-oculography system. We were also interested in verifying an otoneurological hands-on convention called Ewald's first law in a strict physiological sense in vestibular patients. We recorded nystagmus from 42 patients all suffering from vertigo or dizziness. The underlying pathology was unilateral in 39 patients, bilateral in one patient, and central in two patients. Video-oculography was used to record three-dimensional nystagmus to separately produce horizontal, vertical, and torsional signals for each eye. On the basis of signal analysis techniques and straightforward vector calculus, we were able to recognize slow phases of nystagmus to compute their angular velocities to estimate from which part of the inner ear the disorder originated. We found that for all 42 patients the plane of one of the two horizontal semicircular canals was the closest. We were able to quantitatively estimate the influence of different semicircular canals, and, despite the pathology, horizontal canals seemed to be predominant in driving the nystagmus. The signal analysis and modeling algorithm developed is effective in studying otoneurological problems registered with nystagmus and opens new insights in three-dimensional nystagmography. Our results strongly support Ewald's first law.
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http://dx.doi.org/10.1007/s10439-010-0211-3DOI Listing
March 2011