Objective: The aim of this study was to develop Greek Sentence Based Speech Audiometry Test in qu... more Objective: The aim of this study was to develop Greek Sentence Based Speech Audiometry Test in quiet test for Hearing Impaired (HI) children (G-SEBSAT). Methods: Seventy-six children were recruited following approval by the local ethics committee and after obtaining informed consent from their parents. The collection of vocabulary was based on showing pictures selected from popular reading materials in Greek to hearing impaired HI children. A grammatical content analysis was carried out to determine the average syntactic and morphological structures of the sentences used by the HI children. Ten picture related sentence lists were developed based on the vocabulary and the grammatical analysis, and recorded by a male native speaker of standard Modern Greek. These were presented to both normal hearing (NH) and HI children, and the average speech response threshold (SRT) as well as the slope of the SRT curve at the SRT level of 50% correct responses (S 50) were recorded in both groups. Sentence lists were validated with respect to the variability of their difficulty within each group, as well the test-retest variability of the respective SRT scores. Results: The average speech response threshold (SRT) across all lists for HI children was 65.27 dB and the slope of the SRT curve at the SRT level of 50% correct responses was 3.11%/dB. The corresponding results across all lists for NH children were 17.66 dB and 9.7%/dB, respectively. The SRT of HI children were strongly positively correlated, in a statistically significant manner with the PTA in both the test and the retest sessions (test: r=0.750, P < 0.0005; retest: r=0.753, P < 0.0005). The Spearman correlation of the rankings of SRT values and the slope values was 0.998 and 0.997 respectively for the HI and 0.939 and 0.88, for the NH group, indicating very low variability across the test and retest sessions. In addition, the analysis of variance (ANOVA) of the average SRT in NH children and the SRT residuals in the HI group indicated that the different sentences were of the same difficulty within each group. ((F(9,81)=0.401, p=0.930 and (F(9,93)=2.241, p=0.025 respectively). Conclusions: A validated sentence based speech audiometry test was created in Greek for the first time. SRT and S50 values for both NH and HI children are comparable to similar tests developed in other languages.
Somatosensory tinnitus is a generally agreed subtype of tinnitus that is associated with activati... more Somatosensory tinnitus is a generally agreed subtype of tinnitus that is associated with activation of the somatosensory, somatomotor, and visual-motor systems. A key characteristic of somatosensory tinnitus is that is modulated by physical contact or movement. Although it seems common, its pathophysiology, assessment and treatment are not well defined. We present a scoping review on the pathophysiology, diagnosis, and treatment of somatosensory tinnitus, and identify priority directions for further research. Methods: Literature searches were conducted in Google Scholar, PubMed, and EMBASE databases. Additional broad hand searches were conducted with the additional terms etiology, diagnose, treatment. Results: Most evidence on the pathophysiology of somatosensory tinnitus suggests that somatic modulations are the result of altered or cross-modal synaptic activity within the dorsal cochlear nucleus or between the auditory nervous system and other sensory subsystems of central nervous...
In Europe alone, over 70 million people experience tinnitus; for seven million people, it creates... more In Europe alone, over 70 million people experience tinnitus; for seven million people, it creates a debilitating condition. Despite its enormous socioeconomic relevance, progress in successfully treating the condition is somewhat limited. The European Union has approved funding to create a pan-European tinnitus research collaboration network (2014-2018). The goal of one working group is to establish an international standard for outcome measurements in clinical trials of tinnitus. Importantly, this would enhance tinnitus research by informing sample-size calculations, enabling meta-analyses, and facilitating the identification of tinnitus subtypes, ultimately leading to improved treatments. The first meeting followed a workshop on "Agreed Standards for Measurement: An International Perspective" with invited talks on clinimetrics and existing international initiatives to define core sets for outcome measurements in hearing loss (International classification of functioning, ...
We present a 46-year-old psychiatric patient presenting with a lingual abscess. This paper covers... more We present a 46-year-old psychiatric patient presenting with a lingual abscess. This paper covers the epidemiology, clinical features, diagnosis, and differential diagnosis with a view to assisting emergency physicians in the timely recognition and management of this rare but potentially life-threatening condition.
13th IEEE International Conference on BioInformatics and BioEngineering, 2013
ABSTRACT The SIFEM project targets the development of an infrastructure in order to semantically ... more ABSTRACT The SIFEM project targets the development of an infrastructure in order to semantically link open source tools and libraries with existing data as well as new knowledge towards the multi-scale finite element modelling of the inner-ear. The SIFEM system is designed based on an open architecture schema that consists of a set of tools and subsystems in order to develop robust multi-scale models. The project mainly delivers: (i) tools for finite elements modelling, (ii) cochlea reconstruction tool and (iii) 3D inner ear models visualization tool. The main scientific results contribute to the knowledge of alterations associated to diverse cochlear disorders and could lead, in long-term, to personalized healthcare. The overview of the SIFEM platform and its architecture is presented in this paper.
Advances in Experimental Medicine and Biology, 2014
In this work, we present the concept, the methodological ideas and the architecture of the EMBALA... more In this work, we present the concept, the methodological ideas and the architecture of the EMBALANCE platform. EMBALANCE platform extends existing but generic and currently uncoupled balance modeling activities, leading to a multi-scale and patient-specific balance Hypermodel, which is incorporated to a Decision Support System (DSS), towards the early diagnosis, prediction and the efficient treatment planning of balance disorders. Various data feed the intelligent system increasing the dimensionality and personalization of the system. Human Computer Interaction techniques are utilized in order to develop the required interfaces in a user-intuitive and efficient way, while interoperable web services enhance the accessibility and acceptance of the system. The platform will be validated using both retrospective as well as prospective experimental and clinical data. The final tool will be a powerful web-based platform provided to primary and secondary care physicians across specialties, levels of training and geographical boundaries, targeting wider clinical acceptance as well as the increased confidence in the developed DSS towards the early diagnostic evaluation, behaviour prediction and effective management planning of balance problems. Currently we focus and present the management and modeling of the balance disorders.
Due to the inaccessibility of the inner ear, direct in vivo information on cochlear mechanics is ... more Due to the inaccessibility of the inner ear, direct in vivo information on cochlear mechanics is difficult to obtain. Mathematical modelling is a promising way to provide insight into the physiology and pathology of the cochlea. Finite element method (FEM) is one of the most popular discrete mathematical modelling techniques, mainly used in engineering that has been increasingly used to model the cochlea and its elements. The aim of this overview is to provide a brief introduction to the use of FEM in modelling and predicting the behavior of the cochlea in normal and pathological conditions. It will focus on methodological issues, modelling assumptions, simulation of clinical scenarios, and pathologies.
We present a 46-year-old psychiatric patient presenting with a lingual abscess. This paper covers... more We present a 46-year-old psychiatric patient presenting with a lingual abscess. This paper covers the epidemiology, clinical features, diagnosis, and differential diagnosis with a view to assisting emergency physicians in the timely recognition and management of this rare but potentially life-threatening condition.
ORL; journal for oto-rhino-laryngology and its related specialties, 2011
To explore in a prospective study the evidence of certain viral and toxoplasmosis infections in s... more To explore in a prospective study the evidence of certain viral and toxoplasmosis infections in sudden sensorineural hearing loss (SSHL).
Superior semicircular canal syndrome (SSCS) includes vestibular and audiological symptoms which r... more Superior semicircular canal syndrome (SSCS) includes vestibular and audiological symptoms which result from the introduction of a third mobile window into the osseous cochlea. Surgical repair is considered in cases of incapacitating symptoms. The present paper aims at comparing the diVerent surgical approaches and modes of dehiscence repair, regarding their respective eYcacy and potential pitfalls. A systematic literature review and metaanalysis of pooled data were performed. Study selection included prospective-and retrospective-controlled studies, prospective-and retrospective-cohort studies, ex vivo studies, animal models, case-reports, systematic reviews and clinical guidelines. A total of 64 primary operations for SSC repair were identiWed; 56 ears were operated for vestibular and 7 for auditory complaints. A total of 33 ears underwent canal plugging, 16 resurfacing, and 15 capping. Success rates were 32/33, 8/16, and 14/15, respectively. The observed diVerences were statistically signiWcant (P = 0.001). Resurfacing proved less eVective than both plugging (P = 0.002), and capping (P = 0.01) techniques. Temporalis fascia was commonly used as sealing material and was combined with bone-pâté/bone-wax (plugging), bone-graft (resurfacing), or hydroxyapatite-cement (capping). Most operations were performed via middle-fossa approach; higher success rates were associated with plug-ging and capping techniques. SNHL and disequilibrium were the most frequent complications encountered. Most cases were followed for 3-6 months. Precise criteria regarding follow-up duration and objective success measures are not determined. Surgical repair of SSCS is considered as a valid therapeutic option for patients with debilitating symptoms. Consensus regarding strict follow-up criteria and objective assessment of success is necessary before larger scale operations can be implemented in clinical practice.
Both epistaxis and hypertension are frequent problems in the adult population. The relationship b... more Both epistaxis and hypertension are frequent problems in the adult population. The relationship between the level of arterial pressure and incidence of epistaxis in a patient with hypertension is a question that appears frequently in the clinical practice. A systematic review of the literature regarding the relation of arterial hypertension with epistaxis was performed through MEDLINE and EMBASE. All studies, whether examining the correlation of arterial pressure at presentation of a patient with nasal bleeding or the repercussion of episodes of epistaxis in hypertensive patients, were included in this review. Studies were evaluated independently by two reviewers according to a standard evaluation form. Overall, nine studies fulfilled our inclusion criteria. Five of them were single-group (patient) studies, while the remaining four included a control group. In eight studies, the patient group included patients with epistaxis, while one focused on hypertensive patients. Six out of nine studies agree that arterial pressure is higher at the time of epistaxis, as compared to the control group or to the general population. Seven out of nine studies conclude that there is cross-correlation between arterial pressure and the actual incident of epistaxis. The presence of high arterial blood pressure during the actual episode of nasal bleeding cannot establish a causative relationship with epistaxis, because of confounding stress and possible white coat phenomenon, but may lead to initial diagnosis of an already installed arterial hypertension.
The aim of this study was to report our experience with cartilage tympanoplasty (CT) in smokers a... more The aim of this study was to report our experience with cartilage tympanoplasty (CT) in smokers and compare it with that of non-smokers using a retrospective chart review at a tertiary referral center. Between September 2008 and September 2010, cartilage tympanoplasty was performed in 52 patients. Among them, 27 were active smokers and 25 former or non-smokers. The entire tympanic membrane was replaced with conchal cartilage, shaped either as a shield for cases with intact canal wall mastoidectomies, or crashed for cases with canal wall down procedures. The mean post-operative follow-up was 12 months (range 6-18 months). A complete pre- and post-operative audiologic evaluation was obtained in all patients. Graft take was successful in all patients. The overall average pre-operative and post-operative pure tone average air-bone gaps (PTA-ABG) was 52.2 dB ± 17.7 dB and 35.4 dB ± 17.9 dB, respectively, with an overall improvement of 16.8 dB (p &lt; 0.001). A post-operative PTA-ABG of 25 dB or less was achieved in 39 (75 %) patients (p &lt; 0.001). In smokers, the hearing improvement was 17.6 dB (p &lt; 0.001) with a PTA-ABG of 25 dB or less in 19 (70 %). In non-smokers, the average hearing improvement was 16.8 dB (p &lt; 0.0005) with a post-operative PTA-ABG of 25 dB or less in 19 (76 %), (p &lt; 0.001). The results showed that the CT technique is a very effective procedure for smokers. Excellent graft take and satisfactory hearing results can be accomplished regardless of smoking habits.
Objective: The aim of this study was to develop Greek Sentence Based Speech Audiometry Test in qu... more Objective: The aim of this study was to develop Greek Sentence Based Speech Audiometry Test in quiet test for Hearing Impaired (HI) children (G-SEBSAT). Methods: Seventy-six children were recruited following approval by the local ethics committee and after obtaining informed consent from their parents. The collection of vocabulary was based on showing pictures selected from popular reading materials in Greek to hearing impaired HI children. A grammatical content analysis was carried out to determine the average syntactic and morphological structures of the sentences used by the HI children. Ten picture related sentence lists were developed based on the vocabulary and the grammatical analysis, and recorded by a male native speaker of standard Modern Greek. These were presented to both normal hearing (NH) and HI children, and the average speech response threshold (SRT) as well as the slope of the SRT curve at the SRT level of 50% correct responses (S 50) were recorded in both groups. Sentence lists were validated with respect to the variability of their difficulty within each group, as well the test-retest variability of the respective SRT scores. Results: The average speech response threshold (SRT) across all lists for HI children was 65.27 dB and the slope of the SRT curve at the SRT level of 50% correct responses was 3.11%/dB. The corresponding results across all lists for NH children were 17.66 dB and 9.7%/dB, respectively. The SRT of HI children were strongly positively correlated, in a statistically significant manner with the PTA in both the test and the retest sessions (test: r=0.750, P < 0.0005; retest: r=0.753, P < 0.0005). The Spearman correlation of the rankings of SRT values and the slope values was 0.998 and 0.997 respectively for the HI and 0.939 and 0.88, for the NH group, indicating very low variability across the test and retest sessions. In addition, the analysis of variance (ANOVA) of the average SRT in NH children and the SRT residuals in the HI group indicated that the different sentences were of the same difficulty within each group. ((F(9,81)=0.401, p=0.930 and (F(9,93)=2.241, p=0.025 respectively). Conclusions: A validated sentence based speech audiometry test was created in Greek for the first time. SRT and S50 values for both NH and HI children are comparable to similar tests developed in other languages.
Somatosensory tinnitus is a generally agreed subtype of tinnitus that is associated with activati... more Somatosensory tinnitus is a generally agreed subtype of tinnitus that is associated with activation of the somatosensory, somatomotor, and visual-motor systems. A key characteristic of somatosensory tinnitus is that is modulated by physical contact or movement. Although it seems common, its pathophysiology, assessment and treatment are not well defined. We present a scoping review on the pathophysiology, diagnosis, and treatment of somatosensory tinnitus, and identify priority directions for further research. Methods: Literature searches were conducted in Google Scholar, PubMed, and EMBASE databases. Additional broad hand searches were conducted with the additional terms etiology, diagnose, treatment. Results: Most evidence on the pathophysiology of somatosensory tinnitus suggests that somatic modulations are the result of altered or cross-modal synaptic activity within the dorsal cochlear nucleus or between the auditory nervous system and other sensory subsystems of central nervous...
In Europe alone, over 70 million people experience tinnitus; for seven million people, it creates... more In Europe alone, over 70 million people experience tinnitus; for seven million people, it creates a debilitating condition. Despite its enormous socioeconomic relevance, progress in successfully treating the condition is somewhat limited. The European Union has approved funding to create a pan-European tinnitus research collaboration network (2014-2018). The goal of one working group is to establish an international standard for outcome measurements in clinical trials of tinnitus. Importantly, this would enhance tinnitus research by informing sample-size calculations, enabling meta-analyses, and facilitating the identification of tinnitus subtypes, ultimately leading to improved treatments. The first meeting followed a workshop on "Agreed Standards for Measurement: An International Perspective" with invited talks on clinimetrics and existing international initiatives to define core sets for outcome measurements in hearing loss (International classification of functioning, ...
We present a 46-year-old psychiatric patient presenting with a lingual abscess. This paper covers... more We present a 46-year-old psychiatric patient presenting with a lingual abscess. This paper covers the epidemiology, clinical features, diagnosis, and differential diagnosis with a view to assisting emergency physicians in the timely recognition and management of this rare but potentially life-threatening condition.
13th IEEE International Conference on BioInformatics and BioEngineering, 2013
ABSTRACT The SIFEM project targets the development of an infrastructure in order to semantically ... more ABSTRACT The SIFEM project targets the development of an infrastructure in order to semantically link open source tools and libraries with existing data as well as new knowledge towards the multi-scale finite element modelling of the inner-ear. The SIFEM system is designed based on an open architecture schema that consists of a set of tools and subsystems in order to develop robust multi-scale models. The project mainly delivers: (i) tools for finite elements modelling, (ii) cochlea reconstruction tool and (iii) 3D inner ear models visualization tool. The main scientific results contribute to the knowledge of alterations associated to diverse cochlear disorders and could lead, in long-term, to personalized healthcare. The overview of the SIFEM platform and its architecture is presented in this paper.
Advances in Experimental Medicine and Biology, 2014
In this work, we present the concept, the methodological ideas and the architecture of the EMBALA... more In this work, we present the concept, the methodological ideas and the architecture of the EMBALANCE platform. EMBALANCE platform extends existing but generic and currently uncoupled balance modeling activities, leading to a multi-scale and patient-specific balance Hypermodel, which is incorporated to a Decision Support System (DSS), towards the early diagnosis, prediction and the efficient treatment planning of balance disorders. Various data feed the intelligent system increasing the dimensionality and personalization of the system. Human Computer Interaction techniques are utilized in order to develop the required interfaces in a user-intuitive and efficient way, while interoperable web services enhance the accessibility and acceptance of the system. The platform will be validated using both retrospective as well as prospective experimental and clinical data. The final tool will be a powerful web-based platform provided to primary and secondary care physicians across specialties, levels of training and geographical boundaries, targeting wider clinical acceptance as well as the increased confidence in the developed DSS towards the early diagnostic evaluation, behaviour prediction and effective management planning of balance problems. Currently we focus and present the management and modeling of the balance disorders.
Due to the inaccessibility of the inner ear, direct in vivo information on cochlear mechanics is ... more Due to the inaccessibility of the inner ear, direct in vivo information on cochlear mechanics is difficult to obtain. Mathematical modelling is a promising way to provide insight into the physiology and pathology of the cochlea. Finite element method (FEM) is one of the most popular discrete mathematical modelling techniques, mainly used in engineering that has been increasingly used to model the cochlea and its elements. The aim of this overview is to provide a brief introduction to the use of FEM in modelling and predicting the behavior of the cochlea in normal and pathological conditions. It will focus on methodological issues, modelling assumptions, simulation of clinical scenarios, and pathologies.
We present a 46-year-old psychiatric patient presenting with a lingual abscess. This paper covers... more We present a 46-year-old psychiatric patient presenting with a lingual abscess. This paper covers the epidemiology, clinical features, diagnosis, and differential diagnosis with a view to assisting emergency physicians in the timely recognition and management of this rare but potentially life-threatening condition.
ORL; journal for oto-rhino-laryngology and its related specialties, 2011
To explore in a prospective study the evidence of certain viral and toxoplasmosis infections in s... more To explore in a prospective study the evidence of certain viral and toxoplasmosis infections in sudden sensorineural hearing loss (SSHL).
Superior semicircular canal syndrome (SSCS) includes vestibular and audiological symptoms which r... more Superior semicircular canal syndrome (SSCS) includes vestibular and audiological symptoms which result from the introduction of a third mobile window into the osseous cochlea. Surgical repair is considered in cases of incapacitating symptoms. The present paper aims at comparing the diVerent surgical approaches and modes of dehiscence repair, regarding their respective eYcacy and potential pitfalls. A systematic literature review and metaanalysis of pooled data were performed. Study selection included prospective-and retrospective-controlled studies, prospective-and retrospective-cohort studies, ex vivo studies, animal models, case-reports, systematic reviews and clinical guidelines. A total of 64 primary operations for SSC repair were identiWed; 56 ears were operated for vestibular and 7 for auditory complaints. A total of 33 ears underwent canal plugging, 16 resurfacing, and 15 capping. Success rates were 32/33, 8/16, and 14/15, respectively. The observed diVerences were statistically signiWcant (P = 0.001). Resurfacing proved less eVective than both plugging (P = 0.002), and capping (P = 0.01) techniques. Temporalis fascia was commonly used as sealing material and was combined with bone-pâté/bone-wax (plugging), bone-graft (resurfacing), or hydroxyapatite-cement (capping). Most operations were performed via middle-fossa approach; higher success rates were associated with plug-ging and capping techniques. SNHL and disequilibrium were the most frequent complications encountered. Most cases were followed for 3-6 months. Precise criteria regarding follow-up duration and objective success measures are not determined. Surgical repair of SSCS is considered as a valid therapeutic option for patients with debilitating symptoms. Consensus regarding strict follow-up criteria and objective assessment of success is necessary before larger scale operations can be implemented in clinical practice.
Both epistaxis and hypertension are frequent problems in the adult population. The relationship b... more Both epistaxis and hypertension are frequent problems in the adult population. The relationship between the level of arterial pressure and incidence of epistaxis in a patient with hypertension is a question that appears frequently in the clinical practice. A systematic review of the literature regarding the relation of arterial hypertension with epistaxis was performed through MEDLINE and EMBASE. All studies, whether examining the correlation of arterial pressure at presentation of a patient with nasal bleeding or the repercussion of episodes of epistaxis in hypertensive patients, were included in this review. Studies were evaluated independently by two reviewers according to a standard evaluation form. Overall, nine studies fulfilled our inclusion criteria. Five of them were single-group (patient) studies, while the remaining four included a control group. In eight studies, the patient group included patients with epistaxis, while one focused on hypertensive patients. Six out of nine studies agree that arterial pressure is higher at the time of epistaxis, as compared to the control group or to the general population. Seven out of nine studies conclude that there is cross-correlation between arterial pressure and the actual incident of epistaxis. The presence of high arterial blood pressure during the actual episode of nasal bleeding cannot establish a causative relationship with epistaxis, because of confounding stress and possible white coat phenomenon, but may lead to initial diagnosis of an already installed arterial hypertension.
The aim of this study was to report our experience with cartilage tympanoplasty (CT) in smokers a... more The aim of this study was to report our experience with cartilage tympanoplasty (CT) in smokers and compare it with that of non-smokers using a retrospective chart review at a tertiary referral center. Between September 2008 and September 2010, cartilage tympanoplasty was performed in 52 patients. Among them, 27 were active smokers and 25 former or non-smokers. The entire tympanic membrane was replaced with conchal cartilage, shaped either as a shield for cases with intact canal wall mastoidectomies, or crashed for cases with canal wall down procedures. The mean post-operative follow-up was 12 months (range 6-18 months). A complete pre- and post-operative audiologic evaluation was obtained in all patients. Graft take was successful in all patients. The overall average pre-operative and post-operative pure tone average air-bone gaps (PTA-ABG) was 52.2 dB ± 17.7 dB and 35.4 dB ± 17.9 dB, respectively, with an overall improvement of 16.8 dB (p &lt; 0.001). A post-operative PTA-ABG of 25 dB or less was achieved in 39 (75 %) patients (p &lt; 0.001). In smokers, the hearing improvement was 17.6 dB (p &lt; 0.001) with a PTA-ABG of 25 dB or less in 19 (70 %). In non-smokers, the average hearing improvement was 16.8 dB (p &lt; 0.0005) with a post-operative PTA-ABG of 25 dB or less in 19 (76 %), (p &lt; 0.001). The results showed that the CT technique is a very effective procedure for smokers. Excellent graft take and satisfactory hearing results can be accomplished regardless of smoking habits.
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Papers by D. Kikidis