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Research

The claims on this site are meant to be checkable. This page explains the research tradition they come from and where to find the primary sources.

An evidence-based approach to ear surgery

Otology has a long tradition of case series and a shorter one of randomised trials. The work behind this site belongs to the effort to bring the standards of clinical epidemiology to ear surgery: asking whether an intervention on the ear actually buys the person who has to live with it something that can be measured, in conditions close to daily life; measuring outcomes in ways that can be compared across centres; and being clear about what is known, what is uncertain, and what is opinion.

That approach is visible on every page here as an evidence box with three parts — what the evidence shows, what remains uncertain, and what this means in practice — and in the professional-insight layers that give figures together with their limits.

The method

Each of the randomised programmes followed the same sequence: a systematic review first, to find out how thin the existing evidence really was and whether a trial was worth running; a trial designed to the exposed gap, in a setting close enough to practice that the answer transfers; patient-reported outcomes and economic evaluation written into the protocol rather than added later; and follow-up long enough for the answer to change — two- and five-year readouts, with the single-sided-deafness randomisation still reporting new outcomes in 2025. Forty-nine systematic reviews are indexed on PubMed. Evidence itself was also a subject of study, including a methodological assessment of the quality of reporting and risk of bias in the specialty’s own therapeutic literature (Kaper NM, Swart KMA, Grolman W, van der Heijden GJMG. J Laryngol Otol 2018;132:22–28).

The programmes

Run mostly out of UMC Utrecht between 2009 and 2018, and still reporting. Details, designs and numbers are on orl.nl/research.

  1. Bilateral cochlear implantation — adults randomised to one implant or two, tested with separated sound sources rather than a single loudspeaker. Binaural benefit appeared where the physics predicts it: speech in noise and sound localisation; stable at two years. Randomised, multicentre; 38 adults; reported 2016–2019.
  2. CINGLE — single-sided deafness — a cochlear implant against a bone-conduction device and a contralateral-routing hearing aid, with economic evaluation in the protocol. The implant was the only option that restored objective localisation and produced the largest reduction in tinnitus. Randomised plus national multicentre; 113 patients; 2015–2025.
  3. Hearing protection at a live festival — volunteers randomised to earplugs or none at an outdoor music festival, audiometry before and after. Temporary threshold shift in 8% of protected ears against 42% of unprotected. Randomised, field setting; 51 participants; cited in the WHO Global Standard for Safe Listening Venues and Events.
  4. Day-case ear surgery — two randomised equivalence trials, in stapes surgery and in cochlear implantation, testing the assumption that same-day discharge is cheaper and just as good. Hearing, quality of life and complications were comparable; the promised total saving was not found and crossover to admission was substantial. 112 + 28 randomised; reported 2022–2025.
  5. Stapes laser physics — temporal-bone measurements of the thermal, mechanical and acoustic effects of surgical lasers in the middle ear (1,470 nm diode, thulium). After clinical complications with a thulium laser, the group advised against it on the basis of its own measurements. 2013–2017.
  6. 7 Tesla inner-ear imaging — ex-vivo and in-vivo feasibility of depicting fine cochlear structure in living patients: technically possible, artefact-limited. Diffusion tensor imaging of the auditory nerve in long-term single-sided deafness came from the same programme. 2014–2015.
  7. Auditory-nerve preservation — preclinical work showing that temporary neurotrophin treatment preserved spiral ganglion cells and electrically evoked responses after deafness (Journal of Neuroscience). 2014–2015.
  8. Vestibular science and canal dehiscence — imaging, audiometry, VEMPs and follow-up combined to tell an anatomical dehiscence apart from a symptomatic patient, including how dehiscence size and location change intracochlear sound pressure. 2014–2016. This is the work behind the warnings about third-window lesions on this site.

Clinical topics closest to this website — otosclerosis and stapes surgery (including an internally validated prognostic model for revision stapes surgery), conductive and mixed hearing loss, single-sided deafness — are listed under career.

What is not claimed

Senior authorship is not the same as originating an idea. The inter-phase-gap and eCAP auditory-nerve biomarker programme is credited to its originators; the contribution was supervisory. In the intratympanic gentamicin trial for Ménière’s disease the role was collaborating author, and the trial was stopped early at 15 of 48 planned patients — reported as such. Median authorship across the portfolio is five; there are no solo-authored papers.

Bibliometrics

Retrieved from Google Scholar on 22 August 2026: 10,808 citations, h-index 59, i10-index 203. PubMed exact-author search, 17 August 2026: 222 records, 218 of them journal articles, concentrated in Otology & Neurotology (54), The Laryngoscope (30) and Otolaryngology–Head and Neck Surgery (21). No global rank is claimed, because ranking services disagree with each other; the underlying counts are given with the profiles to check them: orl.nl/impact, ORCID 0000-0002-3524-3526.

How research is used on this site

Numbers quoted on treatment pages are deliberately given as ranges and are drawn from the published literature as a whole, not from a single study or surgeon. Where a figure is contested or rests on weak evidence, the text says so. Where a page draws on the programmes above, it says so and links here. No references are fabricated.

Collaboration

Enquiries about collaboration, data sharing, trial participation or educational projects can be made through the contact form under “Research / education”.

This page provides general educational information. It cannot replace an individual assessment, which depends on a full history, examination, audiometry and, where relevant, imaging. If you have sudden hearing loss, severe pain, facial weakness, severe dizziness or discharge with fever, seek medical care promptly.