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Prof. Hamersma's Bio

Dr Herman Hamersma (the surname is from Friesland, now a province of the Netherlands), was born in South Africa.


Medical Training:  University of Pretoria.

 

ENT Specialist Training:  University of Pretoria, and also in Amsterdam under Prof Jongkees, well known authority on Physiology of Equilibrium, diseases of balance, and paralysis of the facial nerve. In 1957 - Dr H. graduated M.D. (Amsterdam) -equivalent to the Ph.D. degree of the USA,  with the thesis "The Caloric Test. An Electronystagmographical Investigation". This method of recording eye movements had just been improved in the ENT department of Uppsala University, Sweden, by Aschan, Bergstedt and Stahle (Acta Oto-Laryngologica Suppl. 129). The thesis reported on the introduction of this method to the vestibular laboratory of Amsterdam, and was the first on ENG in Holland.


After returning to South Africa, Dr Hamersma was in private practice as ENT specialist in Pretoria 1959 -1975, and then professor of ENT at the University of Pretoria for 8 years.. Dr Hamersma introduced ENG to South Africa in 1967, when the first transistorized ENG equipment became available from Sweden (ELEMA).  In 1984 he returned to private practice at the Life Flora Clinic in Florida Hills, Roodepoort, on the West Rand. From 2005 he also sees special patients at the Audiology practice of Mariet du Plooy in the Pretoria East Hospital, where he and Mariet du Plooy had established a Neuro-Otology facility.

Dr Hamersma now confines his practice to:

Otology (Ear diseases and deafness), and Neurotology : Facial paralysis, Bell's Palsy, Dizziness and Balance disturbances,  e.g.,Menière disease, BPPV (positioning vertigo), Vestibular neuritis. Acoustic neuroma., etc.

Surgery is seldom necessary for balance problems, but if indicated endolymphatic sac surgery and labyrinthectomies  are done at the Life Flora Clinic.

 

Balance nerve section, Acoustic Neuroma surgery and skull base surgery are operated on at Muelmed Hospital in Pretoria, as a team together with Prof Louis Hofmeyr (ENT at 1. Military Hospital, and adjunct professor of University of Pretoria), Dr Thomas Bingle (neurosurgeon, Pretoria), and Dr Gerrie Moolman (ENT Pretoria).

To investigate complaints of Dizziness and Imbalance, it is necessary to examine the patient for involuntary jerking eye movements (nystagmus). A goggle with infrared video cameras is used, which can examine eye movements in the dark, i.e. Infrared videonystagmography (VNG). No skin electrodes are necessary, the eye movements are observed on a monitor, and recorded on videotape or DVD. The VNG method has replaced the ENG method, because ENG can only record hoirizontal and vertical eye movements. For observing all eye movements, including rotational (torsional) eye movements (which occur in positioning vertigo = BPPV). VNG gives more information. An additional test for balance is also available, i.e., an objective Romberg test using a piezo-electric platform, called Computerized static posturography, where the patient first stands on a firm platform with eyes closed, and then on a soft pillow placed on top of the platform.

Facial paralysis, , e.g., Bell's palsy. To assess nerve function, a technique of electrodiagnosis without introducing needles into the face is used:, i.e. electric stimulation just below the ear + observation of muscle movements elicited (Maximal Stimulation Test, also called Visual ENoG), as well as ENoG (Evoked Electromyography developed by Esslen in Zürich), i.e, stimulation below the ear + recording action potentials on the cheek with a myograph, but using soft felt tipped surface electrodes. When indicated, the facial nerve's pathway through the temporal (ear) bone can be explored surgically, i.e., either via the mastoid bone (for the section in the middle ear), or via an opening into the skull above the ear (middle cranial fossa approach) for the deeper section of the nerve.

 
Dr Hamersma is a founder member of the Ear, Nose and Throat Institute of Johannesburg (an academic organisation) and presently serves as secetary, and is a member of the library committee..

Dr H. is a member of several professional organisations:
  • ENT Society of South Africa- served as secretary, chairman and president for many years;
  •  The SA Medical Association- served on the branch councils of Northern Transvaal and the West Rand, was president of both councils for one year, and Federal councillor for four years;
  • Collegium Otorhinolaryngologicum amicitiae sacrum - an international research organisation..

He has been a featured and plenary speaker at major world conferences dealing with Sclerosing Bone Dysplasias (marble bone disease) and Facial paralysis, e.g. moderator of the Session on Bell's Palsy at the International ENT Congress in Miami, 1985.

Research on Marble Bone Disease: 

Dr Hamersma saw his first patient with sclerosteosis in 1964. The literature on this condition was very confusing, and the various clinical entities not clearly defined (no internet or Google at that stage, only the Index Meicus). Up to 1974, Dr Hamersma had already seen 14 more patients with marble bone disease, and researched previously diagnosed cases in South Africa.. To research the clinical picture and genetics of the various sclerosing bone diseases, it became necessary to see some of the patients already published, and to visit libraries and museums (skull specimens) . Thanks to the kind cooperation of the overseas doctors and patients, frequent visits could be made to the patients in Holland (Van Buchem disease), and patients suffering from sclerosteosis and osteopetrosis were also examined in Italy, Switzerland, France, UK, USA and Canada. Because patients often suffered from facial paralysis attacks, similar to Bell's palsy, it was necessary to learn the newer approaches of exploring the facial nerve's course through the ear and temporal bone, as well as the ENoG method of electrodiagnosis of facial palsy - thus numerous trips were made to Prof Fisch in Zürich. 

The research on Marble Bone Disease became more productive when Prof Peter Beighton, head of the Dept Human Genetics of Cape Town University, joined him in his endeavour in 1973. Up to 2011 they now have already  identified and published the world's largest series of patients with Sclerosteosis (74 in South Africa, of whom 30 are still alive). Sclerosteosis is an inherited condition, occurs mostly amongst Afrikaners (Dutch, French and German descent). All the bones of the body and the skull become thick and hard, resulting in hearing loss, facial paralysis and increased intracranial pressure. Together with Prof Beighton, Dr Jessica Gardner, Dr Mary Brunkow & associates of the Darwin Molecular Biology Laboratory in Seattle (USA), and using DNA material from the South African patients (with their consent), it was possible to discover the gene for slerosteosis (now called the SOST gene) in 1996. This gene was then patented by Celltech-Chiroscience (which took over Darwin Laboratories) because they wanted to use this knowledge to develop a cure for Osteoporosis, where bone is weak (in contrast to sclerosteosis where the bone is thick and never fractures). Amgen (Los Angeles) then took over Celltech-Chiroscience and is continuing the research for treatment of osteoporosis.

The trio Beighton, Brunkow and Hamersma are presently the authors of a chapter in GENE REVIEWS of the University of Washington, Seattle, USA, called 'The SOST-related Sclerosing Bone Dysplasias - including sclerosteosis and Van Buchem disease'. see http://genetest.org.

In 2003 Dr Hamersma was invited to address the Dutch Society of Calcium and Bone metabolism on the topic 'Too much Bone'. The clinical research and basic scientific research on sclerosteosis and Van Buchem disease are continuing in collaboration with Prof Beighton and the Department of Endocrinology of the University of Leiden. The goal of the research is to determine the mechanism of excessive bone formation, with the view to developing a treatment for osteoporosis (weak bones) and eventually treating the patients with too much bone formation. The patients with too much bone are looking forward to the results, and all of them cooperate in the research. At that stage Prof Louis Hofmeyr, Chief ENT specialist of the 1. Military Hospital in Pretoria, and adjunct professor of Pretoria University, joined the team who are looking after 30 patients suffering from the sclerosteosis variety of marble bone disease) a nickname for the group of sclerosing bone dysplasias. Since 1990, Dr Jacques du Plessis, neurosurgeon in Pretoria, has also been a vital member of the team, because many patients required craniectomies to treat the increased intracranial pressure caused by the thick bone of the skull - see his ublication in the library section of this webpage. Dr Thomas Bingle, neurosurgeon in Pretoria,  now also participates in the team work.

In December 2011, the latest publication on sclerosteosis appeared in the Journal of Bone and Mineral Research (see the library section of this website). This original article was made possible by a grant of the European Commision (TALOS project) to seven European universities, with the Dept of Endocrinology and Metabolic Diseases of Leiden University (head Prof Socrates Papapoulos) as the leader. This paper reported the Sclerostin levels in 19 South African patients and their heterozygote (carrier) parents. This study forms the basis of the Ph.D thesis of Dr Antoon van Lierop, and will be of vital importance for all investigations on osteoporosis. In the near future, Prof Louis Hofmeyr 's  Ph.D. thesis on the audiological aspects of sclerosteosis and dominant osteopetrosis will also be a big contribution, because more than 30 patients are still alive here in South Africa, and he is taking them over from Dr Hamersma (and more new cases are still diagnosed every year).

n 1995 Dr Hamersma organised a 'Workshop on Electrodiagnosis of Facial Paralysis' in Johannesburg with the following speakers: ENT- Dr Kedar Adour (San Francisco), Dr Pieter Devriese (Amsterdam) and Dr Hamersma; Neurologists: Dr Johan Smuts and Dr Malcolm Baker of Pretoria.

 
  • Dr Hamersma is a founder member of the cochlear implant team of Johannesburg, which is led by Dr Maurice Hockman of Linksfield Park Clinic. The ENT Journal Club of Johannesburg of which Dr Hamersma is a founder member, honorary secretay and librarian, founded the ENT Institute of Johannesburg as an academic organisation body, and, thanks to sponsorships, this website has been created. Dr Hamersma serves as honorary secretary and also serves on the library committee.    

    PRINTED HANDOUTS from Dr Hamersma's private practice are available to doctors and patients, and most of them are now available in the library section of this website. 

    Polyganglionitis Episodica (PGE),  Menière syndrome,  Die Sinfroom van Meniere,

             Benign Paroxysmal Positionng Vertigo (BPPV) , Vestibular Neuritis ,

            Dizziness in the aged, Otitis Externa,  Dizziness in Childhood,

            Bell's Palsy and Related Conditions, Electrodiagnosis of facial palsy, 

           The Practice of Medicine - an Industry or a Profession? 

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