Clinical and Experimental Otorhinolaryngology最新文献

{"title":"Continuous Positive Airway Pressure Therapy Alters Monocyte Activation and Immune Phenotype in Obstructive Sleep Apnea in Relation to Hypoxic Burden.","authors":"Seung-No Hong, Ara Jo, Jin-A Park, Hee-Suk Lim, Kyoung Mi Eun, Jivianne T Lee, Jeffrey D Suh, Dae Woo Kim","doi":"10.21053/ceo.2025-00258","DOIUrl":"10.21053/ceo.2025-00258","url":null,"abstract":"<p><strong>Objectives: </strong>Obstructive sleep apnea (OSA) is associated with chronic intermittent hypoxia and systemic inflammation, both of which contribute to vascular and metabolic complications. Monocytes, as key immune cells of innate immunity, have been implicated in this inflammatory state. However, the effect of OSA treatment on monocyte function and inflammatory phenotype remains poorly understood.</p><p><strong>Methods: </strong>In this prospective cohort study, OSA patients were evaluated before and after 3 months of continuous positive airway pressure (CPAP) therapy. Circulating monocytes were isolated, and inflammatory cytokine production (tumor necrosis factor [TNF]-α, interleukin [IL]-1β, and IL-6) was assessed at baseline and post-treatment, both at rest and after lipopolysaccharide (LPS) stimulation. Monocyte polarization (M1/M2-like marker expression) was measured by flow cytometry. Clinical severity parameters, including the apnea-hypopnea index (AHI) and oxygen desaturation index (ODI), were correlated with immune changes.</p><p><strong>Results: </strong>Following CPAP treatment, LPS-induced inflammatory cytokine secretion and LPS responsiveness, defined as the increase in cytokine levels upon stimulation, both declined after CPAP in proportion to baseline ODI, but not AHI. Apart from TNF-α, baseline IL-1β and IL-6 levels were below the quantifiable range of the assay, which precluded reliable comparison after treatment. This effect may be explained by a parallel post-treatment shift in monocyte phenotype toward an anti-inflammatory M2-like (CD163+CD206+) profile, as demonstrated by our flow cytometry data, which was also significantly associated with baseline ODI.</p><p><strong>Conclusion: </strong>CPAP alleviates systemic inflammation in OSA by reducing hypoxic burden and reprogramming monocytes toward an anti-inflammatory phenotype. The magnitude of immune modulation was more closely linked to ODI than AHI, suggesting that oxygen desaturation burden serves as a meaningful adjunct to AHI in assessing monocyte-driven immune dysregulation in OSA.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":"177-184"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13256467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Efficacy of Intranasal Insulin in the Treatment of Post-Viral Persistent Olfactory Dysfunction: A Systematic Review.","authors":"Do Hyun Kim, David W Jang, Se Hwan Hwang","doi":"10.21053/ceo.2025-00252","DOIUrl":"10.21053/ceo.2025-00252","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the therapeutic efficacy of intranasal insulin in treating persistent and refractory olfactory dysfunction following viral infections.</p><p><strong>Methods: </strong>A comprehensive literature search was performed across PubMed, Scopus, Embase, Web of Science, Google Scholar, and the Cochrane Library, covering all articles indexed up to July 2025. Studies were included if they evaluated changes in olfactory scores in patients receiving intranasal insulin, either compared with a control group (placebo or no treatment) or between pre- and post-treatment measurements. Secondary outcomes included serum glucose and insulin levels and the proportion of patients achieving significant olfactory recovery.</p><p><strong>Results: </strong>Eight studies including 457 participants were reviewed. Intranasal insulin was generally associated with improvement in olfactory scores. Delivery via absorbable materials may enhance both threshold and discrimination outcomes, whereas self-administration demonstrated minimal benefit. Several studies also reported higher rates of substantial olfactory recovery with absorbable material-based delivery. Combination therapy with intranasal insulin and budesonide was suggested to further improve threshold scores. Overall, treatment was well tolerated, with no major changes in serum glucose levels, although one study documented a mild hypoglycemic event.</p><p><strong>Conclusion: </strong>Current evidence suggests that intranasal insulin, particularly when delivered using absorbable materials, may offer therapeutic benefit for persistent post-viral olfactory dysfunction. Corticosteroid coadministration may also provide additional improvements. These findings remain preliminary and require confirmation in larger, well-controlled studies.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":"120-128"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13256464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145660582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Harnessing Machine Learning for Personalized Care of Patients With Idiopathic Sudden Sensorineural Hearing Loss: A Multicenter Cohort Study.","authors":"Yen-Ting Guo, Ching-Ting Tan, Chen-Chi Wu, Chun-Ying Wang, Chein-Yu Huang, Tzu-Hsiang Yang, Ting-Yi Lee, Ting-Hua Yang, Tien-Chen Liu, Pey-Yu Chen, Pei-Hsuan Lin","doi":"10.21053/ceo.2025-00084","DOIUrl":"10.21053/ceo.2025-00084","url":null,"abstract":"<p><strong>Objectives: </strong>Idiopathic sudden sensorineural hearing loss (ISSNHL) is a significant cause of hearing loss. Intratympanic steroid injection (ITSI) is commonly used as an initial or salvage treatment; however, the lack of a standardized treatment protocol has resulted in variability in clinical practice. In addition, no efficient prediction model currently exists to support personalized management. Therefore, this study aimed to develop tailored management strategies for ISSNHL using a machine-learning model.</p><p><strong>Methods: </strong>This retrospective multicenter cohort study was conducted between January 2015 and December 2020, with data analysis performed between January 2021 and March 2024. Patients were selected based on the International Classification of Diseases, 10th Revision criteria for ISSNHL, along with relevant medication and procedure codes. Patients with pure-tone audiogram results not meeting ISSNHL criteria, better initial hearing in the affected ear, an identifiable etiology, no post-treatment audiogram, or delayed treatment (>6 weeks) were excluded. We included 770 patients diagnosed with ISSNHL who received ITSI. The primary outcome was the area under the receiver operating characteristic curve for prediction performance. Recovery status was determined using the last pure-tone audiogram. Modeling was conducted on the Quanta for Medical Care AI platform using five machine-learning algorithms and a nested cross-validation framework, in which feature selection and hyperparameter tuning were performed in the inner folds and model performance was evaluated in the outer folds.</p><p><strong>Results: </strong>A random forest classifier outperformed the other models in predicting hearing outcomes, achieving an area under the receiver operating characteristic curve of 0.788. Time to ITSI was the most influential treatment-related factor, with ITSI administered within 10 days of hearing loss being associated with better outcomes. This model can be used to provide personalized prognostic estimates under different treatment protocols.</p><p><strong>Conclusion: </strong>The machine-learning-based prediction model facilitates personalized treatment strategies and timely treatment adjustments for ISSNHL, thereby optimizing the likelihood of complete recovery.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":"194-204"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13256474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145654066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Comparison of Long-Term Outcomes and Nodal Recurrence for Persistent and Recurrent Differentiated Thyroid Cancer.","authors":"Yung Jee Kang, Ji-Hoon Kim, Ji Ye Lee, Sun Wook Cho, Young Joo Park, Kyu-Eun Lee, Su-Jin Kim, Hanaro Park, Sung Joon Park, Soon-Hyun Ahn, Eun-Jae Chung","doi":"10.21053/ceo.2025-00305","DOIUrl":"10.21053/ceo.2025-00305","url":null,"abstract":"<p><strong>Objectives: </strong>Differentiated thyroid cancer (DTC) has a favorable prognosis. However, indeterminate lymph nodes (LNs) are common, making it challenging to distinguish recurrent from persistent DTC. Previous studies have not specifically compared the prognosis between recurrent and persistent DTC. Therefore, we aimed to compare prognosis and oncologic characteristics between these two groups.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted at a single tertiary care institution and included 265 patients with DTC (recurrent, 109; persistent, 156) who underwent reoperation between November 1, 1999, and August 31, 2018, for structural disease. Patients with distant metastasis at the time of initial diagnosis were excluded. Clinical and oncological characteristics, patterns of LN metastasis, disease-free survival (DFS), and overall survival (OS) were compared between the two groups. For DFS, time zero was defined as the date of the second operation.</p><p><strong>Results: </strong>Recurrent DTC had a higher incidence of central LN metastasis (P=0.003), infield recurrence (P<0.001), and distant metastasis (P<0.001). In contrast, persistent DTC more frequently exhibited lateral LN metastasis (P=0.003) and outfield recurrence (P<0.001). The most common site of neck LN metastasis was ipsilateral level VI/VII (51.4%) in recurrent DTC and ipsilateral level IV (43.0%) in persistent DTC. Ten-year DFS was significantly lower in recurrent DTC than in persistent DTC (41.0% vs. 67.9%; P<0.001). Recurrent DTC, older age, a higher number of metastatic LNs at the second operation (first reoperation), and R1/R2 resection at the second operation were associated with decreased DFS. OS did not significantly differ between recurrent and persistent DTC (P=0.160).</p><p><strong>Conclusion: </strong>Recurrent DTC is associated with poorer DFS than persistent DTC, although OS does not significantly differ between the two groups.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":"185-193"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13256473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145699948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative Hearing Aids Improve Outcomes of Cochlear Implantation.","authors":"YouYoung An, JaeSeok Oh, JaeYoung Choi, SeongHoon Bae","doi":"10.21053/ceo.2025-00070","DOIUrl":"10.21053/ceo.2025-00070","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to investigate the effects of preoperative auditory rehabilitation using hearing aids in patients with prolonged hearing deprivation.</p><p><strong>Methods: </strong>We retrospectively enrolled 204 patients who underwent cochlear implantation surgery at age >60 years using a single university hospital database. In total, 135 patients with a duration of deafness (DoD) >10 years were divided into three groups according to perioperative hearing aid use: unaided (n=22, 16.3%), aided (n=92, 68.1%; comprising 22 ipsilateral hearing aid users and 70 bilateral hearing aid users), and contralateral-only aided (n=21, 15.5%). We identified the highest postoperative sentence recognition score (Max_S) and compared this measure across groups.</p><p><strong>Results: </strong>Max_S was significantly higher in the DoD <10 years group than in the DoD ≥10 years group (72.38±25.74 vs. 64.09±32.29, P=0.048). Among patients with DoD ≥10 years, the aided group had significantly better Max_S than the unaided group (69.84±28.72 vs. 47.86±37.14, P=0.015). After one-to-two propensity score matching, Max_S remained significantly better in the aided group than in the unaided group (73.64±29.10 vs. 47.86±37.14, P=0.007).</p><p><strong>Conclusion: </strong>Our study demonstrated the need for hearing rehabilitation during the period of hearing deprivation, including on the ear to be implanted, regardless of whether it produced immediate improvement in hearing levels.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":"158-163"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13256469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146104379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Montelukast-Antihistamine Combination Therapy Versus Antihistamine Monotherapy in Allergic Rhinitis: A Systematic Review and Meta-Analysis.","authors":"Ji-Sun Kim, Gulnaz Stybayeva, Se Hwan Hwang","doi":"10.21053/ceo.2025-00201","DOIUrl":"10.21053/ceo.2025-00201","url":null,"abstract":"<p><strong>Objectives: </strong>Allergic rhinitis (AR) can substantially compromise daily functioning and well-being, and many patients require more than a single agent to obtain satisfactory symptom control. This study examined whether adding montelukast to antihistamine could manage AR symptoms and quality-of-life outcomes effectively.</p><p><strong>Methods: </strong>A review was performed in PubMed, Embase, Medline, Scopus, the Cochrane Library, and Google Scholar to identify eligible studies reported through April 2025. Eligible studies compared combination therapy with montelukast plus antihistamine against antihistamine monotherapy and reported nasal symptoms or rhinoconjunctivitis quality of life questionnaire (RQLQ) scores. Treatment effects were further examined by antihistamine class.</p><p><strong>Results: </strong>Fifteen studies including 2,882 subjects were analyzed. Combination therapy significantly improved daytime nasal symptoms (standardized mean difference [SMD] [95% CI], 0.44 [0.21-0.67]), nighttime nasal symptoms (0.12 [0.01-0.23]), and RQLQ scores (0.14 [0.00-0.27]) versus monotherapy. Individual nasal or ocular symptoms, sneezing, nasal obstruction, and rhinorrhea improved significantly, while nasal itching and ocular symptoms did not. Combinations with desloratadine and levocetirizine showed greater benefits than those with loratadine or fexofenadine.</p><p><strong>Conclusion: </strong>Montelukast-antihistamine combination therapy reduced overall symptoms and improved quality of life versus antihistamine monotherapy. The magnitude of benefit appears to vary depending on the specific antihistamine used, highlighting the possible value of individualized treatment strategies in the treatments of AR.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":"164-176"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13256472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: Guidelines for the Use of Botulinum Toxin in Otolaryngology From the Korean Society of Laryngology, Phoniatrics and Logopedics Guideline Task Force.","authors":"Myung Jin Ban, Chang Hwan Ryu, Joo Hyun Woo, Young Chan Lee, Dong Kun Lee, Minsu Kwon, Yong Tae Hong, Gil Joon Lee, Hyung Kwon Byeon, Seung Ho Choi, Seung Won Lee","doi":"10.21053/ceo.2023.00458.e1","DOIUrl":"10.21053/ceo.2023.00458.e1","url":null,"abstract":"","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":"19 2","pages":"209"},"PeriodicalIF":2.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13255977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Precision Prognostic Modeling in Laryngeal Carcinoma: Construction and Validation of Genomic-Clinicopathologic Nomograms in a Multi-Center Cohort.","authors":"Zhenwei Wang, Huiying Huang, Ji Sun, Weida Dong, Danhui Li, Chi-Yao Hsueh, Ming Zhang","doi":"10.21053/ceo.2025-00343","DOIUrl":"https://doi.org/10.21053/ceo.2025-00343","url":null,"abstract":"<p><strong>Objectives.: </strong>This study aimed to develop nomograms for predicting overall survival (OS) and disease-free survival (DFS) in patients with laryngeal squamous cell carcinoma (LSCC) using a costeffective targeted next-generation sequencing (tNGS) panel integrating with genomic and clinicopathological features in order to provide a concrete decision-support tool improve individualized prognostic assessment.</p><p><strong>Methods.: </strong>A total of 124 LSCC patients from a multi-center cohort were analyzed using a targeted sequencing panel covering 113 cancer-associated genes. Single nucleotide variants/Insertiondeletions (SNVs/Indels) and Copy number variants (CNVs) were identified and correlated with survival outcomes. Kaplan-Meier analysis and Cox regression were performed to select significant prognostic markers. Nomograms incorporating genetic and clinical variables were developed, and their predictive performance was evaluated using the receiver operating characteristic (ROC) curves, and calibration curves.</p><p><strong>Results.: </strong>The LSCC Mutation (SNVs/Indels) and CNV panels were constructed based on genes with high mutational frequencies in tNGS and prognostic significance. In multivariable analysis, age, maximum tumor diameter, and the LSCC Mutation Panel were independent predictors of OS, while maximum tumor diameter and the LSCC DFS Mutation Panel were predictive of DFS. Both models demonstrated good calibration and discrimination.</p><p><strong>Conclusion.: </strong>This study developed genomic-clinicopathologic nomograms for predicting LSCC prognosis, providing a precise, cost-effective and clinically feasible tool for personalized survival assessment.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic landscapes and audiological trajectories in pediatric asymmetric hearing loss and interaural asymmetry.","authors":"Sang-Yoon Han, Myeong Sin Kang, Sung Ho Jung, Myung-Whan Suh, Moo Kyun Park, Jun Ho Lee, Sang-Yeon Lee","doi":"10.21053/ceo.2026-00021","DOIUrl":"https://doi.org/10.21053/ceo.2026-00021","url":null,"abstract":"<p><strong>Objectives.: </strong>To delineate the genetic landscapes and audiological trajectories of pediatric asymmetric hearing loss (AHL) and interaural asymmetry (IA) using a systematic multi-tiered genetic testing strategy extending to whole-genome sequencing (WGS), and to assess the clinical implications for individualized auditory rehabilitation.</p><p><strong>Methods.: </strong>The study was a retrospective cohort study of pediatric patients (≤18 years) with sensorineural hearing loss (SNHL) who underwent comprehensive genetic testing at a tertiary cochlear implantation (CI) center between March 2021 and February 2025. AHL was defined as better-ear pure-tone audiometry (PTA) of 30-60 dB HL, and worse-ear PTA >70 dB HL on two consecutive baseline audiograms. IA was defined as an interaural difference of >15 dB, and subclassified as mild (15-30 dB) or severe (>30 dB). Longitudinal changes in better-ear thresholds and progression to CI were evaluated.</p><p><strong>Results.: </strong>Of 551 pediatric patients with SNHL, 486 pediatric patients met the above inclusion criteria. AHL was present in 29/486 (6.0%), and mild and severe IA were observed in 45/486 (9.3%) and 40/486 (8.2%), respectively. Genetic diagnostic yield did not differ between AHL and symmetric SNHL (55.1% vs 62.1%, p=0.462), whereas it decreased with increasing IA (0-15 dB: 64.3%; 15-30 dB: 60.0%; >30 dB: 37.5%; p=0.004), The genetic landscape of AHL/IA was heterogeneous but converged on two recurrent deafness genes (SLC26A4 and GJB2), with SLC26A4 variants the most frequent. Genetically diagnosed patients exhibited progressive deterioration in better-ear thresholds across most frequencies, whereas genetically undiagnosed patients showed minimal change. Specifically, SLC26A4-related DFNB4 patients had the highest progression to CI in the better ear.</p><p><strong>Conclusion.: </strong>Genetically diagnosed cases show progressive better-ear deterioration. This is particularly evident in SLC26A4-related DFNB4, which has a higher rate of progression to CI than other AHL/IA-associated genes. These findings support etiology-based prognostication and individualized rehabilitation planning.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomy-Based Fitting for Cochlear Implants: Evaluation of Hearing Performance in Newly Implanted Cochlear Implant Users - A Randomized Clinical Trial.","authors":"Antoine De Deurwaerdère, Thomas Gimenez, Vincent Péan, Pierre Valognes, Damien Bonnard","doi":"10.21053/ceo.2025-00251","DOIUrl":"https://doi.org/10.21053/ceo.2025-00251","url":null,"abstract":"<p><strong>Objectives.: </strong>The current settings of cochlear implants (CIs) do not respect specific cochlear tonotopy, resulting in tonotopic mismatch and potentially decreased auditory performance. The development of new implant settings adapted to individual tonotopy, called anatomybased fitting (ABF), could improve the auditory information coding, particularly by making surrounding sounds more recognizable. This study aimed to evaluate whether ABF allows better environmental sound recognition in new CI users compared to the conventional setting (CS); and to investigate the effect of ABF on speech recognition in quiet and noise.</p><p><strong>Methods.: </strong>A prospective, randomized, double-blind, two-period cross-over study in 17 new CI users was performed between March 2022 and August 2024. Adult subjects were recruited from candidates selected for cochlear implantation within a single French university hospital. Newly implanted adult recipients of a MED-EL cochlear implant with an electrode array insertion angle greater than 540° were eligible. Subjects were randomized to receive either ABF or CS for 6 weeks, then switched to the other setting for the same duration. Audiometric testing, including Environmental Sound Identification Test (Test d'Identification des Sons de l'Environnement, TISE), speech audiometry in quiet using Fournier lists, and speech audiometry in noise (Vocale Rapide dans le Bruit, VRB) was performed at 6 and 12 weeks.</p><p><strong>Results.: </strong>Sixteen subjects (mean age 60 years [SD=15.1]) were analyzed. ABF showed a significant improvement in the TISE score (mean effect (ME)=1.2, 95% confidence interval (CI95%)=[0.3;2.0], standardized effect size (SES)=0.97, p=0.016). Speech recognition in quiet was statistically better with CS (ME=3.6, CI95%=[1.8;5.3], SES=1.4, p=0.001) while no statistically significant difference was found for speech recognition in noise (CI95%=[- 2.8;0.1], p=0.08).</p><p><strong>Conclusion.: </strong>In newly implanted cochlear implant users, ABF improved environmental sound recognition, suggesting improved perceived sound naturalness in the first weeks after implantation. This benefit did not extend to speech recognition in quiet and remains inconclusive in noise due to floor effect.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147580613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}