European Archives of Oto-Rhino-Laryngology最新文献

{"title":"Early activation of active middle ear implants: a prospective study.","authors":"Medhat F Yousef, Eman Hajr, Athair Alradhi, Anas Ibrahim, Farid Alzhrani","doi":"10.1007/s00405-025-09346-4","DOIUrl":"https://doi.org/10.1007/s00405-025-09346-4","url":null,"abstract":"<p><strong>Purpose: </strong>Vibrant Soundbridge (VSB) is an active middle ear implant that serves as a solution for people unable to use conventional hearing aids properly. Surgical techniques for VSB implantation have progressively advanced, improving its outcomes. Traditionally, VSB processor activation transpires around four weeks after the surgery to provide enough healing; however, contemporary practices in cochlear implant and bone-anchored hearing device activations indicate reduced waiting times. The purpose of this research is to explore the feasibility, safety, and advantages of early VSB activation.</p><p><strong>Methods: </strong>This prospective study was conducted in two phases. In phase one, the patients only attempt using the device on the first business day after surgery and then return in 4 weeks for a complete and standard fitting and device use. In the second phase, participants had a thorough fitting and began using the device on a regular basis the first working day after surgery. Feasibility, safety, and audiological results were assessed throughout both phases.</p><p><strong>Results: </strong>Early activation was successfully achieved in all patients in the early group without significant complications. When comparing the audiological examination and fitting parameters between the initial session the day after surgery and the one-month follow-up, there was no statistically significant change.</p><p><strong>Conclusion: </strong>The study emphasizes the possibility for early VSB activation, which might minimize wait times and enhance patient satisfaction without compromising device function. Further study is required to validate these results in broader groups and investigate long-term consequences.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788168","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":"Investigation of PDE5 effect on NOS in nasal polyp pathophysiology.","authors":"Vahit Mutlu, Zülküf Kaya, Zekai Halıcı, Ayşegül Tavacı Özçelik, Abdullah Serdar Topatan","doi":"10.1007/s00405-025-09362-4","DOIUrl":"https://doi.org/10.1007/s00405-025-09362-4","url":null,"abstract":"<p><strong>Purpose: </strong>Nasal polyps are masses resulting from chronic mucosal inflammation. Nitric oxide (NO) has recently attracted attention in nasal polyps as it plays an important role in both acute and chronic inflammation. One of the important mechanisms controlling NO production is phosphodiesterase (PDE) enzymes. The enzyme phosphodiesterase type 5 (PDE5) is an important regulator of cyclic guanosine 3'-5'-monophosphate (cGMP) signalling. PDE5 inhibitors increase intracellular cGMP concentration by inhibiting cGMP degradation and prolong NO signalling. NO is thought to cause nasal congestion because it increases microvascular permeability and causes mucosal oedema. The aim of our study was to investigate the role of PDE5, inducible nitric oxide synthase (iNOS), and endothelial nitric oxide synthase (eNOS) in the pathophysiology of nasal polyps with mucosal oedema in histopathology.</p><p><strong>Methods: </strong>Nasal mucosal tissues were obtained from 25 patients with nasal polyps who underwent endoscopic sinus surgery as the study group and 25 patients who underwent rhinoplasty as the control group. eNOS, iNOS and PDE5 levels were measured in nasal mucosal tissues.</p><p><strong>Results: </strong>The mean age was 47.40 ± 16.33 years in the nasal polyp group and 35.44 ± 12.47 years in the normal group, and 64.0% (n = 16) of both groups were male. ELISA measurements showed that PDE5 levels were significantly decreased and iNOS and eNOS levels were significantly increased in the nasal polyp group compared with the control group. CONCLUSıON: This study suggest that iNOS, eNOS, and PDE5 may play important roles in the pathophysiology of nasal polyps.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788174","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":"Ethical challenges of artificial intelligence in otolaryngology: balancing transparency, autonomy, and clinical judgment.","authors":"Rebecca Attal, Armin Farzad, Sholem Hack","doi":"10.1007/s00405-025-09374-0","DOIUrl":"https://doi.org/10.1007/s00405-025-09374-0","url":null,"abstract":"","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788170","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":"Balancing survival rates and quality-of-life outcomes after transoral laser microsurgery for locally advanced glottic cancer.","authors":"Eduardo Breda, Joana Marques, Isabel Vasquez, Eurico Monteiro","doi":"10.1007/s00405-025-09349-1","DOIUrl":"https://doi.org/10.1007/s00405-025-09349-1","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to analyze resectable T3-T4a glottic cancer patients treated with TOLM at a tertiary hospital, evaluating survival, function, and QoL in organ-preserved cases.</p><p><strong>Methods: </strong>Patients with diagnosis of laryngeal glottic squamous cell carcinoma pT3-pT4a N < 3 M0 treated with primary curative intention TOLM from 2005 to 2021 were included. Statistical analysis was performed, including survival rates. Quality of life was evaluated using VHI-10, EORTC-QLQ-C30 and EORTC-QLQ-HN43.</p><p><strong>Results: </strong>82 patients were included in this study, predominantly male, with a mean age of 65.5 years old. Laryngeal preservation rate was 76.83%. 5-year overall survival was 68.3%, 5-year Disease Specific Survival was 80.9%, 5-year Local disease-free survival was 91.2%. Medium VHI-10 score was 9.20 (SD ± 5.90), with nearly two thirds (63.33%) having a normal score. On the QLQ-C30 questionnaire, five of the six functional scales were over 80. On the QLQ-HN43 all the scales (single and multi-item) scored less than 16.</p><p><strong>Conclusion: </strong>TOLM achieved comparable survival rates to radical surgery and other organ-preserving methods for locally advanced glottic cancer, as well as good functional outcomes with minimal post-surgical symptoms and mild voice impairment.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779303","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":"Robotic excision of parapharyngeal and retropharyngeal lesions.","authors":"Stephen Robertson, Philip Touska, Jack Faulkner, Alastair Fry, Aleix Rovira, Ricard Simo, Jean-Pierre Jeannon, Asit Arora","doi":"10.1007/s00405-025-09345-5","DOIUrl":"https://doi.org/10.1007/s00405-025-09345-5","url":null,"abstract":"<p><strong>Introduction: </strong>Robotic surgery is currently transforming Head and Neck cancer surgery by providing novel approaches to previously challenging procedures, with a wide range of benefits including reduced morbidity and length of stay for patients. Currently at Guy's and St. Thomas' hospital, extended applications are constantly being evaluated to advance the scope of robotic surgery further, which includes using it for parapharyngeal (PPS) and retropharyngeal space (RPS) tumours. Literature suggests over 50% of PPS tumours are pleomorphic adenomas, whereas RPS tumours often represent nodal metastasis or soft tissue inflammatory masses(4,9). We have collated a case series of fifteen patients who had either PPS or RPS tumours excised via robotic surgery.</p><p><strong>Methods: </strong>A prospective study of fifteen patients collected between October 2018 and August 2024 with retrospective swallow assessment, for all patients with a mass in the PPS or RPS treated by trans-oral robotic surgery. Excision was performed by the Intuitive da Vinci Xi robotic surgical system.</p><p><strong>Results: </strong>The average age was 51 yrs (10 males, 5 females), with an average radiological tumour diameter of 3.79 cm and volume of 35.48 cm³. 33% of PPS cases were pleomorphic adenoma, whilst 33% of cases were malignant (carcinoma ex-pleomorphic adenoma). There was no surgical capsular breach, with complete excision in all cases and no cases required conversion to open. Close margins were seen in 40%. Median length of stay was 2 days with patients starting oral diet on day 1 post operation, however three patients later required NG-tube insertion due to wound dehiscence. There have been no recurrences with mean follow up currently at 3.32 years.</p><p><strong>Conclusions: </strong>TORS provides a safe and feasible option for excision of both PPS and RPS tumours, with no sacrifice of surgical or oncological outcomes. Given the successful results, further adoption of TORS for PPS and RPS tumours is recommended. Careful patient selection and specialist radiological input to aid three-dimensional anatomical understanding are fundamental to these outcomes.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779304","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":"Hearing loss secondary to novel variants of the KCNQ4 gene.","authors":"Rocío González-Aguado, Julia Fernández-Enseñat, Esther Onecha, Carmelo Morales-Angulo","doi":"10.1007/s00405-025-09288-x","DOIUrl":"https://doi.org/10.1007/s00405-025-09288-x","url":null,"abstract":"<p><strong>Purpose: </strong>Heterozygous variants of the KCNQ4 gene are associated with isolated sensorineural hearing loss (DFNA2A). This study aimed to determine the frequency and clinical characteristics of pathogenic, likely pathogenic, and uncertain variants in the KCNQ4 gene among patients with sensorineural hearing loss of unknown origin in North Spain.</p><p><strong>Methods: </strong>We conducted a prospective observational study of patients with sensorineural hearing loss of unknown etiology at a tertiary hospital over six years. Next-generation sequencing carried out with a panel of genes was used to identify genetic variants related to both syndromic and non-syndromic hearing loss.</p><p><strong>Results: </strong>Among 370 patients, seven (1.89%) harbored pathogenic or likely pathogenic variants in the KCNQ4 gene: c.777_778delinsCC, c.626 T > G, and c.778G > C. None of these variants had been previously described. One patient also had a variant of uncertain significance (c.419 T > C). All patients exhibited progressive bilateral sensorineural hearing loss, predominantly at high frequencies, with variable onset and severity. None reported dizziness or vertigo. Five patients used hearing aids, and one received a cochlear implant with good results.</p><p><strong>Conclusions: </strong>KCNQ4 gene variants are rare in Cantabria, present in less than 2% of patients with sensorineural hearing loss of unknown origin. Although most variants identified in our study had not been previously described, the observed phenotype aligned with the typical presentation: bilateral, progressive sensorineural hearing loss with variable onset and severity. Some patients may benefit from cochlear implants.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771844","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":"Volume rendering technique and high-resolution microCT: 3D exploration of the cochlear anatomy.","authors":"Gabriela O'Toole Bom Braga, Robert Zboray, Annapaola Parrilli, Franca Wagner","doi":"10.1007/s00405-025-09360-6","DOIUrl":"https://doi.org/10.1007/s00405-025-09360-6","url":null,"abstract":"<p><strong>Purpose: </strong>Given its unique anatomical position and the amalgamation of bony and soft tissues within the cochlea, exploring its intricacies poses persistent challenges. Histopathology remains the gold standard in research, but given its inherent limitations, there is a clear need for innovative alternatives. The integration of microCT technology with advanced volume rendering techniques emerges as a promising approach for overcoming the hurdles associated with anatomical investigations of the cochlea.</p><p><strong>Methods: </strong>We seamlessly integrated high-resolution microCT cochlear images with medical imaging analysis software to create detailed 3D anatomical images of the human cochlea without the need of sample processing.</p><p><strong>Results: </strong>Volume rendering allowed a multiplanar, non-destructive, detailed anatomical evaluation of the human cochlea, including its capillary system, as well as soft tissue visualization at single-micron resolution in 3D.</p><p><strong>Conclusion: </strong>The use of volume rendering in cochlear anatomical studies is underexplored despite the prevalence of 3D reconstruction. This technique presents a promising avenue for scientific investigation, providing researchers with unprecedented insights that can potentially benefit patients with hearing disorders.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771849","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":"Correction to: Optimising diagnostics for hard-of-hearing infants: factors associated with successful MRI scanning without general anaesthesia.","authors":"Marlise D van der Veen, Ithri Kaman, Bas Jasperse, Thadé Goderie, Fenna A Ebbens, K Mariam Slot, Marjo S van der Knaap, Paul Merkus","doi":"10.1007/s00405-025-09308-w","DOIUrl":"https://doi.org/10.1007/s00405-025-09308-w","url":null,"abstract":"","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771831","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":"Clinico-radiological predictors of facial palsy incidence after transcanal cochlear implantation: an ambispective multicenter study.","authors":"Nidhin Das K, Amit Keshri, Rajat Jain, Ravi Sankar Manogaran, Vidhu Sharma, Nazrin Hameed, Mohd Aqib, Kalyan Chidambaram, Mohit Sinha, Amit Goyal","doi":"10.1007/s00405-025-09340-w","DOIUrl":"https://doi.org/10.1007/s00405-025-09340-w","url":null,"abstract":"<p><strong>Objective: </strong>To assess the incidence, risk factors, and outcomes of facial palsy following cochlear implantation using the transcanal technique, incorporating radiological predictors.</p><p><strong>Methods: </strong>An ambispective observational study involving 978 patients who underwent cochlear implantation via the transcanal technique at three tertiary academic referral center from January 2014 to December 2024. Radiological parameters measured on preoperative computed tomography (CT) scans included facial nerve annulus distance (FAD), facial nerve-round window distance (FNRWD), facial recess width (FRW), alpha angle, and beta angle. Clinical data, including demographics, intraoperative details, and postoperative facial nerve function, were recorded.</p><p><strong>Results: </strong>Facial palsy occurred in 7 out of 978 patients (0.71%), all were prelingually deaf children under five years old. Six out of seven had immediate onset facial palsy, with House-Brackmann grades IV-VI. In the non-facial palsy group (n = 971), mean radiological values were: FAD 7.12 mm (± 1.08), FRW 4.52 mm (± 0.67), and Alpha angle 51.2° (± 4.3°). In the facial palsy group (n = 7), values were 7.05 mm (± 1.15), 4.48 mm (± 0.73), and 50.1° (± 3.9°), with no significant differences between the groups.</p><p><strong>Conclusion: </strong>Facial palsy following the transcanal technique is a rare complication, with an incidence of less than 1 in 100 patients. While reduced FRW and FAD were explored as potential contributors, no statistically significant risk factors could be established.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771828","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":"Adenoid hypertrophy detection inventory in children for primary care physicians and pediatricians.","authors":"Fatih Kurt, Abdullah Belada, Buşra Oz, Sengul Cangur, Abdulkadir Kaya","doi":"10.1007/s00405-025-09350-8","DOIUrl":"https://doi.org/10.1007/s00405-025-09350-8","url":null,"abstract":"<p><strong>Objective: </strong>Adenoid tissue consists of clusters of lymphoid tissue within the nasopharynx and can cause symptoms due to obstruction when hypertrophied. The gold standard for diagnosis is endoscopic nasopharyngoscopy, but it is not always readily available. This study aims to develop an inventory that primary care physicians and pediatricians can use to predict the degree of adenoid hypertrophy clinically, facilitating the planning of patient follow-up and treatment.</p><p><strong>Study design: </strong>A diagnostic test study.</p><p><strong>Settings: </strong>tertiary referral hospital.</p><p><strong>Methods: </strong>The study involved 123 cases, with 82 in the patient group and 41 in the control group. Evaluation encompassed demographic characteristics, history, and physical examination findings. Additionally, a child psychiatrist assessed cases neurocognitively, behaviorally, and psychologically. Finally, cases underwent endoscopic nasopharyngoscopy by an ENT specialist, recording adenoid sizes and choanae narrowing. Multinomial Logistic Regression (MLR) analysis determined the most suitable model for the clinical inventory.</p><p><strong>Results: </strong>Snoring, restless sleep, noisy breathing, recurrent throat infections, and recurrent rhinosinusitis constitute the items of the clinical inventory. The average score of relevant items categorized patients into absent and mild, moderate, and severe groups. The area under the ROC curve for average scores of the inventory was 0.67, significantly surpassing the probability of random assignment (0.17). The inventory's accuracy rate was 70%.</p><p><strong>Conclusion: </strong>This user-friendly and highly accurate inventory aids in predicting obstruction degree in patients. Primary care physicians and pediatricians can effectively manage follow-up and treatment, referring cases requiring surgery to an ENT specialist based on the inventory results.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771824","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}