European Archives of Oto-Rhino-Laryngology最新文献

{"title":"Development of a new maneuver to rapidly restore positional nystagmus from benign paroxysmal positional vertigo fatigue in patients with posterior canal-type benign paroxysmal positional vertigo: a single-arm prospective interventional clinical trial.","authors":"Takao Imai, Naomiki Kimura, Takashi Nakajima, Tadashi Kitahara, Shinji Mikami","doi":"10.1007/s00405-025-09327-7","DOIUrl":"https://doi.org/10.1007/s00405-025-09327-7","url":null,"abstract":"<p><strong>Purpose: </strong>Posterior canal-type benign paroxysmal positional vertigo (pc-BPPV) is diagnosed when positional torsional nystagmus is induced by the Dix-Hallpike test (DHT). When the DHT is repeated, positional nystagmus disappears. This phenomenon is known as BPPV fatigue. In cases where positional nystagmus cannot be induced by the DHT because of BPPV fatigue occurring just before a medical examination, or where positional nystagmus is not observed during the first DHT, we cannot make a diagnosis of pc-BPPV because the DHT can no longer induce the positional nystagmus typical of pc-BPPV. Therefore, this study aimed to develop a new maneuver to rapidly restore positional nystagmus in cases of BPPV fatigue, thereby facilitating accurate diagnosis.</p><p><strong>Methods: </strong>Twenty patients with pc-BPPV performed the DHT twice to induce BPPV fatigue, with the new maneuver being used, and then performed a third DHT to verify the restoration of positional nystagmus. The primary outcome measure (POM) was the ratio between the maximum slow-phase eye velocity of positional nystagmus during the third DHT and that during the first DHT. A higher ratio indicates a greater ability of the new maneuver to restore nystagmus.</p><p><strong>Results: </strong>The 95% confidence interval for the POM was 0.712-1.026, exceeding the pre-defined lower limit of efficacy of 0.7 specified in the protocol.</p><p><strong>Conclusion: </strong>The high values for the POM suggest that the new maneuver successfully restores positional nystagmus and demonstrates its potential applicability in clinical practice for diagnosing pc-BPPV in cases complicated by BPPV fatigue.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718285","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":"Evaluating the diagnostic accuracy and reliability of mobile audiometry for screening hearing loss in adults in comparison to pure tone audiometry.","authors":"Umashri Sundararaju, Shanmathi Subramanian, Shanmuga Ashok Siva, Aishwarya Prateep, Bhoobli Thulasiram Lavanya, Hamrish Kumar Rajakumar","doi":"10.1007/s00405-025-09321-z","DOIUrl":"https://doi.org/10.1007/s00405-025-09321-z","url":null,"abstract":"<p><strong>Background: </strong>Hearing loss affects approximately 1.5 billion people globally, with a significant proportion unaware of their condition due to inadequate screening. The current standard for diagnosing hearing loss, pure tone audiometry (PTA), faces limitations in accessibility and cost, especially in low-resource settings. Our study aimed to evaluate mobile audiometry (MA) as a self-assessment screening tool for the general public.</p><p><strong>Methods: </strong>The study compared audiograms obtained via PTA in a sound-proof room and MA using a smartphone in a physician's office with ambient noise using relatively inexpensive, readily available generic headsets and earphones. MA was a self-assessment test where patients followed instructions from investigators but conducted the test independently under supervision. Each ear was tested separately without masking. Spearman's correlation assessed the association between MA and PTA, and Bland-Altman's analysis evaluated agreement. Diagnostic accuracy, sensitivity, and specificity were calculated using contingency tables. Kappa statistic measured reliability and test-retest reliability was assessed with Intraclass Correlation Coefficient (ICC).</p><p><strong>Results: </strong>The study consisting of 250 participants (110 males and 140 females), with an average age of 43.5 years revealed strong agreement and correlation between audiograms obtained from PTA and MA. The diagnostic accuracy for classifying the degree of hearing loss was moderate, at 70%. MA exhibited high sensitivity (94.51%) and good specificity (70.96%) for screening hearing loss. The reliability of MA is good with a kappa statistic value of 0.659. The test-retest reliability of MA was assessed using ICC which was found to be 0.843.</p><p><strong>Conclusions: </strong>MA could serve as an effective screening tool for hearing loss. Individuals identified with hearing loss through MA could be referred to a physician's office for further evaluation and timely management. However, limitations such as environmental noise and variability in headset quality may affect the accuracy of the results. Further research is needed to address these challenges and improve the reliability of MA.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718291","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":"Scarless chondrolaryngoplasty combined with a surgical reshaping of the lower face through a single transoral approach for transgender patients.","authors":"Ralph Haddad, Antoine Giovanni, Hugo Frandjian","doi":"10.1007/s00405-025-09323-x","DOIUrl":"https://doi.org/10.1007/s00405-025-09323-x","url":null,"abstract":"<p><strong>Background: </strong>Chondrolaryngoplasty, one of the most visible gender affirmation surgeries, is traditionally performed through a cervical approach, leaving a residual visible cervical scar.</p><p><strong>Method: </strong>We proposed a scarless technique for chondrolaryngoplasty done through a transoral incision used for concomitant genioplasty and gonioplasty, with satisfying results on the first 15 patients.</p><p><strong>Conclusion: </strong>The combination of these interventions through a single transoral incision was safe and feasible, helping transgender male-to-female patients reduce the number of interventions needed. It avoided a visible cervical scar that can constitute a constant reminder of the transition process.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718360","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":"Relationship between obstructive sleep apnea and metabolic syndrome based on the NHANES and mendelian randomization study.","authors":"Tong Feng, Qingyuan Li, Ran Duan","doi":"10.1007/s00405-025-09209-y","DOIUrl":"https://doi.org/10.1007/s00405-025-09209-y","url":null,"abstract":"<p><strong>Background: </strong>Obstructive Sleep Apnea (OSA) is associated with metabolic disturbances, including hypertension, insulin resistance, and dyslipidemia, collectively known as Metabolic Syndrome (MetS). The relationship between OSA and MetS remains controversial. This study aims to investigate the relationship between OSA and MetS by conducting an observational study using data from NHANES and applying Mendelian Randomization (MR) analysis to examine the bidirectional causal relationship.</p><p><strong>Methods: </strong>We utilized data from the National Health and Nutrition Examination Survey (NHANES) collected between 2005 and 2008. Diagnosis of OSA was evaluated using the multivariate apnea predictive index (MAP index), while MetS was identified based on established clinical criteria. Genetic data were sourced from recent genome-wide association studies (GWAS) to perform a two-sample MR analysis. Instrumental variables were selected based on strict significance thresholds and linkage disequilibrium criteria. The primary MR analysis employed the inverse variance weighted (IVW) method, supplemented by weighted median and MR-Egger regression methods.</p><p><strong>Results: </strong>A strong association was identified between OSA and Mets through multivariate logistic regression analysis by using data from the NHANES. The MR analysis revealed a significant bidirectional causal relationship between OSA and MetS. Specifically, OSA was found to increase the risk of MetS (IVW OR = 1.52, 95% CI = 1.08-2.14, P = 0.016), and MetS was similarly found to elevate the risk of OSA (IVW OR = 1.97, 95% CI = 1.76-2.21, P = 7.58E-32). Sensitivity analyses confirmed the robustness of these findings, with no significant evidence of pleiotropy.</p><p><strong>Conclusion: </strong>This study provides genetic evidence supporting a bidirectional causal relationship between OSA and MetS. These findings underscore the interlinked nature of sleep-disordered breathing and metabolic health, suggesting that addressing one condition could benefit the other. Integrated treatment strategies targeting shared risk factors, such as obesity, may enhance overall health outcomes.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718387","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":"Spontaneous regression of adenoid hypertrophy in adults after nasal surgery.","authors":"Filippo Cascio, Ferdinando Stagno d'Alcontres, Daria Costanzo, Francesco Gazia","doi":"10.1007/s00405-025-09341-9","DOIUrl":"https://doi.org/10.1007/s00405-025-09341-9","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study is to analyse the possible spontaneous regression of severe adenoid hypertrophy in patients who performed nasal surgery.</p><p><strong>Methods: </strong>Following the inclusion criteria, 83 adult patients were retrospective selected. These patients were characterized by adenoid hypertrophy from second to fourth grade before performing septoplasty andbilateral or monolateral reduction of hypertrophy of the turbinates and/or endoscopical sinus surgery (ESS).</p><p><strong>Results: </strong>Adenoid hypertrophy (grade 2-3-4) can be noted in 6.8% (83/1220) of patients who performed nasal surgery. Regarding the grade of hypertrophy before and after surgery, a clear decrease in adenoid size was obtained after nasal surgery (p < 0.001), without performing adenoidectomy, after at least one year of follow-up.</p><p><strong>Conclusion: </strong>Spontaneous regression of severe adenoid hypertrophy was observed in all patients who performed nasal surgery. Avoid adenoidectomy during nasal surgery should be a great advantage for patients, eliminating the possibility of complications such as bleeding and uncontrolled scars.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718399","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":"Machine learning in risk assessment for microvascular head and neck surgery.","authors":"Gabriele Monarchi, Davide Buso, Chiara Paolantonio, Suhayeb Saidam, Aldo Bruno Giannì, Valentino Valentini, Antonio Tullio","doi":"10.1007/s00405-025-09347-3","DOIUrl":"https://doi.org/10.1007/s00405-025-09347-3","url":null,"abstract":"<p><strong>Purpose: </strong>The integration of machine learning (ML) into microvascular surgery for the head and neck offers significant potential to enhance risk stratification, outcome prediction, and decision support. Traditional risk assessment methods are often limited in addressing the dynamic complexity of surgical outcomes. ML can analyze preoperative, intraoperative, and postoperative data to optimize patient management, minimize complications, and improve both functional and aesthetic results.</p><p><strong>Results: </strong>ML has demonstrated potential in several key areas of microvascular surgery. It can be used for risk stratification by assessing preoperative patient data to predict complications such as flap failure or infections. Outcome prediction models, trained on large datasets, provide estimations of functional and cosmetic results, helping surgeons set realistic expectations for patients. ML-driven decision support systems assist in flap selection by considering anatomical and patient-specific factors.</p><p><strong>Conclusion: </strong>Despite its potential, ML adoption in microvascular surgery faces challenges, including the need for high-quality annotated datasets, interpretability issues, and ethical concerns such as data privacy and algorithmic bias. To fully leverage ML's capabilities, standardized datasets, interpretable models, and seamless clinical integration are necessary. With further research and implementation, ML has the potential to revolutionize risk assessment in microvascular head and neck surgery, improving patient outcomes and surgical precision.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718328","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":"Long-term clinical and audiometric outcomes after the implantation of piezoelectric bone conduction devices in children: a prospective cohort study.","authors":"Faisal Zawawi, Afnan F Bukhari, Sara A Khairy, Mohamed Garrada","doi":"10.1007/s00405-025-09339-3","DOIUrl":"https://doi.org/10.1007/s00405-025-09339-3","url":null,"abstract":"<p><strong>Background: </strong>Bone conduction devices are hearing assistive devices that are used in many children who have conductive hearing loss, mixed hearing loss or single sided deafness. The aim of this study is to assess long-term outcomes of children who underwent piezoelectric bone conductive device implantation.</p><p><strong>Method: </strong>A prospective cohort of children who underwent Osia system implantation (OSI200) between the period of Jan 2021 and December 2022. The main Outcome measures were; Long-term complications, hearing thresholds, speech discrimination, sound localization and quality of life.</p><p><strong>Results: </strong>25 children were implanted with 27 devices. The median surgical time 39 min. 6 children had single sided deafness, 21 ears had conductive hearing loss due to microtia/canal atresia (20 ears) or chronic ear disease (1 ear). None of the patients had any major adverse events. In children with conductive hearing loss, the median threshold of improvement was 37.5 dB. All patients reported significant improvement of their auditory function. Aided thresholds were best at 1 kHz (median 20 dB HL). Recorded gains were measured up 8000 Hz reflecting good auditory performance even at high frequencies. Speech Discrimination when using the Osia was 89% and self-reported hearing and quality of life by participants improved in all domains assessed.</p><p><strong>Conclusion: </strong>Osia system is a safe and effective solution to restore hearing without any major long term complications. It provides auditory benefits that covers a wide range of frequencies. Children had significant improvement in their ability to sound localize as well as QoL. Osia surgery can be performed in a routine day surgery setting safely in children.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718327","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":"Changes in olfactory function of adults following surgically assisted maxillary expansion.","authors":"Yun-Ting Chao, Janina Dimow, Thomas Hummel","doi":"10.1007/s00405-025-09336-6","DOIUrl":"https://doi.org/10.1007/s00405-025-09336-6","url":null,"abstract":"<p><strong>Purpose: </strong>Surgically Assisted Rapid Maxillary Expansion (SARME) is widely used to address transverse maxillary deficiency and associated malocclusion. However, SARME-induced structural changes in the nasal cavity can influence olfactory function. This study assessed the impact of SARME on olfactory outcomes and explored the relationship between those olfactory changes and extent of maxillary expansion.</p><p><strong>Methods: </strong>This prospective study included 28 adult patients (mean age: 26.6 ± 9.4 years; range: 18-53 years) who underwent SARME for transverse maxillary deficiency. Olfactory function was evaluated preoperatively and six months postoperatively using the Sniffin' Sticks Test, which provided scores for odor threshold, discrimination, and identification. Patients were categorized into two groups based on the extent of maxillary expansion, as follows: limited (≤ 6 mm) and wide (> 6 mm). Statistical analysis was conducted to characterize changes in olfactory scores and assess their correlation with the extent of expansion.</p><p><strong>Results: </strong>SARME was shown to have a significantly positive effect on olfactory function, with the most notable enhancements observed in suprathreshold tests, such as odor discrimination and identification. Improvements in odor threshold scores, indicative of peripheral olfactory function, were more pronounced in patients that underwent limited expansion than in patients with wide expansion.</p><p><strong>Conclusion: </strong>Modifications to the nasal anatomy induced by SARME can enhance olfactory function in adults. Nonetheless, excessive maxillary expansion may hinder olfactory improvements by disrupting the nasal valve and compromising airflow dynamics. The extent of expansion should be optimized to balance improvements in nasal patency with the preservation of beneficial airflow characteristics.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718340","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":"3D exoscopic assisted parotidectomy: practical considerations from a preliminary case series.","authors":"Pietro De Luca, Angelo Camaioni, Marco Radici","doi":"10.1007/s00405-025-09285-0","DOIUrl":"https://doi.org/10.1007/s00405-025-09285-0","url":null,"abstract":"","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718337","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":"Does the visual system affect the learning curve of the Otosurgeon? A cadaveric study comparing microscopy vs exoscopy.","authors":"Gabriele Testa, Carlo Conti, Isabelle Dohin, Mara Arcuri, Claudia Lodovica Modesti, Elisa Marazzi, Barbara Buffoli, Rita Rezzani, Davide Mattavelli, Silvia Zorzi, Daniele Borsetto, Michele Tomasoni, Vittorio Rampinelli, Cesare Piazza","doi":"10.1007/s00405-025-09300-4","DOIUrl":"https://doi.org/10.1007/s00405-025-09300-4","url":null,"abstract":"<p><strong>Purpose: </strong>Optical magnification is crucial in ear surgery, ensuring the precise identification of anatomical structures. Traditionally, microscopes have been the standard due to their magnification and stereoscopic capabilities. However, the introduction of exoscopes has introduced new possibilities, particularly in ergonomics, teaching, collaboration, and surgical training. This cadaveric study aimed to evaluate the feasibility, effectiveness, and trainee performance when using the exoscope in ear dissection and to compare it with the traditional microscope.</p><p><strong>Methods: </strong>This study involved 10 non-expert medical trainees who undertook a series of surgical tasks on cadaveric specimens using both the microscope and exoscope. The tasks included different surgical approach simulations and exercises. NASA Task Load Index and a Visual Analog Scale questionnaires were administered to assess participants' subjective experiences with each instrument.</p><p><strong>Results: </strong>All participants successfully completed the assigned tasks with both the microscope and exoscope. While there were no significant differences in the timing of surgical steps between the two instruments, participants perceived the microscope as less physically demanding and temporally taxing, while the exoscope excelled in structural identification and offered benefits for teaching and collaboration.</p><p><strong>Conclusions: </strong>The choice between microscope and exoscope should be guided by the specific surgical demands, educational context, and preferences of the team. While the microscope excels in flexibility, the exoscope provides advantages in structural identification and collaborative learning, making it a valuable tool in ear surgery. This study contributes valuable insights for otological surgeons and educators to optimize surgical outcomes and learning experiences of trainees.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709145","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}