Otology & Neurotology最新文献

{"title":"The Incidence and Prognosis of Positive Autoimmune Laboratory Markers in Idiopathic Sudden Sensorineural Hearing Loss: A National Database Study.","authors":"Adam S Vesole, Joseph T Breen","doi":"10.1097/MAO.0000000000004415","DOIUrl":"10.1097/MAO.0000000000004415","url":null,"abstract":"<p><strong>Objective: </strong>To identify the incidence of positive autoimmune laboratory markers in idiopathic sudden sensorineural hearing loss (iSSNHL) and its impact on hearing prognosis.</p><p><strong>Study design: </strong>Retrospective cohort database study.</p><p><strong>Setting: </strong>A collaborative national database (TriNetX) sourced from 79 large healthcare organizations in the United States.</p><p><strong>Patients: </strong>Adults (≥18 years old) diagnosed with iSSNHL (ICD-10 H91.2) treated with systemic steroids.</p><p><strong>Interventions: </strong>Autoimmune laboratory markers and salvage intratympanic (IT) steroids for SSNHL (CPT 69801).</p><p><strong>Main outcome measures: </strong>1) Positivity of autoimmune laboratory markers-rheumatoid factor (RF), ANCA, DNA double strand antibody (Ab), Sjogren syndrome A and B Abs, SCL-70 Ab, cardiolipin IgG Ab, Jo-1 Ab, ANA, mitochondria Ab. 2) Percent of patients that underwent salvage IT steroids, cochlear implantation, or hearing aid evaluation-all utilized as a proxy for hearing outcomes.</p><p><strong>Results: </strong>Subjects with iSSNHL who had autoimmune testing (n = 17,413) were marginally more likely to be positive for at least one autoimmune laboratory marker compared to subjects without iSSNHL (n = 17,413; 23.0% vs. 21.4%, p = 0.0006). Statistical significance was lost after removing nonspecific autoimmune markers, however. Of those with iSSNHL who received systemic steroid treatment, subjects with positive autoimmune markers (n = 5,153) versus negative autoimmune markers (n = 5,153) underwent similar rates of salvage IT steroids (7.1% vs. 7.8%, p = 0.154), hearing aid evaluation (2.76% vs 2.47%, p = 0.354), and cochlear implantation (1.65% vs. 1.69%, p = 0.878).</p><p><strong>Conclusions: </strong>Patients with iSSNHL have a marginally higher incidence of nonspecific positive autoimmune laboratory markers compared to those without iSSNHL; however, the presence of these markers does not predict treatment response or prognosis. Specifically, autoimmune markers did not predict the need for salvage IT steroids, nor CI and hearing aid use in iSSNHL. Autoimmune laboratory testing may be useful in iSSNHL patients with additional symptoms suspicious for an autoimmune disorder; however, a generalized screening is not recommended as it is unlikely to alter management or prognosis.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"753-758"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449864","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":"Increasing Inpatient Costs and Complication Rates After Vestibular Schwannoma Resections from 1998 to 2021.","authors":"Rance J T Fujiwara, Donald Tan, Hitomi Sakano, Brandon Isaacson, Joe Walter Kutz","doi":"10.1097/MAO.0000000000004498","DOIUrl":"10.1097/MAO.0000000000004498","url":null,"abstract":"<p><strong>Objective: </strong>To examine temporal trends in postoperative surgical and medical complications after vestibular schwannoma (VS) resections, and to describe changes in inpatient hospitalization costs.</p><p><strong>Study design: </strong>Cross-sectional analysis.</p><p><strong>Setting: </strong>National Inpatient Sample, 1998-2021.</p><p><strong>Participants: </strong>50,991 admissions.</p><p><strong>Interventions: </strong>VS resection.</p><p><strong>Main outcome measures: </strong>Surgical and medical complications after VS resection were recorded annually and trended over time. The annual average cost of inpatient hospitalization (in inflation adjusted 2024 US dollars) and length of stay were also documented for each year. Multivariate analysis was performed to determine whether subsequent calendar years were associated with changes in costs.</p><p><strong>Results: </strong>From 1998 to 2021, the annual average number of VS resections decreased by 32.7% from 3,813 to 2,557. Rates of surgical and medical complications increased from 18.2 to 34.2% ( b = 0.73 [95% CI, 0.53-0.93], p < 0.001), and from 4.3 to 7.6% ( b = 0.17 [95% CI, 0.11-0.22], p < 0.001), respectively. The number of comorbidities among surgical patients increased over time, and rates of complications increased among patients with higher comorbidity scores, with 54.0% of those with ≥4 comorbidities experience a complication, compared with 28.1% of those with no comorbidities. The mean inpatient cost per admission increased from $30,922 to $45,973, which was statistically significant on multivariate regression ( b = $412 [95% CI, 208-615], p < 0.001), despite a decrease in average inpatient stay from 5.4 (SE 0.5) to 4.5 (SE 0.3) days.</p><p><strong>Conclusions: </strong>As the number of VS operations has decreased, the percentage with postoperative complications has increased, likely due to changes in patient selection as well as increasing comorbidities in operative cases. Healthcare expenditures for postoperative admissions have increased significantly over the last two decades, resulting in a roughly $15,000 increase in mean inflation-adjusted inpatient costs per postoperative admission.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"848-854"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972902","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":"Factors Associated With Follow-Up Appointment Attendance in Adults With Sensorineural Hearing Loss.","authors":"Preetha Velu, Carolyn Wilson, Rohith R Kariveda, Peter C Weber, Jessica R Levi","doi":"10.1097/MAO.0000000000004530","DOIUrl":"10.1097/MAO.0000000000004530","url":null,"abstract":"<p><strong>Objective: </strong>Sensorineural hearing loss has a high disease burden and requires close follow-up to manage long-term sequelae of the disease. This study aims to identify patient- and appointment-related factors including demographic data and medical comorbities associated with sensorineural hearing loss follow-up appointment attendance in adults to better understand barriers to care.</p><p><strong>Study design: </strong>Retrospective chart review.</p><p><strong>Setting: </strong>Tertiary-care, safety-net hospital.</p><p><strong>Patients: </strong>Adult patients seen in an otolaryngology clinic for sensorineural hearing loss between May 1, 2015, and December 31, 2021.</p><p><strong>Interventions: </strong>Analysis of patient demographic, medical comorbidity, and appointment factors.</p><p><strong>Main outcome measures: </strong>Follow-up appointment attendance rates for otolaryngology and audiology appointments.</p><p><strong>Results: </strong>Of 5,632 patients, 54.9% attended, 28.7% canceled, and 16.3% were no-show at follow-up appointments. On univariate analysis, factors associated with appointment cancellation and no-show included sex, race, language, education, employment status, insurance, country of birth, housing insecurity, hypertension, smoking status, timing of appointments before or after the beginning of COVID-19, and having a physician within hospital network. In multivariate analysis, factors significantly associated with appointment nonattendance included age greater than 60 years old, higher education levels, unemployment, housing insecurity, having a primary care physician outside the hospital network, and residing outside a 5-mile radius of the hospital.</p><p><strong>Conclusions: </strong>Patient and appointment characteristics such as age, education level, employment status, housing insecurity, and distance to appointment had an independent association with higher rates of missed follow-up appointments in sensorineural hearing loss. Accessibility of appointments and interventions such as telehealth and reminder systems may be key to ensuring equitable care.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"759-765"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151392","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":"Decreasing Medicare Reimbursement for Facility-Performed Neurotology Procedures From 2000 to 2024.","authors":"Julia Jiazhen Shi, Rance J T Fujiwara, Lisa Mary Punnen, Hitomi Sakano, Brandon Isaacson","doi":"10.1097/MAO.0000000000004524","DOIUrl":"10.1097/MAO.0000000000004524","url":null,"abstract":"<p><strong>Objective: </strong>To understand trends in Medicare reimbursement for neurotology procedures from 2000 through 2024.</p><p><strong>Methods: </strong>The Physician Fee Schedule (PFS) Look-Up Tool from the Center for Medicare and Medicaid Services was used to assess reimbursement data for relevant otologic/neurotologic Current Procedural Terminology (CPT) codes from 2000 to 2024. All monetary data were adjusted to 2024 U.S. dollars using the U.S. Bureau of Labor Statistics Consumer Price Index. Percent changes in reimbursement were calculated.</p><p><strong>Results: </strong>The average nominal value of reimbursement for all procedures increased by 11.20% from 2000 to 2024. However, after adjusting for inflation, the average change in Medicare reimbursement was -33.52%. The greatest decrease was in CPT code 69714, which saw a 2024 U.S. dollar -66.43% change. The greatest increase was in CPT code 61798, which saw a 43.43% change. An increase in reimbursement for all CPT codes occurred only in 2024. This increase was associated with the calendar year 2024 PFS final rule, which came into effect on March 9 and increased the PFS conversion factor from $32.7442 to $33.2875. From 2000 to 2024, the PFS conversion factor decreased from $36.6137 to $33.2875.</p><p><strong>Conclusion: </strong>From 2000 to 2023, Medicare reimbursements for otologic and neurotologic procedures decreased after adjusting for inflation. The only year with an increase in reimbursement was 2024, which saw an increase to the PFS conversion factor. These trends highlight the need for greater awareness of, and agreement on, neurotology reimbursement models among surgeons, policy makers, and facility administrators.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"871-876"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226138","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":"Botulinum Toxin Type A Injection Near the Stylomastoid Foramen: A Safe and Effective Therapeutic Modality for Tinnitus in Patients With Hemifacial Spasm.","authors":"Lingxi Zhu, Lizhen Pan, Xiaolong Zhang, Yougui Pan, Lingjing Jin, Fei Teng","doi":"10.1097/MAO.0000000000004542","DOIUrl":"10.1097/MAO.0000000000004542","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the efficacy and safety of botulinum toxin type A (BTX-A) injection near the stylomastoid foramen for tinnitus in patients with hemifacial spasm (HFS).</p><p><strong>Study design: </strong>Retrospective study from 2011 to 2024.</p><p><strong>Setting: </strong>Tongji Hospital affiliated to Tongji University in Shanghai, China.</p><p><strong>Patients: </strong>Patients with HFS combined with tinnitus.</p><p><strong>Intervention: </strong>BTX-A injection near the stylomastoid foramen.</p><p><strong>Main outcome measures: </strong>The efficacy of BTX-A was assessed based on subjective improvement reported by patients after 1 month. Adverse events were also documented.</p><p><strong>Results: </strong>A total of 869 HFS patients were analyzed, including 122 with tinnitus. Among the 122 patients with tinnitus, 110 received BTX-A injections near the stylomastoid foramen, and complete follow-up data were available for 105 of them. The 3.75 U group showed a higher improvement rate (69.2 ± 14.3%) compared with the 2.5 U group (46.3 ± 25.0%, p < 0.05). The majority received a 5 U dose, with a significantly higher improvement rate (76.9 ± 15.1%) compared with the 2.5 U group ( p < 0.01). All reported adverse events were related to routine injection sites and were mild, requiring no special treatment. No adverse events related to BTX-A injection near the stylomastoid foramen were reported.</p><p><strong>Conclusion: </strong>In patients with HFS-associated tinnitus, additional injection of 5 U BTX-A near the stylomastoid foramen, targeting the stapedius muscle, proved to be an effective therapy with minimal adverse effects.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"855-861"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040878","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":"Using a 3D Radiological Planning Software to Predict the Intraoperative Surgical View.","authors":"Adrian Felix Balciunas, Annika Gebel, Jonghui Kim, Frank Hippe, Sabine Eichhorn, Simon Bohmann, Stefan Dazert, Andreas Prescher, Jonas Park","doi":"10.1097/MAO.0000000000004522","DOIUrl":"10.1097/MAO.0000000000004522","url":null,"abstract":"<p><strong>Introduction: </strong>A 3D radiological planning software for general otology has been developed to assist preoperative planning by providing anatomical measurements based on CT or MRI scans in cochlear implant candidates. This study aimed to investigate its usability for predicting the required posterior tympanotomy (PT) opening length to ensure visualization of the round window (RW).</p><p><strong>Material and methods: </strong>CT scans were performed on 30 petrous bone specimens. Correlations were analyzed between software-calculated distances of the ideal trajectory to critical inner ear structures and the intraoperatively measured required PT length to ensure visualization of the RW. This was assessed using the posterior tympanotomy window (PTW), which was defined as the distance between the most prominent curvature of the short process of the incus and the round window. We also analyzed the degree of facial nerve exposure and the feasibility of electrode array insertion.</p><p><strong>Results: </strong>The mean PTW length was 7.31 mm (range, 5-9 mm). The intraoperative PTW significantly positively correlated with the distance between the chorda tympani and the ideal trajectory calculated by the software. The intraoperative PTW significantly positively correlated with the software-calculated facial recess size. A caudal extension of the PTW correlated with short distances between the facial nerve and the ideal trajectory. Facial nerve exposure negatively correlated with the software-calculated distance between the facial nerve and the ideal trajectory. Electrode insertion was possible in all study specimens.</p><p><strong>Conclusion: </strong>The software was useful in the preoperative planning of CI surgery. It may help to anticipate the RW visualization through the chorda-facial angle.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"e243-e249"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151440","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":"Randomized Controlled Trial Comparing Outcomes for Adult Cochlear Implant Recipients Using a Lateral Wall or Perimodiolar Electrode Array.","authors":"Robert J S Briggs, Timothy McLean, Alexandra Rousset, Sylvia Tari, Stephen J O'Leary, Richard C Dowell, Jaime Leigh, Robert Cowan","doi":"10.1097/MAO.0000000000004518","DOIUrl":"10.1097/MAO.0000000000004518","url":null,"abstract":"<p><strong>Objective: </strong>The primary aim of this study was to compare outcomes of adult cochlear implant recipients receiving either perimodiolar or lateral wall electrode arrays.</p><p><strong>Study design: </strong>A prospective randomized controlled study was conducted to investigate final electrode array position, speech perception, and vestibular symptoms.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Patients: </strong>One hundred forty-four adults were assessed for the study. Inclusion criteria were bilateral postlingual severe to profound sensorineural hearing loss, with 500-Hz threshold in the implant ear of 75 dB HL or greater.</p><p><strong>Interventions: </strong>Subjects were randomized to receive either perimodiolar or lateral wall electrode arrays.</p><p><strong>Main outcome measures: </strong>Postoperative electrode array position was assessed by cone-beam computed tomography. Speech perception was measured preoperatively in best-aided conditions, and 3 and 12 months postoperatively. Vestibular symptoms were assessed using two self-reported questionnaires and/or clinician reports.</p><p><strong>Results: </strong>Postoperative speech perception results for 124 implants in 123 adults showed significant improvement from preoperative scores and from 3 to 12 months postoperatively. Multiple regression analysis indicated no significant effect of electrode array position for any speech perception results at 3 and 12 months postoperatively. Auditory alone, monosyllabic word, and phoneme scores at 12 months were 48.4 and 71.4% for lateral wall electrode arrays and 49.8% and 72.0% for perimodiolar electrode arrays, respectively. No relationships between angle (depth) of electrode array insertion and speech perception outcomes were detected. There was no significant difference in incidence of vestibular symptoms between the groups.</p><p><strong>Conclusions: </strong>Correct scala tympani placement of either the perimodiolar or lateral wall electrode arrays used in this study provides excellent speech perception outcomes, with no significant difference demonstrated between groups.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"802-808"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009354","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":"Effect of Simvastatin on Irradiated Primary Vestibular Schwannoma Cells.","authors":"Matthew Wiefels, Olena Bracho, Mikhail Marasigan, Fred Telischi, Michael E Ivan, Scott Welford, Cristina Fernandez-Valle, Christine T Dinh","doi":"10.1097/MAO.0000000000004469","DOIUrl":"10.1097/MAO.0000000000004469","url":null,"abstract":"<p><strong>Hypothesis: </strong>Simvastatin enhances radiation cytotoxicity of primary vestibular schwannoma (VS) and NF2 -mutant human Schwann (HS01) cells.</p><p><strong>Background: </strong>Approximately 10% of VS progress after radiotherapy. Simvastatin is a lipid-lowering medication that promotes apoptosis, inhibits cell proliferation, and enhances radiation response in various cancers. In this study, we determine the effect of simvastatin on the viability of irradiated and nonirradiated primary VS and HS01 cells.</p><p><strong>Methods: </strong>Primary VS (N = 5) and HS01 cells were pretreated with simvastatin (0 or 1 μM) prior to irradiation (0 or 18 Gy). A cell-based assay was used to measure cell viability. Immunocytochemistry was performed for γH2AX (DNA damage marker) and RAD51 (DNA repair protein). Statistical analysis was conducted with parametric and nonparametric one-way analysis of variance tests.</p><p><strong>Results: </strong>Radiation initiated double-stranded breaks in DNA in both VS and HS01 cells. Two VS were radiation-resistant and the remaining three VS were radiation-sensitive. In response to radiation, radiation-resistant VS cells activated RAD51-mediated DNA repair. Simvastatin blocked RAD51 activation in radiation-resistant VS, increased levels of lethal DNA damage, and enhanced radiation-induced cell death. Simvastatin also enhanced radiation-induced cell death in radiation-sensitive VS cells through RAD51-independent mechanisms. However, simvastatin was not effective as a radiosensitizer in HS01 cells.</p><p><strong>Conclusion: </strong>Simvastatin improved radiation response of radiation-resistant primary VS cells by inhibiting RAD51-related DNA repair. Although through RAD51-independent mechanisms, simvastatin also improved radiation response in radiation-sensitive VS cells. Additional preclinical investigations are warranted to evaluate the mechanisms of action and efficacy of statin drugs as radiosensitizers for VS patients.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"842-847"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586535","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":"Influence of CT Radiation Dose and Field-of-View on Automatic Morphometry for Cochlear Implant Planning.","authors":"Henner Huflage, Tobias Wech, Kristen Rak, Magnus Schindehuette, Jonas Engert, Stephan Hackenberg, Mirko Pham, Thorsten Alexander Bley, Jan-Peter Grunz, Bjoern Spahn","doi":"10.1097/MAO.0000000000004534","DOIUrl":"10.1097/MAO.0000000000004534","url":null,"abstract":"<p><strong>Introduction: </strong>In cochlear implantation (CI), precise preoperative cochlear duct length (CDL) and angular insertion depth (AID) measurements are pivotal for individualized electrode carrier selection, since recipients benefit from sufficient cochlear coverage of the electrode carrier, enabling electric stimulation of all crucial frequency bands. Since the quality of temporal bone CT largely depends on acquisition and reconstruction settings and is limited by the technical capabilities of the CT scanner, this study aims to assess how radiation dose and reconstruction field-of-view (FOV) affect automatic cochlear morphometry and electrode contact determination in conventional multislice CT.</p><p><strong>Methods: </strong>Twenty fresh-frozen human petrous bone specimens were examined at three radiation dose levels (40, 20, and 10 mGy) using a multislice CT scanner. Each dataset was reconstructed with three different FOV settings (250, 125, and 50 mm). Preoperative CDL and AID measurements were performed with dedicated otological planning software. Maxed-out dose images (250 mGy) served as standard of reference for comparing the morphometric results.</p><p><strong>Results: </strong>Regardless of the selected combination of dose level and FOV, significant CDL or AID measurement differences were neither ascertained among the individual groups, nor in comparison to the reference scans (all p ≥ 0.05). Likewise, the simulation of all stimulable frequency bandwidths showed no dependency on radiation dose or FOV settings (all p ≥ 0.05).</p><p><strong>Conclusion: </strong>The assessment of cochlear morphometry with conventional multislice CT imaging before CI surgery allowed a radiation dose reduction up to 75% without compromising the accuracy of software-based cochlear analysis. Notably, automatic CDL and AID measurements for surgical planning did not benefit from a smaller reconstruction FOV.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"e250-e256"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024545","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":"Intraoperative Auditory Brainstem Response (ABR) Measurement During Vibroplasty in Congenital Aural Malformation.","authors":"Bjoern Spahn, Kristen Rak, David P Herrmann, Mario Cebulla, Jonas Engert, Anja Kurz, Johannes Voelker, Stephan Hackenberg, Franz-Tassilo Müller-Graff","doi":"10.1097/MAO.0000000000004529","DOIUrl":"10.1097/MAO.0000000000004529","url":null,"abstract":"<p><strong>Objective: </strong>To determine the optimal coupling efficiency by auditory brainstem response (ABR) in patients with aural atresia undergoing vibroplasty to ensure optimal sound transmission and minimize the need for revision surgery.</p><p><strong>Study design: </strong>Retrospective data analysis.</p><p><strong>Setting: </strong>Tertiary referral center with an established active middle ear implant program.</p><p><strong>Patients: </strong>14 ears of 13 patients with congenital aural malformation receiving active middle ear implant surgery.</p><p><strong>Interventions: </strong>Therapeutic surgical treatment for hearing rehabilitation in human subjects.</p><p><strong>Main outcome measures: </strong>Intraoperative coupling efficiency as determined by ABR and postoperative audiologic outcomes (sound-field thresholds, speech perception) after active middle ear implantation in patients with congenital aural malformations.</p><p><strong>Results: </strong>Intraoperative ABR was performed in all patients and revealed thresholds that were not significantly different from preoperative PTA4 bone-conduction thresholds ( p = 0.67). Pearson correlation coefficient r was 0.57. Speech perception improved by 65.0% at 65 dB SPL and by 60.9% at 80 dB SPL. PTA4 Vibrogram thresholds showed stable long-term coupling outcomes (mean, 28.7 ± 8.3 dB HL eq ).</p><p><strong>Conclusion: </strong>ABR measurement during vibroplasty is applicable in patients with congenital aural malformation. There are often fewer options for coupling the vibratory element of the VSB (floating mass transducer [FMT]) to the ossicular chain or directly to the cochlea in this patients' collective. Confirmation of a stable and valid coupling efficacy during FMT positioning can be of great benefit in malformed middle ears for efficient hearing restoration and to reduce the risk of revision surgery.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"821-828"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226144","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}