Otology & Neurotology最新文献

{"title":"MI-SI-R: A Mini-Invasive, Drill-Free, Anchor-Free Subperiosteal Reverse Technique for Active Bone Conduction Implants-An Early Clinical Experience.","authors":"Pierre-François Dolhen, Jean-Marc Gerard, Morgan Potier","doi":"10.1097/MAO.0000000000004940","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004940","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the feasibility, safety, and preliminary audiological outcomes of the mini-invasive subperiosteal reverse (MI-SI-R) technique, a screw-free and drill-free approach for the implantation of active piezoelectric bone conduction devices.</p><p><strong>Setting: </strong>Tertiary referral otology center.</p><p><strong>Study population and methods: </strong>Fourteen patients underwent 15 procedures using the MI-SI-R technique, with follow-up periods ranging from 12 to 26 months (mean: 19.6 mo; median: 22 mo). The cohort included 3 patients with single-sided deafness (SSD) and 12 with mixed hearing loss (MHL). Detailed audiological outcomes were available for a homogeneous subgroup of 9 MHL cases. A preoperative Softband bone conduction trial was performed in the same patients for intrasubject comparison, and outcomes were contrasted with published data.</p><p><strong>Design: </strong>Retrospective, single-center feasibility study.</p><p><strong>Intervention: </strong>Implantation of an active piezoelectric bone conduction device without bone anchoring or bone-bed drilling, using a 3 cm vertical retroauricular skin-periosteal incision and an endoscopically created subperiosteal pocket. The implant was positioned in reverse orientation (magnet/microphone anterior, actuator posterior).</p><p><strong>Main outcome measures: </strong>Pure-tone average (PTA), speech recognition threshold (SRT), overclosure, sound localization, SSQ, and APHAB scores; operative time, complications, and feasibility of early fitting.</p><p><strong>Results: </strong>At 3 months, mean PTA improved by 55.1±25.3 dB and mean SRT by 20.2±6 dB, with a mean overclosure of 19.2±9 dB HL in MHL patients. One minor surgical complication (magnet extrusion) required device replacement and was successfully managed using the same subperiosteal pocket. No implant migration was observed during follow-up.</p><p><strong>Conclusion: </strong>MI-SI-R is a safe and feasible mini-invasive, drill-free, and anchor-free technique for active bone conduction implantation. By preserving the periosteum and avoiding bone drilling, it represents a reusable tissue-sparing approach with encouraging short-term audiological outcomes. By optimizing implant orientation, the reverse positioning allows a more favorable anterior positioning of the external processor and microphone, consistent with expected processor placement. Larger, multicenter studies with comparative control groups will be required to confirm long-term stability and to further evaluate potential applications, including pediatric indications.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856846","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":"Analyzing Postoperative Vestibulopathy in Vestibular Schwannoma Patients Through Physical Therapy-Based Assessments.","authors":"Robert J Macielak, Kara Gillum, Matthew Bjelac, Yin Ren, Edward E Dodson, Oliver F Adunka, Daniel M Prevedello, Kyle C Wu, Desi P Schoo","doi":"10.1097/MAO.0000000000004939","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004939","url":null,"abstract":"<p><strong>Objective: </strong>To assess vestibulopathy in vestibular schwannoma (VS) patients who have undergone microsurgical resection and have received vestibular rehabilitation therapy (VRT).</p><p><strong>Study design: </strong>Retrospective case series.</p><p><strong>Setting: </strong>Tertiary care center.</p><p><strong>Patients: </strong>Patients reporting persistent dizziness following microsurgical resection of sporadic VS referred to VRT from January 2023 to August 2024 using a recently published clinical practice guideline on vestibular rehabilitation for peripheral vestibular hypofunction.</p><p><strong>Interventions: </strong>VRT.</p><p><strong>Main outcome measures: </strong>Computerized horizontal-dynamic visual acuity (cH-DVA), functional gait assessment (FGA), and dizziness handicap inventory (DHI).</p><p><strong>Results: </strong>Eighteen patients (11 females, 61%) received VRT with a median age at surgery of 51-years-old [interquartile range (IQR) 41 to 55]. Fifteen patients (83%) had tumors with a cerebellopontine angle component with a median tumor size of 17.7 mm (IQR: 9.9 to 21.2), and 3 patients (17%) had intracanalicular tumors with sizes of 9.3, 12.5, and 13.0 mm. After a median of 5 (IQR: 3 to 10) guided VRT sessions over a median of 7.5 weeks (IQR: 4 to 16), the cH-DVA error for head movements to the operative side was 3.5 lines (IQR: 2.0 to 4.3). The cH-DVA error to the nonoperative side was 2.5 lines (IQR: 1.8 to 3.5) suggesting unanticipated contralateral gaze instability. Following completion of VRT, the median FGA score was 26 (IQR: 22.5 to 27.5), signifying near-normal gait function, and the median DHI was 8 (IQR: 4 to 34), representing minimal handicap.</p><p><strong>Conclusions: </strong>Most VS patients with postoperative dizziness and cH-DVA-confirmed functional impairment of the vestibulo-ocular reflex achieved minimal dizziness and near-normal dynamic balance skills after completing VRT. Most patients showed cH-DVA results consistent with bilaterally impaired gaze stabilization.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856843","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":"Cochlear Implantation in Patients With CHARGE Syndrome: A Systematic Review and Meta-Analysis.","authors":"Kalena Liu, Jacob Beiriger, Eric Fei, Daniel Campbell, William Parkes, Andrew Bluher, Jacob B Hunter","doi":"10.1097/MAO.0000000000004929","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004929","url":null,"abstract":"<p><strong>Objective: </strong>Currently, there are limited large studies exploring cochlear implantation (CI) outcomes in patients with CHARGE syndrome. We aim to evaluate preoperative and postoperative speech and auditory outcomes in patients with CHARGE syndrome undergoing CI from a review of published single-center studies.</p><p><strong>Databases reviewed: </strong>PubMed, Scopus, and CINAHL.</p><p><strong>Methods: </strong>A total of 15 studies were included for analysis, encompassing 85 CHARGE patients with a total of 99 implanted ears. Extracted data included demographic information, study characteristics, and speech perception and auditory outcomes. Pooled analyses of scaled auditory outcome measures were performed using standardized mean differences (SMDs). Risk of bias was assessed using the Joanna Briggs Critical Appraisal Checklist to evaluate the quality and validity of included studies.</p><p><strong>Results: </strong>This meta-analysis demonstrates significant global postoperative improvement in auditory outcomes for patients with CHARGE syndrome who underwent CI. Meta-analyzed data showed a significant increase in Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) scores following CI, with an estimated overall pre/post mean difference of 11.9 (P = 0.036), and a significant increase in categories of auditory performance (CAP) scores following CI, with an estimated overall pre/post mean difference of 2.9 (P = 0.004).</p><p><strong>Conclusion: </strong>Despite the complexity of inner ear malformations in this population, these findings contribute to the growing body of evidence supporting the use of CIs in CHARGE patients.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841346","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":"A Unique Perspective: Intrapatient Comparison of Perimodiolar and Lateral Wall Cochlear Implant Electrodes.","authors":"Anandhan Dhanasingh","doi":"10.1097/MAO.0000000000004915","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004915","url":null,"abstract":"","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841340","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":"The Landscape of Vestibular Schwannoma Microsurgical Resection Clinical Trials: A Scoping Review.","authors":"Syed Ameen Ahmad, Sarah Gao, Maria Armache, Jenny X Chen","doi":"10.1097/MAO.0000000000004932","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004932","url":null,"abstract":"<p><strong>Objective: </strong>We sought to analyze contemporary clinical trials since 2010 involving vestibular schwannoma (VS) patients undergoing microsurgical resection to characterize the landscape of trial outcomes studied, as well as the representation of recruited participants by sex, race, and ethnicity.</p><p><strong>Databases reviewed: </strong>PubMed, Embase, CENTRAL, and Web of Science.</p><p><strong>Methods: </strong>Each study's title/abstract and full texts were independently reviewed by 2 study team members. Articles were included if they reported data for both age and sex of VS adult participants undergoing microsurgical resection. Articles were also required to meet the NIH's definition of a clinical trial to be included. Studies before 2010, those with pediatric participants, or those with any participants with neurofibromatosis-related VS or other cerebellopontine angle pathologies were excluded. Categorical variables were reported as raw numbers/percentages. Participation-to-prevalence ratios (PPR) were calculated to assess sex representation compared with the general population.</p><p><strong>Results: </strong>Fifty-two studies (n=3666 participants) met the inclusion criteria. The mean age of participants was 49.1 years old. Most studies were conducted in Europe (44.2%) or North America (26.9%). Only 9 studies (17.3%) were randomized controlled trials. Common primary outcomes assessed included postoperative outcomes (36.5%) and intraoperative measurements (eg, of auditory nerve function) (28.8%), reporting hearing, vestibular, and facial nerve outcomes. There was good representation of both females and males as compared with the general population with respect to primary outcomes, surgical approach, and study continent (0.8> PPR <1.2). Only one study reported on race/ethnicity.</p><p><strong>Conclusion: </strong>Greater emphasis on geographically diverse and demographically inclusive clinical trials may strengthen evidence produced by VS microsurgery research efforts.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841264","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":"Auditory Brainstem Response as a Predictor of Hearing After Vestibular Schwannoma Radiosurgery.","authors":"Avinash Beharry, Constantin Tuleasca, Mohamed Faouzi, Marc Levivier, Raphael Maire","doi":"10.1097/MAO.0000000000004937","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004937","url":null,"abstract":"<p><strong>Objective: </strong>To identify prognostic factors for preserving useful hearing (Gardner-Robertson class 1 or 2) 2 years after stereotactic radiosurgery (SRS) for vestibular schwannoma, with a focus on auditory brainstem response (ABR) and baseline auditory status.</p><p><strong>Study design: </strong>Retrospective case review.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Patients: </strong>Eighty-six patients treated between 2010 and 2019 with Gamma Knife SRS and presenting with serviceable hearing at diagnosis. All patients included had ABR pretreatment and pure tone and speech audiometry before treatment and at 2 years after radiosurgery.</p><p><strong>Interventions: </strong>Stereotactic radiosurgery; audiological evaluation including ABR and pure tone and speech audiometry before treatment and at 2-year follow-up.</p><p><strong>Main outcome measures: </strong>Preservation of useful hearing (Gardner-Robertson class 1 or 2) using pure tone average and word recognition score at 2 years post-treatment.</p><p><strong>Results: </strong>Useful hearing was preserved in 77.9% (pure tone audiometry) and 86.7% (speech audiometry) of patients at 2 years. Pathologic ABR Wave I and initial Gardner-Robertson class 2 were significantly associated with the likelihood of loss of useful hearing at 2 years.</p><p><strong>Conclusions: </strong>Auditory brainstem response and quality of audition at baseline are predictive factors of preservation of useful hearing at 2 years after SRS.Level of Evidence : Level 3.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841279","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":"Survival and Outcomes of Type I Ventilation Tubes Insertion in Adult Adhesive Otitis Media: A Longitudinal Analysis.","authors":"Seong Hoon Bae, Dae Hyun Kim, Sung Il Cho, Gi-Sung Nam","doi":"10.1097/MAO.0000000000004936","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004936","url":null,"abstract":"<p><strong>Objective: </strong>To characterize short- and mid-term outcomes of standard type I ventilation tube insertion (VTI) in adults with adhesive otitis media (AdOM).</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Single tertiary referral center.</p><p><strong>Patients: </strong>Adults with AdOM graded by Sade classification who underwent type I transtympanic VTI (n=23, 30 ears).</p><p><strong>Intervention: </strong>Type I transtympanic VTI (Paparella type I, Medtronic).</p><p><strong>Main outcome measures: </strong>Four-frequency pure-tone average (PTA₄) and air-bone gap (ABG) at 1 month; tympanic membrane (TM) stage change (Sade classification) at 1 month; tube retention (Kaplan-Meier); and post-extrusion TM sequelae at 12 months.</p><p><strong>Results: </strong>At 1 month, mean PTA₄ improved from 29.04±17.06 to 21.71±17.04 dB HL and mean ABG improved from 14.17±11.96 to 7.38±9.65 dB HL (both P<0.001). TM morphology improved as stage 0 increased to 66.7% and stages 3-4 decreased to 13.3% (P<0.001). Tube retention was 57% at 6 months and 20% at 12 months; retraction recurrence (53.3%) and persistent TM perforation (13.3%) were observed.</p><p><strong>Conclusion: </strong>Type I VTI in adult AdOM yields short-term auditory and structural improvements but limited 1-year durability, with frequent recurrence after extrusion.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147819078","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":"Impact of Chronic Kidney Disease on the Risk of Hearing Loss: A Retrospective Cohort Study and Genetic Analysis.","authors":"Li Li, Xueyu Wei, Kunlin Pu, Hongmei Song","doi":"10.1097/MAO.0000000000004920","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004920","url":null,"abstract":"<p><strong>Background: </strong>Hearing loss (HL) and chronic kidney disease (CKD) are both significant components of the global health burden. We explored the phenotypic association between CKD and HL, along with the underlying genetic drivers, through studies ranging from clinical cohorts to genetic analyses.</p><p><strong>Methods: </strong>First, we utilized data from the China Health and Retirement Longitudinal Study (CHARLS) and assessed the relationship between CKD and hearing loss using Cox proportional hazards models. Subsequently, we employed genome-wide genetic aggregation data to investigate the genetic drivers underlying CKD and HL.</p><p><strong>Results: </strong>In the cohort study, 7,084 individuals were included, of whom 1,509 participants (21.3%) experienced hearing loss. Cox regression analysis showed that CKD was associated with an increased risk of hearing loss (HR=1.541, 95% CI=1.317-1.804). In genetic analysis, CKD was positively genetically correlated with HL (rg=0.155, P<0.05). Multi-trait analysis of GWAS (MTAG) and cross-phenotype association analysis (CPASSOC) from the genome-wide association study identified two significant pleiotropic SNPs (rs12149832 and rs2044993) for both CKD and HL. Transcriptome-wide association study (TWAS) identified shared tissue-specific expression-trait associations, but Mendelian randomization did not reveal causal relationships (OR=1.035, 95% CI=0.973-1.101).</p><p><strong>Conclusions: </strong>Our cohort study confirms the clinical association between CKD and HL. Genetic analysis reveals a shared genetic link between the two conditions and potential underlying genetic drivers. These findings may provide effective strategies for preventing and managing hearing loss in clinical CKD patients.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777975","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 Interaural Angular Insertion Depth Mismatch on Sound Localization in Adolescent Bilateral Cochlear Implant Users.","authors":"Fatima M Denanto, Bo Tideholm, Jeremy Wales, Anders Svensson-Marcial, Torkel B Brismar, Filip Asp","doi":"10.1097/MAO.0000000000004925","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004925","url":null,"abstract":"<p><strong>Objectives: </strong>To examine whether interaural angular insertion depth (AID) mismatch affects horizontal sound localization accuracy (SLA) in adolescents with bilateral cochlear implants (BiCI) since early childhood.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>University hospital.</p><p><strong>Patients: </strong>Twenty subjects with mean age of 16.9 years (range: 12.8 to 21.6 y) and 14.7 years (9.6 to 19.6 y) of BiCI experience.</p><p><strong>Methods/main outcome measures: </strong>On the basis of three-dimensional modeling of photon-counting detector-computed tomography images of the inner ears, interaural AID mismatch of the most apical electrodes was estimated. SLA was objectively measured using 4 stimuli providing various spatial cues, quantified by an Error Index (EI). The effect of interaural AID mismatch on the EI was studied using linear regression analyses, and by comparing the EI between a matched and a mismatched group stratified on a mismatch criterion of 75 degrees.</p><p><strong>Results: </strong>The median interaural AID absolute difference was 45.5 degrees (range: 4 to 256 degrees). Across sounds, no linear relationship between interaural AID mismatch and EI existed. No effect of group (matched vs. mismatched) on the EI existed. A significant effect of stimulus (P<0.001) and an interaction between stimulus and group (P<0.02) was found, with performance differences between stimuli for the mismatched but not the matched group.</p><p><strong>Conclusions: </strong>Individuals who have been listening through BiCI since early childhood show large variability in AID mismatch between the ears. Horizontal SLA seems unrelated to this mismatch. For large mismatches, the spatial cues present in a sound seem to affect localization accuracy.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777996","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":"The Relationship Between Body Mass Index and Skull Soft Tissues: Implications for Bone Conduction Coupling.","authors":"Vanessa J Zhang, Soomin Myoung, Yoshiaki Inuzuka, Jeffrey T Cheng, Behroze A Vachha, Aaron K Remenschneider","doi":"10.1097/MAO.0000000000004930","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004930","url":null,"abstract":"<p><strong>Objective: </strong>Quantify mastoid soft-tissue thickness on temporal bone computed tomography (CT) and evaluate associations with body mass index (BMI), age, and sex.</p><p><strong>Study design: </strong>Retrospective cross-sectional study.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Patients: </strong>Adults with temporal bone CT and a recorded BMI within 12 months.</p><p><strong>Main outcome measures: </strong>Mean mastoid soft-tissue thickness measured at 6 sites (3 per ear) on multiplanar reconstructions.</p><p><strong>Results: </strong>One hundred forty-seven CT scans (mean age: 57.4±22.0 y; 46.3% male; mean BMI: 30.2±9.9 kg/m 2 ). The mean mastoid thickness was 9.7±4.1 mm (range: 3.4 to 27.0 mm). BMI was associated with greater mastoid thickness (adjusted β =0.30 mm per kg/m 2 , 95% CI: 0.25-0.34; P <0.001). Male sex was associated with thicker tissue (adjusted difference: 1.37 mm, 95% CI: 0.46-2.27; P =0.003), whereas age was not independently associated. Interaural means were highly correlated ( r =0.89), with a negligible paired difference. Interrater ICC for mean mastoid thickness was 0.995 (n=59).</p><p><strong>Conclusions: </strong>Mastoid soft-tissue thickness varies widely and increases predictably with BMI. BMI may serve as an accessible clinical proxy for the soft-tissue envelope at bone conduction coupling sites, with potential implications for the interpretation of bone conduction audiometry and the planning of skin-drive and magnet-retained bone conduction hearing devices.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778000","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}