Otology & Neurotology最新文献

{"title":"Implementation of Robot-Assisted Minimally Invasive Cochlear Implantation: A Feasibility Study.","authors":"Anne-Lise Fourez, Akil Kaderbay, Charles Villerabel, Julia Korchagina, Vincent Pean, Michel Mondain, Frederic Venail","doi":"10.1097/MAO.0000000000004531","DOIUrl":"10.1097/MAO.0000000000004531","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate if robot-assisted image-guided cochlear implant surgery can be used efficiently and safely in our center.</p><p><strong>Study design: </strong>Clinical prospective interventional monocentric study.</p><p><strong>Setting: </strong>The study was conducted in subjects over the age of 18 years who underwent unilateral cochlear implantation using a robotic system between September 2021 and December 2022.</p><p><strong>Patients: </strong>Subjects were included if the anatomy allowed for a safe trajectory for direct cochlear access to be planned.</p><p><strong>Intervention: </strong>Subjects underwent surgery using the robotic procedure.</p><p><strong>Main outcome measures: </strong>The ratio of successful electrode array insertions through the robotically drilled tunnel.</p><p><strong>Results: </strong>Ten subjects were included. The robot-assisted procedure was successful in nine cases (one bur failure). No case of facial palsy was observed. The mean drilling accuracy was 0.13 ± 0.08 mm (range, 0.03-0.26 mm) at the facial nerve, 0.14 ± 0.09 mm (range, 0.07-0.38 mm) at the chorda tympani, and 0.2 ± 0.12 mm (range, 0.03-0.26 mm) at the round window. In all robotically drilled cases, it was possible to insert the electrode array through the tunnel. One case required a second-turn cochleostomy due to an unexpected fibrosis of the basal turn. One case of partial electrode array insertion required conversion to standard procedure, which showed no improvement. For the remaining seven cases, the mean insertion depth was 520 ± 104 degrees (range, 378-712 degrees). The surgical time was 247 ± 37 minutes (range, 177-299 minutes).</p><p><strong>Conclusion: </strong>This study demonstrated the safety and efficiency of the direct tunnel approach.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"809-815"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151411","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":"Precision in Practice: Inter- and Intra-rater Reliability of Linear Measurements and Tumor Growth in Vestibular Schwannoma.","authors":"Ineke M J Pruijn, Jolanda Derks, Jérôme J Waterval, Mark Ter Laan, Yasin Temel, Sjoert A H Pegge, Alida A Postma, Wietske Kievit, Henricus P M Kunst","doi":"10.1097/MAO.0000000000004515","DOIUrl":"10.1097/MAO.0000000000004515","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study is to compare and assess the inter- and intra-rater reliability of various linear measurement techniques for vestibular schwannomas (VS) and their impact on determining tumor growth in a multidisciplinary multicenter setting.</p><p><strong>Methods: </strong>Six experts (neurosurgeons, otorhinolaryngologists, and radiologists) involved in VS management, from two tertiary referral centers, measured linear extrameatal VS tumor size parallel and perpendicular to the petrous ridge, and as maximum axial and maximum coronal diameter. Inter- and intra-rater reliability were evaluated using the intraclass correlation coefficient (ICC). The repeatability coefficient was computed for each measurement direction. Fleiss' kappa was used to determine the degree of agreement on tumor growth.</p><p><strong>Results: </strong>Reliability between raters was significantly excellent (ICC >0.9) across all measurement directions, with the highest ICC observed for measurements parallel to the petrous ridge (ICC, 0.974; 95% CI, 0.957-0.986). Good or excellent reliability was achieved in 95.8% of all intra-rater measurements, with predominantly higher ICC scores for measurements in the coronal plane. Fleiss' kappa for interrater variability of determining tumor growth was highest and substantial for measurements parallel to the petrous ridge 0.672 (95% CI, 0.546-0.799).</p><p><strong>Conclusion: </strong>Linear measurements of VS parallel to the petrous ridge yield excellent interrater reliability and the most favorable repeatability coefficient. Good to excellent intra-rater reliability across all measurement directions was observed. The most accurately defined tumor growth was obtained comparing measurements parallel to the petrous ridge. We recommend measurements parallel to the petrous ridge as the standard linear method for evaluating VS and growth.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"e278-e284"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Stapedectomy: Does Oval Window Packing Matter?","authors":"Maria A Mavrommatis, Jun Yun, Jennifer Ren, Sunder Gidumal, Maura K Cosetti, Enrique Perez, George B Wanna, Zachary G Schwam","doi":"10.1097/MAO.0000000000004496","DOIUrl":"10.1097/MAO.0000000000004496","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether differences in audiometric outcomes and postoperative vertigo exist among different approaches to oval window packing after endoscopic stapedectomy.</p><p><strong>Study design: </strong>Retrospective chart review.</p><p><strong>Setting: </strong>Academic tertiary care otology-neurotology practice.</p><p><strong>Patients: </strong>Patients who underwent endoscopic stapedectomy from 2017 to 2023.</p><p><strong>Interventions: </strong>Oval window reinforcement was performed with one of five techniques: lobular fat graft, promontory blood patch, both, other autologous patch, or none.</p><p><strong>Main outcome measures: </strong>Our primary outcome measures were subjective postoperative vertigo, change in air-bone gap (ABG; 250-4000 Hz), and air-conduction pure-tone average (PTA; 500/1000/2000/4000 Hz). Patient and surgical variables such as age, sex, laterality, surgeon, primary versus revision surgery, laser versus drill stapedotomy, and prosthesis type and length were secondarily investigated.</p><p><strong>Results: </strong>A total of 256 ears of 220 patients (mean age, 47.8 ± 12.9 yr) were included for analysis: 143 received promontory blood patch; 54, lobular fat graft; 10, both blood patch and fat graft; 2, temporalis fascia or tragal perichondrium; and 47, no reconstruction. There was no difference in incidence of subjective postoperative vertigo between groups at first and most recent follow-up ( p = 0.92 and p = 0.76, respectively). Average improvements in ABG and PTA were not significantly different among groups at first ( p = 0.35 and p = 0.27, respectively) and most recent audiograms ( p = 0.87 and p = 0.99, respectively). Although there were also no significant differences in percentage of patients achieving ABG closure to within 20 or 10 dB at first postoperative audiogram ( p = 0.48 and p = 0.51, respectively), blood patch yielded higher ABG closure to within 10 dB ( p = 0.048), but not within 20 dB ( p = 0.48) at second postoperative visit.</p><p><strong>Conclusions: </strong>Blood patch reconstruction may yield better long-term ABG closure compared with fat graft packing and no reconstruction alternatives to oval window reconstruction after endoscopic stapedectomy.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"748-752"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036423","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":"Anatomical Considerations for Achieving Optimized Outcomes in Individualized Cochlear Implantation.","authors":"Max E Timm, Emilio Avallone, Malena Timm, Rolf B Salcher, Niels Rudnik, Thomas Lenarz, Daniel Schurzig","doi":"10.1097/MAO.0000000000004520","DOIUrl":"10.1097/MAO.0000000000004520","url":null,"abstract":"<p><strong>Hypothesis: </strong>Machine learning models can assist with the selection of electrode arrays required for optimal insertion angles.</p><p><strong>Background: </strong>Cochlea implantation is a successful therapy in patients with severe to profound hearing loss. The effectiveness of a cochlea implant depends on precise insertion and positioning of electrode array within the cochlea, which is known for its variability in shape and size. Preoperative imaging like CT or MRI plays a significant role in evaluating cochlear anatomy and planning the surgical approach to optimize outcomes.</p><p><strong>Methods: </strong>In this study, preoperative and postoperative CT and CBCT data of 558 cochlea-implant patients were analyzed in terms of the influence of anatomical factors and insertion depth onto the resulting insertion angle.</p><p><strong>Conclusions: </strong>Machine learning models can predict insertion depths needed for optimal insertion angles, with performance improving by including cochlear dimensions in the models. A simple linear regression using just the insertion depth explained 88% of variability, whereas adding cochlear length or diameter and width further improved predictions up to 94%.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"e234-e242"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151380","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":"Intelligence Quotient Testing in Children With Cochlear Implantation: A Systematic Review and Meta-Analysis.","authors":"Liliya Benchetrit, Shannon Wu, Diya Ramanathan, Mihika Thapliyal, Suzanne Sutliff, David H Chi, Ksenia Aaron, Jessica R Levi, Patricia Klaas, Samantha Anne","doi":"10.1097/MAO.0000000000004538","DOIUrl":"10.1097/MAO.0000000000004538","url":null,"abstract":"<p><strong>Objectives: </strong>Evaluate intelligence quotient (IQ) scores among children with bilateral hearing loss (HL) pre- and post-cochlear implantation (CI) and compared with normative means.</p><p><strong>Databases reviewed: </strong>PubMed (MEDLINE), Embase, Cochrane, and CINAHL databases searched until December 2021.</p><p><strong>Methods: </strong>Studies of patients 1) 18 years or younger (2) with bilateral sensorineural HL diagnosis who underwent CI, and (3) with ≥1 specific IQ score post-CI were included. Mean differences in IQ scores pre- and post-CI and compared with normal-hearing controls were meta-analyzed. Studies not amenable to meta-analysis were qualitatively analyzed.</p><p><strong>Results: </strong>Included 15 articles (636 patients, 247 age-matched normal-hearing controls), with mean (SD) age in years at CI (4.1 [1.5]) and neurocognitive testing (8.6 [1.6]). Children with HL had significant performance IQ score improvement post-CI (MD, 7.0; 95% confidence interval, 1.95 to 12.05; I2 = 0%), and full-scale IQ scores comparable to normal-hearing group (MD 1.52; 95% confidence interval -4.46 to 7.50; I2 = 0%). Qualitatively, 9 of 12 studies evaluating performance IQ and 5 of 6 studies evaluating full-scale IQ showed mean scores of children with CI comparable to normative means, whereas 5 of 6 studies reported verbal IQ scores lower than normative means.</p><p><strong>Conclusions: </strong>Children with CI show significant improvement in full-scale and performance IQ testing, with a significant proportion achieving normal ranges scores. Verbal IQ scores remain lower than normative means, even after CI, likely due to the reduced access to sound before CI. Earlier implantation and therefore earlier access to sound may help lessen the impact on verbal IQ in these children.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"e257-e268"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226143","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 Modifiable Surgical Factors on Ossiculoplasty Outcomes After Controlling for Ear Environment Risk: A Multi-Institutional Study.","authors":"Ryan T Judd, Michael B Gluth, Richard K Gurgel, John L Dornhoffer, Matthew L Carlson, Brandon Isaacson, Jafri Kuthubutheen, Ng Jia Hui, Mark Quick, Ryan D Anderson, Mark Sakai, Jason H Barnes, Wanda L Fussell","doi":"10.1097/MAO.0000000000004611","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004611","url":null,"abstract":"<p><strong>Objective: </strong>To determine the impact of modifiable surgical factors on ossiculoplasty outcomes after controlling for ear environment risk.</p><p><strong>Study design: </strong>Multi-institutional retrospective review.</p><p><strong>Setting: </strong>Six tertiary care centers from 2011 to 2019.</p><p><strong>Patients: </strong>Adults and children.</p><p><strong>Interventions: </strong>Ossiculoplasty, including synthetic ossicular replacement prosthesis, autograft interposition, bone cement repair, and mobilization.</p><p><strong>Main outcome measure: </strong>Correlation between modifiable surgical factors and pure-tone average air-bone gap (ABG) at most recent audiogram after controlling for preoperative risk using the statistically validated Ear Environment Risk (EER) score.</p><p><strong>Results: </strong>A total of 1,679 cases were included with a median follow-up time of 20 months (IQR, 5-51). After controlling for EER score, malleus engagement of prosthesis yielded favorable ABG versus direct contact to tympanic membrane without malleus engagement (beta = -2.4 dB [-3.8, -1.1], p < 0.001). For total ossicular replacement prostheses (TORP), use of a footplate prosthesis yielded favorable ABG as compared with no footplate prosthesis (-3.6 dB [-6.1, -1.1], p = 0.005). For synthetic prostheses, polyethylene prostheses had a less favorable ABG compared with full titanium or titanium with hydroxyapatite prostheses (p < 0.05). In cases where the malleus was not engaged in reconstruction, amputation of the malleus head yielded worse ABG (+3.9 dB [1.2, 6.7], p = 0.005). There was no significant difference (p > 0.05) in ABG for single-stage versus multistaged approach, use of a cartilage cap over the prosthesis versus no cartilage, use of bone cement to secure a PORP to the stapes versus no cement, mastoid cavity obliteration versus no obliteration, and incudostapedial joint reconstruction with joint prosthesis/bone cement versus synthetic PORP.</p><p><strong>Conclusions: </strong>With statistical correction for ear environment risk, several modifiable surgical factors are noted to impact ossiculoplasty hearing outcomes.</p><p><strong>Level of evidence: </strong>4.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144743844","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":"Intrathecal Gadolinium-Enhanced MR Cisternography Improves the Detection of Skull Base CSF Leaks.","authors":"Douglas J Totten, Nicholas A Koontz, Hunter L Elms, Evan C Cumpston, William Schneider, Cody Whitted, Mark Tann, Kevin T Booth, Kristine M Mosier, Rick F Nelson","doi":"10.1097/MAO.0000000000004601","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004601","url":null,"abstract":"<p><strong>Objective: </strong>To compare the efficacy of contrast enhanced magnetic resonance cisternography (CE-MRC), computed tomography cisternography (CTC), and single-photon emission computed tomography (SPECT-CT) radionuclide cisternography (RNC) in detection of skull base cerebrospinal fluid (CSF) leaks.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Patients: </strong>Adult patients with suspected anterior skull base (ASB) or lateral skull base (LSB) CSF leak who underwent CE-MRC, CTC, and/or SPECT-CT RNC to assess for CSF leak from 2018 to 2024.</p><p><strong>Main outcome measures: </strong>Evidence of CSF leak on single or multiple cisternogram types.</p><p><strong>Results: </strong>Fifty patients (74% female) had a mean (standard deviation) age of 50 (17) years and a median BMI of 34 (IQR, 28-42) kg/m2. Nineteen patients had a surgically or laboratory-confirmed CSF leak. Of these, 78% were spontaneous CSF leaks. There were no false-positive tests for any mode of cisternograms. CT cisternograms had a sensitivity of 53% (ASB: 86%, LSB: 33%) compared with a sensitivity of 90% (ASB: 100%, LSB: 86%) for CE-MR cisternograms and 67% (ASB: 100%, LSB: 33%) for SPECT-CT RN cisternograms.</p><p><strong>Conclusions: </strong>CE-MRC appears to be more sensitive than CTC and SPECT-CT RNC in detecting skull base CSF leaks, particularly in the lateral skull base. CE-MRC should be used when appropriate in combination with high-resolution CT to assess for CSF leaks when there is a high index of suspicion with inconclusive beta-2 transferrin testing.</p><p><strong>Level of evidence: </strong>4.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144743845","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":"Effects of CI Electrode Pullback on Electrophysiology, Audiology, and Postoperative Imaging.","authors":"Gina Mittmann, Philipp Mittmann, Jelena Bevanda, Anne-Marie Demel, Arneborg Ernst, Lenneke Kiefer, Rainer Seidl, Sven Mutze, Leonie Goelz","doi":"10.1097/MAO.0000000000004519","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004519","url":null,"abstract":"<p><strong>Introduction: </strong>The position between the cochlea implant (CI) electrode array and the neural structures is crucial for the audiological outcome in CI surgery. Using the pullback technique, an electrode position closer to the modiolus can be achieved in perimodiolar electrode arrays. An approximation to the modiolus could be demonstrated by improved electrophysiological recordings after finalizing the pullback.</p><p><strong>Methods: </strong>Forty-six patients were implanted with Nucleus Slim perimodiolar electrode arrays (Cochlear Pty, Sydney). After complete insertion of the electrode, a controlled pullback by about 1.5 mm was performed in 20 subjects. Electrophysiological measurements were performed before and after the pullback. Radiological examination was performed on the first day postoperative with flat-panel tomography.</p><p><strong>Results: </strong>Significant lower threshold neural response telemetry data were found between electrodes 7 and 11 after the pullback. Impedances remained unchanged during this procedure. Radiological and audiological examination revealed nonsignificant changes between both groups.</p><p><strong>Discussion: </strong>In this series, a pullback of the CI electrode after full insertion showed an improved electrophysiological pattern of neural response telemetry data intraoperatively. It remains a matter for further studies to correlate those data with long-term audiological outcome data.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675428","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":"Anatomical Relationship of Cochlear Basal Turn and Facial Nerve in Patients With Tip Fold-Over During Cochlear Implantation Using Slim Modiolar Electrode.","authors":"Yeonjoo Choi, Hye Ah Joo, Woo Seok Kang, Joong Ho Ahn, Jong Woo Chung, Hong Ju Park","doi":"10.1097/MAO.0000000000004573","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004573","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the anatomical factors contributing to tip fold-over (TFO) during electrode insertion in cochlear implantation (CI).</p><p><strong>Study design: </strong>Retrospective study.</p><p><strong>Setting: </strong>Tertiary care academic center.</p><p><strong>Patients: </strong>A total of 239 ears underwent CI with Slim Modiolar Electrodes (SME) between August 2018 and December 2023.</p><p><strong>Main outcomes and measures: </strong>Preoperative temporal bone CT scans were analyzed to identify differences between patients with and without TFO. The positional relationship between a horizontal line at the cochlear basal turn and the facial nerve was assessed, and the angle between this horizontal line and the lateral margin of the facial nerve was measured.</p><p><strong>Results: </strong>TFO occurred in 4.2% of cases, requiring an average of 2.7 reinsertion attempts for proper placement. In the TFO group, the horizontal line at the cochlear basal turn was positioned below the facial nerve in 90% of cases, compared with only 11.3% in the non-TFO group (p < 0.001). The mean angle between the cochlear basal turn and the facial nerve was -6.7 degrees (±2.9) in the TFO group and -0.4 degrees (±2.7) in the non-TFO group (p < 0.001).</p><p><strong>Conclusion: </strong>TFO is more likely to occur when the facial nerve is positioned laterally relative to the cochlear basal turn, causing the electrode sheath to prematurely contact the scala tympani floor. These findings highlight a potential anatomical risk factor for TFO, emphasizing the need for tailored surgical strategies in high-risk cases.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675425","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":"Ménière's Disease With a Prior Diagnosis of Idiopathic Sudden Hearing Loss.","authors":"Minerva Rodriguez-Martín, Rocío González-Aguado, Trinidad Dierssen Sotos, Carmelo Morales-Angulo","doi":"10.1097/MAO.0000000000004508","DOIUrl":"10.1097/MAO.0000000000004508","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to determine the percentage of patients with idiopathic sudden hearing loss later diagnosed with Ménière's disease. It also seeks to identify predictive factors for Ménière's diagnosis and compare treatment responses between first-time Ménière's patients and those with idiopathic sudden hearing loss.</p><p><strong>Study design: </strong>A prospective observational study.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Patients: </strong>Cohort of apparently idiopathic sudden hearing loss patients over a period of 30 years (1992-2022).</p><p><strong>Intervention: </strong>Identification of Ménière's disease cases during follow-up.</p><p><strong>Main outcome measure: </strong>Determining how many were subsequently diagnosed with definitive Ménière's disease.</p><p><strong>Results: </strong>From a cohort of 369 patients with apparently idiopathic sudden hearing loss treated over 30 years, 15 (4%) developed definite Ménière's disease.The predictive factors for developing Ménière's disease were mild to moderate hearing loss, vertigo, tinnitus at the initial episode, and a predominantly ascending audiometric curve.When comparing treatment responses, patients with Ménière's disease showed better outcomes than those with idiopathic sudden hearing loss.</p><p><strong>Conclusions: </strong>Cases of sudden sensorineural hearing loss that represent the first episode of definite Ménière's disease are rare. A moderate hearing loss at low frequencies, accompanied by tinnitus and vertigo during an episode of sudden hearing loss, should raise suspicion for Ménière's disease rather than idiopathic sudden hearing loss. Patients with sudden hearing loss secondary to an episode of Ménière's disease tend to show significantly greater hearing improvement compared with those with idiopathic sudden hearing loss.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"680-685"},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049491","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}