Otology & Neurotology最新文献

{"title":"Factors Associated with Preoperative Patient Expectations in the Cochlear Implant Evaluation Process.","authors":"Christian M Shannon, Joshua E Fabie, Brittany N Hand, Kara C Schvartz-Leyzac, Judy R Dubno, Theodore R McRackan","doi":"10.1097/MAO.0000000000004521","DOIUrl":"10.1097/MAO.0000000000004521","url":null,"abstract":"<p><strong>Objective: </strong>To determine what factors are associated with patients' preoperative expectations of their postimplantation experience with their cochlear implant devices.</p><p><strong>Study design: </strong>A retrospective review of data from a prospectively maintained cochlear implant database was conducted.</p><p><strong>Setting: </strong>Tertiary, academic hospital.</p><p><strong>Patients: </strong>Adult patients who underwent a cochlear implant candidacy evaluation and completed the CIQOL-Expectations validated instrument were included.</p><p><strong>Results: </strong>Age was found to have a weak association with increased expectations in some domains of the CIQOL-Expectations. There were some very weak associations identified between a patient's baseline functional ability and their expectations in the corresponding domain. However, no modifiable variable included in the current analysis was found to have an association with patient expectations.</p><p><strong>Conclusion: </strong>Understanding patient expectations is a critical part of the success of medical interventions such as cochlear implantation. However, they are complex and likely multifactorial, and future studies are needed to look at other potential variables that may contribute to their formation.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"648-653"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038607","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":"Caloric Test, and Qualitative and Quantitative vHIT Analysis in Vestibular Schwannoma.","authors":"Pasqualina Maria Picciotti, Rolando Rolesi, Giorgia Rossi, Angelo Tizio, Bruno Sergi, Jacopo Galli","doi":"10.1097/MAO.0000000000004503","DOIUrl":"10.1097/MAO.0000000000004503","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate relationships and discordant results between caloric testing and video head impulse testing (vHIT) among patients with unilateral vestibular schwannoma (VS), trying to establish if caloric testing and vHIT may provide complementary information on vestibular assessment.</p><p><strong>Study design: </strong>Retrospective case review.</p><p><strong>Setting: </strong>Tertiary care academic center.</p><p><strong>Patients: </strong>218 patients affected by unilateral VS and managed by \"wait and scan\" (WS), microsurgery (MS), or fractionated stereotactic radiotherapy (SRT). The analysis included patients' age, tumor size (KOOS stage), hearing level, facial nerve function, vestibular function, tumor control, and complications.The subjects' vestibular function was assessed evaluating the caloric response, vHIT gains for lateral canals and saccades, with and without gain abnormalities.</p><p><strong>Results: </strong>In the 167 eligible patients, the most common finding was both caloric and vHIT abnormal results (74 patients). In 40 cases, caloric test abnormal response was not associated with ipsilesional vestibular oculomotor reflex (VOR) amplitude alterations. In 53 patients, caloric tests and vHIT showed no abnormalities. In the three groups of patients, the number of compensatory saccadic eye movements after head motion was significantly higher, which were strongly correlated with caloric unilateral weakness (UW). Tumor size was significantly associated with an increase both in caloric UW and VOR asymmetry.</p><p><strong>Conclusion: </strong>Results highlight the importance of an accurate vHIT morphological analysis in the context of patients affected by VS. Indeed, given the relationship between vestibular deficit and number of compensatory saccades, our data further suggest that an increase in the generation of late compensatory saccadic events may reveal a vestibular deficit not adequately characterized by VOR gain analysis. A correct vestibular assessment must include the caloric test and the vHIT including both qualitative and quantitative analysis of the saccades in the presence of a normal VOR gain and normal symmetry.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"e215-e223"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hearing Outcome in Idiopathic Sudden Sensorineural Hearing Loss After COVID-19 Vaccine in Asian Population: A Preliminary Study.","authors":"Pey-Yu Chen, Ting-Chia Young, Che-Yi Lin, Kun-Tai Kang, Chia-Huei Chu, Hsun-Tien Tsai, Hung-Ching Lin","doi":"10.1097/MAO.0000000000004509","DOIUrl":"10.1097/MAO.0000000000004509","url":null,"abstract":"<p><strong>Objective: </strong>To determine the hearing outcomes in patients with sudden sensorineural hearing loss (SSNHL) after exposure to different brands of vaccines against COVID-19.</p><p><strong>Study design: </strong>Cohort study.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Patients: </strong>Patients who met the International Classification of Disease, Tenth Revision code, medications, and procedure criteria for SSNHL in 2021. Patients were classified according to their vaccination status. A total of 128 patients (71 males and 57 females; mean age, 53.9 ± 16.5 yr; range, 7.6-82.1 yr) who met the criteria of idiopathic SSNHL were included.</p><p><strong>Intervention: </strong>Exposure to COVID-19 vaccines in 2021.</p><p><strong>Main outcome measurements: </strong>Hearing outcomes were classified according to the pure-tone audiometry hearing level, including complete recovery (CR), partial recovery (PR), and no recovery (NR). Time to recovery was defined as the point at which the patient achieved CR or PR.</p><p><strong>Results: </strong>Among them, 35, 54, and 39 patients achieved CR, PR, and NR, respectively. The median time to recovery was 22 (interquartile range, 11-37) days. No significant differences were observed in hearing recovery in vaccinated or unvaccinated patients.</p><p><strong>Conclusion: </strong>Our preliminary study failed to show significant differences in hearing recovery among patients with SSNHL regardless of the vaccine exposure status. The administration of COVID-19 vaccines should not be influenced by their potential association with SSNHL, as our findings indicate no significant effect on hearing outcomes. However, as a preliminary study with limited statistical power, future large-scale studies are necessary to validate these results.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"718-724"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991926","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":"Preliminary Outcomes of the 445-nm Blue Light Laser for Stapedotomy.","authors":"Regan C Manayan, Victoria W Huang, James G Naples","doi":"10.1097/MAO.0000000000004539","DOIUrl":"10.1097/MAO.0000000000004539","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy of the 445-nm blue light laser in stapedotomy, compared with the CO 2 laser.</p><p><strong>Patients: </strong>Patients 18 years or older with a history of otosclerosis who underwent stapedotomy with either carbon dioxide (CO 2 ) or blue light (BL) laser from September 2020 to May 2024. Patients who had revision surgery, underwent stapedotomy without the use of CO 2 or BL laser, or were without an available preoperative or postoperative audiogram were excluded.</p><p><strong>Intervention: </strong>Stapedotomy with the 445-nm BL laser.</p><p><strong>Main outcome measure: </strong>Postoperative improvement in air-bone gap (ABG) on audiogram for patients who underwent stapedotomy with BL laser, as compared with those who underwent stapedotomy with CO 2 laser.</p><p><strong>Results: </strong>Thirty-two patients were included in the final cohort, with 16 patients in the CO 2 laser and BL laser groups, respectively. Although there was no significant difference in the postoperative ABG between the CO 2 and BL laser groups (9.1 versus 6.5 dB, p = 0.27), there was a difference in the number of footplate fractures between the CO 2 and TB laser groups, although this neither was significant (0 versus 3 events, p = 0.23) nor impacted hearing status.</p><p><strong>Conclusion: </strong>The BL laser offers comparable closure of the ABG in stapes surgery, as well as a similar safety profile, when compared with the CO 2 laser.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"e207-e209"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031348","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":"Proton Radiotherapy for Unilateral Vestibular Schwannoma-A Histopathological Study.","authors":"Sheng-Chiao Lin, Anbuselvan Dharmarajan, MengYu Zhu, Felipe Santos","doi":"10.1097/MAO.0000000000004532","DOIUrl":"10.1097/MAO.0000000000004532","url":null,"abstract":"","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"e226-e228"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031301","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 Top 100 Cited Articles in Otology and Neurotology and Analysis of Female Authorship.","authors":"Helia Rahimian, Khushi Bhatt, Karen Tawk, Yalda Yazdani, Hamid R Djalilian, Mehdi Abouzari","doi":"10.1097/MAO.0000000000004507","DOIUrl":"10.1097/MAO.0000000000004507","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the increasing number of female trainees in otology and neurotology, women remain underreported in academic medicine. This gender disparity persists in high-impact research, where women are less represented as first and corresponding authors.</p><p><strong>Methods: </strong>The top 100 most-cited articles from Otology & Neurotology (1980-2024) were identified using total citation counts. First and corresponding author gender was determined, and trends in female authorship were analyzed over time.</p><p><strong>Results: </strong>A total of 7,485 Otology & Neurotology articles published between 1980 and 2024 were reviewed and the top 100 cited studies (1.3%) were identified. Women accounted for 29% of first authors and 23% of corresponding authors, with a significant increase in female authorship over time. However, overall representation remains disproportionately low.</p><p><strong>Discussion: </strong>Our study highlights the persistent underrepresentation of women in otology and neurotology research, despite their growing presence in medicine. Additional efforts are needed to promote greater inclusivity in academic literature of otology and neurotology.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"706-717"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037568","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":"Lindsay-Hemenway Syndrome Involving the Horizontal Semicircular Canal: Some Considerations Upon Residual Canal Afferents in BPPV Secondary to an Ipsilateral Acute Unilateral Vestibulopathy.","authors":"Salvatore Martellucci, Pasquale Malara, Giulio Pagliuca, Andrea Castellucci","doi":"10.1097/MAO.0000000000004512","DOIUrl":"10.1097/MAO.0000000000004512","url":null,"abstract":"<p><strong>Objective: </strong>To describe benign paroxysmal positional vertigo (BPPV) involving the horizontal semicircular canal (HSC) after ipsilateral acute unilateral vestibulopathy (AUVP) and to advance some hypotheses on the underlying pathomechanism.</p><p><strong>Study design: </strong>Retrospective case review.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Patients: </strong>A case series of four patients presenting with HSC-BPPV after ipsilateral AUVP with impaired function of the involved canal at the video-head impulse test (vHIT). Ipsilateral sudden sensorineural hearing loss was detected in one case.</p><p><strong>Intervention: </strong>All patients underwent bedside examination and an instrumental audio-vestibular assessment, including pure-tone audiometry, vHIT, and vestibular-evoked myogenic potentials. Three patients underwent bithermal caloric testing (BCT). Brain magnetic resonance imaging scan was performed in all cases. Successful canal repositioning was conducted.</p><p><strong>Main outcome measure: </strong>Clinical presentation with video recording and audio-vestibular findings.</p><p><strong>Results: </strong>Secondary HSC-BPPV was observed from 3 weeks to 8 months after the onset of ipsilateral AUVP. Two cases exhibited an apogeotropic variant, whereas two cases presented with a geotropic form. All BPPV resolved after physical therapy. Instrumental audio-vestibular assessment revealed vestibulo-ocular reflex (VOR) impairment for the affected canal on vHIT in all cases, whereas BCT revealed a borderline normal canal paresis.</p><p><strong>Conclusions: </strong>BPPV after an AUVP can involve the HSC. A reduced VOR gain in the high-frequency domain attributable to a damage of the type I (phasic) afferents does not exclude the occurrence of a BPPV if type II (tonic) afferents are preserved or slightly impaired. Clinicians should not neglect to evaluate for provoking nystagmus in patients with vestibular symptoms and vestibular hypofunction on vHIT.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"693-699"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023153","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":"Outcomes of Primary Acquired Cholesteatoma Managed with Endoscopic-Microscopic Approaches According to EAONO-JOS and SAMEO-ATO Classifications.","authors":"Tyler J Gathman, Huong Dang, Nell Adams, Tajanae Henderson, Manuela Fina","doi":"10.1097/MAO.0000000000004461","DOIUrl":"10.1097/MAO.0000000000004461","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the utility of the European Academy of Otology and Neurotology-Japanese Otological Society (EAONO-JOS) and SAMEO-ATO tympanomastoid surgery classification systems in predicting recidivistic disease in patients with primary acquired cholesteatoma and to compare outcomes between endoscopic and combined approaches.</p><p><strong>Study design: </strong>Retrospective chart review.</p><p><strong>Setting: </strong>Academic teaching hospital.</p><p><strong>Methods: </strong>Eighty-one surgical ears from 77 patients were operated on between 2015 and 2022 by the senior author and fit the inclusion criteria. Surgeries were retrospectively classified according to SAMEO-ATO and EAONO-JOS classifications. Descriptive statistics for staging and demographics were reported. Multivariate analysis was completed to assess the correlation between EAONO-JOS and SAMEO-ATO classification and residual disease with covariates including age. The incidence of residual and recurrent disease was investigated using Kaplan-Meier survival analysis. Patients had a median follow-up of 36.7 months.</p><p><strong>Results: </strong>Based on EAONO-JOS staging, 13.6% of ears were stage I, 65.4% were stage II, 21.0% were stage III, and 0% were stage IV. Exclusive endoscopic approaches (A1Mx, A1M2a, and A1M2b) were performed in 50.6% of all ears, and combined approaches (A4M1a, A4M1b, A4M1a + M2a, and A4M2c) in the remaining 49.4% of ears. Overall residual disease rate was 41.9% (n = 34), while recurrence occurred in 7.4% (n = 6). In Kaplan-Meier analysis, SAMEO-ATO and EAONO staging did not predict residual or recurrent disease. In multivariate analysis, age was correlated with a lower risk of residual disease for each advancing year (HR 0.97, 95% CI = 0.95-0.99, p < 0.01). Compared to combined approaches during primary surgery, exclusive endoscopic approaches were correlated with lower conversion to CWU or CWD mastoidectomy for revision surgery (HR 0.19, 95% CI = 0.05-0.71, p = 0.014).</p><p><strong>Conclusion: </strong>In this cohort of patients with primary acquired cholesteatoma, predominantly EAONO-JOS stage II and III, half were managed with an exclusive transcanal endoscopic approach. Although EAONO-JOS and SAMEO-ATO did not predict recidivism, the classification is an important starting point for maintaining uniformity in collecting outcomes. The study was limited by a small sample size and limited follow-up duration.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"660-667"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586563","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":"Panic Disorder in Patients With Vestibular Dysfunction: A Systematic Review and Meta-analysis.","authors":"Lauren R McCray, Cory H Kim, Shaun A Nguyen, Erin A Harvey, Ted A Meyer","doi":"10.1097/MAO.0000000000004506","DOIUrl":"10.1097/MAO.0000000000004506","url":null,"abstract":"<p><strong>Objective: </strong>To assess the prevalence of panic disorder (PD) among patients with vestibular dysfunction.</p><p><strong>Databases reviewed: </strong>CINAHL, Cochrane Library, PubMed, PsycINFO, and SCOPUS.</p><p><strong>Methods: </strong>Databases were searched from inception through August 2024. Observational studies on PD in adults with vestibular dysfunction were included. Studies of patients without a vestibular disorder diagnosis or vertigo arising from trauma or tumors were excluded. Primary outcome measures included continuous measures (mean), proportions (%), and relative risk (RR) with 95% confidence intervals (CI). Two authors extracted data and discrepancies were resolved with a third party. Level of evidence was evaluated using Oxford Centre for Evidence-Based Medicine criteria. Risk of bias was assessed with Risk Of Bias In Non-randomized Studies-of Exposure for cohort studies and Joanna Briggs Institute criteria for case-control and cross-sectional studies.</p><p><strong>Results: </strong>Ten studies (n = 874) on PD and vestibular disorders were included. The mean age was 49.7 years for the vestibular group and 46.0 years for the control group. Although there were no significant differences in the prevalence of anxiety and depression, there was a significantly higher prevalence of PD (7.4% vs. 2.5%) in patients with vestibular dysfunction than the control population ( p = 0.02). However, the risk of developing PD among patients with vestibular disorders was not significantly higher (RR = 1.9, 95% CI: 0.4-8.1) than the controls.</p><p><strong>Conclusion: </strong>The prevalence of PD in patients with vestibular dysfunction is nearly three times higher than in people without vestibular dysfunction. This evidence suggests otolaryngologists treating this condition should consider screening for PD.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"621-626"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034477","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":"Transmastoid Cerebrospinal Fluid Leak Repair After Retrosigmoid Approach for Resection of Vestibular Schwannoma With Hearing Preservation.","authors":"Alexandra M Loosli, Neil S Patel, Richard K Gurgel, Mana Espahbodi","doi":"10.1097/MAO.0000000000004425","DOIUrl":"10.1097/MAO.0000000000004425","url":null,"abstract":"","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"e229"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034565","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}