Otology & Neurotology最新文献

{"title":"Tumor-to-Tumor Metastasis Involving Vestibular Schwannoma: Case Report and Literature Review.","authors":"Patrick R Toyota, Celine D Hounjet, Eva Liu, Joel D Scott, Roland N Auer, Stephen Yip, Amit Rl Persad, Luke Hnenny","doi":"10.1097/MAO.0000000000004977","DOIUrl":"10.1097/MAO.0000000000004977","url":null,"abstract":"<p><strong>Objective: </strong>To present a case of tumor-to-tumor metastasis involving vestibular schwannoma and review previously reported cases, with focus on histopathologic and immunohistochemical characteristics.</p><p><strong>Patients: </strong>Case report of a 55-year-old female with a history of invasive ductal breast carcinoma who presented with unilateral hearing loss and gait disturbance.</p><p><strong>Interventions: </strong>MRI demonstrated a right-sided extra-axial cerebellopontine angle lesion. Patient underwent surgical resection with histopathologic and immunohistochemical profiling of the tumor.</p><p><strong>Main outcome measures: </strong>A near-total resection was achieved. Microscopic analysis demonstrated vestibular schwannoma with nests of glandular elements. Immunohistochemical staining confirmed metastasis of her known invasive ductal carcinoma to vestibular schwannoma. Subsequent staging imaging showed advanced oncologic spread.</p><p><strong>Conclusions: </strong>Including the present case, there have been 11 reports of tumor-to-tumor metastasis involving vestibular schwannoma. The risk of tumor-to-tumor metastasis should be considered in patients with concomitant systemic malignancy and vestibular schwannoma. Cell-cell adhesion mechanisms may facilitate the spread of breast cancer to vestibular schwannoma. Further reports may help to better understand vestibular schwannoma by analyzing its interaction with other oncologic entities.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"e1094-e1099"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148227386","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 Involvement in Inflammatory Bowel Disease: Clinical Predictors and Prognostic Implications.","authors":"Kaori Mohri, Taro Fujikawa, Toshimitsu Fujii, Akihiro Hirakawa, Koichiro Wasano, Mitsutaka Sawada, Yoshiyuki Kawashima, Taku Ito, Takeshi Tsutsumi","doi":"10.1097/MAO.0000000000004985","DOIUrl":"10.1097/MAO.0000000000004985","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the prevalence, characteristics, and clinical significance of hearing loss as an extraintestinal manifestation (EIM) in patients with inflammatory bowel disease (IBD).</p><p><strong>Study design: </strong>Cross-sectional observational study.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Patients: </strong>A total of 281 patients with ulcerative colitis (UC) or Crohn disease in remission and 10,681 controls with normal hearing for comparison.</p><p><strong>Main outcome measures: </strong>Questionnaires were used to assess auditory and vestibular symptoms, and pure-tone audiometry was also assessed. Predictors of hearing loss were examined using multivariate logistic regression. Intestinal prognosis was evaluated using Kaplan-Meier survival analysis.</p><p><strong>Results: </strong>Fifty-one patients (19%) reported subjective hearing loss, 57 (21%) reported tinnitus, and 76 (28%) experienced dizziness. Sensorineural hearing loss was identified in 92 patients (33%), beginning with a subtle (<10 dB) low-frequency threshold elevation as early as in the 20s, progressing across all frequencies with age ( P <0.001), and becoming evident in the 60s. Multivariate analysis identified male sex [odds ratio: 2.19 (95% CI: 1.26-3.80); P =0.005], UC diagnosis [1.94 (1.08-3.46); P =0.026], longer disease duration [1.04 (1.01-1.07); P =0.022], and a negative C-reactive protein/albumin ratio [0.51 (0.26-1.00); P =0.049] as independent predictors of hearing loss. Hearing loss was not associated with intestinal relapse during 50 months of follow-up ( P =0.832).</p><p><strong>Conclusions: </strong>Hearing loss is one of the most common EIMs and may develop from early adulthood despite intestinal disease remission. Early identification of subclinical hearing loss is warranted to prevent more significant hearing impairment.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"1087-1093"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295947","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 Role of Total Transcanal Endoscopic Modified Radical Mastoidectomy in Extensive Mastoid Cholesteatoma: A Preliminary Report.","authors":"Tengku Mohamed Izam Tengku Kamalden, Guhan Kumarasamy, Khairunnisak Misron","doi":"10.1097/MAO.0000000000005014","DOIUrl":"10.1097/MAO.0000000000005014","url":null,"abstract":"<p><strong>Introduction: </strong>Mastoid cholesteatoma is classically managed through a postauricular mastoidectomy approach. With the increasing use of endoscopic techniques in otologic surgery, various middle ear diseases can now be managed endoscopically. Modified radical mastoidectomy (MRM) still has a role in managing extensive mastoid cholesteatoma.</p><p><strong>Objectives: </strong>To evaluate the feasibility of total transcanal endoscopic modified radical mastoidectomy (TTEMRM) for mastoid cholesteatoma at a single tertiary center.</p><p><strong>Methods: </strong>This 5-year retrospective review included 16 patients involving 17 operated ears with extensive cholesteatoma involving the middle ear and mastoid cavity, as demonstrated on preoperative high-resolution computed tomography of the temporal bone. All patients underwent TTEMRM under general anesthesia between January 2019 and December 2023.</p><p><strong>Results: </strong>Complete removal of mastoid cholesteatoma was achieved by lowering the posterior canal wall through the TTEMRM approach. Two cases developed delayed-onset facial nerve paresis, both of which resolved completely with conservative management. No evidence of recurrence was observed in all but 2 cases. Two cases required revision surgery through a postauricular mastoidectomy approach because of recurrent cholesteatoma. Four cases were lost to follow-up.</p><p><strong>Conclusion: </strong>TTEMRM appears to be a useful technique for selected cases of extensive mastoid cholesteatoma requiring an open-cavity approach. Avoidance of an external incision and excellent visualization of the surgical field are among the advantages of this procedure.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"e1114-e1118"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631100","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":"Prognostic Factors in Cochlear Implant in Otosclerosis: Radiologic and Clinical Variables: Cochlear Implant Predictors in Otosclerosis.","authors":"Giulia Zambonini, Sara Ghiselli, Giuseppe Di Trapani, Daria Salsi, Domenico Cuda","doi":"10.1097/MAO.0000000000005008","DOIUrl":"10.1097/MAO.0000000000005008","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to determine whether radiologic and clinical data can predict the cochlear implant (CI) benefit in patients with otosclerosis, with a focus on the prognostic value of computed tomography (CT) features and relevant clinical variables.</p><p><strong>Methods: </strong>A retrospective single-centre analysis was conducted on 126 otosclerotic patients (143 implanted ears) who underwent CI between 2009 and May 2025. Preoperative and postoperative CT scans were reviewed and classified using established grading systems (Symons/Fanning, Rotteveel, Veillon). Clinical variables included age at implantation, duration of hearing loss (HL), preoperative audiometric thresholds, history of stapes surgery, electrode design, and scala of insertion. Audiological outcomes were evaluated at 12 months postactivation using aided pure tone average and aided speech perception score. Univariate and multivariate statistical analyses were performed.</p><p><strong>Results: </strong>No significant correlation was found between CT-based otosclerosis staging or radiologic features and post-CI audiological outcomes. Multivariate analysis identified increased age at implantation, electrode insertion into the scala vestibuli, and use of straight electrodes as predictors of poorer speech perception. A longer duration of HL also negatively impacted outcomes. Precurved electrodes and scala tympani placement were associated with superior results. Previous successful stapes surgery predicted better performance.</p><p><strong>Conclusions: </strong>While CI provides effective auditory rehabilitation in otosclerotic patients, radiologic CT staging does not predict functional outcomes. Instead, clinical factors-age, duration of HL, electrode design, and array placement-are more influential. Preoperative CT remains essential for surgical planning, but patient counselling should focus on clinical history and procedural details.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"1079-1086"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13566390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148689609","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":"Quality of Tinnitus Information From Generative AI Systems and Web Search: An Expert‑Rated Comparative Study.","authors":"Sholem Hack, Idit Tessler, David Saltz, Daor Hayu, James A Henry, Gladys Sanda, Tomer Boldes, Amit Wolfovitz, David L Horn, Habib G Zalzal, Ksenia A Aaron","doi":"10.1097/MAO.0000000000005015","DOIUrl":"10.1097/MAO.0000000000005015","url":null,"abstract":"<p><strong>Objective: </strong>To compare the quality of tinnitus-related information generated by multiple generative artificial intelligence (GenAI) systems and web search using expert evaluation.</p><p><strong>Study design: </strong>Cross-sectional comparative study.</p><p><strong>Setting: </strong>Digital platforms evaluated in their native public interfaces.</p><p><strong>Patients: </strong>Not applicable. Thirty commonly searched tinnitus-related questions derived from United States Google Trends data (2020-2025).</p><p><strong>Interventions: </strong>Questions were submitted to 6 GenAI systems (OpenEvidence, Claude, DeepSeek, GPT-5, Gemini, GPT-4) and Google Search (first organic result). Responses were independently rated by 6 experts using the QAMAI framework.</p><p><strong>Main outcome measures: </strong>Mean expert-rated quality scores across 5 domains (accuracy, clarity, relevance, completeness, and usefulness).</p><p><strong>Results: </strong>Overall quality differed significantly across systems (Friedman P <0.001; Kendall W=0.34). OpenEvidence achieved the highest mean score (4.45±0.72; 95% CI: 4.40-4.49), followed by Claude (4.00±1.02), DeepSeek (3.92±1.13), GPT-4 (3.89±0.84), Gemini (3.62±0.98), and GPT-5 (3.30±1.11). Google Search scored lowest (2.27±1.12; 95% CI: 2.20-2.35). Completeness was the lowest-performing domain across systems (range: 1.70-4.41). Pairwise comparisons showed significant differences between OpenEvidence and all other systems (effect size r =0.49-0.86). Inter-rater reliability was high (ICC=0.82). Readability demonstrated an inverse pattern relative to expert-rated quality. OpenEvidence demonstrated the lowest readability (Flesch-Kincaid Grade Level 17.5; Flesch Reading Ease 2.2), corresponding to a postgraduate reading level, whereas general-purpose LLMs produced more accessible responses at a sixth-seventh grade reading level.</p><p><strong>Conclusions: </strong>The quality of tinnitus information varies substantially across digital platforms. While GenAI systems generally outperform web search, deficiencies in completeness persist. Readability analysis revealed an inverse relationship between expert-rated quality and response accessibility, suggesting that clinician and patient assessments of informational value may not always align. These findings highlight the need for continued evaluation and clinician oversight to ensure safe, comprehensive, and accessible patient-facing information.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"1196-1204"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520772","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":"Prevalence of Intraoperative Superior Semicircular Canal Dehiscence in Spontaneous Cerebrospinal Fluid Leak Patients.","authors":"Mikayla G Hubbard, Douglas J Totten, Hunter L Elms, Kelli L McCurdy, Charles W Yates, Evan C Cumpston, Rick F Nelson","doi":"10.1097/MAO.0000000000005012","DOIUrl":"10.1097/MAO.0000000000005012","url":null,"abstract":"<p><strong>Objective: </strong>Determine superior semicircular canal dehiscence (SSCD) prevalence in lateral spontaneous cerebrospinal fluid leak (sCSFL) patients and assess the predictive value of CT in identifying SSCD.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Patients: </strong>sCSFL patients surgically treated between January 2015 and July 2025.</p><p><strong>Interventions: </strong>Preoperative high-resolution CT and middle fossa craniotomy (MCF) skull base repair.</p><p><strong>Main outcome measures: </strong>Preoperative CT prevalence of near-dehiscence or definite SSCD and intraoperative near-dehiscence (\"blue-lined\") or definitive SSCD.</p><p><strong>Results: </strong>One hundred eighty-two MCF repairs were performed on 161 patients (66.0% female). Intraoperative SSCD (7.1%) and \"blue-lined\" near-dehiscence (9.9%) were both present at lower rates than expected based on CT findings (13.1% SSCD, 12.6% near-dehiscence). Compared with patients with a nondehiscent superior canal intraoperatively, those patients with SSCD or near-dehiscence showed no significant differences in mean±standard deviation age (55.0±10.0 vs. 58.2±12.9 y), BMI (38.9±8.6 vs. 39.3±7.5 kg/m 2 ), AHI (28.7±33.7 vs. 32.2±34.6 events/h), or opening pressure (24.0±10.4 vs. 22.6±7.4 cm H 2 O). Patients with intraoperative SSCD or near-dehiscence were more likely to report preoperative dizziness (OR=4.97, 95% CI=1.71-13.05, P =0.001). CT demonstrated 80.6% sensitivity, 85.4% specificity, 53.1% PPV, and 95.6% NPV for detecting SSCD or near-dehiscent findings.</p><p><strong>Conclusions: </strong>The intraoperative prevalence of SSCD and near-dehiscence (17%) in sCSFL patients was substantially higher than the general population, yet significantly lower than rates predicted by preoperative CT. Obesity, sleep apnea, and intracranial pressure do not predict intraoperative SSCD in this cohort. CT should guide the need for intraoperative confirmation of SSCD in patients with sCSFLs.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"1144-1150"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148456326","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":"Robotic Insertion of Cochlear Implants and Vestibular Function in Children.","authors":"Enrica Fabiano, Baptiste Grenier, Marine Parodi, Daniele De Seta, Isabelle Rouillon, Vincent Couloigner, François Simon, Natalie Loundon","doi":"10.1097/MAO.0000000000005000","DOIUrl":"10.1097/MAO.0000000000005000","url":null,"abstract":"<p><strong>Objectives: </strong>To analyze the impact of robotic-assisted electrode array insertion on vestibular function after cochlear implantation (CI) in children.</p><p><strong>Methods: </strong>This single-center retrospective study included 80 ears from pediatric patients who underwent CI: 42 in the robotic-assisted group (2021-2024) and 38 in the manual group (2015-2020). All surgeries were performed by the same surgeon. Vestibular function was assessed preoperatively and postoperatively using objective tests, including cervical vestibular evoked myogenic potentials (cVEMP) and video head impulse test (vHIT). Subpopulations were defined based on the availability of complete vestibular data: 68 ears were included in the cVEMP analysis and 74 in the vHIT analysis. Statistical analysis was performed using the Fisher exact test and the Wilcoxon rank-sum test.</p><p><strong>Results: </strong>Overall mean age at CI was 56±51 months and post-CI vestibular assessment was performed at a mean delay of 18±13 months. In the robotic group, 100% of the sample (n=36) preserved saccular function (cVEMP), compared with 85% (n=27/32) in the manual group ( P =0.02). vHIT analysis revealed no statistically significant differences between groups in canal function preservation; 92% (n=36/39) of the robotic group and 100% (n=35/35) of the manual group maintained normal canal responses postoperatively. Per-canal delta-gain analysis for vHIT showed no significant changes for any canal (anterior: P =0.75; lateral: P =0.06; posterior: P =0.92).</p><p><strong>Conclusions: </strong>Robotic-assisted electrode array insertion had significantly higher post-CI cVEMP preservation compared with manual techniques after pediatric cochlear implantation. This may suggest that robotic slow electrode array insertion is less traumatic for the vestibule and helps preserve saccular function.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"e1080-e1086"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13566405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430894","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":"Quality of Life in Patients With Vestibular Schwannoma Treated With the Retrolabyrinthine Approach.","authors":"Takeshi Wakabayashi, Yutaro Mokudai, Marie N Shimanuki, Makoto Hosoya, Takanori Nishiyama, Hiroyuki Ozawa, Naoki Oishi","doi":"10.1097/MAO.0000000000005025","DOIUrl":"10.1097/MAO.0000000000005025","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the factors affecting postoperative quality of life (QOL) and its longitudinal changes in patients undergoing vestibular schwannoma resection through the retrolabyrinthine approach (RLA).</p><p><strong>Study design: </strong>Retrospective case review.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Patients: </strong>Fifty-nine patients who underwent RLA for vestibular schwannoma between March 2016 and November 2022 and completed the Penn Acoustic Neuroma Quality of Life (PANQOL) questionnaire preoperatively and at least once at ≥6 months postoperatively. Patients were categorized into hearing preservation (n=37), hearing deterioration (n=19), and preoperative deafness (n=3) groups.</p><p><strong>Intervention: </strong>Surgical resection of vestibular schwannoma through RLA with the intent of preserving hearing.</p><p><strong>Main outcome measures: </strong>Changes in PANQOL composite and subdomain scores over time.</p><p><strong>Results: </strong>Total PANQOL scores remained stable postoperatively (mean scores: 69.7 preoperative, 72.3 at 6 mo, 76.4 at 1 y, and 75.1 at 2 y). Anxiety scores significantly improved after surgery. At 6 months postoperatively, hearing and balance scores were significantly lower in the hearing deterioration group compared with the hearing preservation group, though differences diminished by 1 and 2 years. Energy scores tended to be higher in the hearing preservation group.</p><p><strong>Conclusions: </strong>RLA contributes to maintaining or improving postoperative QOL. Hearing preservation supports not only auditory function but also emotional and social well-being.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"1151-1158"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670079","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":"Differentiating Ménière Disease and Vestibular Migraine: A Prospective MRI Study of Endolymphatic Hydrops.","authors":"Carolanne Gagnon, Laurent Letourneau, Issam Saliba","doi":"10.1097/MAO.0000000000005003","DOIUrl":"10.1097/MAO.0000000000005003","url":null,"abstract":"<p><strong>Objectives: </strong>The advancement of high-resolution magnetic resonance imaging (MRI) has enabled clinicians to detect endolymphatic hydrops, thereby prompting interest in distinguishing between Ménière disease (MD) and vestibular migraine (VM) in patients presenting with vertigo, headache, hearing loss, ear fullness, and tinnitus. The aim of this study is to compare cochlear and vestibular endolymphatic hydrops in diagnosing VM, MD, and vestibular migraine with Ménière disease (VMMD).</p><p><strong>Method: </strong>A prospective clinical study evaluating patients with episodic vertigo meeting criteria for either MD, VM, or both was conducted between July 2019 and December 2021. All patients underwent an MRI to assess hydrops in both ears. Treatment response was evaluated and considered the gold standard for diagnosis.</p><p><strong>Results: </strong>A total of 231 patients were included. The gold standard diagnosis was determined based on treatment response over at least 2 years. For MD, regardless of definite or probable diagnosis, grade I hydrops was most common for the cochlea (59.6%) and grade II for the vestibule (50.6%). No cochlear or vestibular hydrops were identified in 58.0% and 50.7% of VM cases, respectively. Grade I hydrops predominated in VM (cochlear: 39.1%; vestibular: 39.1%). Our study revealed statistically significant differences between the final diagnoses of MD, VM, and VMMD and the severity grading of vestibular and cochlear hydrops.</p><p><strong>Conclusion: </strong>Endolymphatic hydrops and its severity grading are associated with MD. More than 50% of VM patients demonstrated no evidence of hydrops. However, it is important to recognize that when hydrops is present in VM patients, it is most often mild.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"1137-1143"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148456315","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 Wait and Scan Protocol for Asymptomatic Postsurgical Cholesteatoma Recurrence: A Novel Management Strategy.","authors":"David Kiderman, Daniel Goldstein, Meital Adi, Elchanan Zloczower, Udi Katzenell","doi":"10.1097/MAO.0000000000005022","DOIUrl":"10.1097/MAO.0000000000005022","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the feasibility and safety of active MRI surveillance as an alternative to immediate surgical re-exploration in patients with small, asymptomatic postoperative cholesteatoma recurrence.</p><p><strong>Study design: </strong>Prospective single-arm pilot study.</p><p><strong>Setting: </strong>Secondary referral otology center.</p><p><strong>Patients: </strong>Patients with prior cholesteatoma surgery demonstrating postoperative recurrence ≤5 mm on non-echo-planar diffusion-weighted MRI without otologic symptoms, suspicious findings on otoscopy for cholesteatoma, or radiologic proximity to critical structures.</p><p><strong>Intervention: </strong>Structured active surveillance with serial non-echo-planar diffusion-weighted MRI scans at 12- to 18-month intervals.</p><p><strong>Main outcome measures: </strong>Surgery-free survival (SFS) is defined as the time from baseline MRI demonstrating recurrence to surgical intervention. The secondary outcome included the annual lesion growth rate.</p><p><strong>Results: </strong>Thirteen patients were included in the longitudinal analysis with a mean follow-up of 43±17 months. Ten patients (77%) remained surgery-free throughout the surveillance. Three patients (23%) required surgical intervention due to lesion enlargement or symptom development. The mean lesion growth rate was 0.32±1.0 mm/year. Three patients (23%) demonstrated spontaneous radiologic regression during follow-up. Kaplan-Meier analysis demonstrated cumulative SFS of 100% at 24 months and 91% (95% CI: 74-100) at 36 months.</p><p><strong>Conclusions: </strong>In selected patients with small, asymptomatic postoperative cholesteatoma recurrence, active MRI surveillance may safely defer surgical re-exploration. These findings support further prospective evaluation of imaging-guided surveillance strategies for the management of MRI-detected recurrence.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"1190-1195"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148713389","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}