Otology & Neurotology最新文献

{"title":"Influence of CT Radiation Dose and Field-of-View on Automatic Morphometry for Cochlear Implant Planning.","authors":"Henner Huflage, Tobias Wech, Kristen Rak, Magnus Schindehuette, Jonas Engert, Stephan Hackenberg, Mirko Pham, Thorsten Alexander Bley, Jan-Peter Grunz, Bjoern Spahn","doi":"10.1097/MAO.0000000000004534","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004534","url":null,"abstract":"<p><strong>Introduction: </strong>In cochlear implantation (CI), precise preoperative cochlear duct length (CDL) and angular insertion depth (AID) measurements are pivotal for individualized electrode carrier selection, since recipients benefit from sufficient cochlear coverage of the electrode carrier, enabling electric stimulation of all crucial frequency bands. Since the quality of temporal bone CT largely depends on acquisition and reconstruction settings and is limited by the technical capabilities of the CT scanner, this study aims to assess how radiation dose and reconstruction field-of-view (FOV) affect automatic cochlear morphometry and electrode contact determination in conventional multislice CT.</p><p><strong>Methods: </strong>Twenty fresh-frozen human petrous bone specimens were examined at three radiation dose levels (40, 20, and 10 mGy) using a multislice CT scanner. Each dataset was reconstructed with three different FOV settings (250, 125, and 50 mm). Preoperative CDL and AID measurements were performed with dedicated otological planning software. Maxed-out dose images (250 mGy) served as standard of reference for comparing the morphometric results.</p><p><strong>Results: </strong>Regardless of the selected combination of dose level and FOV, significant CDL or AID measurement differences were neither ascertained among the individual groups, nor in comparison to the reference scans (all p ≥ 0.05). Likewise, the simulation of all stimulable frequency bandwidths showed no dependency on radiation dose or FOV settings (all p ≥ 0.05).</p><p><strong>Conclusion: </strong>The assessment of cochlear morphometry with conventional multislice CT imaging before CI surgery allowed a radiation dose reduction up to 75% without compromising the accuracy of software-based cochlear analysis. Notably, automatic CDL and AID measurements for surgical planning did not benefit from a smaller reconstruction FOV.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"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":"https://doi.org/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 CO2 laser.</p><p><strong>Patients: </strong>Patients 18 years or older with a history of otosclerosis who underwent stapedotomy with either carbon dioxide (CO2) or blue light (BL) laser from September 2020 to May 2024. Patients who had revision surgery, underwent stapedotomy without the use of CO2 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 CO2 laser.</p><p><strong>Results: </strong>Thirty-two patients were included in the final cohort, with 16 patients in the CO2 laser and BL laser groups, respectively. Although there was no significant difference in the postoperative ABG between the CO2 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 CO2 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 CO2 laser.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-08","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":"Rationale for the Development of a Universal Hearing Metric for Public Consumption: Initiative 1 of the Hearing Health Collaborative.","authors":"Nicholas S Reed, Sahar Assi, Matthew Bush, Matthew L Carlson, Maura Cosetti, Liza Creel, Samuel Gubbels, Richard Gurgel, Meredith Holcomb, Anna M Jilla, Frank R Lin, John P Marinelli, Clarice Myers, Douglas P Sladen, Christopher Spankovich, Sarah Sydlowski, Bevan Yueh, Ashley M Nassiri","doi":"10.1097/MAO.0000000000004523","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004523","url":null,"abstract":"<p><strong>Objective: </strong>Present the rationale for the development of a new, patient-facing vital sign for adult hearing.</p><p><strong>Study design: </strong>Structured A3 process.</p><p><strong>Setting: </strong>Fourteen virtual meetings and two in-person meetings held between May 2021 and June 2022.</p><p><strong>Main outcome measures: </strong>Identification and refinement of a countermeasure to develop and imbed a hearing health vital sign for adult hearing.</p><p><strong>Results: </strong>Through a rigorous, structured A3 process, the Hearing Health Collaborative identified and refined the rationale for and the qualities associated with a public-facing vital sign for adult hearing loss. Specifically, such a vital sign must embody five qualities: simple, accessible, stable, inclusive, and meaningful. These qualities together would ensure that a hearing health vital sign would be useful not only as a screening tool but also as an instrument to guide next steps in workup and potentially treatment.</p><p><strong>Conclusions: </strong>Successful identification and implementation of a hearing metric or \"vital sign\" for the presence of adult hearing loss, using precedent convention of other medical diseases, may help reframe public perceptions surrounding hearing loss, improve awareness and literacy regarding the presence of the disease, and prompt action to seek diagnostic assessment.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008407","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 Sticky Situation: Case Series of Successful Treatment of Glue Ear With Dupilumab.","authors":"Ethan M Kallenberger, Snimarjot Kaur, Brynn E Everist, Gregory A Ator, Selina A Gierer, Andrea F D'Mello","doi":"10.1097/MAO.0000000000004501","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004501","url":null,"abstract":"<p><strong>Objective: </strong>To highlight the efficacy of dupilumab in treating chronic otitis media with effusion (glue ear).</p><p><strong>Patients: </strong>Three patients with chronic otitis media with effusion (OME) refractory to medical and surgical treatment were retrospectively identified. All patients had medical history suggestive of the presence of eosinophilic inflammation.</p><p><strong>Interventions: </strong>Each patient received a 300-mg injection of dupilumab every 4 weeks for a total of three injections.</p><p><strong>Main outcome measures: </strong>Audiometric data, patient-reported incidence of new ear infections, patient-reported symptoms.</p><p><strong>Results: </strong>All patients reported subjective improvement in ear pain, drainage, and hearing loss between 2 weeks and 6 months on dupilumab therapy. In case 1 and case 2, audiograms showed some improvement in hearing loss posttreatment. Case 2 had an unexpected interruption of treatment for 4 weeks and reported return of thick ear drainage and difficulty with hearing.</p><p><strong>Conclusions: </strong>Dupilumab may be a novel, effective, and nonsurgical treatment option for patients with chronic otitis media with effusion and underlying atopic conditions.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036654","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":"https://doi.org/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":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-07","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":"Clinical Evidence on the Influence of Implant Position onto Maximum Output with the Bonebridge Bone Conduction Implant.","authors":"Daniel Schurzig, Rebecca Iseke, Hannes Maier, Nils Kristian Prenzler, Thomas Lenarz, Mohammad Ghoncheh","doi":"10.1097/MAO.0000000000004533","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004533","url":null,"abstract":"<p><strong>Hypothesis: </strong>In bone conduction implantation, the position of the implant influences the audiological benefit of the patient.</p><p><strong>Background: </strong>One way of treating hearing loss is the implantation of bone conduction implants (BCIs), which effectively transmit vibrations through the skull bone to the cochlea given that the implant transducer is securely fixated. Laboratory research on the efficacy of bone conduction sound transmission found that a closer proximity of the transducer to the ipsilateral cochlea yields significantly higher cochlear promontory vibrations and hence, higher stimulation efficacy. Up to now, this finding has not been reproduced using clinical data such as the functional or effective gain.</p><p><strong>Methods: </strong>The present, retrospective study was conducted on a cohort of 28 BCI patients to correlate the implantation site of the BC transducer, derived from clinical postoperative imaging and defined in a standardized coordinate system, with maximum output values that are exclusively based on a novel calculation method only employing clinical audiological data.</p><p><strong>Results: </strong>It could be shown that the efficacy of BCI stimulation is in fact correlated with the transducer distance to the cochlea, and that this correlation is frequency dependent. Furthermore, the longitudinal distance of the transducer and the ipsilateral external auditory canal is negatively correlated with the maximal output while the sagittal distance is not.</p><p><strong>Conclusion: </strong>The present study is hence the first one to clinically demonstrate the significance of BCI placement for maximizing patient benefit, which should be considered during the preoperative planning of bone conduction implantation.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated with 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":"https://doi.org/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":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-02","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":"Image Quality Improvement in MRI of Cochlear Implants and Auditory Brainstem Implants After Metal Artifact Reduction Techniques.","authors":"Arianna Winchester, Justin Cottrell, Emily Kay-Rivest, David Friedmann, Sean McMenomey, J Thomas Roland, Mary Bruno, Mari Hagiwara, Gul Moonis, Daniel Jethanamest","doi":"10.1097/MAO.0000000000004517","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004517","url":null,"abstract":"<p><strong>Objective: </strong>Observe if metal artifact reduction (MAR) techniques applied to magnetic resonance imaging (MRI) performed on patients with cochlear implants (CI) or auditory brainstem implants (ABI) improves image quality.</p><p><strong>Study design: </strong>Retrospective review.</p><p><strong>Setting: </strong>Tertiary care center.</p><p><strong>Patients: </strong>Patients with auditory implants who underwent clinical MRI before and after the application of MAR techniques previously described.</p><p><strong>Interventions: </strong>From September 2022 to March 2023, patients who underwent brain or internal auditory canal (IAC) MRI with and without MAR were identified. Sequences included T1 and T2 weighted with turbo-spin-echo (TSE) correction and fluid-attenuation inversion recovery (FLAIR). Images were analyzed for visualization of intracranial structures by two neuroradiologists.</p><p><strong>Main outcome measures: </strong>Visibility of 14 structures graded on a four-point Likert scale. Average scores per structure and sequence were compared using paired two-tailed t-tests and change in mode score.</p><p><strong>Results: </strong>Ten patients underwent pre- and post-MAR MRI. Six had a unilateral CI, three had a unilateral ABI, and one had an ABI and CI. Three patients had four devices with the internal magnet removed for both scans. All structures had significantly improved visibility on post-MAR scan except ipsilateral parietal and occipital lobes and contralateral inner ear. Mode score increased from 2 to 4 for the ipsilateral occipital lobe and from 3 to 4 for the ipsilateral semicircular canals, brainstem, and cerebellar peduncles. Significant improvement was seen in all sequences except for ipsilateral structures on T1w axial precontrast and contralateral structures on T1w coronal postcontrast. ABIs did not improve as much as CIs because they scored better on the pre-MAR scan.</p><p><strong>Conclusions: </strong>MAR techniques improve image quality for patients with MRI-compatible implants with magnets. Benefits may be more evident in CIs than ABIs.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005082","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":"Evaluating Patient Motivation Behind Device Removal in Cochlear Implant Patients.","authors":"Robert J Macielak, Lisa Zhang, Diana Hallak, Desi P Schoo, Edward E Dodson, Oliver F Adunka, Yin Ren","doi":"10.1097/MAO.0000000000004513","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004513","url":null,"abstract":"<p><strong>Objective: </strong>To assess indications behind cochlear implant (CI) removal without subsequent re-implantation.</p><p><strong>Patients: </strong>Patients who underwent CI explantation between January 2013 and December 2022.</p><p><strong>Interventions: </strong>Explantation of CI device without ipsilateral re-implantation.</p><p><strong>Main outcome measures: </strong>Indications for and audiometric testing before CI explantation.</p><p><strong>Results: </strong>Within a cohort of 743 CI patients, 35 patients (5%) underwent implant revision. A total of 16 patients (2%) underwent explantation without ipsilateral re-implantation (mean age of 51 yr [SD, 23]), and 19 (3%) underwent explantation followed by re-implantation (mean age of 51 yr [SD, 18]). The average time between CI insertion and removal was 56 months (SD, 72). Six explantations (6 of 16 [37.5%]) were due to infectious complications: 2 (13%) did not undergo re-implantation given severe life-threatening comorbidities, 1 (6%) underwent simultaneous contralateral implantation, 1 (6%) experienced insurance barriers preventing re-implantation, and 2 (13%) were lost to follow-up. Ten patients (10 of 16 [62.5%]) underwent device removal for noninfectious indications, including 6 (38%) with non-audiologic symptoms attributed to CI, 3 (19%) who required repeated MRIs and desired avoidance of peri-imaging procedures, and 1 (6%) who had poor audiometric outcomes due to cochlear ossification. Patients who were not re-implanted performed worse on AzBio (35% versus 59%; p = 0.10) and CNC testing (27% versus. 70%; p = 0.02) after initial successful implantation compared with those who did undergo re-implantation.</p><p><strong>Conclusions: </strong>Patients undergo explantation for a variety of reasons, with ill-defined symptoms being the motive in over half of the cases. These desires are compounded by poor postoperative audiometric performance, which likely hinders the patient's desire to undergo re-implantation.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023151","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":"https://doi.org/10.1097/MAO.0000000000004532","url":null,"abstract":"","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-01","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}