Otology & Neurotology最新文献

{"title":"Effects of Customized Web Video-Based Vestibular Rehabilitation for Patients With Vestibular Hypofunction: A Randomized Controlled Study.","authors":"Tomohiko Kamo, Hirofumi Ogihara, Ryozo Tanaka, Masato Azami, Takumi Kato, Reiko Tsunoda, Hiroaki Fushiki","doi":"10.1097/MAO.0000000000004494","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004494","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effects of customized web video-based vestibular rehabilitation in patients with chronic vestibular hypofunction.</p><p><strong>Study design: </strong>This study is a randomized controlled trial.</p><p><strong>Setting: </strong>The dizziness specialty clinic.</p><p><strong>Patients: </strong>The participants were diagnosed with chronic vestibular hypofunction.</p><p><strong>Interventions: </strong>The study used a randomized controlled trial design, in which participants were randomly assigned to either the customized web video-based vestibular rehabilitation or booklet-based vestibular rehabilitation in a 1:1 ratio.</p><p><strong>Main outcome measures: </strong>Patients were assessed at three time points: before-intervention (baseline), post-intervention completion (6 wk), and follow-up (12 wk). The primary outcome was the Dynamic Gait Index (DGI), the secondary outcome was the Dizziness Handicap Inventory (DHI), and tertiary outcomes included other functional and psychological assessments.</p><p><strong>Results: </strong>The baseline characteristics of the patients were comparable between the two groups. Statistical analysis revealed a significant time effect for the DGI score (p < 0.0001). Comparing the post-intervention and follow-up assessments to the baseline assessment, the customized web video-based VR group showed a significant increase in the DGI score. Time × group interaction effects were observed (F = 5.739, p < 0.01). Both groups showed decreased DHI_total scores when comparing the postintervention and follow-up assessments to the baseline assessment. No serious adverse events were reported during intervention period.</p><p><strong>Conclusions: </strong>The present study demonstrated that customized web video-based VR improved DGI compared with booklet-based VR, and the intervention effect was maintained at 6-week follow-up. Additionally, the findings suggested that both interventions improve to a similar extent DHI. Therefore, vestibular rehabilitation with motion visualized by video may be more effective than that with still image by booklet.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753973","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 Impact of Dual-Tasking on the Vestibulo-Ocular Reflex.","authors":"Noa Rozendorn, Itay Avivi, Amit Wolfovitz, Yoav Gimmon","doi":"10.1097/MAO.0000000000004470","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004470","url":null,"abstract":"<p><strong>Objective: </strong>Daily activities often involve performing multiple tasks simultaneously and require stable gait and posture. The vestibular system provides balance control through its reflexes mediated via the vestibulospinal tract and gaze stability mediated via the vestibulo-ocular reflex (VOR), which maintains stable vision during head motion while continuously adapting to environmental changes. Cognitive and motor activities reportedly can adversely affect balance function and vice versa. We hereby investigate how dual cognitive and motor tasks influence the VOR and its adaptability to varying target distances by means of the video head impulse test (vHIT).</p><p><strong>Study design: </strong>Prospective interventional study.</p><p><strong>Setting: </strong>Tertiary academic medical center.</p><p><strong>Patients: </strong>Adults aged 18 to 40 without a history of instability disorders, otologic surgeries, or prior strokes.</p><p><strong>Intervention: </strong>vHIT testing.</p><p><strong>Main outcome measure: </strong>Sixteen participants underwent 14 vHITs under single-task and dual-task (cognitive or motor) conditions with far (1.5 m) and near (15 cm) target distances. Two types of activities were chosen for both the cognitive and motor tasks. The VOR gain and its adaptation, measured as the ratio of near-to-far gain, were assessed. A paired t-test was used to evaluate differences in reflex gain and adaptation between single- and dual-task conditions.</p><p><strong>Results: </strong>There were no significant differences in VOR gain or adaptation between single-task and either cognitive or motor dual-task conditions. Similar reflex gains were observed between dual-task conditions for both far and near targets.</p><p><strong>Conclusions: </strong>Gaze stability mediated by the VOR is a robust function with low sensitivity to external loads, unlike gait and posture balance control.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753590","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 Characteristics in Children With Enlarged Vestibular Aqueduct.","authors":"Punam Patel, William Parkes, Cedric Pritchett, Matt Stewart, Arabinda Choudhari, Rahul Nikam, Jobayer Hossain, Robert O'Reilly, Thierry Morlet","doi":"10.1097/MAO.0000000000004485","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004485","url":null,"abstract":"<p><strong>Objective: </strong>Enlarged vestibular aqueduct (EVA) is the most common radiographic finding in children diagnosed with congenital sensorineural hearing loss (SNHL). Many institutions use the Cincinnati criteria for diagnosis: width ≥2.0 mm at the operculum and/or ≥1.0 mm at the midpoint. Our goals are to expand our understanding of EVA by examining the audiometric and auditory brainstem response (ABR) characteristics of a large population of children with EVA and hearing loss.</p><p><strong>Study design: </strong>Retrospective chart review.</p><p><strong>Setting: </strong>Tertiary-care children's hospital.</p><p><strong>Patients: </strong>All children diagnosed with EVA from 2006 to 2016.</p><p><strong>Interventions: </strong>Diagnostic.</p><p><strong>Main outcome measures: </strong>Vestibular aqueduct measurements were taken at the operculum.</p><p><strong>Results: </strong>One hundred six patients were included (63 females; 60 bilateral EVA). The age of hearing loss diagnosis was significantly younger in patients with bilateral EVA compared with unilateral (0.0 [0-3] yr versus 5.0 [0.9-7.0] yr, p = 0.001). The most common pattern seen on ABR was SNHL-like (57%), followed by large wave I pattern (28.6%), followed by auditory neuropathy spectrum disorder (14.3%). Patients with bilateral EVA were more likely to have progressive hearing loss compared with patients with unilateral EVA (p = 0.001). There was no correlation between EVA size and hearing stability or between EVA size and pure-tone average at the time of diagnosis.</p><p><strong>Conclusion: </strong>There is a wide range of clinical manifestations of EVA, though we found no significant correlation between size and progressiveness or severity. The clinical significance of a large wave I tracing on ABR is not fully understood and warrants further research.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753957","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 Elevated Intracranial Pressure in Lateral Spontaneous Cerebrospinal Fluid (CSF) Leaks.","authors":"Evan C Cumpston, William Zhang, Ritika S Bhadouriya, Douglas J Totten, Charles W Yates, Rick F Nelson","doi":"10.1097/MAO.0000000000004466","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004466","url":null,"abstract":"<p><strong>Objective: </strong>Evaluate postoperative opening pressures (OP) on lumbar puncture (LP) and polysomnogram (PSG) findings in patients who underwent middle cranial fossa (MCF) repair with lateral spontaneous cerebrospinal fluid (sCSF) leaks.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Interventions: </strong>MCF repair of sCSF leak, PSG, and postoperative LP.</p><p><strong>Main outcome measures: </strong>Prevalence of intracranial hypertension (IH; LP OP >25 cm H2O), and of obstructive sleep apnea (OSA) (apnea-hypopnea index [AHI] >5).</p><p><strong>Results: </strong>Seventy-two patients had an average (standard deviation) age of 56.7 (±11.7) years and BMI of 39.0 (±9.9) kg/m2. There were no unilateral recurrent CSF leaks. OP was completed by 39 patients at a mean 155.5 days (±172.3) postop with a mean OP 22.3 cm H2O (±8.3). Only 10 (32%) patients had an LP ≥25 cm H2O, of which 9 were female and 1 male. Papilledema was observed in 1 of 12 patients on retinal exam. Polysomnogram was completed by 35 patients and OSA was observed in 93% of patients with a mean AHI of 25.6 (±35.1). There was a positive correlation between AHI and elevated OP. All patients with an OP>25 cm H2O had an AHI > 15. In the three patients who developed a contralateral leak, the mean OP was 27.5 (±8.8), AHI 16.5 (±2.5), and mean BMI 37.2 (±12.6). In the four patients with a history of anterior and lateral sCSF leak, mean OP was significantly elevated at 28.75 (±2.9) (p = 0.03). In the six patients with a history of bilateral sCSF leaks, mean OP was also significantly elevated at 31.5 (±6.9) (p = 0.03).</p><p><strong>Conclusions: </strong>The prevalence of IH on postoperative LP was 32% in lateral sCSF leak patients and nearly all patients had OSA. There was a positive correlation between AHI and elevated OP. All patients should obtain a PSG and those with an AHI >15, multifocal sCSF leaks, or visual symptoms should also obtain a postoperative LP.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143616638","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 Benefits of Cochlear Implantation in Older Adults With Asymmetric Hearing Loss.","authors":"Heather J Smith, Samira Takkoush, Taylor J Mendenhall, Makenzie L Bramwell, Jason L Steele, Mana Espahbodi, Neil S Patel, Richard K Gurgel","doi":"10.1097/MAO.0000000000004487","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004487","url":null,"abstract":"<p><strong>Objective: </strong>To examine the benefit of cochlear implantation (CI) in older adults with single-sided deafness (SSD) and asymmetric hearing loss (AHL).</p><p><strong>Study design: </strong>Retrospective chart review.</p><p><strong>Setting: </strong>Veterans Affairs Medical Center and tertiary referral center, 2019-2023.</p><p><strong>Patients: </strong>Adults ≥60 years with either SSD or AHL who underwent unilateral CI.</p><p><strong>Interventions: </strong>Cochlear implantation.</p><p><strong>Main outcome measures: </strong>Audiometric testing (preoperative and postoperative pure-tone averages [PTA], sentence and word recognition), presence of hearing-related symptoms, CI utilization.</p><p><strong>Results: </strong>Twelve subjects were identified who underwent CI for SSD or AHL after being determined to obtain limited benefit from an appropriately fitted unilateral hearing aid (mean age 72.6 yr, 91.7% male, 100% White). Mean duration of hearing loss was 13.7 years, and the most common etiology was idiopathic (25%). Subjects were followed for a median length of 9.1 months after implantation. Mean daily CI use was 9.3 hours per day.Preoperatively, median unaided PTAs of the implanted and contralateral ear were 103.1 and 41.3 dB, respectively; median aided AZBio sentence recognition values in quiet were 0.0 and 81.5%, respectively. In the implanted ear with the CI in use, median PTA improved from 103.1 to 28.1 dB (p = 0.002), CNC word scores improved from 0.0 to 42.0% (p = 0.027), CNC phoneme scores improved from 0.0 to 60.0% (p = 0.043), and AZBio improved from 0.0 to 48.0% (p = 0.012). Seventy-five percent preoperatively, compared to 33.3% postoperatively, experienced dizziness (p = 0.063), whereas 83.3 and 33.3% experienced tinnitus (p = 0.375).</p><p><strong>Conclusions: </strong>In this group of older adults with SSD or AHL, CI demonstrated significant benefits in hearing thresholds and speech recognition in the implanted ear. Moreover, the average of 9.3 hours of daily use suggests that patients' CI is tolerated and beneficial in this population.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143616632","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":"Surgical Results of Canalplasty Using a Pedicled Periosteal Flap for External Auditory Canal Cholesteatoma.","authors":"Yukiko Iino, Saori Seki, Tomonori Sugiyama, Saori Kikuchi","doi":"10.1097/MAO.0000000000004486","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004486","url":null,"abstract":"<p><strong>Objective: </strong>We evaluated the outcomes of canalplasty for external auditory canal cholesteatoma (EACC) using an inferior-pedicled periosteal flap to cover the eradicated diseased bone.</p><p><strong>Study design: </strong>Retrospective chart review.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Patients: </strong>Thirty-one ears in 30 patients surgically treated for stages III and IV primary EACC.</p><p><strong>Intervention: </strong>Canalplasty using an inferior-pedicled periosteal flap with or without tympanoplasty.</p><p><strong>Main outcome measures: </strong>Disease recurrence, hearing, and clinical factors influencing the time taken to achieve complete epithelization of the external auditory canal.</p><p><strong>Results: </strong>The 31 ears with EACC required 2 to 40 weeks (mean, 7.8 wk; median, 4 wk) to achieve complete epithelization. After epithelization, 84% of the ears became self-cleaning ear canals without any local treatment. Two patients with renal dysfunction experienced recurrence of EACC in the anterior-superior bony canal wall and needed additional treatment. Younger patients took a significantly shorter time to achieve epithelization than older patients (p < 0.001). Patients with renal dysfunction tended to need longer periods for epithelization than those without renal dysfunction (p = 0.092).</p><p><strong>Conclusion: </strong>Canalplasty for stages III and IV EACC using an inferior-pedicled periosteal flap achieved good postoperative results, with 86% of ears becoming self-cleaning ear canals in a short healing time. Special attention must be paid to the patients with renal dysfunction to create a pedicled flap of sufficient size to cover the bone and maintain a good blood supply.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586474","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":"Efficacy of Image-Guided Percutaneous Endoscopic Ear Surgery: A Novel Augmented Reality-Assisted Minimally Invasive Surgery.","authors":"Masaya Uchida, Yu Matsumoto, Shigefumi Morioka, Ryusuke Hori, Kunio Mizutari","doi":"10.1097/MAO.0000000000004488","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004488","url":null,"abstract":"<p><strong>Objective: </strong>Although transcanal endoscopic ear surgery (TEES) offers benefits of minimal invasion, it is difficult to access certain regions of the temporal bone, often necessitating a switch to more invasive methods, such as mastoidectomy. To overcome these challenges, we developed \"image-guided percutaneous endoscopic ear surgery (IGPEES),\" a novel technique designed to enhance the precision and safety of ear operations by integrating augmented reality (AR) and advanced navigation systems, allowing precise, minimally invasive access to the mastoid antrum and other difficult-to-reach areas. This study aimed to evaluate the efficacy and safety of IGPEES through a retrospective analysis of 11 cases.</p><p><strong>Study design: </strong>Retrospective analysis.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Main outcome measures: </strong>We analyzed the setup time and accuracy for navigation and complication rates of IGPEES.</p><p><strong>Results: </strong>Our results demonstrated that IGPEES reduced setup time and enhanced navigation accuracy compared with conventional surgical navigation systems, with no postoperative complications observed, thereby representing a promising advancement in otologic surgery.</p><p><strong>Conclusion: </strong>The integration of AR into IGPEES facilitates better surgical visualization and precision, potentially transforming standard practices for treating complex ear conditions.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143616630","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":"Modified Push-Through Technique in Bilateral Same-Day Myringoplasty: A Prospective Study.","authors":"Alper Tabaru, Ozgur Yıgıt, Salih Akyel, Zeliha Kapusuz Gencer, Sahin Ogreden, Iskender Bayram","doi":"10.1097/MAO.0000000000004493","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004493","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the efficacy and safety of the modified push-through technique in bilateral same-day myringoplasty for patients with chronic otitis media. Bilateral myringoplasty, while advantageous in terms of cost and recovery time, is often avoided due to the perceived risks, particularly iatrogenic sensorineural hearing loss (SNHL). This study contributes to the limited literature on simultaneous bilateral ear surgeries by assessing surgical outcomes, including graft success rates and postoperative hearing improvement.</p><p><strong>Methods: </strong>A prospective study was conducted on 50 patients (100 ears) undergoing bilateral same-day myringoplasty at a tertiary care center. The modified push-through technique was employed for all surgeries. Postoperative follow-up was carried out at 1, 3, and 6 months, with evaluations including otomicroscopy and audiometric testing. The primary outcome was graft take rate, and secondary outcomes included air-bone gap (ABG) reduction and incidence of SNHL.</p><p><strong>Results: </strong>The study demonstrated a graft success rate of 94% across the 100 operated ears. Postoperative audiometry revealed significant improvement in hearing, with the ABG reduced from a preoperative mean of 20 dB to a postoperative mean of 10 dB (p < 0.001). No cases of SNHL were observed.</p><p><strong>Conclusion: </strong>Bilateral same-day myringoplasty using the modified push-through technique is a viable surgical option for patients with chronic otitis media, offering high graft success rates and significant hearing improvement without increasing the risk of SNHL. This technique could be considered a preferred approach in suitable patients, potentially reducing the need for multiple surgical interventions and associated healthcare costs.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143616635","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":"https://doi.org/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":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-03","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":"Long-Term Results of Cochlear Implantation in Single-Sided Deaf Patients: Influence of Duration of Deafness and Age at Onset of Deafness.","authors":"Clemens Honeder, Anselm J Gadenstaetter, Rudolfs Liepins, Alice B Auinger, Dominik Riss, Christoph Arnoldner, Valerie Dahm","doi":"10.1097/MAO.0000000000004419","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004419","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the current study was to investigate the influence of duration, time point, and etiology of deafness on cochlear implant user rates, and to investigate the long-term hearing performance in single-sided deaf patients.</p><p><strong>Study design: </strong>Retrospective study.</p><p><strong>Setting: </strong>Tertiary care hospital.</p><p><strong>Patients: </strong>77 subjects with single-sided deafness.</p><p><strong>Intervention: </strong>Unilateral cochlear implantation between 2009 and 2022.</p><p><strong>Main outcome measures: </strong>Patients were categorized into users and nonusers. Duration of deafness, onset of deafness, etiology, and further demographic data were collected. Pure tone audiometry, Freiburg numbers, and monosyllables test were carried out at activation, as well as 1 year, 2 to 3 years, and 5 years after cochlear implant activation.</p><p><strong>Results: </strong>Most patients who lost their hearing after the age of 10 years were cochlear implant users, while patients who lost their hearing earlier and were implanted with a significant delay were likely nonusers. Even patients implanted more than 10 years after the hearing loss regularly used the cochlear implant, if deafness occurred at the age of 10 years or later. Implanted patients showed an improvement of hearing from activation to 1 year postoperatively as well as stable hearing thresholds for 5 years.</p><p><strong>Conclusions: </strong>The timing of hearing loss influences cochlear implant user rates. Patients who acquired single-sided deafness above the age of 10 years use the device regularly even if the duration of deafness was more than 10 years. This challenges the 10-year cutoff for cochlear implant indication. Furthermore, results show good long-term hearing thresholds and speech understanding for cochlear implant patients who use their device regularly.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":"46 3","pages":"279-286"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416962","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}