Otology & Neurotology最新文献

{"title":"Increased Adrenergic Receptor Expression in Meniere Disease.","authors":"Adam Y Xiao, Achilles Kanaris, Masanori Ishii, Gregory P Lekovic, Ivan A Lopez, Gail Ishiyama, Akira Ishiyama","doi":"10.1097/MAO.0000000000005010","DOIUrl":"10.1097/MAO.0000000000005010","url":null,"abstract":"<p><strong>Hypothesis: </strong>There is increased expression of adrenergic receptors in the vestibular end organs of Meniere disease.</p><p><strong>Background: </strong>Meniere disease (MD) is an inner ear condition characterized by episodic vertigo, hearing loss, tinnitus, and aural fullness. It is believed to be due to an imbalance in inner ear fluid, often leading to hydrops; however, the exact mechanism is unclear. Pupillometry data have suggested a role for autonomic dysfunction, specifically sympathetic hyperactivity, but few studies have investigated the molecular pathways involved in this.</p><p><strong>Methods: </strong>Vestibular end organs from patients undergoing labyrinthectomy for MD (n=6), as well as control specimens (n=3) from patients with vestibular schwannoma undergoing translabyrinthine resection, were collected and processed for RNA in situ hybridization using the RNAscope Multiplex Fluorescent V2 Assay with probes for β 1 -, β 2 -, and α 1a -adrenergic receptors (AR). Positive and negative control experiments were also performed for quality control. Immunofluorescence was used to characterize protein expression of α 1a -AR and to identify vestibular hair cells (VHC) in the sensory epithelium (Myosin VIIa).</p><p><strong>Results: </strong>There is increased expression of α 1a -AR transcripts in MD utricles compared with control. This appears to be concentrated in the sensory epithelium VHC, confirmed with MyoVIIa positivity, although expression can be seen in the stroma as well. This was further confirmed with immunofluorescence, demonstrating increased expression in MD. There is also transcriptional expression of β 2 -AR with no difference between the 2 groups.</p><p><strong>Conclusions: </strong>There are limited molecular studies investigating the pathogenesis of MD, especially those utilizing human surgical tissue. This is the first study to demonstrate increased expression of α 1a -AR both at the transcriptional and protein levels in MD compared with controls. These results may help explain the mechanism behind sympathetic hyperactivity and guide future therapies.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"e1100-e1105"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631162","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":"Cardiovascular and Autonomic Effects of Auricular Vagus Nerve Stimulation in an Anesthetized Rat Model.","authors":"Lohane Moreira Da Costa, Bharadwaj Nandakumar, Allison Oliva, Cameron Herter, Zihan Yan, Fred F Telischi, Xue-Zhong Liu, Jeffrey J Goldberger, Patrick D Ganzer, Vivek V Kanumuri","doi":"10.1097/MAO.0000000000005017","DOIUrl":"10.1097/MAO.0000000000005017","url":null,"abstract":"<p><strong>Hypothesis: </strong>Electrical stimulation of the external ear mediates cardiovascular changes in anesthetized rats.</p><p><strong>Background: </strong>Auricular vagus nerve stimulation (aVNS) has been proposed as a noninvasive treatment for cardiovascular disease. Stimulation is typically achieved via electrodes placed on the external ear, but the exact mechanisms by which aVNS induces cardiovascular changes remains unclear. In particular, the relative contributions of sympathetic and parasympathetic pathways have not been well elucidated. In this study, we use a rodent model to determine the hemodynamic effects of stimulating two auricular regions and assess the autonomic pathways mediating these responses.</p><p><strong>Methods: </strong>Bipolar transcutaneous electrical stimulation was applied to the external ear of adult Sprague-Dawley rats. Cardiovascular parameters including mean arterial pressure (MAP), photoplethysmography (PPG), and cardiac electrical activity were recorded. Cervical vagotomies and hexamethonium sympathetic blockade were performed to assess the parasympathetic and sympathetic contributions to evoked cardiovascular responses.</p><p><strong>Results: </strong>Electrical stimulation at the concha resulted in significant changes in MAP and PPG. MAP changes were larger with stimulation in the concha compared with the anterior pinna. MAP responses increased in a dose-dependent manner with increasing current amplitude. Bilateral vagotomy resulted in persistent but decreased evoked cardiovascular responses. Complete autonomic blockade using intravenous hexamethonium resulted in the absence of any evoked cardiovascular responses with aVNS.</p><p><strong>Conclusion: </strong>Cardiovascular changes from aVNS are mediated by modulation of both parasympathetic and sympathetic activity.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"e1106-e1113"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707434","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":"Round Window Drill-Out in Advanced Otosclerosis.","authors":"Kaitlyn E Aragon, Jeffrey T Vrabec","doi":"10.1097/MAO.0000000000004989","DOIUrl":"10.1097/MAO.0000000000004989","url":null,"abstract":"<p><strong>Objective: </strong>To discuss the effect of round window drill-out for otosclerosis cases with radiographic evidence of round window obliteration.</p><p><strong>Patients: </strong>Four adult patients (5 ears) were included with audiometric findings of a mixed hearing loss and radiographic evidence of otosclerosis causing round window obliteration.</p><p><strong>Interventions: </strong>Round window obliterative disease was addressed with a formal round window drill-out (RWD) by opening the lumen of the basal turn of the cochlea with a micro drill. The opening was then reconstructed with fascia to recreate a 2-window system.</p><p><strong>Main outcome measures: </strong>Feasibility, Δ pure-tone air conduction thresholds, and Δ pure-tone average air-bone gap (PTA-ABG).</p><p><strong>Results: </strong>Three (60%) ears underwent primary or revision stapedectomy with RWD, 1 (20%) ear underwent delayed RWD years after stapedectomy, and 1 (20%) ear underwent RWD without stapedectomy. Median preoperative PTA-ABG was 31.3 dB. One patient (2 ears) had significant benefit with PTA-ABG improvements of 45 dB (left) and 30 dB (right). Two patients (2 ears) had a small improvement in PTA-ABG (2.5 dB, 1.3 dB), whereas 1 patient (1 ear) had worsening in PTA-ABG (2.5 dB).</p><p><strong>Conclusions: </strong>Patients suffering from severe mixed hearing loss due to advanced otosclerosis may benefit from formal RWD to facilitate hearing aid use as an alternative to cochlear implantation.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"e1064-e1068"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148278314","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":"Cochlear Implantation in Sickle Cell Disease: A Systematic Review of Feasibility and Outcomes.","authors":"Jasmine Stewart, Kenny Nguyen, Ajibola B Bakare, Lindsay Blake, Robert Saadi","doi":"10.1097/MAO.0000000000004997","DOIUrl":"10.1097/MAO.0000000000004997","url":null,"abstract":"<p><strong>Introduction: </strong>Sickle cell disease (SCD) is associated with systemic complications, including sensorineural hearing loss (SNHL) from microvascular occlusion and chronic inflammation. Although reports link SCD to higher rates of SNHL, current evidence is limited by small sample size, varied audiologic methods, and lack of standardized screening. This systematic review summarizes available literature on SNHL and cochlear implantation (CI) in SCD.</p><p><strong>Methods: </strong>A literature search of PubMed MEDLINE, Embase, Scopus, Web of Science, and CINAHL identified 79 citations. After removal of duplicates, 35 records were screened in Rayyan. Studies published between January 1, 2000, and June 30, 2025, were eligible if they reported patients with SCD who developed hearing loss and underwent CI. Nine full texts were reviewed, and 4 met the inclusion criteria. Screening and review were performed independently by 2 authors per PRISMA guidelines.</p><p><strong>Results: </strong>Across 4 case reports, a total of 5 patients with SCD underwent CI, ranging in age from 2 to 42 years. Four presented with bilateral severe-to-profound SNHL and one with unilateral loss. Implantation was technically feasible in all cases, including patients with cochlear fibrosis or ossification requiring modified insertion techniques. Postoperative outcomes were favorable: all patients demonstrated reliable device function and low impedances. Only 60% showed meaningful auditory benefit, characterized by improved functional speech perception in 2 patients (40%) and access to the speech frequency range with hearing testing going from moderate/profound hearing loss to mild hearing loss in 3 patients (60%). Complications occurred in 2 patients (40%): one developed unilateral middle ear infection leading to meningitis, and another experienced a postoperative pulmonary embolism requiring anticoagulation. The remaining 3 patients (60%) had uncomplicated recoveries with reported improved hearing from moderate/profound hearing loss to mild hearing loss post implantation.</p><p><strong>Conclusion: </strong>While CI appears feasible in SCD, our findings suggest that additional data are needed to assess its effectiveness in this patient population. However, evidence is limited to case reports, and complications such as thromboembolism and rapid cochlear fibrosis highlight the need for close perioperative management. More comprehensive studies with larger sample size are required to define surgical risk, optimize management, and establish best practices for timely implantation in this population.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"1103-1107"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471992","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":"Intact Bridge Mastoidectomy: A Hybrid Approach as a Middle-Ground Between Intact Canal Wall and Open Cavity Techniques.","authors":"Gi Jung Im, Young-Chan Kim, Soo Jeong Choi, Euyhyun Park, Jiwon Chang, Hak Hyun Jung","doi":"10.1097/MAO.0000000000005001","DOIUrl":"10.1097/MAO.0000000000005001","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the usefulness of intact bridge mastoidectomy (IBM) and compare its postoperative hearing outcomes and tympanic membrane (TM) graft success rates with those of intact canal wall (ICW) and open cavity (OC) mastoidectomy.</p><p><strong>Study design: </strong>Retrospective case review.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Patients: </strong>Three hundred twenty-two adult patients who underwent tympano-mastoidectomy for chronic otitis media with or without cholesteatoma. Patients were classified into 3 surgical groups: ICW (n=185), IBM (n=61), and OC (n=76).</p><p><strong>Interventions: </strong>Therapeutic surgical interventions include intact canal wall mastoidectomy, intact bridge mastoidectomy, and open cavity mastoidectomy.</p><p><strong>Main outcome measures: </strong>Preoperative and postoperative pure-tone averages (PTA), hearing gain, and tympanic membrane (TM) graft success rates.</p><p><strong>Results: </strong>Preoperative PTAs were significantly different among the 3 groups: 42.7±15.9 dB HL (ICW), 54.6±16.0 dB HL (IBM), and 61±26.3 dB HL (OC) ( P <0.001). Significant postoperative hearing gain was observed in the ICW (11.1±9.8 dB HL, P <0.001) and IBM (6.1±12.5 dB HL, P <0.001) groups, but not in the OC group (0.1±15.1 dB HL). TM graft success rates were highly stable across all methods (98.4% for ICW, 95.1% for IBM, and 93.4% for OC). These results demonstrate that the hearing outcomes of IBM naturally position themselves exactly between those of ICW and OC.</p><p><strong>Conclusions: </strong>Intact bridge mastoidectomy (IBM) functions as an effective anatomic and functional middle-ground between ICW and OC. It is a highly useful alternative surgery for difficult cases involving a small antrum, sclerotic mastoid, and intractable infection, as it can successfully eradicate otologic pathologies, restore hearing, and achieve a stable TM graft in a single step.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"1183-1189"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430874","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 Correlation Between the Prognostic Nutritional Index and Sudden Sensorineural Hearing Loss With Comorbid Nonalcoholic Fatty Liver Disease: A Prospective Study.","authors":"Xu Zhang, Maohua Wang, Daoming Bai, Rui Yang, Hanzhang Cao, Zhaojun Wang, Bing Guan, Chunping Yang","doi":"10.1097/MAO.0000000000004987","DOIUrl":"10.1097/MAO.0000000000004987","url":null,"abstract":"<p><strong>Objective: </strong>Sudden sensorineural hearing loss (SSNHL) is a frequent emergency in the field of otolaryngology. A comprehensive analysis of its clinical traits and risk factors is essential for clarifying its pathogenesis and creating effective prevention and treatment methods. The objective of this study was to investigate the correlation between the Prognostic Nutritional Index (PNI) and SSNHL in patients with comorbid nonalcoholic fatty liver disease (NAFLD).</p><p><strong>Methods: </strong>This prospective study enrolled 120 SSNHL patients, who were subsequently divided into an NAFLD group and a non-NAFLD group. Using propensity score matching (PSM), a comparative analysis was conducted on clinical indicators between the two patient groups, including the severity, type, prognosis of SSNHL, and PNI levels.</p><p><strong>Results: </strong>The analyses revealed that, compared with their non-NAFLD counterparts, patients with comorbid NAFLD exhibited significantly lower PNI levels, were older, had abnormal audiometric configurations, more severe hearing loss, and had a weaker prognosis. These variations are statistically remarkable. Across the various types of SSNHL patients, PNI levels progressively decreased as the disease severity progressed ( P < 0.001). However, no remarkable association was observed between PNI and the prognosis of SSNHL.</p><p><strong>Conclusion: </strong>Among individuals with SSNHL, patients with comorbid NAFLD exhibit lower PNI levels, more severe hearing loss, and a weaker prognosis than those without NAFLD. A remarkable correlation was identified between PNI levels and both the severity and type of SSNHL. No significant association was found between PNI and the prognosis of SSNHL.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"1094-1102"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148258997","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":"Intratympanic Application of Betahistine for Menière Disease-An Animal Study on Safety and Diffusion to the Inner Ear.","authors":"Jennifer L Spiegel, Yumai Situ, Omer J Ungar, Karen Lam, Anjutha Selvaraj, Joseph M Chen, Trung N Le","doi":"10.1097/MAO.0000000000005004","DOIUrl":"10.1097/MAO.0000000000005004","url":null,"abstract":"<p><strong>Hypothesis: </strong>Intratympanic (IT) application of betahistine diffuses to the inner ear after 15 minutes of exposure and exhibits no ototoxicity.</p><p><strong>Background: </strong>Management of Menière disease involves oral treatment with betahistine; however, is mitigated by a delayed bioavailability (enteral resorption; first-pass effect). Topical IT administration might achieve higher intracochlear concentration.</p><p><strong>Methods: </strong>Animal study on wild-type rats with different IT-betahistine concentrations: 100 mg/mL, 50 mg/mL, 10 mg/mL, 1 mg/mL, and control (saline). For diffusion (n=18) perilymph was sampled postinjection and tested for betahistine concentration via ultra-high performance liquid chromatography (UHPLC). To assess safety (n=16) each animal was IT-injected every other week for a total of 3 injections to one ear with betahistine and contralateral with saline. Pre- and postinterventional audiometric (otoacoustic emissions; auditory brainstem response, 4 to 32 kHz), and vestibular behavioral testing (forced swim test; beam test) were performed. Cochleae were harvested 2 weeks postinjection for morphologic and histologic processing.</p><p><strong>Results: </strong>UHPLC confirmed dose-dependent diffusion of IT-administered betahistine to the inner ear ( P <0.001). Pre- and postinterventional audiometric thresholds were similar, as well as forced swim and beam test. Morphologic and histologic assessment of cochleae demonstrated integrity of hair cells.</p><p><strong>Conclusion: </strong>This preclinical study demonstrated that IT-administered betahistine diffuses dose-dependently into the inner ear and is safe pertaining to cochlear and vestibular function and inner ear microstructures. Higher intracochlear concentration can be achieved by this route of application. This opens the option for a novel treatment for patients with Menière disease.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"1166-1173"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148422961","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":"Comparative Long-Term Outcomes of Lateral Wall and Slim Modiolar Cochlear Implant Electrodes in Children With Normal Cochlear Anatomy.","authors":"Faisal Zawawi, Afnan F Bukhari, Mohamed Garrada","doi":"10.1097/MAO.0000000000005088","DOIUrl":"10.1097/MAO.0000000000005088","url":null,"abstract":"<p><strong>Background: </strong>Electrode design may influence neural stimulation efficiency, speech outcomes, and long-term stability. While both lateral wall and slim modiolar electrodes are widely used in pediatric cochlear implantation, comparative long-term outcome data in children with normal cochlear anatomy remain limited.</p><p><strong>Methods: </strong>This retrospective comparative study included children with bilateral prelingual severe-to-profound sensorineural hearing loss who underwent cochlear implantation with either a lateral wall electrode (CI522/622) or a slim modiolar electrode (CI532/632) at a tertiary academic center between 2017 and 2021. All children had normal cochlear anatomy and a minimum follow-up of 4 years. Demographic data, surgical details, intraoperative electrophysiologic measures, postoperative audiologic and speech outcomes, data logging, and radiologic assessments were analyzed.</p><p><strong>Results: </strong>A total of 161 ears were included (83 lateral wall, 78 slim modiolar). Mean age at implantation did not differ between groups. The slim modiolar group demonstrated significantly lower intraoperative NRT thresholds and impedance values, higher 4-year speech discrimination scores (75.5% vs. 68.8%; P =0.001), and greater mean daily device use (11.2 vs. 9.7 h; P =0.02). Electrode migration occurred exclusively in the lateral wall group (8.4%), while none was observed in the slim modiolar group. Suspected scalar translocation was uncommon overall but more frequent with lateral wall electrodes (4.8% vs. 1.2%; P =0.02).</p><p><strong>Conclusion: </strong>In children with normal cochlear anatomy, slim modiolar electrodes were associated with superior long-term speech outcomes, lower stimulation requirements, greater device use, and improved intracochlear stability compared with lateral wall electrodes.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081552","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":"Skill Transfer From 3D-Printed Temporal Bone Training to Cadaveric Mastoidectomy: A Randomized Controlled Trial.","authors":"Santiago L Vallejos Riart, Francisco Marques da Silva Neto, Robinson Koji Tsuji, Ricardo Ferreira Bento","doi":"10.1097/MAO.0000000000005074","DOIUrl":"10.1097/MAO.0000000000005074","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether structured precadaveric simulation training using a 3D-printed temporal bone model improves mastoidectomy performance during cadaveric dissection among novice otolaryngology residents.</p><p><strong>Study design: </strong>Prospective randomized controlled trial.</p><p><strong>Setting: </strong>Temporal bone laboratory of a tertiary academic medical center.</p><p><strong>Participants: </strong>Thirty otolaryngology residents without prior mastoidectomy experience.</p><p><strong>Intervention: </strong>Participants were randomized into 2 groups. The intervention group completed a 2-hour structured simulation session using a 3D-printed temporal bone model (Auris-Otobone) before cadaveric dissection, whereas the control group received standard theoretical instruction. All residents subsequently performed a simple cadaveric mastoidectomy under standardized laboratory conditions without instructor assistance.</p><p><strong>Main outcome measures: </strong>Technical performance was assessed using the 25-item Modified Welling Scale by 5 blinded expert otologists. Inter-rater reliability was evaluated using the intraclass correlation coefficient (ICC). Group differences were analyzed using a linear mixed-effects model.</p><p><strong>Results: </strong>Baseline characteristics were comparable between groups except for sex distribution. The intervention group achieved significantly higher global Modified Welling Scale scores than the control group (16.44±2.62 vs. 12.28±2.63), corresponding to a mean difference of 4.16 points (95% CI: 2.68-5.64; P <0.001). Variance analysis showed that most score variability was attributable to differences between residents rather than evaluators, and the adjusted ICC indicated moderate inter-rater agreement (∼0.56).</p><p><strong>Conclusions: </strong>Structured precadaveric simulation training using a 3D-printed temporal bone model was associated with improved mastoidectomy performance among novice otolaryngology residents. These findings suggest that 3D-printed temporal bone models may represent a useful adjunct within otologic simulation curricula, particularly for early technical skill acquisition before cadaveric dissection.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081577","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 VA HEARS Model for Predicting Audiogram Changes in Adults Undergoing Cisplatin Chemoradiotherapy.","authors":"Garnett P McMillan, J Riley DeBacker, Dawn Konrad-Martin","doi":"10.1097/MAO.0000000000005056","DOIUrl":"https://doi.org/10.1097/MAO.0000000000005056","url":null,"abstract":"<p><strong>Objective: </strong>Develop and validate a model for predicting complete audiograms of individual patients that also supports cisplatin-ototoxicity forecasting and early identification using any existing diagnostic and classification criteria.</p><p><strong>Study design: </strong>Prospective observational study.</p><p><strong>Setting: </strong>Veterans Administration hospital cancer ambulatory care.</p><p><strong>Patients: </strong>One hundred thirty-one Veterans undergoing cisplatin chemotherapy or chemoradiation.</p><p><strong>Main outcome measures: </strong>Predicted 0.5 to 8 kHz audiogram thresholds in both ears. Hearing changes were derived from the predicted audiograms using American Speech-Language Hearing Association (ASHA) and Common Terminology Criteria for Adverse Events (CTCAE) criteria.</p><p><strong>Results: </strong>The VA Hearing Loss Evaluation and Risk Screener (VA HEARS) is a Bayesian multivariate linear mixed model trained on cisplatin patient audiograms collected from 2010-2022 and validated with data from 2019-2024. Audiogram thresholds are forecast conditional on the pretreatment audiogram, patient age, and prescribed cisplatin chemoradiation.Each patient had 1 to 8 audiograms measured before, during, and after cancer treatment. Forty-seven percent of patients received concurrent cochlear radiation.Forecasted thresholds achieved average prediction errors of 5.2 to 10.6 dB across frequencies. Ears were accurately diagnosed as having changed hearing with an area under the receiver operating characteristic curves of 0.79 and 0.78 for ASHA and CTCAE grade 1 predictions in validation data. After 280 mg/m² cumulative cisplatin, 8 kHz thresholds increase by an average of 12 dB with concurrent radiation versus 8 dB without.</p><p><strong>Conclusion: </strong>The VA HEARS is the first validated model for forecasting cisplatin-related audiogram changes in adult cancer patients and to output multiple ototoxicity classification criteria simultaneously. This model is intended to personalize pretreatment counseling and guide timely interventions for patients receiving ototoxic medications.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075694","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}