Otology & Neurotology最新文献

{"title":"OCCLUSAL SPLINTS AS A THERAPEUTIC OPTION FOR PATIENTS WITH TEMPOROMANDIBULAR JOINT DISORDERS AND MENIÈRE'S DISEASE.","authors":"Karen Tawk, Ryka Vahidi, Avissa Khoshsar, Madeleine Chao, Mehdi Abouzari, Hamid R Djalilian","doi":"10.1097/MAO.0000000000004296","DOIUrl":"10.1097/MAO.0000000000004296","url":null,"abstract":"","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142056233","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":"Protective Effects of Gastrodin Against Gentamicin-Induced Vestibular Damage by the Notch Signaling Pathway.","authors":"Wen Jiang,Feifan Li,Handong Xu,Maorong Cao,Bin Xiao,Ke Gong,Jingyu Ma,Weiguo Zhang,Xuxia Tang,Fenye Liu,Shudong Yu","doi":"10.1097/mao.0000000000004250","DOIUrl":"https://doi.org/10.1097/mao.0000000000004250","url":null,"abstract":"PURPOSEGentamicin is a broad-spectrum antibiotic commonly used in clinical practice. However, the drug causes side effects of ototoxicity, leading to disruption in balance functionality. This study investigated the effect of gastrodin, a prominent compound present in Gastrodia, and the underlying mechanism on the development of gentamicin-induced vestibular dysfunction.METHODSWild-type C57BL/6 mice were randomly assigned to three groups: control, gentamicin, and gentamicin + gastrodin groups. The extent of gentamicin-induced vestibular impairment was assessed through a series of tests including the swimming test, contact righting reflex test, and air-righting reflex. Alterations in vestibular hair cells were monitored through immunofluorescence assay, and cellular apoptosis was observed using TUNEL staining. The mRNA and protein expression of Notch1, Jagged1, and Hes1 was quantified through qRT-PCR, immunofluorescence, and western blot analyses.RESULTSGentamicin treatment led to pronounced deficits in vestibular function and otolith organ hair cells in mice. Nevertheless, pretreatment with gastrodin significantly alleviated these impairments. Additionally, the Notch signaling pathway was activated by gentamicin in the utricle, contributing to a notable increase in the expression levels of apoptosis-associated proteins. By contrast, gastrodin treatment effectively suppressed the Notch signaling pathway, thereby mitigating the occurrence of apoptosis.CONCLUSIONCollectively, these findings underscore the crucial role of gastrodin in safeguarding against gentamicin-induced vestibular dysfunction through the modulation of the Notch signaling pathway. This study suggests the potential of gastrodin as a promising therapeutic agent for preventing vestibular injuries.","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142248427","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 Systematic Review and Meta-analysis Examining Outcomes of Cochlear Implantation in Children With Bilateral Cochlear Nerve Deficiency.","authors":"Jay R Maturi,Kimberley S Noij,Vidya Babu,Francis X Creighton,Deepa Galaiya,Carolyn M Jenks","doi":"10.1097/mao.0000000000004274","DOIUrl":"https://doi.org/10.1097/mao.0000000000004274","url":null,"abstract":"OBJECTIVETo assess hearing and speech outcomes in pediatric patients with bilateral cochlear nerve deficiency (CND) who underwent cochlear implantation (CI) and to identify factors associated with improved outcomes.DATABASES REVIEWEDPubMed, Embase, Web of Science, and Cochran databases were searched following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.METHODSStudies that reported hearing and speech outcomes of pediatric patients with bilateral CND who underwent CI were included. Demographics, comorbidities, inner ear abnormalities, CND classification (aplasia or hypoplasia), details of diagnostic workup, and outcomes data were extracted. Outcomes were assessed using the four-level auditory performance level (APL) scale. Meta-analysis, using Cochran-Armitage tests, was performed on patients with individual data to assess factors associated with performance.RESULTSA total of 314 papers were screened, and 40 papers with 378 total patients met inclusion criteria. A total of 339 patients had patient-level data and were included in the meta-analysis. Of the 339 patients, 19% (n = 63) of patients had no measurable stimulation, 28% (n = 95) had improved detection, 22% (n = 76) achieved closed-set speech perception, and 31% (n = 105) achieved open-set speech perception. Patients with cochlear nerve aplasia (p = 0.016) and syndromes (p < 0.001) had significantly worse APL scores relative to patients with cochlear nerve hypoplasia and patients without syndromes, respectively.CONCLUSIONSWhile most patients with bilateral CND benefit from CI and almost one-third of patients achieved open-set speech perception, outcomes were heterogenous and one-fifth of patients did not experience measurable benefit from CI.","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142248430","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":"Evaluation of Clinical Performance of Ponto Implantation Using a Minimally Invasive Surgical Technique-A Prospective Multicenter Study.","authors":"Emma M Teunissen, Tjerk W Aukema, Rupan Banga, Måns Eeg-Olofsson, Myrthe K S Hol, Dan D Hougaard, James R Tysome, Martin L Johansson, Sara Svensson, Harry R F Powell","doi":"10.1097/MAO.0000000000004315","DOIUrl":"10.1097/MAO.0000000000004315","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the clinical outcomes of bone-anchored hearing implant surgery using the MONO procedure.</p><p><strong>Study design: </strong>Multicenter, multinational, single-arm, prospective trial with a 12-month follow-up.</p><p><strong>Setting: </strong>Seven European university hospitals from the United Kingdom, Sweden, Denmark, and The Netherlands.</p><p><strong>Patients: </strong>Fifty-one adult patients requiring surgical intervention for bone conduction hearing.</p><p><strong>Intervention: </strong>Bone-anchored hearing implant surgery using the MONO procedure.</p><p><strong>Main outcome measures: </strong>The primary endpoint assessed implant usability 3 months after surgery. Implant status, soft tissue reactions, pain and numbness, postoperative events, and sound processor usage were assessed at all follow-up visits. Hearing-related quality of life was evaluated using the Glasgow Benefit Inventory (GBI).</p><p><strong>Results: </strong>At 3 months, 94.2% of the implant/abutment complexes provided reliable anchorage for sound processor usage. No severe intraoperative complications occurred. Sixty-nine percent of surgeries were performed under local anesthesia, with surgery lasting 10 minutes on average. Four implants were lost due to trauma (n = 2), spontaneous loss of osseointegration (n = 1), or incomplete insertion (n = 1). Adverse soft tissue reactions occurred in 2.6% of visits, with a maximum Holgers grade of 3 (n = 1) and grade 2 (n = 5) across patients. Hearing-related quality of life at 3 months improved in 96% of patients.</p><p><strong>Conclusion: </strong>The MONO procedure provides a safe and efficient surgical technique for inserting bone-anchored hearing implants with few and minor intra- and postoperative complications.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142056278","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":"Mendelian Randomization Study Reveals a Predicted Relationship between Sensorineural Hearing Loss and Mitochondrial Proteins.","authors":"Jiangyu Yan, Linrong Wu, Mengmeng Zheng, Yuan Lv, Feng Jiang, Weibo Gao, Fangfang Pan","doi":"10.1097/MAO.0000000000004266","DOIUrl":"10.1097/MAO.0000000000004266","url":null,"abstract":"<p><strong>Background: </strong>Mitochondrial proteins assume a pivotal role in the onset and progression of diverse diseases. Nonetheless, the causal interconnections with sensorineural hearing loss (SNHL) demand meticulous exploration. Mendelian randomization analysis is a method used in observational epidemiological studies to predict the relationship between exposure factors and outcomes using genetic variants as instrumental variables. In this study, we applied this analytical approach to two distinct samples to predict the causal impact of mitochondrial proteins on SNHL.</p><p><strong>Methods: </strong>Two-sample Mendelian randomization analyses were executed to scrutinize the predicted associations between 63 mitochondrial proteins (nuclear-encoded) and SNHL, utilizing summary statistics derived from genome-wide association studies. Assessments of pleiotropy and heterogeneity were carried out to gauge the robustness of the obtained findings.</p><p><strong>Results: </strong>Four mitochondrial proteins exhibited a suggestive causal relationship with the susceptibility to SNHL. Dihydrolipoamide dehydrogenase (DLD; OR = 0.9706, 95% CI = 0.9382-0.9953, p = 0.0230) was linked to a diminished risk of SNHL. Conversely, elevated levels of mitochondrial ribosomal protein L34 (MRPL34; OR = 1.0458, 95% CI = 1.0029-1.0906, p = 0.0362), single-pass membrane protein with aspartate-rich tail 1 (SMDT1; OR = 1.0619, 95% CI = 1.0142-1.1119, p = 0.0104), and superoxide dismutase 2 (SOD2; OR = 1.0323, 95% CI = 1.0020-1.0634, p = 0.0364) were associated with an elevated risk of SNHL.</p><p><strong>Conclusion: </strong>This research utilized Mendelian randomization analysis to predict the relationship between mitochondrial proteins and SNHL. It provides a potential viewpoint on the etiology and diagnosis.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141760202","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 Loss in the Unoperated Ear After High-Speed Drilling in Otologic and Skull Base Surgery.","authors":"Philip Perez, Tsung-Heng Tsai, John Hawks, Heather Malyuk Barbone, Joey Pinkl, Partha Thirumala, Jianxin Bao","doi":"10.1097/MAO.0000000000004316","DOIUrl":"10.1097/MAO.0000000000004316","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate if permanent hearing loss occurred in the unoperated ear of patients undergoing otologic and skull base surgery with high-speed otologic drilling.</p><p><strong>Study design: </strong>We retrospectively studied 250 patients (mean age 57.8 yr; 120 males, and 130 females) undergoing otologic or skull base surgery with high-speed drilling between 2013 and 2019.</p><p><strong>Setting: </strong>The University of Pittsburgh Medical Center.</p><p><strong>Patients: </strong>We evaluated preoperative and postoperative audiograms for patients undergoing surgery for cochlear implantation (95 patients, 38.0%), cholesteatoma or chronic ear disease (88 patients, 35.2%), repair of lateral skull base encephalocele (26 patients, 10.4%), resection of vestibular schwannoma or meningioma of the cerebellopontine angle (23 patients, 9.2%), lateral temporal bone resection (8 patients, 3.2%), microvascular decompression (7 patients, 2.8%), or other operations involving a high-speed otologic drill (3 patients, 1.2%).</p><p><strong>Main outcome measures: </strong>Hearing threshold shift, measured as the difference between postoperative threshold and preoperative threshold for each frequency. The association of age, gender, tested frequency, and surgery type with hearing threshold shift was investigated with analysis of covariance.</p><p><strong>Results: </strong>A total of 102 patients (40.8%) had a 10-dB or greater worsening of their hearing in at least one frequency on their postoperative audiogram in the contralateral, unoperated ear. One hundred six subjects (42.4%) had no change in hearing of 10 dB or greater at any frequency. Among patients with longitudinal postoperative audiograms, accelerated age-related hearing loss was observed in low frequencies.</p><p><strong>Conclusions: </strong>A significant number of patients demonstrated poorer hearing thresholds in the contralateral, unoperated ear after otologic and skull base surgery.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142110573","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":"Facial Nerve Tractography Using Diffusion MRI: A Comparison of Acquisition b -Values and Single- and Multifiber Tracking Strategies.","authors":"Lorenz Epprecht, Leo Zekelman, Katherine L Reinshagen, Guoqiang Xie, Isaiah Norton, Ron Kikinis, Nikos Makris, Marco Piccirelli, Alexander Huber, Daniel J Lee, Fan Zhang, Lauren J O'Donnell","doi":"10.1097/MAO.0000000000004310","DOIUrl":"10.1097/MAO.0000000000004310","url":null,"abstract":"<p><strong>Hypothesis: </strong>This study investigates the impact of different diffusion magnetic imaging (dMRI) acquisition settings and mathematical fiber models on tractography performance for depicting cranial nerve (CN) VII in healthy young adults.</p><p><strong>Background: </strong>The aim of this study is to optimize visualization of CN VII for preoperative assessment in surgeries near the nerve in the cerebellopontine angle, reducing surgery-associated complications. The study analyzes 100 CN VII in dMRI images from the Human Connectome Project, using three separate sets with different b values ( b = 1,000 s/mm 2 , b =2,000 s/mm 2 , b =3,000 s/mm 2 ) and four different tractography methods, resulting in 1,200 tractographies analyzed.</p><p><strong>Results: </strong>The results show that multifiber and free water (FW) compartment models produce significantly more streamlines than single-fiber tractography. The addition of an FW compartment significantly increases the mean streamline fractional anisotropy (FA). Expert quality ratings showed that the highest rated tractography was the 1 tensor (1T) method without FW at b values of 1,000 s/mm2.</p><p><strong>Conclusions: </strong>In this young and healthy cohort, best tractography results are obtained by using a 1T model without a FW compartment in b =1,000 diffusion MR images. The FW compartment increased the contrast between streamlines and cerebrospinal fluid (higher mean streamline FA). This finding may help ongoing research to improve CN VII tractography results in tumor cases where the nerve is often stretched and thinned by the tumor.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11458140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133410","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":"Evaluation of Semicircular Canal Function in Relapsing Polychondritis Patients With Dizziness and Sensorineural Hearing Loss Using Video Head Impulse Test.","authors":"Kimiko Hoshino, Keishi Fujiwara, Shinya Morita, Atsushi Fukuda, Hideaki Takeda, Yuji Nakamaru, Akihiro Homma","doi":"10.1097/MAO.0000000000004303","DOIUrl":"10.1097/MAO.0000000000004303","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate semicircular canal function using video head impulse test (vHIT) in relapsing polychondritis (RP) patients presenting with dizziness and sensorineural hearing loss.</p><p><strong>Study design: </strong>Retrospective case review.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Patients: </strong>Three patients with RP underwent vHIT and hearing tests.</p><p><strong>Intervention: </strong>Diagnostic.</p><p><strong>Main outcome measures: </strong>The gain in vestibulo-ocular reflex (VOR) and the presence of catch-up saccade were examined, and the correlation between semicircular canal dysfunction and hearing loss was investigated.</p><p><strong>Results: </strong>Of the six ears, five exhibited semicircular canal dysfunction. Among these, one ear showed dysfunction in two semicircular canals, while the remaining four ears demonstrated dysfunction in all three semicircular canals. Sensorineural hearing loss, ranging from moderate to profound, was detected by pure-tone audiometry in all six ears. Furthermore, a significant correlation was observed between VOR gain in the horizontal semicircular canal (HSC) and hearing level.</p><p><strong>Conclusions: </strong>This study demonstrated semicircular canal dysfunction in RP patients presenting with dizziness and hearing loss using vHIT. Moreover, a significant correlation was found between HSC dysfunction and the severity of hearing loss. While inner ear involvement is a key clinical symptom included in the diagnostic criteria for RP, there have been few reports evaluating vestibular dysfunction, and this is the first report on the evaluation of several cases using vHIT. Accurate assessment of vestibular function by vHIT may facilitate early diagnosis and intervention in RP, potentially improving patient outcomes.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142056231","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":"Tympanic Membrane Regeneration Therapy for Pediatric Tympanic Membrane Perforation.","authors":"Shin-Ichi Kanemaru, Shin-Ichiro Kita, Rie Kanai, Tomoya Yamaguchi, Akiko Kumazawa, Ryohei Yuki, Misaki Yoshida, Toru Miwa, Hiroyuki Harada, Toshiki Maetani","doi":"10.1097/MAO.0000000000004285","DOIUrl":"10.1097/MAO.0000000000004285","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate tympanic membrane regeneration therapy (TMRT) for pediatric tympanic membrane perforations (TMPs).</p><p><strong>Study design: </strong>Intervention study.</p><p><strong>Setting: </strong>Research institute hospital.</p><p><strong>Patients: </strong>In this study, 20 patients with chronic TMP (M/F: 13/7, 13/8 ears, age 0-15 years) treated with TMRT were evaluated. As comparison, 20 pediatric patients with chronic TMP who underwent myringoplasty/tympanoplasty were included.</p><p><strong>Interventions: </strong>For the TM repair procedure, the edge of the TMP was disrupted mechanically, and gelatin sponge immersed in basic fibroblast growth factor was placed inside and outside the tympanic cavity and covered with fibrin glue. The TMP was examined 4 ± 1 weeks later. The protocol was repeated up to four times until closure was complete.</p><p><strong>Main outcome measures: </strong>Closure of the TMP and hearing improvement were evaluated at 16 weeks after the final regenerative procedure. Adverse events were monitored.</p><p><strong>Results: </strong>The mean follow-up period was 427.1 days. The TM regenerated in all cases, but pinhole reperforation occurred in two cases, and the final closure rate was 90.5% (19 of 21). Hearing improved to 24.9 ± 7.6 dB on average before surgery and to 13.8 ± 5.4 dB after surgery. The AB gap improved from 12.9 ± 8.0 to 5.2 ± 3.5 dB.The myringoplasty/tympanoplasty group had significantly lower AB gap improvement compared with the TMRT group. There were no adverse events.</p><p><strong>Conclusions: </strong>TMRT can be expected to regenerate near-normal TMs with a high closure ratio, resulting in better-hearing improvement compared with the myringoplasty/tympanoplasty group, and is an effective treatment for children with long life expectancy.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009154","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 Outcomes of Modified Endoscopic Transcanal Approach to Small Acoustic Tumors.","authors":"Riana Kipiani Abdul Halim, Gerard Lapina, Seung Ho Shin, Youngrak Jung, Jeong Gum Lee, In Seok Moon","doi":"10.1097/MAO.0000000000004302","DOIUrl":"10.1097/MAO.0000000000004302","url":null,"abstract":"<p><strong>Objective: </strong>The management options for small acoustic tumors are still controversial, and surgery is indicated in a select number of patients only. This is to avoid unnecessary extensive operations and risk of complications. Endoscopic transcanal approach, which was recently introduced, can be an alternative option to overcome these challenges. We have developed a modified technique for endoscopic transcanal removal of small acoustic tumors with tympanoplasty using tragal cartilage and without the need to harvest abdominal fat for obliteration. There was also no need to do an ear cul-de-sac procedure compared with the previous method. We report the long-term outcomes of this approach.</p><p><strong>Study design: </strong>Retrospective review.</p><p><strong>Setting: </strong>Tertiary hospital.</p><p><strong>Patients: </strong>Those who were diagnosed with small acoustic tumors between June 2016 and June 2022 were enrolled.</p><p><strong>Interventions: </strong>Tumor removal via a Modified Endoscopic Transcanal Transpromontorial Approach (mETTA).</p><p><strong>Main outcome measure: </strong>Tumor control rate, closure rate of tympanic membrane, and complications such as cerebrospinal fluid (CSF) leakage and facial palsy were analyzed. Operation time and hospital stay were also analyzed.</p><p><strong>Results: </strong>Twenty-two patients with a mean age of 55.5 ± 9.4 years were enrolled. Eighteen were vestibular schwannomas (VS), two were intracochlear schwannomas (ICS), and two were with intravestibulocochlear schwannomas (IVCS). Gross total removal was achieved in 21 cases. One had developed significant CSF leakage, and the other patient complicated with permanent facial palsy. The tympanic membrane healed well in all patients, but three patients showed delayed healing until several months and treated conservatively. Mean operation time was 149.6 ± 48.4 minutes, mean hospital stay was 8.9 ± 4.5 days, and mean postoperative follow-up period was 42.0 ± 15.7 months.</p><p><strong>Conclusion: </strong>Long-term results of modified endoscopic transcanal approach to small acoustic tumors are acceptable and comparable to classical treatments such as translabyrinthine approach or gamma knife radiation. This is an alternative option for smaller tumors warranting surgical removal and maintained cosmetic advantages.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142110574","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}