Otology & Neurotology最新文献

{"title":"Listening Fatigue Contributes to Hearing-Related Quality of Life in Adult Cochlear Implant Candidates.","authors":"Andrew L S Thornton, Annie Shen, Jack Y Lin, Justin H Oh, Andrea J DeFreese, Jessica H Lewis, David S Haynes, Benjamin W Y Hornsby, Terrin N Tamati, Aaron C Moberly","doi":"10.1097/MAO.0000000000005054","DOIUrl":"https://doi.org/10.1097/MAO.0000000000005054","url":null,"abstract":"<p><strong>Objective: </strong>To identify factors independently contributing to preoperative hearing-related quality of life (HRQOL) in adult cochlear implant (CI) candidates.</p><p><strong>Study design: </strong>Retrospective cross-sectional analysis.</p><p><strong>Setting: </strong>Tertiary academic medical center.</p><p><strong>Patients: </strong>A total of 171 adults were evaluated for CI candidacy from 2018 to 2024.</p><p><strong>Main outcome measures: </strong>Cochlear Implant Quality of Life-10 Global (CIQOL Global) scores served as the main outcome measure. Independent variables included the 10-item Vanderbilt Fatigue Scale (VFS-A-10), Tinnitus Handicap Inventory (THI), age, duration of deafness, and preoperative AzBio sentence recognition in quiet (AzBioQ) scores.</p><p><strong>Results: </strong>Bivariate analyses revealed significant correlations between CIQOL Global scores and both VFS-A-10 (r=-0.56, P<0.001) and THI (r=-0.31, P=0.005). No significant correlations were found between CIQOL Global and age, duration of deafness, or AzBioQ performance. In multivariable linear regression (n=67), VFS-A-10 was the sole independent predictor of preoperative CIQOL Global (β=-0.55, P<0.001). THI, age, duration of deafness, and AzBioQ performance did not contribute additional explanatory value. Sensitivity analysis in a larger sample of adult CI candidates (n=144) confirmed these findings.</p><p><strong>Conclusions: </strong>Listening fatigue was the primary independent factor associated with preoperative HRQOL among CI candidates, whereas traditional audiologic measures and perceived tinnitus did not contribute independently. These findings highlight the importance of assessing listening fatigue as part of CI candidacy evaluation and suggest that interventions targeting fatigue management may improve patient well-being. Routine assessment of listening fatigue could enable more personalized counseling and identify CI candidates who might benefit from earlier intervention.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031191","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 New Methodology for Evaluation of Large Vestibular Aqueduct Syndrome in CT and MRI Images: Defining the Syndrome and Finding Clinical Correlation.","authors":"Jurgita Ivanauskaite, Justina Ivanauskaite, Anja M Giesemann, Thomas Lenarz, Anke Lesinski-Schiedat","doi":"10.1097/MAO.0000000000005040","DOIUrl":"https://doi.org/10.1097/MAO.0000000000005040","url":null,"abstract":"<p><strong>Hypothesis: </strong>The goal of the research is to propose criteria to define large vestibular aqueduct (LVA)/large endolymphatic sac anomaly (LESA) using our previously developed method based on analysis of CT/CBCT and MRI, and to propose a new classification of the clinical course of hearing loss.</p><p><strong>Background: </strong>Previous studies did not provide results that would conclusively relate audiological and radiologic data.</p><p><strong>Methods: </strong>A retrospective analysis of radiologic images and clinical data was performed at a tertiary center. The dataset involved 173 patients (315 ears), who were diagnosed with LVA/LESA based on CT/CBCT and/or MRI of the temporal bone. The retrospective radiologic analysis was performed in the control groups on CT/CBCT images: 93 (100 ears) patients with normal hearing and 50 (100 ears) patients with various hearing loss. Measurements in the control and LVA groups were compared.</p><p><strong>Results: </strong>Logistic regression model suggests that variables that correlate significantly with hearing loss are length of vestibular aqueduct (VA) (P<0.05) and operculum diameter (P<0.05) obtained from CT/CBCT images, and \"sac_volume_to_dura_contact ratio\" (P<0.05) measured in MRI. The decision tree model showed that CT opening [maximum perpendicular width of the opening of the VA (closest to the vestibule)] (<0.075 mm) is a significant factor differentiating the control and LVA groups.</p><p><strong>Conclusion: </strong>The presence of the CT opening can be used for screening and diagnosis of the LVA in bony images. The presence of contact between the sac and dura on MRI can confirm the diagnosis of LESA. MRI is superior for LVA/LESA diagnosis. The shorter and brighter the vestibular aqueduct, the smaller the \"sac_volume_to_dura_contact ratio,\" which indicates a worse prognosis of hearing loss.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025760","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":"Mastoid Obliteration in Addition to the Canal Wall Up Tympanomastoidectomy: A Systematic Review.","authors":"Chiara Erfurt, Maud J de Rooij, Louise V Straatman, Hans G X M Thomeer","doi":"10.1097/MAO.0000000000005075","DOIUrl":"https://doi.org/10.1097/MAO.0000000000005075","url":null,"abstract":"<p><strong>Purpose: </strong>This systematic review aimed to summarize the available evidence on clinical, patient-related, and economic outcomes of the canal wall up (CWU) tympanomastoidectomy, with and without the obliteration technique in surgical cholesteatoma care.</p><p><strong>Methods: </strong>A comprehensive search was conducted in PubMed, Embase, Cochrane, Scopus, ClinicalTrials.gov, and the EU Clinical Trials Register. The NHS EED database was also searched for economic evaluations. All searches were completed by July 7, 2025. Studies were included if they evaluated the obliteration technique alongside CWU or compared it to CWU without obliteration in adults. The primary outcome was recurrent/residual disease. Secondary outcomes included hearing results, complications, quality of life, and economic evaluations. Two authors independently screened and included the literature; quality assessment was assessed by all authors and determined by consensus.</p><p><strong>Results: </strong>Four comparative and 5 noncomparative retrospective studies addressed the primary outcome. Surgical complications were reported in all but one of the articles. Three additional studies focused on secondary outcomes: 2 on quality of life and 1 on hearing. No studies were identified on economic evaluations or cost analyses. Furthermore, no prospective studies or randomized controlled trials were found.</p><p><strong>Conclusion: </strong>The results of nearly all included studies indicate a reduction in recidivism rates when the obliteration technique is added to the canal wall up (CWU) approach. However, no high-level evidence studies are currently available, and the existing studies are likely subject to confounding factors. In addition, significant heterogeneity among the studies limits the ability to draw definitive conclusions at this stage.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025693","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":"Optimal Head Position for Intratympanic Dexamethasone Injection Relative to the Round Window.","authors":"Michelle Kwon, Jeong Gum Lee, Jamol Ergashev, Udi Shapira, In Seok Moon","doi":"10.1097/MAO.0000000000004993","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004993","url":null,"abstract":"<p><strong>Objective: </strong>Intratympanic dexamethasone injection (ITDI) is widely used for inner ear disorders. However, optimal head positioning to maximize drug absorption through the round window membrane (RWM) while minimizing Eustachian tube (ET) washout remains undefined. This study aimed to determine the ideal head position for ITDI using a multimodal approach and to compare it with the traditional 45-degree head rotation.</p><p><strong>Methods: </strong>A multimodal analysis incorporating cadaveric dissection, 3-dimensional (3D) anatomic modeling, and clinical perilymph sampling from patients was performed. Twelve sagittal-sectioned human temporal bone cadavers were dissected to identify the transcanal angle required for direct RWM contact, and corresponding yaw, roll, and pitch head-position angles were measured. A 3D-printed anatomic model of the external auditory canal, RWM, and ET was constructed to confirm fluid flow toward the RW. Additional fresh-frozen cadavers were used to compare perilymph dexamethasone concentrations following ITDI administered in either the traditional or ideal head position. Clinically, 5 patients undergoing translabyrinthine vestibular schwannoma resection received ITDI after induction of anesthesia and surgical positioning, followed by perilymph sampling during surgery.</p><p><strong>Results: </strong>The optimal head position relative to the RWM was identified as 58.9 degrees of yaw, 31.1 degrees of roll, and 22.5 degrees of pitch. Three-dimensional modeling demonstrated increased drug flow toward the RWM and reduced ET washout when roll and pitch were optimized together, while yaw alone had minimal effect. Cadaveric and clinical patient perilymph sampling showed a consistent trend toward higher perilymph dexamethasone concentrations in the ideal head position than in the traditional 45-degree position. When the cadaveric and clinical samples were pooled for exploratory comparison, the ideal head position showed a 2.94-fold higher dexamethasone concentration than the traditional position (0.0447% vs. 0.0152%), although this difference did not reach statistical significance.</p><p><strong>Conclusion: </strong>Ideal intratympanic dexamethasone delivery requires adjustment of roll and pitch in addition to yaw. Implementing a 3-axis ideal head position is a simple, cost-effective strategy to improve intratympanic steroid absorption and therapeutic efficacy.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025729","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":"Changes in Electrode Impedance and Cochlear Microphonic in Cochlear Implant Recipients in the First Year After Cochlear Implantation.","authors":"Imogen A M L van Beurden, Frank T Hartong, Ilse Y Haan, Dyan Ramekers, Robert J Stokroos, Hans G X M Thomeer, Huib Versnel","doi":"10.1097/MAO.0000000000005069","DOIUrl":"https://doi.org/10.1097/MAO.0000000000005069","url":null,"abstract":"<p><strong>Objective: </strong>We examined changes in electrode impedance and cochlear microphonic (CM) during the first year after implantation and investigated the extent to which changes in impedance related to changes in CM. In addition, we explored whether residual hearing was related to impedance and/or CM.</p><p><strong>Study design: </strong>Prospective longitudinal design.</p><p><strong>Setting: </strong>Tertiary referral center in Utrecht, the Netherlands.</p><p><strong>Patients: </strong>Twenty-one adults underwent cochlear implantation surgery between January 2020 and January 2025.</p><p><strong>Interventions: </strong>Impedance and CM responses to pure-tone stimuli (125, 250, and 500 Hz; sound levels 100 to 115 dB HL) at all 16 electrodes were measured at 5 timepoints: intraoperatively, postoperatively after 6 weeks, 3 months, 6 months, and 12 months. Residual hearing was measured by pure-tone average (PTA) to 125 to 500 Hz (70 to 115 dB HL) at 12 months.</p><p><strong>Main outcome measures: </strong>Longitudinal analyses of impedance and CM amplitude were performed per segment of the electrode array (apex, middle, and base). Impedance was averaged across the electrodes of the segment. The CM amplitudes were derived by averaging the mean amplitudes of electrodes per segment and then averaging across the 3 frequencies. Correlation analyses were performed (a) between absolute impedance and CM; (b) between impedance differences and CM amplitude ratio; (c) between PTA and impedance; and (d) between PTA and CM.</p><p><strong>Results: </strong>Changes in impedance and in CM over time differed between segments. The most robust changes in impedance were seen in the middle segment between surgery and the visit after 6 weeks. CM decreased postoperatively, especially in the apical and middle segments between surgery and the visit after 6 weeks. Impedance and CM were uncorrelated for absolute and relative measures. Twelve-month postoperative residual hearing was poorer when 6-week impedance was higher and when 3-month CM amplitude was lower.</p><p><strong>Conclusions: </strong>CM and impedance were not correlated, although both metrics can be affected by tissue growth triggered by the electrode array. Larger clinical studies are needed to investigate the predictive value of impedance and CM for postoperative residual hearing.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025778","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":"Data-Driven Multiparameter Predictive Analysis of Cochlear Implant Rehabilitation Outcomes.","authors":"Connie Chang-Chien, Max Jiam, Stephanie M Younan, Yew Song Cheng, Nicole T Jiam","doi":"10.1097/MAO.0000000000005076","DOIUrl":"https://doi.org/10.1097/MAO.0000000000005076","url":null,"abstract":"<p><strong>Objective: </strong>This study analyzes intersections between preoperative predictors of postcochlear implant (CI) hearing outcomes to address the gap in counseling CI candidates on postoperative hearing expectations beyond binary candidacy criteria.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Tertiary academic medical center and a third-party CI database.</p><p><strong>Methods: </strong>Preoperative audiometric measures included word recognition score (WRS) and pure-tone average (PTA) for the unimplanted contralateral ear (CE) and implanted ear (IE). Postoperative WRS assessments extended to 500 days postsurgery, with the ~6-month mark as the primary outcome time point. Treatment success was defined as a postoperative WRS≥60% or clinically meaningful improvement (ΔWRS≥20%) for individuals with preoperative WRS≥30%. Statistical analyses included heatmaps and Kaplan-Meier plots to assess relationships between preoperative variables and time to treatment success.</p><p><strong>Results: </strong>Both CE and IE audiometric status demonstrated comparable predictive ability for CI outcomes when using the WRS<60% and PTA>60 criteria; however, IE status had a higher F1 score (0.27 vs. 0.069). Age was a critical modifier; patients below 60 years achieved treatment success faster than older patients (275 vs. 470 d; HR=0.41; 95% CI: 0.31-0.55, P<0.05). Patients below 60 years achieved hearing improvement at a significantly faster rate when using a pre-PTA<60 dB than a pre-PTA≥60 dB (HR=0.47, 95% CI: 0.22-0.99, P<0.05). Among older patients, those with CE WRS≥60% had a substantially higher likelihood of improvement compared with those with WRS <60% (HR=5.15; 95% CI: 3.29-8.08, P<0.05).</p><p><strong>Conclusion: </strong>Preoperative audiometric predictors of CI success vary significantly by age, with younger patients benefiting from residual hearing in the implanted ear and older patients relying on their contralateral, unimplanted ear for rehabilitation. These age-stratified patterns enable more personalized prognostic counseling about expected time to functional hearing improvement following cochlear implantation.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017442","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":"Tumor Nerve of Origin and Hearing Preservation Outcomes for Patients With Small Vestibular Schwannomas Undergoing Middle Fossa Craniotomy.","authors":"Pawina Jiramongkolchai, Magnus Wahlin, Alexandra Vacaru, Tamara Wahlin, Marc S Schwartz, Rick A Friedman","doi":"10.1097/MAO.0000000000005072","DOIUrl":"https://doi.org/10.1097/MAO.0000000000005072","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate hearing preservation (HP) outcomes based on tumor nerve origin for patients with small sporadic vestibular schwannomas (VS) undergoing microsurgical resection using the middle cranial fossa (MCF) approach.</p><p><strong>Study design: </strong>Retrospective single-institution study.</p><p><strong>Setting: </strong>Tertiary academic institution.</p><p><strong>Patients: </strong>Adults 18 years or older with small sporadic VS (≤15 mm).</p><p><strong>Intervention: </strong>MCF.</p><p><strong>Main outcome measure: </strong>Hearing preservation is defined as a word recognition score of ≥50%.</p><p><strong>Results: </strong>Of the 189 consecutive patients who underwent surgery, 164 (89%) had intraoperative identification of the tumor nerve of origin. Of those 164 patients, 88 (54%) had inferior vestibular nerve (IVN) tumors, and 76 (46%) had superior vestibular nerve (SVN) tumors. Hearing was preserved in 83% of patients with SVN tumors compared with 49% of patients with IVN tumors. When stratified by size, the rate of HP was highest (91%) for tumors of SVN origin ≤5 mm in size. In multivariate analysis, patients with SVN tumors ≤5 mm in size had a 7.5-fold increase (95% CI: 1.60-34.9) in HP compared with patients with SVN tumors larger than 10 mm in size. There was no significant difference in facial nerve outcomes between the 2 groups. At initial follow-up, 70 (92%) patients with SVN tumors and 83 (94%) patients with IVN tumors had a HB 1/2, respectively.</p><p><strong>Conclusions: </strong>Patients with small SVN tumors have a significantly higher likelihood of HP as well as shorter operative time compared with IVN tumors, suggesting that, in appropriate candidates, early surgical intervention may be beneficial.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017480","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 Outcomes of Exoscopic Versus Microscopic Retrosigmoid Vestibular Schwannoma Surgery.","authors":"Aleš Vlasák, Jackie Shpilman, Jan Betka, Eduard Zvěřina, Zdeněk Fík","doi":"10.1097/MAO.0000000000005073","DOIUrl":"https://doi.org/10.1097/MAO.0000000000005073","url":null,"abstract":"<p><strong>Objective: </strong>To compare clinical outcomes of vestibular schwannoma (VS) resection with the operating microscope versus an exoscope.</p><p><strong>Study design: </strong>Retrospective single-center cohort study.</p><p><strong>Setting: </strong>Tertiary referral skull base center.</p><p><strong>Patients: </strong>A total of 245 adults underwent retrosigmoid VS resection: 103 microscope (2017-2020) and 142 exoscope (2021-2024); exclusions: NF2, revision surgery, and translabyrinthine approaches.</p><p><strong>Interventions: </strong>Microscope-assisted or exoscope-assisted retrosigmoid VS resection using identical surgical technique and intraoperative neuromonitoring.</p><p><strong>Main outcome measures: </strong>Operative time; tumor volume; extent of resection; facial nerve continuity and function (House-Brackmann grade at discharge and ≥1-year follow-up); cochlear nerve continuity and hearing preservation; CSF leak and revision surgery rates.</p><p><strong>Results: </strong>Operative duration was comparable between groups (median: 6.5 vs. 7.0 h; P=0.37). On multivariate analysis, Koos grade was the only significant predictor of duration. Cochlear nerve preservation (38.3% vs. 36.3%), HB I-II at discharge (63.4% vs. 64.1%), facial nerve intraoperative interruption (4.2% vs. 8.7%), nerve reconstruction (4.9% vs. 8.7%), CSF leak, and revision surgery rates were also similar (all P>0.05). At follow-up, the exoscope group showed lower House-Brackmann scores (adjusted OR: 2.54, 95% CI: 1.31-4.94; P=0.006).</p><p><strong>Conclusions: </strong>Exoscope-assisted retrosigmoid VS resection achieves comparable clinical outcomes to the operating microscope without prolonging operative times. Exoscope adoption, therefore, provides ergonomic and educational advantages without compromising patient outcomes.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991095","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":"Neoadjuvant Immune Checkpoint Inhibitor Therapy in Temporal Bone Squamous Cell Carcinoma.","authors":"Kaitlyn E Aragon, Nathan R Lindquist, Meera Patel, Erich M Sturgis, Ray Y Wang, Neil D Gross, Marc-Elie Nader, Neal S Akhave, Paul W Gidley","doi":"10.1097/MAO.0000000000005078","DOIUrl":"https://doi.org/10.1097/MAO.0000000000005078","url":null,"abstract":"<p><strong>Objective: </strong>To present immune checkpoint inhibitor immunotherapy (IO) outcomes for temporal bone-involving squamous cell carcinoma and guide neurotologic decision-making.</p><p><strong>Study design: </strong>Multi-institutional retrospective cohort.</p><p><strong>Setting: </strong>Two tertiary-care referral centers.</p><p><strong>Patients: </strong>Twenty-three patients (42 to 86 years old) with biopsy-proven temporal bone-involving squamous cell carcinoma (SCC).</p><p><strong>Interventions: </strong>Neoadjuvant IO, imaging to assess response, and surgical interventions.</p><p><strong>Main outcome measures: </strong>Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 outcomes, pathologic response, surgery de-escalation, and overall survival.</p><p><strong>Results: </strong>For final RECIST 1.1 response, 6 (26.1%, 95% CI: 10%-48%) patients completely responded (CR), 4 (17.4%, 95% CI: 5%-39%) patients partially responded (PR), 3 (13.0%, 95% CI: 3%-34%) patients had stable disease (SD), and disease progressed (PD) in 10 (43.5%, 95% CI 23%-66%) patients. For primary temporal bone tumors, 36.4% (95% CI: 11%-69%) achieved pathologic CR, radiologic CR, or radiologic PR; cutaneous SCC tumors had a 66.7% (95% CI: 35%-90%) response rate. Two (8.7%) patients with resectable disease were de-escalated to nonsurgical management, and 2 (8.7%) patients were de-escalated from lateral temporal bone resection (LTBR) to mastoidectomy. Overall 3-year survival for patients with CR, PR, or SD was 100% versus 78% for PD patients (P=0.029, HR 13.2, 95% CI: 1.3-134).</p><p><strong>Conclusions: </strong>Neoadjuvant IO is an option for early-stage and advanced temporal bone SCC, with roughly 50% of patients exhibiting response and avoidance of radical surgery and/or adjuvant radiation in selected cases; ongoing phase 3 trials of neoadjuvant IO will add prospective evidence.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990488","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":"Feasibility of Electrode-Location Estimates Based on Preoperative CT-Imaging for Anatomy-Based Fitting in Cochlear Implant Recipients.","authors":"Nina Rubicz, Nikolaus Poier-Fabian, Paul M Zwittag","doi":"10.1097/MAO.0000000000005077","DOIUrl":"https://doi.org/10.1097/MAO.0000000000005077","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate whether there is a difference between electrode frequencies estimated in OTOPLAN according to anatomy using a preoperative CT scan and electrode frequencies based on postoperative cone beam computer tomography (CBCT).</p><p><strong>Study design: </strong>Monocentric retrospective registry study.</p><p><strong>Setting: </strong>Tertiary academic medical center.</p><p><strong>Patients: </strong>Twenty-three CI recipients between 2004 and 2025.</p><p><strong>Interventions: </strong>CI.</p><p><strong>Main outcome measures: </strong>Comparison between frequency maps and angular insertion depth predicted from preoperative measurements and estimated from postoperative DVT imaging data. In addition, the frequency map should be compared with that provided by the standard setting of the CI fitting software.</p><p><strong>Results: </strong>When comparing preoperative CT and postoperative CBCT, there were no significant differences for electrode contacts 1 and 2. Estimated preoperative frequency values are closer to the postoperative measured values than to the standard settings.</p><p><strong>Conclusions: </strong>The use of preoperative scans to predict the frequency map for anatomy-based fitting cannot be recommended; however, when applied with caution, such simulations may serve as a useful starting point for fitting in special cases.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991100","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}