Otology & Neurotology最新文献

{"title":"Long-Term Results in Cochlear Implantation in Single-Sided Deafness in Children and Adult Populations.","authors":"Ángel Ramos Macías, Juan Carlos Falcón González, Silvia Borkoski Barreiro, Nadia Falcón Benítez, Joyce Tang, Annery Peguero, Pino Delia Domínguez Trujillo, Ángel Ramos de Miguel","doi":"10.1097/MAO.0000000000004527","DOIUrl":"10.1097/MAO.0000000000004527","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study is to show the long-term effects of cochlear implant as a treatment in both children and adults with acquired single-sided deafness.</p><p><strong>Study design: </strong>Observational, descriptive, cross-sectional.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Patients: </strong>21 children and 20 adults with SSD.</p><p><strong>Interventions: </strong>Unilateral CI.</p><p><strong>Methods: </strong>Speech detection thresholds and disyllabic words test (65 dB SPL) were performed in the modalities azimuth (S0), signal CI side (SCI), and signal on the normal hearing (SNH). The normal ear was masked with both white noise of +10 dB of the hearing threshold and plugging the same ear, whereas the speech testing was performed using the cochlear implant wireless system.</p><p><strong>Results: </strong>All results were obtained up to 48 months after the activation of the sound processor. All study subjects showed improvements in speech test results in all conditions tested. Word recognition in noise in children improved from 42.76% at 6 months after activation of the sound processor to 76.38% at 48 months in the S0 condition, from 50 to 78.10% in the SCI condition, and from 38.48 to 66.48% in the SNH modality. Regarding adults, word recognition in noise went from 45.40% at 6 months of activation of the sound processor to 73.40% at 48 months in the S0 condition, from 52.60 to 76.20% in the SCI condition, and from 43.60 to 64.80% in the SCI condition ( p < 0.001). The average duration of use of the speech processor daily was 11 hours in children and 9.4 hours in adults.</p><p><strong>Conclusion: </strong>When comparing children's performance with adults', progressive improvement in speech discrimination compared with adults was observed.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"654-659"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12244958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037537","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":"Electric Acoustic Versus Electric-Only Stimulation in Full-Length Lateral Wall Cochlear Array Recipients With Preserved Hearing.","authors":"Todd A Hillman, Douglas A Chen, Kristin M Rathe, Amanda Rago, Michael M Weber, Derrick R Tint","doi":"10.1097/MAO.0000000000004584","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004584","url":null,"abstract":"<p><strong>Objective: </strong>To determine if cochlear implant recipients who have low-frequency hearing preservation after surgery can benefit from electric-acoustic stimulation (EAS) even after a period of electric-only stimulation.</p><p><strong>Study design: </strong>Prospective, crossover controlled, clinical study.</p><p><strong>Setting: </strong>Private practice single-specialty clinic.</p><p><strong>Patients: </strong>Patients who are native English speakers, implanted with a 28-mm lateral wall electrode, had residual low-frequency hearing post-cochlear implantation and had at least 3 months of electric-only stimulation before enrollment.</p><p><strong>Intervention: </strong>Participants were reprogrammed from electric-only stimulation to EAS-A (with electric and acoustic overlap in the preserved frequencies) for 3 months. Outcomes were measured, and then the participants were changed to EAS-B, a non-overlap program. Outcomes and the patients' map preferences were recorded.</p><p><strong>Main outcome measures: </strong>Speech perception for each programming strategy was measured with CNC and AzBio testing. Participants subjective performance was measured with CCIQ and APHAB testing for each modality.</p><p><strong>Results: </strong>Out of a total of 117 consecutive CI patients with preoperative low-frequency hearing thresholds of at least 65 db HL, 43 (36.8%) had at least one low-frequency threshold less than 65 dB allowing the use of EAS. Twelve participants with 16 implanted ears were enrolled and completed the study. Statistical analysis showed that participants performed significantly better (p < 0.05) on CNC words with EAS-A (overlap, 71.6%) versus electric (65.5%) or EAS-B (non-overlap, 68%). There was not a difference between the strategies on AzBio testing. The overall scores on CCIQ and APHAB were also not statistically significant. A chi-squared test was performed for subjects' preferred programming strategy, revealing that there was a preference of the EAS strategies over electric only (p = 0.04).</p><p><strong>Conclusions: </strong>There may be an advantage to EAS over electric-only stimulation in patients with low-frequency hearing preservation after cochlear implant even after a period of electric-only stimulation.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675429","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 and Vestibular Outcomes in Patients Undergoing Labyrinthectomy and Cochlear Implant in End-Stage Menière's Disease.","authors":"Mohanad Almashhadani, Anna Lisa Giannuzzi, Mohammed Alkhateeb, Elisabetta Rebecchi, Francesco Di Pierro, Mario Sanna","doi":"10.1097/MAO.0000000000004578","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004578","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the results of hearing, vertigo, and tinnitus after simultaneous or sequential labyrinthectomy and cochlear implant (CI) and evaluate the effectiveness of end-stage Menière's disease (MD) treatment.</p><p><strong>Study design: </strong>Retrospective study.</p><p><strong>Method: </strong>The medical records of 39 patients who underwent labyrinthectomy and CI ipsilaterally for intractable vertigo and hearing loss with preoperative and postoperative documents were evaluated. Auditory outcomes were assessed with pure tone and speech audiometry (word test, closed set) and compared with the preoperative audiometric evaluation. Dizziness was graded according to the Dizziness Handicap Inventory Questionnaire (DHI). Tinnitus outcomes were assessed by the Tinnitus Handicap Inventory (THI).</p><p><strong>Results: </strong>Paired t tests revealed significant improvements in post-CI pure tone average (p = 0.0001), speech discrimination (p = 0.009), and tinnitus (p = 0.0001). Fifty-eight percent of patients had complete resolution of the vestibular symptoms in the operated ear, while 42% showed little or no improvement. However, over half (54.5%) of the patients with no or partial improvement were over 65 years old, as evidenced by the postoperative DHI. Patients demonstrated significant reductions in tinnitus as indicated by a significant improvement on the THI (p = 0.0001).</p><p><strong>Conclusion: </strong>Patients with vertigo and profound hearing loss who have end-stage Menière's disease (MD) or secondary Menière's disease can benefit from labyrinthectomy with a cochlear implant (CI). Older individuals should be treated with caution due to the possibility of chronic instability. Cochlear implantation greatly benefits both tinnitus suppression and hearing restoration.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675432","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":"Endoscopic Versus Microscopic Tympanoplasty: A Single-Blinded Randomized Comparative Trial.","authors":"Aparna Govindan, Mia Saade, Jennifer Ren, Vivian F Kaul, Zachary G Schwam, Enrique R Perez, Maura K Cosetti, George Wanna","doi":"10.1097/MAO.0000000000004590","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004590","url":null,"abstract":"<p><strong>Objective: </strong>To provide prospective evidence comparing differences in audiometric and patient-reported outcomes following endoscopic and microscopic tympanoplasty techniques.</p><p><strong>Study design: </strong>Single-blinded prospective randomized comparative trial.</p><p><strong>Setting: </strong>Tertiary care center between 2022 and 2023.</p><p><strong>Patients: </strong>English- and Spanish-speaking adults undergoing transcanal tympanoplasty for dry tympanic membrane perforation (without cholesteatoma or chronic ear disease).</p><p><strong>Intervention: </strong>Endoscopic or microscopic tympanoplasty.</p><p><strong>Main outcome measures: </strong>The primary outcome was air-bone gap change at 3 months. Secondary measures included speech recognition thresholds (SRT), word recognition scores (WRS), and patient-reported outcome measures (PROMs), including visual analog scale (VAS) of pain, Return to Work Self-Efficacy (RTWSE-19), and Glasgow Benefit Inventory (GBI).</p><p><strong>Results: </strong>Thirty-eight adults (mean age, 39.9 yr; range, 21-74 yr) were enrolled. Fifteen received microscopy, and 16 received endoscopy. Seven were excluded from the analysis: three required a post-auricular incision, and four were lost to follow-up without postoperative audiograms. Only PROMs collected within 3 weeks postoperatively were analyzed due to high participant dropout rates beyond 3 weeks. There were no differences in any audiometric or patient-reported outcomes between treatment groups (p > 0.05).</p><p><strong>Conclusions: </strong>Our findings suggest that transcanal endoscopic and microscopic approaches to tympanoplasty do not differ in postoperative audiometric outcomes or PROMs.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675430","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 Role of Lengthening Temporalis Myoplasty in the Management of Facial Paralysis: Evaluating Patient-Reported Quality of Life Improvements.","authors":"Francesco Bussu, Pierangela Tramaloni, Paolo Tropiano, Marta Bonomo, Claudia Crescio, Nicolò Sotgiu, Marco Perla, Davide Rizzo, Jacopo Galli","doi":"10.1097/MAO.0000000000004580","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004580","url":null,"abstract":"<p><strong>Objective: </strong>This study aims at evaluating the outcomes and patient satisfaction of the Labbé operation, a lengthening temporalis myoplasty procedure, in the treatment of longstanding complete facial paralysis.</p><p><strong>Study design: </strong>We conducted a multicenter, retrospective observational study.</p><p><strong>Setting: </strong>The research analyzed 38 patients with unilateral facial paralysis treated at three Italian institutions between 2009 and 2024.</p><p><strong>Patients: </strong>The study included patients with severe unilateral facial paralysis, classified as House-Brackmann grades V or VI, of various etiologies. The patients, predominantly females, had a mean age of 43 years.</p><p><strong>Interventions: </strong>These patients underwent surgical rehabilitation of facial nerve paralysis through the Labbé procedure, which involves transferring the temporalis muscle tendon to the labial rim while maintaining innervation through the trigeminal nerve, to restore dynamic function of the inferior part of the face.</p><p><strong>Main outcome measures: </strong>Preoperative and postoperative outcomes were assessed using the Facial Clinimetric Evaluation (FaCE) questionnaire, which measures functional and psychosocial impacts.</p><p><strong>Results: </strong>The only early surgical complication recorded was bleeding (1 of 38 cases). Out of the 38 patients, 17 completed the follow-up evaluations. Postoperative results showed significant improvements in quality of life and facial function, with a mean FaCE score increase of 38.6 points. Complications and long-term sequelae were rare and exclusively related to underlying malignant pathology (and to further treatments).</p><p><strong>Conclusions: </strong>In selected cases, the Labbé procedure has proven to be an effective, single-stage surgical option for addressing the aesthetic and functional deficits associated with longstanding facial paralysis. This procedure offers rapid recovery and low morbidity, making it a valuable therapeutic option for improving patient outcomes.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675449","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":"Superior Semicircular Canal Dehiscence in the General Population With Otosclerosis: A Meta-Analysis.","authors":"Omer J Ungar, Oren Ziv, Daniel Yafit","doi":"10.1097/MAO.0000000000004588","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004588","url":null,"abstract":"<p><strong>Objective: </strong>To present the prevalence of concomitant superior semicircular canal dehiscence (SSCD) among patients with osteosclerosis and to compare it to the general population by using a pooled meta-analysis based upon a systematic literature review.</p><p><strong>Data sources: </strong>PubMed, Web of Science, Google Scholar, enrolled papers' references lists.</p><p><strong>Review methods: </strong>A systematic literature review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. The database search yielded 371 articles, and 92 studies underwent full-text review. The extracted data include age, sex, computerized tomographic (CT) characteristics, and the presence of SSCD in the general population and among otosclerosis patients.</p><p><strong>Results: </strong>The general population arm included 17 papers, and the otosclerosis arm included 5 papers, resulting in 8,392 and 1,169 ears, respectively. The pooled prevalence of radiologic SSCD was 4.0% (95% CI: 2.7-5.5%) in the general population and 3.2 to 4.3% (95% CI: 1.2-6.1% and 2.5-6.6%, respectively) among patients with otosclerosis (p = 0.650 and p = 0.813, respectively). The minor difference in SSCD prevalence in the general population is the result of disagreement between investigators.</p><p><strong>Conclusion: </strong>The prevalence of SSCD among patients with otosclerosis is not significantly different from that of the general population. CT should therefore be considered as part of the preoperative workup for patients with otosclerosis.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507299","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":"Assessing the Role of Nystagmus Slow Phase Velocity as a Prognostic Indicator in Idiopathic Sudden Sensorineural Hearing Loss: A Prospective Study.","authors":"Raul Andres Rosero Morales, Diana Carolina Hernandez Rodriguez, Juanita Izquierdo Monsalve, Jessica Andrea Echeverría López, Juan Carlos Izquierdo Velásquez","doi":"10.1097/MAO.0000000000004514","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004514","url":null,"abstract":"<p><strong>Introduction: </strong>Idiopathic sudden sensorineural hearing loss (ISSNHL) exhibits a diverse range of clinical presentations and treatment responses. Currently, there are no established variables that clinicians can utilize for the purposes of patient counseling when treating ISSNHL.</p><p><strong>Materials and methods: </strong>This prospective study involved 35 patients diagnosed with ISSNHL who were treated with oral and intratympanic steroid injections. We measured the peak and average slow phase velocity (SPV) (°/sec) of nystagmus after caloric stimulation during the first session of intratympanic steroid injection (ITI), and four variables were evaluated: age, time elapsed before treatment (ET), gain, and pure tone average (PTA) posttreatment. An association between these variables was determined using Spearman's Rho statistical analysis, followed by regression modeling.</p><p><strong>Results: </strong>We found a strong significant correlation between SPV and gain and PTA posttreatment (Spearman Rho 0.000). A significant correlation between SPV and ET was also detected (Spearman Rho 0.05). The linear regression analysis indicated that for every 1° increase in SPV, there is an expected increase of 0.27 dB in gain and a decrease of 0.18 dB in PTA posttreatment. Furthermore, an SPV of 17.7 (°/sec) demonstrated a strong correlation with Siegel grade 1 posttreatment (p 0.000).</p><p><strong>Conclusions: </strong>The SPV (°/sec) of nystagmus during the first ITI may serve as a valuable tool for patient counseling in the management of ISSNHL, thereby encouraging the continuation or consideration of alternative treatment options. Further studies are warranted to validate these findings.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507292","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 Therapeutic Effects of Systemic Corticosteroid and Immunosuppressants for New-Onset Cases and Mepolizumab for Recurrent Cases of Otitis Media Associated With Eosinophilic Granulomatosis with Polyangiitis.","authors":"Shinya Morita, Atsushi Fukuda, Kimiko Hoshino, Yuji Nakamaru, Keishi Fujiwara, Masanobu Suzuki, Aya Honma, Akira Nakazono, Akihiro Homma","doi":"10.1097/MAO.0000000000004541","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004541","url":null,"abstract":"<p><strong>Objective: </strong>The aims of this study were to evaluate the otologic features and outcomes of otitis media associated with eosinophilic granulomatosis with polyangiitis (EGPA) and validate the current treatment strategies, including systemic corticosteroid (CS) and immunosuppressants for new-onset cases and therapeutic targeting of interleukin (IL)-5 for recurrent cases.</p><p><strong>Study design: </strong>Retrospective case series.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Patients: </strong>Patients with otitis media associated with EGPA were eligible for inclusion.</p><p><strong>Intervention: </strong>Systemic CS alone or a combination of systemic CS and intravenous cyclophosphamide (IVCY) was performed as induction therapy. Maintenance therapy with oral CS and immunosuppressant, such as rituximab, methotrexate, or azathioprine, was administered. Treatment with mepolizumab was performed at the time of relapse of major organ involvement in EGPA, exacerbation of asthma, and/or recurrence of ear, nose, and throat symptoms after remission induction.</p><p><strong>Main outcome measures: </strong>Air- and bone-conduction pure-tone thresholds, overall survival rate, EGPA relapse rate, and otitis media recurrence rate.</p><p><strong>Results: </strong>Systemic CS-based induction therapy achieved remission in all patients with EGPA. In both the CS + IVCY and CS-alone groups, hearing thresholds in the remission and/or resolution phase were significantly better than those at initial presentation at all frequencies (p < 0.01). The 5-year estimated relapse rate of major organ involvement was 29.2%, and the 5-year estimated recurrence rate of otitis media was 43.6%. All cases of recurrent otitis media treated with mepolizumab achieved improvement in otologic symptoms and subsequent reduction in maintenance CS dose. However, half of ears with recurrent otitis media showed repeated secretion and cessation of middle ear discharge and required additional topical CS treatment during mepolizumab administration.</p><p><strong>Conclusions: </strong>Immunosuppressive treatment affords a good response to systemic manifestations as well as otitis media associated with EGPA. Meanwhile, a significant proportion of patients experienced exacerbation of otitis media during maintenance therapy. Mepolizumab might be the treatment of choice for recurrent cases.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507321","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 Case of Calcification Discovered Within the Membranous Labyrinth During Resection of a Vestibular Schwannoma.","authors":"Syed Ameen Ahmad, Haley Zawitoski, Hakim Hiel, Yassine Balhi, Amanda Lauer, Adam Kaufman, Bryan K Ward","doi":"10.1097/MAO.0000000000004593","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004593","url":null,"abstract":"<p><strong>Objective: </strong>To report a case of calcification discovered in the membranous labyrinth of a patient with a vestibular schwannoma after transtemporal labyrinthectomy.</p><p><strong>Study design: </strong>Clinical capsule report.</p><p><strong>Setting: </strong>Tertiary academic referral center.</p><p><strong>Patient: </strong>An adult male with a 3-year history of left-sided hearing loss and balance issues was confirmed by MRI to have a cystic vestibular schwannoma.</p><p><strong>Interventions: </strong>Transtemporal labyrinthectomy.</p><p><strong>Main outcome measures: </strong>Appearance of the membranous labyrinth on CT imaging and immunohistochemistry.</p><p><strong>Results: </strong>A patient presented with a 3-year history of left-sided hearing loss and balance issues. MRI revealed a heterogeneously enhancing mass in the left cerebellopontine angle, consistent with a cystic vestibular schwannoma. After a transtemporal labyrinthectomy, a gross examination revealed calcification within the membranous labyrinth. Retrospective review of imaging identified a preoperative ring of calcification, confirmed with visual inspection of the removed tissue via light microscope. Immunohistochemical analysis demonstrated a reduced number of nuclei in the hypertrophied crista compared with the unaffected crista.</p><p><strong>Conclusions: </strong>Calcification in the membranous labyrinth may reflect underlying inner ear pathology. Further research is warranted to establish reliable methods for detecting this calcification to enhance our understanding of inner ear disorders.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507274","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":"Carbon Dioxide (CO2) Laser Glomus Tympanicum Resection: Hearing Outcomes and Recurrence Rates.","authors":"Amed Natour, Hitam Hagog Natour, Robert DeDio, Adam Vesole, Ravi N Samy","doi":"10.1097/MAO.0000000000004526","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004526","url":null,"abstract":"<p><strong>Introduction: </strong>Paragangliomas of the middle ear (glomus tympanicum, GT) are commonly encountered neoplasms of the temporal bone. GT is a benign tumor of vascular origin, arising from the neural crest cells and located on the promontory. The treatment of choice is surgical excision of the lesion.</p><p><strong>Objective: </strong>Our aim was to describe the surgical and hearing outcomes in a cohort of patients with middle ear paragangliomas following resection.</p><p><strong>Methods: </strong>We retrospectively reviewed the data of patients with GT who were treated with a CO2 laser from 2014 to 2021. Preoperative and postoperative audiometric outcomes, symptom evaluations, and otomicroscopic examinations were performed. The surgical approach was individualized for each patient based on tumor characteristics demonstrated on computed tomography. Three different approaches were used: (1) canal wall down, canal wall reconstruction, and mastoid obliteration (CWD, CWR, and MO) mastoidectomy; (2) canal wall up (CWU) mastoidectomy; and (3) endaural/transcanal.</p><p><strong>Results: </strong>Three males and 12 females aged between 33 and 76 years (mean, 56 yr) were included. Complete removal was accomplished in all cases using a CO2 laser with no recurrence or complications during the postoperative follow-up period.CWU mastoidectomy, CWD mastoidectomy with CWR/MO, and endaural/transcanal approaches were used in 5, 3, and 7 patients, respectively. A flexible 500-micron CO2 laser fiber was employed at 3-4 watts on the continuous mode setting.Three patients underwent concurrent ossicular chain reconstruction along with CWD/CWR mastoidectomy owing to preoperative conductive hearing loss with an air-bone gap (ABG) of wider than 30 dB, resulting in postoperative ABG closure. In relation to the remaining patients, no statistically significant postoperative worsening of audiometric outcomes in Word Recognition Score, pure tone average, and speech recognition threshold were observed. The mean follow-up period was 12 months.</p><p><strong>Conclusions: </strong>We found that using a flexible CO2 laser fiber and CWD mastoidectomy with canal wall reconstruction and mastoid obliteration are beneficial for managing these tumors.CO2 lasers are safe and reliable for GT resection. The advantages of this modality include complete removal, low complication and recurrence rates, and minimum morbidity.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507294","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}