Otology & Neurotology最新文献

{"title":"Prognostic Factors for Facial Nerve Outcome after Vestibular Schwannoma Surgery: A 12-Year Multicentric Retrospective Study.","authors":"Lucidi Daniela, Marchioni Daniele, Bisi Nicola, Calvaruso Federico, Presutti Livio, Alicandri-Ciufelli Matteo, Donvito Sara","doi":"10.1097/MAO.0000000000004582","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004582","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to evaluate facial nerve (FN) impairment in patients undergoing three vestibular schwannoma (VS) surgical techniques and identify variables influencing FN function.</p><p><strong>Materials and methods: </strong>A retrospective multicentric analysis was conducted on patients treated between 2010 and 2022 using retrosigmoid (RS), translabyrinthine (TL), or transcanal transpromontorial surgery (TTS). All participants had normal preoperative FN function and no previous radiotherapy. FN function was evaluated immediately, 6, 12, and 24 months post-surgery using the HB scale.</p><p><strong>Results: </strong>Among 234 patients, the median FN grade was HB III immediately post-surgery, improving to HB II at 6, 12, and 24 months. Transient FN palsy occurred in 48%, whereas permanent palsy affected 39%. Higher Koos grades were significantly associated with worse FN outcomes. Older age correlated with poorer recovery at 6, 12, and 24 months (p = 0.03, 0.009, 0.02). In Koos II cases, TL yielded better FN function than RS at 48 hours and 12 months (p = 0.03). Among Koos III patients, FN preservation rates were significantly higher with TL versus RS at all time points (p = 0.003, 0.003, 0.001, 0.004). TTS demonstrated superior FN preservation compared with RS at 12 and 24 months (p = 0.007, 0.001). Multivariate analysis revealed younger age, lower Koos, TL, and TTS as predictors of better FN outcomes.</p><p><strong>Discussion: </strong>Younger age, lower Koos grades, and the TL and TTS approaches are significantly linked to improved FN function after VS surgery.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275542","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":"Consistent Visualization of the Round Window Niche Veil With Ultrahigh-Resolution Photon-Counting Detector CT.","authors":"Yu Si, Konstantin Klambauer, Thomas Flohr, Hatem Alkadhi, Alexander Huber, Merlin Schär","doi":"10.1097/MAO.0000000000004562","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004562","url":null,"abstract":"<p><strong>Objective: </strong>To assess whether the ultrahigh-resolution (UHR) mode of photon-counting detector (PCD) CT can consistently visualize the round window niche veil (RWNV) in human ex vivo specimens.</p><p><strong>Samples: </strong>This ex vivo study was conducted on nine human cadaveric temporal bones (four male and five female body donors) with an average age of 72 years (range of 56-83 yr).</p><p><strong>Intervention: </strong>Imaging with a dual-source PCD-CT scanner in ultrahigh-resolution (UHR) mode.</p><p><strong>Main outcome measures: </strong>Two blinded, independent board-certified radiologists reviewed CT images in axial and coronal reformations to determine the presence and extent of an RWNV (complete or partial). The performance of the PCD-CT was evaluated by comparing the readings of the radiologists to inspection of the dissected specimens with a surgical endoscope and microscope.</p><p><strong>Results: </strong>The UHR mode of PCD-CT provided consistent visualization of the RWNVs. Five out of six RWNVs were accurately identified, and all three specimens without RWNVs were correctly recognized. All complete RWNVs were correctly identified. The readers missed one partial RWNV due to its close proximity and minimal fluid next to the round window membrane. The visualization of the RWNV was superior in the coronal plane compared with the axial plane.</p><p><strong>Conclusions: </strong>This study is the first to demonstrate that the UHR mode of PCD-CT enables a consistent visualization of the RWNV in ex vivo specimens. The promising results of the current study support verification of the results in prospective patient studies.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275540","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":"Integrating Expression Quantitative Trait Loci and Genome-Wide Association Study Identifies Druggable Genes for Tinnitus.","authors":"Tao Guo, Jingqi Zhang, Xianpeng Xu, Dehong Liu, Guobing Jia, Xinghong Liu, Hui Xie","doi":"10.1097/MAO.0000000000004574","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004574","url":null,"abstract":"<p><strong>Background: </strong>The investigation of druggable target genes through large-scale expression quantitative trait loci (eQTL) and genome-wide association study (GWAS) data has demonstrated promise across various diseases. This approach has yet to be explored in the context of tinnitus.</p><p><strong>Methods: </strong>We obtained cis-eQTL data for 3,453 druggable genes from eQTLGen. Tinnitus phenotype derived from the UK Biobank was used as the discovery cohort. A large-scale Mendelian randomization (MR) analysis was conducted to investigate the inferred causal relationships between the 3,453 druggable genes and tinnitus. Replication analyses were conducted using tinnitus phenotypes from FinnGen. We further conducted colocalization analysis to identify actionable drug targets for tinnitus. Besides, MR analysis was used to explore the association of the identified genes with hearing loss and inflammation.</p><p><strong>Results: </strong>Genetic predictions indicated that the expression of NEU1 (β = 0.137, 95% CI = 0.112 to 0.162, p = 2.21 × 10-26), APOM (β = 0.139, 95% CI = 0.112 to 0.166, p = 1.23 × 10-24), and TUBB (β = -0.043, 95% CI = -0.062 to -0.024, p = 5.46 × 10-6) was causally associated with tinnitus. Our replication analysis in FinnGen yielded consistent results. There is a strong colocalization association between the three genes and tinnitus (PPH4 > 0.8). No evidence indicated these three genes were associated with hearing loss. Network MR suggested that IL-17C and CCL20 mediates effects of APOM on tinnitus, and IL-17C accounts for effects of NEU1 on tinnitus.</p><p><strong>Conclusions: </strong>Our findings investigated the potential pathological mechanisms and therapeutic targets of tinnitus, providing novel strategies for future clinical trials.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249055","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":"Systematic Review of the Impact of Magnetic Resonance Imaging on Diametric Magnet Cochlear Implants.","authors":"Quan Lu, Sidney Spencer, Anita Jeyakumar","doi":"10.1097/MAO.0000000000004556","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004556","url":null,"abstract":"<p><strong>Objective: </strong>Review the properties, safety, and artifacts of current cochlear implants (CI) with freely rotatable magnets during MRI scans.</p><p><strong>Databases reviewed: </strong>PubMed, Cochrane, and Web of Science; last accessed September 2023.</p><p><strong>Methods: </strong>The study was BSMH IRB exempted. MESH term \"magnetic resonance imaging\" and phrases of \"Med-el Synchrony,\" \"Cochlear Nucleus Profile Plus,\" \"Advanced Bionics HiRes Ultra 3D,\" \"rotatable magnet cochlear,\" \"rotatable magnet,\" \"diametric magnet,\" \"diametric magnet cochlear implant,\" and \"MRI-safe cochlear implant\" using \"AND\" function. Non-English, non-human, non-implanted CI, and cadaveric studies were excluded. Methodological quality was assessed using the Mixed Methods Appraisal Tool, and quality of the evidence was evaluated using the GRADE criteria.</p><p><strong>Results: </strong>The review included 18 studies. Fifteen assessed pain as a complication, with two reporting its occurrence: two cases for Synchrony and one for Ultra 3D. Demagnetization did not occur in the 12 studies that reported on it. One magnet displacement was noted with the Ultra 3D implant out of the 16 reporting studies. Artifacts were reported by 11 studies, with most scans retaining most to limited diagnostic usability. One Synchrony device required explantation due to artifact, and one was explanted before MRI.</p><p><strong>Conclusion: </strong>Of the CI models reviewed with diametric magnets, Med-El Synchrony may enable MRI usage with fewer safety concerns when following the manufacturer's recommendations. However, clinical reports of freely rotatable CI safety during MRI scans are sparse and contain incomplete data. MRI artifacts from CI still pose concerns for image quality but can be minimized with appropriate implant location and scanning protocols.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226147","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":"Impact of Vestibular Schwannoma Management on Cochlear Implant Programming and Outcomes.","authors":"Courtney Kolberg, Jamie Bogle, Melissa D DeJong, Nicholas Deep, Peter Weisskopf, James R Dornhoffer, Brian A Neff, Colin L W Driscoll, Matthew L Carlson, Aniket A Saoji","doi":"10.1097/MAO.0000000000004572","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004572","url":null,"abstract":"<p><strong>Objectives: </strong>To compare electrical stimulation and speech perception in vestibular schwannoma (VS) patients across treatment modalities and standard cochlear implant (CI) patients.</p><p><strong>Study design: </strong>Retrospective review.</p><p><strong>Setting: </strong>Tertiary academic center.</p><p><strong>Patients: </strong>Sixty-seven CI ears consisting of 23 standard CI controls and 44 VS patients with ipsilateral CI. VS patients were separated by treatment modality: 24 microsurgical resection, 15 radiation therapy, and 5 observation. Eleven VS patients with CI did not receive auditory sensation from electrical stimulation.</p><p><strong>Interventions: </strong>VS microsurgical resection, radiation therapy, and observation.</p><p><strong>Main outcome measures: </strong>Threshold (T-levels), comfort (C-levels), consonant-nucleus-consonant (CNC) word score, and AzBio sentence recognition scores.</p><p><strong>Results: </strong>Patients who underwent microsurgical resection required significantly higher (p < 0.001) T-levels and C-levels compared with the standard CI group. Stimulation levels in the VS radiation therapy and observation groups were higher but not significantly different compared with standard CI controls. Overall rate of CI nonstimulation across all VS patients was 25%: 38% for microsurgery and 13% for radiation. Average CNC score for microsurgery group was 18% compared with 44% for radiation, 55% for observation, and 68.5% for standard CI controls. CNC word and AzBio scores were significantly lower (p < 0.001) for the microsurgery group compared with standard CI group.</p><p><strong>Conclusions: </strong>Resection may negatively affect auditory nerve function, leading to higher stimulation levels, increased risk of nonstimulation, and poorer postoperative CI speech outcomes compared with observation or radiosurgery. When medically appropriate, nonsurgical VS management may be used to allow for optimization of CI programming and postoperative hearing outcomes.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249054","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":"Histopathology of Opioid-Induced Sensorineural Hearing Loss: A Case Report.","authors":"Emily C Wong, Arman Danielian, Ivan Lopez, Akira Ishiyama, Gail Ishiyama","doi":"10.1097/MAO.0000000000004549","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004549","url":null,"abstract":"","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226140","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":"Blastomycosis of the Temporal Bone With Intracranial Extension.","authors":"Bronson Wessinger, Michael Nisiewicz, Monica McGrath, Matthew Bush, Nathan Cass","doi":"10.1097/MAO.0000000000004565","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004565","url":null,"abstract":"","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249053","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":"Perspectives on Minimum Neurotology Fellowship Case Numbers: A Survey of American Neurotology Society Members.","authors":"Edward Harwick, Walter Kutz, Karl Doerfer, Rick F Nelson, Maura Cosetti, Robert Hong, Deepa Galaiya, Tina Huang, Jacques Herzog, Oliver Adunka, Michael S Harris","doi":"10.1097/MAO.0000000000004570","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004570","url":null,"abstract":"<p><strong>Objective: </strong>Compare the Accreditation Council for Graduate Medical Education (ACGME) Neurotology Minimum Number case requirements for graduating neurotology fellows with what American Neurotology Society (ANS) members believe to be the number of cases needed to achieve competency and other clinically relevant benchmarks.</p><p><strong>Methods: </strong>An anonymous Internet-based ratio scale survey of current ANS members to assess 1) respondents' demographic and practice characteristics (e.g., years in practice, practice environment); 2) self-reflection estimates regarding fellowship case numbers needed to achieve surgical competency and case numbers post-training needed to achieve key benchmarks (current case duration, outcomes comparable to the literature); and 3) opinions on what minimum case numbers should be for conventional lateral skull base approaches.</p><p><strong>Results: </strong>A total of 143 ANS members (24% response rate) completed the survey, representing both academic and private practice neurotology and a broad range of years in practice. To achieve competency, respondents reported needing approximately 20 translabyrinthine approaches, 15 retrosigmoid approaches, 18 middle cranial fossa (MCF) approaches for tumors, and 13 MCF approaches for non-neoplastic indications each. Most (85%) respondents believed the translabyrinthine approach should be assigned a minimum case number requirement. A substantial proportion of respondents (21-31%) reported rarely or never using the MCF approach for vestibular schwannoma resection.</p><p><strong>Conclusion: </strong>For any single lateral skull base approach, ANS members' responses fell within the ACGME's current 25-case minimum. Cumulatively, however, for competency in multiple conventional approaches coming out of fellowship, these data may suggest that more cases are necessary. Additionally, making a specific requirement for translabyrinthine approach should be considered.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249056","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 Nerve Atrophy in Postlingual ANSD: Diagnostic Clue and Implications for Cochlear Implantation.","authors":"Kyu Ha Shin, Kherlen Altanbayar, Hye-Rim Park, Jin Hee Han, Jiyeon Yang, Pil Geum Jang, Ngoc-Trinh Tran, Ju Ang Kim, Bong Jik Kim, Byung Yoon Choi","doi":"10.1097/MAO.0000000000004567","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004567","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate cochlear nerve (CN) atrophy in postlingual auditory neuropathy spectrum disorder (post-ANSD) versus simple sensorineural hearing loss (sSNHL) and its implications for cochlear implantation (CI).</p><p><strong>Design: </strong>A retrospective study of 61 CI recipients (15 post-ANSD, 46 sSNHL) assessed CN size through imaging, analyzed auditory performance, and compared outcomes based on etiology, age, and molecular subtypes.</p><p><strong>Results: </strong>Post-ANSD exhibited more severe CN atrophy despite better pure tone averages than sSNHL. Postsynaptic post-ANSD showed significantly greater CN atrophy than presynaptic cases and sSNHL. Although CN atrophy was pronounced, it did not predict poor CI outcomes within the observed thresholds. Speech scores improved markedly post-CI, with no correlation to CN size.</p><p><strong>Conclusion: </strong>CN atrophy severity is etiology-dependent and most pronounced in postsynaptic post-ANSD. Severe atrophy could serve as a diagnostic marker of postsynaptic post-ANSD without auditory test clues. Early CI is recommended for optimal outcomes, emphasizing timely intervention in post-ANSD patients.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226137","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":"RESPONSE TO LETTER TO EDITOR FOR \"MORPHOMETRIC MEASUREMENTS OF THE INCOMPLETE PARTITION TYPE II (IP-II) COCHLEA AND IMPLICATIONS ON COCHLEAR IMPLANTATION\".","authors":"Adam Y Xiao, Miryam Saad, Rance J T Fujiwara, Emily C Wong, Grant O Korte, Levent Sennaroglu, Ivan A Lopez, Gail Ishiyama, Akira Ishiyama","doi":"10.1097/MAO.0000000000004569","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004569","url":null,"abstract":"","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226146","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}