Otology & Neurotology最新文献

{"title":"Socioeconomic and Demographic Trends of Non-English-Speaking Cochlear Implantees: A Large National Database Analysis.","authors":"Christopher Z Wen, Marcelina Puc, Charlyn Gomez, Danielle S Powell, David J Eisenman, Adam C Kaufman","doi":"10.1097/MAO.0000000000004603","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004603","url":null,"abstract":"<p><strong>Objective: </strong>To describe national trends in cochlear implantation for non-English-speaking cochlear implant (CI) users.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>US institutions participating in the Epic Cosmos database.</p><p><strong>Patients: </strong>Cochlear implantees between 2015 and 2023.</p><p><strong>Main outcome measures: </strong>Implantation rate, age at implantation, and measures of socioeconomic status.</p><p><strong>Results: </strong>A total of 25,883 patients (47% female) received 29,693 cochlear implants; 1,138 (4.4%) spoke a non-English language, with the most common being Spanish (73.4%), Arabic (4.7%), and Chinese (3.0%). Non-English speakers were implanted at lower population-adjusted rates across all age groups compared with English speakers. However, the percentage of non-English-speaking CI recipients (4.6 ± 0.4%) changed little from year to year. A greater proportion of non-English (53.8%; OR, 4.31; 95% CI, 3.86-4.82) and Spanish-speaking (58.5%; OR, 5.23; 95% CI, 4.60-5.95) CI users were children compared with English-speaking (21.2%) cochlear implantees. Compared with English-speaking CI users (79.5%), non-English-speaking CI recipients (93.1%; OR, 3.49; 95% CI, 2.76-4.41) and Spanish-speaking CI recipients (91.8%; OR, 2.88; 95% CI, 2.24-3.71) were more likely to live in urban areas. Both were also more likely to live in ZIP codes with greater social vulnerability as measured by the social vulnerability index (V = 0.15, V = 0.16).</p><p><strong>Conclusions: </strong>There exists evidence of disparities in rates of cochlear implantation based on spoken language at a national level, with rates of cochlear implantation in non-English speakers remaining unchanged over the past 9 years. Non-English CI users are more likely to be implanted as children and are more likely to live in urban areas and ZIP codes with higher SES and SVI compared with English-speaking CI users.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789666","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":"Contemporary Tympanostomy Tube Complications in Children: A Population-Based Longitudinal Study.","authors":"Nofar Ben-Mordechai Sharon, Sharon Ovnat Tamir, Marina Gitin, Yehuda Schwarz, Tal Marom","doi":"10.1097/MAO.0000000000004536","DOIUrl":"10.1097/MAO.0000000000004536","url":null,"abstract":"<p><strong>Objective: </strong>To describe the current tympanostomy tube insertion (TTI) complication rates occurring within 3 years of surgery in the post-intervention era. Current TTI complication rates in children are based on reports from a meta-analysis that was published in 2001, reporting on 16 to 26% otorrhea rates, cholesteatoma development of 0.7%, and tympanic membrane perforation (TMP) of 2.2 to 16%. Since then, interventions aimed at reducing pediatric otitis media burden have been largely implemented worldwide, and indications for TTI have been published.</p><p><strong>Study design: </strong>Population-based longitudinal study. Data were anonymously retrieved from a big stable healthcare database between 2005 and 2021.</p><p><strong>Setting: </strong>Hospitals and ambulatory surgical centers, nationwide.</p><p><strong>Patients: </strong>Children who underwent TTI and completed 3 postoperative follow-up years within the health insurance. We excluded children with previous otological surgery and congenital craniofacial anomalies. Children were categorized into the younger (0-<7 yr) and older (7-18 yr) age groups.</p><p><strong>Intervention: </strong>TTI (therapeutic).</p><p><strong>Main outcome measures: </strong>Number of TTI performed per 100,000 children per study year, and cumulative incidence of these postoperative complications: TT removal, otorrhea, TMP, cholesteatoma development, and need for mastoidectomy.</p><p><strong>Results: </strong>Of the 19,920 unique children identified, 86.6% were in the younger age group with a mean age of 3.57 ± 1.59 years, and 61% were boys. At the end of follow-up, older children had statistically significantly higher TMP (6.9% versus 3.3%, p < 0.001), TT removal (5.1% versus 3.8%, p < 0.001), cholesteatoma (2.2% versus 0.8%, p < 0.001), and mastoidectomy (0.8% versus 0.3%, p < 0.001) rates when compared with younger children, respectively. Younger children experienced higher otorrhea rates when compared with older children (11% versus 6.4%, p < 0.001) but for a shorter period (324 ± 290 versus 404 ± 303 days, p < 0.001).</p><p><strong>Conclusions: </strong>Post-TTI complication rates are lower in the post-intervention era, except for cholesteatoma. This current quantitative appreciation of TTI complications can help both patients and caregivers define realistic postoperative expectations.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"829-835"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cochlear Implantation of Slim Precurved Arrays Using Automatic Preoperative Insertion Plans.","authors":"Kareem O Tawfik, Mohammad M R Khan, Ankita Patro, Miriam R Smetak, David Haynes, Robert F Labadie, René H Gifford, Jack H Noble","doi":"10.1097/MAO.0000000000004525","DOIUrl":"10.1097/MAO.0000000000004525","url":null,"abstract":"<p><strong>Hypothesis: </strong>Preoperative cochlear implant (CI) electrode array (EL) insertion plans created by automated image analysis methods can improve positioning of slim precurved EL.</p><p><strong>Background: </strong>This study represents the first evaluation of a system for patient-customized EL insertion planning for a slim precurved EL.</p><p><strong>Methods: </strong>Twenty-one temporal bone specimens were divided into experimental and control groups and underwent cochlear implantation. For the control group, the surgeon performed a traditional insertion without an insertion plan. For the experimental group, customized insertion plans guided entry site, trajectory, curl direction, and base insertion depth. An additional 35 clinical insertions from the same surgeon were analyzed, 7 of which were conducted using the insertion plans. EL positioning was analyzed using postoperative imaging auto-segmentation techniques, allowing measurement of angular insertion depth (AID), mean modiolar distance (MMD), and scalar position.</p><p><strong>Results: </strong>In the cadaveric temporal bones, three scalar translocations, including two foldovers, occurred in 14 control group insertions. In the clinical insertions, translocations occurred in 2 of 28 control cases. No translocations or folds occurred in the seven experimental temporal bone and the seven experimental clinical insertions. Among the nontranslocated cases, overall AID and MMD were 401 ± 41 degrees and 0.34 ± 0.13 mm for the control insertions. AID and MMD for the experimental insertions were 424 ± 43 degrees and 0.34 ± 0.09 mm overall and were 432 ± 19 degrees and 0.30 ± 0.07 mm for cases where the planned insertion depth was achieved.</p><p><strong>Conclusions: </strong>Trends toward improved EL positioning within scala tympani were observed when EL insertion plans are used. Variability in MMD was significantly reduced (0.07 versus 0.13 mm, p = 0.039) when the planned depth was achieved.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"862-870"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974912","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 Implantable Hearing Devices on Delirium Risk in Patients with Hearing Loss: A National Database Study.","authors":"Bryce Hambach, Jena Patel, Kathryn Nunes, Elliott M Sina, Pablo Llerena, Alexander Knops, Rebecca C Chiffer, Jacob B Hunter","doi":"10.1097/MAO.0000000000004416","DOIUrl":"10.1097/MAO.0000000000004416","url":null,"abstract":"<p><strong>Objective: </strong>Exploring whether the utilization of implantable hearing rehabilitation devices is associated with a reduced likelihood of developing delirium in patients with hearing loss.</p><p><strong>Study design: </strong>A retrospective cohort database study with propensity score matching (PSM) utilizing TriNetX clinical database.</p><p><strong>Setting: </strong>The US Collaborative Network within the TriNetX database (100 million people).</p><p><strong>Patients: </strong>Patients over 55 years old were selected based on three categories: a non-hearing loss study control (ICD-10: H90-91), a hearing loss (HL without implantable device), and an implantable device cohort (ICD-10: Z96.21, Z96.29, 09HD, 09HE; CPT: 69714, 69930). Patients with prior dementia or memory loss diagnosis were excluded (F01-03, 27-29).</p><p><strong>Interventions: </strong>Observational.</p><p><strong>Main outcome measures: </strong>Odds ratios with 95% confidence intervals for delirium diagnosis code (F0.5).</p><p><strong>Results: </strong>The control cohort (n = 36.5 million) was 1:1 PSM for age and sex with the HL cohort (n = 1.77 million) in which 0.28% of patients developed delirium compared to 0.74% in the HL cohort (OR 2.66, 95% CI = 2.58-2.75). When looking at the same PSM between HL and implantable device cohorts (n = 20,847), 0.81% developed a delirium diagnosis compared to 0.45% in the implantable device cohort (OR = 1.79, 95% CI = 1.39-2.31). Further analysis accounting for 16 PSM covariates showed that 0.74% of the HL cohort developed delirium compared to 0.45% of the implantable device cohort (OR = 1.64, 95% CI = 1.27-2.13).</p><p><strong>Conclusions: </strong>The present study shows that patients with hearing loss were more likely to develop delirium than those with normal hearing. Importantly, patients with implantable hearing devices were significantly less likely to develop delirium compared to hearing loss patients without an implantable device. Our research highlights the importance of treating hearing loss to prevent delirium.Level of Evidence: III.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"775-780"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586540","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 Preservation of Slim Modiolar and Slim Straight Electrodes: A Systematic Review and Meta-Analysis.","authors":"Shuang Geng, Sudanthi Wijewickrema, Bridget Copson, Jean-Marc Gerard, Stephen O'Leary","doi":"10.1097/MAO.0000000000004540","DOIUrl":"10.1097/MAO.0000000000004540","url":null,"abstract":"<p><strong>Purpose: </strong>This meta-analysis aims to investigate the hearing preservation (HP) rates of slim straight electrodes (SSE) and slim modiolar electrodes (SME) after cochlear implantation, in the short- and long-term (≤4 months and 4-12 months, respectively).</p><p><strong>Methods: </strong>A systematic search was conducted in PubMed, Embase, Cochrane Library, and ClinicalTrials databases for studies published between 1 January, 2014, and 1 January, 2024. Cohort studies, case series, and randomized controlled trials written in English, reporting HP rates using the HEARRING classification system, were included.</p><p><strong>Results: </strong>Sixteen studies were included, comprising 15 observational studies and 1 randomized controlled trial. The overall short-term HP rate for SSE was 68.70% (95% CI: 52.27-85.12%), which decreased to 56.38% (95% CI: 42.87-69.90%) in the long-term. In contrast, SME maintained stable HP rates of 59.07% (95% CI: 50.03-68.10%) in the short-term, and 59.09% (95% CI: 46.48-71.70%) in the long-term.</p><p><strong>Conclusion: </strong>The meta-analysis revealed that SME and SSE have a similar HP ability in both the short- and long-terms. Notably, a prominent decline in HP rate over time was observed in the SSE compared with SME.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"733-742"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009119","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":"Prevalence of Elevated Intracranial Pressure in Lateral Spontaneous Cerebrospinal Fluid (CSF) Leaks.","authors":"Evan C Cumpston, William Zhang, Ritika S Bhadouriya, Douglas J Totten, Charles W Yates, Rick F Nelson","doi":"10.1097/MAO.0000000000004466","DOIUrl":"10.1097/MAO.0000000000004466","url":null,"abstract":"<p><strong>Objective: </strong>Evaluate postoperative opening pressures (OP) on lumbar puncture (LP) and polysomnogram (PSG) findings in patients who underwent middle cranial fossa (MCF) repair with lateral spontaneous cerebrospinal fluid (sCSF) leaks.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Interventions: </strong>MCF repair of sCSF leak, PSG, and postoperative LP.</p><p><strong>Main outcome measures: </strong>Prevalence of intracranial hypertension (IH; LP OP >25 cm H 2 O), and of obstructive sleep apnea (OSA) (apnea-hypopnea index [AHI] >5).</p><p><strong>Results: </strong>Seventy-two patients had an average (standard deviation) age of 56.7 (±11.7) years and BMI of 39.0 (±9.9) kg/m 2 . There were no unilateral recurrent CSF leaks. OP was completed by 39 patients at a mean 155.5 days (±172.3) postop with a mean OP 22.3 cm H 2 O (±8.3). Only 10 (32%) patients had an LP ≥25 cm H 2 O, of which 9 were female and 1 male. Papilledema was observed in 1 of 12 patients on retinal exam. Polysomnogram was completed by 35 patients and OSA was observed in 93% of patients with a mean AHI of 25.6 (±35.1). There was a positive correlation between AHI and elevated OP. All patients with an OP>25 cm H 2 O had an AHI > 15. In the three patients who developed a contralateral leak, the mean OP was 27.5 (±8.8), AHI 16.5 (±2.5), and mean BMI 37.2 (±12.6). In the four patients with a history of anterior and lateral sCSF leak, mean OP was significantly elevated at 28.75 (±2.9) ( p = 0.03). In the six patients with a history of bilateral sCSF leaks, mean OP was also significantly elevated at 31.5 (±6.9) ( p = 0.03).</p><p><strong>Conclusions: </strong>The prevalence of IH on postoperative LP was 32% in lateral sCSF leak patients and nearly all patients had OSA. There was a positive correlation between AHI and elevated OP. All patients should obtain a PSG and those with an AHI >15, multifocal sCSF leaks, or visual symptoms should also obtain a postoperative LP.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"816-820"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143616638","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":"Rationale for the Development of a Universal Hearing Metric for Public Consumption: Initiative 1 of the Hearing Health Collaborative.","authors":"Nicholas S Reed, Sahar Assi, Matthew Bush, Matthew L Carlson, Maura Cosetti, Liza Creel, Samuel Gubbels, Richard Gurgel, Meredith Holcomb, Anna M Jilla, Frank R Lin, John P Marinelli, Clarice Myers, Douglas P Sladen, Christopher Spankovich, Sarah Sydlowski, Bevan Yueh, Ashley M Nassiri","doi":"10.1097/MAO.0000000000004523","DOIUrl":"10.1097/MAO.0000000000004523","url":null,"abstract":"<p><strong>Objective: </strong>Present the rationale for the development of a new, patient-facing vital sign for adult hearing.</p><p><strong>Study design: </strong>Structured A3 process.</p><p><strong>Setting: </strong>Fourteen virtual meetings and two in-person meetings held between May 2021 and June 2022.</p><p><strong>Main outcome measures: </strong>Identification and refinement of a countermeasure to develop and imbed a hearing health vital sign for adult hearing.</p><p><strong>Results: </strong>Through a rigorous, structured A3 process, the Hearing Health Collaborative identified and refined the rationale for and the qualities associated with a public-facing vital sign for adult hearing loss. Specifically, such a vital sign must embody five qualities: simple, accessible, stable, inclusive, and meaningful. These qualities together would ensure that a hearing health vital sign would be useful not only as a screening tool but also as an instrument to guide next steps in workup and potentially treatment.</p><p><strong>Conclusions: </strong>Successful identification and implementation of a hearing metric or \"vital sign\" for the presence of adult hearing loss, using precedent convention of other medical diseases, may help reframe public perceptions surrounding hearing loss, improve awareness and literacy regarding the presence of the disease, and prompt action to seek diagnostic assessment.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"743-747"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008407","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 Multi-Institutional Analysis of Device Failures in a Recent Cochlear Implant Series.","authors":"Michael H Freeman, Nathan R Lindquist, James R Dornhoffer, Kristen L Yancey, Ankita Patro, Benjamin D Lovin, Taimur Siddiqui, Aniket A Saoji, Jourdan R Holder, Walter Kutz, Alex D Sweeney, David S Haynes, Matthew L Carlson, Marc L Bennett","doi":"10.1097/MAO.0000000000004438","DOIUrl":"10.1097/MAO.0000000000004438","url":null,"abstract":"<p><strong>Objective: </strong>To assess Advanced Bionics (AB) HiRes Ultra and Ultra 3D initial version (V1) cochlear implant electrode failures over time at four large cochlear implant programs.</p><p><strong>Study design: </strong>Retrospective cohort.</p><p><strong>Setting: </strong>Four tertiary referral centers.</p><p><strong>Patients: </strong>Patients receiving AB HiRes Ultra and Ultra 3D initial version (V1) devices as of December 31, 2022.</p><p><strong>Main outcome measures: </strong>Failure rate, revision surgery, speech recognition scores.</p><p><strong>Results: </strong>Over a span of 7 years, 205 (42.6%) of 483 implanted V1 devices have failed. Device failure rate varied across institutions from 32 to 67%. Of the 205 detected failures, 163 (79%) have undergone revision surgery, with 94% of revisions being performed with Advanced Bionics devices. Average time from implantation to diagnosis of device failure was 2.7 ± 1.2 years. Most patients (89.8%) with available testing were matched or exceeded their best prefailure speech performance after implant revision. After revision, patients had an average CNC score improvement of 24.7 percentage points over their most recent pre-revision scores and demonstrated average datalogging of 12.7 ± 4.1 h/d at most recent evaluation.</p><p><strong>Conclusions: </strong>Comparison of patients across multiple high-volume implant centers confirms the presence of ongoing device failures. There is variability across institutions in the rate of revision surgery once a patient is diagnosed with a V1 device failure, as well as in the rate of device failure detection. Inter-institutional variability in failure rates may be explained by the variation in the routine use of electrical field imaging. Reimplantation with a new device typically results in a return to prefailure peak performance.</p><p><strong>Professional practice gap educational need: </strong>To our knowledge, a comparison of AB HiRes (V1) device failures across multiple institutions has not been conducted.</p><p><strong>Learning objective: </strong>To identify device failure rate across multiple institutions with different testing protocols.</p><p><strong>Desired result: </strong>Providers will have an improved understanding of the trajectory of device failures for HiRes (V1) devices over time.</p><p><strong>Level of evidence: </strong>Level IV-Historical cohort or case-controlled studies.</p><p><strong>Indicate irb or iacuc: </strong>IRB #230017; IRB #22-000183; IRB #STU-032018-085; IRB #H-49479.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"789-795"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586529","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":"Qualifying Cochlear Implant Candidates-Does it Matter How Patients Are Qualified?","authors":"David S Lee, Jacques A Herzog, Amit Walia, Miriam R Smetak, Cole Pavelchek, Nedim Durakovic, Cameron C Wick, Amanda J Ortmann, Craig A Buchman, Matthew A Shew","doi":"10.1097/MAO.0000000000004429","DOIUrl":"10.1097/MAO.0000000000004429","url":null,"abstract":"<p><strong>Objective: </strong>Evaluate variable qualification criteria for cochlear implant (CI) recipients and 12-month speech perception outcomes.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>HERMES national database and nonoverlapping single-institution CI database.</p><p><strong>Patients: </strong>A total of 2,124 adult unilateral CI recipients categorized by qualifying status: AzBio in quiet (n = 1,239), +10 dB SNR (but not in quiet; n = 519), +5 dB SNR (but not in quiet or +10 dB SNR; n = 366); CNC ≤40% (n = 1,037), CNC 41% to 50% (n = 31), and CNC 51% to 60% (n = 20).</p><p><strong>Interventions: </strong>CI.</p><p><strong>Main outcome measures: </strong>Pre- and 12-month postoperative speech perception performance. Clinically significant improvement was defined as ≥15% gain.</p><p><strong>Results: </strong>Quiet qualifiers experienced improvement in all listening conditions, whereas +10 dB SNR and +5 dB SNR qualifiers only improved in their qualifying condition and implanted ear CNC. When stratified by expanded Medicare criteria (binaural AzBio ≤60% correct), patients that qualified in quiet experienced improvements regardless of qualifying threshold or background noise. However, those that qualified in noise and AzBio ≤60% experienced mixed results in quiet and limited gain in background noise. When ≤60% criteria was applied to CNC of the worse ear, ≤40% qualifiers experienced large improvements in all tested conditions, but those who qualified by 41% to 50% or 51% to 60% only demonstrated modest improvements in AzBio sentence testing.</p><p><strong>Conclusions: </strong>Quiet qualifiers improved in all testing conditions, while those qualifying in noise improved in their qualifying condition. Patients who qualified by expanded Medicare criteria (≤60%) showed improvement when qualifying with AzBio in quiet, but should be used with caution when qualifying patients in background noise or CNC due to more limited gains in performance.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"781-788"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449656","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":"Exacerbation of Preexisting Otologic Conditions After COVID-19 Infection.","authors":"Víctor de Cos, Omer Baker, Nicollette Pepin, Omid Moshtaghi, Peter R Dixon, Akihiro J Matsuoka, Jeffrey P Harris","doi":"10.1097/MAO.0000000000004492","DOIUrl":"10.1097/MAO.0000000000004492","url":null,"abstract":"<p><strong>Background: </strong>Since the height of the COVID-19 pandemic, there have been an increasing number of reports of incidence of otologic conditions after infection. We aim to investigate whether a history of otologic conditions was associated with elevated risk of similar or exacerbated symptoms after COVID-19 infection.</p><p><strong>Methods: </strong>Surveys were administered to patients 18 years or older who had tested positive via PCR testing for COVID-19 infection between January 2020 and September 2022. Incidence of otologic symptoms within the 10-day period after COVID-19 infection was compared between participants with a preexisting otologic condition and control participants.</p><p><strong>Results: </strong>Of 1,499 patients who tested positive for COVID-19, 63.2% were female, 87.5% were White, and the mean age was 58 years. Of these, 721 (48%) reported a preexisting otologic condition, with loss of hearing (25.5%) and history of dizziness (18.8%) being most highly represented among this subcohort. Of patients with a preexisting condition, 35.5% subjectively reported that they believed COVID-19 infection had worsened otologic symptoms of their condition. Univariable analysis revealed that individuals were more likely to report dizziness post-COVID-19 infection if they had a preexisting history of dizziness (29.1% versus 17.8%, p < 0.001) or preexisting history of vestibular neuritis (58.8% versus 19.5%, p < 0.001) than those who did not. Similarly, individuals with a history of vestibular migraine were more likely to report migraine symptoms after infection than those who did not (27.9% versus 7.2%, p < 0.001). Multivariable analysis revealed that preexisting history of dizziness, vestibular neuritis, vestibular migraine, and autoimmune conditions increased the odds of several otologic symptoms, although an exception was observed with decreased odds for changes in hearing in patients with preexisting history of dizziness. Younger age and female gender were associated with higher odds for various otologic symptoms after COVID-19 infection.</p><p><strong>Conclusions: </strong>These findings indicate that certain preexisting otologic conditions may be associated with a greater likelihood of exacerbation after COVID-19 infection and may help guide screening protocols for those at greatest risk.</p><p><strong>Level of evidence: </strong>III.</p><p><strong>Irb: </strong>UCSD IRB #801971.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"836-841"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037100","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}