The Annals of otology, rhinology, and laryngology最新文献

{"title":"The Maxillary Lid Approach to Intra-Antral Pathology.","authors":"Brady J Anderson, Scott M Graham, Brian Andrews, Joseph D Camargo, Douglas E Kendrick","doi":"10.1177/00034894251401095","DOIUrl":"10.1177/00034894251401095","url":null,"abstract":"<p><strong>Objectives: </strong>The primary objective of this series is to describe the adaptation of a common dental procedure (the maxillary bony window approach) to clinical otolaryngology for a variety of pathologies affecting the maxillary sinus. While the sublabial approach to the maxillary sinus has been widely described, contemporary plating methods may reduce historical drawbacks which include oroantral fistula, maxillary sinusitis, and facial asymmetry.</p><p><strong>Methods: </strong>Four patients underwent en bloc removal of the antero-lateral maxillary wall for removal of intra-antral pathology, with bony lid reconstruction using contemporary plating methods. Clinical course, complications, and follow-up information were examined.</p><p><strong>Results: </strong>Diagnoses included keratocystic odontogenic tumor, foreign body (displaced tooth), bony cyst, and juvenile nasopharyngeal angiofibroma. All patients underwent successful surgery with excellent exposure of the maxillary sinus and reapproximation of the bony lid. Long-term follow-up radiograph of 1 patient showed excellent position of the bony lid with no mucosal thickening.</p><p><strong>Conclusions: </strong>Re-apposition of a bony lid after a sublabial approach to the maxillary sinus could ameliorate historical drawbacks of the procedure, possibly expanding its application. Larger cohorts and long-term follow-up will further characterize ideal indications and potential pitfalls of the approach.</p>","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"400-404"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145759368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Auditory Localization Skills of Adult Cochlear Implant Users: Self-Report Assessment Results.","authors":"Merve İkiz Bozsoy, Betül Çiçek Çınar","doi":"10.1177/00034894261422107","DOIUrl":"10.1177/00034894261422107","url":null,"abstract":"<p><strong>Objectives: </strong>Auditory localization, an essential skill for survival and communication, enables individuals to identify the source of sounds in their environment. Hearing loss (HL) in one or both ears often disrupts binaural hearing mechanisms, compromising auditory localization abilities. This study aimed to compare auditory localization abilities among unilateral cochlear implant (UnCI) users, bimodal cochlear implant (BimCI) users, and individuals with normal hearing (NH).</p><p><strong>Methods: </strong>This study included a total of 119 participants: 50 with NH, 46 UnCIs, and 23 BimCIs. The Auditory Localization Scale was used to compare the participants' localization abilities. The scale consists of 24 items across 5 subdimensions: traffic zone, outdoor situations, indoor situations, psychological aspects, and quiet situations. On this scale, higher scores represent greater difficulty with hearing and sound localization, whereas lower scores correspond to better performance in these situations.</p><p><strong>Results: </strong>A statistically significant difference was observed among the 3 groups across all subsections of the Auditory Localization Scale (traffic-zone, <i>P</i> < .001; outdoor situations, <i>P</i> < .001; indoor situations, <i>P</i> < .001; psychological aspects, <i>P</i> = .001; quiet situations, <i>P</i> < .001), as well as in the total score (<i>P</i> < .001). Post-hoc analyses revealed no significant difference between the bimodal and unilateral CI users (<i>P</i> > .017). However, the NH group obtained significantly lower scores across all subsections and in the total score compared with both CI groups. (<i>P</i> < .017).</p><p><strong>Conclusions: </strong>While bimodal hearing is advantageous for providing binaural signals, it may not be adequate for auditory localization; consequently, further endeavors are required to enhance subjective benefits and hearing outcomes in adult CI users.</p>","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"329-334"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146198336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Benign Nasal Triton Tumor: Its Diagnosis and Treatment.","authors":"Marco Berlucchi, Iara Comincini, Luca O Redaelli de Zinis, Iacopo Ghini, Maria P Bondioni","doi":"10.1177/00034894251391662","DOIUrl":"10.1177/00034894251391662","url":null,"abstract":"<p><strong>Background: </strong>Benign triton tumor (BTT) is a rare, benign peripheral nerve tumor typically affecting young children. While most found in the brachial plexus or sciatic nerve, BTT can occur in other various locations, including cranial nerves.</p><p><strong>Methods: </strong>Case report and review of literature.Results/Case:This report describes an infant who showed a swelling localized at nasal pyramid. Patient underwent ultrasound and magnetic resonance imaging. Following, a surgical treatment was performed and histological examination supported the diagnosis of a BTT (neuromuscular choristoma).</p><p><strong>Conclusions: </strong>BTT is a very rare tumor at the head and neck area in pediatric age. Given the unusual presentation and rarity of this tumor, this case highlights the importance of considering BTT in the diagnosis of pediatric nasal masses. Imaging of this lesion is fundamental to plan the surgical therapy. To date, present patient is the first case in which this neoplasm is localized to the nasal pyramid.</p>","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"313-318"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145446944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parotid Massage Facilitated by Straightening Stensen's Duct.","authors":"Evgeniya Molotkova, Joan Maley, Henry Hoffman","doi":"10.1177/00034894251393110","DOIUrl":"10.1177/00034894251393110","url":null,"abstract":"<p><p>Obstructive sialadenitis may be associated with acute angulation at the masseteric bend of Stensen's duct previously reported to be associated with masseter enlargement. We report the case of a 44-year-old male who presented with intermittent left parotid pain and swelling without identifiable etiology on ultrasound and computed tomography imaging but with sialography notable for an acute masseteric bend in Stensen's duct. Fluoroscopic imaging on removal of the sialogram catheter demonstrated straightening of the masseteric bend, prompting patient education toward similar straightening of the duct with anterior traction to the cheek to facilitate parotid massage. Interval evaluations up to 4 months later identified a consistent response to this maneuver to prevent the previously experienced episodes of salivary gland swelling and pain. This maneuver, termed the \"Molotkova Maneuver\" offers an adjunct to standard parotid massage as a conservative management strategy to improve parotid drainage for select patients.</p>","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"319-322"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145608609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Observation of Laryngeal Postures via High-Speed Videoendoscopy in Adductor Laryngeal Dystonia.","authors":"Katherine L Marks, Jenny Vojtech, Manuel E Díaz Cádiz, Laura E Toles, Taylor F Feaster, Andrew Wrede, Maanya Baranwal, Anastasia Haubrich, Misora Ito, Sophie Li, Bonnie Little, Samantha Lonergan, Franklin Phan, Giavanna Siracusano, Alex Estrada, Jose M Rojas, Daniel P Buckley, Cara L Sauder, Andrew Keltz, Michael Lerner, Pavan Mallur, Gregory Grillone, Pieter Noordzij, Lauren F Tracy, Ted Mau, Cara E Stepp","doi":"10.1177/00034894251388829","DOIUrl":"10.1177/00034894251388829","url":null,"abstract":"<p><strong>Objective: </strong>Adductor laryngeal dystonia (AdLD) is a neurological disorder characterized by spasms of the laryngeal muscles during speech, resulting in acoustic discontinuities. High-speed videoendoscopy (HSV) has been used to capture supraglottic compression and visual obstructions of the vocal folds during sustained phonation in speakers with AdLD. The purpose of this study was to investigate the co-occurrence of these laryngeal postures via HSV and acoustic discontinuities in speakers with and without AdLD during connected speech.</p><p><strong>Methods: </strong>Speakers with (n = 16) and without (n = 16) AdLD read sentences while undergoing trans nasal laryngoscopy. Microphone and HSV signals were simultaneously recorded. Acoustic discontinuities and laryngeal postures via HSV were independently manually labeled. A multinomial logistic regression was performed to examine the relationship between the presence of acoustic discontinuities-labeled as phonatory break, creak, or frequency shift-and that of view of vocal fold obstruction and supraglottic compression. Additional fixed factors included in the regression model were group (AdLD, control), sex, and the interactions of group × obstruction and group × supraglottic compression.</p><p><strong>Results: </strong>Factors that were significantly associated with the odds of an acoustic discontinuity included group, vocal fold obstruction, supraglottic compression, and the interaction of group × vocal fold obstruction. There was not a significant interaction effect of group on supraglottic compression events.</p><p><strong>Conclusions: </strong>These findings suggest that acoustic discontinuities co-occur with supraglottic compression and vocal fold obstructions. Understanding this relationship may lead to more effective voice assessment methods for individuals with AdLD.</p>","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"268-279"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12671927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inferior Turbinate Reduction Using Bipolar Cautery: Technique and Outcomes in Pediatric Patients.","authors":"Ahmed Hashim Ali, Cynthia Riley, German Paul Digoy","doi":"10.1177/00034894251388843","DOIUrl":"10.1177/00034894251388843","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate extended outcomes up to 6 years following bipolar-cautery inferior turbinate reduction (ITR) in a large pediatric cohort.</p><p><strong>Methods: </strong>Retrospective case series of 326 children (mean age 9.0 ± 4.1 years) who underwent 12-W bipolar-cautery ITR between December 2017 and May 2024 at a single-surgeon tertiary practice. Concurrent procedures were performed in 82% of patients; 59 underwent ITR alone. Parent-reported nasal breathing improvement was assessed at regular intervals up to 6 years. Statistical analyses included Cochran's Q tests and generalized estimating equations (GEE).</p><p><strong>Results: </strong>In the full cohort, nasal breathing improvement rates were: 95.4% at 3 months, 91.7% at 6 months, 90.2% at 1 year, 88.1% at 2 years, and 78.7% at 3 years. Sample sizes decreased beyond 3 years due to follow-up attrition. Cochran's Q test showed significant changes over time through 3 years (Q = 60.101, <i>P</i> < .001). The ITR-only subgroup showed more marked decline: 98% improvement at 3 months to 69.0% at 3 years (<i>P</i> = .002), compared to more stable rates with concurrent surgery. GEE analysis confirmed significant time effects (<i>P</i> < .001). Compared to ITR alone, concurrent septoplasty (OR 0.39, <i>P</i> = .002) and sinus surgery (OR 0.34, <i>P</i> = .020) were each associated with significantly lower odds of reporting persistent symptoms (i.e., a greater likelihood of improvement). Complications remained low: minor bleeding (4.6%), major bleeding requiring intervention (1.2%), MRSA infection (0.3%), and synechiae (1.5%).</p><p><strong>Conclusions: </strong>Bipolar-cautery ITR provides safe, effective symptom improvement with excellent short-term results (>90% at 1 year). However, efficacy declines over time, particularly in ITR-only patients (78.7% overall at 3 years). Concurrent airway procedures may provide more stable outcomes. These findings emphasize the need for long-term follow-up and appropriate patient selection.</p>","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"256-261"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145446880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Transoral Robotic Surgery and Hypoglossal Nerve Stimulation Using Mean Disease Alleviation in OSA.","authors":"Shreya Mandloi, Jefferson DeKloe, Praneet Kaki, Riya Shah, Leonard E Estephan, Bita Naimi, Maurits S Boon, Colin T Huntley","doi":"10.1177/00034894251388836","DOIUrl":"10.1177/00034894251388836","url":null,"abstract":"<p><strong>Background: </strong>The majority of the current literature assessing OSA utilizes change in AHI as the outcome measure. Clinical effectiveness of therapy is influenced by treatment adherence. Mean disease alleviation (MDA) was designed to determine the effectiveness of treatment as a function of both treatment efficacy and adherence. Our study compares outcomes in OSA patients treated with transoral robotic surgery (TORS) with lingual tonsillectomy and hypoglossal nerve stimulation (HGNS) using MDA.</p><p><strong>Methods: </strong>A retrospective study of CPAP-intolerant OSA patients that underwent HGNS or TORS from 2015 to 2022 was conducted. Comparisons of MDA and treatment efficacy were performed using a Wilcoxon sum rank tests after 3:1 matching for race, age, sex, body mass index, and baseline AHI. Statistical significance was defined as <i>P</i> < .05.</p><p><strong>Results: </strong>One hundred fifty-nine patients (127 HGNS and 32 TORS) were included. Mean AHI decreased postoperatively in both TORS and HGNS patients (<i>P</i> < .001). There was no difference in AHI reduction between TORS and HGNS patients (22.95 ± 21.99 vs 23.27 ± 15.28; <i>P</i> = .50). This relationship persisted when examining MDA between TORS and HGNS patients (41.56 ± 58.24 vs 51.46 ± 29.05; <i>P</i> = .40).</p><p><strong>Conclusion: </strong>Mean disease alleviation is a useful metric combining both adherence and efficacy to determine the effectiveness of OSA treatments expanding beyond AHI. Our data suggests that the clinical effectiveness of TORS and HGNS is comparable, and both are promising treatment options for well-selected OSA patient's refractory to CPAP.</p>","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"262-267"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145515538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of the Effects of Hypothyroidism Duration on Hearing Function: An Experimental Animal Study.","authors":"Arzu Tatlıpınar, Ahmet Kutluhan, Bülent Şerbetçioğlu, Dilek Özbeyli, Furkan Büyükkal, Pınar Eker, Serhan Keskin, Dilek Akakın","doi":"10.1177/00034894251394776","DOIUrl":"10.1177/00034894251394776","url":null,"abstract":"<p><strong>Objective: </strong>Congenital hypothyroidism is well known to impair auditory development and function. However, the effect of acquired hypothyroidism, particularly regarding its duration, has not been clearly defined. Data investigating the relationship between prolonged hypothyroidism and hearing remain scarce. This experimental study aimed to evaluate the impact of different durations of hypothyroidism on hearing function and cochlear morphology in Wistar albino rats.</p><p><strong>Materials and methods: </strong>Four groups were established, each consisting of at least 8 Wistar albino rats. The groups included a control group and 3 hypothyroid groups exposed to 6-n-propyl-2-thiouracil (PTU) for 15, 30, and 45 days, respectively. PTU was administered intraperitoneally on a daily basis. Auditory evaluation was performed using otoacoustic emission (OAE) and auditory brainstem response (ABR) testing before and after the experimental period. Biochemical confirmation of hypothyroidism was obtained through measurement of serum T4 and TSH levels, collected from intracardiac blood samples prior to sacrifice. Additionally, cochlear tissue was examined histopathologically to assess possible structural alterations.</p><p><strong>Results: </strong>ABR analysis revealed that the 15-, 30-, and 45-day hypothyroid groups exhibited increased auditory thresholds and prolonged wave latencies compared with baseline values (<i>P</i> < .05). Intergroup comparisons demonstrated significant differences in latency values across all groups (<i>P</i> < .05). OAE responses also showed reduced amplitudes in hypothyroid animals. Histopathological evaluation indicated marked structural changes in the cochlea in all hypothyroid groups when compared to controls (<i>P</i> < .05), consistent with the electrophysiological findings.</p><p><strong>Conclusion: </strong>Experimentally induced hypothyroidism adversely affects auditory function in a duration-dependent manner. The condition was found to impair both ABR and OAE outcomes, accompanied by histopathological changes in cochlear tissue. These findings confirm that thyroid hormones play a crucial role in preserving auditory physiology, and prolonged hypothyroidism may progressively disrupt hearing at both functional and structural levels.</p>","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"295-304"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145717174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinician Attitudes and Knowledge of Pediatric Sleep-Disordered Breathing.","authors":"Walter Nicholas Jungbauer, Jenna H Barengo, Paul J Nietert, Marvella E Ford, Phayvanh P Pecha","doi":"10.1177/00034894251391649","DOIUrl":"10.1177/00034894251391649","url":null,"abstract":"<p><strong>Objectives: </strong>The goals of this study are to assess primary care provider (PCP) knowledge of and attitudes toward pediatric obstructive sleep apnea (OSA), and to identify variations in practice patterns.</p><p><strong>Design: </strong>A cross-sectional survey including the Obstructive Sleep Apnea Knowledge and Attitudes in Children (OSAKA-KIDS) questionnaire was administered to PCPs from August to December 2021. Univariable analyses and multivariable linear regressions were performed to analyze associations between demographics and knowledge, attitudes, and screening frequency.</p><p><strong>Results: </strong>Eighty-two PCPs completed the survey (age 43.4 ± 9.6 years, 69.6% female, 90.2% non-Hispanic White). Specialties included Pediatrics (65.9%) and Family Medicine (32.9%). Respondents answered a mean 84.9 ± 10.7% questions correctly on the knowledge portion. Years in practice, provider training, and academic affiliation were not associated with knowledge scores. Less than half (45.1%) of respondents screened for OSA \"most of the time\" (32.9%) or \"always\" (12.2%). Higher screening frequency was associated with clinics with higher Medicaid beneficiaries (<i>P</i> = .002) and a lower proportion of Black patients (<i>P</i> = .033). Providers who felt more confident in managing OSA were more likely to screen \"most of the time\" (<i>B</i> = 0.532, 95% CI [0.120-0.926], <i>P</i> = .012), or \"always\" (<i>B</i> = 0.708, 95% CI [0.129-1.29], <i>P</i> = .017).</p><p><strong>Conclusion: </strong>these results suggest guideline-recommended screening for OSA is low among PCPs. Higher confidence in OSA management was associated with higher screening rates. Further studies on interventions aimed to increase screening and confidence may improve equitable care.</p>","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"280-287"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13556168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145608535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Graft Material and Surgical Technique on Frequency-specific Audiometric Outcomes Following Tympanoplasty.","authors":"Diana Hallak, Robert J Macielak, Lisa Zhang, Roberto A Cueva, Edward E Dodson, Oliver F Adunka, Yin Ren","doi":"10.1177/00034894251388782","DOIUrl":"10.1177/00034894251388782","url":null,"abstract":"<p><strong>Objective: </strong>Investigate frequency-specific audiometric outcomes following tympanoplasty without ossiculoplasty using different grafting materials and techniques.</p><p><strong>Methods: </strong>A multi-institutional review of patients who underwent tympanoplasty via either medial or lateral graft techniques from May 2017 to August 2022 was performed. Frequency-specific audiometric outcomes were analyzed using multivariable logistic regression.</p><p><strong>Results: </strong>A total of 88 patients (93 ears) met criteria (mean age 46 years). Median follow-up was 6.7 ± 6.1 months. Perforation closure was achieved in 87% cases and did not vary between graft materials. Loose areolar fascia (LAF) was used in 32% of tympanoplasties (N = 30) and temporalis fascia (TF) in 48% cases (N = 45). Compared to TF, LAF was associated with better low-frequency (500 and 1 kHz) pure-tone average (PTA) improvement (12.4 dB vs 1.6 dB, <i>P</i> < .001) and air-bone gap (ABG) closure (11.4 dB vs 1.6 dB, <i>P</i> = .003). PTA improvement and ABG closure were superior in medial technique cases compared to lateral technique (<i>P</i> < .001for both). When considering only medial underlay technique, ABG closure were comparable for both grafting materials (9.5 dB in LAF vs 10.5 dB in TF, <i>P</i> = .7). Multivariable logistic regression accounting for graft material, identified surgical technique as a significant predictor of postoperative audiometric outcomes.</p><p><strong>Conclusion: </strong>Loose areolar fascia may be associated with better low-frequency hearing than TF following tympanoplasty. However, when using only medial underlay technique, both materials offered similar improvements, suggesting surgical technique may be more crucial than the choice of grafting material.</p>","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"249-255"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145446898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}