Hno最新文献

{"title":"[Correlation between stimulation levels und ECAP thresholds for audiometry-based fitting of cochlear implants. German version].","authors":"Annett Franke-Trieger, Thomas Hocke, Thomas Zahnert, Susen Lailach","doi":"10.1007/s00106-025-01584-6","DOIUrl":"10.1007/s00106-025-01584-6","url":null,"abstract":"<p><strong>Background: </strong>Persons whose speech recognition with hearing aids at 65 dB_SPL, WRS₆₅(HA), is inadequate but whose maximum monosyllabic word recognition score (WRS_max) is still measurable may benefit from a cochlear implant (CI). Using a validated prediction model, one can estimate word recognition with a CI, WRS₆₅(CI), for these patients. The aim of this study was to investigate the relationship between electrically evoked compound action potentials (ECAP) and stimulation parameters of the CI system.</p><p><strong>Patients and methods: </strong>In this prospective study, 37 patients were included. The WRS₆₅(CI) was determined after 6 and 12 months and compared with the predicted WRS₆₅(CI). The correlation of minimum and maximum electrical stimulation with the ECAP was investigated.</p><p><strong>Results: </strong>All patients showed a significantly better WRS₆₅(CI) after 12 months compared with the preoperatively determined WRS₆₅(HA). The proportion of patients whose WRS₆₅(CI) fell short of the predicted value by more than 20 percentage points was 19% after 6 months and 5% after 12 months. In the patient population, there was a closer correlation of the ECAP thresholds with the maximum than with the minimum electrical stimulation.</p><p><strong>Conclusion: </strong>For patients whose speech understanding with hearing aids is inadequate-even with a very high preoperative WRS_max in moderately severe hearing loss-CI fitting appears to be a promising treatment option. The predictive model enables individual treatment planning. Its application contributed to a quality of care that was higher than was found in an earlier retrospective study. The correlation found between stimulation intensity and ECAP in a cohort of patients with achieved predicted values supports the hypothesis that a fitting procedure based on ECAP and audiometry is a promising approach.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":" ","pages":"502-509"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The Floating Mass Transducer as a microphone. German version].","authors":"Stefan Kaulitz, Carolina Köstler, Kristen Rak, Rudolf Hagen, Stephan Hackenberg, Mario Cebulla","doi":"10.1007/s00106-025-01596-2","DOIUrl":"10.1007/s00106-025-01596-2","url":null,"abstract":"<p><strong>Background: </strong>This study investigates the inverse use of the Vibrant Soundbridge® Floating Mass Transducer (FMT; MED-EL, Innsbruck, Austria) as a microphone in a pilot test. Should this be applicable, it would open up interesting application possibilities, e.g., as a microphone for a fully implantable cochlear implant.</p><p><strong>Materials and methods: </strong>Experimental measurements on an ear canal-eardrum model were used to analyze the acoustic properties of the FMT when used as a microphone, including frequency response and sensitivity. The FMT from the Direct Drive Simulation Set was coupled to the artificial eardrum for this purpose.</p><p><strong>Results: </strong>The results show that the FMT has a usable signal-to-noise performance over the entire frequency range investigated, albeit with a non-linear frequency characteristic. The highest sensitivity was found between 1500 and 2000 Hz.</p><p><strong>Conclusion: </strong>The study suggests that an FMT optimized for microphone properties could be used as a microphone in the middle ear, which would open up new possibilities for the development of fully implantable hearing systems. Further investigations, in particular measurements on the petrous bone, are required to determine the suitability of the FMT as a middle ear microphone more precisely.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":" ","pages":"497-501"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[New judgments pertaining to private physician (Wahlarzt) contracts].","authors":"Kim-Victoria Seibert","doi":"10.1007/s00106-025-01638-9","DOIUrl":"10.1007/s00106-025-01638-9","url":null,"abstract":"","PeriodicalId":55052,"journal":{"name":"Hno","volume":" ","pages":"514-515"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Acute rhinosinusitis in the adult patient].","authors":"Bernhard Olzowy","doi":"10.1007/s00106-025-01641-0","DOIUrl":"10.1007/s00106-025-01641-0","url":null,"abstract":"<p><p>Acute rhinosinusitis (ARS) is usually primarily a viral disease. During the course of the disease, bacteria can be detected by culture in about half of the cases. With a focus on the resulting treatment options, ARS is classified as acute viral RS (AVRS; duration < 10 days), acute post-viral RS (APVRS; worsening after approximately 5 days and/or duration > 10 days), and acute bacterial RS (ABRS; at least three of the following five criteria: fever > 38 °C, biphasic disease course, unilateral symptoms, severe pain, and elevated C‑reactive protein [CRP]). AVRS can be treated with zinc, decongestants, nonsteroidal anti-inflammatory drugs (NSAIDs), and phytotherapeutics. Intranasal steroids (INS) are additionally helpful for APVRS and antibiotics only for ABRS. The substance of first choice is amoxicillin; the potential benefit should be weighed against possible side effects and development of resistance in each individual case.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":" ","pages":"516-526"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Diagnosis and treatment of vertigo and dizziness : Interdisciplinary guidance paper for clinical practice. German version].","authors":"Alexander Andrea Tarnutzer, Hassen Kerkeni, Suzie Diener, Roger Kalla, Claudia Candreia, Renato Piantanida, Raphaël Maire, Antje Welge-Lüssen, Joris Budweg, Andreas Zwergal, Julia Dlugaiczyk","doi":"10.1007/s00106-025-01598-0","DOIUrl":"10.1007/s00106-025-01598-0","url":null,"abstract":"<p><strong>Background: </strong>Vertigo and dizziness belong to the most common leading symptoms in clinical practice. Their differential diagnosis, however, often poses a challenge.</p><p><strong>Objective: </strong>This work aims to provide evidence-based and practice-oriented recommendations for diagnosis and treatment of vertigo and dizziness in primary care.</p><p><strong>Materials and methods: </strong>The consensus statement of an interdisciplinary working group following a national survey among Swiss primary care physicians and neurotology specialists (neurologists, otorhinolaryngologists) is presented. The associated literature search in PubMed was conducted up to October 2024.</p><p><strong>Results and conclusion: </strong>Structured history taking and clinical neurotological examination form the basis for the differential diagnosis of the various acute (AVS), episodic (EVS), and chronic (CVS) vestibular syndromes (AVS: e.g., stroke or acute unilateral vestibulopathy; EVS: e.g., benign paroxysmal positional vertigo [BPPV], Menière's disease, vestibular migraine, vestibular paroxysmia; CVS: e.g., bilateral vestibulopathy, persistent postural perceptual dizziness). The present paper covers the following topics: i) \"red flags\" for a potentially dangerous cause in patients with acute vertigo/dizziness/gait and balance disorders; ii) essential clinical neurotological examination steps; iii) diagnostic and therapeutic maneuvers for posterior and lateral canal BPPV; iv) the most important therapeutic strategies for the vestibular syndromes named above; and v) the top 10 recommendations regarding history taking, diagnosis, and treatment of vertigo and dizziness in clinical practice. This review aims to serve as a clinical companion for physicians of all specialties dealing with the primary diagnosis and treatment of vertigo and dizziness.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":" ","pages":"461-473"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Diagnosis and drug therapy of chronic rhinosinusitis].","authors":"Sven Becker","doi":"10.1007/s00106-025-01635-y","DOIUrl":"10.1007/s00106-025-01635-y","url":null,"abstract":"<p><p>Chronic rhinosinusitis is one of the most common chronic diseases of the upper respiratory tract and is associated with a significant reduction in quality of life. Precise diagnostic workup is therefore necessary to provide patients with adequate treatment. The introduction of biologics has opened up new options for the treatment of severely affected patients with chronic rhinosinusitis with nasal polyps in the sense of precision medicine that goes beyond the mere control of symptoms. This has been accompanied by a certain degree of standardization with regard to diagnostic procedures and the assessment of disease-specific quality of life. Against the background of the 2025 congress theme \"Individualization vs. standardization in otorhinolaryngology,\" this paper examines and summarizes the diagnosis and drug therapy of chronic rhinosinusitis, with a focus on biologic therapy.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":" ","pages":"441-460"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Pneumolabyrinth after barotrauma in a patient with cochlear implants].","authors":"S Marti, N Iob, D Bächinger, C Schlegel, A Huber, J Dlugaiczyk, A Dalbert","doi":"10.1007/s00106-025-01602-7","DOIUrl":"10.1007/s00106-025-01602-7","url":null,"abstract":"<p><p>We report the case of a 54-year-old female patient with bilateral cochlear implants suffering from recurrent left-sided pneumolabyrinth due to barotrauma. These episodes caused acute peripheral vestibular disorder and cochlear implant malfunction. Over a 6-year period, the suspected causative perilymphatic fistula was surgically sealed on three occasions. A preventative balloon dilation of the Eustachian tube was finally performed. This case report is the first to describe barotrauma-induced recurrent pneumolabyrinth in a patient with cochlear implants.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":" ","pages":"510-513"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Different immunological types of CRSwNP in the context of the new European EAACI nomenclature : Part 1: Hypersensitivity reactions of type IVa-c as a correlate to T1, T2, and T3 endotypes].","authors":"L Klimek, S Becker, B Haxel, M Cuevas, P Huber, A Chaker, O Pfaar, M Laudien, C Beutner, J Hagemann, U Förster-Ruhrmann, H Olze, B P Ernst, A Beule, C Rudack, A S Hoffmann, C Betz, M Gröger","doi":"10.1007/s00106-025-01600-9","DOIUrl":"10.1007/s00106-025-01600-9","url":null,"abstract":"<p><strong>Background: </strong>Chronic rhinosinusitis (CRS) affects up to 11% of the population in Europe and the USA, making it one of the most common chronic diseases. The classification of immunological endotypes, particularly the T2 endotype, is gaining increasing importance. This classification is based on the Coombs and Gell hypersensitivity model, which categorizes cell-mediated type IV reactions into T1, T2, and T3 endotypes. In chronic rhinosinusitis with nasal polyps (CRSwNP), genetic and epigenetic alterations in the mucosal immune system play a key role. Identifying specific endotypes helps to better understand the heterogeneity of the disease and develop tailored treatment approaches. This paper aims to systematize the underlying immunological mechanisms and highlight their relevance for diagnosis and therapy.</p><p><strong>Methods: </strong>The European Academy of Allergy and Clinical Immunology (EAACI) recently published an updated nomenclature for immunological hypersensitivity reactions. The original Coombs and Gell classification of antibody-mediated reactions (type I-III) has been expanded. Cell-mediated reactions now include: type IVa (T1) → Th1-dominated reactions; type IVb (T2) → Th2-dominated reactions; type IVc (T3) → Th17-dominated reactions. These new insights into T1, T2, and T3 signaling pathways form the basis of this study. Additional mechanisms such as epithelial barrier defects (type V), chemical reactions (type VI), and metabolism-related immune dysregulations (type VII) are addressed separately.</p><p><strong>Results: </strong>Endotyping reveals distinct regional differences: The T2 (Th2-high) endotype, predominant in Europe, North and South America, and Australia, is characterized by elevated Th2 cytokines (IL‑4, IL‑5, IL-13) and eosinophilic inflammation. The T1 (Th1-high) endotype shows dominant interferon-gamma activity and non-eosinophilic, mainly neutrophilic inflammation. The T3 (Th17-high) endotype is defined by increased IL-17 presence and can occur in both eosinophilic and non-eosinophilic CRSwNP.</p><p><strong>Conclusion: </strong>In CRSwNP patients, all three hyperreactivity endotypes (T1, T2, T3) can occur individually or in combination. The T2 endotype is the most common in Europe. Targeted endotyping enables differentiated treatment approaches and novel therapeutic options.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":" ","pages":"474-482"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Routine diagnostics prior to ear surgery-results of a survey among otorhinolaryngology departments in German-speaking countries. German version].","authors":"Joseph Morgenstern, Marcus Neudert, Thomas Zahnert, Susen Lailach","doi":"10.1007/s00106-025-01556-w","DOIUrl":"10.1007/s00106-025-01556-w","url":null,"abstract":"<p><strong>Background: </strong>Diagnostic testing prior to ear surgery is an important part of the work of ear specialists in hospitals. To date, there is no national or international diagnostic standard. Rather, the test batteries used are dependent on hospitals' own doctrinal opinions.</p><p><strong>Objective: </strong>The aim of this study was to conduct a survey in German-speaking countries to determine the routine diagnostic methods used prior to various ear surgery procedures.</p><p><strong>Methods: </strong>An online questionnaire with 18 general questions on the hospital's equipment and availability of tests and 6 questions on specific ear operations was sent to the departmental directors.</p><p><strong>Results: </strong>Of the 180 hospitals contacted, 56 (31%) took part in the survey. For eight specific operations (rehabilitative ear surgery with and without cholesteatoma, hearing-improving surgery, stapesplasty, ear canal stenosis surgery, ear canal atresia surgery, implantation of active middle ear implants, and cochlear implant surgery), the test batteries most commonly used in German-speaking countries could be determined. It was found that the majority of clearly defined diagnostic batteries are implemented in the hospital's own diagnostic steps. In German-speaking countries, neurootological diagnostics are preferably carried out before treatment with hearing implants, but are of only minor importance for middle ear surgery in German-speaking hospitals.</p><p><strong>Conclusion: </strong>There is inhomogeneity regarding diagnostic pathways in ear surgery in German-speaking countries. The results of this survey provide a further basis for discussion concerning the development of a diagnostic standard, which is to be developed in corresponding guidelines and consensus papers.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":" ","pages":"483-496"},"PeriodicalIF":0.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Routine diagnostics prior to ear surgery-results of a survey among otorhinolaryngology departments in German-speaking countries.","authors":"Joseph Morgenstern, Marcus Neudert, Thomas Zahnert, Susen Lailach","doi":"10.1007/s00106-025-01557-9","DOIUrl":"https://doi.org/10.1007/s00106-025-01557-9","url":null,"abstract":"<p><strong>Background: </strong>Diagnostic testing prior to ear surgery is an important part of the work of ear specialists in hospitals. To date, there is no national or international diagnostic standard. Rather, the test batteries used are dependent on hospitals' own doctrinal opinions.</p><p><strong>Objective: </strong>The aim of this study was to conduct a survey in German-speaking countries to determine the routine diagnostic methods used prior to various ear surgery procedures.</p><p><strong>Methods: </strong>An online questionnaire with 18 general questions on the hospital's equipment and availability of tests and 6 questions on specific ear operations was sent to the departmental directors.</p><p><strong>Results: </strong>Of the 180 hospitals contacted, 56 (31%) took part in the survey. For eight specific operations (rehabilitative ear surgery with and without cholesteatoma, hearing-improving surgery, stapes surgery, ear canal stenosis surgery, ear canal atresia surgery, implantation of active middle ear implants, and cochlear implant surgery), the test batteries most commonly used in German-speaking countries could be determined. It was found that the majority of clearly defined diagnostic batteries are implemented in the hospital's own diagnostic steps. In German-speaking countries, neuro-otological diagnostics are preferably carried out before treatment with hearing implants, but are of only minor importance for middle ear surgery in German-speaking hospitals.</p><p><strong>Conclusion: </strong>There is inhomogeneity regarding diagnostic pathways in ear surgery in German-speaking countries. The results of this survey provide a further basis for discussion concerning the development of a diagnostic standard, which is to be developed in corresponding guidelines and consensus papers.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}