Hno最新文献

{"title":"[Otorhinolaryngology specialist training in Germany in the context of the hospital reform].","authors":"Thomas K Hoffmann, Janina Hahn, Thomas Deitmer, Martin Jäckel, Marcus Neudert, Timo Stöver","doi":"10.1007/s00106-026-01737-1","DOIUrl":"10.1007/s00106-026-01737-1","url":null,"abstract":"<p><strong>Background: </strong>In otorhinolaryngology, the majority of specialist training takes place in inpatient facilities. Against the backdrop of current structural reforms in the hospital sector, it is necessary to collect fundamental structural data of these training institutions. To date, no centrally collected data exist that capture the number of inpatient training centers, the number of trainees and authorized trainers, or the scope of training accreditation. The aim of this study was therefore to establish a nationwide baseline assessment to support evaluation of the potential impact of the ongoing hospital reform.</p><p><strong>Materials and methods: </strong>The German Society of Oto-Rhino-Laryngology, Head and Neck Surgery (DGHNO-KHC) conducted a nationwide digital survey among the heads of ENT departments in Germany. The survey collected structural and capacity-related parameters relevant to specialist training.</p><p><strong>Results: </strong>A total of 95 fully completed questionnaires were returned (response rate 54.9%). All federal states were represented (32 university and 63 non-university hospitals). In 2024, 84 clinics (88,4 %) reported more than 1500 inpatient cases. On average, 1.5 physicians per institution held formal authorization to conduct specialist training. The number of trainees remained stable in 56.8% of clinics and increased in 32.6%. Overall, 96.8% of departments had full accreditation for the complete 5‑year training period.</p><p><strong>Conclusion: </strong>Otorhinolaryngology specialist training in Germany is broadly available and delivered at a consistently high level within hospitals. Based on the collected data, a stable and robust training structure can be expected to persist, even when considering potential effects of the Hospital Care Improvement Act (Krankenhausversorgungsverbesserungsgesetz, KHVVG). These training capacities remain essential for ensuring nationwide high-quality specialist care.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":" ","pages":"133-138"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12935782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Assessment of noise damage-part 1 : Occupational fundamentals of causal attribution].","authors":"O Michel","doi":"10.1007/s00106-025-01714-0","DOIUrl":"10.1007/s00106-025-01714-0","url":null,"abstract":"<p><p>Noise has the potential to exert a harmful effect on the auditory system. Whether damage actually results depends primarily on the individual susceptibility of the auditory system as well as on the intensity and duration of exposure. Occupational noise-induced hearing loss typically develops over years to decades of hazardous exposure, affects only a subset of those exposed, and is irreversible. To assess whether an insured activity constitutes a health-relevant noise exposure in terms of causal attribution (\"Einwirkungskausalität\"), a fundamental understanding of physical and technical parameters is required; a medical diagnosis alone is insufficient for establishing causality. In part 1 of this article, the fundamentals of exposure assessment and causal relationship (e.g., daily noise exposure level normalized to 8 h [L_EX,8h], single event sound exposure level [L_AE], effective noise dose [ELD]) are outlined, while part 2 addresses the medically professional requirements for recognizing occupational noise-induced hearing loss as an occupational disease under item 2301 of the Occupational Diseases Ordinance (BKVO).</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":" ","pages":"194-203"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146088060","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 2: Hypersensitivity reactions of type V (epithelial barrier defects)].","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/s00106-025-01705-1","DOIUrl":"10.1007/s00106-025-01705-1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Chronic rhinosinusitis (CRS) has a prevalence of up to 11% in Europe and the United States, making it one of the most common chronic diseases. Classification according to immunological endotypes is increasingly being incorporated into disease definitions, particularly for chronic rhinosinusitis with nasal polyps (CRSwNP). Genetic and epigenetic alterations within the mucosal immune system play an important role in this context. Identification of endotypes may help to elucidate disease heterogeneity and guide development of personalized therapeutic approaches. In part 1 of this publication series, we presented the immunological classification of type IV hypersensitivity reactions (T1, T2, and T3 endotypes).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The European Academy of Allergy and Clinical Immunology (EAACI) recently published a position paper introducing the updated nomenclature for immunological hypersensitivity reactions based on nine distinct immunological reaction types. The antibody-mediated reactions originally classified by Coombs and Gell as type I, type II, and type III have been expanded and described in greater detail. Epithelial barrier defects are defined as type V hypersensitivity reactions and are the focus of part 2 of this publication series.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Type V hypersensitivity is characterized by impairment of epithelial barrier function, resulting in aberrant and persistent activation of the mucosal immune system and, consequently, chronic inflammation. In addition to barrier dysfunction, microbial dysbiosis and dysregulation of immune responses play a major role, including broad activation of Th1, Th2, and Th17 pathways, accompanied by a loss of regulatory T and B cells (Treg, Breg). Further mechanisms involve the production of serum (s)IgE against inhalant or food allergens; activation of macrophages (Mφ); and release of proinflammatory cytokines, chemokines, and inflammatory mediators such as histamine and leukotrienes. Loss of epithelial barrier integrity may result from defects in several key components, including structural elements; tight junction proteins; protective antiproteases; expression of antimicrobial proteins; and altered transport of ions, protons, water, or antimicrobial substances. Disruption of the epithelial barrier is also associated with activation of sensory nerve fibers within the mucosa, thereby contributing to the development of inflammatory symptoms.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In patients with CRSwNP, immunological hyperreactivity reactions of various types-particularly type IV, type V, and type VI hypersensitivity-may occur in either isolation or combination. While type IV and type VI reactions primarily contribute to the cellular inflammatory response and chronic persistence, type V reactions, characterized by dysregulated receptor signaling, are increasingly recognized as clinically relevant in the context of epithelial barrier defects and impa","PeriodicalId":55052,"journal":{"name":"Hno","volume":" ","pages":"174-182"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12935805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145851384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Research in university ENT departments-results of a Germany-wide survey on motivation, barriers, and structural conditions].","authors":"C H L Kürten, L Boosfeld, L Holtmann, S Hansen, A Daser, K Stähr, S Mattheis, T Deitmer, T Stöver, T K Hoffmann, Stephan Lang","doi":"10.1007/s00106-025-01701-5","DOIUrl":"10.1007/s00106-025-01701-5","url":null,"abstract":"<p><strong>Background: </strong>Research is a central pillar of academic otorhinolaryngology. However, clinicians increasingly face difficulties with integrating scientific activity into their demanding clinical routines.</p><p><strong>Objective: </strong>This study aimed to assess research motivation, perceived barriers, and structural conditions among clinicians at German university ENT departments and to derive practical recommendations for improvement.</p><p><strong>Materials and methods: </strong>An anonymized online survey was distributed among otorhinolaryngologists working in German academic hospitals. Data were analyzed descriptively.</p><p><strong>Results: </strong>Of 131 respondents, 84% worked fulltime, 89% held a doctoral degree, and 28% had completed habilitation. While extrinsic motivation dominated among doctoral candidates, habilitation aspirants were more driven by intrinsic factors such as scientific curiosity and enjoyment of research. Main obstacles included insufficient staffing, high documentation load, and lack of protected research time. Research was frequently conducted outside of regular working hours. Although research development was regularly addressed by management levels, only 36% felt adequately supported. Moreover, 68% of participants reported no perceived benefit of research engagement for their surgical training opportunities.</p><p><strong>Conclusion: </strong>These findings highlight a systemic tension between clinical demands and research. To ensure sustainable academic productivity in university ENT departments, institutional strategies such as protected time, reduction of the bureaucratic burden, and transparent support mechanisms are needed.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":" ","pages":"154-163"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12935777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Establishment of a newborn hearing screening center in Baden-Württemberg, Germany].","authors":"M Gestewitz, M Hornisch, P Feyh, J Okun, P Beckert, I Bruder, G Hoffmann, P K Plinkert, P J Schuler","doi":"10.1007/s00106-025-01717-x","DOIUrl":"10.1007/s00106-025-01717-x","url":null,"abstract":"<p><p>Since 01.01.2019, the central tracking of conspicuous hearing screening results in the federal state of Baden-Württemberg has been carried out by a specially established hearing screening center for newborn hearing screening based in Heidelberg and Stuttgart. In this paper, we report on the current conceptualization and implementation of tracking in the federal state. A screening program is only effective and goal oriented if all involved parties-including parents, birthing facilities, specialists in private practice, and other service providers-work together. The amount of work involved in providing information, carrying out the screening examinations, and performing confirmatory diagnostics within the specified timeframe is immense. A follow-up mechanism in terms of quality assurance for newborn hearing screening appears to be necessary.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":" ","pages":"139-145"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12935855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145999856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Supplementary use of broadband absorbance measurements for classification of normal hearing].","authors":"Milena Walter, Marie-Christin Quandt, Alexander Mewes, Kevyn Kogel, Matthias Hey","doi":"10.1007/s00106-025-01704-2","DOIUrl":"10.1007/s00106-025-01704-2","url":null,"abstract":"<p><strong>Background: </strong>The definition of normal hearing according to the DIN standard refers to the air conduction threshold of tympanometry. However, middle ear function is not specifically considered in this definition. The present study aimed to prospectively collect audiometric data for normal hearing that are based not only on tone audiometry but also supplemented by objective data on middle ear function.</p><p><strong>Methods: </strong>The examinations were carried out in 84 ears of test subjects aged 18-25 years with normal hearing according to tone audiometry. Objective middle ear diagnostics were performed using classic tympanometry, broadband absorbance tympanometry, and stapedius reflex threshold measurement. A distortion product otoacoustic emission (DPOAE) measurement was also carried out.</p><p><strong>Results: </strong>Compliance of more than 2 mmho was found in 7 of the 84 ears examined, which are considered separately in the following. The resonance frequency of these 7 ears was below the first quartile of the comparison group (759 Hz), and the absorbance of this group was above the third quartile of the absorbance of the group with regular compliance for frequencies up to 750 Hz. In the group with increased compliance, in more cases than in the comparison group (14% vs. 5%) were no DPOAEs detectable at at least one frequency. In 6 of the 7 ears with increased compliance, stapedius reflex thresholds were found within the whisker range of the group with regular compliance at all measured frequencies.</p><p><strong>Conclusion: </strong>In the DIN standard for classification of normal hearing, the definition of normal hearing is based solely on tone audiometric parameterization. The reference values measured in this study with regard to compliance of the eardrum show clear inter-individual variance. Supplementing the assessment of middle ear function, such as by measuring compliance, resonance frequency, and/or absorbance curves, could provide additional information to confirm normal hearing.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":" ","pages":"164-173"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12935711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145812324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Legal reform in Germany: new jurisdiction for disputes arising from medical treatment].","authors":"Kim-Victoria Seibert","doi":"10.1007/s00106-026-01726-4","DOIUrl":"10.1007/s00106-026-01726-4","url":null,"abstract":"","PeriodicalId":55052,"journal":{"name":"Hno","volume":" ","pages":"192-193"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146013346","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":"[Voice-related quality of life and emotional distress in functional dysphonia during the COVID-19 pandemic].","authors":"Sven Schwenke de Wall, Frank Rosanowski, Ulrich Hoppe","doi":"10.1007/s00106-025-01693-2","DOIUrl":"10.1007/s00106-025-01693-2","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic led to physical illness, mental health disorders, social problems, and ongoing societal conflicts that have not yet been entirely resolved. Among the inflammatory processes associated with the virus, organic otorhinolaryngologic diseases occurred, resulting in functional impairments such as voice disorders caused by laryngeal affections. This study focused on the subjective suffering caused by functional dysphonia during the pandemic in patients who had not been affected by COVID-19. The underlying assumption was that the overall pandemic situation would alter both the healthcare-seeking behavior of affected individuals as well as their subjective assessments compared to the periods before and after the pandemic.</p><p><strong>Materials and methods: </strong>The study was based on clinical routine data collected from the phoniatric and pedaudiologic specialist practice of the second author covering the second quarter of 2019 through to the second quarter of 2023. A total of 972 adult patients who presented for the first time with functional dysphonia were included. Assessment tools were the Voice-Related Quality of Life (VRQoL) questionnaire and the Depression Anxiety Stress Scales (DASS) that measure depression, anxiety, and stress.</p><p><strong>Results: </strong>In the quarter preceding the first lockdown, the number of patients was higher than the average of all other quarters, while it was lower during the quarter of the first lockdown. For the remainder of the observation period, patient numbers fluctuated without statistical significance. Across all measured domains, no significant differences were observed when comparing the periods before and after the pandemic.</p><p><strong>Conclusion: </strong>No pandemic-related changes were found in the subjective experience of suffering from functional dysphonia, neither in terms of voice-specific dysfunction nor in emotional domains.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":" ","pages":"146-153"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12935774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145710246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A rare cause of otitis externa : Manifestation of myeloid sarcoma in the petrous bone].","authors":"V Ihle, E Goldberg-Bockhorn, E Lemaitre, V I Gaidzik, T K Hoffmann, A S Kuhn","doi":"10.1007/s00106-026-01731-7","DOIUrl":"10.1007/s00106-026-01731-7","url":null,"abstract":"<p><p>A 45-year-old male patient presented with pronounced swelling of the external auditory canal and symptoms of otitis externa which did not respond to conservative treatment. Due to concomitant mastoiditis, mastoidectomy was performed in the later course, which did not provide conclusive histological results. In the absence of improvement, biopsy of the external auditory canal and mastoid revision with repeated pathological analysis were carried out. Ultimately, a myeloid sarcoma representing a relapse of previously remitted acute myeloid leukemia (AML) was identified.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":" ","pages":"188-191"},"PeriodicalIF":1.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12935836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146168031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The new Mainz Audiometric Test for Children aged 3-7 years (MATCH) in noise : Design, normalization, and validation].","authors":"A Bohnert, A Keilmann, C Harmuth, T Rader, V Schirkonyer","doi":"10.1007/s00106-026-01747-z","DOIUrl":"https://doi.org/10.1007/s00106-026-01747-z","url":null,"abstract":"<p><strong>Background: </strong>The Mainz Audiometric Test for Children (MATCH) was originally developed for children aged 3-7 years and validated in quiet conditions.</p><p><strong>Objective: </strong>The present study aimed to extend the MATCH to testing in noise, to establish normative data, and to validate the test under these conditions.</p><p><strong>Materials and methods: </strong>A total of 103 children aged 3 years and 3 months to 7 years and 7 months participated, including 76 with normal hearing and 27 with a hearing impairment. Recruitment took place via local kindergartens (mainly normal-hearing children) and the Department of Phoniatry and Pediatric Audiology at the University Medical Center Mainz (mainly hearing-impaired children). To account for age-specific differences, children were divided into three groups: (1) < 4.5 years (n = 28), (2) 4.5-5.5 years (n = 35), (3) > 5.5 years (n = 40). Testing was performed monaurally using a touchscreen-based picture-pointing task, with adaptive determination of the speech reception threshold (SRT) in noise.</p><p><strong>Results: </strong>The SRTs improved with age: -4.6 dB SNR (< 4.5 years), -7.4 dB SNR (4.5-5.5 years), and -9.3 dB SNR (> 5.5 years) at 71.4% speech intelligibility. The slope of the psychometric functions increased with age, while variability and test duration decreased. Test-retest reliability was high (r = 0.84), and results correlated significantly with pure-tone audiometry (r = 0.75).</p><p><strong>Conclusion: </strong>The MATCH in noise is a reliable and child-appropriate tool for assessing speech reception thresholds as early as preschool age. It addresses a methodological gap in existing procedures, which typically provide valid results only from school age onwards, and enables early and differentiated evaluation of hearing aid outcomes in children with hearing impairment.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147312747","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}