Hno最新文献

{"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185562/pdf/","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":"OA","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}

{"title":"Provision of hearing technology in children and adolescents with permanent hearing loss in Germany.","authors":"Elena Pützer, Heike van de Sand, Jasmin Filip, Ingrid Schubert, Ursula Marschall, Ingo Meyer, Karolin Schäfer","doi":"10.1007/s00106-025-01617-0","DOIUrl":"https://doi.org/10.1007/s00106-025-01617-0","url":null,"abstract":"<p><strong>Background: </strong>To date, data on the prevalence and age at first management of permanent childhood hearing loss in Germany are lacking.</p><p><strong>Objective: </strong>This study aims to depict how often and at what age children and adolescents receive their (first) hearing technology.</p><p><strong>Materials and methods: </strong>In this study, we analyzed claims data from a large German statutory health insurance company (BARMER). A cross-sectional study determined the provision of hearing devices and cochlear implants for children and adolescents aged under 18 years with permanent hearing loss from 2010 to 2020. A longitudinal analysis of a cohort of children born in 2010 was performed to gain insights about age at first management with hearing technology during the first 10 years of life.</p><p><strong>Results: </strong>Between 2010 and 2020, approximately 2800 to 3600 children and adolescents per year were provided with hearing devices and 10 to 30 with cochlear implants. In the 2010 birth cohort, 1.22% of children received their first prescription for hearing devices before the age of 10. The proportionately highest number of first prescriptions was found between 3 and 6 years. In 2020, particularly few children gained access to hearing technology.</p><p><strong>Conclusion: </strong>The analysis of the prescribed hearing systems reveals inaccuracies in documentation but also a possible care gap in hearing loss management. For a large percentage of children and adolescents, management of hearing loss took place after the age of 1. The frequent initial provision of hearing technology at preschool age indicates that the proportion of hearing loss that is acquired, detected late, or treated late remained quite high even after the introduction of newborn hearing screening. There is an obvious need for comprehensive tracking of children who fail newborn hearing screening and for other screening and hearing tests. The data for 2020 suggest that hearing loss was diagnosed and treated later due to the COVID-19 pandemic.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318763","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":"Recommendations for selection of target parameters and process recommendations for audiological and technical functional testing of cochlear implant : Prepared by the ERA consortium (AG-ERA) of ADANO in cooperation with the Implantable Hearing Systems expert committee of the DGA. Confirmed by the board of ADANO on 31.01.2025.","authors":"A Müller, M Blümer, O C Dziemba, A Elsholz, L Fröhlich, U Hoppe, D Polterauer, T Rahne, T Steffens, M Walger, T Weißgerber, T Wesarg, S Zirn, T Rader","doi":"10.1007/s00106-025-01629-w","DOIUrl":"https://doi.org/10.1007/s00106-025-01629-w","url":null,"abstract":"<p><p>Continuous monitoring of the technical and physiological function of cochlear implants (CI) is a central part of the care process. Despite worldwide efforts to standardise procedures, there is still considerable variation between CI centres, particularly in terms of the methods used, their practical implementation and the definition of meaningful target parameters. A standardised structured test procedure is needed for reliable quality assurance and better comparability. Against this background, the ADANO Working Group for Evoked Response Audiometry (AG-ERA), in close cooperation with the Cochlear Implants and Implantable Hearing Systems Committee of the German Society of Audiology (DGA), developed a minimum standard for audiological and technical functional testing of CIs in an open consensus process. This standard defines basic requirements for performance and documentation and serves as a practical recommendation for CI centres. It is intended to improve interdisciplinary cooperation, increase the quality of care and enable structured long-term optimised care for CI patients.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227752","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-a pilot study.","authors":"Stefan Kaulitz, Carolina Köstler, Kristen Rak, Rudolf Hagen, Stephan Hackenberg, Mario Cebulla","doi":"10.1007/s00106-025-01597-1","DOIUrl":"https://doi.org/10.1007/s00106-025-01597-1","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":""},"PeriodicalIF":0.8,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210300","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":"Correlation between stimulation levels and ECAP thresholds for audiometry-based fitting in cochlear implants.","authors":"Annett Franke-Trieger, Thomas Hocke, Thomas Zahnert, Susen Lailach","doi":"10.1007/s00106-025-01585-5","DOIUrl":"https://doi.org/10.1007/s00106-025-01585-5","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":""},"PeriodicalIF":0.8,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200887","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":"[Chronic tinnitus from a psychological perspective].","authors":"Benjamin Boecking, Birgit Mazurek","doi":"10.1007/s00106-025-01586-4","DOIUrl":"10.1007/s00106-025-01586-4","url":null,"abstract":"<p><p>Chronic tinnitus is a common and often highly distressing phenomenon that, in its chronic phase, is primarily maintained by psychological factors. Individuals affected by tinnitus frequently attribute fluctuations in their emotional well-being causally to the tinnitus symptom. However, from a psychotherapeutic perspective, both the perception of symptoms and the resulting emotional distress are shaped by complex, dynamic interactions involving (a) personal life experiences, (b) personality traits, (c) the subjective interpretation of intrapsychic and interpersonal stimuli, (d) emotional states, and (e) coping strategies at both intrapsychic and interpersonal levels. This review begins with a brief introduction and then connects a well-established psychological theory of chronic tinnitus development and maintenance with a broader vulnerability-stress-coping model. Within this framework, we present key research findings from both somatic and psychological perspectives, ultimately offering insights for psychotherapeutic prevention and treatment approaches.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":" ","pages":"367-381"},"PeriodicalIF":0.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006515","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":"[Prehabilitation and enhanced recovery after surgery protocols for head and neck cancer : Value and application of these concepts].","authors":"Markus Blaurock, Chia-Jung Busch, Mats Lukas Wiese","doi":"10.1007/s00106-025-01637-w","DOIUrl":"10.1007/s00106-025-01637-w","url":null,"abstract":"<p><p>Prehabilitation is gaining traction in complex oncological interventions and treatments. This CME article is focused on the basic principles of prehabilitation. We discuss the objective evaluation of physical fitness and how to improve it by physio- and speech therapy. Thereafter, we explain how to judge nutritional status, especially in oncological patients, and discuss modes of nutritional supplementation. Finally, the enhanced recovery after surgery concept is briefly explained and its current value in head and neck cancer patients discussed.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":" ","pages":"430-440"},"PeriodicalIF":0.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058443","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":"[Psychological stress and psychiatric comorbidities in the treatment of dysphagia in patients with head and neck cancer].","authors":"Stephan Dürr, Philipp Stangl, Sarah Vester, Julian Künzel, Christopher Bohr, Peter Kummer","doi":"10.1007/s00106-025-01634-z","DOIUrl":"10.1007/s00106-025-01634-z","url":null,"abstract":"<p><strong>Background: </strong>Dysphagia, along with dysphonia and dyspnea, is undoubtedly one of the major problems in the treatment of head and neck tumors. However, impairment of the ability to swallow has many different aspects.</p><p><strong>Objective: </strong>This article aims to shed light on the interactions and interdependencies between dysphagia and psychological stress and psychiatric comorbidities. This should provide the basis for improved treatment coordination.</p><p><strong>Materials and methods: </strong>A literature search was carried out in the PubMed database using the search terms \"dysphagia AND hnc/hnscc AND psychiatric,\" \"dysphagia AND hnc/hnscc AND psychologic,\" and \"dysphagia AND hnc/hnscc AND stress.\" In addition, the authors were able to draw on their many years of experience with the treatment of patients with dysphagia on the background of head and neck tumors.</p><p><strong>Results: </strong>Psychological stress and psychiatric comorbidities play a significant role in the treatment of dysphagia in patients with head and neck tumors, which makes an early examination and, if necessary, psycho-oncological intervention useful.</p><p><strong>Conclusion: </strong>In our view, multidisciplinary patient care is recommended, e.g., as part of an oncology ward round with medical staff from the fields of otorhinolaryngology or oral and maxillofacial surgery, phoniatrics, and pediatric audiology as well as professionals from the fields of nursing, speech therapy, nutritional counseling, psycho-oncology, and social services.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":" ","pages":"382-386"},"PeriodicalIF":0.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095998","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":"[A clinical screening tool for potential somatosensory tinnitus designed for otorhinolaryngologists : The SOMASENSO check for manual identification of relevant dysfunctions].","authors":"Anett Reißhauer, Isabelle Hoffmann, Birgit Mazurek, Norman Best, Max E Liebl","doi":"10.1007/s00106-025-01603-6","DOIUrl":"10.1007/s00106-025-01603-6","url":null,"abstract":"<p><strong>Background: </strong>Somatosensory tinnitus is associated with functional disorders of the cervical spine and/or temporomandibular joint region. Manual medicine can be helpful here. However, the diagnostic criteria for somatosensory tinnitus can only partly be derived from the specific anamnesis; in some cases, clinical manual examination techniques are also necessary. The aim of this work was to design a pragmatic screening instrument for somatosensory tinnitus that can be carried out in the ENT practice with a seated patient.</p><p><strong>Materials and methods: </strong>In a modified Delphi procedure, a group of manual medicine specialists and otorhinolaryngologists identified suitable manual medicine procedures and evaluated them for their feasibility in the ENT practice.</p><p><strong>Results: </strong>The SOMASENSO check is a pragmatic examination tool that makes it easier for otorhinolaryngologists to identify potential somatosensory tinnitus patients.</p><p><strong>Conclusion: </strong>The technical difficulty and lack of test-retest reliability of many manual segmental function tests has led to a focus on the detection of movement disorders, pain, and tinnitus modulation.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":" ","pages":"395-400"},"PeriodicalIF":0.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722430","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}