Auris Nasus Larynx最新文献

{"title":"Improved visualization of temporal bone structures with photon-counting detector CT: An intra-patient comparison","authors":"Hiroshi Sakaida ,&nbsp;Kento Takeichi ,&nbsp;Yasutaka Ichikawa ,&nbsp;Akio Yamazaki ,&nbsp;Hajime Sakuma","doi":"10.1016/j.anl.2025.08.004","DOIUrl":"10.1016/j.anl.2025.08.004","url":null,"abstract":"<div><h3>Objective</h3><div>To directly compare the image quality of photon-counting detector CT (PCD-CT) and conventional energy-integrating detector CT (EID-CT) for temporal bone imaging within the same patient cohort.</div></div><div><h3>Methods</h3><div>This retrospective study included seven patients who underwent both EID-CT and PCD-CT for clinical indications. To ensure a valid comparison of the imaging technologies, images of the non-operated, contralateral temporal bone were evaluated. Radiation dose parameters, including volume CT dose index (CTDIvol) and dose-length product (DLP), were recorded. Two board-certified otolaryngologists independently rated the visualization of six key anatomical structures (incudostapedial joint, incudomalleolar joint, oval window, round window, modiolus, and scutum) using a 5-point Likert scale.</div></div><div><h3>Results</h3><div>PCD-CT demonstrated significantly superior visualization for all six evaluated structures according to both readers (<em>p</em> &lt; 0.05 for all). The average Likert scores for PCD-CT compared to EID-CT ranged from 3.7 to 5.0, indicating that image quality was consistently rated as \"mildly superior\" to \"substantially superior.\" There was no significant difference in radiation dose (CTDIvol and DLP) between the two protocols.</div></div><div><h3>Conclusion</h3><div>In a direct intra-patient comparison, PCD-CT provides superior image quality and visualization of fine anatomical structures of the temporal bone at a radiation dose comparable to conventional EID-CT. This technology represents a significant advancement for otologic imaging.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 5","pages":"Pages 563-566"},"PeriodicalIF":1.5,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144896139","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":"Clinical impact of 68Ga-DOTATOC PET on treatment decisions in jugulotympanic paragangliomas: A case series","authors":"Keishi Ueda ,&nbsp;Koji Nishimura ,&nbsp;Sho Koyasu ,&nbsp;Shinya Otsuki ,&nbsp;Yasuhide Takeuchi ,&nbsp;Shinya Hiraoka ,&nbsp;Ryota Nakashima ,&nbsp;Keigo Honda ,&nbsp;Yo Kishimoto ,&nbsp;Daiki Takahashi ,&nbsp;Hiroshi Yamazaki ,&nbsp;Yosuke Tona ,&nbsp;Yuji Nakamoto ,&nbsp;Koichi Omori","doi":"10.1016/j.anl.2025.08.003","DOIUrl":"10.1016/j.anl.2025.08.003","url":null,"abstract":"<div><div>The study aimed to highlight the complementary roles of computed tomography (CT), magnetic resonance imaging (MRI), and gallium-68 DOTA-(Tyr³)-octreotide positron emission tomography (⁶⁸Ga-DOTATOC PET) in the diagnosis and treatment of jugulotympanic paragangliomas. We present cases of three patients: a 48-year-old woman with tympanic paraganglioma associated with left facial paralysis (patient 1), a 60-year-old man with asymptomatic jugular paraganglioma (patient 2), and a 73-year-old woman with a small tympanic paraganglioma (patient 3). All patients underwent CT, MRI, and ⁶⁸Ga-DOTATOC PET imaging. Tumor localization, extent, and anatomical relationships were assessed using CT and MRI. Functional confirmation of neuroendocrine tumor identity and exclusion of multifocal or metastatic disease were achieved through ⁶⁸Ga-DOTATOC PET. CT and MRI provided high-resolution anatomical details. ⁶⁸Ga-DOTATOC PET demonstrated intense radiotracer uptake in all lesions, including a 4-mm lesion in patient 3, with no evidence of multifocality or metastasis. Patient 1 underwent complete tumor resection with facial nerve reconstruction. Patient 2 was treated with radiotherapy. Patient 3 underwent transcanal resection with ossicular preservation. In conclusion, ⁶⁸Ga-DOTATOC PET serves as a valuable adjunct to CT and MRI for evaluating jugulotympanic paragangliomas, confirming diagnosis, and supporting precise treatment planning.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 5","pages":"Pages 557-562"},"PeriodicalIF":1.5,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144879643","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":"Radiologic prevalence of otic capsule dehiscence and development of the Yenigun classification for semicircular canal dehiscence","authors":"Alper Yenigun ,&nbsp;Yagmur Basak Polat ,&nbsp;Emre Polat ,&nbsp;Serdar Balsak ,&nbsp;Meliha Basoz ,&nbsp;Sabri Baki Eren ,&nbsp;Orhan Ozturan","doi":"10.1016/j.anl.2025.07.009","DOIUrl":"10.1016/j.anl.2025.07.009","url":null,"abstract":"<div><h3>Objective</h3><div>The superior semicircular canal dehiscence is the most well-known otic capsule dehiscence. However, several other dehiscences affect the semicircular canals, cochlea, and vestibule. Our research aimed to examine the frequency, distribution, and correlation between radiologic otic capsule dehiscence in patients exhibiting symptoms of third window syndrome. Additionally, we proposed a new classification system for semicircular canal dehiscence.</div></div><div><h3>Methods</h3><div>In this retrospective study, we included cases who applied to the Otolaryngology Department of our university hospital between January 2015 and September 2023 and underwent standard reformations and Poschl plane CT scans due to symptoms suggestive of third window syndrome. A head and neck radiologist and a general radiologist jointly assessed each CT and decided on measurements.</div></div><div><h3>Results</h3><div>The study examined 219 patients (438 temporal bones) with suggestive symptoms of third window syndrome. Semicircular Canal Dehiscences were categorized into five types: Type 0 (No dehiscence), Type 1 (Unilateral single canal dehiscence), Type 2 (Bilateral single canal dehiscence), and Type 3 (Unilateral multiple localization dehiscence), and Type 4 (Bilateral multiple localization dehiscence). Semicircular Canal Dehiscence was observed in 71/219 (32,4 %) patients. Type 0:148 (67,6 %), Type1:31(14,2 %), Type2:21(9.6 %), Type 3:15(6.8 %) and Type 4: 4(1.8 %) patients were detected. Cochlear-Facial Dehiscence and Vestibular Aqueduct-Jugular Bulb Dehiscence were seen in 63/219(28,8 %) and 21/219(9,6 %) patients. When cases with Semicircular Canal Dehiscences were examined, Type 2 and Type 4 were seen significantly more frequently than other types in cases with Cochlear-Facial Dehiscence.</div></div><div><h3>Conclusion</h3><div>When we examine the otic capsule, we see that the possibility of Cochlear-Facial Dehiscence increases in bilateral Semicircular Canal Dehiscence cases. The radiologist should evaluate the otic capsule as a whole. Particular attention should be paid to multiple channels, bilateral localization, cochlear and vestibular dehiscences.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 5","pages":"Pages 550-556"},"PeriodicalIF":1.5,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144867008","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":"Clinical characteristics and surgical indications in pediatric patulous Eustachian tube: The importance of habitual sniffing","authors":"Hideshi Shindo ,&nbsp;Marin Yoshida ,&nbsp;Ryoji Hirai ,&nbsp;Takeshi Oshima","doi":"10.1016/j.anl.2025.07.003","DOIUrl":"10.1016/j.anl.2025.07.003","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the clinical characteristics of pediatric patulous Eustachian tube (PET), with a particular focus on the presence or absence of habitual sniffing, and to assess the role of this behavior in disease severity and management.</div></div><div><h3>Methods</h3><div>A retrospective review was conducted of 52 patients under 18 years of age who were diagnosed with PET (definite or possible) based on the Japan Otological Society Diagnostic Criteria for PET between December 2014 and November 2024. Clinical data, including symptoms, otoscopic findings, tympanometry, and Eustachian tube function tests (TTAG and sonotubometry), were analyzed. Patients were divided into two groups based on the presence (Group A) or absence (Group B) of habitual sniffing. Surgical outcomes, including those from ventilation tube placement and Kobayashi Plug Surgery (KPS), were also evaluated.</div></div><div><h3>Results</h3><div>Among 1633 PET patients, 52 (3.2 %) were under 18 years of age. Voice autophony (78.9 %), breath autophony (75.0 %), and aural fullness (71.1 %) were the most common symptoms. Habitual sniffing was identified in 32 cases (61.5 %). Tympanic membrane retraction was significantly more frequent in Group A (<em>p</em> &lt; 0.001). Tympanometry showed abnormal (type B or C) patterns in 42.6 % of Group A ears, while all tested ears in Group B showed type A (<em>p</em> &lt; 0.0001). Eustachian tube function test results did not differ significantly between groups. Surgical intervention was required in 11 cases, of which 10 were in Group A. Post-KPS, PHI-10 scores significantly improved, although sonotubometry probe tone levels did not show statistically significant changes.</div></div><div><h3>Conclusion</h3><div>Pediatric PET is often associated with habitual sniffing, which correlates with abnormal tympanic findings and may necessitate surgical treatment. Assessing for habitual sniffing is essential in pediatric PET, and otoscopic and tympanometric findings are more reliable indicators of this behavior than Eustachian tube function tests. Early detection and intervention may prevent progression to retraction-type middle ear disease.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 5","pages":"Pages 545-549"},"PeriodicalIF":1.5,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805348","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 advance medical care outcomes for cochlear implantation in single-sided deafness","authors":"Masahiro Takahashi,&nbsp;Satoshi Iwasaki,&nbsp;Sakiko Furutate,&nbsp;Shin-ichiro Oka,&nbsp;Shogo Oyamada","doi":"10.1016/j.anl.2025.07.008","DOIUrl":"10.1016/j.anl.2025.07.008","url":null,"abstract":"<div><h3>Objective</h3><div>The present study aimed to show the results of the advance medical care for cochlear implantation (CI) in cases of single-sided deafness.</div></div><div><h3>Materials and Methods</h3><div>A prospective, non-randomized, historically controlled clinical trial was conducted at a single institution from July 2021 to July 2023. Participants were patients diagnosed with unilateral, severe to profound sensorineural hearing loss and with average hearing levels over 70 dB on the poor side and under 40 dB on the better side. CI surgeries were performed through the round window approach under general anesthesia. Preoperatively and at 1, 3, 6, and 12 months after device activation, speech discrimination score was measured using the 67-S monosyllabic list under noise conditions, and sound localization ability was also assessed. Assessments of tinnitus disturbance and hearing handicap were performed using a questionnaire.</div></div><div><h3>Results</h3><div>Speech discrimination score using the Japanese monosyllabic list improved significantly from preoperatively to 12 months postoperatively, and significant improvement of sound localization ability was also observed 12 months postoperatively. Tinnitus disturbance and hearing handicap according to the questionnaire were also significantly improved. All adverse events believed to be related to this treatment are well-known occurrences in CI surgery, and the risks associated with the treatment are not considered to outweigh the benefits.</div></div><div><h3>Conclusion</h3><div>The advance medical care with CI for single-sided deafness demonstrated a significant and favorable improvement using a Japanese monosyllabic list, indicating the effectiveness of the CI intervention for patients with single-sided deafness. Considering that the benefits of treatment outweigh the risks, this treatment was deemed effective for patients with single-sided deafness.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 4","pages":"Pages 535-542"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769345","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":"Can the nasal area ratio of the left and right nasal cavities measured by computed tomography serve as an objective diagnostic criterion for caudal septal deviation?","authors":"Yu Hosokawa ,&nbsp;Masafumi Sawada ,&nbsp;Yuki Shiko ,&nbsp;Maiko Osawa ,&nbsp;Yohei Kawasaki ,&nbsp;Yasuhiro Kase ,&nbsp;Tetsuo Ikezono","doi":"10.1016/j.anl.2025.07.007","DOIUrl":"10.1016/j.anl.2025.07.007","url":null,"abstract":"<div><h3>Objective</h3><div>Nasal septal surgery is an effective procedure for nasal obstruction; however, caudal deviation (CD) must be managed carefully. The diagnosis of CD is often subjective, and an objective index test method is required. Accordingly, we established reference values for the nasal area ratio in the horizontal section (NAR-H) and nasal area ratio in the coronal section (NAR-C) on computed tomography in CD.</div></div><div><h3>Methods</h3><div>This retrospective observational study included 120 patients who underwent septoplasty for nasal obstruction. Patients who underwent caudal septoplasty were categorised into the CD group, while those who underwent classical septoplasty were categorised into the septal deviation (SD) group. The mean NAR-H and NAR-C values of both groups were compared. Moreover, the cutoff NAR-H and NAR-C values in the CD group were calculated, and the sensitivity and specificity of each were calculated.</div></div><div><h3>Results</h3><div>CD and SD groups included 49 and 71 patients, respectively. The mean NAR-H was 0.43 and 0.75 in the CD and SD groups, respectively (<em>p</em> &lt; 0.0001). The mean NAR-C was 0.56 and 0.80 in the CD and SD groups, respectively (<em>p</em> &lt; 0.0001). The cutoff NAR-H and NAR-C values in the CD group were 0.56 and 0.675, respectively. The area under the ROC curve of the NAR-H and NAR-C were 0.90 and 0.88, respectively.</div></div><div><h3>Conclusions</h3><div>The NAR-H and NAR-C may be useful for diagnosing CD. An NAR-H of &lt;0.56 and NAR-C of &lt;0.675 indicates the need to prepare for a caudal septoplasty.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 4","pages":"Pages 531-534"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762441","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":"Health-related lifestyle behaviors in patients with vestibular migraine and migraine only: A cross-sectional comparative study","authors":"Sinan Buran ,&nbsp;Birgul Balci ,&nbsp;Burcin Aktar ,&nbsp;Gülden Akdal","doi":"10.1016/j.anl.2025.04.002","DOIUrl":"10.1016/j.anl.2025.04.002","url":null,"abstract":"<div><h3>Objective</h3><div>There is an increasing interest in lifestyle modification in the disease management of patients with vestibular migraine<span> (VM) and migraine only (MO) without vertiginous complaints. The primary aim of this study was to compare health-related lifestyle factors, including sedentary behavior, sleep quality, mood, and nutrition habits, between patients with VM, MO, and healthy controls (HCs). The secondary aim was to explore the association between health-related lifestyle factors and disability status in VM and MO groups.</span></div></div><div><h3>Methods</h3><div><span>This cross-sectional case-control study included 21 patients with VM, 30 patients with MO, and 33 HCs. Vertigo and </span>headache severity caused by migraine-triggering foods with Numeric Rating Scale-NRS, disability status with Migraine Disability Assessment-MIDAS, sedentary behavior with Sedentary Behavior Questionnaire-SBQ, sleep quality with Pittsburgh Sleep Quality Index-PSQI and mood with Hospital Anxiety and Depression Scale-HADS were recorded in 3 groups.</div></div><div><h3>Results</h3><div>While the exercising, smoking, SBQ, PSQI, HADS-anxiety, and HADS-depression were similar for patients with VM and MO, a higher rate of alcohol consumption was found for patients with VM compared to the MO group (<em>p</em><span> &lt; 0.05). The VM and MO groups demonstrated significant correlations between the headache severity caused by migraine-triggering foods and disability status (</span><em>p</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Adapting new lifestyle interventions and dietary counseling should be encouraged to improve the disease management of patients with VM and MO.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 4","pages":"Pages 484-489"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007797","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":"Corrigendum to “Treatment strategy for intermediate-risk papillary thyroid cancer: Focus on postoperative hypothyroidism following lobectomy” [Auris Nasus Larynx, Volume 52, Issue 1, February 2025, Pages 66-70]","authors":"Akifumi Kariya ,&nbsp;Tomoyasu Tachibana ,&nbsp;Asuka Sato ,&nbsp;Chieko Furukawa ,&nbsp;Yuto Naoi ,&nbsp;Yorihisa Orita ,&nbsp;Mizuo Ando","doi":"10.1016/j.anl.2025.04.001","DOIUrl":"10.1016/j.anl.2025.04.001","url":null,"abstract":"","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 4","pages":"Page 543"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010678","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":"Early detection and successful management of postoperative external jugular vein thrombosis using color doppler ultrasonography after free jejunal transfer","authors":"Kohei Ida ,&nbsp;Hideki Kadota ,&nbsp;Ryo Shimamoto ,&nbsp;Chikafumi Oryoji ,&nbsp;Do Emura ,&nbsp;Atsushi Imaizumi","doi":"10.1016/j.anl.2025.07.001","DOIUrl":"10.1016/j.anl.2025.07.001","url":null,"abstract":"<div><div>Postoperative venous thrombosis is a known complication of free flap reconstruction, yet thrombosis of the external jugular vein (EJV) remains underreported. We present two cases of EJV thrombosis following free jejunal transfer, both detected early using color Doppler ultrasonography (CDU) and successfully managed with anticoagulation therapy. In Case 1, EJV was used after failure of a prior jejunal flap anastomosed to the internal jugular vein (IJV). CDU on postoperative day (POD) 0 showed thrombus characterized by flow voids and incomplete vein collapse, prompting heparin administration. In Case 2, CDU on POD 1 similarly revealed early thrombus in the EJV. In both cases, daily CDU monitoring demonstrated progressive improvement, allowing flap salvage without surgical reintervention. These cases highlight the utility of CDU for early postoperative surveillance and timely clinical decision-making. CDU facilitated early detection of venous thrombosis, often preceding clinical signs of vascular compromise. Although less favored than the IJV, the EJV can be safely used for microvascular anastomosis with careful monitoring. Our experience supports the use of CDU to guide anticoagulation therapy and optimize outcomes in free flap reconstruction involving the EJV.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 4","pages":"Pages 502-506"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669058","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":"Robotic and computer-assisted techniques in ear surgery","authors":"Takeshi Fujita ,&nbsp;Taku Ito ,&nbsp;Masaya Uchida ,&nbsp;Hajime Koyama ,&nbsp;Masahiro Takahashi ,&nbsp;Takara Nakazawa ,&nbsp;Takashi Fujiwara ,&nbsp;Nozomu Matsumoto ,&nbsp;Tadao Yoshida ,&nbsp;Naohiro Yoshida ,&nbsp;Seiji Kakehata ,&nbsp;Manabu Komori ,&nbsp;Naohito Hato","doi":"10.1016/j.anl.2025.06.013","DOIUrl":"10.1016/j.anl.2025.06.013","url":null,"abstract":"<div><div>Robotic and computer-assisted systems for ear surgery are receiving growing attention as tools to overcome the challenges intrinsic to the delicate, restricted operative field of the middle and inner ear. This review highlights recent advances in robotic platforms, clinical outcomes, and emerging technologies such as augmented reality (AR), virtual reality (VR), and artificial intelligence (AI). Multiple groups worldwide have introduced robotic devices that aid or automate tasks like mastoid drilling, stapes footplate fenestration, and cochlear implant (CI) electrode insertion. Seminal studies involving systems such as HEARO, iotaSoft, and RobOtol reveal sub-millimeter accuracy and minimized trauma during CI, suggesting the potential to reduce postoperative complications and improve hearing preservation.</div><div>Although these technologies have progressed from proof-of-concept prototypes to early clinical usage, significant barriers remain before they become routine. Cost is a key concern, given the relatively small patient population for otologic procedures compared to other surgical fields. Regulatory pathways also require strict safety validations, particularly for semi-autonomous or fully autonomous functions. Nevertheless, FDA and European CE approvals for certain robotic systems illustrate their growing feasibility. Meanwhile, AR- and VR-based navigation is improving intraoperative visualization by overlaying critical structures such as the facial nerve onto the surgeon’s field, while AI-driven algorithms for instrument tracking and real-time monitoring offer further enhancements in safety and precision. In addition, simulation-based training in VR environments can accelerate surgical expertise and reduce learning curves.</div><div>Larger-scale clinical trials that directly compare robotic and conventional approaches are still needed to quantify benefits related to complication rates, operative times, and long-term auditory outcomes. Ongoing innovations in software integration and miniaturized hardware are likely to broaden the range of feasible robotic tasks within the ear’s narrow anatomical boundaries.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 4","pages":"Pages 496-501"},"PeriodicalIF":1.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719159","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}