Acta Oto-Laryngologica最新文献

{"title":"Evaluation of parotid tumors using systemic inflammation markers and diffusion-weighted magnetic resonance images.","authors":"Ahmet Ufuk Kilictas, Ozlem Celebi Erdivanlı, Mehmet Birinci, Fatma Beyazal Celiker, Suat Terzi, Metin Celiker, Zerrin Ozergin Coskun, Engin Dursun","doi":"10.1080/00016489.2025.2554650","DOIUrl":"https://doi.org/10.1080/00016489.2025.2554650","url":null,"abstract":"<p><strong>Background: </strong>Preoperative differentiation between benign and malignant parotid gland tumors is challenging. Apparent Diffusion Coefficient (ADC) from Diffusion-Weighted Magnetic Resonance Imaging (DW-MRI) and systemic inflammatory markers such as neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have emerged as non-invasive diagnostic tools.</p><p><strong>Aims/objectives: </strong>To evaluate the diagnostic utility of ADC, NLR, and PLR individually and in combination for distingushing benign from malignant parotid tumors and for differentiating major histopathological subtypes.</p><p><strong>Material and methods: </strong>This retrospective study included 138 patients with histopathologically confirmed parotid tumors. ADC values were obtained from DW-MRI, and NLR and PLR were calculated from preoperative CBC. A decision tree model incorporating age, gender, ADC, PLR, and NLR was developed, and diagnostic performance was assessed using ROC analysis.</p><p><strong>Results: </strong>Complete data was available for for 108 patients. The decision tree achieved an AUC of 0.837 for malignancy prediction, with age and PLR as key predictors. Excluding ADC did not impact model performance (AUC=0.837; <i>p</i>=1.0). While ADC alone did not differentiate malignancy, it was effective for subtype classification: AUC=0.891 for Warthin tumor vs pleomorphic adenoma, and 0.771 for pleomorphic adenoma vs mucoepidermoid carcinoma.</p><p><strong>Conclusions and significance: </strong>Systemic inflammation markers enhance malignancy prediction, whereas ADC contributes meaningfully to histological subtype differentiation.</p>","PeriodicalId":6880,"journal":{"name":"Acta Oto-Laryngologica","volume":" ","pages":"1-9"},"PeriodicalIF":1.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145038951","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":"Validation of sentinel lymph node biopsy with completion neck dissection in oral cavity cancer.","authors":"Erim Pamuk, Burçay Tellioğlu, Ergin Eroğlu, Oğuz Kuşcu, Nilda Süslü, Murat Tuncel, Yeşim Gaye Güler","doi":"10.1080/00016489.2025.2556821","DOIUrl":"https://doi.org/10.1080/00016489.2025.2556821","url":null,"abstract":"<p><strong>Background: </strong>Sentinel lymph node biopsy (SLNB) is increasingly used in oral cavity squamous cell carcinoma (OCSCC) as a minimally invasive approach that may reduce overtreatment and morbidity compared to elective neck dissection (END).</p><p><strong>Aim: </strong>This study evaluated the diagnostic performance of SLNB in clinically node-negative (cN0) OCSCC and its utility in mapping lymphatic drainage, particularly in advanced tumors.</p><p><strong>Methods: </strong>A retrospective cohort of 57 cN0 OCSCC patients undergoing SLNB followed by completion neck dissection was analysed.</p><p><strong>Results: </strong>In early-stage tumors (T1/T2), SLNB demonstrated 100% sensitivity and negative predictive value, with an occult metastasis rate of 23.8%. No false negatives were observed, and only one patient was upstaged. In T3/T4 tumors, sensitivity and NPV decreased to 55.6% and 60%. The false-negative rate (FNR), calculated as the proportion of false negatives among patients with histopathologically confirmed nodal metastases, was 44.4%. Contralateral or bilateral drainage occurred in 40% of well-lateralized advanced tumors, reflecting altered drainage with progression.</p><p><strong>Conclusion: </strong>SLNB is a reliable staging tool in early OCSCC. In advanced disease, although diagnostic accuracy is reduced, it provides valuable information on atypical drainage pathways.</p><p><strong>Significance: </strong>These findings support SLNB as an effective staging and lymphatic mapping tool, reinforcing its selective integration into OCSCC management.</p>","PeriodicalId":6880,"journal":{"name":"Acta Oto-Laryngologica","volume":" ","pages":"1-9"},"PeriodicalIF":1.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145051621","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":"Preoperative anxiety in vestibular schwannoma surgery: prevalence, risk factors, and a retrospective cohort of 404 patients.","authors":"Yiru Wang, Songyuan Chi, Xia Shen","doi":"10.1080/00016489.2025.2558155","DOIUrl":"https://doi.org/10.1080/00016489.2025.2558155","url":null,"abstract":"<p><strong>Background: </strong>Vestibular schwannoma (VS) is a benign, slow-growing tumor arising from schwann cells of the vestibulocochlear nerve. Despite its non-malignant pathology, its location in the cerebellopontine angle and lies close to the brainstem, leading to both neurological deficits and emotional strain. Microsurgical resection remains a primary treatment option, for large or symptomatic tumors. However, surgery and general anesthesia can also heighten patients' emotional distress.</p><p><strong>Aims/objectives: </strong>To investigate the prevalence and clinical predictors of preoperative anxiety in patients undergoing microsurgical resection of vestibular schwannoma (VS).</p><p><strong>Material and methods: </strong>In this retrospective cohort study, 404 adult patients who underwent elective VS resection between September 2019 and July 2024 were analyzed. Preoperative anxiety was assessed using the Hospital Anxiety and Depression Scale-Anxiety subscale (HADS-A), with scores ≥8 indicating clinically relevant anxiety. Univariable and multivariable logistic regression analyses were performed to identify variables associated with anxiety.</p><p><strong>Results: </strong>Among the 404 patients, 24.8% (<i>n</i> = 100) had preoperative anxiety (HADS-<i>A</i> ≥ 8). Multivariable logistic regression identified vertigo (OR: 1.800; 95% CI: 1.083-2.991; <i>p</i> = 0.023), facial paralysis (OR: 4.241; 95% CI: 1.417-12.688; <i>p</i> = 0.010), headache (OR: 1.833; 95% CI: 1.039-3.234; <i>p</i> = 0.036), and subjective hearing loss (OR: 5.070; 95% CI: 1.149-22.366; <i>p</i> = 0.032) as independent predictors of preoperative anxiety.</p><p><strong>Conclusion and significance: </strong>Preoperative anxiety is common among VS patients and is significantly associated with vestibular and auditory symptoms. Vestibular dysfunction and subjective perceptions of hearing may be more relevant to emotional distress than objective audiometric thresholds, warranting tailored perioperative support.</p><p><strong>Key points: </strong>Nearly one in four patients with vestibular schwannoma reported clinically relevant preoperative anxiety, underscoring the need for routine psychological screening before surgery.Vertigo, facial paresis, headache, and subjective hearing loss were key symptom-related risk factors for anxiety, suggesting that symptom type may be more informative than symptom count.Subjective hearing complaints, even without audiometric confirmation, were strongly linked to anxiety and should be considered during preoperative counseling and support planning.</p>","PeriodicalId":6880,"journal":{"name":"Acta Oto-Laryngologica","volume":" ","pages":"1-7"},"PeriodicalIF":1.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145038802","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":"Invisible saccule in 3T MRI: insights into inner ear vulnerability and fluid dynamics.","authors":"Yuya Yokoyama, Masumi Kobayashi, Tadao Yoshida, Shinji Naganawa, Tsutomu Nakashima, Michihiko Sone","doi":"10.1080/00016489.2025.2546390","DOIUrl":"https://doi.org/10.1080/00016489.2025.2546390","url":null,"abstract":"<p><strong>Background: </strong>The trabecular mesh of the inner ear plays a critical role in maintaining the structure of the vestibular organs, particularly within the pars superior. Cases have been reported in which the saccule cannot be visualized in the pars inferior lacking this structure.</p><p><strong>Objectives: </strong>To investigate the clinical features and endolymphatic hydrops (EH) and perilymphatic enhancement (PE) on MRI in ears with an invisible saccule (IS) and to clarify the mechanism of IS.</p><p><strong>Materials and methods: </strong>Retrospective study of 89 IS ears and 71 contralateral visible saccule (VS) ears from 406 patients with hearing impairment and vertigo between 2021 and 2024. Middle ear disease, schwannoma, perilymphatic fistula, and ears after intratympanic injection were excluded.</p><p><strong>Results: </strong>Compared with VS ears, IS ears had worse hearing, especially in the low-frequency range, and higher PE. Cases diagnosed with Meniere's disease accounted for 13% of IS, all of which showed EH limited to the cochlea, and PE showed higher in IS ears with vertigo than in those without.</p><p><strong>Conclusions and significance: </strong>The development of IS is associated with loss of anatomical support and subsequent collapse and fistula of the membranous labyrinth, which may cause the breakdown of the blood-labyrinth barrier and changes in lymphatic flow.</p>","PeriodicalId":6880,"journal":{"name":"Acta Oto-Laryngologica","volume":"145 9","pages":"837-844"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938074","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":"Analysis of factors influencing the effective dose of intratympanic steroid injection of dexamethasone in idiopathic sudden sensorineural hearing loss.","authors":"Zhengjie Zhu, Jianyong Chen, Shuna Li, Jun Yang, Wei Wei","doi":"10.1080/00016489.2025.2521809","DOIUrl":"10.1080/00016489.2025.2521809","url":null,"abstract":"<p><strong>Background: </strong>Currently, Intratympanic steroid injection (ITSI) has been identified as a common method for delivering dexamethasone to the inner ear in idiopathic sudden sensorineural hearing loss (ISSNHL).</p><p><strong>Objective: </strong>This study analyzed factors influencing dexamethasone effective dose in ITSI, aiming to optimize injection protocols and efficacy assessment.</p><p><strong>Materials and methods: </strong>A total of 251 ISSNHL patients received ITSI with 5 mg dexamethasone, and drug leakage from the external auditory canal was quantified. The effects of Eustachian tube function (assessed <i>via</i> taste method), injection speed (5 vs. 10 s), and injection site (anteroinferior, posteroinferior, anterosuperior tympanic membrane) on the effective dose were evaluated. The pretreatment and posttreatment audiological examination results were collected, and the relationship between the effective dosage and the efficacy was analyzed.</p><p><strong>Results: </strong>Significantly higher median leakage (1.90 mg vs. 0.75 mg, <i>p</i> < 0.01) was showed in patients with bitter taste, indicating passive eustachian tube opening. However, injection speed and site had no significant impact on leakage (<i>p</i> > 0.05). No significant differences in hearing outcomes were observed between high (>3.5 mg) and low (≤3.5 mg) effective dose groups (<i>p</i> > 0.05).</p><p><strong>Conclusions and significance: </strong>ITSI effective dose primarily depends on eustachian tube function, and low-dose dexamethasone (sufficient to fill the tympanic cavity) is equally efficacious, suggesting simplified clinical protocols.</p>","PeriodicalId":6880,"journal":{"name":"Acta Oto-Laryngologica","volume":" ","pages":"811-819"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144493315","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":"Eustachian tube dysfunction in professional navy divers workers.","authors":"Annamaria Quarato, Simone Di Cianni, Fabio Germano, Luca Filaferro, Federica Lo Re, Maria Scala Manni, Giuseppe Magliulo, Antonio Greco, Armando De Virgilio, Annalisa Pace, Mario Giuseppe Bellizzi, Enrica Croce, Lodovica Gatti, Giannicola Iannella","doi":"10.1080/00016489.2025.2546389","DOIUrl":"https://doi.org/10.1080/00016489.2025.2546389","url":null,"abstract":"<p><strong>Background: </strong>Eustachian tube represents the anterior part of the middle ear. Its role is to maintain the pressure balance between the external and middle ear, especially in some jobs such as divers.</p><p><strong>Objectives: </strong>This clinical study aimed to evaluate Eustachian tube (ET) dysfunction in a cohort of professional divers. The primary objectives were: 1) to compare the prevalence of ET dysfunction in experienced divers versus non-divers, and 2) to assess the potential impact of diving-related immersion factors on ET function.</p><p><strong>Materials and methods: </strong>This case-control study enrolled 34 professional divers from the Italian Navy (Group A) and 35 individuals with no diving experience (Group B). Both groups underwent clinical and physical examinations, assessment of ET function <i>via</i> tympanometry, and completed the Eustachian Tube Dysfunction Questionnaire-7 (ETDQ-7).</p><p><strong>Results: </strong>Tympanometry revealed that 2.9% of participants in both groups had a pathological tympanogram, with no significant differences between groups. ETDQ-7 scores were similarly distributed. However, significant differences were found in tympanometric results after the Valsalva maneuver (<i>p</i> = 0.004 for right ear pressure peaks and <i>p</i> = 0.001 for left ear pressure peaks, comparing Groups A and B). Professional divers showed a low risk of developing ET dysfunction, comparable to non-divers, and this risk was not associated with the duration or frequency of diving activity.</p><p><strong>Conclusions: </strong>Navy divers show a lower incidence of ET dysfunction.</p><p><strong>Significance: </strong>This article could explain to the readers the functioning of the ET function between navy divers and normal divers.</p>","PeriodicalId":6880,"journal":{"name":"Acta Oto-Laryngologica","volume":"145 9","pages":"800-805"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938018","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":"Surgical treatment outcomes of naso-orbito-ethmoid fractures using 3D printing-assisted patient specific mesh: a prospective study.","authors":"Taiqin Wang, Donghui Yan, Hongxun Gong, Ning Huang, Chunlan Lin, Maoxin Wang, Shiyan Chen","doi":"10.1080/00016489.2025.2527113","DOIUrl":"10.1080/00016489.2025.2527113","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the efficacy of three-dimensional (3D) printing-assisted treatment for naso-orbito-ethmoid (NOE) fractures and to compare it with conventional surgical methods.</p><p><strong>Methods: </strong>This research conducted a retrospective analysis of 84 patients with NOE fractures who received surgical treatment at the 900th Hospital of Joint Logistics Support Force of the Chinese People's Liberation Army from January 2018 to July 2023. The patients were divided into two groups based on whether 3D printing was applied as the experimental group (<i>n</i> = 44) and the traditional group (<i>n</i> = 40). Surgical duration, hospital stay duration, intraoperative blood loss, postoperative visual analog scale (VAS) score, simotic index, and complications were compared.</p><p><strong>Results: </strong>The 3D printing group had a shorter average surgical time, average hospital stay duration, average indwelling time of drainage tube, intraoperative blood loss, postoperative pain and satisfaction VAS score, and complications compared to the traditional group. No statistically significant differences were found between the two groups in the simotic index after treatment.</p><p><strong>Conclusions: </strong>Compared to conventional surgical treatment, preoperative 3D printing-assisted treatment for adult patients with NOE fractures can significantly reduce surgical duration, intraoperative bleeding loss and complications, reducing surgical difficulty and improving surgical safety.</p>","PeriodicalId":6880,"journal":{"name":"Acta Oto-Laryngologica","volume":" ","pages":"845-850"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648185","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":"Global and national burden of laryngeal cancer from 1990 to 2021 and future projections to 2045.","authors":"Yandan Wang, Junpeng Luo","doi":"10.1080/00016489.2025.2541618","DOIUrl":"10.1080/00016489.2025.2541618","url":null,"abstract":"<p><strong>Background: </strong>Laryngeal cancer poses a persistent global health burden. Although age-standardized rates have declined, absolute case numbers continue to rise due to population growth and aging.</p><p><strong>Aims/objectives: </strong>To assess global, regional, and national trends in laryngeal cancer burden (1990-2021), evaluate disparities by Socio-demographic Index (SDI), and project future trends to 2045.</p><p><strong>Material and methods: </strong>We used data from the Global Burden of Disease 2021 study. Trends in incidence, mortality, prevalence, and DALYs were analyzed using estimated annual percentage change (EAPC). Das Gupta decomposition assessed contributions of aging, population growth, and epidemiological shifts. Frontier analysis evaluated control efficiency across SDI levels. Forecasts were generated using a Bayesian age-period-cohort (BAPC) model selected by root mean square error.</p><p><strong>Results: </strong>From 1990 to 2021, age-standardized rates declined, but absolute burden increased. Middle-SDI regions and males bore disproportionately high burden. Low-SDI areas saw increases mainly from demographic drivers, while high-SDI areas saw reductions from improved epidemiology. Frontier analysis showed widening control inefficiencies. An inverted U-shaped SDI-burden pattern was identified. Projections indicate continued increases in absolute burden by 2045.</p><p><strong>Conclusion and significance: </strong>Despite falling rates, global laryngeal cancer burden is growing. Targeted, SDI- and sex-specific interventions are needed to reduce disparities and improve outcomes.</p>","PeriodicalId":6880,"journal":{"name":"Acta Oto-Laryngologica","volume":" ","pages":"880-891"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144797917","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":"Long-term outcomes of ossiculoplasty techniques.","authors":"Tankut Uzun, Hamdi Çaklı, Ercan Kaya, Mehmet Özgür Pınarbaşlı, Melek Kezban Gürbüz, Armağan İncesulu","doi":"10.1080/00016489.2025.2521807","DOIUrl":"10.1080/00016489.2025.2521807","url":null,"abstract":"<p><strong>Background: </strong>The ideal ossiculoplasty technique should effectively restore sound transmission, be surgically feasible, biocompatible, and stable. Currently, no single material fully meets these criteria in a cost-effective manner.</p><p><strong>Objectives: </strong>To evaluate and compare the long-term audiological outcomes of various ossiculoplasty techniques.</p><p><strong>Materials and methods: </strong>This retrospective study included 116 patients (aged 11-72) who underwent ossiculoplasty using cortical bone, bone cement, or titanium prostheses between 2013 and 2019. Preoperative and 2-year postoperative air and bone conduction thresholds (500-4000 Hz), air-bone gap (ABG), and hearing gains were analyzed.</p><p><strong>Results: </strong>Significant postoperative ABG improvement was observed in the malleus-incus, incus-stapes bone cement, TORP, and PORP groups (<i>p</i> < 0.05). Although hearing gain was noted in the malleus-stapes bone cement and cortical bone groups, the improvement was not statistically significant (<i>p</i> = 0.18 and <i>p</i> = 0.95, respectively). Hearing gain >10 dB was achieved in 76.5% of incus-stapes bone cement and 53% of TORP procedures.</p><p><strong>Conclusions and significance: </strong>Bone cement offers an effective and economical option for ossiculoplasty, particularly in incudostapedial repairs. Despite no statistically significant difference (<i>p</i> = 0.206), the favorable outcomes of TORP suggest it may be superior to cortical bone in patients with non-functional ossicular chains.</p>","PeriodicalId":6880,"journal":{"name":"Acta Oto-Laryngologica","volume":" ","pages":"806-810"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144493316","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 of tuberculous otitis media: when to sound the alarm?","authors":"Na Zhang, Danni Wang, Qijuan Zou, Xiaobo Ma, Yi Li, Yingshi Piao, Shouqin Zhao","doi":"10.1080/00016489.2025.2522899","DOIUrl":"10.1080/00016489.2025.2522899","url":null,"abstract":"<p><strong>Background: </strong>Tuberculous otitis media (TOM) is a rare form of chronic otitis media, which presents diagnostic challenges due to nonspecific symptoms.</p><p><strong>Aims/objectives: </strong>To characterize the clinical features and identify strategies for early diagnosis.</p><p><strong>Materials and methods: </strong>A retrospective analysis was conducted on 32 patients (40 ears) diagnosed with TOM between 2002 and 2024. Clinical, audiologic, radiologic, and laboratory findings were reviewed.</p><p><strong>Results: </strong>Mean diagnostic delay was 28.9 months. Persistent otorrhea (90%) and hearing loss (HL) (100%) were predominant. Tympanic membrane findings varied: single perforation (70%), multiple (12.5%), and intact (17.5%). Granulations were universal. Age stratification revealed conductive HL and pneumatized mastoids predominated in patients <40 years, while mixed HL and mixed-type mastoid were more common in patients >40 years (<i>p</i> = 0.016, <i>p</i> = 0.005). Bone destruction was evident in 25% of the cases. Mastoid type correlated with HL patterns in non-destructive cases (<i>p</i> = 0.040). Interferon-gamma release assay (IGRA) and polymerase chain reaction (PCR) showed relatively high detection rates.</p><p><strong>Conclusions and significance: </strong>Early suspicion of TOM in refractory/recurrent otitis media, combined with IGRA/PCR screening, prompt imaging, and consideration of age-specific patterns, facilitates timely diagnosis. Surgical biopsy remains critical for confirmation. Integration of age-stratified clinical, laboratory, and radiological findings improves detection accuracy and patient outcomes.</p>","PeriodicalId":6880,"journal":{"name":"Acta Oto-Laryngologica","volume":" ","pages":"778-786"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504363","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}