Otology & neurotology open最新文献

{"title":"Screening Utility of Ambient Pressure Tympanometry for the Detection of Radiologic Correlates of Subjective Pulsatile Tinnitus.","authors":"Christian Bernard, Cyrus Khorassani, Monica Amarante, Greta Stamper, Joseph Breen, Mallory Raymond","doi":"10.1097/ONO.0000000000000097","DOIUrl":"10.1097/ONO.0000000000000097","url":null,"abstract":"<p><strong>Objective: </strong>To determine the sensitivity and specificity of ambient pressure tympanometry (APT) for the detection of a radiologic correlate of subjective pulsatile tinnitus (PT).</p><p><strong>Study design: </strong>Retrospective review.</p><p><strong>Setting: </strong>Tertiary care clinic.</p><p><strong>Patients: </strong>107 adults (147 ears) with PT who underwent APT between 2021 and 2025.</p><p><strong>Interventions: </strong>Blinded audiologists classified APT tracings as pulse-synchronous or not.</p><p><strong>Main outcome measures: </strong>Sensitivity and specificity of APT using any radiologic diagnosis or surgeon-defined diagnosis as 2 separate gold standards.</p><p><strong>Results: </strong>Of 137 (93.2%) ears that underwent imaging, 63 (46%) had a pulse-synchronous APT pattern. Fifty-one (37.2%) had a radiologic correlate, and 65 (44.2%) were given a surgeon diagnosis. Respectively, APT sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 51%, 57%, 41.3%, and 66.2% for a radiologic correlate and were 43.1%, 54.9%, 43.1%, and 54.9% for a surgeon diagnosis. In a subgroup of 86 patients (116 ears) with a chief complaint of PT, APT sensitivity, specificity, PPV, and NPV for a radiologic correlate were 56.9%, 54.2%, 46%, and 55.2%, and for a surgeon diagnosis were 43.6%, 54.1%, 46.2%, and 51.6%.</p><p><strong>Conclusion: </strong>With a low sensitivity and specificity, APT may not be a reliable screening tool for the detection of a radiologic correlate of subjective PT. Clinicians should continue to pursue radiologic evaluation of PT despite a negative APT and counsel patients on the limits of imaging and the potential need for multiple modalities for the detection of subjective PT sources.</p>","PeriodicalId":74382,"journal":{"name":"Otology & neurotology open","volume":"6 3","pages":"e097"},"PeriodicalIF":1.3,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13610171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Notched Cartilage With Incus Interposition Ossiculoplasty Combined With Cavity Obliteration: A Novel Approach: Analysis of Hearing Results in 50 Cases.","authors":"Sekhar Bandyopadhyay, Arijit Das","doi":"10.1097/ONO.0000000000000095","DOIUrl":"10.1097/ONO.0000000000000095","url":null,"abstract":"<p><strong>Background: </strong>In chronic suppurative ear disease, conductive hearing loss with ossicular chain erosion, poses a serious challenge to the otologist. To overcome this hurdle, various ossiculoplasty techniques have been developed to date. Little modifications in the ossicular reconstruction technique, combined with cavity obliteration in selected cases, can yield predictably good results.</p><p><strong>Objective: </strong>A) To study the hearing outcome in 50 patients of Austin group A ossicular defect, using a piece of notched autologous conchal cartilage over the stapes suprastructure, combined with incus interposition and cavity obliteration. B) To compare the results of hearing outcomes of the present study with other methods of ossiculoplasty.</p><p><strong>Methods: </strong>The present study includes patients who underwent ossiculoplasty for Austin classification group A ossicular defect (M+, S+, and eroded long process of incus) with radiologic evidence of bone erosion involving air cells in the tympanomastoid region, and patients with tubotympanic (safe) disease having peroperative findings of massive irreversible mucosal disease involving the mastoid antrum and aditus. The study was done at North Bengal Medical College Hospital, Darjeeling, between November 1, 2017 and October 31, 2021. Preoperative high resolution computed tomography temporal bone, pure tone audiometry (preoperative and postoperative), and histopathological examination of the diseased tissue were done in all cases. Canal wall down mastoidectomy was done in all cases. A small piece of conchal cartilage was harvested (thickness: 0.5 mm, diameter: 5 mm). A central notch was fashioned with a 0.6 mm diamond burr to accommodate the head of the stapes. The body of the incus was placed between the notched cartilage and the malleus head. Temporalis fascia was harvested and placed between the anterior part of the annulus and the mastoid cavity, covering the neo-ossicular chain. Two flaps (superiorly based and inferiorly based) with periosteum and soft tissue were used for cavity obliteration.</p><p><strong>Results: </strong>n = 50, male 26, female 24. Atticoantral disease: 32 cases, tubotympanic disease:18 cases. Preoperative average air-bone (AB) gap: 29.3 dB, postoperative average AB gap: 19.7 dB. Significant improvement in postoperative AB gap (mean: 19.7 dB) in comparison with preoperative AB gap (mean: 29.3 dB) with a <i>P</i> < 0.001 was observed in 74% of patients with notched cartilage and incus interposition ossiculoplasty and cavity obliteration.</p><p><strong>Conclusion: </strong>Seventy-four percent of ossiculoplasty patients achieved a postoperative AB gap within 20 dB. This technique of ossiculoplasty with autologous cartilage and ossicle with cavity obliteration is physiological, biocompatible, and stable.</p>","PeriodicalId":74382,"journal":{"name":"Otology & neurotology open","volume":"6 3","pages":"e095"},"PeriodicalIF":1.3,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13610215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Access and Attrition Across Audiology and Cochlear Implant Care Among Older Adults with Bilateral Sensorineural Hearing Loss.","authors":"Payal V Patel, Varun Gopal, Divya Patel, Ryan G Porter","doi":"10.1097/ONO.0000000000000096","DOIUrl":"10.1097/ONO.0000000000000096","url":null,"abstract":"<p><strong>Objective: </strong>To quantify progression through the hearing care pathway among US adults aged ≥65 years with bilateral sensorineural hearing loss (SNHL) and describe variation across geographic and community contexts.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>Epic Cosmos Database, January 1, 2021, through December 31, 2024.</p><p><strong>Patients: </strong>Adults aged ≥65 years with bilateral SNHL identified using International Classification of Diseases, Tenth Revision codes.</p><p><strong>Main outcomes and measures: </strong>Stage-specific unadjusted odds ratios with 95% confidence intervals were calculated for progression across audiology evaluation, cochlear implant evaluation, and cochlear implantation. Statistical significance was defined as <i>P</i> < 0.05, with <i>P</i> < 0.001 considered a strong signal given the large sample size.</p><p><strong>Results: </strong>Among 1,461,489 older adults with bilateral SNHL, 746,118 (51.1%) underwent audiology evaluation; fewer than 2% received cochlear implant candidacy evaluation, while approximately 64% of those evaluated for cochlear implantation proceeded to surgery. Marked stage-specific attrition was observed. Adults aged 85 years or older had lower odds of audiology access, higher odds of candidacy evaluation, and lower odds of cochlear implantation. Black and Asian patients had lower odds of candidacy evaluation. Women were less likely to undergo candidacy evaluation but more likely to receive implantation once evaluated for candidacy. Patients living farther from a cochlear implant center and those in rural areas had higher odds of both candidacy evaluation and cochlear implantation, a counterintuitive finding that likely reflects a selection effect among patients who overcome distance barriers rather than improved geographic access.</p><p><strong>Conclusions: </strong>In this national cohort, disparities along the cochlear implant care pathway were associated less with audiologic access due to distance and more with attrition at cochlear implant candidacy assessment. Candidacy referral and evaluation represent a critical, potentially modifiable bottleneck for improving equity in hearing care among older adults.</p>","PeriodicalId":74382,"journal":{"name":"Otology & neurotology open","volume":"6 3","pages":"e096"},"PeriodicalIF":1.3,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13610227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cochlear Implantation in Adults 65 Years and Older With Single-sided Deafness and Asymmetric Hearing Loss.","authors":"Daniel M Zeitler, Nathalie Chouery, Seth R Schwartz, Maura K Cosetti","doi":"10.1097/ONO.0000000000000094","DOIUrl":"10.1097/ONO.0000000000000094","url":null,"abstract":"<p><strong>Background: </strong>Cochlear implantation has proven success as a treatment for single sided deafness (SSD) and asymmetric hearing loss (AHL) in children and adults. However, in adults 65 years and older, cochlear implantation for the treatment of SSD and AHL has been difficulty to study given the restrictions in insurance coverage for cochlear implants (CI) due to current Medicare guidelines.</p><p><strong>Objective: </strong>This study aimed to evaluate outcomes in patients 65 years old and older who underwent cochlear implantation for SSD and AHL to provide data supporting a change in CI candidacy indications for Medicare beneficiaries.</p><p><strong>Methods: </strong>A cohort of CI recipients over the age of 65 years with either SSD (4-frequency pure tone average [4fPTA] ≥90 dB in the implanted ear and ≤30 dB in the better hearing ear) or AHL (interaural difference in 4fPTA ≥15 dB HL, better hearing ear 4fPTA >30 dB HL and ≤70 dB HL) was identified from a single tertiary-level CI center.</p><p><strong>Results: </strong>Forty CI recipients ≥65 years (9 SSD; 31 AHL) were identified. There were significant improvements (percentage point change, ∆%) demonstrated with CI use on consonant-nucleus-consonant (CNC) scores from baseline to 3 timepoints in both SSD (3 m, +38 ∆%; 6 m, +40 Δ%; 12 m, +47 Δ%) and AHL subjects (3 m, 40 Δ%; 6 m, +41 Δ%; 12 m, +42 Δ%). Significant improvements were also seen on AzBio sentences in quiet in both SSD (3 m, +67 Δ%; 6 m, +45 Δ%; 12 m, +68 Δ%) and AHL subjects (3 m, +44 Δ%; 6 m, +57 Δ%; 12 m, +54 Δ%). The status of the contralateral ear accounted for little variance in CNC improvement at 6 or 12 months. Moderate positive associations between device usage and CNC word and AzBio sentence testing were observed at 6 months.</p><p><strong>Conclusions: </strong>Outcomes in adults ≥65 years old with SSD and AHL who undergo CI support the use of implantation in Medicare beneficiaries and provide further evidence for ear-specific candidacy criteria.</p>","PeriodicalId":74382,"journal":{"name":"Otology & neurotology open","volume":"6 3","pages":"e094"},"PeriodicalIF":1.3,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13610223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isotretinoin-induced Intracranial Hypertension Presenting as Unilateral Pulsatile Tinnitus.","authors":"Kaeden L McClintock, Kathryn Wie, Daniel H Coelho","doi":"10.1097/ONO.0000000000000086","DOIUrl":"10.1097/ONO.0000000000000086","url":null,"abstract":"<p><strong>Background: </strong>Pulsatile tinnitus (PT), a challenging condition for patients and clinicians alike, is often linked to vascular, neoplastic, and systemic disorders. The most common cause is idiopathic intracranial hypertension (IIH). However, physicians must recognize that not all intracranial hypertension (IH) is idiopathic and can be due to secondary causes, including cerebral venous anomalies, medications, and systemic medical conditions.</p><p><strong>Objective: </strong>To highlight the importance of this entity, we report a case of drug-induced IH (DIIH), caused by isotretinoin (ISO), that presented with persistent unilateral PT.</p><p><strong>Methods: </strong>Informed consent for the publication of clinical information was obtained from the patient.</p><p><strong>Results: </strong>A 30-year-old female developed unilateral PT and blurred vision shortly after initiating ISO for acne. She was diagnosed with IH, and despite ISO cessation, acetazolamide escalation, and multiple therapeutic lumbar punctures, her PT persists 1 year later. Neuroimaging revealed a high-riding jugular bulb with diverticulum and possible sigmoid sinus dehiscence, likely contributing to the persistence of her symptoms following resolution of her headaches and visual changes.</p><p><strong>Conclusion: </strong>While DIIH typically resolves after discontinuation of the offending agent, this case demonstrates a unique presentation of ISO-associated DIIH manifesting as unilateral PT that persisted despite medical therapy and drug cessation. This highlights the importance of recognizing DIIH as a potential cause of PT, as well as evaluating coexisting anatomic variants and medical comorbidities, which are crucial for timely diagnosis and treatment.</p>","PeriodicalId":74382,"journal":{"name":"Otology & neurotology open","volume":"6 1","pages":"e086"},"PeriodicalIF":1.3,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13012612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved Speech Recognition with Automated ForwardFocus in Cochlear Kanso 3 Sound Processor Users.","authors":"Marian Jones, Wei Hong, I Manjula Schou, Marjan Emjay Mashal","doi":"10.1097/ONO.0000000000000087","DOIUrl":"10.1097/ONO.0000000000000087","url":null,"abstract":"<p><strong>Objective: </strong>The primary objective of this study was to evaluate adult cochlear implant (CI) users' speech perception in spatially separated noise (S0Nrearhalf) with SCAN 2 FF (automated ForwardFocus) versus SCAN 2 (ForwardFocus off) with the Cochlear Kanso 3 Sound Processor. Secondary objectives included comparing speech perception in the S0N3 configuration, speech perception in quiet between the Kanso 3 Sound Processor and the Kanso 2 Sound Processor, and evaluating user satisfaction and subjective hearing performance with the Kanso 3 Sound Processor versus their own sound processor.</p><p><strong>Study design: </strong>Single-center, within-subject, interventional study (NCT05619575).</p><p><strong>Setting: </strong>Purpose-built clinical research unit for auditory device evaluation.</p><p><strong>Patients: </strong>Twenty adults who were postlingually deafened, with at least 6 months of experience with a CI and 3 months of experience with the SCAN program, were recruited.</p><p><strong>Intervention: </strong>The Kanso 3 Sound Processor with the SCAN 2 FF program.</p><p><strong>Main outcome measure: </strong>Paired difference in speech reception threshold (dB SNR) between the SCAN 2 FF and SCAN 2 programs with the Kanso 3 Sound Processor, as measured using the Australian Sentence Test in Noise.</p><p><strong>Results: </strong>Mean speech recognition thresholds were significantly lower (better) with SCAN 2 FF compared with SCAN 2 in both the S0Nrearhalf and S0N3 configurations by 2.00 dB and 1.43 dB, respectively (<i>P</i> < 0.001). Speech perception in quiet was comparable between the Kanso 3 and Kanso 2 Sound Processors. Participants reported high satisfaction with the Kanso 3 Sound Processor, and subjective hearing performance was similar to their own sound processor.</p><p><strong>Conclusions: </strong>This study reinforces the effectiveness of SCAN 2 FF in the Kanso 3 Sound Processor for improving speech perception in noise.</p>","PeriodicalId":74382,"journal":{"name":"Otology & neurotology open","volume":"6 1","pages":"e087"},"PeriodicalIF":1.3,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13012574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tympanic Bone: Small Neglected Bone with Extreme Anatomic Importance in Lateral Skull-Base Surgery.","authors":"Golda Grinblat, Melcol Hailu Yilala, Wenlong Tang, Giuseppe Fancello, Mario Sanna","doi":"10.1097/ONO.0000000000000085","DOIUrl":"10.1097/ONO.0000000000000085","url":null,"abstract":"<p><strong>Introduction: </strong>The tympanic bone (TB) is 1 of the 4 essential parts of the temporal bone, located on its lateral-inferior aspect. It plays a pivotal role in forming the bony part of the external auditory canal, facilitating the transmission of sound to the middle ear.</p><p><strong>Objective: </strong>The current study aims to underline the surgical importance of the TB and its role as a key structure in lateral skull-base surgery, particularly the infratemporal fossa approach type A and removal of the TB during the surgical management of tympanojugular paraganglioma (TJP).</p><p><strong>Materials and methods: </strong>In this study, we examined 20 formalin-prepared temporal bones to highlight the significant anatomical importance of the tympanic portion and its association with the styloid process in TJP surgery. Furthermore, a comprehensive MEDLINE (PubMed) search was conducted using the MeSH term (tympanic bone).</p><p><strong>Results: </strong>The minimum, maximum, and average thicknesses of the TB were 9.3 mm, 12.2 mm, and 10.6 mm, respectively. Whereas the length of the styloid process ranged from 29 mm to 52 mm, with a mean measurement of 43 mm. Among the 272 TJP cases operated on at our center, there were (26%) C1, (49%) C2, (22%) C3, and (3%) C4 cases according to the modified Fisch classification. TB infiltration was evident in virtually all C3 and C4 cases, approximately 70% of C2 tumors, and about 40% of C1 tumors.</p><p><strong>Conclusion: </strong>Although the TB is rarely discussed explicitly as a distinct structure in the literature, it plays a crucial role in many otologic and lateral skull-base procedures. These surgeries frequently require the partial or complete removal of the TB to access the hypotympanum and the internal carotid artery. A meticulous study of high-resolution computed tomography scans, especially coronal sections, is essential for understanding the detailed anatomy of TB.</p>","PeriodicalId":74382,"journal":{"name":"Otology & neurotology open","volume":"6 1","pages":"e085"},"PeriodicalIF":1.3,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13012567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vestibular Profile of Patients with Hearing Loss Caused by Pathogenic Variants of the <i>STRC</i> Gene.","authors":"Zuzana Balatková, Veronika Svobodová, Vladimír Koucký, Zuzana Libáková, Anna Kameníková, Dana Šafka Brožková, Martin Komarc, Markéta Bonaventurová, Vít Kruntorád, Zdeněk Čada","doi":"10.1097/ONO.0000000000000084","DOIUrl":"10.1097/ONO.0000000000000084","url":null,"abstract":"<p><strong>Introduction: </strong>The second most frequent cause of autosomal recessive nonsyndromic sensorineural hearing loss (AR-NSHL) worldwide is a biallelic pathogenic alteration of the <i>STRC</i> (stereocilin) gene, also named DFNB16. The type and severity of hearing impairment in DFNB16 patients were studied thoroughly, while information on a detailed examination of their vestibular function is still lacking. Our aim was to characterize the vestibular status of patients with biallelic pathogenic variants in <i>STRC</i> by performing a complete up-to-date test battery.</p><p><strong>Methods: </strong>Eight AR-NSHL patients, aged 6-37 (mean age ± standard error of the mean [SEM] 16.13 ± 8.67), underwent standard audiological testing and otoneurologic investigation, including videonystagmography (VNG) with caloric stimulation, video head-impulse test (vHIT), and cervical vestibular evoked myogenic potentials (c-VEMPs). Subjects were divided into three groups (group 1, 2, and 3) according to the type of diagnosed <i>STRC</i> gene variant.</p><p><strong>Results: </strong>The grade of the hearing loss was calculated as pure tone average (PTA) (mean PTA ± SEM 41.88 dB ± 5.49). The vHIT displayed nearly normal bilateral gain and mostly the absence of saccades in all examined groups. Cervical VEMPs in response to air-conducted and bone-conducted stimuli showed prolonged latencies of waves P1 and N1 bilaterally in group 1, although latencies in groups 2 and 3 were within normal range. The results of VNG indicated normal vestibular and central oculomotor function.</p><p><strong>Conclusions: </strong>Biallelic pathogenic variants in the <i>STRC</i> gene influence the inner ear's cochlear and vestibular function. Certain vestibular abnormalities in DFNB16 patients were detected by detailed evaluation, despite none of the DFNB16 subjects in our study reported subjective symptoms.</p>","PeriodicalId":74382,"journal":{"name":"Otology & neurotology open","volume":"6 1","pages":"e084"},"PeriodicalIF":1.3,"publicationDate":"2026-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13012269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estrogen Exposure is Associated With Reduced Otosclerosis Risk in Obesity and Hormone Therapy.","authors":"Maia Smith, Sudhanvan Iyer, Delaney E S Clark, Simon Warren, Brian McKinnon","doi":"10.1097/ONO.0000000000000083","DOIUrl":"10.1097/ONO.0000000000000083","url":null,"abstract":"<p><strong>Objective: </strong>To examine whether conditions associated with elevated-estrogenic states, including obesity, type 2 diabetes mellitus (T2DM), and postmenopausal estradiol hormone replacement therapy (HRT), are associated with the development of otosclerosis.</p><p><strong>Methods: </strong>We performed 3 retrospective cohort analyses using the US TriNetX network. Population included adults ≥18 years of age with an ear evaluation (the International Classification of Diseases [ICD]-10 Z01.1). Exposures included obesity (ICD-10 E66), T2DM (ICD-10 E11), and HRT (RxNorm 4083). Primary outcome of interest was otosclerosis (ICD-10 H80). Exclusion criteria for obesity and T2DM cohorts included type 1 diabetes (ICD-10 E10); for all cohorts, criteria included congenital ear abnormalities (ICD-10 Q16) or outcome of interest ≥20 years ago. 1:1 propensity score matching was performed on each cohort for demographics, metabolic comorbidities, ototoxic medications, lifestyle, body mass index, age, and sex. Relative risk with 95% confidence intervals was calculated; <i>P</i> < 0.05 represents statistical significance.</p><p><strong>Results: </strong>Otosclerosis occurred in 25 individuals with obesity with 52 controls (risk ratio [RR] = 0.48, <i>P</i> < 0.005). In the T2DM cohort, 15 cases were present, whereas the control population had 27 cases (RR = 0.56, <i>P</i> = 0.06). Among the estradiol HRT cohort, 303 cases were present compared with 369 in control (RR = 0.82, <i>P</i> < 0.05).</p><p><strong>Conclusions: </strong>Obesity and estradiol HRT are associated with a decreased risk of developing otosclerosis. A similar but nonsignificant trend was found in patients with T2DM. This suggests a protective role of estrogen against otosclerosis. Future studies may serve to elucidate longitudinal hormone profiling and identify a therapeutic local intervention for individuals with otosclerosis.</p>","PeriodicalId":74382,"journal":{"name":"Otology & neurotology open","volume":"6 1","pages":"e083"},"PeriodicalIF":1.3,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13012311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Audiovisual Speech Recognition in Adult Cochlear Implant Candidates: Relations with Cognitive-Linguistic Abilities.","authors":"Gabriella Cote, Gizem Babaoglu, Morgan A Zupkus, Hugh M Birky, Michayla M Saraino, Jonathan D Neukam, Terrin N Tamati, Aaron C Moberly","doi":"10.1097/ONO.0000000000000082","DOIUrl":"10.1097/ONO.0000000000000082","url":null,"abstract":"<p><strong>Objective: </strong>To examine audiovisual (AV) sentence recognition performance in adults with moderate-to-profound sensorineural hearing loss who are cochlear implant (CI) candidates, and to identify the demographic, audiologic, and cognitive-linguistic abilities that explain individual differences in AV performance.</p><p><strong>Study design: </strong>Cross-sectional observational study.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Patients: </strong>Twenty-four postlingually deafened adults (mean age = 70.3 years, SD = 11.2) meeting clinical CI candidacy criteria in both ears, with no known history of cognitive or neurological disorders.</p><p><strong>Interventions: </strong>Participants completed the Multimodal Lexical Sentence Test (MLST) for Adults for AV sentence recognition and a battery of cognitive-linguistic tasks measuring short-term memory, working memory, inhibition-concentration, nonverbal reasoning, and speed of lexical/phonological access.</p><p><strong>Main outcome measures: </strong>AV sentence recognition accuracy on the MLST.</p><p><strong>Results: </strong>MLST performance varied broadly across participants (range = 11%-98%, mean = 67.6, SD = 29.7) and was strongly correlated with auditory-only sentence recognition abilities (<i>rho</i> = 0.85, <i>P</i> < 0.001). Otherwise, AV sentence recognition was not significantly correlated with demographic or additional audiological variables. Short-term memory capacity, measured using visual Forward Digit Span, significantly explained MLST performance (partial <i>rho</i> = 0.44, <i>P</i> = 0.02), after controlling for auditory-only sentence recognition in quiet. Other cognitive-linguistic measures were not significantly associated with MLST scores.</p><p><strong>Conclusions: </strong>AV sentence recognition in adult CI candidates is partially explained by short-term memory capacity. Ecologically valid AV assessments may help identify cognitively mediated barriers to real-world communication that are not captured using conventional auditory-only speech recognition tests.</p>","PeriodicalId":74382,"journal":{"name":"Otology & neurotology open","volume":"6 1","pages":"e082"},"PeriodicalIF":1.3,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13012211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}