American Journal of Otolaryngology最新文献

{"title":"Psychological interventions for weight management of patients with obstructive sleep apnea syndrome: A systematic review","authors":"Yue Wang ,&nbsp;Min He ,&nbsp;Ye Tian ,&nbsp;Yunping Deng ,&nbsp;Weiqi Deng","doi":"10.1016/j.amjoto.2026.104840","DOIUrl":"10.1016/j.amjoto.2026.104840","url":null,"abstract":"<div><h3>Introduction</h3><div>Obstructive sleep apnea syndrome (OSAS) is a respiratory disorder commonly associated with obesity, and weight management is considered a key therapeutic strategy. However, conventional weight-loss methods often fail due to poor long-term adherence. While psychological interventions may help address behavioral barriers, their effectiveness in managing weight in OSAS patients remains uncertain. This systematic review aimed to evaluate the effectiveness of psychological interventions for weight loss in individuals with OSAS.</div></div><div><h3>Methods</h3><div>A systematic search (up to April 2025) was conducted across PubMed, Embase, the Cochrane Library, Web of Science, and Scopus to identify randomized controlled trials (RCTs) evaluating psychological interventions in OSAS patients. The primary outcomes included changes in weight, BMI, and body circumference, while secondary outcomes focused on sleep quality, as measured by the Epworth Sleepiness Scale (ESS). (Registration ID: PROSPERO CRD420251024106).</div></div><div><h3>Results</h3><div>Thirteen RCTs (N ≈ 1300) published between 1998 and 2022 were included. Overall, psychological interventions showed more consistent benefits for weight-related outcomes than for sleep-related outcomes. Reductions in body weight, BMI, waist circumference, and neck circumference were more frequently observed in intervention groups, whereas findings for hip circumference were limited. Most studies reporting ESS showed greater improvement in daytime sleepiness with psychological interventions than with control conditions. Studies reporting AHI also generally favored intervention, although the magnitude of benefit varied across trials. Most included studies were judged to have low risk of bias or some concerns.</div></div><div><h3>Conclusion</h3><div>Psychological interventions may be a useful adjunct to lifestyle-based management in adults with OSAS, with stronger evidence for weight-related than sleep-related benefits. Further high-quality trials are needed to determine long-term effectiveness.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 3","pages":"Article 104840"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147803287","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":"Role of the sternocleidomastoid muscle flap in modified radical neck dissection: A retrospective single-institution series of 32 patients","authors":"Yong Tae Hong ,&nbsp;HyunJun Lee ,&nbsp;Sein Lee","doi":"10.1016/j.amjoto.2026.104841","DOIUrl":"10.1016/j.amjoto.2026.104841","url":null,"abstract":"<div><h3>Background/objective</h3><div>The sternocleidomastoid (SCM) muscle flap technique was incorporated into modified radical neck dissection (MRND-SCM flap) to reduce traction injury to the spinal accessory nerve (SAN), improve surgical visualization, protect the carotid artery, and maintain postoperative neck contour. This study aimed to evaluate the feasibility and safety of this approach in patients with N2–N3 head and neck cancer.</div></div><div><h3>Methods</h3><div>Thirty-two patients with clinically N2–N3 head and neck cancer underwent MRND-SCM flap at a single tertiary institution between May 2017 and December 2022 (34 total procedures). Surgical outcomes, perioperative complications, and active shoulder range of motion (ROM) — measured using a standard goniometer preoperatively and at 1, 3, and 6 months postoperatively — were analyzed.</div></div><div><h3>Results</h3><div>The operative procedure was successfully completed in all 32 patients. One patient had SCM muscle partial necrosis during the early postoperative period due to wound infection. Neck tightness developed in 5 patients (15.6%). No SCM rupture, severe atrophy, or clavicle fracture occurred. One patient developed a postoperative hematoma requiring reoperation. Shoulder abduction and flexion decreased significantly at 1 and 3 months but recovered to near-baseline by 6 months. External rotation recovered by 3 months. One patient (3.1%) showed shoulder droop on clinical inspection.</div></div><div><h3>Conclusions</h3><div>MRND-SCM flap demonstrates favorable feasibility and safety profiles in this single-institution retrospective series. The technique preserves the SCM muscle, maintains postoperative neck contour, enables en bloc lymph node dissection, and is associated with near-complete shoulder ROM recovery by six months. These findings represent preliminary safety and feasibility signals. Prospective multicenter studies with larger cohorts are warranted to validate these results.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 3","pages":"Article 104841"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147803289","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":"Duration-dependent associations of sound therapy on tinnitus in hearing loss: A cross-sectional analysis of treatment duration cohorts","authors":"Yingxi Wu ,&nbsp;Yuan Wang ,&nbsp;Wendi Shi ,&nbsp;Yongtao Xiao ,&nbsp;Jian Zhang ,&nbsp;Yonghua Wang ,&nbsp;Lei Tu ,&nbsp;Shanchen Zhou","doi":"10.1016/j.amjoto.2026.104850","DOIUrl":"10.1016/j.amjoto.2026.104850","url":null,"abstract":"<div><h3>Background</h3><div>This cross-sectional observational study analyzed data from routine clinical practice to compare outcomes across independent treatment duration cohorts (3, 6, and 9 months).</div></div><div><h3>Methods</h3><div>This retrospective cohort study analyzed data from 85 patients with chronic tinnitus (≥6 months) and hearing loss who received hearing aid-based sound therapy. Patients were grouped by treatment duration (3, 6, or 9 months) based on clinical circumstances. Pure-tone audiometry, tinnitus psychoacoustic matching, and Tinnitus Handicap Inventory (THI) were assessed at baseline and post-treatment.</div></div><div><h3>Results</h3><div>Post-treatment assessments showed significant reductions in THI scores and tinnitus loudness versus baseline (<em>P</em> &lt; 0.05). Repeated-measures ANOVA revealed a significant time × group interaction for THI changes (F = 5.856, <em>P</em> = 0.004), but Bonferroni-corrected pairwise comparisons showed no significant between-group differences. Multivariate ordinal regression identified longer treatment duration as an independent factor associated with better outcomes: the 3-month cohort showed a lower likelihood of improvement compared with the 9-month cohort (OR = 0.141, 95% CI: 0.038–0.513, <em>P</em> = 0.003), while no difference was found between 6- and 9-month cohorts. Hearing loss severity was not associated with efficacy.</div></div><div><h3>Conclusion</h3><div>In this observational cohort, hearing aid-based sound therapy was associated with reductions in tinnitus-related handicap and loudness. Longer treatment duration was associated with a higher probability of clinical improvement. Patients showed continued improvement up to 9 months, although causal inference is precluded by the observational design.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 3","pages":"Article 104850"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147803401","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":"Predictors of therapeutic response and pain after near-infrared photoimmunotherapy in head and neck cancer","authors":"Junya Matsumoto,&nbsp;Takuma Makino,&nbsp;Yuto Naoi,&nbsp;Shohei Fujimoto,&nbsp;Mizuo Ando","doi":"10.1016/j.amjoto.2026.104848","DOIUrl":"10.1016/j.amjoto.2026.104848","url":null,"abstract":"<div><h3>Objective</h3><div>Near-infrared photoimmunotherapy (NIR-PIT) has been approved by the Japanese national health insurance for approximately five years, and clinical experience has steadily accumulated. However, reports analyzing treatment outcomes and pain-related factors remain limited. This study aimed to identify predictors of therapeutic response and pain following NIR-PIT.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included 25 patients who underwent NIR-PIT for head and neck cancer between January 2021 and June 2025. Lesion diameter and thickness were evaluated in relation to complete response (CR), and the frequency and predictors of post-treatment pain were assessed.</div></div><div><h3>Results</h3><div>Among 22 evaluable patients, eight achieved CR. Lesions with a shorter longest diameter and thinner thickness were significantly associated with higher CR rates (<em>p</em> = 0.011 and <em>p</em> = 0.024). Moderate-to-severe pain (Numerical Rating Scale ≥4) occurred in 18 of 48 treatment cycles (37.5%) but was significantly less frequent in patients with a history of reconstructive surgery (<em>p</em> = 0.017).</div></div><div><h3>Conclusions</h3><div>NIR-PIT demonstrated particularly favorable efficacy for short, thin lesions, suggesting that early introduction of treatment may be associated with improved therapeutic outcomes. A history of reconstructive surgery was associated with reduced post-treatment pain, highlighting the importance of individualized treatment and pain management strategies in head and neck cancer patients undergoing NIR-PIT.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 3","pages":"Article 104848"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147803403","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":"Effects of different hyrax maxillary expansion protocols compared with novel magnetic expansion on the pharyngeal airway and maxillary sinus spaces: A retrospective CBCT-based observational study","authors":"Ahmed Lotf Algahefi ,&nbsp;Maged S. Alhammadi ,&nbsp;Zhihua Li ,&nbsp;Fei Tong","doi":"10.1016/j.amjoto.2026.104844","DOIUrl":"10.1016/j.amjoto.2026.104844","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate three-dimensional changes in the maxillary sinus (MS) and pharyngeal airway space (PAS) following rapid (RME), slow (SME), and magnetic maxillary expansion (MME) using cone-beam computed tomography (CBCT).</div></div><div><h3>Methods</h3><div>This retrospective observational study included 60 patients (35 males, 25 females; mean age 12.83 ± 0.92 years) with transverse maxillary deficiency, allocated equally to RME, SME, and MME groups (<em>n</em> = 20 each). Expansion was carried out according to protocol-specific activation schedules, with appliances retained for three months post-expansion. CBCT scans were obtained at baseline (T1), post-expansion (T2), and after retention (T3). Measurements of MS volume, area, minimum constriction area, and PAS subdivisions (nasopharynx, oropharynx, hypopharynx) were analyzed using Dolphin Imaging software. An adjusted <em>p</em>-value of &lt;0.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>All three expansion protocols demonstrated numerical increases in maxillary sinus and pharyngeal airway dimensions during the active expansion phase (T1–T2); however, after adjustment for multiple comparisons, statistically significant changes were limited. Significant within-group increases in maxillary sinus volume were observed only in the slow maxillary expansion group, while no pharyngeal airway parameter showed a statistically significant change after correction. No significant dimensional changes were detected during the retention period (T2-T3). Inter-group comparisons revealed no statistically significant differences among the three expansion protocols.</div></div><div><h3>Conclusion</h3><div>Magnetic maxillary expansion demonstrates anatomical effects comparable to conventional expansion protocols; importantly, no distinct or superior pharyngeal airway benefit was identified, highlighting the limits of airway-related effects of maxillary expansion rather than evidence of enhanced functional respiratory impact.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 3","pages":"Article 104844"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147803402","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":"Why does sound stimulation not cause dizziness?","authors":"Hiroaki Ichijo,&nbsp;Hisako Ichijo","doi":"10.1016/j.amjoto.2026.104839","DOIUrl":"10.1016/j.amjoto.2026.104839","url":null,"abstract":"<div><h3>Background</h3><div>Sound waves stimulate the saccule. Therefore, sound waves are transmitted from the perilymph to the endolymph, causing the otolithic membrane of the saccule to vibrate and the cilia of the hair cells to move. Nevertheless, dizziness does not occur in response to auditory stimuli. To investigate this mystery, we examined the presence or absence of dizziness and nystagmus when loud sounds were presented to healthy individuals and reconsidered the auditory reception mechanism.</div></div><div><h3>Methods</h3><div>Ten healthy individuals without ear pathology were studied. Stapedial reflex testing was performed on both ears using an impedance audiometer and the occurrence of dizziness and nystagmus was examined.</div></div><div><h3>Results</h3><div>None of the subjects complained of dizziness or showed nystagmus.</div></div><div><h3>Conclusions</h3><div>The saccule does not cause nystagmus or dizziness. Sound waves do not stimulate the lateral semicircular canal, this means that sound waves selectively stimulate the saccule (i.e., no vertical expansion). As an auditory mechanism, we propose the endolymph conduction theory, in which sound waves are transmitted through the ductus reuniens to the endolymph of the cochlear duct and directly bend the cilia of the hair cells. This is more scientific and credible than Bekesy's traveling wave theory.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 3","pages":"Article 104839"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759880","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 influence of transcutaneous electrical acupoint stimulation combined with ear copper needle scraping on the clinical efficacy and quality of life of patients with sudden sensorineural hearing loss accompanied by tinnitus: A randomized controlled trial.","authors":"Xinyue Sheng, Wenxin Rao, Yujing Huang, Qinzhi Sun, Lulu Wang, Yawen Jia, Yehai Liu, Biaoxin Zhang","doi":"10.1016/j.amjoto.2026.104851","DOIUrl":"https://doi.org/10.1016/j.amjoto.2026.104851","url":null,"abstract":"<p><strong>Background: </strong>Patients with sudden sensorineural hearing loss (SSNHL) often experience tinnitus, which adversely affects hearing and quality of life. This study aimed to evaluate the combined effects of transcutaneous electrical acupoint stimulation (TEAS) and ear copper needle scraping on clinical efficacy and quality of life in patients with SSNHL accompanied by tinnitus.</p><p><strong>Methods: </strong>In this randomized controlled trial, 86 patients with SSNHL accompanied by tinnitus were randomly assigned to control group or observation group, with 43 participants in each group. The control group received conventional pharmacological treatment and nursing care, while the observation group additionally received TEAS combined with ear copper needle scraping. Outcomes were assessed after 2 weeks. Pure-tone average (PTA), tinnitus severity (tinnitus evaluation questionnaire [TEQ] and tinnitus handicap inventory in Chinese Version [THI]), and quality of life (SF-36) were evaluated before and after treatment. Adverse events were recorded.</p><p><strong>Results: </strong>A total of 78 patients completed the study. Both groups showed significant improvements in PTA, TEQ, THI and SF-36 scores compared with baseline (all P < 0.05). The clinical efficacy was higher in the observation group than in the control group (87.50% vs. 50.00%). The observation group demonstrated greater benefits in hearing, tinnitus severity and quality of life (all P < 0.001). Neither group experienced any serious adverse events.</p><p><strong>Conclusion: </strong>In patients with SSNHL accompanied by tinnitus, the combination of TEAS and ear copper needle scraping may effectively improve hearing thresholds, reduce tinnitus severity, and enhance quality of life over a short-term period, with a favorable safety profile.</p><p><strong>Trial registration: </strong>International Traditional Medicine Clinical Trial Registry, No. ITMCTR2025002155. The date of registration is 2025.11.08 (Retrospectively registered).</p>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 4","pages":"104851"},"PeriodicalIF":1.7,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832290","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 intriguing condition of eosinophilic sialodochitis: insights into an emerging type 2 disorder.","authors":"Matteo Lazzeroni, Eugenio De Corso, Andrea De Lena, Cristina Amaglio, Emanuele Bizzi, Giulia Gramellini, Niccolò Cenzato, Michele Gaffuri, Antonino Maniaci, Pasquale Capaccio","doi":"10.1016/j.amjoto.2026.104810","DOIUrl":"https://doi.org/10.1016/j.amjoto.2026.104810","url":null,"abstract":"<p><strong>Background: </strong>Eosinophilic sialodochitis is a rare and increasingly recognized inflammatory disorder of the salivary glands, characterized by eosinophil-rich mucus plugs, periductal eosinophilic infiltration, and frequent association with type 2 disorders.</p><p><strong>Methods: </strong>A systematic search was conducted on PubMed, Embase, Scopus, and Web of Science for papers reporting on eosinophilic sialodochitis. PRISMA 2020 guidelines were followed, and the study protocol was registered in PROSPERO with registration number CRD42023433994. Data was summarized descriptively and presented as percentages or medians with interquartile range.</p><p><strong>Results: </strong>A total of 157 studies were identified and 21 met the inclusion criteria of the present review, comprising 179 patients. The majority were female (73%) and their ages ranged from 15 to 80 years old. Eosinophilic sialodochitis often presented with multiglandular involvement of the parotid glands. Allergic rhinitis (72%) and asthma (28%) were the most common associated type 2 comorbidities, while elevated serum IgE and blood eosinophil count were frequently reported. Diagnosis was based on different examinations, ranging from ultrasonography to MRI, fine-needle or core-needle biopsy, and conventional sialography. Therapeutic interventions included antihistamines, montelukast, and oral corticosteroids. Sialendoscopy and sialadenectomy were used in refractory cases, while biologics such as dupilumab, benralizumab and mepolizumab were employed only in 4 patients.</p><p><strong>Conclusions: </strong>This review highlights the diagnostic complexity, therapeutic challenges, and potential role of targeted biologic therapies in managing eosinophilic sialodochitis.</p>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 3","pages":"104810"},"PeriodicalIF":1.7,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832343","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":"Reply to the commentary on “Impact of time-to-surgery on survival and quality of life in oral cancer”","authors":"Giancarlo Tirelli ,&nbsp;Margherita Tofanelli ,&nbsp;Paolo Boscolo-Rizzo","doi":"10.1016/j.amjoto.2026.104801","DOIUrl":"10.1016/j.amjoto.2026.104801","url":null,"abstract":"","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 2","pages":"Article 104801"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147321122","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":"Management and graft outcomes of chronic tympanic membrane perforation with isolated malleus cholesteatomas","authors":"Qinghua Wang ,&nbsp;Zhengcai Lou","doi":"10.1016/j.amjoto.2026.104802","DOIUrl":"10.1016/j.amjoto.2026.104802","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to evaluate the graft outcomes of endoscopic cartilage-perichondrium underlay myringoplasty, without raising the tympanomeatal flap, for managing chronic central perforation associated with isolated malleus cholesteatomas.</div></div><div><h3>Materials and methods</h3><div>Twenty-three patients with chronic perforation and isolated malleus cholesteatomas underwent endoscopic cholesteatoma removal followed by cartilage underlay myringoplasty. The graft success rate, hearing improvement, and recurrence of cholesteatoma were assessed at 24 months postoperatively.</div></div><div><h3>Results</h3><div>Intraoperative findings in all 23 patients revealed the accumulation of keratin debris in the superior part of the tympanic membrane perforation around the tip of the malleus handle. Histopathological analysis confirmed the presence of squamous epithelium with keratin debris in all cases. All grafts were successful, and complete closure of the perforations was achieved at the 24-month follow-up. Postoperative pure-tone average air conduction thresholds improved significantly from 56.2 ± 11.6 dB to 43.4 ± 16.6 dB (<em>P</em> &lt; 0.05, paired-sample <em>t</em>-test). Similarly, the air-bone gap (ABG) improved from 35.8 ± 8.2 dB to 19.7 ± 10.5 dB, with a significant difference (<em>P</em> &lt; 0.05, paired-sample t-test). The average ABG gain was 16.1 ± 6.6 dB. No recurrence of cholesteatoma was detected through computed tomography or endoscopic examination during the 24-month follow-up period.</div></div><div><h3>Conclusions</h3><div>Endoscopic removal of malleus cholesteatomas combined with cartilage graft underlay myringoplasty, without raising the tympanomeatal flap, demonstrated a high rate of graft success and significant hearing improvement in patients with chronic perforation and isolated malleus cholesteatoma. No recurrence of cholesteatoma was observed during the two-year follow-up.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 2","pages":"Article 104802"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147372077","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}