American Journal of Otolaryngology最新文献

{"title":"Postoperative recurrent laryngeal nerve paralysis in thyroid carcinoma surgery","authors":"Takemasa Terao,&nbsp;Ryota Kiwaki,&nbsp;Yorihisa Orita","doi":"10.1016/j.amjoto.2026.104849","DOIUrl":"10.1016/j.amjoto.2026.104849","url":null,"abstract":"<div><h3>Objective</h3><div>Recurrent laryngeal nerve (RLN) paralysis is a significant complication of thyroid surgery. Even with meticulous nerve preservation, postoperative RLN paralysis can still occur. We investigate risk factors for postoperative RLN paralysis among the patients with thyroid carcinoma.</div></div><div><h3>Methods</h3><div>Between 2017 and 2023, 216 patients underwent surgery for thyroid carcinoma at Kumamoto University Hospital. Among these, 26 patients displayed preoperative vocal cord paralysis. Records for the remaining 190 patients were reviewed retrospectively to identify risk factors for postoperative RLN paralysis.</div></div><div><h3>Results</h3><div>Among the 190 cases, 16 required RLN resection during surgery due to tumor invasion. Out of the remaining 174 patients who preserved RLN, 29 suffered temporary and 7 permanent postoperative RLN paralysis. Tracheal invasion was identified as a significant risk factor for the need to resect RLN during surgery, even in the absence of preoperative RLN paralysis (OR 7.0, <em>P</em> = 0.038). For patients suffering postoperative RLN paralysis even though preserving RLN during surgery, RLN shaving (OR 42.8, <em>P</em> &lt; 0.001) and blood loss (OR 1.51 per 100 mL increase, <em>p</em> = 0.024) were identified as an independent factor. Excluding RLN shaving cases, blood loss was an independent factor.</div></div><div><h3>Conclusion</h3><div>Patients with suspected tracheal invasion preoperatively are at high risk of requiring intraoperative RLN resection. Among the patients with thyroid carcinoma who preserved RLN during surgery, the cases in which nerve preservation was achieved by shaving technique and those with greater intraoperative bleeding had a higher risk of postoperative RLN paralysis.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 3","pages":"Article 104849"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759853","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":"Hyperbaric oxygen combined with postauricular and intratympanic steroid injections in diabetic patients with severe or profound refractory sudden sensorineural hearing loss","authors":"Huimei Li,&nbsp;Chenyang Zhao,&nbsp;Weihong Zhang,&nbsp;Yin Fu","doi":"10.1016/j.amjoto.2026.104838","DOIUrl":"10.1016/j.amjoto.2026.104838","url":null,"abstract":"<div><h3>Background</h3><div>Patients with type 2 diabetes mellitus (T2DM) and severe or profound refractory sudden sensorineural hearing loss (RSSNHL) urgently require more effective salvage therapies.</div></div><div><h3>Aim</h3><div>This study aimed to evaluate the efficacy of a triple salvage therapy—combining hyperbaric oxygen (HBO), intratympanic steroids (ITS), and postauricular steroid injections (PSI)—for severe or profound RSSNHL in diabetic patients.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed 117 patients with unilateral severe or profound RSSNHL and concurrent T2DM between January 2020 and December 2024. All patients underwent salvage therapy with PSI and ITS, either with (<em>n</em> = 60) or without (<em>n</em> = 57) HBO. The primary efficacy endpoint was the change in hearing level, while secondary endpoints included changes in glycemic control, tinnitus and vertigo symptoms, anxiety and depression scores, and sleep quality.</div></div><div><h3>Results</h3><div>Compared to the No-HBO group, the HBO group achieved superior post-salvage efficacy, with significantly higher cure rates, clinical effectiveness rates, and hearing threshold gain (<em>P</em> &lt; 0.05), while maintaining a comparable safety profile (<em>P</em> &gt; 0.05). Salvage therapy improved glycemic control, neurotological symptoms, sleep, and psychological status in both groups, with greater benefits observed in the HBO group (<em>P</em> &lt; 0.05). Shorter intervals from symptom onset to salvage therapy and shorter T2DM duration were associated with significantly greater hearing improvement (<em>P</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>This triple salvage therapy effectively treats severe or profound RSSNHL in diabetic patients, improving auditory outcomes, glycemic control, and comorbid symptoms without increasing the incidence of adverse events.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 3","pages":"Article 104838"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759912","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":"“Critical methodological considerations in the study of combined tDCS and counseling for chronic tinnitus”","authors":"Ho Yun Lee","doi":"10.1016/j.amjoto.2025.104785","DOIUrl":"10.1016/j.amjoto.2025.104785","url":null,"abstract":"","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 3","pages":"Article 104785"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147803290","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":"Self-perception of balance function in adults following cochlear implant surgery: A cross-sectional study","authors":"Rania Alkahtani ,&nbsp;Abeer Alotaibi ,&nbsp;Arwa Alhussain ,&nbsp;Layan Algharbi ,&nbsp;Reenad Al-hlail ,&nbsp;Reem Elbeltagy ,&nbsp;Hadeel Alsaleh ,&nbsp;Sahar Asqool","doi":"10.1016/j.amjoto.2026.104843","DOIUrl":"10.1016/j.amjoto.2026.104843","url":null,"abstract":"<div><h3>Objective</h3><div>To assess self-perceived balance function in adults after cochlear implantation and explore factors associated with postoperative vertigo.</div></div><div><h3>Methods</h3><div>A cross-sectional questionnaire-based study was conducted among adult cochlear implant recipients (≥18 years). Collected data included demographics, hearing history, vestibular symptoms before and after implantation, and satisfaction with hearing outcomes. Chi-square analysis was used to examine associations between vertigo and clinical variables.</div></div><div><h3>Results</h3><div>A total of 50 adult participants were included. Perception of vertigo was reported by 38% prior to implantation and 48% post-implantation. Among those with post-implant symptoms, 58.3% experienced vertigo daily, and 54.2% rated their symptoms as moderate in severity. The majority of symptoms developed within one month post-surgery. Male sex was significantly associated with a higher incidence of post-implant vertigo (<em>p</em> = 0.049), while no significant associations were observed with other factors.</div></div><div><h3>Conclusion</h3><div>Nearly half of adult cochlear implant recipients reported postoperative vertigo, with many describing symptoms of moderate severity that interfered with daily activities. These findings underscore the importance of incorporating systematic pre- and post-operative vestibular assessment and follow-up into standard cochlear implant care.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 3","pages":"Article 104843"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147803288","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":"Epidemiological characteristics and surgical management of external auditory canal foreign bodies: A 16-year single center retrospective study","authors":"Seok Hyun Kim ,&nbsp;Dae Sup Lee ,&nbsp;Sung Won Choi ,&nbsp;Se Joon Oh ,&nbsp;Il Woo Lee ,&nbsp;Hyun Min Lee","doi":"10.1016/j.amjoto.2025.104774","DOIUrl":"10.1016/j.amjoto.2025.104774","url":null,"abstract":"<div><h3>Objective</h3><div>External auditory canal foreign bodies (EAC-FBs) are common otologic emergencies across all age groups. While many cases are managed outpatient, some require surgery with risk of complications. This study analyzed epidemiological characteristics and risk factors for surgical management of EAC-FBs over a 16-year period at a single center.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 411 EAC-FB cases from November 2008 to June 2024. Data on demographics, FB type, removal methods, surgical need, and complications were collected. Foreign bodies were categorized into eight types and analyzed by age group, season, and treatment outcome.</div></div><div><h3>Results</h3><div>The mean age was 27.78 ± 22.63 years; adults comprised 48.8 % of patients. The peak incidence occurred in summer (29.7 %). Surgical intervention was required in 10.2 % of cases, with higher rates in preschoolers (27.5 %) and patients with prior hospital visits (31.6 %). The most common FBs were insects (27.3 %) and ear-related medical supplies (25.1 %), with age-specific patterns. Toys were predominant in preschoolers (47.1 %), while adults more often had insects or medical items. The overall complication rate was 1.9 %, increasing to 19.0 % in surgical cases.</div></div><div><h3>Conclusion</h3><div>EAC-FBs display age-dependent patterns in FB type and treatment outcome. Preschool children and patients with prior visits are at higher surgical risk. Although overall complication rates are low, those requiring surgery have substantially elevated risk. Careful initial evaluation and early referral are essential, along with age-specific management and prevention strategies.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 3","pages":"Article 104774"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147803285","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":"Prognostic risk factors in patients with jaw osteoradionecrosis: A retrospective cohort study at a tertiary teaching hospital","authors":"Chen-xi Li ,&nbsp;Zhong-cheng Gong ,&nbsp;Sakendeke Jumatai ,&nbsp;Chang Fang ,&nbsp;Parekejiang Pataer ,&nbsp;Hua-rong Zhao","doi":"10.1016/j.amjoto.2026.104845","DOIUrl":"10.1016/j.amjoto.2026.104845","url":null,"abstract":"<div><h3>Background/Objective</h3><div>Osteoradionecrosis of the jaws (ORNJ) is a severe complication of radiotherapy for head and neck cancer, with limited data on prognostic factors. This study aimed to identify risk factors associated with wound healing prognosis in ORNJ patients.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted following STROBE guidelines, including 106 ORNJ patients treated at a tertiary hospital between 2005 and 2020. Patients were divided into normal wound healing (NH, within 7–10 days postoperatively) and delayed wound healing (DH, ≥11 days postoperatively) groups. Univariate analysis, multivariate Logistic regression, and Cox proportional hazards models were used to identify prognostic factors.</div></div><div><h3>Results</h3><div>The median follow-up was 38.6 months. Univariate analysis showed DH patients had significantly higher baseline PIV (median: 490.1 vs 437.8) and SII (median: 775.6 vs 732.2) than NH patients (all <em>p</em> &lt; 0.001). Multivariate logistic regression showed that diabetes mellitus (OR = 9.687, <em>p</em> = 0.010), Charlson comorbidity index (CCI, OR = 10.004, <em>p</em> &lt; 0.001), primary tumor site (OR = 10.384, <em>p</em> = 0.006), T stage (OR = 27.340, <em>p</em> &lt; 0.001), ORNJ grade at diagnosis (OR = 4.367, p &lt; 0.001), pan-immune-inflammatory value (PIV, OR = 1.043, p &lt; 0.001), and systemic immune-inflammatory index (SII, OR = 1.023, <em>p</em> &lt; 0.001) were independent risk factors for delayed healing. Kaplan-Meier curves showed that patients in the highest PIV tertile had significantly longer time-to-healing (median: 31.5 vs 18.3 days, Log-rank p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>PIV and SII, along with clinical factors (diabetes mellitus, CCI, T stage, ORNJ grade), are independent prognostic factors for wound healing in ORNJ patients. These findings may help clinicians optimize treatment strategies and predict outcomes.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 3","pages":"Article 104845"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147803286","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":"Tinnitus severity and dizziness: The role of psychological distress in a population-based study","authors":"Hyunji Kim ,&nbsp;Kyoungwoo Kim","doi":"10.1016/j.amjoto.2026.104842","DOIUrl":"10.1016/j.amjoto.2026.104842","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the association between tinnitus severity and dizziness in a nationally representative sample of adults aged ≥40 years and to evaluate the contribution of psychological distress (anxiety and perceived stress).</div></div><div><h3>Methods</h3><div>We analyzed data from 7634 participants in the Korea National Health and Nutrition Examination Survey (2022−2023). Dizziness was defined as self-reported symptoms within the past 12 months. Tinnitus severity was categorized as mild, moderate, or severe compared with no tinnitus. Survey-weighted logistic regression models estimated odds ratios (ORs) and 95% confidence intervals (CIs) with sequential adjustment for sociodemographic factors, health behaviors, comorbidities, and psychological variables.</div></div><div><h3>Results</h3><div>Among adults aged 40 years and older, the weighted proportions of participants reporting dizziness and tinnitus symptoms were 33.7% and 10.2%, respectively. Tinnitus severity showed a graded association with dizziness (p for trend = 0.003 in Model 4). Compared with the no‑tinnitus group, moderate and severe tinnitus were associated with higher odds of dizziness after full adjustment (OR 1.71, 95% CI 1.33–2.20; OR 2.43, 95% CI 1.75–3.39). Anxiety severity and perceived stress were independently associated with dizziness, and adjustment for these factors attenuated the tinnitus–dizziness association by approximately 9% and 19% for moderate and severe tinnitus.</div></div><div><h3>Conclusions</h3><div>Tinnitus severity was independently associated with dizziness in a graded manner. Psychological distress was also associated with dizziness and partially attenuated this relationship, supporting a clinical approach that integrates auditory and psychological factors in the assessment of dizziness.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 3","pages":"Article 104842"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological 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}