The journal of international advanced otology最新文献

{"title":"Pressure Therapy in Bilateral Ménière's Disease: A Prospective Study.","authors":"Edoardo Covelli, Piero Giuseppe Meliante, Chiara Filippi, Pietro Canzi, Sofia Pizzolante, Haitham Elfarargy, Maurizio Barbara","doi":"10.65717/iao.2026.262419","DOIUrl":"https://doi.org/10.65717/iao.2026.262419","url":null,"abstract":"<p><strong>Background: </strong>Ménière's disease (MD) is an inner ear disorder characterized by unpredictable vertigo attacks, tinnitus, and aural fullness, ultimately leading to a decline in audiovestibular function. Linked to endolymphatic hydrops (EH), MD often progresses to bilateral involvement (BMD). When conservative therapies fail, MD requires destructive treatments. However, this is a high-risk choice in bilateral cases for hearing preservation. Pressure therapy (PT), a non-invasive treatment using low-pressure pulses to the middle ear, has shown potential in reducing EH and alleviating MD symptoms. This study aims to evaluate the efficacy of PT in treating BMD.</p><p><strong>Methods: </strong>This prospective study enrolled patients with BMD refractory to standard therapy. Electrocochleography (ECochG) using click stimuli was used to identify the active MD ear. Patients underwent PT for 24 months on the affected side. Outcomes were re-assessed using the ECochG Summating Potential-to-Action Potential (SP/AP) ratio and the Dizziness Handicap Inventory (DHI) after 1, 3, 6, and 24 months. The contralateral ear was used as a control.</p><p><strong>Results: </strong>Pressure therapy significantly reduced the EH (ECochG SP/AP ratio) in active MD ears (P < .001) and improved DHI scores (P < .001). The contralateral non-treated ear showed no significant changes (P=.9687).</p><p><strong>Conclusion: </strong>Pressure therapy alleviates symptoms and improves quality of life in refractory BMD, offering a non-destructive alternative before invasive procedures in case of standard conservative therapy failure.</p>","PeriodicalId":94238,"journal":{"name":"The journal of international advanced otology","volume":"22 3","pages":"1-7"},"PeriodicalIF":1.2,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148964196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lateral Semicircular Canal Occlusion in Patients with Refractory Meniere's Disease.","authors":"Mario Emilio Zernotti, Lola Gonzalez Andrian, Ana Carolina Binetti, Victor Pacheco, Maria Fernanda Di Gregorio, Maximo Zernotti","doi":"10.65717/iao.2026.252243","DOIUrl":"https://doi.org/10.65717/iao.2026.252243","url":null,"abstract":"<p><strong>Background: </strong>Meniere's disease remains a controversial condition not only in terms of its etiology and diagnosis but also its treatment. Approximately 2%-5% of patients do not improve or reach the control of their vestibular symptoms with any pharmacological therapy. Surgery of lateral semicircular canal (LSCC) occlusion could be an alternative to control the symptoms.</p><p><strong>Methods: </strong>Twenty consecutive patients with clinical and oto-neurological diagnosis of Meniere's disease were included. Twelve women and 8 men with a mean age of 51 years (range, 29-72) were studied. All affected with unilateral or at least marked unilateral asymmetry in audio-gram. All patients who underwent surgery received general anesthesia. Canal wall up mastoidectomy was performed. After the LSCC was identified, a bony surface of the semicircular canal was drilled using a 1 mm diamond burr until the membranous labyrinth was discovered (blue line). The canal was then blocked with a mixture of bone wax and bone dust in an area of 2 or 3 mm, at the most prominent part of the semicircular canal.</p><p><strong>Results: </strong>All patients in the study had an average hospital stay of 36 hours, of which 10 required additional medication (ondansetron). All were given 75 mg of cinnarizine orally once daily for 10 days. After that, only 4 patients continued taking betahistine for 1 month. One month later, no patients were taking medication for vertigo.</p><p><strong>Conclusion: </strong>Lateral semicircular canal occlusion seems to be an effective surgical option for patients with refractory Meniere's disease.</p>","PeriodicalId":94238,"journal":{"name":"The journal of international advanced otology","volume":"22 3","pages":"1-5"},"PeriodicalIF":1.2,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148964182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Bilateral Congenital Aural Stenosis with Down Syndrome Underwent Canalplasty with Underwater Transcanal Endoscopic Ear Surgery.","authors":"Chikako Shinkawa, Miyoko Nakamura, Takanari Goto, Shintaroh Amano, Tsukasa Ito","doi":"10.65717/iao.2026.251914","DOIUrl":"https://doi.org/10.65717/iao.2026.251914","url":null,"abstract":"<p><strong>Unlabelled: </strong>Congenital aural stenosis (CAS) sometimes can be a risk for external auditory canal (EAC) cholesteatoma and may require surgical treatment. We report a child of Down syndrome with bilateral CAS who underwent bilateral canalplasty with underwater transcanal endoscopic ear surgery (TEES). Case Report: A 12-year-old boy with bilateral EAC stenosis, in whom tympanostomy tube insertion for secretory otitis media (SOM) had failed at 5 and 8 years of age, was referred to our department for surgical treatment. The bilateral EACs were so narrow and curved that the tym-panic membranes could not be entirely observed. The osseous EAC (OEAC) diameters were measured on sagittal computed tomography (CT) images with ImageJ. The minimum Feret diameter was 3.05 mm in the right ear and 2.98 mm in the left ear. Bilateral canalplasty with underwater TEES and tympanostomy tube insertion was performed for CAS complicated by SOM. One month after surgery, bilateral EACs were well-epithe-lialized and the tympanic membranes were easily observed. Canalplasty with underwater TEES is minimally invasive, secure, and provides a clear surgical field, and is therefore a useful option for children with EAC stenosis.</p>","PeriodicalId":94238,"journal":{"name":"The journal of international advanced otology","volume":"22 3","pages":"1-4"},"PeriodicalIF":1.2,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148964034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Audiological Profile of Adult Patients Awaiting Kidney and Liver Transplantation.","authors":"Javier Iribarren, Claudia Heider, Javier Oyarzún, Gabriela Calderara, Jai-Sen Leung, Ivan Novoa, Sofia Waissbluth","doi":"10.65717/iao.2026.262414","DOIUrl":"https://doi.org/10.65717/iao.2026.262414","url":null,"abstract":"<p><strong>Objective: </strong>Hearing loss is an underrecognized comorbidity in patients with chronic kidney disease (CKD) and chronic liver disease (CLD), particularly among those awaiting solid organ transplantation. Early identification of auditory dysfunction is essential to optimize communication, treatment adherence, and post-transplant care. To describe the prevalence, severity, and audiometric patterns of hearing loss in adult candidates for kidney or liver transplantation.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in 36 adult patients with advanced CKD or CLD evaluated for kidney or liver transplantation at a tertiary academic center. All participants underwent otomicroscopy, tympanometry, pure-tone audiometry, distortion product otoacoustic emissions (DPOAEs), and tinnitus assessment using the Tinnitus Handicap Inventory. Hearing loss was defined as a pure-tone average >20 dB HL across 0.5-4 kHz in either ear.</p><p><strong>Results: </strong>Hearing loss was identified in 30.6% of patients (CLD: 31.6%; CKD: 29.4%), predominantly mild to moderate, with symmetrical high-frequency sensorineural patterns. Distortion product otoacoustic emissions abnormalities were observed in 56.9% of ears, suggesting subclinical cochlear dysfunction. Tinnitus was reported in 38.2% of participants, with no significant differences between groups. All cases of tinnitus were classified as slight or mild handicap. Use of acetylsalicylic acid was significantly associated with hearing loss among CKD patients (P=.003).</p><p><strong>Conclusions: </strong>Hearing loss and tinnitus are common in patients with advanced CKD or CLD awaiting transplantation. Comprehensive audiological assessment, including DPOAEs, may improve pre-transplant evaluation by identifying patients at risk for auditory impairment and informing ototoxic medication decisions.</p>","PeriodicalId":94238,"journal":{"name":"The journal of international advanced otology","volume":"22 3","pages":"1-6"},"PeriodicalIF":1.2,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148964142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Audiological Features in Pendred Syndrome: A Scoping Review.","authors":"Marianna Manuelli, Andrea Migliorelli, Chiara Bianchini, Francesco Stomeo, Daniele Monzani, Stefano Pelucchi, Silvia Palma, Andrea Ciorba","doi":"10.65717/iao.2026.262401","DOIUrl":"10.65717/iao.2026.262401","url":null,"abstract":"<p><strong>Background: </strong>Pendred syndrome (PS) is one of the main causes of congenital hearing loss and is estimated to be the cause of 4-7.5% of hereditary deafness cases worldwide. Pendred syndrome is an autosomal recessive disorder associated with alterations in the SLC26A4 gene characterized by sensorineural hearing loss and goiter. The aim of the study is to compile a review providing an accurate and updated description of the audiological features of PS, offering clinicians a practical tool for a feasible and early diagnosis.</p><p><strong>Methods: </strong>A detailed review of the English literature to date on hearing loss and PS has been performed using Pubmed, Scopus, Google Scholar and Medline databases. The literature review was performed using the guidelines proposed by the study \"Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA)\" for scoping review.</p><p><strong>Results: </strong>A total of 13 full text articles were included in this review, collecting 75 patients with PS. The audiological outcomes, clinical variants, presence of enlarged vestibular aqueduct and Mondini dysplasia, and thyroid status were described for each patient.</p><p><strong>Conclusions: </strong>Pendred syndrome is a condition in which hearing loss is among the main features and can manifest at early stages, eventually impacting children's language development. Pendred syndrome may occur in different clinical variants, which can make diagnosis challenging. It is therefore crucial for clinicians to have a detailed knowledge of the condition. Further studies on large, multicenter case series will therefore be essential to expand knowledge of the disease and enable multidisciplinary development of care.</p>","PeriodicalId":94238,"journal":{"name":"The journal of international advanced otology","volume":"22 3","pages":"1-6"},"PeriodicalIF":1.2,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148964157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cochlear Implantation in Arnold-Chiari Malformation Type 1: Expanding the Boundaries of Pediatric Neuro-Otology.","authors":"Jaimanti Bakshi, Sukriti Nehra, Krishna Gharti, Ritik Arora, Dharam Vir, Noorain Alam, Vikas Saini, Ishita Sood","doi":"10.65717/iao.2026.252196","DOIUrl":"https://doi.org/10.65717/iao.2026.252196","url":null,"abstract":"<p><strong>Unlabelled: </strong>Arnold-Chiari malformation (ACM) is a rare congenital hindbrain anomaly, with types 1-4 depending of degree of herniation of posterior fossa contents. The incidence of type 1 ACM is highest, with most cases being asymptomatic. Cases are incidentally picked up; however, some may present with headache, cough, paresthesia, and very rarely, symptoms of compression of lower cranial nerves such as sensorineural hearing loss. Surgical challenges are anticipated due to associated skeletal malformations and raised intracranial pressure. The youngest reported case-a 3-year-old girl with delayed speech and language milestones-is presented, in whom ACM type 1 was incidentally diagnosed. Audiological workup revealed profound sensorineural hearing loss in both ears. After multidisciplinary clearance, she underwent right-sided cochlear implantation. Intraoperative challenges faced were dilated emissary veins, an anteriorly placed sigmoid sinus, and a low-lying dura. However, a full electrode insertion was achieved and confirmed on neural response telemetry. The postoperative course was uneventful. Literature review suggests this to be the youngest reported case of cochlear implantation in ACM type 1. While hearing loss in this case may have been unrelated to ACM, nonetheless, successful cochlear implantation is feasible with meticulous preoperative planning and intraoperative vigilance. After a thorough anatomical assessment, multidisciplinary preoperative workup, intraoperative vigilance, and neuro-anesthetist backup, cochlear implantation can be safely performed in children with ACM type 1.</p>","PeriodicalId":94238,"journal":{"name":"The journal of international advanced otology","volume":"22 3","pages":"1-4"},"PeriodicalIF":1.2,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148964175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delayed Detection of Bilateral High-Frequency Sensorineural Hearing Loss Following Childhood Cisplatin Therapy: A Case Report.","authors":"Takeshi Tada, Tsunetaro Morino, Akihiro Oue, Kazuhisa Yamamoto","doi":"10.65717/iao.2026.262467","DOIUrl":"https://doi.org/10.65717/iao.2026.262467","url":null,"abstract":"<p><strong>Unlabelled: </strong>Cisplatin is a widely used chemotherapeutic agent in pediatric oncology; however, it is well known for its marked ototoxicity. While hearing impairment typically emerges during or soon after therapy, progressive or previously undetected auditory dysfunction may occasionally present years later. The reported case involves an 11-year-old boy who previously received cisplatin-based chemotherapy for hepatoblastoma and was first identified as having bilateral sensorineural hearing loss 9 years after completion of treatment. Pure-tone audiometry revealed bilateral elevation of high-frequency thresholds without an air-bone gap, and distortion product otoacoustic emissions (DPOAE) were absent at high frequencies. Auditory brainstem responses (ABRs) demonstrated elevated thresholds at 4 kHz, and neuroimaging showed no structural abnormalities of the cochlea or auditory nerve. Expanded genetic testing revealed no pathogenic variants associated with hereditary hearing loss. Although the exact etiology could not be definitively established, the audiologic pattern and treatment history suggested that cisplatin may have contributed to the hearing loss. This case highlights the need for long-term hearing surveillance in childhood cancer survivors, as progressive or previously undetected deficits may not become clinically apparent until many years after treatment.</p>","PeriodicalId":94238,"journal":{"name":"The journal of international advanced otology","volume":"22 3","pages":"1-5"},"PeriodicalIF":1.2,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148964109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Review: Pediatric Patulous Eustachian Tube Dysfunction-An Underestimated Entity in Otolaryngology.","authors":"Holger Sudhoff","doi":"10.65717/iao.2026.252127","DOIUrl":"10.65717/iao.2026.252127","url":null,"abstract":"<p><strong>Background: </strong>Pediatric patulous Eustachian tube dysfunction (PETD) is uncommon in daily practice and is often overshadowed by more prevalent middle ear disorders. Because symptoms may be difficult for children to describe and objective confirmation is inconsistently used, the true frequency and clinical burden of PETD in childhood remain uncertain. This systematic review synthesized the literature on pediatric PETD to clarify reported prevalence, clinical presentation, diagnostic approaches, associated factors, and treatment strategies.</p><p><strong>Methods: </strong>Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses principles, cohort studies, clinical trials, and case series published from 2000 to July 2025 that reported pediatric PETD were reviewed. Data were extracted on study design, patient population, prevalence, presenting symptoms, diagnostic methods, associated conditions, management, and outcomes. Methodological quality was interpreted using study-design-appropriate appraisal approaches.</p><p><strong>Results: </strong>Forty-five studies met the inclusion criteria. Reported prevalence in pediatric populations ranged from 0.3% to 1.2%, likely underestimating the true burden. The evidence base was heterogeneous and largely composed of small observational series. Recurrent themes included misclassification as obstructive Eustachian tube dysfunction or otitis media with effusion, inconsistent use of objective testing, limited pediatric-specific diagnostic criteria, and sparse longitudinal outcome data. Conservative strategies were most frequently described, whereas evidence for procedural intervention in children was limited.</p><p><strong>Conclusion: </strong>Pediatric PETD is likely substantially underdiagnosed. Greater awareness of characteristic symptoms, structured age-appropriate diagnostic pathways, and standardized outcome reporting are needed to improve recognition and management. Prospective pediatric studies should validate diagnostic criteria and compare conservative and interventional strategies.</p>","PeriodicalId":94238,"journal":{"name":"The journal of international advanced otology","volume":"22 3","pages":"1-6"},"PeriodicalIF":1.2,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148964188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Prediction Nomogram for the Risk of Adhesive Otitis Media Based on Temporal Bone Computed Tomography: A Retrospective Study.","authors":"Jiawei Chen, Xiaoxiao Liu, Rui Li, Huangyue Wang, Wenyue Wang, Xinhui Wang, Changming Zhang, Dingjun Zha, Yu Han","doi":"10.65717/iao.2026.262512","DOIUrl":"https://doi.org/10.65717/iao.2026.262512","url":null,"abstract":"<p><strong>Background: </strong>To develop a nomogram model for predicting the risk of adhesive otitis media based on temporal bone computed tomography (CT).</p><p><strong>Methods: </strong>A retrospective cross-sectional study was performed to analyze high-resolution CT images of the temporal bone in patients diagnosed with adhesive otitis media (AdOM). The comparison of the incidence of anatomical variants of the temporal bone between groups was performed. A nomogram for predicting the risk of AdOM was developed and validated.</p><p><strong>Results: </strong>A total of 153 ears from 110 patients were analyzed. In the AdOM group, 86% of the cases had poor mastoid pneumatization (MC0/MC1). The incidence rates of high jugular bulb (HJB), jugular bulb dehiscence, and agenesis of the mastoid antrum were 45.4%, 6.4%, and 2.7%. The incidence of HJB was significantly higher (P=.047), the sigmoid sinus-external auditory canal (SS-EAC) distance was significantly shorter (P < .001), and the depth of the dural plate was significantly deeper (P=.019) than in the control. The SS-EAC distance shortening was identified as an independent risk factor for the incidence of AdOM (odds ratio=1.34, P < .001). A nomogram for predicting the risk of AdOM was developed, with an area under the receiver operating characteristic curve of 0.751. The optimal cutoff value was -0.753 with sensitivity of 64.3% and specificity of 80.0%.</p><p><strong>Conclusion: </strong>The presence of HJB, a shorter SS-EAC distance, and a deeper dural plate depth may be associated with a higher incidence of AdOM. A novel nomogram based on anatomical variations of the temporal bone for predicting the risk of AdOM was developed to assist clinical decision-making in the treatment of otitis media.</p>","PeriodicalId":94238,"journal":{"name":"The journal of international advanced otology","volume":"22 3","pages":"1-8"},"PeriodicalIF":1.2,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148964160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Patient and Surgical Factors on Outcomes of Facial Re-innervation Procedures.","authors":"Thomas Stubley, Colin G Leonard, Richard Irving, Demetrius Evriviades","doi":"10.65717/iao.2026.241343","DOIUrl":"https://doi.org/10.65717/iao.2026.241343","url":null,"abstract":"<p><strong>Background: </strong>Patients in whom the facial nerve has been resected or divided during surgical treatment may have it repaired by direct anastomosis, interposition graft, or may either primarily or up to 2 years later undergo reinnervation of the facial musculature, in most cases using the masseteric or hypoglossal nerve. The aim of this study is to compare outcomes of facial reanimation procedures for those who have undergone either direct anastomosis, nerve grafting, or masseteric nerve transfer.</p><p><strong>Methods: </strong>Retrospective case note review of patients attending the Facial Palsy Clinics. Patients in whom surgery was not part of the treatment provided, revision cases, patients with recurrence of pathology, or incomplete datasets were excluded. Patient factors, etiology, operative findings, and pre- and post-operative Sunnybrook Facial Grading were recorded. In order to allow for differences in recovery time, the post-operative score was considered as the score recorded when improvement had plateaued.</p><p><strong>Results: </strong>Thirty (16 female, 14 male) patients underwent primary surgery for facial palsy. Median age was 44 years. Sixteen patients underwent \"Nerve Transfer,\" 10 \"Nerve Grafting,\" and 4 \"End-to-End.\" Pre-operative Sunnybrook Facial Grading Scale did not differ between the three subgroups. Nerve transfer patients had a mean post-operative score of 58.1, nerve graft 51.4, and end-to-end 68.8 (Chi2=2.196, P=.33).</p><p><strong>Conclusion: </strong>End-to-end anastomosis, where viable, appears to give the greatest improvement in facial nerve function. Where this is not viable, both grafting and nerve transfer should be given equal weighting when considered in a patient specific context.</p>","PeriodicalId":94238,"journal":{"name":"The journal of international advanced otology","volume":"22 3","pages":"1-5"},"PeriodicalIF":1.2,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148964198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}