Journal of otology最新文献

{"title":"Characterizing Age Effects on Wideband Absorbance in Normal-Hearing Children Via Statistical and Machine Learning Analyses.","authors":"Jie Qiu, Chanfeng Shen, Yan Wang, Xiaohui Lai, Yi Mu, Fei Zhao, Wen Liu, Wen Jiang","doi":"10.26599/JOTO.2026.9540071","DOIUrl":"https://doi.org/10.26599/JOTO.2026.9540071","url":null,"abstract":"<p><strong>Objective: </strong>To characterize age-related changes in wideband absorbance (WBA) among normal-hearing children aged 0-6 years through combined statistical and machine learning analyses, and to establish developmental reference patterns supporting pediatric middle-ear diagnostics.</p><p><strong>Methods: </strong>A cross-sectional study was conducted on 579 children (1158 ears) categorized into five age groups. All participants passed age-appropriate hearing screenings. WBA was measured under both ambient pressure (AP) and tympanometric peak pressure (TPP) conditions across 16 frequencies (226-8000 Hz). Repeated-measures analysis of variance examined the effects of age, ear side, and gender, while Random Forest classifiers and principal component analysis (PCA) explored the discriminative structure and feature importance of WBA data.</p><p><strong>Results: </strong>Neither gender nor ear side had a significantly effect on WBA patterns (<i>p</i> > 0.05). In constrast, Age significantly influenced WBA patterns (<i>p</i> < 0.001). Younger infants (< 6 months) exhibited dual-peaked \"M-shaped\" curves, whereas older children (3-6 years) showed single-peaked, inverted \"U-shaped\" profiles centered near 1600 Hz, reflecting progressive middle-ear maturation. The Random Forest model achieved a mean accuracy of 0.73 (balanced accuracy = 0.58), with the top-ranked predictors (AP_1000, and AP_793) emphasizing low-to-mid frequency absorbance and pressure-compensation effects as key age indicators. PCA with k-means clustering further revealed partially distinct groupings aligned with chronological age, supporting the developmental encoding of WBA responses.</p><p><strong>Conclusion: </strong>WBA demonstrates distinct, age-dependent acoustic characteristics that correspond to physiological maturation of the middle ear. These findings provide a quantitative reference for pediatric wideband acoustic immittance and highlight the potential of machine learning in delineating developmental auditory patterns.</p>","PeriodicalId":94336,"journal":{"name":"Journal of otology","volume":"21 3","pages":"183-190"},"PeriodicalIF":0.0,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804286","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":"Reverse Nystagmus During Canalith Repositioning: A Misunderstood Predictor of Failed Epley Maneuver: A Retrospective Study Based on 60 Patients with Posterior Semicircular Canal BPPV.","authors":"Jing Chen, Shuo Yang","doi":"10.26599/JOTO.2026.9540069","DOIUrl":"https://doi.org/10.26599/JOTO.2026.9540069","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the types, directions, and intensities of nystagmus occurring during each step (positions 2, 3, and 4) of the Epley maneuver in patients with posterior semicircular canal benign paroxysmal positional vertigo (BPPV), and to explore their relationship with a positive Dix-Hallpike test at 24-48 hours post-maneuver, indicating incomplete canalith clearance.</p><p><strong>Methods: </strong>Clinical data from 60 patients with unilateral posterior semicircular canal canalithiasis were retrospectively analyzed. All patients underwent a standard Epley maneuver under video nystagmography (VNG) monitoring. The direction and slow phase velocity (SPV) of nystagmus were recorded at each repositioning step. The need for a second repositioning was determined by repeat Dix-Hallpike test 24-48 hours after the maneuver. Univariate and multivariate logistic regression analyses were performed to identify associations between nystagmus characteristics at each step and the need for a second procedure. Sensitivity, specificity, and predictive values were calculated.</p><p><strong>Results: </strong>Among 60 patients, 19 (31.7%) required a second repositioning. Univariate analysis showed that reverse nystagmus at position 3, reverse nystagmus at position 4, reverse nystagmus at either position 3 or 4, SPV of reverse nystagmus at position 4 ≥10°/s, diagnostic vertical SPV ≥20°/s, and latency ≤2 s were significantly associated with the need for a second procedure (all P<0.01). Multivariate logistic regression identified reverse nystagmus at position 4 as the strongest independent predictor (OR=32.1, 95%CI 6.2-166.7). Reverse nystagmus at position 4 predicted the need for a second procedure with a sensitivity of 84.2%, specificity of 97.6%, positive predictive value of 94.1%, and negative predictive value of 93.0%. Although reverse nystagmus at position 3 was also associated with the need for a second procedure (OR=18.5), its sensitivity was low (47.4%). Orthotropic nystagmus at position 2 showed no correlation with outcome (P>0.05). All four patients who exhibited down-beating nystagmus did not require a second procedure.</p><p><strong>Conclusion: </strong>During the Epley maneuver, reverse nystagmus occurring at position 4 is the strongest predictor of the need for a second repositioning, with a positive predictive value exceeding 94%. Down-beating nystagmus indicates a favorable outcome and was associated with a lower probability of requiring a second repositioning. Real-time nystagmus feedback during the procedure allows early identification of high-risk patients and enables optimized, individualized follow-up strategies.</p>","PeriodicalId":94336,"journal":{"name":"Journal of otology","volume":"21 3","pages":"172-176"},"PeriodicalIF":0.0,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804289","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":"High-Frequency Vulnerability and Sex Differences in Age-Related Hearing Loss: A Cross-Sectional Audiometric Analysis of Older Chinese Otolaryngology Outpatients.","authors":"Hongyi Hu, Xin Huang, Fei Ji, Jiatao Zhong, Lingchao Ji","doi":"10.26599/JOTO.2026.9540072","DOIUrl":"https://doi.org/10.26599/JOTO.2026.9540072","url":null,"abstract":"<p><strong>Objective: </strong>To determine the prevalence, severity, and audiometric characteristics of age-related hearing loss (ARHL) in older Chinese adults attending a tertiary otolaryngology clinic, with emphasis on age- and sex-specific patterns based on the updated World Health Organization (WHO 2020) criteria.</p><p><strong>Methods: </strong>In this cross-sectional study, 1,000 adults aged ≥60 years underwent otologic examination, tympanometry, and pure-tone audiometry at a tertiary medical center between March 2022 and January 2023. Individuals with abnormal tympanograms or evidence of middle ear disease were excluded. Pure-tone averages (0.5, 1, 2, and 4 kHz) from the better ear were used to define and grade ARHL. Age- and sex-related differences in hearing thresholds were assessed using chi-square tests, t-tests, and two-way ANOVA.</p><p><strong>Results: </strong>Within this tertiary-care outpatient cohort, the prevalence of hearing loss according to WHO 2020 criteria was 84.1%, rising from 78.3% in the 60s to 100% in those aged over 90 years. Hearing thresholds showed a consistent high-frequency-sloping configuration, with high-frequency (8,000 Hz) thresholds declining at nearly double the rate of low-to-mid frequencies (11.7 dB vs. 4.5-6.3 dB per decade). The steepest decadal deterioration occurred between the 70s and 80s, characterized by a transition from high-frequency sensory loss to generalized cochlear decline. A sex-dependent \"crossover\" was observed: females exhibited superior hearing in their 60s and 70s but experienced more rapid deterioration in late life, resulting in comparable or poorer thresholds than males by their 80s and 90s.</p><p><strong>Conclusion: </strong>In this tertiary-care outpatient cohort of older Chinese adults, ARHL demonstrated distinct age- and sex-specific trajectories,including disproportionate high-frequency vulnerability and a late-life sex crossover effect. Adoption of WHO 2020 criteria substantially increased hearing-loss identification, particularly among adults in their 60s and 70s.</p>","PeriodicalId":94336,"journal":{"name":"Journal of otology","volume":"21 3","pages":"191-196"},"PeriodicalIF":0.0,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804291","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":"The relationship between vertigo severity, psychiatric symptoms and obstructive sleep apnoea.","authors":"András Molnár, Stefani Maihoub, Viktória Molnár","doi":"10.26599/JOTO.2026.9540070","DOIUrl":"https://doi.org/10.26599/JOTO.2026.9540070","url":null,"abstract":"<p><strong>Objectives: </strong>This study assessed the connection between vertigo severity and OSA.</p><p><strong>Material and methods: </strong>111 patients (78 men and 33 women, 48.35 ± 9.24 years) patients with OSA accompanied by vertigo were included in the investigation. These patients underwent respiratory polygraphy, and completed self-reported questionnaires, including the Dizziness Handicap Inventory (DHI), Beck Depression Inventory (BDI), and the Symptom Checklist-90-Revised (SCL-90-R) questionnaires.</p><p><strong>Results: </strong>In the study, 25.2% of the patients did not have OSA, 40.5% presented with mild symptoms, 9.9% had moderate symptoms, and 24.3% exhibited severe OSA symptoms. Although the difference in DHI scores based on OSA severity was statistically insignificant (<i>p</i>=0.35, <i>H</i>=3.21, Kruskal-Wallis test), there was a noticeable trend indicating higher DHI values in patients with severe OSA. A logistic regression model observed depression (<i>p</i>=0.010*; OR= 190.252, 95% CI=3.587-10090.086) and BMI obese category (<i>p</i>=0.019*; OR=141.068, CI=2.290-8688.383) as significant predictors for vertigo in OSA. When analysing the correlations between psychiatric symptoms and vertigo in OSA, significant relationships were observed between BDI and total DHI (rho=0.332, <i>p</i>= 0.002*), and the SCL-90-R depression (rho=0.480, <i>p</i>=0.000*) and anxiety points (rho=0.480, <i>p</i>=0.000*) and the total DHI, respectively.</p><p><strong>Conclusions: </strong>Our analysis indicates a connection between the severity of vertigo symptoms and the severity of OSA. Additionally, the significant correlation between psychiatric symptoms and OSA severity emphasises the need to consider these factors when managing OSA patients in everyday practice.</p>","PeriodicalId":94336,"journal":{"name":"Journal of otology","volume":"21 3","pages":"177-182"},"PeriodicalIF":0.0,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804275","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":"Complication rates of Reuter Bobbin titanium versus Sheehy Collar Button fluoroplastic tympanostomy tubes in children with otitis media: a retrospective cohort study.","authors":"Jad Hosri, Anne Marie Daou, Omar Aboul Hosn, Jonathan Abou Chaar, Nader Zalaquett, Randa Barazi","doi":"10.26599/JOTO.2026.9540073","DOIUrl":"https://doi.org/10.26599/JOTO.2026.9540073","url":null,"abstract":"<p><p><i>Background:</i> Tympanostomy tube (TT) insertion is one of the most common pediatric otologic procedures. This study compares postoperative complications between two commonly used tympanostomy tubes: Reuter Bobbin titanium tubes and Sheehy Collar Button fluoroplastic tubes. <i>Design:</i> Retrospective cohort study. <i>Methods:</i> The medical records of children aged 6 months to 7 years who underwent TT insertion at a tertiary care center between July 2022 and June 2023 were reviewed. Patients were divided according to the inserted tube model: Reuter Bobbin titanium or Sheehy Collar Button fluoroplastic. The main outcomes were postoperative ear drainage and complications, including tube clogging, granulation tissue formation, premature extrusion, and tympanic membrane perforation, assessed across the first, second, and third follow-up visits. <i>Results:</i> A total of 138 patients who underwent TT insertion in 268 ears were included; 181 ears received Sheehy Collar Button fluoroplastic tubes and 87 ears received Reuter Bobbin titanium tubes. At the third follow-up visit (7.46 ± 2.93 months), the overall complication rate was higher in ears with Reuter Bobbin titanium tubes than in those with Sheehy Collar Button fluoroplastic tubes (44.4% vs. 5.6%, p < 0.001). Ear drainage was more frequent in the fluoroplastic tube group across follow-up visits (7.2%, 18.4%, and 27.8% vs. 1.1%, 7.4%, and 0%, respectively; p = 0.054, p = 0.12, and p < 0.001). <i>Conclusion:</i> In this retrospective cohort, Reuter Bobbin titanium tubes were associated with higher later complication rates, whereas Sheehy Collar Button fluoroplastic tubes were associated with higher postoperative drainage.</p>","PeriodicalId":94336,"journal":{"name":"Journal of otology","volume":"21 3","pages":"197-201"},"PeriodicalIF":0.0,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804258","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":"Auditory Biomarkers in Neurodegenerative Disorders: A Literature Review.","authors":"Sreevidhya Palakkot, Arun Banik","doi":"10.26599/JOTO.2026.9540067","DOIUrl":"https://doi.org/10.26599/JOTO.2026.9540067","url":null,"abstract":"<p><p>The prevalence of neurodegenerative diseases is escalating globally. However, the conventional diagnostic framework fails to identify the pathology until substantial neuronal damage occurs. The evidence from the recent literature indicates that auditory dysfunction commonly precedes motor and cognitive symptoms across multiple neurodegenerative diseases. The pathophysiology involves both the peripheral and cortical auditory structures, which produce distinctive patterns reflects systemic neurodegeneration. Hence, this suggests auditory assessment as a valuable tool for early identification of neural degeneration. This review synthesises the contemporary literature on auditory dysfunctions and underlying pathophysiology in Alzheimer's disease, Parkinson's disease, Frontotemporal dementia, Amyotrophic lateral sclerosis, etc. The analysis included the temporal trajectories of auditory impairment, subjective-objective measurements, and evaluated the importance of early identification and longitudinal tracking. Objective measures of central auditory processing, including Auditory Brainstem Responses, P300, Mismatch Negativity, and speech-in-noise testing, provide objective, non-invasive diagnostic tools and its sensitivity comparable to established biomarkers. Integration of standardised auditory assessment batteries into clinical protocols could enable the early identification of pathology, differential diagnosis and the development of novel therapeutic strategies for both auditory and cognitive deficits. Current review suggests that future longitudinal studies with neurodegenerative conditions should focus on the clinical utility of auditory, cognitive, and neuroimaging biomarkers and facilitate clinical translation of these findings.</p>","PeriodicalId":94336,"journal":{"name":"Journal of otology","volume":"21 3","pages":"160-166"},"PeriodicalIF":0.0,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804209","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":"Usefulness of ^99mTc-HMPAO leukocyte scintigraphy in necrotizing external otitis/skull base osteomyelitis.","authors":"Tomáš Bakaj, Libuše Quinn, Richard Salzman","doi":"10.26599/JOTO.2026.9540064","DOIUrl":"https://doi.org/10.26599/JOTO.2026.9540064","url":null,"abstract":"<p><p>Necrotizing external otitis (NEO) is a rare but serious disease of the skull base (osteomyelitis). Immunosuppressed, and elderly patients are most commonly affected. The most common pathogen is <i>Pseudomonas aeruginosa</i>. Early diagnosis is crucial for the prognosis. To establish the diagnosis, both positive imaging findings, and clinical criteria are required to be met. Imaging is used during follow-up to monitor a potential recurrence due to its high risk, even after successful treatment. The use of radiological or nuclear medicine methods (scintigraphy) in the management of NEO is not currently standardised. We report a series of 5 patients with necrotizing external otitis/otogenic skull base osteomyelitis over a period of 12 years (2012-2024). In all patients, ^99mTc-HMPAO (hexa-methyl-propylene-amine-oxime) labelled autologous leukocyte scintigraphy was used to diagnose, to monitor therapy response and for a follow-up. The primary diagnosis of necrotizing otitis was confirmed by scintigraphy in all cases (positive predictive value of 100%). In monitoring of treatment response, true negative scintigraphic findings were observed in two cases, two findings were false-negative (negative predictive value of 50%), and one case was found to be a false-positive. In a follow-up, the recurrence of the disease was truly detected or ruled out by subsequent scintigraphy in all subjects. Technetium-99m-labelled leukocyte scintigraphy is a convenient and reliable method, especially for diagnosing, and follow-up of necrotizing external otitis/otogenic skull base osteomyelitis. In terms of monitoring treatment response, further studies could be suggested for improving the estimated low negative predictive value.</p>","PeriodicalId":94336,"journal":{"name":"Journal of otology","volume":"21 3","pages":"136-151"},"PeriodicalIF":0.0,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804259","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":"Occupational metallic foreign body in the hypotympanum: the critical role of timely treatment. Two case reports and a review of the literature.","authors":"Andrea Nosiglia, Jacopo Cambi, Simone Boccuzzi, Marco Mandalà","doi":"10.26599/JOTO.2026.9540068","DOIUrl":"https://doi.org/10.26599/JOTO.2026.9540068","url":null,"abstract":"<p><strong>Background: </strong>We present two rare cases where a metal splinter became lodged in the middle ear (hypotympanum) as a result of occupational accidents.</p><p><strong>Methods: </strong>Retrospectiveanalysis of two patients underwent surgical procedures for the removal of a metallic foreign body from the middle ear was reported. A systematicliterature review was conducted using PubMed.</p><p><strong>Results: </strong>The patients reported symptoms of hearing loss, otorrhea, and vertigo following the injury. Temporalbone CT scans confirmed the presence of a foreign body in the hypotympanum in both cases. In the first case, the patient sought medical attentionpromptly and underwent a single surgical procedure: exploration of the tympanic cavity allowed removal of the foreign body, followed bymyringo-plasty. In contrast, the second patient delayed seeking treatment for 11 days, resulting in severe inflammation. This patient required two surgicalinterventions, the second involving mastoidectomy, to extract the foreign body. This highlights the need for improved occupational health safetymeasures, particularly in professions at risk for such injuries, and emphasizes the importance of timely medical care for optimal outcomes.</p><p><strong>Conclusion: </strong>Delayedt reatment can lead to complications, necessitating more complex surgical procedures and prolonged recovery. Early diagnosis and timely surgicalmanagement are essential to minimize complications and preserve auditory function.</p>","PeriodicalId":94336,"journal":{"name":"Journal of otology","volume":"21 3","pages":"167-171"},"PeriodicalIF":0.0,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804254","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":"Bone conduction threshold improvement after otosclerosis surgery.","authors":"Nina Chen, Te Li, Yue-Lin Hsieh, Jingji Yuan, Xianqiong Ma, Wuqing Wang, Yibo Huang","doi":"10.26599/JOTO.2026.9540065","DOIUrl":"https://doi.org/10.26599/JOTO.2026.9540065","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the characteristics of bone conduction (BC) threshold changes after stapedotomy in patients with otosclerosis, and to explore the clinical significance and implications for the evaluation of surgical outcomes.</p><p><strong>Methods: </strong>It is a retrospective, single-center study. A total of 97 ears from patients with otosclerosis who underwent endoscopic stapedotomy (footplate fenestration with titanium piston implantation) between November 2015 and February 2025 were included. Pure tone audiometry (PTA) was performed preoperatively, and at 1 month and 6 months postoperatively. Air conduction (AC) thresholds were tested at 125-8000 Hz, and bone conduction (BC) thresholds at 250-4000 Hz. Pre- and postoperative changes in BC thresholds, AC thresholds, and air-bone gap (ABG) were documented, and the results were compared with findings from other studies.</p><p><strong>Results: </strong>The average postoperative BC threshold across 250-4000 Hz showed significant improvement, with a mean gain of 7.5 dB (<b>Z = -6.343,</b> <b>p<0.001</b>). At individual frequencies, improvements were significant at 250, 500,1000, 2000 Hz, with the most notable gain at 250 Hz (10 dB), followed by 500 Hz, 1000 Hz, and 2000 Hz (5 dB gain each) (<b>all</b> <b>p<0.001</b>). No statistically significant improvement of BC threshold was observed at 4000 Hz (<b>Z = -0.368, p = 0.713</b>). AC thresholds also showed significant improvements across all tested frequencies (125-4000 Hz) (<b>all</b> <b>p<0.001</b>), with a mean gain of 19 dB; the greatest improvement was observed at 1000 Hz (30 dB). Although the average ABG narrowed by 13 dB, the degree of closure underestimates the actual hearing improvement, as it fails to account for concurrent BC enhancement. Compared with those of other studies, the study cohort demonstrated more pronounced BC improvements.</p><p><strong>Conclusion: </strong>Stapedotomy not only effectively restores AC hearing but also significantly improves BC thresholds. This improvement in BC thresholds may be attributed to the restoration of bone conduction mechanisms following stapedotomy. Traditional evaluation methods for surgical outcomes that rely solely on ABG closure tend to underestimate overall surgical efficacy. For clinical implementation, we suggest a multidimensional framework can be applied by simultaneously evaluating postoperative air conduction gain, bone conduction gain, and air‑bone gap closure at each frequency, rather than relying on ABG closure alone.</p>","PeriodicalId":94336,"journal":{"name":"Journal of otology","volume":"21 3","pages":"130-135"},"PeriodicalIF":0.0,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804153","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":"Genetically predicted body mass index and self-reported hearing difficulty: a two-sample Mendelian randomization study with external replication.","authors":"Yubin Xue, Hongwei Ma, Lin Yang, Qiang Liu","doi":"10.26599/JOTO.2026.9540066","DOIUrl":"https://doi.org/10.26599/JOTO.2026.9540066","url":null,"abstract":"<p><strong>Background: </strong>Self-reported hearing difficulty is a common hearing-related complaint and may reflect perceived auditory impairment, communication difficulties, or clinically relevant hearing loss. Observational studies have linked cardiometabolic traits to hearing-related outcomes, but these associations are difficult to interpret because of residual confounding and reverse causation.</p><p><strong>Methods: </strong>We performed a two-sample Mendelian randomization (MR) study to evaluate the potential associations of five genetically predicted cardiometabolic traits-body mass index (BMI), C-reactive protein (CRP), systolic blood pressure (SBP), low-density lipoprotein cholesterol (LDL-C), and liability to type 2 diabetes (T2D)-with self-reported hearing difficulty. The primary outcome was self-reported hearing difficulty in the UK Biobank (field 2247; OpenGWAS: ebi-a-GCST90013961). External replication was conducted using a large genome-wide association meta-analysis of hearing loss/difficulty in hearing (OpenGWAS: ebi-a-GCST90018857). The inverse-variance weighted (IVW) method was prespecified as the primary estimator, complemented by sensitivity analyses and multivariable MR (MVMR) to assess robustness and the independence of the observed association.</p><p><strong>Results: </strong>Genetically predicted higher BMI was associated with higher odds of hearing difficulty in the primary analysis (IVW OR 1.076, 95% CI 1.030-1.124; P = 0.0011), and a directionally concordant association was observed in the external replication dataset (OR 1.092, 95% CI 1.012-1.178; P = 0.0226). By contrast, IVW estimates for CRP, SBP, LDL-C, and T2D liability were close to the null and showed no consistent evidence of association across the two outcome datasets. In MVMR including BMI and CRP, the BMI estimate attenuated toward the null, whereas CRP showed no independent association.</p><p><strong>Conclusions: </strong>These findings provide suggestive genetic evidence that higher BMI is associated with increased liability to self-reported hearing difficulty, whereas the other cardiometabolic traits examined showed limited evidence of consistent associations. However, the BMI association should be interpreted cautiously given the heterogeneity, pleiotropy-related findings, and attenuation observed in MVMR.</p>","PeriodicalId":94336,"journal":{"name":"Journal of otology","volume":"21 3","pages":"152-159"},"PeriodicalIF":0.0,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804277","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}