Acta Oto Laryngologica 2024-04-18

Minimal invasive LASER-resection vs. radiotherapy as primary treatment of early glottic cancer. A population-based study with, up to 16 years follow up of survival, rate of laryngectomy and voice function

Roland RydellJosefine AndreassonSara Gustafsson (Baldwin)Nathalie Clarheda Department of Clinical Sciences Lund, Otorhinolaryngology/Head and Neck Surgery, Lund University, Skane University Hospital, Lund, Swedenb Department of Clinical Sciences Lund, Logopedics, Phoniatrics and Audiology, Lund University, Skane University Hospital, Lund, Sweden

Publication date 31-01-2024


Early glottic cancer can be treated with laser resection or radiotherapy. In an earlier study, we found that voice function after laser resection was inferior to that after radiotherapy. This study was designed to determine if reduced margins at laser resection improved voice function without impairing oncologic results. A total of 268 patients with previously untreated T1-T2 glottic carcinoma were studied. They were primarily treated with either radiotherapy ( Median follow up time was 7 years with range 0.5-16.6. There was no difference in the overall survival ( By reducing the surgical margins, we have achieved a better voice function (T1A) but more patients have needed repeated laser excisions and some have also needed supplementary radiotherapy. The risk of laryngectomy and survival were apparently not affected.

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The effect of local dexamethasone on stapedotomy surgery outcomes in patients with otosclerosis

Mohammad MandegariMojtaba MeybodianMohammadhossein BaradaranfarSedighe VaziribozorgMahmood VakiliSaeedeh Dehghanifirouzabadia Department of Otolaryngology-Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iranb Department of Community Medicine, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

Publication date 28-01-2024


Some studies have shown a positive effect of systemic corticosteroid on hearing results after stapedotomy, but its side effects can limit its routine administration. The aim of this study was to investigate the effect of local dexamethasone on the results of stapedotomy surgery. Fifty two patients undergone stapedotomy surgery for otosclerosis involved. In the case group after stapedotomy we fulfilled the middle ear with dexamethasone and then the placement of the prosthesis was done. In the control group after stapedotomy we did not use dexamethasone in the middle ear. Gender, age, nausea, vomiting, postoperative vertigo and nystagmus did not significantly differ between the groups. A significant difference was observed in tinnitus rate between two groups. In the case group ABG decrease was higher and bone conduction thresholds improved at frequencies of 1000, 2000, and 4000 three months after surgery. Since local dexamethasone had a positive effect on the results of stapedotomy surgery, it can be used instead of systemic corticosteroids to reduce the side effects and increasing surgery's success rate. If local dexamethasone had a positive influence on the results of stapedotomy surgery, it can be used instead of systemic corticosteroids to reduce the side effects and increasing surgery's success rate.

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Immediate effect of recurrent laryngeal nerve stimulation in patients with idiopathic unilateral vocal fold paralysis

Jing YanJin HouHuihui ZhangXinyi YangYing ShengXiaoying DuDemin KongZhenghui WangXiaoyong RenLiang Wua Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an Jiaotong University, Xi’an, Shaanxi, P. R. Chinab The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi’an Jiaotong University, Xi’an, Shaanxi, P. R. China

Publication date 24-01-2024


There is a lack of effective treatment for idiopathic unilateral vocal fold paralysis (IUVFP). A better phonation was reported by patients after laryngeal nerve stimulation during our clinical examination. This study aims to investigate immediate effect of recurrent laryngeal nerve (RLN) stimulation on phonation in patients with IUVFP. Sixty-two patients with clinically identified IUVFP underwent RLN stimulation with needle electrodes. Laryngoscopy, acoustic analysis, and voice perception assessment were performed for quantitative comparison of vocal function and voice quality before and after the intervention. Laryngoscopic images showed a larger motion range of the paralyzed vocal fold ( This study shows a short-term improvement of phonation in IUVFP patients after RLN stimulation, which provides proof-of-concept for trialing a controlled delivery of RLN stimulation and assessing durability of any observed responses.

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Study of the factors related to air-bone gap in enlarged vestibular aqueduct

Rong WangBo-xiang ZhuangWeiwei GuoJianan LiChang LinShiming Yanga The First Affiliated Hospital of Fujian Medical University, Fuzhou, PR Chinab Department of Otolaryngology-Head and Neck Surgery, the Sixth Medical Center of PLA General Hospital, Beijing, PR Chinac National Key Laboratory of Hearing and Balance Science, Beijing, PR Chinad National Clinical Research Center for Otolaryngologic Diseases, Beijing, PR Chinae Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, PR China

Publication date 30-01-2024


Over half of patients with enlarged vestibular aqueducts (EVA) will have an air-bonr gap (ABG), however, current research on audiology has focused on the influencing factors of air-conducted. To retrospectively analyse the influencing factors and clinical manifestations of the bone-conduction threshold and ABG in patients with EVA. We included 286 patients with EVA; among them, 126 had full Among 555 ears, 312 (57.8%) ears had ABG; approximately 94% of the patients' bone-conduction hearing is almost completely lost at frequencies of 2 and 4 k Hz. There was no linear correlation between age and bone-conduction threshold ( Among patients with EVA, ABG is mainly produced at low frequencies and is not significantly correlated with age, size of the VA opening or

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Association of iron deficiency with chronic suppurative otitis media in adults

Jingwen CaoZixuan YangWei LiuSijing ChenGaoya QuCuiping Zhonga Otolaryngology-Head and Neck Surgery, The 940th Hospital Joint Logistics Support Force of the Chinese People’s Liberation Army, Lanzhou, Gansu, Chinab Ningxia Medical University, Ningxia, China

Publication date 05-02-2024


Chronic suppurative otitis media (CSOM) is a prevalent chronic inflammatory disease globally. Current research suggests a possible association between anaemia and the development of CSOM. The objective of this trial was to investigate the relationship between iron metabolism and chronic suppurative otitis media (CSOM) in adults aged 20-60 years. A consecutive sampling case-control study was used. The study participants were divided into a case group (42 children diagnosed with CSOM) and a control group (42 children with normal ears). Haemoglobin (Hb), Hematocrit (Hct), mean corpuscular volume of erythrocytes (MCV), serum iron level (SI), unsaturated iron-binding capacity (UIBC), total iron-binding capacity (TIBC), transferrin (TF), ferritin (Fer) were tested in all the participants, and the results were compared with the normal ranges of the World Health Organization (WHO). The comparative analysis of cases and controls was performed using the Fisher extract test, independence There were 61 patients with CSOM and 61 controls included in the study. In the case group, 16 out of 61 patients (26.2%) had low ferritin levels and in the control group, 1 out of 61 patients (1.6%) had low ferritin levels ( In adult patients, the incidence of iron deficiency was higher in CSOM patients than in controls. Iron deficiency may be considered a potential risk factor for chronic suppurative otitis media, and serum iron parameters should be evaluated in these CSOM patients and further studies should be conducted to better understand the potential link between iron deficiency and CSOM.

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Risk factors for late postoperative bleeding after partial glossectomy for tongue cancer

Hidehito MatsuiTakashi MukaigawaSeiya GotoShinichi OkadaYohei HiiragiKota Wadaa Division of Head and Neck Surgery, Shizuoka Cancer Center, Shizuoka, Japanb Department of Otolaryngology, Toho University Omori Medical Center, Tokyo, Japan

Publication date 12-02-2024


Partial glossectomy is the most common procedure for early-stage tongue cancer. Although late postoperative bleeding occasionally occurs, the associated risk factors have not been adequately identified. We aimed to investigate the rate and risk factors for late postoperative bleeding after transoral partial glossectomy with or without neck dissection for tongue cancer at our institution. We analysed 211 patients who had undergone transoral partial glossectomy between January 2016 and January 2023. The potential risk factors associated with late postoperative bleeding were investigated using univariate and multivariate logistic regression analyses. Of the 211 patients, 40 (19%) showed late postoperative bleeding, with 19 (9%) classified as grade IIIa (Clavien-Dindo classification). Regarding all grades, late postoperative bleeding was significantly higher in patients aged <70 years and in those with polyglycolic acid (PGA) sheets ( The findings of this study suggest that primary closure decreases the frequency of late postoperative bleeding.

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A 3-hour time interval may not be sufficient for delayed enhancement magnetic resonance imaging with intravenous gadoteridol injection based on 3d-real IR sequence of the inner ear in Meniere’s disease patient

Wei ChenHanyu XiaoYiyin ZhangLuxi WangBingrong LiYan Shaa Department of Radiology, Eye & ENT Hospital of Fudan University, Shanghai, Chinab Shanghai Institute of Medical Imaging, Fudan University, Shanghai, Chinac Department of Radiology, Lishui Central Hospital, Lishui, China

Publication date 05-02-2024


Magnetic resonance imaging (MRI) can be applied to visualize endolymphatic hydrops (EH). To explore whether a 3-h time interval was feasible for clinical practice. We prospectively enrolled 15 patients with unilateral Meniere's disease, each of whom underwent delayed enhancement MRI scan of the inner ear after intravenous gadoteridol injection at a 3-h interval. The ears of these patients were divided into two groups (group A: the affected ears; group B: the unaffected ears). Among the two groups, the signal intensity in perilymphatic area of the basal turn of cochlea, the results of visual evaluations in the vestibule, cochlea and semicircular canal and the detection results of EH were compared. Regarding the signal intensity, a difference was found between group A and group B ( In the clinical application of gadoteridol for the inner ear, 3-h delayed MR imaging may not be sufficient.

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Tympanostomy tube placement for intractable Meniere’s disease in the elderly

Wenting DengYuebo ChenHao XiongYongkang OuDepartment of Otolaryngology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China

Publication date 20-02-2024


The treatment of refractory elderly Meniere's disease is a challenge. To investigate the efficacy of tympanostomy tube placement in elderly patients with Meniere's disease. 31 patients over 60 years old with Meniere's disease who had failed medical treatment and underwent tympanostomy tube placement. Vertigo control, hearing level, tinnitus, and ear fullness were recorded and analyzed preoperatively and postoperatively. All patients completed a 6-month follow-up. At 6 months postoperatively,complete control, substantial control and limited control of vertigo were achieved in 10 (32%), 13 (42%), and 6 (19%) patients respectively. Two patients (6%) reported no substantial improvement. Twelve patients completed a 2-year follow-up. At 2 years postoperatively, complete control, substantial control and limited control of vertigo were achieved in 3 (25%), 5 (42%), and 1 (8%) patients respectively. Three (25%) patients showed no significant improvement in vertigo. The majority of patients reported significant improvement in the functional level scale, the Dizziness Handicap Inventory scores, and ear fullness at 6 months and 2 years postoperatively. Tympanostomy tube placement may reduce vertigo attacks and improved the quality of life in elderly patients with Meniere's disease.

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Mucosal melanoma of the head and neck: a retrospective analysis of 34 cases in Japan

Keiichi TamuraYohei KumabeYo KishimotoMorimasa KitamuraMasanobu MizutaHisanobu TamakiKeigo HondaKoichiro YamadaShinzo TanakaTsuyoshi KojimaRyo AsatoKoji UshiroShogo ShinoharaShinji TakebayashiToshiki MaetaniKazuyuki IchimaruYoshiharu KitaniKoichi Omoria Department of Otolaryngology–Head & Neck Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japanb Department of Otolaryngology–Head & Neck Surgery, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japanc Department of Head and Neck Surgery, Kanazawa Medical University, Ishikawa, Japand Katsuragawa Mizuta ENT Clinic, Kyoto, Japane Department of Otolaryngology–Head & Neck Surgery, Kurashiki Central Hospital, Okayama, Japanf Department of Otolaryngology–Head & Neck Surgery, Uji-Tokushukai Medical Center, Kyoto, Japang Department of Otolaryngology–Head & Neck Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japanh Department of Otolaryngology–Head & Neck Surgery, Kobe City Medical Center General Hospital, Hyogo, Japani Department of Otorhinolaryngology–Head & Neck Surgery, Shiga General Hospital, Shiga, Japanj Department of Otolaryngology–Head and Neck Surgery, Medical Research Institute, Kitano Hospital, Osaka, Japank Department of Otolaryngology–Head & Neck Surgery, Kokura Memorial Hospital, Fukuoka, Japanl Department of Otorhinolaryngology–Head & Neck Surgery, Shizuoka General Hospital, Shizuoka, Japan

Publication date 16-02-2024


Mucosal melanoma of the head and neck (MMHN) is a rare condition. This study aimed to investigate oncological outcomes of surgical intervention in patients with MMHN. The study included 34 patients with MMHN who underwent surgical resection as initial treatment at 10 institutions in Japan between July 2005 and June 2015.
Results: The 5-year overall survival (OS), local control rate (LCR), disease-free survival (DFS), and disease-specific survival (DSS) rates were 48.7%, 53.4%, 32.4%, and 55.1%, respectively. Based on multivariate analysis, no independent prognostic factors for the 5-year OS and DSS were found. Based on univariate analysis, the 5-year LCR was worse in patients with lesions in the nasal cavity and paranasal sinuses than in the oral cavity and pharynx. However, no differences in oncological outcomes were identified in relation to primary sites, and postoperative radiotherapy (PORT) and adjuvant systemic therapy did not contribute to improvements in the 5-year OS. No independent prognostic factors for the 5-year OS or DSS were identified. Regional or distant recurrences are often identified, regardless of local control with surgical resection. Difficult control of MMHN with conventional therapeutic strategies, such as surgical intervention, PORT, and systemic therapy, has been suggested.

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Can Mandarin-speaking prelingual deaf adults benefit from cochlear implant?

Po-Kai HuangPei-Hsuan HoChia-Huei ChuPey-Yu ChenHung-Ching Lina Department of Otolaryngology and Head Neck Surgery, MacKay Memorial Hospital, Taipei, Taiwanb Department of Audiology and Speech Language Pathology, MacKay Medical College, New Taipei City, Taiwanc Department of Medicine, MacKay Medical College, New Taipei City, Taiwan

Publication date 24-02-2024


With advances in cochlear implant (CI) technology, prelingual deaf adults may experience improved speech perception and quality of life (QoL). It is still a challenge for Mandarin-speaking CI user with tone recognition due to CI technology focused on intonation language. To evaluate the long-term post-CI auditory performance and social-emotional benefits in prelingual deaf Mandarin-speaking adults and the difference between them and post-lingual deaf adults. Fifty-five adult implanted ears were included (forty-six postlingual deaf group; nine prelingual deaf group). Post-CI long-term outcomes were using vowels, consonants, disyllabic words, Mandarin monosyllable words, categories of audiology performance, speech intelligibility rating, subjective social-emotional questionnaires. Post-CI auditory performance and speech intelligibility of prelingual deafness adults was significantly inferior to that of those with postlingual deafness. However, both groups presented improved social-emotional benefits, with no significant difference between both groups. Adult CI recipients who deaf before the age of 4 can experience benefits in social-emotional life functioning, regardless of their limited auditory performance and speech intelligibility. Therefore, prelingual Mandarin-speaking deaf adults, especially those using oral communication, can be considered as relative indications for cochlear implantation. To clarify and validate the benefits among Mandarin-speaking prelingual deaf adult recipients.

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Low-sodium diet with adequate water intake improved the clinical efficacy in Ménière’s disease

Xia YangCaihong LinQingyun WuLvye LiXiaofeng Meia Department of Otolaryngology, Foshan Fosun Chancheng Hospital, Foshan City, Guangdong Province, Chinab Department of Nursing, Foshan Fosun Chancheng Hospital, Foshan City, Guangdong Province, China

Publication date 20-02-2024


Ménière's disease (MD) is a common idiopathic inner ear disorder in otorhinolaryngology characterized by recurrent episodes of vertigo, fluctuating sensorineural hearing loss, tinnitus and ear fullness. To study the effects of low-sodium diet with adequate water intake on the clinical efficacy in MD. Fifty patients diagnosed with stage-3 unilateral MD were randomly divided into control group( The pure tone audiometry and electrocochleography showed better improvements after treatment in the experimental group than the control group ( Low-sodium diet with adequate water intake improved the hearing and alleviated vertigo and tinnitus in MD patients.

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Automatic prediction of obstructive sleep apnea event using deep learning algorithm based on ECG and thoracic movement signals

Zufei LiYajie JiaYanru LiDemin Hana Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, People’s Republic of Chinab Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Capital Medical University, Beijing, People’s Republic of China

Publication date 19-01-2024


Obstructive sleep apnea (OSA) is a sleeping disorder that can cause multiple complications. Our aim is to build an automatic deep learning model for OSA event detection using combined signals from the electrocardiogram (ECG) and thoracic movement signals. We retrospectively obtained 420 cases of PSG data and extracted the signals of ECG, as well as the thoracic movement signal. A deep learning algorithm named Res Ne St34 was used to construct the model using ECG with or without thoracic movement signal. The model performance was assessed by parameters such as accuracy, precision, recall, F1-score, receiver operating characteristic (ROC), and area under the ROC curve (AUC). The model using combined signals of ECG and thoracic movement signal performed much better than the model using ECG alone. The former had accuracy, precision, recall, F1-score, and AUC values of 89.0%, 88.8%, 89.0%, 88.2%, and 92.9%, respectively, while the latter had values of 84.1%, 83.1%, 84.1%, 83.3%, and 82.8%, respectively. The automatic OSA event detection model using combined signals of ECG and thoracic movement signal with the Res Ne St34 algorithm is reliable and can be used for OSA screening.

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Human papilloma virus (HPV) vaccination is associated with reduced number of surgical treatments, an observational study on recurrent respiratory papillomatosis in Northern Sweden

Alexandra SchindeleSemma Al-SabttiKatarina Olofssona Department of Clinical Sciences, Otorhinolaryngology, Umeå University, Östersund, Swedenb Department of Clinical Sciences, Otorhinolaryngology, Umeå University, Umeå, Sweden

Publication date 14-03-2024


Recurrent respiratory papillomatosis (RRP) is a wart-like lesion mainly affecting the larynx, caused by human papillomavirus (HPV) genotypes 6 and 11. The disease affects both children and adults, and there is no cure. Surgery is the current symptom-relieving treatment; however, HPV vaccination is used as an adjuvant treatment. The aims were to study effects of HPV vaccination in RRP cases and to compare juvenile-onset to adult-onset disease and high treatment frequency (TF) to low TF cases. Medical records of RRP patients were studied from May 2006 to January 2023. Eighty-five RRP cases, tested for HPV genotypes with Papillo Check®, were included. Vaccination- onset- and treatment analysis were performed. Twelve percent of the cases were vaccinated. The number of surgeries decreased from 2.0 to 0.8/year after HPV vaccination. Most cases had an adult-onset and less than one treatment per year. Juvenile-onset cases had a higher vaccination treatment ratio compared to adult-onset. HPV vaccination was associated with a lower number of treatments per year, supporting the use of vaccination as an adjuvant treatment. Vaccination as adjuvant treatment to surgery may lead to increased quality of life for RRP patients and saved healthcare resources.

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Compensation in neuro-system related to age-related hearing loss

Tongxiang DiaoXin MaXuan FangMaoli DuanLisheng Yua Department of Otolaryngology, Head and Neck Surgery, People’s Hospital, Peking University, Beijing, Chinab Department of Human Anatomy, Histology & Embryology, School of Basic Medical Sciences, Peking University, Beijing, Chinac Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Swedend Department of Otolaryngology, Head and Neck Surgery & Audiology and Neurotology, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden

Publication date 24-01-2024


Age-related hearing loss (ARHL) is a major cause of chronic disability among the elderly. Individuals with ARHL not only have trouble hearing sounds, but also with speech perception. As the perception of auditory information is reliant on integration between widespread brain networks to interpret auditory stimuli, both auditory and extra-auditory systems which mainly include visual, motor and attention systems, play an important role in compensating for ARHL. To better understand the compensatory mechanism of ARHL and inspire better interventions that may alleviate ARHL. We mainly focus on the existing information on ARHL-related central compensation. The compensatory effects of hearing aids (HAs) and cochlear implants (CIs) on ARHL were also discussed. Studies have shown that ARHL can induce cochlear hair cell damage or loss and cochlear synaptopathy, which could induce central compensation including compensation of auditory and extra-auditory neural networks. The use of HAs and CIs can improve bottom-up processing by enabling 'better' input to the auditory pathways and then to the cortex by enhancing the diminished auditory signal. The central compensation of ARHL and its possible correlation with HAs and CIs are current hotspots in the field and should be given focus in future research.

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Red flags alerting a posterior cranial fossa tumor from audiovestibular perspectives - a review

Yi-Ho YoungYi-Hong Wua Department of Otolaryngology, Far Eastern Memorial Hospital, New Taipei, Taiwanb Department of Medical Education, National Taiwan University Hospital, Taipei, Taiwan

Publication date 10-03-2024


There is no comprehensive and up-to-date overview of audiovestibular approach to the posterior fossa tumors in the literature. This paper reviewed the literature relating to tumors at the posterior cranial fossa to find red flags alerting a posterior fossa lesion from audiovestibular perspectives. This review was developed from articles published in those journals listed on the journal citation reports. Through the Pub Med database, Embase, Google Scholar, and Cochrane library, 60 articles were finally obtained based on the PRISMA guidelines for reporting reviews. The presence of one red flag indicates a positive predictive value of 33% for detecting a posterior fossa lesion. Clinical features, namely, 1) mid-frequency sudden sensorineural hearing loss (SNHL), 2) bilateral sudden SNHL, and 3) rebound nystagmus may indicate a posterior fossa lesion, representing one, two, and three red flags, respectively. Those with 1) mid-frequency sudden SNHL, 2) bilateral sudden SNHL, and 3) rebound nystagmus trigger one, two, and three red flags, respectively, alerting clinicians the possibility of a posterior fossa lesion, which warrant MR imaging to exclude life-threatening or treatable conditions. Patients with posterior fossa tumors may have potential life-threatening outcome.

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Did our cochlear implant program make any difference in the lives of our patients? Achievements of 30 patients with long term follow-up averaging 20 years after cochlear implantation

Marcos V. GoycooleaRaquel LevyPilar AlarcónCatherine CatenacciGloria RibaltaByanka CagnacciRosario GarridoElisa VarasJosé Manuel Zúñigaa Department of Otolaryngology, Clínica Universidad de Los Andes, Santiago, Chileb Department of Otolaryngology, Clínica Las Condes, Santiago, Chilec Department of Otolaryngology, Clínica Meds, Santiago, Chiled Latin American Division, Cochlear Latin America, Panama

Publication date 17-11-2023


Cochlear implants are standard of care for the patients with sensorineural hearing loss not benefited from hearing aids. Evaluate qualitatively the impact of cochlear implantation in the long-term. Thirty middle-class patients with similar patterns of loss and social environment averaging 20 years post-implantation responded to 52 questions that evaluated psychosocial benefits from cochlear implantation. All completed secondary education and 93% had postgraduate studies. Educational and workwise they are at the same level as their hearing counterparts. All use their cochlear implants and would recommend one to people who need it. They attribute their success to the implant, the rehabilitation program, their family, and a stimulating social environment. Despite their success, most experience difficulties relating with others (socially and at work) due to their hearing condition. They manage but work much harder than their hearing peers to achieve the same. We made a difference in the lives of these patients, however, there is more to be done. Early intervention, rehabilitation, plus family, and stimulating-environment are crucial in children with sensory deficits.

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Interpretable machine learning model for prediction of overall survival in laryngeal cancer

Rasheed Omobolaji AlabiAlhadi AlmangushMohammed ElmusratiIlmo LeivoAntti A. Mäkitiea Research Program in Systems Oncology, University of Helsinki, Helsinki, Finlandb Department of Industrial Digitalization, School of Technology and Innovations, University of Vaasa, Vaasa, Finlandc Department of Pathology, University of Helsinki, Helsinki, Finlandd Institute of Biomedicine, University of Turku, Pathology, Finlande Department of Otorhinolaryngology – Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finlandf Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden

Publication date 28-01-2024


The mortality rates of laryngeal squamous cell carcinoma cancer (LSCC) have not significantly decreased in the last decades.

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Analysis of the effect of reconstructing the ossicular chain under otoendoscopy with and without a stapes superstructure

Yufeng YangWenjing GuiCong WuXianmin WuDepartment of Otorhinolaryngology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

Publication date 04-03-2024


Numerous studies have been conducted on the effect of the stapes superstructure after ossicular chain reconstruction, but the findings are not uniform. To compare the hearing outcomes of ossicular chain reconstruction with partial ossicular replacement prosthesis (PORP) or total ossicular replacement prosthesis (TORP) under otoendoscopy. The records of 111 patients diagnosed with chronic suppurative otitis media were retrospectively analyzed. These patients were divided into PORP group ( The mean postoperative air conduction hearing thresholds improvement, mean air-bone gap improvement, and the success rate of reconstruction were significantly higher in the PORP group than in the TORP group ( The stapes superstructure has an important positive effect on the postoperative outcome of endoscopic ossicular chain reconstruction.

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Selection of speech processor in cochlear implant patients: experience in a tertiary hospital

Sung-Min ParkYejun ChunByung Yoon Choia Department of Otorhinolaryngology–Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, South Koreab Sensory Organ Research Institute, Seoul National University Medical Research Center, Seoul, South Korea

Publication date 12-03-2024


There are two types of speech processors used in CI devices: behind-the-ear (BTE) and off-the-ear (OTE). This study aimed to investigate the characteristics of patients and revision cases in relation to the type of speech processors. A retrospective review of 452 ears that underwent CI was performed. Children with severe inner ear anomalies (91.7%) more frequently preferred BTE speech processors than those without severe inner ear anomalies ( Overall, our findings suggest factors to consider when choosing the type of speech processor and modifying the magnet strength of the implant device. The choice between BTE and OTE speech processors led to different required magnet strengths, contributing to the occurrence of skin flap inflammation.

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Effect of wearing masks on odor detection and recognition

Taiga KatoJun SuzukiYuta KobayashiTetsuya OishiHiroyuki IkushimaYasunari YamauchiYukio KatoriDepartment of Otolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan

Publication date 12-03-2024


The effect of wearing masks on olfaction remains unclear. This study aimed to clarify the differences between the effects of no masks, surgical masks, and N95 respirator masks by conducting both identification and threshold olfaction tests. Young, healthy volunteers aged ≥ 18 years and < 30 years without awareness of apparent olfactory disorder were included. All participants filled out a questionnaire on olfaction and completed an acuity smell identification test (Open Essence test) and an olfactory threshold test (T&T olfactometry) while wearing no masks, surgical masks, or N95 respirator masks. In the Open Essence tests, the no-mask group score was significantly higher than those of the surgical- and N95-mask groups. Using T&T olfactometry, the median-detection threshold of the no-mask group was significantly lower than that of the surgical-mask group, and the surgical-mask group threshold was significantly lower than that of the N95-mask group. Similar patterns were observed for the median-recognition threshold. Wearing masks, especially an N95 mask, reduces the ability to detect and identify odors. This disadvantage should be considered by professionals such as healthcare workers, who require proper olfaction to perform appropriate tasks.

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Clinical implication of neck dissection for metastatic lymph nodes originating from non-head and neck regions

Min Ji KimSo Hee KangMinSu KwonYoung Ho JungSeung-Ho ChoiSoon Yuhl NamYoon Se LeeDepartment of Otolaryngology-Head & Neck Surgery, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, South Korea

Publication date 16-03-2024


Cervical lymph node metastasis (CLNM) from remote primary sites is rare in head and neck cancer. The efficacy of neck dissection is still being investigated for therapeutic benefits of local management in oligometastasis from non-head and neck cancer. To evaluate the clinical efficacy of neck dissection (ND) in CLNM from distant primary cancers and identify factors contributing to improved survival. This retrospective case-control study enrolled patients who underwent ND for CLNM from distant primary cancer at Asan Medical Centre between January 2010 and December 2020. We analysed overall survival and association between clinical covariate and survival. The study included 31 (14 males, 17 females) among 114 patients. Ovarian cancer was the most common primary malignancy (32.3%). Patients with fewer than three metastatic lymph nodes, without extranodal extension and with adjuvant therapy after surgery had better survival rates. In patients with CLNM from a distant primary cancer, ND is beneficial as local treatment. And adequate selection of patients for ND is pivotal to improve prognosis.

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The correlation of hearing prognosis and caloric test results in Meniere’s disease: a follow up study

Zhengtao SunYi ZhangBo LiuJinping DuanGang LiuXinyang Zhoua Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, Chinab Beijing Institute of Otolaryngology, Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Beijing, China

Publication date 04-03-2024


Hearing loss is important in the diagnosis and treatment of Meniere's disease (MD). However, little is known about the factors associated with hearing changes in MD. This study aimed to investigate the correlation between hearing prognosis and caloric test (CT) results in MD. Ninety consecutive patients diagnosed with unilateral definite MD underwent pure tone audiometry (PTA) and CT at initial visits, and were re-tested PTA at the 6-month follow-up. Fifty-three of ninety MD patients (58.89%) had abnormal CT results. The change of PTA (cPTA = initial PTA-last PTA) was negatively correlated with canal paresis (CP) values (overall association Elevated CP values may be linked to worse hearing outcomes in MD, especially in Stage 1 and 2 patients. Conducting a caloric test at the initial consultation may aid in assessing hearing regression in MD.

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Expression of AQP-10, -11 and -12 in the rat stria vascularis

Rie IchikawaTaizo TakedaAkinobu KakigiHiroaki ItoTaisuke KobayashiMasamitsu Hyodoa Department of Otolaryngology, Kochi Medical School, Nankoku, Japanb Department of Otolaryngology, Niyodo Hospital, Ino, Japanc Department of Otolaryngology-Head & Neck Surgery, Graduate School of Medicine, Kobe University, Kobe, Japan

Publication date 21-03-2024


Water homeostasis is essential for inner ear function. Several aquaporins (AQPs), which are water transport proteins in the cell or plasma membrane, have been reported in the lateral wall of the rat inner ear (cochlea). However, the presence of AQP-10, -11 and -12 has not been reported in the rat stria vascularis (SV) to date. We have aimed to clarify the expression of AQP-10, -11 and -12 in the cochlea lateral wall. Using Wistar rats, we examined the expression of AQP-10, -11 and -12 in the cochlea lateral wall using molecular approaches and immunohistochemistry. AQP-11 was molecular biologically expressed, but the expression of AQP-10 and -12 was not observed. Immunohistochemically, AQP-11 was diffusely localized in the basal cells and marginal cells of the rat SV but was not expressed at the apical site of marginal cells with double staining. The expression of AQP-10 and -12 was not observed. Only AQP-11 was expressed in the basal cells and marginal cells, but it was not expressed at the apical site of marginal cells. Based on this study, AQP-11 may not have an important role in water flux between the perilymph and endolymph.

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Incidental 18FFDG-avid focuses in parotid glands on PET/CT

Tejs Ehlers KlugSara HillerupAndré Henrique DiasLars Christian GormsenPeter Nørgaard Kristensena Department of Otorhinolaryngology, Head and Neck Surgery, Aarhus University Hospital, Aarhus, Denmarkb Aarhus University, Aarhus, Denmarkc Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark

Publication date 26-03-2024


The number of unexpected focal [18F]FDG-avid findings (incidentalomas) within the parotid gland (PGI) continues to increase with the expanding use of PET/CT scanning. The prevalence of malignancy in PGIs is uncertain and appropriate management is unsettled. We aimed to explore the underlying pathologies associated with PGI. A retrospective review of all patients with parotid gland incidentaloma(s) treated at the Ear-Nose-Throat Department, Aarhus University Hospital, Denmark in the period 2012-2021, was performed. In total, 94 patients with one ( The prevalence of malignancy was low (2/94, 2.4%) in PGIs. Based on our findings, PGI in patients without a history of parotid malignancy, who undergo PET/CT scanning for reasons other than head and neck cancer (including malignant melanoma), may be managed similarly to patients with asymptomatic parotid gland tumors.

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Clinical significance of posterior expansion of the utricular endolymphatic space

Hideyuki KaidaTadao YoshidaSatofumi SugimotoMasumi KobayashiShinji NaganawaMichihiko Sonea Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japanb Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan

Publication date 27-03-2024


Posterior expansion of the utricular endolymphatic space (ES) is a finding occasionally observed, and often occurs in bilateral ears. The clinical significance of posterior expansion of the utricular ES is not clear. To investigate the clinical significance of posterior expansion of the utricular ES detected on magnetic resonance imaging (MRI). Among 957 patients who underwent contrast-enhanced MRI to investigate the presence of endolymphatic hydrops (EH), clinical findings in cases with posterior expansion of the utricular ES were evaluated and the significance of their existence is considered. Posterior expansion of the utricular ES was detected in 30 ears from 20 cases (7 males, 13 females; mean age 48.7 years). The ears with posterior expansion had a significantly lower incidence of vestibular EH than those without, and this tendency was more prominent in cases in bilateral ears. Some cases with posterior expansion had vestibular symptoms and were diagnosed with Ménière's disease, although EH was not detected in their vestibules. Posterior expansion of the utricular ES was associated with Ménière's disease without vestibular EH. Posterior expansion of the utricular ES might not be associated with the formation of EH but may occur independently.

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High fluence in laser stapedotomy aggravates transient subjective dizziness

Yoshie MizoguchiTaro FujikawaYoshiyuki KawashimaTaku ItoKen KitamuraYoshihiro NoguchiMasatoki TakahashiKeiji HondaTakamori TakedaTakeshi Tsutsumia Department of Otolaryngology, Tokyo Medical and Dental University, Tokyo, Japanb Department of Otolaryngology, Chigasaki Chuo Hospital, Kanagawa, Japanc Department of Otorhinolaryngology, Head and Neck Surgery, International University of Health and Welfare, Chiba, Japan

Publication date 28-03-2024


Laser fenestration in stapedotomy has thermal effect to the vestibule. To evaluate the role of energy density (fluence) in the severity of postoperative vestibular symptoms. The retrospective chart-review study included 84 patients with otosclerosis that underwent primary laser stapedotomy. Surgical outcomes, including nystagmus, and subjective vestibular symptoms during one-month follow-up, were compared between potassium titanyl phosphate (KTP) and CO The KTP and CO Appropriate setting of parameters with lower fluence is desirable for the efficiency and safety of laser stapedotomy.
Abbreviations: ABG: air-bone gap; SD: standard deviation.

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Differences in semicircular canal function in the video head impulse test in patients in the chronic stage of sudden sensorineural hearing loss with vertigo and vestibular neuritis

Natsuko NakamichiTomoyuki ShiozakiMasaharu SakagamiTadashi KitaharaDepartment of Otolaryngology-Head and Neck Surgery, Nara Medical University, Kashihara-city, Japan

Publication date 28-03-2024


Sudden sensorineural hearing loss with vertigo (SHLV) and vestibular neuritis (VN) can result in prolonged dizziness. This study aimed to compare the video head impulse test (vHIT) of patients with SHLV and VN. Fifteen patients with SHLV and 21 patients with VN who visited the Vertigo/Dizziness Center of our hospital between December 2016 and February 2023 were included. vHIT was performed at the time of admission, and the VOR gain and catch up saccade (CUS) in the three types of semicircular canals (SCCs) were analyzed. Pathologic vHIT results were observed most frequently in the posterior SCC (73%), followed by lateral (53%) and anterior (13%) SCCs in the SHLV group. In contrast, pathologic vHIT results were observed most frequently in the lateral SCC (100%), followed by the anterior (43%) and posterior SCC (24%) SCCs in the VN group. Pathological vHIT results in the lateral and posterior SCC showed significant differences between the two groups, but for anterior SCC, no significant differences were found. Comparison of the two vHIT results revealed differences in the SCC dysfunction patterns. This may be due to the different pathophysiological mechanisms of the two vestibular disorders, which may result in prolonged vertigo.

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Electrically evoked auditory brainstem responses in deaf children with cochlear nerve canal stenosis

Wenyun LuoHanyu ZhuLi ChenKai ShiXiaoyan HouJingwu SunJiaqiang SunXiaotao Guoa Wannan Medical College, Wuhu, Anhui, Chinab Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China

Publication date 18-04-2024


Deaf children with cochlear nerve canal stenosis (CNCs) are always considered poor candidates for cochlear implantation. To investigate the function of the peripheral auditory pathway in deaf children with CNCs, as revealed by the electrically evoked auditory brainstem response (EABR), and postoperative cochlear implants (CIs) outcomes. Thirteen children with CNCs and 13 children with no inner ear malformations (IEMs) who received CIs were recruited. The EABR evoked by electrical stimulation from the CI electrode was recorded. Postoperative CI outcomes were assessed using Categories of Auditory Performance (CAP) and Speech Intelligibility Rate (SIR). Compared with children with no IEMs, children with CNCs showed lower EABR extraction rates, higher thresholds, a longer wave V (eV) latency and lower CAP and SIR scores. The auditory and speech performance was positively correlated with the diameter of the cochlear nerve canal and the number of channels showing wave III (eIII) and eV in children with CNCs. The physiological function of the peripheral auditory pathway in children with CNCs is poorer than that in children with no IEMs. Postoperative auditory and speech abilities may depend on the severity of cochlear nerve malformation and auditory conduction function.

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The risk of facial nerve palsy after benign parotidectomy. A quality project

Nicoline Bebe MortensenKristine Bjørndala Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Odense University Hospital, Odense, Denmarkb OPEN, Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark

Publication date 18-04-2024


Facial nerve palsy is a potential complication of parotidectomy for benign salivary gland tumours, necessitating a comprehensive understanding of its incidence and associated risk factors for improved patient counselling and preoperative planning. This single-centre retrospective study aimed to assess the rate of facial nerve palsy following benign parotidectomy at a University Teaching Hospital. Over a 3-year period, 160 patients undergoing parotid surgery for benign tumours were included. Data, encompassing sex, age, operation technique, tumour pathology, facial nerve function, and follow-up duration, were collected from medical records. Exclusion criteria comprised patients with prior parotid gland surgery or preoperative facial nerve palsy. The study revealed a 3.75% incidence of facial nerve palsy with no total paralysis post-parotidectomy for benign disease. Pleomorphic adenoma (50.6%) and Warthin's tumour (44.4%) were the predominant tumour types. No significant differences were noted between groups with and without postoperative facial palsy based on obtained covariates. Our findings endorse partial superficial parotidectomy and extracapsular dissection as low-risk treatments for benign parotid tumours. However, prospective studies are warranted to elucidate recovery rates and long-term consequences of facial nerve palsy, contributing to refined surgical approaches and patient care in parotid surgery.

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Squamous cell carcinoma of the temporal bone: the impact of local control on survival

Antoine Dubray-VautrinBenjamin VérillaudPhilippe HermanRomain Kaniaa Department of Oto-Rhino-Laryngology, Head & Neck Surgery, Center of Neurosensorial-Head&Neck Diseases, Lariboisière Hospital, University of Paris Cité, Assistance Publique des Hôpitaux de Paris & UMR 1141 Center for the Developing Brain, Paris Biobank BB-0033-00064, Platform of Biopathology and Innovative Technologies for Health, Paris, Franceb Department of Oto-Rhino-Laryngology, Head & Neck Surgery, Institut Curie, Paris, France

Publication date 12-02-2024


Squamous cell carcinoma (SCC) of the temporal bone (TB) is a rare pathology originating from the external auditory canal (EAC). Surgery remains the gold standard to achieve local control.
Aims/Objectives:The aim of this study was to evaluate overall survival (OS) and disease-free survival (DFS) after surgery of the SCC of EAC.
A retrospective chart review in a tertiary referral center included 26 patients: 23 were operated with lateral temporal bone resection (LTBR, Adjuvant radiotherapy was performed in 91.3% ( En bloc surgical resection with free margins, coupled with postoperative radiotherapy, provides optimal local control. For stage IV tumors, where complete margins are achievable, ETBR is recommended to enhance local control.

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