Acta Oto Laryngologica 2022-01-13

Magnetic resonance imaging of endolymphatic hydrops in patients with unilateral Meniere’s disease: volume ratio and distribution rate of the endolymphatic space

Hiroshi Inui,Tsuyoshi Sakamoto,Taeko Ito,Tadashi Kitahara

Publication date 23-11-2021


Endolymphatic hydrops (ELH), which is a pathological feature of Meniere's disease (MD), is characterized by an extended endolymphatic space (ELS). We aimed to perform a quantitative volumetric analysis of inner-ear ELH in patients with unilateral MD (uMD). This study included 97 patients with definite uMD and 49 control subjects (CS). The ELS/total fluid space (TFS) volume ratio (%) and the distribution rate of the inner-ear components in the ELS (%) were measured using 3D magnetic resonance imaging and compared between patients with uMD and CS. Compared to CS, patients with uMD had significantly higher mean ELS/TFS volume ratios for inner-ear components. The mean distribution rate of the inner-ear components in the ELS was not significantly different between the two groups. In patients with uMD, ELH was noted to be spread throughout the entire inner ear and the endolymph was evenly distributed in the total ELS. These findings should be useful as a standard reference for further research.

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Frequency and natural course of congenital cytomegalovirus-associated hearing loss in children

Mariko Kasuga,Hidekane Yoshimura,Jun Shinagawa,Shin-ya Nishio,Yutaka Takumi,Shin-ichi Usami

Publication date 27-11-2021


Congenital cytomegalovirus-associated hearing loss (cCMV-associated HL) is a common cause of congenital or early-onset deafness. Although cCMV infection has been reported to lead to various types of HL, the natural course of cCMV-associated HL over a long period is not yet known. To investigate the clinical phenotype of cCMV-associated HL in the largest study to date. Thirty-one CMV-positive children, diagnosed by examining CMV DNA extracted from their dried umbilical cords retrospectively, were divided into unilateral and bilateral HL groups, and their hearing ability was evaluated using pure-tone audiometry and auditory steady-state response over time. Thirteen patients (41.9%) had unilateral HL and 18 (58.1%) had bilateral HL. In most cases of unilateral cCMV-associated HL, the ear with better hearing maintained a normal hearing threshold. Notably, in most cases of both unilateral and bilateral HL, the ear with worse hearing ultimately showed severe to profound HL. Our findings revealed that the natural course of cCMV-associated HL was different between the cases of unilateral and bilateral HL, as well as between the ears with better or worse hearing in all cases. These findings indicate that accurate diagnosis could enable proper follow-up and management of cCMV-associated HL in children.

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Safety of high-power short pulse single spot diode laser stapedotomy: an experimental animal study

"Sergey Anatolevich Karpishchenko",Mikhail Ur’evich Ulupov,Maria Ur’evna Boboshko,Olga Nikolaevna Sopko,Anna Nikolaevna Bervinova

Publication date 27-11-2021


We present a new method of diode laser stapedoplasty - high-power short-pulse mode with preliminary carbonization of the waveguide and a single spot of laser ablation. The aim of our research is the safety evaluation of presented mode 0.98 µm diode laser cochleostomy in guinea pigs. Guinea pigs ( To evaluate the negative impact of laser energy on OHCs and auditory function, we analyzed DPOAE amplitudes for 6400 and 8000 Hz since high frequency. The paired Student's Our study confirms that the proposed method of high-power short pulse diode laser stapedotomy is safe for the inner ear. Further prospective and randomized clinical trials are required to evaluate the possible benefits of this method.

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Risk factors of decompensated tinnitus and the interaction effect of anxiety and poor sleep on decompensated tinnitus: a multicenter study

Huiying Sun,Guodong Feng,Hong Yu,Yongjin Su,Fengying Zhang,Juan Feng,Zhiqiang Gao

Publication date 16-11-2021


Decompensated tinnitus substantially degrades quality of life. Anxiety and poor sleep are comorbidities in decompensated tinnitus. This multicenter study was designed to investigate the risk factors of decompensated tinnitus and to analyze the interaction effect of anxiety and poor sleep on decompensated tinnitus by conducting a multicenter study. We retrospectively analyzed patients with subjective chronic tinnitus who presented to five Chinese hospitals in China from September 2019 to November 2020. Demographic characteristics, pure tone audiometry, tinnitus-related tests, psychometric and sleep questionnaires were applied. A total of 338 patients were included, and 99 (29.3%) patients were in the decompensated group. Poor sleep and anxiety were possible risk factors of decompensated tinnitus by a forced-entry binary logistic analysis. Sleep disturbances and anxiety had an additive interaction that accounted for 87% of the decompensated tinnitus cases in our study population (RERI = 10.96, Anxiety and sleep disturbances are possible risk factors of decompensated tinnitus. The combination of poor sleep and anxiety exerts a greater impact on tinnitus severity than either risk factor alone.

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The optimal probe tone frequency for eSRT measurements at individual electrodes in children with cochlear implants

Haowei Guo,Biyu Lin,Ting Chen,Yanping Li,Mingyong Guo

Publication date 23-11-2021


Higher probe tone frequencies have been shown to increase the elicitation rates in electrically evoked stapedius reflex threshold (eSRT) measurements. To determine the optimal probe tone frequency for contralateral eSRT measurements at individual electrodes in children with unilateral cochlear implants and to assess the relationship between eSRTs for this frequency and most comfortable levels (M-levels). Contralateral eSRT measurements with three probe tone frequencies (226, 678, and 1000 Hz) at individual electrodes were performed on 26 paediatric Advanced Bionics cochlear implant recipients. The elicitation rates of eSRTs for 226, 678, and 1000 Hz probe tones were 73.08% (57/78), 88.46% (69/78), and 88.46% (69/78), respectively. The average eSRT for the 1000 Hz probe tone was significantly lower than those for 226 and 678 Hz probe tones ( The optimal probe tone frequency for contralateral eSRT measurement at individual electrodes in children with unilateral cochlear implants is 1000 Hz. ESRTs for the 1000 Hz probe tone are significantly correlated with M-levels and can be used to guide the M-levels setting in these children.

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Intra-arterial chemotherapy targeting metastatic cervical lymph nodes in head and neck cancer

Shigeyuki Murono,Takeshi Komori,Kazuhira Endo,Satoru Kondo,Naohiro Wakisaka,Tomokazu Yoshizaki

Publication date 27-11-2021


Large cervical lymph nodes and the extranodal extension of metastatic lymph nodes are considered poor prognostic factors in head and neck squamous cell carcinoma (HNC). The efficacy of intra-arterial chemotherapy (iaCT) targeting lymph node (LN) in HNC was examined. We performed a retrospective review of 41 patients with laryngeal and hypopharyngeal cancer showing metastatic cervical LN larger than 20 mm treated with iaCT with concurrent radiotherapy.
The administration of cisplatin into LN was divided into three groups: no administration (NO), A trend toward a more favorable three-year regional control in DIFFERENT compared to NO was observed, although the mean size of LN in DIFFERENT was larger than in the other groups. A better regional control was obtained in both DIFFERENT ( Targeting lymph node may be helpful to avoid neck dissection when iaCT was planned in HNC with relatively large LNs.

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Decrement of prognostic nutrition index in laryngeal diseases: from precancerous lesion to squamous cell carcinoma

Wu Daquan,Wang Tian,Na Shen,Liu Danzheng,Huang Xinsheng

Publication date 27-11-2021


Malnutrition and systemic inflammatory response have been confirmed to be important risk factors for various cancers. To compare pretreatment prognostic nutrition index (PNI) among patients with laryngeal squamous cell carcinoma (LSCC), laryngeal precancerous lesion (LPL) and laryngeal benign lesion (LBL). A total of 253 male patients with laryngeal lesions were divided into LBL, LPL with low risk (LPL (l)), LPL with high risk (LPL(h)), LSCC (i), LSCC (ii) and LSCC (iii) groups according to their histopathological findings and the TNM staging system. PNI and other clinical parameters were calculated. Kruskal-Wallis, Mann-Whitney The PNI in the LSCC group was significantly lower than those of the LBL and LPL groups ( PNI could be a simple and reproducible marker for predicting the severity of laryngeal diseases.

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Clinical application of a curved video suspension laryngoscope in laryngeal surgery

Hangjin Li,Wei Zhang,Hui Qu,Jizhe Wang

Publication date 13-01-2022


Suspension laryngoscopy (SL) is a common procedure performed by otolaryngologists. Studies have shown that adverse effects occur often during SL. To demonstrate the value of clinical application, this study compared the surgical time and postoperative oropharyngeal complications of SL using a novel curved video suspension laryngoscope with those of conventional SL. A total of 185 patients who underwent curved video SL, and 128 who underwent conventional SL were included. Characteristics including age, sex, body mass index (BMI), postoperative complications, and surgical time were compared in conventional and curved SL patients diagnosed with vocal cord polyps. The use of a curved laryngoscope significantly reduced surgical time (median, 10 min IQR 7-15 Curved video SL provided a clear surgical field, consumed less surgical time, and yielded fewer complications than conventional SL. This procedure is a cost-effective, minimally invasive alternative to conventional SL.

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Does COVID-19 have an impact on hearing?

Numan Kokten,Serdal Celik,Ahmet Mutlu,Emel Pektas,Sacit Icten,M. Tayyar Kalcioglu

Publication date 11-01-2022


SARS-CoV-2 is known to be a neurotrophic virus. However, the effect of this virus on the hearing system is still uncertain. We aimed to investigate the possible effect of COVID-19 on hearing. Thirty healthcare workers who had COVID-19 after hearing evaluation with pure tone audiometry (PTA) for any reason in the last 1 year were included in the study. PTA and transient evoked otoacoustic emissions (TEOAE) tests were performed in 15 of 30 patients during the active infection period. For all 30 patients, otoscopic examination plus PTA and TEOAE tests were performed at the end of the first month after their treatment. When the PTA results of 30 patients (60 ears) before and after COVID-19 were compared, a significant decrease in hearing level was found only at 1000 Hz ( We conclude that COVID-19 may cause hearing loss. However, this result needs to be confirmed with comprehensive studies to be conducted in larger patient groups.

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Clinical efficacy of the ‘sandwich technique’ in repairing cholesteatoma with labyrinthine fistula

Huanhuan Sun,Taiqin Wang,Liangwen Shi,Suling Zhuang,Jianzhi Liu

Publication date 11-01-2022


Labyrinthine fistula is the most common complication of middle ear cholesteatoma. To explore the postoperative hearing changes and surgical results of repairing middle ear cholesteatoma with labyrinthine fistula using the 'sandwich technique'. We retrospectively studied the clinical data of 36 patients (36 ears) who underwent surgical treatment for cholesteatoma with labyrinthine fistula. All patients were treated by completely removing the cholesteatoma matrix and repairing the fistula using the 'sandwich technique'. The hearing, clinical features, radiological data, intraoperative findings, and surgical results were respectively analyzed. Most labyrinthine fistulas were located in the lateral semicircular canal (94%). Fifty percent of fistulas were of medium size. Based on Dornhoffer classification, 17 cases of labyrinthine fistulas were classified as I. In 34 patients, the average bone conduction threshold improved or did not change after surgery. Two patients had preoperative facial paralysis. During follow-up (3-60 months), all patients had no postoperative vertigo symptoms and disease recurrence. Following the removal of the cholesteatoma matrix, the fistula is repaired using the "sandwich technique", which preserves or increases hearing and achieves an anti-vertiginous effect. This finding suggests that, 'sandwich technique' is a feasible procedure to treat cholesteatoma with labyrinthine fistula.

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Examination of inner ear structures: a micro-CT study

Ferhat Geneci,Muhammet Bora Uzuner,Burak Bilecenoğlu,Bilge İpek Torun,Kaan Orhan,Mert Ocak

Publication date 06-01-2022


We investigated the inner ear anatomy accurately in detail by microcomputed tomography (micro-CT) to contribute to the data related to the inner ear anatomy and the potential clinical contribution of these data in the treatment of the inner ear's pathologies. This study aimed to define a range for normal measurements of the VA, vestibule, lateral semicircular canal, and cochlea. We scanned temporal dry bone samples at high resolution using micro-CT. Forty dry temporal bones used in anatomy student education were included in this study with a micro-CT device. All measurements were made on sections in the axial plane with micro-CT programs. The operculum and the vestibular aqueduct middle diameters median values were 0.487 mm and 0.294 mm, respectively. The median value of middle diameters for the nonampullated section of lateral semicircular canal was 1.103 mm. The mean height of the cochlea was 3.417 mm and the width of the cochlea was 5.615 mm. The mean length of the vestibule was 6.085 mm and the width of the vestibule was 3.002 mm. We present a database that clinicians can consider in their studies by creating normal anatomical values measured with high precision for the bone labyrinth.

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Postnatal hearing loss: a study of children who passed neonatal TEOAE hearing screening bilaterally

Maoli Duan,Wen Xie,Linda Persson,Sten Hellstrom,Inger Uhlén

Publication date 01-01-2022


Universal newborn hearing screening (UNHS) contributes to the early diagnosis of hearing loss. However, not all permanent pediatric hearing impairments can be identified by UNHS. To investigate children who have successfully passed the UNHS, but have later-onset hearing loss at an early stage. UNHS of children, was reviewed retrospectively from databases at Karolinska University Hospital, Sweden. Gender, age, the reason for contact, the first contact and the most recent audiogram, the hearing diagnosis, the degree of hearing loss when they were enrolled in hearing rehabilitation, and the hearing aids they used were analysed. 63 children who had passed the UNHS at birth and were diagnosed with a hearing impairment at a later stage were included in the study. The average age was 3.3 and 3.9 years old when the children were diagnosed and were finally enrolled in the hearing habilitation, respectively. The reasons for diagnostic evaluation of a suspected hearing loss at present study are preschool hearing tests at the Child Health Care Centres, parents suspect, and/or delayed speech and language development. Our findings suggest that a passed UNHS does not exclude a future delayed onset of hearing loss, particularly in children with risk factors.

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Comparison of hearing outcomes in patients with congenital aural atresia managed with canaloplasty and bone conduction hearing devices

Sun A Han,Sang-Youp Lee,Moo Kyun Park,Jun Ho Lee,Seung Ha Oh,Myung-Whan Suh

Publication date 01-01-2022


Treatment options for congenital aural atresia (CAA) include canaloplasty and implantation of an osseointegrated bone conduction device (OBCD). Few studies have compared hearing outcomes in these two treatment methods. Hearing outcomes and revision surgery rates were compared in CAA patients managed by canaloplasty and surgically implanted OBCD. This study retrospectively analyzed 36 patients with CAA at a single institution. The same surgeon performed canaloplasty on 23 patients. Hearing outcomes before surgery as well as 3 and 6 months after surgery were compared to those of 13 patients with OBCD implantation. Postoperative hearing outcomes were better in the OBCD group, but the difference was not statistically significant. At 6-month follow-up, the hearing thresholds in the canaloplasty and OBCD group were 38.6 ± 21.4 and 31.9 ± 6.4 dB, respectively. The success rates 6 months after surgery were 75.0% in the canaloplasty group and 100% in the OBCD group. Two out of 23 patients in the canaloplasty group and 7 out of 13 patients in the OBCD group underwent revision surgery. In terms of hearing, the outcome was better with the OBCD compared to canaloplasty. Canaloplasty may be an alternative option in patients who refuse OBCD implantation.

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Examining the consequences of tinnitus using the multidimensional perspective

Vinaya Manchaiah,K. V. Nisha,Prashanth Prabhu,Sarah Granberg,Elin Karlsson,Gerhard Andersson,Eldré W. Beukes

Publication date 30-12-2021


Tinnitus is one of the most frequent chronic conditions in adults with wide range of consequences. The aim of the current study was to determine the problems and life effects reported by individuals with tinnitus using the International Classification of Functioning, Disability and Health (ICF) framework. The study used a cross-sectional survey design. A total of 344 individuals with tinnitus completed a series of questionnaires. The responses to open-ended questions were linked to ICF categories. Activity limitations and participation restrictions were most dominant consequence of tinnitus followed by effect on the body function with limited emphasis on the contextual factors. Frequently reported responses to body function involved emotional functions (b152), attention function (b140), and sleep functions (b134). Commonly reported responses to activity limitations and participation restrictions were recreation and leisure (d920), conversation (d350), communicating with-receiving-spoken messages (d310), listening (d115), and remunerative employment (d850). Sound intensity (e2500) and sound quality (e2501) were the frequently reported responses to environmental factors. Coping styles, past and present experiences, and lifestyle were the most frequently occurring personal factors. The study highlighted some key influencing factors of tinnitus in different ICF domains which can be helpful in rehabilitation planning.

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Correlating intraepithelial papillary capillary loops of vocal cord leukoplakia with histopathology

Yi Fang,Yue Yang,Min Chen,Jian Chen,Peijie He,Lei Cheng,Haitao Wu

Publication date 30-12-2021


The pathology of vocal fold leukoplakia (VFL) was hard to predict before surgery. To investigate the correlation of intraepithelial papillary capillary loops (IPCLs) with the malignant transformation in VFL. The IPCLs in 90 patients were classified according to 2019 Ni classification. Type I-III represented to non- to moderate dysplasia in pathology being viewed as 'benign leukoplasia', type IV-VI represented to severe dysplasia/cancer Forty-one cases were classified as type I-III, the consistency of type I-III with pathology was 61.0%, with 100.0% of type I, 47.1% of type II and 30.0% of type III. 49 cases were classified as type IV-VI, all were 'malignant leukoplasia', the consistency of type IV-VI and pathology was 100.0%. The accuracy of type I-III, IV-VI to predict pathology were 61.0, 100.0%. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value of Ni classification corresponding to 'benign/malignant leukoplasia' was 75.8, 100.0, 82.2, 100.0, 60.0%, respectively. IPCLs of type IV-VI in vocal cord leukoplasia had a close correlation with pathology. The degree of dysplasia was underestimated in type II and type III.

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Prevalence of cystic metastases in a consecutive cohort of surgically removed branchial cleft cysts

Lalle Hammarstedt Nordenvall,Evelina Jörtsö,Mathias von Beckerath,Edneia Tani,Sushma Nordemar,Rusana Bark

Publication date 29-12-2021


Solitary cystic lesion of the neck may often be the only initial presenting symptom for branchial cleft cysts and cystic metastases. To analyse the malignancy rate detected in patients undergoing surgical treatment for lateral branchial cleft cyst. The records of all patients with surgical procedure code ENB40 (Excision of lateral branchial cleft cyst- or fistula) between 2003 and 2019 were reviewed. After excluding 150 patients, 436 patients were included for final analysis. Re-evaluation of the cytology including HPV-analysis was performed in those who had a malignant cyst. Cystic metastases were demonstrated histologically after surgical excision in 13 patients (3%). In patients over 18 years of age, the prevalence of cystic metastasis regardless of the primary tumour type was 3.3%. When the investigation protocol for solitary cystic lesions of the neck is followed, the negative predictive value for malignancy is 97%. All adult patients with a cytologic verified diagnosis of branchial cyst should be examined with HPV-analysis of the cystic sample before excision of the cyst. Failure of predicting a malignancy is often associated with cytology of poor cellularity which may be improved by more frequent use of ultrasound guided fine-needle aspiration cytology (FNAC).

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Insulin regulates Nedd4-2 via a PKB-dependent mechanism in HEI-OC1 auditory cells-crosstalks with sphingolipid and cAMP signaling

Ann-Ki Pålbrink,Björn Morén,Karin G. Stenkula,Måns Magnusson,Eva Degerman

Publication date 29-12-2021


The mechanisms of association between diabetes and inner ear dysfunction are unknown, although endolymphatic hydrops may be involved. We have previously shown that insulin signaling components are expressed in human saccule and that insulin signaling takes place in HEI-OC1 auditory cells. To explore Nedd4-2 as a target for insulin signaling. Effects of insulin were analyzed using western blot and confocal microscopy in HEI-OC1 auditory cells. Insulin induced phosphorylation of Nedd4-2 and increased the amount of ENaC at the plasma membrane. Also, protein kinase B (PKB) and NDRG1, a substrate for SGK1 (serum and glucocorticoid stimulated kinase), were phosphorylated in response to insulin. The SGK1 inhibitor GSK650394 prevented insulin-induced phosphorylation of NRDG1, but not of PKB and Nedd4-2, whereas the phosphatidylinositol 3-kinase (PI3K) inhibitor wortmannin and the PKB inhibitor MK2206 inhibited phosphorylation of all components. Ceramides prevented insulin-induced phosphorylation of PKB and NDRG1, but not of Nedd4-2. The ceramide metabolite sphingosine 1-phosphate induced phosphorylation of Nedd4-2. Insulin induces phosphorylation of Nedd4-2, most likely involving PI3K/PKB signaling. Sphingosine 1-phosphate might protect Nedd4-2 against ceramide-induced insulin resistance. Insulin-mediated regulation of Nedd4-2 might impact on inner ear sodium homeostasis with implications for diabetes-induced inner ear damage.

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Anterior glottoplasty: the effect of inclusion of the vocal fold lamina propria to frequency elevation

Pengcheng Yu,Rui Fang,Chao Xue,Jack Jiang

Publication date 29-12-2021


Anterior glottoplasty is a commonly used treatment for voice feminization. But it remains in dispute over whether to suture of the ligament as part of the procedure. This study aimed to explore the effect of inclusion of the vocal lamina propia. Anterior webs were created in 8 excised canine larynges by sutures placed at 10%, 20%, and 30% of the vocal fold length, respectively.
The suture depth was divided into two groups: epithelium layer (Shallow Suture, SS group) and deep layers of vocal fold lamina propia (Deep Suture, DS group). For anterior webs between 0% and 30%, the frequency elevation ranged from 3% to 151% of the pre-web fundamental frequency (fo) in SS group and from 13% to 222% in DS group. No significance was found between two groups at three different sutures ( The frequency in excised canine larynx increased continuously as the anterior glottic webs ranged from 0% to 30%. The inclusion of the vocal fold lamina propia does not affect the frequency elevation.

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Gene mutations and clinical prognosis of mucosal melanoma in different locations of head and neck

Wei Guo,Gaofei Yin,Chuanliang Cui,Yan Kong,Zhigang Huang,Xiaohong Chen

Publication date 28-12-2021


Mucosal melanoma is the second most common subtype of melanoma in China and head and neck region is one of the main sites of this disease. Analyzed the phenotypes of C-Kit, NRAS, PDGFRA and BRAF genes in patients with in different locations to explore the characteristics of gene mutations. 96 patients were included in this study. C-Kit (exons 9, 11, 13, 17 and 18), NRAS (exons 1 and 2), PDGFRA (exons 12, 14 and 18) and BRAF (exons 11 and 15) were analyzed by PCR amplification and Sanger sequencing. 14 (14.58%) patients had C-Kit mutation, 6 (6.25%) had BRAF mutation, 23 (23.96%) had PDGFRA mutation, and 12 (12.50%) had NRAS mutation. The NRAS mutation ( Gene phenotypes of mucosal melanoma in different locations has differences. Lesions in the nasal cavity and paranasal sinus should be assessed separately from other parts such as the nasopharynx.

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Pseudo-spontaneous nystagmus in patients with lateral canal benign paroxysmal positional vertigo

Sertac Yetiser,Dilay Ince

Publication date 28-12-2021


Pseudo-spontaneous nystagmus (PSN) can be detected in patients with lateral canal benign paroxysmal positional vertigo (LC-BPPV). Its frequency, and correlation with the therapeutic outcome have been less described and conflicting results have been reported. This study aims to investigate its clinical and prognostic significance. One hundred and eighty-four patients with LC BPPV (98 apogeotropic, 86 geotropic type) were enrolled for the study. Clinical parameters were reviewed in patients with or without PSN. The Chi-square and one way ANOVA tests were used to compare the difference between study groups. Statistical significance was set at Twenty-two patients with apogeotropic (22.4%; 98/22) and 17 patients with geotropic nystagmus (19.7%; 86/17) had PSN. The incidence, age, male-female ratio, mean slow phase velocity (SPV), duration of BPPV and the rate of recurrence were not significant in patients with LC-BPPV whether they have PSN or not. Prognostic role of PSN in patients with LC BPPV seems to be questionable. Appearance and disappearance of PSN with regard to head position helps to differentiate BPPV from other acute vestibular disorders. Additionally, direction of nystagmus assists to determine the site of the affected canal. However, prognostic significance is obscure.

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Depression and female gender associated with higher postoperative pain scores after sinonasal surgery

Katharina Schinz,Lukas Steigerwald,Konstantinos Mantsopoulos,Antoniu-Oreste Gostian,Maximilian Traxdorf,Matti Sievert,Robin Rupp,Heinrich Iro,Sarina Katrin Mueller

Publication date 24-12-2021


Although it is extremely necessary to reduce the number of opioids taken postoperatively after sinonasal surgery, this is the subject of controversial discussion. The objective of this study was to identify factors that predict higher postoperative pain scores (PPS) and the need for opioid analgesics after sinonasal surgery. This was a retrospective study of Significant predictors for a higher pain score were depression ( The study identified risk factors for a higher PPS and the need for opioids. The results indicated that reducing postoperative opioids might be possible in patients without these risk factors and might help guide individualized postoperative therapy.

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Characteristics of electrically evoked auditory brainstem response in children with large vestibular aqueduct syndrome after cochlear implantation

Han-yu Zhu,Xiao-tao Guo,Jia-qiang Sun,Jing-wu Sun

Publication date 23-12-2021


The vestibular aqueduct (VA) width may affect the auditory conduction pathway of large vestibular aqueduct syndrome (LVAS) children. Analyzing the electrically evoked auditory brainstem response (EABR) after cochlear implantation (CI) in severe to profound sensorineural hearing loss (SNHL) children with LVAS. Fifty-four children with SNHL who received CI were selected, including 21 children with LVAS and 33 children without inner ear malformations (IEMs). The VA width was measured in LVAS children. The post-operative EABRs were recorded in all children. For the LVAS group, the VA width was positively correlated with wave III (eIII) latency of EABR at the No. 2 electrode (E2), E5, E8, and E11, the VA width was positively correlated with wave V (eV) latency of EABR at E2, E5, E8, and E11. Only the eV latency of E2 showed a significant difference between the two groups. SNHL children with LVAS and no IEMs have similar conduction of the auditory pathway. In the LVAS group, the conduction of the auditory pathway becomes better with the decrease of VA width. Rational use of post-operative EABRs and the measurement of anatomical parameters can effectively assess the development of part auditory pathways in LVAS children, which may be helpful in predicting post-operative speech and hearing recovery.

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Molecular screening of patients with profound hearing loss from Chengdu, China

Qingqing Dai,Wei Dai,Dan Wang,Xia Liu,Ling Zou,Jiani Chen,Hong Zheng,Maoli Duan

Publication date 23-12-2021


The rate of genetic deafness in Chengdu is still underestimated. To investigate patients' molecular etiology with profound hearing loss and facilitate genetic counseling for their families, we screened deafness-related genes of profound hearing loss in the population. A total of 1427 unrelated patients with profound hearing loss containing all age groups in the administrative area of City Chengdu (Sichuan, China) were enrolled in this study, and the average examination rate is 81.13%. Nine loci of four deaf-associated genes ( The average age of all subjects is 48.537 ± 19.077 years, peak range in 41-70 years (985/1427, 69.03%). The positive mutation rates of patients in GJB2, SLC26A4, and 12S rRNA are respectively 8.90%, 4.84%, and 5.96%, and GJB3 none. In group A the GJB2 and SLC26A4 mutation rate is 14.17% (36/254), which is remarkably higher than group B (6.14%, 72/1173). The frequency of 12SrRNA mutations is 3.15% (8/254) in group A, which is significantly different ( The mutation rate of mtDNA 12SrRNA is higher than

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A simple and convenient 3D printed temporal bone model for drilling simulating surgery

Zhi-Ming Yuan,Xiao-Dong Zhang,Shou-Wu Wu,Zhong-Zhu Nian,Jun Liao,Wen Lin,Li-Ming Zhuang

Publication date 21-12-2021


It is still far away from most of us in that it requires complex 3D modeling. To investigate a more precision, simple, convenient and economical three-dimensional (3D) printed temporal bone model printed by a commercial desktop 3D printer, which can be widely promoted and applied in the training of beginners in otology. The CT data of the temporal bone were imported into Mimics to construct a 3D digital model of the temporal bone. After loaded into a high-precision 3D printer, a high-precision temporal bone model was printed at a scale of 1:1. Then, the model was evaluated by 5 senior attending physicians, including its morphological accuracy, simulation about surgery, advantages and educational value, using the 7-point Likert scale. A life-like temporal bone model was successfully printed out. Five senior attending physicians all thought that the printed model was similar to the natural temporal bone in physical properties and the haptic sensation of bone drilling, and was accurate, simple, convenient and effective. In addition, the model was considered to be of high application value in the teaching of temporal bone anatomy and surgery simulation, which had a material cost of only 3 dollars. The high-precision 3D printed temporal bone model is highly similar to the natural temporal bone, and can be conveniently and effectively used in the training of simulating temporal bone surgery for beginners in otology. Its production is simple and economical, so it can be popularized on a large scale.

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Tracheotomy as a predictor of remission and demise for juvenile-onset recurrent respiratory papillomatosis

Zijie Niu,Yang Xiao,Lijing Ma,Xiaoli Qu,Yuge Wang,Sihan Zhou,Jun Wang

Publication date 21-12-2021


The pros and cons of tracheotomy, as a classic treatment of juvenile-onset recurrent respiratory papillomatosis (JORRP), have gradually been recognized, but the exact impact of tracheotomy on remission and demise is not clear. To investigate the predicting influence of tracheotomy on prognosis for JORRP. Three hundred forty two patients with JORRP treated in Beijing Tongren Hospital were retrospectively reviewed. The clinical characteristics and prognosis parameters were compared in the group of tracheotomy and non-tracheotomy. The rate of tracheotomy was 24.6% (84/342). Among these patients, 68 (81.0%) developed the tracheal papillomatosis. The onset age of RRP occurred earlier in tracheostomized group, and patients performed tracheotomy needed a greater number of surgeries and developed distal spread more easily ( The age at diagnosis, the surgical frequency and the medical level of hospital are important factors affecting the occurrence of tracheotomy. Patients who had undergone tracheotomy are prone to possess the low remission rate and high mortality.

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Examination of risk factors for postoperative vestibular symptoms in patients with cholesteatoma

Takaaki Kobayashi,Shusuke Iwamoto,Toshihito Sahara,Yujiro Hoshi,Anjin Mori,Hajime Koyama,Takeshi Fujita,Mitsuo P. Sato,Yasuhiro Osaki,Katsumi Doi

Publication date 21-12-2021


In cholesteatoma, the prognosis of tympanoplasty has been well discussed in terms of hearing outcomes and residual or recurrent lesions. Postoperative dizziness and vertigo are major complications of tympanoplasty; however, few reports are available. We investigated each condition of cholesteatoma postoperative vestibular risk using the STAM system and staging published by EAONO/JOS, as well as findings on bony destruction. From April 2010 to March 2021, 156 patients (166 ears) with cholesteatoma who underwent primary microscopic tympanoplasty at our hospital were registered. Subjective vestibular symptoms were recorded the day after surgery. Postoperative vestibular symptoms were observed in 13.9% of subjects. All of them were stage II and had both attic and mastoid lesions. Attic ( In the exposed dura group, the length of the prominence of the lateral semicircular canal to the middle cranial fossa dura was significantly shorter than that of the non-exposed group (

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Clinical manifestations and genetic analysis of a family with neurofibromatosis type 2

Victoria Y. Wang,Te-Yi Liu,Te-Yung Fang,Ya-Hui Chen,Chi-Jung Huang,Pa-Chun Wang

Publication date 18-12-2021


Neurofibromatosis type 2 (NF2) is an autosomal dominantly inherited disease with slow, yet potentially life-threatening progression. We describe the clinical manifestations and genetic profile of a family with NF2. We enrolled a 16-member family with NF2. We collected clinical examinations and imaging information. Genetic analysis was conducted through multiplex ligation-dependent probe amplification (MLPA). The SALSA MLPA probemix P044-B2 NF2 kit was used to detect genetic variations in genomic upstream and 17 exons of the The most common clinical manifestation was hearing impairment (37.5%), followed by tinnitus (18.8%).
Four participants had vestibular schwannoma: 2 were bilateral and 2 unilateral, and tumor size ranged from 86.3 to 5064 mm Hearing impairment was the most common clinical manifestation in this family. The

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