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Leahy J, Wong K, Govindan A, Powers A, Perez ER, Wanna GB, Cosetti MK. Long-term outcomes following pediatric endoscopic titanium ossiculoplasty: A single-institution experience. Int J Pediatr Otorhinolaryngol 2024; 179:111938. [PMID: 38579403 DOI: 10.1016/j.ijporl.2024.111938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 03/11/2024] [Accepted: 03/31/2024] [Indexed: 04/07/2024]
Abstract
INTRODUCTION Endoscopic ossicular chain reconstruction (OCR) in adults has demonstrated equivalent outcomes to the traditional microscopic approach. Less data exist on endoscopic OCR outcomes in children, who have unique considerations including a smaller transcanal corridor and variable pathology. The purpose of this study was to investigate surgical and audiometric outcomes in children undergoing fully endoscopic and endoscopic-assisted OCR in both the short and long-term. METHODS Retrospective review of all children (<17 years) who underwent endoscopic OCR at one tertiary care center between 2017 and 2021. Children undergoing primary and revision endoscopic OCR with either partial (PORP) and total ossicular reconstruction prostheses (TORP) were included. Children undergoing surgery for juvenile otosclerosis or congenital stapes fixation, or any child receiving a stapes prosthesis were excluded. Primary outcome measures were post-operative change in 4 frequency (500 Hz, 1, 2, 4 KHz) air conduction pure tone average (AC PTA) and change in air-bone gap (ABG). Secondary measures included need for readmission and/or revision surgery, complication rate, and surgery duration. RESULTS Seventeen patients met inclusion criteria. Average age was 11.3 years (range, 5-17 years); 14 were male. A variety of fixed length, titanium total and partial prostheses were used. The most common prosthesis length was 2 mm (range 2-5 mm), and there were no intra- or perioperative complications. Mean long-term follow-up was 2.6 years. Most common pathology was congenital cholesteatoma (11/17, 64%), followed by chronic otitis media with tympanic membrane perforation (5/17, 29.4%), and extruded prosthesis (1/17, 5.9%). Intraoperatively, the most common finding was incus erosion (10/17, 58.8%), followed by malleus erosion (6/17, 35.3%), stapes erosion (4/17, 23.5%), and stapes absence (4/17, 23.5%). Eight children (47%) were reconstructed with PORPs, and 9 children (52.9%) were reconstructed with TORPs. Average ABG improved from 36.8 dB preoperatively to 19.9 dB postoperatively in the short-term and remained stable at 19.5 dB in the long-term. Average short-term ABG improvement was 4.2 dB for PORPs and 18 dB for TORPs. In the long-term, average ABG improved by 2.3 dB in PORPs and 13.4 dB in TORPs. PORPs had higher rates of ABG closure and lower AC PTAs than TORPs in the long-term. DISCUSSION Endoscopic ossiculoplasty is a viable option in children presenting with ossicular erosion from various causes. Audiometric improvement following endoscopic partial and total ossicular reconstruction remains stable over time, with a preference towards partial in the long-term, and mirrors published outcomes for microscopic surgery.
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Affiliation(s)
- Jasmine Leahy
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Kevin Wong
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Aparna Govindan
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ann Powers
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Enrique R Perez
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - George B Wanna
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Maura K Cosetti
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Job K, Wiatr A, Skladzien J, Wiatr M. The Audiometric Assessment of the Effectiveness of Surgical Treatment of Otosclerosis Depending on the Preoperative Incidence of Carhart's Notch. Ear Nose Throat J 2024; 103:241-247. [PMID: 34633243 DOI: 10.1177/01455613211043685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: The presence of Carhart's notch at 2000 Hz in otosclerosis links the changed bone conduction for this frequency with the otosclerotic process occurring in the oval window. The aim of this study is to perform an audiometric assessment of the effectiveness of surgical treatment of otosclerosis depending on the incidence of Carhart's notch. Methods: The analysis included 116 patients treated surgically for the first time due to otosclerosis. Patients were divided into 4 groups depending on the occurrence of Carhart's notch, determined by pure-tone audiometry (PTA) before the surgery and 36 months afterward. The mean value of bone conduction thresholds was calculated for 500 Hz, 1000 Hz, 2000 Hz, and 3000 Hz in the groups in which the Cahart's notch was observed. This value of bone conduction (BC) was a reference point for further analysis in patients who had no preoperative or postoperative Carhart's notch. Results: The analysis indicated that Cahart's notch in preoperative PTA is a statistically significant improvement factor for average BC. It was found that over a longer observation period, the presence of Carhart's notch has adverse effects on the size of the postoperative air-bone gap, and consequently on hearing improvement after surgical treatment. A comparison between patients from the two groups without preoperative Carhart's notch found that no beneficial effects of the surgery on speech comprehension were observed regarding high-level sensorineural hearing loss (SNHL). Conclusions: (1) In a long-term observation post-stapedotomy, average BC values were found to improve. Nevertheless, the improvement is less evident in patients with preoperative Carhart's notch. (2) Disappearance of Cahart's notch after surgical treatment of otosclerosis is a good prognosis of improvement in speech audiometry. (3) Deep SNHL in the absence of Carhart's notch in PTA constitutes a bad prognostic factor for improvement in speech audiometry in patients qualified for surgical treatment of otosclerosis.
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Affiliation(s)
- Katarzyna Job
- Department of Otolaryngology, Jagiellonian University Medical College in Kraków, Krakow, Poland
| | - Agnieszka Wiatr
- Department of Otolaryngology, Jagiellonian University Medical College in Kraków, Krakow, Poland
| | - Jacek Skladzien
- Department of Otolaryngology, Jagiellonian University Medical College in Kraków, Krakow, Poland
| | - Maciej Wiatr
- Department of Otolaryngology, Jagiellonian University Medical College in Kraków, Krakow, Poland
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Zhang L, Xu L, Guan B, Jiao C, Zhu B. [A study of mismatched negative in normal hearing patients of different ages]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2024; 38:273-277. [PMID: 38563167 DOI: 10.13201/j.issn.2096-7993.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Indexed: 04/04/2024]
Abstract
Objective:To study the characteristics of Mismatch negativity(MMN) in normal hearing patients of different ages, and to compare the MMN of normal hearing subjects at different ages to explore the differences in MMN between different ages. Methods:MMN test was performed on both ears using the classic Oddball mode. A frequency of 1 000 Hz(standard stimuli) and 2 000 Hz(deviant stimuli) was used to evoked the MMN. According to different age groups: the juvenile group(7-17 years old), the youth group(18-44 years old), the middle-aged group(45-59 years old), and the elderly group(60-75 years old), with 25 cases in each group. The MMN characteristics of normal hearing subjects in different age groups were analyzed statistically and the differences between groups were compared. All subjects underwent pure tone threshold test, tympanic reactance test and ABR test before MMN test. Results:MMN waveform could be elicited from both ears of 100 subjects. Among them, the average latency of the juvenile group was(159.70±20.34) ms while the average amplitude was(4.34±2.26) μV, For the youth group, the average latency was(166.01±28.67) ms and the average amplitude was(3.70±2.28) μV. Then in the middle-aged group, the average latency was(175.16±37.24) ms, meanwhile, the average amplitude was(2.69±0.84) μV. Finally, the elderly group has an average latency of(178.03±14.37) ms and an average amplitude of(2.11±0.70) μV. Therefore, there was no statistical difference in latency and amplitude between all groups(P>0.05), and there was no statistical difference in latency and amplitude between left and right ears among all subjects as a whole(P>0.05). However, when the left and right ears of all groups were compared, it was found that the latency between the left and right ears of the Juvenile group had statistical significance(P<0.05), and the amplitude difference was not statistically significant(P>0.05), while the latency and amplitude differences between the left and right ears of other groups had no statistical significance(P>0.05). There were also no significant differences in latency and amplitude between men and women(P>0.05). Conclusion:There was no statistically significant difference in the latency and amplitude of mismatched negative among normal hearing subjects of different ages, and no statistically significant difference in the MMN latency and amplitude between the left and right ears of subjects and between men and women. Therefore, the study inferred that the auditory cerebral cortex of subjects aged 7-75 years old maintained a stable state for a long time after maturity, and the latency and amplitude of mismatched negative waves were relatively stable. It is not affected by age, gender and ear side, and can stably reflect the auditory cortex function of the subjects. It has broad application prospects in clinical practice, and provides a reliable detection means for future research on the changes of the auditory cerebral cortex of patients, which is worthy of our further research and clinical promotion.
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Affiliation(s)
- Liuyan Zhang
- Medical College of Yangzhou University,Yangzhou,225001,China
| | - Li Xu
- Department of Otorhinolaryngology,Northern Jiangsu People's Hospital Affiliated to Yangzhou University
| | - Bing Guan
- Department of Otorhinolaryngology,Northern Jiangsu People's Hospital Affiliated to Yangzhou University
| | - Cheng Jiao
- Department of Otorhinolaryngology,Northern Jiangsu People's Hospital Affiliated to Yangzhou University
| | - Bin Zhu
- Department of Otorhinolaryngology,Northern Jiangsu People's Hospital Affiliated to Yangzhou University
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Hsue VBC, Wong YT, Wu A, Tang D. Reconstruction of an obliterated Eustachian tube: transnasal lighted guidewire catheter stenting. BMJ Case Rep 2024; 17:e256748. [PMID: 38490712 PMCID: PMC10946367 DOI: 10.1136/bcr-2023-256748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024] Open
Abstract
An obliterated Eustachian tube (ET) is a rare occurrence that can lead to chronic otitis media (OM) and aural fullness even with treatment. Our study presents a review of the literature on methods of stenting the ET. We additionally present a case of a man with mucoepidermoid carcinoma of the ET who underwent a radical nasal pharyngectomy with reconstruction and adjuvant radiation, and who had symptoms of intolerable otorrhea after tympanostomy tube placement to treat aural fullness and mucoid OM. We used a novel method of stenting the ET using a transnasal lighted guidewire catheter and steroid eluting stents placed along the entire medial ET. Previously described methods in the literature were unable to be used due to the complex middle ear anatomy filled with granulation tissue and the lack of a visible nasopharyngeal ET ostium available for straightforward placement of the stent. The procedure was successful, and postoperatively, the patient experienced decreased otorrhea.
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Affiliation(s)
| | - Yu-Tung Wong
- Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Arthur Wu
- Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Dennis Tang
- Cedars-Sinai Medical Center, Los Angeles, California, USA
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Al-Salim S, Skretta D, Merchant GR. Survey of Wideband Acoustic Immittance Use by Clinical Audiologists. Am J Audiol 2024; 33:254-268. [PMID: 38315574 PMCID: PMC11005003 DOI: 10.1044/2023_aja-23-00228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 12/12/2023] [Accepted: 12/14/2023] [Indexed: 02/07/2024] Open
Abstract
PURPOSE Wideband acoustic immittance (WAI) is a promising measure of middle-ear mechanics. In contrast to standard tympanometry, which is generally measured at a single stiffness-dominated low frequency, WAI detects mechanical effects on both the mass and stiffness properties of the middle ear across a wide range of frequencies, resulting in a more comprehensive assessment of middle-ear mechanics in healthy and pathological ears. Despite a plethora of research demonstrating the clinical utility of this measure, clinical adoption of WAI is still limited. This work explores audiologists' use and perceptions of WAI, with the goal of identifying the barriers to its clinical adoption. METHOD A survey on the perception and use of WAI by clinical audiologists in the United States was developed and administered using the Research Electronic Data Capture application. The survey was distributed broadly across the United States. Participation was voluntary and anonymous, and no compensation was provided. RESULTS Findings from 132 survey respondents across 32 states were included in the analyses. Overall, findings suggest the largest barriers to clinical adoption of WAI are lack of access to equipment that measures WAI and lack of training and/or confidence in measuring or interpreting WAI. CONCLUSIONS Several barriers to clinical adoption of WAI were identified. However, findings also provide optimism in that audiologists utilizing WAI find it more useful than standard tympanometry, and most audiologists who do not currently use WAI are open to implementing the measure in their clinical practice. We proposed steps to address the highest priority issues and increase the clinical viability of WAI.
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Affiliation(s)
- Sarah Al-Salim
- Center for Hearing Research, Boys Town National Research Hospital, Omaha, NE
| | - Delaney Skretta
- Center for Hearing Research, Boys Town National Research Hospital, Omaha, NE
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Faramarzi M, Faramarzi A, Roosta S, Pishgar S, Owji SH. Hyaluronic Acid Gel as Middle Ear and External Auditory Canal Packing Material in Tympanoplasty. Otolaryngol Head Neck Surg 2024; 170:853-861. [PMID: 37811664 DOI: 10.1002/ohn.554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 09/01/2023] [Accepted: 09/07/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVE This study aims to evaluate the effect of hyaluronic acid gel (HAG) on tympanic membrane (TM) graft success rate and audiometric outcomes in patients with large TM perforations during tympanoplasty. STUDY DESIGN A single-blinded randomized controlled trial. SETTING Tertiary hospital. METHODS In the study, we performed tympanoplasty via postauricular approach on 488 ears and compared 2 groups: the control group (n = 247) with absorbable gelatin sponge packing and the HAG group (n = 241) with HAG packing in both the middle ear and medial 2/3 of the external auditory canal. We compared the graft success rates and postoperative audiometric outcomes between the 2 groups. RESULTS In a study of 488 ears (HAG group = 241, control group = 247), the HAG group had a higher graft success rate of 96.7% (233/241 ears) compared to the control group's 91.5% (226/247 ears; P = .015). No significant difference was observed between HAG and control in postoperative ABG closure within 20 dB (HAG: 66.8% or 161 ears; control: 59.1% or 146 ears; P = .078). There were no significant differences in improvements, compared to their preoperative condition, in mean bone conduction (HAG: -0.1 ± 6.5; control: 1.3 ± 7.6), air conduction (HAG: 8.7 ± 12.1; control: 9.7 ± 13.1), air-bone gap (HAG: 8.8 ± 10.6; control: 8.4 ± 12.0), and speech reception threshold (HAG: 9.4 ± 11.8; control: 9.2 ± 13.5) between the control and HAG groups (two one-sided T test, P < .001). CONCLUSION In tympanoplasty, HAG packing in the middle ear and external auditory canal yields higher graft success rates than absorbable gelatin sponge, while audiometric outcomes are similar for both the HAG and absorbable gelatin sponge packing cohorts.
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Affiliation(s)
- Mohammad Faramarzi
- Otolaryngology Research Center, Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Faramarzi
- Otolaryngology Research Center, Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sareh Roosta
- Otolaryngology Research Center, Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sajad Pishgar
- Otolaryngology Research Center, Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Hossein Owji
- Otolaryngology Research Center, Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
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Baskadem Yilmazer A, Tanrısever O, Alagoz MH, Yilmazer R, Goker AE, Tutar B, Uyar Y. Evaluation of inner ear damage by mastoid drilling with measurement of serum prestin (SLC26A5) levels. Braz J Otorhinolaryngol 2024; 90:101380. [PMID: 38237483 PMCID: PMC10828577 DOI: 10.1016/j.bjorl.2023.101380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 12/01/2023] [Accepted: 12/07/2023] [Indexed: 02/03/2024] Open
Abstract
OBJECTIVE The objective of this study is to demonstrate any inner ear injury caused by drilling in mastoid surgery with prestin, outer hair cell motor protein specific to the cochlea. METHODS The patients with chronic otitis media requiring mastoidectomy (n = 21) and myringoplasty (n = 21) were included. Serum prestin level obtained from blood samples was measured before surgery and on postoperative days 0, 3, and 7 using Human Prestin (SLC26A5) ELISA Kit. All patients underwent the Pure Tone Audiometry (PTA) test before surgery and on the postoperative 7th day. The drilling time was also recorded for all patients who underwent mastoidectomy. RESULTS In both mastoidectomy and myringoplasty groups, the postoperative serum prestin levels increased on days 0 and 7 (pday-0 = 0.002, pday-7 = 0.001 and pday-0 = 0.005, pday-7 = 0.001, respectively). There was no significant difference in the serum prestin levels between the two groups, postoperatively. The PTA thresholds at day 7 did not change in either group. A significant decline at 2000 Hz of bone conduction hearing threshold in both groups and a decline at 4000 Hz in the myringoplasty group were found. There was no correlation between the drilling time and the increase of prestin levels in the postoperative day 0, 3, and 7. CONCLUSION Our results showed that mastoid drilling is not related to a significant inner ear injury. Although the myringoplasty group was not exposed to drill trauma, there was a similar increase in serum prestin levels as the mastoidectomy group. Also, a significant decline at 2000 Hz of bone conduction hearing threshold in both groups and a decline at 4000 Hz in the myringoplasty group were found. These findings suggest that suction and ossicular manipulation trauma can lead to an increase in serum prestin levels and postoperative temporary or permanent SNHL at 2000 and 4000 Hz. LEVEL OF EVIDENCE Level-4.
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Affiliation(s)
- Ayca Baskadem Yilmazer
- Saglik Bilimleri University, Prof. Dr. Cemil Tascioglu Hospital, Department of Otorhinolaryngology, Head and Neck Surgery, Istanbul, Turkey.
| | - Onur Tanrısever
- Saglik Bilimleri University, Prof. Dr. Cemil Tascioglu Hospital, Department of Otorhinolaryngology, Head and Neck Surgery, Istanbul, Turkey
| | - Maide Hacer Alagoz
- Saglik Bilimleri University, Prof. Dr. Cemil Tascioglu Hospital, Department of Biochemistry, Istanbul, Turkey
| | - Rasim Yilmazer
- Saglik Bilimleri University, Dr. Lutfi Kirdar City Hospital, Department of Otorhinolaryngology, Head and Neck Surgery, Istanbul, Turkey
| | - Ayse Enise Goker
- Saglik Bilimleri University, Prof. Dr. Cemil Tascioglu Hospital, Department of Otorhinolaryngology, Head and Neck Surgery, Istanbul, Turkey
| | - Belgin Tutar
- Saglik Bilimleri University, Prof. Dr. Cemil Tascioglu Hospital, Department of Otorhinolaryngology, Head and Neck Surgery, Istanbul, Turkey
| | - Yavuz Uyar
- Saglik Bilimleri University, Prof. Dr. Cemil Tascioglu Hospital, Department of Otorhinolaryngology, Head and Neck Surgery, Istanbul, Turkey
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Kemps G, Geven L, Kunst H, Mylanus E, Mulder J, Lanting C, Pennings R. Surgical Treatment for Troublesome Mastoid Cavities: Canal Wall Reconstruction With Bony Obliteration Versus Subtotal Petrosectomy. Otol Neurotol 2024; 45:273-280. [PMID: 38270225 DOI: 10.1097/mao.0000000000004109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
INTRODUCTION A chronically discharging modified radical mastoid cavity may require surgical intervention. We aim to explore two techniques. OBJECTIVE To compare outcomes of subtotal petrosectomy (STP) and canal wall reconstruction with bony obliteration technique (CWR-BOT). STUDY DESIGN Retrospective cohort study. SETTING A tertiary referral center. PATIENTS All patients with a chronically discharging mastoid cavity surgically treated at the Radboud University Medical Center by STP or CWR-BOT in 2015 to 2020, excluding patients with preoperative cholesteatoma. MAIN OUTCOME MEASURES Dry ear rate, audiometry, and rehabilitation. SECONDARY OUTCOME MEASURES Healing time, number of postoperative visits, complications, cholesteatoma, and need for revision surgeries. RESULTS Thirty-four (58%) patients underwent STP, and 25 (42%) CWR-BOT. A dry ear was established in 100% of patients (STP) and 87% (CWR-BOT). The air-bone gap (ABG) increased by 12 dB in STP, and decreased by 11 dB in CWR-BOT. Postoperative ABG of CWR-BOT patients was better when preoperative computed tomography imaging showed aerated middle ear aeration. ABG improvement was higher when ossicular chain reconstruction took place. Mean follow-up time was 32.5 months (STP) versus 40.5 months (CWR-BOT). Healing time was 1.2 months (STP) versus 4.1 months (CWR-BOT). The number of postoperative visits was 2.5 (STP) versus 5 (CWR-BOT). Cholesteatoma was found in 15% (STP) versus 4% (CWR-BOT) of patients. Complication rate was 18% (STP) and 24% (CWR-BOT) with a need for revision in 21% (STP) and 8% (CWR-BOT), including revisions for cholesteatoma. CONCLUSION STP and CWR-BOT are excellent treatment options for obtaining a dry ear in patients with a chronically discharging mastoid cavity. This article outlines essential contributing factors in counseling patients when opting for one or the other. Magnetic resonance imaging with diffusion-weighted imaging follow-up should be conducted at 3 and 5 years postoperatively.
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Affiliation(s)
- Glen Kemps
- Department of Otorhinolaryngology, Isala Hospital, Zwolle
| | | | | | | | - Jef Mulder
- Department of Otorhinolaryngology, Radboudumc, Nijmegen
| | - Cris Lanting
- Department of Otorhinolaryngology, Radboudumc, Nijmegen
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Whyte-Orozco J, Cisneros-Gimeno AI, García-Barrios A, Lozano-Langarita ME, Whyte-Orozco A, Rubio-Aranda E. Association of the superior semicircular canal and tegmen tympani dehiscences and its relationship with the pneumatisation of the temporal bone. Eur Arch Otorhinolaryngol 2024; 281:1267-1272. [PMID: 37777625 PMCID: PMC10858096 DOI: 10.1007/s00405-023-08243-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 09/12/2023] [Indexed: 10/02/2023]
Abstract
PURPOSE To analyse the degree of pneumatisation of the temporal bone when there is an association between dehiscence of the superior semicircular canal and dehiscence of the tegmen tympani. MATERIALS AND METHODS We analysed a retrospective CT study of 124 selected cases. A single inclusion criterion was applied: the presence of a dehiscence of the tegmen tympani. On the other hand, the degree of temporal pneumatisation was assessed by axial and coronal planes, and has been divided into the following grades O, I, II and III, according to the status and relationship of the mastoid, the bony labyrinth, the petrous segment of the carotid canal and sigmoid sinus. RESULTS Of the 124 cases studied, 35 (28.2%) presented both dehiscences. In 26 of the 35 (47.3%), grade II pneumatisation, 4 (14,8%), grade I, and 5 (11,9%) grade III was observed, with a statistically significant relationship (p < 0.001). On the other hand, we did not find a significant relationship when relating both dehiscences in any age or sex group. However, when relating the degree of pneumatisation to sex, among those with grade III pneumatisation, the proportion of men (52.4%) was significantly higher than that of women (47.6%) (p = 0.017). CONCLUSION We have detected a statistically significant relationship between the coexistence of grade II pneumatisation and the presence of both dehiscences in the temporal bone.
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Affiliation(s)
- J Whyte-Orozco
- Department of Human Anatomy and Histology, School of Medicine, University of Zaragoza, C/ Domingo Miral, S/N, 50009, Zaragoza, Spain
- Medical and Genetic Research Group (GIIS099) Aragon Health Research Institute, Zaragoza, Spain
- Antecessor B51_23D (Government of Aragon), Zaragoza, Spain
| | - A I Cisneros-Gimeno
- Department of Human Anatomy and Histology, School of Medicine, University of Zaragoza, C/ Domingo Miral, S/N, 50009, Zaragoza, Spain
- Medical and Genetic Research Group (GIIS099) Aragon Health Research Institute, Zaragoza, Spain
- Antecessor B51_23D (Government of Aragon), Zaragoza, Spain
| | - A García-Barrios
- Department of Human Anatomy and Histology, School of Medicine, University of Zaragoza, C/ Domingo Miral, S/N, 50009, Zaragoza, Spain.
- Medical and Genetic Research Group (GIIS099) Aragon Health Research Institute, Zaragoza, Spain.
- Antecessor B51_23D (Government of Aragon), Zaragoza, Spain.
| | - M E Lozano-Langarita
- Department of Human Anatomy and Histology, School of Medicine, University of Zaragoza, C/ Domingo Miral, S/N, 50009, Zaragoza, Spain
| | - A Whyte-Orozco
- Department of Animal Pathology, School of Veterinary, University of Zaragoza, Zaragoza, Spain
| | - E Rubio-Aranda
- Department of Microbiology, Pediatrics, Radiology and Public Health, School of Medicine, University of Zaragoza, Zaragoza, Spain
- Water and Environmental Health /B43_23R, Zaragoza, Spain
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Leffers D, Penxova Z, Kempin T, Därr M, Fleckner J, Hollfelder D, Ryan AF, Bruchhage KL, Kurabi A, Leichtle A. Immunomodulatory Response of the Middle Ear Epithelial Cells in Otitis Media. Otol Neurotol 2024; 45:e248-e255. [PMID: 38238924 PMCID: PMC10922874 DOI: 10.1097/mao.0000000000004096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
HYPOTHESIS The middle ear (ME) epithelium transforms because of changed immunomodulation during infection. INTRODUCTION The epithelial cells of the tympanic cavity represent the first line of defense in the context of otitis media. They can convert from a typical mucosal site into a respiratory epithelium and vice versa. Our goal is to depict the specific immune response of epithelial cells after infection at the molecular level. METHODS The investigations were carried out on healthy and inflamed ME tissue, removed during surgical interventions in mouse and human models, and in a human in-vitro cell model in human ME epithelial cell line. We determined the epithelial localization of the protein expression of Toll- and NOD-like immune receptors and their associated signaling molecules using immunohistochemistry. In addition, we examined growth behavior and gene expression due to direct stimulation and inhibition. RESULTS We found clinically and immunobiologically confirmed transformation of the inflamed ME epithelium depending on their origin, as well as differences in the distribution of Toll-like receptors and nucleotide-binding oligomerization domain-like receptors in the epithelial cell lining. Dysregulated gene and protein expression of the inflammatory and apoptotic genes could be modulated by stimulation and inhibition in the epithelial cells. CONCLUSIONS The local ME mucosal tissue is believed to modulate downstream immune activity after pathogen invasion via intrinsic cellular mechanism. Using translation approaches to target these molecular pathways may offer more reliable clinical resolution of otitis media in the future.
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Affiliation(s)
- David Leffers
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Schleswig-Holstein, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Zuzana Penxova
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Schleswig-Holstein, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Thorge Kempin
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Schleswig-Holstein, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Markus Därr
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Schleswig-Holstein, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Jonas Fleckner
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Schleswig-Holstein, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Daniela Hollfelder
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Schleswig-Holstein, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Allen F Ryan
- University of California, San Diego, Department of Surgery/ Otolaryngology, San Diego, USA
| | - Karl-Ludwig Bruchhage
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Schleswig-Holstein, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Arwa Kurabi
- University of California, San Diego, Department of Surgery/ Otolaryngology, San Diego, USA
| | - Anke Leichtle
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Schleswig-Holstein, Ratzeburger Allee 160, 23538 Lübeck, Germany
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11
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Saadoun A, Guigou C, Lavedrine A, Bozorg Grayeli A. Minimally invasive ossiculoplasty via an endoscopic transtympanic approach. Eur Ann Otorhinolaryngol Head Neck Dis 2024; 141:93-97. [PMID: 37620172 DOI: 10.1016/j.anorl.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
INTRODUCTION The aim of this study was to evaluate the feasibility of ossiculoplasty via a minimally invasive endoscopic transtympanic approach (ETTA). CASE SERIES We investigated the exposure of target structures (incus and stapes) on 4 human temporal bones by placing an endoscope into the middle ear cleft through the 4 tympanic quadrants. Then, on 3 additional specimens, we performed an incudostapedial disjunction and repaired it with a drop of hydroxyapatite cement via ETTA. We measured the size of tympanic perforation, and the acoustic transfer function of the middle ear (125-8000Hz) before and after repair by placing an insert in the external auditory canal and recording the acoustic signal in the utricle by a microphone. The acoustic signal gain was estimated in dB μV. Exposure was similar in all four quadrants but ergonomics was better with a posteroinferior myringotomy. Ossicular chain repair was conducted successfully in all cases and the acoustic transfer function of the middle ear was significantly improved. Residual tympanic perforation (n=3) was 2±0.3mm in diameter. CONCLUSION ETTA to reconstruct incudostapedial joint with bone cement was feasible and effective. It opens perspectives for robot-based procedures guided by augmented reality.
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Affiliation(s)
- A Saadoun
- Department of Oto-Rhino-Laryngology - Head and Neck Surgery, Dijon University Hospital, 2, boulevard du Maréchal-de-Lattre de Tassigny, 21000 Dijon, France
| | - C Guigou
- Department of Oto-Rhino-Laryngology - Head and Neck Surgery, Dijon University Hospital, 2, boulevard du Maréchal-de-Lattre de Tassigny, 21000 Dijon, France; ICMUB Laboratory, UMR CNRS 6302, University of Burgundy, 21000 Dijon, France.
| | - A Lavedrine
- Department of Oto-Rhino-Laryngology - Head and Neck Surgery, Dijon University Hospital, 2, boulevard du Maréchal-de-Lattre de Tassigny, 21000 Dijon, France
| | - A Bozorg Grayeli
- Department of Oto-Rhino-Laryngology - Head and Neck Surgery, Dijon University Hospital, 2, boulevard du Maréchal-de-Lattre de Tassigny, 21000 Dijon, France; ICMUB Laboratory, UMR CNRS 6302, University of Burgundy, 21000 Dijon, France
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12
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Zhang X, Yang L, Chen P, Liu Y, Yang J, Li Y, Zhao S. Congenital enlargement of the bony Eustachian tube: A retrospective study of the clinical and radiological features in nine patients. Clin Otolaryngol 2024; 49:247-253. [PMID: 37945001 DOI: 10.1111/coa.14124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 10/09/2023] [Accepted: 10/22/2023] [Indexed: 11/12/2023]
Affiliation(s)
- Xiangbao Zhang
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Key Laboratory of Otolaryngology Head and Neck Surgery, Capital Medical University, Beijing, China
- Department of Otolaryngology Head and Neck Surgery, No. 2 Hospital, Ningbo, China
| | - Lin Yang
- Department of Otolaryngology Head and Neck Surgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Peiwei Chen
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Key Laboratory of Otolaryngology Head and Neck Surgery, Capital Medical University, Beijing, China
| | - Yujie Liu
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Key Laboratory of Otolaryngology Head and Neck Surgery, Capital Medical University, Beijing, China
| | - Jinsong Yang
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Key Laboratory of Otolaryngology Head and Neck Surgery, Capital Medical University, Beijing, China
| | - Ying Li
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Key Laboratory of Otolaryngology Head and Neck Surgery, Capital Medical University, Beijing, China
| | - Shouqin Zhao
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Key Laboratory of Otolaryngology Head and Neck Surgery, Capital Medical University, Beijing, China
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13
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Kavruk H, Öztürk B. Investigation of Age and Gender Effects on the Middle Ear With Wideband Tympanometry in Adults. Ear Hear 2024; 45:476-485. [PMID: 38017621 DOI: 10.1097/aud.0000000000001444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
OBJECTIVES Several studies have reported the effects of age and gender on the middle ear of adults using wideband acoustic immittance (WAI) that measures middle ear function over a range of frequencies rather than the traditional measures with a single probe tone. Although these results are often based on WAI measurements under ambient pressure, using WAI under varying ear-canal pressures (wideband tympanometry [WBT]) may be able to provide more information about age and gender effects on the middle ear. The aim of this study is to examine the effects of age and gender on the middle ear with WBT in three different age groups consisting of young, middle-aged, and older adults. DESIGN A total of 95 adults with normal middle ear function were assessed, including 32 young adults (16 men, 16 women, aged 20 to 39 years), 31 middle-aged adults (15 men, 16 women, aged 41 to 60 years), and 32 older adults (16 men, 16 women, aged 65 to 82 years). WBT measurements were performed from 226 to 8000 Hz using Interacoustics Titan. Energy absorbance data at tympanometric peak pressure (EA TPP ) and ambient pressure (EA AP ) at 1/3 octave frequencies, and resonance frequency (RF) data were analyzed according to age and gender variables. RESULTS Analysis results showed that the mean EA TPP was significantly higher from 500 to 794 Hz and at 5040 and 6350 Hz, and significantly lower from 1587 to 3175 Hz in older adults compared with young adults. The mean EA AP was significantly lower from 1587 to 3175 Hz, and significantly higher at 5040 and 6350 Hz in older adults compared with young adults. There was no significant difference in the mean EA TPP and mean EA AP at any frequency between young and middle-aged adults, and middle-aged and older adults. RF was significantly lower in older adults compared with young adults. In all age groups, men had higher mean EA TPP and mean EA AP at lower frequencies and lower mean EA TPP and mean EA AP at higher frequencies than women. Men had slightly lower RF than women in young and older adults, while men had significantly lower RF than women in middle-aged adults. CONCLUSIONS This study demonstrated that there are possible age and gender effects on the middle ear that may affect the mechanical transmission of sound. It may be useful to consider this finding in clinical evaluation in adults of different ages and genders, and to establish age- and gender-specific WBT norms in the adult population.
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Affiliation(s)
- Hatice Kavruk
- Department of Speech and Language Therapy, Faculty of Health Sciences, Necmettin Erbakan University, Konya, Turkey
| | - Burak Öztürk
- Department of Audiology, Faculty of Health Sciences, İzmir Bakirçay University, İzmir, Turkey
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Shafiee S, Hong W, Lucas J, Khampang P, Runge CL, Wells C, Yan K, Kerschner JE, Joshi A. In vivo biodistribution and ototoxicity assessment of cationic liposomal-ceftriaxone via noninvasive trans-tympanic delivery in chinchilla models: Implications for otitis media therapy. Int J Pediatr Otorhinolaryngol 2024; 178:111894. [PMID: 38350381 PMCID: PMC10939715 DOI: 10.1016/j.ijporl.2024.111894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/01/2024] [Accepted: 02/07/2024] [Indexed: 02/15/2024]
Abstract
OBJECTIVES We report the in vivo biodistribution and ototoxicity of cationic liposomal-ceftriaxone (CFX) delivered via ear drop formulation in adult chinchilla. METHODS CFX was encapsulated in liposomes with size of ∼100 nm and surface charge of +20 mV. 100 μl liposomes or free drug was applied twice daily in both external ear canals of adult chinchillas for either 3 or 10 days. Study groups included free ceftriaxone (CFX, Day 3: n = 4, Day 10: n = 8), liposomal ceftriaxone (CFX-Lipo, Day 3: n = 4, Day 10: n = 8), and a systemic control group (Day 3: n = 4, Day 10: n = 4). Ceftriaxone delivery to the middle ear and systemic circulation was quantified by HPLC assays. Liposome transport was visualized via confocal microscopy. Auditory brainstem response (ABR) tests and cochlear histology were used to assess ototoxicity. RESULTS Liposomal ceftriaxone (CFX-Lipo) displayed a ∼658-fold increase in drug delivery efficiency in the middle ear relative to the free CFX (8.548 ± 0.4638% vs. 0.013 ± 0.0009%, %Injected dose, Mean ± SEM). CFX measured in blood serum (48.2 ± 7.78 ng/ml) following CFX-Lipo treatment in ear was 41-fold lower compared to systemic free-CFX treatment (1990.7 ± 617.34 ng/ml). ABR tests and histological analysis indicated no ototoxicity due to the treatment. CONCLUSION Cationic liposomal encapsulation results in potent drug delivery across the tympanic membrane to the middle ear with minimal systemic exposure and no ototoxicity.
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Affiliation(s)
- Shayan Shafiee
- Joint Department of Biomedical Engineering, Medical College of Wisconsin and Marquette University, Milwaukee, WI, USA
| | - Wenzhou Hong
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Pawjai Khampang
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Christina L Runge
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Clive Wells
- Department of Microbiology and Immunology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Ke Yan
- Department of Pediatrics Quantitative Health Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Joseph E Kerschner
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Amit Joshi
- Joint Department of Biomedical Engineering, Medical College of Wisconsin and Marquette University, Milwaukee, WI, USA.
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15
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Yu Q, Liu S, Guo R, Chen K, Li Y, Jiang D, Gong S, Yin L, Liu K. Complete Restoration of Hearing Loss and Cochlear Synaptopathy via Minimally Invasive, Single-Dose, and Controllable Middle Ear Delivery of Brain-Derived Neurotrophic Factor-Poly(dl-lactic acid- co-glycolic acid)-Loaded Hydrogel. ACS Nano 2024; 18:6298-6313. [PMID: 38345574 DOI: 10.1021/acsnano.3c11049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
Noise-induced hearing loss (NIHL) often accompanies cochlear synaptopathy, which can be potentially reversed to restore hearing. However, there has been little success in achieving complete recovery of sensorineural deafness using nearly noninvasive middle ear drug delivery before. Here, we present a study demonstrating the efficacy of a middle ear delivery system employing brain-derived neurotrophic factor (BDNF)-poly-(dl-lactic acid-co-glycolic acid) (PLGA)-loaded hydrogel in reversing synaptopathy and restoring hearing function in a mouse model with NIHL. The mouse model achieved using the single noise exposure (NE, 115 dBL, 4 h) exhibited an average 20 dBL elevation of hearing thresholds with intact cochlear hair cells but a loss of ribbon synapses as the primary cause of hearing impairment. We developed a BDNF-PLGA-loaded thermosensitive hydrogel, which was administered via a single controllable injection into the tympanic cavity of noise-exposed mice, allowing its presence in the middle ear for a duration of 2 weeks. This intervention resulted in complete restoration of NIHL at frequencies of click, 4, 8, 16, and 32 kHz. Moreover, the cochlear ribbon synapses exhibited significant recovery, whereas other cochlear components (hair cells and auditory nerves) remained unchanged. Additionally, the cochlea of NE treated mice revealed activation of tropomyosin receptor kinase B (TRKB) signaling upon exposure to BDNF. These findings demonstrate a controllable and minimally invasive therapeutic approach that utilizes a BDNF-PLGA-loaded hydrogel to restore NIHL by specifically repairing cochlear synaptopathy. This tailored middle ear delivery system holds great promise for achieving ideal clinical outcomes in the treatment of NIHL and cochlear synaptopathy.
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Affiliation(s)
- Qianru Yu
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Shengnan Liu
- School of Materials Science and Engineering,Tsinghua University, Beijing 100084, China
| | - Rui Guo
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Kuntao Chen
- School of Materials Science and Engineering,Tsinghua University, Beijing 100084, China
| | - Yang Li
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Dan Jiang
- Hearing Implant Centre, Guy's and St. Thomas NHS Foundation Trust, London SE1 7EH, United Kingdom
- Centre for Craniofacial and Regenerative Biology, King's College London, London SE1 9RT, United Kingdom
| | - Shusheng Gong
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
- Clinical Center for Hearing Loss, Capital Medical University, Beijing 100050, China
| | - Lan Yin
- School of Materials Science and Engineering,Tsinghua University, Beijing 100084, China
| | - Ke Liu
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
- Clinical Center for Hearing Loss, Capital Medical University, Beijing 100050, China
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16
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Zhao ZX, Zhang YQ, Chen X, Wang X, Wang JL, Wu BJ, Ren XY, Li Y. [Spontaneous otogenic pneumocephalus: a case report]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2024; 59:169-171. [PMID: 38369796 DOI: 10.3760/cma.j.cn115330-20230816-00048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Affiliation(s)
- Z X Zhao
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital Of Xi'an Jiaotong University, Xi'an 710004, China
| | - Y Q Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital Of Xi'an Jiaotong University, Xi'an 710004, China
| | - X Chen
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital Of Xi'an Jiaotong University, Xi'an 710004, China
| | - X Wang
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital Of Xi'an Jiaotong University, Xi'an 710004, China
| | - J L Wang
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital Of Xi'an Jiaotong University, Xi'an 710004, China
| | - B J Wu
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital Of Xi'an Jiaotong University, Xi'an 710004, China
| | - X Y Ren
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital Of Xi'an Jiaotong University, Xi'an 710004, China
| | - Y Li
- Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital Of Xi'an Jiaotong University, Xi'an 710004, China
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17
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Wang LS, Zhang LL, Liu SF, Hu N, Li JY, Hao SZ, Gong RZ. [The imaging presentations of the fallopian canal cerebrospinal fluid leaking]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2024; 59:147-151. [PMID: 38369793 DOI: 10.3760/cma.j.cn115330-20231124-00240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
Objective: To summarize the imaging presentations of the fallopian canal cerebrospinal fluid leaking (FCCFL). Methods: The high resolution CT (HRCT)and MRI materials of 4 patients (4 ears) with FCCFL confirmed by surgery between August 2016 to November 2023 were retrospectively analyzed. Among these, there were 2 males and 2 females, their ages ranged from 6 to 69 years. Results: All of the FCCFL were unilateral, including 2 on the left and 2 on the right.Clinically, the patients with FCCFL suffered from clear nasal fluid flow, ear tightness, and hearing loss. On CT, all of the affected ears were depicted markedly dilatation of the proximal portion of fallopian canal(FC), the labyrinthine segment and geniculate fossa were involved in 4 cases, and involvement of tympanic segment in 1 case at the same time. The geniculate fossa in the affected side were significantly enlarged, protruding upwards into the tympanic cavity, with one case simultaneously involving the cochlea. On MRI, the hyposignal on T1WI and hypersignal on T2WI or water sequence like cerebrospinal fluid (CSF) were shown in the enlargement FC, without diffusion restriction, and non-enhancing with administration Gadolinium contrast.CSF-like signal effusion was shown in all of the affected tympanum, of which, the CSF-like signal effusion was demonstrated in the area along the superficial petrosal nerve, the right pterygopalatine fossa and the parapharyngeal space. The adjacent intracranial meninges were presented thickening in 3 cases. Conclusion: The imaging appearances of FCCFL present some characteristics:on HRCT, the proximal portions of the affected FC depicts markedly enlargement,especially the geniculate fossa.While they present CSF-like signal, no diffusion restriction, and no enhancement administration, Gadolinium contrast on MRI, accompanying the CSF-like signal effusion in the affected tympanum.
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Affiliation(s)
- L S Wang
- Department of Medical Imaging Center, Shandong Provincial ENT Hospital, Ji'nan 250023, China
| | - L L Zhang
- Department of Medical Imaging Center, Central Hospital Affiliated to Shandong First Medical University, Shandong University, Ji'nan 250013, China
| | - S F Liu
- Department of Medical Imaging Center, Shandong Provincial ENT Hospital, Ji'nan 250023, China
| | - N Hu
- Department of Medical Imaging Center, Shandong Provincial ENT Hospital, Ji'nan 250023, China
| | - J Y Li
- Department of Medical Imaging Center, Shandong Provincial ENT Hospital, Ji'nan 250023, China
| | - S Z Hao
- Department of Radiology, the People's Hospital of Zoucheng, Zoucheng 273599, China
| | - R Z Gong
- Department of Medical Imaging Center, Shandong Provincial ENT Hospital, Ji'nan 250023, China
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Mahajan N, Vijayendra VK, Redleaf M, Honnurappa V. Endoscopic classification system of pars tensa retractions. J Laryngol Otol 2024; 138:136-141. [PMID: 37340960 DOI: 10.1017/s0022215123001123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
BACKGROUND Previous classification systems of pars tensa retractions have not consistently incorporated ossicular erosion or the presence of cholesteatoma. OBJECTIVE This study aimed to illustrate our classification of pars tensa retractions, which is more precise than previous systems, with aided use of the endoscope. METHODS A retrospective study was carried out on 200 ears of 170 patients whose pars tensa retractions had been documented at a tertiary otological referral centre. RESULTS A classification system was developed. Pars tensa retractions were divided into the following subcategories: grade 0, grade 1, grade 2a, grade 2b, grade 3a, grade 3b, grade 3c, grade 4a, grade 4b, grade 4c, grade 5a, grade 5b and grade 5c. CONCLUSION This classification system was able to accommodate all pars tensa retractions. The distribution of grades of pars tensa retractions was based on ossicular status and the presence or absence of cholesteatoma. It is therefore a more applicable, and functionally based system than previous alternatives.
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Affiliation(s)
- Nilesh Mahajan
- Vijaya ENT Care Centre, Superspeciality Otology Centre, Bangalore, India
| | | | - Miriam Redleaf
- Otology/Neurotology, University of Illinois Hospitals - Chicago, Chicago, IL, USA
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Thornton RB, Jeffares S, Seppanen E, Jacoby P, Kirkham LS, Bennett H, Coates HL, Vijayasekaran S, Brennan-Jones CG, Richmond PC. Safety, tolerability, and effect of a single aural dose of Dornase alfa at the time of ventilation tube surgery for otitis media: A Phase 1b double randomized control trial. Int J Pediatr Otorhinolaryngol 2024; 177:111832. [PMID: 38215661 DOI: 10.1016/j.ijporl.2023.111832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/05/2023] [Accepted: 12/15/2023] [Indexed: 01/14/2024]
Abstract
BACKGROUND One third of children require repeat ventilation tube insertion (VTI) for otitis media. Disease recurrence is associated with persistent middle ear bacterial biofilms. With demonstration that Dornase alfa (a DNase) disrupts middle ear effusion biofilms ex vivo, we identified potential for this as an anti-biofilm therapy to prevent repeat VTI. First, safety and tolerability needed to be measured. METHODS This was a phase 1B double-blinded randomized control trial conducted in Western Australia. Children between 6 months and 5 years undergoing VTI for bilateral middle ear effusion were recruited between 2012 and 2014 and followed for two years. Children's ears were randomized to receive either Dornase alfa (1 mg/mL) or 0.9 % sodium chloride (placebo) at time of surgery. Children were followed up at 2 weeks post-VTI and at 3-monthly intervals for 2 years. Outcomes assessed were: 1) safety and tolerability, 2) otorrhoea frequency, 3) blocked or extruded ventilation tube (VT) frequency, 4) time to blockage or extrusion, 5) time to infection recurrence and/or need for repeat VTI. RESULTS Sixty children (mean age 2.3 years) were enrolled with 87 % reaching study endpoint. Treatment did not change otorrhoea frequency. Hearing improved in all children following VTI, with no indication of ototoxicity. Dornase alfa had some effect on increasing time until VT extrusion (p = 0.099); and blockage and/or extrusion (p = 0.122). Frequency of recurrence and time until recurrence were similar. Fourteen children required repeat VTI within the follow-up period. CONCLUSION A single application of Dornase alfa into the middle ear at time of VTI was safe, non-ototoxic, and well-tolerated. TRIAL REGISTRATION ACTRN12623000504617.
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Affiliation(s)
- R B Thornton
- Centre for Child Health Research, University of Western Australia, Perth, Western Australia, Australia; Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia.
| | - S Jeffares
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia
| | - E Seppanen
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia
| | - P Jacoby
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia
| | - L S Kirkham
- Centre for Child Health Research, University of Western Australia, Perth, Western Australia, Australia; Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia
| | - H Bennett
- Kids Hear Diagnostic Audiology, Perth, Western Australia, Australia
| | - H L Coates
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia
| | - S Vijayasekaran
- Child Health Research Network, Perth Children's Hospital, Perth, Western Australia, Australia; School of Medicine, University of Western Australia, Perth, Western Australia, Australia
| | - C G Brennan-Jones
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia; Child Health Research Network, Perth Children's Hospital, Perth, Western Australia, Australia; School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - P C Richmond
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia; Child Health Research Network, Perth Children's Hospital, Perth, Western Australia, Australia; School of Medicine, University of Western Australia, Perth, Western Australia, Australia
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Wojciechowski T, Skadorwa T, Fermi M, Szopiński K. Radiologic evaluation and clinical assessment of facial sinus in adults and children - computed tomography study. Auris Nasus Larynx 2024; 51:189-197. [PMID: 37330319 DOI: 10.1016/j.anl.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/15/2023] [Accepted: 06/05/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVE The facial sinus is a recess of the lateral retrotympanum located between the chorda tympani (ChT) and facial nerve (FN). Chronic otitis media with cholesteatoma often spreads from the pars flaccida to the facial sinus (FS). In stapedotomy, if an unfavorable ChT type is encountered, there is a need for removal of bone between the ChT and FN. The aim of the study was to assess FSs in adults and children according to Alicandri-Ciufelli classification, to measure FS width and depth in computed tomography scans, evaluate the correlation between measurements and different types of facial sinuses, and provide a clinical context of these findings. METHODS Cone Beam Computed Tomography (CBCT) of 130 adults and High Resolution Computed Tomography of 140 children were reviewed. The type of facial sinus was assessed according to Alicardi-Ciufelli's classification in different age groups. Width of entrance to facial sinus (FSW) and depth of FS (FSD) were evaluated among age groups. RESULTS Type A of FS is dominant in both adult and children populations included in the study. The average depth of FS was 2.31±1.43 mm and 2.01±0.90 in children and adults respectively. The width of FS was 3.99±0.69 and 3.39±0.98 in children and adults respectively. The depth of FS (FSD) presented significant deviations (ANOVA, p<0.05) among all three types and age groups. In 116/540 (21.5%) cases the value of FSD was below 1 mm. CONCLUSION The qualitative classification of facial sinuses into types A, B and C, introduced by Alicandri-Ciufelli and al. is justified by statistically significant differences of depth between individual types of tympanic sinuses. Type A sinuses may be extremely shallow (<1 mm - As) or normal (>1 mm - An). Preoperative assessment of CT scans of the temporal bones gives crucial information about type and size of facial sinus. It may increase the safety of surgeries in this area and play a role in choosing an optimal approach and surgical tools.
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Affiliation(s)
- Tomasz Wojciechowski
- Department of Descriptive and Clinical Anatomy, The Medical University of Warsaw, 5 Chałubińskiego St., 02004 Warsaw, Poland; Department of Otorhinolaryngology, Head and Neck Surgery, The Medical University of Warsaw, 1a Banacha St., 02097 Warsaw, Poland.
| | - Tymon Skadorwa
- Department of Descriptive and Clinical Anatomy, The Medical University of Warsaw, 5 Chałubińskiego St., 02004 Warsaw, Poland; Department of Pediatric Neurosurgery, Bogdanowicz Memorial Hospital for Children, 4/24 Niekłańska St., 03924 Warsaw, Poland
| | - Matteo Fermi
- Department of Otorhinolaryngology-Head and Neck Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Specialist, Diagnostic and Experimental Medicine (DIMES), Alma Mater Studiorum, Università di Bologna, Bologna, Italy
| | - Kazimierz Szopiński
- Department of Dental and Maxillofacial Radiology, The Medical University of Warsaw, 6 Binieckiego St., 02097 Warsaw, Poland
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Zhang JZ, Graf L, Banerjee A, Yeiser A, McHugh CI, Kymissis I, Lang JH, Olson ES, Nakajima HH. An Implantable Piezofilm Middle Ear Microphone: Performance in Human Cadaveric Temporal Bones. J Assoc Res Otolaryngol 2024; 25:53-61. [PMID: 38238525 PMCID: PMC10907555 DOI: 10.1007/s10162-024-00927-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 12/31/2023] [Indexed: 01/30/2024] Open
Abstract
PURPOSE One of the major reasons that totally implantable cochlear microphones are not readily available is the lack of good implantable microphones. An implantable microphone has the potential to provide a range of benefits over external microphones for cochlear implant users including the filtering ability of the outer ear, cosmetics, and usability in all situations. This paper presents results from experiments in human cadaveric ears of a piezofilm microphone concept under development as a possible component of a future implantable microphone system for use with cochlear implants. This microphone is referred to here as a drum microphone (DrumMic) that senses the robust and predictable motion of the umbo, the tip of the malleus. METHODS The performance was measured by five DrumMics inserted in four different human cadaveric temporal bones. Sensitivity, linearity, bandwidth, and equivalent input noise were measured during these experiments using a sound stimulus and measurement setup. RESULTS The sensitivity of the DrumMics was found to be tightly clustered across different microphones and ears despite differences in umbo and middle ear anatomy. The DrumMics were shown to behave linearly across a large dynamic range (46 dB SPL to 100 dB SPL) across a wide bandwidth (100 Hz to 8 kHz). The equivalent input noise (over a bandwidth of 0.1-10 kHz) of the DrumMic and amplifier referenced to the ear canal was measured to be about 54 dB SPL in the temporal bone experiment and estimated to be 46 dB SPL after accounting for the pressure gain of the outer ear. CONCLUSION The results demonstrate that the DrumMic behaves robustly across ears and fabrication. The equivalent input noise performance (related to the lowest level of sound measurable) was shown to approach that of commercial hearing aid microphones. To advance this demonstration of the DrumMic concept to a future prototype implantable in humans, work on encapsulation, biocompatibility, and connectorization will be required.
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Affiliation(s)
- John Z Zhang
- Massachusetts Institute of Technology, Cambridge, USA
| | - Lukas Graf
- Harvard Medical School, Massachusetts Eye and Ear, Boston, USA
| | | | - Aaron Yeiser
- Massachusetts Institute of Technology, Cambridge, USA
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Kita T, Yabe Y, Maruyama Y, Tachida Y, Furuta Y, Yamamura N, Furuta I, Yamahara K, Ishikawa M, Omori K, Yamaguchi T, Nakagawa T. Pharmacokinetics of monoclonal antibodies locally-applied into the middle ear of guinea pigs. Hear Res 2024; 442:108950. [PMID: 38218017 DOI: 10.1016/j.heares.2024.108950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/20/2023] [Accepted: 01/07/2024] [Indexed: 01/15/2024]
Abstract
Countless therapeutic antibodies are currently available for the treatment of a broad range of diseases. Some target molecules of therapeutic antibodies are involved in the pathogenesis of sensorineural hearing loss (SNHL), suggesting that SNHL may be a novel target for monoclonal antibody (mAb) therapy. When considering mAb therapy for SNHL, understanding of the pharmacokinetics of mAbs after local application into the middle ear is crucial. To reveal the fundamental characteristics of mAb pharmacokinetics following local application into the middle ear of guinea pigs, we performed pharmacokinetic analyses of mouse monoclonal antibodies to FLAG-tag (FLAG-mAbs), which have no specific binding sites in the middle and inner ear. FLAG-mAbs were rapidly transferred from the middle ear to the cochlear fluid, indicating high permeability of the round window membrane to mAbs. FLAG-mAbs were eliminated from the cochlear fluid 3 h after application, similar to small molecules. Whole-body autoradiography and quantitative assessments of cerebrospinal fluid and serum demonstrated that the biodistribution of FLAG-mAbs was limited to the middle and inner ear. Altogether, the pharmacokinetics of mAbs are similar to those of small molecules when locally applied into the middle ear, suggesting the necessity of drug delivery systems for appropriate mAb delivery to the cochlear fluid after local application into the middle ear.
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Affiliation(s)
- Tomoko Kita
- Department of Otolaryngology Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
| | - Yoshiyuki Yabe
- R&D Division, Daiichi Sankyo Co., Ltd., 1-2-58 Hiromachi, Shinagawa-ku, Tokyo 140-8710, Japan
| | - Yuki Maruyama
- R&D Division, Daiichi Sankyo Co., Ltd., 1-2-58 Hiromachi, Shinagawa-ku, Tokyo 140-8710, Japan
| | - Yuki Tachida
- R&D Division, Daiichi Sankyo Co., Ltd., 1-2-58 Hiromachi, Shinagawa-ku, Tokyo 140-8710, Japan
| | - Yoshitake Furuta
- R&D Division, Daiichi Sankyo Co., Ltd., 1-2-58 Hiromachi, Shinagawa-ku, Tokyo 140-8710, Japan
| | - Naotoshi Yamamura
- R&D Division, Daiichi Sankyo Co., Ltd., 1-2-58 Hiromachi, Shinagawa-ku, Tokyo 140-8710, Japan
| | - Ichiro Furuta
- Department of Otolaryngology Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
| | - Kohei Yamahara
- Department of Otolaryngology Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
| | - Masaaki Ishikawa
- Department of Otolaryngology Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
| | - Koichi Omori
- Department of Otolaryngology Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
| | - Taro Yamaguchi
- Faculty of Pharmaceutical Sciences, Setsunan University, Hirakata 573-0101, Japan
| | - Takayuki Nakagawa
- Department of Otolaryngology Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan.
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Alaqel SL, Alzahrani MS, Alharbi A, Almalki AH, Algarni MA, Abdelazim MH, Abdelazim AH. Exploring the role of copper and zinc in chronic otitis media: A novel spectrofluorometric method for precise determination and association study. Spectrochim Acta A Mol Biomol Spectrosc 2024; 305:123534. [PMID: 37883893 DOI: 10.1016/j.saa.2023.123534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 10/10/2023] [Accepted: 10/12/2023] [Indexed: 10/28/2023]
Abstract
Chronic otitis media is a common condition characterized by fluid accumulation in the middle ear, leading to a perforated eardrum and persistent middle ear drainage. Despite its impact on global health, the role of heavy metals, particularly copper and zinc, in its development and progression remains understudied. Herein, a spectrofluorometric method was developed for the precise determination of copper and zinc in human plasma samples and investigate their association with chronic otitis media. The method involves the use of the fluorescent probe 6,7-dihydroxy-4-phenylcoumarin to selectively quantify copper through fluorescence quenching and zinc through fluorescence enhancement with a remarked bathochromic shift. The method was validated and exhibited good linearity over a concentration range of 100-3000 ng/mL for copper and 200-5000 ng/mL for zinc. Application of the method to healthy volunteers and patients with chronic otitis media revealed significantly decreased copper and zinc levels in patients with chronic otitis media compared to the healthy individuals. These findings shed light on the involvement of copper and zinc in the pathogenesis of chronic otitis media and open avenues for additional treatment approaches.
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Affiliation(s)
- Saleh L Alaqel
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Northern Border University, Rafha 91911, Saudi Arabia
| | - Mohammad S Alzahrani
- Department of Clinical Pharmacy, College of Pharmacy, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - Adnan Alharbi
- Clinical Pharmacy Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Atiah H Almalki
- Department of Pharmaceutical Chemistry, College of Pharmacy, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia; Addiction and Neuroscience Research Unit, Health Science Campus, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - Majed A Algarni
- Department of Clinical Pharmacy, College of Pharmacy, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - Mohamed H Abdelazim
- Department of Otolaryngology, Faculty of Medicine, Al-Azhar University, 34518 Damietta, Egypt
| | - Ahmed H Abdelazim
- Pharmaceutical Analytical Chemistry Department, Faculty of Pharmacy, Al-Azhar University, 11751 Cairo, Egypt.
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Santarelli R, Scimemi P, Cama E, Domínguez-Ruiz M, Bonora C, Gallo C, Rodríguez-Ballesteros M, del Castillo I. Preservation of Distortion Product Otoacoustic Emissions in OTOF -Related Hearing Impairment. Ear Hear 2024; 45:250-256. [PMID: 37677959 PMCID: PMC10718209 DOI: 10.1097/aud.0000000000001421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 07/16/2023] [Indexed: 09/09/2023]
Abstract
OBJECTIVES Attenuation of otoacoustic emissions over time has been reported for many patients with hearing impairment harboring mutations in the OTOF gene. In this study, the time course of changes of distortion product otoacoustic emissions (DPOAEs) has been analyzed in a cohort of patients in the light of tympanometry results. DESIGN The changes of DPOAEs in 16 patients with OTOF -related hearing impairment were retrospectively analyzed. RESULTS All but one subject showed DPOAEs bilaterally at the time of diagnosis. Three patients diagnosed as adults still had DPOAEs at ages of 27, 31, and 47 years, respectively. Follow-up was available for 7 children diagnosed at the age of 1 to 3 years, who still showed preservation of DPOAEs at ages of 5 to 16 years. The responses were absent or attenuated in amplitude at some follow-up appointments in association with type B or C tympanograms. CONCLUSIONS DPOAEs are preserved much longer than expected in a cohort of patients with OTOF -related hearing impairment. The previously reported loss of DPOAEs may have been caused in some children by increased middle ear impedance due to otitis media.
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Affiliation(s)
- Rosamaria Santarelli
- Department of Neurosciences, University of Padua, Padua, Italy
- Audiology Service, Santi Giovanni e Paolo Hospital, Venezia, Italy
| | - Pietro Scimemi
- Department of Neurosciences, University of Padua, Padua, Italy
- Audiology Service, Santi Giovanni e Paolo Hospital, Venezia, Italy
| | - Elona Cama
- Department of Neurosciences, University of Padua, Padua, Italy
- Audiology Service, Santi Giovanni e Paolo Hospital, Venezia, Italy
| | - María Domínguez-Ruiz
- Servicio de Genética, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Madrid, Spain
| | - Chiara Bonora
- Department of Neurosciences, University of Padua, Padua, Italy
| | - Chiara Gallo
- Department of Neurosciences, University of Padua, Padua, Italy
| | | | - Ignacio del Castillo
- Servicio de Genética, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Madrid, Spain
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25
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Ivoylov AY, Polunin MM, Mileshina NA, Osipenkov SS, Radtsig AN. [Clinical case of tuberculous otitis media in early childhood]. Vestn Otorinolaringol 2024; 89:32-36. [PMID: 38506023 DOI: 10.17116/otorino20248901132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
Nowadays, the incidence of tuberculosis remains high all over the world, despite the vaccination, medical support, social policy. The main reasons for this are the high level of migration, the prevalence of bad habits, the prevalence of immunodeficiency conditions, the formation of resistance to antimicrobial drugs, the tendency to refuse vaccination. At the same time, great difficulties arise in the diagnosis of extrapulmonary forms of infection. The purpose of this publication is to remind about the peculiarities of the course and diagnosis of tuberculous otitis media. According to the literature, the main characteristic features of tuberculous of the middle ear are prolonged suppuration without pronounced pain syndrome, inefficiency of standard antibacterial therapy, the anamnestic data about contacts or violation of the vaccination schedule, multiple perforations and a pronounced granulation process during otoscopy, a pronounced destructive process in the temporal bone during X-ray examination. The article presents a clinical case of the development of tuberculous otitis media in a young child with delayed diagnostics and the development of mastoiditis with required emergency surgical treatment. Verification of the etiology of the disease and the specific treatment carried out made it possible to achieve complete relief of ear symptoms, restoration of the tympanic membrane and ventilation of the middle ear.
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Affiliation(s)
- A Yu Ivoylov
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
- Pirogov Russian National Research Medical University, Moscow, Russia
- Speransky Pediatric Municipal Clinical Hospital No. 9, Moscow, Russia
| | - M M Polunin
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - N A Mileshina
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
- Speransky Pediatric Municipal Clinical Hospital No. 9, Moscow, Russia
- Russian Medical Academy for Continuous Professional Education, Moscow, Russia
| | - S S Osipenkov
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
- Speransky Pediatric Municipal Clinical Hospital No. 9, Moscow, Russia
| | - A N Radtsig
- Pirogov Russian National Research Medical University, Moscow, Russia
- Speransky Pediatric Municipal Clinical Hospital No. 9, Moscow, Russia
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26
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Pokorny MA, Thorne PR, Whitfield BCS, Wilson WJ. Diagnostic and management plan concordance across advanced audiologists, paediatric audiologists and non-specialist ENT doctors. Int J Audiol 2024; 63:69-73. [PMID: 36384388 DOI: 10.1080/14992027.2022.2145515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 10/30/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To compare the concordance of advanced audiologists (AA), junior doctors (JD) and paediatric audiologists (PA) with an Ear, Nose and Throat (ENT) specialist on the diagnosis and management of children with middle ear or hearing concerns. DESIGN A clinical equivalence (concordance) study. STUDY SAMPLE Three AAs, five JDs, three PAs and one ENT specialist asynchronously reported diagnoses and management plans for ten, online paediatric cases consisting of video-otoscopic images and clinical findings. RESULTS For medical diagnosis, significant agreement with the ENT specialist was observed at moderate and near-perfect levels for two AAs (k = 0.561 and 0.815), moderate levels for four JDs (k = 0.5 to 0.603) and near-perfect level for one PA (k = 0.815). For management decisions, significant agreement with the ENT specialist was observed at substantial (k = 0.636) and near-perfect (k = 0.818) levels for two AAs, and at a moderate level (k = 0.538) for one PA. Within group inter-rater agreement for management plans was substantial for AAs and JDs, and moderate for PAs. CONCLUSIONS For children with middle ear disease or hearing concerns, AAs, JDs and PAs showed similar levels of agreement with an ENT specialist on diagnosis, but AAs were more likely than JDs or PAs to agree with an ENT specialist on management.
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Affiliation(s)
- Michelle A Pokorny
- Discipline of Audiology, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Peter R Thorne
- Section of Audiology, School of Population Health, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
- Eisdell Moore Centre, University of Auckland, Auckland, New Zealand
| | - Bernard C S Whitfield
- Logan Hospital Integrated Specialist ENT Service, Metro South Health Service District, Queensland Health, Queensland, Australia
- School of Medicine and Dentistry, Griffith University, Brisbane, Australia
| | - Wayne J Wilson
- Discipline of Audiology, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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Aaron KA, Eltawil Y, Fernandez-Miranda JC, Jackler RK. Spontaneous Otogenic Pneumocephalus Triggered by Air Travel. Otol Neurotol 2024; 45:e68-e70. [PMID: 38085769 DOI: 10.1097/mao.0000000000004054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Affiliation(s)
- Ksenia A Aaron
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California
| | - Yasmin Eltawil
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California
| | | | - Robert K Jackler
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California
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Kersten S, Sgard F, Vorländer M. Impact of the ear canal motion on the impedance boundary conditions in models of the occlusion effect. J Acoust Soc Am 2024; 155:56-67. [PMID: 38174970 DOI: 10.1121/10.0024244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024]
Abstract
The occlusion effect (OE) denotes the increased low-frequency perception of bone-conducted sounds when the ear canal (EC) is occluded. Circuit and finite element (FE) models are commonly used to investigate the OE and improve its prediction, often applying acoustic impedances at the EC entrance and tympanic membrane (TM). This study investigates the sound generation caused by the structural motion of the EC. In addition to the EC wall vibration, it accounts for the motions of the EC entrance and TM, resulting from nondeforming motion of the surrounding structures. A model extension including these motions with the impedances is proposed. Related mechanisms are illustrated based on a circuit model. Implications are discussed by using an EC motion extracted from a FE model of a human head. The results demonstrate that the motions of the EC entrance and TM, addressed by the proposed extension, affects the TM sound pressure and may lead to a reduction of the OE at lower frequencies compared to solely considering the EC wall vibration. Accordingly, this phenomenon potentially reconciles differences between experimental data and OE simulations at frequencies below about 250 Hz, highlighting the importance to discern between multiple contributing mechanisms to the TM sound pressure.
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Affiliation(s)
- Simon Kersten
- Institute for Hearing Technology and Acoustics, RWTH Aachen University, 52074 Aachen, Germany
| | - Franck Sgard
- Direction de la Recherche, Institut de Recherche Robert-Sauvé en Santé et Sécurité du Travail (IRSST), Montréal, Québec, H3A 3C2, Canada
| | - Michael Vorländer
- Institute for Hearing Technology and Acoustics, RWTH Aachen University, 52074 Aachen, Germany
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Zhao Z, Ren C, Fan X, Zha D, Lin Y. Study on characteristics of wideband acoustic immittance in patients with Inner Ear Malformations. Int J Pediatr Otorhinolaryngol 2024; 176:111802. [PMID: 38041987 DOI: 10.1016/j.ijporl.2023.111802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 10/07/2023] [Accepted: 11/19/2023] [Indexed: 12/04/2023]
Abstract
OBJECTIVE To compare the differences in wideband absorbance and the resonance frequency (RF) between patients with inner ear malformations and normal control, and to explore the auditory diagnostic value of wideband acoustic immittance (WAI). METHODS A total of 38 patients (59 ears) with enlarged vestibular aqueduct (EVA), 13 patients (14 ears) with incomplete partition type I (IP-I) and 13 patients (26 ears) with incomplete partition type II (IP-II) were included. 50 normal control (100 ears). All subjects underwent WAI tests to compare the absorbance configuration and resonance frequency. RESULTS All the group showed lower absorbance at ambient pressure than at peak pressure in certain frequencies under 2000Hz. Under 1000Hz, the absorbance of EVA was higher than that of other groups. The average absorbance and highest absorbance of IP-I were the lowest(P<0.05). However, IP-II and normal group had similarity on some characteristics. The three IEM groups mainly different at low and high frequencies, but not at medium frequencies. The highest absorbance of all the groups were appeared around 3000Hz. The RF of all the groups from low to high were EVA<IP-II<normal control<IP-I, and the lowest was EVA(P<0.05). CONCLUSION Inner ear malformations can affect energy absorbance and RF. WAI is sensitive and non-invasive to provide useful information about inner ear status and facilitate detection of ear pathology.
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Affiliation(s)
- Zhemaiwei Zhao
- Department of Otolaryngology-Head and Neck Surgery, Xijing Hospital, Air Force Military Medical University, Xi'an, China.
| | - Cuncun Ren
- Department of Otolaryngology-Head and Neck Surgery, Xijing Hospital, Air Force Military Medical University, Xi'an, China.
| | - Xiaoqin Fan
- Department of Otolaryngology-Head and Neck Surgery, Xijing Hospital, Air Force Military Medical University, Xi'an, China.
| | - Dingjun Zha
- Department of Otolaryngology-Head and Neck Surgery, Xijing Hospital, Air Force Military Medical University, Xi'an, China.
| | - Ying Lin
- Department of Otolaryngology-Head and Neck Surgery, Xijing Hospital, Air Force Military Medical University, Xi'an, China.
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Kurabi A, Dewan K, Kerschner JE, Leichtle A, Li JD, Santa Maria PL, Preciado D. PANEL 3: Otitis media animal models, cell culture, tissue regeneration & pathophysiology. Int J Pediatr Otorhinolaryngol 2024; 176:111814. [PMID: 38101097 DOI: 10.1016/j.ijporl.2023.111814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/13/2023] [Accepted: 11/29/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVE To review and summarize recently published key articles on the topics of animal models, cell culture studies, tissue biomedical engineering and regeneration, and new models in relation to otitis media (OM). DATA SOURCE Electronic databases: PubMed, National Library of Medicine, Ovid Medline. REVIEW METHODS Key topics were assigned to the panel participants for identification and detailed evaluation. The PubMed reviews were focused on the period from June 2019 to June 2023, in any of the objective subject(s) or keywords listed above, noting the relevant references relating to these advances with a global overview and noting areas of recommendation(s). The final manuscript was prepared with input from all panel members. CONCLUSIONS In conclusion, ex vivo and in vivo OM research models have seen great advancements in the past 4 years. From the usage of novel genetic and molecular tools to the refinement of in vivo inducible and spontaneous mouse models, to the introduction of a wide array of reliable middle ear epithelium (MEE) cell culture systems, the next five years are likely to experience exponential growth in OM pathophysiology discoveries. Moreover, advances in these systems will predictably facilitate rapid means for novel molecular therapeutic studies.
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Affiliation(s)
- Arwa Kurabi
- Department of Otolaryngology, University of California San Diego, School of Medicine, La Jolla, CA, USA.
| | - Kalyan Dewan
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Joseph E Kerschner
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Anke Leichtle
- Department of Otorhinolaryngology, University of Luebeck, Luebeck, Germany
| | - Jian-Dong Li
- Center for Inflammation, Immunity and Infection, Institute for Biomedical Sciences, Georgia State University, Atlanta, GA, USA
| | - Peter Luke Santa Maria
- Department of Otolaryngology - Head & Neck Surgery, Stanford University, Stanford, CA, USA
| | - Diego Preciado
- Children's National Hospital, Division of Pediatric Otolaryngology, Washington, DC, USA
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Kamaşak Arpaçay B, Yağmur B, Uğuz E, Çömlekçi E, Öncü R, Ulcay T, Aycan K. Anatomic and morphometric examination of auditory ossicles in sheep. Anat Histol Embryol 2024; 53:e12998. [PMID: 37985461 DOI: 10.1111/ahe.12998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 10/25/2023] [Accepted: 11/08/2023] [Indexed: 11/22/2023]
Abstract
It is important to know the morphometry of the auditory ossicles for middle ear surgical applications. The present study aims to investigate the morphometric measurements of sheep auditory ossicles and the relationship between these ossicles. In this study, 100 malleus, incus and stapes of 50 Akkaraman sheep were examined using at trinocular stereo microscope and a total of 19 morphometric measurements were taken. The mean values of the morphometric measurements were obtained, and correlation analysis was performed between each part of each auditory ossicle. Similarities were found between the measurements of the lengths of the malleus, manubrium mallei and incus, and the width of the base of the stapes with morphometric measurements in human auditory ossicles. A significant positive correlation was found between the length of the malleus with the length of the manubrium mallei, between the length of the incus with the lengths of the long crus and corpus incudis, between the length of the stapes with the lengths of the rostral crus, caudal crus, caput stapedis, and the length and width of the intercrural foramen. Due to the anatomic similarities between sheep and human auditory ossicles, it was concluded that the auditory ossicles of sheep are suitable for use in the training of human ear surgery applications.
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Affiliation(s)
- Burcu Kamaşak Arpaçay
- Department of Anatomy, Faculty of Medicine, Kırşehir Ahi Evran University, Kırşehir, Turkey
| | - Berat Yağmur
- Department of Anatomy, Faculty of Medicine, Kırşehir Ahi Evran University, Kırşehir, Turkey
| | - Emre Uğuz
- Department of Anatomy, Faculty of Medicine, Kırşehir Ahi Evran University, Kırşehir, Turkey
| | - Elif Çömlekçi
- Department of Anatomy, Faculty of Medicine, Kırşehir Ahi Evran University, Kırşehir, Turkey
| | - Ruken Öncü
- Department of Anatomy, Faculty of Medicine, Kırşehir Ahi Evran University, Kırşehir, Turkey
| | - Tufan Ulcay
- Department of Anatomy, Faculty of Medicine, Kırşehir Ahi Evran University, Kırşehir, Turkey
| | - Kenan Aycan
- Department of Anatomy, Faculty of Medicine, Kırşehir Ahi Evran University, Kırşehir, Turkey
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Young BA, Cramberg M. The anatomical basis of amphibious hearing in the American alligator (Alligator mississippiensis). Anat Rec (Hoboken) 2024; 307:198-207. [PMID: 37259899 DOI: 10.1002/ar.25272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 04/27/2023] [Accepted: 05/21/2023] [Indexed: 06/02/2023]
Abstract
The different velocities of sound (pressure waves) in air and water make auditory source localization a challenge for amphibious animals. The American alligator (Alligator mississippiensis) has an extracolumellar cartilage that abuts the deep surface of the tympanic membrane, and then expands in size beyond the caudal margin of the tympanum. This extracolumellar expansion is the insertion site for two antagonistic skeletal muscles, the tensor tympani, and the depressor tympani. These muscles function to modulate the tension in the tympanic membrane, presumably as part of the well-developed submergence reflex of Alligator. All crocodilians, including Alligator, have internally coupled ears in which paratympanic sinuses connect the contralateral middle ear cavities. The temporal performance of internally coupled ears is determined, in part, by the tension of the tympanic membrane. Switching between a "tensed" and "relaxed" tympanic membrane may allow Alligator to compensate for the increased velocity of sound underwater and, in this way, use a single auditory map for sound localization in two very different physical environments.
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Affiliation(s)
- Bruce A Young
- Department of Anatomy, Kirksville College of Osteopathic Medicine, Kirksville, Missouri, USA
| | - Michael Cramberg
- Department of Anatomy, Kirksville College of Osteopathic Medicine, Kirksville, Missouri, USA
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Mandegari M, Meybodian M, Baradaranfar M, Vaziribozorg S, Vakili M, Dehghanifirouzabadi S. The effect of local dexamethasone on stapedotomy surgery outcomes in patients with otosclerosis. Acta Otolaryngol 2024; 144:35-38. [PMID: 38279924 DOI: 10.1080/00016489.2024.2304062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 01/01/2024] [Indexed: 01/29/2024]
Abstract
BACKGROUND Some studies have shown a positive effect of systemic corticosteroid on hearing results after stapedotomy, but its side effects can limit its routine administration. AIM The aim of this study was to investigate the effect of local dexamethasone on the results of stapedotomy surgery. MATERIAL AND METHODS 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. RESULTS 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. CONCLUSION 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. SIGNIFICANCE 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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Affiliation(s)
- Mohammad Mandegari
- Department of Otolaryngology-Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mojtaba Meybodian
- Department of Otolaryngology-Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammadhossein Baradaranfar
- Department of Otolaryngology-Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Sedighe Vaziribozorg
- Department of Otolaryngology-Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mahmood Vakili
- Department of Community Medicine, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Saeedeh Dehghanifirouzabadi
- Department of Otolaryngology-Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Wang X, Mei L, Jiang L. [Advances in research on treatment of tympanosclerosis]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2024; 38:86-90. [PMID: 38297857 DOI: 10.13201/j.issn.2096-7993.2024.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Indexed: 02/02/2024]
Abstract
Tympanosclerosis is the hyaline degeneration and calcium deposition of the lamina propria of tympanic membrane and the submucosa of middle ear under long-term chronic inflammatory stimulation. At present, treatment primarily involves the surgical removal of sclerotic foci and reconstruction of auditory ossicular chain. However, excision of sclerotic lesions near critical structures like the facial nerve canal and vestibular window may result in complications like facial paralysis, vertigo, and sensorineural hearing loss. Developing safer and more effective treatments for tympanosclerosis has become an international research focus. Recent years have seen novel explorations in the treatment of tympanosclerosis. Therefore, this article reviews the latest advancements in research on the treatment of tympanosclerosis.
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Affiliation(s)
- Xin Wang
- Department of Otolaryngology Head and Neck Surgery,Xiangya Hospital of Central South University,Changsha,410008,China
| | - Lingyun Mei
- Department of Otolaryngology Head and Neck Surgery,Xiangya Hospital of Central South University,Changsha,410008,China
- Hunan Province Key Laboratory of Otolaryngology Critical Diseases
| | - Lu Jiang
- Department of Otolaryngology Head and Neck Surgery,Xiangya Hospital of Central South University,Changsha,410008,China
- Hunan Province Key Laboratory of Otolaryngology Critical Diseases
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AlMakadma HA, Reed BF, Sanford CA. An Absorbance Peak Template for Clinical Assessment of Sound Conduction in Newborn Ears. J Speech Lang Hear Res 2023; 66:5152-5168. [PMID: 37971558 DOI: 10.1044/2023_jslhr-23-00122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
PURPOSE Power absorbance measures recorded over a wide range of frequencies allow for clinical inferences about the outer/middle ears' acoustic mechanics. A frequency-dependent feature in the newborn wideband absorbance response, the prominent mid-frequency absorbance peak, has been linked to middle-ear resonance. However, current normative methods were not designed to assess subtle changes in such features. This work aims to develop and validate an absorbance peak template (APT) for assessment of absorbance peaks in newborns. Additional objectives are to compare test performance of absorbance peaks and APTs to existing normative methods, to demonstrate APT-based methods for categorization of abnormal absorbance peaks, and to describe absorbance peak test-retest variability. METHOD Peak absorbance and peak frequency were analyzed in a training data set (490 measurements in 84 newborn ears who passed transient evoked otoacoustic emissions [TEOAEs] screenings), and an APT was developed by computing normal limits on these two absorbance peak variables. Split-set analysis evaluated the reproducibility of APT, and test-retest analysis was performed. Test performance analysis, conveyed by area under the receiver operating characteristic curve (AROC) and 95% confidence intervals (CIs), compared absorbance peak variables to absorbance area indices (AAIs) in a validation data set (359 ears that passed distortion-product OAE [DPOAE] screening and 64 ears that failed). APT-based assessment paradigms for normal and abnormal ears were compared to the common absorbance normative range paradigm. RESULTS Split-set analysis demonstrated a good reproducibility of APT, and test-retest of absorbance peak variables showed that they were stable measures for clinical assessment. Test performance of peak absorbance (AROC = 0.83; 95% CI [0.77, 0.88]) was comparable to the top-performing AAI variables (AROC = 0.85; 95% CI [0.80, 0.90]). APT-based assessment categorized measurements based on their peak absorbance and peak frequency and enhanced the detection of subtle frequency changes that were missed by the normative range method. CONCLUSION Analysis of absorbance peaks guided by APT has the potential to simplify and improve assessments of sound conduction pathways in newborn ears and can be used together with or in-place of current methods for analysis of wideband absorbance data.
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Affiliation(s)
- Hammam A AlMakadma
- Department of Otolaryngology-HNS and Communicative Disorders, School of Medicine, University of Louisville, Louisville, KY
| | - Beth F Reed
- Penn State Health Milton S. Hershey Medical Center, Hershey, PA
| | - Chris A Sanford
- Department of Communication Sciences and Disorders, College of Health, Idaho State University, Pocatello
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Dewan KK, Caulfield A, Su Y, Sedney CJ, Callender M, Masters J, Blas-Machado U, Harvill ET. Adaptive immune protection of the middle ears differs from that of the respiratory tract. Front Cell Infect Microbiol 2023; 13:1288057. [PMID: 38125908 PMCID: PMC10731285 DOI: 10.3389/fcimb.2023.1288057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 11/01/2023] [Indexed: 12/23/2023] Open
Abstract
The efficacy of the adaptive immune system in the middle ear (ME) is well established, but the mechanisms are not as well defined as those of gastrointestinal or respiratory tracts. While cellular elements of the adaptive response have been detected in the MEs following infections (or intranasal immunizations), their specific contributions to protecting the organ against reinfections are unknown. How immune protection mechanisms of the MEs compares with those in the adjacent and attached upper and lower respiratory airways remains unclear. To address these knowledge gaps, we used an established mouse respiratory infection model that we recently showed also involves ME infections. Bordetella bronchiseptica delivered to the external nares of mice in tiny numbers very efficiently infects the respiratory tract and ascends the Eustachian tube to colonize and infect the MEs, where it causes severe but acute inflammation resembling human acute otitis media (AOM). Since this AOM naturally resolves, we here examine the immunological mechanisms that clear infection and protect against subsequent infection, to guide efforts to induce protective immunity in the ME. Our results show that once the MEs are cleared of a primary B. bronchiseptica infection, the convalescent organ is strongly protected from reinfection by the pathogen despite its persistence in the upper respiratory tract, suggesting important immunological differences in these adjacent and connected organs. CD4+ and CD8+ T cells trafficked to the MEs following infection and were necessary to robustly protect against secondary challenge. Intranasal vaccination with heat killed B. bronchiseptica conferred robust protection against infection to the MEs, even though the nasopharynx itself was only partially protected. These data establish the MEs as discrete effector sites of adaptive immunity and shows that effective protection in the MEs and the respiratory tract is significantly different. This model system allows the dissection of immunological mechanisms that can prevent bacteria in the nasopharynx from ascending the ET to colonize the ME.
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Affiliation(s)
- Kalyan K. Dewan
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Amanda Caulfield
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Yang Su
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Colleen J. Sedney
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Maiya Callender
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Jillian Masters
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Uriel Blas-Machado
- Department of Pathology, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
| | - Eric T. Harvill
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA, United States
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37
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Lopez B, Naples JG. Facial Paresis and Pulsatile Middle Ear Mass. Ear Nose Throat J 2023; 102:NP583-NP584. [PMID: 34284609 DOI: 10.1177/01455613211031510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
SIGNIFICANCE STATEMENT Head and neck paragangliomas are uncommon pathologies that present with common symptoms such as pulsatile tinnitus and aural pressure. This article highlights an unusual presentation of a patient with facial paresis who was found to have a jugular paraganglioma. Emphasis is placed on how the otologic examination showed a pulsatile middle ear mass that led to the diagnosis. This case illustrates the importance of maintaining a healthy degree of clinical suspicion when encountering common complaints.
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Affiliation(s)
| | - James G Naples
- Division of Otolaryngology-Head and Neck Surgery, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA
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Mathema L, Adhikari A, Poudyal P, Chalise GB, Chaudhary P, Khatri B. Chronic Otitis Media among Patients Visiting Community-Based Static Outreach Clinics. JNMA J Nepal Med Assoc 2023; 61:923-926. [PMID: 38289754 PMCID: PMC10792720 DOI: 10.31729/jnma.8369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Indexed: 02/01/2024] Open
Abstract
Introduction Chronic otitis media is a chronic inflammation of the middle ear and mastoid cavity, with recurrent ear discharges or otorrhoea through a tympanic perforation for the past 3 months. It is a common cause of hearing impairment, disability, and poor scholastic performance and can lead to fatal intracranial infections and acute mastoiditis. This study aimed to find out the prevalence of chronic otitis media among patients visiting community-based static outreach clinics. Methods A descriptive cross-sectional study was conducted among patients visiting the community-based static outreach clinics from 1 January 2017 to 31 December 2019. The ethical approval was taken from the Ethical Review Board. The diagnosis of chronic otitis media was done using otoscopy. The records of patients coming to outreach clinics visiting for ear, nose and throat care were reviewed using a pre-designed study proforma. A systematic random sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results Among 385 patients, 37 (9.61%) (6.67-12.55, 95% Confidence Interval) had chronic otitis media. The mean age of patients with chronic otitis media was 27.59±13.24 years, with 28 (75.67%) patients aged between 18-60 years. Among them, 30 (81.08%) had unilateral and 34 (91.89%) had a mucosal type. Conclusions The prevalence of chronic otitis media was lower than in other studies done in similar settings. Keywords community health services; otitis media; patients; prevalence.
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Affiliation(s)
- Luna Mathema
- Department of Otolaryngology & HNS, B.P. Eye Foundation, Hospital for Children, Eye, ENT, and Rehabilitation Services, Madhyapur Thimi, Bhaktapur, Nepal
| | - Arun Adhikari
- Department of Otolaryngology & HNS, B.P. Eye Foundation, Hospital for Children, Eye, ENT, and Rehabilitation Services, Madhyapur Thimi, Bhaktapur, Nepal
| | - Prasanta Poudyal
- Department of Otolaryngology & HNS, B.P. Eye Foundation, Hospital for Children, Eye, ENT, and Rehabilitation Services, Madhyapur Thimi, Bhaktapur, Nepal
| | - Ganesh Bahadur Chalise
- Department of Otolaryngology & HNS, B.P. Eye Foundation, Hospital for Children, Eye, ENT, and Rehabilitation Services, Madhyapur Thimi, Bhaktapur, Nepal
| | - Preeti Chaudhary
- Department of Otolaryngology & HNS, B.P. Eye Foundation, Hospital for Children, Eye, ENT, and Rehabilitation Services, Madhyapur Thimi, Bhaktapur, Nepal
| | - Bijay Khatri
- Academic and Research Department, B.P. Eye Foundation, Hospital for Children, Eye, ENT, and Rehabilitation Services, Madhyapur Thimi, Bhaktapur, Nepal
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Flockerzi V, Schick B, Bozzato A. [Experiences with endoscopic ear surgery of a German tertiary hospital for otolaryngology]. HNO 2023; 71:787-794. [PMID: 37599311 PMCID: PMC10663200 DOI: 10.1007/s00106-023-01348-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND The aim of this article is to report on the integration of endoscopic ear surgery (EES) into daily clinical practice. MATERIAL AND METHODS In a monocentric prospective study, the endoscopy unit was set up during even weeks over a period of 10 months and the procedure was primarily started endoscopically via a transmeatal approach. In odd weeks, the endoscopy was omitted. A total of 60 procedures in 59 patients were evaluated. Points of comparison were intraoperative vision, incision-suture time, postoperative hearing outcome, and postoperative otoscopic findings. RESULTS With the exception of the facial nerve (p = 0.15 Mann-Whitney U‑test), the EES showed significantly improved visualization of all areas in the middle ear. The incision-suture times were similar in both methods. If bimanual placement of an ossicular prosthesis was necessary, the incision-suture time increased disproportionately (MES: 57.18 ± 9.7 min, EES: 76.83 ± 24.99 min; p = 0.019, *). There were no statistically significant changes related to hearing outcomes when comparing EES with the microscopic technique. There were no postoperative complications in the EES surgery group. CONCLUSION Integration of EES proved to be successful and advantageous in a real patient collective at this location.
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Affiliation(s)
- Veronika Flockerzi
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum des Saarlandes, 66421, Homburg, Deutschland.
| | - Bernhard Schick
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum des Saarlandes, 66421, Homburg, Deutschland
| | - Alessandro Bozzato
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum des Saarlandes, 66421, Homburg, Deutschland
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Shenouda K, Poillon G, Gargula S, Hervé C, Escalard S, Ayache D, Daval M. Complication of Ear Impression: Foreign Body in the Eustachian Tube Eroding the Carotid Canal. Laryngoscope 2023; 133:3358-3360. [PMID: 37602765 DOI: 10.1002/lary.30932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 06/30/2023] [Accepted: 07/13/2023] [Indexed: 08/22/2023]
Abstract
The realization of customized earing plugs and earmolds for hearing aids requires an impression of the external auditory canal to obtain a siliconized mold. Silicone used for ear impressions is known to be safe and inert but deposition of silicone in the middle ear can middle and inner ear damages. We present a case of accidental injection of silicone in the middle ear and the Eustachian tube resulting in an erosion of the carotid canal. Laryngoscope, 133:3358-3360, 2023.
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Affiliation(s)
- Kerolos Shenouda
- Department of Otolaryngology Head and Neck Surgery, Hôpital Fondation A. de Rothschild, Paris, France
| | - Guillaume Poillon
- Department of Medical Imaging, Hôpital Fondation A. de Rothschild, Paris, France
| | - Stéphane Gargula
- Department of Otolaryngology Head and Neck Surgery, Hôpital Fondation A. de Rothschild, Paris, France
| | - Camille Hervé
- Department of Otolaryngology Head and Neck Surgery, Hôpital Fondation A. de Rothschild, Paris, France
| | - Simon Escalard
- Department of Interventional Neuroradiology, Hôpital Fondation A. de Rothschild, Paris, France
| | - Denis Ayache
- Department of Otolaryngology Head and Neck Surgery, Hôpital Fondation A. de Rothschild, Paris, France
| | - Mary Daval
- Department of Otolaryngology Head and Neck Surgery, Hôpital Fondation A. de Rothschild, Paris, France
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41
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Gasenzer ER, Nakamura M. [The sound and musical preferences of tympanic chord]. MMW Fortschr Med 2023; 165:11-15. [PMID: 38062323 DOI: 10.1007/s15006-023-3159-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
The tympanic chord is a part of the 7th cranial nerve (facial nerve), from which it branches off, runs through the middle ear and then joins the lingual nerve, a part of the 5th cranial nerve (mandibular nerve/trigeminal nerve). Despite its course through the ear, the tympanic chord does not carry auditory fibers, but rather sensory and parasympathetic fibers to the front part of the tongue and to the salivary glands.The cranial nerves V and VII have a common phylogenetic origin, establishing a close relationship between auditory and gustative sense.In German language "Geschmack" means both gustative sense and the preference for different ways of thinking or styles in music, art or fashion. "Musikgeschmack" is the preference for special music styles or composers. "Musikgeschmack" therefore forms an interface between the anatomy of the tympanic chord and music preferences.The effect of parallel processing of music and taste is used, for example, in music therapy or as part of marketing strategies. But it could also be used to treat Covid-19 patients who suffer from a loss of sense of smell and taste. However, there are still no studies on this specific question.
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Affiliation(s)
- Elena Romana Gasenzer
- Carl Remigius Medical School, Marienburgstr. 6, 60528, Frankfurt am Mai, Deutschland.
| | - Makoto Nakamura
- Klinik für Neurochirurgie, Kliniken der Stadt Köln gGmbH, Krankenhaus Merheim, Köln, Deutschland
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Lee CM, Go YY, Song JJ. Inhibition of lipopolysaccharide-induced inflammation by trophoblast-conditioned medium and trophoblast-derived extracellular vesicles in human middle ear epithelial cells. Sci Rep 2023; 13:19822. [PMID: 37963902 PMCID: PMC10645728 DOI: 10.1038/s41598-023-46731-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 11/04/2023] [Indexed: 11/16/2023] Open
Abstract
Otitis media is a common disease but can cause severe inner ear inflammation and hearing loss if it persists for more than two weeks. This study elucidates the inflammation-inhibiting efficacy of conditioned medium (CM) and extracellular vesicles (EVs) derived from human trophoblast (TB) cells in lipopolysaccharide (LPS)-induced human middle ear epithelial cells (HMEECs). TB-conditioned medium (TB-CM) reduced the inflammatory response and regulated mucin and epithelial sodium channel genes in LPS-induced HMEECs. The underlying mechanism of cell migration during inflammatory healing in LPS-induced HMEECs treated with TB-CM was determined by RNA-sequencing analysis. Specifically, the NF-κB pathway related to the copper metabolism MURR1 domain protein was studied and verified through siRNA. This elucidation of the anti-inflammatory effect of TB-CM and TB-derived EVs demonstrates their clinical potential to treat chronic inflammation.
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Affiliation(s)
- Chan Mi Lee
- Division of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Republic of Korea
| | - Yoon Young Go
- Division of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Republic of Korea
- Center for Health Care Convergence at Korea University Guro Hospital, Seoul, Republic of Korea
| | - Jae-Jun Song
- Division of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Republic of Korea.
- Center for Health Care Convergence at Korea University Guro Hospital, Seoul, Republic of Korea.
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43
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Tamir SO, Bialasiewicz S, Brennan-Jones CG, Der C, Kariv L, Macharia I, Marsh RL, Seguya A, Thornton R. ISOM 2023 research Panel 4 - Diagnostics and microbiology of otitis media. Int J Pediatr Otorhinolaryngol 2023; 174:111741. [PMID: 37788516 DOI: 10.1016/j.ijporl.2023.111741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/17/2023] [Accepted: 09/19/2023] [Indexed: 10/05/2023]
Abstract
OBJECTIVES To identify and review key research advances from the literature published between 2019 and 2023 on the diagnosis and microbiology of otitis media (OM) including acute otitis media (AOM), recurrent AOM (rAOM), otitis media with effusion (OME), chronic suppurative otitis media (CSOM) and AOM complications (mastoiditis). DATA SOURCES PubMed database of the National Library of Medicine. REVIEW METHODS All relevant original articles published in Medline in English between July 2019 and February 2023 were identified. Studies that were reviews, case studies, relating to OM complications (other than mastoiditis), and studies focusing on guideline adherence, and consensus statements were excluded. Members of the panel drafted the report based on these search results. MAIN FINDINGS For the diagnosis section, 2294 unique records screened, 55 were eligible for inclusion. For the microbiology section 705 unique records were screened and 137 articles were eligible for inclusion. The main themes that arose in OM diagnosis were the need to incorporate multiple modalities including video-otoscopy, tympanometry, telemedicine and artificial intelligence for accurate diagnoses in all diagnostic settings. Further to this, was the use of new, cheap, readily available tools which may improve access in rural and lowmiddle income (LMIC) settings. For OM aetiology, PCR remains the most sensitive method for detecting middle ear pathogens with microbiome analysis still largely restricted to research use. The global pandemic response reduced rates of OM in children, but post-pandemic shifts should be monitored. IMPLICATION FOR PRACTICE AND FUTURE RESEARCH Cheap, easy to use multi-technique assessments combined with artificial intelligence and/or telemedicine should be integrated into future practice to improve diagnosis and treatment pathways in OM diagnosis. Longitudinal studies investigating the in-vivo process of OM development, timings and in-depth interactions between the triad of bacteria, viruses and the host immune response are still required. Standardized methods of collection and analysis for microbiome studies to enable inter-study comparisons are required. There is a need to target underlying biofilms if going to effectively prevent rAOM and OME and possibly enhance ventilation tube retention.
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Affiliation(s)
- Sharon Ovnat Tamir
- Department of Otolaryngology-Head and Neck Surgery, Sasmon Assuta Ashdod University Hospital, Faculty of Health Sciences, Ben Gurion University of the Negev, Israel.
| | - Seweryn Bialasiewicz
- Australian Centre for Ecogenomics, School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, QLD, 4072, Australia
| | - Christopher G Brennan-Jones
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia; Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Carolina Der
- Facultad de Medicina, Universidad Del Desarrollo, Dr Luis Calvo Mackenna Hospital, Santiago, Chile
| | - Liron Kariv
- Hearing, Speech and Language Institute, Sasmon Assuta Ashdod University Hospital, Israel
| | - Ian Macharia
- Kenyatta University Teaching, Referral & Research Hospital, Kenya
| | - Robyn L Marsh
- Menzies School of Health Research, Darwin, Australia; School of Health Sciences, University of Tasmania, Launceston, Australia
| | - Amina Seguya
- Department of Otolaryngology - Head and Neck Surgery, Mulago National Referral Hospital, Kampala, Uganda
| | - Ruth Thornton
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia; Centre for Child Health Research, University of Western Australia, Perth, Australia
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Downing C, Kei J, Driscoll C. Measuring resonance frequency of the middle ear in school-aged children: potential applications for detecting middle ear dysfunction. Int J Audiol 2023; 62:1076-1083. [PMID: 36301688 DOI: 10.1080/14992027.2022.2135033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 10/03/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE This study established a normative range of resonance frequency (RF) values as estimated using Wideband Tympanometry (WBT) and determined the ability of WBT-estimated RF to predict the presence of middle ear dysfunction in school-aged children. DESIGN Cross-sectional data were collected using a hearing screening test battery consisting of WBT, Pure Tone Screening (PTS), 226- kHz tympanometry, and ipsilateral Acoustic Stapedial Reflexes (ASR). STUDY SAMPLE About 1590 children aged 4-13 years. RESULTS RF significantly decreased from 4 to 13 years of age (4-6 years, 928.95 kHz; 7-9 years, 872.80 kHz; 10-13 years, 863.68 kHz). RF had area under the receiver operating characteristic curve (AROC) values between 0.589 and 0.626 to predict ears that failed PTS or 226- kHz tympanometry. RF below 627 kHz accurately predicted the presence of a Type B tympanogram (AROC 0.945). RF had high test-retest reliability with Intra-Class Coefficient value of 0.817 and good agreement according to Bland-Altman plot analysis. CONCLUSIONS WBT-estimated RF had fair diagnostic accuracy for predicting PTS and tympanometry results, but had excellent accuracy for predicting the presence of middle ear dysfunction, indicated by a Type B tympanogram. WBT-estimated RF does not require age-, gender-, ear- or ethnicity-specific normative data for clinical use with children.
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Affiliation(s)
- Cerys Downing
- Hearing Research Unit for Children, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Joseph Kei
- Hearing Research Unit for Children, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Carlie Driscoll
- Hearing Research Unit for Children, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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Al-Alawneh M, Al-Ashqar R, Al-Omari I, Odat H. Attic reconstruction techniques in cholesteatoma surgery: a comparative analysis of cartilage versus bone pate. Acta Otolaryngol 2023; 143:936-939. [PMID: 38127425 DOI: 10.1080/00016489.2023.2293227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Cholesteatoma surgery involves canal wall down (CWD) and canal wall up (CWU) mastoidectomy. CWU is associated with higher cholesteatoma recurrence, often linked to attic retraction pockets. Attic reconstruction with cartilage or bone pate lacks comparative evidence. AIMS/OBJECTIVES To compare the effectiveness of cartilage and bone pate in attic reconstruction during CWU mastoidectomy for cholesteatoma. MATERIAL AND METHODS We conducted a retrospective study at King Abdullah University Hospital (KAUH) in Jordan, analyzing surgeries performed from 2011 to 2021. Patients who underwent CWU mastoidectomy with attic reconstruction using tragal cartilage with perichondrium or bone pate were included. RESULTS Of 48 patients analyzed, 26 had cartilage graft attic reconstruction, and 22 received bone pate. Recurrent cholesteatoma occurred in 19.23% of the cartilage group but none in the bone pate group (p = .001). Ear discharge was observed in 19.23% of the cartilage group and 18.18% of the bone pate group, while tympanic membrane perforations and external auditory canal cholesteatoma were more prevalent in the cartilage group. CONCLUSIONS AND SIGNIFICANCE Our study indicates that bone pate results in significantly lower cholesteatoma recurrence than cartilage grafting in CWU mastoidectomy attic reconstruction. Bone pate offers stability and favorable long-term outcomes for outer attic wall repair.
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Affiliation(s)
- Mohammad Al-Alawneh
- Department of Special Surgery, King Abdullah University Hospital, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Ra'ed Al-Ashqar
- Department of Special Surgery, King Abdullah University Hospital, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Isra Al-Omari
- Department of Special Surgery, King Abdullah University Hospital, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Haitham Odat
- Department of Special Surgery, King Abdullah University Hospital, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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Fan Y, Gao R, Shang Y, Tian X, Zhao Y, Chen X. Presence of SARS-CoV-2 in middle ear fluid and characterization of otitis media with effusion in patients with COVID-19. Int J Infect Dis 2023; 136:44-48. [PMID: 37660727 DOI: 10.1016/j.ijid.2023.08.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/27/2023] [Accepted: 08/28/2023] [Indexed: 09/05/2023] Open
Abstract
OBJECTIVES This study sought to determine whether SARS-CoV-2 is present in the middle ear fluid (MEF) of patients with COVID-19 who have otitis media with effusion (OME). METHODS A case-control study was designed to detect SARS-CoV-2 and six other common respiratory viruses (influenza A virus, influenza B virus, respiratory syncytial virus, adenovirus, human rhinovirus [HRV], and mycoplasma pneumonia) by polymerase chain reaction (PCR) in the MEF of patients with OME. Follow-up tests, including pure-tone audiometry and tympanometry, were conducted. RESULTS In the COVID-19 group, 18 of 27 MEF specimens were PCR-positive for SARS-CoV-2, with cycle thresholds ranging from 24.9-42.2. And one patient tested positive for the HRV. In the control group, all 15 MEF specimens were PCR-negative for SARS-CoV-2, but two patients tested positive for the HRV. After treatment for OME, 11 patients (40.7%) reported complete resolution, 14 (51.9%) reported improvement, and two (7.4%) reported no change. The average improvement in hearing was 14.5 ± 8.1 dB, and the average air-bone gap decrease was 13.5 ± 9.0 dB. CONCLUSION This study confirmed the presence of SARS-CoV-2 in the MEF of patients who were previously COVID-19-positive suggesting a possible association between COVID-19 and OME. OME should be considered a possible symptom of COVID-19.
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Affiliation(s)
- Yue Fan
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Ruzhen Gao
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Yingying Shang
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Xu Tian
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Yang Zhao
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Xingming Chen
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
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Sugimoto H, Toya T, Watanabe Y, Takei W, Nagai R, Donjo Y, Motoo R, Inaba M, Yoshizaki T, Murakoshi M. Wideband frequency impedance for diagnosis of ossicular chain abnormality. Acta Otolaryngol 2023; 143:958-964. [PMID: 38134217 DOI: 10.1080/00016489.2023.2292168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 12/01/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND The accurate estimation of the ossicular chain abnormalities using existing functional examinations has been difficult. AIMS/OBJECTIVES This study aimed to verify the accuracy of preoperative diagnosis of ossicular chain abnormalities using a wideband frequency impedance (WFI) meter, which can measure the dynamic characteristics of the middle ear. MATERIAL AND METHODS Retrospective cohort study. Fourteen ears of patients with ossicular chain abnormalities that were definitively diagnosed surgically were included in this study. The following data were collected for each participant: sound pressure level (SPL) curve measured using the WFI meter and a sweep frequency impedance (SFI) meter, WFI measurements plotted on the resonance frequency (RF)-ΔSPL plane, distribution map of the dynamic characteristics of the middle ear, preoperative audiometry results, and the definitive surgical diagnosis. RESULTS The SPL curve obtained using the WFI meter had lesser noise than that obtained using the SFI meter. The distribution map revealed that the ossicular chain separation range and ossicular chain fixation range were completely separated. The hearing data tended to be poor in cases with small ΔSPL. CONCLUSIONS AND SIGNIFICANCE WFI can potentially enhance the accuracy of SFI. In addition, it can also be used for the classification of ossicular chain separation and fixation as well as the quantification of fixation in cases of ossicular chain anomalies that cannot be diagnosed using conventional tests.
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Affiliation(s)
- Hisashi Sugimoto
- Department of Otolaryngology-Head and Neck Surgery, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Teruki Toya
- Faculty of Engineering, University of Yamanashi, Kofu, Japan
| | - Yoshihiro Watanabe
- Innovative Clinical Research Center, Kanazawa University Hospital, Japan
| | - Wataru Takei
- Faculty of Education, Institute of Human and Social Sciences, Kanazawa University, Japan
| | - Risa Nagai
- Department of Otolaryngology-Head and Neck Surgery, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Yasunori Donjo
- Department of Otolaryngology-Head and Neck Surgery, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Ryosei Motoo
- Department of Otolaryngology-Head and Neck Surgery, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Manabu Inaba
- Department of Otolaryngology-Head and Neck Surgery, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Tomokazu Yoshizaki
- Department of Otolaryngology-Head and Neck Surgery, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Michio Murakoshi
- Faculty of Frontier Engineering, Institute of Science and Engineering, Kanazawa University, Japan
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Womack MC, Hoke KL. Convergent Anuran Middle Ear Loss Lacks a Universal, Adaptive Explanation. Brain Behav Evol 2023; 98:290-301. [PMID: 37913755 PMCID: PMC10885836 DOI: 10.1159/000534936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/27/2023] [Indexed: 11/03/2023]
Abstract
INTRODUCTION Shared selection pressures often explain convergent trait loss, yet anurans (frogs and toads) have lost their middle ears at least 38 times with no obvious shared selection pressures unifying "earless" taxa. Anuran tympanic middle ear loss is especially perplexing because acoustic communication is dominant within Anura and tympanic middle ears enhance airborne hearing in most tetrapods. METHODS Here, we use phylogenetic comparative methods to examine whether particular geographic ranges, microhabitats, activity patterns, or aspects of acoustic communication are associated with anuran tympanic middle ear loss. RESULTS Although we find some differences between the geographic ranges of eared and earless species on average, there is plenty of overlap between the geographic distributions of eared and earless species. Additionally, we find a higher prevalence of diurnality in earless species, but not all earless species are diurnal. We find no universal adaptive explanation for the many instances of anuran tympanic middle ear loss. CONCLUSION The puzzling lack of universally shared selection pressures among earless species motivates discussion of alternative hypotheses, including genetic or developmental constraints, and the possibility that tympanic middle ear loss is maladaptive.
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Affiliation(s)
| | - Kim L. Hoke
- Biology Department, Colorado State University, Fort Collins, CO, USA
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Qiu W, Chen P, Lv M, Zhu J, Wang Y, Zhao S. Diagnosis and treatment of congenital stenosis of external auditory canal with external auditory canal cholesteatoma complicated with exudative effusion in the middle ear and mastoid process. Acta Otolaryngol 2023; 143:940-945. [PMID: 38250795 DOI: 10.1080/00016489.2023.2299689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 12/21/2023] [Indexed: 01/23/2024]
Abstract
BACKGROUND The optimal timing for surgery to promote postoperative recovery in children with congenital stenosis of the external auditory canal with external auditory canal cholesteatoma, who are susceptible to exudative inflammation of middle ear and mastoid process, is still uncertain. OBJECTIVES To investigate the treatment of congenital stenosis of external auditory canal with external auditory canal cholesteatoma complicated with exudative inflammation. MATERIAL AND METHODS A retrospective analysis of 45 patients with congenital stenosis of external auditory canal with external auditory canal cholesteatoma complicated with mastoiditis. Based on whether effusion had resolved at the time of surgery, the patients were divided into two groups. Pure-tone audiometry tests were performed before and after surgery for both groups. RESULTS The average postoperative duration of dry ear was 36.38 days in Group 1 and 47.90 days in Group 2 (p < 0.05). Among patients who underwent hearing reconstruction, the average air conduction threshold decreased by 15-36 dBHL in Group 1 and by 7-22 dBHL in Group 2 (p < 0.05). CONCLUSIONS AND SIGNIFICANCE The postoperative outcomes of dry ear and hearing improvement can be enhanced by performing operation after effusion resolution in cases of congenital external auditory canal stenosis with external auditory canal cholesteatoma exudative inflammation.
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Affiliation(s)
- Wenxi Qiu
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Ministry of Education Key Laboratory of Otolaryngology Head and Neck Surgery, Capital Medical University, Beijing, China
| | - Peiwei Chen
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Ministry of Education Key Laboratory of Otolaryngology Head and Neck Surgery, Capital Medical University, Beijing, China
| | - Mengshuang Lv
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Ministry of Education Key Laboratory of Otolaryngology Head and Neck Surgery, Capital Medical University, Beijing, China
| | - Jikai Zhu
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Ministry of Education Key Laboratory of Otolaryngology Head and Neck Surgery, Capital Medical University, Beijing, China
| | - Yuan Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Ministry of Education Key Laboratory of Otolaryngology Head and Neck Surgery, Capital Medical University, Beijing, China
| | - Shouqin Zhao
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Ministry of Education Key Laboratory of Otolaryngology Head and Neck Surgery, Capital Medical University, Beijing, China
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Honnurappa V, Mahajan N, Vijayendra VK, Vassiliu S, Redleaf M. Management of attic retraction pockets. J Laryngol Otol 2023; 137:1272-1276. [PMID: 37203214 DOI: 10.1017/s002221512300083x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
OBJECTIVE Attic retraction pockets, classified by degree of invasion and erosion, are reconstructed here as outlined by attic retraction pocket grade. METHOD Attic retraction pocket grade, surgical management, subsequent conditions of tympanic membrane and middle ear, and improvement of air-bone gap pure tone average were recorded. RESULTS Our management strategy, based on attic retraction pocket grade, was applied to 200 ears: 44 grade I ears had non-surgical management and 156 grade II-V ears had surgical management. All 200 ears were followed up for 36-240 months, showing only 1 attic retraction pocket reformation and 1 adhesive otitis media (complication rate of 1 per cent), and improved air-bone gaps (p < 0.05). An earlier series of 50 grade IV attic retraction pockets used atticotomy with epitympanic reconstruction. These showed attic retraction pocket recurrence or cholesteatoma onset in 34 ears (68 per cent). When these ears were revised per protocol, there was no evidence of cholesteatoma thereafter. CONCLUSION Reconstruction of the ossicles and scutal defect according to attic retraction pocket grade shows long-term stability of the tympanic membrane, middle ear and hearing.
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Affiliation(s)
| | - Nilesh Mahajan
- Vijaya ENT Care Centre, Super Speciality Otology Centre, Bangalore, India
| | | | - Sofia Vassiliu
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Miriam Redleaf
- Otology/Neurotology, Department of Otolaryngology, University of Illinois Hospitals, Chicago, USA
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