European Archives of Oto-Rhino-Laryngology最新文献

Purpose: To translate and culturally adapt the SPOT-25 to the Dutch language and validate the Dutch SPOT-25 in a Dutch population of otosclerosis patients undergoing primary stapes surgery.

Methods: A multicenter prospective validation study was performed between November 2018 and May 2024. The translation into Dutch and validation process of the SPOT-25 was performed according to the COSMIN guidelines. Patients were asked to complete the SPOT-25 and Glasgow Health Status Questionnaire (GHSQ) preoperatively, the SPOT-25, GHSQ and Glasgow Benefit Inventory six to eight weeks postoperatively and the SPOT-25 eight to ten weeks postoperatively. Healthy controls were asked to complete the translated SPOT-25 once. Preoperative and postoperative audiometric results were also obtained. The evaluated measurement properties included construct validity, measurement invariance, discriminative validity, reliability and responsiveness of the translated SPOT-25.

Results: Hundred and fifteen patients and 50 healthy controls were analyzed. Analyses of the translated SPOT-25 showed adequate construct validity, discriminative validity, reliability and responsiveness. The SPOT-25 scores were strongly correlated with the GHSQ score. The internal consistency and test-retest reliability were good as Cronbach's alpha and intraclass correlation coefficients were higher than 0.70. The four-factor model fitted best in our population of otosclerosis patients; however the results indicated a mediocre fit between the model and the data.

Conclusion: The Dutch SPOT-25 showed good validity, reliability and responsiveness and can be implemented as an additional outcome measure to improve otosclerosis research and clinical practice.

Introduction: In otology consultations, patients with chronic otitis media (COM) often present as candidates for various hearing rehabilitation options. Selecting the most suitable approach requires careful consideration of patient preferences and expectations, the risk of disease progression, and the integrity of the bone conduction pathway. This study aims to evaluate and compare postoperative hearing outcomes in COM patients undergoing tympanoplasty (with or without passive middle ear implants), bone conduction systems (BCI), or active middle ear implants (AMEI). The objective is to assess the effectiveness of each surgical approach in hearing rehabilitation, considering the type and severity of hearing loss as well as the duration of the disease.

Methods: Retrospective data analysis in a tertiary referral center studying average PTA across six different frequencies, speech perception at 65 dB, influence of Eustachian tube dysfunction, reintervention rate and adverse effects, and the influence of disease duration on functional outcomes via linear regression analysis.

Results: 116 patients underwent surgery due to COM between 1998 and 2024. With a slight female predominance (54.31%). AMEIs and bone conduction devices provided the highest amplification in terms of PTA and speech discrimination, with a lower reintervention rate when comparing both groups with passive middle ear implants, OR in BCI group of 0.30 (0.10; 0.89, p = 0.030), OR in VSB group of 0.15 (0.04; 0.56, p = 0.005). It was also observed that a longer evolution time could be associated with greater auditory gain, with a p-value = 0.033.

Conclusions: The selection of each treatment option primarily depends on bone conduction thresholds, along with surgical risk, patient preferences, and MRI compatibility. In our study, AMEIs demonstrated the highest functional gain in terms of speech discrimination and frequency-specific amplification, followed by BCI. These findings support the use of implantable hearing solutions as effective alternatives for auditory rehabilitation in COM patients.

Propose: Osteogenesis imperfecta (OI) is a genetic connective tissue disorder primarily characterized by bone fragility. Hearing loss is an extra-skeletal manifestation of OI. This study aims to characterize the audiological findings of a sample of patients with OI in China.

Methods: A total of 76 patients (aged 4-77 years) were recruited and evaluated using audiometric evaluations, including pure tone audiometry (PTA), acoustic admittance measurements, and distortion-product otoacoustic emissions (DPOAEs). Patients were categorized into 2 age groups: adults (more than 18 years) and children (under 18 years), and classified by hearing type: normal hearing, conductive, sensorineural, or mixed hearing loss.

Results: Tympanometry (152 ears) showed 71.7% Type A tympanograms. There was a significant association between tympanogram type and hearing loss (p < 0.01). DPOAEs were predominantly abnormal in ears with sensorineural and mixed hearing loss (p < 0.01). PTA (146 ears) revealed hearing loss in 39.0%: 16.4% conductive, 15.1% sensorineural, and 7.5% mixed. Age correlated significantly with hearing loss type (p < 0.01). Adults' group exhibited higher pure-tone averages (11.3 dB vs. 8.8 dB, p < 0.01), average air-bone gap (2.5 dB vs.2.5 dB, p < 0.05), and bone conduction thresholds than children's group.

Conclusions: Hearing loss is common and progressive in Chinese OI patients, with a significant age-related increase in both the prevalence and severity of hearing loss. Establishing a hearing baseline and regular follow-up is essential for early intervention.

Objective: To analyze SLC26A4 gene mutations in children with large vestibular aqueduct syndrome (LVAS) with or without Mondini malformation, and to compare their hearing phenotypes, rehabilitation outcomes, and learning performance after cochlear implantation.

Methods: We used T7 Endonuclease I enzyme digestion to detect SLC26A4 mutations in 48 children with LVAS without Mondini malformation (EVA group), 29 children with LVAS and Mondini malformation (EVA + MD group). Negative results were confirmed by Sanger sequencing. Auditory performance (CAP) and speech intelligibility (SIR) scores assessed hearing and speech rehabilitation outcomes, while academic performance evaluated learning post-cochlear implantation.

Results: Electrophoresis showed that the positive detection rates of SLC26A4 mutations were 89.58% in the EVA group, 89.66% in the EVA + MD group, and 0% in the control group. In the EVA group, the most common mutations were in exons 7 + 8 (52.08%), 11 + 12 (22.92%), and 19 (18.75%). In the EVA + MD group, the predominant mutations were in exons 11 + 12 (51.72%), 4 (34.48%), 7 + 8 (27.59%), and 19 (24.14%). The EVA + MD group had higher detection rates for two-site (37.93%) and three-site compound heterozygous mutations (13.79%) compared to the EVA group (22.92% and 10.42%, respectively). The median diagnosis time for profound hearing loss was 6.62 months in the EVA + MD group versus 10.56 months in the EVA group. There were no significant differences in CAP and SIR scores between the groups, but the EVA group showed better learning performance.

Conclusion: This study reports, for the first time, multiple cases exhibiting a three-site compound heterozygous mutation in the SLC26A4 gene. The hotspot exons of the SLC26A4 gene differ between children with simple LVAS and those with LVAS accompanied by Mondini malformation. Children with both conditions show earlier onset of profound hearing loss and poorer learning performance compared to those with only LVAS.

Introduction: The incidence of otosclerosis appears to have been declining since the late 1970s. We conducted a retrospective nationwide study to assess the evolution of the annual number of stapes surgeries and to analyze the changes in technical practices, specifically comparing laser techniques to cold instruments.

Methods: We examined the French national dataset from the "Programme de Médicalisation des Systèmes d'Information" (PMSI). Within this national database, we collected data on the number of stapes surgical procedures performed using cold instruments and laser technology from 2013 to 2022 in France.

Results: The total number of stapes surgeries has decreased each year, dropping from 4,268 procedures in 2013 to 3,007 procedures in 2022, which represents a decline of 29.5% over a decade. On average, 162 fewer procedures were performed each year compared to the previous year. The use of laser technology increased from 42% of cases in 2013 to 61% of cases in 2022. Laser techniques were more commonly employed in university hospitals and private non-profit clinics than in general hospitals and private clinics.

Conclusion: The number of stapes surgeries is decreasing linearly and consistently, raising concerns regarding the training of young surgeons. Furthermore, laser techniques are gradually replacing cold instruments in clinical practice.

Purpose: The diagnosis of eosinophilic otitis media (EOM) remains a major challenge. Current diagnostic methods rely primarily on accurate samples of middle ear tissue or secretions, which can be complex. In this study, we sought to explore the diagnostic value of mastoid pneumatization combined with other temporal radiological features for EOM.

Methods: This study included 28 patients with EOM and 32 patients with ordinary OM. All participants underwent the temporal bone HRCT, and middle ear status was assessed using four sections: mesotympanum, attic, antrum, and mastoid air cells. Quantification of negative temporal bone pressure using three-dimensional analysis of mastoid volume images.

Results: The volumes of eosinophilic/non-eosinophilic mastoid air cells were approximately the same but were asymmetric. In contrast, in the normal OM group, there was a significant difference in the volume of mastoid air cells between the inflammatory and non-inflammatory sides. Statistically, the degree of opacification to the mesotympanum, attic, and mastoid air cells was more severe in patients with EOM than in patients with ordinary OM on the affected side. Furthermore, on the normal side, the opacification of the all four sites in the eosinophil group was basically worse than that in the control group.

Conclusion: Eosinophilic individuals have been found to be specific to the mastoid air cell system and middle ear status and are important factors to consider. Therefore, the potential imaging information of HRCT can help otologists diagnose EOM earlier and provide timely and effective treatment.

Background: Ceruminous adenomas (CA) are rare neoplasms of the external auditory canal (EAC), and their nonspecific symptoms frequently contribute to diagnostic challenges in clinical practice. By examining the clinical features, diagnostic considerations, and therapeutic approaches for these tumors, the findings aim to improve understanding of these tumors and improve clinical outcomes.

Case presentation: A retrospective analysis was conducted on six individuals diagnosed with CAs of the EAC at a single institution between January 2010 and January 2023. Clinical data, histopathological characteristics, and immunophenotypic findings were reviewed, along with a relevant literature analysis. Of the six cases, three involved simple CAs, one was associated with concurrent adenoid cystic carcinoma, and two exhibited localized areas of high mitotic activity, necessitating vigilant follow-up. No recurrences were observed during the follow-up period. Symptomatically, one patient reported occasional tinnitus, while another presented with ear discharge.

Conclusion: The diagnosis of ceruminous gland tumors requires a multidisciplinary approach, incorporating clinical evaluation, imaging studies, and histopathological examination. CAs of the EAC are uncommon, with reports in the literature indicating a risk of recurrence and potential for malignancy. Surgical management should involve wide excision with wound repair, followed by close postoperative monitoring to ensure early detection of any recurrence.

Purpose: This pilot study investigated the efficacy of a novel Tinnitus Retraining Therapy (TRT) device utilizing bone conduction white noise generation, in treating tinnitus in a normal hearing population.

Methods: This study was designed as a prospective, single-arm, observational trial in an outpatient clinic at a tertiary referral center, with 30 consecutive normal hearing patients with tinnitus. Tinnitus-specific questionnaires, namely the Tinnitus Handicap Inventory (THI) and Tinnitus Functional Index (TFI), translated and adapted to European Portuguese were administered. Patients were categorized into Group A (tinnitus characteristics within the device's maximum output performance) and Group B (outside the device's maximum output performance).

Results: 69% of the participants showed improvement in their TFI scores, with Group A exhibiting a significant mean reduction of 10 points (p = 0.0004). The device was well-tolerated, with no adverse effects reported.

Conclusion: The novel bone conduction tinnitus suppression device showed promise in reducing the impact of tinnitus, particularly in patients whose tinnitus profile is within the device maximum performance output. This improvement in TFI scores in the majority of the participants, observed after just a 30-day period, highlights the potential of specifically tailored sound therapy delivered via bone conduction in tinnitus management.

Introduction: Hemifacial spasm (HFS) is a neurological disorder characterized by involuntary contractions of the facial muscles. Botulinum toxin (BTX-A) is an effective treatment, but its efficacy may vary across different geographical contexts. This multicentric study aims to compare the efficacy of BTX-A in treating HFS between centers in Morocco and France.

Methods: A retrospective study was conducted with 128 patients diagnosed with HFS, distributed between one center in Morocco and two centers in France. Parameters studied included age, sex, average treatment duration, dose administered, injection sites, injection frequency, and adverse effects. The results were analyzed separately for primary and secondary HFS. An HSF-8 score was used to evaluate treatment outcomes, assessing patients before treatment and two months after receiving BTX-A injections.

Results: This multicentric study assessed the efficacy of botulinum toxin (BTX-A) for treating hemifacial spasm (HFS) in centers in France and Morocco. Among the 128 patients included, 75% were women, with a mean age of 61.5 years. On average, patients had been receiving BTX-A injections for 6.49 ± 5.4 years, experiencing a mean self-reported improvement of 94.7% ± 2.3%. The treatment effect lasted approximately 3.15 ± 1.2 months per injection. Notable differences were observed between France and Morocco regarding the average dose per injection and injection frequency. Side effects were observed in 39.84% of patients in France compared to 10.94% in Morocco, but there was no significant difference. The most frequently reported side effects included ptosis, diplopia, and dry eyes. These effects are generally temporary and did not require discontinuation of treatment. The efficacy of BTX-A was objectively measured using the HFS-8 score, with significant improvements observed in both countries. Despite variations in therapeutic approaches, the overall efficacy of BTX-A remained comparable between the two countries, indicating consistent therapeutic outcomes across geographical contexts.

Conclusion: This multicentric study confirms the efficacy of botulinum toxin (BTX-A) in the treatment of HFS, with significant improvements and a well-tolerated side effect profile. While differences exist in treatment practices between Morocco and France, the overall efficacy of the treatment remains comparable, underscoring the reliability of BTX-A as an effective therapy across different geographical contexts.

Purpose: This study aims to analyze resectable T3-T4a glottic cancer patients treated with TOLM at a tertiary hospital, evaluating survival, function, and QoL in organ-preserved cases.

Methods: Patients with diagnosis of laryngeal glottic squamous cell carcinoma pT3-pT4a N < 3 M0 treated with primary curative intention TOLM from 2005 to 2021 were included. Statistical analysis was performed, including survival rates. Quality of life was evaluated using VHI-10, EORTC-QLQ-C30 and EORTC-QLQ-HN43.

Results: 82 patients were included in this study, predominantly male, with a mean age of 65.5 years old. Laryngeal preservation rate was 76.83%. 5-year overall survival was 68.3%, 5-year Disease Specific Survival was 80.9%, 5-year Local disease-free survival was 91.2%. Medium VHI-10 score was 9.20 (SD ± 5.90), with nearly two thirds (63.33%) having a normal score. On the QLQ-C30 questionnaire, five of the six functional scales were over 80. On the QLQ-HN43 all the scales (single and multi-item) scored less than 16.

Conclusion: TOLM achieved comparable survival rates to radical surgery and other organ-preserving methods for locally advanced glottic cancer, as well as good functional outcomes with minimal post-surgical symptoms and mild voice impairment.