Journal of Laryngology and Otology最新文献

Objective: To examine the effects of age and hearing loss on travelling wave delay by comparing frequency-specific action potential latencies obtained with electrocochleography.

Methods: A cross-sectional design was applied. Tympanic membrane electrocochleography recordings at 0.5 and 4 kHz were analysed in 85 ears from 49 adults. Participants were divided into four groups: older adults with hearing loss (n = 22), older adults with normal hearing (n = 18), younger adults with hearing loss (n = 19) and younger adults with normal hearing (n = 26).

Results: Age and hearing loss significantly influenced action potential latencies. At 0.5 kHz, the older adults with hearing loss showed the longest latencies (p < 0.001). At 4 kHz, older adults with hearing loss differed from older adults with normal hearing (p = 0.027). Travelling wave delay varied across groups (p < 0.001), with the shortest travelling wave delay in younger adults with normal hearing and the longest travelling wave delay in older adults with hearing loss.

Conclusion: Ageing and hearing loss slow travelling wave velocity, providing an indirect but sensitive marker of early cochlear transmission deficits.

Objective: To assess the efficacy of intranasal cryotherapy to treat chronic rhinitis refractory to medical therapy.

Methods: An evaluation was performed for all patients (n = 36) with chronic rhinitis refractory to medical treatment who underwent intranasal cryotherapy between 2022 and 2024 at this centre. The primary outcome measures were changes in validated pre- and post-operative scoring systems (Total Nasal Symptom Score, Sino-Nasal Outcome Test 22 (SNOT-22), Nasal Obstruction Symptom Evaluation and peak inspiratory nasal flow).

Results: Objective scoring pre- and post-procedure showed statistically significant improvement across all measures (p < 0.001): mean Total Nasal Symptom Score (12 hours) 8.4 to 5.3, Total Nasal Symptom Score (2 weeks) 9.2 to 5.9, SNOT-22 56 to 31, Nasal Obstruction Symptom Evaluation 57.5 to 28.5 and peak inspiratory nasal flow 98 to 138 l/min.

Conclusion: This is the only dataset for patients receiving intranasal cryotherapy in the UK to date and follows patients over a two-year period. The results support the ongoing use of intranasal cryotherapy for sustained treatment of refractory chronic rhinitis.

Objectives: This study aimed to evaluate the effectiveness of the SmartNav in detecting tip fold-over during cochlear implantation and to compare angular insertion depth measurements obtained via SmartNav and transorbital X-ray imaging.

Methods: This retrospective multicentre study included patients with normal cochlear anatomy, comprising 163 individuals and 213 ears who underwent cochlear implantation using Nucleus CI522 and CI622 systems at Gazi University Faculty of Medicine and Gaziantep City Hospital.

Results: Of the 213 cochlear implantations, tip fold-over was detected in 4 implantations (1.88 per cent) intra-operatively with SmartNav. One case (0.47 per cent) of tip fold-over was not detected by SmartNav and identified post-operatively through X-ray imaging. SmartNav showed a sensitivity of 80 per cent, specificity of 100 per cent. A strong correlation was found between SmartNav and X-ray angular insertion depth measurements (p < 0.001).

Conclusion: The SmartNav is a reliable tool for the intra-operative detection of tip fold-overand the assessment of angular insertion depth in patients with normal cochlear anatomy.

Background: Malignant otitis externa is a life-threatening infection in which facial nerve palsy is a morbid complication. This TriNetX study identified predictors of facial nerve palsy in malignant otitis externa.

Methods: Retrospective analysis compared malignant otitis externa-only (n = 12 032) versus malignant otitis externa plus facial nerve palsy (n = 719) cohorts for demographics, biochemical markers and co-morbidities using t-tests and odds ratios (p < 0.05).

Results: Male gender (p = 4.65 × 10^-15) and Hispanic and/or Latino ethnicity (17.66 vs 13.02 per cent, p = 0.0014) predicted facial nerve palsy. The significant biochemical markers were albumin, blood urea nitrogen (p < 10^-18), glucose, erythrocyte sedimentation rate (ESR), creatinine, iron and activated partial thromboplastin time. The key co-morbidities were hypertension (odds ratio = 3.72, p = 6.95 × 10^-55), chronic kidney disease (odds ratio = 3.12, p = 1.44 × 10^-49), malnutrition (odds ratio = 3.44) and electrolyte imbalances (odds ratio = 2.59). Migraines and/or headaches were non-significant.

Conclusion: Male sex, Hispanic and/or Latino ethnicity, hypoalbuminemia, elevated blood urea nitrogen and/or glucose and/or ESR, and co-morbidities (hypertension, chronic kidney disease, malnutrition) strongly predict facial nerve palsy in malignant otitis externa. Early risk factor management may prevent facial nerve palsy.