Laryngo-rhino-otologie最新文献

Hearing means social participation. The prevalence of hearing loss increases with age. The aim of this project was to assess the current hearing situation in nursing homes and to identify problems in the provision of care.Pure tone and speech audiograms were measured in 74 residents in four different nursing homes in the greater Hanover area and questionnaires on the hearing aid care situation were carried out with 97 residents.Of all audiograms measured, 75% showed a hearing loss requiring hearing aids, which was often inadequately cared for. Residents often stated that they could hear well subjectively, but at the same time mentioned many situations in which they would have liked to hear better. Existing hearing aids were often worn not regularly or even not at all. Those who are affected by hearing loss wished for help in using their devices.In an ageing society, a growing burden on care facilities is to be expected. Hearing loss is an omnipresent issue here, for which more awareness must be created in order to ensure adequate hearing care. Furthermore, hearing loss means challenged communication and therefore can deteriorate the care of patients.

Children, who suffer from secretory otitis media during the maturation of the auditory pathways, can develop deprivation of the central auditory system and thus a significant impairment of speech. Based on the case reporting guidelines, a boy without comorbidities, with onset of illness in the 11^th LM and loss of three annual hearing balances is presented.

The management of locally advanced laryngeal and hypopharyngeal squamous cell carcinomas remains challenging for ENT specialists due to the larynx's complex multidimensional function and the high rates of local and locoregional recurrence or distant metastatis. Surgical (including total laryngectomy, LE, followed by adjuvant radio(chemo)therapy) and nonsurgical approaches aiming on larynx organ preservation (including definitive concomitant chemoradiation or sequential induction chemotherapy (IC) followed by radiotherapy) are available. These treatment modalities will be critically discussed in this review.In line with the national German S3 guidelines for laryngeal and oro-/hypopharyngeal cancer, patients must receive comprehensive counseling on both surgical and non surgical concepts. To date, early response to IC constitutes the most robust surrogate marker for organ preservation candidacy, guiding the early redirection of non responders to upfront LE. Late salvage LE after definitive radiochemotherapy is associated with high perioperative morbidity, often rendered unfeasible due to radiation-induced fibrosis and impaired vascularity; thus, it should not be considered as a standard treatment option.IC and response evaluation after just one cycle of IC, as applied in the DeLOS-II study, allow for early identification of non-responders, for whom LE (associated with significantly lower complication rates than salvage surgery) should be recommended prior to radiotherapy. The neoadjuvant use of immunotherapy in combination with IC likely represents the next frontier in the context of laryngeal organ preservation. The ongoing ELOS study is currently investigating the efficacy of an IC regimen comprising docetaxel and cisplatin in combination with pembrolizumab.

This statement paper, prepared on behalf of the Presidential Board of the German Society of Otorhinolaryngology, Head and Neck Surgery (DGHNO-KHC), addresses the classification of postoperative follow-up care after cochlear implantation ("CI rehabilitation"). In September 2024, "follow-up rehabilitation (AHB)" after cochlear implant surgery was included in the indication catalog of the Deutsche Rentenversicherung Bund (DRV Bund). Based on the guideline of the Association of the Scientific Medical Societies in Germany (AWMF) (017-071) and the CI White Paper, the following assessment examines how the AHB is to be integrated within the overall care pathway. At present, the AHB procedure is applied exclusively in adults. The analysis demonstrates that the AHB represents a complementary element within basic therapy and follow-up therapy but does not replace them. A mandatory prerequisite for AHB is the early fitting of the audio processor, according to medical indication, within the first days after cochlear implantation. This alone ensures that the AHB can begin within the required 14 days after discharge from inpatient treatment. At the same time, it must be emphasized that an AHB as the sole measure would deprive patients of essential components of follow-up therapy. Accordingly, AHB is to be regarded as a structured supplement to established treatment pathways, but not as the exclusive format of postoperative care for CI patients.

Septal perforations can severely diminish quality of life. Where surgical closure is impossible, due to size, location or contraindications, septum obturators offer an alternative. Defect anatomy can be assessed two ways: analog via silicone impression, or digitally using preoperative CT scans. This study compares these two methods.Retrospective analysis of 500 patients with symptomatic septal perforations was carried out, including defect size and location, type of closure and closure rate in surgical closures. 19 patients qualified for comparison of defect size and shape determined by conventional impression with CT-based data. For high precision comparison, silicone impressions were converted into plaster models, then digitally scanned, and CT data was converted into 3D models.The analysis of the NSD in the 19 patients and the comparison of the results from analog silicone impressions and preoperative CT scans revealed deviations of less than 10% in 8 out of 19 cases and less than 20% in 13 out of 19 cases. The deviations tended to be smaller in cases of larger defects. Larger deviations were observed when there were longer time intervals between the impression and the CT scan.Measurements of NSD based on CT data yield similar results to those obtained from silicone impressions, particularly when the CT scans are performed in close temporal proximity and in cases of larger defects. Further clinical studies should investigate whether iSOs created from CT data result in comparable clinical patient acceptance.