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Thanks to our predecessors and technical progress, we can nowadays offer our patients a safe and modern paranasal sinus surgery. This article provides an overview of the historical development of paranasal sinus surgery in Austria and Switzerland and to shed light on the dynamic progress of this discipline in an international context. Paranasal sinus surgery has undergone significant change in recent decades, driven by rapid technological advances that have significantly improved surgical procedures and operative outcomes. While indications were originally limited to treatment of inflammatory diseases, today, endoscopic procedures cover interventions in the area of the anterior skull base, the orbit and sinonasal tumors. The concept of functional endoscopic sinus surgery (FESS) may seem simple, but the anatomic variability, especially in the area of the frontal sinus, as well as the wide spectrum and severity of diseases can be a challenge. Therefore, paranasal sinus surgery should not be a casual operation and should only be performed by well-trained surgeons to prevent disease recurrence as well as medical and economic follow-up costs. Standardized surgical training for aspiring paranasal sinus and skull base surgeons is critical. Preoperative planning through systematic analysis of CT images is an essential factor to achieve optimal results and to avoid intraoperative complications. The pathophysiological understanding of sinonasal disease and the recent developments of new drug therapies such as monoclonal antibodies also enable excellent results in the small subgroup of patients who do not benefit from a combination of surgical rehabilitation and long-term drug therapy. The dynamic development of endoscopic paranasal sinus surgery in recent decades shows the potential of the field for the coming decades.

Background: Cochlear implants (CI) provide individuals with severe sensorineural hearing loss the opportunity for artificial auditory perception. The standardized documentation of speech intelligibility tests is widespread, while the systematic capture of patient-related outcome measures (PROMs) remains inconsistent.

Methodology: Relevant PROM instruments were evaluated and selected based on the criteria of dissemination, clarity, and relevance, integrated into routine clinical practice, and tested at longitudinal time points.

Results: A total of three PROM instruments were selected and successfully integrated into the clinical routine. The comparison of 2 measurement points from 25 individuals showed improvements in subjective speech comprehension and tinnitus perception.

Conclusion: This study demonstrates the clinical implementation and integration of PROMs in adult CI candidates and patients. The PROMs are a promising tool to support various phases of treatment, both as a decision aid for potential CI candidates and for monitoring after implantation.

Electrocochleography (ECochG) represents a promising approach for monitoring cochlear function during cochlear implantation and for investigating the causes of residual cochlear function loss after implantation. This paper provides an overview of the current research and application status of ECochG, both during and after cochlear implantation. Intraoperative ECochG can be conducted either via the implant itself or an extracochlear measuring electrode. Postoperative ECochG recordings are also feasible via the implant. Various studies have demonstrated that a significant decrease in ECochG amplitude during electrode insertion correlates with an increased risk of losing residual cochlear function, with critical cochlear events occurring primarily towards the end of the insertion. Postoperative data suggest that the loss of cochlear function mainly occurs in the early postoperative phase. Future research directions include the automation and objectification of signal analysis, as well as a more in-depth investigation into the underlying mechanisms of these signal changes.

This article describes the surgical treatment of superior semicircular canal dehiscence syndrome (SCDS) by isolating the dehiscence using transmastoid two-point canal plugging while preserving the high-frequency vestibulo-ocular reflex (VOR) of the affected semicircular canal. The superior semicircular canal is opened via a transmastoid approach anterior (as far from the ampulla as possible) and posterior to the dehiscence and then plugged with connective tissue and bone dust. In two clinical exemplary cases, vestibular testing showed that the VOR measured by video head impulse (vHIT) test was preserved (patient 1: gain preoperative 0.7, long-term postoperative 0.75; patient 2: gain preoperative 0.64, long-term postoperative 0.79; reduction of corrective saccades in each case) with a simultaneous reduction in pathologically increased amplitudes of vestibular evoked myogenic potentials (VEMPs) and a significant improvement in clinical symptoms with almost complete freedom from symptoms. One possible explanation for preservation of the high-frequency VOR of the superior semicircular canal would be the deformability of the endolymphatic space described at high stimulation frequencies, which can lead to endolymph movements in the area of the ampulla with deflection of the cupula despite blockage of the semicircular canal.

Background: Age-appropriate speech development is a primary aim of the rehabilitation of children treated with cochlear implants (CI). Various assessment tools are available, including the speech development test for 2‑year-olds (SETK-2). All tests are normalized to normal-hearing children; additionally, results are evaluated according to age and the duration of CI (hearing age). The present study presents current practices and evaluates them as far as is possible.

Materials and methods: In a multicentric retrospective study, 375 SETK‑2 datasets of congenitally deaf children treated with CI from five centers were included. All children had been treated before the fourth year of life, and the interval between treatment of the two sides was less than 12 months.

Results: In the analyses according to age and hearing age, all subtests in the observed groups, with the exception of word comprehension, showed significantly worse results than the normative values. Isolated results demonstrated results similar to or even better than the normative values. The more complex the tested performance, the higher the proportion of conspicuous test results. The timepoint of implantation had no significant influence on test performance.

Conclusion: The SETK‑2 should be evaluated according to chronological age; otherwise, the progress of early speech development may be incorrectly assessed and interventions initiated too late. Moreover, evaluation according to hearing age disregards the child's cognitive skills.

Background: After the first appearance of COVID-19 cases, the virus spread worldwide within a few months. This led to a decrease in medical consultations. The present study investigates whether this effect had an impact on the diagnosis and treatment of head and neck cancer during the period from 2018 to 2022.

Materials and methods: Data from the clinical cancer registration center (KKR) of Mecklenburg-Vorpommern from the 2020-2022 period were compared to those from the two previous years (2018, 2019). Demographic data, case numbers, diagnosis data, International Classification of Diseases (ICD) codes, and TNM classifications were recorded. COVID-19 case numbers were obtained from the Robert Koch Institute (RKI). Data were analyzed using the Mann-Whitney U test and Pearson's correlation.

Results: A total of 2332 patient cases could be included in this study. During the lockdown there was neither a significant reduction in tumor diagnoses registered at the KKR nor a correlation between COVID-19 case numbers and tumor diagnoses. Significant differences were found in terms of T category in the year 2022 compared to the pre-COVID years 2018 and 2019. Furthermore, there was a shift in the relative frequencies of some ICD-10 codes.

Conclusion: During the COVID-19 pandemic, no significant differences in tumor diagnoses were observed upon comparing the years 2018 to 2022. Contrary to the expectation of a decrease in case numbers during the pandemic due to the lockdown with an increase in tumor stages, a reduction of the T category could be found in 2022, and a shift in the relative frequencies of some ICD-10 codes in the pandemic period was observed.

Background: To date, there is no consensus on how to standardize the assessment of ototoxicity in serial measurements. For the diagnosis of damage to the cochlear amplifier, measurement methods are required that have the highest possible test-retest reliability and validity for detecting persistent damage. Estimated distortion-product thresholds (L_EDPT) based on short-pulse distortion-product otoacoustic emission (DPOAE) level maps use individually optimal DPOAE stimulus levels and allow reliable quantitative estimation of cochlea-related hearing loss.

Materials and methods: Hearing thresholds were estimated objectively using L_EDPT and subjectively using modified Békésy tracking audiometry (L_TA). Recordings were performed seven times within three months at 14 frequencies (f₂ = 1-14 kHz) in 20 ears (PTA_{4 (0.5-4 kHz)} < 20 dB HL). Reconstruction of the DPOAE growth behavior as a function of the stimulus levels L₁, L₂ was performed on the basis of 21 DPOAE amplitudes. A numerical fit of a nonlinear mathematical function to the three-dimensional DPOAE growth function yielded L_EDPT for each stimulus frequency. For the combined analysis, probability distributions of hearing thresholds (L_TA, L_EDPT), DPOAE levels (L_DP), and combinations thereof were determined.

Results: L_TA and L_EDPT each exhibited a test-retest reliability with a median of absolute differences (AD) of 3.2 dB and 3.3 dB, respectively. Combining L_EDPT, L_DP, and L_TA into a single parameter yielded a significantly smaller median AD of 2.0 dB.

Conclusion: It is expected that an analysis paradigm based on a combination of L_EDPT, suprathreshold L_DP, and fine-structure-reduced L_TA would achieve higher test performance (sensitivity and specificity), allowing reliable detection of pathological or regenerative changes in the outer hair cells.