Journal of Otorhinolaryngology, Hearing and Balance Medicine doi: 10.3390/ohbm5010004
Authors: Santhosh Kumar Rajamani Radha Srinivasan Iyer Anusha Venkatraman
This study aimed to compare the diagnostic efficacy of the Halmágyi–Curthoys head impulse (thrust) test and Romberg’s test in detecting vestibular hypofunctioning among two groups of 50 vertigo patients each; the two groups were randomly assigned. The assessment utilized the visual analog scale (VAS) to quantify subjective experiences of vertigo. The results revealed distinctive patterns in the detection of vestibular hypofunctioning, highlighting the strengths and limitations of each test. The Halmágyi–Curthoys head impulse test demonstrated utility in identifying vestibular hypofunctioning and its effect on vestibulo–ocular reflexes, particularly in cases with sudden head movements. Romberg’s test was useful in assessing postural instability in vestibular hypofunctioning due to defects in vestibulospinal reflexes. The integration of VAS scores provided valuable subjective insights into the patient experience. This comparative analysis contributes to a nuanced understanding of diagnostic tools for vestibular hypofunctioning in vertigo patients, offering clinicians valuable information for tailored assessments and interventions.
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Authors: Isabel Guimarães Gabriela Torrejano Raquel Aires Filomena Gonçalves Susana Vaz Freitas Paula Correia Cláudia Romeiro Inês Silvestre Rita Bom Paulo Martins Ana R. Santos
Background: Body image is a potential psychological burden after total laryngectomy (TL) with devastating effects on patients’ health-related quality of life (HRQOL) and communication. This study focused on TL patients to determine the prevalence of dissatisfied body image and whether they have poorer HRQOL and difficulty adjusting to their new voice than TL patients with satisfied body image. It also aimed to investigate the potential predictors of body image. Methods: A multicenter cross-sectional study was conducted. For TL patients, the Body Image Scale (BIS), the European Organization for Research on Cancer Quality of Life Questionnaire, Core and Neck Module (EORTC QLQ C30 and EORCT H&N35), and the Self-Experiences of Communication after Laryngeal cancer (SECEL) were used. Patients were categorized as dissatisfied with their body image if the BIS score was ≥8. Multiple regression analysis was performed using the BIS as the dependent measure and HRQOL (QLQ C30 and H& N35) and communication (SECEL) as independent variables. Results: Overall, 31.3% of TL patients had dissatisfied body image, significantly worse HRQOL, and difficulty adjusting to their new voice than patients with satisfied body image. The regression model showed that social eating and socializing (H&N35) and adjustment to their new voice (SECEL) were independent predictors of body image. The model explained 52% of the variance. Conclusions: Screening TL patients at risk for body image concerns may help develop effective interventions to optimize HRQOL and patient communication.
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Authors: Daniel Polterauer Maike Neuling Sophia Stoecklein Joachim Mueller
Implantation of two electrical stimulators of different cranial nerves in one patient is rare. We report the case of a forty-seven-year-old patient already implanted with a trigeminus nerve stimulator. In addition, this patient suffered from hearing problems. In one ear, the patient was deaf. On the other side, the patient wore a bone conduction hearing aid to improve hearing. In this complex situation, we decided to check the possibility of cochlear implantation on the deaf side. Finally, we managed to provide electrical stimulation of the auditory pathway of the deaf ear to improve the patient’s hearing tests. In addition, this case report shows how the trigeminus stimulator interferes with the electrical stimulation in auditory evoked potentials measurement of the auditory brainstem and cortex via EABR (evoked auditory brainstem response) resp. EALR (evoked auditory late response).
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Authors: Esmat Mahmoud Eman Mahdi Humera Ahsan Joseph Cousins Carlos Leiva-Salinas Ayman Nada
Even if the management of parotid gland tumors depends on the histopathological subtype, preoperative imaging of parotid gland tumors is clinically relevant. Preoperative imaging gives insight into the differentiation between benign and malignant tumors, which might potentially decrease the number of unnecessary aggressive surgeries. Characteristic imaging findings on cross-sectional imaging, such as computed tomography (CT) and magnetic resonance imaging (MRI), can help narrow the differential diagnosis and guide the further management of patients presenting with parotid masses. While MRI is imperative for the determination of perineural spread, which is frequently encountered with malignant parotid tumors, CT is important for the evaluation of osseous invasion. Furthermore, multi-parametric MRI protocols provide insights into the tumor behavior and internal composition, which is helpful in the case of benign mixed tumors and others. While distant metastasis is uncommon with parotid neoplasms, PET/CT provides a valuable tool for the improved evaluation of loco-regional and distant metastatic disease. This article discusses the imaging features of common benign and malignant parotid tumors.
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Authors: Karthik Nagaraja Rao Ripudaman Arora Ambesh Singh Prajwal Dange Nitin M. Nagarkar
Objective—The objective of this study was to systematically assess meta-analyses to determine the lacunae in the literature for PCF following laryngectomy. Methods—Bibliometric analysis were carried out on meta-analyses on PCF after total laryngectomy for laryngeal cancer in the PubMed database. Results—Twenty-four meta-analyses were considered eligible and chosen for analysis. Six meta-analyses (25%) focused on the risk factors for PCF in TL. Four meta-analyses (16.6%) focused on the role of the onlay flap. Four meta-analyses (16.6%) focused on the timing of feed initiation. Three meta-analyses (12.5%) focused on using a stapler for pharyngeal closure. Two meta-analyses focused on types of pharyngeal reconstruction. Other meta-analyses analyzed the use of salivary bypass tubes, the method of pharyngeal closure, organ preservation protocols on PCF, primary and secondary TEP, and the effect of non-surgical treatment on PCF. Conclusion—Despite plenty of published meta-analyses, there is a lack of scrutiny on certain critical aspects of PCF.
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Authors: Fabio Piazza Annamaria Iole Palmeri Andrea Bacciu Giuseppe Spriano Giuseppe Mercante
Background: En block resection of squamous cell carcinoma (SCC) of the concha represents a reconstruction challenge, due to the complex topography and difficult access. Objective: The objective of the present paper is to describe the chemically assisted dissection (CADISS) of SCC originating in the auricular concha and the following reconstruction of the conchal cavity with a post-auricular island flap (PIF), taking care to minimize injury to the donor site. Methods: Twenty-six patients having a diagnosis of SCC of the auricular concha were included in the study. ‘En bloc’ removal of the tumor was accomplished, leaving the adjacent conchal cartilage attached to the tumor and using the CADISS technique to preserve the deep perichondrium. A PIF was used to repair the auricular conchal defect. Results: Flaps were normal at 10 days and at 1-month follow-up. No tumor recurrence was observed. No complications were observed. According to the SCAR scale, good aesthetic outcomes were achieved in all cases, both at the auricular concha and at the donor site. Conclusion: CADISS facilitates the complete removal of the tumor with the preservation of the surrounding normal tissues. A post-auricular island flap can be easily pulled through a post-auricular tunnel to repair the defect and the donor site can be closed primarily.
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Authors: Francesco Lazzerini Luca Baldassari Adriana Angileri Luca Bruschini Stefano Berrettini Francesca Forli
Despite the evolution of hearing aids and cochlear implants, noisy environments are reportedly still an important hurdle for persons with hearing loss, especially in the process of speech recognition. The development of pre-processing algorithms and the pairing with a wireless device can bring relief to this situation, but it is still under scrutiny whether one or the other is more effective. The purpose of this study was to compare the benefits of speech recognition in a noisy environment by recipients of cochlear implants when using the pre-processing automatic algorithms or when using a wireless microphone. Twenty-nine participants were selected, aged 14 to 83, suffering from sensorineural hearing loss and recipients of cochlear implants for at least 6 months. The proprietary Cochlear Limited SCAN technology uses pre-processing algorithms to attenuate various noises; the wireless device MiniMic2 uses a 2.4 GHz connection to facilitate communications between the recipient and the signal source. Participants were asked to repeat 20 sentences randomly generated by the adaptive Italian Matrix Sentence Test, first while using the SCAN technology and then with the wireless MiniMic2. Both signal and noise were administered through a single loudspeaker set 1 m away from the subject. Significantly better results in speech recognition of noise were achieved with the wireless MiniMic2 when compared to the SCAN technology.
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Authors: Rita Alegria Susana Vaz-Freitas Fátima Maia Maria Conceição Manso
(1) Background: Vocal fold nodules are bilateral lesions that can have an important negative impact on a person’s job performance, social interaction, and quality of life. This study aims to analyze multidimensional voice evaluation outcomes in a group of patients with bilateral vocal fold nodules who underwent voice therapy. (2) Methods: A retrospective analysis was performed in 42 patients on the following voice evaluations, before and after voice therapy: visual-perceptual (video-laryngostroboscopic evaluation), auditory-perceptual voice analysis based on the GRBAS scale, and aerodynamic voice analysis. Data were collected from January 2001 to December 2019. Data analyses were performed with non-parametric tests (Wilcoxon test) using α = 0.05. (3) Results: The patient average age was 33.6.1 ± 10 years (range 19–60), and 95.2% were female. Voice therapy was delivered by an experienced speech-language pathologist once a week, with an average of 9.8 ± 3 appointments (range 8–17). Vocal fold lesions disappeared in 40.4% of the patients after voice therapy, especially in participants receiving early voice therapy (p = 0.035). When comparing pre- and post-therapy audio-perceptual results, all parameters were improved with statistical significance (p < 0.05) except for the asthenic voice scale. Aerodynamic parameters were all improved but without statistical significance (p > 0.05); (4) Conclusions: Early timing to initiate voice therapy after the onset of symptoms or diagnosis seems to be an important factor for the success of voice therapy (absence of vocal fold nodules).
]]>Journal of Otorhinolaryngology, Hearing and Balance Medicine doi: 10.3390/ohbm4020007
Authors: Hemanth Narayan Shetty Srirangam Vijayakumar Narasimhan Sharath Mahanthesh
Past studies have reported that there are higher sound-pressure levels for each vowel in a child’s ear canal than those in adults due to reduced volume and a shorter ear canal. Furthermore, longer vocal tracts are associated with lower formant frequencies, and vice versa. The structural differences in this regard may reflect the difference in the occlusion effect. Thus, the present study compares the sound pressure levels (SPLs) and first formant frequencies of children and adults with normal hearing and determines the best vowel stimulus to assess the occlusion effect. A repeated measures research design was utilized to investigate the best stimulus with which to measure the occlusion effect among children and adults. Group 1 included ten children, and Group 2 comprised ten adults with normal hearing. The SPLs at frequencies between 200 Hz and 1000 Hz for three uttered vowels, with steps of 100 Hz, were measured using a hearing aid analyzer. The recorded vowels were saved in a ‘.wav’ format for formant frequency analysis. Furthermore, a paired comparison method was used to identify the vowel stimulus that most effectively induced the occlusion effect. A significantly higher SPL was observed for children compared to adults for each vowel. The formant frequency F1 value was higher for children than adults for each vowel, constituting a significant finding. In the paired comparison, the occlusion effect was reported to be significantly greater with respect to the vowel /u/ among adults, while it was reported to be greater in relation to the vowel /i/ among children. The vowel /u/ was the best stimulus with which to assess the occlusion effect among adults. The vowel /i/ was the best stimulus with which to assess the occlusion effect among children.
]]>Journal of Otorhinolaryngology, Hearing and Balance Medicine doi: 10.3390/ohbm4020006
Authors: Hanan Hamad Nilesh J. Washnik Chandan H. Suresh
The Auditory Steady-State Response (ASSR) provides objective and ear-specific information essential for early and appropriate intervention. Test–retest reliability is essential for audiological monitoring. The test–retest reliability of the ASSR has received limited attention. Only a handful of studies found in the literature investigated the test–retest reliability of old-generation ASSR using amplitude or mixed modulated stimuli. However, to our knowledge, no published reports have specifically examined the test–retest reliability of the next-generation ASSR using Chirp family stimuli as implemented in the Interacoustics Eclipse system. This pilot study investigated (a) the test–retest reliability of air conduction (AC) ASSR thresholds across two test sessions and (b) the relationship between differences in ASSR thresholds across two sessions to the residual noise levels in normal-hearing adults. Methods: Fifteen normal-hearing adults (12 females) (30 ears) with an average age of 28 years were recruited for the study. The ASSRs were recorded using a two-channel recording montage. The automatic default stimuli and recording protocol using 90 Hz ASSR, and the accuracy method (p < 0.01) as implemented in the Eclipse system is used to measure ASSR. Results: The study demonstrated strong test–retest reliability for ASSR across frequencies (500 Hz, 1000 Hz, 2000 Hz, and 4000 Hz). Notably, the highest reliability was observed at 500 Hz. The mean test–retest reliability of ASSR was found to be comparable to pure-tone thresholds, but the intra-subject variability is higher for ASSR compared to pure-tone thresholds. Additionally, no significant correlation was found between the difference in ASSR residual noise levels at the threshold and the difference in ASSR thresholds at all tested frequencies. Conclusion: The next-generation system demonstrated strong test–retest reliability across the frequencies examined in this pilot study. Particularly, an improvement in reliability was observed at 500 Hz compared to the old-generation ASSR. This enhancement can be attributed to the utilization of narrow-band CE-chirp stimuli, which generate large amplitude responses, and the implementation of an improved detection paradigm involving multiple harmonics spectral and phase analysis. This pilot study only enrolled adults with normal hearing, and future investigations should include a larger sample size comprising both normal-hearing and hearing-impaired individuals, as well as the pediatric population.
]]>Journal of Otorhinolaryngology, Hearing and Balance Medicine doi: 10.3390/ohbm4010005
Authors: Pedro Pestana Susana Vaz-Freitas Maria Conceição Manso
Fado is an urban Portuguese musical style rooted in popular culture. Previously found data suggests that Fado singers may have an increased risk of developing voice disorders. (1) Aim: To determine the risk factors for the development of voice disorders among Fado singers. (2) Methods: A cross-sectional study was conducted through the administration of a questionnaire containing questions related to voice disorders in singers. The relationship between personal and social data, musical background, performance demands and habits, vocal health and wellbeing, and strategies to overcome voice problems are reported. Beyond a comprehensive characterization, odds ratios (ORs) and their 95% confidence intervals (CIs) for the association with voice disorders were calculated through univariate and multivariate logistic regression analyses. (3) Results: The significant risk factors for voice disorders were as follows in decreasing order: nose-related disorders; decongestants or antihistamines; oral contraceptives or hormone replacement therapy; previous smoking habits; and vocal fatigue after performances. (4) Conclusion: These activities significantly increased the risk of developing voice disorders. The evidence from this study and the relative low prevalence of self-reported voice disorders suggest that these singers may develop a kind of protective combination of factors beyond the scope of this research.
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Authors: Anna Magrini Gelsomina Di Feo Andrea Cerniglia
The subjective judgment on the annoyance produced by noise is always an important tool to complete an investigation, and to find the best way for its reduction. Therefore, acoustic analyses for environmental improvement frequently combine objective measures with subjective surveys to gain a comprehensive understanding of the problem. The technical specification, concerning the “Assessment of noise annoyance by means of social and socio-acoustic surveys”, ISO/TS 15666 (revised in 2021), has represented a basis for these activities since 2003, when it aimed to obtain information about noise annoyance “at home”. The more recent ISO/TS 12913-2 (2018), aimed at soundscape studies, investigations and applications, provides guidelines for conducting social and socio-acoustic surveys to assess noise annoyance and, in particular, it gives detailed indications on data collection and reporting. The indications provided by the technical specifications represent a common guideline for addressing the implementation of a subjective survey in the acoustic field, and to make investigations as comparable as possible. However, they do not cover all the fields of acoustic subjective investigations. Therefore, to make the collection of information from questionnaires more effective, it is useful to have a broader review of the issues that need to be addressed. To support this type of activity, this paper collects and presents relevant observations for the design of subjective survey questionnaires focused on outdoor acoustic quality. Drawing on previous research studies and experiences, it provides a series of observations on the main aspects to be considered in order to structure multipurpose acoustic evaluation questionnaires, including discussion of the general considerations for questionnaire structure, administration methods, population sample characterization, question formulation, and classification. It also deals with specific indications related to acoustic evaluations, such as the characteristics of annoying noise, boundary conditions, subjective feelings, and source features.
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Authors: Henrique F. Pauna Maria Stella A. Do Amaral Daniela S. Fonseca Rodrigo Pessini Denny M. Garcia Jéssica Echeverria Alexandre C. Guimarães Vagner A. R. Da Silva Miguel A. Hyppolito
Background: There is evidence that the cochlear volume may influence audiometric thresholds and CI electrodes’ impedance. The aim of the present study was to evaluate the impedance changes over time and correlate them to the residual volume of the cochlea. Methods: An MRI scan was performed via 3-D reconstruction before every surgery to obtain a residual volume for each ear. We performed repeated assessments of electrode impedance, both intra-operatively and post-implant, at the following intervals: 3 months, 6 months, and one year. The same type of perimodiolar array was implanted for each. Results: Thirty-four patients (10 (29.41%) male patients and 24 (70.59%) female patients) were evaluated. Patients received the implants between 2008 and 2017. The mean age of implantation was 13 ± 17.17 years, and the average of hearing thresholds improved after one year of the surgery. The mean cochlear volumes of the implanted ears were 68.16 ± 10.74 mm3 (right ear) and 56.54 ± 13.75 mm3 (left ear). We observed an increase in the basal electrodes’ impedance at the 3rd month. Yet, for the apical electrodes’ impedance, there was a decrease in averaged values. Conclusions: Post-operative impedance measurements were increased when compared to the intraoperatively measured basal values. Newly formed connective tissue is thought to be the cause of the higher impedance values.
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Authors: Mirko Aldè Lorenzo Pignataro Diego Zanetti
We report the case of a 51-year-old woman with multiple otologic and vestibular symptoms. She presented with two different types of tinnitus in her right ear, vertigo, and fluctuating aural symptoms in the left ear. She also complained of disequilibrium; chronic headache; hyperhidrosis; amenorrhea; insomnia; broadened hands and feet; and widened, thickened, and stubby fingers. The patient underwent careful collection of medical history, otomiscroscopy, pure tone audiometry, tympanometry, reflex threshold measurements, vestibular assessments, blood tests, magnetic resonance imaging (MRI), and cone beam computed tomography (CBTC) of the head. The audiogram showed: (1) a mild low-to-mid frequency conductive hearing loss, and a sharply sloping sensorineural hearing loss above 4000 Hz in the right ear; (2) a mild low-frequency sensorineural hearing loss in the left ear. MRI with 3D FLAIR sequences detected an acoustic neuroma (7.4 mm × 5.2 mm) in the middle-third of the right internal auditory canal, a pituitary macroadenoma (13 mm × 10 mm × 10 mm) and left saccular hydrops. The CBCT scan documented an outbreak of otosclerosis (3 mm) around the fissula ante fenestram in the right ear. Therefore, acoustic neuroma (right ear), growth hormone-secreting macroadenoma of the pituitary gland, Menière’s disease (left ear), and otosclerosis (right ear) were diagnosed/strongly suspected. A watch-and-wait strategy was adopted for acoustic neuroma and otosclerosis, while transsphenoidal surgery was successfully performed to remove the pituitary macroadenoma. This case report confirms that multiple otologic disorders can occur simultaneously in the same patient, requiring prompt audiological and imaging evaluations.
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Authors: Eva Dröge Rainer Probstmeier Matthias Wenghoefer Jochen Winter
Background: The goal of this study is the identification of potential marker molecules for characterizing different basal cell carcinoma entities, to help improve clinical decisions for surgical resection therapy. Methods: Three different entities, sclerodermiform, solid and superficial basal cell carcinomas, were subjected to immunohistochemical microscopy and histomorphometric analyses for human α- (DEFA1/3; DEFA4) and β-defensins (hBD1/2/3) and special S100 proteins (S100A4/7/8/9). Thirty specimens of the three entities were evaluated. Analyses were performed by comparing tissue and cellular localization and staining intensities of tumorous with non-tumorous areas. Staining intensities were semiquantitatively examined by using an RGB-based model. Results: Human defensins are present in all three entities of basal cell carcinomas. They all show cytoplasmic immunostaining in cells of the epithelium, stroma and tumor. Notably, human β-defensin3 is accumulated in the cell nuclei of sclerodermiform and superficial basal cell carcinomas. S100A4 and A7 are undetectable in tumor regions. However, S100A4 occurs in cancer-associated stroma cells with nuclear staining in superficial basal cell carcinomas. Conclusion: Two candidates, namely hBD3 and S100A4, might be used as potential clinical tools for evaluating successful surgical resection therapy to avoid aesthetic and functional facial deformation.
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Authors: Anne B. Harris Elizabeth Seeliger Christi Hess Allison L. Sedey Kayla Kristensen Yen Lee Winnie Chung
This study examines the relationship between the early identification of hearing loss and language outcomes for deaf/hard of hearing (D/HH) children, with bilateral or unilateral hearing loss and with or without additional disabilities. It was hypothesized that hearing loss identified by 3 months of age would be associated with better language outcomes. Using a prospective, longitudinal design, 86 families completed developmental instruments at two time points: at an average age of 14.8 months and an average age of 32.1 months. Multiple regression examined how hearing loss identified by 3 months of age contributed to later language outcomes while controlling for developmental level at the first time point. Hearing loss identified by 3 months of age was positively associated with better language outcomes for D/HH children at 32 months of age; however, D/HH children still exhibited language delays, compared to normative scores for same-aged hearing peers for reported measures. Language outcomes of children with unilateral hearing loss were not better than those of children with mild-to-moderate bilateral hearing loss. Children with additional disabilities and more severe bilateral hearing loss had lower language scores than those without.
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Authors: Kotaro Tsutsumi Sina Soltanzadeh-Zarandi Pooya Khosravi Khodayar Goshtasbi Hamid R. Djalilian Mehdi Abouzari
The application of machine learning (ML) techniques to otolaryngology remains a topic of interest and prevalence in the literature, though no previous articles have summarized the current state of ML application to management and the diagnosis of lateral skull base (LSB) tumors. Subsequently, we present a systematic overview of previous applications of ML techniques to the management of LSB tumors. Independent searches were conducted on PubMed and Web of Science between August 2020 and February 2021 to identify the literature pertaining to the use of ML techniques in LSB tumor surgery written in the English language. All articles were assessed in regard to their application task, ML methodology, and their outcomes. A total of 32 articles were examined. The number of articles involving applications of ML techniques to LSB tumor surgeries has significantly increased since the first article relevant to this field was published in 1994. The most commonly employed ML category was tree-based algorithms. Most articles were included in the category of surgical management (13; 40.6%), followed by those in disease classification (8; 25%). Overall, the application of ML techniques to the management of LSB tumor has evolved rapidly over the past two decades, and the anticipated growth in the future could significantly augment the surgical outcomes and management of LSB tumors.
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Authors: Dunja Vajsakovic Michael R. D. Maslin Grant D. Searchfield
Auditory categorisation is a phenomenon reflecting the non-linear nature of human perceptual spaces which govern sound perception. Categorisation training paradigms may reduce sensitivity toward training stimuli, decreasing the representation of these stimuli in auditory perceptual maps. Reduced cortical representation may have clinical implications for conditions that arise from disturbances in cortical activation, such as tinnitus. This review explores the categorisation of sound, with a particular focus on tinnitus. The potential of categorisation training as a sound-based tinnitus therapy is discussed. A narrative review methodological framework was followed. Four databases (PubMed, Google Scholar, Scopus, and ScienceDirect) were extensively searched for the following key words: categorisation, categorical perception, perceptual magnet effect, generalisation, and categorisation OR categorical perception OR perceptual magnet effect OR generalisation AND sound. Given the exploratory nature of the review and the fact that early works on categorisation are crucial to the understanding and development of auditory categorisation, all study types were selected for the period 1950–2022. Reference lists of articles were reviewed to identify any further relevant studies. The results of the review were catalogued and organised into themes. In total, 112 articles were reviewed in full, from which 59 were found to contain relevant information and were included in the review. Key themes identified included categorical perception of speech stimuli, warping of the auditory perceptual space, categorisation versus discrimination, the presence of categorisation across several modalities, and categorisation as an innate versus learned feature. Although a substantial amount of work focused on evaluating the effects of categorisation training on sound perception, only two studies investigated the effects of categorisation training on tinnitus. Implementation of a categorisation-based perceptual training paradigm could serve as a promising means of tinnitus management by reversing the changes in cortical plasticity that are seen in tinnitus, in turn altering the representation of sound within the auditory cortex itself. In the instance that the categorisation training is successful, this would likely mean a decrease in the level of activity within the auditory cortex (and other associated cortical areas found to be hyperactive in tinnitus) as well as a reduction in tinnitus salience.
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Authors: Maria Y. Boboshko Ekaterina S. Garbaruk Sof’ya M. Vikhnina Larisa E. Golovanova Elena A. Ogorodnikova Anna V. Rabchevskaya Ekaterina V. Zhilinskaia
In this study, we assessed the impact of COVID-19 on the hearing function in adults. A total of 161 subjects were examined, and the results of a previous audiological examination of 24 patients were reviewed. Pure tone audiometry, impedancemetry, speech audiometry in quiet and noise, the Binaural Fusion Test, the dichotic digits test, and a cognitive status examination were performed. A total of 81% of patients complained about hearing disorders, and 43% noted memory impairment. According to pure tone audiometry, 24% of the subjects had normal hearing, while 76% had some degree of hearing loss. No significant changes in hearing thresholds were found in comparison with audiological examinations performed before COVID-19. Disorder of monosyllabic words’ intelligibility in quiet was found in 33% of patients, and in 42% in noise, along with low indicators in the dichotic digits test in 54% of patients. Moreover, 71% of patients had low scores on the MoCA scale that indicated cognitive impairment. Conclusions: The deterioration of speech test scores in patients after COVID-19 can occur due to central auditory processing disorders (CAPD), memory impairment, or changes in cognitive status in general.
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Authors: Bich-Ty Tran-Thi Minh Quach-Thieu Bao-Ngoc Le-Tran Duy Nguyen-Duc Nguyen Tran-Hiep Thao Nguyen-Thi Yen-Linh Nguyen-Ngoc Anh Nguyen-Tuan Tram Tang-Thi-Thao Toi Nguyen-Van Sy Duong-Quy
Background: Obstructive sleep apnea (OSA) is a common disorder and can lead to many severe complications; however, the majority of patients remain undiagnosed. Although polysomnography (PSG) remains the gold standard of diagnosis, it is usually uncomfortable and costly for patients. Purpose: The study aims to assess the agreement of the AHI measured by polygraphy (PG) (Philips Alice NightOne) with that of polysomnography (Philips Alice PDx) simultaneously recorded in-lab. Methods: A total of 11 voluntary participants over 18 years old underwent one night of simultaneous PSG and PG recording in sleep laboratories. Studied parameters (AHI, OAI, CAI, MAI, and minSpO2) were analyzed and reported by the Philips Sleepware G3 software. PSG and PG results were scored by qualified staff. Results: In terms of AHI, the mean AHI derived from PG was different from that of PSG—7.78 and 2.37 events/h, respectively. A Bland–Altman analysis of the AHI on PSG versus PG showed a mean difference of 5.41; limits of agreement (equal to ±2 standard deviations) were from −6.74 to 17.56. The Bland–Altman analysis showed a slight difference between the two methods, with a mean difference of −0.12 events/h in CAI, 1.35 events/h in OAI, and 0.42 events/h in MAI. Conclusions: In the population with a low suspicion of OSA, the PG showed a low agreement with the simultaneous PSG in the sleep lab. Therefore, PG should only be used as a screening method. Further studies with sufficient sensors in the expanded populations of OSA are needed.
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Authors: Mirko Aldè Henri Albert Didier Aldo Bruno Giannì Fabiola Sessa Giulia Borromeo Alexandre Henri Didier Stefania Barozzi Diego Zanetti Federica Di Berardino
The aim of this retrospective study was to evaluate the prevalence of new-onset otological symptoms and the possible associations between tinnitus and oral parafunctional habits among patients with temporomandibular disorders (TMD) who attended a Craniofacial Pain Outpatient and a Dentistry Clinic. The medical reports and charts of patients who experienced TMD between 1 February 2016 and 31 December 2017 were reviewed, in order to evaluate the prevalence of new-onset aural fullness, vertigo and tinnitus. Tinnitus was also analyzed in more detail to evaluate possible associations with parafunctional habits. A total of 400 patients (301 females, 99 males) met the inclusion criteria, with a median age of 39.6 ± 15.6 years. Overall, new-onset otological symptoms were reported by 304 (76%) subjects with TMD. Among otological symptoms, aural fullness was the most common (n = 133, 33.3%), followed by tinnitus (n = 92, 23%) and vertigo (n = 79, 19.8%). No significant correlations were found between tinnitus and bruxism (p = 0.28), clenching (p = 0.11), nail-biting (p = 0.96), sleeping prone (p = 0.27), chewing gum (p = 0.99) and talking for a long time (p = 0.42). The present study suggests that all patients with TMD should be investigated for new-onset otological symptoms, regardless of oral parafunctional habits. Early diagnosis would allow to plan personalized and appropriate therapeutic and rehabilitative pathways, minimizing the negative impact due to TMD.
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Authors: Norihiko Narita
The field of otolaryngology has developed through the continuous efforts of otolaryngologists around the world [...]
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Authors: Wen-Hsuan Tseng Tzu-Yen Huang
The production of voice is a powerful tool not only for communication, but also for artistic performances [...]
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Authors: Beeshman Saireuben Nandakumar Naomi Natasha Amalee Niles Larry Hilton Kalish
Odontogenic maxillary sinusitis (OMS) is an inflammatory condition affecting the paranasal sinuses and is commonly encountered by both Otorhinolaryngologists and Dentists. However, there is an ongoing debate regarding the best sequence of management. Clinicians are faced with the dilemma of first addressing either the affected tooth or the affected sinus. This paper provides a review of the current literature on the aetiology, presentation, and management of OMS, as well as our experience in managing this condition. Overall, the causative pathology of the patient’s OMS, their symptoms, and the risk of surgery should drive decision making with regards to sequence of management.
]]>Journal of Otorhinolaryngology, Hearing and Balance Medicine doi: 10.3390/ohbm2030007
Authors: Norihiko Narita Yumi Ito Yukinori Kato Yukihiro Kimura Yoshimasa Imoto Kazuhiro Ogi Masayuki Okamoto Tetsuji Takabayashi Shigeharu Fujieda
Orbital floor fracture, especially with constriction of orbital soft tissue, should be reconstructed surgically. Although various approaches to treat the orbital floor have been reported, procedures have not been unified among hospitals or surgeons. Since 2009, we have adopted a procedure combining a transorbital approach via subciliary incision with a transantral approach through upper gingival incision. The combined approach compensates for the shortcomings of each approach, leading to successful reconstruction. It is applicable safely for trapdoor fracture of the orbital floor in children, which more frequently constricts orbital soft tissue and which leaves permanent diplopia. This report retrospectively assessed clinical preoperative findings and postoperative outcomes of patients who received reconstruction of orbital floor fracture with the combined approach in our department from August 2009 through March 2021. Data of 21 patients with orbital floor fracture were analyzed, only one (4.8%) of whom had postoperative diplopia. Specifically, we describe children with trapdoor fracture treated with the combined approach, resulting in complete recovery. The combined approach stands as an excellent procedure for reconstruction of orbital floor fracture in adults and even in children.
]]>Journal of Otorhinolaryngology, Hearing and Balance Medicine doi: 10.3390/ohbm2020006
Authors: Dong Jun Park
Recently, studies on the mechanism and clinical application of stem cell-derived exosomes have increased. Although the number of patients with hearing loss is increasing, there is no ideal therapy for the recovery of auditory cells of an independent organ in humans. In this review, we proposed the use of stem cell-derived exosomes for treating hearing loss and summarized the exosome research strategy platform for preclinical studies. It is necessary to select a research direction to assess direct or indirect effects on recipients based on the physiological mechanisms of exosomes that deliver useful molecules (called payloads) to recipient cells or tissues. To apply exosomes in the auditory field, researchers should select a model for assessing the toxicity to the auditory cells and analyzing their mechanisms in the recipient tissue. Such in vitro, ex vivo, and in vivo models have been designed and reported in previous studies. The analytical strategies in various models can evaluate the mechanism of exosomes based on exosome surface markers or the payload, thus helping the researchers in finding evidence regarding the efficacy of exosomes. Here, we propose three strategies for exosome application research in the auditory field.
]]>Journal of Otorhinolaryngology, Hearing and Balance Medicine doi: 10.3390/ohbm2020005
Authors: Masashi Matsumura Toshihisa Murofushi
Human postural control is regulated by the vestibular, somatosensory, and visual systems. These types of sensory information are integrated in the central nervous system to ascertain the body’s position in space. Proper functioning of the vestibular, somatosensory, and visual senses is necessary for the body to maintain equilibrium. Bilateral vestibulopathy (BVP) is a condition in which bilateral peripheral vestibular function is reduced. Its treatment includes vestibular rehabilitation (VeR), balance training, counseling, treating the underlying cause, and avoiding further damage to the vestibular system. As VeR is often tedious for patients, patient motivation is required or patients may drop out of the program. To solve this problem, in recent years, there have been increasing reports of VeR using virtual reality, which increases vestibulo-ocular reflex gain and decreased dizziness by inducing adaptation. In this review, we discuss VeR, particularly for BVP, and VeR using virtual reality.
]]>Journal of Otorhinolaryngology, Hearing and Balance Medicine doi: 10.3390/ohbm2010004
Authors: Nader Nassif Maria Grazia Barezzani Luca Oscar Redaelli de Zinis
The aim of the study was to evaluate the outcomes of cochlear implantation (CI) in a group of immigrant deaf children living in a foreign language family, following up to 3 years of a personalized habilitation program compared to age-matched Italian CI recipients. Tests of speech perception ability such as the IT-MAIS, the LiP, the CAP, and speech production such as the MUSS have been used before CI and then after 6 months, 1 year, 2 years, and 3 years. Nonparametrical tests were chosen for comparison. Eight bilingual CI recipients were included in the study and matched to 11 Italian CI recipients. The difference between chronological age at implantation, age at diagnosis, hearing age, and verbal age in the two groups of children was not significant. Comparison of the auditory perceptive and linguistic abilities between the two groups showed significant differences only in preoperative MAIS and postoperative CAP (1 to 3 years). In agreement with other studies, we achieved good performances from bilingual children with CI and our personal experience confirm the attitude of promoting bilingualism throughout the rehabilitation process.
]]>Journal of Otorhinolaryngology, Hearing and Balance Medicine doi: 10.3390/ohbm2010003
Authors: Víctor Manuel Suárez-Vega Pablo Domínguez Nicolás Pérez-Fernández
Isolated lateral semicircular canal dysplasia (LSCCD) is one of the most frequent malformations of the bony labyrinth. The aim of this study is to depict morphology and size of the vestibular endolymphatic space in patients with isolated LSCCD using a dedicated 3D high resolution MR sequence called 3D inversion recovery with REAL reconstruction (3D-REAL-IR). From January 2018 to February 2020, we reviewed 281 CT and 241 MR temporal bone studies, and 103 MR studies performed for the evaluation of endolymphatic hydrops (EH). Five patients with LSCCD were found, one of them with bilateral malformation. Three patients (four affected ears) underwent specific MR examination for the evaluation of EH, consisting of a heavily T2-weighed cisternography sequence (T2 SPACE) and a 3D inversion-recovery with REAL reconstruction. The endolymphatic volumetric ratio (ELR) was calculated as the total endolymphatic volume divided by the total lymph (vestibular) volume multiplied by 100. Hydrops MR imaging was available in four of the affected ears. ELR ranged from 22% to 81%. Both extremes were present in the same patient, corresponding to a patient with right unilateral Ménière’s syndrome but with bilateral LSCCD. A patient affected with hearing loss had an ELR of 33% and the last patient with unilateral probable Ménière’s syndrome showed an ELR of 42%. Endolymphatic hydrops imaging is feasible and can be performed on patients with inner ear malformations like LSCCD. The endolymphatic volumetric ratio could be a useful and reproducible tool in daily clinical practice.
]]>Journal of Otorhinolaryngology, Hearing and Balance Medicine doi: 10.3390/ohbm2010002
Authors: Mario Sanna
Dear colleagues, [...]
]]>Journal of Otorhinolaryngology, Hearing and Balance Medicine doi: 10.3390/ohbm2010001
Authors: OHBM Editorial Office
MDPI was founded in 1996 as a non-profit project for the promotion and preservation of the diversity of chemical compounds [...]
]]>Journal of Otorhinolaryngology, Hearing and Balance Medicine doi: 10.3390/ohbm1020010
Authors: Alberto Behar
In most cases, hearing loss is the result of exposure to high levels of noise for extended periods of time or as an effect of aging. Although this is found in most situations, hearing can also be damaged by certain chemical agents in pure state, or as a combination. These chemicals can even include parts of drugs used for the treatment of illnesses for which there are no other remedies. Ototoxic chemicals are also found in the workplace, in most occasions as solvents. The effects from these elements are worst when combined with exposure to a high level of noise. This paper examines the effects of these chemicals in isolation or in combination with noise and gives recommendations on how to deal with this problem.
]]>Journal of Otorhinolaryngology, Hearing and Balance Medicine doi: 10.3390/ohbm1020009
Authors: Sagung Rai Indrasari Kartono Sudarman Jessica Fedriani
Background: Nasopharyngeal carcinoma (NPC) is a squamous cell carcinoma derived from nasopharyngeal epithelium. NPC characteristic is highly invasive and can metastasize rapidly. The presence of distant metastasis is a major factor in determining the patient’s management and prognosis. The magnitude of radiologic and molecular costs encouraging the need to know the clinical variables associated with distant metastasis of NPC. Methods: Cross-sectional analytical retrospective studies of undifferentiated NPC (WHO type III) patients at initial diagnosis in the ORL-HNS Department of Dr. Sardjito Hospital Yogyakarta from January 2014 to December 2016. Results: At 276 NPC patients with the ratio of 197 men (71.4%) and 79 women (28.6%) was 2.5:1, mean age 48.5 years, distant metastasis was found in 37 patients (13.4%). There was no significant difference in the frequency of sex (p = 0.346), age (p = 0.784), and primary tumor clinical status (p = 0.297) between NPC with distant metastasis and without distant metastasis. There was significant difference in the frequency of regional lymph node clinical status between NPC with distant metastasis and without distant metastasis (p = 0.004; PR = 3.866). Conclusions: There is no statistically significant difference of primary tumor clinical status between NPC with and without distant metastasis. There is statistically significant difference of lymph node clinical status between NPC with and without distant metastasis.
]]>Journal of Otorhinolaryngology, Hearing and Balance Medicine doi: 10.3390/ohbm1020008
Authors: Yu Zheng Juan-Mei Yang Meng Zhao Xiao-Qing Qian Fang-Lu Chi
Hearing loss is not uncommon among patients with Down syndrome (DS). It has been reported in 38–78% of the Down syndrome population. However, profound hearing loss in DS patients is rarely noticed due to its low incidence. In this article, we reported two Down syndrome patients with bilateral profound hearing loss in two cases. The first case involved an eight-year-old DS child experiencing extremely severe defects in terms of language and severe defects in terms of gross motor function, adaptability, and sociability. The second case revolved around another DS child with bilateral cochlear nerve absence. We review literature on the DS patients with hearing loss and conclude that profound sensorineural hearing loss in those patients has not received enough attention so far. We also recommend that cochlear implantation (CI) suitability assessment and timely intervention via cochlear implantation are necessary in DS patients. Besides, benefits from CI would be limited and hearing rehabilitation process could be much slower when compared with children without additional inabilities.
]]>Journal of Otorhinolaryngology, Hearing and Balance Medicine doi: 10.3390/ohbm1010007
Authors: Zuhong He Qiaojun Fang Muhammad Waqas Xia Wu Cheng Cheng Li He Yu Sun Weijia Kong Renjie Chai
Autophagy is a natural catabolic process of the cell that dismantles the useless or dysfunctional components. Autophagy allows the systematic and the lysosomal-mediated deterioration of cellular organelles. During the embryonic development, autophagy plays a critical role by remodeling the tissue and organs of the body, and the deletion of some of the autophagy related genes results in the defective embryonic development. Inner ear is the most sophisticated organ of the body responsible for the sound perception. In mammalian inner ear, autophagy protects the hair cells (HCs) from drug and noise induced damage. In this review, we particularly discuss how autophagy implicates during the auditory system development in mammals and presents its role in age-related hearing loss. Moreover, we discuss the protecting effects of autophagy after noise and drug induced auditory trauma.
]]>Journal of Otorhinolaryngology, Hearing and Balance Medicine doi: 10.3390/ohbm1010006
Authors: Woongsang Sunwoo Yung Jin Jeon Han Gyeol Park Yoonjae Song Jae-Jin Song Byung Yoon Choi Ja-Won Koo
The presence of an ipsilateral cerebellopontine angle (CPA) tumor should be ruled out in patients with asymmetric sensorineural hearing loss (ASNHL). Although many patients with CPA tumors have ipsilateral vestibular hypofunction, some of them do not experience dizziness even with ipsilateral vestibular hypofunction. We analyzed the incidence of CPA tumors among patients with ASNHL without subjective dizziness based on the presence of vestibulopathy. We hypothesized that a patient with silent unilateral vestibular hypofunction (UVH) is more likely to be diagnosed with a CPA tumor. Among 157 subjects who underwent MRI for ASNHL, those who did not have “subjective dizziness” were selected. All subjects underwent hearing and vestibular function tests. UVH was diagnosed if canal paresis ≥ 25%, positive head-shake nystagmus, or gain of head-impulse test < 0.8 were detected. The diameters of the CPA tumors were measured along the petrosal ridge on the axial plane of MRI. Among the enrolled subjects, 44 (28.02%) were diagnosed with a CPA tumor. The 37 patients (84.1%) with a CPA tumor had silent UVH, while only 33 of the 113 patients (29.2%) without a CPA tumor had silent UVH (chi-square test, odds ratio = 12.8, p < 0.001). Silent UVH in patients with ASNHL may be a sign of a CPA tumor.
]]>Journal of Otorhinolaryngology, Hearing and Balance Medicine doi: 10.3390/ohbm1010005
Authors: Yan Tang Christopher Arnold Trevor J. Cox
This study investigates the relationship between the intelligibility and quality of modified speech in noise and in quiet. Speech signals were processed by seven algorithms designed to increase speech intelligibility in noise without altering speech intensity. In three noise maskers, including both stationary and fluctuating noise at two signal-to-noise ratios (SNR), listeners identified keywords from unmodified or modified sentences. The intelligibility performance of each type of speech was measured as the listeners’ word recognition rate in each condition, while the quality was rated as a mean opinion score. In quiet, only the perceptual quality of each type of speech was assessed. The results suggest that when listening in noise, modification performance on improving intelligibility is more important than its potential negative impact on speech quality. However, when listening in quiet or at SNRs in which intelligibility is no longer an issue to listeners, the impact to speech quality due to modification becomes a concern.
]]>Journal of Otorhinolaryngology, Hearing and Balance Medicine doi: 10.3390/ohbm1010004
Authors: Nathan Hayward Vincent Cousins
Head and neck paraganglioma (HNPGL) are rare, highly vascular; typically slow growing and mostly benign neoplasms arising from paraganglia cells. HNPGL cause morbidity via mass effect on adjacent structures (particularly the cranial nerves), invasion of the skull base and, rarely, catecholamine secretion with associated systemic effects. The last decade has seen significant progress in the understanding of HNPGL genetics, with pertinent implications for diagnostic assessment and management of patients and their relatives. The implicated genes code for three of the five subunits of mitochondrial enzyme succinate dehydrogenase (SDH); recent literature reports that approximately one third of all HNPGL are associated with SDH mutations—a prevalence significantly greater than traditionally thought. There are distinct phenotypical syndromes associated with mutations in each individual SDH subunit (SDHD, SDHB, SDHC, and SDHAF2). This article focuses on the clinical features of HNPGL, the implications of HNPGL genetics, and the current evidence relating to optimal identification, investigation, and management options in HNPGL, which are supported by reference to a personal series of 60 cases. HNPGL require a systematic and thorough assessment to appropriately guide management decisions, and a suggested algorithm is presented in this article. Recent developments are particularly pertinent to surgeons of multiple disciplines, including otolaryngology, neurosurgery, vascular, and general surgery.
]]>Journal of Otorhinolaryngology, Hearing and Balance Medicine doi: 10.3390/ohbm1010003
Authors: Yanfei Wang Xiangguo Liu Zhigang Xu
The endoplasmic reticulum (ER) plays important roles in coordinating protein biosynthesis and secretion in the cell. Accumulation of misfolded and/or unfolded proteins in the ER causes ER stress and the so-called unfolded protein response (UPR). The UPR alleviates ER stress through blocking protein synthesis and activating expression of chaperone genes, whereas prolonged UPR could induce cell death. Recent research has showed that ER stress and UPR are involved in hearing loss. Accordingly, animal experiments showed that chemical chaperones or ER stress inducers alleviate environment-related hearing loss, whereas ER stress inhibitor has been used to treat certain types of hereditary deafness. Further investigations are needed to fully understand the detailed mechanisms of how ER stress contributes to the loss of auditory function, which will help us to eventually develop ER-stress-related treatment of various types of deafness.
]]>Journal of Otorhinolaryngology, Hearing and Balance Medicine doi: 10.3390/ohbm1010002
Authors: Yeunjung Kim Xi Lin
Mutations in GJB2, gene coding for connexin 26 (Cx26), and GJB6, gene coding for connexin 30 (Cx30), are the most common genetic defects causing non-syndromic hereditary hearing loss. We previously reported that overexpression of Cx26 completely rescues the hearing in a mouse model of human GJB6 null mutations. The results suggest that therapeutic agents up-regulating the expression of Cx26 may potentially be a novel treatment for non-syndromic hereditary deafness caused by Cx30 null mutations. Retinoids are a family of vitamin A derivatives that exert broad and profound effects on cochlear protein expression including connexins. They are readily available and already utilized as therapeutic agents for recurrent otitis media and hearing loss due to noise exposure. In this study, we characterized the expression of Cx26 and Cx30 in the postnatal inner ear by different retinoids including retinyl palmitate (RP), the main source of vitamin A in over-the-counter (OTC) supplements, retinyl acetate (RAc) which is an isomer of RP, and all-trans-retinoic acid (ATRA), the most active retinoid derivative. The results revealed ATRA significantly increased cochlear Cx26 expression and improved hearing in Cx30 knockout (KO) mice by 10 dB suggesting its potential benefits as a therapeutic agent. In contrast, RP selectively reduced cochlear Cx30 expression and did not improve hearing thresholds at the dosages we tested.
]]>Journal of Otorhinolaryngology, Hearing and Balance Medicine doi: 10.3390/ohbm1010001
Authors: Wei-Jia Kong Richard Salvi Jochen Schacht
To date, much progress has been achieved in the field of Otorhinolaryngology—Head and Neck surgery, as well as hearing and balance science and medicine.[...]
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