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One of the symptoms observed in tonic tensor tympani syndrome is hyperacusis. Manual therapy on the palatine aponeurosis can help treat this symptom. The physiotherapist's performance is fundamental for treatment. [ABSTRACT FROM AUTHOR]

This study aims to examine the relationship between the locations of Fovea Palatinae and the posterior vibrating line in different classes of soft palate angulation (House Classification), accordingly determine its reliability as a landmark and a tool for determining the posterior limit of the maxillary complete denture. 280 completely edentulous patients with normal healthy mucosa from both genders were randomly selected. The House classification of the soft palate angulation was identified and recorded as Class I, II, or III. Phonation was used to determine the position of the vibrating line. The Fovea Palatinae was then marked. Then, the distance between the Fovea Palatinae and the vibrating line was measured and recorded. Finally, the relative position of the Fovea Palatinae to the vibrating line was recorded as being anterior, posterior, or on the vibrating line. The Chi Square test, the effect size measures (Eta and Cramer's V tests), The Spearman's Rho rank correlation test, and multinominal logistic regression analysis were utilized to analyse the data. House classification percentages were measured among people whose Fovea Palatinae was detectable; Class II palate was the most prevalent (47.14%), followed by Class I (43.93%), and then Class III (8.93%). Based on vibrating line position, 129 (58%) had a vibrating line anterior to Fovea Palatinae, 57 (26%) on the Fovea Palatinae, 36 (16%) posterior to Fovea Palatinae, and in 58 (21%) Fovea Palatinae were not detected. The mean distance between the vibrating line and Fovea Palatinae was 3.66 ± 1.6 mm anteriorly and 2.97 ± 1.36 mm posteriorly. No significant differences were found between males and females in regard to House classification and vibrating line position. The odds of having the fovea posterior to the vibrating line would increase by 5% for each year increase in the age (P = 0.035, odds ratio = 1.050). Class II House classification of the soft palate was found to be the most prevalent among the study participants. Also, the vibrating line was anterior to the Fovea Palatinae in the majority of cases. The odds of having the fovea posterior to the vibrating line would increase by age. The Fovea Palatinae could be considered a useful guide for locating the vibrating line. [ABSTRACT FROM AUTHOR]

Simple Summary: The nasal cavity has been studied extensively in dogs. However, in cats, there are few studies of the specific anatomy of the nasal cavity, and as far as big cats are concerned, we have not currently found any studies. This work describes the anatomy of the nasal cavity of the domestic cat and three big cats (leopard, lion, and cheetah) using computed tomography, magnetic resonance, and rhinoscopy. The aim of this study is to highlight the specific anatomical characteristics of each of these species, as well as the differences between the domestic cat and its nondomestic congeners. This study highlights the advantages and disadvantages that each imaging technique provides for the study of the nasal cavity. This will help veterinary clinicians diagnose the pathologies that can affect this anatomical region and thereby improve their treatment. In addition, these big cats are in a vulnerable state, close to extinction, and better diagnosis and treatment of their pathologies would improve the survival of these species. The objective of this work was to study the normal anatomy of the nasal cavity of the three species of big cats (leopard, lion, and cheetah) compared to the domestic cat through the use of computed tomography, magnetic resonance imaging, and rhinoscopy. Computed tomography allowed us to clearly visualize the entire bony and cartilaginous framework that supports the nasal cavity. Magnetic resonance imaging permitted better visualization of the soft tissues of this cavity. On the other hand, rhinoscopy enabled the direct visualization of the mucosa of the vestibule and nasal cavity, which is very useful in the diagnosis of masses or foreign bodies. Furthermore, with this technique, it has been possible to observe several small orifices from the nasolacrimal duct, the pharyngeal auditory tube, and the lateral nasal gland. Computed tomography, magnetic resonance imaging, and rhinoscopy are useful tools in analysis of the anatomical characteristics of the nasal cavity in these species. [ABSTRACT FROM AUTHOR]

Surgical management of Obstructive Sleep Apnea (OSA) and Snoring has undergone many major and minor changes over a period of last decade. The most common surgical approach for OSA is uvulopalatopharyngoplasty (Stuck et al. in Sleep Med 50:152–165, 2018). The main goals of treatment of OSA are to decrease the risk of deleterious health effects and improve quality of sleep (Evans et al. in Otolaryngol Clin North Am 53: 319–328, 2020). Since bimanual surgical techniques in the depth of oral cavity have been tricky, search for a less demanding & easy to learn technique is always on. The surgical technique should also provide long term results with manageable complications. Barbed suture has been in sporadic use for the last decade amongst sleep apnea surgeons for its advantage of knotless application and distributed suture tension. However, the barbed suture which has been used is absorbable and is used only to close the surgical wound on the soft palate. In this paper we are describing our technique of using the 3-0 Polybutester non absorbable barbed suture to perform a novel technique of palatal surgery, in which we suspend the lower part of the soft palate permanently as a suspension bridge between the right and left Pterygomandibular raphae, so that the lower part of the soft palate cannot move posteriorly to touch the posterior pharyngeal wall preventing airway obstruction whereas it can still move superiorly freely while swallowing or during phonation. This technique can prove to be a technically less demanding one which provides excellent long-term results in snoring and OSA with manageable complications. [ABSTRACT FROM AUTHOR]

Background: The authors aimed to report a hitherto undescribed class of patients with the obvious phenotype of a novel soft palate dysplasia (SPD) combining unilateral soft palate hypoplasia with a fully developed uvula. The authors also aimed to investigate and evaluate the corresponding surgical approaches., Methods: Twelve patients were clinically diagnosed with SPD. Clinical examination, including radiographic tests, was performed to characterize the congenital deformity. The effectiveness of velopharyngeal closure and speech were tested preoperatively and postoperatively., Results: SPD was featured with velopharyngeal insufficiency, food regurgitation, and speech disorders. It was commonly manifested as structural deformities of the soft palate, tongue palatine arch, pharyngeal palatine arch, and pterygomandibular fold, but with complete uvula shape. According to radiographic analysis, in five patients, the lateral pterygoid processes were poorly developed, and other malformations were present. Velopharyngoplasty based on the unilateral posterior pharyngeal flap can well restore the velopharyngeal closure and speech intelligibility without respiration obstruction., Conclusions: SPD is characterized as congenital velopharyngeal insufficiency manifested as a primary soft palate defect. It is highly associated with other physical deformities but independent of conventionally known syndromes. The cause may be an abnormal development of the pterygoid process. Unilateral velopharyngoplasty based on the posterior pharyngeal flap is a great technique to repair SPD., Clinical Question/level of Evidence: Therapeutic, IV., (Copyright © 2023 by the American Society of Plastic Surgeons.)

Introduction: Hyperacusis is a kind of decreased tolerance to sound and is difficult to measure objectively. It often co-occurs with tinnitus. There is a need for valid and reliable patient-reported outcome measures to capture this subjective phenomenon. Aim: The aim of the study to create a questionnaire capturing hyperacusis in terms of loudness, fear, and pain and then to evaluate its psychometric properties. Material and methods: The study group consisted of 106 patients, made up of 51 men and 55 women. They were aged between 19 and 72 years, mean 45.2 years (SD = 12.4). An initial pool of 33 questions capturing hyperacusis was subjected to expert evaluation and pilot testing. Then, a shortened 19-item version of the tool was checked out. Medical interview, au-diological examination and a set of questionnaires: Tinnitus Handicap Inventory, Hyperacusis Questionnaire, State-Trait Anxiety Inventory, and Visual Analogue Scale was completed by all subjects. Results: The final 14-item Hyperacusis Assessment Questionnaire showed an appropriate three-factor structure that explained 70.5% of the variance. Convergent validity and divergent validity were confirmed by correlations with other measures of hyperacusis, anxiety, tinnitus severity, misophonia, and hearing thresholds. Internal consistency as assessed with Cronbach's alpha was excellent (a = 0.91) as was reproducibility (intra-class correlation, ICC = 0.96). Conclusions: The new Hyperacusis Assessment Questionnaire is a psychometrically sound and brief tool that can assess the severity of hyperacusis in terms of loudness, fear, and pain. It can be used in clinical practice and scientific research for patients with hyperacusis and tinnitus. [ABSTRACT FROM AUTHOR]

Introduction: There are cases of hyperacusis (Hy) among CI patients (CI candidates and CI users) and the level of suf- fering is high. However, prevalence data are not available. Furthermore, unlike tinnitus, little is known about how this condition should be treated in CI aftercare. We have there- fore initiated case series with the primary goal of providing information on the frequency with which the diagnosis of Hy is encountered in CI patients in the clinics in Salzburg and Wels, and association between Hy, and CI aftercare, without specific treatment of Hy. Material and methods: At least 10 individual cases are planned. "Cases" of these prospective case series are all adult CI patients with bilateral sensorineural hearing loss and with the additional diagnosis of hyperacusis. Clinical measures are: (1) four frequency hearing thresholds (PTA), (2) Data Logging, (3) Freiburg Monosyllables, (4) HSM sentences in noise, (5) uncomfortable loudness levels (ULL), (6) Abbreviated Profit of Hearing Aid Benefit APHAB (subjective hearing), (7) HIQ, (8) SSSQ, (9) Visual Analog Scale (VAS), (10) Tinnitus questionnaire, (11) Hospital Anxiety and Depression Scale, (12) Hearing Stress Questionnaire. Results: Preliminary results in Salzburg, over a period of 9 months, Hy was observed in 10.3 percent of all CI patients who met the study criteria. All Hy cases were older than 56 years, 83 percent of them were male. Examples are the following two cases (case description not yet complete). Case 1: Man, 57 years old: The causes of progressive hearing loss include chronic otitis media and granulomatosis with pol-yangiitis (GPA). He was fitted with hearing aids 6 years ago. Before the CI, he had a severe hearing loss on the left and a slight hearing loss on the right, furthermore a strong tinnitus and Hy. Six months after the CI (left), subjective hearing and tinnitus have improved. However, social withdrawal and Hy scores have deteriorated. Case 2: Woman, 61 years old, had her first sudden hearing loss 15 years ago, 13 years ago she was fitted with hearing aids. After a stapesplasty 10 years ago, she lost her residual hearing in her right ear. On the left she suffered from a slight hearing loss. She also suffered from tinnitus (not clear which side). Two months after the CI fitting 8 years ago, Hy developed and at the same time the left ear deteriorated (moderate hearing loss) and the tinnitus (both sides) increased dramatically. Hearing training and a change in the fine-tuning of the speech processor reduced Hy. After a viral infection, Hy worsened again. At present, five years after the first CI, the second ear is within the CI indications and the impairment due to the recurring Hy has increased to the maximum. The tinnitus had also improved considerably in the meantime. However, it has now increased significantly again, especially without hearing aid and CI (50% speech recognition at quiet, CI ear (FreiburgMonosyllables, 65 dB)). Last year, she had to quit her stressful job because of her hearing problems and the negative impact on her subjective well-being. [ABSTRACT FROM AUTHOR]

Is it hyperacusis, sound oversensitivity, or something else? Whatever we want to call it, we have seen children and adults in the ASD population who show over-reaction to auditory signals. This over-reaction can be due to the loudness or the content of the auditory stimuli. The underlying pathophysiology of hyperacusis is not entirely clear. For some, it is due to neuronal and anatomical variations and for others it can be related to a specific reason such as those with Bell's palsy, superior canal dehiscence, or aneurysm of the middle cerebral artery. The pathophysiology of misophonia seems to be totally different. The neurodiversity in the ASD population can cause challenges for clinicians and make it difficult to understand, diagnose and manage hyperacusis and misophonia in this population. This presentation will address decreased sound tolerance (DST) disorders in the ASD and will discuss diagnosis and management strategies. Ali A. Danesh, MS, PhD, CCC-A, FAAA, is currently a Professor at the Department of Communication Sciences and Disorders, and also has a Secondary appointment as Professor of Integrated Medical Sciences in the Charles E. Schmidt College of Medicine, Florida Atlantic University (FAU), Boca Raton, Florida. Dr. Danesh has affiliate positions in the College of Science, Department of Psychology and the Department of Electrical Engineering and Computer Science at the College of Engineering and Computer Science. He has faculty appointments at the Audiology Department of Salus University and Department of Otolaryngology, Miller School of Medicine, University of Miami. His research interests are in the areas of tinnitus, hyperacusis, misophonia, auditory evoked potentials, auditory processing disorders, and vestibular assessment. [ABSTRACT FROM AUTHOR]