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Artificial intelligence (AI) using deep learning approaches the capabilities of human experts in medical image diagnosis. However, due to liability issues in medical decisions, AI is often relegated to an assistant role. Based on this responsibility constraint, the effective use of AI to assist human intelligence in real-world clinics remains a challenge. Given the significant inter-individual variations in clinical decisions among physicians based on their expertise, AI needs to adapt to individual experts, complementing weaknesses and enhancing strengths. For this adaptation, AI should not only acquire domain knowledge but also understand the specific human experts it assists. This study introduces a meta-model for human–machine cooperation that first evaluates each expert's class-specific diagnostic tendencies using conditional probability, based on which the meta-model adjusts the AI's predictions. This meta-model was applied to ear disease diagnosis using otoendoscopy, highlighting improved performance when incorporating individual diagnostic characteristics, even with limited evaluation data. The highest accuracy was achieved by combining each expert's conditional probabilities with machine classification probability, using optimal weights specific to each individual's overall classification accuracy. This tailored model aims to mitigate potential misjudgments due to psychological effects caused by machine suggestions and to capitalize on the unique expertise of individual clinicians. [ABSTRACT FROM AUTHOR]

There is no report about the definition, classification and clinical epidemiological study of congenital ear malformation (CEM). Aims/Objectives: To investigate the definition, clinical classification and distribution of a large number of CEM cases, along with the clinical and epidemiological characteristics associated with congenital malformation of the middle and outer ear (CMMOE). A total of 3231 cases (4714 ears) with CEM and related malformations were retrospectively analyzed, including 2,658 cases (4,064 ears) CEM and 573 cases (650 ears) preauricular fistulas and accessory ears, specifically related malformations to CEM. Among the 2,658 cases (4,064 ears) CEM, 64.9% cases were male and 35.1% were female. 52.9% cases with bilateral, 29.1% with right and 18.0% with left CEM. A subgroup of 1,050 cases (1,331 ears) was identified as CMMOE out of 1,090 cases (1,379 ears) microtia. In the CMMOE subgroup, 74.0% cases were male, 46.3% on the right side, 26.8% showed bilateral involvement. Out of the CMMOE with available images, there were 947 cases (1,105 ears). Additionally, related malformations including preauricular fistulas and accessory ears, were solely occured in 573 cases (650 ears), except for their occurrence simultaneously with CEM. The classification and distribution of CEM are as follows: 1. 2658 cases of CEM (1) 69.9% of them were confined to the ear, including: ① the outer ear 2.6%, the middle ear 17.0% and the inner ear 32.4%, ② two parts simultaneous malformations of the outer ear, the middle ear and the inner ear 17.2%, ③ three parts simultaneous malformations of the outer ear, the middle ear and the inner ear 0.6%, (2) Multiple malformations including in CEM 29.1%; (3) syndromes related to CEM 1.0%. 2. 1050 cases of CMMOE (1) 36.3% of them were confined to the middle and outer ears; (2) Multiple malformations associated with CMMOE 61.4%, including hemifacial microsomia 50.5%, accessory ears 9.8%, preauricular fistulas 9.2%, heart malformation 7.1%, and kidney malformation 2.0%; and (3) syndromes related to CMMOE 2.3%, (4) Complications of the ear 16.9%, mainly including otitis media 7.9%, outer ear canal cholesteatoma 6.3%, retroauricular abscess 1.1%, and nasal and pharyngeal complications 18.6%. The proportions of microcia grades I–Ⅴ based on the images of 1105 ears CMMOE were 5.2%, 10.5%, 74.1%, 6.9%, and 3.3%, respectively. Among the 1331 ears CMMOE, the incidence rates of outer ear canal atresia, stenosis, normal, and ossicles malformation were 86.5%, 9.9%, 3.6%, and 98.3%, respectively. Conclusion and Significance: Approximately 69.9% of CEM cases were confined to the ear itself, with the highest proportion being inner ear malformation alone. Multiple malformations were predominantly associated with CMMOE. Syndromes related to CEM were relatively rare. Among cases of microtia, 96.3% were classified as CMMOE. These cases were predominantly observed in males, right ear and exhibited characteristics such as grade III microtia, atresia of the outer ear canal, ossicles malformation, and multiple malformations. The multiple malformations frequently included hemifacial microsomia, accessory ear, preauricular fistula, as well as heart and kidney deformities. CMMOE often coexisted with ear infections, cholesteatoma, and complications in the nasal and pharyngeal regions. [ABSTRACT FROM AUTHOR]

Background: At present, there are not international unified standards and reports on Congenital Ear Malformation (CEM) in the world, which makes it difficult to transfer information and compare the literature. Aims/objectives: Through the statistical analysis of a large sample of CEM, a unified standard of all aspects of CEM is proposed and the data are provided for reference, which is convenient for the international work and literature comparison in this field. Materials and methods: Based on the author's 30 years of clinical and scientific research work on CEM and the relevant cases of 3231 (4714 ears) in our hospital, and combined with literature, statistical analysis was made. Results: This paper summarizes the classification, definition, epidemiology, embryonic development, pathogenic factors of CEM and elaborates on the clinical manifestations, examination and sequence therapy of representative Congenital Malformation of the Middle and Outer Ear (CMMOE). We also introduce malformation of the auricle and inner ear, so as to cover the outer, middle and inner ear. At the same time, we introduce our achievements and contributions in this field. Conclusions and significance: This study provides reference to the international unified standard and treatment principle of the CEM. [ABSTRACT FROM AUTHOR]

Background and Aim: Ear disease is relatively important in veterinary medicine as it significantly affects the quality of life of pets. Two hundred and twenty-one cases of canine ear diseases were collected and collated at the Xi’an Teaching Hospital of Northwest A&F University from 2012 to 2016. An epidemiological analysis was conducted to evaluate the prevalence and causes of various ear diseases in various breeds of dogs in Xi’an. Materials and Methods: Data were collected and statistically analyzed by reviewing previous cases and obtaining medical history data and laboratory results. This study included the following experiments: systematic examination of the animals’ skin, auricular skin scraping test, ear canal endoscopy, and examination of ear canal secretion. Results: The top three dog breeds most commonly afflicted with ear diseases in Xi’an were Toy poodles , Cocker Spaniels, and Golden Retrievers, accounting for 18.5%, 10.4%, and 9.5% of the total cases, respectively. The prevalence was the highest in August and September, with male dogs having a higher prevalence rate than female dogs. Common ear diseases were categorized as otitis externa, otitis media, otitis interna, or ear hematoma. Conclusion: This study determined the prevalence of external otitis, ear hematoma, otitis media, and inner otitis in dogs in the Xi’an area. These results can help expand the current understanding of the development and epidemiology of canine ear diseases and provide a reference for clinical diagnosis, treatment, and prevention. [ABSTRACT FROM AUTHOR]

Background and Aim: Fungal infections are a growing problem for both humans and animals due to the emergence of pathogenic strains resistant to modern antifungal treatments. To evaluate the efficacy of new antifungal drugs, it is essential to develop animal models that demonstrate typical responses to both the infection (pathogenesis and clinical course) and to the treatment, including adverse effects. In this study, we established a rabbit otitis model by infection of an aggressive multidrug-resistant strain from dogs, Malassezia pachydermatis C23, with no need for concomitant immunosuppression. Materials and Methods: Twenty healthy adult male gray giant rabbits (1 year old, 5.5 kg) were inoculated once with M. pachydermatis C23 at 108 colony-forming units/mL. We observed the clinical signs of the disease and collected ear smears and blood samples every 5 days. Results: The infection progressed rapidly and exhibited characteristic clinical signs without spontaneous recovery for at least 1 month. In fact, substantial deterioration was observed as evidenced by blood parameters. Conclusion: This rabbit otitis model established using an aggressive drug-resistant fungus strain without immunosuppression could prove valuable for testing novel antifungal agents. [ABSTRACT FROM AUTHOR]

The article presents the discussion on Herpes zoster oticus (HZO) and vestibular neuritis (VN) both can cause acute vestibular dysfunction. Topics include HZO is characterized by a painful, blistering rash in the auricular and external auditory canal accompanied by audiovestibular dysfunction; and investigate radiological changes in the vestibular nuclei of the brain as seen on MRI.

Objective: Attic retraction pockets, classified by degree of invasion and erosion, are reconstructed here as outlined by attic retraction pocket grade. Method: Attic retraction pocket grade, surgical management, subsequent conditions of tympanic membrane and middle ear, and improvement of air–bone gap pure tone average were recorded. Results: Our management strategy, based on attic retraction pocket grade, was applied to 200 ears: 44 grade I ears had non-surgical management and 156 grade II–V ears had surgical management. All 200 ears were followed up for 36–240 months, showing only 1 attic retraction pocket reformation and 1 adhesive otitis media (complication rate of 1 per cent), and improved air–bone gaps (p < 0.05). An earlier series of 50 grade IV attic retraction pockets used atticotomy with epitympanic reconstruction. These showed attic retraction pocket recurrence or cholesteatoma onset in 34 ears (68 per cent). When these ears were revised per protocol, there was no evidence of cholesteatoma thereafter. Conclusion: Reconstruction of the ossicles and scutal defect according to attic retraction pocket grade shows long-term stability of the tympanic membrane, middle ear and hearing. [ABSTRACT FROM AUTHOR]

Inner ear hemorrhage (IEH) is an increasingly recognized cochlear lesion that can cause sensorineural hearing loss (SNHL). Magnetic resonance imaging (MRI) is known to be the best imaging modality for clarifying the causes of SNHL and providing images that point to those causes. Evaluate the lesional patterns in patients with presumed Inner ear hemorrhage (IEH) from radiological and functional aspects. We retrospectively reviewed 10 patients performed in our institution from 2014 to 2020, with suspected labyrinthine hemorrhage based on radiological and functional examination. We included 8 patients with IEH and sensorineural hearing loss (SNHL). The median age was 55 years (range: 3 months − 78 years). The results from the MRI and functional tests were compared for each end-organ. Only three cases (37.5%) showed a correlation between signal abnormalities and dysfunction in the labyrinthine apparatus. In patients with SNHL inner ear hemorrhage needs to be ruled out in the differential diagnosis, so specific MRI sequences should be requested. It represents a way to a better understanding of the disorder and the variety of findings claim for a complete auditory and vestibular testing. [ABSTRACT FROM AUTHOR]

Infants and young children with vestibulocochlear nerve (VCN) hypoplasia/aplasia present with severe hearing loss and are candidates for cochlear implantation (CI). It is unknown whether vestibular function is related to CI outcome and if vestibular tests can guide the operation decision. Our aim was to describe the vestibular function in patients with VCN hypoplasia/aplasia before a possible CI. Forty-two ears in 23 patients were tested between 2019 and 2022 with bone-conducted cervical vestibular evoked myogenic potentials (BCcVEMP), video head impulse test (vHIT) and miniice-water caloric test (mIWC). All ears could be tested with at least one vestibular test and 83% could be tested with more than one method. Twenty-nine ears (61%) showed normal function with at least one method. The presence of a normal response to any test doubled the likelihood of a measured hearing threshold after CI, the best predictors being the BCcVEMP and vHIT (p < 0.05). Canal function may represent a predictor of auditive pathway integrity with a possible favourable audiological outcome after CI operation Our results demonstrate high vestibular response rates suggesting a functioning pathway despite the radiological diagnosis. [ABSTRACT FROM AUTHOR]

Secondary autoimmune inner ear disease (AIED) is often bilateral and asymmetric in patients presenting with audiovestibular symptoms due to a systemic autoimmune disease. This systematic review and meta-analysis are aimed at identifying and highlighting patterns in prevalence of vestibular dysfunction, symptom presentation, and diagnostic methods in extant literature by combining clinical context from case reports with quantitative analyses from cohort studies. Screening of articles by title, abstract, and full text was completed by four reviewers (K.Z., A.L., S.C., and S.J.). In this study, we grouped secondary AIED and systemic autoimmune diseases by pathophysiologic mechanism: (1) connective tissue disease (CTD), (2) vasculitides (VAS), (3) systemic inflammatory disorders (SID), and (4) other immune-mediated disorders (OIMD). The search for AIED disease identified 120 articles (cohorts and case reports) that met the final inclusion criteria. All 120 were included in the qualitative review, and 54 articles were included for meta-analysis. Of these 54 articles, 22 included a control group (CwC). Ninety individual cases or patient presentations from 66 articles were included for analysis in addition to the 54 cohort articles. Secondary AIED does not have a diagnostic algorithm for managing vestibular symptoms. The management of audiovestibular symptoms requires close collaboration between otolaryngologists and rheumatologists to preserve end-organ function of the ear. To improve our ability to understand the impact on the vestibular system, vestibular clinicians need to develop a standardized reporting method. Clinical presentation should frequently be paired with vestibular testing to contextually investigate symptom severity and provide higher quality care. [ABSTRACT FROM AUTHOR]

Introduction Tympanoplasty is the main treatment of mucosal type of chronic suppurative otitis media. Objective The aim of the present study was to compare clinical outcomes in terms of healing and audiological outcomes of two groups. The authors used single layer graft (perichondrium with cartilage island) graft in one group and double layer grafts (perichondrium cartilage island composite plus temporalis fascia) were used in the second group. Methods Forty patients complained of chronic suppurative otitis media safe type with subtotal perforation subdivided into two groups. The first group author used single-layer perichondrium with cartilage island graft (composite graft) while in the second group authors used double graft in the form of perichondrium/cartilage island (composite graft) plus temporalis fascia. Results There was no significant difference in the mean Air bone gap (ABG) between pre- and post-operative audiometry in subjects who had single layer tympanoplasty. There was a significant difference in the mean ABG between pre- and postoperative audiometry in subjects who had double layer tympanoplasty. There was a significant difference in in the mean ABG differences between subjects who had single layer tympanoplasty and double layer tympanoplasty. Also, there was a significant difference in the healing of the tympanic membrane between subjects who had single layer tympanoplasty and double layer tympanoplasty. Conclusion Tympanoplasty by double graft (temporalis fascia and tragal cartilage/perichondrium) achieved a considerable improvement in healing of the tympanic membrane ™ with lower risk for residual perforation or graft rejection. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this overview of systematic reviews (SRs; umbrella review) was to systematically summarize and critically appraise current evidence of cochlear implant (CI) outcomes in children with auditory neuropathy spectrum disorder (ANSD). Method: This study was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement. The methodological quality and the risk of bias in the included SRs were assessed using A MeaSurement Tool to Assess systematic Reviews 2 checklist and the Risk of Bias in Systematic Reviews tool, respectively. Results: According to eight included SRs, children with ANSD achieve CI outcomes (speech perception performance) similar to their peers with sensorineural hearing loss. In children with postsynaptic ANSD (cochlear nerve deficiency), cochlear nerve hypoplasia is associated with better speech recognition outcomes compared with cochlear nerve aplasia, especially in the absence of additional disabilities. Except for one study, the overall quality of the included SRs was critically low, and except for three studies, evidence of a high risk of bias was identified in other included SRs. Conclusions: Current evidence supports CI benefits for children with ANSD. To improve the quality of evidence, well-designed, prospective studies with appropriate sample sizes, using valid outcome measures, clarifying matching criteria, and taking into account the role of confounding factors are essential. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to evaluate the relationship between the cochlear nerve and the anatomical structures of the cochlea and internal acoustic canal in patients with congenital hearing loss. Materials and Methods: Temporal tomography and magnetic resonance images of 44 patients (88 ears) with non-syndromic congenital hearing loss were retrospectively analyzed between 2018 and 2021. Patients were divided into 2 groups according to cochlear nerve hypoplasia. Cochlear nerve canal width, cochlear basal/ middle turn widths, and internal auditory canal widths were examined. Results: Cochlear nerve hypoplasia was detected in 18.2% (n = 16) of the patients and all of the patients with cochlear nerve hypoplasia had severe hearing loss. A statistically significant difference was found between the structures' widths in patients with and without cochlear nerve hypoplasia, in cochlear nerve canal and coronal width of the internal auditory canal. When stenosis is accepted as <1.4 mm for cochlear nerve canal and <3.80 mm for coronal width of the internal auditory canal, cochlear nerve hypoplasia differs statistically between the groups in measurements (respectively; P < .001, P = .018). Conclusions: In patients with sensorineural hearing loss, cochlear nerve hypoplasia may accompany. Anatomical structures are important in predicting cochlear nerve hypoplasia from temporal computed tomography. Cochlear nerve hypoplasia should be suspected if the cochlear nerve canal and coronal width of the internal auditory canal are less than 1.4 mm and 3.8 mm, respectively, on temporal computed tomography. [ABSTRACT FROM AUTHOR]

Large vestibular aqueduct syndrome (LVAS) is one of the etiology of hearing loss. Clinically, we observed that the VA size of patients with idiopathic sudden sensorineural hearing loss (ISSNHL) did not meet the diagnostic criteria of VA enlargement, but there were individual variations. Through this study, we want to understand the VA development and explore its risk for suffering from ISSNHL. 74 patients with ISSNHL were retrospectively reviewed in our department from June 2018 to September 2021. Meanwhile, 57 people with no ear diseases were randomly selected as the control group. All their clinical information were systematically collected. The axial thin-slice CT images of temporal bone were used to observe and measure the VA in ISSNHL and controls. ISSNHL were classified as different types and grades according to pure tone audiometry and the degree of hearing loss, respectively. Logistic regression analysis was adopted to evaluate the risk factors of different types and grades of ISSNHL. The operculum morphology could be funnel-shaped, tubular and invisible, but they had no statistical difference in the morbidity of ISSNHL. The operculum width of the affected sides in the case group was significantly wider than that of the matched sides in the control group (0.84±0.35mm vs 0.68±0.34mm, p=0.009), but the midpoint width had no statistical difference (p=0.447). The operculum width was an independent risk factor for the total hearing loss type (p=0.036, OR=4.49, 95% CI=1.10-18.29), moderate (p=0.013, OR=17.62, 95% CI=1.82-170.95) and profound (p=0.031, OR=4.50, 95% CI=1.14-17.67) grade of ISSNHL. Hypertension was an independent risk factor for the severe grade (p=0.004, OR=12.44, 95% CI=2.19-70.64) of ISSNHL. Both the operculum width (p=0.048, OR=7.14, 95% CI=1.02-50.26) and hypertension (p=0.014, OR=6.73, 95% CI=1.46-30.97) were the risk factors for the flat type of ISSNHL. The midpoint width of the VA, gender, age, diabetes mellitus, hyperlipidemia, and plasma fibrinogen concentration had no significant effect on the risk for suffering from ISSNHL. The development of the VA operculum is a risk factor for some types and grades of ISSNHL. Hypertension remained a risk factor for ISSNHL. [ABSTRACT FROM AUTHOR]

The paper presents the behaviour of some wheat varieties under the years 2014, 2016, 2018, 2019, 2020, 2023 conditions in Dobrogea area in demonstrative plots carried out at S.C. SPORT AGRA S.R.L. Amzacea, Constanta County. The main aspects emphasized in this research area have been: climatic conditions, obtained yield, and economical efficiency. Looking to the pathogens, for wheat Septoria tritici showed an AR between 17-27% and Pyrenophora graminea showed a low atack (AR = 4.5-17.5%). The pathogen Puccinia striiformis was present in low precentage (AR = 0-13.5%) in the 2018 April observations. For crop protection against pathogens, 2 foliar tratments with fungicides were applied, Artea 330 EC(ciproconazol 80 g/l + propiconazol 250 g/l) 0,4 l/ha, in March and Priaxor EC (fluxapiroxad 150 g/l + piraclostrobin 75 g/l) 1l/ha and in April respectively. Fungal treatments have stopped the development of foliar and ear diseases. The beneficial effects were found in the good yields obtained in 2014, 2016, 2018, 2019, except the years 2020 and 2023. In 2020 Otilia reached 2,370 kg/ha, Miranda 2,260 kg/ha and Solindo variety 4,297 kg/ha and Ursita 4,165 kg/ha in 2023. All these special yields have been obtained under non-irrigated conditions. [ABSTRACT FROM AUTHOR]

Maize (Zea mays L.) is a major staple crop in most of the sub-Sahara Africa (SSA) region, constrained by a multitude of plant diseases, with the ear and kernel rots being the most widespread and difficult to manage on maize. The objective of this study was to access the agronomic performance of F1 maize hybrids exposed to Aspergillus flavus, under different agro-ecological conditions, in Cameroon. A total of 120 genotypes of maize, including four commercial hybrids, were evaluated under A. flavus infection at two sites; namely Bangangte in the Western Highlands and Mbalmayo, in the Bimodal Humid Forest Zone of Cameroon. The study was conducted during 2020 - 2021 cropping seasons. Results revealed that at Bangangte site, six (89343X88094, 88099X88094, 90204XExp 124, 89246X87036, TZI-5-1171XExp 124 and 90219X1368) out of the top 20 high yielding hybrids, had significantly high (p<0.001 tolerance (0% severity) to Aspergillus ear rot infection. At Mbalmayo site, eight (8923X88094, TZI-5-1171XExp124, 89343X88094, 90219X87036, 89243X87036, 87014X88094, TZSTR1150X87036 and 89248X88094) out of the top 20 high yielding hybrids also showed significant high (P<0.001) tolerance (0% severity) to Aspergillus ear rot infection. The interaction between hybrids and location was significant (P<0.05) for all measured traits, except ear height, grain texture, ear insect damage and husk cover (P>0.05). The pooled broad sense heritability of hybrids in the two locations varied from 5% for grain texture to 92% for days to 50% physiological maturity. Grain yield was negatively correlated with Aspergillus ear rot disease incidence and severity. Hence, promising high yielding maize hybrids with appreciable tolerance to Aspergillus ear rot disease could be selected among the tested genotypes. [ABSTRACT FROM AUTHOR]

Summary: This consensus statement provides new recommendations for primary care assessment of ear health and hearing status of young Aboriginal and Torres Strait Islander children who are not known to have, or are not being actively managed for, ear health and hearing problems. Any child identified with otitis media should be actively managed. This national consensus statement extends existing treatment and management guidelines. Main recommendations: Undertake checks at least 6‐monthly, commencing at 6 months until 4 years of age, then at 5 years. Undertake checks more frequently in high risk settings for children under 2 years, when acceptable to families, or in response to parent/carer concerns.Ask parents/carers about concerns, signs, and symptoms; check children's listening and communication skills; and assess middle ear appearance and mobility.Otoacoustic emissions testing is suggested when equipment is available, primary health practitioners have capability and confidence to use the equipment, and there is local preference for its use.Video otoscopy is suggested for health promotion purposes, and/or for sharing images with other health practitioners.Audiometry should be done as per existing guidelines: when there are parent/carer concerns, signs of persistent/recurrent otitis media, or when listening and communication development is not yet on track. Changes in management as a result of this statement: Key practice changes include routine use of tympanometry, and listening and communication skills checklists. Implementation will require access to equipment and training; clear information on immediate, practical actions for families; timely pathways to referral services; and a change management process that shifts perception and tolerance of otitis media and its impacts and raises expectations that Aboriginal and Torres Strait Islander children can have healthy ears and hearing. [ABSTRACT FROM AUTHOR]

Objective: To investigate the epidemiological situation of hearing impairment in children aged 0～14 years in Suzhou, and to analyze the risk factors of the disease. Methods: Using the method of multi-stage and random sampling,1478 samples were selected from 46 streets and 51 towns in the region from January 2020 to January 2022. On-site investigation was carried out using the 《WHO Survey Plan on Ear Diseases and Hearing Impairment》. Pure tone audiometry was performed on children aged 0～14 years with AA222 screening audiometer. Hearing threshold greater than or equal to 26dB indicated that there was hearing impairment. The epidemiology of hearing impairment in children aged 0~14 years in Suzhou was investigated, and the risk factors of hearing impairment were analyzed. Results: 1478 subjects aged 0~14 years were included, 1459 of whom had complete data, with a recovery rate of 98.71%. All the subjects were divided into hearing impairment group (n=42) and non-hearing impairment group (n=1417) according to the occurrence of hearing impairment. The incidence of hearing impairment was 2.88%. Among them, the prevalence rate of male was higher than that of female, the prevalence rate of 8~14 years was higher than that of 0~7 years, and the prevalence rate of town was higher than that of countryside. The incidence of hearing impairment was related to the previous use of ototoxic drugs, family history of positive deafness, maternal perinatal infection, hyperbilirubinemia, neonatal asphyxia, maternal disease during pregnancy, adverse living habits during maternal pregnancy, adverse social environmental factors during maternal pregnancy, gender and age (P<0.05), but not related to head and neck deformities, bacterial meningitis, previous disease history in infancy and place of residence (P>0.05). Multivariate Logistic regression analysis showed that age 8~14 years, previous use of ototoxic drugs, had maternal perinatal infection, had hyperbilirubinemia, had maternal disease during pregnancy, had adverse living habits during maternal pregnancy, had adverse social environmental factors during maternal pregnancy, had family history of positive deafness, and had neonatal asphyxia were risk factors for hearing impairment (P<0.05). Conclusion: The incidence of hearing impairment in children aged 0～14 years in Suzhou is 2.88%, most of whom were aged 8~14 years. The incidence of hearing impairment is affected by many factors, such as the previous use of ototoxic drugs, maternal perinatal infection, hyperbilirubinemia, maternal disease during pregnancy, adverse living habits during maternal pregnancy, adverse social environmental factors during maternal pregnancy, family history of positive deafness, neonatal asphyxia and so on. [ABSTRACT FROM AUTHOR]

To explore a side of lesion differences in Meniere's disease (MD). A retrospective review (2019–2021) was conducted of patients with definite MD, as defined by 2015 Bárány Society diagnostic criteria. Testing information included pure tone audiometry, tympanometry, and extra-tympanic electrocochleography (ECochG). Normative ECochG data from healthy subjects determined the 95% cut-off value for clinical abnormality. 107 patients with definite MD were included in the study and 40 healthy controls. The review identified 75 patients with unilateral MD and 32 patients with bilateral MD according to their clinical histories. 79% of unilateral cases were found to have MD on the L ear. 94% of bilateral MD cases had L ears more affected than R ears. Objective ECochG testing indicated a greater incidence of elevated SP/AP area curve and amplitude ratios in L ears. On binomial testing, all results indicate a highly significant bias of MD to the L side. Unilateral MD appears more common on the L side than the R, suggesting that the disease process underlying MD is not symmetrical. MD also appears more common in females than males. It appears that there is a physiological asymmetry in the progression/cause of MD. [ABSTRACT FROM AUTHOR]

This study utilized AIML (artificial intelligence & machine learning) techniques to analyze 115 images of central perforation of tympanic membrane obtained from Telemyringoscopy through Borescope in order to establish a facilitation-model for the community ear diagnosis. The Modified VGG19 with batch normalization revealed the highest training accuracy of 85 as compared to other CNN techniques. The training accuracy started to saturate around mid-70% and the Test accuracy was around 50%. Although AIML did not reveal a high predictive value, its potential based on our observations cannot be underestimated considering many limitations (sample size, image-quality, associated pathologies, illumination-factor) in this study. Such limitations if resolved may revolutionize community ear care through a better cost effective tele-myringoscopy with innovations in AIML/ telemedicine. [ABSTRACT FROM AUTHOR]

COVID-19 has infected millions of people worldwide causing millions of deaths. COVID-19 has many serious effects on organs of the body especially the respiratory system causing pneumonia and acute respiratory distress syndrome (ARDS). The disease also has severe complications on other different organs; kidneys and liver which may end in multi-organ failure. Most common symptoms that have been detected in large section of patients were fever, cough and loss of taste or smell and less commonly sore throat, headache and muscle pain. The incidence of vertigo or dizziness is a rare symptom of COVID-19. In this case report, we introduce a 59-year-old male patient suffering from acute vertigo attack after COVID-19 infection. The patient had negative medical history of vertigo and any ear diseases. The patient received REGEN-COV (casirivimab and imdevimab) for COVID-19 and meclizine for vertigo. Vertigo attacks lasted for the two weeks follow up after disappearance of COVID-19 symptoms despite receiving vertigo medication. In conclusion, vertigo may be the sole neurological manifestation of COVID-19. More observational studies should address this symptom and researchers should also focus on identifying the origin of developing vertigo and the direct or indirect mechanisms that SARS-CoV-2 triggers to develop dizziness in general. This research should deliver a clear message, especially to ER physicians to consider proper referral of these patients without underestimating the risk of developing more serious COVID-19 symptoms as ARDS and multi-organ failure if no proper testing and follow-up are provided. [ABSTRACT FROM AUTHOR]

Objective: Granular myringitis is characterised by de-epithelialisation of the tympanic membrane. Patients present with intermittent otorrhoea, otalgia or itching. With improper or inadequate treatment, granular myringitis could cause ear canal fibrosis and stenosis. There are no standard topical ear drops for granular myringitis. Treatments have inconsistent success rates and variable timelines. This study aimed to compare the effectiveness of treating granular myringitis with 1 and 2 per cent acetic acid solutions for two weeks. Method: This double-blind, randomised, controlled trial enrolled and randomly allocated 47 participants to 2 groups between October 2021 and June 2022. Results: After two weeks, the groups' treatment success rates did not differ significantly. There was a 10 per cent recurrence rate 8 weeks after treatment completion. All patients tolerated the diluted vinegar. Conclusion: There is no difference in the efficacy of 1 and 2 per cent diluted vinegar in treating granular myringitis for two weeks. [ABSTRACT FROM AUTHOR]

Objective: This paper describes 20 years of microtia and craniofacial microsomia (CFM) psychosocial and healthcare studies and suggests directions for clinical care and research. Design: A narrative review of papers January 2000 to July 2021 related to psychosocial and healthcare experiences of individuals with microtia and CFM and their families. Results: Studies (N = 64) were mainly cross-sectional (69%), included a range of standardized measures (64%), and were with European (31%), American (27%), or multinational (23%) samples. Data were generally collected from both patients and caregivers (38%) or patient self-report (35%). Sample sizes were 11 to 25 (21%), 26 to 50 (19%), 51 to 100 (22%), or over 100 (38%). Studies addressed 5 primary topics: (1) Healthcare Experiences, including Medical Care, Hearing Loss/Amplification, Diagnostic Experiences, and Information Preferences; (2) Psychosocial Experiences, including Teasing, Behavioral Adjustment, Psychosocial Support, and Public Perception; (3) Neurocognitive Functioning and Academic Assistance; (4) Pre- and Post-Operative Psychosocial Outcomes of Ear Reconstruction/Canaloplasty; and (5) Quality of Life and Patient Satisfaction. Conclusions: Care involved multiple specialties and was often experienced as stressful starting at diagnosis. Psychosocial and neurocognitive functioning were generally in the average range, with possible risk for social and language concerns. Coping and resiliency were described into adulthood. Satisfaction and positive benefit of ear reconstruction/canaloplasty were high. Care recommendations include increasing: hearing amplification use, microtia and CFM knowledge among providers, efficient treatment coordination, psychosocial support, academic assistance, and advances to minimize surgical scarring. This broad literature overview informs clinical practice and research to improve psychosocial outcomes. [ABSTRACT FROM AUTHOR]

The article highlights the importance of considering antibiotic therapy for moderate cases of acute otitis media, especially in children with uncertain access to follow-up care. Topics discussed include the types of infections commonly associated with acute otitis media, the potential benefits and risks of antibiotic treatment, and the role of shared decision-making between clinicians and parents regarding treatment options.

Introduction Tympanoplasty is the main treatment of mucosal type of chronic suppurative otitis media.

Background and Aim: Real-Ear Unaided Gain (REUG) can reveal the outer-ear resonance which reflects the effects of body and ear factors. Deformity in the outer ear may change the real-ear unaided responses. Cauliflower ear is a common ear deformity in wrestlers. This study aimed to compare the REUG of normal and cauliflower ear in wrestlers to investigate the frequencies at which the gain may be inaccurate. Methods: Ten male wrestlers with the age ranged from 21 to 31 years participated in this study. The study had within-subject design and only one group. The REUGs was recorded for both ears, normal and cauliflower ears, and the results analyzed. Results: The mean of REUG values were significantly different between the deformed and normal ears. There were two distinct peaks in the REUG curve of the deformed ear, while there was a single peak in that of the normal ear. Conclusion: The differences in the REUG at 2-6 kHz between the deformed and normal ears was seen. [ABSTRACT FROM AUTHOR]

(1) Background: Otitis externa (OE) is a common inflammatory disease of the external ear canal. Given the numerous manifestations of OE, the high rate of recurrence of the disease, as well as the emergence of resistance to antibiotics, therapeutic strategies are numerous and still not well standardized. The aim of this study was to investigate the patient journey of Italian patients suffering from OE, paying greater attention to new therapeutic options. (2) Methods: We conducted a national survey to evaluate the characteristics of patients affected by OE and to analyze the most-prescribed treatments. (3) Results: OE is a common, often relapsing disease that has several clinical manifestations. Prior to observation, the combination of corticosteroids and topical antibiotics was the most common therapeutic strategy. At the time of observation, new liposomal ozone-based preparations were the most-prescribed treatment. (4) Conclusions: This multi-center study investigated key aspects of the OE patient journey, highlighting the growing problem of antibiotic resistance. Restoring a correct ear microbiome is the therapeutic goal. In this context, new liposomal ozone-based drugs represent a promising therapeutic strategy. [ABSTRACT FROM AUTHOR]

Aim: To investigate whether anisocytosis in circulating blood plays a role in benign paroxysmal positioning vertigo (BPPV) pathology or not. Methods: This study is retrospectively and enrolled with 32 patients and 32 control group. Patients with chronic ear disease and systemic disease that affect red cell distribution width (RDW) value excluded from the study. Mean platelet volume (MPV), RDW, platelet distribution width (PDW), Neutrophil-Lymphocyte ratio and Platelet-Lymphocyte ratio were compared between study and control group. Results: RDW is significantly higher than in control group (p<0,001). The platelet/lymphocyte ratio (PLR) was statistically higher in BPPV patients than in control group (p=0,044). There were no statistically differences between MPV, PDW and neutrophil/lymphocyte ratio. Conclusion: RDW is a quantitative parameter of anisocytosis and can be considered as subclinical systemic inflammation marker. RDW value was higher than control group. BPPV may cause systemic inflammation or BPPV may occur as a result of systemic inflammation. This is the first study about whether anisocytosis in circulating blood plays a role in BPPV pathology or not. [ABSTRACT FROM AUTHOR]

To gain medical insight into the clinical course and safety of otolaryngologic disorders following immunisation with severe acute respiratory coronavirus (SARS-CoV-2) mRNA-based vaccines. Case description. We report four cases of transient audio-vestibular symptoms, which occurred shortly after inoculation of two BNT162b2 (Pfizer-BioNTech®) and mRNA-1273 (Moderna®) vaccines. Hearing loss was unilateral in all cases and recovered at least partially: it was associated with persistent gait instability in two cases, after 1 and 7 months. Trigger mechanisms underpinning audio-vestibular impairment remain uncertain. Immune tolerance mechanisms with off-target innate activation of T-lymphocytes may be involved in vestibulocochlear nerve disorders, as for other cranial nerves involvement. The occurrence of audio-vestibular manifestations following mRNA-based vaccines needs ENT monitoring to support their causality in such rare vaccine-related adverse events. Audio-vestibular disorders appeared of transitory nature, including hearing loss, and should not deter further efforts in large-scale vaccination campaigns against SARS-CoV-2. [ABSTRACT FROM AUTHOR]

In medicine, a misdiagnosis or the absence of specialists can affect the patients health, leading to unnecessary tests and increasing the costs of healthcare. In particular, the lack of specialists in otolaryngology in third world countries forces patients to seek medical attention from general practitioners, whom might not have enough training and experience for making correct diagnosis in this field. To tackle this problem, we propose and test a computer-aided system based on machine learning models and image processing techniques for otoscopic examination, as a support for a more accurate diagnosis of ear conditions at primary care before specialist referral; in particular, for myringosclerosis, earwax plug, and chronic otitis media. To characterize the tympanic membrane and ear canal for each condition, we implemented three different feature extraction methods: color coherence vector, discrete cosine transform, and filter bank. We also considered three machine learning algorithms: support vector machine (SVM), k-nearest neighbor (k-NN) and decision trees to develop the ear condition predictor model. To conduct the research, our database included 160 images as testing set and 720 images as training and validation sets of 180 patients. We repeatedly trained the learning models using the training dataset and evaluated them using the validation dataset to thus obtain the best feature extraction method and learning model that produce the highest validation accuracy. The results showed that the SVM and k-NN presented the best performance followed by decision trees model. Finally, we performed a classification stage -i.e., diagnosis- using testing data, where the SVM model achieved an average classification accuracy of 93.9%, average sensitivity of 87.8%, average specificity of 95.9%, and average positive predictive value of 87.7%. The results show that this system might be used for general practitioners as a reference to make better decisions in the ear pathologies diagnosis.

B. dracunculifolia is popularly used to treat skin diseases. This work aimed to evaluate the topical anti-inflammatory properties of B. dracunculifolia root extract (BdR) and its major compound baccharis oxide (BOx) on mice ear edema models. BdR was analyzed by GC-MS, and BOx was isolated by chromatographic fractionation. Topical anti-inflammatory activities were determined by using the croton oil, capsaicin, histamine, and phenol-induced mouse ear edema models. N-acetyl-β-D- glucosaminidase (NAG) and myeloperoxidase (MPO) activities, as well as NO dosage and histopathological analyses, were also evaluated. Phytochemical analysis of BdR showed BOx as one of the major constituents. BdR and BOx (both at 0.1, 0.5, and 1.0 mg/ear) significantly reduced croton oil, histamine, and phenol-induced ear edema, while only BOx was effective in reducing capsaicin-induced edema. MPO and NAG activities, as well as NO production, were significantly inhibited by BdR and BOx. Histopathological analysis confirmed the topical anti-inflammatory properties of BdR and BOx. Our findings showed that BdR and BOx demonstrated significant topical anti-inflammatory effects in mouse ear edema induced by different agents, suggesting their possible application on skin inflammatory diseases. [ABSTRACT FROM AUTHOR]

Background: Due to an expansion in the usage of medications (such as anticancer therapies), increased exposure to noise, and an increase in life expectancy, the prevalence of inner ear disease-related hearing loss is rising. Diseases of the inner ear are frequently accompanied by other conditions, such as chronic heart failure, systemic inflammation, arterial hypertension, and cerebrovascular disease. The aim of this study was to investigate the profile of hospital admissions linked to inner ear diseases in England and Wales. Method: This was an ecological descriptive study using public medical databases in England and Wales. Diagnostic codes for diseases of the inner ear (H80–H83) were used to identify all hospital admissions. Between 1999 and 2020, the chi-squared test was used to assess the difference between the admission rates. Results: From 5704 in 1999 to 19,097 in 2020, the total annual number of hospital admissions increased by 234.8%, which corresponds to a 192.3% increase in the admission rate [from 10.94 (95% CI 10.66–11.22) in 1999 to 31.98 (95% CI 31.52–32.43) in 2020 per 100,000 people, p < 0.01]. "Disorders of vestibular function" and "other inner ear diseases" were the most frequent causes of hospital admissions due to inner ear diseases, accounting for 47.6% and 43.6%, respectively. The age range of 15 to 59 years accounted for 42.3% of all diseases of the inner ear hospital admissions. Around 59.6% of all admissions were made by females. The female admission rate increased by 210.1% (from 12.43 (95% CI 12.01–12.85) in 1999 to 38.54 (95% CI 37.84–39.24) in 2020 per 100,000 people). The male admission rate for diseases of the inner ear increased by 169.6% [from 9.37 (95% CI 9.00–9.75) in 1999 to 25.26 (95% CI 24.69–25.84) per 100,000 people] in 2020. Conclusion: Inner ear disease admissions increased markedly in England and Wales during the past two decades. Females and the middle-aged population were at higher risk of being admitted for inner ear diseases. Further cohort studies are warranted to identify other risk factors and develop effective prevention strategies. [ABSTRACT FROM AUTHOR]

Objectives: The neurotropic and neuroinvasive properties of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) have been described. It remains unknown how SARS-CoV-2 affects the audiovestibular system when it causes mild or severe disease. In this study, the sequelae effect of SARS-CoV-2 on the audiovestibular systems of different patient groups was investigated using objective and subjective test batteries. Methods: In this present study, we evaluated vestibulocochlear functions of patients who previously had Coronavirus Disease-2019 (COVID-19) with pure tone audiometry, ocular vestibular-evoked myogenic potential (o-VEMP), and cervical vestibular-evoked myogenic potential (c-VEMP) tests to identify possible sequelae by comparing them with the control group. Results: We found that the amplitude of p13-n23 was lower in both groups of patients than in the control group (p < 0.001). In the results of the left ear c-VEMP, the amplitude of p13-n23 was statistically different between the outpatient, inpatient, and control groups. The amplitude of p13-n23 was lower in both groups of patients than in the control group (p < 0.001). In the evaluation of the o-VEMP in the left ear, we observed a statistically significant difference in the latency of n10 (p = 0.006) and the amplitude of n10-p15 (p < 0.001) between the groups. The n10 latency was prolonged in both groups of patients compared to the control group and there was no statistically significant difference between groups of patients. Furthermore, the amplitude of n10-p15 was lower in both groups of patients compared to the control group and there were no statistically demonstrable differences between the groups of patients. Conclusions: In conclusion, our results suggest that SARS-CoV-2 may affect the vestibulocochlear system. But we could not find a direct relationship according to the severity of the disease. [ABSTRACT FROM AUTHOR]

Background: Endolymphatic hydrops (EH) is universal in Ménière´s disease (MD). Given its chronic course, with variable interval before complete clinical picture is installed, it seems relevant to understand the progression of vestibular EH and hemato-perilymphatic barrier disruption in patients with MD and monosymptomatic presentations. Methods: 239 consecutive patients were referred to us with suspected hydropic ear disease. 50 individuals accepted to participate in this study—final longitudinal sample included 24 patients (7 D1, 7 D2, 10 D3). Control group included ten patients. At recruitment, a clinical and MRI re-evaluation was done (3T, intravenous technique) (MR2) and 2 years after MRI was repeated (MR3). Previous MRI (MRI1) were retrospectively evaluated. Patients were classified as definite (D1), possible (D2) and atypical (D3—monosymptomatic) MD. Control group included non-typical symptoms (C2/C3) and 6 asymptomatic (C1). Vestibular endolymphatic ratio (vER) and grading, presence/absence of cochlear EH, asymmetry of cochlear perilymphatic enhancement, and rate of progression of vER were assessed by two independent neuroradiologists and compared between patient and control groups (index ear). Results: EH was universal and pronounced in D1 and remained stable. vER progression was more variable and higher in some D3 patients (index ear worse) and in D2 (non-index), although this observation was not statistically significant. Conclusions: Considering that many probable and monosymptomatic presentations progress years later into definite MD and given the bilateral tendency of the disease, these findings may indicate that there is an initial accelerated worsening of EH in initial stages of the disease. These data should be confirmed with controlled and larger sample studies. [ABSTRACT FROM AUTHOR]

Background: A short course of corticosteroids is among the management strategies considered by specialists for the treatment of vestibular neuritis (VN). We conducted an umbrella review (systematic review of systematic reviews) to summarize the evidence of corticosteroids use for the treatment of VN. Methods: We included systematic reviews of randomized controlled trials (RCTs) and observational studies that evaluated the effects of corticosteroids compared to placebo or usual care in adult patients with acute VN. Titles, abstracts, and full texts were screened in duplicate. The quality of reviews was assessed with the A MeaSurement Tool to Assess systematic Reviews (AMSTAR‐2) tool. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) assessment was used to rate certainty of evidence. No meta‐analysis was performed. Results: From 149 titles, five systematic reviews were selected for quality assessment, and two reviews were of higher methodological quality and were included. These two reviews included 12 individual studies and 660 patients with VN. In a meta‐analysis of two RCTs including a total of 50 patients, the use of corticosteroids (compared to placebo) was associated with higher complete caloric recovery (risk ratio 2.81, 95% confidence interval [CI] 1.32 to 6.00, low certainty). It is very uncertain whether this translates into clinical improvement as shown by the imprecise effect estimates for outcomes such as patient‐reported vertigo or patient‐reported dizziness disability. There was a wide CI for the outcome of dizziness handicap score (one study, 30 patients, 20.9 points in corticosteroids group vs. 15.8 points in placebo, mean difference +5.1, 95% CI −8.09 to +18.29, very low certainty). Higher rates of minor adverse effects for those receiving corticosteroids were reported, but the certainty in this evidence was very low. Conclusions: There is limited evidence to support the use of corticosteroids for the treatment of VN in the emergency department. [ABSTRACT FROM AUTHOR]

Objective: To explore the relationship between blood lipid and hemorheology indexes and hearing curve types in patients with sudden sensorineural hearing loss(SSHL), and to analyze the influencing factors of clinical efficacy. Methods: 103 patients with SSHL who were admitted to our hospital from June 2020 to January 2022 were selected as the SSHL group, and another 103 healthy people were selected as the healthy group. The blood lipid level and hemorheology indexes of the two groups were analyzed, and the blood lipid level and hemorheology indexes of the patients with different hearing curve types were compared. Spearman correlation analysis was used to analyze the relationship between the blood lipid level and hemorheology indexes and the hearing curve types of the patients with SSHL. Univariate and multivariate Logistic regression models were used to analyze the influencing factors of clinical efficacy in patients with SSHL. Results: Compared with the healthy group, the total cholesterol(TC), triacylglycerol(TG), whole blood high shear, middle shear, low shear viscosity and plasma viscosity in the SSHL group were significantly higher(P＜0.05), while there were no significant differences between high density lipoprotein C(HDL-C) and low density lipoprotein C(LDL-C)(P＞0.05). There was no statistically significant difference in the levels of various blood lipid indexes among different hearing curve types of patients with SSHL(P＞0.05), and there was a statistically significant difference in the levels of various hemorheology indexes among different hearing curve types of patients with SSHL(P＜0.05). Among them, the hemorheology indexes of patients with total deafness type were significantly higher than those of patients with low frequency decline type(P＜0.05). There were no significant correlation between the four items of blood lipid and the type of SSHL hearing curve(P＞0.05), while the indexes of hemorheology were significantly correlated with the type of SSHL hearing curve(P＜0.05). The proportion of bilateral ear disease, the proportion of hearing curve type of total deafness, the whole blood high shear viscosity, the whole blood low shear viscosity and the plasma viscosity of patients in the ineffective group after treatment were significantly higher than those in the effective group(P＜0.05). The results of multivariate Logistic analysis showed that bilateral disease, hearing curve type of total deafness, and increased plasma viscosity were risk factors for ineffective treatment in patients with SSHL(P＜0.05). Conclusion: There are abnormal blood lipid and hemorheology in patients with SSHL, and hemorheology is related to the type of hearing curve and clinical efficacy in patients with SSHL. Bilateral disease, total deafness and increased plasma viscosity are risk factors for ineffective treatment in patients with SSHL. Detection of blood lipid and hemorheology has certain clinical guiding significance for diagnosis and treatment of SSHL. [ABSTRACT FROM AUTHOR]

Sickness absence from work is a measure of both poor health and social functioning. In order to assess the frequency of sick leave due to ear-related diagnoses, we performed a retrospective analysis on the registry of paid sick leave certificates supplied by the main social security institution in Mexico during the years 2018 and 2019, just prior to the SARS-CoV-2 pandemic. We observed that, in the two years, 22,053 sick leave certificates due to ear-related diagnoses were provided to 18,033 workers. The most frequent ear-related diagnoses were those of vestibular disorders (94.64%); among them, the most common diagnosis was Benign Paroxysmal Positional Vertigo (75.16%), followed by Labrynthitis and Meniere's disease (circa 8% each). A total of 4.63% of the diagnoses were related to external and middle ear disorders, and 0.71% were mainly related to hearing. Consistently, the highest cumulative days of sick leave required were given for the group of diagnoses related to vestibular disorders; although the less frequent diagnoses required the highest cumulative days per case (e.g., ototoxicity). During 2018 and 2019, the most frequent diagnoses of ear-related sick leave were due to vestibular diagnoses (particularly Benign Paroxysmal Positional Vertigo). [ABSTRACT FROM AUTHOR]

Objectives: This study compared the rate of graft success, as well as hearing improvement and dry ear time between dry ears and wet ears with otomycosis or without otomycosis in patients with chronic suppurative otitis media (CSOM) after endoscopic cartilage myringoplasty. Methods: This retrospective study was conducted in a tertiary hospital in Shanghai. In total, 83 patients with CSOM (43 with dry ears and 40 with wet ears) were included. Among the 40 patients with CSOM and wet ears, 25 exhibited otomycosis. All patients underwent endoscopic myringoplasty, and perforations were repaired using tragal cartilage with a singlesided perichondrium. Patients were followed up for at least 6 months. Pure-tone hearing was examined preoperatively and at 3 months postoperatively. The graft uptake rate, hearing improvement, and dry ear time were compared between the groups. Results: The graft success rate did not differ significantly between the dry-ear and wet-ear groups (95.35% and 90.00%, respectively). Furthermore, the graft success rate also did not differ significantly between patients with wet ears and otomycosis and those with wet ears without otomycosis (92.00% and 86.67%, respectively). Hearing gain did not differ significantly between the dry-ear and wet-ear groups. No significant difference in hearing gain was also found in patients with wet ears with or without otomycosis. However, the time to dry ear was significantly longer in the wet-ear group than in the dry-ear group. Conclusion: Patients with CSOM and wet ears required more time to achieve a completely healthy status. However, the graft success rate and hearing improvement were not affected by a wet middle ear and otomycosis. Thus, endoscopic myringoplasty using tragus cartilage is an effective treatment for refractory CSOM in patients with wet ears and otomycosis. [ABSTRACT FROM AUTHOR]

The Eustachian tube is a canal from the tympanic cavity to the nasopharynx that is responsible for the aeration, drainage, and pressure equalization of the middle ear. Partial or complete blockage of the tube can trigger severe ear disease. We evaluated pathologic changes from Eustachian tube obstruction (ETO) in 15 temporal bones from cats with bilateral ETO from the temporal bone collection at the University of Minnesota Medical School Otopathology Laboratory. The samples were evaluated for histopathological changes to investigate the continuum of the disease at intervals of 2 days, 1-week, 2-weeks and 4-weeks. Temporal bones were sectioned in the horizontal plane and every 10th section was stained with hematoxylin and eosin. One section from each ear was stained with periodic acid-Schiff and Alcian blue. Sections were studied under light microscopy. The results revealed moderate hyperplasia equally developed throughout the epithelial layer surrounding the middle ear and neutrophil-rich inflammatory cell infiltration. As the duration of obstruction prolonged to the 4th week, compositional change of the middle ear effusion from serous to mucoid that was accompanied with granulation tissue formation was observed. In conclusion, the severity of the findings related to ETO are directly proportional to the duration of the disease. Therefore, patients presenting with long-lasting complaints of ear diseases should be examined for dysfunction or blockage of the Eustachian tube. [ABSTRACT FROM AUTHOR]

Background: In cases of chronic otitis media (COM) presenting with unilateral squamosal disease, there may be the possibility of a potential disease in the opposite ear, which may lead to future complications. Therefore, it needs to be known whether there is any silent pathological process in the contralateral ear (CLE) that is currently asymptomatic but likely to be diseased in the near future. Therefore, this study was undertaken to analyze the fate of the contralateral asymptomatic ear in patients with unilateral squamosal disease. Results: A total of 32 patients with COM squamosal disease were included. All the patients were subjected to clinical examination and a high-resolution computed tomography (CT) scan of bilateral temporal bones. The mean duration of age at presentation was 20.4 years. The male-to-female ratio was 1.28. Out of 32 patients, 11 (34%) showed either clinical or radiological findings in the asymptomatic CLE, out of which 7 showed both abnormal clinical and radiological findings, 3 demonstrated only abnormal clinical findings, and 1 showed only abnormal CT changes without obvious clinical findings in the CLE. In the CLE, 7 (21%) patients had mild conductive hearing loss. There was no statistically significant association of clinical findings or radiological findings in CLE to that of the unilateral squamosal diseased ear. Conclusion: In cases with unilateral squamosal disease, an asymptomatic CLE can undergo subclinical changes and conductive hearing loss. Patients can also have silent radiological changes in the CLE detected on the CT scan, which are significant but remain undetected. No statistical significance could be reported in this study, yet other studies with even larger samples are required to show a causal relation between unilateral squamosal disease and a quiescent process in the asymptomatic CLE. [ABSTRACT FROM AUTHOR]

Objective: Chronic suppurative otitis media is a major global disease disproportionately affecting low- and middle-income countries, but few studies have explored access to care for those with ear and hearing disorders. Method: In a tertiary hospital in Cambodia providing specialist ear services, a mixed method study was undertaken. This study had three arms: (1) quantitative analysis of patients undergoing ear surgery, (2) a questionnaire survey and (3) semi-structured in-depth interviews. Results: Patients presented with advanced middle-ear disease and associated hearing loss at rates that are amongst the highest per capita levels globally. Patients reported several structural, financial and socio-cultural barriers to treatment. This study showed a significant burden of ear disease in Cambodia, which reflects a delay in receiving timely and effective treatment. Conclusion: This study highlights the opportunity to integrate effective ear and hearing care into primary care service provision, strengthening the package of activities delivered at government facilities. [ABSTRACT FROM AUTHOR]

Objective: Hearing loss is the third leading cause globally for 'years lived with disability'. The majority of those affected live in low and middle-income countries. Method: This study used qualitative research methods to explore the impact of chronic ear disease on quality of life in Nepal. Twenty face-to-face semi-structured interviews were conducted during a visiting ear camp at the Britain Nepal Otology Service Ear Care Centre in Nepal. Interviews were recorded, transcribed and translated with thematic content analysis performed manually by two researchers. Results: Chronic ear disease has a significant impact on social interactions, emotional well-being and functionality. Barriers to surgery are cost, accessibility, reputation, gender and fear of complications. Conclusion: This study provided valuable new insight into patient perspectives on living with chronic ear disease in Nepal. Patients with chronic ear disease experience discrimination and stigmatisation across all levels of personal, family and social life, with their function across all domains being directly limited by symptoms. [ABSTRACT FROM AUTHOR]

Background: Langerhans cell histiocytosis (LCH) or histiocytosis X is considered as a rare disease that may have effect on multiple organs. The initial presentation of LCH is varied. The signs and symptoms of otologic histiocytosis can be the same as the acute or chronic infectious ear diseases. Definitive diagnosis of LCH is confirmed by biopsy and immunohistochemically staining of S-100 protein and CD1a antigen. Chemotherapy is the main mode of treatment. Case presentation: In this report, we explained the clinical manifestation, diagnosis and treatment of a case of 15 month-old girl with diagnosed of LCH that initially presented with otitis media with effusion (OME). Conclusion: LCH is a rare disease that presented with variable sign and symptoms and have an effect on multiple organs. LCH should be regarded in cases with recurrent ear infection without response to medical treatments. Moreover, biopsy with IHC is the gold standard of diagnosis and chemotherapy is the main form of treatment. [ABSTRACT FROM AUTHOR]

Background Given the multifaceted nature of the balance system, an interdisciplinary approach to patient care is imperative. For surgical patients with complex medical histories, comprehensive vestibular evaluations provide information on baseline vestibular function and identify possible surgical risks and outcomes. This case study follows a patient diagnosed with probable right vestibular neuronitis immediately preceding surgical resection of a left brainstem lesion, later diagnosed as a B cell lymphoma (BCL) and provides details regarding pre- and postsurgical outcomes. Purpose This case study expands on the importance of the inclusion of vestibular audiologists on the interdisciplinary team for related surgical procedures to provide insight into possible surgical risks and subsequent effects on patients' postsurgical quality of life. Research Design Case report. Study Sample A 68-year-old female patient evaluated within the Henry Ford Health System for management of diffuse large BCL. Data Collection Standard neuro-otology, neuro-surgical, audiological, and vestibular evaluations were conducted to evaluate the patient's complex symptomology. Results This case report outlines a patient hospitalized for a left brainstem mass, later diagnosed as an aggressive form of lymphoma, with a concurrent episode of vestibular neuronitis on the contralesional side. Functional outcomes are discussed following surgical intervention to remove the mass. Postsurgical vestibular testing revealed a bilateral vestibular hypofunction. Conclusions Vestibular audiology plays an essential role in the multidisciplinary team for complex dizzy patients with related surgical procedures, as this subset of the field can offer critical insight into postsurgical recommendations and patient expectations. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) may lead to many otolaryngological disorders such as loss of smell and taste, sudden sensorineural hearing loss (SSNHL), facial palsy, and parotitis. The involvement of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in vestibular neuritis (VN) has been reported in 2 adult patients but not really confirmed through objective testings. We present a case of a 13-year-old girl with left superior vestibular neuritis confirmed by Video Head Impulse Test during a proven COVID-19 infection. To the best of our knowledge, this is the first case associating VN and COVID-19 that was demonstrated with an objective peripheral assessment. Physicians may be aware about the occurrence of VN in patients with COVID-19, keeping in mind that this condition may develop not only in adults. Early detection of SARS-CoV-2 in this pandemic is required to prevent its spread. [ABSTRACT FROM AUTHOR]