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This article discusses a case report and literature review on the treatment of relapsing polychondritis with inverse psoriasis using tofacitinib and risankizumab. Relapsing polychondritis is an inflammatory condition that primarily affects cartilaginous tissues, while inverse psoriasis is a form of psoriasis that occurs in skin folds. The patient in the case study had a history of Hashimoto's thyroiditis and presented with symptoms such as chest pain, recurrent swelling of the nose and ears, joint pain, and psoriatic lesions. The patient was initially treated with methotrexate and systemic steroid therapy but did not respond well. Tofacitinib and risankizumab were then added to the treatment regimen, resulting in significant clinical improvement. The article also discusses the challenges of treating relapsing polychondritis and the effectiveness of different treatment options. [Extracted from the article]

Introduction Illnesses among Navy divers degrade readiness, decrease manpower levels, and increase costs for medical care. Prior research has shown that Navy divers have high rates of the types of illnesses that might be because of diving in contaminated water. The objectives of this study were to examine medical records of U.S. Navy Sailors from 2016 to 2022 and determine if divers have higher incidence rates of health conditions that might be associated with contaminated water diving compared to non-divers. Materials and Methods For this retrospective cohort study, we used data from the Defense Medical Epidemiology Database (DMED). The DMED is operated by the Armed Forces Health Surveillance Division and uses data from the Defense Manpower Data Center to classify occupations. The DMED provides free online access to a de-identified subset of data contained within the Defense Medical Surveillance System. The population was U.S. Navy enlisted males, aged 25 to 29 years. Divers were compared to non-divers using 8 selected diagnoses that may reasonably be associated with diving in contaminated water. Results During the study period, the database contained a total of 5,474 diver and 827,406 non-diver person-years. Of the 8 diagnoses, the ones with the largest number of cases for divers were upper respiratory infections with 128 and ear disorders with 62. The relative risks (RRs) for divers compared to non-divers were higher for otitis externa (RR = 1.44; confidence interval = 1.03, 2.01) and for ear disorders (RR = 1.15; confidence interval = 0.89, 1.47); for the other 6 diagnoses, the divers had lower rates than the non-divers. Conclusions The high RRs found for otitis externa and ear disorders support the need to devote resources to better understand the reasons for these higher risks and to develop, test, and implement targeted risk-reduction strategies. Future studies should attempt to link verified contaminated water exposures with adverse health outcomes and calculate risks based on criteria such as age and dive factors. [ABSTRACT FROM AUTHOR]

Objectives: Pendred syndrome, an autosomal recessive disorder, is often associated with pathogenic variants of the SLC26A4 gene that encodes the pendrin protein. Given its autosomal recessive inheritance, tracing the family history and screening siblings become crucial once a diagnosis of Pendred syndrome is confirmed. This case report aims to underscore the variability in inner ear morphology within a family diagnosed with Pendred syndrome, all carrying the same SLC26A4 gene mutation. Methods: A chart review and a review of the literature. Results: We present a family of 4, all of whom possess sensorineural hearing loss due to the same homozygous SLC26A4 variant c.919-2A>G. Intriguingly, clinical manifestations, especially inner ear deformities, displayed variability among family members. Notably, 1 family member exhibited a normal cochleovestibular structure morphology, which was rarely reported in the literature. Conclusions: This report highlights the significance of genetic testing and familial consultation when a proband exhibits typical Pendred syndrome symptoms. It also underscores that the inner ear morphology can exhibit variability among family members, even with the same homozygous SLC26A4 variant. [ABSTRACT FROM AUTHOR]

This study aimed to determine whether more stable electroretinography parameters could be obtained in younger children using skin electrodes placed at the inner canthus and ears compared to using contact lens electrodes. The study included three Japanese patients (two girls and one boy) who presented with epileptic spasms before the age of 3 years. We compared the electroretinography parameters obtained with skin electrodes and contact lens electrodes. We could record reproducible results using skin ERG with a montage of electrodes placed at the inner canthus and the ear in children. Moreover, standard data for younger children were created, enabling the evaluation of electroretinography parameters recorded with skin electrodes in individual pediatric patients. The skin electroretinography using the new montage may be stable parameters for evaluating retinal function in younger children. [ABSTRACT FROM AUTHOR]

Trichoderma afroharzianum, a ubiquitous soil-borne fungus found on plant roots and decaying residues, displays competitive traits and mycoparasitic behavior against diverse microorganisms. Selected strains of this fungus are known in agriculture for their beneficial effects on plant growth and as bio-fungicides. However, recent findings have pinpointed Trichoderma afroharzianum as the causal agent behind maize ear rot disease in Europe since 2018, notably impacting maize cobs in Germany, France, and Italy. This study aims to evaluate the severity of Trichoderma ear rot disease on maize fresh matter content and specific quality parameters under semi-field conditions. Two distinct maize varieties were artificially inoculated with a pathogenic Trichoderma isolate at the flowering stage using needle pin or silk channel methods. Disease severity was assessed visually at the time of harvest based on the percentage of infected kernels according to EPPO Guidelines (PP 1/285). Fresh matter content and quality parameters such as alpha-amylase activity, C/N ratio, water, and sugar content were analyzed. Results showed that needle pin inoculation led to higher disease severity (60%) compared to silk channel inoculation (39%). Cob weight decreased significantly at the highest disease severity level by up to 50% compared to control plants. In both varieties, alpha-amylase activity increased significantly with higher Trichoderma disease severity, resulting in starch degradation and increased glucose release. The germination rate was severely affected by the infection, with only 22% of grains germinating, and the seedlings showed shortened and deformed growth. This is the first report on Trichoderma ear rot infection and its effect on fresh matter content and quality parameters in maize after artificial inoculation under field conditions. The results address an important knowledge gap and provide valuable insights into the infection pathway and impact on maize quality. [ABSTRACT FROM AUTHOR]

Cytomegalovirus infection contributes to 10–30% of congenital hearing loss in children. Vertebrate peripheral auditory organs include the outer, middle, and inner ear. Their development is regulated by multiple signaling pathways. However, most ear diseases due to viral infections are due to congenital infections and reactivation and affect healthy adults to a lesser extent. This may be due to the fact that viral infections affect signaling pathways that are important for the development of peripheral hearing organs. Therefore, an in-depth understanding of the relationship between viral infections and the signaling pathways involved in the development of peripheral hearing organs is important for the prevention and treatment of ear diseases. In this review, we summarize the effects of viruses on signaling pathways and signaling molecules in the development of peripheral auditory organs. [ABSTRACT FROM AUTHOR]

Otitis media with effusion (OME) is a common presentation to the Otorhinolaryngology clinic. Besides hearing impairment, recent evidence shows that approximately 30% of these children have some degree of vestibular and balance impairment. To assess the presence of vestibular dysfunction among children with OME. Children between 4 and 17, with and without OME, underwent vestibular assessment using video head impulse test (VHIT), subjective visual subjective (SVV), and single leg raising test (SLS). Data were recorded and analysed. 24 OME children were included with male predominance. No statistical significance was found between the VOR gain (p > 0.05), SVV (p = 0.056) and SLS (p = 0.06). Simple linear regression analysis showed that age and gender are potential factors for VOR gain. Our study found that children with OME have normal vestibular function. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to compare daily and total recreational music exposure levels and extended-spectrum audiogram results in young adults without pre-existing hearing problems. Design: The study included healthy volunteers aged 18–25 with no known ear disease or hearing loss. Participants completed a questionnaire, underwent otoscopic and tympanometric examinations, and determined preferred music volumes in an audiometry booth using calibrated music samples of their preferred genres. Hearing thresholds up to 16 kiloHertz (kHz) were measured. Daily music exposure for each participant was normalized to 8 h to calculate a time-weighted average of 8 h (TWA8). Total exposure (TE) was calculated by multiplying TWA8 by the number of years of music listening. Results: A total of 32.4% of participants had TWA8s above 65 dB. Their hearing thresholds at 125, 250, 500, and 16,000 Hz and the average of 125 Hz–8 kHz were significantly higher. Participants with TWA8s above 65 dB were also more prone to speaking loudly and experiencing communication difficulties on the phone. Those with a TE of more than 400 experienced significantly more speech discrimination difficulty in noisy environments and temporary hearing loss/tinnitus after exposure to loud music. Participants with a TE above 700 had worse thresholds at 4, 14, and 16 kHz frequencies, as well as 125–8000 Hz and 500–4000 Hz averages compared to those with a TE below 700. Conclusions: This study provides evidence that recreational music with much lower exposure levels than the universally accepted TWA8 of 85 dB could negatively impact hearing in healthy young adults. Therefore, maintaining a maximum TWA8 of 65 dB is recommended. [ABSTRACT FROM AUTHOR]

Background: The term temporomandibular disorder (TMD) indicates a set of musculoskeletal conditions involving temporomandibular joint (TMJ), masticatory musculature, and related anatomical structures. Pain is the most common clinical manifestation of TMD, and the auditory system might be involved and affected, through tinnitus, dizziness, otalgia and ear fullness sensation. Objectives: The aim of this systematic review of randomised controlled trails (RCTs) was to evaluate the efficacy of rehabilitative approaches on otologic symptoms in patients with TMD. Methods: PubMed, Scopus and Web of Science were systematically searched from the inception until 8th October 2023 to identify RCTs presenting participants with a diagnosis of TMD associated with otologic signs and symptoms, rehabilitative approaches as interventions, and modification of the otological symptoms as outcome. Results: Out of 931 papers suitable for title/abstract screening, 627 articles were assessed for eligibility. Five studies were included reporting the efficacy of occlusal splint therapy, low‐level laser therapies, and physical therapy in patients diagnosed whit secondary otalgia or tinnitus associated with TMD. No RCTs evaluating other otologic symptoms, ear fullness, dizziness or vertigo were found. Conclusions: Results of this systematic review suggested that rehabilitative approaches might be effective in improving secondary otalgia and tinnitus in TMD patients. Thus, further RCTs with a higher level of evidence and more representative samples should be conducted to better understand the effects of TMD therapy on otologic complains. [ABSTRACT FROM AUTHOR]

Background: Auriculocondylar syndrome (ARCND) is an extremely rare autosomal dominant or recessive condition that typically manifests as question mark ears (QMEs), mandibular condyle hypoplasia, and micrognathia. Severe dental and maxillofacial malformations present considerable challenges in patients' lives and clinical treatment. Currently, only a few ARCND cases have been reported worldwide, but most of them are related to genetic mutations, clinical symptoms, and ear correction; there are few reports concerning the treatment of dentofacial deformities. Case presentation: Here, we report a rare case of ARCND in a Chinese family. A novel insertional mutation in the guanine nucleotide-binding protein alpha-inhibiting activity polypeptide 3 (GNAI3) was identified in the patient and their brother using whole-exome sequencing. After a multidisciplinary consultation and examination, sequential orthodontic treatment and craniofacial surgery, including distraction osteogenesis and orthognathic surgery, were performed using three-dimensional (3D) digital technology to treat the patient's dentofacial deformity. A good prognosis was achieved at the 5-year follow-up, and the patient returned to normal life. Conclusions: ARCND is a monogenic and rare condition that can be diagnosed based on its clinical triad of core features. Molecular diagnosis plays a crucial role in the diagnosis of patients with inconspicuous clinical features. We present a novel insertion variation in GNAI3, which was identified in exon 2 of chromosome 110116384 in a Chinese family. Sequential therapy with preoperative orthodontic treatment combined with distraction osteogenesis and orthognathic surgery guided by 3D digital technology may be a practical and effective method for treating ARCND. [ABSTRACT FROM AUTHOR]

Background and purpose: Otological symptoms (OS) are highly prevalent in individuals with temporomandibular disorders (TMD). Individuals with TMD and OS have more neck disability and decreased deep neck muscles endurance when compared to individuals without OS. However, no studies have evaluated whether OS is associated with lower Quality of Life (QoL) and worse levels of physical activity. This study aimed to evaluate the QoL and level of physical activity of individuals with TMD with and without OS. Methods: In this cross‐sectional study, 62 individuals with TMD were allocated into 2 groups: TMD with OS (n = 36) or TMD without OS (n = 26). Self‐reported complaints of dizziness, vertigo, tinnitus, earache, ear fullness, or hypoacusis were considered as OS. QoL was assessed with the WHOQOL‐Bref and physical activity with the IPAQ‐SF. Independent t‐test and chi‐squared test were used for analysis between‐groups. Effect sizes were reported using Cohen's d. A Pearson correlation was used to compare the number of OS and QoL scores. A significance level of p < 0.05% and 95% confidence intervals were considered statistically significant. Results: The total generic scores for QoL were not different between‐groups (p = 0.076), but individuals with TMD with OS had lower satisfaction (p = 0.015; d: 0.63) and physical domain (p = 0.015; d: 0.64) scores with a moderate effect size. In TMD with OS, 69.4% of individuals were irregularly active and 50% for the TMD without OS, with no statistical significance (p > 0.05). The number of OSs was inversely and weakly associated with the QoL total score. Conclusion: Individuals with TMD and OS are associated with worsened QoL (physical domain and satisfaction) when compared to individuals with TMD without OS. The higher the number of OS, the worse the QoL score. Individuals with TMD with and without OS had similar levels of physical activity, but a high prevalence of irregularly active and sedentary individuals within TMD diagnosed population was found. [ABSTRACT FROM AUTHOR]

Maize (Zea mays L.) Fusarium ear rot (FER), which is caused by the fungal pathogen Fusarium verticillioides, is a major ear disease affecting maize production in China. Developing resistant maize hybrids is a cost‐effective and environmentally friendly method of reducing yield losses due to FER. Using the nail punch inoculation method, 17 highly resistant and 16 highly susceptible inbred lines were identified in this study, and a large‐scale maize hybrid consisting of 528 F1's was produced using a half‐diallel cross model. The hybrids were inoculated with F. verticillioides in 6 year–location environment combinations during 2020–2022. Our results showed that estimates of genotypic, environmental, and genotype × environment interaction variance components were very significant (p < 0.001). All the crosses generated from highly resistant inbred lines exhibited high kernel resistance, whereas those generated from highly susceptible inbred lines mostly exhibited high susceptibility to FER. Crosses between resistant and susceptible inbred lines showed intermediate resistance to FER. The general combining ability (GCA) effect was greater than the specific combining ability effect across multiple environments, indicating that the inheritance of FER resistance was mainly influenced by additive genetic effects. The correlation coefficient between the expected GCA value and hybrid resistance was 0.789, whereas that between the mid‐parent value and hybrid resistance was only 0.644. Inbred performance per se and their corresponding hybrids across multiple environments were significantly correlated (r = 0.823). However, no relationship was observed between the FER resistance of F1's and that of their parental heterotic groups. Core Ideas: In breeding, selecting parents with Fusarium ear rot (FER) resistance is more crucial than selecting the hybrids themselves.The additive effect is the main genetic component of ear rot in maize, whereas the non‐additive effect is minor.Additional inoculation tests for FER resistance are required for specific hybrid combinations.Hybrid resistance can be inferred based on the general combining ability of parental inbred lines.The additive effects of resistance genes in highly inbred lines are minor. [ABSTRACT FROM AUTHOR]

Aim: This is a study is to estimate hearing outcome after type 1 tympanoplasty using temporalis fascia as graft by underlay technique and to know about factors influencing outcome like age, gender, affected ear and size of the perforation. It is done by comparing our preoperative and post-operative audiological results with that of previous studies. Method: A total of 33 patients (34 ears) with CSOM who underwent type I tympanoplasty in the department of E.N.T, K.R. Hospital, Mysore were studied during the period of 18 months (January 2021 to June 2022). A detailed proforma was filled for each patient regard to personal details, clinical history, examination, investigations, surgical procedures and post-operative follow up visits. Audiological evaluation using pure tone audiometry was done pre operatively and at 6 and 12 weeks post operatively. Results are tabulated. Statistical analysis is done. Results: In our study of 34 cases, graft take up is 91.17%, mean hearing gain is 12.6dB and mean air bone gap closure is 13.7dB. Incidence of cases is more in the age group of 21-30 years (32.4%). Graft take up and hearing gain in younger age group (93.75% &12.9dB), male patients (100% &13.5dB) are better but this finding is not statistically significant. Patients with normal contralateral ear (100% &14.35dB), perforation size <50% size (90% & 11.5dB) have better graft take up rate and hearing outcome, which are statistically significant. Conclusion: The primary objective of surgery for CSOM is to eradicate infection and disease and make the ear safe and dry and second objective is to restore hearing. For central perforations with good cochlear reserve Type 1 tympanoplasty is good choice. Status of the opposite ear and size of the perforation have a significant role in the outcome of type I tympanoplasty. [ABSTRACT FROM AUTHOR]

This article provides information on superficial necrolytic dermatitis (SND), a dermatologic condition that affects humans, dogs, and rarely cats. SND is often associated with metabolic disturbances and can be caused by glucagon-secreting tumors or hepatopathy. It is characterized by cutaneous lesions and is most commonly found in older, smaller-breed dogs. Diagnostic findings include increased alkaline phosphatase and alanine aminotransferase levels, as well as hypoaminoacidemia. The article discusses the cause, diagnosis, and treatment options for SND, emphasizing the importance of early recognition and treatment to improve survival times. The optimal treatment involves a combination of intravenous amino acid infusions, enteral supplements, and high-protein home-cooked diets. [Extracted from the article]

OBJECTIVE: This study aims to identify clinical predictors of treatment response to Eustachian Tube Balloon Dilation (ETBD) as measured by changes in Eustachian Tube Dysfunction Questionnaire-7 (ETDQ-7) scores. METHODS: One hundred thirteen patients who underwent ETBD at an institution from 2017 to 2021 completed ETDQ-7 pre- and post-operatively. We conducted multivariable regression analyses with ETDQ-7 normalization (0.5 pre-op - post-op), and quantitative improvement in ETDQ-7 score as outcome variables. Pre-operative ETDQ-7 score, tympanogram type, chronic otitis media, chronic rhinosinusitis (CRS), inferior turbinate hypertrophy, deviated septum, allergic rhinitis, and rhinorrhea were included as covariates. Models controlled for age, sex, ethnicity, prior ear or sinus surgery, and follow-up duration. RESULTS: The mean age was 49 years old. 51% were females, and all patients had pre-operative ETDQ-7 above 2.1. After a mean follow-up period of 13 months, 77% achieved MCID and 37% had normalized. Higher pre-operative ETDQ-7 score was associated with greater ETDQ-7 score improvement (B = 0.60, 95% CI = [0.37, 0.83]) and greater odds of achieving MCID (aOR = 1.65; 95% CI = [1.06, 2.59]). A history of CRS improved chances of achieving MCID (aOR = 4.53; 95% CI = [1.11, 18.55]) and a history of chronic otitis media predicted increased odds of ETDQ-7 normalization (aOR = 2.88; 95% CI = [1.09, 7.58]). CONCLUSIONS: Our findings suggest that ETBD was highly effective among patients with pre-operative ETDQ-7 above 2.1. Furthermore, higher pre-operative ETDQ-7 score, CRS, and chronic otitis media predicted more favorable symptomatic benefit from ETBD. These factors may be important to consider when counseling potential candidates for this procedure.

Background: Adenoid cystic carcinoma is an uncommon malignancy primarily arising from salivary glands. An extremely rare site for adenoid cystic carcinoma is the skull base. We report a case of adenoid cystic carcinoma of skull base who presented with common complaints of pain and right ear discharge. The discussion is made with emphasis on imaging evaluation simulating infective etiology with adjacent skull base osteomyelitis. Careful observation of the imaging findings and further evaluation of the patient revealed the neoplastic nature of the lesion with the final diagnosis being adenoid cystic carcinoma. Case presentation: A 40-year-old female presented to our department with complaints of pain and right ear discharge since 6 months with progressive, extensive facial swelling and facial nerve palsy. The patient had undergone modified radical mastoidectomy thrice, but the details were not available. On imaging, there was a heterogenous extensive lesion extending from scalp till upper cervical region with extensive destruction of skull base and intra-cranial extension. The possibilities of temporal bone squamous cell carcinoma and extensive skull base osteomyelitis were considered. Further the biopsy of the lesion revealed adenoid cystic carcinoma. Conclusions: Extensive lesions of the skull base can be of infective, neoplastic and inflammatory etiology. Distinguishing between these conditions is crucial, as they have similar imaging characteristics but require different management approaches. The presence of a lesion that displaces or destroys fascial planes, accompanied by solid mass-like enhancement, indicates a higher probability of a neoplastic origin rather than an infectious etiology. With squamous cell carcinoma being the most common neoplasm, adenoid cystic carcinoma of the skull base also needs to be understood due to its propensity for perineural spread and a high likelihood of recurrence. [ABSTRACT FROM AUTHOR]

Purpose: The association between microtia severity and hearing function has been thoroughly investigated. This study examined the relationship between microtia grade, number of ear subunits (i.e., helix, antihelix, scapha, triangularis fossa, concha, lobule, tragus, and antitragus) with auditory brainstem response (ABR) findings in children with microtia. Study Design: A retrospective chart review was employed in this study. Method: We analyzed the ABR test results and photographs of 22 children with 30 microtia ears at Dr. Cipto Mangunkusumo National Hospital, Jakarta. The ABR test results were acquired using click (air conduction only) and 500-Hz tone burst stimuli (air- and bone-conduction). Ear photographs were overlaid with a template of a normal ear to determine the number of ear subunits present and the subsequent microtia grade. Number of ear subunits and ABR results were analyzed using the chi-square, Mann--Whitney U, and Spearman's correlation tests. Results: ABR thresholds for click and 500-Hz tone bursts air-conduction were significantly poorer for ears with a subunit < 5 compared to ears with a subunit ≥ 5. No significant difference was observed in 500 Hz bone-conduction ABR thresholds between these groups. Correlation analysis showed a significant negative correlation between increased ear subunits and click ABR thresholds. No significant correlation was found between ear subunits and 500-Hz air- and bone-conduction ABR thresholds. Conclusions: A higher number of ear subunits are associated with a lower hearing threshold, as assessed using ABR with click stimuli. Therefore, the number of ear subunits and microtia grades can be used to examine the hearing level thresholds in infants and children with microtia. [ABSTRACT FROM AUTHOR]

Purpose: Otosclerosis is a common ear disease causing ankylosis of the stapedio-vestibular joint and conductive hearing loss. Stapedoplasty is the most advisable surgical solution. The restoration of hearing depends on the condition of the patient and the surgery itself. The aim of our work was to compare the surgical and audiological results of stapedoplasty performed with endoscopic versus microscopic technique. Methods: This is a retrospective study of 254 patients treated with stapedoplasty with a microscopic approach (91/254) or with an endoscopic approach (163/254) between 2014 and 2021 at our tertiary referral center. Statistical significance of differences between the two methods was determined using the Mann–Whitney test for quantitative variables and the Wilcoxon matched-pairs signed-rank test for repeated measures. Categorical variables were assessed with Fisher's exact test. Results: Both techniques improved the hearing status of patients, with no statistically significant difference between them. There was also no statistically significant difference in reported complications between the two techniques. There is a statistical difference (p < 0.001) in operating time between the two techniques: the endoscopic technique had a mean operating time of 39 min versus 45 min for the microscopic technique. Conclusions: The two techniques are comparable in terms of results and the choice depends on the surgeon's preferences and experience. [ABSTRACT FROM AUTHOR]

Background: Subtotal petrosectomy (STP) has attracted massive interest over last two decades. The aim is to present our experience of this uncommon surgery. The indications, outcomes, and our variation in surgical technique would be presented and literature reviewed. Methods: A retrospective observational study of all patients who underwent STP at a tertiary care center in India was analyzed. Results: A total of 9 ears (in 8 patients) underwent STP over last 5 years at our center. The pathological conditions for which STP was done included chronic otitis media squamous (four ears), middle ear tumors (three ears), petrous apicitis (one ear), and traumatic cerebrospinal fluid (CSF) otorhinorrhea (one ear). The indication of STP included disease clearance (eight ears), unserviceable hearing (seven ears), hearing rehabilitation with otological implants (six ears), and intraoperative CSF gusher (one ear). Intraoperative indications included CSF gusher, large tegmen defect with erosion of apical turn of cochlea, and erosion of anterior bony wall of external auditory canal. The mean follow-up period was 36 months (range of 6 months to 60 months). None of the patients had any dehiscence of blind sac closure or secondary acquired cholesteatoma on imaging. Conclusions: STP facilitates disease clearance by providing unmatchable exposure in difficult otological scenarios and additionally isolates middle ear cleft from external environment, thereby eliminating problems of mastoid cavity. Furthermore, it also prepares ear for second stage otological implants. It is a safe surgery with minimal complications. [ABSTRACT FROM AUTHOR]

To explore the correlation between the width of the bony cochlear nerve canal (CNC) and long-term auditory rehabilitation after unilateral cochlear implantation (CI) in pediatric patients with congenital deafness and bilateral cochlear nerve canal stenosis (CNCS). A retrospective review was performed on 10 patients with bilateral CNCS and bilateral congenital profound hearing loss who each underwent unilateral cochlear implantation. The width of the CNC was determined on computed tomography (CT) imaging and following CI, auditory and speech performance following CI were graded using categories of auditory performance (CAP), speech intelligibility rating (SIR), and the meaningful auditory integration scale (MAIS) at 24 months following implantation. No correlation was noted between CAP score and CNCS at 24 months post CI (P >.05). A positive correlation was noted between SIR score and CNC width (ρ =.81, P <.05). Similarly, a positive correlation was noted between MAIS and CNC width (ρ =.71, P <.05). The width of the CNC in patients with CNCS is positively correlated with some long-term auditory and speech outcomes after CI. [ABSTRACT FROM AUTHOR]

Objective: Eustachian Tube Balloon Dilation (ETBD) represents an innovative therapeutic approach for chronic Eustachian tube dysfunction (CETD), a common disease in children. Some evidence of a benefit of ETBD in the adults exist in contrast to sparse reports in children. The objective was to analyze short- and long-term outcome of ETBD in children with CETD. Methods: A retrospective chart-review was performed in a cohort of 19 children (mean age 13 years, 7-17) who underwent ETBD. The following parameters were analyzed: tubomanometry (R -value), tympanogram, hearing (CPT-AMA, Air-bone gap [ABG]), Eustachian Tube Score (ETS and ETS-7), and Eustachian Tube Disease questionnaire (ETDQ). Results: Twenty-four ears were dilated (in 5 patients subsequently after successful first intervention) and grouped as A (17) without and B (7) with additional T-tube insertion. Most children suffered from either chronic otitis media with effusion or chronic perforation (12, 63%), the remainder comprising recurrent otitis media, adhesive otitis media and CETD with barotrauma. Mean duration of symptoms were 7/8.2 years and mean follow-up 13.7/11.1 months. Eighty percent of patients reported a subjective benefit. Accordingly, the R -value, ETS, and ETS-7 were significantly (P <.05) improved. Tympanometry, CPT-AMA and ABG showed a positive trend, but the result was not significant. Tympanic retraction remained largely the same; a spontaneous closure of a chronic tympanic perforation was seen in 1 of 3 cases. Conclusions: The high subjective benefit and some significant objective improvement warrants further analysis of ETBD as part of the therapeutic management in pediatric CETD. [ABSTRACT FROM AUTHOR]

Background: Exploratory tympanotomy in cases of traumatic ossicular disruption with intact tympanic membrane is crucial for both diagnostic and therapeutic purposes. Performing this procedure using the endoscope is gaining popularity. Hence, this study aimed to demonstrate varieties of ossicular pathology and their management in our institution. Methods: A retrospective evaluation was conducted of 136 ears in patients with traumatic ossicular disruption with an intact tympanic membrane, who underwent endoscopic exploratory tympanotomy. A proposed algorithm was followed, to incorporate different traumatic ossicular possibilities. Assessment of hearing outcomes and surgical complications was performed six months post-operatively. Results: Incudostapedial dislocation was the most commonly encountered type of traumatic ossicular disruption (35.3 per cent). Air conduction threshold improved significantly following endoscopic ossiculoplasty, from 50.9 ± 6.35 dB pre-operatively to 22.35 ± 3.27 dB post-operatively, with successful air–bone gap closure. Conclusion: Endoscopic ear surgery is effective in the diagnosis and management of challenging cases of post-traumatic ossicular disruption with an intact tympanic membrane. [ABSTRACT FROM AUTHOR]

We report a case of cochleovestibular neurovascular compressive syndrome (CVCS)-induced drop attack treated with microvascular decompression (MVD) of the superior vestibular nerve. This report discusses the merits of surgical intervention through a review of related literature. A 58-year-old woman was referred to our clinic with a chief complaint of intermittent, strong, right-sided tinnitus lasting for a few seconds immediately prior to drop attack. Magnetic resonance imaging (MRI) showed bilateral neurovascular contact between the anterior inferior cerebellar artery (AICA) and the vestibulocochlear nerve. Based on MRI findings, history of present illness, and response to anticonvulsants, CVCS was suspected, and surgical decompression on the right side was subsequently performed. The patient became asymptomatic immediately after the surgery, and the vestibular-evoked myogenic potentials were normalized. No recurrence was reported during a 1-year follow-up period. [ABSTRACT FROM AUTHOR]

Background: The Thai Rural ENT foundation has been conducting ear camps in Bhutan for many years to address the shortage of ENT specialists in the kingdom where patients are examined and treated for various ear illnesses. However, there has been no study conducted to assess the outcomes of such camps. This is the first study of its kind to be carried out in Bhutan. Objective: To study the spectrum of ear cases seen during the mobile ear camp, the intervention done and treatment outcomes. Materials and Methods: The study enrolled patients with ear disorders who presented to the mobile ear camp at Monggar Regional Referral Hospital, Bhutan, from January 6, 2020, to January 8, 2020. The following data were recorded: demographic details, preoperative clinical symptoms and otoscopic findings, preoperative audiogram, treatment or surgery done, postoperative middle ear and mastoid infection, wound infection, graft condition, any complications, and postoperative audiogram of operated cases. Patients who underwent surgery were followed up at 1 day, 6 weeks, and 2 months postoperatively. Results: Two hundred ten patients presented with otologic conditions and 43 underwent surgeries. Otitis media was the commonest disease detected, and tympanoplasty was the commonest surgery performed. The tympanic membrane closure rate was 92.1%, and the rate of hearing improvement was 63.2%. Conclusion: The ear camp had beneficial effect and showed good results. [ABSTRACT FROM AUTHOR]

The pathway by which drugs are injected subcutaneously behind the ear to act on the inner ear has not been fully elucidated. To compare the uptake of gadopentetate dimeglumine (Gd-DTPA) and dexamethasone (Dex) in the cochlea and facial nerve of rats following different administrations. Magnetic resonance imaging was applied to observe the distribution of Gd-DTPA in the facial nerve and inner ear. We observed the uptake of Dex after it was injected with different methods. Images of the intravenous (IV) and intramuscular (IM) groups showed that the bilateral cochlea of the rat was visualized almost simultaneously. While in the left post-auricular (PA) injection group, it was asynchronous. The maximum accumulation (Cmax) of the Gd in the left facial nerve of the PA group (35.406 ± 5.32) was substantially higher than that of the IV group (16.765 ± 3.7542) (p <.01). Compared with systemic administration, PA has the advantages of long Gd and Dex action time and high accumulation concentration to treat facial nerve diseases. The distribution of Gd and Dex in the inner ear and facial nerve of rats following PA injection might be unique. [ABSTRACT FROM AUTHOR]

Objectives: To explore the views of parents and carers regarding the management of acute otitis media in urban Aboriginal and Torres Strait Islander children who are at low risk of complications living in urban communities. Study design: Qualitative study; semi‐structured interviews and short telephone survey. Setting, participants: Interviews: purposive sample of parents and carers of urban Aboriginal and Torres Strait Islander children (18 months – 16 years old) screened in Aboriginal medical services in Queensland, New South Wales, and Canberra for the WATCH study, a randomised controlled trial that compared immediate antibiotic therapy with watchful waiting for Aboriginal and Torres Strait Islander children with acute otitis media. Survey: parents and carers recruited for the WATCH trial who had completed week two WATCH surveys. Results: We interviewed twenty‐two parents and carers, including ten who had declined participation in or whose children were ineligible for the WATCH trial. Some interviewees preferred antibiotics for managing acute otitis media, others preferred watchful waiting, expressing concerns about side effects and reduced efficacy with overuse of antibiotics. Factors that influenced this preference included the severity, duration, and recurrence of infection, and knowledge about management gained during the trial and from personal and often multigenerational experience of ear disease. Participants highlighted the importance of shared decision making by parents and carers and their doctors. Parents and carers of 165 of 262 WATCH participants completed telephone surveys (63%); 81 were undecided about whether antibiotics should always be used for treating acute otitis media. Open‐ended responses indicated that antibiotic use should be determined by clinical need, support for general practitioners' decisions, and the view that some general practitioners prescribed antibiotics too often. Conclusions: Parents and carers are key partners in managing acute otitis media in urban Aboriginal and Torres Strait Islander children. Our findings support shared decision making informed by the experience of parents and carers, which could also lead to reduced antibiotic use for managing acute otitis media. [ABSTRACT FROM AUTHOR]

Sudden sensorineural hearing loss with vertigo (SHLV) and vestibular neuritis (VN) can result in prolonged dizziness. This study aimed to compare the video head impulse test (vHIT) of patients with SHLV and VN. Fifteen patients with SHLV and 21 patients with VN who visited the Vertigo/Dizziness Center of our hospital between December 2016 and February 2023 were included. vHIT was performed at the time of admission, and the VOR gain and catch up saccade (CUS) in the three types of semicircular canals (SCCs) were analyzed. Pathologic vHIT results were observed most frequently in the posterior SCC (73%), followed by lateral (53%) and anterior (13%) SCCs in the SHLV group. In contrast, pathologic vHIT results were observed most frequently in the lateral SCC (100%), followed by the anterior (43%) and posterior SCC (24%) SCCs in the VN group. Pathological vHIT results in the lateral and posterior SCC showed significant differences between the two groups, but for anterior SCC, no significant differences were found. Comparison of the two vHIT results revealed differences in the SCC dysfunction patterns. This may be due to the different pathophysiological mechanisms of the two vestibular disorders, which may result in prolonged vertigo. [ABSTRACT FROM AUTHOR]

The article describes the case of a previously one-year, three-month-old child with a history of intermittent low-grade fever relieved by antipyretics for one month. Topics discussed include findings on clinical examination, factor which raised the possibility of acute monocytic leukemia (AMoL), and laboratory results which led to the diagnosis of histiocytic sarcoma (HS).

Bilateral sensorineural hearing loss can be a very distressing symptom and can affect the efficiency of a person and one's quality of life. Conditions causing bilateral hearing loss are very few and autoimmune aetiology is one of them. Autoimmune ear disease is characterised by bilateral, mostly fluctuating audiovestibular symptoms and symptoms which respond to steroids. Diagnosis of AIED presents a unique challenge to clinicians due to the lack of standardized diagnostic criteria or reliable pathognomonic tests. The purpose of the study is to evaluate the patients who fit into criteria of autoimmune inner ear disease and understand the clinical features and response to medications for the same. A retrospective chart review of patients presenting with rapidly progressive bilateral hearing loss was done. The clinical presentation including detailed history and examination findings along with the blood investigation reports and audiograms were recorded in a tabular form. The study included 6 patients – 3 male and 3 female patients. Age of the patients at onset of hearing loss varied between 24–35 years. 3 of 6 patients presented with primary autoimmune ear disease and other 3 had hearing loss secondary to systemic autoimmune disease. All patients were treated with systemic steroids, but however showed a varied response. Patients with primary AIED were administered inner ear steroid therapy as well. AIED is thus a diagnosis of exclusion done with high index of suspicion. Patients with bilateral progressive sensorineural hearing loss should be evaluated for autoimmune etiology. Oral steroids with intratympanic steroids are currently the mainstay of treatment for AIED. Guarded prognosis of hearing improvement is noted in these patients. Hence, emphasis should be placed on early hearing rehabilitation for better quality of life. [ABSTRACT FROM AUTHOR]