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Zusammenfassung Hintergrund Durch die Digitalisierung hat sich das Internet zu einem wesentlichen Informationsmedium für Patienten entwickelt. Patienten mit Hörsturz haben aufgrund unsicherer wissenschaftlicher Erkenntnisse einen besonders großen Informationsbedarf. In der vorliegenden Arbeit wurden daher die Ergebnisse einer Internetsuche zum Thema Hörsturz untersucht. Material und Methoden Die ersten 30 Treffer einer Google-Suche mit dem Begriff „Hörsturz“ wurden kategorisiert, eine Lesbarkeitsstatistik anhand verschiedener Formeln (Flesch-Reading-Ease-Score; 0=schwer, 100=leicht lesbar) berechnet und falsche Informationen dokumentiert. Eine strukturierte inhaltliche Bewertung erfolgte mit dem DISCERN-Fragebogen (1=niedrige, 5=hohe Qualität) getrennt durch 2 verblindete Untersucher. Die Einhaltung empfohlener Standards wurde anhand einer Health-On-The-Net-Zertifizierung erfasst. Ergebnisse 18 Internetseiten (60,0%) waren Informationsportale, 7 (23,3%) von Medizinprodukteunternehmen (davon 3 Hörgerätehersteller), 2 (6,7%) von öffentlichen Einrichtungen und je 1 (3,3%) von einem Ärzteverband und einer Selbsthilfeorganisation sowie ein wissenschaftlicher Artikel. Im Mittel lag die Wortanzahl bei 1307,0±840,2 Wörtern, die letzte Aktualisierung war vor 17,1±32,5 Monaten und der Flesch-Reading-Ease-Score lag bei 36,1±13,9. Am schwierigsten lesbar war der wissenschaftliche Artikel (13,7). Insgesamt lag der DISCERN bei 2,2±0,7 mit schlechtester Bewertung von Medizinprodukteunternehmen (1,6±0,5). Zwei Internetseiten (6,7%) hatten ein Health-On-The-Net-Zertifikat, 14 (46,7%) zeigten falsche Informationen. Schlussfolgerung Patienteninformationen im Internet sind aufgrund geringer Lesbarkeit, potenzieller Interessenkonflikte, niedriger Qualität oder falscher Informationen kritisch zu bewerten. Eine mögliche Konsequenz wäre eine Bereitstellung verlässlicher Gesundheitsinformationen im Internet durch medizinische Leistungserbringer und Fachgesellschaften.

Purpose It has been established that the infection with SARS-CoV-2 may cause an impairment of chemosensory function. However, there is little data on the long-term effects of SARS-CoV-2 infection on chemosensory function. Methods Twenty three SARS-CoV-2-positive patients diagnosed in spring 2020 with subjective hyposmia (out of 57 positive patients, 40.3%) were compared to SARS-CoV-2-positive patients without hyposmia (n = 19) and SARS-CoV-2-negative patients (n = 14). Chemosensory function was assessed by the Brief Smell Identification Test (BSIT), Taste Strips (TS), Visual Analogue Scales (VAS), and the SNOT-22. The initial cohort with hyposmia were also examined at 8 weeks and 6 months after initial examination. Results There were no differences between the SARS-CoV-2-positive cohort without hyposmia and negative controls in terms of BSIT (8.5 ± 2.6 vs. 10.2 ± 1.8), TS (3.4 ± 0.6 vs. 3.9 ± 0.3) or VAS (2.1 ± 1.3 vs. 1.1 ± 0.5); yet the SNOT-22 was significantly elevated (27.7 ± 11.2 vs. 16.4 ± 10.8). The SARS-CoV-2-positive group with hyposmia performed significantly poorer in BSIT (4.0 ± 1.7 vs. 8.5 ± 2.6/10.2 ± 1.8), TS (2.6 ± 1.3 vs. 3.4 ± 0.6/3.9 ± 0.3), and VAS (7.9 ± 2.2 vs. 2.1 ± 1.3/1.1 ± 0.5) compared to both control groups. At week 8 and month 6 control, six and five patients, respectively, still suffered from subjectively and objectively impaired chemosensory function. The other patients had recovered in both respects. Conclusion SARS-CoV-2 patients with subjectively impaired chemosensory function regularly perform poorly in objective measurements. About 70% of patients suffering from olfactory dysfunction in SARS-CoV-2 quickly recover—the rest still suffers from considerable impairment 6 months after infection.

Purpose Treatment of Menière’s Disease (MD) comprises an array of both non-destructive and destructive treatment options. In patients who are therapy–refractory to non-destructive medical treatment, endolymphatic mastoid shunt surgery (EMSS) is both recommended and debated controversially. The aim of this study was to investigate safety in terms of hearing, vestibular function, complication rate, and efficacy with regards to vertigo control of EMSS in patients with MD according to the current diagnostic criteria of 2015. Methods Retrospective analysis of 47 consecutive patients with definite or probable MD with description of demographic parameters, pre- and postoperative MD treatment, pre- and postoperative audiometric (pure tone audiometry) and vestibular (caloric testing) results. The parameters were compared between patients with and without postoperative vertigo control. Results 31/47 patients (66.0%) had improved vertigo control postoperatively. Postoperative hearing and vestibular preservation were predominantly stable. No significant differences between patients with improved vertigo control and patients with no change or worse vertigo episodes were found. In the treatment refractory group, 4 patients required a revision EMSS and 6 a destructive MD treatment (5 gentamicin intratympanically, 1 labyrinthectomy). No peri- or postsurgical complications were reported. Conclusions EMSS was found to be beneficial in two thirds of the patients with definite or probable Morbus Menière and a safe procedure regarding hearing and vestibular preservation with no postoperative complications. Therefore, EMSS should be considered before inducing destructive treatment options, such as intratympanic gentamicin application or labyrinthectomy.

BACKGROUND: The diagnosis of Menière’s disease (MD) is made according to diagnostic criteria, the last revision of which was in 2015. For diagnosis, symptoms are weighted with audiometric findings and this can be challenging in individual patients. OBJECTIVE: To analyze patient’s characteristics and symptoms in a real-life cohort of 96 patients with diagnosed MD regarding sociodemographic parameters, clinical specifics, and audiometry. METHODS: Prospective clinical patient registry containing demographic and socioeconomic parameters, symptoms, as well as pure-tone audiometry data. RESULTS: 31 patients with definite MD, and 36 with probable MD were identified. 29 patients showed typical clinical signs of MD, but did not meet the full diagnostic criteria, and were considered separately. Mean duration of symptoms prior to presentation was 3.9±4.6 years. Significant differences between categories were found regarding aural fullness, tinnitus, and fluctuating hearing. If multiple audiograms were available, 28.6 % (6/21) documented fluctuating hearing. CONCLUSIONS: Current diagnostic criteria probably do not represent patients with monosymptomatic presentation or an early stage very well. Long-term follow-up with repeated audiometry is advisable.

As a result of digitalization, the internet embodies the essential information medium. Especially, patients with sudden sensorineural hearing loss (SSNHL) require profound education due to unclear scientific evidence. Thus, our study investigated a German-language internet search about SSNHL.The first 30 Google-search results with the term18 websites (60.0%) accounted for digital media, 7 (23.3%) manufacturers of medical devices, 2 (6.7%) government institutions, and respectively 1 (3.3%) healthcare provider, support-group, and scientific article. Mean word count was 1307.0±840.2, last update 17.1±32.5 months ago, and FRES 36.1±13.9, with the most difficult text by the scientific article (13.7). Mean of DISCERN was 2.2±0.7 with worst rating of manufacturers of medical devices (1.6±0.5). 2 websites (6.7%) were HON-certified, and 14 (46.7%) contained misinformation.Internet-based patient-information should be assessed cautiously due to poor readability, potential conflict of interests, low quality, or wrong information. Hence, healthcare providers and professional associations are urged to provide high-quality patient-information in the internet.Durch die Digitalisierung hat sich das Internet zu einem wesentlichen Informationsmedium für Patienten entwickelt. Patienten mit Hörsturz haben aufgrund unsicherer wissenschaftlicher Erkenntnisse einen besonders großen Informationsbedarf. In der vorliegenden Arbeit wurden daher die Ergebnisse einer Internetsuche zum Thema Hörsturz untersucht.Die ersten 30 Treffer einer Google-Suche mit dem Begriff „Hörsturz“ wurden kategorisiert, eine Lesbarkeitsstatistik anhand verschiedener Formeln (Flesch-Reading-Ease-Score; 0=schwer, 100=leicht lesbar) berechnet und falsche Informationen dokumentiert. Eine strukturierte inhaltliche Bewertung erfolgte mit dem DISCERN-Fragebogen (1=niedrige, 5=hohe Qualität) getrennt durch 2 verblindete Untersucher. Die Einhaltung empfohlener Standards wurde anhand einer Health-On-The-Net-Zertifizierung erfasst.18 Internetseiten (60,0%) waren Informationsportale, 7 (23,3%) von Medizinprodukteunternehmen (davon 3 Hörgerätehersteller), 2 (6,7%) von öffentlichen Einrichtungen und je 1 (3,3%) von einem Ärzteverband und einer Selbsthilfeorganisation sowie ein wissenschaftlicher Artikel. Im Mittel lag die Wortanzahl bei 1307,0±840,2 Wörtern, die letzte Aktualisierung war vor 17,1±32,5 Monaten und der Flesch-Reading-Ease-Score lag bei 36,1±13,9. Am schwierigsten lesbar war der wissenschaftliche Artikel (13,7). Insgesamt lag der DISCERN bei 2,2±0,7 mit schlechtester Bewertung von Medizinprodukteunternehmen (1,6±0,5). Zwei Internetseiten (6,7%) hatten ein Health-On-The-Net-Zertifikat, 14 (46,7%) zeigten falsche Informationen.Patienteninformationen im Internet sind aufgrund geringer Lesbarkeit, potenzieller Interessenkonflikte, niedriger Qualität oder falscher Informationen kritisch zu bewerten. Eine mögliche Konsequenz wäre eine Bereitstellung verlässlicher Gesundheitsinformationen im Internet durch medizinische Leistungserbringer und Fachgesellschaften.

In patients with conductive (CHL) or mixed hearing loss (MHL), hearing rehabilitation with an implantable hearing system, active middle ear implant (AMEI) or a semi-implantable bone-conduction device (SIBCD), is an option when conventional hearing aids are insufficient, or patients are unable to wear them. Retrospective analysis of 20 consecutive patients (24 implants) with a comparison of demographic characteristics and audiometric results (air-bone gap = ABG, effective hearing gain = EHG, functional hearing gain = FHG, Freiburg Monosyllabic Test in quiet, Oldenburg Sentence Test in noise = OLSA). Patients, eligible for both devices, who received either AMEI or SIBCD due to CHL or MHL. Analysis showed no significant differences in post-operative functional hearing results between the group of AMEI vs. SIBCD (ABG-reduction: 31.6 ± 12.4 dB HL vs. 28.0 ± 11.8 dB HL; p = 0.702; EHG: −1.6 ± 7.7 dB HL vs. −1.2 ± 4.2 dB HL; p = 0.090; FHG: 33.4 ± 12.6 dB HL vs. 26.1 ± 11.7 dB HL; p = 0.192; Freiburg: 83.0 ± 15.6% vs. 83.6 ± 14.2%; Freiburg-improvement: 57.7 ± 26.8% vs. 68.2 ± 19.7%; p = 0.294; OLSA: −2.7 ± 3.0 SNR vs. −1.4 ± 3.6 SNR; OLSA-improvement: 2.6 ± 2.1 dB vs. 3.7 ± 2.8 dB; p = 0.323). Four patients had the AMEI explanted due to insufficient functioning and later received a SIBCD. Due to more challenging anatomical conditions, a surgical technique for the AMEI is more complex. However, functional results are comparable to the SIBCD. Therefore, proper patient counselling and cautious choice of the device are mandated before surgery.

Rationale: Currently, there are no blood-based biomarkers with clinical utility for acute ischemic stroke (IS). MicroRNAs show promise as disease markers because of their cell type–specific expression patterns and stability in peripheral blood. Objective: To identify circulating microRNAs associated with acute IS, determine their temporal course up to 90 days post-stroke, and explore their utility as an early diagnostic marker. Methods and Results: We used RNA sequencing to study expression changes of circulating microRNAs in a discovery sample of 20 patients with IS and 20 matched healthy control subjects. We further applied quantitative real-time polymerase chain reaction in independent samples for validation (40 patients with IS and 40 matched controls), replication (200 patients with IS, 100 healthy control subjects), and in 72 patients with transient ischemic attacks. Sampling of patient plasma was done immediately upon hospital arrival. We identified, validated, and replicated 3 differentially expressed microRNAs, which were upregulated in patients with IS compared with both healthy control subjects (miR-125a-5p [1.8-fold; P =1.5×10 −6 ], miR-125b-5p [2.5-fold; P =5.6×10 −6 ], and miR-143-3p [4.8-fold; P =7.8×10 −9 ]) and patients with transient ischemic attack (miR-125a-5p: P =0.003; miR-125b-5p: P =0.003; miR-143-3p: P =0.005). Longitudinal analysis of expression levels up to 90 days after stroke revealed a normalization to control levels for miR-125b-5p and miR-143-3p starting at day 2 while miR-125a-5p remained elevated. Levels of all 3 microRNAs depended on platelet numbers in a platelet spike-in experiment but were unaffected by chemical hypoxia in Neuro2a cells and in experimental stroke models. In a random forest classification, miR-125a-5p, miR-125b-5p, and miR-143-3p differentiated between healthy control subjects and patients with IS with an area under the curve of 0.90 (sensitivity: 85.6%; specificity: 76.3%), which was superior to multimodal cranial computed tomography obtained for routine diagnostics (sensitivity: 72.5%) and previously reported biomarkers of acute IS (neuron-specific enolase: area under the curve=0.69; interleukin 6: area under the curve=0.82). Conclusions: A set of circulating microRNAs (miR-125a-5p, miR-125b-5p, and miR-143-3p) associates with acute IS and might have clinical utility as an early diagnostic marker.