J. Otorhinolaryngol. Hear. Balance Med., Volume 5, Issue 1 (June 2024) – 8 articles

Cochlear implantation is the therapy used for patients with severe to profound sensorineural hearing loss. For the success of the surgery, it is important that each surgical step is performed with meticulous precision, starting from the correct patient position on the operating table. In elderly or obese patients, this can be difficult to achieve due to cervical rigidity. With this technical note, we want to describe a new position from orthopedic surgery to perform a posterior tympanotomy accurately, ensuring a safe procedure and avoiding unpleasant complications. Full article

Objective: The primary objective of this research is to conduct a systematic review of the available studies and evidence to determine if there is a significant relationship between otosclerosis and psychiatric disorders. By critically evaluating the existing data, this study aims to provide insights into the potential interplay between these medical conditions. Data Sources: PubMed, Embase, Ebsco, Proquest, and Web of Science Review Methods: PubMed, Embase, Ebsco, Proquest, and Web of Science databases were queried for original English articles from 1950 to 2023. This review was conducted in accordance with the 2020 PRISMA guidelines. The publications were screened by two independent viewers. The Newcastle–Ottawa Scale quality instrument was used to assess the quality of studies. Results: Initially, 153 abstracts were screened for eligibility. After a rigorous selection process, five studies met the criteria, collectively encompassing 262 patients diagnosed with otosclerosis. The reported mean ages ranged from 25 to 52 years. A combined assessment of psychiatric disorder rates among otosclerosis patients revealed a rate of 36%. Depression, anxiety, and schizophrenia were the most common mental illnesses reported in all six studies. One of the studies specifically examined psychiatric disorder rates before and after stapedectomy, revealing a statistically significant decrease in depressive and anxiety-related symptoms following the surgical intervention. Conclusions: This systematic review emphasizes the emerging evidence connecting otosclerosis with psychiatric disorders and underscores the importance of adopting a multidisciplinary approach to assess and manage otosclerosis patients. Full article

The universal newborn hearing screening (NHS) program was implemented in Russia in 2008 to replace the high-risk newborn hearing screening. More than 95% coverage and significant improvement in early detection and intervention is achieved. Meanwhile, it was shown that current OAE-based hearing screening missed 13% of newborns with genetically ascertained hereditary sensorineural hearing loss (SNHL). The aim of the study is to assess the results of genetic investigation and NHS in a large cohort of Russian children with bilateral SNHL and to study the feasibility of implementation of combined hearing and genetic screening in Russia. Genetic, audiological and NHS data of 1292 pediatric patients with bilateral SNHL born in 2008–2021 were analyzed. GJB2 sequencing was performed for all subjects, 644 patients had pathological GJB2 genotype, 406 of them were homozygous for c.35delG variant. The group of 155 GJB2-negative patients were searched for other SNHL genes, The pathological genotypes were identified at 87 patients. The most frequent genes were STRC (21.8%), USH2A (16.1%), OTOF (8%) and SLC26A4 (6.9%). Children with confirmed genetic etiology passed NHS in 21% of cases. The perspectives of implementation of national comprehensive newborn hearing and genetic screening including whole exome sequencing technologies are discussed. Full article

Speech intelligibility is a concern for public health, especially in non-ideal listening conditions where listeners often listen to the target speech in the presence of background noise. With advances in technology, synthetic speech has been increasingly used in lieu of actual human voices in human–machine interfaces, such as public announcement systems, answering machines, virtual personal assistants, and GPS, to interact with users. However, previous studies showed that speech generated by computer speech synthesizers was often intrinsically less natural and intelligible than natural speech produced by human speakers. In terms of noise, listening to synthetic speech is challenging for listeners with normal hearing (NH), not to mention for hearing-impaired (HI) listeners. Recent developments in speech synthesis have significantly improved the naturalness of synthetic speech. In this study, the intelligibility of speech generated by commercial synthesizers from Google, Amazon, and Microsoft was evaluated by both NH and HI listeners in different noise conditions. Compared to a natural female voice as the baseline, listeners’ listening performance suggested that some of the synthetic speech was significantly more intelligible even at rather adverse listening conditions for the NH cohort. Further acoustical analyses revealed that elongated vowel sounds and reduced spectral tilt were primarily responsible for improved intelligibility for NH, but not for HI due to their impairment at high frequencies and possible cognitive decline associated with aging. Full article

This study aimed to compare the diagnostic efficacy of the Halmágyi–Curthoys head impulse (thrust) test and Romberg’s test in detecting vestibular hypofunctioning among two groups of 50 vertigo patients each; the two groups were randomly assigned. The assessment utilized the visual analog scale (VAS) to quantify subjective experiences of vertigo. The results revealed distinctive patterns in the detection of vestibular hypofunctioning, highlighting the strengths and limitations of each test. The Halmágyi–Curthoys head impulse test demonstrated utility in identifying vestibular hypofunctioning and its effect on vestibulo–ocular reflexes, particularly in cases with sudden head movements. Romberg’s test was useful in assessing postural instability in vestibular hypofunctioning due to defects in vestibulospinal reflexes. The integration of VAS scores provided valuable subjective insights into the patient experience. This comparative analysis contributes to a nuanced understanding of diagnostic tools for vestibular hypofunctioning in vertigo patients, offering clinicians valuable information for tailored assessments and interventions. Full article

Background: Body image is a potential psychological burden after total laryngectomy (TL) with devastating effects on patients’ health-related quality of life (HRQOL) and communication. This study focused on TL patients to determine the prevalence of dissatisfied body image and whether they have poorer HRQOL and difficulty adjusting to their new voice than TL patients with satisfied body image. It also aimed to investigate the potential predictors of body image. Methods: A multicenter cross-sectional study was conducted. For TL patients, the Body Image Scale (BIS), the European Organization for Research on Cancer Quality of Life Questionnaire, Core and Neck Module (EORTC QLQ C30 and EORCT H&N35), and the Self-Experiences of Communication after Laryngeal cancer (SECEL) were used. Patients were categorized as dissatisfied with their body image if the BIS score was ≥8. Multiple regression analysis was performed using the BIS as the dependent measure and HRQOL (QLQ C30 and H& N35) and communication (SECEL) as independent variables. Results: Overall, 31.3% of TL patients had dissatisfied body image, significantly worse HRQOL, and difficulty adjusting to their new voice than patients with satisfied body image. The regression model showed that social eating and socializing (H&N35) and adjustment to their new voice (SECEL) were independent predictors of body image. The model explained 52% of the variance. Conclusions: Screening TL patients at risk for body image concerns may help develop effective interventions to optimize HRQOL and patient communication. Full article

Implantation of two electrical stimulators of different cranial nerves in one patient is rare. We report the case of a forty-seven-year-old patient already implanted with a trigeminus nerve stimulator. In addition, this patient suffered from hearing problems. In one ear, the patient was deaf. On the other side, the patient wore a bone conduction hearing aid to improve hearing. In this complex situation, we decided to check the possibility of cochlear implantation on the deaf side. Finally, we managed to provide electrical stimulation of the auditory pathway of the deaf ear to improve the patient’s hearing tests. In addition, this case report shows how the trigeminus stimulator interferes with the electrical stimulation in auditory evoked potentials measurement of the auditory brainstem and cortex via EABR (evoked auditory brainstem response) resp. EALR (evoked auditory late response). Full article

Even if the management of parotid gland tumors depends on the histopathological subtype, preoperative imaging of parotid gland tumors is clinically relevant. Preoperative imaging gives insight into the differentiation between benign and malignant tumors, which might potentially decrease the number of unnecessary aggressive surgeries. Characteristic imaging findings on cross-sectional imaging, such as computed tomography (CT) and magnetic resonance imaging (MRI), can help narrow the differential diagnosis and guide the further management of patients presenting with parotid masses. While MRI is imperative for the determination of perineural spread, which is frequently encountered with malignant parotid tumors, CT is important for the evaluation of osseous invasion. Furthermore, multi-parametric MRI protocols provide insights into the tumor behavior and internal composition, which is helpful in the case of benign mixed tumors and others. While distant metastasis is uncommon with parotid neoplasms, PET/CT provides a valuable tool for the improved evaluation of loco-regional and distant metastatic disease. This article discusses the imaging features of common benign and malignant parotid tumors. Full article