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Mechanism, Diagnosis and Treatment of ENT Diseases: Otological and Sinus Disorders - Volume II

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A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: closed (20 November 2022) | Viewed by 27773

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Prof. Dr. Piotr Henryk Skarzynski

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1. Department of Teleaudiology and Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing, 05-830 Kajetany, Poland
2. Institute of Sensory Organs, 05-830 Kajetany, Poland
Interests: otorhinolaryngology; pediatric otorhinolaryngology; audiology, hearing loss; deafness; partial deafness treatment; hearing aids; hearing implants; implantable devices; otology; tinnitus; telemedicine; teleaudiology; hearing screening; speech disorders; central auditory processing disorders; rhinology; middle ear surgery; otosclerosis
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Dr. Magdalena Beata Skarzynska

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Institute of Sensory Organs, 05-830 Kajetany, Poland
Interests: pharmacy; hospital pharmacy; management in pharmacy; clinical trials; hearing screening in Poland and all over the world; telemedicine; ototoxicity; glucocorticosteroids; corticosteroids; hearing impairments treatment
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

According to the World Health Organization, around 466 million people all over the world experience hearing loss caused by various factors; therefore, proper diagnosis, treatment, and rehabilitation of ENT diseases are extremely important to help patients to hear and live better. However, early and accurate diagnosis and appropriate, effective treatment are not easy; these are complex and difficult processes. Nowadays, a lot of people suffer from moderate and severe hearing loss and other serious hearing impairments, for instance, otosclerosis or sudden sensorineural hearing loss. Fortunately, there are also several possible methods of treatment, starting from hearing aids and minor surgical procedures to implantable hearing devices and complicated surgeries. The following surgeries need to be mentioned here: cochlear implantations, bone conduction, and middle ear implants, middle ear surgery, stapedotomy, and procedures using different protheses and attachments. Additionally, it is worth noting that glucocorticosteroids and corticosteroids might be helpful in the treatment of some cases. All these otological solutions need to be discussed to improve possible methods of treatment, share personal experiences, and, as a result, provide better healthcare for patients with hearing impairments. Secondly, apart from random ENT diseases, sinus disorders are common in patients. Therefore, it is important to pay more attention to the diagnosis and treatment of sinus infections, which are often underestimated.

The first volume of this Special Issue was a great success. Now, we invite you to publish in the second volume. (https://www.mdpi.com/journal/life/special_issues/ENT_diseases_otology_rhinology)

The main aims of the Special Issue are to share knowledge and current studies of mechanisms of ENT diseases and share personal experiences, current strategies, and future perspectives and expectations in the diagnostic process and treatment of most common otorhinolaryngological diseases, especially in the field of otology and rhinology.

Prof. Dr. Piotr Henryk Skarzynski
Dr. Magdalena Beata Skarzynska
Guest Editors

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Keywords

ENT diseases
otology
middle ear surgery
implantable devices
rhinology

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Research

10 pages, 948 KiB

Open AccessArticle

Diamine Oxidase Activity Deficit and Idiopathic Rhinitis: A New Subgroup of Non-Allergic Rhinitis?

by Miguel Mayo-Yáñez, Andrea Díaz-Díaz, Christian Calvo-Henríquez, Jerome R. Lechien, Luigi A. Vaira and Angélica Figueroa

Life 2023, 13(1), 240; https://doi.org/10.3390/life13010240 - 14 Jan 2023

Cited by 4 | Viewed by 2906

Abstract

Idiopathic rhinitis represents more than 50% of non-allergic rhinitis, a heterogeneous group that involves the symptomatic inflammation of the nasal mucosa. The TRPV1 receptor of unmyelinated C-type neurons appears to be involved in its pathophysiology. Histamine, whose main catabolic enzyme is DAO, is one of the mediators that can activate this receptor. The failure of DAO causes an increase in the level of histamine in the body and, consequently, the activation of TRPV1. The objective was to investigate the existence of a DAO enzyme activity deficit in idiopathic rhinitis and its correlation with symptoms. A cross-sectional study was conducted in 116 idiopathic rhinitis patients, and DAO activity, nasal peak inspiratory flow, and rhinitis severity were recorded. The prevalence of a DAO activity deficit was 41.38% (95%CI 0.33–0.50; p = 0.05). The DAO activity in patients with mild rhinitis was 52.93 ± 8.72 HDU/mL, in those with moderate rhinitis it was 120.33 ± 71.63 HDU/mL, and in those with severe rhinitis it was 92.58 ± 27.75 HDU/mL (p = 0.006). The NPIF in patients with a DAO activity deficit was 107.92 ± 34.05 L/min, compared to 72.35 ± 27.16 L/min in patients with normal enzymatic activity (p < 0.001), demonstrating a linear correlation between activity levels and nasal obstruction (−0.45; p < 0.001). Therefore, patients with a DAO deficiency and idiopathic rhinitis could present a milder disease course, because the repeated and continuous activation of TRPV1 led to a partial or total decrease in their response (desensitization). This new theory represents a different perspective for the study of idiopathic rhinitis and its relationship with TRPV1, with the regulation or modulation of the desensitization of TRPV1 being an important therapeutic target for patients with idiopathic rhinitis in the future. Full article

(This article belongs to the Special Issue Mechanism, Diagnosis and Treatment of ENT Diseases: Otological and Sinus Disorders - Volume II)

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10 pages, 495 KiB

Open AccessArticle

Does Metabolic Syndrome Affect the Incidence and Prognosis of Sudden Sensorineural Hearing Loss?

by Joong Su Park, Seung Ho Kim, Ikhee Kim, Hantai Kim, Ji Hyun Kim and Jong Bin Lee

Life 2022, 12(7), 930; https://doi.org/10.3390/life12070930 - 21 Jun 2022

Cited by 9 | Viewed by 1779

Abstract

Earlier studies reported that the occurrence of sudden sensorineural hearing loss (SSNHL) is associated with chronic metabolic disorders such as hypertension, diabetes, and hyperlipidemia. Instead of focusing on the relationship between SSNHL and each metabolic disorder, this study aimed to identify the association with metabolic syndrome as a whole, including either prehypertension or prediabetes. As a case-control study, we reviewed 239 patients who experienced SSNHL, and compared them with the same number of healthy subjects (N = 478). Metabolic syndrome-related variables of SSNHL patients were compared to those of healthy control subjects. In addition, patients with SSNHL were classified into two subgroups: the first subgroup showed improvement in hearing (‘response group’), and the second did not present significant improvement (‘non-response group’). Metabolic syndrome was diagnosed according to the US National Heart, Lung, and Blood Institute’s National Cholesterol Education Program Adult Treatment Panel III criteria. The risk for SSNHL was 4.3 times higher in patients with metabolic syndrome compared with patients without the syndrome (95% confidence interval, 1.98 to 9.33), even after adjusting for variables that showed significant between-group differences. The likelihood of being unresponsive to treatment was higher in those with metabolic syndrome (1.21 to 3.93; adjusted odds ratio = 2.18), and when the initial hearing loss pattern on a pure-tone audiometry was high tone or flat. Metabolic syndrome appears to be an independent risk factor for SSNHL and, simultaneously, a predictor of poor prognosis. Full article

(This article belongs to the Special Issue Mechanism, Diagnosis and Treatment of ENT Diseases: Otological and Sinus Disorders - Volume II)

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10 pages, 1589 KiB

Open AccessArticle

Assessment of Subjective Tinnitus Treatment Results Using a Prototype Device for Electrical and Magnetic Stimulation of the Ear-Preliminary Study

by Jurek Olszewski, Marzena Bielińska and Andrzej Julian Kowalski

Life 2022, 12(6), 918; https://doi.org/10.3390/life12060918 - 19 Jun 2022

Cited by 4 | Viewed by 3335

Abstract

Background: The aim of the study was to evaluate the effectiveness of subjective tinnitus treatment in patients with cochlear sensorineural hearing loss with magnetic ear stimulation using a prototype device. Since the 1970s, studies have been conducted on the use of electrical stimulation of the ear in the treatment of tinnitus. The available literature contains various hypotheses about the influence of electrical stimulation of the ear on tinnitus. Material and Methods: Preclinical studies were performed for 100 patients, 40 women and 60 men (124 ears in total), aged 38–72 years, treated for tinnitus. A subjective assessment of the loudness of tinnitus was performed, and the frequency and intensity as well as hearing threshold were determined using a prototype device for electro-magnetic stimulation of the ear. The treatment cycle consisted of 10 five-minute stimulations performed daily 5 times a week. Results: Before treatment, persistent tinnitus was found in 100 ears (80.6%) and periodic tinnitus in 24 ears (19.4%). Immediately after treatment, persistent tinnitus was present only in 50 ears (40.3%) and periodic tinnitus in 40 ears (32.3%). Complete resolution of tinnitus was noted in 34 ears (27.4%). On the other hand, the examination performed 3 months after the treatment showed persistent tinnitus in 40 ears (32.3%) and periodic tinnitus in 50 ears (40.3%), and complete resolution of tinnitus was recorded in 34 ears (27.4%). Based on the VAS analog scale, there was an improvement in tinnitus in 98 ears (79.0%) immediately after treatment and no improvement in 26 ears (20.0%). The mean VAS scale before treatment was 4.9 points, after treatment it was 2.1 points and 3 months after treatment it was 1.9 points. Conclusions: The preliminary research results show the high effectiveness of magnetic stimulation in the treatment of tinnitus with the use of a prototype device for electromagnetic stimulation of the ear. There was no negative effect of the stimulation on hearing or tinnitus. Full article

(This article belongs to the Special Issue Mechanism, Diagnosis and Treatment of ENT Diseases: Otological and Sinus Disorders - Volume II)

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14 pages, 1589 KiB

Open AccessArticle

Ameliorative Effect of a Neoteric Regimen of Catechin plus Cetirizine on Ovalbumin-Induced Allergic Rhinitis in Rats

by Mohamed A. Morsy, Snehal S. Patel, Anita Bakrania, Mahmoud Kandeel, Anroop B. Nair, Jigar N. Shah, Sabah H. Akrawi and Mahmoud El-Daly

Life 2022, 12(6), 820; https://doi.org/10.3390/life12060820 - 31 May 2022

Cited by 2 | Viewed by 2155

Abstract

Allergic rhinitis (AR) affects 20–50% of the global population. Available treatments are limited by their adverse effects. We investigated the anti-allergic effects of catechin alone and combined with cetirizine against ovalbumin-induced AR. Rats were sensitized with ovalbumin and received catechin (14 days) and then challenged with aerosolized ovalbumin (1%) to determine AR clinical scores. Histamine, histamine release, and histidine decarboxylase (HDC) activity were determined in blood, peritoneal mast cells, and stomachs, respectively. Vascular permeability and safety were assessed using Evans blue leakage and barbiturate-induced sleeping-time assays, respectively. Catechin and cetirizine binding with HDC was investigated by docking and binding energy analyses. The clinical scores of the combination regimen were superior to either drug alone. All treatments reduced vascular leakage, with no effect on barbiturate-induced sleeping time. Only the catechin-treated rats showed reduced histamine levels and HDC activity. Docking studies revealed that catechin has a 1.34-fold higher extra-precision docking score than L-histidine. The binding energy scores for catechin-HDC, L-histidine-HDC, and histamine-HDC were −50.86, −37.64, and −32.27 kcal/mol, respectively. The binding pattern of catechin was comparable to the standard HDC inhibitor, histidine methyl ester, but with higher binding free energy. Catechin binds the catalytic residue S354, unlike cetirizine. The anti-allergic effects of catechin can be explained by HDC inhibition and possible antihistaminic activity. Full article

(This article belongs to the Special Issue Mechanism, Diagnosis and Treatment of ENT Diseases: Otological and Sinus Disorders - Volume II)

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10 pages, 1866 KiB

Open AccessArticle

Multi-Frequency Intraoperative Monitoring of Hearing Preservation during Cochlear Implantation

by Piotr Henryk Skarżyński, Artur Lorens, Adam Walkowiak, Marek Polak and Henryk Skarżyński

Life 2022, 12(5), 636; https://doi.org/10.3390/life12050636 - 25 Apr 2022

Cited by 3 | Viewed by 2421

Abstract

(1) Background: Current indications for cochlear implants (CIs) have expanded to include patients with appreciable low-frequency hearing. However, longitudinal results indicate that only one-third of these recipients retain full hearing preservation. In another words, the remaining two-thirds lose this facility either partially or fully. This points to the need to better understand the impact of cochlear implantation on cochlear integrity. Intracochlear electrocochleography (ECochG) involves the recording of electrical potentials generated in the inner ear in response to acoustic stimuli, and previous studies have shown that these potentials give an indication of residual inner ear function. Aim of the research: The aim is to monitor intracochlear ECochG during CI surgery and gain a better understanding of how the implant impacted inner ear function. A newly developed SPL Chirp was used for stimulation. (2) Methods: Intracochlear ECochG signals were measured in a subject with residual preoperative low-frequency hearing, while an electrode array was introduced into the cochlea and was continued until the round window was sealed. Afterwards, surgical events were reviewed with the surgeon; preoperative and postoperative radiological data and hearing thresholds were also evaluated. (3) Conclusions: Real-time intraoperative monitoring, with multifrequency evaluation and video recording, has the potential to allow surgeons and audiologists to continuously assess cochlear function. ECochG monitoring may be a useful tool during cochlear implantation to gain frequency-specific information on the status of the patient’s hearing, assisting surgeons to lower hearing trauma during the operation. Full article

(This article belongs to the Special Issue Mechanism, Diagnosis and Treatment of ENT Diseases: Otological and Sinus Disorders - Volume II)

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12 pages, 3021 KiB

Open AccessArticle

The Clinical Effect of Steroid Therapy on Preserving Residual Hearing after Cochlear Implantation with the Advanced Bionics HiRes Ultra 3D Cochlear Implant System

by Magdalena Beata Skarzynska, Aleksandra Kolodziejak, Elżbieta Gos, Piotr Henryk Skarzynski, Artur Lorens and Adam Walkowiak

Life 2022, 12(4), 486; https://doi.org/10.3390/life12040486 - 27 Mar 2022

Cited by 4 | Viewed by 2320

Abstract

(1) Background: The main aim of this study was to assess the clinical effectiveness of two different schemes of administration of steroids ((1) dexamethasone administered intravenously in comparison with (2) combination of steroid treatments: orally administered prednisone and intravenously administered dexamethasone) in comparison with a control group (no steroid administration) on hearing preservation (HP) in patients who underwent an Advanced Bionics cochlear implantation. (2) Methods: Thirty-five adult patients met the inclusion criteria. All patients were randomly divided into three subgroups depending on the scheme of steroid administration: (1) the first subgroup with only intravenously administered dexamethasone (0.1 mg per kg body weight twice a day for three days), (2) the second subgroup with a combination of methods of administration of steroids (intravenous and oral steroid therapy (dexamethasone, 0.1 mg/kg body weight twice a day plus prednisone, 1 mg/kg weight once a day for three days before surgery and after administration of dexamethasone (4th, 5th, 6th day) and after this time the dose of prednisone was reduced)) and (3) the third subgroup without steroid therapy (control group). The results were measured by pure tone audiometry (PTA) in three periods: (1) before implantation, (2) during activation of the processor (one month after implantation), and (3) 12 months after activation. Patients’ hearing thresholds before implantation were on average 82 dB HL, 77 dB HL, and 88 dB HL, respectively. (3) Results: The majority of the patients from the first subgroup had hearing preserved partially (77.8%). A similar result was observed in the second study group (oral + i.v.) (partial hearing preservation was found in 61.5% of the participants). The opposite was true in the control group; a plurality of control patients (38.5%) had no measurable hearing 12 months after the activation of the processor. (4) Conclusions: Pharmacological treatment consisting of the administration of steroids in patients who had undergone cochlear implantation with the Advanced Bionics HiRes Ultra 3D cochlear implant system may be beneficial for preserving residual hearing in patients. Full article

(This article belongs to the Special Issue Mechanism, Diagnosis and Treatment of ENT Diseases: Otological and Sinus Disorders - Volume II)

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11 pages, 1487 KiB

Open AccessArticle

Laryngeal Electromyography in the Therapeutic Process of Patients with Vocal Fold Immobility or Dysmobility

by Paulina Krasnodębska, Agata Szkiełkowska, Ludmiła Czarkwiani-Woźniakowska, Beata Miaśkiewicz, Anna Sinkiewicz and Henryk Skarżyński

Life 2022, 12(3), 390; https://doi.org/10.3390/life12030390 - 8 Mar 2022

Cited by 4 | Viewed by 2370

Abstract

(1) Background: Laryngeal electromyography (LEMG) plays a key role in classifying the severity of nerve damage and determining the prognosis of the nerve recovery. LEMG is primarily a qualitative study, without a standardized approach to interpretation. The development of qualitative and quantitative analysis would situate LEMG in the gold standard of modern neurolaryngologic diagnostics. The aim of this study was to quantitatively evaluate laryngeal electromyography recorded in patients with vocal fold immobility or dysmobility. (2) Methods: The electromyographic material comprised 84 thyroarytenoid muscles recordings of 42 patients. (3) Results: In our study, we observed significant differences between EMG characteristics of healthy and paralyzed VF. Our study showed that recording laryngeal muscle activity during successive phases of breathing provides additional valuable information. We noticed that the frequency and amplitude of motor unit potentials correlates with the return of vocal fold functionality. (4) Conclusions: Laryngeal EMG guides the clinician on the best course of treatment for the patient. It is therefore important to develop an effective methodology and consensus on the quantitative interpretation of the record. Amplitude and frequency parameters are valuable in predicting neural recovery and in the return of vocal fold mobility. Full article

(This article belongs to the Special Issue Mechanism, Diagnosis and Treatment of ENT Diseases: Otological and Sinus Disorders - Volume II)

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22 pages, 1844 KiB

Open AccessArticle

ARTFit—A Quick and Reliable Tool for Performing Initial Fittings in Users of MED-EL Cochlear Implants

by Lutz Gärtner, Timo Bräcker, Mathias Kals, Richard T. Penninger, Mareike Billinger-Finke, Thomas Lenarz and Andreas Büchner

Life 2022, 12(2), 269; https://doi.org/10.3390/life12020269 - 11 Feb 2022

Viewed by 2563

Abstract

This study assessed the safety and performance of ARTFit, a new tool embedded in MAESTRO, the cochlear implant (CI) system software by MED-EL GmbH (Innsbruck, Austria). ARTFit automatically measures thresholds of the electrically evoked compound action potential (ECAP) to produce initial ‘maps’ (ECAPMAPs), i.e., configuration settings of the audio processor that the audiologist switches to live mode and adjusts for comfortable loudness (LiveECAPMAPs). Twenty-three adult and ten pediatric users of MED-EL CIs participated. The LiveECAPMAPs were compared to behavioral maps (LiveBurstMAPs) and to the participants’ everyday clinical maps (ClinMAPs). Four evaluation measures were considered: average deviations of the maximum comfortable loudness (MCL) levels of the LiveECAPMAPs and the LiveBurstMAPs from the MCLs of the ClinMAPs; correlations between the MCLs of the LiveECAPMAPs (MCL_ecap) and the LiveBurstMAPs (MCL_burst) with the MCLs of the ClinMAPs (MCL_clin); fitting durations; and speech reception thresholds (SRTs). All evaluation measures were analyzed separately in the adult and pediatric subgroups. For all evaluation measures, the deviations of the LiveECAPMAPs from the ClinMAPs were not larger than those of the LiveBurstMAPs from the ClinMAPs. The Pearson correlation between the MCL_ecap and the MCL_clin across all channels was r² = 0.732 (p < 0.001) in the adult and r² = 0.616 (p < 0.001) in the pediatric subgroups. The mean fitting duration in minutes for the LiveECAPMAPs was significantly shorter than for that of the LiveBurstMAPs in both subgroups: adults took 5.70 (range 1.90–11.98) vs. 9.27 (6.83–14.72) min; children took 3.03 (1.97–4.22) vs. 7.35 (3.95–12.77). SRTs measured with the LiveECAPMAPs were non-inferior to those measured with the ClinMAPs and not statistically different to the SRTs measured with the LiveBurstMAPs. ARTFit is a safe, quick, and reliable tool for audiologists to produce ECAP-based initial fitting maps in adults and young children who are not able to provide subjective feedback. Full article

(This article belongs to the Special Issue Mechanism, Diagnosis and Treatment of ENT Diseases: Otological and Sinus Disorders - Volume II)

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12 pages, 1063 KiB

Open AccessArticle

Self-Rated Benefits of Auditory Performance after Bonebridge Implantation in Patients with Conductive or Mixed Hearing Loss, or Single-Sided Deafness

by Anna Ratuszniak, Piotr H. Skarzynski, Elżbieta Gos and Henryk Skarzynski

Life 2022, 12(2), 137; https://doi.org/10.3390/life12020137 - 18 Jan 2022

Cited by 6 | Viewed by 2224

Abstract

The Bonebridge implant can be a satisfactory solution for patients with conductive or mixed hearing loss (CHL or MHL), or with single-sided deafness (SSD). The aim of the study was to assess patients’ self-reported benefits with the Bonebridge and characterize the relationships between pre-implantation audiometric data, auditory functioning, and satisfaction after implantation. A focus was to see whether different types of hearing loss were associated with particular benefits. The study sample consisted of 81 patients. Procedures comprised pure tone audiometry before implantation, the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire, and a structured interview asking about satisfaction. Statistically significant improvements after implantation were found in all groups (CHL, MHL, SSD) on the APHAB questionnaire. In the structured interview, patients with SSD were the least satisfied. No significant correlation was found between pre-operative air-bone gap and bone conduction thresholds or with APHAB score. Bonebridge implantation is beneficial to patients with CHL or MHL, or with SSD. Assessment of patients for Bonebridge implantation is complex, and audiometric data should be complemented by patient-reported outcomes to provide deeper insight into their individual needs and attitudes. Full article

(This article belongs to the Special Issue Mechanism, Diagnosis and Treatment of ENT Diseases: Otological and Sinus Disorders - Volume II)

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13 pages, 1131 KiB

Open AccessArticle

Effectiveness of Various Treatments for Sudden Sensorineural Hearing Loss—A Retrospective Study

by Magdalena B. Skarżyńska, Aleksandra Kołodziejak, Elżbieta Gos, Milaine Dominici Sanfis and Piotr H. Skarżyński

Life 2022, 12(1), 96; https://doi.org/10.3390/life12010096 - 10 Jan 2022

Cited by 10 | Viewed by 4045

Abstract

(1) Background: A retrospective clinical study was conducted to compare the effectiveness of different pharmacological and non-pharmacological regimens for treating sudden sensorineural hearing loss (SSNHL). (2) Methods: Adult patients (n = 130) diagnosed with sudden sensorineural hearing loss (SSNHL) and hospitalized between 2015 and 2020 were enrolled in this study. Depending on the treatment regimen applied, patients were divided into five groups. Inclusion criteria were as follows: (i) hearing loss of sudden onset; (ii) hearing loss of at least 30 dB at three consecutive frequencies; (iii) unilateral hearing loss; (iv) age above 18 years. Exclusion criteria were as follows: (i) no follow-up audiogram; (ii) bilateral hearing loss; (iii) recognized alternative diagnosis such as tumor, disorder of inner ear fluids, infection or inflammation, autoimmune disease, malformation, hematological disease, dialysis-dependent renal failure, postdural puncture syndrome, gene-related syndrome, mitochondrial disease; and (iv) age below 18 years. (3) Results: Complete recovery was found in 14% of patients (18/130) and marked improvement was found in 6% (8/130), giving an overall success rate of 20%. The best results were obtained in the second group (i.e., patients given intratympanic glucocorticoid + prolonged orally administered glucocorticoid) where the success rate was 28%. In general, the older the patient, the smaller the improvement in hearing, a correlation that was statistically significant. (4) Conclusions: In treating SSNHL, the highest rate of hearing recovery—28%—was in the group of patients given intratympanic corticoid plus prolonged treatment with orally administered glucocorticoid. Full article

(This article belongs to the Special Issue Mechanism, Diagnosis and Treatment of ENT Diseases: Otological and Sinus Disorders - Volume II)

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