J. Otorhinolaryngol. Hear. Balance Med., Volume 6, Issue 1 (June 2025) – 8 articles

Background: Hearing aids are essential for managing hearing loss, yet their accessibility, consistent use, and maintenance remain challenging in public healthcare systems, particularly in low- and middle-income countries (LMICs) such as South Africa. Despite the availability of these services, many patients struggle with device utilization, resulting in suboptimal rehabilitation outcomes. This study explores patient experiences with hearing aids in South Africa’s public healthcare sector. Aim: This study aimed to (1) assess patients’ experiences with hearing aid access, including waiting times and service delivery; (2) identify challenges related to hearing aid maintenance and repairs in the public sector; (3) explore factors influencing consistent hearing aid use, including social, psychological, and practical barriers; and (4) propose strategies to enhance hearing aid provision and aftercare services in South Africa. Methods: This descriptive qualitative study was conducted at two public healthcare facilities in Johannesburg. Purposive sampling was used to recruit 15 adult hearing aid users who had received government-funded hearing aids within the past 12 months. Semi-structured interviews were conducted, transcribed verbatim, and analyzed using thematic analysis. Results: Participants reported long waiting periods (up to a year) for hearing aids, with poor communication regarding timelines. Challenges included difficulties adjusting to amplification, discomfort, and battery shortages, leading to inconsistent use or device abandonment. Social stigma and lack of family support further discouraged consistent use. Repair services were slow, with waiting times exceeding three months. Participants recommended decentralized battery distribution, structured follow-up appointments, improved aftercare, awareness campaigns, and mobile audiology services to improve accessibility and usability. Conclusions: While public hearing aid provision is essential for hearing rehabilitation, systemic inefficiencies, maintenance issues, and social barriers limit its impact. Strengthening aftercare services, decentralizing hearing aid distribution, and increasing public awareness could significantly improve hearing aid accessibility and adherence. Furthermore, policy interventions that incorporate tele-audiology, community-based maintenance programs, and integrated healthcare approaches are crucial in ensuring sustainable hearing healthcare outcomes. Full article

Background/Objectives: Long-term prosthetic stability in ossicular chain reconstruction (OCR) surgery may be affected by multiple factors, including prosthesis type. We compared audiometric outcomes including air–bone gap (ABG) and air conduction pure-tone average (AC PTA) over a multi-year period in titanium clip partial prosthetics and other titanium partial and total ossicular reconstruction prostheses. Methods: This was a retrospective study of 92 adult patients (19–74 years) receiving primary, second-look, or revision OCR at a single institution between 2017 and 2021. ABG and AC PTA at short (3–6 months) and long-term (>12 months) postoperative follow-up were compared among patients receiving clip partial prosthetics, traditional PORPs, and TORPs. Results: Overall, AC PTA and ABG were significantly improved in the short term and did not significantly deteriorate in the long term. Clip partial prostheses had significantly lower AC PTAs and ABGs than TORPs in both the short and long term and no difference with PORPs. There was also no significant deterioration in audiometric outcomes in either clip partials, PORPs, or TORPs over time. Clip partials had the highest rate of short- and long-term surgical success (i.e., ABG ≤ 20 dB) with 62.2% and 54.1%, respectively. Cholesteatoma and revision status were not independent predictors of long-term ABG success. Conclusions: The clip partial prosthesis seems to demonstrate similar, and potentially increased, resilience compared to the PORP and TORPs in both the short and long term. They may have comparable effects on audiometric outcomes to PORPs, demonstrating postoperative ABG and AC PTAs that reflect the previous literature. Clip partials appear to be a safe and effective prosthetic for OCR in patients with intact stapes regardless of cholesteatoma or revision status. Full article

Background/Objectives: This study focuses on examining treatment outcomes of sinonasal squamous cell carcinoma (SNSCC) when induction chemotherapy is added to definitive treatment regimens. A systematic literature search was conducted in the following four bibliographic databases: Embase, MEDLINE, Web of Science and Cochrane Central Register of Controlled Trials (CENTRAL). A total of 604 patients across 12 studies were included in the final review. Methods: This systematic review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Pooled survival curves were derived from reconstructed individual patient data using Guyot et al.’s methodology, in which K-M curve drops are measured relative to the numbers-at-risk and number of events. Results: In this study, 71% of patients were male and 93% presented with late-stage (T3–4) cancer. The 24-month and 60-month overall survival rates were 55.1% and 35.0%, respectively. The 24-month disease-free survival was 44.4% and remained relatively stable at 42.1% at 60 months. The local control rate remained stable from 24 to 60 months at 72.7%. Conclusions: Compared to the results from the existing literature, this review reveals an overall survival and disease-free survival (DFS) that is comparable to that of other multimodality treatment options. The local control rate (LCR) was also high. This review suggests that induction chemotherapy can be utilised for patients with advanced SNSCC. Full article

Background: The nasal septal swell body (NSB) is a thickened area of the nasal septum with erectile tissues, located above the nasal floor. We hypothesized that the presence of the NSB in this space exerts favorable effects to generate laminar nasal airflow by developing its morphology as adjusted to nasal septal deviation (NSD). Patients and Methods: We objectively measured the NSB morphology in 152 patients by computed tomography (CT) and assessed its relationship with the width of the inferior turbinate (IT), the severity of NSD, and the patency of the nasal airflow passage (NAP). Results: In the patients with moderate or severe NSD, the mean widths of the NSB, IT, and NAP were significantly narrower at the convex side compared to the paired concave side, with the degree being more prominent in the severe-NSD group. A positive correlation was observed between the degree of the NSD angles and the difference in the widths of the NSB (r = 0.805) and IT (r = 0.609). Conclusions: These results imply novel roles of the NSB in the maintenance of physiological nasal airflow to generate a laminar airflow from the nostrils toward the middle nasal meatus at a constant rate. Full article

Objectives: Slag injuries in industrial settings pose risks of hearing loss and complications. The aim of this study is to provide specialists with a better understanding of the sequelae, treatment, and long-term outcomes that a patient may have following a slag injury to the tympanic membrane. Data Sources: PubMed, Embase, and Web of Science. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), multiple databases were queried for articles published from inception to 2023 describing Tympanic membrane injuries from welding. The publications were screened by two independent viewers. The Joanna Briggs Institute 2017 Critical Appraisal Checklist was used to assess the quality of studies. Results: A total of 227 articles were identified, and 9 full-text articles were included in this review, comprising a total of 18 patients. The patients’ ages ranged from 18 to 75 years. Most commonly, patients were welding overhead in a tight working space, and none of the patients were wearing protective ear equipment in addition to their welding masks. Patients experienced otalgia (n = 10; 55%), hearing loss (n = 11; 65%), vertigo (n = 6; 35%), chronic otorrhea (n = 5; 29%), and facial paralysis (n = 4; 23%). A total of 12 patients (70.6%) required surgery, most requiring debridement of metallic foreign body multiple times, some undergoing surgery up to four years post-injury. Conclusions: Tympanic membrane injuries from welding are often overlooked. They cause hearing loss and facial nerve damage. Following a period of observation, sturdy reconstruction with cartilage grafting is recommended, given the poor vasculature and inflammation after this injury. Full article

Background and Clinical Significance: GLI1 gene alterations have recently been identified as a pathological phenomenon associated with a distinct novel entity of mesenchymal neoplasms. They have been reported to occur in any soft tissue of the body, with a specific affinity for the head and neck region. The aim of this article is to increase awareness of this entity and provide a detailed summary of the modes of presentation and diagnostic and therapeutic issues surrounding these tumours occurring in the head and neck region. Case Presentation: We report the case of a 39-year-old male patient with ACTB::GLI1 fusion-related mesenchymal tongue tumour who was successfully treated by surgery. Conclusions: GLI1-altered mesenchymal tumours in the head and neck may harbour various clinical presentations. Larger series are needed to better define the clinicopathological range of this novel entity. We suggest a follow-up period of at least 2 years with imaging, followed by a clinical follow-up of 3 years. Certain clinicopathological features may warrant further and more extensive follow-up. Full article

Background/Objectives: Galvanic vestibular stimulation (GVS) integrated into virtual reality (VR) environments enhances immersion and mitigates cybersickness. It is well known that GVS can affect standing balance. Most studies have investigated the effects of GVS in VR in seated conditions. The purpose of this study was to evaluate the impact of joint GVS and VR with moving visual stimulus on standing balance. Methods: Using a repeated measures counter-balanced design, motion sickness, postural sway, and velocity utilizing the center of pressure (COP) along the mediolateral (ML) and anteroposterior (AP) axes were obtained in 18 subjects during optokinetic (OPK) stimulus (black and white vertical bars moving from left to the right) in VR across three interventions: GVS in the same direction of visual stimulus—left to right ear (Positive GVS), GVS in the opposite direction of visual stimulus—right to left ear (Negative GVS), and without GVS (Null GVS). Motion sickness symptom scoring was obtained using the Pensacola Diagnostic Index. Results: The PDI score was increased significantly in the Negative GVS. The root mean square and sway range of COP along ML was greater during the Positive GVS and Negative GVS than the Null GVS, while, along AP, it was only greater during Negative GVS. During Positive GVS, mean positive and negative peak velocities, only in ML, were increased and decreased, respectively. During Negative GVS, only negative peak velocities in both ML and AP directions were decreased. Conclusions: This research highlights the importance of testing combined VR and GVS to assess standing balance while mitigating cybersickness. Full article