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Diagnostics
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Advances in Diagnostic Approaches for Otologic Diseases in Otolaryngology
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Advances in Diagnostic Approaches for Otologic Diseases in Otolaryngology

A Special Issue of Diagnostics (ISSN 2075-4418) belonging to the section "Clinical Diagnosis and Prognosis".

Deadline for manuscript submissions: 30 September 2026 | Viewed by 3641

Editor

Dr. Sung-Won Choi

E-Mail Website
Guest Editor
Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
Interests: hearing loss; eustachian tube; bilateral vestibulopathy

Special Issue Information

Dear Colleagues,

Otologic diseases comprise a broad range of disorders involving the external, middle, and inner ear and are a major cause of hearing loss, vertigo, tinnitus, and balance dysfunction worldwide. Accurate and timely diagnosis is essential for appropriate management.

Recent advances in diagnostic technologies have substantially improved the evaluation of otologic disorders. High-resolution imaging techniques, including advanced temporal bone computed tomography and inner ear magnetic resonance imaging, now allow more precise anatomical and pathological assessment. In parallel, objective auditory and vestibular function tests—such as wideband tympanometry, electrocochleography, vestibular evoked myogenic potentials, and video head impulse testing—have enhanced functional evaluation across a wide spectrum of otologic diseases. Moreover, emerging diagnostic approaches incorporating molecular biomarkers, genetic testing, and artificial intelligence-based analysis are paving the way toward precision diagnosis and personalized management in otology.

This Special Issue aims to present recent advances and future perspectives in the diagnosis of otologic diseases. We welcome original research articles, comprehensive reviews, and technical studies that address innovative diagnostic methods, multimodal assessment strategies, and translational approaches that bridge basic research and clinical practice, offering an updated overview of evolving diagnostic paradigms in otology.

Dr. Sung-Won Choi
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • otologic diseases
  • diagnostic methods
  • hearing loss
  • vestibular disorders
  • advanced imaging
  • audiovestibular testing

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Published Papers (4 papers)

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Research

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13 pages, 4968 KB  
Article
Clinical Utility of Modified Inflation–Deflation Test in Eustachian Tube Function Testing
by Dong-Hoon Lee, Yun Heo, Han-Seul Na, Seokhwan Lee, Se-Joon Oh and Sung-Won Choi
Diagnostics 2026, 16(16), 2534; https://doi.org/10.3390/diagnostics16162534 - 11 Aug 2026
Viewed by 290
Abstract
Background/Objectives: The modified inflation–deflation test (MIDT) is a physiological test used to evaluate eustachian tube function in patients with tympanic membrane perforation. However, the clinical characteristics and diagnostic value of MIDT have not been fully established. This study aimed to investigate the characteristics [...] Read more.
Background/Objectives: The modified inflation–deflation test (MIDT) is a physiological test used to evaluate eustachian tube function in patients with tympanic membrane perforation. However, the clinical characteristics and diagnostic value of MIDT have not been fully established. This study aimed to investigate the characteristics of MIDT findings in normal function and patients with Eustachian tube dysfunction (ETD) classified by sonotubometry. Methods: We retrospectively assessed 192 ears of 181 patients with tympanic membrane perforation who underwent sonotubometry and MIDT. Based on sonotubometry findings, 117 ears were classified into the normal function group and 75 ears into the ETD group. The MIDT parameters of the groups, including the first opening pressure (OP1), first closing pressure (CP1), residual pressure after three openings (RP3), and pressure difference between OP1 and CP1 were compared. Correlation and receiver-operating characteristic (ROC) analyses were performed. Results: The ETD group had significantly higher OP1, CP1, and RP3 levels than the normal function group (all p < 0.001). The pressure difference between OP1 and CP1 was significantly greater for the normal function group. Failure of Eustachian tube opening was observed in 46.7% and 3.4% of ears in the ETD and normal function groups, respectively. Eustachian tube opening duration measured by sonotubometry was negatively correlated with OP1, CP1, and RP3 but positively correlated with the OP1–CP1 difference. ROC analysis identified an optimal cutoff value of 112.50 daPa for the OP1–CP1 difference, yielding a sensitivity of 92.3% and a specificity of 58.7%. Conclusions: MIDT was significantly associated with sonotubometry findings and effectively differentiated ETD from normal Eustachian tube function. These findings support the clinical utility of the MIDT as a physiological tool for assessing Eustachian tube function in patients with tympanic membrane perforation. Full article
(This article belongs to the Special Issue Advances in Diagnostic Approaches for Otologic Diseases in Otolaryngology)
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12 pages, 535 KB  
Article
Diagnostic Value of Ocular Hemodynamics and Choroidal Thickness in Unilateral Sudden Sensorineural Hearing Loss: Non-Invasive Biomarkers of Systemic Microvascular Disease
by Hüseyin Findik, Muhammet Kaim, Feyzahan Uzun, Murat Okutucu, Metin Çeliker, Fatma Beyazal Çeliker and Merve Solak
Diagnostics 2026, 16(12), 1903; https://doi.org/10.3390/diagnostics16121903 - 19 Jun 2026
Viewed by 351
Abstract
Background/Objectives: Although vascular mechanisms are increasingly implicated in the etiology of sudden sensorineural hearing loss (SSNHL), the inability to directly visualize the labyrinthine artery remains a diagnostic obstacle. Sharing embryological and physiological parallels with the inner ear, the eye represents an accessible surrogate [...] Read more.
Background/Objectives: Although vascular mechanisms are increasingly implicated in the etiology of sudden sensorineural hearing loss (SSNHL), the inability to directly visualize the labyrinthine artery remains a diagnostic obstacle. Sharing embryological and physiological parallels with the inner ear, the eye represents an accessible surrogate organ capable of reflecting systemic microvascular status. This study aimed to evaluate the diagnostic value of ocular hemodynamic and structural parameters in patients with acute unilateral idiopathic SSNHL. Methods: This prospective, comparative, cross-sectional study enrolled 30 patients with acute unilateral idiopathic SSNHL and 25 age and sex matched healthy controls. Three groups were defined: the affected eye, the contralateral eye, and the control eye. Retrobulbar hemodynamics (PSV, EDV, RI, PI) were assessed by color Doppler imaging; peripapillary choroidal thickness, RNFL, GCC+, and macular thickness by swept-source OCT; and macular microvascular perfusion by OCT angiography. Results: End diastolic velocity in the posterior ciliary arteries was significantly reduced in both patient eye groups relative to controls (p < 0.001), while RI and PI were significantly elevated (p = 0.001 and p = 0.004, respectively). Comparable hemodynamic impairment was observed in the ophthalmic artery. Peripapillary choroidal thickness was bilaterally reduced in the inferior and temporal quadrants in both patient groups (p = 0.003 and p = 0.010). No significant difference was detected between affected and contralateral eyes in any parameter. RNFL, GC+, and macular thickness remained comparable across all groups. Conclusions: The bilateral symmetry of hemodynamic impairment and choroidal thinning suggests that SSNHL arises against a background of systemic microvascular disease. The combined use of OCT and color Doppler ultrasonography holds clinical potential as a non-invasive biomarker panel for defining the vascular phenotype of the condition. Full article
(This article belongs to the Special Issue Advances in Diagnostic Approaches for Otologic Diseases in Otolaryngology)
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12 pages, 920 KB  
Article
Validation of NB CE-Chirps in the Diagnosis of Superior Semicircular Canal Dehiscence Syndrome
by Quentin Mat, Christophe Lelubre, Antonino Maniaci, Stéphane Gargula, Giannicola Iannella, Jerome R. Lechien and Sophie Tainmont
Diagnostics 2026, 16(6), 868; https://doi.org/10.3390/diagnostics16060868 - 14 Mar 2026
Viewed by 570
Abstract
Background/Objectives: The aim of this study was to assess NB CE-Chirps for diagnosing Superior Semicircular Canal Dehiscence Syndrome (SSCDS) with cervical and ocular vestibular evoked myogenic potentials (cVEMPs and oVEMPs), and to compare them with Tone Bursts (TBs). Methods: Nine subjects [...] Read more.
Background/Objectives: The aim of this study was to assess NB CE-Chirps for diagnosing Superior Semicircular Canal Dehiscence Syndrome (SSCDS) with cervical and ocular vestibular evoked myogenic potentials (cVEMPs and oVEMPs), and to compare them with Tone Bursts (TBs). Methods: Nine subjects diagnosed with SSCDS were included (four men/five women, median = 61 years, range = 31–79 years). Intensity thresholds at 500 Hz were investigated with both stimuli. A response was also sought when NB CE-Chirps and TBs were delivered at 4000 Hz for c and oVEMPs. Results: Both 500 Hz TBs and 500 Hz NB CE-Chirps significantly differentiated affected ears from healthy ears for cVEMPs (p < 10−3 in both cases) and oVEMPs (p < 10−3 in both cases). Furthermore, we observed significantly lower intensity thresholds in SSCDS ears with 500 Hz NB CE-Chirps than with 500 Hz TBs for both cVEMPs (p < 10−3) and oVEMPs (p = 0.036). Regarding the response rate at 4000 Hz, only TBs consistently showed a response in 100% of cases for the affected ears, with no response in healthy ears for both cVEMPs and oVEMPs. However, there was no significant difference between the response rates obtained at 4000 Hz using TBs and NB CE-Chirps in affected ears (p = 1.000 for cVEMPs and p = 1.000 for oVEMPs). Conclusions: Searching for intensity thresholds with NB CE-Chirps 500 Hz in cVEMPs and oVEMPs is an effective method for diagnosing SSCDS, likely with better frequency specificity than with 500 Hz TBs. Stimulation at 4000 Hz with both TBs and NB CE-Chirps appears to be a promising test for easily screening this syndrome, reducing both sound exposure and the duration of the examination. The possibility to reduce rise time in 4000 Hz TBs may favor this stimulus over NB CE-Chirps at this frequency for this disease. These results should be confirmed in larger cohorts including patients with more severe forms. Full article
(This article belongs to the Special Issue Advances in Diagnostic Approaches for Otologic Diseases in Otolaryngology)
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Review

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19 pages, 1245 KB  
Review
Otologic Manifestations of Temporomandibular Disorders
by Fatemeh Ebrahimi, Ali Akbar, Vivian Jin, Vivian F. Kaul and Craig B. Pearl
Diagnostics 2026, 16(12), 1757; https://doi.org/10.3390/diagnostics16121757 - 7 Jun 2026
Cited by 1 | Viewed by 1942
Abstract
Background/Objectives: Temporomandibular disorder (TMD) affects a third of the adult population and has been associated with otologic symptoms. These symptoms are frequently misattributed to primary otologic diseases, leading to delays in diagnosis and treatment. This review aims to summarize the reported prevalence, [...] Read more.
Background/Objectives: Temporomandibular disorder (TMD) affects a third of the adult population and has been associated with otologic symptoms. These symptoms are frequently misattributed to primary otologic diseases, leading to delays in diagnosis and treatment. This review aims to summarize the reported prevalence, proposed pathophysiologic mechanisms, and management strategies of otologic manifestations in patients with TMD. Methods: A literature review was conducted using the MeSH terms “temporomandibular joint disease” and “otologic symptoms.” Five additional searches were performed using “temporomandibular disease/dysfunction” combined with each of the five most common otologic symptoms. Meta-analyses, randomized controlled trials, reviews, and systematic reviews were prioritized, with preference for studies published within the last 10 years. Inclusion criteria focused on human studies addressing the etiology, clinical presentation, and management of otologic symptoms in TMD populations. Results: The literature supports an association between TMD and otologic symptoms in the absence of primary ear disease. The most commonly described symptoms were aural fullness, otalgia, tinnitus, vertigo, and hearing loss. Conservative approaches, including occlusal splints, physical therapy, behavioral modification, and pharmacologic therapy, demonstrated partial or complete symptom resolution after management of underlying TMD. Conclusions: The literature demonstrates a consistent association between otologic symptoms and TMD, although the underlying mechanisms remain incompletely understood. While conservative TMD management may improve symptoms, exact mechanisms remain unproven. Clinicians should consider TMD in the differential diagnosis when patients present with unexplained otologic complaints. Further research is necessary to establish causality, confirm the efficacy of management protocols, and improve diagnostic accuracy in this overlapping domain. Full article
(This article belongs to the Special Issue Advances in Diagnostic Approaches for Otologic Diseases in Otolaryngology)
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