Diagnosis and Treatment of ENT Diseases: Otological and Sinus Disorders

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

Deadline for manuscript submissions: closed (15 August 2021) | Viewed by 28012

Special Issue Editors


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Guest Editor
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
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
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 have 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 is also a number of 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 treatment of some cases. All these otological solutions need to be discussed to improve possible methods of treatment; share personal own experiences; and, as a consequence, provide better healthcare for patients with hearing impairments. Secondly, 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 main aim of the Special Issue is to share knowledge, personal experiences, current strategies and future perspectives and expectations in 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

Published Papers (7 papers)

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Research

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16 pages, 2126 KiB  
Article
Correlation of Electrically Evoked Compound Action Potential Amplitude Growth Function Slope and Anamnestic Parameters in Cochlear Implant Patients—Identification of Predictors for the Neuronal Health Status
by Lutz Gärtner, Katharina Klötzer, Thomas Lenarz and Verena Scheper
Life 2021, 11(3), 203; https://doi.org/10.3390/life11030203 - 5 Mar 2021
Cited by 6 | Viewed by 2405
Abstract
Cochlear implants (CI) are the treatment of choice in profoundly deaf patients. Measuring the electrically evoked compound action potential (ECAP) has become an important tool for verifying the function of the spiral ganglion neurons (SGN), which are the target cells of the CI [...] Read more.
Cochlear implants (CI) are the treatment of choice in profoundly deaf patients. Measuring the electrically evoked compound action potential (ECAP) has become an important tool for verifying the function of the spiral ganglion neurons (SGN), which are the target cells of the CI stimulation. ECAP measurement is only possible after electrode insertion. No information about the neuronal health status is available before cochlear implantation. We investigated possible correlations between the ECAP amplitude growth function (AGF) slope and anamnestic parameters to identify possible predictors for SGN health status and therefore for CI outcome. The study included patients being implanted with various electrode array lengths. Correlation analysis was performed for the mean AGF slope of the whole array, for separate electrodes as well as for grouped electrodes of the apical, medial, and basal region, with duration of deafness, age at implantation, residual hearing (grouped for electrode length), and etiology. The mean ECAP AGF slopes decreased from apical to basal. They were not correlated to the length of the electrode array or any etiology. For the mean of the full array or when grouped for the apical, middle, and basal part, the ECAP AGF slope was negatively correlated to the duration of hearing loss and the age at implantation. Since a significant negative correlation of the ECAP AGF slope and age at cochlear implantation and duration of deafness was observed, this study supports the statement that early implantation of a CI is recommended for sensorineural hearing loss. Additional factors such as the cochlear coverage and insertion angle influence the ECAP AGF slope and performance of the patient and should be included in future multifactorial analysis to study predictive parameters for the CI outcome. Full article
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10 pages, 1427 KiB  
Article
Titanium and Platinum–Fluoroplastic Stapes Prostheses Visualization on Cone Beam Computed Tomography and High-Resolution Computed Tomography
by Valerie Dahm, Ursula Schwarz–Nemec, Alice B. Auinger, Michael A. Arnoldner, Alexandra Kaider, Dominik Riss, Christian Czerny and Christoph Arnoldner
Life 2021, 11(2), 156; https://doi.org/10.3390/life11020156 - 17 Feb 2021
Cited by 2 | Viewed by 2847
Abstract
Objective: The aim of this study was to evaluate whether stapes prostheses can be visualized with less metal artifacts and therefore more accurately on cone beam computed tomography in comparison to computed tomography imaging. Recent studies have shown that cone beam computed tomography [...] Read more.
Objective: The aim of this study was to evaluate whether stapes prostheses can be visualized with less metal artifacts and therefore more accurately on cone beam computed tomography in comparison to computed tomography imaging. Recent studies have shown that cone beam computed tomography has advantages when imaging metal artifacts. Patients with hearing loss or vertigo, who have undergone stapedotomy, often present a challenge for otologic surgeons. Imaging studies can deliver crucial additional information. Methods: A retrospective analysis of imaging studies and clinical data in a tertiary care center were carried out. Forty-one patients with forty-five implanted ears were evaluated in the study. All included patients had been implanted with a platinum–fluoroplastic (n = 19) or titanium (n = 26) piston and subsequently had undergone imaging months or years after surgery for various reasons. Patients underwent computed tomography or cone beam computed tomography of the temporal bone depending on availability. Piston visualization, prosthesis length, vestibular intrusion and audiologic results were compared between the groups. Piston position on imaging studies were compared to intraoperative findings. Results: Functional length measurements of all prostheses were carried out with a mean error of −0.17 mm (±0.20). Platinum–fluoroplastic protheses were significantly underestimated in length compared to titanium prostheses. To analyze the material-dependent difference in the measurement errors of the imaging techniques the interaction was tested in an ANOVA model and showed no statistically significant result (p = 0.24). The blinded neuroradiologist viewed two implants, both platinum–fluoroplastic pistons, as located outside of the vestibule due to an underestimation of the prothesis length and the missing radiodensity of the lower end of the prosthesis. Conclusion: Surgeons and radiologists should be aware of the different types and radiologic features of stapes prostheses and the missing radiodensity of some protheses parts. Cone beam computed tomography is an imaging alternative with a potential advantage of reduced radiation in patients after stapes surgery suffering from vertigo or hearing loss to evaluate piston position. Full article
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12 pages, 907 KiB  
Article
Decreased Sound Tolerance in Tinnitus Patients
by Danuta Raj-Koziak, Elżbieta Gos, Justyna Kutyba, Henryk Skarzynski and Piotr H. Skarzynski
Life 2021, 11(2), 87; https://doi.org/10.3390/life11020087 - 26 Jan 2021
Cited by 10 | Viewed by 3054
Abstract
(1) Background: Decreased sound tolerance is a significant problem in tinnitus sufferers. The aim of the study was to evaluate the relationship between tinnitus and decreased sound tolerance (hyperacusis and misophonia). (2) Methods: The study sample consisted of 74 patients with tinnitus and [...] Read more.
(1) Background: Decreased sound tolerance is a significant problem in tinnitus sufferers. The aim of the study was to evaluate the relationship between tinnitus and decreased sound tolerance (hyperacusis and misophonia). (2) Methods: The study sample consisted of 74 patients with tinnitus and decreased sound tolerance. The procedure comprised patient interviews, pure tone audiometry, impedance audiometry, measurement of uncomfortable loudness levels, and administration of the Hyperacusis Questionnaire, Tinnitus Handicap Inventory, and Visual Analogue Scales. (3) Results: The majority (69%) of the patients reported that noise aggravated their tinnitus. The correlation between tinnitus and hyperacusis was found to be statistically significant and positive: r = 0.44; p < 0.01. The higher the tinnitus severity, the greater the hyperacusis. There was no correlation between misophonia and hyperacusis (r = 0.18; p > 0.05), or between misophonia and tinnitus (r = 0.06; p > 0.05). (4) Conclusions: For tinnitus patients the more significant problem was hyperacusis rather than misophonia. The diagnosis and treatment of decreased sound tolerance should take into account not only audiological, but also psychological problems of the patients. Full article
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9 pages, 1403 KiB  
Article
Functional Magnetic Resonance Imaging in the Olfactory Perception of the Same Stimuli
by Andrea Ciorba, Stavros Hatzopoulos, Cristina Cogliandolo, Chiara Bianchini, Martina Renna, Luca Perrucci, Magdalena Skarzynska, Piotr Henryk Skarżyński, Paolo Campioni, Corrado Cittanti, Aldo Carnevale, Melchiore Giganti and Stefano Pelucchi
Life 2021, 11(1), 11; https://doi.org/10.3390/life11010011 - 25 Dec 2020
Cited by 5 | Viewed by 2545
Abstract
Background. Data in the literature report that a number of studies have attempted to identify the exact location of the cortical olfaction representation, searching for evidence suggesting that sniffing odors can initiate a primary activation of the piriform cortex and the insula. Nowadays, [...] Read more.
Background. Data in the literature report that a number of studies have attempted to identify the exact location of the cortical olfaction representation, searching for evidence suggesting that sniffing odors can initiate a primary activation of the piriform cortex and the insula. Nowadays, due to the SARS-CoV-2 (COVID-19) outbreak, the functional study of the olfactory system could offer a better understanding of the physiopathology of olfactory perception, elucidating better the possible site(s) of damage induced by the COVID-19 infection. The aim of this paper was to evaluate brain maps generated from functional Magnetic Resonance Imaging (fMRI) data, collected from healthy individuals in response to the same olfactory stimulus. Methods. A total of 45 healthy volunteers, without history and/or no clinical signs of sinonasal disease and without history and/or presence of olfactory dysfunction underwent fMRI assessment. Subjects were presented with the same odorous stimuli at specific intervals. fMRI generated brain maps were used in the identification of different cortical areas, involved in the stimuli perception. Results. The fMRI brain maps showed that odorous stimuli activate primarily the left anterior insula (in 35/45 cases or 77.8%). Other activated areas include: the low temporal gyri, the middle and superior temporal gyri, the frontal and piriform cortex, the anterior cingulate gyrus, the parahippocampal gyrus, the temporopolar area, the para-insular area, the subcentral area, the supramarginal gyrus, the occipital cortex and the cerebellum. Conclusions. fMRI resulted as a safe and reliable means to study the perception of olfaction in the cortex. The data of this study suggest that the anterior insula is the main stimulated area when olfactory stimuli are present. This area is always activated, despite the hand and nostril dominance. Full article
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10 pages, 4554 KiB  
Article
High Variability of Postsurgical Anatomy Supports the Need for Individualized Drug-Eluting Implants to Treat Chronic Rhinosinusitis
by Ziwen Gao, Farnaz Matin, Constantin Weber, Samuel John, Thomas Lenarz and Verena Scheper
Life 2020, 10(12), 353; https://doi.org/10.3390/life10120353 - 17 Dec 2020
Cited by 8 | Viewed by 2951
Abstract
Chronic rhinosinusitis (CRS) is a common disease in the general population that is increasing in incidence and prevalence, severely affecting patients’ quality of life. Medical treatment for CRS includes self-management techniques, topical and oral medical treatments, and functional endoscopic sinus surgery (FESS). FESS [...] Read more.
Chronic rhinosinusitis (CRS) is a common disease in the general population that is increasing in incidence and prevalence, severely affecting patients’ quality of life. Medical treatment for CRS includes self-management techniques, topical and oral medical treatments, and functional endoscopic sinus surgery (FESS). FESS is a standard procedure to restore sinus ventilation and drainage by physically enlarging the inflamed sinus passageways. Nasal drug-releasing stents are implanted to keep the surgically expanded aperture to the sinus frontalis open. The outcome of such an intervention is highly variable. We defined the anatomical structures which should be removed, along with ‘no-go areas’ which need to be preserved during FESS. Based on these definitions, we used cone beam computed tomography (CBCT) images to measure the dimensions of the frontal neo-ostium in 22 patients. We demonstrate anatomical variability in the volume and diameter of the frontal sinus recess after surgery. This variability could be the cause of therapy failure of drug-eluting implants after FESS in some patients. Implants individually made to fit a given patient’s postsurgical anatomy may improve the therapeutic outcome. Full article
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12 pages, 271 KiB  
Article
Otoacoustic Emissions in Children with Long-Term Middle Ear Disease
by Milaine Dominici Sanfins, Luisa Frata Bertazolli, Piotr H. Skarzynski, Magdalena Beata Skarzynska, Caroline Donadon and Maria Francisca Colella-Santos
Life 2020, 10(11), 287; https://doi.org/10.3390/life10110287 - 18 Nov 2020
Cited by 3 | Viewed by 2705
Abstract
Introduction: Otoacoustic emissions (OAEs) evaluate the functional status of the cochlea. Repeated otitis media (OM) can cause changes in the peripheral structures of the auditory system, and, in this way, middle ear infection may irreversibly damage the middle ear, or even the cochlea. [...] Read more.
Introduction: Otoacoustic emissions (OAEs) evaluate the functional status of the cochlea. Repeated otitis media (OM) can cause changes in the peripheral structures of the auditory system, and, in this way, middle ear infection may irreversibly damage the middle ear, or even the cochlea. Objectives: To analyze the results of transiently evoked otoacoustic emissions (TEOAEs) and distortion product otoacoustic emissions (DPOAEs) in individuals with a history of OM. Method: Participants with 8 to 16 years of schooling were split into two groups: a control group (CG) of 50 subjects who had no history of otological disease and an experimental group (EG) of 50 subjects who had a history of recurrent otitis in childhood and had consequently undergone myringotomy to insert bilateral ventilation tubes. All children underwent basic audiological assessment (tonal audiometry, speech audiometry, and immittance testing) and otoacoustic emission testing (TEOAEs and DPOAEs). Results: There were no significant differences between the groups when audiometrically tested via air and bone conduction. OAEs were found in all CG subjects. For the EG, there were no TEOAE responses in 17 ears and no DPOAEs in nine ears; response amplitudes were lower at all frequencies. The emission level and the signal-to-noise ratio were statistically different between the two groups, and OAEs in the EG were statistically smaller compared to the GC. Conclusion: In the EG, responses were more likely to be absent and were of statistically smaller amplitude compared to the CG. A history of repeated OM apparently interferes with the generation and transmission of TEOAEs and DPOAEs. Full article

Review

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13 pages, 652 KiB  
Review
How Effective Is Auditory–Verbal Therapy (AVT) for Building Language Development of Children with Cochlear Implants? A Systematic Review
by Paris Binos, Elina Nirgianaki and George Psillas
Life 2021, 11(3), 239; https://doi.org/10.3390/life11030239 - 13 Mar 2021
Cited by 17 | Viewed by 9900
Abstract
This systematic review sheds light on the effectiveness of auditory–verbal therapy (AVT) outcomes in children with cochlear implants (CIs). The presented outcome is based on research findings from the last 10 years. The systematic review was designed based on the Preferred Reporting Items [...] Read more.
This systematic review sheds light on the effectiveness of auditory–verbal therapy (AVT) outcomes in children with cochlear implants (CIs). The presented outcome is based on research findings from the last 10 years. The systematic review was designed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and Critical Appraisal of Treatment Evidence (CATE) checklist. Specific keywords were chosen based on the research question and searched on the PubMed database. All searched papers were analysed based on specific exclusion criteria and classified into four evidence levels. The results revealed that children who participated in AV therapy can achieve linguistic skills at the same level as their hearing peers. Voice quality seemed positively affected, placing young children with CIs in the normal range for receptive vocabulary development. In contrast, reading skills seemed less benefited. AV therapy seems to contribute to integration into mainstream society. Despite the recorded speech and language improvements of young children with CIs, the aim of AV therapy is still not fulfilled. AV therapy can be seen as the best clinical practice for young children with CIs till now, but the lack of well-controlled studies is undermining. Full article
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