Journal Description
Journal of Otorhinolaryngology, Hearing and Balance Medicine
Journal of Otorhinolaryngology, Hearing and Balance Medicine
is an international, scientific, peer-reviewed, open access journal of otorhinolaryngology, hearing and balance medical studies, published semiannually online by MDPI.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 29.5 days after submission; acceptance to publication is undertaken in 3.2 days (median values for papers published in this journal in the first half of 2025).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
Latest Articles
Efficacy of Combined Hyperbaric Oxygen, per Os Steroid, and Prostaglandin E1 Therapy for Idiopathic Sudden Sensorineural Hearing Loss and Prognostic Factors for Recovery
J. Otorhinolaryngol. Hear. Balance Med. 2025, 6(2), 25; https://doi.org/10.3390/ohbm6020025 - 14 Dec 2025
Abstract
Background: Idiopathic sudden sensorineural hearing loss (ISSNHL) is an abrupt unilateral hearing loss of unknown origin. Combination therapy with hyperbaric oxygen (HBO), systemic steroids (SS), and prostaglandin E1 (PGE1) has been used in Japan; however, its prognostic factors remain unclear. Objective: To evaluate
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Background: Idiopathic sudden sensorineural hearing loss (ISSNHL) is an abrupt unilateral hearing loss of unknown origin. Combination therapy with hyperbaric oxygen (HBO), systemic steroids (SS), and prostaglandin E1 (PGE1) has been used in Japan; however, its prognostic factors remain unclear. Objective: To evaluate the efficacy of HBO combined with SS and PGE1 and to identify prognostic factors for hearing recovery in patients with ISSNHL. Methods: This retrospective study included 116 patients treated within 14 days of ISSNHL onset. Sixty patients received HBO, SS, and PGE1 (HBO group), and 56 received SS and PGE1 alone (No-HBO group). Hearing outcomes were assessed using PTA (arithmetic mean hearing at 250–4000 Hz) and graded by Siegel’s criteria. Prognostic factors were analyzed by multivariate logistic regression. Results: The HBO group showed significantly better hearing grade outcomes (p = 0.007) and greater PTA improvement (p = 0.003) than the No-HBO group. Vertigo and higher initial PTA were identified as independent predictors of poor hearing outcomes. Patients without vertigo showed significantly greater improvement at 2000 Hz (p = 0.009). Receiver operating characteristic analysis revealed an optimal initial PTA cutoff of ≥90.5 dB for predicting poor hearing outcome. Conclusions: HBO combined with SS and PGE1 significantly improves hearing outcomes in ISSNHL. However, the presence of vertigo and severe initial hearing loss remain poor prognostic indicators. These findings suggest that while the addition of HBO may enhance hearing outcomes, prognosis remains limited in severe cases. Further prospective studies are needed to confirm these results.
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(This article belongs to the Section Otology and Neurotology)
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Open AccessReview
Pupillometry as an Objective Measure of Auditory Perception and Listening Effort Across the Lifespan: A Review
by
Shruthi Raghavendra
J. Otorhinolaryngol. Hear. Balance Med. 2025, 6(2), 24; https://doi.org/10.3390/ohbm6020024 - 6 Dec 2025
Abstract
Background/Objectives: This narrative review aims to evaluate the use of pupillometry as an objective measure of auditory perception and listening effort across the lifespan. Specifically, it synthesizes research examining pupillary responses in individuals with and without hearing impairment across pediatric, adult, and older
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Background/Objectives: This narrative review aims to evaluate the use of pupillometry as an objective measure of auditory perception and listening effort across the lifespan. Specifically, it synthesizes research examining pupillary responses in individuals with and without hearing impairment across pediatric, adult, and older adult populations. The review addresses methodological practices and clinical implications for integrating pupillometry into routine audiological assessment. Methods: 12 peer-reviewed studies published between 2010 and 2025 were selected through a systematic search of databases including PubMed, Scopus, Web of Science, and Google Scholar. Inclusion criteria required empirical use of pupillometry in auditory tasks involving human participants with normal hearing or hearing impairment. Studies were analyzed for population characteristics, experimental paradigms, pupillometric metrics (e.g., peak pupil dilation), level of evidence, and relevance to clinical audiology. This article uses a narrative review approach to organize and interpret findings. Results: Across age groups and hearing conditions, pupillometry consistently demonstrated sensitivity to cognitive load and listening effort, particularly in noisy environments or during complex auditory tasks. Pediatric studies revealed its potential as a non-invasive tool for preverbal children. Adult and older adult studies confirmed that pupillary responses reflect device performance (e.g., hearing aids, cochlear implants) and cognitive–linguistic demands. Methodological variability and individual differences in pupil response patterns were noted as limitations. Conclusions: The findings support the use of pupillometry as a valuable adjunct to behavioral audiometry, offering objective insight into auditory–cognitive load. Its application holds promise for pediatric diagnostics, hearing technology evaluation, and geriatric audiology. Standardization of measurement protocols and development of normative data are necessary to enhance clinical applicability and generalizability.
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(This article belongs to the Section Otology and Neurotology)
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Open AccessSystematic Review
A Systematic Review and Network Meta-Analysis of Efficacy of Postmaneuver Rehabilitation in Benign Paroxysmal Positional Vertigo Treatment
by
Jiann-Jy Chen, Bing-Yan Zeng, Bing-Syuan Zeng, Che-Sheng Chu, Chih-Sung Liang, Yi-Cheng Wu, Brendon Stubbs, Kuan-Pin Su, Yu-Kang Tu, Tien-Yu Chen, Yen-Wen Chen, Chih-Wei Hsu, Yow-Ling Shiue and Ping-Tao Tseng
J. Otorhinolaryngol. Hear. Balance Med. 2025, 6(2), 23; https://doi.org/10.3390/ohbm6020023 - 3 Dec 2025
Abstract
Background/Objectives: The high prevalence of benign paroxysmal positional vertigo (BPPV) poses a considerable burden on healthcare systems, with an estimated annual cost of 2 billion dollars per year in the United States. The results of previous network meta-analyses (NMAs) have been inconclusive regarding
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Background/Objectives: The high prevalence of benign paroxysmal positional vertigo (BPPV) poses a considerable burden on healthcare systems, with an estimated annual cost of 2 billion dollars per year in the United States. The results of previous network meta-analyses (NMAs) have been inconclusive regarding the efficacy of different treatment strategies for managing BPPV. This study aimed to provide updated evidence of the comparative efficacy and safety of different treatment strategies in patients with BPPV. Methods: The present study was divided into two subgroups. The first part was the posterior canal BPPV, and the second was the horizontal canal BPPV. This frequentist model-based NMA included randomized controlled trials (RCTs) of treatments for BPPV, either in the posterior or horizontal canal. Results: This NMA of 82 RCTs revealed that, regarding posterior canal BPPV, most maneuvers plus postmaneuver rehabilitation/self-treatments were ranked superior to the traditional maneuver with/without medication in terms of the resolution rate. Among them, the modified Epley maneuver + self-treatment at home [odds ratio (OR) = 33.70, 95% confidence intervals (95%CIs) = 6.45–176.13] was ranked to be associated with the highest resolution rate. Regarding horizontal canal BPPV, only the Gufoni maneuver was associated with a significantly better resolution rate (OR = 4.40, 95%CIs = 1.13–17.12) and a higher transition/conversion rate (OR = 3.55, 95%CIs = 1.20–10.57) than that of sham/control groups. Conclusions: This study provides evidence that treatment strategies consisting of maneuvers in combination with postmaneuver rehabilitation/self-treatment may be preferred for managing BPPV affecting the posterior canal. However, no effective treatment strategy for horizontal canal involvement has been identified.
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(This article belongs to the Section Otology and Neurotology)
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Open AccessArticle
Development of a Speech-in-Noise Test in European Portuguese Based on QuickSIN: A Pilot Study
by
Margarida Serrano, Jéssica Simões, Joana Vicente, Maria Ferreira, Ana Murta and João Tiago Ferrão
J. Otorhinolaryngol. Hear. Balance Med. 2025, 6(2), 22; https://doi.org/10.3390/ohbm6020022 - 26 Nov 2025
Abstract
Background and Objectives: Speech-in-noise testing is essential for evaluating functional hearing abilities in clinical practice. Although the Quick Speech-in-Noise test (QuickSIN) is widely used, no equivalent tool existed for European Portuguese. This study aimed to develop a Speech-in-Noise Test for European Portuguese
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Background and Objectives: Speech-in-noise testing is essential for evaluating functional hearing abilities in clinical practice. Although the Quick Speech-in-Noise test (QuickSIN) is widely used, no equivalent tool existed for European Portuguese. This study aimed to develop a Speech-in-Noise Test for European Portuguese (SiN-EP), linguistically adapted and calibrated for native speakers, to support clinical assessment of speech perception in realistic listening environments. Materials and Methods: The SiN-EP was developed through a multi-stage process. Sentences were drafted to reflect natural speech patterns and reviewed by native speakers for clarity and grammatical accuracy. Selected sentences were recorded by a female native speaker in a controlled acoustic environment and mixed with multi-talker babble at signal-to-noise ratios (SNR (dB)) from 25 to 0 SNR (dB). A pre-test in a free-field setting at 65 dB SPL was conducted with fifteen normal-hearing young adults. Participants repeated each sentence, and their responses were analyzed to refine list composition, adjust difficulty, and ensure phonetic balance. Results: Intelligibility decreased systematically as SNR (dB) worsened, with ceiling effects at 25 and 20 SNR (dB). At 5 SNR (dB), high variability was observed, with set 5 showing disproportionate difficulty and set 14 containing an incomplete sentence; both were removed. At 0 SNR (dB), all sets demonstrated expected low intelligibility. The final test comprises thirteen lists of six sentences, each maintaining stable intelligibility, phonetic representativeness, and consistent difficulty across SNRs (dB). Conclusions: The SiN-EP provides a linguistically appropriate, phonetically balanced, and SNR (dB) calibrated instrument for assessing speech-in-noise perception in European Portuguese. The refinement process improved reliability and list equivalence, supporting the test’s clinical and research applicability. The SiN-EP fills a critical gap in assessing speech-in-noise perception in European Portuguese speakers, providing a reliable tool for both clinical and research applications.
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(This article belongs to the Section Otology and Neurotology)
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Open AccessCase Report
A Humanized Anti-IL-4Rα Monoclonal Antibody Improves Aural Fullness
by
Yiyun Zhang, Mengwen Shi, Yan Zhou, Jianjun Chen, Huabin Li and Yu Sun
J. Otorhinolaryngol. Hear. Balance Med. 2025, 6(2), 21; https://doi.org/10.3390/ohbm6020021 - 21 Nov 2025
Abstract
Background and Clinical Significance: Otitis media with effusion (OME) is characterized by persistent middle ear effusion without acute infection. Type 2 inflammation, mediated by IL-4 and IL-13 signaling via the IL-4Rα receptor, has been implicated in the pathogenesis of chronic rhinosinusitis with
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Background and Clinical Significance: Otitis media with effusion (OME) is characterized by persistent middle ear effusion without acute infection. Type 2 inflammation, mediated by IL-4 and IL-13 signaling via the IL-4Rα receptor, has been implicated in the pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP), asthma, and possibly OME. Refractory OME in adults remains a therapeutic challenge, as conventional treatments often fail to achieve long-term resolution. Targeted biologic therapies that modulate type 2 inflammation may offer a novel treatment option. Case Presentation: We report the case of a 60-year-old man with a 15-year history of allergic rhinitis and CRSwNP, complicated by recurrent asthma exacerbations, who presented with bilateral aural fullness, hearing loss, and tinnitus. His symptoms persisted despite repeated tympanic punctures, Eustachian tube insufflation, and corticosteroid therapy. Otoscopy revealed dull tympanic membranes with effusion, and audiometry showed conductive hearing loss with a B-type tympanogram on the left. Laboratory findings demonstrated mild peripheral eosinophilia. The patient was diagnosed with OME, likely secondary to type 2 inflammation. After nine biweekly injections of Stapokibart (CM310)—a humanized monoclonal antibody targeting IL-4Rα—aural fullness completely resolved. Otoscopic findings and tympanograms normalized, and hearing thresholds improved significantly. Retrospective evaluation using Iino’s diagnostic framework suggested that the patient did not meet the full criteria for eosinophilic otitis media (EOM); nevertheless, marked symptomatic and functional improvement was achieved. No recurrence or adverse effects were observed during follow-up. Conclusions: This case suggests that IL-4Rα blockade with Stapokibart may be effective in treating refractory OME associated with type 2 inflammation, even in patients who do not fulfill the diagnostic criteria for EOM. These findings highlight the potential of anti-IL-4Rα biologics as a novel therapeutic option for middle ear diseases driven by type 2 inflammation.
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(This article belongs to the Special Issue Etiology, Diagnosis, and Treatment of Congenital Hearing Loss)
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Open AccessCase Report
Unilateral Vocal Cord Paresis Caused by Diffuse Idiopathic Skeletal Hyperostosis: Case Report and Literature Review
by
Emily Kwon, Michael Moentmann, Hugo Bueno, Wayne Hsueh and Rachel Kaye
J. Otorhinolaryngol. Hear. Balance Med. 2025, 6(2), 20; https://doi.org/10.3390/ohbm6020020 - 6 Nov 2025
Abstract
Background/Objectives: Diffuse idiopathic skeletal hyperostosis (DISH) is characterized by calcification and ossification of ligaments and tendons, primarily affecting the spine. While often asymptomatic, DISH in the cervical spine can cause dysphagia and, more rarely, vocal cord paralysis due to compression of the recurrent
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Background/Objectives: Diffuse idiopathic skeletal hyperostosis (DISH) is characterized by calcification and ossification of ligaments and tendons, primarily affecting the spine. While often asymptomatic, DISH in the cervical spine can cause dysphagia and, more rarely, vocal cord paralysis due to compression of the recurrent laryngeal nerve at the cricothyroid joint. Here, we report cases of unilateral vocal fold paresis in two patients with DISH. Case Presentation: Our first case is an 80-year-old male presented with two months of dysphonia. Strobovideolaryngoscopy found left vocal fold paresis with glottic insufficiency. Computed Tomography (CT) imaging showed DISH with large anteriorly projecting osteophytes in the cervical spine causing rightward deviation of the laryngeal structures and compressing the cricothyroid joint. Second, a 30-year-old female with Turner Syndrome and subglottic stenosis who developed progressively worsening dysphonia over 6 months, characterized by diminished voice projection and clarity. Strobovideolaryngoscopy revealed a mild-to-moderate right vocal fold paresis. CT of the neck demonstrated multiple right-sided osteophytes projecting into the right tracheoesophageal groove, along the course of the right recurrent laryngeal nerve, in the absence of significant disc degeneration. Discussion and Conclusions: On our review of the literature, no other similar instances of unilateral vocal fold paresis were found. We present these cases to emphasize the need for early recognition and treatment to prevent symptom progression of DISH.
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(This article belongs to the Section Laryngology and Rhinology)
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Open AccessArticle
Integrating Quality of Life Metrics into Head and Neck Cancer Treatment Planning: Evidence and Implications
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Paula Luiza Bejenaru, Gloria Simona Berteșteanu, Raluca Grigore, Ruxandra Ioana Nedelcu-Stancalie, Teodora Elena Schipor-Diaconu, Simona Andreea Rujan, Bianca Petra Taher, Bogdan Popescu, Irina Doinița Popescu, Alexandru Nicolaescu, Anca Ionela Cîrstea, Catrinel Beatrice Simion-Antonie and Șerban Gabriel Vifor Berteșteanu
J. Otorhinolaryngol. Hear. Balance Med. 2025, 6(2), 19; https://doi.org/10.3390/ohbm6020019 - 24 Oct 2025
Abstract
Background/Objectives: Head and neck cancers significantly affect patients’ functional and psychosocial well-being. Multidisciplinary tumor boards have a central role in optimizing treatment strategies, but the relationship between tumor characteristics, comorbidities, and quality of life (QoL) remains insufficiently explored. Methods: We conducted a
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Background/Objectives: Head and neck cancers significantly affect patients’ functional and psychosocial well-being. Multidisciplinary tumor boards have a central role in optimizing treatment strategies, but the relationship between tumor characteristics, comorbidities, and quality of life (QoL) remains insufficiently explored. Methods: We conducted a retrospective study of 94 patients with head and neck cancers evaluated by the oncology committee of Coltea Clinical Hospital in 2024. QoL was assessed post-surgery using the EORTC QLQ-C30 and H&N35 questionnaires. Descriptive statistics, non-parametric tests, correlations, and multivariate regression analyses were performed to examine associations between clinical variables and QoL outcomes. Results: The cohort comprised 82 men (87.2%) and 12 women (12.8%), with a mean age of 61.5 ± 9.8 years. The most common tumor site was the larynx (43.6%). Global QoL was low (mean = 42.3, SD = 11.7), and fatigue scores were high (mean = 61.5, SD = 13.5). All EORTC domains showed non-normal distributions (Shapiro–Wilk, p < 0.05). Kruskal–Wallis analysis revealed significantly lower QoL scores in patients with metastatic adenopathy with aunknown primary (p = 0.03). Spearman’s correlation indicated a moderate negative association between Charlson Comorbidity Index and QoL (r = −0.38, p = 0.01). Multivariate regression confirmed comorbidities (β = −2.5, p = 0.02) and tumor type (metastatic adenopathy, β = −8.0, p = 0.04) as independent predictors of reduced QoL. Conclusions: Patients with advanced disease and higher comorbidity burden experience significantly poorer QoL after head and neck cancer surgery. Tumor board decisions facilitate individualized treatment planning; however, systematic integration of QoL metrics is essential to optimize both oncological and functional outcomes.
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(This article belongs to the Section Head and Neck Surgery)
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Open AccessSystematic Review
A Systematic Review of Hearing Loss and Its Associated Factors Among Workers in the Metal Industry
by
France Selepeng Raphela
J. Otorhinolaryngol. Hear. Balance Med. 2025, 6(2), 18; https://doi.org/10.3390/ohbm6020018 - 1 Oct 2025
Abstract
Background/Objectives: Hearing loss is a disorder that develops because of being exposed to high noise levels affecting the quality of life among affected individuals. A review of the literature was conducted to explore the prevalence of hearing loss and its associated factors among
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Background/Objectives: Hearing loss is a disorder that develops because of being exposed to high noise levels affecting the quality of life among affected individuals. A review of the literature was conducted to explore the prevalence of hearing loss and its associated factors among workers in the metal industry. Methods: The literature search was conducted on ScienceDirect, Google Scholar, Pub Med, ResearchGate and African Journals Online databases to identify articles according to the Preferred Reporting Items for Systematic Reviews and Meta analyses (PRISMA) guidelines. The studies published in scientific journals between January 2014 and December 2024 describing hearing loss and its associated factors among workers in the metal industry were considered for inclusion in the review. The articles were screened by the author. The Critical Appraisal Skills Programme (CASP) quality assessment tool with modified checklist questions was used to evaluate the quality of studies. Results: Following the literature search and using the relevant inclusion criteria, a total of 127 articles were identified, and 8 articles with a total of 2605 participants were included in the review. The sample sizes ranged from 93 to 606. The participants’ age ranged from 19 to 65 years. A review of studies showed varying prevalence of hearing loss ranging from 13.8% to 59%. Furthermore, the studies have found working experience, advanced age, cigarette smoking, tinnitus, working in areas of high noise levels and not using hearing protective devices to be associated with a risk of developing hearing loss. Conclusions: The review found that workers in the metal industry are at risk of developing hearing loss and, therefore, implementation of control measures to prevent the occurrence of hearing loss is necessary.
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(This article belongs to the Section Otology and Neurotology)
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Open AccessArticle
Lip Reconstruction Using Buccal Fat Pad Free Graft: A Clinical Series
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Jameel Ghantous, Eran Regev, Kareem Abu-Libdeh, Ayalon Hadar, Chanan Shaul and Rizan Nashef
J. Otorhinolaryngol. Hear. Balance Med. 2025, 6(2), 17; https://doi.org/10.3390/ohbm6020017 - 29 Sep 2025
Abstract
Background/Objectives: Maxillofacial volumetric deficits are often treated using structural fat grafting with autologous free fat grafts. The buccal fat pad (BFP) is commonly used as a pedicled flap for limited oral cavity applications. This study explores its use as a free graft
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Background/Objectives: Maxillofacial volumetric deficits are often treated using structural fat grafting with autologous free fat grafts. The buccal fat pad (BFP) is commonly used as a pedicled flap for limited oral cavity applications. This study explores its use as a free graft for reconstructing deformities in the upper and lower lips caused by trauma or tumor resections. Methods: Five patients underwent soft tissue defect reconstruction using a free fat graft from the BFP, following standard surgical procedures. Techniques for harvesting, transferring, and evaluating aesthetic and functional outcomes up to three months post-surgery are detailed, with long-term follow-up extending to an average of 20 months (range 12–24 months). Results: Initial post-operative assessments showed lip asymmetry due to edema and excessive graft volume. Partial necrosis was observed within 1–2 weeks, typical of tissue healing. By 4–5 weeks, mucosal revascularization occurred, with desired lip volume and functionality achieved between 8–12 weeks. Long-term follow-up averaging 20 months demonstrated excellent graft stability with no volume regression beyond the vermilion border in all patients. Conclusions: The BFP as a free graft offers advantages such as high survival rates and easy harvesting. It effectively restores lip function, volume, and aesthetics. Challenges include graft manipulation, retention, potential fibrosis, and volume unpredictability. Future refinements in technique and follow-up are necessary to overcome these issues, enhancing the reliability of BFP for lip reconstruction.
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(This article belongs to the Section Head and Neck Surgery)
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Open AccessCase Report
Recurrent Conductive Hearing Loss and Malleus Fixation After Stapes Surgery
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Pierfrancesco Bettini, Edoardo Maria Valerio, Alessandro Borrelli, Alberto Caranti, Michela Borin, Nicola Malagutti, Francesco Stomeo, Stefano Pelucchi and Luca Cerritelli
J. Otorhinolaryngol. Hear. Balance Med. 2025, 6(2), 16; https://doi.org/10.3390/ohbm6020016 - 25 Sep 2025
Abstract
Background/Objectives: Conductive hearing loss (CHL) recurrence or persistence after stapes surgery is often due to prosthesis displacement or malfunction, with malleus fixation being a less common cause. While persistent CHL linked to malleus fixation can be managed with appropriate diagnosis and surgical
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Background/Objectives: Conductive hearing loss (CHL) recurrence or persistence after stapes surgery is often due to prosthesis displacement or malfunction, with malleus fixation being a less common cause. While persistent CHL linked to malleus fixation can be managed with appropriate diagnosis and surgical intervention, recurrent CHL cases remain poorly documented. This report describes a rare case of recurrent CHL due to malleus neck fixation, likely secondary to surgical trauma. Case Presentation: A 49-year-old woman underwent bilateral stapedectomy. CHL worsened after two years. CT showed right incus erosion and a left bony bridge. Revision surgery corrected the right side. Left tympanotomy revealed malleus fixation from a prior atticotomy. Removing the bony bridge restored ossicular mobility and hearing, stable at 6 and 12 months. Discussion: Malleus fixation after stapedectomy is rare and often related to congenital anomalies, chronic otitis media, tympanosclerosis, or surgical trauma. Bone dust or fragments from surgery may promote new bone formation, causing delayed fixation. Ossicular fixation can develop postoperatively and may be missed during primary surgery. High-resolution CT aids in diagnosis, especially in revision cases, while intraoperative palpation is key to detecting subtle abnormalities. Treatment options include ossicular mobilization, prosthesis revision, or chain reconstruction, tailored to the fixation’s location and severity. Conclusions: Surgical trauma should be considered a potential cause of recurrent CHL post-stapedectomy. Thorough removal of bone debris through aspiration and irrigation during surgery is essential to minimize this risk and optimize long-term hearing outcomes.
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(This article belongs to the Section Otology and Neurotology)
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Open AccessCase Report
Acute Bilateral Vestibular Neuropathy During Myocardial Infarction: A Case Report
by
Francesco Comacchio, Elia Biancoli, Elisabetta Poletto, Barbara Bellemo and Paola Magnavita
J. Otorhinolaryngol. Hear. Balance Med. 2025, 6(2), 15; https://doi.org/10.3390/ohbm6020015 - 12 Sep 2025
Abstract
Background: The posterior labyrinth is particularly vulnerable to ischemic injury. Vertigo can occasionally be the only presenting symptom of acute myocardial infarction (AMI). Acute Bilateral Vestibular Neuropathy (ABVN) is an extremely rare condition, with only three cases previously reported in the literature. Its
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Background: The posterior labyrinth is particularly vulnerable to ischemic injury. Vertigo can occasionally be the only presenting symptom of acute myocardial infarction (AMI). Acute Bilateral Vestibular Neuropathy (ABVN) is an extremely rare condition, with only three cases previously reported in the literature. Its exact pathophysiological mechanisms remain unclear. Case Presentation: We present the case of a 76-year-old male who presented to the emergency department (ED) with vertigo and severe postural unsteadiness. Subsequently, a silent AMI was diagnosed, prompting cardiac stenting. Vestibular function assessments over the following eight months confirmed the diagnosis of ABVN. A cycle of vestibular rehabilitation yielded limited objective benefit, although the patient reported subjective improvement as measured by the Dizziness Handicap Inventory (DHI). Discussion and Conclusions: This case suggests a potential association between peripheral vestibular dysfunction and acute hemodynamic impairment due to myocardial infarction. Notably, it represents the first reported case of ABVN following a silent AMI, presenting solely with vestibular symptoms.
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(This article belongs to the Section Otology and Neurotology)
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Open AccessReview
Review of Patient Outcomes Following Nasal Fracture Reduction Under Local Anaesthesia Versus General Anaesthesia
by
Juliet Laycock and Philippe Bowles
J. Otorhinolaryngol. Hear. Balance Med. 2025, 6(2), 14; https://doi.org/10.3390/ohbm6020014 - 29 Aug 2025
Abstract
The aim of this study article is to better understand patient outcomes following simple nasal fracture realignment, comparing outcomes when performed under LA versus GA. A systematic search of the evidence base is conducted. Data extraction and documentation are performed in keeping with
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The aim of this study article is to better understand patient outcomes following simple nasal fracture realignment, comparing outcomes when performed under LA versus GA. A systematic search of the evidence base is conducted. Data extraction and documentation are performed in keeping with PRISMA guidance. Critical appraisal tools are applied to aid quality assessment and assessment of bias. Twelve articles were selected for inclusion in this review, accumulating 2405 participants in total. No significant difference in patient outcomes between the LA and GA groups was observed. There was high variation in article quality, with some assessed as having a high risk of bias. Although some methodological limitations and outcome heterogeneity between studies hamper our ability for direct comparison, it seems likely that patient outcomes after nasal fracture correction under LA versus GA are comparable. Further large-scale studies with an agreed set of outcome measures are required to understand this relationship more fully.
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(This article belongs to the Section Laryngology and Rhinology)
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Open AccessCase Report
Diagnosis of Leishmania Following Septoplasty: A Case Report
by
Agustina Arbía, Andrés Navarro, Gabriela Bosco, Claudia M. Morante and Guillermo Plaza
J. Otorhinolaryngol. Hear. Balance Med. 2025, 6(2), 13; https://doi.org/10.3390/ohbm6020013 - 25 Aug 2025
Abstract
Background/Objectives: Leishmania spp. are protozoan parasites transmitted by female sandflies (Phlebotomus or Lutzomyia). Clinical manifestations depend on species and host immunity. While cutaneous and visceral forms prevail, mucocutaneous involvement—particularly isolated nasal septum leishmaniasis—is rare and frequently misdiagnosed as an inflammatory,
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Background/Objectives: Leishmania spp. are protozoan parasites transmitted by female sandflies (Phlebotomus or Lutzomyia). Clinical manifestations depend on species and host immunity. While cutaneous and visceral forms prevail, mucocutaneous involvement—particularly isolated nasal septum leishmaniasis—is rare and frequently misdiagnosed as an inflammatory, infectious, or neoplastic condition. Risk factors associated with mucocutaneous leishmaniasis include systemic or local immunodeficiency, prior renal transplantation, treatment with chronic inhaled steroids, residence in endemic areas or travel to such regions, and previous Leishmania infections. Immunosuppressed patients are at higher risk for atypical presentations and delayed diagnosis, which can result in extensive tissue destruction. Early clinical suspicion, histopathological confirmation, and prompt therapy are essential to prevent permanent mucosal damage. Therefore, a multidisciplinary approach is needed for adequate evaluation and effective treatment. Methods: A 67-year-old man with rheumatoid arthritis on methotrexate reported a two-year history of right-sided nasal obstruction and ulceration that failed to respond to antibiotics. He did not present systemic symptoms. Results: Facial CT revealed a septal deviation; the patient underwent septoplasty, and biopsy confirmed Leishmania amastigotes. Serology (rK39 immunochromatographic test) was positive. He was treated with liposomal amphotericin B at 4 mg/kg/day for five days, followed by miltefosine at 100 mg/day orally for 14 days. At an eight-week follow-up, the nasal mucosa was fully healed, obstruction was resolved, and there was no evidence of recurrence. Conclusions: Although nasal septum leishmaniasis is uncommon, it should be considered in the differential diagnosis of chronic nasal lesions, especially in immunocompromised patients or those from endemic regions. Definitive diagnosis requires biopsy with histological or molecular confirmation. Combined liposomal amphotericin B and miltefosine therapy yields high cure rates and prevents mucosal destruction. Early recognition is critical to avoid diagnostic delays and long-term sequelae.
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(This article belongs to the Section Laryngology and Rhinology)
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Open AccessCorrection
Correction: Rajamani et al. Comparison of Halmágyi–Curthoys Head Impulse (Thrust) Test with Romberg’s Test in Detection of Vestibular Hypofunctioning in Vertigo Patients. J. Otorhinolaryngol. Hear. Balance Med. 2024, 5, 4
by
Santhosh Kumar Rajamani, Radha Srinivasan Iyer and Anusha Venkatraman
J. Otorhinolaryngol. Hear. Balance Med. 2025, 6(2), 12; https://doi.org/10.3390/ohbm6020012 - 21 Aug 2025
Abstract
In the published publication, the affiliation of the second author is “SEC Centre for Independent Living, Naigaon, Pune 410405, India” [...]
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(This article belongs to the Section Otology and Neurotology)
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Open AccessReview
Enhanced Evaluation of Bioresorbable Steroid-Releasing Stents and Corticosteroid-Infused Nasal Dressings in Postoperative Management of Chronic Rhinosinusitis
by
Morad Faoury
J. Otorhinolaryngol. Hear. Balance Med. 2025, 6(2), 11; https://doi.org/10.3390/ohbm6020011 - 7 Jul 2025
Cited by 1
Abstract
Chronic rhinosinusitis (CRS) is a prevalent inflammatory condition of the nasal and paranasal mucosa that significantly impacts the quality of life. Postoperative inflammation and polyp recurrence remain common despite advances in endoscopic sinus surgery (ESS), prompting interest in localized corticosteroid delivery systems. This
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Chronic rhinosinusitis (CRS) is a prevalent inflammatory condition of the nasal and paranasal mucosa that significantly impacts the quality of life. Postoperative inflammation and polyp recurrence remain common despite advances in endoscopic sinus surgery (ESS), prompting interest in localized corticosteroid delivery systems. This review analyzes bioresorbable steroid-releasing implants and corticosteroid-impregnated nasal dressings, focusing on their pharmacologic mechanisms, safety, and clinical outcomes. A synthesis of findings from randomized trials and observational studies was performed, with emphasis on devices such as Propel™, NasoPore, Merocel, SinuBand FP, and gel-based dressings. The Propel implant demonstrated robust evidence for reducing adhesions and inflammation with negligible systemic absorption. NasoPore and Merocel provided structural support and localized steroid delivery but lacked controlled-release kinetics. Gel-based dressings and SinuBand FP offered anatomic adaptability, with limited systemic effects. Some methods showed systemic steroid exposure in cortisol monitoring. Corticosteroid-releasing devices enhance ESS outcomes through localized therapy. While Propel is the most validated, other devices remain viable alternatives in specific clinical contexts. Comprehensive safety monitoring and standardized trials are essential to optimize their integration into postoperative care.
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(This article belongs to the Section Laryngology and Rhinology)
Open AccessCase Report
Interdigitating Dendritic Cell Sarcoma: Case Report and Review of Literature
by
Gábor Dénes Répássy, Judit Halász, Katalin Dezső, András Molnár, Stefani Maihoub, Fanni Keserű, Dóra Hargas and László Tamás
J. Otorhinolaryngol. Hear. Balance Med. 2025, 6(2), 10; https://doi.org/10.3390/ohbm6020010 - 30 Jun 2025
Abstract
Background: Interdigitating dendritic cell sarcoma (IDCS) is a very rare haematologic malignant tumour that arises from antigen-presenting cells. While it primarily affects the lymph nodes, extranodal manifestations have been observed, and there is a slight male predominance. Due to its rarity, diagnosing IDCS
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Background: Interdigitating dendritic cell sarcoma (IDCS) is a very rare haematologic malignant tumour that arises from antigen-presenting cells. While it primarily affects the lymph nodes, extranodal manifestations have been observed, and there is a slight male predominance. Due to its rarity, diagnosing IDCS can be challenging, as illustrated in our case report of a 61-year-old woman. Methods: In this case presentation, the oncological management of a patient suspected of having malignant melanoma metastasis in the neck lymph nodes is discussed. This includes otorhinolaryngological examinations, fine needle aspiration biopsy, PET CT imaging, and histological analysis with immunohistochemistry. Results: The patient’s medical history included the excision of a pigmented lesion from the left ala of her nose, which was diagnosed as malignant melanoma. After surgical treatment, she experienced a tumour-free period of one year; however, during a follow-up ultrasonography three pathological lymph nodes were detected on the left side of her neck. Initially, a nodal metastasis of melanoma was suspected. Yet, fine needle aspiration cytology revealed myofibroblastic tumour invasion, and a re-biopsy showed no signs of malignancy. To further investigate, PET-CT scans were conducted, and a modified radical neck dissection was performed based on the findings. The histological analysis of the lymph nodes revealed an IDCS, a second independent tumour distinct from the initially diagnosed malignant melanoma, originating from the submandibular, upper jugular, and mid-jugular lymph nodes. Conclusions: This case highlights the diagnostic difficulties associated with IDCS. Initially, the clinical suspicion of malignant melanoma was considered, necessitating further examinations and a multidisciplinary approach to reach a final diagnosis and provide the patient with appropriate treatment.
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(This article belongs to the Section Head and Neck Surgery)
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Open AccessReview
Recent Advances in Cochlear Implantation
by
Eric C. Shawkey, J. Dixon Johns, Armine Kocharyan, Breanna Corle, Emma Woolf, Abbie Parks and Selena E. Briggs
J. Otorhinolaryngol. Hear. Balance Med. 2025, 6(1), 9; https://doi.org/10.3390/ohbm6010009 - 31 May 2025
Abstract
Since the inception of cochlear implantation, the field of technological advancements associated with cochlear implantation has continued to evolve, providing patients with sensorineural hearing loss access with greater sound appreciation capabilities. These advances include evolving cochlear implantation criteria, including increased residual hearing and
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Since the inception of cochlear implantation, the field of technological advancements associated with cochlear implantation has continued to evolve, providing patients with sensorineural hearing loss access with greater sound appreciation capabilities. These advances include evolving cochlear implantation criteria, including increased residual hearing and single-sided deafness; changes in electrode design; options for hearing preservation; and advancements in connectivity, to name a few. This article reviews the various aspects of the recent advancements in relation to cochlear implantation.
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(This article belongs to the Section Otology and Neurotology)
Open AccessArticle
Patient Experiences with Hearing Aids in South African Public Healthcare
by
Katijah Khoza-Shangase and Theresa-Joy Munyembate
J. Otorhinolaryngol. Hear. Balance Med. 2025, 6(1), 8; https://doi.org/10.3390/ohbm6010008 - 28 May 2025
Cited by 1
Abstract
Background/Objectives: 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
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Background/Objectives: 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. 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.
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(This article belongs to the Section Otology and Neurotology)
Open AccessArticle
Comparing the Long-Term Stability of Titanium Clip Partial Prostheses with Other Titanium Partial and Total Ossicular Reconstruction Prostheses
by
Jasmine Leahy, Alicia Yang, Kevin Wong, Enrique R. Perez, George B. Wanna and Maura K. Cosetti
J. Otorhinolaryngol. Hear. Balance Med. 2025, 6(1), 7; https://doi.org/10.3390/ohbm6010007 - 1 Apr 2025
Abstract
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
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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.
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(This article belongs to the Section Otology and Neurotology)
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Open AccessSystematic Review
Induction Chemotherapy for Sinonasal Squamous Cell Carcinoma: A Systematic Review of Kaplan–Meier Individual Patient Data
by
Ruth S. Goh and Christopher Goh Hood Keng
J. Otorhinolaryngol. Hear. Balance Med. 2025, 6(1), 6; https://doi.org/10.3390/ohbm6010006 - 17 Mar 2025
Abstract
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
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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.
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(This article belongs to the Section Head and Neck Surgery)
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