2026-03-24
Swathi Ramasamy, A Senthil Vadivu, S Raghu Nandhan, Mohan Kameswaran
BACKGROUND : Otosclerosis is a hereditary disorder that causes progressive hearing loss in the adult population. Owing to its progressive nature, a multimodal treatment approach is often required. Management options were offered to patients following comprehensive audiological and radiological evaluation, incorporating the Merkus algorithm in clinical decision-making. This study aims to compare the audiological and speech-related outcomes of cochlear implantation (CI) and stapedotomy with hearing aid use in patients with bilateral advanced otosclerosis. METHODS : This cohort study included 38 patients divided into 2 groups: Group A consisted of patients who underwent CI (n=15), and Group B comprised patients who underwent stapedotomy followed by hearing aid use (n=23). Outcomes were compared using paired t-tests both within and between the groups. RESULTS : Both groups demonstrated significant improvement in hearing and speech outcomes post-intervention. Speech-related outcomes were superior in Group A (cochlear implant recipients) with a statistically significant P value (<.005), whereas hearing-related outcomes were comparable between the 2 groups. Vertigo and tinnitus symptoms showed greater improvement in Group A compared to the Group B cohort. CONCLUSION : In cases of progressive hearing loss, early and appropriate intervention is crucial to preserve residual hearing. Cochlear implantation is effective in improving both audiological and speech outcomes, and it also alleviates symptoms such as tinnitus and vertigo. Conversely, stapedotomy combined with hearing aid use remains a cost-effective management option, providing comparable audiological outcomes.
2026-02-27
Mustafa Karabulut, Wolfgang Viechtbauer, Lisa Van Stiphout, Merel Kimman, Vincent Van Rompaey, Alfarghal Mohamad, Nils Guinand, Angélica Perez Fornos, Raymond van de Berg
BACKGROUND : To compare symptom burden, functional impact, emotional well-being, and health-related quality of life (HRQoL) between patients with chronic unilateral vestibular hypofunction (UVH) and bilateral vestibulopathy (BVP). METHODS : This cross-sectional study included 100 patients with chronic UVH and 148 patients with BVP from a tertiary referral center. Symptom burden and functional impact were assessed using the Bilateral Vestibulopathy Questionnaire, Dizziness Handicap Inventory, and Oscillopsia Severity Questionnaire (OSQ). Emotional well-being was evaluated with the Hospital Anxiety and Depression Scale, and HRQoL with the EuroQol 5-Dimension 5-Level and Health Utility Index Mark 3. Total scores were compared across groups. Standardized mean differences (SMDs) were calculated to quantify the differences across all patient-reported outcome measures. RESULTS : Bilateral vestibulopathy patients reported significantly greater symptom burden and functional limitations than chronic UVH patients (P < .05). No significant group differences were found in emotional well-being or generic HRQoL. Both patient groups showed significantly worse outcomes than healthy controls across most domains (P < .05). Standardized mean difference analysis showed that when effect sizes between groups were large or moderate, the differences were statistically significant. Conversely, when effect sizes were very low or small, there were no statistically significant differences (except for the OSQ, which remained significant despite a small effect size). CONCLUSION : Chronic UVH and BVP are associated with significantly reduced QoL. Bilateral vestibulopathy patients report a greater symptom burden and functional limitations compared to patients with chronic UVH. These findings demonstrate the need for tailored assessments and targeted rehabilitation strategies for vestibular patients.
2026-02-24
Gul Dogan, Olcay Boyacioglu, Murat Dogan, Mustafa Sahin, Seda Orenay Boyacioglu
BACKGROUND : Brain-derived neurotrophic factor (BDNF) plays a crucial role in the initial formation of the central auditory system and the sensory epithelium within the inner ear. Mounting evidence indicates that BDNF administration promotes microRNA (miRNA) production in neurons, despite the typical suppressive effect of miRNAs on BDNF expression. Therefore, miRNAs regulating BDNF expression may impact the auditory system and serve as potential gene polymorphisms affecting human hearing ability. This study aimed to investigate the contribution of miRNA polymorphisms affecting BDNF to tinnitus pathophysiology. METHODS : A total of 70 tinnitus patients aged 18-55 years and 70 age-matched healthy controls without tinnitus or systemic illnesses were recruited from an Ear, Nose & Throat clinic. Tinnitus assessment included tympanometric, audiological, and psychoacoustic evaluations. Seven miRNA single-nucleotide polymorphisms (miR-30e rs112439044, rs10489167, miR-206 rs16882131, miR-30a rs1491500379, miR-26b rs565919718, rs188612260, and miR-124 rs5315564) regulating the BDNF gene were analyzed using the Fluidigm platform. RESULTS : Significant differences in genotype distributions were observed for miR-30e rs112439044, miR-124 rs5315564, and miR-206 rs16882131 between the tinnitus patients and controls (P < .05). Genetic inheritance-model analysis revealed that miR-30e rs112439044 was associated with 0.20- and 0.83-fold risks under dominant and additive models, respectively. The miR-124 rs5315564 showed a 1.65-fold risk in the dominant model, while miR-206 rs16882131 exhibited an 11.1-fold protective effect under the dominant model and an 8.57-fold risk under the additive model. CONCLUSION : The findings suggest that polymorphisms in miR-206, miR-30e, and miR-124 may influence the auditory pathway by modulating BDNF gene expression, potentially contributing to the pathophysiology of chronic tinnitus.
2026-02-23
Jasmine Van de Kerkhof, Ellen Vermaete, Robert Hermans, Elke Loos, Nicolas Verhaert
BACKGROUND :Intracochlear and intravestibular lipomas are rare benign lesions that may clinically and radiologically mimic retrocochlear pathologies such as vestibular schwannomas. They typically present with progressive sensorineural hearing loss, tinnitus, or dizziness. Due to their rarity, optimal management strategies, particularly in pediatric patients, remain challenging and require individualized decision-making. METHODS :We report the case of an 8-year-old girl who presented with progressive right-sided sensorineural hearing loss. Magnetic resonance imaging (MRI) revealed an intravestibular lipoma extending into the cochlea. Considering the patient’s young age and the potential for tumor growth, surgical excision was performed via a translabyrinthine approach. Simultaneous cochlear implantation was undertaken to facilitate auditory rehabilitation. Histopathological analysis was conducted to confirm the diagnosis. RESULTS :Histopathological examination confirmed the lesion as a lipoma. The postoperative course was uneventful. The cochlear implant was successfully activated and provided effective hearing restoration. CONCLUSION :Intravestibular lipomas are rare entities that require careful radiological evaluation to ensure accurate diagnosis and differentiation from other retrocochlear lesions. Management should be individualized, particularly in pediatric patients, balancing surgical risks against the benefits of tumor removal and hearing rehabilitation. Simultaneous cochlear implantation may represent a viable strategy for auditory restoration in selected cases