To investigate the spatial gradient of intraoperative impedance across the cochlear electrode array in pediatric cochlear implant recipients and assess its potential as a physiological indicator for the electrode-neural interface. A prospective observational study involving 56 pediatric patients underwent cochlear implantation with Cochlear Nucleus devices. Intraoperative polarized impedance and electrically evoked compound action potential (ECAP) threshold were recorded across all 1232 electrodes using AutoNRT software. Eight electrodes with open- or short-circuit were excluded, leaving 1,224 for analysis. Impedance values were categorized by cochlear region (basal, middle, apical), and electrodes with elevated impedance (10-20 kΩ) were analyzed for regional distribution and clinical relevance. Data were analyzed for spatial patterns and correlation with the ECAP threshold profiles. A consistent basal-to-apical increase in impedance was observed (7.7 ± 1.9, 9.2 ± 1.4, 10.8 ± 1.5 kΩ; p<0.001). Impedance and ECAP threshold were weakly correlated (ρ = -0.20, p<0.001; β = -1.26, p<0.001), with a positive association in the apical region (ρ = 0.12, p = 0.048). Electrodes with higher impedance (10-20 kΩ) were less likely to show elevated or absent TNRT (OR = 0.175, p = 0.02). The impedance gradient persisted across age groups and was significantly correlated with ECAP threshold patterns. Intraoperative impedance monitoring reveals a strong and physiologically consistent gradient, with higher values in apical electrodes. This gradient reflects anatomical and tissue interface variations, which may offer a valuable physiological indicator for intraoperative electrode positioning and neural interface integrity.

the hearing of a sound that has not been produced by any external or internal source, is a rather heterogeneous hearing disorder. Hearing loss has been shown to be the main risk factor for tinnitus while emotional disorders are risk factors for developing intrusive or bothersome tinnitus. Moreover, aging has also been identified as another risk factor. The aim of this paper was to analyse the correlation between hearing loss, age and tinnitus severity in a cohort of 610 tinnitus sufferers. Age, audiometric (hearing condition) and tinnitus (time duration and severity) data were assessed and analysed for all subjects just after recruiting (baseline). Furthermore, the average hearing loss (HL) curves of the participants for age groups were compared to these with the corresponding Age Related HL (ARHL). For most of the age groups, the measured HL curves exceeded in 10-20 dB those of the ARHL. The average age of tinnitus onset (age minus tinnitus duration) was found to be 44-46 years in both men and women. Weak correlation between audiometric feature and tinnitus distress was observed. Hearing loss has been shown to be a clear risk factor for triggering tinnitus (86% of participants were hearing impaired). In this cohort, average measures of hearing loss showed, at most, weak associations with tinnitus-related distress, suggesting that non-audiological factors may play a predominant role.

Objectives The causal association between presbycusis and changes in cerebral cortex structure was evaluated through Mendelian randomization (MR).Methods Presbycusis data, serving as the exposure trait, was analyzed using data from the ninth release of the FinnGen biobank. Genome-wide association study (GWAS) datasets for cortical surface area (SA) and thickness (TH) were sourced from the ENIGMA Consortium, whereas cortical volume (V) GWAS data came from the UK Biobank. The inverse-variance weighted (IVW) approach was adopted as the principal analytical method. To ensure robustness, sensitivity analyses were systematically implemented to evaluate potential heterogeneity and pleiotropic effects.Results Following rigorous filtering through IVW and sensitivity analyses, eleven robust MR associations emerged, offering preliminary evidence for a causal link between presbycusis and cortical architecture, including frontal pole SA with global weighted (GW) (β=1.858 mm2, P=0.004) and without GW (β=1.778 mm2, P=0.012), pars orbitalis SA with GW (β=2.717 mm2, P=0.042), transverse temporal SA with GW (β=2.349 mm2, P=0.033), pars orbitalis TH with GW (β=-0.009 mm, P=0.008) and without GW (β=-0.011 mm, P=0.008), rostral middle frontal TH with GW (β=-0.005 mm, P=0.020) and without GW (β=-0.007 mm, P=0.012), precuneus TH without GW (β=-0.006 mm, P=0.049), left hippocampus V (β=-12.296 mm3, P=0.033) and right hippocampus V (β=-11.991 mm3, P=0.049).Conclusion From a genetic standpoint, our findings indicate region-specific neuroanatomical modifications in presbycusis patients, supporting the notion of neurodegenerative or adaptive alterations in brain structure from a genetic perspective.

BackgroundThe masseter vestibular evoked myogenic potential (mVEMP) is a novel test that has been explored in various brainstem lesions. However, it has not yet been studied in individuals with definite Meniere’s disease. Therefore, the current study aimed to investigate mVEMP responses in individuals with definite Meniere’s disease and compare them with those of a reference group.MethodThe present study investigated narrowband Claus Elberling chirp-evoked mVEMP responses in 22 ears diagnosed with definite Meniere’s disease and 22 ears with hearing sensitivity ≤ 15 dB HL across three stimulation frequencies.ResultsmVEMP responses in participants with definite Meniere’s disease varied from normal to reduced or absent across three octave frequencies. These individuals exhibited significantly reduced P11-N21 peak-to-peak amplitudes compared to those in the reference group. Although a frequency tuning shift toward 1000 Hz was observed, the inter-frequency amplitude ratio of mVEMP was not found to be a sensitive parameter for detecting individuals with definite Meniere’s disease. Additionally, no association was found between the degree of hearing loss or the duration of the disease and mVEMP responses. Conclusion Participants with definite Meniere’s disease exhibited reduced P11-N21 amplitude and a tuning shift toward 1000 Hz. These findings suggest the involvement of the vestibulo-trigeminal reflex pathway in this condition.

[This corrects the article DOI: 10.26599/JOTO.2025.9540018.].

ObjectiveCritically appraise the current state of alternate temporal bone training techniques (virtual reality (VR) simulation, 3D-printed models, and mental practice (MP)) compared to traditional and cadaver methods. Databases Reviewed: PubMed, Cochrane, Web of Science. Methods Search terms utilized “temporal bone training”, “temporal bone surgical modalities”, and “training modalities temporal bone surgery” with “3D”, “rapid prototyp*”, “stereolithography”, “additive manufact*”, “plaster”, “VR”, “virtual reality”, “animal model”, “animal temporal bone”, and “synthetic” with “AND” for all literature. Exclusion criteria: non-ENT, non-English, and did not compare against alternative/traditional methods. Results10 studies were included with 322 participants (83.9% ENT residents and 16.1% medical students). Costs include the FDM printer ($300), materials ($5/3D model), and <$5,000 for freeware simulator hardware. The Welling scale was used in 50% of studies. Alternate methods produced comparable or improved assessment scores to traditional and cadaver methods. Injuries were reported in three VR studies, with two reported significantly lower injury scores in the intervention groups. Time to completion was not significantly different in four VR studies, except for one finding that the time to visualize the incus was significantly lower in the intervention group. Performance after MP was not statistically different.ConclusionMore data are needed to assess whether the alternate methods are comparable to cadaveric dissection in temporal bone training. 3D models and VR simulation demonstrate promising potential for novel trainees to acquire the basic skills and produce performance comparable to or significantly better than traditional methods of lectures, textbooks, CT images, and operative videos.

Objective To develop and evaluate an automated system for digitizing audiograms, classifying hearing loss levels, and comparing their performance with traditional methods and otolaryngologists' interpretations.Designed and Methods We conducted a retrospective diagnostic study using 1,959 audiogram images from patients aged 7 years and older at the Faculty of Medicine, Vajira Hospital, Navamindradhiraj University. We employed an object detection approach to digitize audiograms and developed multiple machine learning models to classify six hearing loss levels. The dataset was split into 70% training (1,407 images) and 30% testing (352 images) sets. We compared our model's performance with classifications based on manually extracted audiogram values and otolaryngologists' interpretations.Result Our object detection-based model achieved an F1-score of 94.72% in classifying hearing loss levels, comparable to the 96.43% F1-score obtained using manually extracted values. The Light Gradient Boosting Machine (LGBM) model is used as the classifier for the manually extracted data, which achieved top performance with 94.72% accuracy, 94.72% f1-score, 94.72 recall, and 94.72 precision. In object detection based model, The Random Forest Classifier (RFC) model showed the highest 96.43% accuracy in predicting hearing loss level, with a F1-score of 96.43%, recall of 96.43%, and precision of 96.45%.Conclusion Our proposed automated approach for audiogram digitization and hearing loss classification performs comparably to traditional methods and otolaryngologists' interpretations. This system can potentially assist otolaryngologists in providing more timely and effective treatment by quickly and accurately classifying hearing loss.

Background It has been reported that factors such as age and vestibular pathology (i.e. vestibular migraine) could impact self-motion perception during vestibular stimulation. However, to our knowledge, no objective test has been developed to quantify self-motion perception during clinical vestibular evaluation.Objective The main objective of the present study was to quantify vestibular perception during caloric vestibular stimulation using a tachometer.Methods Twenty-two participants were divided into three groups: 1) younger healthy adults, 2) older healthy adults and 3) vestibular impaired adults. All participants performed bithermal water caloric irrigation during which slow-phase eye velocity (SPV) was measured using videonystagmography and self-motion velocity perception was assessed using a handheld tachometer (RPM).Results The results revealed a significant difference in SPV between vestibular impaired ears and both healthy groups, and a significant difference in self-motion velocity perception between healthy young and vestibular impaired participants.Conclusions This study suggest that the SPV similarly to self-motion perception (RPM) can differentiate between vestibular impaired and young healthy participants. Future work is required to assess the influence of self-motion perception in aging.