Ear Function Research Articles

Age-Related Increase in Type C Tympanogram

Background: This study evaluated the relationship between aging and tympanometric changes, specifically the incidence of type C tympanograms, using data from the Korea National Health and Nutrition Examination Survey (KNHANES). Methods: We analyzed data from the 2019–2022 KNHANES, including 26,738 ears from individuals aged 40 and older. Tympanometry at 226 Hz identified type C tympanograms based on peak pressure below −100 daPa. Multiple logistic regression evaluated the association between age and type C tympanograms, adjusting for confounders such as sex, smoking status, allergic rhinitis, chronic sinusitis, and lifestyle disease markers. Results: The incidence of type C tympanograms increased significantly with age (R2 = 0.953, p < 0.001). Age was the most significant factor associated with type C tympanograms (p < 0.001, odds ratio 1.052), while other factors were not statistically significant. Ears with type C tympanograms had significantly poorer hearing thresholds compared to those with type A tympanograms (p < 0.001). Conclusions: Aging is significantly associated with an increased incidence of type C tympanograms, indicating possible middle ear dysfunction in older adults. The correlation between type C tympanograms and poorer hearing thresholds suggests that age-related changes in middle ear function may contribute to hearing impairment. Tympanometric screening in older adults may facilitate early detection and management of middle ear dysfunction, potentially improving hearing outcomes and quality of life.

Spatiotemporal characteristics of eustachian tube development in C57BL/6 mice: Correlation between morphological and functional maturation.

The eustachian tube (ET), a critical conduit connecting the middle ear and nasopharynx, is essential for normal middle ear function. However, it remains one of the least understood anatomical structures due to its complexity and the challenges of in vitro manipulation. Historically, these challenges have hindered research into the morphology and function development of the ET. This study elucidates the spatiotemporal relationship of ET morpho-functional maturation in mice, identifying key periods and factors that lay the theoretical foundation for exploring the molecular mechanisms of ET-related diseases. We comprehensively characterized the ET development in C57BL/6 mice from embryonic day (E) 12.5 to postnatal day (P) 30, focusing on the development of cilia, secretory cells, surrounding glands, and macrophages. Immunostaining identified the localization and secretion patterns of the mucins Muc5b and Muc5ac within the ET. Additionally, using improved ET function assessment tools, we evaluated the developmental features of ET mucociliary clearance and ventilation functions. In C57BL/6 mice, E16.5 marks a critical period for middle ear cavity and ET formation. Muc5b plays a foundational role during early stages, while Muc5ac enhances function in later stages. During P7-11, despite morphological maturity, ET function remains underdeveloped but continues to improve with growth.

Comparative analysis of classic and delayed Ménière's disease: clinical characteristics and endolymphatic hydrops manifestations in an Asian cohort.

To investigate the clinical characteristics and endolymphatic hydrops (ELH) Manifestations in patients with delayed Ménière's disease (DMD) compared to classic Ménière's disease (CMD). A prospective cohort study was conducted involving 523 patients diagnosed with MD. Clinical data, inner ear function, and ELH characteristics were analyzed and compared between CMD and DMD groups. Assessments included audiometry, VEMP, and MRI. DMD prevalence was 6.1%. Bilateral MD was significantly more common in DMD (34.4% vs. 14.5%, P = 0.003). DMD patients had more severe hearing loss in the first involved ear and more deteriorated VEMP in the contralateral ear (P < 0.05). ELH was present in 100% of affected ears, with a higher contralateral ELH proportion in DMD (34.4% vs. 15.0%, P = 0.005). DMD patients exhibit a higher prevalence of bilateral MD, more severe hearing loss, and greater contralateral ELH compared to CMD patients. Both subtypes share similar ELH characteristics, suggesting common underlying mechanisms.

Wideband tympanometry in otitis Media

BackgroundOtitis media with effusion (OME) is one of the most frequent infectious diseases in children and is the most common cause of acquired hearing loss in childhood. Diagnosis of OME is mainly dependent on the single-frequency tympanometry. Wideband tympanometry (WBT) is an emerging technology that has been utilized to overcome the limitations of conventional tympanometric procedures. This study aimed to evaluate the diagnostic value of wideband acoustic absorbance in children suffering from otitis media.MethodsThis study included a control group of 50 children with 100 ears with bilateral normal peripheral hearing and bilateral normal middle ear function and a study group which included 100 children with 176 ears complaining of otitis media. Measures included subjects history, basic audiological evaluation and wideband tympanometry. Resonant frequency, tympanometric peak pressure and middle ear absorbance were measured from wideband tympanometry and compared in both groups.ResultsThere was a statistically significant reduction of resonsnce frequency in the study group in comparison to the control group. Also, there was a statistically significant reduction of tympanometric peak pressure in the study group in comparison to the control group. As regards the absorbance, there was a statistically significant reduction of absorbance in the study group in comparison to the control group at all tested frequencies (250Hz- 8000Hz). The best area under the receiver operating characteristic curve values for diagnosing OM were obtained at all tested frequencies. Data of this work showed that higher values were mainly at 250Hz, 500Hz and 1kHz (0.84, 0.88 and 0.93 respectively).ConclusionFindings of this study suggested that wide band tympanometry can be used efficiently in various degrees of OM.

Reflection function, reflectance, and area function measurements in ears of children and adults.

The main experiment concerned time-domain measurements of the acoustical reflection function (RF) of the human ear in adults and children (aged 5 to 8 years) using a probe inserted into the ear canal. This RF was used to calculate the area function of the ear canal versus distance along its centerline. Acoustical reflectance was calculated in the frequency domain from the RF, as was the difference in sound pressure level near the tympanic membrane relative to the probe tip. Group responses in area function, total ear-canal length, absorbance and group delay, and admittance magnitude and phase were analyzed based on sex, ear, and age. Responses were compared between children/adults and younger/older adults relative to age 50 years. Ear and sex were never significant. Significant differences were observed in children compared to adults in the area function, absorbance and group delay, and admittance magnitude and phase (0.25-4 kHz). Group delay differed between younger and older adults. A second experiment assessed level dependence of responses to better understand limitations in probe performance observed in the main experiment. These results show the utility of time-domain measurements of the area function and derived reflectance to understand sound-transmission differences across age at frequencies important to middle-ear function.

Quantitative in-vitro assessment of a novel robot-assisted system for cochlear implant electrode insertion.

As an increasing number of cochlear implant candidates exhibit residual inner ear function, hearing preservation strategies during implant insertion are gaining importance. Manual implantation is known to induce traumatic force and pressure peaks. In this study, we use a validated in-vitro model to comprehensively evaluate a novel surgical tool that addresses these challenges through motorized movement of a forceps. Using lateral wall electrodes, we examined two subgroups of insertions: 30 insertions were performed manually by experienced surgeons, and another 30 insertions were conducted with a robot-assisted system under the same surgeons' supervision. We utilized a realistic, validated model of the temporal bone. This model accurately reproduces intracochlear frictional conditions and allows for the synchronous recording of forces on intracochlear structures, intracochlear pressure, and the position and deformation of the electrode array within the scala tympani. We identified a significant reduction in force variation during robot-assisted insertions compared to the conventional procedure, with average values of 12mN/s and 32mN/s, respectively. Robotic assistance was also associated with a significant reduction of strong pressure peaks and a 17dB reduction in intracochlear pressure levels. Furthermore, our study highlights that the release of the insertion tool represents a critical phase requiring surgical training. Robotic assistance demonstrated more consistent insertion speeds compared to manual techniques. Its use can significantly reduce factors associated with intracochlear trauma, highlighting its potential for improved hearing preservation. Finally, the system does not mitigate the impact of subsequent surgical steps like electrode cable routing and cochlear access sealing, pointing to areas in need of further research.

Vestibular-Evoked Myogenic Potential in Otosclerosis: A Systematic Review

Background: Vestibular symptoms are noted in about 40% of the individuals with otosclerosis. Vestibular-evoked myogenic potential (VEMP) is a short latency potential that assesses the functioning of otolithic organs in the vestibular system. Aim/Objectives: This systematic review explored the VEMP findings in individuals with otosclerosis. Material and Methods: Three databases, PubMed, Scopus, and Cochrane were used to perform a systematic literature review regarding VEMP findings among individuals with otosclerosis. Results: A total of 14 studies that encompasses various VEMP parameters in otosclerosis patients were included. The air-conducted vestibular-evoked myogenic potential (AC-VEMP) often had poor response rates in otosclerosis due to conductive hearing loss. Presence of bone-conducted vestibular-evoked myogenic potential (BC-VEMP) before surgery indicated intact otolithic organs in otosclerosis. Postoperatively, presence of VEMP indicated intact vestibular structures postsurgery, while its absence could indicate vestibular trauma, though other factors like stimulus intensity or efficacy of the fitted piston could influence the results. AC-VEMP responses postsurgery suggested resolution of conductive pathology or absence of lasting effects of otosclerosis. Studies show cVEMP is more affected, indicating saccular dysfunction. Conclusion: Otosclerosis affects VEMP responses, with variations observed between AC- and BC-VEMPs. While AC-VEMP responses may be affected by conductive hearing loss, BC-VEMPs offer insights into inner ear function.

Study of word-in-noise perception scores at saccular acoustic sensitivity level: randomized clinical trial

BackgroundIn humans, saccular acoustic sensitivity has been confirmed. The aim of this study was to determine the scores of the word-in-noise perception test at the saccular acoustic sensitivity level.MethodologyIn this randomized clinical trial study, 101 participants in the age group of 14 to 25 years with normal hearing and middle ear function, detectable vestibular evoked myogenic potentials (VEMP), normal states of mental health, and night sleep were investigated. The scores of word-in-noise perception and word-in-noise discrimination tests were evaluated for each person at two intensity levels, most comfortable level (MCL) and saccular acoustic sensitivity. Mann-Whitney was used for the multiple comparisons.ResultsThere was a significant difference between the scores of the word-in-noise perception test at MCL and saccular acoustic sensitivity (U = 3971.50, Z = − 2.10, p’ = 0.04), and also between the scores of the word-in-noise discrimination test at the MCL compared to saccular acoustic sensitivity (U = 399.89, Z = − 2.49, p’ = 0.04). Word-in-noise discrimination scores in MCL (U = 3484.00, Z = -3.72, p’ = 0.00) and saccular acoustic sensitivity (U = 705.50, Z = − 3.78, p’ = 0.00) were higher than word-in-noise perception.ConclusionsWord-in-noise perception and word-in-noise discrimination scores are higher in saccular acoustic sensitivity level than MCL, suggesting that the vestibular system participates in loud speech perception. Also, in people with normal hearing thresholds, word-in-noise perception scores will be lower than word-in-noise discrimination scores for both loud and common intensity levels.

Functional pathogenicity of ESRRB variant of uncertain significance contributes to hearing loss (DFNB35)

Advances in next-generation sequencing technologies have led to elucidation of sensorineural hearing loss genetics and associated clinical impacts. However, studies on the functional pathogenicity of variants of uncertain significance (VUS), despite their close association with clinical phenotypes, are lacking. Here we identified compound heterozygous variants in ESRRB transcription factor gene linked to DFNB35, specifically a novel splicing variant (NM_004452.4(ESRRB): c.397 + 2T>G) in trans with a missense variant (NM_004452.4(ESRRB): c.1144C>T p.(Arg382Cys)) whose pathogenicity remains unclear. The splicing variant (c.397 + 2T>G) caused exon 4 skipping, leading to premature stop codon formation and nonsense-mediated decay. The p.(Arg382Cys) variant was classified as a VUS due to its particularly higher allele frequency among East Asian population despite disease-causing in-silico predictions. However, functional assays showed that p.(Arg382Cys) variant disrupted key intramolecular interactions, leading to protein instability. This variant also reduced transcriptional activity and altered expression of downstream target genes essential for inner ear function, suggesting genetic contribution to disease phenotype. This study expanded the phenotypic and genotypic spectrum of ESRRB in DFNB35 and revealed molecular mechanisms underlying ESRRB-associated DFNB35. These findings suggest that variants with high allele frequencies can also possess functional pathogenicity, providing a breakthrough for cases where VUS, previously unexplored, could be reinterpreted by elucidating their functional roles and disease-causing characteristics.

Audio-Vestibular Evaluation of Pediatric Pseudo-Conductive Hearing Loss: Third Window Syndromes.

Conductive hearing loss caused by external or middle ear problems prevents the transmission of sound waves from the external auditory canal to the cochlea, and it is a common condition, especially in pediatric patients aged 1-5 years. The most common etiological factors are otitis media and cerumen during childhood. In some patients, external and middle ear functions and structures may be normal bilaterally despite the air-bone gap on the audiogram. This condition, which is often a missed diagnosis in children, is defined as a pseudo-conductive hearing loss (PCHL) caused by third window syndromes (TWSs) such as semicircular canal dehiscence, inner ear malformations with third window effect, and perilymphatic fistula. In this review of the literature, the authors emphasize the pitfalls of pediatric audio-vestibular evaluation on TWSs as well as the key aspects of this evaluation for the differential diagnosis of PCHL brought on by TWSs. This literature review will provide audiologists and otologists with early diagnostic guidance for TWSs in pediatric patients.

Differentiating Definite and Probable Ménière Disease: A Comprehensive Evaluation of Audio-Vestibular Function Testing Combined with Inner Ear MRI.

To evaluate the differences between audio-vestibular function testing and inner ear gadolinium magnetic resonance imaging (MRI) in distinguishing definite Ménière disease (DMD) and probable Ménière disease (PMD), and to provide a reference for early clinical diagnosis and intervention. A total of 116 patients diagnosed with DMD (n = 80) and PMD (n = 36) were enrolled. The differences in the results of pure tone audiometry, caloric test, and tympanic injection of gadolinium for contrast-enhanced MRI between the two groups were compared and analyzed. Parameters that could differentiate between the two conditions were identified, and the sensitivity and specificity and the area under the curve (AUC) of individual and combined indices in the differential diagnosis of DMD and PMD were evaluated. The hearing threshold and hearing asymmetry rate of the DMD group were significantly higher than those of the PMD group (p < 0.001), 98.8% and 30.6%, respectively. The abnormal rates of canal paresis (CP) and severity of endolymphatic hydrops in the DMD group were higher than those in the PMD group (p < 0.05). When combined with high-frequency hearing thresholds, hearing asymmetry, hearing curve type, endolymphatic hydrops, and abnormal CP, the diagnostic accuracy of DMD was improved compared to using high-frequency alone (p < 0.05). This study showed that PMD and DMD may represent two different stages in the development of MD disease. The comprehensive assessment of audio-vestibular function testing and inner ear MRI proves beneficial for early diagnosis, potentially contributing to the preservation of inner ear function.

Exploration of technique for preservation of external-middle ear structure in surgery of jugular foramen paraganglioma （appended 2 case reports）

Objective:To investigate the feasibility and effect of the modified surgery of the classic infratemporal fossa type A approach for the surgical treatment of jugular foramen paraganglioma with preservation of the external and middle ear structures. Methods:The medical data of 2 patients with jugular foraminal paraganglioma treated by sublabyrinthic-transmastoid approach were retrospectively analyzed. The clinical feature, degree of tumor resection, postoperative facial nerve function and hearing retention, and the incidence of postoperative complications were evaluated. Results:Two patients were both female, and were pathologically confirmed as paraganglioma. The tumor of case 1 was staged as C2De1, and case 2 as C1De1. Tumors were completely resected in both patients. Case 1 suffered infection after surgery, with residual tympanic membrane perforation and mixed deafness. Case 2 developed mild facial paralysis（grade Ⅱ） after surgery, and recovered after symptomatic treatment. There was no tumor residue or recurrence during half a year of follow-up. Conclusion:Surgical treatment of certain paragangliomas in the jugular foramen with a combined sublabyrinthic-transmastoid and upper neck approach might achieve both complete resection of the tumor and preserving the structure and function of the outer-middle ear. This procedure is suitable for paragangliomas restricted in the jugular foramen area, with no or limited involvement of the internal carotid artery（C1 or C2）, and with no or mild hearing loss.

The long-term efficacy and safety of balloon dilation eustachian tuboplasty combined with tympanostomy tube insertion for patients with otitis media with effusion: study protocol for a prospective randomized controlled trial

BackgroundOtitis media with effusion (OME) is a common disease in ear, nose, and throat clinics characterized by aural fullness and hearing loss and mainly caused by eustachian tube dysfunction (ETD). Tympanostomy tube insertion (TTI) is a conventional surgical treatment option that can alleviate symptoms but does not provide a definitive cure, and it is prone to recurrence. Balloon dilation eustachian tuboplasty (BDET) has become a novel procedure for the treatment of ETD, demonstrating significant potential in addressing the aforementioned limitations. However, it is not widely available in the clinic and few high-quality randomized clinical trials was conducted to investigate its long-term efficacy and security in OME. Therefore, the purpose of this study is to verify the efficacy of BDET combined with TTI for patients with OME and its prospects for providing a definitive cure.Methods and analysisThis is a prospective, parallel-group, single-blind, randomized controlled prospective trial. Totally 124 patients with OME will be randomized into either group A or B. Group A will receive conventional therapy (TTI) while group B will use BDET therapy in addition to TTI. Outcome assessments will take place at baseline and at the 3rd, 6th, 12th, and 24th months after surgery. The primary outcome is eustachian tube function, which will be measured by the eustachian tube dysfunction questionnaire (ETDQ-7) and eustachian tube score (ETS). The secondary outcomes include middle ear function, hearing situation, and quality of life, which will be measured by acoustic impedance measurement, pure-tone audiometry, and Chinese-version Chronic Ear Survey (CCES). The main analysis of change in the outcomes will use mixed-model with repeated measures (MMRM) analyses of variance (ANOVAs).DiscussionThis is the first prospective trial in Chinese populations that aims to validate the long-term efficacy and safety of BDET-combined TTI therapy in patients with OME. This parallel-group, single-blind, randomized controlled trial may provide an opportunity to decrease the recurrence rate of OME and explore a definitive cure for patients with OME. This trial’s rigorous design enhances the reliability of the findings, ensuring a robust answer to the research question. In the future, the research team will further expand upon the clinical evidence and applications of the BDET combined therapy.Trial registrationChinese Clinical Trial Registry ChiCTR2400079632. Registered on 8 January 2024, https://www.chictr.org.cn/bin/project/edit?pid=214452.

Evaluation of reproducibility and accuracy of measurements of the transfer function of the outer ear by the F-MIRE method

Evaluation of reproducibility and accuracy of measurements of the transfer function of the outer ear by the F-MIRE method

Electrocochleography in Cochlear Implant Recipients: Correlating Maximum Response With Residual Hearing.

Electrocochleography (ECochG) is increasingly recognized as a biomarker for assessing inner ear function in cochlear implant patients. This study aimed to objectively determine intraoperative cochlear microphonic (CM) amplitude patterns and correlate them with residual hearing in cochlear implant recipients, addressing the limitations in current ECochG analysis that often depends on subjective visual assessment and overlook the intracochlear measurement location. In this prospective study, we investigated intraoperative pure-tone ECochG following complete electrode insertion in 31 patients. We used our previously published objective analysis method to determine the maximum CM amplitude and the associated electrode position for each electrode array. Using computed tomography, we identified electrode placement and determined the corresponding tonotopic frequency using Greenwood's function. Based on this, we calculated the tonotopic shift, that is, the difference between the stimulation frequency and the estimated frequency of the electrode with the maximum CM amplitude. We evaluated the association between CM amplitude, tonotopic shift, and preoperative hearing thresholds using linear regression analysis. CM amplitudes showed high variance, with values ranging from -1.479 to 4.495 dBµV. We found a statistically significant negative correlation () between maximum CM amplitudes and preoperative hearing thresholds. In addition, a significant association () between the tonotopic shift and preoperative hearing thresholds was observed. Tonotopic shifts of the maximum CM amplitudes occurred predominantly toward the basal direction. The combination of objective signal analysis and the consideration of intracochlear measurement locations enhances the understanding of cochlear health and overcomes the obstacles of current ECochG analysis. We could show the link between intraoperative CM amplitudes, their spatial distributions, and preoperative hearing thresholds. Consequently, our findings enable automated analysis and bear the potential to enhance specificity of ECochG, reinforcing its role as an objective biomarker for cochlear health.

Microplastic polyethylene induced inner ear dysfunction in murine model

While the hazardous effects of microplastics (MPs) are increasingly reported, it remains uncertain if MPs induce inner ear dysfunction. Nonetheless, prevalence of inner ear dysfunction was observed across all age groups. In this study, we investigated whether MP polyethylene affect inner ear function in a murine model. To detect hearing loss and balance defect after polyethylene (PE) exposure, we evaluated hearing threshold levels, assessed cerebral glucose metabolism, conducted transcriptome analysis, and performed behavioral studies. C57BL/6 J mice (5-week-old) were grouped into control (n = 10) and PE-fed groups (n = 10). Mice were orally administered 100 ppm/100 μL (equivalent to 10 μg) of PE every day for 4 months. We identified the accumulation of PE in the cochlea and vestibular region. The fragmented PE in inner ear was 3.00 ± 0.38 µm in size; the administered PE concentration was 1.14 ± 1.06 mg/g. Fourier transform infrared spectrometry confirmed that the properties of the MP were identical with those of PE fed to the mice. Transcriptomic analysis showed up-regulation of PER1, NR4A3 and CEBPB at the PE exposed inner ear tissue and it was confirmed using qRT-PCR, western blotting, and immunofluorescence staining. We observed abnormalities in balance related behavior assessment in the PE group. Exposure to PE increased the hearing thresholds and decreased glucose metabolism in the bilateral lateral entorhinal cortex, right primary auditory cortex, and right secondary auditory cortex. We can conclude that PE exposure induced inner ear dysfunction such as hearing loss and balance disorder.

The Effect of Rheumatoid Arthritis on Middle and Inner Ear Functions.

To investigate the middle and inner ear functions, and efferent auditory systems in patients with rheumatoid arthritis (RA). Thirty-five RA patients and 40 control subjects participated in the study. Pure-tone audiometry, high-frequency audiometry, multifrequency tympanometry, transient evoked otoacoustic emissions, and contralateral suppression tests were administered to all participants. Pure-tone hearing thresholds of RA patients were significantly higher at all frequencies except for 2000 Hz, 14,000 Hz, and 16,000 Hz in the right ear and 16,000 Hz in the left ear (p<0.05). Resonance frequency values of RA patients were statistically significantly lower than those of the control group (p<0.001). Emission amplitudes obtained with contralateral acoustic stimulation were significantly lower at 1400 Hz frequency in both groups than without contralateral acoustic stimulation (p<0.05). While contralateral suppression was observed at all frequencies in the control group, no suppression occurred at 2800 Hz and 4000 Hz in RA patients. The results obtained in this study demonstrated the presence of hearing dysfunction in patients with RA. When a patient is diagnosed with RA, an audiological evaluation should be made, and the patient should be informed about the possibility of audiological involvement.

Bionic fusion perspective: Audiovisual-motivated integration network for solar irradiance prediction

Accurate and reliable prediction of solar irradiance (SI) is an important requirement to develop solar energy while a challenging task due to stochastic and nonlinear data characteristics. Additionally, most deep networks show powerful prediction capabilities but lack the supports from biological science, reflecting that bionically-inspired networks in SI analysis are still not enough explored. To this end, this paper proposes an audiovisual-motivated Transformer-CNN integration network, called ATI-net, for predicting SI. The audiovisual cognition gives a superior design framework for ATI-net with signal capture, signal analysis, and prediction blocks. In the first block, through mimicking the function of both eye and ear in external signal conversion, multi-scale features are extracted by incorporating multi-branch convolutions with varying kernels, where the Mish function addresses the problem that traditional ReLU function stops learning when the input is negative. In the second block, through mimicking the function of left and right hemispheres in neuronal signal analysis, two structures triggered by Transformers and convolutions are designed to remember temporal evolutionary rules, where residual connections are beneficial to mine deep information and avoid forgetting. In the third block, through mimicking the function of a higher brain region in generating understanding, the above information is integrated to make the SI prediction. Besides, the nonlinear dependencies and linear relationships are independently extracted and integrated into the ATI-net, which not only reduces information interference but is consistent with the “divide and conquer” idea. Experimental results show that the ATI-net outperforms 18 benchmarks, and average improvements of root mean squared error (RMSE) are 26.28% and 26.01% for two datasets, respectively. In summary, the ATI-net is one of the reliable alternatives to SI prediction.

Does Primary Cleft Palate Repair by Furlow Z-Plasty Technique With a Buccinator Myomucosal Flap Change Speech and Middle Ear Outcomes?

Children with repaired cleft lip and palate may present with middle ear effusion and disturbed speech due to velopharyngeal (VP) insufficiency. Furlow Z-palatoplasty with a buccinator myomucosal flap is one of the effective surgical techniques for primary cleft palate repair and lengthening of the palate. This study aimed to evaluate the effect of Furlow Z-palatoplasty with buccal myomucosal flap as a primary cleft palate repair technique on the VP function during speech and the Eustachian tube function. Forty patients with non-syndromic cleft lip and palate aged 3 to 7 years surgically repaired with Furlow palatoplasty with a buccinator myomucosal flap were assessed. Perceptual speech assessment, nasopharyngoscopic examination, otoscopic examination, and tympanometry were done for all patients to assess the speech and middle ear function. The percentage of mild hypernasality was significant in 22.5% of children with repaired cleft lip and palate, while 77.5% showed no hypernasality. Speech intelligibility was normal in 77.5% and mildly affected in 22.5% of children with repaired cleft palate. Compensatory misarticulations were recorded in 12.5% of children. Nasopharyngoscopic examination revealed adequate VP closure in 75% of children with repaired cleft palate. Twenty-five percent of children with repaired cleft lip and palate had middle ear effusion and required myringotomy with insertion of tympanostomy tubes. Primary cleft palate repair with Furlow Z-palatoplasty with buccal myomucosal flap had beneficial effects on speech outcomes. It was associated with a low prevalence of middle ear effusion, and a low number of tympanostomy tubes were needed.

Symptoms and Factors Associated With Eustachian Tube Dysfunction Among the Population of Qassim, Saudi Arabia.

Introduction The Eustachian tube regulates middle ear functions such as ventilation and pressure normalization. Eustachian tube dysfunction (ETD) is defined as the failure of the Eustachian tube to maintain one or more of its functions. It is a common condition that is associated with other middle ear disorders such as cholesteatoma, tympanic membrane atelectasis, and otitis media with effusion (OME). This study aims to assess ETD prevalence and risk factors in the Qassim region. Methodology This cross-sectional study was conducted in the Qassim region of Saudi Arabia during the period from September 20 to October 10, 2023. Data were gathered via a validated, self-administered electronic questionnaire that encompasses socio-demographic information, the prevalence of ETD, and the prevalence of its various symptoms, as assessed by the Eustachian Tube Dysfunction Questionnaire (ETDQ-7). Results Our study in Qassim, Saudi Arabia, with 467 participants reveals a high prevalence of ETD at 12.2%. The 18-25 age group dominates (50.1%), with a majority of females (66.2%). Symptom analysis using the ETDQ-7 questionnaire shows varied prevalence, with severe pain (7%) and muffled hearing (29.8%) notable. Logistic regression identifies significant predictors, including hearing loss history (odds ratio = 28.2) and smoking (odds ratio = 3.70). Specific symptoms, such as feeling blocked or underwater, significantly correlate with more severe ETD symptoms (odds ratio = 1.73). Conclusion Our study highlights a notable prevalence of ETD. Significant predictors, including hearing loss history and smoking, were identified. Specific symptoms, such as feeling blocked or underwater, were associated with more severe ETD symptoms.