Objective:To sinicize the Speech, Spatial and Qualities of Hearing Scale (SSQ) and to assess its reliability and validity based on the Rasch model and Classical Test Theory (CTT).Methods:The acquisition of the Chinese version of the SSQ relies on the systematic translation of the SSQ using the Brislin model. A total of 416 patients who attended the Department of Otorhinolaryngology, Head and Neck Surgery, Chaoyang Hospital, Beijing, between October 2022 and October 2023 were randomly selected using the Chinese version of the SSQ, of which 400 questionnaires were valid, with 281 subjects with hearing impairment [aged 16-92 (59.4±14.4) years, 164 females and 117 males] and 119 subjects with normal hearing [aged 18-72 (39.9±13.6) years, 82 females and 37 males]. The reliability and validity of the Chinese version of the SSQ were assessed by SPSS 24.0 and Winstep 3.72.3 statistical software.Results:Rasch model analysis showed that the Chinese version of the SSQ consisted of a speech perception dimension (14 items), a spatial hearing dimension (17 items), and an auditory quality dimension (18 items), each with unidimensional properties, and the data measured by the scale could be adapted for Rasch model analysis. The Chinese version of the SSQ had reliability indices over 0.8 and separation indices over 2.0 for all three dimensions. The distribution of the difficulty of the questions in the three dimensions was relatively concentrated (the three dimensions of means was: Logit 0.00), and the participants competence was relatively broad (the respective means was: Logit 0.67, Logit-1.71, Logit 0.83). Among them, the item-total correlation coefficients (ITCC) of item 28 and 30 were below 0.7, while ITCC values for the rest were all greater than 0.7. The discriminative validity was good (t=9.604-12.268, P<0.01). Exploratory factor analysis showed that the contribution rate of the three principal components was 78.49%, and the loadings of the items on the corresponding common factors were all greater than 0.4. The three rotated common factors were basically consistent with those of the original SSQ in the three dimensions. The Chinese version of the SSQ had a high predictive value for hearing loss (AUC of 0.789, P<0.001), with a sensitivity of 61.3% and specificity of 80.1% for predicting hearing loss in case of its mean score <8.5. Conclusion:The Chinese version of the SSQ has favorable reliability and validity, which can serve as a self-assessment tool of hearing ability for people with hearing loss in China in clinical application.

Objective:To assess the sound localization ability of patients with unilateral sudden hearing loss during the early period of treatment, to explore its changing characteristics and to analyze influencing factors.Methods:A total of 22 patients with unilateral sudden sensorineural hearing loss, with onset within 3 days, who were hospitalized at Shandong Provincial ENT Hospital between January and April 2024, were collected in this study. The cohort included 13 males and 9 females, with a mean age of 36.5 years. Among them, 10 suffered in the right ear and 12 in the left ear. Additionally, 15 healthy individuals (8 males and 7 females, mean age 29.2 years) were selected as controls. Pure tone audiometry and sound localization tests were reviewed on the first day, third day, fifth day of admission; the third week after onset, and the pure tone average and the root-mean-square error(RMSE) were used as indicators, respectively. The improvement of the ability of sound localization and pure tone average were assessed by correlation analyses using SPSS, version 27.0, and multiple regression analysis was employed to explore effects that might influence sound localization ability.Results:The pure tone threshold and sound localization ability on the third week of onset were improved compared with those on the initial three instances(the first, third, and fifth days of admission). 9 of the 22 patients (40.91%, 9/22) presented normal sound localization ability whereas their hearing loss had not recurred yet. The Spearman correlation analysis revealed a significant positive correlation between the improvement of sound localization ability and hearing improvement ( r=0.57, P<0.001). Meanwhile, multiple regression analysis showed that hearing threshold was a significant factor for sound localization when there was audible frequency. Vice versa, at this circumstance, ages and vertigo were significant factors. Conclusions:For most of the patients with unilateral sudden hearing loss, ability of sound localization improves with the decrease of hearing threshold. Notably, some patients can restore normal levels of sound localization for white noise, even in the presence of hearing loss at certain frequencies, by relying on binaural acoustic cues provided by residual hearing.

Objective:This study evaluates the horizontal sound localization ability of young and middle-aged individuals with symmetric sensorineural hearing loss (SNHL) in noisy environments. It also examines the impact of hearing loss severity and signal-to-noise ratio (SNR) on localization accuracy.Methods:In this cross-sectional study, conducted from April 2023 to April 2024, 135 young and middle-aged patients (73 males and 62 females, aged 18-60 years) with SNHL who sought care at Beijing Chaoyang Hospital, were categorized into mild, moderate, and moderate-to-severe hearing loss groups (45 per group), with 45 normal-hearing controls (23 males and 22 females, aged 20-60 years). Participants completed localization tasks in quiet and noisy environments with SNR levels of 5 dB, 0 dB, -5 dB, and-10 dB. Root mean square error (RMSE) was used to measure localization accuracy. Repeated measures ANOVA assessed the effects of hearing loss and SNR on RMSE, while, Pearson correlation evaluated the relationship between binaural 4-frequency pure-tone average (4fPTA) and RMSE. Multiple linear regression analyzed the predictive role of 4fPTA and age.Results:(1) Two-way repeated measures ANOVA showed that both hearing loss severity and SNR significantly affected RMSE ( F=92.67, P<0.01; F=430.29, P<0.01), with a significant interaction between the two factors( F=92.67, P<0.01). (2) RMSE increased with hearing loss severity. At SNRs of 5 dB, 0 dB, and-5 dB, the moderate-to-severe group had significantly higher RMSE than the mild and moderate groups ( P<0.01). No significant differences were found between mild and moderate groups ( P=0.53, 0.57, 0.22). At-10 dB SNR, significant differences were observed across all groups ( P<0.01). (3) RMSE increased non-linearly as SNR decreased. Mean RMSE values under quiet conditions and at SNRs of 5 dB, 0 dB, -5 dB, and-10 dB were (7.43±5.01)°, (9.80±5.74)°, (11.60±6.22)°, (14.56±7.07)°, and (18.74±8.02)°, respectively. (4) RMSE was significantly positively correlated with binaural 4fPTA ( r=0.54-0.58, P<0.01). Multiple linear regression analysis indicated that the binaural average 4fPTA significantly predicted RMSE ( P<0.01), explaining 30.5%-34.1% of RMSE variance. Age did not significantly contribute to RMSE variation. Conclusions:The degree of hearing loss and background noise SNR significantly affect horizontal sound localization in young and middle-aged SNHL patients. RMSE increases with hearing loss severity and decreases with higher SNR. The interaction between hearing loss and SNR is significant, and RMSE correlates with binaural 4fPTA. However, the regression model based on 4fPTA and age explains only part of the RMSE variance, suggesting other contributing factors.

Objective:To investigate the correlations and regression models among adenoid-nasopharynx measurement indices (the linear ratio A/N, the two-dimensional area ratio 2D_A/N, and the three-dimensional volume ratio 3D_A/N), to evaluate the feasibility of predicting three-dimensional parameters from two-dimensional measurements.Methods:This cross-sectional study analysed 4 307 CBCT scans and lateral nasopharyngeal radiographs from 4-12-year-old children (July 2023-January 2025). Children with acute infection, major systemic disease, craniofacial anomalies, prior maxillofacial surgery, poor-quality images, or no consent were excluded. 3D_A/N was defined as adenoid volume/(adenoid+airway volume); 2D_A/N as adenoid area/total area; and linear A/N as adenoid thickness/nasopharyngeal thickness. Pearson correlation and multiple linear regression were used to quantify 2D-to-3D agreement, and independent-sample t-tests were employed to compare age, sex and seasonal subgroups. Results:(1) Significant sex-related differences in adenoid hypertrophy were detected at ages 5, 8, 9 and 11 years. In the 5-year-old group, females had significantly higher 3D_A/N and 2D_A/N values than males (3D_A/N: 0.76±0.10 vs. 0.74±0.10, t=-1.99, P=0.047; 2D_A/N: 0.66±0.10 vs. 0.64±0.09, t=-2.71, P=0.007). In the 8-year-old group, males exhibited significantly higher A/N and 3D_A/N values than females (A/N: 0.64±0.06 vs. 0.63±0.06, t=4.49, P<0.001; 3D_A/N: 0.66±0.12 vs. 0.64±0.12, t=2.00, P=0.046). In the 9-year-old group, males showed significantly higher 3D_A/N values than females (0.65±0.11 vs. 0.63±0.12, t=2.46, P=0.014). In the 11-year-old group, males had significantly higher A/N values than females (0.62±0.06 vs. 0.59±0.05, t=4.79, P<0.001). (2) The linear A/N ratio correlated moderately with 3D_A/N ( r=0.82), whereas, 2D_A/N showed an excellent correlation ( r=0.97); multiple regression confirmed 2D_A/N as the principal predictor of 3D_A/N. (3) Seasonal analysis revealed markedly greater adenoid hypertrophy in winter than in summer for children aged 4-9 years, while, no seasonal difference was found in the 10-12 year group; overall, winter hypertrophy was most pronounced in younger children. Conclusion:2D_A/N demonstrates a marked advantage in predicting 3D_A/N. When combined with A/N and age factors, it can effectively model changes in the 3D volume ratio of the adenoid, underscoring the clinical value of lateral cephalometric measurements for evaluating adenoid hypertrophy in children. Moreover, adenoid hypertrophy is influenced by age, sex and seasonal factors.

Objective:To evaluate the early efficacy and safety of the exclusively transnasal endoscopic approach and the combined transconjunctival-endoscopic approach in the resection of benign orbital apex lesions.Methods:A retrospective analysis was conducted on 51 patients who underwent transnasal endoscopic resection of benign lesions in the orbital apex at Peking University Third Hospital from May 2021 to December 2024. The study population was composed of 17 males and 34 females, with the age of (39.4±12.4) years (range: 4 to 65 years). Pathology diagnoses were identified as orbital cavernous hemangioma (OCH, n=38), schwannoma ( n=8), solitary fibrous tumor ( n=1), mucocele ( n=1), optic nerve sheath meningioma ( n=1), pseudotumor ( n=1), and organized hematoma ( n=1). Two surgical approaches were compared as the exclusively transnasal endoscopic resection ( n=27) and the combined transconjunctival-endoscopic approach (combined approach, n=24). Preoperative and postoperative evaluations were conducted for the best corrected visual acuity (BCVA), visual field, intraocular pressure (IOP), and exophthalmos before and after surgery. Demographic characteristics, tumor features, and postoperative complications were analyzed between the two surgical groups. Differences in Orbital Resection by Intranasal Technique (ORBIT) stage between the two surgical approaches were analyzed. SPSS 27.0 software was used for statistical analysis. Results:Among the 51 patients, 3 schwannomas underwent intracapsular resection (1 via exclusively transnasal endoscopic approach, and 2 via combined approach), and the remaining 48 patients underwent complete tumor resection. Significant postoperative improvements were observed in BCVA, visual field, IOP and exophthalmos ( t value was 2.96, 4.34, 4.85, and 4.63, respectively, all P<0.05). The combined approach required longer operative time but showed comparable intraoperative blood loss. Tumors resected via the combined approach were larger in volume, though not statistically significant. Postoperative complications (e.g., diplopia, mydriasis) were more frequent in the combined approach group but resolved within a short-term period. There was no significant difference in ORBIT stage between the two groups ( P=0.178). Conclusions:Both exclusively transnasal and combined transconjunctival-endoscopic approaches prove safe and effective for benign orbital apex lesions resection. The combined approach ensures complete tumor removal.

Objective:To analyze the efficacy and safety of different surgical approaches for the treatment of anterior skull base malignancies involving the orbit.Methods:Retrospective analysis was conducted on patients with anterior skull base malignancies involving orbit who attended Xuanwu Hospital of Capital Medical University from April 2013 to July 2021. They were divided into endoscopic endonasal approach(EEA), lateral orbital approach(ELOA), and sublabial transmaxillary approach(ESTMA) groups according to the primary surgical approach. One-way analysis of variance and χ 2 test were used to compare the clinical characteristics, degree of tumour resection, rate of postoperative cranial nerve palsy and improvement of visual acuity; Log-rank test was applied to assess the difference in overall survival (OS). Results:One hundred and ninety-eight patients were enrolled, including 107 males and 91 females, aged (48.5±15.3) years. There were 153, 33, and 12 patients in the EEA, ESTMA, and ELOA groups, respectively. There were no significant differences among the three groups in age, gender, and history of radiotherapy, chemotherapy or surgery ( P>0.05 for all). All patients in ELOA group had preoperative visual impairment (12/12), with a significantly higher percentage than EEA group (56/153) and ESTMA group (14/33) ( χ2=19.72, P<0.001). There was no significant difference between three groups in the degree of tumor resection (gross total resection: 84.97% vs. 81.82% vs. 58.33%, χ2=5.58, P>0.05), postoperative cranial nerve palsy rate (13.07% vs. 30.30% vs. 16.67%, χ2=5.95, P>0.05), visual improvement rate (58.93% vs. 57.14% vs. 58.33%, χ2=0.04, P>0.05) and 5-year OS (60.69% vs. 42.66% vs. 50.00%, χ2=3.22, P>0.05). Conclusion:All three surgical approaches were safe, effective and feasible treatment modalities.

Objective:To identify the risk factors affecting the effectiveness of conservative treatment for acute sinusitis with orbital complications and provide evidence for recognition of high-risk patients.Methods:A retrospective analysis was conducted on 86 patients with acute sinusitis and orbital complications treated at Qingdao University Affiliated Hospital from 2017 to 2024 (61 males, 25 females; median age: 6.5 years). Patients were divided into an ineffective conservative treatment group and an effective conservative treatment group based on the outcomes after 48-72 hours of conservative treatment. Clinical characteristics were collected, and variables were screened using Lasso regression. Multivariate logistic regression was used to analyze the risk factors for poor conservative treatment outcomes, and a nomogram model was constructed to validate its predictive performance.Results:The overall success rate of conservative treatment was 50% (43/86). Multivariate logistic analysis showed that type Ⅲ orbital complications ( OR=0.17, P=0.017) and the presence of bone destruction ( OR=0.29, P=0.046) were independent risk factors for poor conservative treatment outcomes. The area under the ROC curve (AUC) of the combined predictive model was 0.762, with a sensitivity of 76.7% and a specificity of 69.8%. Conclusion:Patients with acute sinusitis and orbital complications, especially those with subperiosteal abscesses (type Ⅲ) and concurrent bone destruction, have a lower effectiveness rate of conservative treatment. These patients should be closely monitored for clinical signs and considered for prompt surgical intervention when necessary.

Objective:To investigate the clinical features of patients with congenital atresia of the oval window (CAOW).Methods:A retrospective analysis was conducted on 7 cases (8 ears) of surgically confirmed CAOW treated at our department from July 2018 to July 2024. Among the cases, 1 patient had bilateral CAOW, and 4 patients had unilateral CAOW combined with other types of ossicular chain malformations in the contralateral ear. We collected and analyzed the clinical data, audiological features, and temporal bone HRCT results of all patients.Results:The 7 patients were diagnosed at ages ranging from 8 to 19 years, with a mean age of (13.2±6.9) years. None of the patients exhibited significant auricular deformities. All presented with conductive hearing loss or mixed hearing loss predominantly of the conductive type, with an intact tympanic membrane. The diagnosis of CAOW was confirmed via endoscopic tympanotomy, revealing a concave oval window area on the medial wall of the tympanic cavity, sealed by a bony plate. All 8 ears exhibited additional ossicular chain deformities. Stapes absence was present in all 8 ears. Partial absence of the incus long process was observed in 3 ears, while, abnormal bony connections between the incus long process and the promontory were seen in 4 ears, 1 ear had a short malleolar handle, 1 ear had a smaller than normal malleus volume. In addition, facial nerve deformities were found in 6 ears, with 4 ears showing bifurcation of the facial nerve and 2 ears showing facial nerve obscuration of the oval window. Pure-tone audiometry revealed that 62.5% (5/8 ears) of patients had air conduction (AC) thresholds≥60 dB preoperatively, with a mean pure-tone average (PTA) of (69.0±11.8) dB HL and a mean air-bone gap (ABG) of (52.0±7.0) dB. The mean AC threshold and ABG were higher in the low-frequency (125-1 000 Hz) range compared to the high-frequency (2 000-8 000 Hz) range (both P<0.05). Preoperative HRCT showed abnormalities in all patients, with 7 ears being diagnosable as CAOW. Although the remaining 1 ear could not be diagnosed as CAOW, stapes and incus long process absence were detected. Conclusion:CAOW is rare in clinical, as the patients with non-progressive conductive hearing loss (AC≥60 dB, ABG≥50 dB) since childhood, intact tympanic membrane without malformations of auricle and external auditory canal, and thick bony plate covered the oval window of the HRCT imaging, CAOW should be highly suspected, which could be confirmed by the exploratory tympanotomy.

Objective:To evaluate the efficacy of glottic closure in preventing postoperative aspiration in elderly patients undergoing supraglottic horizontal partial laryngectomy.Methods:A retrospective case series analysis was conducted on the clinical data of 12 elderly patients who underwent supraglottic horizontal partial laryngectomy with concurrent glottic closure at the Sixth Medical Center of Chinese PLA General Hospital from January 1, 2002, to December 31, 2024. Among them, there were 8 males and 4 females, aged from 68 to 80 years, with an average age of 74 years. There were 11 cases of supraglottic laryngeal cancer and 1 case of tongue base cancer. The TNM staging was T2N0M0 in 8 cases, T3N0M0 in 2 cases, T3N1M0 in 1 case, and T3N2M0 in 1 case. All patients existed comorbid cardiovascular dysfunction of varying severity. Pulmonary function tests were impaired in 8 cases. Comorbidities included hypertension ( n=5), prior coronary stent placement ( n=3), and thrombocytopenia ( n=1). Swallowing function was assessed using the EAT-10 (Eating Assessment Tool-10) one month postoperatively. All patients were followed up regularly. Results:The mean EAT-10 score at one month postoperatively was 2.42±1.71. Eleven patients successfully resumed oral feeding without obvious aspiration. Voice quality was intelligible when the tracheostomy tube was blocked. In the early stage, in 1 case, due to the suture technique problem of the glottis closure, the suture site of the glottis completely split open after the operation. The patient′s breathing was normal when the tube was blocked, and the tracheostomy tube was removed. As arytenoid edema resolved, the patient developed varying degrees of dysphagia with recurrent aspiration. This patient was hospitalized twice due to aspiration pneumonia, at 5 months and 19 months, postoperatively. The remaining 11 patients exhibited no signs of significant aspiration during follow-up. The 3-year and 5-year postoperative survival rates were 7/8 and 5/7, respectively.Conclusion:For elderly patients with supraglottic laryngeal cancer or tongue base cancer, and those who are at high risk for persistent postoperative aspiration after fully evaluated systematically, glottis closure during supraglottic horizontal partial laryngectomy is an effective strategy to prevent aspiration and to facilitate safe oral intake.

Objective:To evaluate the efficacy of combined cricopharyngeal myotomy (CPM) and autologous fat injection laryngoplasty (AFIL) in the management of dysphagia secondary to glossopharyngeal and vagal nerve injury.Methods:This retrospective cohort study collected the clinical data of 18 patients with persistent dysphagia due to glossopharyngeal and vagus nerve injuries, who underwent concurrent cricopharyngeal myotomy (CPM) and autologous fat injection laryngoplasty (AFIL) at the Department of Otolaryngology, Peking Union Medical College Hospital, from January 2017 to December 2024. Pre-and postoperative assessments included electronic flexible laryngoscope, the Chinese version of Swallow Quality-of-Life Questionnaire (CSWAL-QOL), videofluoroscopic swallowing study (VFSS), body weight changes, and nasogastric tube (NGT) removal status with routine follow-up. The comparison of swallowing function before and after surgery was conducted using paired samples t-test and χ2 test. Results:The study cohort comprised 10 male and 8 female patients, with ages ranging from 33 to 70 years (mean±SD: 53.8±10.5). All surgical procedures were completed successfully without complications. During the 6-to 24-month follow-up period, 10 of the 13 patients who were initially nasogastric tube-dependent achieved successful decannulation. Compared with preoperative values, postoperative measurements demonstrated statistically significant improvements across all parameters: mean body weight increased from (56.95±9.14) kg to (59.22±8.72) kg ( t=3.689 , P<0.01), CSWAL-QOL scores improved from 91.89±17.81 to 130.83±25.42 ( t=6.921 , P<0.01), while, both VFSS scales showed marked reductions (VFSS-SWAL: 6.78±1.40 to 3.39±1.61, t=-8.001, P<0.01; PAS: 6.56±1.15 to 2.94±1.26, t=-10.114, P<0.01). Conclusions:Combined CPM and AFIL represents an effective surgical approach for dysphagia following glossopharyngeal and vagal nerve injury, thereby demonstrating significant improvements in both swallowing function and quality of life.