Objective: To examine the surgical, audiological and patient-reported outcomes of the Osia 2 implant. Methods: Data from 14 consecutive subjects undergoing implantation between April 2022 and November 2023 were reviewed. Ten subjects had conductive hearing loss, three had mixed hearing loss and one had single-sided deafness (SSD). Warble tone thresholds, Pure Tone Average (PTA4) and Speech Discrimination Score (SDS) in quiet and in noise were determined unaided and aided. The subjective outcome was determined from two standardized questionnaires: (1) International Outcome Inventory for Hearing Aids (IOI-HA) and (2) Speech, Spatial and Qualities of Hearing Scale 12 (SSQ12b). Results: Unexpected postoperative pain was found in four cases. The warble tone thresholds exhibited a consistent reduction across all frequencies, contributing to a mean decrease of 27 dB in the aided PTA4. SDS demonstrated notable improvements, with a 57.3% increase at 50 dB and a 55.6% increase at 65 dB. In noise, SDS exhibited a 43.9% improvement. The mean IOI-HA Score was 3.8, and the mean overall score for SSQ12b was 6.6, with consistent findings across the subgroups. Conclusions: The Osia device emerges as a promising recommendation for individuals with conductive or mixed hearing loss, possibly also for those with SSD. Its safety and efficacy profile aligns with the broader category of active transcutaneous devices, demonstrating a reduced risk of wound infection compared to percutaneous alternatives. Both audiological assessments and subjective evaluations revealed positive outcomes.

Symptomatic nasopharyngeal cysts are relatively uncommon. Here is a case report of 50 years of age female with hearing loss secondary to the nasopharyngeal cyst. She underwent endoscopic marsupialization and achieved normal hearing postoperatively.The study aims to determine the incidence of hearing loss, radiological patterns and histopathological findings associated with the nasopharyngeal cyst.

BACKGROUND: Congenital ossicular chain anomalies are rare conductive hearing loss conditions that remain difficult to diagnose even with high-resolution computed tomography (CT). The preoperative diagnosis is helpful for surgical planning and counseling patients regarding treatment outcomes.
METHODS: We report a case involving a 14-year-old boy presenting with left conductive hearing loss without history of trauma for 5 years, physical examination showed normal otoscopic examination bilaterally and high-resolution CT showed absent of stapes suprastructure and footplate. Subsequent diagnosis was done via endoscopic middle ear exploration which revealed an absent long process of the incus, stapes suprastructure and footplate, but with intact oval window membrane. The residual incus was removed, and a tragal perichondrium graft was used over the oval window. A total ossicular replacement prosthesis was placed between the malleus and oval window to repair the chain. Postoperatively, the patient had no complications. Preoperative pure tone average revealed an air/bone result of 52/8 dB. Follow-up after surgery at 6 months showed a pure tone average air/bone result of 15/3 dB. The air-bone gap was reduced from 44 to 12 dB.
CONCLUSIONS: Congenital absence of the stapes suprastructure and footplate remains a rare condition compared to the myriad of middle ear anomalies in the literature.

In this case report, we present a 23-year-old patient with complaints of a recurrent plop sound in the left ear. Non-contrast CT and MR imaging revealed an enlargement of the tympanic segment of the facial canal due to venous congestion. A persistent stapedial artery (PSA) and absent foramen spinosum were identified as concomitant factors. This unique combination of anomalies has not been previously reported and knowledge about this condition is essential to avoid unnecessary surgery.
UNASSIGNED: A persistent stapedial artery may be associated with enlargement of the tympanic facial nerve canal due to venous congestion.

BACKGROUND: When adenoids enlarge and elicit symptoms it is referred to as symptomatic adenoids, which is a preventable cause of hearing loss and nasal obstruction in the pediatric age group. This study was done to correlate conductive hearing loss with the size of adenoids and to emphasize the importance of screening in the pediatric age group.
METHODS: An observational case-control study was conducted to analyze the degree of hearing impairment in children with adenoid hypertrophy. In total, 98 patients with at least one symptom of adenoid hypertrophy aged between 5 and <15 years were recruited. Those with conductive hearing loss were in the case group and those with normal hearing were in the control group. Audiometry, tympanogram, X-ray, and fibreoptic nasal endoscopy were conducted and compared.
RESULTS: The mean age of presentation of conductive hearing loss with adenoids was 7.67 years. The mean conductive hearing loss on audiometry was 31.69 dB. Tympanogram showed a type B curve in 40.81% of ears and type C in 26.53%. On X-ray nasopharynx, the majority of cases had grade III hypertrophy followed by grade II and grade IV. In nasal endoscopy, most cases had second-degree adenoid hypertrophy followed by third degree, first degree, and then fourth degree. The highest degree of hearing loss of 32-48 dB was present with fourth-degree adenoids. Conductive hearing loss was five times more in patients with third- and fourth-degree adenoids.
CONCLUSIONS: In our study, adenoid hypertrophy has a positive correlation with conductive hearing loss in pediatric patients. So proper screening and early management should be done to prevent hearing loss in children.

We present a case report of a middle ear osteoma presenting as gradual unilateral conductive hearing loss in a healthy 32-year-old lady. The decision for treatment was influenced by the relatively small burden of the disease, and the size and location of the osteoma, which made the decision for surgical excision prohibitively difficult. Taking patient wishes and circumstances into account, the decision was made for a bone conduction hearing implant in conjunction with close follow-up.

Conductive hearing loss with normal otoscopic findings has many differential diagnosis, but the diagnosis of otosclerosis is retrospective after exploratory tympanotomy. Congenital ossicular anomalies in isolation are rare and often have a delayed diagnosis, particularly if unilateral. Herein we present a rare case of stapes abnormality that was encountered as a surprise during exploratory tympanotomy in a case of conductive hearing loss mimicking clinical otosclerosis and was managed accordingly.

We present the case of a patient treated as affected by conductive hearing loss due to recurrent otitis, then as a juvenile otosclerosis, who was finally diagnosed as affected by bilateral ossicular chain fixation and enlarged vestibular aqueduct by means of cone-beam CT.

A new non-invasive adhesive bone conduction hearing device (ABCD) has been proposed as an alternative solution for reversible bilateral conductive hearing loss in recurrent or long-lasting forms of otitis media with effusion (OME) in children that cannot undergo surgical treatment. Our aim was to assess the effectiveness of ABCD in children with OME. Twelve normal-hearing Italian-speaking volunteers, in whom a conductive hearing loss was simulated, participated in the study. The free-field average hearing threshold was determined and, to evaluate binaural hearing skills, loudness summation and the squelch effect were assessed. Five conditions were tested: (1) unaided without earplugs, (2) unaided with bilateral earplugs, (3) aided right ear with bilateral earplugs, (4) aided left ear with bilateral earplugs, and (5) bilateral aid with bilateral earplugs. Post-hoc analysis showed a significant statistical difference between plugged, unplugged, and each aided condition. The main results were a better loudness summation and a substantial improvement of the squelch effect in the bilaterally aided. Our results suggest that ABCD is a valid treatment for patients with conductive hearing loss that cannot undergo bone conduction implant surgery. It is also important to consider bilateral aids in order to deal with situations in which binaural hearing is fundamental.

Difficulty hearing in the presence of background noise is a common complaint heard by audiologists. This can be accompanied by additional difficulty in classrooms and other difficult listening situations. This was recently exacerbated by the coronavirus disease 2019 (COVID-19) shutdowns and the accompanying mask usage and virtual meetings. This article describes one such patient seen during the recent shutdown. This patient reported difficulty hearing during her college coursework for her music performance major. She was an established otology patient with an extensive middle ear history including multiple surgeries. During the shutdown, she virtually consulted with the auditory processing disorders clinic at the recommendation of her otologist to discuss her college-related difficulty and pursue educational accommodations. Challenges and solutions for seeing this patient and other, similar patients virtually are discussed as well as a review of how this patient proceeded and how the knowledge gained from this patient could apply to others with similar concerns.