Objectives: This article provides an overview of the causes and differential diagnosis of sudden deafness (SD) and sudden sensorineural hearing loss (SSHL).Design: Contemporary review.Study sample: This review is based on peer-reviewed articles published in those journals listed on journal of citation reports. Through the PubMed database of the US National Library of Medicine, Scopus, and Google Scholar using the keywords of \"sudden deafness\", \"acute hearing loss\", and \"sudden sensorineural hearing loss\", totally 1493 papers were considered and 166 relevant papers were selected.Results: Sensorineural hearing loss of sudden onset may be classified as primary SD and secondary SSHL. Proposed aetiologies of primary SD comprised viral infection, vascular insufficiency, autoimmune disorder and stress theory, while causes of secondary SSHL include neoplasm, stroke and irradiation.Conclusion: SD/SSHL is a syndrome that comprises various entities, and results from a variety of aetiologies. An inner ear test battery in SD/SSHL patients helps determine its aetiology, and provides comprehensive information on the affected territory. Identification of the cause and differential diagnosis of the different types of SD/SSHL may provide substantial benefits such as determining the prognosis, identifying associated risk factors and preventing further hearing loss.

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Baro-challenge-induced Eustachian tube dysfunction (baro-induced ETD) is characterized by failure of the Eustachian tube (ET) to open adequately to permit middle-ear pressure regulation during ambient pressure changes. There are no well-characterized tests for identifying the condition, which makes both patient diagnosis and research into treatment efficacy challenging. This systematic review evaluates ET function tests as potential outcome measures for baro-induced ETD.
MEDLINE and CENTRAL were searched (database inception to March 2017) and reference lists reviewed for all relevant English Language articles.
Tests in included studies were required to measure ET function in patients reporting baro-induced ear symptoms or barotrauma.
Data were extracted in a standardized manner, and studies assessed according to Standards for Reporting of Diagnostic Accuracy Studies (STARD) criteria. The primary outcome of interest was the accuracy of ET function tests.
Heterogeneity of subject demographics, ET function test methodology, and reference standards only permitted narrative systematic review.
Sixteen studies involving seven different types of ET function tests were identified. The nine-step test was the most commonly used outcome measure, with overall test sensitivity and specificity ranges of 37 to 100% and 57 to 100%, respectively. Tympanometry test sensitivity was consistently poor (0-50%) while specificity was higher (52-97%). Published accuracy data for other ET function tests and test combinations were limited. Currently, no single test can be recommended for use in clinical practice. A combination of the nine-step test with other objective tests or patient-reported measures appears most promising as a core set of outcome measures for baro-induced ETD.

The authors reviewed the literature regarding the safety and efficacy of Laser Eustachian Tuboplasty (LETP) in the treatment of Eustachian tube dysfunction (ETD). Medline via Pubmed, OvidSP and Science Direct were consulted, with a supplementary manual review of citations. English language case series constituted a baseline for inclusion. Primary outcome measures were pre- and post-operative tympanometry, otoscopy findings, subjective symptoms and pure tone audiometry, and findings were stratified into short term (≤6 months) and long term (>6 months-5 years). Eight unique case series were identified, detailing LETP procedures in 306 patients (462 Eustachian tubes). LETP demonstrated mixed short-term and positive long-term results across primary outcome measures. There was an overall complication rate of ≈4.4%, and no major adverse events were reported. Poor documentation of pre- and post-operative primary outcome measures and inter-study outcome heterogeneity prevents substantive comment on efficacy. Whilst LETP is safe, its use should remain limited to research in adults. Future trials should be case controlled, and detail pre- and post-operative tympanometry, otoscopy findings, subjective symptoms, and pure tone audiometry. Patients should also be stratified into those suffering from baro-challenge induced ETD, and those suffering from ETD with intractable sequelae, such as Chronic Otitis Media.

Lymphoid hyperplasia (LH) is a benign lymphoproliferative disorder that, in a minority of cases, may be associated with concurrent or metachronous non-Hodgkin lymphoma. LH cases are further subdivided into \"reactive\" and \"atypical\" categories based on the presence or absence of unequivocal malignant features. With improving molecular diagnostic technologies, \"reactive\" LH is by far the most common category of LH, with atypical LH accounting for only a small minority of specimens. Similarly, lesions previously diagnosed as LH are now being revised as low-grade B-cell non-Hodgkin lymphoma or diagnosed as newly described benign conditions such as IgG4-related disease. Additional differential diagnoses include specific and nonspecific orbital inflammations, infiltrative processes, and depositions. Hence, there are emerging changes in the patterns and proportions of entities that fall within the spectrum of lymphoproliferative disorders of the orbit and ocular adnexa. Reactive LH and low-grade malignant lymphoproliferative disorders in the orbit and ocular adnexa are clinically and radiologically indistinguishable from each other, requiring tissue biopsy in all cases. The prognosis of ocular adnexal LH is generally favorable, but the small risk of non-Hodgkin lymphoma mandates follow-up for at least 5 years. We summarize the current state of knowledge on LH occurring in the orbit and ocular adnexa.

Eustachian tube (ET) primary tumors and tumor-like lesions are rare diseases presenting with common ear, nose and throat symptoms. Pathology can range from developmental anomalies to high malignant neoplasms. Hence this review aimed at suggesting a classification and outline relevant aspects of ET primary tumors and tumor-like lesions, describing clinical findings, diagnostic management and therapeutic approaches. MEDLINE, CINAHL, OVIDSP, HIGHWIRE, and GOOGLE databases were searched from inception to July 2011 for relevant studies. Further papers were identified by examining the reference lists of all included. Sixty-five papers met the inclusion criteria, enclosing 78 cases. Case reports are increasing in the past few years. Benign lesions and tumor-like lesions of ET have been reported. Moreover, melanomas, carcinomas, and sarcomas can affect the ET as a primary site.

OBJECTIVE: Review physiological methods of evaluating function of the auditory neural pathways in infants, children, and adults. Present two case studies to demonstrate the usefulness of physiological measures in assessing abnormalities of the auditory neural pathways.
METHODS: Review of applications of physiological measures of auditory neural function.
METHODS: Review otoacoustic emissions, auditory evoked potentials, and efferent reflexes, and discuss their use in identifying disorders of the auditory neural pathways from the cochlea to the cortex.
RESULTS: Auditory disorders occur from peripheral to central areas of the neural system. Patients with disorders of the peripheral nerve and/or the input from the cochlear inner hair cells, such as the patients presently described as having auditory neuropathy, demonstrate abnormal efferent reflexes, including middle ear muscle reflexes and efferent suppression of otoacoustic emissions, as well as grossly abnormal brainstem evoked potentials. In contrast, patients with more central disorders can be differentiated by normal results on tests of the neural periphery and abnormal findings on cortical evoked potentials and other measures of central function.
CONCLUSIONS: Physiological measures are sensitive, objective, and less variable in assessing neural disorders than traditional behavioral measures such as pure-tone or speech audiometry.

Pneumatic otoscopy is a universally recommended method of diagnosing otitis media by detecting the presence of a middle ear effusion and hypomobility of the tympanic membrane. This review presents a synthesis of the existing research on the value of pneumatic otoscopy as a diagnostic tool. A literature search from 1987 to 1997 produced 11 applicable research articles. In five studies, which compared pneumatoscopy with myringotomy, the mean sensitivity score was 89% and the mean specificity score was 80%. In the only study of clinical use of pneumatic otoscopy, 21% of respondents always used it, while 42% never used it as part of their routine examinations. Education level of the examiner had no affect on the value of pneumatoscopic findings. Pneumatic otoscopy is an important diagnostic tool available to all health care providers, but replication of these studies is essential to support these results. Furthermore, research is needed to quantify its actual application on the clinical level.