Olfactory neuroblastoma (ONB) is an uncommon malignant tumor and is usually treated by a multidisciplinary approach includes surgery, radiotherapy, and chemotherapy. A 62 years-old male had a tumor in the nasal cavity and diagnosed as ONB with Kadish A stage. Anterior skull base surgery was performed as radical treatment. Since the surgical margin was negative, no postoperative radiotherapy was administered. 14 years after the surgery, bilateral otitis media with effusion (OME) was occurred, we found the recurrence tumor at bilateral retropharyngeal lymph node (RPLN) which surrounded the internal carotid arteries. Since these were unresectable, we planned chemoradiotherapy which was 70Gy of intensity modulated radiotherapy combined with two courses of carboplatin and etoposide. The tumor volume was reduced and bilateral OME were improved. He has been alive for 3 years after salvage treatment. Although ONB has a relatively good prognosis, it is known to often cause cervical lymph node metastasis. Grades III and IV of Hyams classification are considered high risk. This case, initial tumor was limited in the nasal cavity and its clinical classification was early stage, but Hyams classification was grade III. In reference to this case, considering that RPLN metastasis are difficult to radically resect at the salvage surgery, including this area in postoperative radiotherapy was considered an option.

In recent years, the use of smartphones and other wireless technology in medical care has developed rapidly. However, in some cases, especially for pediatric medical problems, the reliability of information accessed by mobile health technology remains debatable. The main aim of this paper is to evaluate the relevance of smartphone applications in the detection and diagnosis of pediatric medical conditions for which the greatest number of applications have been developed. This is the case of smartphone applications developed for the diagnosis of acute otitis media, otitis media with effusion, hearing impairment, obesity, amblyopia, and vision screening. In some cases, the information given by these applications has significantly improved the diagnostic ability of physicians. However, distinguishing between applications that can be effective and those that may lead to mistakes can be very difficult. This highlights the importance of a careful application selection before including smartphone-based artificial intelligence in everyday clinical practice.

OBJECTIVE: To describe secondary secretory otitis media (SSOM) due to obstruction of the nasopharyngeal opening of the auditory tube in cats and dogs and to characterize the effusion by macroscopic description, microscopic cytology and bacteriological analysis.
METHODS: Three cats and 2 dogs with middle ear effusion and obstruction of the nasopharyngeal opening of the auditory tube detected on CT scans received myringotomy followed by macroscopic description, microscopic cytology and bacteriological analysis of the fluid obtained.
RESULTS: All animals had serous to mucoid middle ear effusions and, in 2 cases, large numbers of inflammatory cells and secondary infection. Causes of auditory tube dysfunction ranged from iatrogenic stents (2) to neoplasia (3). In the non-neoplastic cases, effusion resolved in all cases after removal of the underlying cause.
CONCLUSIONS: Obstruction of the nasopharyngeal opening of the auditory tube leads to accumulation of fluid within the middle ear in cats and dogs. If the cause of obstruction can be removed, fluid accumulation resolves. Fluid characteristics are comparable to middle ear effusions in pugs and French bulldogs. It is important to always examine the nasopharynx in cases of middle ear effusion to rule out SSOM.
UNASSIGNED: Eine sekretorische Otitis media mit Paukenhöhlenerguss kann durch Obstruktionen der pharyngealen Öffnung der Eustachischen Röhre ausgelöst werden. Ziel dieser Arbeit war die makroskopische Beschreibung des Ergusses bei Katzen und Hunden sowie die mikroskopische und bakteriologische Analyse.
METHODS: Drei Katzen und 2 Hunde mit Paukenhöhlenergüssen und einer in der Computertomografie detektierten Obstruktion der nasopharyngealen Öffnung der Eustachischen Röhre wurden in die Studie eingeschlossen. Das per Myringotomie gewonnene Sekret wurde makroskopisch, zytologisch und bakteriologisch untersucht.
UNASSIGNED: In allen Fällen war das Sekret serös bis mukös. In 2 Fällen wurde eine hohe Anzahl an Entzündungszellen mit einer sekundären Infektion nachgewiesen. Ursachen für die Obstruktion der Eustachischen Röhre reichten von iatrogen durch einen nasopharyngealen Stent (2) bis zu Neoplasie (3). In allen nicht-neopastischen Fällen waren die Paukenhöhlenergüsse nach Entfernung der auslösenden Obstruktion reversibel.
UNASSIGNED: Eine Obstruktion der nasopharyngealen Öffnung der Eustachischen Röhre führt zu einem Flüssigkeitserguss im Mittelohr bei Hunden und Katzen. Wenn die Obstruktion behoben werden kann, sind diese Ergüsse reversibel. Analysen der Ergüsse gleichen denen bei brachyzephalen Hunden. Im Falle eines Paukenhöhlenergusses sollte immer auch der Nasopharynx untersucht werden, um eine sekundäre sekretorische Otitis media auszuschließen.

OBJECTIVE: Increased neonatal referral rate of conductive hearing loss (CHL) related to otitis media with effusion (OME) following universal neonatal hearing screening (UNHS) may cause an unnecessary clinical, emotional, and financial burden. This study analyzes the long-term, audiological, and medical characteristics of CHL associated with OME in neonates in order to establish a standardized protocol following technology-driven improvements in detection and referral rates in UNHS.
METHODS: A retrospective study of all neonates with OME-related CHL referred to the University Hospital of Leuven (Belgium) after failing UNHS with the MAICO devices between January 1, 2013 and December 31, 2021 was performed. Follow-up consultations, auditory tests, referral side, birth month, hearing loss degree, underlying pathologies and risk factors, time to normalization, and need for ventilation tubes were assessed.
RESULTS: The incidence of CHL related to OME was stable between 2013 and 2021. Of all referred infants with OME, 52.3 % demonstrated spontaneous recovery. The average time to hearing normalization was significantly longer in children with underlying congenital pathologies compared to those without. Moreover, 74.4 % of these children received ventilation tubes compared to 32.0 % of children without underlying pathologies. No correlation was found between the incidence of OME-related CHL with either a hearing loss degree, admission to neonatal intensive care, or history of a nasogastric feeding tube.
CONCLUSIONS: In children who failed UNHS due to OME, hearing recovers spontaneously without surgical intervention in 2/3 of the infants without underlying conditions within one year. In children with underlying congenital disorders, the time to hearing recovery is longer and the risk for surgical intervention is higher, underlining the need for implementing a UNHS standardized protocol.

OBJECTIVE: Otitis media with effusion (OME) is a prevalent and costly disease, especially in children. This article analyzed the expression patterns and clinical significance of T helper-1 (Th1)/Th2 cytokines in the peripheral blood of children with OME and allergic rhinitis (AR).
METHODS: Subjects were assigned to the OME + AR group and the Control group (children with OME), with their clinical baseline data documented. The correlations between Th1/Th2 cytokines and between the total nasal symptom score (TNSS) and Th1/Th2 cytokines were analyzed. The risk factors and the predictive value of Th1/Th2 cytokines for OME + AR were analyzed using logistics multivariate regression analysis and receiver operating characteristic curve.
RESULTS: Significant differences were observed in tympanic pressure/speech frequency/air conduction valve/TNSS score/immunoglobulin E (IgE) level between both groups. The OME + AR children exhibited evidently elevated interleukin-2 (IL-2)/tumor necrosis factor-α (TNF-α)/IL-4/IL-10/IL-6 levels and no significant difference in interferon-γ (IFN-γ) level. Th1/Th2 cytokines were remarkably positively-correlated with the TNSS score. IL-2/TNF-α/IL-4/IL-6 were risk factors for OME with AR. The area under the curves (AUCs) of IL-6/IL-2/IL-4/TNF-α levels in predicting the occurrence of OME + AR were 0.805/0.806/0.775/0.781, with sensitivities of 75.76 %/89.39 %/72.21 %/72.73 % and specificities of 74.29 %/61.34 %/72.86 %/70.00 %, and the cut-off values were 239.600/20.300/29.880/34.800 (pg/mL). The AUC of their combination in predicting OME + AR was 0.955 (93.94 % sensitivity, 85.71 % specificity).
CONCLUSIONS: Th1/Th2 cytokine levels were imbalanced and obviously positively-correlated with the TNSS score in OME + AR children. IL-2, TNF-α, IL-4, and IL-6 levels had auxiliary predictive value in the occurrence of OME + AR.

UNASSIGNED:
Eosinophilic otitis media (EoOM) is a variant of exudative otitis media characterized by a persistent persistent course, the presence of a very viscous effusion in the tympanic cavity, comorbidally associated with chronic polypous rhinosinusitis and bronchial asthma. The disease is characterized by a persistent progressive course, which can lead to a gradual decrease in hearing up to complete deafness. Conservative treatment methods for EoOM include local and systemic administration of glucocorticosteroids. Encouraging data on the effectiveness of biological therapy have appeared in recent publications. The above clinical observation examines the course of EoOM in a patient who received biological therapy with dupilamab.
Эозинофильный средний отит (ЭоСО) — вариант экссудативного среднего отита, характеризующийся упорным персистирующим течением, наличием очень вязкого выпота в барабанной полости, коморбидно связанный с хроническим полипозным риносинуситом и бронхиальной астмой. Заболевание отличается упорным прогредиентным течением, что может привести к постепенному снижению слуха вплоть до полной глухоты. Консервативные методы лечения ЭоСО включают местное и системное введение глюкокортикостероидов. В публикациях последних лет появились обнадеживающие данные об эффективности биологической терапии. В приведенном клиническом наблюдении рассматривается течение ЭоСО у пациентки, получавшей биологическую терапию дупилумабом.

OBJECTIVE: To present and evaluate the treatment of ciprofloxacin-resistant Pseudomonas mastoid cavity otorrhea with a ceftazidime thermosensitive poloxamer gel.
METHODS: A retrospective clinical capsule report.
METHODS: Three patients diagnosed with ciprofloxacin-resistant Pseudomonas otorrhea in the setting of a previous canal-wall-down mastoidectomy between March 2019 and June 2023 visiting our tertiary care institution were retrospectively reviewed.
METHODS: Application of a 2% ceftazidime thermosensitive poloxamer gel to mastoid cavity.
METHODS: No evidence of disease during microscopic inspection of the ear within a month of initial treatment or bacterial eradication on subsequent culture.
RESULTS: Two patients had complete resolution of symptoms and achieved a safe and dry ear after topical application of the hydrogel. The second patient had pseudomonal eradication on culture, but persistent otorrhea due to other multidrug-resistant bacteria and an anatomically unfavorable mastoid cavity, which ultimately resolved after revision surgery.
CONCLUSIONS: This small case series suggests that topical treatment of mastoid cavity otorrhea with a 2% ceftazidime poloxomer gel is a potential therapeutic avenue in patients with ciprofloxacin-resistant Pseudomonas .

OBJECTIVE: Surgery with ventilation tubes (VT) in children suffering from otitis media with effusion is quite common. However, the knowledge surrounding parents\' expectations to the treatment and postoperative care is sparse. The aim of this study was to describe the parents\' expectations to VT surgery and postoperative care shortly after surgery.
METHODS: A qualitative study was conducted based on semi-structured individual interviews with parents recruited from a study where postoperative care was randomized to either an otolaryngologist or the patient\'s general practitioner (GP). The interviews were conducted within the first weeks after surgery and analyzed by reflexive thematic analysis.
RESULTS: In total, 13 parents aged 29-42 years participated in the study. We identified three main themes elucidating parents\' expectations to VT surgery and postoperative care: 1) Preconceptions about VT surgery and hearing - most parents expected surgery to restore the child\'s normal hearing, and some were uncertain about their knowledge of normal hearing and VT treatment; 2) A safety net to ensure hearing and function - it was reassuring if the child received structured postoperative care that secured and notified appointments and had quick access to a specialist if needed; 3) High-quality care - most parents expected the otolaryngologist to provide the highest level of quality of care due to their specialist competence, special equipment and sufficient understanding of the problem to communicate well with parents. Postoperative care by the GP was perceived as incomplete among most parents due to a lack of both specialist competence and access to audiometry.
CONCLUSIONS: Parents expect postoperative care to safeguard their child as long as needed after VT surgery, and they expect access to high-quality care. Low health literacy among some parents challenges the current method of postoperative care and requires that more emphasis be set on both informing and educating parents regarding hearing and VT treatment.

BACKGROUND: Few studies have examined the otologic symptoms of Coronavirus disease 2019 (COVID-19). The objective of this study was to identify the effect of COVID-19 on the characteristics and outcomes of patients who have otitis media with effusion (OME).
METHODS: This case-control study compared the characteristics and outcomes of OME patients who did or did not have COVID-19. A total of 65 patients with previous COVID-19 and 40 patients who did not have COVID-19 (controls) were enrolled from October 1, 2022 to January 31, 2023 at a single institution in China. Demographics, medical histories, morbidities, hearing test results, treatments, and outcomes of the two groups were compared.
RESULTS: The COVID-19 group had significantly better outcomes from OME than the control group, with higher rates of complete resolution (64.6% vs. 30%) and improvement (30.8% vs. 17.5%), and a lower rate of persistent OME (4.6% vs. 52.5%). Previous COVID-19 was independently associated with a more favorable OME outcome in three multivariate logistic regression models. The COVID-19 group also had a greater improvement in hearing threshold based on air-bone gap measurements.
CONCLUSIONS: The outcomes of OME patients who had previous COVID-19 were generally good, in that most patients responded well to treatment and achieved complete resolution or improvement within one month.

OBJECTIVE: To evaluate the influencing factors of otitis media with effusion (OME) in children with adenoid hypertrophy and to provide evidence for clinical treatment and care of children with adenoid hypertrophy.
METHODS: A retrospective study.
METHODS: Preschool children with adenoid hypertrophy treated in our hospital from 1 January 2021 to 30 July 2022 were included. We analysed the characteristics of OME and non-OME children with adenoid hypertrophy. Pearson correlation analysis and logistic regression analysis were performed to evaluate the risk factors for OME in children with adenoid hypertrophy.
CONCLUSIONS: A total of 166 children with adenoid hypertrophy were included; the incidence of OME in children with adenoid hypertrophy was 34.94%. The incidence of OME decreased significantly with the increase in age (p = 0.014). Logistic regression analysis showed that age < 3 years (OR = 3.149, 95%CI: 2.812-3.807) and duration of adenoid hypertrophy ≥12 months (OR = 2.326, 95%CI: 2.066-2.612) were the risk factors of OME in children with adenoid hypertrophy (all p < 0.05).
UNASSIGNED: The incidence of adenoid hypertrophy with OME is high in preschool children, and it is related to the age and duration of adenoid hypertrophy.