Self-reported mini olfactory questionnaire (Self-MOQ): A simple and useful measurement for the screening of olfactory dysfunction.

OBJECTIVES: Olfactory dysfunction is a common problem. However, too little attention has been paid to questionnaires used to evaluate quantitative olfactory dysfunction. Therefore, the current study aimed to develop a simple self-reported Mini Olfactory Questionnaire (Self-MOQ) for the screening of quantitative olfactory dysfunction in clinical practice. METHODS: Two hundred and eighty-five patients who had subjective complaints of olfactory disorder participated. The Sniffin' Sticks test score was used to define functional anosmia, hyposmia, or normosmia. We assessed the factor structure as well as internal consistency, convergent validity, and discrimination performance. RESULTS: The results showed that the final version of the Self-MOQ included only one factor with five items. The Self-MOQ has a good internal reliability (Cronbach's α = 0.84) and validity (r = -0.60, P < 0.001). The receiver operating characteristic analyses indicated that the Self-MOQ as compared to a visual analogue scale (VAS) is an effective measure for discriminating normosmic from hyposmic/anosmic patients, anosmic patients, and hyposmic patients. CONCLUSION: The Self-MOQ is a simple, reliable and valid questionnaire to screen olfactory dysfunction in clinical practice that appears to be superior to the use of VASs but does not replace olfactory testing. LEVEL OF EVIDENCE: 4 Laryngoscope, 2019.

[Diagnostics and Surgical Therapy of Otosclerosis - Part 2: Indication, Surgical Procedure and Postoperative Treatment]. / Diagnostik und operative Therapie der Otosklerose.

After approximately 100 years of development and stepwise improvement, stapes surgery is a succesful strategy of managing hearing loss in otosclerosis, although challanges remain. Contraindications include too poor speech understanding (not enough inner ear reserve), and acute or chronic inflammation of the external ear and middle ear. Stapes surgery in the last hearing ear can today be indicated in exceptional cases, especially if the contralateral ear was supplied with a cochlear implant. In case of simultaneous occurrence of pronounced external auditory canal exostoses, a staged procedure may be useful.The surgical principle is to mechanically replace the fixed stapes with a piston-shaped implant under perforation or partial removal of the stapes footplate. Laser-assisted stapes surgery has proven itself in practice and the laser is used regularly today. In regard to revision surgery the increased risk of hearing loss or deafness and vertigo has to be considered. Revisions are made in the event of complications and persistent or newly occurring conductive components. In the case of insufficient hearing rehabilitation, alternative options should be considered, e. g. the combination of a stapes plastic with an active middle ear implant, or a cochlear implant.

[Diagnosis and operative therapy of otosclerosis - Part 1: Basics, Diagnostics and Differential Diagnosis]. / Diagnostik und operative Therapie der Otosklerose.

Otosclerosis is an important condition for the otorhinolaryngologist, and often in (differential) diagnosis and therapy challenging disease. Although a causal therapy option does not exist until today, if the diagnosis is correct, an operative or apparative hearing rehabilitation with very high chances of success can be promised. In addition to hearing aids surgical treatment with passive implants as a standard therapy, and in special cases also the implantation of active middle ear implants or cochlear implants, in advanced otosclerosis with significant involvement of the inner ear, are of importance. Knowledge of the definition, pathogenesis, diagnostics and in particular of the differential diagnosis as well as the current conservative and operative therapeutic limits are indispensable for the indication and selection of the optimal treatment path.In a two-part presentation, the current specialist medical knowledge of the disease in diagnosis and therapy is summarized. In addition to modern diagnostic procedures, aspects of therapy and prognosis are considered in a second article. This article therefore primarily refers to continuing education for residents in training and for young specialists.

A New Intraoperative Real-time Monitoring System for Reconstructive Middle Ear Surgery: An Experimental and Clinical Feasibility Study.

HYPOTHESIS: Electromagnetical excitation of ossicular vibration is suitable for middle ear transmission measurements in the experimental and clinical setting. Thereby, it can be used as a real-time monitoring system for quality control in ossiculoplasty. BACKGROUND: Positioning and coupling of middle ear prosthesis are a precondition for good postoperative hearing results, but at the same time completely dependent upon the surgeon's subjective judgment during surgery. We evaluated an electromagnetically driven measurement system that enables for in vitro and in vivo transmission measurements and thus can be used as a real-time monitoring tool in ossicular reconstruction. METHODS: For electromagnetical excitation a magnet was placed on the umbo of the malleus handle and driven by a magnetic field. The induced stapes displacement was picked up by laser Doppler vibrometry on the footplate. Measurements were performed on the intact ossicular chain in five cadaveric temporal bones and during five cochlear implant surgeries. Additionally, two ossiculoplasties were performed under real-time transmission feedback with the monitoring system. RESULTS: Experimentally, the equivalent sound pressure level of the electromagnetic excitation was about 70 to 80 dB which is 10 to 20 dB less than the acoustic stimulation. In the intraoperative setup the generated stapes displacements were about 5 to 20 dB smaller compared with the temporal bone experiments. Applied as real-time feedback system, an improvement in the middle ear transfer function of 4.5 dB in total and 20 dB in partial ossicular reconstruction were achieved. CONCLUSION: The electromagnetical excitation and measurement system is comparable to the gold standard with acoustical stimulation in both, the experimental setup in temporal bones as well as in vivo. The technical feasibility of the electromagnetical excitation method has been proven and it is shown that it can be used as a real-time monitoring system for ossiculoplasty in the operation room.