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Objective: Analysis of labyrinthine 3T-3D flair MRI changes in patients suffering from confirmed Menière's disease (Md). Material and methods: Patients with definite Md were fully explored in a prospective study, using auditory and vestibular tests on the one hand, and labyrinthine 3T-3D flair MRI, during or near (<7 days) an attack of the disease, on the other hand. In particular, they all had pure tone and speech audiometry, either transient otoacoustic emissions or distortion product otoacoustic emissions. The cubic distortion tone at 2f1-f2, around 1kHz with equilevel f1 and f2, and f2/f1@1.2, was recorded in terms of intensity and phase. An acoustic phase shift >40° was considered significant, with or without position changes. Cochlear potential as recorded through electrocochleography were also analyzed, the ratio SP/AP ≥40% being considered abnormal. Vestibular testing used caloric videonystagmography, and vestibular Evoked myogenic potentials. MRI images were acquired 4 hours after injection of gadolinium, using FLAIR sequences in a 3T magnetic field. Endoymphatic hydrops was defined according to the ratio of the volumes between saccule and utricule (SURI), when the saccule was greater than the utricule, or when both structures were convergent and indistinguishable. Results: 50 patients underwent this prospective diagnostic protocol after giving their approval for participating. The sex ratio, female/male was 29/21, and the mean age 52±15 year-old. They all had objective alteration of their functional exploration confirming the diagnosis of Md. Labyrinthine 3T-3D flair MRI was interpreted as abnormal in 39 patients (78%). Conclusions: Coupling clinical examination, electroacoustic auditory and vestibular explorations together with labyrinthine 3T Flair MRI, shows that hydrops can nowadays be visualized in a majority of cases, at least in symptomatic patients. [ABSTRACT FROM AUTHOR]

An earlier report by Mecacci and Rocchetti showed a significant, weak, and positive correlation between Evening type as measured by the Morningness-Eveningness Questionnaire and Type A personality as measured by the Jenkins Activity Survey and the Bortner Type A Scale in Italian college students. The present study of 503 Japanese college students yielded a significant and weakly negative correlation. The bases for the different results were discussed in a psychophysiological context. [ABSTRACT FROM AUTHOR]

Introduction: In clinical practice, speech understanding in noise is most often evaluated using co-located speech and noise (i.e., without spatial cues). The French Matrix test was indeed validated in this condition of administration. Yet, most hearing aid centers in France are equipped with fiveloudspeaker arrays, which allows for speech to be presented from a single loudspeaker directly in front of the listener (0° azimuth) and noise to simultaneously presented from 4 loudspeakers (45°, 135°, 225°, and 315° azimuth; "diffuse noise"). This configuration is meant to be more representative of «ecological condition». Material and methods: We designed a prospective observational study in normal hearing (NH) and hearing impaired (HI) adults. Data were collected between June 2019 and December 2020 and consisted in: pure-tone air conduction thresholds for each ear using headphones for audiometric frequencies 0.5, 1, 2, 4, 6, and 8 kHz. Unaided monosyllable word recognition in quiet was measured in sound field at 65 dBA using monosyllable words from Lafon, in binaural condition. Unaided sentence recognition in noise was measured in sound field using the French Matrix (binaural performance). Results: 297 listeners across 9 hearing centers completed the study. Unaided SRTs in diffuse noise were significantly correlated with PTA thresholds, age at testing, as well as word and phoneme recognition scores in quiet. Stepwise linear regression analysis showed that SRTs in diffuse noise were significantly predicted by a combination of PTA threshold and word recognition scores in quiet. SRTs were measured in co-located and diffuse noise for 65 listeners (13 NH, 22 Mild HL, 19 Mod HL1, and 11 Mod HL2). With co-located noise, the mean SRT and standard deviation was 4.2±1.1, 0.2±3.2, 2.9±2.6, and 8.4±7.0 dB for the NH, Mild HL, Mod HL1, and Mod HL2 groups, respectively. With diffuse noise, the mean SRT and standard deviation was 8.9±1.4, 2.4±4.6, 1.9±4.3, and 8.8±9.2 dB for the NH, Mild HL, Mod HL1, and Mod HL2 groups, respectively. A RM ANOVA with noise type (diffuse, co-located) as the within-subject factor and hearing status group (NH, Mild HL, Mod HL1, Mod HL2) as the between-subject factor showed significant effects for noise type [F(1, 61)=30.3, p<0.001] and subject group [F(3, 61)=15.3, p<0.001]; there was a signifi- cant interaction [F(3, 46)=4.1, p=0.010]. Post-hoc Bonferroni pairwise comparisons showed that SRTs in diffuse noise were significantly lower than SRTs in co-located noise only for the NH and Mild HL groups (p<0.05 in both cases). For diffuse noise, there were significant differences in SRTs among all groups; for co-located noise, there was a significant difference in SRTs among all groups, except for between the Mild HL and Mod HL1 groups. Linear regression analysis showed a significant correlation between SRTs in co-located and diffuse noise (r2=0.71, p<0.001). Conclusions: The results are consistent with previous studies that found that hearing-impaired listeners had greater difficulty using spatial cues to segregate speech and noise. While diffuse noise may not be suitable for clinical evaluation of speech understanding in noise in hearing- impaired listeners, it may provide additional insights into their "real-world" speech understanding in complex listening environments. Moreover, as our study provides the range of possible values of unaided SRTs, they may serve as references for comparison with aided SRTs, more likely to be measured in a diffuse noise setup than in a co-located noise one. [ABSTRACT FROM AUTHOR]

Il existe un consensus depuis 2004 pour proposer une dose de 12 à 13 Gy sur l'isodose d'enveloppe afin de limiter les taux de complication pour les radiochirurgies stéréotaxiques des schwannomes vestibulaires. L'objectif était d'évaluer rétrospectivement l'efficacité et la toxicité de la radiochirurgie stéréotaxique des schwannomes vestibulaires traités sur accélérateur linéaire avec différentes doses d'enveloppe. De 1995 à 2019, chez 97 patients, des schwannomes vestibulaires de stade 1 (1 %), 2 (56 %), 3 (21,5 %) et 4 (21,5 %) ont été traités par irradiation stéréotaxique par accélérateur linéaire avec cadre invasif avant février 2014 (62 %), puis sans cadre (38 %). La dose médiane prescrite en enveloppe était de 14 Gy (extrêmes : 12-16 Gy) avant 2006, puis de 11 Gy pour tous les patients (61)(protocole de désescalade institutionnel). Le volume moyen tumoral était 1,96 cm3 (extrêmes : 0,1–13,2 cm3). Le suivi médian était 8,2 ans. Pour les 97 patients pris en charge, le taux de contrôle local était de 100 %, 98,4 % et 95,6 % respectivement à 2, 5 et 10 ans. Le taux de contrôle local pour une dose d'enveloppe de 11 Gy était de 100 % à 10 ans contre 100 %, 97 % et 94 % respectivement à 2, 5 et 10 ans pour la dose d'enveloppe d'au moins 12 Gy (p = 0,35). Une augmentation transitoire tumorale pouvait être observée jusqu'à 2 ans (12,4 % sur l'IRM à 6 mois et 3,1 % à 1 an). À 5 ans, le taux de toxicité était de 5,5 % sur le nerf facial (1,7 % pour une dose d'enveloppe de 11 Gy contre 11,2 % pour 12 Gy avec p = 0,11, contre 11,2 % si la dose d'enveloppe était supérieure ou égale à 12 Gy avec p = 0,05) et 8,6 % sur le nerf trijumeau (3,7 % si la dose d'enveloppe était de 11 Gy contre 0 % pour 12 Gy avec p = 0,51, contre 14,2 % pour une dose d'enveloppe supérieure ou égale à 12 Gy avec p = 0,11). Le taux de baisse de l'audition chez les patients ayant initialement une audition utile était 41,4 % à 5 ans (42,3 % si la dose d'enveloppe était de 11 Gy contre 44,4 % si elle était supérieure ou égale à 12 Gy, p = 0,71). Une diminution de la dose d'enveloppe à 11 Gy pour les radiochirurgies stéréotaxiques de schwannomes vestibulaires permet de conserver le même taux de contrôle local (100 % à 10 ans) mais avec une réduction du taux de toxicité. [ABSTRACT FROM AUTHOR]

Background and Aims: Patients with head and neck cancer (HNC) are often malnourished with a low muscular mass at the outset of management. This is thought to be mainly due to poor nutritional intake. The aim of this study was to assess the correlation between tumor metabolic activity, inflammatory status and body composition in HNC patients., Materials and Methods: This retrospective study included 112 patients with HNC. Tumor metabolic activity was assessed using the total lesion glycolysis (TLG) and maximum standardized uptake value (SUVmax). Body composition was measured by the third cervical vertebra skeletal muscle index (C3 SMI). Systemic inflammation was measured by the modified Glasgow Prognostic Score (mGPS) and the neutrophil-to-lymphocyte ratio (NLR). Nutritional status was assessed by the Nutritional Risk Index (NRI)., Results: The majority of patients had advanced tumor stage (75%). Malnutrition was found in 39.3% (NRI), and systemic inflammation in 44.7% (mGPS) and 41.1% (NLR) of patients. High TLG was associated with low C3 SMI (p = 0.021), low NRI (p = 0.01), high mGPS (p = 0.001), and high NLR (p = 0.003). A high NLR was associated with a low C3 SMI (p = 0.046) and low body mass index (BMI) (p = 0.01)., Conclusion: Our study establishes a relationship between the high metabolic activity of tumor, the loss of muscle mass, and increased systemic inflammation., (Copyright © 2025. Published by Elsevier Ltd.)

Background/Objectives : Vestibular schwannomas (VSs), also called acoustic neuromas, are benign tumors affecting the vestibulocochlear nerve, often leading to hearing loss and balance issues. This condition is particularly challenging in patients with neurofibromatosis type 2 (NF2), where VSs tend to develop bilaterally. Conventional treatments, such as surgery and radiotherapy, although effective, carry risks like hearing loss and nerve damage. Bevacizumab, a VEGF-targeting monoclonal antibody, has emerged as a less invasive treatment option, showing potential for tumor volume reduction and hearing preservation. This systematic review aims to assess the efficacy of bevacizumab in controlling tumor volume, preserving hearing, and identifying associated adverse events. Methods : A comprehensive systematic review was performed using PRISMA guidelines. PubMed and Cochrane Library databases were searched for studies evaluating the effects of bevacizumab on VS, focusing on key outcomes like tumor volume reduction, hearing preservation, and adverse events. Data extraction and quality assessment were independently conducted by two reviewers using the Newcastle-Ottawa Scale. Results : Nine studies involving 176 patients were included. Bevacizumab showed a partial tumor volume reduction (≥20%) in 40% of cases and disease stabilization in 50%, while 10% experienced tumor progression. Hearing outcomes revealed improvement in 36% of patients, stabilization in 46%, and deterioration in 18%. Severe adverse effects, including hypertension and thromboembolic events, occurred in 13% of patients, while 18% reported no side effects. Tumor regrowth was observed in some patients after treatment discontinuation, emphasizing the need for long-term monitoring. Conclusions : Bevacizumab demonstrates effectiveness in managing VS, particularly in NF2 patients, by reducing tumor size and preserving hearing in a substantial proportion of cases. However, the variability in patient response and the risk of adverse events underscore the need for individualized treatment approaches and further research, including randomized controlled trials, to optimize its clinical application.

Purpose: Diagnosis of Menière's disease relies on clinical symptoms. Injected 3T MRI can show endolymphatic hydrops (EH), but correlation with the clinical status of MD, (probable -PMD or definite-DMD) remains doubtful. We revealed endolymphatic pressure disruption through functional exploration and verified if it was associated with an EH through MRI., Materials and Methods: We prospectively analyzed 3D3T FLAIR MRI of DMD and PMD patients. All of them underwent electrocochleography (EcoG), distortion-product otoacoustic emissions (DPOAEs), and videonystagmograhy (VNG). Amplitudes of summating potential (SP) and cochlear nerve action potential (AP) were measured on EcoG. DPOAE-phase was collected at 1 kHz for the 2f1-f2 DPOAE between sitting and laying position. A SP/AP ≥ 40% and a DPOAE phase-shift > 40° revealed pressure disruption., Results: 39 patients (25 women, 53 y.o. 20-78), were included, with 32 DMD ears and 11 PMD ears. MRI was performed in a median of 21 days [0; 68] from the MD incident. Audiovestibular exploration took place 41 days after the crisis [0;83]. MRI revealed an EH in 71.9% and 27.2% of DMD and PMD, respectively. When combining functional explorations and MRI, testing was positive in 97% for DMD and 82% for PMD. When abnormal (59%), VNG mainly showed hyporeflexia in the diseased ear., Conclusion: In patients suffering from DMD or PMD, with endolymphatic pressure disturbances confirmed by combined DPOAE-phase and EcoG, 3T 3D MRI reveals EH mostly in DMD but rarely in PMD. This seems to confirm that disturbance of endolymphatic pressure precedes EH., (© 2024. The Author(s).)