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Objectives: Training of temporal bone drilling requires more than mastering technical skills with the drill. Skills such as visual imagery, bimanual dexterity, and stress management need to be mastered along with precise knowledge of anatomy. In otorhinolaryngology, these psychomotor skills underlie performance in the drilling of the temporal bone for access to the inner ear in cochlear implant surgery. However, little is known about how psychomotor skills and workload management impact the practitioners' continuous and overall performance. Methods: To understand how the practitioner's workload and performance unfolds over time, we examine task‐evoked pupillary responses (TEPR) of 22 medical students who performed transmastoid‐posterior tympanotomy (TMPT) and removal of the bony overhang of the round window niche in a 3D‐printed model of the temporal bone. We investigate how students' TEPR metrics (Average Pupil Size [APS], Index of Pupil Activity [IPA], and Low/High Index of Pupillary Activity [LHIPA]) and time spent in drilling phases correspond to the performance in key drilling phases. Results: All TEPR measures revealed significant differences between key drilling phases that corresponded to the anticipated workload. Enlarging the facial recess lasted significantly longer than other phases. IPA captured significant increase of workload in thinning of the posterior canal wall, while APS revealed increased workload during the drilling of the bony overhang. Conclusion: Our findings contribute to the contemporary competency‐based medical residency programs where objective and continuous monitoring of participants' progress allows to track progress in expertise acquisition. Laryngoscope, 134:5087–5095, 2024 [ABSTRACT FROM AUTHOR]

Background: Our population‐based study has previously shown that being born in winter or spring was associated with adult‐onset asthma. The aim was to study if season of birth (SOB) is associated with airway allergy and related diseases: NSAID exacerbated respiratory disease (N‐ERD), asthma, allergic rhinitis (AR), nonallergic rhinitis (NAR), chronic rhinosinusitis with nasal polyps (CRSwNP) and CRS without nasal polyps (CRSsNP) in Finland. Methods: A randomly sampled retrospective registry‐based follow‐up data (n = 74,868) of patients visiting Hospital District of Helsinki and Uusimaa (HUS) in Finland was used. The birth date, sex, visit date and comorbidities were collected from electronic health record data during visits from 2005 to 2019. Results: The mean (SD, range) age of the sample was 34.53 (25.47, 0–102) years, with 48.7 % being men. We divided the whole population in four groups based on the season they were born (SOB‐groups). When observing these four SOB‐groups, the proportion of those having asthma was 43.1%, 42.1%, 41.1%, 42.7%, in winter, spring, summer, and autumn SOB‐groups, respectively. The proportion of those having AR was 12.6%, 12.0%, 10.7%, 12.1%, respectively. When having summer as a reference, being born in any other time of year was significantly associated with AR and, being born in autumn or winter was associated with asthma. No significant association was observed in CRS or N‐ERD or NAR groups in adjusted models. Conclusions: The study suggests that early life immunological events may have a role a role in pathogenesis of asthma and AR. As no association was observed between SOB and CRSsNP, CRSwNP, N‐ERD or NAR, further studies on this are warranted. [ABSTRACT FROM AUTHOR]

Purpose: Consumer-grade virtual reality (VR) has recently enabled various medical applications, but more evidence supporting their validity is needed. We investigated the accuracy of simulated surgical planning in a VR environment (VR) with temporal bones and compared it to conventional cross-sectional image viewing in picture archiving and communication system (PACS) interface. Methods: Five experienced otologic surgeons measured significant anatomic structures and fiducials on five fresh-frozen cadaveric temporal bones in VR and cross-sectional viewing. Primary image data were acquired by computed tomography. In total, 275 anatomical landmark measurements and 250 measurements of the distance between fiducials were obtained with both methods. Distance measurements between the fiducials were confirmed by physical measurement obtained by Vernier caliper. The experts evaluated the subjective validity of both methods on a 5-point Likert scale qualitative survey. Results: A strong correlation based on intraclass coefficient was found between the methods on both the anatomical (r > 0.900) and fiducial measurements (r > 0.916). Two-tailed paired t-test and Bland–Altman plots demonstrated high equivalences between the VR and cross-sectional viewing with mean differences of 1.9% (p = 0.396) and 0.472 mm (p = 0.065) for anatomical and fiducial measurements, respectively. Gross measurement errors due to the misidentification of fiducials occurred more frequently in the cross-sectional viewing. The mean face and content validity rating for VR were significantly better compared to cross-sectional viewing (total mean score 4.11 vs 3.39, p < 0.001). Conclusion: Our study supports good accuracy and reliability of VR environment for simulated surgical planning in temporal bones compared to conventional cross-sectional visualization. [ABSTRACT FROM AUTHOR]

Speech-in-noise tests are widely used in hearing diagnostics but typically without reverberation, although reverberation is an inextricable part of everyday listening conditions. To support the development of more real-life-like test paradigms, the objective of this study was to explore how spatially reproduced reverberation affects speech recognition thresholds in normal-hearing and hearing-impaired listeners. Thresholds were measured with a Finnish speech-in-noise test without reverberation and with two test conditions with reverberation times of ∼0.9 and 1.8 s. Reverberant conditions were produced with a multichannel auralisation technique not used before in this context. Thirty-four normal-hearing and 14 hearing-impaired listeners participated in this study. Five people were tested with and without hearing aids. No significant differences between test conditions were found for the normal-hearing listeners. Results for the hearing-impaired listeners indicated better performance for the 0.9 s reverberation time compared to the reference and the 1.8 s conditions. Benefit from hearing aid use varied between individuals; for one person, an advantage was observed only with reverberation. Auralisations may offer information on speech recognition performance that is not obtained with a test without reverberation. However, more complex stimuli and/or higher signal-to-noise ratios should be used in the future. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Capture the human inner-ear malformation types in 3D by segmenting the inner-ear structures from clinical CT (computed tomography) and MR (magnetic resonance) image datasets. Volumetric analysis was done to find the variations in the volume of cochlear part alone from complete inner-ear followed by 3D printing from the 3D segmented models. MATERIALS AND METHODS: Using 3D slicer freeware, the complete inner-ear structures were segmented from anonymized CT and MR image by setting a tight grey-scale threshold to avoid capturing unwanted structures followed by volumetric analysis of the cochlear part alone. 3D printing was done using Form labs desktop 3D printer. RESULTS: We identified 2x normal anatomy (NA) cochlea, 1x enlarged vestibular aqueduct syndrome (EVAS), 3x incomplete partition (IP) type-I, 4x IP type-II, 3x IP type-III, 5x common cavity (CC) and 5x cochlear hypoplasia (CH). 3D segmented models along with the 3D printed models showed huge variation in size, shape and the anatomy among the image data-sets analyzed. Volumetric analysis showed that on average, volume of CC was above 150mm3, volume of CH fell below 80mm3, Volume of NA, EVAS and IP-I were all around 85-105mm3 whereas the volume of IP-II was around 50mm3. CONCLUSION: Visualizing human inner-ear malformation types in 3D both as computer models and as 3D printed models is a whole-new experience as demonstrated in this study. The volumetric analysis showed a huge variation among the volume of cochlear part alone among the malformation types. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of this study was to evaluate and compare myringoplasty results from two different consecutive series conducted at the Kuopio University Hospital during a four-decade period. MATERIALS and METHODS: We reviewed 315 patients (a total of 338 ears) who underwent myringoplasty at Kuopio University Hospital between the years 1986 and 2012. The results from this series were compared with those form a previously published series of 404 patients who underwent myringoplasty between 1970 and 1985 at the same institution. RESULTS: Myringoplasty was considered to be successful whenever the tympanic membrane remained closed without atelectasis. The results were analyzed at the 1- and 3-year follow-up. The overall success rate after 1 year was 82.8% compared with 88% in the previous series. The success rate after 3 years was 87.4%. The best closure rate after 1 year (85.7%) was achieved with fascia grafts (n=272) and perichondrium (85.7%, n=14). The closure rate of 61.9% with the perichondrium/cartilage graft (n=21) and 71.0% with the fat graft (n=31) was statistically significantly lower (p<0.05) compared with that with the fascia graft. The postoperative air-bone gap (0.5-4 kHz) was <10 dB(HL) in 56.2% and <20 dB(HL) in 79.6% cases compared with 61% and 87%, respectively, in previous series. CONCLUSION: Myringoplasty is a safe procedure with a reasonably high success rate. We observed a slight deterioration in the overall results compared with the previous series. This study highlights the importance of systematic quality control and the results and the need for follow-up of the learning curve after the introduction of new surgical techniques and materials. [ABSTRACT FROM AUTHOR]