[Feasibility of clinical examination scenarios under pandemic conditions]. / Möglichkeit von Prüfungsszenarien unter Pandemiebedingungen.

BACKGROUND: Due to the COVID-19 pandemic, contact restrictions occurred worldwide, which affected medical schools as well. It was not possible to hold classroom lectures. Teaching contents had to be converted to a digital curriculum within a very short time. Conditions for assessments posed an even greater challenge. For example, solutions had to be found for objective structured clinical examinations (OSCE), which were explicitly forbidden in some German states. The aim of this study was to evaluate the feasibility of an OSCE under pandemic conditions. MATERIALS AND METHODS: At the end of the 2020 summer semester, 170 students completed a combined otolaryngology and ophthalmology OSCE. Examinations were held in small groups over the course of 5 days and complied with strict hygiene regulations. The ophthalmology exam was conducted face to face, and the ENT OSCE virtually. Students were asked to rate the OSCE afterwards. RESULTS: Between 106 and 118 of the students answered the questions. Comparing the face-to-face OSCE with the virtual OSCE, about 49% preferred the face-to-face OSCE and 17% preferred the virtual OSCE; 34% found both variants equally good. Overall, the combination of an ENT and ophthalmology OSCE was rated as positive. CONCLUSION: It is possible to hold an OSCE even under pandemic conditions. For optimal preparation of the students, among other things, it is necessary to transform teaching contents to a digital curriculum. The combination of an ENT and ophthalmology OSCE was positively evaluated by the students, although the face-to-face OSCE was preferred. The overall high satisfaction of the students confirms the feasibility of a virtual examination with detailed and well-planned preparation.

Navigated, endoscopically controlled, transtympanic resection of an infracochlear cholesteastoma recurrence.

An infracochlear cholesteatoma of the petrous apex with direct contact to the internal carotid artery (ICA) is rare. Due to the risk of cochlear injury with consecutive deafness or injury of the ICA, precise preoperative planning of the approach and strategy is recommended, as well as thorough preoperative counseling of the patient for their informed consent. This case report presents navigated endoscopically controlled transtympanic resection of such a cholesteatoma recurrence. Hearing capacity was not impaired and the patient shows no signs of recurrence.

Speech Recognition in Noise in Single-Sided Deaf Cochlear Implant Children on Using Adaptive Digital Microphone Technology.

BACKGROUND: Previous research demonstrated benefits of adaptive digital microphone technologies (ADMTs) in adults with single-sided deafness (SSD) having a cochlear implant (CI). Children with SSD are especially affected by background noise because of their noise exposure in kindergarten and school. PURPOSE: This article aims to evaluate possible effects of ADMT on speech recognition in background noise in children with SSD who use a CI. STUDY SAMPLE: Ten children between 5 and 11 years of age were included. DATA COLLECTION AND ANALYSIS: Speech recognition in noise was assessed for one frontal distant and two lateral speakers. The speech stimulus was presented at a speech level of 65 dB(A) and noise at a level of 55 dB(A). For the presentation condition with one frontal speaker, four listening conditions were assessed: (1) normal-hearing (NH) ear and CI turned off; (2) NH ear and CI; (3) NH ear and CI with ADMT; and (4) NH ear with ADMT and CI. Listening conditions (2) to (4) were also tested for each lateral speaker. The frontal speaker was positioned directly in front of the participant, whereas the lateral speakers were positioned at angles of 90 degrees and -90 degrees to the participant's head. RESULTS: Children with SSD who use a CI significantly benefit from the application of ADMT in speech recognition in noise for frontal distant and for lateral speakers. Speech recognition improved significantly with ADMT at the CI and the NH ears. CONCLUSION: Application of ADMT significantly improves speech recognition in noise in children with SSD who use a CI and can therefore be highly recommended. The decision of whether to apply ADMT at the CI NH ear or bilaterally should be made for each child individually.

[Navigated endoscopically controlled transtympanic resection of an infracochlear cholesteatoma recurrence. German version]. / Navigierte endoskopisch-kontrollierte transtympanale Resektion eines infracochleären Cholesteatomrezidivs.

An infracochlear cholesteatoma of the petrous apex with direct contact to the internal carotid artery (ICA) is rare. Due to the risk of cochlear injury with consecutive deafness or injury of the ICA, precise preoperative planning of the approach and strategy is recommended, as well as thorough preoperative counseling of the patient for their informed consent. This case report presents navigated endoscopically controlled transtympanic resection of such a cholesteatoma recurrence. Hearing capacity was not impaired and the patient shows no signs of recurrence.

[Synchronous schwannoma of the vagus nerve and the cervical sympathetic chain]. / Synchrones Schwannom des N. vagus und des zervikalen sympathischen Grenzstrangs.

Schwannomas are rare neural sheath tumors which are generally benign. Up to 45% of all schwannomas originate in the head and neck region. In the parapharyngeal space (PPS) they may arise from any of the lower cranial nerves IX, X, XI and XII or from the cervical sympathetic chain. We report a unique case of a synchronous schwannoma of the vagal nerve and the cervical sympathetic chain in a patient without neurofibromatosis.

[Stimulation-dependent gene expression in the central auditory system]. / Stimulationsabhängige Genexpression im zentralen auditorischen System.

Acoustic or electrical stimulation activate specific populations of neurons in specific regions of the central auditory system to prepare for a molecular, structural, and functional remodeling within hours. Among the indicators for the initiation of neuronal remodeling is the expression of immediate early genes (IEGs). The IEG c-fos is one of the first genes to be expressed following sensory-evoked neuronal activity. In order to investigate activity-dependent neuroplasticity in the central auditory system we applied acute unilateral electrical intracochlear stimulation (EIS) in a rat model. By using different stimulation parameters we found that laterality, intensity, and frequency effect different kinds of neurons in different regions. We investigated the ventral and dorsal cochlear nucleus (VCN and DCN), the lateral superior olive (LSO), the central inferior colliculus (CIC), and the medial geniculate body (MGB). In each region a unique dynamic pattern of c-Fos expression was found.