Die Inzidenz von mit humanen Papillomaviren (HPV-)assoziierten Oropharynxkarzinomen („oropharyngeal squamous cell carcinoma“, OPSCC) nimmt weltweit zu, insbesondere bei jüngeren Männern ohne klassische Risikofaktoren. Hochrisiko-HPV-Typen sind die Hauptursache. Prophylaktische Impfstoffe bieten erstmals eine effektive Primärprävention, deren Wirksamkeit bislang über die Reduktion oropharyngealer HPV-Infektionen belegt ist. Ziel war die Darstellung des aktuellen Evidenzstands zur HPV-Impfung in der Prävention von OPSCC, einschließlich Impfquoten, Leitlinienempfehlungen und Implikationen für Betroffene und Angehörige. Dazu erfolgte eine systematische Literaturrecherche in PubMed (2000–2025) zu HPV-Impfung und OPSCC und die Berücksichtigung von Übersichtsarbeiten, Metaanalysen, Kohorten- und randomisierten Studien sowie von nationalen und internationalen Leitlinien. Die HPV-Impfung reduziert die Prävalenz oropharyngealer Hochrisiko-HPV-Infektionen um 80–90

The German Society of Otorhinolaryngology, Head and Neck Surgery (DGHNO-KHC) and the German Academy of Otorhinolaryngology, Head and Neck Surgery (DAHNO-KHC), in cooperation with the relevant working groups, have developed expert certificates for the subfields "head and neck onco-surgery" and "paranasal sinus and (anterior) skull base surgery." The aim was to demonstrate the applicants' expertise in the respective subfield, in line with international standards. For the subspecialty "surgical otology, neurotology, and lateral skull base surgery," the Association of German-Speaking Audiologists, Neurotologists, and Otologists (ADANO) has developed a set of criteria for obtaining the expert certificate "Otological, neurotological, and (lateral) skull base surgery." This personal certificate can be used to demonstrate individual expertise. Practical implementation is carried out by an independent certification body (ClarCert GmbH) on behalf of the DGHNO-KHC and in cooperation with the DAHNO-KHC and the respective working groups. Applications for the expert certificate can now be submitted by members of the DGHNO-KHC and the DAHNO-KHC.

Die Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V. (DGHNO-KHC) und die Deutsche Akademie für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V. (DAHNO-KHC) haben unter Mitwirkung der entsprechenden Arbeitsgemeinschaften Expertenzertifikate für die Teilbereiche „Kopf-Hals-Onkochirurgie“ und „Nasennebenhöhlen- und (anteriore) Schädelbasis-Chirurgie“ entwickelt. Ziel war es, in Analogie zu internationalen Standards die Expertise der Antragstellenden für den jeweiligen Teilbereich im Sinne der Personenzertifizierung darzustellen. Für den Teilbereich der chirurgischen Otologie, Neurootologie und lateralen Schädelbasis wurde nun durch die Arbeitsgemeinschaft Deutschsprachiger Audiologen, Neurootologen und Otologen (ADANO) ein Kriterienkatalog erarbeitet, dessen Erfüllung eine Person für den Erwerb des Expertenzertifikats „Otologische‑, Neurootologische- und (laterale) Schädelbasis-Chirurgie“ qualifiziert. Das Personen-Zertifikat kann als Nachweis der individuellen Expertise verwendet werden. Die praktische Umsetzung erfolgt durch eine unabhängige Zertifizierungsstelle (ClarCert GmbH) im Auftrag der DGHNO-KHC und unter Mitarbeit der DAHNO-KHC sowie der jeweiligen Arbeitsgemeinschaften. Anträge können ab sofort von Mitgliedern der DGHNO-KHC oder der DAHNO-KHC für das Expertenzertifikat „Otologische‑, Neurootologische- und (laterale) Schädelbasis-Chirurgie“ gestellt werden.

Zusammenfassung Schwitzen im Kopfbereich kann bei Träger*innen von Hörgeräten und teilimplantierbaren Hörsystemen zu lokalen Hautproblemen wie Juckreiz oder Ekzemen, erhöhtem Energieverbrauch der Hörhilfen sowie Funktionsstörungen führen. Ziel dieser Studie war es, Häufigkeiten zu erfassen und die Wirksamkeit von Botulinumtoxin-A (BoNT-A) -Injektionen zur Behandlung der lokalen Hyperhidrose zu evaluieren. In einer monozentrischen Beobachtungsstudie wurden 51 Patient*innen mit Cochlea-Implantaten, aktivem Mittelohrimplantat, Knochenleitungs- und konventionellen Hörgeräten mittels eines 12-teiligen Anamnesefragebogens zu Schweißproduktion, geräteassoziierten Problemen sowie Begleitumständen befragt. Bei ausgeprägter Hyperhidrose erfolgte eine intrakutane Behandlung mit BoNT-A (n=6). 22/51 Befragten (43%) gaben eine häufige, 17/51 (33%) eine seltene Schweißproduktion im Kopfbereich an. Bei 35/51 Patient*innen (69%) traten lokale Probleme wie Hautirritationen oder Juckreiz auf. 16/51 (31%) berichteten über einen erhöhten Energieverbrauch der Hörgeräte und 16/51 (31%) gaben eine Beeinträchtigung des Tragekomforts oder der Funktion an. Nach intrakutaner BoNT-A-Behandlung berichteten alle behandelten Patient*innen über eine deutliche Besserung der Beschwerden, Funktionsausfälle wurden nicht mehr beobachtet. Die erhobenen Daten lassen eine nicht unerhebliche Anzahl von Patient*innen mit schweißbedingten Problemen erkennen und deuten darauf hin, dass eine verstärkte Schweißproduktion teilweise mit relevanten Beeinträchtigungen assoziiert ist. Diese kann sowohl lokale Hautreizungen als auch technische Störungen verursachen. Intrakutane BoNT-A-Injektionen sind eine effektive, sichere und praktikable Therapieoption zur Reduktion Hyperhidrose-bedingter Beschwerden.

Zusammenfassung Die Cochlea-Implantat (CI)-Versorgung ist in Deutschland durch die AWMF-Leitlinie „Cochlea-Implantat-Versorgung“, das CI-Weißbuch der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V. (DGHNO-KHC) sowie etablierte Zertifizierungsstrukturen standardisiert. Ziel dieses im Auftrag des Präsidiums der DGHNO-KHC erstellten Dokuments ist die fachliche, organisatorische und vergütungsbezogene Einordnung der Delegation technischer Nachsorgeleistungen auf Grundlage der CI-Leitlinie, des CI-Weißbuchs sowie praktischer Erfahrungen aus leitlinienbasierten Kooperationen. Die Analyse zeigt, dass technische Nachsorgeleistungen leitliniengerecht delegiert werden können, sofern sie durch die verantwortliche CIVE im Rahmen einer Kooperationsvereinbarung veranlasst werden, das Einverständnis des Patienten vorliegt und die Gesamtverantwortung für den Versorgungsprozess bei der CIVE verbleibt. Die Delegation kann sich auf einzelne oder sämtliche Anteile der technischen Nachsorge erstrecken; ein „Alles-oder-Nichts-Prinzip“ besteht nicht. Nicht delegierbar bleiben insbesondere medizinische und komplexe audiologische Nachsorgeleistungen sowie sämtliche audiologischen und technischen Leistungen der Basis- und Folgetherapie. Ein eigenständiger Anspruch externer Leistungserbringer auf Durchführung technischer Nachsorge besteht nicht. Die Zustimmung zur Delegation kann von der CIVE oder dem Patienten jederzeit widerrufen werden. Die Vergütung technischer Nachsorgeleistungen ist bislang bundesweit nicht einheitlich geregelt, insbesondere aufgrund fehlender Vertragsstrukturen.

PURPOSE:Cartilage is widely used for tympanic membrane (TM) reconstruction, but the impact of graft position relative to the bony ear canal on middle ear mechanics remains unclear. This study examined how cartilage placement affects the middle ear transfer function (METF) and TM vibration. METHODS:Single‑point Laser Doppler Vibrometry (LDV) was performed on five fresh frozen human temporal bones before and after creating a 2.5 mm perforation in the posterior inferior TM quadrant and after reconstruction with a round-shaped cartilage graft of 4 mm diameter and 0.5 mm thickness placed either on (on‑bony) or separated from (off‑bony) the bony ear canal. TM motion was further assessed using a scanning LDV in a technical membrane model. A validated finite element (FE) model of the middle ear was used to replicate temporal bone measurements and the effect of an experimentally opened versus closed tympanic cavity, representing the in-vivo condition in patients, was evaluated by FE modelling. RESULTS:After TM perforation, the METF significantly decreased between 562 - 2094 Hz, and 2951 - 3194 Hz, while showing increased measurement variability below 500 Hz. When performing reconstruction with either the on-bony or the off-bony technique, the METFs partially recover, but show a significant difference in METF compared to the intact TM in the frequency range of 146 - 195, 200 - 217, 739 - 933 Hz (on-bony) and 146 - 295, 718 - 930, 722 - 930 and 1332 - 1719 Hz (off-bony). No significant difference in METF between the on-bony and off-bony reconstruction were found (p > 0.05). Scanning LDV analysis of a technical membrane model showed similar membrane peak velocities between the two graft positions, although the off‑bony configuration shifted the best frequency to lower values. FE simulations of the middle ear confirmed the findings of the temporal bone measurements. Additionally, the model work showed that middle ear transmission with an experimentally opened tympanic cavity differed by <2 dB after on- or off-bony reconstruction compared to a closed tympanic cavity. This was different for the perforated TM: While the transmission loss was nearly constant with an experimentally opened tympanic cavity, a closed tympanic cavity produced frequency‑dependent transmission loss exceeding 40 dB. CONCLUSION:In this temporal bone study, placing the cartilage on the bony ear canal wall did not have an impact on the METF. FE modeling supported the temporal bone findings and suggested that similar behavior could be expected in vivo with a closed tympanic cavity. However, the FE-model suggests that perforation‑induced losses were substantially underestimated in the temporal bone measurements with an experimentally opened tympanic cavity. Positioning of the cartilage graft on the bony ear canal can be advantageous in patients with chronic middle-ear disease to reduce the risk of medialization and formation of retraction pockets without compromising the patients hearing outcome.

BACKGROUND:The incidence of human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC) is increasing worldwide, particularly among younger men without classical risk factors. High-risk HPV types are the primary cause. Prophylactic vaccines offer the first effective means of primary prevention, with efficacy demonstrated primarily through the reduction in oropharyngeal HPV infections. OBJECTIVE:This article aims to present the current evidence on HPV vaccination for prevention of OPSCC, including vaccination coverage, guideline recommendations, and implications for patients and their close contacts. MATERIALS AND METHODS:A systematic literature search was performed in PubMed (2000-2025) on HPV vaccination and oropharyngeal cancer, including systematic reviews, meta-analyses, and cohort and randomized studies as well as national and international guidelines. RESULTS:Human papillomavirus vaccination reduces the prevalence of oropharyngeal high-risk HPV infections by 80-90% and significantly lowers the risk of persistent infections. Relatives and sexual partners of OPSCC patients have a mildly increased risk of HPV-associated malignancies. Vaccination coverage in Germany is particularly low among boys; therapeutic HPV vaccines are currently being investigated in clinical trials. Modeling studies indicate that substantial reductions in the OPSCC incidence can only be achieved with significantly higher vaccination rates than those currently seen in Germany. CONCLUSION:Human papillomavirus vaccination is an effective tool for primary prevention of oropharyngeal infections and, indirectly, OPSCC. Sustainable impact requires gender-neutral and easily accessible vaccination programs, targeted inclusion of close contacts, and further research into therapeutic vaccination strategies.

Objective Excessive sweating in the head area may cause skin irritation, increased energy consumption, and functional impairment of hearing aids and semi-implantable hearing systems. This study investigated the frequency of sweat-related complaints and evaluated the effectiveness of intracutaneous Botulinumtoxin A (BoNT-A) injections for treating local hyperhidrosis in hearing aid and implant users.Material and Methods In this single-center observational study, 51 users of cochlear implants, active middle ear implants, bone conduction devices, or conventional hearing aids completed a 12-item questionnaire addressing sweat production and device-related problems. Patients with severe hyperhidrosis received intracutaneous BoNT-A treatment (n = 6).Results Frequent sweating in the head area was reported by 22/51 patients (43%), while 17/51 (33%) reported occasional sweating. Local skin problems occurred in 35/51 patients (69%). Increased energy consumption and impaired wearing comfort or device function were each reported by 16/51 patients (31%). All patients treated with BoNT-A reported marked symptom improvement, with no further functional impairment.Conclusion The collected data reveals a significant number of patients with sweat-related problems and suggests that increased sweat production is associated with clinically relevant impairments in some of the respondents and may lead to skin irritation and technical malfunctions of the hearing aids. Intracutaneous BoNT-A injections are an effective, safe, and practical treatment option for reducing hyperhidrosis-related complaints in this area.

BACKGROUND:Hereditary hearing loss is one of the most common disabling disorders in children and lacks effective pharmacological treatments. Recent breakthroughs in OTOF gene therapy clinical trials necessitate standardized frameworks to guide emerging therapies. This study aims to establish the first international consensus on the clinical application of gene therapy for hereditary hearing loss. METHODS:A modified Delphi process was conducted from March 2024 to March 2025, involving 46 multidisciplinary experts from several countries across otology, genetics, audiology, gene therapy, and hearing rehabilitation. After a systematic literature review, as well as integration of research and clinical expertise and experience, three iterative voting rounds (two anonymous surveys and one online consensus meeting) were performed. Statements required ≥75% agreement for inclusion. FINDINGS:From 9,093 publications, 69 were used to draft and support the consensus statements. A total of 30 statements relevant to six domains achieved consensus on gene therapy for hereditary hearing loss, including ethical review (1 statement), patient selection criteria (12 statements), diagnosis and preoperative evaluation (9 statements), gene therapy drug delivery (4 statements), follow-up (3 statements), and post-treatment auditory and speech rehabilitation (1 statement). CONCLUSIONS:This consensus provides the first globally endorsed framework for gene therapy in hereditary hearing loss. It standardizes clinical trial design and patient management, accelerating translation from research to practice while ensuring safety. The guidelines are immediately applicable to OTOF-related hearing loss and adaptable to other genetic forms. FUNDING:This work was supported by the National Natural Science Foundation of China, the German Research Foundation (DFG) via the Cluster of Excellence, and others.

Perioperative care in ear surgery plays a central role in treatment success. However, significant differences in clinical standards may exist, especially in the absence of evidence-based guidelines. Given the increasing complexity of otologic procedures and the importance of high-quality postoperative care, standardizing measures is essential to minimize complications and improve outcomes.Thirty multiple-choice questions on pre-, peri-, and postoperative standards at participants' clinics were distributed via an online survey to members of the Otology Section of the German-speaking Association of Audiologists, Neurotologists, and Otologists (ADANO).Responses from 14 participants revealed considerable heterogeneity in perioperative care. Differences were particularly evident in the use of ear packing, administration of antibiotics and glucocorticoids, and postoperative behavioral recommendations (e.g., physical activity, protection from noise and water). Postoperative follow-up examinations such as the Weber tuning fork test or nystagmus assessment are applied relatively uniformly.The results highlight current inhomogeneity in perioperative care in ear surgery, even among specialized centers. The survey outlines current practices as expert opinion but lacks high-level evidence. Few high-quality studies systematically investigate the discussed standards, indicating a clear need for clinical research. Extending the survey to international otologic centers and experts would also be of interest.

Die perioperative Versorgung in der Ohrchirurgie spielt eine zentrale Rolle für den Behandlungserfolg. Dennoch bestehen möglicherweise erhebliche Unterschiede in den klinischen Standards, zumal evidenzbasierte Leitlinien fehlen. Angesichts der zunehmenden Komplexität ohrchirurgischer Eingriffe und der Bedeutung einer hochwertigen Nachsorge ist die Standardisierung von Maßnahmen essenziell, um Komplikationen zu minimieren und Ergebnisse zu verbessern. Dreißig Multiple-Choice-Fragen zu prä-, peri- und postoperativen Standards in der eigenen Klinik wurden den Mitgliedern der Otologie-Fachgruppe der Arbeitsgemeinschaft Deutschsprachiger Audiologen, Neurootologen und Otologen (ADANO) über einen Online-Fragebogen gestellt. Die Antworten der 14 Teilnehmenden zeigten teils erhebliche Heterogenität in der perioperativen Versorgung. Unterschiedliche Ansätze zeigten sich insbesondere bei der Verwendung von Tamponaden, der Gabe von Antibiotika und Glukokortikoiden sowie bei postoperativen Verhaltensempfehlungen (z.B. sportliche Aktivität, Schutz vor Lärm und Wasser). Postoperative Kontrolluntersuchungen wie der Stimmgabel-Test nach Weber oder die Nystagmusprüfung werden relativ einheitlich angewendet. Die Ergebnisse verdeutlichen die aktuelle Inhomogenität der prä-, peri- und postoperativen Versorgung in der Ohrchirurgie, selbst in spezialisierten Zentren. Die Umfrage liefert eine Übersicht über gelebte Praktiken im Sinne einer Expertenmeinung, bietet jedoch keine höhere Evidenz. Derzeit gibt es kaum Studien in ausreichender Qualität, die die diskutierten Standards systematisch untersucht hätten – hier besteht klinischer Forschungsbedarf. Von Interesse wäre zudem, die Umfrage auf internationale ohrchirurgische Zentren und Experten auszuweiten.

The sensation of mechanical stimuli is initiated by elastic gating springs that pull open mechanosensory transduction channels. Searches for gating springs have focused on force-conveying protein tethers such as the amino-terminal ankyrin tether of the Drosophila mechanosensory transduction channel NOMPC. Here, by combining protein domain duplications with mechanical measurements, electrophysiology, molecular dynamics simulations and modeling, we identify the NOMPC gating-spring as the short linker between the ankyrin tether and the channel gate. This linker acts as a Hookean hinge that is ten times more elastic than the tether, with the linker hinge dictating channel gating and the intrinsic stiffness of the gating spring. Our study shows how mechanosensation is initiated molecularly; disentangles gating springs and tethers, and respective paradigms of channel gating; and puts forward gating springs as core ion channel constituents that enable efficient gating by diverse stimuli and in a wide variety of channels. Hehlert et al. report that the gating spring that pulls open mechanosensitive NOMPC channels is not their helical ankyrin tether, but instead an elastic hinge that suspends that tether on the channel gate.

This multicentric, retrospective study aimed to analyze the safety and effectiveness of the mXACT Partial Prosthesis, mXACT PRO Partial Prosthesis, mCLIP Partial Prosthesis, and mCLIP ARC Partial Prosthesis. Patients underwent partial ossicular replacement with a mXACT Partial Prosthesis, mXACT PRO Partial Prosthesis, mCLIP Partial Prosthesis, or mCLIP ARC Partial Prosthesis (MED-EL). The clinical data was retrospectively analyzed according to the coupling type, bell or clip. Follow-up examination included access to medical records (for adverse events (AE) of the patients, ear microscopy and pure-tone audiometry to determine the post-operative pure tone average of the frequencies 0.5, 1, 2 and 3 kHz (PTA4)). The post-operative PTA4 air bone gap (ABG) was used to evaluate the audiological outcome. A post-operative PTA4 ABG ≤ 20 dB was defined as successful rehabilitation. A post-operative minimum and maximum follow-up period was not defined. 203 patients were implanted, 202 patients were examined for AEs (bell group: 68 patients, clip group: 134 patients), 186 patients were examined audiologically (bell group: 63 patients, clip group: 123 patients). In the bell group, 4 patients (5.9

This European multicentric, retrospective study aimed to analyze the short-term safety and effectiveness of the mCLIP ARC Ball Joint Prosthesis. Type III Tympanoplasty with implantation of a mCLIP-ARC Partial Prosthesis was performed. During patients’ follow-up, ear microscopic evaluation and pure-tone audiometry were used for analysis. The post-operative pure-tone average of the frequencies 0.5, 1, 2 and 3 kHz (PTA4) were used for calculation of the air bone gap (ABG). Adverse events (AE) were evaluated during follow-up. 62 patients underwent implantation of the mCLIP-ARC Partial Prosthesis. 55 complete data sets were available for audiological examination. The mean follow-up time was 58 days. In two cases adverse events were recorded. The post-operative bone conduction (BC) PTA4 thresholds were stable in 96.4

Since the development and scientific validation of peripheral arterial tonometry regarding relevant target parameters of sleep diagnostics, an equivalent alternative to ambulatory polygraphy has been established in recent years. However, many aspects of the method remain unclear, as the validation of the system focused on the apnoea-hypopnoea index (AHI), the main classifying parameter of sleep apnea. The present study is a retrospective analysis of the peripheral arterial tonometry after the introduction of tonometry as a standard of outpatient sleep diagnostics at the Otorhinolaryngology Department of the University of Göttingen Medical Center (UMG). Since the introduction of the method, about 300 patients have been examined at the UMG. The sample is mainly divided into two large subgroups: On the one hand, these are patients with a high pre-test probability for a sleep-related breathing disorder and tonometry is applied to confirm the suspected diagnosis. On the other hand, the method was used in cases of known sleep-related breathing disorder for re-evaluation or follow-up. The results initially show a high rate of valid measurements. Operating errors on the part of the patients were rare. For the subgroups examined, good correlations with clinical parameters were found, especially for position-dependent findings. In contrast, the comparison with external polygraphy and polysomnography showed mixed results. In summary, peripheral arterial tonometry is also suitable for routine outpatient sleep diagnostics in the context of an tertiary Otolaryngology department. Existing disadvantages are counterbalanced by a high proportion of valid measurements regarding initial diagnosis, therapy evaluation and follow-up.

Einleitung Studierende sollten in HNO-Untersuchungstechniken angeleitet werden, da die Befunderhebung im HNO-Gebiet nicht nur in der HNO selbst, sondern auch in anderen Fachbereichen relevant ist. Im Rahmen des Moduls der HNO-Heilkunde der Universitätsmedizin Göttingen wurde die Untersuchung demonstriert und im Anschluss durch die Studierenden durchgeführt. Dabei waren sowohl die Demonstration, Durchführung und Kontrolle dadurch eingeschränkt, dass nur der Untersuchende den Befund sehen konnte.

Einleitung Die Rekontruktion der Gehörknöchelchenkette erfolgt überwiegend durch starre Implantate. Neue Mittelohrprothesen versuchen die physiologischen Mikrobewegungen der Gehörknöchelchenkette zu imitieren und Protrusionen zu vermeiden

This multicentric, retrospective study provides safety and performance data of the MED-EL total ossicular replacement prostheses (TORP). Patients underwent tympanoplasty with mXACT Total Prosthesis Center, mXACT Total Prosthesis Offcenter or mXACT PRO Total Prosthesis. The clinical data were retrospectively analyzed. Follow-up examination included access to the medical record (for adverse events) of the patients, ear microscopy and pure-tone audiometry to determine the post-operative pure tone average of the frequencies 0.5, 1, 2 and 3 kHz (PTA4). The post-operative PTA4 air bone gap (ABG) was used to evaluate the audiological outcome. A post-operative minimum and maximum follow-up period was not defined. 103 patients were implanted with a TORP. 102 (88 adults, 14 children; 37 CHL, 64 MHL, 1 not specified) patients were analyzed for safety and 92 (79 adults, 13 children) patients for performance of the prostheses. In 1 patient (child, mXACT Total Prosthesis Offcenter) a prosthesis dislocation was reported, which lead to a revision surgery. No prosthesis extrusion or migration was reported. 49 (53.3

Einleitung Mikrozystische Adnexkarzinome (MAK) sind seltene, niedrig-maligne Tumoren der Haut, charakterisiert durch ein lokal-invasives Wachstum mit hoher Rezidivrate. Lymphogene oder hämatogene Metastasierung werden selten beschrieben. MAK werden als Tumore der ekkrinen/apokrinen Schweißdrüsen eingestuft und treten im Kopf-und Halsbereich auf. MAK wurden erstmals 1982 durch den amerikanischen Dermatologen D. Goldstein in 6 Fallberichten langsam progredienter Hautläsionen mit destruktivem Wachstumsmuster beschrieben. Seither sind in der Literatur etwa 200 Fälle von MAK beschrieben.