BACKGROUND Hemangiomas are relatively common in the head and neck but rarely involve the external auditory canal (EAC). Surgical approaches for EAC hemangiomas vary, and optimal surgical management remains unclear. CASE REPORT We present 2 cases of hemangioma involving the EAC. Case 1 involved a 68-year-old man who presented with a sensation of fullness in the left ear. Case 2 involved a 62-year-old woman who presented with right-ear fullness, hearing loss, and persistent tinnitus. Preoperative assessment included otologic examination, computed tomography, magnetic resonance imaging, and corresponding auditory evaluations. Imaging across both cases consistently revealed well-defined soft-tissue masses confined to the EAC, accompanied by localized bony irregularities but preserving the middle ear structures. Both patients underwent complete trans-canal excision with concurrent skin flap reconstruction. Histopathological analysis of the excised specimens confirmed the diagnosis of cavernous hemangioma in each case. At 1-year follow-up, both patients achieved full symptom resolution, intact canal anatomy, and no recurrence. CONCLUSIONS In our 2 cases, trans-canal resection combined with local flap reconstruction served as a practical approach for EAC cavernous hemangiomas, resulting in symptom resolution and preservation of canal integrity at the 1-year follow-up.

Background Allergic rhinitis (AR) is a common chronic inflammatory disorder that can adversely affect both middle and inner ear function through Eustachian tube dysfunction (ETD) and cochlear involvement. Despite increasing evidence of auditory complications, hearing impairment among adults with AR remains under-recognized in routine clinical practice. This study aimed to estimate the prevalence of hearing impairment and identify sociodemographic and clinical factors independently associated with hearing impairment among adults with allergic rhinitis attending a tertiary care centre in Tiruvannamalai district of Tamil Nadu, India. Materials and methods A hospital-based cross-sectional study was conducted among 136 adults with clinically diagnosed allergic rhinitis attending the Otorhinolaryngology outpatient department of a tertiary care medical college and hospital in Tamil Nadu. Audiological assessment included pure-tone audiometry (PTA), tympanometry, and otoacoustic emissions (OAE). Data were analysed using IBM SPSS Statistics for Windows, version 26 (IBM Corp., Armonk, New York, United States). Descriptive statistics were expressed as frequencies, percentages, and mean ± SD. Independent samples t-test, one-way ANOVA, paired t-test, Pearson's correlation, and multivariable logistic regression were used to identify factors associated with hearing impairment. A p-value <0.05 was considered statistically significant. Results The mean age of the study participants was 32.51 ± 10.77 years, and 57.4% were female. Abnormal OAE findings, interpreted alongside tympanometry and PTA, were identified in 20 (14.7%) participants, suggesting possible cochlear dysfunction, while 28 (20.6%) had hearing impairment on PTA and 14 (10.3%) demonstrated Type C tympanograms indicating ETD in at least one ear. Mean PTA thresholds increased significantly with age, longer symptom duration, antihistamine use, congested nasal mucosa, abnormal OAE findings, and Type C tympanograms. Septal deviation showed an ear-specific association. In multivariable analysis, female sex was associated with lower odds of hearing impairment, whereas longer symptom duration and previous antihistamine use were associated with higher odds. Age and duration of symptoms also showed significant positive correlations with PTA thresholds. Conclusion Adults with allergic rhinitis demonstrated a considerable burden of audiological abnormalities. Female sex, prolonged symptom duration, and previous antihistamine use were independently associated with hearing impairment in the multivariable model. Routine audiological evaluation using PTA, tympanometry, and OAE should be considered in patients with persistent allergic rhinitis to facilitate early detection and appropriate management of auditory dysfunction.

This brief review summarizes the most recent progress in in vivo voltage imaging in the neurosciences, as an extension to the work presented at the voltage imaging session of the 2025 FENS regional meeting in Oslo. First, we outline the latest advances in genetically encoded voltage indicators. Next, we examine technical innovations that have reshaped imaging platforms and lay the groundwork to investigate neural activity in real time across large fields of view and in deep tissue. Finally, we highlight a selection of compelling applications that have emerged over the past 5 years, illustrating how voltage imaging evolved from a proof of concept to being deployed to answer pending neuroscientific questions.

Venous pulsatile tinnitus and tinnitus-like symptoms associated with internal jugular venous outflow disturbance represent an emerging clinical topic with specific diagnostic and management challenges. A narrative review was conducted using English-language literature identified through searches of PubMed, Web of Science, and Google Scholar. The review focused on studies published through February 2026 that addressed venous pulsatile tinnitus, internal jugular vein stenosis or compression, cerebral venous outflow disturbance, imaging and hemodynamic assessment, and management strategies. This review summarizes current evidence on vascular anatomy, clinical presentation, pathophysiological mechanisms, imaging evaluation, and treatment. Structural venous abnormalities and external compression may produce disturbed flow and local vascular sound, particularly in classical venous pulsatile tinnitus, whereas venous congestion, intracranial pressure dysregulation, altered cerebral perfusion, and central auditory plasticity remain proposed mechanisms for other tinnitus-like symptoms. MRI/MRV, CTV/CTA, and Doppler ultrasonography provide complementary anatomical and hemodynamic information. Invasive angiography is reserved for selected patients, with venous manometry added when pressure-gradient assessment is clinically relevant. Management options include conservative care, intracranial pressure management, endovascular treatment, surgical decompression, and supportive tinnitus therapy. However, current evidence is derived mainly from selected retrospective cohorts and small case series and does not establish the prevalence or causal contribution of IJVOD in unselected patients with venous pulsatile tinnitus. Standardized terminology, validated diagnostic criteria, improved patient selection, and prospective multicenter studies are required to enhance diagnostic confidence and enable robust assessment of long-term outcomes.

Epithelioid hemangioma (EH) represents a rare, benign neoplastic vascular proliferation that predominantly manifests within the cutaneous and subcutaneous tissues of the head and neck region. While well-documented in areas such as the scalp and forehead, its primary occurrence within the otolaryngologic tract, specifically involving the auricle and the cartilaginous portion of the external auditory canal, remains exceedingly uncommon. Due to its overlapping clinical and radiological features with other vascular and lymphoid pathologies, EH poses a significant diagnostic challenge for clinicians and pathologists alike. This case report highlights the importance of differential diagnosis with similar vascular and lymphoid conditions.

Previous studies indicate that the dual formats of templates recursively operate in tandem during visual search tasks. The guiding template with coarse features supports target localization, whereas the target template with precise features supports target identification. However, whether a sound that provides target-consistent identity information would flexibly interact with these two templates to optimize search behavior remains unclear. Across two experiments, event-related potentials (ERPs) were recorded while participants searched for and identified a visual target letter ("V" or "K"). In Experiment 1, visual targets were presented in isolation (V) or synchronously with a speech sound that was congruent (AVcon) or incongruent (AVincon) with the target; Experiment 2 additionally paired the target with a sound unrelated to both potential targets and distractors (AVun). Behaviorally, converging findings across experiments indicated that relative to AVun and V conditions, congruent sounds improved accuracy and shortened response times, whereas incongruent sounds prolonged response times. ERP results revealed early cross-modal interactions, reflected in amplitude modulations of the occipital P195 and centroparietal N270 components in the AVcon and AVincon conditions relative to summed unimodal ERPs (Exp. 1); these interactions were reduced in the AVun condition, in which the sound was uninformative about potential targets (Exp. 2). Cross-condition multivariate pattern analysis (MVPA) showed higher target-presence decoding accuracy in the AVcon condition than in the AVincon, AVun, and V conditions. Peak-to-peak improvements in the AVcon-AVincon and AVcon-V comparisons, but not the AVcon-AVun comparison, were positively correlated with corresponding improvements in behavioral accuracy. These findings suggest that the interaction between sounds and the dual formats of templates is contingent on the usefulness of available information. When the guiding template is relatively efficient, task-irrelevant sounds may generally interact with the entire visual search array. Subsequently, congruent sounds selectively enhance target-template processing, potentially contributing to improved target identification.

The discovery of decomposed human remains in private residences is a relatively common occurrence in forensic practice. However, finding a living individual cohabiting with a corpse represents an exceptionally rare medico-legal situation, raising complex psychiatric, forensic, and ethical issues. Such cases are most often associated with severe mental illness, social isolation, or pathological grief. We report the case of a 55-year-old unmarried former military serviceman with a long-standing history of schizophrenia who was brought to the psychiatric emergency department under police requisition after being found living with the decomposing body of his brother. Following a report of a foul odor, authorities entered the home and discovered the patient's brother's decomposed body after the patient threatened them with a knife and exhibited bizarre behavior. Upon examination, the patient exhibited severe psychotic symptoms, including persecutory delusions, auditory hallucinations, thought disorganization, impaired insight, and marked behavioral disturbances. The deceased brother had apparently remained undiscovered for 15 days, while the patient continued to occupy the residence without notifying authorities. A multidisciplinary forensic and psychiatric assessment was conducted to clarify the circumstances surrounding the delayed discovery and to evaluate the patient's mental state. Cohabitation with a deceased individual should prompt systematic psychiatric evaluation whenever severe mental illness is suspected. The early identification of vulnerable individuals living in social isolation may help prevent delayed corpse discovery and improve both public health and forensic outcomes.

Dementia with Lewy bodies (DLB) is characterized by visual hallucinations. Isolated auditory hallucinations as the presenting psychiatric symptom are uncommon, and misdiagnosis as a primary psychiatric disorder with consequent inappropriate antipsychotic exposure is a substantial risk. A case of probable DLB presenting with isolated auditory hallucinations as the initial manifestation, accompanied by RBD, parkinsonism, and characteristic neuroimaging findings, is described. Initial misdiagnosis as schizophrenia led to severe adverse reactions to antipsychotic agents. After multimodal evaluation, treatment with a cholinesterase inhibitor, combined with a monoamine oxidase-B inhibitor and a melatonin receptor agonist, improved motor and sleep symptoms, and the patient's condition gradually stabilized. Although isolated auditory hallucinations are not a typical presenting feature of DLB, they should be regarded as a warning signal for α-synucleinopathy when occurring against a background of neurodegeneration accompanied by RBD, autonomic dysfunction, or Parkinsonism. When clinical features satisfy the criteria for probable DLB, core clinical features are sufficient to establish the diagnosis; cholinesterase inhibitors should be the first-line treatment for neuropsychiatric symptoms in DLB.

Introduction: Obsessive-compulsive disorder (OCD) is clinically heterogeneous, and the neurocognitive characteristics of autogenous and reactive obsessional presentations remain insufficiently understood. This study compared neurocognitive performance and exploratory clinical-cognitive associations in strictly classified autogenous and reactive OCD presentations. Methods: This cross-sectional study included 67 outpatients with OCD classified as having reactive (n = 35) or autogenous (n = 32) presentations based on clinical evaluation and the Yale-Brown Obsessive Compulsive Scale Symptom Checklist. Patients with mixed presentations were excluded. Executive functioning, attentional control, cognitive flexibility, and verbal learning and memory were assessed using the Wisconsin Card Sorting Test, Stroop Test, and Rey Auditory Verbal Learning Test. Depressive symptoms were assessed using the Beck Depression Inventory. Results: The groups were comparable in age, age at OCD onset, illness duration, and overall OCD symptom severity, whereas depressive symptom scores were higher in the autogenous group. Neuropsychological performance was broadly comparable between groups. The autogenous group showed better RAVLT-6 performance, reflecting recall after interference, with a nominally significant unadjusted group difference. This difference remained significant in an exploratory ANCOVA adjusting for depressive symptoms, education, and age at OCD onset, although it did not survive false-discovery-rate correction. Exploratory within-group correlations were observed; however, formal Fisher's r-to-z comparisons revealed no significant differences between groups. Conclusions: Strictly classified autogenous and reactive OCD presentations showed broadly similar neuropsychological profiles, with a preliminary group difference in recall after interference. Within-group correlations should be interpreted as exploratory and hypothesis-generating rather than as evidence of presentation-specific clinical-cognitive mechanisms. Replication in larger samples is warranted.

Severe mental illness (SMI) includes neuropsychiatric disorders of adult onset, but also those that begin to show symptoms in adolescence and early childhood. This review treats the psychotic spectrum disorders and autism as neurodevelopmental in origin, each arising from perturbation of early brain development rather than from a process beginning at the age of clinical presentation. Grouping them is a claim about developmental origin and not about shared pathogenesis: they differ in the nature and timing of the perturbation and in the cortical systems being organized when it occurs. The diversity of social, language, behavioral, and cognitive symptoms and traits observed within this class is now well recognized. The language adopted to recognize such diversity has employed the term "spectrum" (e.g., autism spectrum disorder (ASD) and schizophrenia or psychotic spectrum). The substantial expansion of structural and functional connectivity research over the past 40 years has shown that both ASD and psychotic spectrum disorders have also been conceptualized as disorders of brain circuitry. Moreover, and particularly for ASD, this research was developed within a diagnostic time frame that itself underwent six revisions of the Diagnostic and Statistical Manual of Mental Disorders (DSM), from the third edition (DSM-III; 1980) to the fifth edition, text revision (DSM-5-TR; 2022), with the largest changes involving the elimination of the early language onset requirement and the consolidation of prior subtypes into a single autism spectrum disorder. The present review develops a mechanistic account of cerebral connectivity differences in autistic disorder as defined under DSM-III and DSM-IV, where diagnostic practice, and in particular the exclusion of clinically significant language delay from Asperger's disorder, enriched cohorts for a subgroup in which cerebellar vermal lobule VI and VII abnormality, posterior callosal reduction, and atypical predictive processing were originally identified. The present account proposes, as a hypothesis rather than as an established finding, that deviation of vermal lobules VI and VII from typical development, in the direction of either hypoplasia or hyperplasia, both reported within the same DSM-III/IV cohort, and on evidence consistent with prenatal origin, initiates a developmental cascade that may shape postnatal cerebral connectivity through disinhibition of deep cerebellar nuclei and altered excitatory drive to thalamocortical circuits during sensitive periods. Cross-condition evidence indicates that vermal abnormality also occurs in conditions with distinct primary diagnoses (Joubert syndrome, fragile X, Rett syndrome, Williams syndrome, schizophrenia), producing the autistic-disorder cluster only when the upstream perturbation also affects cortical context-integration substrates at the relevant developmental window. These conditions are treated as further instances of a common neurodevelopmental class rather than as separate kinds of disorder, with autistic disorder as the focal case because it is where the vermal findings were first identified. Transdiagnostic connectivity evidence spanning autism and schizophrenia cohorts is examined to establish whether the cerebellar account generalizes across the SMI class or is specific to autistic disorder, and the regional and directional distribution of the cerebellar findings in each condition is treated as the discriminating variable. The framework proposes the cerebellum as a substrate for predictive internal models scaffolding auditory, social, and contextual learning, and is empirically testable through infant connectivity and event-related potential studies and through stratified re-analysis of multisite samples.

Stickler syndrome, first described by Günnar Stickler in the United States in 1965 as "progressive hereditary arthro-ophthalmopathy", is classified by ophthalmologists as a rare hereditary vitreoretinopathy of connective tissue. Thanks to advances in molecular genetics, different subtypes of the syndrome are now recognized. Its prevalence at birth has been estimated to be between 1 in 7500 and 1 in 10,000. Stickler syndrome is a rare genetic disorder, specifically a multi-system collagenopathy. It is characterized by ocular abnormalities such as severe congenital myopia, cataracts, and retinal detachment, as well as systemic anomalies including craniofacial, auditory, and musculoskeletal (joint) issues. It is primarily caused by mutations in genes encoding various types of collagen and can be inherited in either an autosomal dominant or autosomal recessive pattern. However, this syndrome is both phenotypically and genotypically heterogeneous, which makes recognition and diagnosis challenging. Genetic testing can confirm the diagnosis. Management and regular clinical monitoring of the patient by specialists such as ophthalmologists, ENT (ear, nose, and throat) doctors, physical medicine and rehabilitation specialists, and, if necessary, orthopedic surgeons are essential to prevent secondary complications. Additionally, support from pain management or palliative care teams may be required. However, primary care physicians are often unfamiliar with the symptoms of Stickler syndrome or its potential complications, including blindness and deafness. The goal of consultations is to confirm the diagnosis, rule out other differential diagnoses, identify complications, and optimize care in the ophthalmological, ENT, rheumatological, and physical medicine and rehabilitation fields, as well as in orthopedic surgery, with the possibility of consulting pain management or palliative care specialists as necessary. The objective of this National Protocol for Diagnosis and Management (PNDS) is to present healthcare professionals with the most current and optimal diagnostic and therapeutic management strategies, as well as to standardize and improve patient care across the healthcare system.