Objective: to evaluate recent contributions to the literature on prognostic factors of hearing preservation in small vestibular schwannoma microsurgery. Methods: review of the most recent studies. Results: factors such as tumor size, preoperative hearing status, tumor growth rate, tumor origin, surgical approach, radiological characteristics, results of preoperative neurophysiological tests, preoperative symptoms and demographic features have been investigated and some of them reported to be significant in the prediction of hearing preservation. Conclusions: tumor size and preoperative hearing status are the most impactful factors and play a key role in patient selection for hearing preservation surgery. Other features such as fundal extension, tumor origin and impaired ABR could have prognostic value on hearing preservation. Tumor growth rate, preoperative impedance, cVEMPs and age have also recently been found to be significant, but more studies are needed. The role of preoperative tinnitus, vertigo and gender is lacking and controversial, whereas the differences between available surgical approaches have been smoothed out in recent years.
Air pollution (AP) is a critical environmental factor influencing public health, with well-documented associations with upper respiratory tract (URT) diseases. This study investigates the relationship between ENT emergency department (ENT-ED) visits at Azienda Ospedale Università di Padova (AOPD) and daily concentrations of environmental pollutants during the first year of the COVID-19 pandemic (March 2020–March 2021), compared to pre-pandemic data from 2017. The study focuses on patients diagnosed with URT inflammatory diseases, excluding those with COVID-19 infection, who sought care at the AOPD ENT-ED. Environmental data, including meteorological variables, air pollutants, and major aeroallergen levels, were collected from regional monitoring stations. A total of 4594 patients were admitted in 2020/2021, marking a 37% reduction from 2017, with URT inflammatory admissions decreasing by 52%. A significant decline in PM10, NO2 and Alternaria levels was observed, whereas Betullaceae and Corylaceae concentrations significantly increased. Multivariate analyses revealed strong associations between aeroallergen exposure and ENT admissions, particularly for Alternaria, which had a notable impact on total admissions (p < 0.001) and was significantly linked to cases of otitis media and tonsillitis. PM10 concentrations on specific days preceding ED visits were associated with increased incidences of pharyngitis and rhinosinusitis (p < 0.05). These findings reinforce the connection between environmental pollutants and ENT emergency visits, highlighting the adverse effects of AP and climate variables on URT diseases, even during a pandemic when enhanced airway protection measures were in place. This study underscores the necessity of stringent air quality regulations and interdisciplinary strategies to mitigate environmental health risks and inform future public health policies.