{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T02:06:10Z","timestamp":1771380370753,"version":"3.50.1"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,1,4]],"date-time":"2024-01-04T00:00:00Z","timestamp":1704326400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2024,1,4]],"date-time":"2024-01-04T00:00:00Z","timestamp":1704326400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004410","name":"T\u00fcrkiye Bilimsel ve Teknolojik Ara\u015ft\u0131rma Kurumu","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004410","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Although previous research has indicated inner ear changes in diabetes mellitus (DM) patients, no prior study has explored the middle ear, particularly the ossicles and their joints, in DM patients. This study aimed to investigate whether type 2 DM is associated with middle ear changes, specifically affecting the ossicular chain and joints.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This study included 47 ears from 25 patients with DM (male\u2009=\u200913, female\u2009=\u200912, age: 51.0\u2009\u00b1\u200920.5) and age\u2010 and sex\u2010matched controls (male\u2009=\u200910, female\u2009=\u200910, age: 54.8\u2009\u00b1\u200915.9) (sex;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20091.000, Age;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.991). Otopathological evaluations of the auditory ossicles and incudomalleolar joint (IMJ) were performed using light microscopy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the IMJ of DM cases, malleus hyalinized cartilage (Malleus hC) and incus hyalinized cartilage (Incus hC) were significantly increased compared with control cases (Malleus hC; DM, 34.17\u2009\u00b1\u20099.71\u2009\u03bcm vs. control 21.96\u2009\u00b1\u20094.16\u2009\u03bcm,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) (Incus hC; DM 35.11\u2009\u00b1\u200910.12\u2009\u03bcm vs. control 22.42\u2009\u00b1\u20094.368\u2009\u03bcm,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). In addition, bone\u2010line distance was significantly longer than in DM cases than control cases (DM 266.72\u2009\u00b1\u200959.11\u2009\u03bcm vs. control 239.81\u2009\u00b1\u200935.56\u2009\u03bcm\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.040). On the other hand, joint discus distance was longer in the control group than in DM cases (DM 96.84\u2009\u00b1\u200936.80\u2009\u03bcm vs. Control 113.63\u2009\u00b1\u200923.81\u2009\u03bcm,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study reveals a notable increase in the hyalinized cartilage layer and bone\u2010line distance accompanied by reducing joint discus distance within the IMJ in DM cases. These findings suggest that DM may influence microjoints, such as the IMJ, and potentially impact auditory function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Evidence Level<\/jats:title>\n                    <jats:p>\n                      N\/A\n                      <jats:italic>Laryngoscope<\/jats:italic>\n                      , 134:2871\u20132878, 2024\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.31257","type":"journal-article","created":{"date-parts":[[2024,1,4]],"date-time":"2024-01-04T06:33:10Z","timestamp":1704349990000},"page":"2871-2878","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Middle Ear Ossicular Joint Changes in Type 2 Diabetes Mellitus: A Histopathological Study"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1164-6977","authenticated-orcid":false,"given":"Tomotaka","family":"Shimura","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Head &amp; Neck Surgery University of Minnesota  Minneapolis Minnesota U.S.A."},{"name":"Department of Otorhinolaryngology Showa University Fujigaoka Hospital  Yokohama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nevra","family":"Keskin Yilmaz","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head &amp; Neck Surgery University of Minnesota  Minneapolis Minnesota U.S.A."},{"name":"Department of Internal Medicine, Faculty of Veterinary Medicine Ankara University  Ankara Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dilshan","family":"Rajan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head &amp; Neck Surgery University of Minnesota  Minneapolis Minnesota U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebahattin","family":"Cureoglu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head &amp; Neck Surgery University of Minnesota  Minneapolis Minnesota U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9124-593X","authenticated-orcid":false,"given":"Rafael","family":"Da Costa Monsanto","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head &amp; Neck Surgery University of Minnesota  Minneapolis Minnesota U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,1,4]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2021.109119"},{"key":"e_1_2_7_3_1","unstructured":"Centers for Disease Control and Prevention.Type 2 diabetes.2023.https:\/\/www.cdc.gov\/diabetes\/basics\/type2.html."},{"key":"e_1_2_7_4_1","unstructured":"American Diabetes Association.Diabetes and hearing loss.2023.https:\/\/diabetes.org\/diabetes\/diabetes-and-hearing-loss#:~:text=It's%20possible%20that%20the%20high higher%20rate%20of%20hearing%20loss."},{"issue":"3","key":"e_1_2_7_5_1","first-page":"176","article-title":"Diabetes mellitus and hearing loss: clinical and histopathologic relationships","volume":"7","author":"Wackym PA","year":"1986","journal-title":"Am J Otol"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-1697033"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199712000-00004"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1121\/1.1808221"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.heares.2005.01.002"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/AUD.0b013e31815d63a5"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1969.00770030761019"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348947408300109"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000000456"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599821993813"},{"key":"e_1_2_7_15_1","volume-title":"Audiometric Interpretation: A Manual of Basic Audiometry","author":"Lloyd LL","year":"1978"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar2713"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2016.10.021"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.exger.2021.111354"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1063-4584(03)00150-X"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00256-018-3088-0"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2018.03.010"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.4103\/0366-6999.168045"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.21037\/atm-20-6797"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2010.05.030"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbm4.10625"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/joa.13661"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12093145"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1177\/1479164119826292"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.31257","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.31257","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.31257","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T01:41:44Z","timestamp":1771378904000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.31257"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,4]]},"references-count":27,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["10.1002\/lary.31257"],"URL":"https:\/\/doi.org\/10.1002\/lary.31257","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,4]]},"assertion":[{"value":"2023-10-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}