{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T18:57:11Z","timestamp":1781636231103,"version":"3.54.5"},"reference-count":44,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T00:00:00Z","timestamp":1771804800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T00:00:00Z","timestamp":1771804800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004375","name":"Tel Aviv University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004375","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Arch Otorhinolaryngol"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The impact of military noise exposure on auditory function is not well established and may not be fully captured by standard audiometry. This study aimed to evaluate: (1) the effects of military noise exposure on auditory function in young adults using (a) self-reported otological symptoms, (b) standard and ultra-high frequency (UHF; 9\u201314\u00a0kHz) audiometry, (c) distortion product otoacoustic emissions (DPOAE); (2) oral steroids effects on audiometric results, outer hair-cell function, and otological symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review of medical records was conducted for 189 young adults exposed to military noise. Participants with normal hearing underwent one assessment, while those with hearing loss or otological symptoms were reassessed after ~\u200910 days and 3 months. Steroid-treated patients were compared to untreated controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Over half the cohort showed hearing loss in the standard or UHF range. Otological symptoms, particularly tinnitus and aural fullness, were prevalent even among individuals with normal standard-range thresholds. UHF audiometry and DPOAEs detected abnormalities missed by standard audiometry. Partial spontaneous recovery occurred within 10 days post-injury. Steroid treatment was linked to greater hearing thresholds improvements, particularly in the high-frequency range. UHF recovery was significantly greater in the right ear, suggesting asymmetry in vulnerability and recovery patterns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Military noise exposure leads to a highly prevalent and multifaceted impact on auditory function. Although treated patients showed greater gains, post-exposure threshold differences between treated and untreated patients restrict direct inference regarding steroid efficacy. Comprehensive assessment, including symptoms, UHF audiometry, and DPOAEs, is essential for accurate diagnosis and monitoring.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00405-025-09989-3","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T20:52:23Z","timestamp":1771879943000},"page":"2329-2338","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond standard audiometry: Auditory dysfunction and steroid treatment outcomes in young adults following acoustic trauma"],"prefix":"10.1007","volume":"283","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0927-0528","authenticated-orcid":false,"given":"Yael","family":"Zaltz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yael","family":"Solomon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yisgav","family":"Shapira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Wolfovitz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daphne","family":"Ari-Even Roth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yael","family":"Henkin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,23]]},"reference":[{"key":"9989_CR1","volume-title":"Military service: implications for hearing loss and tinnitus","author":"Noise","year":"2006","unstructured":"Noise (2006) and Military service: implications for hearing loss and tinnitus. National Academies, Washington, D.C."},{"issue":"3","key":"9989_CR2","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1016\/0378-5955(83)90031-X","volume":"9","author":"D Robertson","year":"1983","unstructured":"Robertson D (1983) Functional significance of dendritic swelling after loud sounds in the Guinea pig cochlea. Hear Res 9(3):263\u2013278","journal-title":"Hear Res"},{"issue":"2","key":"9989_CR3","doi-asserted-by":"publisher","first-page":"166","DOI":"10.3109\/00016487109125346","volume":"71","author":"H Spoendlin","year":"1971","unstructured":"Spoendlin H (1971) Primary structural changes in the organ of Corti after acoustic overstimulation. Acta Otolaryngol 71(2):166\u2013176","journal-title":"Acta Otolaryngol"},{"key":"9989_CR4","doi-asserted-by":"crossref","unstructured":"Natarajan N, Batts S, Stankovic KM (2023) Noise-Induced hearing loss. J Clin Med 12(6):2347","DOI":"10.3390\/jcm12062347"},{"key":"9989_CR5","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1016\/j.heares.2012.11.010","volume":"297","author":"EC Oesterle","year":"2013","unstructured":"Oesterle EC (2013) Changes in the adult vertebrate auditory sensory epithelium after trauma. Hear Res 297:91\u201398","journal-title":"Hear Res"},{"issue":"2","key":"9989_CR6","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1001\/dmphp.D-08-00057R2","volume":"4","author":"DS Darley","year":"2010","unstructured":"Darley DS, Kellman RM (2010) Otologic considerations of blast injury. Disaster Med Public Health Prep 4(2):145\u2013152","journal-title":"Disaster Med Public Health Prep"},{"issue":"10","key":"9989_CR7","doi-asserted-by":"publisher","first-page":"1825","DOI":"10.1097\/MAO.0000000000000616","volume":"35","author":"AK Remenschneider","year":"2014","unstructured":"Remenschneider AK, Lookabaugh S, Aliphas A, Brodsky JR, Devaiah AK, Dagher W et al (2014) Otologic outcomes after blast injury: the Boston Marathon experience. Otol Neurotol 35(10):1825\u201334","journal-title":"Otol Neurotol"},{"issue":"1","key":"9989_CR8","doi-asserted-by":"publisher","first-page":"272","DOI":"10.1002\/lary.24169","volume":"124","author":"A Shah","year":"2014","unstructured":"Shah A, Ayala M, Capra G, Fox D, Hoffer M (2014) Otologic assessment of blast and nonblast injury in returning middle East-deployed service members. Laryngoscope 124(1):272\u2013277","journal-title":"Laryngoscope"},{"key":"9989_CR9","first-page":"173","volume":"Suppl 26(1)","author":"H Van Hoecke","year":"2016","unstructured":"Van Hoecke H, Calus L, Dhooge I (2016) Middle ear damages. B-ENT Suppl 26(1):173\u201383","journal-title":"B-ENT"},{"issue":"suppl2","key":"9989_CR10","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1093\/milmed\/usy167","volume":"183","author":"CR Esquivel","year":"2018","unstructured":"Esquivel CR, Parker M, Curtis K, Merkley A, Littlefield P, Conley G et al (2018) Aural blast injury\/acoustic trauma and hearing loss. Mil Med 183(suppl2):78\u201382","journal-title":"Mil Med"},{"issue":"2","key":"9989_CR11","doi-asserted-by":"publisher","first-page":"884","DOI":"10.1121\/10.0001789","volume":"148","author":"BCJ Moore","year":"2020","unstructured":"Moore BCJ (2020) Diagnosis and quantification of military noise-induced hearing loss. J Acoust Soc Am 148(2):884","journal-title":"J Acoust Soc Am"},{"issue":"8","key":"9989_CR12","doi-asserted-by":"publisher","first-page":"e271","DOI":"10.1097\/MAO.0000000000001071","volume":"37","author":"AF Ryan","year":"2016","unstructured":"Ryan AF, Kujawa SG, Hammill T, Le Prell C, Kil J (2016) Temporary and permanent Noise-induced threshold shifts: A review of basic and clinical observations. Otol Neurotol 37(8):e271\u2013e275","journal-title":"Otol Neurotol"},{"issue":"7","key":"9989_CR13","doi-asserted-by":"publisher","first-page":"1005","DOI":"10.1682\/JRRD.2012.03.0038","volume":"49","author":"FJ Gallun","year":"2012","unstructured":"Gallun FJ, Diedesch AC, Kubli LR, Walden TC, Folmer RL, Lewis MS et al (2012) Performance on tests of central auditory processing by individuals exposed to high-intensity blasts. J Rehabil Res Dev 49(7):1005\u20131025","journal-title":"J Rehabil Res Dev"},{"issue":"3","key":"9989_CR14","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1682\/JRRD.2014.11.0275","volume":"52","author":"GH Saunders","year":"2015","unstructured":"Saunders GH, Frederick MT, Arnold M, Silverman S, Chisolm TH, Myers P (2015) Auditory difficulties in blast-exposed veterans with clinically normal hearing. J Rehabil Res Dev 52(3):343\u2013360","journal-title":"J Rehabil Res Dev"},{"key":"9989_CR15","doi-asserted-by":"publisher","first-page":"109263","DOI":"10.1016\/j.heares.2025.109263","volume":"461","author":"NF Bramhall","year":"2025","unstructured":"Bramhall NF, Buran BN, McMillan GP (2025) Associations between physiological indicators of cochlear deafferentation and listening effort in military veterans with normal audiograms. Hear Res 461:109263","journal-title":"Hear Res"},{"key":"9989_CR16","doi-asserted-by":"publisher","first-page":"108310","DOI":"10.1016\/j.heares.2021.108310","volume":"408","author":"NF Bramhall","year":"2021","unstructured":"Bramhall NF, McMillan GP, Kampel SD (2021) Envelope following response measurements in young veterans are consistent with noise-induced cochlear synaptopathy. Hear Res 408:108310","journal-title":"Hear Res"},{"issue":"Pt B","key":"9989_CR17","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1016\/j.heares.2015.02.009","volume":"330","author":"SG Kujawa","year":"2015","unstructured":"Kujawa SG, Liberman MC (2015) Synaptopathy in the noise-exposed and aging cochlea: primary neural degeneration in acquired sensorineural hearing loss. Hear Res 330(Pt B):191\u2013199","journal-title":"Hear Res"},{"key":"9989_CR18","first-page":"233121652412395","volume":"28","author":"NF Bramhall","year":"2024","unstructured":"Bramhall NF, McMillan GP (2024) Perceptual consequences of cochlear deafferentation in humans. Trends Hear 28:23312165241239540","journal-title":"Trends Hear"},{"issue":"2","key":"9989_CR19","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1055\/s-0038-1641743","volume":"39","author":"CM Barbee","year":"2018","unstructured":"Barbee CM, James JA, Park JH, Smith EM, Johnson CE, Clifton S et al (2018) Effectiveness of auditory measures for detecting hidden hearing loss and\/or cochlear synaptopathy: A systematic review. Semin Hear 39(2):172\u2013209","journal-title":"Semin Hear"},{"issue":"8","key":"9989_CR20","doi-asserted-by":"publisher","first-page":"1315","DOI":"10.1097\/MAO.0b013e318263d598","volume":"33","author":"M B\u00fcchler","year":"2012","unstructured":"B\u00fcchler M, Kompis M, Hotz MA (2012) Extended frequency range hearing thresholds and otoacoustic emissions in acute acoustic trauma. Otol Neurotol 33(8):1315\u20131322","journal-title":"Otol Neurotol"},{"key":"9989_CR21","doi-asserted-by":"crossref","unstructured":"Kuo C-Y, Hung C-L, Chen H-C, Shih C-P, Lu R-H, Chen C-W et al (2021) The immediate and Long-Term impact of military aircraft noise on hearing: a cross-sectional comparison of fighter pilots and ground staff. Int J Environ Res Public Health 18(6):2982","DOI":"10.3390\/ijerph18062982"},{"key":"9989_CR22","doi-asserted-by":"publisher","DOI":"10.1016\/j.heares.2024.109171","volume":"456","author":"SK Mishra","year":"2025","unstructured":"Mishra SK, Saxena U, Rodrigo H (2025) Early signs of auditory aging: hearing declines faster in individuals with extended high frequency hearing loss. Hear Res 456:109171","journal-title":"Hear Res"},{"issue":"5","key":"9989_CR23","doi-asserted-by":"publisher","first-page":"2027","DOI":"10.1121\/1.400897","volume":"89","author":"R Probst","year":"1991","unstructured":"Probst R, Lonsbury-Martin BL, Martin GK (1991) A review of otoacoustic emissions. J Acoust Soc Am 89(5):2027\u20132067","journal-title":"J Acoust Soc Am"},{"key":"9989_CR24","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1093\/bmb\/63.1.223","volume":"63","author":"DT Kemp","year":"2002","unstructured":"Kemp DT (2002) Otoacoustic emissions, their origin in cochlear function, and use. Br Med Bull 63:223\u2013241","journal-title":"Br Med Bull"},{"issue":"12","key":"9989_CR25","first-page":"19","volume":"3","author":"J Attias","year":"2001","unstructured":"Attias J, Horovitz G, El-Hatib N, Nageris B (2001) Detection and clinical diagnosis of noise-induced hearing loss by otoacoustic emissions. Noise Health 3(12):19\u201331","journal-title":"Noise Health"},{"issue":"1\u20132","key":"9989_CR26","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1016\/j.heares.2009.02.008","volume":"251","author":"A Job","year":"2009","unstructured":"Job A, Raynal M, Kossowski M, Studler M, Ghernaouti C, Baffioni-Venturi A et al (2009) Otoacoustic detection of risk of early hearing loss in ears with normal audiograms: a 3-year follow-up study. Hear Res 251(1\u20132):10\u20136","journal-title":"Hear Res"},{"issue":"1S","key":"9989_CR27","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1044\/2018_AJA-TTR17-18-0042","volume":"28","author":"KF Carlson","year":"2019","unstructured":"Carlson KF, Gilbert TA, O\u2019Neil ME, Zaugg TL, Manning CA, Kaelin C et al (2019) Health care utilization and mental health diagnoses among veterans with tinnitus. Am J Audiol 28(1S):181\u2013190","journal-title":"Am J Audiol"},{"key":"9989_CR28","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1016\/j.heares.2017.01.013","volume":"349","author":"AA Swan","year":"2017","unstructured":"Swan AA, Nelson JT, Swiger B, Jaramillo CA, Eapen BC, Packer M et al (2017) Prevalence of hearing loss and tinnitus in Iraq and Afghanistan veterans: a chronic effects of neurotrauma consortium study. Hear Res 349:4\u201312","journal-title":"Hear Res"},{"key":"9989_CR29","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1093\/epirev\/mxu005","volume":"37","author":"SM Theodoroff","year":"2015","unstructured":"Theodoroff SM, Lewis MS, Folmer RL, Henry JA, Carlson KF (2015) Hearing impairment and tinnitus: prevalence, risk factors, and outcomes in US service members and veterans deployed to the Iraq and Afghanistan wars. Epidemiol Rev 37:71\u201385","journal-title":"Epidemiol Rev"},{"issue":"8","key":"9989_CR30","doi-asserted-by":"publisher","first-page":"e971","DOI":"10.1097\/MAO.0000000000002760","volume":"41","author":"S Koochakzadeh","year":"2020","unstructured":"Koochakzadeh S, Gupta A, Nguyen SA, McRackan TR, Kil J, Bhenswala PN et al (2020) Hearing outcomes of treatment for acute Noise-induced hearing loss: A systematic review and Meta-analysis. Otol Neurotol 41(8):e971\u2013e981","journal-title":"Otol Neurotol"},{"issue":"5\u20136","key":"9989_CR31","doi-asserted-by":"publisher","first-page":"e661","DOI":"10.1093\/milmed\/usaa579","volume":"187","author":"MM Ahmed","year":"2022","unstructured":"Ahmed MM, Allard RJ, Esquivel CR (2022) Noise-induced hearing loss treatment: systematic review and meta-analysis. Mil Med 187(5\u20136):e661\u2013e666","journal-title":"Mil Med"},{"issue":"10","key":"9989_CR32","doi-asserted-by":"publisher","first-page":"949","DOI":"10.1177\/1060028020908067","volume":"54","author":"J Li","year":"2020","unstructured":"Li J, Ding L (2020) Effectiveness of steroid treatment for sudden sensorineural hearing loss: a meta-analysis of randomized controlled trials. Ann Pharmacother 54(10):949\u2013957","journal-title":"Ann Pharmacother"},{"issue":"11","key":"9989_CR33","doi-asserted-by":"publisher","first-page":"3524","DOI":"10.7150\/thno.83383","volume":"13","author":"K Xu","year":"2023","unstructured":"Xu K, Xu B, Gu J, Wang X, Yu D, Chen Y (2023) Intrinsic mechanism and pharmacologic treatments of noise-induced hearing loss. Theranostics 13(11):3524\u20133549","journal-title":"Theranostics"},{"issue":"5","key":"9989_CR34","doi-asserted-by":"publisher","first-page":"436","DOI":"10.3766\/jaaa.16043","volume":"28","author":"N Yehudai","year":"2017","unstructured":"Yehudai N, Fink N, Shpriz M, Marom T (2017) Acute acoustic trauma among soldiers during an intense combat. J Am Acad Audiol 28(5):436\u2013443","journal-title":"J Am Acad Audiol"},{"issue":"1","key":"9989_CR35","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1121\/1.4973618","volume":"141","author":"KK Charaziak","year":"2017","unstructured":"Charaziak KK, Shera CA (2017) Compensating for ear-canal acoustics when measuring otoacoustic emissions. J Acoust Soc Am 141(1):515","journal-title":"J Acoust Soc Am"},{"issue":"4","key":"9989_CR36","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1159\/000522051","volume":"27","author":"E Zloczower","year":"2022","unstructured":"Zloczower E, Tsur N, Hershkovich S, Fink N, Marom T (2022) Efficacy of oral steroids for acute acoustic trauma. Audiol Neurootol 27(4):312\u2013320","journal-title":"Audiol Neurootol"},{"issue":"1","key":"9989_CR37","doi-asserted-by":"publisher","first-page":"10","DOI":"10.7874\/jao.2024.00024","volume":"28","author":"HA Lee","year":"2024","unstructured":"Lee HA, Chung JH (2024) Contemporary review of idiopathic sudden sensorineural hearing loss: management and prognosis. J Audiol Otol 28(1):10\u201317","journal-title":"J Audiol Otol"},{"key":"9989_CR38","doi-asserted-by":"publisher","first-page":"22573","DOI":"10.1038\/srep22573","volume":"6","author":"Y Sun","year":"2016","unstructured":"Sun Y, Yu J, Lin X, Tang W (2016) Inhibition of cyclooxygenase-2 by NS398 attenuates noise-induced hearing loss in mice. Sci Rep 6:22573","journal-title":"Sci Rep"},{"issue":"10","key":"9989_CR39","doi-asserted-by":"publisher","first-page":"1250","DOI":"10.1097\/MAO.0000000000002012","volume":"39","author":"G Van Haesendonck","year":"2018","unstructured":"Van Haesendonck G, Van Rompaey V, Gilles A, Topsakal V, de Van Heyning P (2018) Otologic outcomes after blast injury: the brussels bombing experience. Otol Neurotol 39(10):1250\u20135","journal-title":"Otol Neurotol"},{"issue":"3","key":"9989_CR40","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1055\/s-0035-1548671","volume":"19","author":"P Simonetti","year":"2015","unstructured":"Simonetti P, Oiticica J (2015) Tinnitus neural mechanisms and structural changes in the brain: the contribution of neuroimaging research. Int Arch Otorhinolaryngol 19(3):259\u2013265","journal-title":"Int Arch Otorhinolaryngol"},{"issue":"6","key":"9989_CR41","doi-asserted-by":"publisher","first-page":"520","DOI":"10.5152\/iao.2021.21139","volume":"17","author":"VAR da Silva","year":"2021","unstructured":"da Silva VAR, Kruchewsc MM, Lavinsky J, Pauna HF, Guimaraes AC, Castilho AM et al (2021) Progressive asymmetry in occupational noise-induced hearing loss: a large population-based cohort study with a 15-year follow-up. J Int Adv Otol 17(6):520\u20135","journal-title":"J Int Adv Otol"},{"issue":"4","key":"9989_CR42","doi-asserted-by":"publisher","first-page":"677","DOI":"10.3109\/00016489109138399","volume":"111","author":"T Piril\u00e4","year":"1991","unstructured":"Piril\u00e4 T (1991) Left-right asymmetry in the human response to experimental noise exposure. I. Interaural correlation of the temporary threshold shift at 4\u00a0kHz frequency. Acta Otolaryngol 111(4):677\u2013683","journal-title":"Acta Otolaryngol"},{"issue":"2","key":"9989_CR43","doi-asserted-by":"publisher","first-page":"199","DOI":"10.3109\/00206098309072783","volume":"22","author":"DY Chung","year":"1983","unstructured":"Chung DY, Willson GN, Gannon RP (1983) Lateral differences in susceptibility to noise damage. Audiology 22(2):199\u2013205","journal-title":"Audiology"},{"issue":"2","key":"9989_CR44","doi-asserted-by":"publisher","first-page":"91","DOI":"10.3109\/01050398109076167","volume":"10","author":"A Axelsson","year":"1981","unstructured":"Axelsson A, Jerson T, Lindberg U, Lindgren F (1981) Early noise-induced hearing loss in teenage boys. Scand Audiol 10(2):91\u201396","journal-title":"Scand Audiol"}],"container-title":["European Archives of Oto-Rhino-Laryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00405-025-09989-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00405-025-09989-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00405-025-09989-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T18:43:32Z","timestamp":1781635412000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00405-025-09989-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,23]]},"references-count":44,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["9989"],"URL":"https:\/\/doi.org\/10.1007\/s00405-025-09989-3","relation":{},"ISSN":["0937-4477","1434-4726"],"issn-type":[{"value":"0937-4477","type":"print"},{"value":"1434-4726","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,23]]},"assertion":[{"value":"7 August 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 December 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 February 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethics approval was obtained from the Sheba Medical Center\u2019s Institutional Review Board (reference number: 1534-14 SMC) and included full exemption from informed consent as the utilized methods included routine clinical tests used at the Sheba Medical Center. All tests were performed in accordance with the relevant guidelines and regulations.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}