Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
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The radiologic appearance of arachnoid granulations (AGs) in typical locations is well established and they are rarely mistaken for other pathologies. However, when large and seen in atypical locations, such as along the posterior petrous bone, AGs can be a source of diagnostic and therapeutic confusion. We present two cases of giant posterior temporal bone AGs and review their clinical presentation, potential complications, and an imaging-based differential diagnosis. ⋯ The posterior temporal bone is an atypical location for AGs and can lead to diagnostic confusion, particularly when they are large. Familiarity with the characteristic imaging appearance of giant AGs in this location can help avoid misinterpretation as a more aggressive pathology and help recognize patients who are at risk for a CSF leak.
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The American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) recently published guidelines on the treatment of tinnitus. This paper examines the possible impact of those guidelines on otologic practice. ⋯ Opinions regarding the treatment of tinnitus vary considerably. The AAO-HNS clinical practice guideline: tinnitus has not significantly altered the practices of otologists, but the guidelines provide meaningful, important information for other clinicians who deal infrequently with tinnitus.