Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
-
To evaluate the results of facial nerve (FN) grafting using great auricular cable graft and fibrin glue without suturing to palliate FN disruption after removal of large cerebellopontine angle (CPA) vestibular schwannoma (VS) or facial nerve schwannoma (FNS). To assess whether tumor size and origin influenced the results. ⋯ Immediate FN reconstruction with fibrin glue-aided greater auricular nerve graft can effectively restore FN function with excellent outcomes. The results seem better than those observed by other authors using sutured grafts or delayed hypoglossal-facial nerve anastomosis.
-
To compare preoperative and postoperative sound localization and surgical outcomes in patients with a history of osseointegrated hearing device (OHD) placement who underwent cochlear implantation for severe to profound sensorineural hearing loss in one ear and normal cochlear function in the contralateral ear (single-sided deafness [SSD]). ⋯ Cochlear implantation for this population of patients produced modestly improved localization accuracy, and most patients expressed satisfaction with this intervention. In this series of cochlear implantation after OHD, our first two patients had wound infection and dehiscence. We recommend perioperative and postoperative antibiotics to prevent this complication.
-
Neurosarcoidosis is a rare granulomatous disease that can result in cranial neuropathy, chronic meningitis, and intracranial granuloma formation. Meningeal involvement may cause focal nodular enhancement that can simulate common cranial base tumors. The objective of the current study is to further define the clinical features of neurosarcoidosis in a large cohort of patients, focusing on characteristics relevant to the skull base surgeon. ⋯ Establishing the diagnosis of neurosarcoidosis remains challenging. Meningeal involvement and cranial neuropathy often mimic other more common conditions. Careful review of patient history and clinical imaging can reveal important clues toward the diagnosis of neurosarcoidosis. The clinician must maintain a high index of suspicion in patients with atypical presentation to avoid misdiagnosis and facilitate early medical treatment.
-
To review the clinical presentation, differential diagnosis, management strategy, and outcomes after microsurgical resection of cavernous hemangiomas (CHs) arising primarily within the internal auditory canal (IAC) and cerebellopontine angle (CPA). ⋯ Primary CHs of the IAC and CPA are rare and present clinically and radiographically similar to vestibular schwannoma. Microsurgical resection provides excellent facial nerve outcomes and tumor control for most patients; however, the majority of individuals will acquire non-serviceable hearing either from disease or as a result of treatment.
-
Is conscious sedation an effective, safe, and efficient anesthetic choice in patients undergoing select neurotologic and otologic procedures? ⋯ Select neurotologic and otologic procedures can be safely, effectively, and efficiently performed under conscious sedation with dexmedetomidine infusion as the primary anesthetic choice for patients who are deemed poor medical candidates for general endotracheal anesthesia.