Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
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Case Reports
Herpes simplex meningitis after removal of a vestibular schwannoma: case report and review of the literature.
We present a case of postoperative herpes simplex type 1 viral meningitis after retrosigmoid craniotomy and uncomplicated removal of a vestibular schwannoma. This is a very rare complication that can mimic aseptic meningitis and could lead to devastating consequences for the patient, if unrecognized. ⋯ The diagnosis of herpes simplex viral meningitis should be suspected in clinical cases of postsurgical meningitis with a lymphocyte predominant pleocytosis and negative bacterial cultures. Antiviral therapy should be initiated immediately after confirmatory polymerase chain reaction testing to avoid potential long-term sequelae of a herpes simplex infection of the central nervous system.
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Temporal bone encephaloceles and cerebrospinal fluid (CSF) otorrhea can lead to life-threatening sequelae such as meningitis and cerebritis. Obesity has been associated with spontaneous CSF leaks. We wished to determine if there were differences in the body mass index (BMI) of patients with spontaneous temporal bone encephaloceles/CSF leaks and nonspontaneous temporal bone encephaloceles/CSF leaks to help determine if obesity may be associated with their development. ⋯ 4.
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This study aims to examine the mechanism of damage to the basilar membrane caused by the proximal section of the cochlear implant electrode array. ⋯ Results from this study are useful for cochlear implant surgeons in better understanding the mechanism of damage by the electrode array's proximal section to the basilar membrane and in establishing advanced insertion techniques for reducing the damage (in particular, the results strongly support the "advance off-stylet" technique). The outcomes of the study also are beneficial for cochlear implant designers in selecting appropriate stiffness profiles for future electrode arrays, which are expected to cause minimal damage to the basilar membrane (a new design of the contour array with stiffness increasing from the front to the proximal section is highly recommended).
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To review the current literature to assess the effectiveness of rehabilitation treatment for peripheral facial nerve palsy. ⋯ Peripheral injury of the VIIth cranial nerve can have serious repercussions on the patient's functioning and quality of life. The recovery rate is related to the preservation of the nerve and to the cause of palsy. We obtained a third level of recommendation (level C); mime therapy could be effective to improve functional outcome in these patients. Evidence of specific treatment addressed to specific cause is lacking; likewise, no evidence is available on timing of intervention with respect to time of onset. Well-designed randomized controlled trials are required to evaluate the effect of rehabilitation in patients with facial palsy.
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To investigate the long-term patient outcomes after tumor debulking for internal auditory canal facial schwannoma (FNS). ⋯ Tumor debulking for FNS provides an opportunity for tumor removal and excellent facial nerve function. Continuous facial nerve monitoring is vital for successful debulking surgery. FNS debulking is feasible via the middle cranial fossa approach. Serial postoperative imaging is warranted to monitor for recurrence.