Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
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High-resolution temporal bone computed tomography (CT) may erroneously demonstrate a superior semicircular canal dehiscence (SSCD) where none exists and inaccurately display the size of a dehiscence. ⋯ These findings confirm that medical CT cannot be used as the exclusive gold standard for SSCD and that, particularly for small dehiscences on CT, clinical symptoms must be clearly indicative of a dehiscence before surgical treatment is undertaken. Preoperative counseling for small dehiscences may need to include the possibility that no dehiscence may be found despite radiologic evidence for it.
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To examine hearing preservation rates, facial nerve outcomes, and tumor recurrence rates in patients with neurofibromatosis Type 2 undergoing a primary middle cranial fossa approach for vestibular schwannoma removal. ⋯ In patients with neurofibromatosis Type 2, proactive treatment of smaller tumors provides a chance to maintain serviceable hearing and obtain tumor control for extended periods. When examining hearing outcomes, it is important to use word recognition scores, in addition to American Academy of Otolaryngology-Head and Neck Surgery hearing class, to better assess functionality. Although facial nerve outcomes tend to be favorable, the growth of new tumors, including facial schwannomas, may occur within the surgical field. Continued surveillance with serial magnetic resonance scans after surgery is mandatory.
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Cochlear trauma due to electrode insertion can be detected in acoustic responses to low frequencies in an animal model with a hearing condition similar to patients using electroacoustic stimulation. ⋯ The results indicate that a recording algorithm based on physiological markers to low-frequency acoustic stimuli can identify cochlear trauma during implantation. Future work will focus on translating these results for use with current cochlear implant technology in humans.
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To report the little known fact that systemically administered gentamicin can cause severe unilateral, rather than only bilateral vestibular loss. ⋯ These results mean that any patient presenting with imbalance due to a compensated, selective unilateral vestibular loss, who has never experienced vertigo, should be closely questioned about any hospital admission just before symptoms started and the hospital records for that admission requisitioned and scrutinized for possible gentamicin therapy.
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Controlled Clinical Trial
Resorbable plate cranioplasty after the translabyrinthine approach.
To determine the safety of resorbable plate cranioplasty after translabyrinthine cerebellopontine angle tumor excision and to determine efficacy of this technique in the reduction of cerebrospinal fluid (CSF) leaks compared with fat grafting alone. ⋯ Cranioplasty with a resorbable plate after translabyrinthine craniotomy is safe. This technique results in a CSF leak rate equivalent to fat grafting alone.