Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
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The objective of the present study was to report our surgical strategy in the management of 81 patients with posterior petrous face meningiomas. ⋯ Total tumor removal (Simpson Grades I-II) remains our treatment of choice and takes priority over hearing preservation. Subtotal resection is indicated for older and debilitated patients with giant lesions to relieve the tumor compression on the cerebellum and brainstem. Subtotal removal is also preferred in the face of the absence of a plane of cleavage between the tumor and the brainstem, in the presence of encasement of vital neurovascular structures, in elderly patients with tumors adherent to preoperatively normal facial or lower cranial nerves.
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Comparative Study
Transmastoid labyrinthectomy versus translabyrinthine vestibular nerve section: does cutting the vestibular nerve make a difference in outcome?
Analyze differences in outcomes between labyrinthectomy with and without vestibular nerve section, including characteristics of symptoms and time course for improvement. ⋯ Both transmastoid labyrinthectomy and TLVNS provide good control of vertigo (>85% Class A or B). However, patients undergoing TLVNS were more likely to show improvement in imbalance and functional disability. This difference was less pronounced in patients with Meniere's disease.
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The number of spectral channels is the number of discriminable pitches heard as current is delivered to distinct locations along the cochlea. This study aimed to determine whether cochlear implant users could hear additional spectral channels using current "steering." Current steering involves the simultaneous delivery of current to adjacent electrodes, where stimulation can be steered to sites between the contacts by varying the proportion of current delivered to each electrode in an electrode pair. Current steering may increase the number of spectral channels beyond the number of fixed electrode contacts. ⋯ These results indicate that additional pitch percepts can be created using current steering.
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Multicenter Study
Importance of age and postimplantation experience on speech perception measures in children with sequential bilateral cochlear implants.
Clinical trials in which children received bilateral cochlear implants in sequential operations were conducted to analyze the extent to which bilateral implantation offers benefits on a number of measures. The present investigation was particularly focused on measuring the effects of age at implantation and experience after activation of the second implant on speech perception performance. ⋯ Sequential bilateral cochlear implantation in children of diverse ages has the potential to improve speech perception abilities in the second implanted ear and to provide access to the use of binaural mechanisms such as the head shadow effect. The improvement unfolds over time and continues to grow during the 6 to 12 months after activation of the second implant. Younger children in this study achieved higher open-set speech perception scores in the second ear, but older children still demonstrate bilateral benefit in noise. Determining the long-term impact and cost-effectiveness that results from such potential capabilities in bilaterally implanted children requires additional study with larger groups of subjects and more prolonged monitoring.
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To use the improved resolution available with 64-slice multidetector computed tomography (MDCT) in vivo to localize the cochlear implant electrode array within the basal turn. ⋯ Sixty-four-slice MDCT with multiplanar reconstructions of the postoperative cochlea after cochlear implantation allows for accurate localization of the electrode array within the basal turn where normal cochlear anatomy is not obscured by the underlying disease process. Correlating the position of the electrode in the basal turn with surgical technique and implant design could be helpful in improving outcomes.