Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
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Randomized Controlled Trial Clinical Trial
The inhibitory effect of intravenous lidocaine infusion on tinnitus after translabyrinthine removal of vestibular schwannoma: a double-blind, placebo-controlled, crossover study.
Intravenous infusion of lidocaine has previously been demonstrated to have a transient inhibitory effect on tinnitus in 60% of individuals. The site of action has variously been proposed as the cochlea, the cochlea nerve, and the central auditory pathways. To determine whether a central site of action exists, this study investigated the effect of intravenous infusion of lidocaine in individuals with tinnitus who had previously undergone translabyrinthine excision of a vestibular schwannoma, which involves division of the cochlear nerve. ⋯ Intravenous infusion of lidocaine has a statistically significant inhibitory effect on tinnitus in patients who have previously undergone translabyrinthine removal of a vestibular schwannoma. The site of action of lidocaine in this instance must be in the central auditory pathway, as the cochlear and vestibular nerves are sectioned during surgery, and this finding has important implications for the task of identifying other agents that will have a similar tinnitus-inhibiting effect.
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The goal is to confirm the effectiveness of cochlear implantation performed at the time of surgery for tumor removal, using a translabyrinthine approach. ⋯ The present cases demonstrate that cochlear implantation can be successful after a translabyrinthine approach for VS, regardless of the tumor size, the kind of patient (NF2, unilateral VS), and the type of implant. The results also are suggestive that cochlear implantation is more successful if done concurrent with surgery for tumor removal and before hearing is completely lost.
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Comparative Study
A comparison of surgical techniques used in dynamic reanimation of the paralyzed face.
To compare the outcomes of three surgical techniques used in the rehabilitation of the paralyzed face. ⋯ End-to-end anastomosis confers the best facial function, followed by cable nerve graft interposition and then classic faciohypoglossal transposition. Contrary to some previous opinions, improvement in facial function can still occur 2 years after surgical repair, particularly with classic faciohypoglossal transposition.
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To evaluate the short-term facial prognostic value of a four-channel facial electromyographic device in vestibular schwannoma surgery. ⋯ A four-channel device may enhance electromyographic sensitivity. Determination of stimulation threshold below 0.05 mA yields facial prognostic information.
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Multicenter Study Clinical Trial Controlled Clinical Trial
Benefits of bilateral electrical stimulation with the nucleus cochlear implant in adults: 6-month postoperative results.
To evaluate the benefits of bilateral electrical stimulation for hearing-impaired adult subjects using the Nucleus 24 cochlear implant in a multicenter study, and to compare and quantify performance on speech perception measures in quiet and in noise and localization ability for unilateral and bilateral cochlear implant use. ⋯ Similar to what has been observed for bilateral acoustic stimulation in the past, bilateral electrical stimulation provides the foundation for the potential advantages of the head-shadow effect, providing a binaural head-shadow benefit and binaural auditory processing such as binaural redundancy and binaural squelch effects, all of which combine to lead to improved speech comprehension over unilateral listening conditions. The combination of improved speech comprehension and improved localization ability made available through bilateral electrical stimulation provides the necessary foundation to further assist the hearing-impaired listener to better cope with communication in the everyday listening situation both in noise and in quiet.