Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
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The aim of this study was assessment of the use of endoscopy in minimally invasive surgery of the cerebellopontine angle in cases of trigeminal neuralgia. ⋯ The minimally invasive retrosigmoid endoscopic-assisted microvascular decompression is an acceptable treatment of primary trigeminal neuralgia. Endoscopy provides a unique way to explore the cerebellopontine angle and to identify the exact location of the neurovascular conflict.
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To inventory computed tomographic and magnetic resonance imaging findings in the branchio-oto-renal (BOR) syndrome. ⋯ Hypoplasia and dysplasia of the cochlea were consistent findings, and only magnetic resonance imaging was able to evaluate the intracochlear changes in detail and corrected computed tomography in most patients. Moreover, magnetic resonance imaging also detected bilateral hypoplasia of the cochlear branch of the eighth nerve in one patient. A widened vestibular aqueduct and a widened vestibular sac were frequent but not obligatory features of the BOR syndrome. Other malformations of the middle ear included a reduced middle ear cavity and malformations of the ossicular chain.
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To determine the surgical efficacy of a simplified retrosigmoid approach for vestibular nerve sectioning. ⋯ With excellent efficacy, short operative time, and a low incidence of postoperative hearing loss or headache, this simplified retrosigmoid technique should be considered for vestibular nerve sectioning in patients with intractable peripheral vestibular disorders.
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We compared the treatment outcome of patients with benign paroxysmal positional vertigo unassociated with additional objective evidence of vestibular pathology (BPPV) with that in patients who did demonstrate additional vestibular pathology on standard neurotologic testing (BPPV+). ⋯ Our study demonstrates that patients with BPPV+ do not have a worse prognosis with respect to resolution of positional nystagmus, on performing the particle repositioning procedure, compared with patients with uncomplicated BPPV. However, they do suffer incomplete resolution of symptoms because of a coincidental anterior or horizontal canal dysfunction and otolithic or central vestibular dysfunction. It appears that the majority of patients with BPPV+ need further vestibular rehabilitation after the particle repositioning maneuver.
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In an effort to improve patient confidentiality as well as cosmesis, the authors have stopped shaving for all intracranial procedures. The objective was to determine whether this lack of shaving increased the postoperative infection rate. ⋯ The rate of postoperative wound infection was statistically no greater when the hair was shaved than when it was not. Thus, for patient confidentiality as well as patient esteem, we recommend not shaving hair for intracranial procedures.