Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
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The radiologic appearance of arachnoid granulations (AGs) in typical locations is well established and they are rarely mistaken for other pathologies. However, when large and seen in atypical locations, such as along the posterior petrous bone, AGs can be a source of diagnostic and therapeutic confusion. We present two cases of giant posterior temporal bone AGs and review their clinical presentation, potential complications, and an imaging-based differential diagnosis. ⋯ The posterior temporal bone is an atypical location for AGs and can lead to diagnostic confusion, particularly when they are large. Familiarity with the characteristic imaging appearance of giant AGs in this location can help avoid misinterpretation as a more aggressive pathology and help recognize patients who are at risk for a CSF leak.
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The American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) recently published guidelines on the treatment of tinnitus. This paper examines the possible impact of those guidelines on otologic practice. ⋯ Opinions regarding the treatment of tinnitus vary considerably. The AAO-HNS clinical practice guideline: tinnitus has not significantly altered the practices of otologists, but the guidelines provide meaningful, important information for other clinicians who deal infrequently with tinnitus.
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Randomized Controlled Trial
Double-Blind Sham-Controlled Crossover Trial of Repetitive Transcranial Magnetic Stimulation for Mal de Debarquement Syndrome.
To determine whether the chronic rocking dizziness that occurs in Mal de Debarquement Syndrome (MdDS) can be suppressed with repetitive transcranial magnetic stimulation (rTMS) beyond the treatment period. ⋯ Our study provides evidence that the dizziness, mood and anxiety symptoms of MdDS can be improved with 10 Hz rTMS over left DLPFC beyond the treatment period in selected individuals. rTMS may be a useful adjunctive treatment for the management of chronic rocking dizziness in individuals with MdDS but treatment durations longer than 5 days or maintenance treatment are likely needed for sustained symptom suppression.
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Clinical Trial
Controlled Clinical Trial on Bone-anchored Hearing Implants and a Surgical Technique With Soft Tissue Preservation.
To compare the clinical and audiological outcomes after linear incision with soft-tissue preservation and standard linear incision with soft-tissue reduction for placement of percutaneous bone-anchored hearing implants. ⋯ Tissue preservation compared with tissue reduction leads to a generally favorable clinical outcome, comparable audiology results, and significantly shorter surgery time. Longer follow-up is warranted to conclude on the increased adverse soft-tissue reactions after 6 months.
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To assess the effects of data-driven instruction (DDI) on spoken language outcomes of children with cochlear implants and hearing aids. ⋯ The preliminary results of this study support further investigation regarding DDI to investigate whether this method can consistently and significantly improve the achievement of children with hearing loss in spoken language skills.