Techniques in Management of Cholesteatoma: Endoscopic Approaches.

Outcomes from cholesteatoma surgery are improved by using endoscopes to guide dissection as the wide-angled view facilitates more complete removal of cholesteatoma matrix, reducing the risk of residual disease. Furthermore, surgery can often be completed transcanal, reducing postoperative morbidity. The decision to complete cholesteatoma removal endoscopically transcanal is made from a combination of preoperative imaging and intraoperative findings.

Endoscopic Transnasal Management of Meningoceles and Encephaloceles in Children: A Systematic Review.

Objective: To review surgical techniques used in the endoscopic transnasal repair of pediatric basal meningoencephaloceles and compare perioperative outcomes in children <2 and ≥2 years old.

Data Sources: MEDLINE, EMBASE, and CENTRAL.

Review Methods: Data sources were searched from inception to August 22, 2022, using search terms relevant to endoscopic transnasal meningoencephalocele repair in children.

Public knowledge of button battery ingestions: A social media based cross-sectional analysis.

Introduction: Button battery (BB) ingestion injuries are a devastating and preventable event within the pediatric population. Efforts to reduce the prevalence of esophageal button battery ingestion injuries include primary preventative measures. It is integral to assess the public's baseline knowledge about BB injuries to tailor future primary prevention efforts.

Cholesteatoma Severity Determines the Risk of Recurrent Paediatric Cholesteatoma More Than the Surgical Approach.

Objective: To evaluate factors that influence the rate of cholesteatoma recurrence (growth of new retraction cholesteatoma) in children.

Methods: Review of children with primary acquired or congenital cholesteatoma. Severity was classified by extent and EAONO-JOS stage, and surgery by SAMEO-ATO.

Use of a Caprine Model for Simulation and Training of Endoscopic Ear surgery.

Background: The objective of this study was to evaluate the utility of a caprine model in endoscopic ear surgical education using the index procedures of tympanoplasty and ossiculoplasty. Specifically, this study assessed the face and content validity of the caprine model, and the potential impact of anatomical differences on trainee understanding of human middle ear anatomy.

Methods: Twelve otolaryngology trainees attended a 3-hour endoscopic ear surgery course utilizing the caprine model in which they completed canalplasty, tympanoplasty, and ossiculoplasty.

Endoscopic Repair of Round Window Cochleocele.

Objective: To describe the novel presentation, implications, and endoscopic management of a congenital round window cochleocele.

Patient: A 16-month old girl with profound hearing loss from bilateral incomplete partition type 1 (IP1) anomaly of the cochlea plus left-sided cochlear nerve aplasia and cochleocele.

Intervention: Anomalies were identified with computed tomographic scanning and magnetic resonance imaging during cochlear implant candidacy assessment.

Vascular Complications in Children Following Button Battery Ingestions: A Systematic Review.

Context: Children presenting to health care facilities with button battery (BB) impaction.

Objectives: To describe characteristics of children with vascular complications after BB impaction, as well as associated outcomes.

Data Sources: National Capital Poison Center registry and PubMed database from inception to December 2021.

Airway Complications Resulting From Pediatric Esophageal Button Battery Impaction: A Systematic Review.

Importance: Button batteries (BBs) are commonly found in many household items and present a risk of severe injury to children if ingested. The direct apposition of the trachea and recurrent laryngeal nerves with the esophagus puts children at risk of airway injury secondary to the liquefactive necrotic effects of BB impactions.

Objective: To review airway injuries, including long-term sequelae, after BB ingestion in children.

Button battery taping prevents oesophageal injury.

Aim: Most button battery (BB) ingestions in children are unwitnessed leading to prolonged exposures and severe complications. One third of ingestions occur from free BB, that are stored or awaiting disposal. Recommendations have been made to cover the terminals of discarded BB with adhesive tape; however, it is unclear if this practice prevents injury.

Hearing Instability in Children with Congenital Cytomegalovirus: Evidence and Neural Consequences.

Objective/hypothesis: Sensorineural hearing loss (SNHL) is a common sequela of congenital cytomegalovirus (cCMV), potentially exacerbating neurocognitive delay. The objectives of this study were to assess: (1) age at which SNHL in children with cCMV; (2) stimulability of the auditory system in children with cCMV following cochlear implantation (CI); and (3) whether features of magnetic resonance imaging (MRI) potentially are predictive of hearing outcomes.

Methods: In this retrospective study of a prospectively acquired cohort, 123 children with cCMV who were referred for hearing loss at a single tertiary referral hospital over 20 years were compared with an unmatched comparative group of 90 children with GJB2-related deafness.

Esterified Hyaluronic Acid Placed in the Middle Ear Does Not Improve Outcomes in Cholesteatoma Surgery.

Background: The aim of this article is to assess the efficacy of esterified hyaluronic acid as a barrier to formation of adhesions and improvement of tympanomastoid ventilation.

Methods: A prospective cohort analysis was performed at a tertiary referral centre. 126 ears were analysed in children with cholesteatoma.

Transcanal Endoscopic Ear Surgery for Congenital Cholesteatoma: A Multi-institutional Series.

Objective: To assess outcomes of transcanal endoscopic ear surgery (TEES) for congenital cholesteatoma.

Study Design: Case series with chart review of children who underwent TEES for congenital cholesteatoma over a 10-year period.

Setting: Three tertiary referral centers.

The Influence of Ciprofloxacin-Dexamethasone Ear Drops on Perforation Closure Rates After Endoscopic Tympanoplasty.

Objective: Topical ciprofloxacin and dexamethasone have both been shown to disrupt healing of tympanic membrane perforations in animal models. There have been no clinical studies evaluating the effect of ciprofloxacin-dexamethasone (CD) ear drops on success of tympanoplasty. We compare perforation closure rates in pediatric endoscopic tympanoplasty with and without use of postoperative CD.

Comparing Transcanal Endoscopic Ear Surgery to Post-Auricular Microscope-Guided Surgery in Pediatric Ossiculoplasty: Hearing Outcomes and Post-Operative Pain.

Objective: This study compares post-operative hearing outcomes and morbidity after pediatric total ossicular replacement prosthesis (TORP) ossiculoplasty with transcanal totally endoscopic ear surgery (TEES) versus a post-auricular microscope-guided (PAM) approach.

Patients: Forty-four children who underwent ossiculoplasty with titanium TORP after previous cholesteatoma surgery.

Intervention: Ossiculoplasty using TEES or PAM approach.

Prospective Comparison of Pediatric Endoscopic Lateral Graft and Interlay Tympanoplasty.

Objective: To compare outcomes and complications of endoscopic lateral graft (LGT) and interlay (IT) tympanoplasty.

Study Design: Prospective observational cohort study of totally endoscopic ear surgery (TEES) tympanoplasty.

Setting: Pediatric tertiary referral center.

Totally endoscopic tympanic membrane repair.

Background: Transcanal totally endoscopic ear surgery (TEES) has become increasingly popular internationally; however, for surgeons trained with a two-handed microscope-guided approach, the potential challenges of adopting TEES can appear off-putting.

Objectives: This article outlines the pros and cons of TEES for tympanic membrane repair and describes aspects of surgical technique relevant to those who might adopt this approach.

Materials And Methods: Data are provided from the author's experience along with a review of relevant literature, including several meta-analyses of tympanoplasty outcome.

The Effect of the Status of the Ossicular Chain and Choice of Graft Material on Hearing Outcomes in Pediatric Cholesteatoma Surgery.

Objective: Compare hearing benefit of incus preservation in primary cholesteatoma surgery versus cartilage-myringostapediopexy.

Methods: Prospective cohort study in a tertiary referral center. Tympanoplasty utilizing cartilage or other grafts, with or without intact incus was performed in 195 ears (187 children) with intact stapes.

How I do it: Proximal cochlear implant electrode fixation using Ned's Knot.

Objectives: Electrode extrusion is an under-recognized complication of cochlear implants, especially in those with straight electrodes.

Methods: This paper describes in details the steps to perform proximal fixation of an electrode around the incus buttress using Ned's knot technique. Written and video illustration is included.

Measurement Properties of the Hearing Environments and Reflection of Quality of Life (HEAR-QL) 28-item Questionnaire in Cholesteatoma.

Objective: We sought to assess the reliability and construct validity of the Hearing Environments and Reflection on Quality of Life Adolescent (HEAR-QL 28) quality of life measure (QoL) in cholesteatoma.

Study Design: Observational.

Setting: Tertiary referral center.

Does riboflavin depletion cause auditory neuropathy spectrum disorder in at risk neonates?

We present a new hypothesis for the pathogenesis of auditory neuropathy spectrum disorder (ANSD) in at risk neonates involving depletion of riboflavin. The association between neonatal hyperbilirubinemia and ANSD is well recognized, yet causation has not been proven. The risk of ANSD does not correlate clearly with severity of hyperbilirubinemia and ASND only occurs in a small proportion of hyperbilirubinemic neonates.

The limitation of risk factors as a means of prognostication in auditory neuropathy spectrum disorder of perinatal onset.

Objective: The management of hearing loss due to auditory neuropathy spectrum disorder (ANSD) in neonates and infants is challenging because speech and language development prognosis cannot be directly inferred from early audiometric hearing thresholds. Consequently, appropriate intervention with hearing aids or cochlear implantation (CI) can be delayed. Our objective was to determine whether any features of patient history could be used to identify CI candidates with ANSD at an earlier age.

Evaluation of Residual Disease Following Transcanal Totally Endoscopic vs Postauricular Surgery Among Children With Middle Ear and Attic Cholesteatoma.

Importance: Transcanal totally endoscopic ear surgery (TEES) improves tympanic cavity visibility during cholesteatoma resection but does not readily permit 2-handed surgery, which is possible with a postauricular approach and use of an operating microscope. Improved visibility and 2-handed access may reduce rates of incomplete surgical clearance and residual cholesteatoma.

Objective: To compare rates of residual cholesteatoma after TEES vs those after open surgery with a postauricular approach for initial disease limited to the middle ear and/or attic.