Head and neck lipoblastoma in children: A case report and systematic review.

Background: Lipoblastoma is a rare and benign tumor arising from embryonal fat cells. It develops primarily in infancy and early childhood. We present a case study of a 10-month-old child treated for an extensive tumor of the infratemporal fossa and parapharyngeal space.

Application of "banana cochleostomy" and looped electrode insertion for cochlear implantation in children with common cavity malformation and cystic forms of cochlear hypoplasia.

Objectives: Patients with profound hearing loss due to inner ear malformations may benefit from cochlear implantation; however, the surgery may present a substantial problem for the cochlear implant surgeon due to anatomical variations. The authors describe a new surgical and technical advancement for implantation in patients with small inner ear cavities that make the surgery easier and safer. On the basis of experience involving five consecutive surgeries performed in four patients with inner ear malformations, we present the advantages and application possibilities of the technique.

The Petrosquamous Stalactite.

Objective To define the presence and relationship of the petrosquamous stalactite (PsS)-a condensation of the trabecular Korner's septum into a bony plate of the petrosquamous suture-to surrounding structures and understand its surgical implications. Study Design Series of cadaver dissections. Setting University of Missouri Alumni Temporal Bone and Microvascular Laboratory.

Enhancement of the subtemporal approach by partial posterosuperior petrosectomy with hearing preservation.

Background: The microsurgical management of aneurysms in the interpeduncular and ambient cisterns remains challenging. The classic subtemporal approach has several limitations.

Objective: To present a modification of this approach that allows for broader exposure with hearing preservation.

Comparison of Intraoperative Portable CT Scanners in Skull Base and Endoscopic Sinus Surgery: Single Center Case Series.

Precise and safe management of complex skull base lesions can be enhanced by intraoperative computed tomography (CT) scanning. Surgery in these areas requires real-time feedback of anatomic landmarks. Several portable CT scanners are currently available.

The zone-based approach for selection of tympanoplasty technique.

At the outset of surgery, the extent of a tympanic membrane defect is judged including any additional loss of area that may result from disease extirpation or removal of the mucocutaneous junction. There are, three tiers of complexity when deciding upon which technique should be used for repair. Limited central perforations are defects amenable to a standard underlay technique.

Imaging and anatomy for cochlear implants.

At a minimum, successful cochlear implantation requires that electrical impulses be delivered to a surviving spiral ganglion cell population, and that these impulses be transmitted to a functioning auditory cortex by an existent neural connection. Accordingly, imaging the auditory pathway of the implant candidate is necessary to screen for morphologic conditions that will preclude or complicate the implantation process. In addition to radiography, increasing resolution of computed tomography and magnetic resonance imaging technology has provided the clinician with more detailed information about the integrity of the auditory pathway.

Combined surgical and endovascular access of the superficial middle cerebral vein to occlude a high-grade cavernous dural arteriovenous fistula: case report.

Background And Importance: High-grade cavernous sinus (CS) dural arteriovenous fistulae with cortical venous drainage often have a malignant presentation requiring urgent treatment. In the absence of a venous access to the lesion, transarterial embolization can potentially cure these lesions; however, the high concentration of eloquent arterial territories adjacent to the fistula creates a precarious risk of arterial-arterial reflux. In such cases, a combined surgical and endovascular approach may provide the least invasive option.

Modification of the orthodromic temporalis tendon transfer technique for reanimation of the paralyzed face.

Objective: To report a modification of the temporalis tendon transfer technique used in facial paralysis where dynamic adjacent muscle transfer is determined to be the best treatment option.

Study Design: Case series with chart review.

Setting: Tertiary care teaching hospital.

Optical cochlear implants: evaluation of surgical approach and laser parameters in cats.

Previous research has shown that neural stimulation with infrared radiation (IR) is spatially selective and illustrated the potential of IR in stimulating auditory neurons. The present work demonstrates the application of a miniaturized pulsed IR stimulator for chronic implantation in cats, quantifies its efficacy, and short-term safety in stimulating auditory neurons. IR stimulation of the neurons was achieved using an optical fiber inserted through a cochleostomy drilled in the basal turn of the cat cochlea and was characterized by measuring compound action potentials (CAPs).

CO(2) laser fiber soft cochleostomy: development of a technique using human temporal bones and a guinea pig model.

Objective: A novel approach for creating a soft cochleostomy has been described using a handheld CO(2) laser hollow waveguide from termed in the following the handheld CO(2) laser fiber. The effects on cochlear function have been studied in an animal model and were compared to the effects of the micro drill.

Study Design: Combined human temporal bone and experimental animal study.

Prevalence of depression and antidepressant use in an otolaryngology patient population.

Objective: To determine the prevalence of depressive diagnoses and antidepressant use in various subsets of otolaryngology patients.

Study Design: Academic practice EMR database query.

Subjects And Methods: Over 12,000 consecutive otolaryngology patients were analyzed by primary diagnosis and in three groups: Group 1 (tinnitus, vertigo), Group 2 (rhinosinusitis), and Group 3 (sleep apnea).

Quantitative evaluation of transtemporal and facial translocation approaches to infratemporal fossa.

Objective: To compare the extent of exposure and surgical maneuverability provided by facial translocation and transtemporal approaches for access to the infratemporal fossa and anterolateral skull base.

Materials And Methods: Surgical procedures were performed on five fresh frozen adult cadavers (ten sides) with no known pathology. Facial transfacial approaches with and without a mandibulotomy and transtemporal approaches were evaluated.

[Perilymphatic fistula: diagnosis and treatment].

Introduction: Diagnosis and management of perilymphatic fistula (PLF) is a controversial topic in the international neurotologic literature. An illustrative case of post traumatic PLF with clear surgical indications is presented. This manuscript also reviews the various clinical presentations, pathogenesis, diagnostic examinations, and management options of PLF.

Cranial nerve preservation in surgery for large acoustic neuromas.

Facial nerve outcomes and surgical complication rates for other cranial nerves were evaluated retrospectively after the resection of large acoustic neuromas. The charts of all patients who underwent surgical removal of an acoustic neuroma between 1992 and 2001 at New York University Medical Center were reviewed. Fifty-four patients with tumors measuring 3 cm or larger were included in the study.

Total tympanic membrane reconstruction: AlloDerm versus temporalis fascia.

Background And Objective: Patients who require surgery for chronic otitis media with perforation and cholesteatoma frequently provide no residual tympanic membrane that is usable in grafting procedures. A novel technique of total tympanic membrane reconstruction (TTMR) is described that maximizes perforation closure rate in these situations while minimizing mucosalization, incomplete healing, and anterior blunting. The specific aim of this report is to assess the safety and efficacy of TTMR and to compare the results obtained with AlloDerm compared with temporalis fascia as a grafting material.

Prevention and management of cerebrospinal fluid leak following vestibular schwannoma surgery.

Objectives/hypothesis: Postoperative cerebrospinal fluid (CSF) leak is reported in 2% to 30% of cases following vestibular schwannoma surgery. The authors' current surgical techniques for translabyrinthine, retrosigmoid transmeatal, and middle cranial fossa approaches have evolved from analysis of their prior experience in an effort to minimize their complication rate. The authors evaluated the efficacy of their current surgical technique in decreasing the postoperative CSF leak rate.

Fluoroscopically assisted cochlear implantation.

Hypothesis: Real-time intraoperative fluoroscopy is a useful adjunct to cochlear implantation in selected cases. The advantages include the avoidance of complications such as extracochlear array placement, intrameatal array insertion, and avoidance of significant bending or kinking. This is particularly useful when implanting a severely abnormal cochlea.