Delays in Treatment for Temporal Encephaloceles and Cerebrospinal Fluid Leaks.

Objective: Lateral skull base defects (LSBD) pose a diagnostic challenge; however, early recognition and treatment are important to avoid sequelae. This study examines the impact of health care disparities associated with time to diagnosis and treatment for patients with LSBD.

Study Design, Setting, Patients, Intervention, Outcome Measures: Multi-institutional retrospective cohort study at four U.

Evaluation of Cholesteatoma.

Evaluation of cholesteatoma depends on clinical history and examination, with microscope and/or endoscope. A history of hearing loss with a chronic draining ear, refractory to ototopical medication, raises suspicion for cholesteatoma. Symptoms of Eustachian tube dysfunction or prior ear surgery including ear tubes should be elicited.

Management of Foreign Bodies in the Ear Canal.

Using the appropriate instruments and techniques for removing a foreign body from the external auditory canal facilitates the procedure and reduces the risk of complications. Most ear foreign bodies can be addressed on a nonurgent basis, but batteries and caustic materials warrant prompt removal. Referral to an otolaryngologist should be considered for difficult cases or after a failed attempt.

Audiologic Consequences of Gunshot Wounds to the Temporal Bone Show No Relation to Concomitant Neurologic or Vascular Injuries.

Objectives: To evaluate audiologic consequences of gunshot wounds (GSWs) to the temporal bone (TB), and to correlate hearing outcomes with neurologic and vascular injuries adjacent to the temporal bone.

Study Design: Retrospective case series.

Setting: University-based level-one trauma center.

Cochlear implantation through intracochlear fibrosis: A comparison of surgical techniques.

Objective: While the implications of ossification on cochlear implantation (CI) have been extensively described, there is a paucity of data regarding the fibrotic stage. We examined the outcomes of different insertion techniques for managing intracochlear fibrosis.

Study Design: Retrospective review of case series with case-control comparison.

Management of the facial nerve following temporal bone ballistic injury.

Objective: To understand the patterns of temporal bone fracture and facial nerve injury from ballistic trauma.

Study Design: Retrospective case series.

Methods: Retrospective review of 42 patients evaluated following temporal bone ballistic injury at a single institution, university-based level-one trauma center between 2012 and 2021.

Conversations in Cochlear Implantation: The Inner Ear Therapy of Today.

As biomolecular approaches for hearing restoration in profound sensorineural hearing loss evolve, they will be applied in conjunction with or instead of cochlear implants. An understanding of the current state-of-the-art of this technology, including its advantages, disadvantages, and its potential for delivering and interacting with biomolecular hearing restoration approaches, is helpful for designing modern hearing-restoration strategies. Cochlear implants (CI) have evolved over the last four decades to restore hearing more effectively, in more people, with diverse indications.

The Role of Intra-Operative Duplex Ultrasonography Following Translabyrinthine Approach for Vestibular Schwannoma.

Objective: Sigmoid sinus (SS) stenosis is a complication of translabyrinthine approach. Velocity changes in the SS measured by intra-operative doppler ultrasound may help in identifying patients at risk for sinus occlusion.

Patients: SS velocity was measured using doppler ultrasound prior to opening dura and again prior to placement of the abdominal fat graft.

Eugenics and photography in Britain, the USA and Australia 1870-1940.

This essay traces the main ways in which photography was taken up and used by supporters of the eugenics movement, from the time that Darwin's cousin, the British polymath Francis Galton, first used it to demonstrate the role played by heredity in human intelligence, to the early 1940s, when the eugenics movement lost much of its appeal. It is argued that Galton's composite photographs of the socially "fit" and "unfit" members of British society only broadly determined the pattern for how American and Australian eugenicists deployed photography, and that each country's differing social tensions caused them to evolve their own diverse set of photographic practices aimed at promulgating the eugenic cause. Using photographic examples drawn from Britain, the USA and Australia, the essay identifies the leading persons and eugenics organisations that deployed photography, the different kinds of photographic genres they used and the different ideological and statist ends to which their images were put.

Predictors of hearing functional outcome following surgery for cerebellopontine angle meningioma.

Objective: Cerebellopontine angle (CPA) meningiomas can affect hearing function and require expeditious treatment to prevent permanent hearing loss. The authors sought to determine the factors associated with functional hearing outcome in CPA meningioma patients treated with surgery and/or radiation therapy in the form of either stereotactic radiosurgery or stereotactic radiation therapy.

Methods: Consecutive patients with CPA meningiomas who had presented at our hospital from 2008 to 2018 were identified through retrospective chart review.

Anatomic Assessment of the Limits of an Endoscopically Assisted Retrolabyrinthine Approach to the Internal Auditory Canal.

 Data regarding the surgical advantages and anatomic constraints of a hearing-preserving endoscopic-assisted retrolabyrinthine approach to the IAC are scarce. This study aimed to define the minimum amount of retrosigmoid dural exposure necessary for endoscopic exposure of the IAC and the surgical freedom of motion afforded by this approach.  Presigmoid retrolabyrinthine approaches were performed on fresh cadaveric heads.

Phase II randomized study of preoperative calcitriol to prevent hypocalcemia following thyroidectomy.

Background: A prospective, stratified, randomized, double-blind, placebo-controlled study was conducted to observe the impact of preoperative calcitriol supplementation on serum calcium levels following total thyroidectomy.

Methods: Subjects were randomized 1:1 to receive 1 μg calcitriol or placebo for 1 week preceding thyroidectomy. The primary outcome measure was change in serum calcium from baseline to 18 h post-thyroidectomy.

Clinical Significance of Middle Cerebellar Peduncle Ischemia After Translabyrinthine Vestibular Schwannoma Resection.

Objective: To assess clinical symptoms, signs, and radiographic evolution of middle cerebellar peduncle (MCP) diffusion restriction (DR) abnormalities following vestibular schwannoma (VS) resection.

Study Design: Retrospective chart and imaging review.

Setting: Tertiary-referral neurotology and neurosurgery practice.

Isolated Saccular Hydrops on High-resolution MRI Is Associated With Full Spectrum Menière's Disease.

Objective: To describe the clinical presentation of patients with isolated saccular endolymphathic hydrops (EH) detected.

Study Design: Clinical case series.

Setting: University-based tertiary referral center.

Radiation-Induced Malignant Peripheral Nerve Sheath Tumor of the Vagus Nerve Following Radiation Treatment of Cervical Paraganglioma.

Radiation-induced sarcoma is a known but rare complication of radiation treatment for skull base paraganglioma. We present the cases of a female patient with multiple paraganglioma syndrome treated with external beam radiation treatment who presented 4 years later with a malignant peripheral nerve sheath tumor of the vagus nerve.

Hypercoagulability in Vestibular Schwannoma Surgery.

Objective: Patients with vestibular schwannoma who harbor a genetic predisposition for venous thromboembolism require special consideration when determining optimal therapeutic management. The primary objective of the current study was to provide recommendations on treatment of hypercoagulable patients with vestibular schwannoma through a case series and review of the literature.

Patients: Two patients who underwent resection of vestibular schwannomas.

Effect of Vestibular Schwannoma Size and Nerve of Origin on Posterior External Auditory Canal Sensation: A Prospective Observational Study.

Objective: Posterior external auditory canal (EAC) hypesthesia (Hitselberger's sign) has been previously described to occur in all vestibular schwannomas (1966) but has not been studied since. We hypothesized that sensory loss may be related to tumor size and sought to determine if this clinical sign could predict preoperative characteristics of vestibular schwannomas, intraoperative findings, and/or surgical outcomes.

Study Design: Prospective observational study.

A wider influence: The impact of formal humanitarian otology training on otology-neurotology fellows.

Objectives: Long-term commitment to humanitarian surgical outreach requires the opportunity, resources, and time to participate, but perhaps more importantly, it requires a preceding successful outreach experience. The Accreditation Council for Graduate Medical Education (ACGME) expects physician trainees to achieve six Core Competencies: patient care, medical knowledge, interpersonal and communication skills, professionalism, practice-based learning and improvement, and systems-based practice. This study investigates the challenges and benefits of a supervised humanitarian experience with a focus on ACGME Core Competencies, future global outreach, and commitment to education.

Sensitivity of High-Resolution Computed Tomography in Otosclerosis Patients undergoing Primary Stapedotomy.

Objective: To determine the incidence of abnormal otospongiotic or otosclerotic findings on high-resolution computed tomography (HRCT) as read by local radiologists in patients with surgically-confirmed otosclerosis.

Study Design: Retrospective chart review.

Setting: Tertiary-referral private otology-neurotology practice.

Hypofractionated Robotic Stereotactic Radiosurgery for Vagal Paragangliomas: A Novel Treatment Strategy for Cranial Nerve Preservation.

Objective: To provide the first description of hypofractionated stereotactic radiosurgery (SRS) and evaluate tumor control and safety for vagal paragangliomas (VPs), which begin at the skull base but often have significant extracranial extension.

Study Design: Retrospective chart review.

Setting: Tertiary-referral neurotology and neurosurgery practice.

Congenital Cholesteatoma of the Sphenoid, Occipital, and Temporal Bones: 54-Year Follow Up.

Objective: To provide long-term follow up of a unique patient with history of massive petrous apex congenital cholesteatoma.

Patient: 75-year-old man who presented at age 18 with left Gradenigo-like syndrome.

Intervention: Staged left radical mastoidectomy and open transsphenoidal marsupialization.

Failure to close the gap: Concomitant superior canal dehiscence in otosclerosis patients.

Objective: Superior semicircular canal dehiscence (SSCD) causing conductive hearing loss with present reflexes is a known reason for stapes surgery failure. However, concomitant SSCD and otosclerosis occur rarely. We present a case series of SSCD diagnosed in positively identified otosclerosis patients.

Histopathologic Characteristics of Internal Auditory Canal Diverticula.

Hypothesis: We hypothesize that internal auditory canal (IAC) diverticula occur independent of otosclerosis as demonstrated by temporal bone histopathology.

Background: Diverticula at the anterior-inferior aspect of the IAC have been described histologically in the setting of cavitary otosclerosis. Recent radiographic studies show the prevalence of IAC diverticula that is higher than what can be accounted for by cavitary otosclerosis alone.

Cochlear Implant Receiver-Stimulator Migration Using the Subperiosteal Pocket Technique: Objective Measurements of Early and Late Positioning.

Objective: Current clinical practice for fixation of the cochlear implant receiver-stimulator (RS) may not follow recommended manufacturer's guidelines. We investigated short- and long-term RS migration using a subperiosteal pocket technique via serial objective position measurements since previous literature provided only subjective or short-term evaluation.

Study Design: Retrospective review.

Primary Middle Ear Mucosal Melanoma: Case Report and Comprehensive Literature Review of 21 Cases of Primary Middle Ear and Eustachian Tube Melanoma.

Objective: To present a case of primary middle ear mucosal melanoma and perform a comprehensive literature review of middle ear and eustachian tube mucosal melanoma.

Patient: A 61-year-old female presented with no prior history of melanoma and 3 months of aural fullness. A middle ear mass demonstrated primary mucosal melanoma.