Cholesteatoma surgery: management of the labyrinthine fistula--a report of 97 cases.

Preoperative, operative and postoperative findings in 97 cases of labyrinthine fistula are presented. Most of these patients had had symptoms of chronic otitis media for 20 years or more and manifested some degree of sensorineural hearing impairment. Two-thirds had experienced dizziness.

Tympanoplasty: TORPS and PORPS.

We reviewed 106 cases in which PlastiPoreTM prostheses were used for ossicular reconstruction. In all cases a piece of cartilage was interposed between the prosthesis and the tympanic membrane graft to prevent the potential problem of prosthesis extrusion. With total ossicular replacement prostheses (TORPs) 55% closed to within 10 db and 85% closed to within 20 db of the bone conduction level.

Auditory prostheses research with multiple channel intracochlear stimulation in man.

Although single-channel electrode arrays implanted in the scala tympani of deaf patients are useful as an aid to lip reading and for distinguishing some environmental sounds, they do not transmit intelligible speech. However, multichannel electrode arrays, which take advantage of the cochlea's tonotopic organization, may be capable of generating the complex patterns of neural activity necessary for speech discrimination. In this study, multichannel electrodes were implanted in the cochleas of four volunteers, with access to the connecting wires made through the skin via a percutaneous connector.

Facial nerve repair in cerebellopontine angle surgery.

Facial nerve continuity was restored during cerebellopontine angle tumor removal in nine cases. The distal facial nerve was rerouted from the stylomastoid foramen into the cerebellopontine angle. Direct suture was accomplished in seven cases while two required interposition of a greater auricular nerve graft.

Acromegaly and the temporal bone.

Acromegaly is a chronic disease of middle life resulting from excessive secretion of growth hormones by the acidophil cells of the anterior pituitary. The typical clinical features include enlargement of the skull, thorax, hands and feet. Recently, three patients with acromegaly have been operated upon for active otologic disease.

Electric response audiometry: clinical applications.

Electric response audiometry is an exciting new development in the field of otology. At the present time it is the best objective audiometric test for predicting the threshold in infants or uncooperative patients. Brain stem audiometry is a valuable addition to the audiologic test battery for acoustic tumor diagnosis.

Retrolabyrinthine approach: technique and newer indications.

Excellent exposure of the cerebellopontine angle is obtained by an approach through the mastoid posterior to the labyrinth. Since the major portion of the dissection is extradural, this approach is associated with a very low morbidity. The retrolabyrinthine approach has been used for several years for selective partial section of the posterior root of the trigeminal nerve in cases of trigeminal neuralgia.

Cholesteatoma surgery: residual and recurrent disease. A review of 1,024 cases.

This is an analysis of 1,024 primary cases of mastoid surgery for cholesteatoma operated upon during a ten-year period at the Otologic Medical Group, Inc. Our philosophy of management of the mastoid in these cases has been as follows: 1) avoid an open mastoid cavity when possible; 2) perform the operation in two stages if necessary; 3) reexplore the mastoid and middle ear for residual cholesteatoma when indicated. One-third of 380 revised cases had residual cholesteatoma, disease left by the surgeon.

Salivary gland choristoma of the middle ear.

We discuss the eighth reported case of a benign salivary gland tumor in the middle ear. The lesion was a smooth lobulated mass and was found to be intimately associated with the tympanic portion of the facial nerve. Recommended treatment is biopsy without attempting removal.

Eustachian tube blockage and Meniere's disease.

On the basis of our clinical experience, it has been noted that an unusually large proportion of patients with Meniere's disease have intermittent eustachian tube blockage. A review of the tympanograms of 81 patients with Meniere's disease, representing 107 ears, showed that 25 (30.9%) of the patients and 35 (32.

Acoustic tumor detection with brain stem electric response audiometry.

Tumors that press on the audiotry nerve can cause a latency increase that is detectable from the scalp by electric response audiometry (BERA). The response delay is best seen by comparing the Jewett wave V, or P5, latencies for the two ears. This interaural latency difference is normally less than 0.

The cochlear implant; basic principles.

In recent years the cochlear implant has been a subject of much discussion and controversy. The clinician has often been confused by the conflicting reports of success and failure. In this paper the development of the cochlear implant is reviewed and its present status summarized.

Artifical hearing for the deaf by cochlear stimulation: pitch modulation and some parametric thresholds.

The periodicity and place-pitch modulation data, along with the data on loudness, offers promise of the development of a multielectrode, multichannel cochlear auditory prosthesis. Also, the currents required for cochlear stimulation are of the magnitude which can pass across the electrode-perilymph interface, by double-layer charging, without production of toxic by-products of electrolysis(6), supporting the feasibility of long-term chronic stimulation.