Publications by authors named "Brian Neff"

Objective: To analyze the use of electrical field imaging (EFI) in the detection of extracochlear electrodes in cochlear implants (CI).

Study Design: Retrospective cohort study.

Setting: Tertiary academic medical center.

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Objective: To compare the utility of intraoperative electrically evoked auditory brainstem response (eABR) and electrically evoked stapedial reflex testing (eSRT) for cochlear nerve integrity monitoring during simultaneous translabyrinthine resection of vestibular schwannoma (VS) and cochlear implantation.

Study Design: Historical cohort study.

Setting: Tertiary academic referral center.

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Article Synopsis
  • This study investigates the effectiveness of a "wait-and-scan" approach using MRI for managing patients with small to medium-sized vestibular schwannomas (VS), aiming to assess patient adherence to follow-up.
  • Over six years, 270 patients were tracked, revealing that 27% were completely lost to follow-up before receiving treatment, while another 22% missed scheduled MRI follow-ups.
  • The research identified key factors for loss to follow-up, including living out of state and having smaller tumor sizes, indicating that distance and tumor characteristics significantly impact patient adherence to recommended imaging surveillance.
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Objectives: Describe a single institution's cochlear implant outcomes for patients with inner ear schwannomas (IES) in the setting of various tumor management strategies (observation, surgical resection, or stereotactic radiosurgery [SRS]).

Study Design: Single-institution retrospective review.

Patients: Patients diagnosed with isolated, sporadic IES who underwent cochlear implantation (CI).

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Article Synopsis
  • The study investigates the potential long-term effects of radiation treatment, particularly focusing on the rare occurrence of radiation-induced vestibular schwannomas (VSs) among patients who received radiation that covered the posterior fossa.* -
  • A review of eight cases revealed that patients had a median age of 15 years at the time of radiation and were diagnosed with VS a median of 51 years later, with some tumor characteristics noted, such as adherence to the facial nerve.* -
  • The findings suggest that while the occurrence of radiation-induced VS is rare, more research is needed to understand its causative relationship with radiation exposure and to improve management strategies for affected patients.*
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Objective: To describe the experience and results from coordinated and closely scheduled radiosurgery and cochlear implantation (CI) in a vestibular schwannoma (VS) cohort.

Patients: Patients with VS who underwent radiosurgery followed by CI on the same or next day.

Interventions: Interventions included sequential radiosurgery and CI.

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Objectives: A small number of cochlear implant (CI) users experience facial nerve stimulation (FNS), which can manifest as facial twitching. In some patients, this can be resolved by adjusting the electrical stimulation parameters. However, for others, facial stimulation can significantly impair CI outcomes or even prevent its use.

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Objective: The treatment paradigm of vestibular schwannoma (VS) focuses on preservation of neurologic function, with small tumors increasingly managed with active surveillance. Often, tumor size and hearing outcomes are poorly correlated. The aim of the current work was to describe the natural history of hearing among patients with nongrowing VS during observational management.

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Objective: The objective of the current study was to present the results of an international working group survey identifying perceived limitations of existing facial nerve grading scales to inform the development of a novel grading scale for assessing early postoperative facial paralysis that incorporates regional scoring and is anchored in recovery prognosis and risk of associated complications.

Study Design: Survey.

Setting: A working group of 48 multidisciplinary clinicians with expertise in skull base, cerebellopontine angle, temporal bone, or parotid gland surgery.

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Objective: To compare cochlear implant (CI) and auditory brainstem implant (ABI) performance in patients with NF2-related schwannomatosis (NF2).

Study Design: Historical cohort.

Setting: Tertiary academic center.

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Background: Neurofibromatosis type 2 (NF2)-related schwannomatosis is an autosomal dominant tumor-predisposition syndrome characterized by bilateral vestibular schwannomas (VS). In patients with VS associated with NF2, vascular endothelial growth factor A inhibitor, bevacizumab, is a systemic treatment option. The aim of this study is to retrospectively evaluate NF2 patient responses to bevacizumab on VS growth and symptom progression.

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Objective: Comprehensively assess the prevalence of monopolar electrosurgery-related device complications among cochlear implant (CI) recipients.

Study Design: Multifaceted retrospective review and survey.

Setting: Tertiary medical center.

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Objective: Compare cochlear implant (CI) performance between patients with ipsilateral sporadic vestibular schwannoma (VS) and NF2-related schwannomatosis (NF2). Compare CI performance according to VS management modality.

Study Design: Historical cohort.

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Objective: The objective of this study is to assess the influence of age on facial nerve recovery after microsurgical resection of sporadic vestibular schwannoma.

Study Design: A historical cohort study was performed.

Setting: The study was performed at a tertiary referral center.

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Objective: Preoperative differentiation of facial nerve schwannoma (FNS) from vestibular schwannoma (VS) can be challenging, and failure to differentiate between these two pathologies can result in potentially avoidable facial nerve injury. This study presents the combined experience of two high-volume centers in the management of intraoperatively diagnosed FNSs. The authors highlight clinical and imaging features that can distinguish FNS from VS and provide an algorithm to help manage intraoperatively diagnosed FNS.

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Intraoperative electrocochleography (ECOG) is performed using a single low-frequency acoustic stimulus (e.g., 500 Hz) to monitor cochlear microphonics (CM) during cochlear implant (CI) electrode insertion.

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Objective: To characterize the effect of the COVID-19 pandemic on national cochlear implantation utilization by age using inclusive cochlear implantation data from two manufacturers between 2015 and 2020.

Study Design: Analysis of prospectively registered consecutive patient data from two major cochlear implant (CI) manufacturers in the United States.

Patients: Children or adults who received CIs.

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Objective: To evaluate the optimal dose and timing of administration of sodium fluorescein (SF) for selective fluorescence of sporadic vestibular schwannoma (VS) during microsurgery with the YELLOW 560-nm microscope filter (YE560) and to characterize the potential benefit of this fluorescence as determined by intraoperative surgeon assessment.

Study Design: Prospective cohort study.

Setting: Tertiary referral center.

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Objective: To introduce and discuss implementation strategy for the Complete Cochlear Implant Care (CCIC) model, a highly-coordinated cochlear implant (CI) care delivery model requiring a single on-site visit for preoperative workup, surgery, and postoperative programming.

Study Design: Prospective, nonrandomized, two-arm clinical trial.

Setting: Tertiary referral CI center.

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Objective: To determine the relationship between intraoperative electrocochleography (ECochG) measurements and residual hearing preservation after cochlear implant (CI) surgery by comparing differences between preoperative and immediate postoperative bone conduction thresholds.

Study Design: Prospective cohort study.

Setting: Tertiary academic referral center.

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Objective: Develop a predictive model for incomplete microsurgical resection of sporadic vestibular schwannoma (VS).

Study Design: Historical cohort.

Setting: Tertiary referral center.

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Objective: To determine if temporoparietal scalp thickness assessed via preoperative imaging predicts retention events in patients who have cochlear implants with diametric magnets and various sound processor types.

Study Design: Retrospective chart and radiological review.

Setting: Tertiary referral center.

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Objectives: Compare speech perception performance growth and benchmark score achievement among adult cochlear implant (CI) recipients with single-sided deafness (SSD) versus bilateral moderate to profound hearing loss.

Study Design: Retrospective matched cohort analysis.

Setting: Tertiary referral center.

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