Cerebrospinal fluid leaks and encephaloceles of temporal bone origin: nuances to diagnosis and management.

Objective: Temporal bone encephalocele has become less common as the incidence of chronic mastoid infection and surgery for this condition has decreased. As a result, the diagnosis is often delayed, and the encephalocele is often an incidental finding. This situation can result in serious neurologic complications with patients presenting with cerebrospinal fluid leak and meningitis.

Parental restriction of children's access to cochlear implants: case studies.

This article reports on four retrospective case studies in which parental behavioral management of the implanted child included withholding the cochlear implant or activities associated with it as a disciplinary measure or as a means of preventing device loss or damage. The need for parental counseling by health care and educational professionals as to the importance of a child's connection to the hearing world all day long through the implant for optimal speech, language, academic, and psychosocial development is emphasized.

How to measure cerebrospinal fluid pressure invasively and noninvasively.

We describe tympanic membrane displacement (TMD) testing for non-invasive estimation of intracranial pressure (ICP). With the TMD test, displacement of the tympanic membrane of the middle ear is recorded during elicitation of the acoustic middle-ear reflex (AR). Increased intracranial/perilymphatic pressure displaces the resting stapes footplate laterally so that TMD during the acoustic reflex is medial.

Oral vs intratympanic corticosteroid therapy for idiopathic sudden sensorineural hearing loss: a randomized trial.

Context: Idiopathic sudden sensorineural hearing loss has been treated with oral corticosteroids for more than 30 years. Recently, many patients' symptoms have been managed with intratympanic steroid therapy. No satisfactory comparative effectiveness study to support this practice exists.

Revision cochlear implant surgery in patients with suspected soft failures.

Objective: To review our patient series who underwent revision cochlear implantation surgery, with special emphasis on the "soft failure" group.

Study Design: Retrospective chart review of cochlear implant revision surgeries from 1979 to 2008. An extensive review of these patients' medical, audiologic, and radiographic histories was performed.

Repair issues associated with cochlear implants in children.

Objective: To examine the number and type of repair issues associated with the use of cochlear implants in children who have worn either the body-level or ear-level style for 4 to 5 years.

Study Design: Retrospective review.

Setting: Specialty eye and ear institute.

Conservative management of advanced external auditory canal cholesteatoma.

Objective: To investigate the spectrum of disease presentation and clinical management of primary external auditory canal cholesteatoma (EACC).

Study Design: Case series with chart review.

Setting: Specialty teaching hospital.

Efficacy of the bone-anchored hearing aid for single-sided deafness.

Objectives/hypothesis: The aim was to examine short- and long-term efficacy of the bone-anchored hearing aid (BAHA) on adults with single-sided deafness.

Study Design: Prospective investigation.

Methods: The outcome measures included the Hearing in Noise Test (HINT), Abbreviated Profile of Hearing Aid Benefit (APHAB), and Single-Sided Deafness Questionnaire (SSD).

Glomus tumors in patients of advanced age: a conservative approach.

Objectives: Identify and discuss controversies in the management of paragangliomas in elderly patients. Assess and evaluate a conservative treatment strategy involving limited surgical resection and vigilant monitoring of the outcome measures of tumor control, peritreatment morbidity, symptom resolution, and hearing preservation.

Study Design: Retrospective case review.

Perioperative management of intracranial aneurysms and otologic disease.

Objective: Diagnosis and treatment of asymptomatic, unruptured intracranial aneurysms (UIA) are areas of longstanding controversy in the neurologic and neurosurgical literature. Treatment decisions require careful consideration of both the potential for aneurysm rupture as well as the risks associated with repair. Studies examining the natural history of UIA, the morbidity and mortality associated with subarachnoid hemorrhage (SAH), and the various treatment options have led to general guidelines for UIA management.

Malignant cylindroma of the external auditory canal.

Objective: This report describes a case of a malignant cylindroma arising in the external auditory canal.

Study Design: Retrospective surgical case review.

Setting: Tertiary care teaching hospital.

Objective computerized versus subjective analysis of facial synkinesis.

Objectives/hypothesis: To compare the sensitivity of an objective, computerized approach to measurement of facial synkinesis with that for a subjective approach and to examine the test-retest reliability of these approaches.

Study Design: Prospective, nonrandomized, and blinded.

Methods: Remote facial motion at the upper eyelids and oral commissures during a closed-lip smile and eyelid closure were measured using a commercially available computerized motion analysis system.

Facial motion analysis with a video and computer system after treatment of acoustic neuroma.

Objective: To objectively evaluate facial function with a computer and video system in a group of normal adults and a group of adults who have been treated for acoustic neuroma.

Study Design: A prospective descriptive study was performed in which the experimenter performing the objective facial motion analysis was blinded to the subjective rating of facial function.

Patients: The normal subjects comprised 18 women and 16 men.

Objective facial motion analysis in patients with facial nerve dysfunction.

Objectives/hypothesis: To objectively measure facial motion at various facial landmarks using a video-computer interactive system.

Study Design: Clinical, prospective, non-randomized.

Methods: A video-computer interactive system, The Peak Motus Motion Measurement System, was used to study linear displacement at preselected facial landmarks in the normal and abnormal face.