Changes in audiovestibular handicap following treatment of vestibular schwannomas.

Objective: This study aimed to assess degree of audiovestibular handicap in patients with vestibular schwannoma.

Methods: Audiovestibular handicap was assessed using the Hearing Handicap Inventory, Tinnitus Handicap Inventory and Dizziness Handicap Inventory. Patients completed questionnaires at presentation and at least one year following treatment with microsurgery, stereotactic radiosurgery or observation.

Facial Nerve Function Outcome and Risk Factors in Resection of Large Cystic Vestibular Schwannomas.

 Cystic vestibular schwannomas (VS) in contrast to solid VS tend to have accelerated growth, larger volume, rapid/atypical presentation, lobulated/adherent surface, and unpredictable course of the cranial nerves. Cystic VS are surgically challenging, with worse clinical outcomes and higher rate of subtotal resection (STR).  We retrospectively analyzed postoperative outcomes of 125 patients with cystic VS, operated between years 2005 and 2019 in our center.

Headache, Cerebrospinal Fluid Leaks, and Pseudomeningoceles after Resection of Vestibular Schwannomas: Efficacy of Venous Sinus Stenting Suggests Cranial Venous Outflow Compromise as a Unifying Pathophysiological Mechanism.

 Regardless of the operative approach, headache, cerebrospinal fluid (CSF) leaks, and pseudomeningoceles remain disproportionately common problems after surgery for vestibular schwannomas and have a significant negative impact on quality of life and potential to return to full employment. Recent work has raised the possibility that these problems may, in part, be related to acquired obstruction of cranial venous outflow. This article explores this idea further with respect to a group of patients with severe and intractable symptoms.

Squamous cell carcinoma of the temporal bone: clinical outcomes from radical surgery and postoperative radiotherapy.

Objective: To review the treatment of squamous carcinoma of the temporal bone at a regional skull base unit for the period 1982-2012.

Study Design: Retrospective case review.

Setting: Tertiary referral center.

Magnetic resonance imaging after translabyrinthine complete excision of vestibular schwannomas.

The objective of this study is to determine whether magnetic resonance imaging (MRI) at 2 years following complete vestibular schwannoma (VS) excision using a translabyrinthine approach is sufficient to detect recurrent tumor. The study is set in a tertiary referral skull base unit. A service evaluation of a prospective database identified patients who underwent complete translabyrinthine VS excision with prospectively recorded MRI results at 2 and 5 years following surgery.

Middle fossa repair of bilateral large congenital tegmental defects with meningoencephaloceles.

Spontaneous temporal meningoencephaloceles are unusual. When they do occur, they present with a variety of signs and symptoms, which can make diagnosis and management challenging. We report the interesting case of a 49-year-old woman with bilateral congenital temporal meningoencephaloceles.

Growth characteristics of vestibular schwannomas.

Objective: To assess the growth characteristics of small- to medium-sized vestibular schwannomas in patients undergoing watch, wait, and rescan management.

Study Design: Cohort study using prospectively collected size and tumor morphology data.

Setting: Tertiary referral center for cranial base surgery.

Surgical management of vestibular schwannomas and hearing rehabilitation in neurofibromatosis type 2.

Objectives: To report our approach to the surgical management of vestibular schwannomas (VSs) and hearing rehabilitation in neurofibromatosis Type 2 (NF2).

Design: Retrospective cohort study.

Setting: Tertiary referral NF2 unit.

Audiovestibular factors influencing quality of life in patients with conservatively managed sporadic vestibular schwannoma.

Objectives: To measure the health-related quality of life (QoL) of patients undergoing conservative management of a vestibular schwannoma and to identify audiovestibular factors that influence health-related QoL.

Study Design: Cross-sectional case-control study.

Intervention: Adult patients undergoing conservative management of a sporadic vestibular schwannoma were identified from a prospectively updated database.

Hearing improvement in a growing vestibular schwannoma.

Vestibular schwannomas are benign, slow-growing tumors that originate from Schwann cells lining the vestibular nerves, most commonly the superior vestibular nerve. They arise at the neurilemmal/neuroglial junction which is situated within the internal auditory canal. They have an incidence of 1 per 100,000 per year and a prevalence of around 700 per million.

Bruns' nystagmus in patients with vestibular schwannoma.

Objectives: To determine the prevalence of Bruns' nystagmus in patients undergoing surgical treatment for unilateral sporadic vestibular schwannomas (VSs), identify the clinical characteristics of patients with Bruns' nystagmus and compare these characteristics with those of VS patients with no nystagmus and other types of nystagmus, and determine the long-term impact of having preoperative Bruns' nystagmus.

Study Design: A retrospective review using a prospectively updated database of patients who had undergone surgical removal of a VS. Patients were divided into 3 groups: Bruns' nystagmus, other types of nystagmus, or no nystagmus.

A facial nerve schwannoma masquerading as a vestibular schwannoma.

Schwannoma of the facial nerve is an extremely rare condition with an incidence far lower than that of vestibular schwannoma. We discuss the case of a woman who had been diagnosed as having vestibular schwannoma and referred to our hospital. Initially, we concurred with the diagnosis, but on reassessment of magnetic resonance imaging scans before surgery, we revised the diagnosis to facial nerve schwannoma.

Are facial nerve outcomes worse following surgery for cystic vestibular schwannoma?

Objectives: This study sought to determine explicitly whether postsurgical facial nerve outcomes for patients with a cystic component to a vestibular schwannoma were significantly different from those with a solid tumor.

Design: Seventy patients who underwent translabyrinthine surgery for a cystic vestibular schwannoma between May 1981 and the present, and who had complete records in our database, were identified. These were compared with a group of patients with solid tumors matched to the study group on the following parameters: House-Brackmann grade at presentation, tumor size, surgical approach, age.

Change in hearing and tinnitus in conservatively managed vestibular schwannomas.

Objectives: The aim of this study was to evaluate the change of hearing and tinnitus in a group of conservatively managed unilateral vestibular schwannomas (VS).

Design: Retrospective case series review.

Setting: Tertiary referral otoneurological and skull base surgery department.

Reconstructive options after temporal bone resection for squamous cell carcinoma.

Unlabelled: Squamous cell carcinoma (SCC) of the temporal bone is a rare, aggressive and highly malignant tumour that requires specialised, multidisciplinary surgery for its treatment. Reconstruction of the defect is as crucial as the tumour ablation in terms of mortality and postoperative morbidity.

Methods: The experience of the East Anglian Skull Base Surgery Service from 1982 to 2004 in managing 42 consecutive patients (22 females; age range 37-80 years) undergoing extended and lateral temporal bone resection for SCC is presented.

Preoperative audiovestibular handicap in patients with vestibular schwannoma.

Objectives: To evaluate preoperative hearing, dizziness, and tinnitus handicap in patients with unilateral vestibular schwannoma (VS).

Design: Prospective administration of the Hearing Handicap Inventory (HHI), Dizziness Handicap Inventory (DHI), and Tinnitus Handicap Inventory (THI), prior to surgical intervention.

Setting: A tertiary referral neuro-otology clinic.

The clinical characteristics of tinnitus in patients with vestibular schwannoma.

Objectives: To review the symptoms, signs, and clinical findings in a large series of patients diagnosed with unilateral sporadic vestibular schwannoma (VS) to describe the clinical characteristics of tinnitus in this population. Further, to ascertain which of the proposed mechanisms of tinnitus generation in VS was supported.

Design: Retrospective case note and database review.

Malignant peripheral nerve sheath tumors of the head and neck: two cases and a review of the literature.

Malignant peripheral nerve sheath tumors are uncommon lesions that occasionally affect the head and neck. We describe 2 new cases of head and neck pathology. One tumor involved the parotid gland and resulted in erosion of the temporal bone, and the other affected the lower lip.

Use of anterolateral thigh and lateral arm fasciocutaneous free flaps in lateral skull base reconstruction.

Lateral skull base defects following tumor ablation are ideally reconstructed with microvascular free tissue transfer. Although the rectus abdominis free flap is the workhorse in skull base reconstruction, it has a number of drawbacks. Anecdotal reports have indicated that fasciocutaneous free flaps may be useful alternatives in selected cases.

The prevalence and onset of gaze modulation of tinnitus and increased sensitivity to noise after translabyrinthine vestibular schwannoma excision.

Objective: To determine the prevalence and timing of onset of gaze-modulated tinnitus and increased sensitivity to noise in patients who had undergone translabyrinthine excision of a vestibular schwannoma.

Study Design: Retrospective questionnaire study.

Setting: University hospital departments of audiology and neurotology.

Change in tinnitus handicap after translabyrinthine vestibular schwannoma excision.

Objective: To evaluate the change in tinnitus handicap after translabyrinthine vestibular schwannoma excision.

Study Design: Prospective administration of the Tinnitus Handicap Inventory (THI) preoperatively and at 3 and 12 months postoperatively.

Setting: : A tertiary referral neuro-otology clinic.

Simultaneous contralateral vestibular schwannoma and glomus jugulare tumor: a case report.

To the best of our knowledge, only 3 cases of a simultaneous vestibular schwannoma and a glomus jugulare tumor have been previously reported in the literature. In all 3 cases, the lesions were located on the same side. We report a new case of simultaneous vestibular schwannoma and glomus jugulare tumor that is unique in that the two lesions arose on opposite sides.

The inhibitory effect of intravenous lidocaine infusion on tinnitus after translabyrinthine removal of vestibular schwannoma: a double-blind, placebo-controlled, crossover study.

Objective: Intravenous infusion of lidocaine has previously been demonstrated to have a transient inhibitory effect on tinnitus in 60% of individuals. The site of action has variously been proposed as the cochlea, the cochlea nerve, and the central auditory pathways. To determine whether a central site of action exists, this study investigated the effect of intravenous infusion of lidocaine in individuals with tinnitus who had previously undergone translabyrinthine excision of a vestibular schwannoma, which involves division of the cochlear nerve.

The outcome of radical surgery and postoperative radiotherapy for squamous carcinoma of the temporal bone.

Objectives/hypothesis: The objective was to analyze the clinical data and outcome of all the patients treated surgically for squamous carcinoma of the temporal bone in a tertiary referral department of skull base surgery over a 20-year period.

Study Design: Retrospective.

Methods: Thirty-nine patients with squamous carcinoma of the temporal bone were analyzed.