Preservation of conductive hearing in approaches to tumors of the jugular foramen.

Objective: Surgical approaches to the jugular foramen, most often used for the resection of glomus jugulare tumors, may include removal of the external auditory canal wall and overclosure of the meatus, resulting in maximal conductive hearing loss. Modifications have been described that maintain hearing by preserving the canal wall at the price of decreased exposure and are, therefore, suitable only for small and favorably located tumors. Our technique for removal and then reconstruction of the canal wall with hydroxyapatite cement allows for complete anterior translocation of the facial nerve as far proximal as the geniculate ganglion, giving uncompromising exposure of even the most extensive tumors, with the potential for preservation of normal hearing.

Ossiculoplasty using incus interposition: hearing results and analysis of the middle ear risk index.

Objective: To determine the immediate hearing result and the long-term stability of sculpted incus interposition in ossiculoplasty and evaluate the utility of the middle ear risk index in predicting hearing outcome in these cases.

Patients: One hundred thirty-seven surgical patients.

Study Design: Review of 137 patients who underwent ossiculoplasty using autologous or homologous sculpted incus interposition.