Idiopathic Intracranial Hypertension Is Associated with Recurrent CSF Leak and Reoperation for Spontaneous Temporal Encephalocele.

 Spontaneous temporal encephaloceles (STEs) are increasingly recognized as sequelae of idiopathic intracranial hypertension (IIH), which in turn may further complicate their management. We endeavored to review the University of Pennsylvania institutional experience on operative management of STEs, with a focus on factors which may influence surgical outcomes, particularly IIH.  Retrospective chart review over 9 years from 2013 to 2022.

Toward a Diagnostic Imaging Algorithm for Undifferentiated Pulsatile Tinnitus.

Objective: Decisions around the diagnostic evaluation for pulsatile tinnitus (PT) remain challenging. We describe the usage patterns and diagnostic accuracy of imaging modalities and propose an evidence-based diagnostic approach for undifferentiated PT.

Study Design: Retrospective.

A multi-institutional machine learning algorithm for prognosticating facial nerve injury following microsurgical resection of vestibular schwannoma.

Vestibular schwannomas (VS) are the most common tumor of the skull base with available treatment options that carry a risk of iatrogenic injury to the facial nerve, which can significantly impact patients' quality of life. As facial nerve outcomes remain challenging to prognosticate, we endeavored to utilize machine learning to decipher predictive factors relevant to facial nerve outcomes following microsurgical resection of VS. A database of patient-, tumor- and surgery-specific features was constructed via retrospective chart review of 242 consecutive patients who underwent microsurgical resection of VS over a 7-year study period.

Diagnostic Yield and Utility of Radiographic Imaging in the Evaluation of Pulsatile Tinnitus: A Systematic Review.

Objective: The objective of this study is to assess diagnostic yield of imaging modalities used to evaluate patients presenting with pulsatile tinnitus (PT).

Databases Reviewed: PubMed, Embase, and Scopus were queried using the search terms "pulsatile tinnitus," "pulse-synchronous tinnitus," and "pulse synchronous tinnitus" with no date limitations.

Methods: Studies that reported diagnostic imaging for patients presenting with PT were included.

Preliminary Evidence for the Effects of Gentamicin on Vertical Semicircular Canals.

Introduction: Gentamicin is a vestibulotoxic antibiotic often used in patients with Ménière's disease for its vestibular ablative effects. Gentamicin's effect on the horizontal semicircular canal does not always correlate with the degree of vertigo control achieved by patients; its effect on the vertical semicircular canals remains unknown. We sought to examine the effect of intratympanic gentamicin on vertical semicircular canal function in patients with Ménière's disease using video head impulse testing.

Reassessing the Utility of Surgical Intervention for Skull Base Osteomyelitis: A 16-Year Experience.

Objective: The role of surgery in lateral skull base osteomyelitis (SBO) is controversial. Surgical intervention is often requested by consulting services in the interest of additional culture data to inform medical management. However, whether surgery alters subsequent antibiotic treatment or modifies disease outcome remains unknown.

An Update on the Epidemiology and Clinicodemographic Features of Meniere's Disease.

Objective: To characterize the estimated prevalence and clinicodemographic features of Ménière's disease (MD) using current diagnostic criteria.

Methods: A cross-sectional study was undertaken at our tertiary academic referral center. All patients seen in Otolaryngology clinic with ICD-10 diagnoses of MD, from January 1, 2013 to July 31, 2022 were identified.

Caloric function as a predictor of cochlear implant performance.

Objectives: Changes in vestibular function have been demonstrated following cochlear implantation (CI). The functional impact of these changes on CI performance has not been well-studied. We sought to assess whether caloric changes postimplantation could predict CI performance.

Socioeconomic determinants impact quality of life at vestibular schwannoma diagnosis.

Background: Socioeconomic variables including race, education, and income have been shown to affect vestibular schwannoma incidence, treatment, and outcomes. We sought to determine the impact of socioeconomic factors on quality of life at the time of vestibular schwannoma diagnosis.

Methods: Retrospective cohort study conducted at a tertiary academic center.

Socioeconomic Status Among Cochlear Implant Candidates and Association With Surgical Pursuance.

Importance: Despite the sizeable global burden of hearing loss, cochlear implants have poor penetrance among eligible hearing-impaired individuals. Identifying populations who may benefit from a cochlear implant but among whom penetrance is poor is an important aim in reducing the health-related and economic effects of hearing loss on both individuals and society.

Objectives: To explore the association of socioeconomic status (SES) with cochlear implant candidacy and the decision to undergo cochlear implantation.

Long-Term Hearing Outcomes After Hybrid Cochlear Implantation.

Objective: To examine long-term (>5 yr) low-frequency hearing preservation after hybrid cochlear implantation.

Study Design: Retrospective cross-sectional study.

Setting: Tertiary care center outpatient clinic.

Predictive Ability of First-Side Cochlear Implant Performance in Adult Sequential Bilateral Cochlear Implantation.

Objective: Predictors of second-side cochlear implant performance have not been well studied. We sought to assess whether speech recognition scores from first-side cochlear implant (CI1) could predict second-side cochlear implant (CI2) scores in sequential bilaterally implanted adults.

Study Design: Retrospective review using a prospectively collected database.

Rates of Sensorineural Hearing Loss and Revision Surgery After Stapedotomy: A Single-institution Experience Using the Nitinol Prosthesis.

Background: Historically, stapedectomy complication rates are quoted as 1% profound postoperative sensorineural hearing loss (SNHL), 5%-10% nonprofound SNHL, and 5%-10% revision surgery.

Objective: We sought to reassess rates of post-stapedotomy complications based on our experience using contemporary surgical technique.

Methods: A retrospective case series was carried out at an academic tertiary referral center.

Audiometric and Surgical Outcomes of a Novel Bone-Conduction Hearing Aid.

Objective: To report the audiometric and surgical outcomes of a series of patients having undergone implantation of a novel transcutaneous bone conduction implant (t-BCI).

Study Design: Retrospective case series.

Setting: Single academic tertiary referral center.

A Rare Case of Cochlear Implant Electrode Array Misplacement Into the Posterior Semicircular Canal.

Cochlear implant electrode array misplacement is a rare but serious complication that may result in failure of hearing rehabilitation, non-auditory percepts, vestibular disturbance, or damage to adjacent neurovascular structures. We present a case of an elderly patient who suffered electrode array misplacement into the posterior semicircular canal, resulting in vestibular symptoms and severe downstream sequelae. The risk of misplacement may be higher in patients with a history of chronic otitis media or prior otologic surgery, and with the use of pre-curved electrode arrays.

Pure tone audiometry as assessed by a commercially-available mobile phone application compared to formal audiometry.

Purpose: Comparison of audiometric measurements of commercially available smartphone audiogram application thresholds as compared to gold standard audiometric evaluation.

Materials And Methods: A single-institution, original contribution. Ninety consecutive adult patients presenting to a tertiary care auditory clinic with auditory complaints were evaluated using standard audiometric testing and an application-based hearing test.

Comparison of Outcomes of Surgical Repair of Spontaneous Temporal Bone CSF Leaks and Encephaloceles Using Bone Cement and Autologous Material.

Objective: To compare outcomes transmastoid repair of spontaneous middle fossa cerebrospinal fluid (CSF) leak using only bone cement (BC) versus only autologous material (AM) or combined materials (CM) with both bone cement and autologous material.

Study Design: Retrospective Chart Review.

Setting: Tertiary Care Hospital.

Lateral Skull Base Chordoma Mimicking a Paraganglioma.

We present an unusual case of chordoma arising entirely from the lateral skull base with imaging features suggestive of a paraganglioma. Clinical history, management, histopathology, and imaging characteristics are described, including a review of gallium-dotate PET scanning somatostatinreceptor-positive tumors. We further provide a review of management options, including a summary of our approach with surgical biopsy via retrosigmoid and resection via transtemporal approaches.

Age-related Patterns of Vestibular Dysfunction in Dizziness and Imbalance: A Review of Vestibular Testing Results Among 1,116 Patients.

Objective: To characterize differences in vestibular testing results among patients presenting with balance-related complaints; to stratify patterns of testing abnormalities by age.

Study Design: Retrospective chart review.

Setting: Academic Balance Center at a Tertiary Referral Center.

Profound Sudden Sensorineural Hearing Loss in Hematologic Malignancy: A Case for Urgent Cochlear Implantation With Discussion and Systematic Review of the Literature.

Objective: To perform a systematic review of sensorineural hearing loss (SNHL) in hematologic malignancy; to describe an illustrative case of urgent cochlear implantation for bilateral profound SNHL and vestibular hypofunction in hyperviscosity syndrome; to suggest an approach to management of hyperviscosity syndrome-associated deafness with cochlear implantation.

Data Sources: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, systematic search of PubMed and Embase databases was undertaken for articles detailing clinical information about SNHL caused directly by hematologic malignancies.

Results: A total of 37 studies from 1989 to 2020 were qualitatively reviewed, the majority of which were case studies or case series.

Predictors of Postoperative Electrode Deactivation Among Adult Cochlear Implantees.

Objective: To characterize postoperative electrode functionality after adult cochlear implantation; to identify rationale and risk factors for electrode deactivation.

Study Design: Retrospective Chart Review.

Setting: Academic Cochlear Implant Center.

Streamlining the Cochlear Implant Evaluation: Utility of Community Audiometry in Cochlear Implant Candidacy Assessment.

Objective: To identify redundancy in the cochlear implant candidacy evaluation and assess its financial impact.

Study Design: Retrospective chart review.

Setting: Tertiary care academic cochlear implant center.

Impact of Reconstruction With Hydroxyapatite Bone Cement on CSF Leak Rate in Retrosigmoid Approach to Vestibular Schwannoma Resection: A Review of 196 Cases.

Objective: To assess the impact of reconstructive technique on the incidence of cerebrospinal fluid (CSF) leak following retrosigmoid approach to acoustic neuroma resection.

Study Design: Retrospective case series.

Setting: Academic medical center.

Bitter Taste Receptors and Chronic Otitis Media.

Objective: To evaluate the presence of bitter taste receptors (T2Rs) in the middle ear and to examine their relationship with chronic ear infections.

Study Design: Cross-sectional study.

Setting: Tertiary care hospital.