Long-term hearing outcomes following stereotactic radiosurgery for vestibular schwannoma: patterns of hearing loss and variables influencing audiometric decline.

Object: The goals of this retrospective cohort study were as follows: 1) to describe the long-term prevalence and timing of hearing deterioration following low-dose (12- to 13-Gy marginal dose) stereotactic radiosurgery (SRS) for vestibular schwannoma (VS); and 2) to identify clinical variables associated with long-term preservation of useful hearing following treatment.

Methods: Patients with serviceable hearing who underwent SRS for VS between 1997 and 2002 were studied. Data including radiosurgery treatment plans, tumor characteristics, pre- and posttreatment pure tone average, speech discrimination scores, and American Academy of Otolaryngology-Head and Neck Surgery hearing class were collected.

Mercury concentrations in tropical resident and migrant songbirds on Hispaniola.

Despite growing concerns over mercury (Hg) exposure to humans and wildlife on a global scale, little is known about Hg bioaccumulation in the New World tropics. From 2005 to 2011, we monitored Hg concentrations in blood of nine avian species occupying a geographic range of tropical wet broadleaf sites on the island of Hispaniola, including eight passerines (two Nearctic-Neotropical migrant and six resident species) and one top order predatory accipiter. Invertivorous songbirds were further differentiated by foraging guild, with six species of ground-foragers and two species of foliage-gleaners.

Conductive hearing loss and middle ear pathology in young infants referred through a newborn universal hearing screening program in Australia.

Background: Although newborn hearing screening programs have been introduced in most states in Australia, the prevalence of conductive hearing loss and middle ear pathology in the infants referred through these programs is not known.

Purpose: This study was designed to (1) evaluate the prevalence of conductive hearing loss and middle ear pathology in infants referred by a newborn hearing screening program in north Queensland, (2) compare prevalence rates of conductive hearing loss and middle ear pathology in indigenous and nonindigenous infants, and (3) review the outcomes of those infants diagnosed with conductive hearing loss and middle ear pathology.

Research Design: Retrospective chart review of infants referred to the Audiology Department of The Townsville Hospital was conducted.

Normative wideband reflectance measures in healthy neonates.

Objective: Presently, normative wideband reflectance data are available for neonates who have passed a distortion product otoacoustic emission test. However, passing the distortion product otoacoustic emission test alone does not ensure normal middle ear function. The objective of this study was to establish normative wideband reflectance data in healthy neonates with normal middle ear function, as justified by passing a battery of tests.

The anatomically intact but electrically unresponsive facial nerve in vestibular schwannoma surgery.

Background: Permanent facial nerve (FN) paresis after vestibular schwannoma surgery is distressing to both the patient and surgeon. Intraoperative electrophysiological testing has proven invaluable in reducing the incidence of FN injury and may assist in prognosticating long-term function.

Objective: To report definitive FN outcomes among a cohort of patients with an unevokable but anatomically intact seventh nerve after microsurgical vestibular schwannoma resection.

Collision tumor of the facial nerve: a synchronous seventh nerve schwannoma and neurofibroma.

Objective: To report a novel case of a collision tumor involving an intraparotid neurofibroma and a mastoid segment facial nerve schwannoma.

Study Design: Clinical capsule report.

Setting: Tertiary academic referral center.

Herpes simplex meningitis after removal of a vestibular schwannoma: case report and review of the literature.

Objective: We present a case of postoperative herpes simplex type 1 viral meningitis after retrosigmoid craniotomy and uncomplicated removal of a vestibular schwannoma. This is a very rare complication that can mimic aseptic meningitis and could lead to devastating consequences for the patient, if unrecognized.

Patient: A healthy 49-year-old woman underwent retrosigmoid craniotomy and resection of a 2.

Monitoring for postnatal hearing loss using risk factors: a systematic literature review.

Objectives: The aim of this study was to investigate whether there was evidence-based support for targeted surveillance programs using a risk-factor registry to detect postnatal hearing loss or whether other programs were available that may be more effective than targeted surveillance. Particularly, it addressed questions that arose along the targeted surveillance pathway, including: (1) the risk factors used to determine a referral, (2) referral frequencies, (3) the relationship between risk factors and a postnatal hearing loss, and (4) other systems that may be more efficient than the use of risk factors.

Design: A systematic literature review was completed in peer-reviewed and non-peer-reviewed databases.

Inhibition of MEK pathway in vestibular schwannoma cell culture.

Objectives/hypothesis: The purpose of this study was to evaluate the Ras GTPase (Ras) to extracellular signal-regulated kinase (ERK) pathway in vestibular schwannoma (VS) cell cultures and patient excised schwannoma tumors. Mitogen-activated protein kinase kinase (MEK) inhibitor CI-1040 (PD184352) was utilized to evaluate the effect of specific MEK inhibition on benign schwannoma cell culture proliferation and apoptosis.

Study Design: Prospective evaluation of human schwannoma cell lines and tumors.

Auditory and vestibular symptoms and chronic subjective dizziness in patients with Ménière's disease, vestibular migraine, and Ménière's disease with concomitant vestibular migraine.

Objective: To compare presentations of Ménière's disease (MD), vestibular migraine (VM), and Ménière's disease plus vestibular migraine (MDVM), with and without comorbid chronic subjective dizziness (CSD).

Study Design: Retrospective review with diagnosis confirmed by consensus conference of investigators using published criteria for MD, VM, and CSD.

Setting: Ambulatory, tertiary dizziness clinic.

Identification of congenital auricular deformities during newborn hearing screening allows for non-surgical correction: a Mayo Clinic pilot study.

Objective: To introduce a Mayo Clinic pilot study in which newborn hearing screeners are trained to identify congenital auricular deformities, allowing for non-surgical correction with a simple splint initiated in the immediate neonatal period.

Methods: Newborn hearing screeners received education on evaluation of congenital auricular deformities. Ten infants with 19 affected ears amenable to treatment with a simple splint were enrolled between June 15 and December 10, 2009.

Nutrient supply and mercury dynamics in marine ecosystems: a conceptual model.

There is increasing interest and concern over the impacts of mercury (Hg) inputs to marine ecosystems. One of the challenges in assessing these effects is that the cycling and trophic transfer of Hg are strongly linked to other contaminants and disturbances. In addition to Hg, a major problem facing coastal waters is the impacts of elevated nutrient, particularly nitrogen (N), inputs.

Cochlear implantation in patients with neurofibromatosis type 2: variables affecting auditory performance.

Objective: To investigate cochlear implant performance outcomes among patients with Neurofibromatosis type 2 (NF2).

Study Design: Retrospective case series, patient questionnaire, and systematic review of the literature.

Setting: Tertiary academic referral center.

Stem cell transplant for children with sickle cell anemia: parent and patient interest.

We describe adolescents' and parents' interest in hematopoietic stem cell transplant (HSCT) as a cure for sickle cell disease (SCD) and factors associated with increased interest. We administered a 40 question survey to assess the interest in HSCT in parents and adolescents with HBSS or HBSβ(0) thalassemia. The survey tool assessed factors that may influence interest in HSCT including demographic data, disease severity, views on prognosis, and health-related quality of life (HRQOL).

The effect of number and distribution of unsplinted maxillary implants on the load transfer in implant-retained maxillary overdentures: an in vitro study.

Statement Of Problem: There is little information as to how the number and distribution of implants affect the amount of load transmitted to the palate in implant-retained maxillary overdentures.

Purpose: The purpose of this study was to evaluate the effect of the number and distribution of dental implants on the load transmitted to the palate.

Material And Methods: Eight implant analogues were placed in a replica of an average sized edentulous maxilla corresponding to the position of canines, first and second premolars, and first molars.

Targeted surveillance for postnatal hearing loss: a program evaluation.

Objective: The importance of monitoring hearing throughout early childhood cannot be understated. However, there is a lack of evidence available regarding the most effective method of monitoring hearing following the newborn screen. The goal of this study was to describe a targeted surveillance program using a risk factor registry to identify children with a postnatal hearing loss.

Radiation therapy and radiosurgery for vestibular schwannomas: indications, techniques, and results.

This article describes in detail the uses of and distinctions between stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT) for vestibular schwannoma (VS). The authors discuss devices and techniques used in SRS and SRT and, additionally, present readers the approach used by surgeons at Mayo Clinic. They discuss indications and results for both approaches in patients with vestibular schwannoma.

Reimplantation with a conventional length electrode following residual hearing loss in four hybrid implant recipients.

Hypothesis: Revision surgery using a newer-generation conventional length cochlear implant electrode will provide improved speech perception in patients that initially underwent hybrid electrode implantation and experienced post-operative loss of residual hearing and performance deterioration.

Clinical Presentation: We present four patients who experienced delayed post-operative hearing loss following implantation with the Nucleus Hybrid S8 device and underwent reimplantation with the Nucleus Freedom or Nucleus 5 device using the Contour Advance array. Pure-tone thresholds and speech perception data were retrospectively reviewed.

Joint immobilization prevents murine osteoarthritis and reveals the highly mechanosensitive nature of protease expression in vivo.

Objective: Mechanical joint loading is critical for the development of osteoarthritis (OA). Although once regarded as a disease of cartilage attrition, OA is now known to be controlled by the expression and activity of key proteases, such as ADAMTS-5, that drive matrix degradation. This study was undertaken to investigate the link between protease expression and mechanical joint loading in vivo.

Effect of axial wall modification on the retention of cement-retained, implant-supported crowns.

Statement Of Problem: Compromised angulation of implants may result in abutment preparation that is less than ideal. Compromised abutment preparation may affect the retention of implant-retained crowns.

Purpose: The purpose of this study was to investigate the effect of 5 implant abutment designs on the retention of cement-retained crowns by varying the number and position of the axial walls.

Magnetic resonance imaging surveillance following vestibular schwannoma resection.

Objectives/hypothesis: To describe the incidence, pattern, and course of postoperative enhancement within the operative bed using serial gadolinium-enhanced magnetic resonance imaging (MRI) following vestibular schwannoma (VS) resection and to identify clinical and radiologic variables associated with recurrence.

Study Design: Retrospective cohort study.

Methods: All patients who underwent microsurgical resection of VS between January 2000 and January 2010 at a single tertiary referral center were reviewed.

Prophylactic perioperative antibiotic use in endoscopic sinus surgery: a systematic review and meta-analysis.

Context: Perioperative antibiotics are widely used to improve the outcomes of endoscopic sinus surgery.

Objective: The aim of this study was to summarize the evidence on the effect of perioperative antibiotic prophylaxis on outcomes of endoscopic sinus surgery.

Data Sources And Review Methods: We searched electronic databases from inception through May 2011 for any relevant clinical trials or observational studies.

The intraparotid facial nerve schwannoma: a diagnostic and management conundrum.

Objectives: The aims of the study were (1) to review the management strategy and clinical outcomes of all intraparotid facial nerve (FN) schwannomas (PFNSs) treated at a single tertiary academic center from 1975 to 2010 and (2) to summarize all previously reported cases of PFNS in the international literature.

Study Design: A retrospective cohort study and literature review.

Methods: Fifteen patients were diagnosed and treated at the authors' institution from 1975 to 2010.

Cochlear implantation: current and future device options.

Today most cochlear implant users achieve above 80% on standard speech recognition in quiet testing, and enjoy excellent device reliability. Despite such success, conventional designs often fail to provide the frequency resolution required for complex listening tasks. Furthermore, performance variability remains a vexing problem, with a select group of patients performing poorly despite using the most recent technologies and processing strategies.