Complications of Surgery: Recognition and Management.

The middle ear and mastoid spaces contain delicate and functionally important structures. Safe cholesteatoma surgery requires mastery of otologic anatomy as well as thorough preoperative investigation. Cholesteatoma can damage otologic structures on its own; however, there is also an opportunity for an iatrogenic complication given the distortion of anatomy by the disease process.

Changing Management of Intravestibular Schwannomas in the Era of Cochlear Implantation for Single-Sided Deafness.

Objective: Intralabyrinthine schwannomas (ILSs) are a rare cause of deafness. Patients with ILS confined to the semicircular canals and the vestibule (intravestibular schwannomas) are potential candidates for cochlear implantation for hearing rehabilitation, a new option for patients with unilateral hearing loss since the 2019 FDA approval of cochlear implant (CI) for single-sided deafness. In this report, we describe an evolving management approach for ILSs causing hearing loss.

Reversing Synchronized Brain Circuits Using Targeted Auditory-Somatosensory Stimulation to Treat Phantom Percepts: A Randomized Clinical Trial.

Importance: Animal models have shown altered dorsal cochlear nucleus circuitry in animals that develop tinnitus; however, precise treatment using bisensory (auditory and somatosensory) stimuli can reverse altered neural patterns and lessen tinnitus.

Objective: To confirm and extend the findings of a pilot study, which suggested an increased efficacy of bisensory stimulation, to a clinical trial with a greater duration and greater number of participants.

Design, Setting, And Participants: This double-blind, crossover, single-center randomized clinical trial was conducted from March 2019, with a 3-month follow-up per participant ending in July 2022.

The Impact of Social Determinants of Health on Vestibular Schwannoma Management: A Single Institution Review.

Objective: To evaluate social determinants of health and their effect on the management of vestibular schwannoma (VS).

Study Design: Retrospective chart review.

Setting: Tertiary referral center.

A Case of Sensorineural Hearing Loss in Wernicke Encephalopathy.

Extremely rare cases of Wernicke encephalopathy (WE) can involve sensorineural hearing loss (SNHL). Here, we present a 46-year-old female with SNHL and clinical and radiologic suspicion for WE. After initiating thiamine therapy, the patient experienced robust improvement.

Machine Learning for Vestibular Schwannoma Diagnosis Using Audiometrie Data Alone.

Objective: The aim of this study is to compare machine learning algorithms and established rule-based evaluations in screening audiograms for the purpose of diagnosing vestibular schwannomas. A secondary aim is to assess the performance of rule-based evaluations for predicting vestibular schwannomas using the largest dataset in the literature.

Study Design: Retrospective case-control study.

Ear, Nose, and Throat Surgery: Postoperative Complications After Selected Head and Neck Operations.

Unanticipated complications of ENT surgeries may have profound functional and esthetic consequences for patients. Herein, we provide a broad overview of postoperative complications after ENT surgery, illustrating their unique nature, impact, and principles of management. The discussion is organized by subspecialty to highlight the great anatomic complexity of the head and neck and the importance of critical neurovascular and sensory structures that make ENT an impactful, yet challenging surgical specialty.

Endoscopic and fluoroscopic-guided closure of the eustachian tube using a biliary cytology brush and liquid embolic agent for a persistent CSF leak after schwannoma resection.

Vestibular schwannoma is a known cause of progressive sensorineural hearing loss. Treatment options include observation, radiation therapy and surgical resection. Cerebrospinal fluid (CSF) fistula is a known postsurgical complication that can lead to CSF otorrhoea, rhinorrhoea or CSF leakage from the surgical wound.

Review of Bone Conduction Hearing Devices.

Bone conduction is an efficient pathway of sound transmission which can be harnessed to provide hearing amplification. Bone conduction hearing devices may be indicated when ear canal pathology precludes the use of a conventional hearing aid, as well as in cases of single-sided deafness. Several different technologies exist which transmit sound via bone conduction.

Sudden Sensorineural Hearing Loss: A Diagnostic and Therapeutic Emergency.

The family physician's role in recognizing and managing sudden sensorineural hearing loss (SSNHL) is crucial. A recently updated otolaryngologic clinical practice guideline has been released for this emergency syndrome, but dissemination is limited to a specialty journal. As a result, the guidelines may not be widely available in the primary care setting where patients often present.

Collaborative Establishment of Difficult Vascular Access for General Anesthetic Management of an Adult With Tetra-Amelia: A Case Report.

Tetra-amelia is a rare congenital disorder characterized by the absence of limbs. We describe the anesthetic management of a 29-year-old woman with tetra-amelia who underwent general anesthesia for tympanomastoidectomy with meatoplasty for an extensive right ear cholesteatoma. Anesthetic challenges related to tetra-amelia include difficult intravenous access, lack of sites for blood pressure monitoring, and possible difficult airway management due to craniofacial anomalies.

Factors Influencing Cochlear Patency after Translabyrinthine Surgery.

Objective To determine predictive factors for cochlear obliteration after translabyrinthine surgery for vestibular schwannoma. Study Design Case series with chart review. Setting Neurotology referral center.

Endoscopic Resection of Vestibular Schwannomas.

Objective To report our results and the technical details of fully endoscopic resection of vestibular schwannomas. Design Prospective observational study. Setting A single academic institution involving neurosurgery and neurotology.

Noise-induced hearing loss: an occupational medicine perspective.

Purpose Of Review: Up to 30 million workers in the United States are exposed to potentially detrimental levels of noise. Although reliable medications for minimizing or reversing noise-induced hearing loss (NIHL) are not currently available, NIHL is entirely preventable. The purpose of this article is to review the epidemiology and pathophysiology of occupational NIHL.

Factors contributing to cost in partial versus total tonsillectomy.

Objectives/hypothesis: To examine differences between total tonsillectomy and partial intracapsular tonsillectomy techniques that may lead to differences in overall cost and resource utilization between these procedures. Preoperative, perioperative, and postoperative management and outcome factors were examined.

Study Design: Retrospective review at two university-based tertiary care hospitals from January 2007 to June 2010.

The role of obesity in spontaneous temporal bone encephaloceles and CSF leak.

Objective: Temporal bone encephaloceles and cerebrospinal fluid (CSF) otorrhea can lead to life-threatening sequelae such as meningitis and cerebritis. Obesity has been associated with spontaneous CSF leaks. We wished to determine if there were differences in the body mass index (BMI) of patients with spontaneous temporal bone encephaloceles/CSF leaks and nonspontaneous temporal bone encephaloceles/CSF leaks to help determine if obesity may be associated with their development.

The use of KTP laser in revision stapedectomy.

Objective: Revision stapes operations have lower success rates than primary surgeries. Success rates have increased since the introduction of the laser. Visible (KTP, argon) and infrared (CO2) spectrum lasers have been used in stapes surgery.

Clinical and diagnostic evaluation of acoustic neuromas.

In the past century, significant advances have been made in understanding the clinical features of acoustic neuromas. Furthermore, rapid technological advances have led to the development of sensitive, rapid, and relatively noninvasive diagnostic modalities, which has allowed for earlier discovery of acoustic neuromas and has reduced the average tumor size at time of diagnosis. The ultimate result has been improved clinical outcomes after surgery and radiotherapy.

Localization of small parathyroid adenomas using modified 4-dimensional computed tomography/ultrasound.

Objective: To investigate whether parathyroid gland weight has an impact on the accuracy of preoperative localization of parathyroid adenomas with modified 4 dimensional computed tomography/ultrasound. And to determine if the weight of parathyroid adenomas can be calculated accurately based on the dimensions of the gland on the CT images.

Study Design: Case series with chart review.

Oral cavity risk factors: experts' opinions and literature support.

Objective: (1) To assess the knowledge of a group of experts in head and neck cancer regarding risk factors for oral cancer; (2) to describe the quality of the available literature on the topic of oral cancer risk factors; and (3) to compare expert opinion about oral cancer risk factors with the literature.

Methods: Survey of head and neck cancer experts and extensive literature review and classification of levels of evidence for published data.

Results: Extensive data demonstrating the level of published literature support for or against many compounds and behaviours are presented.