Why should multiple dehiscences of the otic capsule be considered before surgically treating patients with superior semicircular canal dehiscence? A radiological monocentric review and a case series.

This review aims to draw attention to the multiple ipsilateral otic capsule dehiscences (OCDs), which may cause therapeutic failure in operated patients. A series of six severely disabled patients with symptoms and signs consistent with a superior semicircular canal dehiscence (SSCD) diagnosis, confirmed by a high-resolution CT scan, is presented here. Five of the patients underwent surgery, and in four of the cases, the postoperative results were poor and/or disappointing.

The clinical findings to notice mild elevation of intracranial pressure in an otology clinic.

Mildly elevated intracranial pressure appears to be a distinct pathology separate from idiopathic increased intracranial pressure and migraine. Many patients present with head fullness-pressure and dizziness, which is often suggestive of a clinical diagnosis of vestibular migraine. These patients may additionally have episodic vertigo as seen in endolymphatic hydrops and positional vertigo in addition to feeling dizzy.

Association between Third Mobile Window Disorders and Symptom Reduction Using a Noise Cancelling Device: Inverse Tullio Phenomena.

Identifying a vestibular source of pathology in patients complaining of post-traumatic brain injury (TBI) dizziness can be difficult. We describe a possible new method utilizing a reduction in post-TBI symptoms (including dizziness) with the use of a noise cancellation device (NCD). This retrospective case series included patients with TBI and dizziness presenting to a binocular vision specialty clinic, who were diagnosed with a vertical heterophoria (VH).

Comorbidities confounding the outcomes of surgery for third window syndrome: Outlier analysis.

Objective: Patients with third window syndrome and superior semicircular canal dehiscence (SSCD) symptoms whose surgical outcomes placed them as outliers were systematically studied to determine comorbidities that were responsible for their poor outcomes due to these confounding factors.

Study Design: Observational analytic case-control study in a tertiary referral center.

Methods: Twelve adult patients with clinical SSCD syndrome underwent surgical management and had outcomes that did not resolve all of their subjective symptoms.

Acoustic neuroma neurophysiologic correlates: vestibular-preoperative, intraoperative, and postoperative.

By the nature of their origin, acoustic neuromas always result in some degree of vestibular dysfunction. The implications of this are typically more notable postoperatively, rather than preoperatively or intraoperatively. However, preoperative vestibular assessment can have implications on operative approach and postoperative rehabilitation.

Evaluation of dizziness in the litigating patient.

Evaluation of dizziness in patients who are involved in litigation can deviate significantly from the evaluation of patients who have no ongoing litigation. This article presents the basic principles of the physician's role in the evaluation of litigating patients. Considerations for physical examination, diagnostic testing, and review of medical records are discussed.

The relationship between the modified somatic perception questionnaire and dynamic platform posturography.

Objective: To analyze if patients whose vestibular symptoms are associated with nonorganic sway patterns show more evidence of somatization and/or malingering than patients whose vestibular symptoms are associated with normal or physiologically abnormal sway patterns observed in people with documented vestibular pathologic findings.

Patients: One hundred fifteen patients with complaints of vestibular dysfunction and hearing impairment.

Interventions: Computerized dynamic posturography (CDP) and completion of the Modified Somatic Perception Questionnaire (MSPQ)--a validated test for the detection of malingering.

Chronic suppurative otitis media, caloric testing, and rotational chair testing.

Objective: To determine the incidence of caloric and rotational chair testing (ROT) abnormalities in a group of patients with chronic suppurative otitis media (CSOM) and to correlate caloric test results with ROT.

Patients: Twenty-five patients with CSOM with or without cholesteatoma who were to undergo tympanomastoid surgery.

Interventions: Caloric and ROT.

Epidural abscess masquerading as lateral sinus thrombosis.

Controversy regarding the use of anticoagulants, the evacuation of the sinus, or the use of medical treatment alone surrounds the treatment of lateral sinus thrombosis. Treatment of an epidural abscess associated with coalescent mastoiditis is much less controversial-drainage is usually recommended. The differing treatments of these complications mandate accurate diagnosis.

Anatomic differences in the lateral vestibular nerve channels and their implications in vestibular neuritis.

Hypothesis: Anatomic differences may render the superior division of the vestibular nerve more susceptible to injury during vestibular neuritis.

Background: Neural degeneration has been identified in temporal bone studies of vestibular neuritis. Previous anatomic and physiologic studies of vestibular neuritis have demonstrated that the superior division of the vestibular nerve is preferentially affected, with sparing of the inferior division.

Viral titers and delayed facial palsy after acoustic neuroma surgery.

Objective: Delayed facial palsy (DFP) after acoustic neuroma surgery has been reported to occur in up to one third of cases. Reactivation of latent virus has been proposed as an etiology for DFP. However, only retrospective case reports and case series have offered data to support this theory.

Transtympanic steroids for treatment of sudden hearing loss.

Objectives: To determine whether transtympanic steroid administration may be an effective treatment for sudden onset sensorineural hearing loss (SSNHL) in patients for whom systemic steroid treatment has failed or who were not candidates for systemic steroids.

Methods: The standard medical regimen for SSNHL usually involves systemic steroid therapy. Unfortunately, some patients do not respond successfully to or are poorly tolerant of systemic steroids.

Anatomic considerations in vestibular neuritis.

Hypothesis: The authors believe that anatomic differences render the superior division of the vestibular nerve more susceptible to injury during vestibular neuritis. The purpose of the study was to investigate anatomic differences between the superior vestibular nerve and singular nerve canals.

Background: Previous studies of temporal bones have revealed vestibular nerve degeneration in patients with vestibular neuritis.

Coronal computed tomography of the normal vestibular aqueduct in children and young adults.

Objective: To characterize the appearance of the normal vestibular aqueduct on coronal computed tomography (CT).

Design: Retrospective evaluation of routine CT images of the temporal bones.

Setting: Private tertiary care center.

Meniere's disease.

Meniere's disease is an idiopathic disorder of the inner ear characterized by the syndrome of endolymphatic hydrops, episodic vertigo, fluctuating hearing loss, tinnitus, and aural fullness. People with this disorder may be severely disabled. Medical therapy exists in the form of diuretics and dietary restriction of salt to minimize the fluid pressure in the labyrinth and cochlea.

Primary meningioma of the fallopian canal.

Meningiomas are slow-growing lesions that represent approximately 20% of all intracranial tumors and are the second most common tumor of the cerebellopontine angle. In contrast, primary extracranial meningiomas are found relatively infrequently, and most cases have inadequate radiologic studies to determine if they were actually an extension from a primary intracranial source. Meningiomas of the intratemporal segment of the facial nerve have also been reported, but they are exceedingly rare and their pathophysiology remains unclear.

Vestibular autorotation testing in patients with benign paroxysmal positional vertigo.

Objectives: The current gold standard for diagnosis of benign paroxysmal positional vertigo (BPPV) is the Dix-Hallpike maneuver. However, because of fatigability, the Dix-Hallpike is often falsely normal. The objective of this study was to evaluate the utility of vestibular autorotation testing in the diagnosis of BPPV.

Avoiding transfusion in head and neck surgery: feasibility study of erythropoietin.

Objective: To determine the feasibility of perioperative erythropoietin to avoid blood transfusion in head and neck cancer surgery.

Study Design: Retrospective chart review.

Methods: Ninety-nine patients undergoing surgical resection of head and neck tumors at our institution were assessed for demographic data, nutritional parameters, tumor/surgical information, hematological/transfusion data, and contraindications to erythropoietin.