Comparison of an Electromagnetic Middle Ear Implant and Hearing Aid Word Recognition Performance to Word Recognition Performance Obtained Under Earphones.

Objective: To report the results of patients with the Maxum middle ear implant (MEI) and compare word recognition scores (WRS) and speech perception gap (SP Gap) of Maxum versus optimally fit hearing aids (HA).

Study Design: Case series with chart review.

Setting: Single, private otology clinic.

The ototronix MAXUM middle ear implant for severe high-frequency sensorineural hearing loss: Preliminary results.

Objectives/hypothesis: To report the preliminary results of the Ototronix MAXUM middle ear implant for treatment of severe high-frequency sensorineural hearing loss.

Study Design: Case series with chart review.

Methods: Six consecutive ears with severe high-frequency sensorineural hearing loss (≥75 dB HL at 2, 3, and 4 kHz) and poor aided word recognition performance (≤60% single words) underwent implantation of the MAXUM system at a single, private otologic referral center.

Glomus tympanicum: a review of 115 cases over 4 decades.

Objective: To characterize the clinical presentation, surgical management, and outcomes of a large consecutive cohort of patients with glomus tympanicum (GT) tumors managed at a single tertiary referral group over 4 decades.

Study Design: Retrospective review.

Setting: Tertiary neurotological referral center.

Implantable hearing devices: the Ototronix MAXUM system.

For many hearing-impaired individuals, the benefits of conventional amplification may be limited by acoustic feedback, occlusion effect, and/or ear discomfort. The MAXUM system and other implantable hearing devices have been developed as an option for patients who derive inadequate assistance from traditional HAs, but who are not yet candidates for cochlear implants. The MAXUM system is based on the SOUNDTEC Direct System technology, which has been shown to provide improved functional gain as well as reduced feedback and occlusion effect compared to hearing aids.

Middle ear implants for rehabilitation of sensorineural hearing loss: a systematic review of FDA approved devices.

Objective: To systematically review the safety and efficacy of the 3 Food and Drug Administration-approved middle ear implant (MEI) systems currently in use for the rehabilitation of sensorineural hearing loss.

Data Sources: MEDLINE and Cochrane Library databases were systematically searched by 2 independent reviewers.

Study Selection: An initial search yielded 3,020 articles that were screened based on title and abstract.

Evolving considerations in the surgical management of cholesteatoma in the only hearing ear.

Objective: To describe a contemporary, pragmatic approach to managing cholesteatoma in the only hearing ear.

Study Design: Retrospective case series.

Setting: Single tertiary referral center.

Facial nerve outcomes in facial nerve schwannomas.

Objective: To better understand the characteristics and outcomes of facial nerve schwannomas (FNSs) over a 30-year period.

Study Design: Retrospective study.

Setting: Subspecialty practice at a tertiary hospital.

Middle ear implantable hearing devices: an overview.

Hearing loss affects approximately 30 million people in the United States. It has been estimated that only approximately 20% of people with hearing loss significant enough to warrant amplification actually seek assistance for amplification. A significant interest in middle ear implants has emerged over the years to facilitate patients who are noncompliant with conventional hearing aides, do not receive significant benefit from conventional aides, or are not candidates for cochlear implants.

Botulinum toxin for aberrant facial nerve regeneration: double-blind, placebo-controlled trial using subjective endpoints.

Background: Aberrant facial nerve regeneration syndrome is systematically studied by constructing a subjective questionnaire organized into pertinent domains (impairment of quality of life, social interactions, perception of self-appearance, visual function, and perception of problem severity) and by physical assessment of degree of involuntary palpebral fissure closure during routine facial movements using videotaping and a physicians' grading scale.

Methods: The videotape measurements of corneal light reflex to upper lid margin distance and vertical palpebral distance were made during adynamic and active facial expression. Thirty-six patients were studied (six in an open-label pilot study design and 30 in a multicenter, double-blind, placebo-controlled trial).

Impact of mastoidectomy on simple tympanic membrane perforation repair.

Objectives/hypothesis: Mastoidectomy has long been identified as an effective method of treatment for chronic ear infection. The effect of mastoidectomy on patients without evidence of active infectious disease remains highly debated and unproven. The objective in the study was to examine the impact of mastoidectomy on the repair of uncomplicated tympanic membrane perforations.

The history of neuro-otology. A personal perspective.

I realize I practiced otology and neuro-otology during a golden era, but I have to admit that I didn't appreciate how important it was until I sat down to outline this article. How fortunate I was to have lived and practiced during these developing years of neuro-otology. How fortunate to have worked with the likes of Howard and William House, James Sheehy, James Crabtree, David Austin, and John Shea.

Hearing preservation surgery for small endolymphatic sac tumors in patients with von Hippel-Lindau syndrome.

Objective: To determine the incidence of bilateral endolymphatic sac tumors in von Hippel-Lindau syndrome and to describe the technique and results of hearing preservation surgery for small endolymphatic sac tumors in a series of patients with von Hippel-Lindau syndrome.

Study Design: Analysis of the literature to determine the incidence of bilateral endolymphatic sac tumors and a retrospective case review of hearing preservation surgery for removal of small endolymphatic sac tumors in four patients with von Hippel-Lindau syndrome.

Setting: Tertiary care academic medical centers.

Lateral skull base surgery for glomus tumors: long-term control.

Objective: The age of modern microsurgery has made resection of glomus tumors with extensive skull base involvement possible. Resection of extensive lesions is not without risk of major complication or new cranial nerve deficit. Because glomus tumors are rare and slow growing, data reflecting recurrence risk after resection using modern skull base techniques are lacking.

Comparison of postoperative headache after retrosigmoid approach: vestibular nerve section versus vestibular schwannoma resection.

Objective: To evaluate intradural drilling as a mechanism for the development of postoperative headache after retrosigmoid craniectomy.

Study Design: A retrospective review of charts was performed on 565 retrosigmoid approaches to the cerebellopontine angle performed between January 1980 and January 1998. Patients treated with retrosigmoid vestibular nerve section without intradural drilling were compared with patients who underwent retrosigmoid removal of vestibular schwannomas in which intradural drilling was performed for exposure of the internal auditory canal.

Malignant glomus tumors.

Objectives/hypothesis: To ascertain the incidence of malignancy in a large glomus and skull base series and to compare the clinical course of such patients with those who do not have malignant skull base lesions.

Study Design: Retrospective review of all skull base surgery cases treated at the Otology Group between 1970 and 1995.

Results: In a series of 175 jugulotympanic glomus tumors, 9 cases (5.

Temporal bone and lateral skull base malignancy: experience and results with 81 patients.

Objective: This study aimed to examine predictive factors and treatment outcome and to devise a staging method for malignant lateral skull base disease.

Study Design: The study design was a retrospective review of all lateral skull base surgery cases.

Setting: The study was conducted at a tertiary referral center.

Facial nerve outcome in lateral skull base surgery for benign lesions.

Objective: To statistically identify factors most important in affecting CN7 outcome in lateral skull base surgery for benign lesions.

Study Design: A retrospective review of 217 nonmalignancy lateral skull base procedures from 1970 to 1995 at the Otology Group in Nashville.

Methods: Charts were reviewed for epidemiology, histopathology, staging, type of CN7 mobilization (none, short, long, severance with reanastomosis, and resection), preoperative and postoperative CN7 function, surgery performed, and survival.

Vagal paraganglioma: a review of 46 patients treated during a 20-year period.

Background: Vagal paragangliomas (VPs) arise from paraganglia associated with the vagus nerve. Approximately 200 cases have been reported in the medical literature. Because of their rarity, most information regarding these tumors has arisen from case reports and small clinical series.

Medical treatment of headache after suboccipital acoustic tumor removal.

Objectives: Suboccipital craniotomy is a frequently used surgical approach for removal of cerebellopontine angle (CPA) tumors. A frequently cited consequence, however, is the high incidence of postoperative headaches. Much has been written regarding prevention of these headaches, but little has been written of their treatment.

Management of nonacoustic cranial nerve neuromata.

Objective: This study aimed to review the authors' experience with diagnosis and management of nonacoustic neuroma of the cerebellopontine angle and skull base. In addition, management strategies for each type of tumor are suggested.

Study Design: A retrospective review of the charts of patients at the authors' institutions who underwent surgery for neuroma of the fifth through twelfth cranial nerves, between the years 1980-1996, was undertaken.

Meningiomas intrinsic to the geniculate ganglion.

Objective: To present the clinical, surgical and histopathological manifestations of meningioma intrinsic to the geniculate ganglion.

Study Design: Retrospective study of outcome.

Setting: Three private tertiary and one university (otology/neurotology) referral centers.

Management of acoustic neuroma in the elderly population.

Objective: Ongoing controversy regarding the optimal treatment of acoustic neuromas in the elderly population has prompted us to examine the our experience in order to arrive at a treatment algorithm.

Study Design: Retrospective case review.

Setting: Tertiary referral center.

Brain herniation into the middle ear and mastoid: concepts in diagnosis and surgical management.

Objective: To review the occurrence characteristics of and clinical repair experience with brain herniation in to the middle ear and mastoid from 1970-1995.

Study Design: Retrospective chart/case review.

Setting: Private Otology/Neurotology referral practice.

Lateral skull base surgery: the otology group experience.

Lateral skull base surgery has remained the surgical frontier of new developments in the treatment of lesions heretofore difficult to access. Examination of surgical results stimulates technical innovation and provides an intervention risk-benefit ratio assessment for particular lesions useful in management planning. With this in mind, we report the updated collective experience with lateral skull base surgery at the Otology Group over the past 20 years.