A clinical conundrum: Temporal bone metastases from lung adenocarcinoma.

Background: Metastatic disease to the temporal bone is rare. Even more uncommonly, it can be the first manifestation of an underlying malignancy. Patients typically present late in the disease process with non-specific symptoms of hearing loss, facial nerve palsy and otorrhea.

Novel use of precipitating hydrophobic injectable liquid (PHIL) in pre-operative angioembolisation of a large posterior auricular arteriovenous malformation.

Background: Large arteriovenous malformations are often managed via endovascular embolisation followed by surgical resection. We describe the use of a new liquid embolic agent (LEA) - precipitating hydrophobic injectable liquid (PHIL) and its advantages over existing LEAs.

Case: A 60-year-old male presented with a progressively enlarging right post-auricular arteriovenous malformation.

The prevalence of isolated otolith dysfunction in a local tertiary hospital.

Objective: Patients with dizziness may present with symptoms of tilting, swaying, rocking, floating or with disequilibrium. This may be suggestive of an isolated otolithic dysfunction yet, there is little emphasis on this emerging clinical entity. To characterize and describe the prevalence of isolated otolith dysfunction in a local tertiary hospital and correlate them with clinical diagnosis.

Post-operative healing and long-term stability after mastoid cavity reconstruction using the middle temporal artery and inferior musculoperiosteal flaps.

Purpose: This study aims to evaluate the surgical outcomes with the use of a combination of the middle temporal artery (MTA) flap and the inferior musculoperiosteal (IMP) flap for mastoid obliteration after canal wall down mastoidectomy.

Methods: Seventy-five patients who have undergone canal wall down mastoidectomy and mastoid obliteration with the MTA and the IMP flaps at a single tertiary hospital were included. Surgical outcomes measured included the creation of a dry mastoid cavity as measured by a previously developed semi-quantitative scale, mastoid cavity epithelization time, rate of revision surgery needed, and rate of recurrent cholesteatoma.

TORP ossiculoplasty in the presence of an intact stapes superstructure.

Introduction: In this series, we describe ossicular reconstruction using routine TORP in the presence of the stapes superstructure using a tympanic-membrane-to-footplate configuration.

Materials And Methods: This is a case series of 12 patients who underwent TORP ossiculoplasties from 1st January 2010 to 31st October 2017. Data collected included demographics, indication for surgery, status of the middle ear and pre-operative and post-operative audiometric data (including pure tone average (PTA) and air-bone gap (ABG)).

Respiratory droplet generation and dispersal during nasoendoscopy and upper respiratory swab testing.

Respiratory particle generation and dispersal during nasoendoscopy and swab testing is studied with high-speed video and laser light illumination. Video analysis reveals droplet formation in three manoeuvres during nasoendoscopy - sneezing, vocalization, and nasal decongestion spray. A capillary bridge of mucus can be seen when a nasoendoscope exits wet nares.

Atypical thyroglossal duct cyst with intra-laryngeal and para-glottic extension.

Thyroglossal duct cysts (TDC) are the most common congenital neck masses. Although they are anatomically closely related to the larynx, intra-laryngeal extension is very rare. We present a case, review the literature and discuss the challenges of intra-laryngeal TDC.

PEAK PlasmaBlade versus monopolar electrocautery tonsillectomy in adults: A prospective double-blinded randomized controlled trial.

Objective: To evaluate the efficacy and compare postoperative pain and recovery following PEAK PlasmaBlade and monopolar electrocautery tonsillectomy in adults.

Study Design: Prospective double-blinded randomized controlled trial.

Methods: Fifty-eight patients were recruited and randomized into 2 groups: PEAK PlasmaBlade (n = 29) or monopolar electrocautery (n = 29) tonsillectomy.

Otosclerosis in a nonendemic population: Utility of CT scan and correlation with audiometry and surgical outcome.

The incidence of otosclerosis in nonendemic patients is low, and preoperative diagnosis can be challenging. The aim of this study was to evaluate computed tomography (CT) findings in patients with otosclerosis and determine their correlation with audiometric findings and surgical outcome in a nonendemic population. We retrospectively reviewed 17 patients from August 2011 to August 2013 with surgically confirmed otosclerosis who underwent preoperative high-resolution CT scans and pre- and postoperative audiometry.

Classification of Temporal Bone Pneumatization on High-Resolution Computed Tomography: Prevalence Patterns and Implications.

Objective The degree of pneumatization of the temporal bone has implications in the pathophysiology and surgical considerations of many temporal bone disorders. This study aims to identify common pneumatization patterns in the petrous apex, mastoid, and infralabyrinthine compartments of the temporal bone. Variables associated with temporal bone pneumatization were also identified.

An unusual case of temporal bone encephalomeningocele occurring together with normal pressure hydrocephalus.

Temporal bone encephalomeningoceles are uncommon clinical entities that can be challenging to diagnose and treat. Common presenting complaints include symptoms of aural fullness, hearing loss, clear otorrhea and meningitis. Common etiologies are chronic middle ear disease and trauma.

Neuroendocrine adenoma of middle ear with new bone formation and review of literature.

Neuroendocrine adenoma of the middle ear has been described in literature as middle ear adenoma with neuroendocrine differentiation or carcinoid tumor. While there have been several case reports describing imaging features of carcinoid tumors of the ear and middle ear adenomas, in our literature review, we have not found a single case where bone formation is described as a prominent radiological feature. We report a first documented case of middle ear carcinoid tumor with new bone formation demonstrated on CT imaging and performed a review literature regarding the tumor.

A case series of complicated infective otitis media requiring surgery in adults.

Introduction: With the advent of antibiotics, complications of otitis media have become less common. It is crucial for physicians to recognise otitis media and treat its complications early. Herein, we present our institution's experience with patients who required emergency surgical intervention for complications of otitis media.

Current evidence for endolymphatic sac surgery in the treatment of Meniere's disease: a systematic review.

This paper aims to identify emerging evidence for endolymphatic sac surgery (ESS) in the treatment of Meniere's disease since the landmark study by Thomsen et al, published in 1998 (conducted from 1981 to 1989). Using the MEDLINE database (PubMed), a systematic review of the literature published from January 1990 to June 2014 was performed. We included all English-language, peer-reviewed randomised controlled trials (RCTs) and controlled studies.

Intratympanic steroids as a salvage treatment for sudden sensorineural hearing loss? A meta-analysis.

Sudden sensorineural hearing loss is typically treated with systemic steroids. The aim of this meta-analysis was to evaluate the efficacy of salvage intratympanic steroid treatment in patients who have initial treatment failure with systemic steroids. A MEDLINE literature search was performed, supported by searches of Web of Science, Biosis, and Science Direct.

Pre-operative high resolution computed tomography scans for cholesteatoma: has anything changed?

Objective: CT temporal bone scans are often performed to aid in surgical planning and management of cholesteatomas. With improvements in the resolution of CT scans today, it is now possible to obtain more information from these scans than before. The aim of this study is to compare findings on high resolution CT (HRCT) temporal bone scans to intra-operative findings, so as to determine how well various middle ear structures are assessed by HRCT scanning.

Sphenoidal mucocele presenting as acute cranial nerve palsies.

Sphenoidal sinus mucoceles are indolent lesions that, when sufficiently large, can compress on the optic canal or superior orbital fissure, rapidly causing loss of vision, optic neuropathy, ptosis, pain, ophthalmoplegia, and diplopia. We herein report a 72-year-old gentleman who presented acutely with Cranial Nerve II, III, and IV palsies secondary to a sphenoidal sinus mucocele that was confirmed on magnetic resonance imaging and successfully treated with endoscopic drainage. This cause of orbital apex syndrome is important for clinicians to know as early diagnosis and treatment is critical in recovering visual potential.

Effects of tonsillectomy on sleep study parameters in adult patients with obstructive sleep apnea--a prospective study.

Objective: The objective of this study is to evaluate the efficacy of tonsillectomy in reduction of respiratory disturbance index (RDI) and other sleep study parameters in patients with obstructive sleep apnea (OSA).

Methods: This study involves 34 adults with OSA and Friedman grade 3 or 4 tonsils. All 34 patients were treated with tonsillectomy, as the only surgical treatment for OSA from 2007 to 2011.