Electronic Health Record Use Among American Neurotology Society Members.

Objective: To describe the use of electronic health records (EHR) among members of the American Neurotology Society (ANS).

Study Design: Cross-sectional.

Setting: Active ANS members in November 2017.

Skull base osteomyelitis secondary to malignant otitis externa.

Purpose Of Review: Skull base osteomyelitis secondary to malignant otitis externa was first described in 1959. Since then, advances have been made in the diagnosis, treatment, and clinical outcomes of this condition.

Recent Findings: This review discusses the pathophysiology and microbiology of malignant otitis externa.

Spontaneous cerebrospinal fluid leakage and middle ear encephalocele in seven patients.

Isolated cases of spontaneous cerebrospinal fluid (CSF) leakage with and without middle ear encephalocele have been reported. These leaks are usually accompanied by episodes of recurrent meningitis, hearing loss, or chronic headache. In this article, we report seven new cases of spontaneous CSF leakage.

Dexamethasone pharmacokinetics in the inner ear: comparison of route of administration and use of facilitating agents.

There is growing otologic interest in treating inner ear disorders, such as sudden sensorineural hearing loss and acute or unremitting Meniere's disease, with intratympanic dexamethasone (IT-DEX). Although anecdotally reported, there are no scientific clinical papers and few prior laboratory research publications on the subject. This study compares perilymph dexamethasone concentrations after systemic and intratympanic administration and assesses the role of 3 potential transport facilitators of IT-DEX into perilymph.

Microsurgical removal of a vestibular schwannoma after stereotactic radiosurgery: surgical and pathologic findings.

Objective: The objective of this study was to provide objective evidence of the enhanced difficulty of preserving the facial nerve in patients who need microsurgery after failed stereotactic radiosurgery (SRS) of vestibular schwannoma.

Study Design: This study was a retrospective case review.

Setting: A tertiary care referral center was the setting for the study.

Complications of gold weight eyelid implants for treatment of fifth and seventh nerve paralysis.

Complications occurred in six patients after gold weights were implanted into the upper eyelid tissues for fifth and seventh nerve palsies. These complications included implant infection without extrusion (in one patient); entropion with trichiasis and presumed inflammatory reaction to the gold weight material (in one patient); upper eyelid distortion and poor eyelid contour with corneal ulceration and scarring (in one patient); significant residual lagophthalmos with exposure keratitis (in one patient); and blepharoptosis obscuring the pupillary access (in two patients). Resolution of the complications required 1.

Persistent trigeminal artery as a cause of dizziness.

Complaints of vertigo and dizziness are common problems referred to otolaryngologists for evaluation. Awareness of uncommon causes of dizziness increases the physician's ability to diagnose and treat these patients. We present the case of a middle-aged woman who presented with episodes of vertigo and symptoms suggestive of vertebrobasilar insufficiency.

Endoscopic closure of the eustachian tube for repair of cerebrospinal fluid leak.

Techniques to repair cerebrospinal fluid (CSF) leak through the eustachian tube (ET) include temporary or permanent CSF diversion; middle fossa craniotomy and packing of the ET from above; and packing of the ET from behind, through the middle ear. We report a case of endoscopic closure of the ET in the nasopharynx (the front). A 26-year-old woman underwent a translabyrinthine removal of a 4.

Management of hydrocephalus resulting from acoustic neuromas.

Patients with large acoustic neuromas may have secondary obstructive hydrocephalus and occasionally significant neurologic deficit develops. At the House Ear Clinic, we have managed patients with hydrocephalus by translabyrinthine tumor removal without preoperative ventriculoperitoneal shunting. Forty-three patients with documented hydrocephalus who underwent acoustic neuroma removal have been reviewed.

Predicting long-term facial nerve outcome after acoustic neuroma surgery.

Although anatomic preservation of the facial nerve is achieved in nearly 90% of reported cases after acoustic neuroma surgery, postoperative long-term facial function is of most concern to the patient. This study examines long-term facial nerve function in relation to the immediate postoperative function and the function at time of discharge from the hospital. Subjects included 515 patients who underwent primary acoustic neuroma removal at House Ear Clinic from 1982 through 1989 and who had normal preoperative facial function, an intact facial nerve after surgery, and a House-Brackmann facial nerve grade available immediately postoperatively, at time of hospital discharge, and at least 1 year postoperatively.

Extended middle fossa and retrolabyrinthine approaches in acoustic neuroma surgery: case reports.

Hearing conservation surgery for small acoustic neuromas is well accepted. At present, two approaches are primarily used: the suboccipital and the middle fossa. The middle fossa approach to the internal auditory canal has the advantage of using bony landmarks to identify and protect the facial nerve.

Lipomas of the internal auditory canal.

Intracranial lipomas are rare tumors which may occur in the cerebellopontine angle (CPA) or internal auditory canal (IAC). Although seemingly innocuous in other parts of the body, lipomas within the CPA and IAC often involve the surrounding cranial nerves, making attempts at hearing conservation largely unsuccessful. In an attempt to differentiate the IAC lipoma from the more commonly found acoustic schwannoma, the preoperative imaging studies (magnetic resonance and computerized tomography) on five previously unreported cases of IAC lipomas were evaluated.

Glomus tympanicum tumors: a clinical perspective.

Since Guild first discovered glomus bodies in the middle ear, the diagnostic evaluation and therapy of glomus tympanicum tumors have remained challenging. This study describes 73 cases diagnosed as glomus tympanicum tumors over the past 30 years. During this period, imaging techniques have markedly improved, and surgical approaches have evolved and been refined.

Facial nerve monitoring in acoustic tumor surgery.

Anatomic and functional preservation of the facial nerve during acoustic tumor surgery remains a primary goal. Intraoperative electromyographic facial nerve monitoring with auditory feedback has enabled the surgeon to more readily achieve this goal. We compared a group of monitored translabyrinthine acoustic tumor removals (N = 89) to a similar unmonitored group (N = 155) in regard to facial nerve function.

Sudden hearing loss due to AIDS-related cryptococcal meningitis--a temporal bone study.

We have presented the clinical history and temporal bone findings in a patient who manifested sudden hearing loss, and who subsequently was found to have cryptococcal meningitis associated with AIDS. The histopathologic findings are similar to earlier reports in patients without AIDS. Because cryptococcal infection is so much more common in AIDS patients than in the general population, it must be considered a causative factor when presented with an AIDS patient with progressive or sudden hearing loss.

Transcanal infracochlear approach to the petrous apex.

Computerized tomography and magnetic resonance imaging have now made it possible to reliably differentiate cholesteatoma from cholesterol granuloma of the petrous apex. The treatment for cholesteatoma is complete surgical excision when possible, whereas cholesterol granuloma needs only adequate drainage for control. A new transcanal infracochlear approach for drainage of cholesterol granuloma involving the anterior petrous apex is described.

Middle fossa decompression of the internal auditory canal in acoustic neuroma surgery: a therapeutic alternative.

Unilateral acoustic neuromas in only-hearing ears and bilateral acoustic neuromas (NF-2) are separate entities, but both pose a common problem because surgical removal has the potential to leave the patient totally deafened. A middle fossa decompression of the internal auditory canal (IAC) was performed in 8 patients (5 with NF-2 tumors and 3 with neuromas in an only-hearing ear). In 5 of the 8, the speech discrimination scores at the 6-month follow-up were better than preoperative scores.

A review of acoustic tumors: 1983-1988.

This is a review of the English literature relative to acoustic tumors from 1983 through 1988. In January of 1984, a similar article was published in this journal which reviewed the literature from 1979 through 1982. We have selected what we consider the most important articles from the hundreds that were published on this subject.