The international expert consensus on management of external auditory canal carcinoma.

Purpose: The objective of this consensus is to provide otolaryngologists with appropriate strategies in the management of external auditory canal (EAC) carcinoma.

Methods: In the absence of randomized controlled trials, the consensus is based on expert opinions utilizing the Rand/UCLA appropriateness method [Fitch and Aguilar in The RAND/UCLA appropriateness method user's manual, RAND Corporation, Santa Monica, CA, 2001], drawing from existing literature and clinical experience.

Results: The management recommendations are structured around 12 key areas, including: definition and pathology, pathogenesis, clinical manifestations, work-up, tumor staging system, surgical management of primary tumor, surgical management of the parotid gland and the temporomandibular joint, lymph node metastasis, radiotherapy, chemotherapy, reconstruction, and follow-up.

Complications of Transcutaneous Protheses - A Systematic Review of Publications Over the Past 10 Years.

 Bone conduction implants, responsible for transmitting sound from an external processor to the inner ear, can be divided into active and passive, depending on the vibratory stimulus location. The use of transcutaneous device has increased, given its aesthetic appeal, the complications and limitations of percutaneous devices, and patient's treatment adherence, focusing mainly on efficacy. However, various complications are associated with the use of transcutaneous prosthesis, which can often be serious.

Management of acquired cholesteatoma in patients with craniofacial anomalies: An institutional experience.

Purpose: To analyze the surgical management of cholesteatoma in patients with craniofacial abnormalities, cleft lip/palate by reviewing the institutional experience. The secondary aim was to identify and describe the epidemiological profile of the collected data, and to relate the cleft palate and cholesteatoma.

Design And Methods: This retrospective chart review includes 97 patients with craniofacial abnormalities and acquired cholesteatoma with anatomopathological proven in 118 ears.

New Insights on the Effect of TNF Alpha Blockade by Gene Silencing in Noise-Induced Hearing Loss.

Unlabelled: Noise exposure represents the second most common cause of acquired sensorineural hearing loss and we observed that tumor necrosis factor α (TNFα) was involved in this context. The effect of gene silencing on the expression profile related to the TNFα metabolic pathway in an experimental model of noise-induced hearing loss had not previously been studied.

Methods: Single ears of Wistar rats were pretreated with small interfering RNA (siRNA) by trans-tympanic administration 24 h before they were exposed to white noise (120 dBSPL for three hours).

Evolution of Acquired Middle Ear Cholesteatoma in Patients With Ectrodactyly, Ectodermal Dysplasia, Cleft Lip/Palate (EEC) Syndrome.

Objective: To review an institutional experience with the surgical and clinical management of acquired middle ear cholesteatoma in patients with ectrodactyly, ectodermal dysplasia, cleft lip/palate (EEC) syndrome.

Study Design: Retrospective chart review.

Setting: Tertiary referral center.

Preservation of the facial and lower cranial nerves in glomus jugulare tumor surgery: modifying our surgical technique for improved outcomes.

Purpose: To describe the neurological results obtained in six patients with large Fisch C glomus jugulare tumors (GJT) in which a less aggressive, nerve-preserving surgical strategy was used to reduce surgical morbidity.

Methods: Prospective study of six patients with Fisch C GJT who underwent surgery in a tertiary care referral center from February 2015 to August 2017 with an average follow-up of 18 months. The intervention is the surgical technique used and the main outcome measures are recurrence and the functional preservation of the facial and lower cranial nerves.

Evaluating Intracochlear Trauma after Cochlear Implant Electrode Insertion through Middle Fossa Approach in Temporal Bones.

Objective To evaluate cochlear trauma after cochlear implant insertion through a middle fossa approach by means of histologic and imaging studies in temporal bones. Study Design Prospective cadaveric study. Setting University-based temporal bone laboratory.

Satisfaction and quality of life in users of auditory brainstem implant.

Purpose To evaluate satisfaction and quality of life of users of Auditory Implant Brainstem. Methods This is a cross-sectional and descriptive study conducted at Divisão de Clínica Otorrinolaringológica of Hospital das Clínicas of Faculdade de Medicina da Universidade de São Paulo, Brazil. For the research, 19 users of an Auditory Brainstem Implant answered the following questionnaires: KINDLR (Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents), for children and adolescents, their parents and/or caregivers; WHOQOL-BREF questionnaire, for adult participants; and the Satisfaction with Amplification in Daily Life (SADL) questionnaire culturally adapted to Brazilian Portuguese.

An Implantable Hearing System As Rehabilitation for Hearing Loss Due to Bilateral Aural Atresia: Surgical Technique and Audiological Results.

Objective: To demonstrate the surgical technique and audiological results of a middle ear implant for restoring hearing in patients with bilateral aural atresia and microtia with conductive or mixed hearing loss.

Materials And Methods: In this prospective study, 12 subjects aged 12 years and older presenting with hearing loss and bilateral congenital aural atresia underwent surgical insertion of a middle ear implant. The patients underwent tympanomastoidectomy with a wide opening of the attic and preservation of the roof of the atresic tympanic bone to expose the middle ear and position the floating mass transducer of the implant.

Decompression of the tympanic and labyrinthine segments of the facial nerve by middle cranial fossa approach: an anatomic study.

Background: Peripheral facial palsy is characterized by the permanent or temporary interruption of facial muscle function. The middle cranial fossa (MCF) approach has been used to decompress the facial nerve (FN) when hearing needs to be preserved. In this work, we describe a technique for decompressing the FN through the MCF approach, which allows the direct exposure of the labyrinthine and entire tympanic segment of the FN, with preservation of inner ear function.

Are Auditory Steady-State Responses Useful to Evaluate Severe-to-Profound Hearing Loss in Children?

Objective: To evaluate Auditory Steady-State Responses (ASSR) at high intensities in pediatric cochlear implant candidates and to compare the results to behavioral tests responses.

Methods: This prospective study evaluated 42 children with suspected severe-to-profound hearing loss, aged from 3 to 72 months. All had absent ABR and OAE responses.

Are auditory steady-state responses a good tool prior to pediatric cochlear implantation?

Introduction: ASSR allow frequency-specific evaluation in intensities up to 120dB HL and detection of residual hearing in patients with severe-to-profound hearing loss.

Aim: to compare ASSR thresholds and behavioral test results in children with suspected severe-to-profound hearing loss.

Methods: Cross sectional study to compare ASSR and behavioral responses (VRA or audiometry) in 63 pediatric cochlear implant candidates (126 ears) aged between 6 and 72 months.

Implantable and semi-implantable hearing AIDS: a review of history, indications, and surgery.

Introduction The complaints associated with the use of conventional amplifying hearing aids prompted research at several centers worldwide that ultimately led to the development of implantable devices for aural rehabilitation. Objectives To review the history, indications, and surgical aspects of the implantable middle ear hearing devices. Data Synthesis Implantable hearing aids, such as the Vibrant Soundbridge system (Med-El Corporation, Innsbruck, Austria), the Maxum system (Ototronix LLC, Houston, Texas, United States), the fourth-generation of Carina prosthesis (Otologics LLC, Boulder, Colorado, United States), and the Esteem device (Envoy Medical Corporation - Minnesota, United States), have their own peculiarities on candidacy and surgical procedure.

Remote programming of cochlear implants.

Purpose: To verify the effectiveness of remote programming of cochlear implants by stimulation levels and results in the perception of speech and free-field audiometry tests.

Methods: Twelve patients from both genders, aged between 18 and 59 years, users of internal cochlear implant and speech processor of the same model for at least 12 months, were selected. Both the remote programming (RP) and the live programming (LP) were performed on the same day, measuring the minimum (T) and maximum (C) stimulation levels of five electrodes with the interpolation of the remaining ones.

Carina® and Esteem®: a systematic review of fully implantable hearing devices.

Objective: To review the outcomes of the fully implantable middle ear devices Carina and Esteem regarding the treatment of hearing loss.

Data Sources: PubMed, Embase, Scielo, and Cochrane Library databases were searched.

Study Selection: Abstracts of 77 citations were screened, and 43 articles were selected for full review.

Retrolabyrinthine approach for cochlear nerve preservation in neurofibromatosis type 2 and simultaneous cochlear implantation.

Introduction:  Few cases of cochlear implantation (CI) in neurofibromatosis type 2 (NF2) patients had been reported in the literature. The approaches described were translabyrinthine, retrosigmoid or middle cranial fossa.

Objectives:  To describe a case of a NF2- deafened-patient who underwent to vestibular schwannoma resection via RLA with cochlear nerve preservation and CI through the round window, at the same surgical time.

Cochlear implantation through the middle fossa: an anatomic study for a novel technique.

Conclusion: The technique proposed is simple, reliable, and provides sufficient exposure of the basal portion of the cochlea while avoiding disabling complications. It enables visualization of the cochlear basal turn and the osseous spiral lamina, facilitating the insertion of the cochlear implant array through the scala tympani.

Objectives: To describe a novel approach for exposing the cochlear basal turn for cochlear implantation through the middle cranial fossa.

Cochlear implantation through the middle cranial fossa: a novel approach to access the basal turn of the cochlea.

Unlabelled: The classic approach for cochlear implant surgery includes mastoidectomy and posterior tympanotomy. The middle cranial fossa approach is a proven alternative, but it has been used only sporadically and inconsistently in cochlear implantation.

Objective: To describe a new approach to expose the basal turn of the cochlea in cochlear implant surgery through the middle cranial fossa.

Cochlear implants and bacterial meningitis: A speech recognition study in paired samples.

Introduction:  Cochlear implants may guarantee sound perception and the ability to detect speech at a close-to-normal hearing intensity; however, differences have been observed among implantees in terms of performance on discrimination tests and speech recognition.

Objective:  To identify whether patients with post-meningitis deafness perform similarly to patients with hearing loss due to other causes.

Method:  A retrospective clinical study involving post-lingual patients who had been using Nucleus-22 or Nucleus-24 cochlear implants for at least 1 year.

Cochlear implantation via the middle fossa approach: surgical and programming considerations.

Objectives: To report the results of cochlear implantation via the middle fossa approach in 4 patients, discuss the complications, and present a detailed description of the programming specifications in these cases.

Study Design: Retrospective case review.

Setting: Tertiary-care referral center with a well-established cochlear implant program.

Prelingual deafness: Benefits from cochlear implants versus conventional hearing aids.

Introduction:  The majority of patients with hearing loss, including those with severe hearing loss, benefits from the use of hearing aids. The cochlear implant is believed to achieve better results in a child with hearing loss in cases where the severity of disability renders hearing aids incapable of providing adequate sound information, as they require sufficient cochlear reserve so that acoustic detention occurs.

Objective:  To assess if cochlear implants provide more benefit than conventional hearing aids in prelingually deaf patients.

Programming peculiarities in two cochlear implant users with superficial siderosis of the central nervous system.

Objective: To report the audiological outcomes of cochlear implantation in two patients with severe to profound sensorineural hearing loss secondary to superficial siderosis of the CNS and discuss some programming peculiarities that were found in these cases.

Method: Retrospective review. Data concerning clinical presentation, diagnosis and audiological assessment pre- and post-implantation were collected of two patients with superficial siderosis of the CNS.

Microangiopathy of the inner ear, deafness, and cochlear implantation in a patient with Susac syndrome.

Conclusion: The cochlear implant was beneficial as an attempt to restore hearing and improve communication abilities in this patient with profound sensorineural hearing loss secondary to Susac syndrome.

Objective: To report the audiological outcomes of cochlear implantation (CI) in a young woman with Susac syndrome after a 6-month follow-up period. Susac syndrome is a rare disorder.

Speech perception in adolescents with pre-lingual hearing impairment with cochlear implants.

Unlabelled: Profound hearing loss is a disability that affects personality and when it involves teenagers before language acquisition, these bio-psychosocial conflicts can be exacerbated, requiring careful evaluation and choice of them for cochlear implant.

Aim: To evaluate speech perception by adolescents with profound hearing loss, users of cochlear implants.

Study Design: Prospective.