Measurements of Trunk Sway for Stance and Gait Tasks 2 Years after Vestibular Neurectomy.

The aim of this study was to investigate changes in balance control for stance and gait tasks in patients 2 years before and after vestibular neurectomy (VN) performed to alleviate intractable Meniere's disease. Amplitudes of trunk sway in roll and pitch directions were measured for stance and gait tasks in 19 patients using gyroscopes mounted at the lower-back. Measurements before VN and 2 years later were compared to those of healthy age-matched controls (HC).

Novel Bone-Anchored Vascular Access on the Mastoid for Hemodialysis: Concept and Preclinical Trials.

Goal: We present the development of a bone-anchored port for the painless long-term hemodialytic treatment of patients with renal failure. This port is implanted behind the ear.

Methods: The port was developed based on knowledge obtained from long-term experience with implantable hearing devices, which are firmly anchored to the bone behind the ear.

[A new bone anchored hemodialysis access].

When classic arteriovenous fistulas or grafts fail, dialysis patients have a vital requirement for a catheter to ensure vascular access. Permanent central venous catheters penetrate the cervical and thoracic soft tissues and the skin without rigid fixation. The infection rate for such devices is high, often requiring explantation.

Functional results and quality of life after retrosigmoid vestibular neurectomy in patients with Ménière's disease.

Background: Severe Ménière's disease (MD) may be debilitating and compromising, despite intensive medical treatment. Vestibular neurectomy (VN) is considered an effective surgical treatment for disabling MD. Our aim was to analyse the medium- to long-term outcome after retrosigmoid VN with special regard to vertigo, quality of life (American Academy of Otolaryngology-Head and Neck Surgery criteria), and pure tone average (PTA).

Mutation analysis of Netrin 1 and HMX3 genes in patients with superior semicircular canal dehiscence syndrome.

Conclusion: In spite of its absence in the control population, there is questionable evidence for the alteration c.114C->T in the HMX3 gene being implicated in the development of superior semicircular canal dehiscence (SSCD). However, the concept of a complex disease is valid for SSCD and a possible molecular origin can neither be confirmed nor excluded by the results of this study.

Retrograde cochlear implantation in postmeningitic basal turn ossification.

Objectives/hypothesis: Postmeningitic basal turn ossification is a challenge for successful cochlear implantation despite the availability of sophisticated implants and advanced drill-out procedures. A less complex concept consisting of a cochleostomy near the apex with retrograde array insertion is evaluated clinically and experimentally with emphasis on imaging of intracochlear array morphology.

Study Design: Retrospective case-control study.

In-the-canal versus behind-the-ear microphones improve spatial discrimination on the side of the head in bilateral cochlear implant users.

Objective: To test whether in-the-canal (ITC) microphones have an impact on spatial discrimination and speech perception by taking advantage of auricular cues.

Study Design: Experimental clinical study.

Setting: Audiologic laboratory in a tertiary referral center.

Meniere's disease in the elderly.

Menière disease usually begins in adults from 20 to 60 years old, and occurs in more than 10% of patients older than 65. The treatment of Menière disease in the elderly represents a challenge because of polymedication. Antivertiginous drugs such as betahistine and cinnarizin give good results with minor secondary effects.

The floating mass transducer at the round window: direct transmission or bone conduction?

The round window placement of a floating mass transducer (FMT) is a new approach for coupling an implantable hearing system to the cochlea. We evaluated the vibration transfer to the cochlear fluids of an FMT placed at the round window (rwFMT) with special attention to the role of bone conduction. A posterior tympanotomy was performed on eleven ears of seven human whole head specimens.

Revision stapedectomy: an analysis of 201 operations.

Introduction: Recurrent or persistent conductive hearing impairment as well as vertigo or tinnitus after a stapes operation can be treated by means of stapes revision surgery. We analyzed stapes revisions performed during the last 15 years at our institution. The aim was to ascertain the causes that led to the failure, to analyze the postrevision results, and to compare them with data from the literature.

Prospective effectiveness of stapes surgery for otosclerosis in a multicenter audit setting: feasibility of the Common Otology Database as a benchmark database.

Introduction: The Common Otology Database (COD) is a joint effort by an international group of otologists to organize audit with a standardized reporting method in middle ear surgery. The first results on hearing outcome of the COD are presented in this article.

Objective: The primary objective was to confirm the validity of the benchmark group by comparing hearing outcome results with previously reported results.

Otologic manifestations in Samter's syndrome.

Objective: It was the aim of this study to investigate the prevalence of otologic manifestations in a cohort of Samter's syndrome patients (nasal polyps with chronic rhinosinusitis, aspirin intolerance and asthma).

Methods: We analyzed a retrospective and prospective case review from 1995 to 2005, performed in the otorhinolaryngology outpatient clinic of a tertiary referral center. Ear history, clinical examinations, treatment and outcome were evaluated using office and hospital records in 23 cases.

External auditory canal cholesteatoma: reassessment of and amendments to its categorization, pathogenesis, and treatment in 34 patients.

Objective: External auditory canal cholesteatoma (EACC) is a rarity. Although there have been numerous case reports, there are only few systematic analyses of case series, and the pathogenesis of idiopathic EACC remains enigmatic.

Study Design: In a tertiary referral center for a population of 1.

International Common Otology Database: taste disturbance after stapes surgery.

Objective: To use a study on dysgeusia to assess the usefulness of an otology database.

Study Design: Data were extracted from the international Common Otology Database.

Intervention: Primary stapes operations.

Cholesterol granuloma of the petrous apex: benefit of computer-aided surgery.

The following is an analysis of the role of computer aided surgery by infralabyrinthine-subcochlear approach to the petrous apex for cholesterol granulomas with hearing preservation. In a retrospective case review from 1996 to 2008 six patients were analysed in our tertiary referral centre, otorhinolaryngology outpatient clinic. Excellent intraoperative localisation of the carotid artery, facial nerve and the entrance into the cholesterol cyst of the bone by means of the navigation system was seen.

Ultrastructural changes in otoconia of osteoporotic rats.

The etiology of benign paroxysmal positional vertigo (BPPV) remains obscure in many cases and women are affected more often than men. A recent prospective study, performed in women >50 years of age suffering from recurrent BPPV, showed associated osteopenia or osteoporosis in a large percentage of these patients. These results suggested the possible relationship between recurrent BPPV and a decreased fixation of calcium in bone in women >50 years.

A novel implantable hearing system with direct acoustic cochlear stimulation.

A new implantable hearing system, the direct acoustic cochlear stimulator (DACS) is presented. This system is based on the principle of a power-driven stapes prosthesis and intended for the treatment of severe mixed hearing loss due to advanced otosclerosis. It consists of an implantable electromagnetic transducer, which transfers acoustic energy directly to the inner ear, and an audio processor worn externally behind the implanted ear.

Benign paroxysmal positional vertigo in mountain bikers.

We evaluated 4 men who had benign paroxysmal positional vertigo (BPPV) that occured several hours after intensive mountain biking but without head trauma. The positional maneuvers in the planes of the posterior and horizontal canals elicited BPPV, as well as transitory nystagmus. This was attributed to both the posterior and horizontal semicircular canals (SCCs) on the left side in 1 patient, in these 2 SCCs on the right side in another patient, and to the right posterior SCC in the other 2 patients.

Echinococcosis presenting as an otogenic brain abscess: an unusual lesion of the middle ear cleft and temporal lobe.

This paper presents a case of a 28-year-old male with a seizure episode and a 4-year history of intermittent tinnitus on the left ear. On computed tomography and magnetic resonance imaging, a density with rim enhancement was found at the temporal lobe, associated with mastoid tegmen destruction and middle ear mass, indicating cholesteatoma with complicating brain abscess. Evacuation of the brain abscess was performed with a combined otolaryngologic and neurosurgical procedures (canal wall-down mastoidectomy and temporal craniotomy).

Speech understanding in quiet and in noise with the bone-anchored hearing aids Baha Compact and Baha Divino.

Conclusions: Speech understanding is better with the Baha Divino than with the Baha Compact in competing noise from the rear. No difference was found for speech understanding in quiet. Subjectively, overall sound quality and speech understanding were rated better for the Baha Divino.

Impact of a self-developed planning and self-constructed navigation system on skull base surgery: 10 years experience.

Conclusion: Our self-developed planning and navigation system has proven its capacity for accurate surgery on the anterior and lateral skull base. With the incorporation of augmented reality, image-guided surgery will evolve into 'information-guided surgery'.

Objective: Microscopic or endoscopic skull base surgery is technically demanding and its outcome has a great impact on a patient's quality of life.

Advantages and risks of various sealing procedures of the oval window: vein graft, adipose tissue, gelfoam, merogel.

An overview of various proposed sealing procedures of the oval window proposed for stapedectomy or stapedotomy are presented. These include vein graft, adipose tissue and substances like Gelfoam or Merogel. The advantages and pitfalls with these materials are discussed.

A new self-fixing and articulated malleus grip stapedectomy prosthesis.

A new prosthesis for malleus-grip stapedectomy is presented: the Clip(R) Piston MVP according to Häusler. The titanium piston is equipped with a self-fixing clip mechanism for automatic fixation of the prosthesis on the proximal malleus handle as well as a ball and socket articulation allowing easy introduction of the piston at an optimal angle into the oval window as well as adjustment of the insertion depth. A first series of malleus-grip stapedectomies performed with the Clip Piston MVP shows a hearing gain of 20 to 50 dB and a residual air-bone gap of < or =20 dB in all cases.

General history of stapedectomy.

The article gives an overview of the historical development of stapedectomy beginning with Kessel in 1876. Then, from the beginning to the middle of the 20th century, surgery on the oval window became obsolete, opening the way for an era of fenestration operations until Shea in 1956 performed the first modern stapedectomy using a Teflon stapes replacement prosthesis. Since then, numerous surgeons worldwide have used this procedure with great success.