Fine needle aspiration of pleomorphic lipoma of the neck: report of two cases.

Pleomorphic lipoma is a rare lipocytic neoplasm that most commonly occurs in the head and neck region in middle-aged to elderly men. Clinically, it presents as a slow-growing, well-circumscribed subcutaneous mass. Histopathologically and cytogenetically, it has some features overlapping with other benign and malignant tumors, such as benign spindle cell lipoma, atypical lipomatous tumor, liposarcoma, and malignant fibrous histiocytoma.

Hypopharyngeal perforation near-miss during transesophageal echocardiography.

Objectives/hypothesis: The traditional blind passage of a transesophageal echocardiography probe transorally through the hypopharynx is considered safe. Yet, severe hypopharyngeal complications during transesophageal echocardiography at several institutions led the authors to investigate whether traditional probe passage results in a greater incidence of hypopharyngeal injuries when compared with probe passage under direct visualization.

Study Design: Randomized, prospective clinical study.

Diagnosis and treatment of sudden-onset sensorineural hearing loss: a study of 51 patients.

Objective: The study purpose was to determine the efficacy of steroid and antiviral therapy in the management of idiopathic sudden sensorineural hearing loss (SSNHL).

Study Design And Setting: We conducted a retrospective study of patients presenting to an academic tertiary care center. Fifty-one patients were evaluated.

Giant cell tumors of the jugular foramen.

Purpose: To review the diagnosis and treatment of giant cell tumors of the jugular foramen.

Materials And Methods: A typical case is reported. Symptoms, signs, and diagnostic studies are reviewed.

Use of glycopyrrolate in the treatment of Meniere's disease.

Objectives/hypothesis: The objective of this study was to determine whether glycopyrrolate is useful as a vestibular suppressant in patients with Meniere's disease. The tested hypotheses were that glycopyrrolate would decrease the perception of dizziness measured by the Dizziness Handicap Inventory in patients with Meniere's disease and that placebo would cause no such decrease.

Study Design: Randomized, prospective.

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.

Electrocochleography in Retrosigmoid Vestibular Nerve Section for Intractable Vertigo Caused by Meniere's Disease.

Interest in electrocochleography has increased in recent years because of the discovery of an elevated summating potential to action potential amplitude ratio (SP/AP ratio) in patients with endolymphatic hydrops caused by Meniere's disease or perilymph fistula. It was the purpose of this investigation to determine whether the intraoperative SP/AP ratio will decrease after vestibular nerve section in patients with intractable Meniere's disease. Fourteen patients with medically intractable classic Meniere's disease underwent retrosigmoid vestibular nerve section.

Electrocochleography in retrosigmoid vestibular nerve section for intractable vertigo caused by Menière's disease.

Interest in electrocochleography has increased in recent years because of the discovery of an elevated summating potential to action potential amplitude ratio (SP/AP ratio) in patients with endolymphatic hydrops caused by Menière's disease or perilymph fistula. It was the purpose of this investigation to determine whether the intraoperative SP/AP ratio will decrease after vestibular nerve section in patients with intractable Meniere's disease. Fourteen patients with medically intractable classic Menière's disease underwent retrosigmoid vestibular nerve section.

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.

Stapedectomy in profound cochlear loss.

Stapedectomy can be used in certain patients with profound sensorineural hearing loss and stapes fixation to improve hearing to a level at which a hearing aid may be effective. This study reviews the outcomes of 11 patients with profound cochlear loss secondary to otosclerosis who underwent stapes surgery performed by the senior author (M.E.

Hearing conservation in surgery for glomus jugulare tumors.

The most common ground on which surgery for glomus jugulare (GJ) tumors is criticized is the perceived risk of functional incapacity that attends possible cranial nerve (CN) loss. It is aggregate lower CN loss that is most often highlighted as particularly disabling to the quality of postsurgical survival. The documented success of both conservation surgery and operative rehabilitation of phonopharyngeal surgical deficits has, however, neutralized much of this criticism.

Twenty-five years of experience with stapedectomy.

The purpose of this report is to review the outcomes of patients undergoing stapes surgery by the senior author during the past 25 years, and to compare these results with those obtained in other series. A retrospective analysis of 902 patients who underwent stapes surgery by the senior author from 1970 to 1994 was performed. Twenty-two patients underwent stapedotomy; the remainder underwent stapedectomy.

Sarcomas of the nasal cavity and paranasal sinuses.

Sarcomas of the nose and paranasal sinuses are rare malignancies. Key issues remain unresolved in the management of these tumors, particularly with regard to the role of radiotherapy. To help clarify these issues, 48 consecutive cases of nasal and paranasal sinus sarcomas treated at the University of California, Los Angeles, between 1958 and 1988 were retrospectively reviewed.

The role of radiation therapy in the treatment of head and neck cutaneous melanoma.

Introduction: This study was undertaken to elucidate the efficacy of external beam irradiation in the treatment of head and neck malignant melanoma, in comparison with the efficacy of surgical excision and the efficacy of surgical excision combined with external beam irradiation.

Materials And Methods: A retrospective chart review of all patients seen at the Department of Radiation Oncology at the University of California at Los Angeles Medical Center with the diagnosis of head and neck melanoma from 1973 to 1992 was conducted. Using chi 2 analysis, survival rates were examined for patients treated with excision alone, irradiation alone, and both excision and irradiation.

The galvanically-induced vestibulo-ocular reflex in the cat.

Rotatory vestibular input is processed by receptor organs and relayed along the vestibular nerves to a central processor, whence the vestibulo-ocular reflex (VOR) is generated. Electrical stimuli applied to the labyrinth can bypass receptors and stimulate the nerve directly, thereby generating horizontal eye movements (EVOR). It was our purpose to mathematically relate the EVOR to the VOR in an effort to generate a parameter by which the experimental effects of ototoxins on the inner ear can be evaluated.

Is human galvanically induced triceps surae electromyogram a vestibulospinal reflex response?

Interest in understanding the human vestibulospinal reflex has increased enormously over the past three decades, because this reflex is the primary effector of maintenance of posture and balance. On a posture platform, forces exerted by the triceps surae (TS) and tibialis anterior muscles are measured to calculate center of mass sway. We wished to determine whether the TS response is a direct component of the vestibulospinal reflex.

Cholesteatoma of the maxillary sinus.

Cholesteatoma of the maxillary sinus, also known as keratoma, primary epidermoid tumor, epidermoid cyst, and keratocyst, is a rare entity, with a clinical presentation and radiologic findings that are difficult to distinguish from those of malignancy. We report a case of cholesteatoma of the maxillary antrum that occurred in a 12-year-old boy without any history of predisposing factors. Multiple theories of pathogenesis have been proposed throughout history; currently there are two accepted ones.

Differential diagnosis of virus-like particles in the human inner ear.

The entire endolymphatic duct and sac as well as the vestibular epithelia were obtained from four patients with Meniere's disease during translabyrinthine (TL) eighth nerve section and from 12 patients undergoing TL resection of acoustic schwannomas. After these specimens were processed for routine transmission electron microscopy (TEM), they were studied for morphologic evidence of viral infection. Although no virus particles were identified, numerous regularly occurring cell components and artifacts were found to morphologically mimic viruses.

Laryngeal edema induced by neck dissection and catheter thrombosis.

Purpose: There are many possible causes of airway edema in a patient being treated for squamous cell carcinoma of the head and neck. The differential diagnosis includes radiation changes, anaphylaxis, and venous or lymphatic obstruction secondary to mechanical compromise resulting from infection, recurrent tumor, or anatomic distortion.

Methods: A 60-year-old man underwent partial glossectomy and right radical neck dissection for squamous cell carcinoma of the tongue.