Predictive nomograms and an algorithm for managing patients with probable Meniere's disease.

Purpose: To explore the efficacy of diagnostic tests in accurately reclassifying patients initially diagnosed with probable Meniere's disease (MD) into either definite or non-MD categories.

Materials And Methods: A retrospective cohort study was conducted at a neurotology clinic between 1/2016 and 5/2022. Patients underwent a battery of tests, from which sensitivity, specificity, positive and negative predictive values, as well as positive and negative likelihood ratios, were calculated.

Single-cell transcriptomic atlas reveals increased regeneration in diseased human inner ear balance organs.

Mammalian inner ear hair cell loss leads to permanent hearing and balance dysfunction. In contrast to the cochlea, vestibular hair cells of the murine utricle have some regenerative capacity. Whether human utricular hair cells regenerate in vivo remains unknown.

Intraoperative hybrid technique for excision of temporal bone paraganglioma: A case report.

Background: Temporal bone paragangliomas are vascularized neoplasms. Although preoperative angioembolization serves as a valuable approach to reduce intraoperative blood loss, it comes with an elevated risk of cranial neuropathies, offers no assurance of complete hemostasis, and precludes real-time adjustments during surgery.

Methods: A 74-year-old patient presented with recurrent episodes of ear bleeding.

Surgical Approaches to Petrous Apex Cholesterol Granulomas: A Systematic Review and Network Meta-analysis.

Objective: To compare the outcomes of different surgical approaches to petrous apex cholesterol granulomas (PACG).

Data Sources: PubMed, Embase, Google Scholar, Cochrane, and Web of Science.

Review Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses-Network Meta-analyses guidelines, databases were searched from inception to November 31, 2022.

Lytic Mastoid Lesion in a Patient with Otalgia.

The differential diagnosis for an isolated lytic mastoid lesion is broad, encompassing various conditions requiring careful consideration. These include granulomatous disorders such as Langerhans cell histiocytosis and sarcoidosis, neoplastic processes like multiple myeloma, leukemia, lymphoma, and metastases, primary bone diseases such as Paget's disease, fibrous dysplasia, and osteitis fibrosa cystica, as well as infectious causes like osteomyelitis. In this report, we present a patient with otalgia and an isolated lytic mastoid lesion.

Evaluation of Asymmetries in Speech-in Noise Abilities in Audiologic Screening for Vestibular Schwannoma.

Objectives: Measures of speech-in-noise, such as the QuickSIN, are increasingly common tests of speech perception in audiologic practice. However, the effect of vestibular schwannoma (VS) on speech-in-noise abilities is unclear. Here, we compare the predictive ability of interaural QuickSIN asymmetry for detecting VS against other measures of audiologic asymmetry.

Content Validity of a High-Fidelity Surgical Middle Ear Simulator: A Randomized Prospective International Multicenter Trial.

Objective: After demonstration of face validity of a surgical middle ear simulator (SMS) previously, we assessed the content validity of the simulator with otolaryngology residents.

Study Design: Multicenter randomized prospective international study.

Setting: Four academic institutions.

[FIRST YEAR EXPERIENCE OF TERTIARY MULTIDISCIPLINARY NEUROTOLOGY (DIZZINESS AND BALANCE) CLINIC].

Background: Dizziness is a common condition that accounts for an estimated 5% of primary care clinic visits. The differential diagnosis is extensive, which may involve the inner ear, central and peripheral nervous system and the cardiovascular system among others. While routine cases can be diagnosed and treated with primary (general practitioner) or secondary (otolaryngologists (medicine in the community, there are many cases in which it is advisable to refer patients to a tertiary dizziness clinic.

Augmented Reality for Retrosigmoid Craniotomy Planning.

While medical imaging data have traditionally been viewed on two-dimensional (2D) displays, augmented reality (AR) allows physicians to project the medical imaging data on patient's bodies to locate important anatomy. We present a surgical AR application to plan the retrosigmoid craniotomy, a standard approach to access the posterior fossa and the internal auditory canal. As a simple and accurate alternative to surface landmarks and conventional surgical navigation systems, our AR application augments the surgeon's vision to guide the optimal location of cortical bone removal.

Surgical Approach for Rapid and Minimally Traumatic Recovery of Human Inner Ear Tissues From Deceased Organ Donors.

Objective: To develop a surgical approach for rapid and minimally traumatic recovery of inner ear tissue from human organ and tissue donors to provide fresh tissue for use in inner ear research.

Study Design: Exploration of novel surgical methodology and evaluation of the steps necessary for obtaining specimens from donors during the procurement of organs for transplantation.

Setting: Donor procurement locations across multiple local hospitals and tissue processing at the microsurgical temporal bone laboratory.

Selection Criteria Optimal for Recovery of Inner Ear Tissues From Deceased Organ Donors.

Objective: To identify optimal conditions for recovering viable inner ear tissues from deceased organ donors.

Setting: Tertiary recovery hospitals and Donor Network West Organ Recovery Center.

Interventions: Recovering bilateral inner ear tissues and immunohistological analysis.

Comparative study of efficiency and characteristics of FMT and DRT installed in human cadavers for round-window stimulation.

Acoustic hearing aids generate amplified sound in the ear canal, and they are the standard of care for patients with mild to moderate sensorineural hearing loss. However, because of their limited frequency bandwidth, gain, and feedback, there is substantial room for improvement. Active middle ear implants, which directly vibrate the middle ear and cochlea, are an alternative approach to conventional acoustic hearing aids.

Canalplasty for Exostosis Removal Comparing Microscopic Versus Endoscopic Ear Surgery Techniques.

Objective: To compare an endoscopic versus microscopic approach to removal of exostoses and osteomas in canalplasty procedures.

Study Design: Retrospective case review.

Setting: Private and tertiary referral centers.

The risk of ergonomic injury across surgical specialties.

Lack of ergonomic training and poor ergonomic habits during the operation leads to musculoskeletal pain and affects the surgeon's life outside of work. The objective of the study was to evaluate the severity of ergonomic hazards in the surgical profession across a wide range of surgical subspecialties. We conducted intraoperative observations using Rapid Entire Body Assessment (REBA) score system to identify ergonomic hazards.

Health Literacy and Hearing Healthcare Use.

Objective: To assess whether health literacy is associated with: 1) degree of hearing loss at initial presentation for audiogram and 2) hearing aid adoption for hearing aid candidates.

Methods: We identified 1376 patients who underwent audiometric testing and completed a brief health literacy questionnaire at our institution. The association between health literacy and degree of hearing loss at initial presentation was examined using linear regression, adjusted for age, gender, marital status, education level, race, language, employment status, and insurance coverage.

Facial Nerve Paralysis Following Endovascular Embolization: A Case Report and Review of the Literature.

Objective: We report a case of facial nerve paralysis post-endovascular embolization of a sigmoid sinus dural arterio-venous fistula from initial presentation to current management and discuss the merits of observation versus decompression through a systematic review of relevant literature.

Patient: 61 F with right facial palsy.

Intervention: Following a single intravenous dexamethasone injection with oral steroids over 2 months, patient was observed with no additional treatment other than Botox chemodenervation and facial rehabilitation.

Ocular Vestibular-Evoked Myogenic Potential Amplitudes Elicited at 4 kHz Optimize Detection of Superior Semicircular Canal Dehiscence.

High-resolution temporal bone computed tomography (CT) is considered the gold standard for diagnosing superior semicircular canal dehiscence (SCD). However, CT has been shown over-detect SCD and provide results that may not align with patient-reported symptoms. Ocular vestibular-evoked myogenic potentials (oVEMPs)-most commonly conducted at 500 Hz stimulation-are increasingly used to support the diagnosis and management of SCD.

Ambient Pressure Tympanometry Wave Patterns in Patients With Superior Semicircular Canal Dehiscence.

Superior semicircular canal dehiscence (SSCD) is a treatable condition, but current diagnostic modalities have numerous limitations. Clinicians would benefit from an additional tool for diagnostic workup that is both rapid and widely available. To assess the utility of ambient pressure tympanometry (APT) in the diagnostic workup of SSCD by determining the sensitivity and specificity of APT for SSCD in comparison to other diagnostic modalities.

Application of holographic augmented reality for external approaches to the frontal sinus.

Background: External approaches to the frontal sinus such as osteoplastic flaps are challenging because they require blind entry into the sinus, posing risks of injury to the brain or orbit. Intraoperative computed tomography (CT)-based navigation is the current standard for planning the approach, but still necessitates blind entry into the sinus. The aim of this work was to describe a novel technique for external approaches to the frontal sinus using a holographic augmented reality (AR) application.

Metformin Potential Impact on the Growth of Vestibular Schwannomas.

Objective: Previous work has suggested that metformin may possess antineoplastic properties. This study aims to assess the effect of metformin on the growth of sporadic vestibular schwannomas.

Methods: A retrospective cohort study was performed on patients presenting with radiologically confirmed vestibular schwannomas to Stanford medical center between January 1990 and October 2018.

Rhythmic Wave Patterns on Ambient Pressure Tympanometry in Patients With Objective Tinnitus-associated Pathologies.

Objective: To introduce the concept of ambient pressure tympanometry (APT) and its association with pathologies that may present with objective tinnitus.

Study Design: Retrospective case series.

Setting: Tertiary referral center.

Sensorineural Hearing Loss in the Nonimplanted Ear Following Cochlear Implantation in a Patient With Bilateral Enlarged Vestibular Aqueducts.

Objective: To document the case of a patient with bilateral enlarged vestibular aqueducts who experienced sensorineural hearing loss in the nonimplanted ear following unilateral cochlear implantation complicated by perilymph gusher requiring lumbar drain insertion and to highlight the need to counsel regarding the risk of potential hearing loss to the contralateral ear when preparing for cochlear implants in the setting of inner ear malformations.

Patients: One patient with bilateral enlarged vestibular aqueducts in a tertiary referral center.

Intervention(s): Cochlear implantation complicated by perilymph gusher requiring lumbar drain insertion.

Hypotympanic Sound Baffle for Amelioration of Pulsatile Tinnitus due to Carotid and Jugular Bulb Dehiscence.

Objective: To share our experience with treating pulsatile tinnitus by insulating a dehiscent carotid artery with a hypotympanic sound baffle, and compare outcomes with a similar resurfacing approach for jugular bulb wall anomalies.

Study Design: Retrospective case series.

Setting: Tertiary academic medical center.