Partial Labyrinth Removal Restricted to the Superior Semicircular Canal in Focal Combined Transpetrosal Approach: Description and Illustrative Cases.

Background And Objectives: The labyrinthine structures obstruct the surgical view of the deep petroclival region in the transpetrosal approach. Historically, labyrinthectomy and removal of all 3 semicircular canals, with resultant deafness, was used in patients with ipsilateral functional hearing deficits to improve access. The advent and systematization of superior and posterior semicircular canal removal (transcrusal approach) with good rates of hearing preservation has allowed a redefinition of the possibility of partial labyrinthectomy in patients without previous hearing deficits.

Hearing preservation middle fossa approach for intracanalicular vestibular schwannoma in a NF2 patient.

Hearing preservation is a cornerstone in the management of intracanalicular vestibular schwannomas. This video demonstrates a middle fossa approach to an intracanalicular schwannoma and highlights some technical and anatomical nuances relevant to the procedure. The patient had sustained hearing preservation in the postoperative period.

Tentorial Peeling: Surgical Extradural Navigation to Protect the Temporal Lobe in the Focused Combined Transpetrosal Approach.

Background: Transpetrosal approaches have been used for treatment of tumors in the petroclival region for many years. Injury to the temporal lobe, however, has been a potential drawback of the techniques described to date.

Objective: To describe modifications of the transpetrosal surgical technique, which allows extradural manipulation of the temporal lobe during the focused combined transpetrosal approach.

Cochlear fistula in a noncholesteatomatous ear.

Bony destruction of the labyrinth is usually associated with long-standing cholesteatomatous otitis media. The promontory is not a common site for bone resorption because (1) it is not an area that is involved in accumulation of cholesteatoma perimatrix substances, (2) it is the densest bone of the human body, and (3) pressure necrosis from overlying tissue is uncommon. We report a case of cochlear erosion associated with noncholesteatomatous middle ear disease.

Outcomes following ossicular chain reconstruction with composite prostheses: hydroxyapatite-polyethylene vs. hydroxyapatite-titanium.

We conducted a retrospective study to compare the results of ossicular chain reconstruction (OCR) with two types of composite prosthesis: a hydroxyapatite-polyethylene (HAPEX) implant and a hydroxyapatite-titanium (HATi) prosthesis. We reviewed the records of 222 patients-104 males and 118 females, aged 8 to 79 years (mean: 39.7)-who had undergone OCR for ossicular chain dysfunction and who met our eligibility criteria.

Endoscopic assisted resection of prepontine epidermoid cysts.

Objective/background: To describe an innovative endoscopic technique to treat prepontine epidermoid cysts. These cysts are typically resected in a microsurgical fashion and can be associated with significant risks and complications. This report is the first description of an endoscopic-assisted removal of an epidermoid cyst without the use of the operative microscope and evaluates the operative findings, technique, and postoperative course.

Longitudinal assessment of quality of life and audiometric test outcomes in vestibular schwannoma patients treated with gamma knife surgery.

Objective: To prospectively assess the quality of life (QOL) and hearing acuity in vestibular schwannoma (VS) patients after gamma knife surgery (GKS).

Patients: Fifty-nine VS patients.

Intervention: GKS.

Assessing stapes piston position using computed tomography: a cadaveric study.

Hypothesis: Temporal bone computed tomographic (CT) scanning in the postoperative stapedotomy patient is inaccurate in assessing stapes piston position within the vestibule.

Background: Poststapedotomy patients that have persistent vertigo may undergo CT scanning to assess the position of the stapes piston within the vestibule to rule out overly deep insertion. Vertigo is a recognized complication of the deep piston, and CT evaluation is often recommended.

Transcutaneous electrical stimulation versus traditional dysphagia therapy: a nonconcurrent cohort study.

Objective: The purpose of this investigation was to critically evaluate the efficacy of electrical stimulation (ES) in treating persons with dysphagia and aspiration.

Study Design: Nonconcurrent cohort study.

Methodology: The charts of 40 consecutive individuals undergoing ES and 40 consecutive persons undergoing traditional dysphagia therapy (TDT) were reviewed.