Dynamic Molecular Markers of Otosclerosis in the Human Cochlea.

Objective: To investigate the role and distribution of various molecular markers using immunohistochemistry and immunofluorescence to further elucidate and understand the pathogenesis of otosclerosis.

Methods: Archival celloidin formalin-fixed 20-micron thick histologic sections from 7 patients diagnosed with otosclerosis were studied and compared to controls. Sections in the mid-modiolar region were immunoreacted with rabbit polyclonal antibodies against nidogen-1, β2-laminin, collagen-IX, BSP, and monoclonal antibodies against TGF β-1 and ubiquitin.

Differential Expression of Na/K-ATPase in the Human Saccule of Patients With and Without Otologic Disease.

Hypothesis: Na + , K + -ATPase (Na/K-ATPase) α1 subunit expression in the saccule of patients diagnosed with otologic disease is different compared with normal controls.

Background: We have recently characterized changes in the expression of Na/K-ATPase α1 subunit in the normal and pathological cochlea; however, no studies have determined the distribution Na/K-ATPase α1 subunit in the human saccule. The present study uses archival temporal bones to study the expression Na/K-ATPase α1 subunit in the human saccule.

End-to-Trunk Masseteric to Facial Nerve Transfer With Selective Neurectomy for Facial Reanimation.

Objective: To examine functional outcomes following end-to-trunk masseteric to facial nerve transfer in patients with chronic flaccid facial paralysis.

Design: Retrospective chart review.

Setting: Tertiary-care private practice setting.

Histopathologic Analysis of Temporal Bones With Otosclerosis Following Cochlear Implantation.

Objective: Analyze changes in osteoneogenesis and fibrosis following cochlear implant (CI) surgery in patients with otosclerosis and compare differences based on insertion technique.

Background: When advanced otosclerotic disease extends to the otic capsule, severe and profound sensorineural hearing loss necessitates consideration of a cochlear implant. Histopathological analysis of the human temporal bone after implantation in the patient with otosclerosis may reveal important variables that predict CI success.

Cisplatin ototoxicity histopathology.

This study investigates the histopathological changes of the cochlea and vestibular end organs of a patient who received cisplatin for Hodgkin's lymphoma. He experienced acute high-frequency sensorineural hearing loss and tinnitus after receiving treatment. Using histopathological analysis of his temporal bones after he unfortunately succumbed to his disease, we found that the ototoxic effect of cisplatin is primarily within the cochlea, with significant damage located at the organ of Corti at the base-hook region, consistent with findings in animal models.

Allergy, Immunotherapy, and Alternative Treatments for Dizziness.

Allergic reactions may result in central symptoms of dizziness, including nonspecific chronic imbalance, Meniere's disease, and autoimmune inner ear disease. Excepting first-generation antihistamines, and short-term use of steroids, most pharmacotherapies used to treat allergic rhinitis have limited benefit in treating allergically induced or related dizziness. Allergy immunotherapy and/or an elimination diet for diagnosed food allergies have been found to be effective treatments.

Developmental Anatomy of the Eustachian Tube: Implications for Balloon Dilation.

Objective: To describe the developmental anatomy of the eustachian tube (ET) and its relationship to surrounding structures on computed tomography.

Study Design: Case series with chart review.

Setting: A tertiary care hospital.

Isolated Saccular Hydrops on High-resolution MRI Is Associated With Full Spectrum Menière's Disease.

Objective: To describe the clinical presentation of patients with isolated saccular endolymphathic hydrops (EH) detected.

Study Design: Clinical case series.

Setting: University-based tertiary referral center.

Meniere's disease: Medical management, rationale for vestibular preservation and suggested protocol in medical failure.

Meniere's disease is a peripheral audiovestibular disorder characterized by vertigo, hearing loss, tinnitus, and aural fullness. Management of these symptoms includes medical and surgical treatment. Many patients with Meniere's disease can be managed using nonablative therapy, such as intratympanic steroids and endolymphatic shunt surgery, prior to ablative techniques such as intratympanic gentamicin.

Facial nerve management in patients with malignant skull base tumors.

Introduction: The course of the facial nerve through the cerebellopontine angle, temporal bone, and parotid gland puts the nerve at risk in cases of malignancy. In contrast to Bell's palsy, which presents with acute facial paralysis, malignancies cause gradual or fluctuating weakness.

Methods: We review malignancies affecting the facial nerve, including those involving the temporal bone, parotid gland, and cerebellopontine angle, in addition to metastatic disease.

American Neurotology Society, American Otological Society, and American Academy of Otolaryngology - Head and Neck Foundation Guide to Enhance Otologic and Neurotologic Care During the COVID-19 Pandemic.

: This combined American Neurotology Society, American Otological Society, and American Academy of Otolaryngology - Head and Neck Surgery Foundation document aims to provide guidance during the coronavirus disease of 2019 (COVID-19) on 1) "priority" of care for otologic and neurotologic patients in the office and operating room, and 2) optimal utilization of personal protective equipment. Given the paucity of evidence to inform otologic and neurotologic best practices during COVID-19, the recommendations herein are based on relevant peer-reviewed articles, the Centers for Disease Control and Prevention COVID-19 guidelines, United States and international hospital policies, and expert opinion. The suggestions presented here are not meant to be definitive, and best practices will undoubtedly change with increasing knowledge and high-quality data related to COVID-19.

Sensitivity of High-Resolution Computed Tomography in Otosclerosis Patients undergoing Primary Stapedotomy.

Objective: To determine the incidence of abnormal otospongiotic or otosclerotic findings on high-resolution computed tomography (HRCT) as read by local radiologists in patients with surgically-confirmed otosclerosis.

Study Design: Retrospective chart review.

Setting: Tertiary-referral private otology-neurotology practice.

Next-Day Loading of a Bone-Anchored Hearing System: Preliminary Results.

Objectives: To demonstrate the feasibility and efficacy for next-day loading of a percutaneous bone-anchored hearing device.

Study Design: Multicenter prospective cohort study.

Setting: Tertiary neurotologic referral centers.

Clinical Practice Guideline: Ménière's Disease Executive Summary.

Objective: Ménière's disease (MD) is a clinical condition defined by spontaneous vertigo attacks (each lasting 20 minutes to 12 hours) with documented low- to midfrequency sensorineural hearing loss in the affected ear before, during, or after one of the episodes of vertigo. It also presents with fluctuating aural symptoms (hearing loss, tinnitus, or ear fullness) in the affected ear. The underlying etiology of MD is not completely clear, yet it has been associated with inner ear fluid volume increases, culminating in episodic ear symptoms (vertigo, fluctuating hearing loss, tinnitus, and aural fullness).

Clinical Practice Guideline: Ménière's Disease.

Objective: Ménière's disease (MD) is a clinical condition defined by spontaneous vertigo attacks (each lasting 20 minutes to 12 hours) with documented low- to midfrequency sensorineural hearing loss in the affected ear before, during, or after one of the episodes of vertigo. It also presents with fluctuating aural symptoms (hearing loss, tinnitus, or ear fullness) in the affected ear. The underlying etiology of MD is not completely clear, yet it has been associated with inner ear fluid (endolymph) volume increases, culminating in episodic ear symptoms (vertigo, fluctuating hearing loss, tinnitus, and aural fullness).

Failure to close the gap: Concomitant superior canal dehiscence in otosclerosis patients.

Objective: Superior semicircular canal dehiscence (SSCD) causing conductive hearing loss with present reflexes is a known reason for stapes surgery failure. However, concomitant SSCD and otosclerosis occur rarely. We present a case series of SSCD diagnosed in positively identified otosclerosis patients.

A Histopathologic Comparison of Eustachian Tube Anatomy in Pediatric and Adult Temporal Bones.

Hypothesis: In children, the distance between the carotid canal (CC) and Eustachian tube (ET) is not significantly narrower than the adult population.

Background: ET dysfunction treated with ET dilation is FDA approved for adults. Several studies describe the close relationship between the CC and the ET in adults, but the anatomy of the ET has not been well defined in children.

A Polymer-Based Extended Release System for Stable, Long-term Intracochlear Drug Delivery.

Objective: Investigate a new polymer-based drug coating suitability for safe intracochlear delivery and ability to maintain long-term physiologically active levels of the corticosteroid fluticasone propionate.

Study Design: In vitro dissolution study to evaluate release profiles of polymer-coated drug particles and in vivo studies using a guinea pig model to measure perilymph drug concentrations at specific time points after implantation with polymer-coated drug particles and evaluate their effect on hearing function.

Methods: Polymer-coated fluticasone propionate (FP) particles were surgically implanted in guinea pigs through the round window membrane into the cochlear scala tympani.

Treatment of Ciprofloxacin-resistant Ear Infections.

Objective: Ciprofloxacin resistance has been reported in 4.5% of patients with otorrhea and is increasing in prevalence. Due to ototoxicity, only fluoroquinolones are Food and Drug Administration approved for topical therapy in the middle ear.

Otolaryngology and the Global Burden of Disease.

The Global Burden of Disease (GBD) project provides longitudinal analysis of the global burden of otolaryngologic diseases by measuring the all-cause mortality, years of life lost, the years of life lived with disability, and disability-adjusted life years. Hearing loss burden is assessed overall and as sequelae of other diseases, such as otitis media or meningitis. Using these measures, we can appreciate the high prevalence and disability related to hearing loss globally.

Management of Chronic Suppurative Otitis Media and Otosclerosis in Developing Countries.

Chronic ear disease is a major cause of acquired hearing loss in the developing world. It is prevalent on every continent, but occurs more commonly in poorer nations owing to a lack of preventative measures. This article outlines the particular challenges in treating this disease in the developing world, including a discussion of surgical management and special situations.

Implementation of Image-Guided Cochlear Implant Programming at a Distant Site.

Our objective was to prospectively evaluate implementation of a new cochlear implant (CI) mapping technique, image-guided cochlear implant programming (IGCIP), at a site distant to the site of development. IGCIP consists of identifying the geometric relationship between CI electrodes and the modiolus and deactivating electrodes that interfere with neighboring electrodes. IGCIP maps for 17 ears of 15 adult CI patients were developed at a central image-processing center, Vanderbilt, and implemented at a distant tertiary care center, House Ear Institute.

Defining the Limits of Endoscopic Access to Internal Auditory Canal.

Objective: To quantify surgical access to the internal auditory canal (IAC) using an exclusively endoscopic transcanal approach (EETA) and investigate surgically relevant relationships with neurovascular and osseous landmarks of the temporal bone.

Materials And Methods: Anatomical dissection of two paired temporal bones and 15 unpaired temporal bones was performed using an exclusively endoscopic approach to IAC. The dissection proceeded until the cerebellopontine angle (CPA) could be accessed.