MRI evaluation of neurofibromatosis 2 patients: a standardized approach for accuracy in interpretation.

Objective: To determine the level of agreement between local radiologists' and an experienced neuroradiologist's measurements of vestibular schwannomas.

Study Design: Prospective study with uniform magnetic resonance acquisition protocol parameters and reporting instructions across 30 magnetic resonance imaging facilities worldwide.

Setting: Multicenter natural history study of neurofibromatosis Type 2.

Magnetic resonance imaging scanner reliability for measuring changes in vestibular schwannoma size.

Objective: To determine the intracranial tumor measurement reliability of three different magnetic resonance imaging machines.

Study Design: Neurofibromatosis Type 2 patients were imaged at three different facilities, two studies per facility, for a total of six studies per patient. Seven subjects were imaged.

Petrous anatomy for middle fossa approach.

Objective: The objective was to describe the relationship of anatomical landmarks required for the middle fossa approach to lesions of the petrous apex and internal auditory canal (IAC). Landmarks for safe identification of the IAC are defined, as are two zones (safe zones I and II) anterior and posterior to the IAC.

Study Design: Temporal bone anatomical study.

Hearing preservation in patients with vestibular schwannomas with sudden sensorineural hearing loss.

Objective: We evaluated hearing outcomes in patients with sudden hearing loss and vestibular schwannoma who underwent a hearing preservation operation for tumor resection in an effort to determine whether a history of sudden sensorineural hearing loss has an impact on subsequent hearing preservation surgery.

Methods: Retrospective chart review of 45 patients operated between 1990 and 1998. Patients were divided into "Recovery" (n = 22) and "No Recovery" (n = 23) groups based on preoperative hearing recovery.

Perioperative morbidity of acoustic neuroma surgery.

Objective: To review complications that occur during the course of acoustic neuroma surgery.

Study Design: Database and retrospective case review.

Setting: Tertiary referral center, private neurotologic practice.

Extrusion rates and hearing results in ossicular reconstruction.

Objectives: To examine hearing results, extrusion rates, and factors likely to affect outcome in patients who underwent ossicular chain reconstruction with Plasti-Pore and hydroxylapatite total ossicular replacement prostheses (TORPs) and partial ossicular replacement prosthesis (PORPs).

Study Design And Setting: Retrospective chart review was used. Subjects were 1210 consecutive tympanoplasties with or without mastoidectomy that involved ossicular reconstruction with TORPs (n = 560) or PORPs (n = 650) performed in a tertiary referral neurotologic private practice.

Early proactive management of vestibular schwannomas in neurofibromatosis type 2.

Objective: The treatment of patients with neurofibromatosis Type 2 has always been challenging for neurosurgeons and neurotologists. Guidelines for appropriate management of this devastating disease are controversial.

Methods: A retrospective study of 28 patients with neurofibromatosis Type 2 who underwent 40 middle fossa craniotomies for excision of their acoustic tumors is reported.

Revision stapedectomy.

Objective: To evaluate results of revision stapedectomy with and without use of the laser and determine factors predictive of hearing outcome.

Study Design And Setting: Retrospective review of 356 revision stapedectomy operations performed at the House Ear Clinic, a tertiary neurotologic private practice, between 1983 and 1995.

Results: A postoperative gap of < or =10 dB was obtained in 60% of cases.

Allergy and health-related quality of life.

Objective: We asked patients with allergies to complete the SF-36 Health Survey, a health-related quality-of-life (QOL) measure, to determine the impact of allergy on QOL.

Study Design And Setting: In total, 377 adults-140 men (37%) and 237 women (63%)-seen in a tertiary care private neurotologic practice allergy clinic completed the questionnaire before beginning immunotherapy and dietary management. One hundred patients completed both initial and 1-year follow-up questionnaires.

Magnetic resonance imaging of stapes prostheses.

Objective: To assess the magnetic resonance imaging (MRI) compatibility of stapes prostheses.

Data Sources: A comprehensive review of the English literature evaluating MRI compatibility of stapes prostheses. Multiple series of stapes prostheses from different manufactures placed in a 1.

Prevalence of allergy in Meniere's disease.

Objectives: The goal of this study was to determine the prevalence of allergy in a population of patients with Meniere's disease.

Methods: A survey was mailed to all patients with Meniere's disease seen at our institution from 1994 to July 1998 (n = 1490). As a control group, 172 patients with otologic problems other than Meniere's disease completed the same survey.

Prognostic factors for hearing preservation in vestibular schwannoma surgery.

Objective: To determine whether prognostic indicators for hearing preservation could be identified in patients with vestibular schwannoma undergoing middle fossa craniotomy resection.

Study Design: Prospective case review.

Setting: Private practice tertiary referral center.

Allergic management of Meniere's disease: an outcome study.

The effect of allergy immunotherapy and elimination of suspected food allergens was evaluated in patients with Meniere's disease. A total of 137 patients with Meniere's disease for whom allergy treatment had been recommended were identified and were mailed and returned a symptoms questionnaire. One hundred thirteen had received allergy treatment; 24 did not have treatment and served as a control group.

The surgical management of Bell's palsy: a review.

Facial nerve paralysis is a devastating problem for those affected. Few areas in otolaryngology have been as controversial as the management of Bell's palsy. The past several decades have witnessed many theories about the etiology and pathogenesis of Bell's palsy.

Maternally inherited nonsyndromic hearing loss.

In this study we characterized clinically and evaluated molecularly a large family with maternally inherited hearing impairment. Relatives were evaluated audiologically and clinically, the most likely pattern of inheritance was deduced, and molecular DNA analysis for the known mitochondrial mutations associated with hearing impairment was performed. Clinical examination of several relatives showed a normal general state of health, but in 14 of the members tested variable degrees of sensorineural hearing loss were noted.

Petrous apex lesions.

Objective: The accurate diagnosis of different petrous apex lesions is increasingly common as a result of modern imaging techniques, combining computed tomography and magnetic resonance imaging. The clinical features, diagnostic evaluation, imaging, and treatment outcomes of patients with petrous apex lesions are reviewed.

Study Design: Retrospective case review.

Sudden bilateral sensorineural hearing loss.

Most cases of sudden sensorineural hearing loss (SHL) remain idiopathic, and the majority are unilateral. From 1989 to 1993, 823 patients with sudden SHL were evaluated. Of these, 14 (1.

Skull base osteomyelitis. Malignant external otitis.

Aggressive medical therapy is warranted to prevent morbidity and mortality that has long been associated with skull base osteomyelitis. Outcomes are now improved because of a better understanding of the pathophysiology of the disease process, improved diagnostic tests, and more effective antipseudomonal therapy.

Allergic and immunologic aspects of Meniere's disease.

Meniere's disease, although idiopathic by definition, has been ascribed to a variety of causes, which more recently include autoimmune factors. Interest in the role of allergy in Meniere's disease has also increased. Studies from this institution and elsewhere provide evidence that allergy and immunologic factors play a role in Meniere's disease in at least some patients.

Magnetic resonance angiography: analysis of vascular lesions of the temporal bone and skull base.

Contrast-enhanced, high resolution, computed tomography (CT), along with gadolinium-enhanced magnetic resonance imaging (MRI), provide the skull-base surgeon with essential information for diagnosis and surgical planning. Evaluation of skull-base vasculature has traditionally been performed with angiography. Four-vessel angiography is an invasive procedure that subjects the patient to the potential risks of vascular injury, stroke, renal damage, anaphylaxis, and radiation.

Binaural cochlear implants.

With the success of monaural cochlear implantation, patients frequently ask about having a second implant. We have performed binaural cochlear implants in 12 adult patients. Desire not to disrupt a functioning implant was the primary consideration in implanting the contralateral ear.