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.

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.

Translabyrinthine approach for acoustic tumor removal. 1992.

The translabyrinthine approach is the most direct route to the cerebellopontine angle. It is the preferred approach for removal of all tumors in patients with poor hearing and for large tumors when the likelihood of hearing preservation is slight. This approach offers the advantages of minimum cerebellar retraction, identification of the facial nerve proximally and medially, and the ability to repair immediately the facial nerve if it is severed during acoustic tumor removal.

Osteosarcoma of the Skull Base after Radiation Therapy in a Patient with McCune-Albright Syndrome: Case Report.

Sarcomas of the skull base occurring in the field of prior radiotherapy are rare; only a few have been reported in the English literature. We report a fatal osteosarcoma of the skull base arising in a patient with McCune-Albright syndrome and severe fibrous dysplasia of the skull base 22 years after radiation therapy for a pituitary adenoma. This malignancy fulfills Cahan's criteria for a radiation-induced tumor in that it arose in the radiation field of a pituitary adenoma with a latency of 22 years.

Hearing outcome after concurrent endolymphatic shunt and vestibular nerve section.

Objective: To determine if endolymphatic shunt surgery concurrent with vestibular nerve section improves hearing outcome compared with vestibular nerve section alone.

Study Design: Retrospective observational study with cross-sectional survey.

Setting: Tertiary otologic private practice.

Daily home tympanometry to study the pathogenesis of otitis media.

A study was conducted to define the temporal relationship between a parent-identified cold episode and the diagnosis of otitis media. Forty children were studied in their homes with the use of daily tympanometry, symptom diaries and weekly otoscopy. A total of 136 patients identified colds, and 43 episodes of otitis media were recorded.

Surgical management of petrous apex cholesterol granulomas.

Objectives: To review surgical approaches for drainage of petrous apex cholesterol granulomas, define the criteria for the selection of each approach, and identify factors affecting surgical outcome.

Study Design: Retrospective chart review and follow-up survey questionnaire.

Setting: Tertiary neurotologic referral center.

Diving after stapedectomy: clinical experience and recommendations.

Objectives: Much controversy exists concerning the risk of inner ear barotrauma after stapes surgery in scuba and sky divers. Uniform consensus has not been established regarding poststapedectomy barorestrictions. The purpose of this study was (1) to determine the prevalence of adverse auditory and/or vestibular sequelae in patients after stapedectomy related to scuba and sky diving, and (2) to offer recommendations on barometric exposure after stapes surgery.

The role of allergy in Meniere's disease.

There is considerable clinical and immunologic evidence for a probable role of allergy in the production of the symptoms of Meniere's disease. The endolymphatic sac is the seat of immune reactivity in the inner ear. Inhalant and food allergies have been linked with symptoms of Meniere's disease, and many of the clinical characteristics of Meniere's disease suggest an underlying autoimmune etiology.

Management of hydrocephalus resulting from acoustic neuromas.

Patients with large acoustic neuromas may have secondary obstructive hydrocephalus and occasionally significant neurologic deficit develops. At the House Ear Clinic, we have managed patients with hydrocephalus by translabyrinthine tumor removal without preoperative ventriculoperitoneal shunting. Forty-three patients with documented hydrocephalus who underwent acoustic neuroma removal have been reviewed.

Translabyrinthine approach for acoustic tumor removal.

The translabyrinthine approach is the most direct route to the cerebellopontine angle. It is the preferred approach for removal of all tumors in patients with poor hearing and for large tumors when the likelihood of hearing preservation is slight. This approach offers the advantages of minimum cerebellar retraction, identification of the facial nerve proximally and medially, and the ability to repair immediately the facial nerve if it is severed during acoustic tumor removal.