Peri-implant bony overgrowth as a cause of revision surgery in auditory osseointegrated implantation.

Implantation of auditory osseointegrated implants, also known as bone-anchored hearing systems (BAHS), represents a surgical option for select pediatric patients aged 5 years or older with hearing loss. Functional indications in this patient population include conductive or mixed hearing loss. Common complications of implantation include skin infections, chronic skin irritation, hypertrophic skin overgrowth, and loose abutments.

Highly Flexible Silicone Coated Neural Array for Intracochlear Electrical Stimulation.

We present an effective method for tailoring the flexibility of a commercial thin-film polymer electrode array for intracochlear electrical stimulation. Using a pneumatically driven dispensing system, an average 232 ± 64 μm (mean ± SD) thickness layer of silicone adhesive coating was applied to stiffen the underside of polyimide multisite arrays. Additional silicone was applied to the tip to protect neural tissue during insertion and along the array to improve surgical handling.

Cost effectiveness of cochlear implants.

Purpose Of Review: Health professionals would be well served to have as good an understanding of cost effectiveness as clinical effectiveness, as both are critical to their patients having access to better health care and achieving better health outcomes. Cost-effectiveness evaluations allow decision makers a means of comparing different interventions when deciding resource allocation. It is a powerful tool, but like any analysis, not understanding the processes and assumptions involved leads to misinterpretation.

Vibrant soundbridge in aural atresia: does severity matter?

Congenital aural atresia (CAA) poses significant challenges to surgical remediation. Both bone anchored hearing aids (BAHA) and the Vibrant Soundbridge (VSB) have been considered as alternatives or adjuncts to conventional atresiaplasty. A consensus statement on VSB implantation in children and adolescents recommended against implantation when the Jahrsdoerfer score was less than 8.

Subcutaneous emphysema and pneumolabyrinth plus pneumocephalus as complications of middle ear implant and cochlear implant surgery.

We conducted a retrospective case review at a tertiary academic medical center for the complications of pneumolabyrinth with pneumocephalus and subcutaneous emphysema after surgery for middle ear and cochlear implants. Charts of 76 cochlear implant and 2 middle ear implant patients from January 2001 through June 2009 were reviewed. We identified 1 cochlear implant recipient with pneumolabyrinth and pneumocephalus, and 1 middle ear implant recipient with subcutaneous emphysema.

Hearing results and quality of life after streptomycin/dexamethasone perfusion for Meniere's disease.

Objectives/hypothesis: To evaluate the hearing changes and quality-of-life outcomes of 393 cases of streptomycin/dexamethasone inner ear perfusion performed by the primary author on 312 ears of 299 patients with Meniere's disease between July 2002 and May 2010.

Study Design: Retrospective chart review.

Methods: Objective arm: A database was used to compile pretreatment and post-treatment audiograms as well as basic demographic information, dates of treatment, number of treatments, and which ear was treated.

Optimizing treatment of nasal fractures.

Objectives/hypothesis: A graduated protocol involving closed reduction, septoplasty, osteotomies, upper lateral cartilage release, anterior perpendicular plate fracture, and camouflaging cartilage grafts yields a higher percentage of straight noses in cases of acute fracture than treatment with closed reduction alone.

Study Design: Retrospective chart and literature review followed by a prospective, non-randomized sequential trial.

Methods: Closed reduction was performed on 26 cases of acute nasal fracture and the results were compared with a subsequent series of 79 cases treated using a more complete protocol.

Transtympanic electrocochleography: a 10-year experience.

Objective: To report the authors' experience with transtympanic electrocochleography during the past 10 years.

Study Design: Retrospective case review.

Setting: Otology/neurotology referral center.

Speech recognition in background noise of cochlear implant patients.

Objectives: The performances of adult patients using Spectral peak (Nucleus 22 or Nucleus 24 patients) or Continuous Interleaved Sampling or Advanced Combination Encoder (Clarion patients) were evaluated in their ability to perform in quiet and in 2 levels of background noise.

Patients And Methods: Ninety-six patients were tested with the City University of New York Sentences presented at 70 dB in quiet and at signal-to-noise ratios (SNR) of +10 and +5 dB. Patients were scored on the number of words perceived correctly.

Delayed facial palsy after stapedectomy.

Objective: To study the incidence, pathogenesis, and prevention of delayed facial palsy after stapedectomy.

Study Design: Retrospective case review.

Setting: Otology/neurotology referral center.

Distortion-product otoacoustic emissions and cochlear microphonics: relationships in patients with and without endolymphatic hydrops.

Objectives: Because endolymphatic hydrops causes cochlear malfunction, and both otoacoustic emissions and cochlear microphonics measure specific cochlear activities, some insight into the pathology of Meniere's disease might be gained by using these two test modalities. Specifically, the involvement of cochlear outer hair cells in patients with endolymphatic hydrops may be detected. Furthermore, it is hoped that these two tests might help determine which regions of the cochlea are affected by endolymphatic hydrops, as well as where along the auditory pathway abnormalities are present.

External aperture of the vestibular aqueduct in Meniere's disease.

Objective: To study the relationship of the length of the external aperture of the vestibular aqueduct and the ratio of the summating potential and action potential (SP:AP) in patients with Meniere's disease.

Study Design: Retrospective case study.

Setting: Neurotology referral center.

Age as a factor in the success of tympanoplasty: a comparison of outcomes in the young and old.

In order to determine if age is a factor in healing after tympanic membrane grafting, the author compared the results of 163 consecutive type I tympanoplasties performed on patients aged 20 to 40 with those of 97 consecutive type I tympanoplasties performed on patients aged 65 and older. The tympanoplasties were performed over a 5-year period. The postoperative followup period ranged from 6 to 10 years.