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The cochlear-carotid interval: anatomic variation and potential clinical implications.

BACKGROUND AND PURPOSE: A temporal bone CT study in a patient with episodic mid-tone sensorineural hearing loss and tinnitus demonstrated absence of bone between the petrous internal carotid artery and the basal turn of the cochlea. The potential implications with respect to increasingly popular cochlear implant surgery compelled us to retrospectively analyze a series of temporal bone CT scans to establish typical measurements for this region, which we termed the "cochlear-carotid interval" (CCI). METHODS: After IRB exemption, 2 observers independently measured the bony interval between the c

Tympano-ossiculoplasty utilizing the Spiggle and Theis titanium total ossicular replacement prosthesis.

OBJECTIVE: Since 1993, titanium prostheses have been used in Europe as a biocompatible implant for ossicular reconstruction. More recently, the titanium ossicular prosthesis has become more widely available in the United States as a newer means of surgical restoration of hearing. We will review the hearing results of patients who have undergone tympano-ossiculoplasty using a titanium total ossicular replacement prosthesis (TOP). We will compare these results to our previously published results using the porous polyethylene TOP. METHODS: Retrospective review in a tertiary otologic practice. R

Computed tomographic study of bone availability for facial prosthesis-bearing endosteal implants.

In a computed tomographic study, 56 patients with facial defects were examined to assess the availability of bone for extraoral Brånemark implants (3 or 4 mm long, 3.75 mm diameter) to bear facial prostheses. Bone depths were determined in the auriculotemporal (2-8 mm), infraorbital (0-10 mm), lateroorbital (8-14 mm), supraorbital (1-14 mm) and medioorbital (1-6 mm) areas as well as at the base of the nasal skeleton (1-5 mm). The low values for the supraorbital and infraorbital areas were determined at the points closest to the frontal- and maxillary sinuses, respectively. Implantation in thes

A novel technique for NGT fixation: Secure, simple, and safe.

UNLABELLED: Nasogastric tubes are often vitally important in post-operative management. Usually required for short term use, they are easily … d without the need to suture. METHOD: Steps of tube Fixation: 1. Distance between xiphisternum and mastoid process is measured and marked [Position A, Fig. 1]. This mark will correspond to the portion of the tube in the pharynx once the NGT is inserted. 2. A silk suture is tied to the NGT at the point marking the pharynx [Position A]. The two loose ends …

The Optimal Length of Insertion for Central Venous Catheters Via the Right Internal Jugular Vein in Pediatric Cardiac Surgical Patients.

OBJECTIVES: The primary objective was to identify the best among 4 techniques that could predict the length of central venous catheter inser … affected by the skin puncture site. Assuming that a skin puncture at the midpoint between the right mastoid process and clavicular insertion of sternocleidomastoid muscle insertion is ensured, a new formula based on height has been proposed.

[Different states of otitis media were retrospectively analyzed of myringoplasty].

Objective:Through analysis of the tympanic membrane perforation rate and hearing improvement rate with chronic suppurative otitis media (CSO … tion or good group; according to the preoperative temporal bone HRCT suggested that the middle ear (mastoid cells,tympanic antrum and tympanic cavity) with or without soft tissue density,divided into the group with no focal lesion and the group with focal lesion. Review endoscopy and pure tone audiometry after 3 to 6 months. Using SPSS 19.0 statistical so …

Extracranial cored method of human en bloc temporal bone harvest.

PURPOSE: Surgical skills requires a combination of anatomical knowledge and manual skills. Human cadaveric temporal bones remain essential f … ory canal. Anatomical integrity, defined as the presence of all temporal bone components (squamous, mastoid, tympanic, styloid, petrous components), external auditory meatus, middle ear, vestibule, was evaluated by two independent otologists. Sixteen temporal bone specimens were obtained and used in a 1 day otologic dissection course involving 16 particip …

Spontaneous remission in diffuse large cell lymphoma: a case report.

BackgroundSpontaneous remission in solid malignancies has been documented. However, spontaneous remission in aggressive diffuse large b cell lymphoma is exceedingly rare. Previous reports of lymphoma remission suggest that not yet fully characterized tumor-intrinsic and microenvironment mechanisms cooperate with spontaneous regression.Case descriptionHere, we report the case of an 88-year-old white woman with diffuse large b cell lymphoma (follicular lymphoma transformed) who achieved morphologic spontaneous remission 3 months after her diagnostic core biopsy. We examined 16 similar cases of d

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… NA NA 105 CR None 21 Remission Case 2 72/F Leg 3 cm I – + NA + ABC f EBV- h (intra-tumor CD3, CD4 and CD8 + cells observed) NA r PR j None 21 Remission 4 3 66/F Tongue 2 × 1 cm I – + – + ABC EBV − 180 CR k None 84 Remission 5 4 71/F Breast 2.6 cm I – + + + ABC EBV − 30 CR None 18 Remission 6 5 2/M Mastoid … McCabe MG Hook CE Burke GA Spontaneous regression of an EBV-associated monoclonal large B cell proliferation in the mastoid of a young child following surgical biopsy Pediatr Blood Cancer 2008 51 4 557 559 10.1002/pbc.21637 18523988 8. …

Extraoral implants in the rehabilitation of craniofacial defects: implant and prosthesis survival rates and peri-implant soft tissue evaluation.

PURPOSE: Few reports have evaluated cumulative survival rates of extraoral rehabilitation and peri-implant soft tissue reaction at long-term follow-up. The objective of this study was to evaluate implant and prosthesis survival rates and the soft tissue reactions around the extraoral implants used to support craniofacial prostheses. MATERIALS AND METHODS: A retrospective study was performed of patients who received implants for craniofacial rehabilitation from 2003 to 2010. Two outcome variables were considered: implant and prosthetic success. The following predictor variables were recorded:

The role of obesity in spontaneous temporal bone encephaloceles and CSF leak.

OBJECTIVE: Temporal bone encephaloceles and cerebrospinal fluid (CSF) otorrhea can lead to life-threatening sequelae such as meningitis and cerebritis. Obesity has been associated with spontaneous CSF leaks. We wished to determine if there were differences in the body mass index (BMI) of patients with spontaneous temporal bone encephaloceles/CSF leaks and nonspontaneous temporal bone encephaloceles/CSF leaks to help determine if obesity may be associated with their development. STUDY DESIGN: Single institution retrospective comparison. METHODS: Demographic and clinical information was obtain

Localized nasopharyngeal amyloidosis: A case report.

Amyloidosis is a rare condition on its own but finding localized amyloidosis of a site such as the nasopharynx is an extremely rare condition with very few cases described in the literature. The condition occurs due to the accumulation of misfolded proteins in the extracellular space disrupting the cell architecture and causing eventual dysfunction. In this case report we discuss the pathophysiology, symptoms, and imaging findings of a patient initially thought to have giant cell arteritis, but who was found on CT to have a mass later determined to be localized nasopharyngeal amyloidosis. Eval

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… Repeat CT reveals opacification of the right mastoid air cells, consistent with previous scans, with partial opacification on the left mastoid air cells and an enhancing soft tissue mass with calcifications in the nasopharynx measuring 5 × 2.9 cm ( Fig. 2 ) and left lower cervical lymphadenopathy, 0.96 … It was believed that the mass may be the cause of the opacification of the mastoid due to the mass effect on the eustachian tube. …

Skull base osteomyelitis: current microbiology and management.

INTRODUCTION: Skull base osteomyelitis typically presents in an immunocompromised patient with severe otalgia and otorrhoea. Pseudomonas aeruginosa is the commonest pathogenic micro-organism, and reports of resistance to fluoroquinolones are now emerging, complicating management. We reviewed our experience of this condition, and of the local pathogenic organisms. METHODS: A retrospective review from 2004 to 2011 was performed. Patients were identified by their admission diagnostic code, and computerised records examined. RESULTS: Twenty patients were identified. A facial palsy was present in

Surgical treatment of the high jugular bulb in patients with Ménière's disease and pulsatile tinnitus.

The aim of this retrospective study was to evaluate the functional results of surgical lowering of the high jugular bulb in the treatment of patients with Ménière's disease and pulsatile tinnitus. Fifteen patients with disabling Ménière's disease associated with pulsatile tinnitus and a high and medial jugular bulb were included in this study. As treatment a complete mastoidectomy was performed, after which the jugular bulb was freed by an infralabyrinthine and subfacial approach. The bulb was then displaced downwards with surgical wax. Functional results of surgery were assessed by a question…

A scoping review of ear and hearing health research in Aotearoa New Zealand: a focus on equity.

A recommendation from a series of Aotearoa New Zealand (NZ) ear and hearing health hui was to summarise literature in ear, hearing, and vest … s a stage of ear disease in which there is chronic inflammation and infection of the middle ear and mastoid cavity; deaf: With a small 'd', deaf refers to hearing loss - e.g. 'he is deaf'; Deaf: The word Deaf (spelt with a capital 'D') denotes a unique community. The use of sign language as one's first language is the principle characteristic of people wh …

Hearing results following endoscopic type I tympanoplasty in medium and large perforations.

OBJECTIVES: To clarify the hearing outcomes after endoscopic type I tympanoplasty for medium and large perforations due to chronic otitis me … ollow-up data, middle ear cholesteatoma, stapes fixation, severe lesions in the tympanic antrum and mastoid necessitating mastoidectomy and/or ossicular chain reconstruction were excluded. RESULTS: A total of 156 patients underwent analysis for audiological outcomes. Among them, 63 had medium tympanic membrane perforations, with 18 cases showing calcific …

Microvascular decompression of cranial nerves: lessons learned after 4400 operations.

OBJECT: Microvascular decompression has become an accepted surgical technique for the treatment of trigeminal neuralgia, hemifacial spasm, glossopharyngeal neuralgia, and other cranial nerve rhizopathies. The senior author (P.J.J.) began performing this procedure in 1969 and has performed more than 4400 operations. The purpose of this article is to review some of the nuances of the technical aspects of this procedure. METHODS: A review of 4415 operations shows that numerous modifications to the technique of microvascular decompression have occurred during the last 29 years. Of the 2420 operat

HIV infection in children--impact upon ENT doctors.

The global epidemic of HIV infection remains appalling. By 2001, there were an estimated 1.4 million HIV-infected children, with 4.5 million … mately 9 years. Children may also present with repeated/unusual ear infections, sinus disease (inc. mastoiditis), tonsillitis, orbital/peri-orbital cellulitis, oral candidiasis, and dental infections. Infections with streptococcus pneumoniae and group A streptococcus are common, and often progress to severe systemic infection with an appreciable mortality …

Three-year multicenter surveillance of pneumococcal meningitis in children: clinical characteristics, and outcome related to penicillin susceptibility and dexamethasone use.

OBJECTIVES: To evaluate the antibiotic susceptibility of Streptococcus pneumoniae isolates obtained from the blood and cerebrospinal fluid o … re because of a documented failure of treatment caused by a resistant strain. Only 1 child, who had mastoiditis and a lymphangioma, experienced a bacteriologic failure with a penicillin-resistant (minimum inhibitory concentration = 2 microgram/mL) organism. Of the 166 surviving children, 41 (25%) developed neurologic sequelae (motor deficits) and 48 (32%) …

Endolymphatic sac tumor with overexpression of V2 receptor mRNA and inner ear hydrops.

CONCLUSION: We reported previously that hyperactivation of vasopressin type-2 receptor (V2R)-mediated signaling in the endolymphatic sac cou … f the endolymphatic sac. METHODS: ELSTs in two rare cases were removed completely through the transmastoidal approach. V2R mRNA expression was examined using real-time PCR. RESULTS: The first case was diagnosed as inflammatory granulation adjacent to the endolymphatic sac, i.e. pseudo-ELST, and the second case was diagnosed as papillary adenoma of ELST. …