bluuebunny/crossref_metadata_2025_split huggingface dataset:
Laser Stapedotomy Using SMART Piston: 5‐Year Results
Authors: Khalil Sherif , Lavy Jeremy 
Published: February 2015

ObjectiveThe SMART piston is composed of a nitinol‐based hook and a Teflon‐based piston. Nitinol is a metal alloy of nickel and titanium that allows self‐crimping by heat activation. The aim of this study is to evaluate the long‐term (5 years) auditory results after the use of the SMART piston in primary laser stapedotomy.MethodThis is a retrospective review of prospectively collected data. The 5‐year postoperative follow‐up data for 32 patients is presented. Preoperative pure tone audiograms recording air and bone conduction thresholds at 0.5, 1, 2, 3, and 4 kHz were recorded. Postoperative pure tone audiograms at the same frequencies were recorded after 6 weeks, 6 months, 1, 2, 3, 4, and 5 years. Air‐bone gaps and pure tone averages at 0.5, 1, 2, and 3 kHz were calculated.ResultsThe 4‐frequency pure tone average of 0.5, 1, 2, and 3 kHz had a mean preoperative value of 58.4dB (SD ± 14.3dB) in air‐conduction thresholds. This has shown a drop in mean thresholds to 28.7 dB (SD ± 11.0 dB) in the 5‐year follow‐up. The air‐bone gap also decreased from 30.1 dB (SD ± 9.6 dB) to 1.5 dB (SD ± 3.8 dB), which was statistically significant (P =. 001). There was no significant change in the pure tone average bone conduction threshold when comparing the preoperative thresholds (28.3 dB, SD ± 12.5dB) and postoperative thresholds (23.9dB, SD ± 11.1 dB; P =. 551).ConclusionResults demonstrate that the SMART piston provides excellent long‐term auditory outcome. The ease of the self‐crimping and the tightness of the crimp provide the advantage of long‐term results.
Lateral External Auditory Canal to Mastoid Fistulas
Authors: Agan Ashley D. , Isaacson Brandon , Kutz Joe W. 
Published: February 2015

Objective1) Describe computed tomography (CT), tympanogram and examination findings seen in patients with lateral external auditory canal (EAC) to mastoid fistulas. 2) Discuss treatment of patients with lateral EAC to mastoid fistulas.MethodRetrospective chart review of patients diagnosed with lateral EAC to mastoid fistulas from January 2006 through January 2012. Data collected included computed tomography (CT) scans, audiograms, and examination and operative findings.ResultsSeventeen patients were identified. A total of 82% (n = 14) had CT scans, all of which demonstrated a fistula between the mastoid and EAC. Examination findings demonstrated 53% (n = 9) with an intact tympanic membrane, 29% (n = 5) with a perforation, and 18% (n = 3) that could not be assessed. In all, 82% (n = 14) had tympanograms, and of those, 86% (n = 12) had type B and 14% (n = 2) had type C. A total of 88% (n = 15) of patients had a history of surgery in the affected ear. Of those, 87% (n = 13) had history of canal wall‐up mastoidotympanoplasty. A total of 65% (n = 11) of patients required a canal wall‐down mastoidectomy.ConclusionExternal auditory canal to mastoid fistula is a potential complication of otologic surgery. This entity can sometimes be identified on examination, but CT is highly sensitive in confirming the diagnosis. Most patients require a canal wall down procedure but the canal wall can be reconstructed in select cases.
Long‐term Surgical Results of Semicircular Canal Fistulae
Authors: Katsura Hirokazu , Mishiro Yasuo , Adachi Osamu , Sakagami Masafumi 
Published: February 2015

ObjectiveAlthough many studies report short‐term hearing results after surgically managing semicircular canal fistulae, long‐term results are still unknown. In the present study, long‐term postoperative hearing outcomes were reviewed in 14 ears of patients with cholesteatoma and semicircular canal fistulae.MethodBetween 1996 and 2010, 84 patients with cholesteatoma and semicircular canal fistulae underwent tympanoplasty at Hyogo College of Medicine Hospital. The location of the fistula was the lateral semicircular canal in all cases and superior semicircular canal in 5 cases. Fourteen patients were followed up for more than 5 years.ResultsPostoperative air‐bone gap was ≤10 dB in 1 case, between 11 and 20 dB in 7 cases, between 21 and 30 dB in 4 cases, and ≥31 dB in 2 cases. Mean bone‐conduction hearing levels on the operated side had deteriorated by 3 dB in 1 kHz, by −1 dB in 2 kHz, and −2 dB in 4 kHz at 1 year postoperatively and by 8 dB, 6 dB, and 2 dB at 5 years postoperatively, respectively. Bone‐conduction hearing levels in 1 and 2 kHz were significantly deteriorated at 5 years postoperatively, compared with baseline and 1‐year (P <. 05).ConclusionEven if the semicircular canal fistula is surgically managed, bone‐conduction hearing level gradually deteriorates in the 1‐ and 2‐ kHz ranges over the long time.
Low‐Cost System for Auditory Brainstem Evoked Response
Authors: Ercolino Jose M. , Chiossone‐Kerdel Juan A. , Hernandez Jorge , Goncalves Stefania 
Published: February 2015

Objective1) Be able to design‐low‐cost ABR equipment. 2) Learn the possibility of mainstream technology applied for laboratory equipment use and be able to standardize the results with commercially available ABR equipment. 3) Apply this technology for research and neurophysiology laboratories.MethodAnimal experimentation study. This system comprises a differential amplifier, high‐pass and low‐pass filters, a main rejection notch filter, an analog to digital converter, and software programs for data acquisition and processing automation. Amplifier and filters were designed using low‐cost and readily available commercial components. Auditory stimuli were reproduced by a portable music player and a miniature rechargeable speaker. The stimuli comprising auditory clicks, tone pips and tone bursts, were generated numerically by the software and transferred digitally to the music player. 25 female and male Sprague‐Dawley rats were tested with amplitude and threshold protocols.ResultsResults demonstrate a linear correlation and morphology with ABR previously recorded by other teams. Amplitude in the response was little affected by the hardware but strongly modified by electrode position. A regression analysis demonstrated a coincidence r = 0.92 with the physiological measured threshold using RMS analysis. Ketamine affects the first 20 minutes of recordings by delaying latency in all waves, the effect fades away after that. Morphological changes were observed by blocking the ear canal in accordance with previous studies.ConclusionThe ABRs obtained compare favorably with other published results in similar conditions. Clear amplification with subdermal electrodes are seen consistently and very little EEG noise is obtain with the recordings, with no significant difference between individuals and results from other studies. The system will rapid determine auditory threshold with good accuracy. We are confident that this approach will make hardware more accessible for low budget research facilities.
Lumbar Puncture Opening Pressure in Spontaneous CSF Otorrhea
Authors: Allen Kyle P. , Isaacson Brandon , Kutz Joe W. , Gerecci Deniz , Roland Peter S. 
Published: February 2015

ObjectiveDetermine the incidence of increased intracranial pressure, measured by lumbar puncture opening pressure, in patients with spontaneous cerebrospinal fluid (CSF) otorrhea.MethodRetrospective case review at a tertiary care referral center. Patients included underwent repair of spontaneous CSF otorrhea between January 2007 and December 2011. These patients have subsequently undergone postoperative lumbar puncture with measurement of the opening pressure to determine the presence of increased intracranial pressure. The main outcome measure is the lumbar puncture opening pressure.ResultsNineteen ears in 17 patients underwent surgical repair for spontaneous CSF otorrhea via a transmastoid or middle fossa craniotomy. The average age at the time of repair was 58.9 years, 82.4% of patients were women, and 94.1% of patients were obese (BMI >30). The left ear was more commonly involved in 68.4% of cases. An encephalocele was observed in 63.2% of ears. Elevated opening pressure (greater than 20 cm/H2O) was noted in 41.2% of patients, and the median opening pressure was 19 cm/H2O. Of patients with elevated intracranial pressure, 55.6% were treated either medically or surgically to reduce ICP. Two patients underwent placement of ventriculoperitoneal shunts and 3 were treated with acetazolamide.ConclusionAs has been reported in the literature regarding spontaneous CSF rhinorrhea, elevated intracranial pressure is common in patients with spontaneous CSF otorrhea with 41.2% of patients affected in this series. These patients frequently require intervention in the postoperative setting to reduce ICP.
Management of Venous Pulsatile Tinnitus
Authors: Wang Yu‐cheng , Jin Lei 
Published: February 2015

ObjectiveTo discuss the therapeutic effect of ligation of the internal jugular vein and how to deal with pulsatile tinnitus of venous origin.MethodA retrospective study was conducted on 12 patients who were diagnosed with venous hum and treated with ligation of the jugular vein. They all had normal otoscopy findings.ResultsThese 12 patients were all women, ranging in age from 27 to 61 years. Seven patients got relief of tinnitus right after the surgery, among which 5 patient’s symptoms recurred within 2 years. The rest got no relief and 1 of them aggravated into intolerable roaring.ConclusionDiagnosis of venous hum should be made only after careful elimination of other disorders, such as BIH, ACAD, HJB, and other rare vascular anomalies. Ligation of IJV should be avoided even for the treatment of venous hum because of the poor effect and unpredictable complications.
Mastoid Obliteration with Autologous Costal Cartilage
Authors: Cho Yong Beom , Lee Chang Joon , Jo Si Young , Cho Sung Woo , Choi Jung Uk , Seo Kyung Sun , Jang Chul Ho 
Published: February 2015

ObjectiveAutologous cartilage such as conchal cartilage has been commonly used as an obliteration material of the mastoid, however sufficient amount could not be harvested. We evaluate the use of autologous costal cartilage for obliteration of mastoid cavity after canal wall down mastoidectomy.MethodRetrospective review of the patients who underwent mastoid obliteration with autologous costal cartilage after CWD was performed. Costal cartilage was harvested at 7th or 8th rib with middle ear surgery. Pre‐ and postoperative audiometry, neodrum findings, temporal bone CT and complications including wound infection and canal wall displacements were evaluated.ResultsA total of 39 patients (29 women, 10 men) with a mean age of 52.5 years underwent the procedure. The follow‐up period ranged from 9 months to 14 months (mean period, 11.4 months). For all cases in the study, complications such as postoperative wound infection, perforation, and canal wall destruction did not develop. Small skin dehiscence at the rib harvest site occurred in one case and healed up with reapproximation of the wound. All except 2 patients showed successful postoperative air‐bone gap within 20 dB. Mastoidectomized cavities of all cases were well obliterated in follow‐up temporal bone CT.ConclusionAdequate amount of cartilage could be harvested from the costal cartilage and mastoid obliteration could be successfully performed with normal‐shaped canal and hearing improvement. We propose the autologous costal cartilage for an obliteration material of the mastoid cavity after canal wall down procedure.
Modified Surgical Approach in Facial Palsy: It’s Worth a Try
Authors: Panda Naresh K. , Kaushal Darwin , Verma Roshan 
Published: February 2015

ObjectiveTo evaluate effectiveness of a modified technique of facial nerve decompression with respect to improvement in facial function and hearing preservation.MethodRetrospective analysis conducted between 2002 and 2005 of 15 cases of posttraumatic facial nerve paralysis. A modified posterior tympanotomy approach was used in these patients. There were 13 males and 2 females aged between 12 and 43 years (mean age, 23.6 years). All the cases were operated by the senior author. Only patients with immediate onset facial paralysis were included in the analysis. These patients had received a full course of corticosteroids as conservative treatment before the surgical exploration. Intervention: Transmastoid facial nerve decompression using the modified technique. Outcome measurement: The clinical, audiometric, and radiologic evaluation was done for all patients. Analysis: Recovery of facial function and hearing status.ResultsEleven out of 15 patients had recovery of facial function to House Brackmann I‐II. Two cases had HB III function. Two patients with bilateral paralysis had HB IV function. Only 1 case reported hearing deterioration. The rest of the patients maintained their preoperative hearing status.ConclusionThis technique provides insight into a favorable way of doing facial nerve decompression with an aim to considerably preserve the hearing.
MRI Safety of Otologic Implants in the United States
Authors: Azadarmaki Roya , Tubbs Rhonda , Chen Douglas , Hillman Todd 
Published: February 2015

ObjectiveTo review information on MRI safety for commonly used otologic implants including cochlear implants, middle ear implantable hearing devices, osseointegrated cochlear stimulators, and middle ear prosthetic devices.MethodA literature review of the National Library of Medicine’s online database was performed with focus on MRI safety of routinely used implanted hearing devices. Manufacturing companies were contacted for devices with no information on MRI safety in the literature.ResultsThe Baha system and Ponto Pro osseointegrated implants’ abutment and fixture, middle ear ossicular reconstruction prosthetic devices, and all stapes prosthetic devices except for the 1987 McGee prosthesis are safe to use in standard MRI fields. Cochlear implants with removable magnets such as the newer Cochlear Americas Implants and the HiResolution Bionic Ear System’s HiRes 90K can be used in standard MRI fields. MED‐EL cochlear implants can be used in low MRI magnetic fields up to 0.2T. All other cochlear implants, middle ear implantable hearing devices, and the Sophono device are not approved for MRI use.ConclusionMRI safety status of otologic implants depends on their magnetic potential. Knowledge of the MRI safety guidelines for the commonly used otologic implants is important. United States guidelines on MRI safety and compatibility are not always the same as in Europe and other parts of the world.
Neuroplastic Surgery of Facial Palsy
Authors: Cosgarea Marcel , Maniu Alma , Pop Sever , Chirila Magdalena , Necula Violeta 
Published: February 2015

ObjectiveThe facial nerve is the most susceptible to injury of all the cranial nerves because of its complex course through the temporal bone confined within a prolonged bony canal. Facial nerve palsy produces important changes in facial aspect with devastating social consequences for the patient.MethodA retrospective study of 10 years of material (2000‐2009) was done on 21 patients. After a thorough evaluation, surgical treatment was decided which comprised nerve decompression, or anastomosis between the end of intratympanic segment and the distal segment of facial nerve by interposing sural or auricularis magnus nerve graft.ResultsThe interposition of the graft in facial nerve was carried out in the mastoid, in 11 cases in the 72 hours after trauma, in 5 cases 3 months later and in 1 case twelve months later. Nerve decompression was performed in 4 cases. The nerve graft and the nervous ends were prepared beforehand by cutting a few millimeters of the epineural sheet. Then the graft was positioned in the bone canal, the ends were put together and the anastomosis was made with autologous fibrin adhesive.ConclusionSurgical therapy in peripheral traumatic facial palsy gives good functional results. Nerve decompression has statistically better results compared to anastomosis and nerve transplant. The choice of surgical technique and results directly depend on location and intensity of the lesion and the treatment time.
Effect of Gastroesophageal Reflux on Base of the Tongue
Authors: Habesoglu Tulay E. , Habesoglu Mehmet , Toros Sema Z. , Gursel Ali O. , Oysu Cagatay 
Published: February 2015

ObjectiveThere are studies about the hypertrophy of the base of the tongue due to gastroesophageal reflux (GER), but there have been no reports explaining the effects of GER on the base of the tongue histopathologically. Therefore, we investigated the histopathologic changes of tongue base using an experimental model of reflux.MethodThe randomized study was conducted at Haydarpasa Numune Hospital. Eighteen rats were divided into 3 groups according to exposure time, and 4 rats were examined as controls. An experimental model of gastroesophageal reflux was induced. The histopathological changes in the base of the tongue were observed under a light microscope.ResultsAt the end of the first week, only subepithelial edema was significantly different in the exposed group when compared to the control group. After 4 weeks in addition to subepithelial edema, submucosal gland hypertrophy was significantly different from the control group. When we assessed submucosal gland hypertrophy and subepithelial edema in the group exposed to refluxate for 12 weeks, they were found to be much increased compared with the 4‐week group. Also, inflamation, vascular dilatation, and achantosis were determined to be significantly increased compared with the control group.ConclusionThe current study suggests that GER results in histopathological changes in the base of the tongue. Therefore, it suggests a new perspective to the relationship between GER and throat clearing, dry cough, and especially globus pharyngeus.
Ouabain‐Induced Cochlear Degeneration in Rat
Authors: Fu Yong , Wei Yan 
Published: February 2015

ObjectiveTo elucidate the neurodegenerative effects of ouabain in vitro and in vivo in rat.MethodOuabain applied in organotypic cultures. Phalloidin and neurofilament antibody used to label hair cells and nerve tissue. In vivo, 1 mM or 10 mM ouabain applied to round window. ABR and DPOAE were recorded 7 days posttreatment. Cochlea sections were used to count SGN and nerve fibers. TUNEL staining were used to assess apoptosis.ResultsIn vitro, low concentrations of ouabain only damaged spiral ganglion neurons; however, high doses destroyed both spiral ganglion neurons and cochlear hair cells. Application of 1 mM ouabain to the rat round window membrane only altered ABR thresholds and DPOAE amplitudes at higher frequencies. In contrast, 10 mM ouabain significantly increased ABR thresholds and decreased DPOAE amplitudes at almost all frequencies. Consistent with physiological results, both spiral ganglion neurons and hair cells were missing or damaged in the basal turn of the cochlea and both hair cells and neurons showed signs of apoptotic cell death.ConclusionIn vitro and vivo, ouabain damage was dose and time‐dependent; SGN were more vulnerable than HCs. ABR thresholds increased at high frequencies with 1mM ouabain and increased at all frequencies with 10 mM ouabain.DPOAE amplitude minimally affected with 1 mM ouabain and got large reduction at all frequencies with 10 mM oubain.
Persistent Petrosquamosal Sinus in Chronic Otitis Media
Authors: Hiraumi Harukazu , Yamamoto Norio , Sakamoto Tatsunori , Ito Juichi 
Published: February 2015

ObjectiveThe petrosquamosal sinus (PSS) is an emissary vein that connects the transverse sinus and the external jugular vein. Recent studies have shown that a PSS can be identified on high resolution CT scan when it is contained within a bony canal. The persistent PSS is a potential risk of bleeding in middle ear surgery. The aim of this study is to determine the prevalence of the PSS in patients with chronic otitis media.MethodBetween February 2011 and January 2012, 61 ears (47 patients) underwent CT scan before surgery for chronic otitis media. Patients younger than 10 years, showing congenital temporal bone anomaly, and having received prior ear surgeries, were excluded. The prevalence of persistent PSS was evaluated using CT scan. During the same period, 66 ears (33 patients) with peripheral facial palsy underwent CT scan. The frequency of a PSS was also examined in these patients.ResultsAmong the 61 ears with chronic otitis media, a PSS was detected in 12 ears on CT scan (20.0%). Among them, the PSS was identified during surgery in 2 ears. The incidence was similar in the 2 ears (right ear: 6/32, left ear: 6/29). The PSS was more frequent in men than in women (men: 9/34, women: 3/27). In patients with facial palsy, a PSS was found in 7 of 66 ears.ConclusionThe persisted PSS was frequently detected in patients with chronic otitis media. Care should be taken to avoid damaging this vein during the mastoid surgery.
Platelet‐Rich Fibrin for the Repair of Tympanic Membrane
Authors: Habesoglu Mehmet , Oysu Cagatay , Sahin Serap , Sahin‐Yilmaz Asli , Korkmaz Deniz , Tosun Ahmet 
Published: February 2015

ObjectiveTo investigate the effect of the Choukroun’s platelet‐rich fibrin (PRF) on the acute tympanic membrane perforations due to trauma without application of any classic tympanoplasty procedure.MethodThis prospective controlled study was conducted at Umraniye Hospital, between April and December 2011. Thirty‐two subjects with acute tympanic membrane perforations due to trauma were divided randomly into 2 groups (study: 14, control: 18). In the study group, PRF was used to repair tympanic membrane perforations. In the control group, no manipulation was performed.ResultsMean area of perforation was 10.93 ± 3.58 mm2 in the study group and 10.05 ± 4.02 mm2 in the control group in the first examination. At the end of the first month the mean area of the perforation was 1.35 ± 2.53 mm2 in the study group and 4.44 ± 3.34 mm2 in the control group (P <. 01). Total closure rate of the tympanic rates was 64.3% for the study group and 22.2% for the control group (P <. 05) at the end of the first month. At the end of the second month, number of patients with a perforation was 1 for the study group, 4 for the control group (P >. 05).ConclusionPRF application in otologic interventions is a new subject and little information is currently available about its use in otology. Our study has shown that PRF is an autogenous, useful and easy to prepare biomaterial which accelerates the healing of the tympanic membrane.
Postauricular Cutaneous Mastoid Fistula Repair
Authors: Vira Darshni , Andrews James C. 
Published: February 2015

Objective1) To review traditional techniques for the closure of postauricular cutaneous mastoid fistulas. 2). To describe a novel double layer closure technique in the management of postauricular cutaneous mastoid fistulas.MethodRetrospective review of patients diagnosed with postauricular cutaneous mastoid fistulas in an academic medical center over a 10‐year period.ResultsFour patients identified from January 2000 to August 2010 were treated for postauricular cutaneous mastoid fistulas. Follow‐up varied from 8 to 48 months. The etiologies of development of postauricular fistulas were all post‐mastoidectomies. All patients were treated using a similar surgical technique involving double layer closure of the fistula tract utilizing 2 rotational flaps of 1) temporalis muscle and fascia and 2) conchal cartilage. All patients had successful fistula closure with lasting results.ConclusionCutaneous mastoid fistulas are often the result of repeated postauricular approaches for surgical treatment of mastoid infections, and can be difficult to surgically manage. These postauricular fistulas can be managed with long‐term success using a novel double layer closure technique using temporalis muscle and fascia and conchal cartilage with skin.