bluuebunny/crossref_metadata_2025_split huggingface dataset:
Posterior Tympanotomy/Endomeatal Combined Approach in Cochlear Implantation
Authors: Cantore Italo , Volpe Antonio Della , Valente Paola , Santandrea Michela , Santandrea Valentina , Cantore Rocco 
Published: February 2015

ObjectiveAn alternative posterior tympanotomy/endomeatal combined approach for cochlear implantation is presented. Surgical steps and our results in 64 patients, 32 submitted to combined posterior tympanotomy/endomeatal approach and 32 underwent to traditional surgery, are reported.MethodSixty‐four patients, 34 men and 30 women, mean age 28 years (range, 1‐81 years), 26 preverbal and 38 postverbal, were submitted to cochlear implantation, 32 by means of a combined posterior tympanotomy/endomeatal approach and 32 with traditional posterior tympanotomy alone approach.ResultsWe reported good anatomic and functional results with intraoperative improvements in visibility and accessibility of cochleostomy site in difficult cases. At 12 months we did not observe any complication such as tympanic membrane perforation, external canal skin lesions, or extrusion. No significant differences were found with traditional technique complication rates excepting for partial insertion data, with statistically significant better results with combined access.ConclusionThe combined posterior tympanotomy/endomeatal approach facilitates the array insertion in conditions of bad exposition/accessibility of promontory and round window. Moreover, this double way access hinders an incomplete or incorrect positioning. It should be always considered as an alternative to the traditional posterior tympanotomy 1‐way access.
Preoperative Hearing Estimation Using a BAHA Testband
Authors: Kim Do Yoon , Park Hong Ju , Ahn Joong Ho , Chung Jong Woo , Yoon Tae Hyun 
Published: February 2015

ObjectiveIt is desirable for patients to have realistic expectations before surgery with preoperative use of a BAHA test‐band. We aimed to investigate how much gain patients can obtain with preoperative use of a BAHA test‐band with full‐on gain and compared the results with those of BAHA users with the volume control at the comfortable level.MethodNineteen patients with single‐sided deafness were included. Sound‐field threshold and speech understanding were measured with naked ears under sound field (condition 1), with an ear‐plug on the intact ear (condition 2), and with an ear‐plug on the intact ear and a BAHA testband on the lesioned ear (condition 3).ResultsThe speech reception thresholds (SRTs) at condition 2 were higher than those at condition 1 by 26 dB, which means that the sound attenuation by an ear‐plug was 26 dB. Although SRTs (17 ± 7 dB HL) at condition 3 were similar to those (19 ± 9 dB HL) at condition 1, tonal thresholds at condition 3 were better at 1 and 2 kHz and poorer at 250 Hz compared to those at condition 1. Those hearing gains with a BAHA testband with full‐on gain are similar to those of BAHA users with the volume level at the comfortable level.ConclusionOur findings suggest that the hearing gain by a BAHA testband with full‐on gain is similar to the postoperative gains of BAHA users with the volume control at the comfortable level. BAHA candidates can experience a postoperative audiologic gain by preoperative use of a BAHA test‐band with full‐on gain.
A Report of Microtia and Ipsilateral Scalp Hemangioma
Authors: Thakkar Punam G. , Butts Sydney C. , Lester Jenna 
Published: February 2015

Objective1) Describe the case of a patient with microtia who developed an infantile hemangioma of the ipsilateral occipital scalp. 2) Investigate possible embryological links between these 2 lesions found together in a common developmental field. 3) Discuss the surgical treatment of an infantile hemangioma of the scalp during the proliferative phase.MethodA type III microtia and an infantile hemangioma of the ipsilateral scalp are reviewed in this case report, from a tertiary‐care medical center. The period of care from July 2010 to February 2012 is reviewed. Hemangioma excision is the main intervention. Surgical outcome and syndrome evaluation will be presented.ResultsThe patient presented for evaluation at 8 months of age with a 4‐cm hemangioma of the right occipital scalp and a type III microtia. A mild marginal mandibular weakness was also observed. No heart murmur was present, and the neurologic examination was nonfocal. The hemangioma became ulcerated. Excision was performed when the patient was 10 months of age with a purse string closure of the defect. A review of the literature indicates no reports of concurrent scalp hemangioma with a classic microtia. In preparation for later microtia reconstruction, early excision of the scalp hemangioma was felt to be advantageous.ConclusionA review of the literature indicates no reports of concurrent scalp hemangioma and microtia. Their co‐occurrence may indicate possible common errors in their pathogenesis. The consistent distribution of hemangiomas with embryological subunits of the face and mesenchymal cell populations unique to each zone could point to a common link.
Radiation‐Induced Sensorineural Hearing Loss
Authors: Mota Mario Mujica , Waissbluth Sofia , Daniel Sam 
Published: February 2015

ObjectiveTo systematically review the literature to characterize radiation‐induced sensorineural hearing loss for head and neck tumors.MethodSeven databases were searched to identify studies assessing the characteristics of sensorineural hearing loss caused exclusively by radiotherapy for head and neck cancer.ResultsFourteen articles were evaluated. The reported incidence of sensorineural hearing loss was higher on frequencies above 4 Hz (up to 95%) when compared to the speech frequencies. Radiation dose and follow‐up time were important factors affecting incidence rates.ConclusionEvidence demonstrates that the resulting SNHL is irreversible, progressive, and dose‐dependent. High‐quality literature regarding SNHL due to radiotherapy is lacking. Improved evaluation protocols should be adopted in the standard of care for patients undergoing radiotherapy.
Saccular Function after Stapedotomy
Authors: Majidi Mohammad Reza , Haghi Mohsen Rajati , Afzalzadeh Mohamadreza , Tale Mohammad R. , Hassanzadeh Nadia 
Published: February 2015

ObjectiveTo evaluate the effect of stapedotomy on saccular function.MethodThis clinical trial was conducted between October 2009 and September 2011. Bone‐conducted tone‐burst‐evoked vestibular‐evoked myogenic potential (VEMP) test was performed in patients with otosclerosis before and 1 week after stapedotomy.ResultsTwenty‐four patients with otosclerosis entered the study. Mean age of patients was 34.66 ± 13.16 years. Female to male ratio was 2:1. VEMP was recorded in 22 patients before surgery. There were no differences in VEMP test results before and after stapedotomy.ConclusionIt seems that stapedotomy does not influence saccular function. Moreover, saccular function seems to be normal in majority of patients with otosclerosis.
Seasonality in Vestibular Neuronitis
Authors: Koors Paul D. , Thacker Leroy R. , Coelho Daniel H. 
Published: February 2015

Objective1) Determine the incidence of vestibular neuronitis at our institution over a 36‐month period. 2) Use statistical methods to assess the incidence of vestibular neuronitis for seasonal variation.MethodA retrospective case review was performed to determine the incidence of vestibular neuronitis at our institution over the 36‐month period from May 1, 2008, to April 30, 2011. The c2 test and Rayleigh test for circular means were then used to assess the incidence for uneven distribution and seasonality, respectively.ResultsA total of 52 patients were diagnosed with vestibular neuronitis during the study period. The 2009‐2010 study year showed uneven distribution (c2 = 24.91, 11 df, P =. 009) as well as evidence of seasonality (R = 7.211, P <. 001). However, the other 2 study years did not show statistical significance by either the c2 test (2008‐2009: c2 = 7.95, 11 df, P =. 718; 2010‐2011: c2 = 11.85, 11 df, P =. 375) or Rayleigh test (2008‐2009: R = 0.320, P =. 732; 2010‐2011: R = 1.626, P =. 199). In addition, when incidence values were aggregated across all 3 study years, both the c2 test (c2 = 4.31, 2 df, P =. 116) and Rayleigh test (R = 1.472, P =. 229) failed to show statistical significance.ConclusionThe present study found minimal evidence of seasonality in the incidence of vestibular neuronitis. However, due to small sample size, further study is warranted, as evidence of seasonality would lend further credit to a viral etiology of the disease.
Sound Localization after Canaloplasty
Authors: Cho Yang‐Sun , Moon Joon , Park Ga‐Young , Byun Ha‐Young , Youm Hye‐Youn , Chung Won‐Ho , Hong Sung Hwa 
Published: February 2015

ObjectiveUnilateral congenital aural atresia (CAA) is much more common than bilateral atresia, and subsequent unilateral hearing loss usually leads to poor sound localization. The objective of this study was to investigate the change in sound localization after canaloplasty for correction of the unilateral hearing loss.MethodTwenty patients with unilateral CAA, who underwent canaloplasty, were enrolled. Pure tone audiometry, sound localization test, and Speech, Spatial, and Quality (SSQ) questionnaire were administered preoperatively and 6 months postoperatively. For sound localization test, 8 loudspeakers were positioned around the patient, and patients were instructed to identify the sound source.ResultsMean air‐bone gap decreased from preoperatively 54.6 dB to 25.3 dB 6 months after canaloplasty. In sound localization test, mean correct response rate and error degree at preoperative evaluation were 27.40% and 60.7°, respectively, and these were improved to 57.5% and 26.2° postoperatively. Mean correct response rate to ipsilesional stimuli following canaloplasty (left/right discrimination) improved from 29.5% to 88.2%, and that to contralesional stimuli improved from 90.0% to 98.7%. In addition, scores in the spatial domain of the SSQ questionnaire improved significantly from 6.6 to 7.5 after canaloplasty (P =. 014).ConclusionSound localization performance including right‐left discrimination ability improved significantly 6 months following canaloplasty. Canaloplasty could restore a binaural hearing ability and may be a good treatment option to improve sound localization ability in unilateral CAA patients.
Superior Canal Dehiscence in Spontaneous Cerebrospinal Fluid Otorrhea
Authors: Allen Kyle P. , Kutz Joe W. , Isaacson Brandon , Duong Thao , Roland Peter S. 
Published: February 2015

ObjectiveDetermine the incidence of superior semicircular canal dehiscence in patients with spontaneous cerebrospinal fluid (CSF) otorrhea.MethodThis is a retrospective case review at a tertiary care referral center. Patients included underwent a middle fossa craniotomy for repair of spontaneous CSF otorrhea between January 2007 and December 2011. The main outcome measure is the presence or absence of a dehiscent semicircular canal observed during spontaneous CSF leak repair.ResultsThirty‐three ears in 31 patients underwent surgical repair for spontaneous CSF otorrhea via a middle fossa craniotomy. The average age at the time of repair was 60.5 years and 80.6% of patients were women. The left ear was more commonly involved in 66.7% of cases. An encephalocele was observed in 69.7% of ears. A dehiscence of the superior canal was observed in 15.2% of ears (16.1% of individuals). All ears with a dehiscent superior canal were also observed to have an encephalocele. No significant difference in age, BMI, or gender was noted between those patients with or without a superior canal dehiscence.ConclusionThe incidence of superior semicircular canal dehiscence in ears with spontaneous otorrhea is 15.2%. This incidence is greater than that reported in a temporal bone study of ears not selected for CSF otorrhea.
The Continuum of Biofilms in Different Types of Otitis Media
Authors: Shibata Dai , Schachern Patricia A. , Tsuprun Vladimir , Harada Tamotsu , Paparella Michael M. , Cureoglu Sebahattin 
Published: February 2015

ObjectiveIt is recognized that the various types of otitis media (OM) follow a continuum with early forms of the disease leading to more chronic forms over time. This study investigates if biofilms play a role in conjunction with the continuum of pathological changes in different stages of OM.MethodThirty human temporal bones of each type, sero‐ purulent OM (SPOM), purulent OM (POM), chronic OM with purulent effusion (PCOM), and fourteen mucoid OM (MOM), were selected. We defined “web‐like structures” with host defense cells and bacterial bodies as biofilm. We examined the occurrence, frequency, and anatomic locations of biofilms.ResultsBiofilms were observed in 10 (33.3%) of the 30 temporal bones with SPOM, 19 (63.3%) with POM, and 20 (66.7%) with PCOM. A significant difference of biofilms’ frequency between SPOM and POM (P =. 038), and SPOM and PCOM (P =. 017), was observed. The most common anatomic location was mastoid antrum and mastoid cells (35 of 49 temporal bones, 71.4%). The number of anatomic locations with biofilms was 2.20 ± 1.03 in SPOM, 2.89 ± 1.70 in POM, and 4.15 ± 1.60 in PCOM. There was a significant difference of locations between PCOM and SPOM (P <. 001), and PCOM and POM (P =. 022).ConclusionThe frequency of biofilms suggests that the presence of biofilms is associated with the severity of OM. The growth and development of biofilms may play an important role in the progression of chronicity of OM.
The Efficacy of Combined Medical Therapy for Tinnitus
Authors: Chung Ji Hyun , Lee Sun Kyu , Lee Ho Yun , Byun Jae Yong , Park Moon‐Suh , Yeo Seung Geun 
Published: February 2015

ObjectiveLittle is known about the mechanism that causes tinnitus and there is no definite treatment. In practice, a combination of drugs is preferred over a single drug regimen. The aim of this study is to evaluate and compare the effectiveness of 3 kinds of combination regimen for tinnitus.MethodWe reviewed the records of 128 patients (157 ears) with tinnitus. Fifty of these patients were treated with ginkgo biloba extract, antiplatelets and anxiolytics. Another 50 patients were treated with ginkgo biloba extract, anxiolytics, and vasodilator. Twenty‐eight patients were treated with anxiolytics and vasodilator. Pre‐ and posttreatment statuses were analyzed by tinnitus handicap inventories.ResultsSubjective tinnitus was improved in all 3 groups with no significant difference in tinnitus handicap inventory scores between the 3 observed groups (P =. 2). The response group had a tendency to have longer periods of medication intake and lower Beck Depression Index scores compared to the nonresponse group. There was no difference between the response group and the nonresponse group in age, sex, or tinnitus characteristics.ConclusionFrom the analysis of this study, combined medical therapy is effective for tinnitus regardless of regimen.
The Multiplicity of Chronic Otitis Media Foci
Authors: Zhang Jiaxiong 
Published: February 2015

ObjectiveTo observe the multiplicity of chronic otitis media mastoiditis foci and to explore their treatment through functional surgery.MethodSixty patients with chronic otitis media mastoiditis were hospitalized and given functional surgeries that consisted of modified radical mastoidectomy, tympanoplasty, and ossicular chain reconstruction between January 2008 and December 2009. The operation emphasized the preservation and reconstruction of the ear function.ResultsThe foci found during operation were cholestoma, cholesterol cyst, sclerosis, mucosa inflammation, and bone pathological changes. Three cases were found to involve only 1 type of foci; 15 cases were found to have 2 types of foci coexisted; 3 kinds of foci were found to coexist in 37 cases, and more than 3 kinds of foci were found to coexist in 5 cases. There were defects in facial nerve canal in 19 cases, and fistula on labyrinth in 3 cases. Postsurgery follow‐up showed the dry ear time ranged from 1 to 3 months, 1.5 months on average. The difference of the air‐bone conduction gap between preoperation 34.95 ± 7.52 dB and postoperation 15.27 ± 5.00 dB was statistically significant (t = 3.68, P <. 01).ConclusionChronic otitis media and mastoiditis have foci including cholestoma, cholesterol cyst, sclerosis, mucosa inflammation, and bone pathological changes. Most of the cases show more than 1 focus and some even involve all of the 5 foci. Skillful microscopic technique is the key to treatment and functional surgery.
The Voices and Speech in Patient with Cochlear Implants
Authors: Ruiz Hector E. , Dotto Gabriela , Sanchez Bibiana , Ruiz Beltran 
Published: February 2015

ObjectiveThis work aims to link the technological advances (cochlear implant) in prosthetic equipment for the deaf to their impact on voice and speech in profound hearing loss.MethodThirty‐three patients between 6 and 30 years old with bilateral profound sensorineural congenital hearing loss, with cochlear implants. The recorded patient voices have been digitally processed with an Acoustic Analysis of Voice and Speech Program ANAGRAF and have also been analyzed and registered by the segmental and suprasegmentals features of voice and speech.ResultsRegarding voice quality, 48% reported a slight improvement and the other 48% a significantly improvement. The remaining 4% did not show changes. A total of 83% of patients tested so far shows a better improvement from personal calibrations between the 1° and 2° sample. Considering all the tested values for voice quality, improvement is observed in almost all subjects tested (32/33).ConclusionIt was observed that patients showing better hearing performance as a result of prosthetic equipment use (cochlear implant), personal adjustment of the acoustic parameters and voice quality in each case, have improved with aspects of vocal quality and articulation precision necessary to achieve good communication.
Treatment of Hearing Gain in Failed Idiopathic Sudden Sensorineural Hearing Loss
Authors: Choi Young‐Seok 
Published: February 2015

ObjectiveTo evaluate the effectiveness of intratympanic steroid injection on patients with a history of idiopathic sudden sensorineural hearing loss (ISSNHL) and failure of steroid therapy compared with patients who receive second oral steroids alone.MethodRetrospective review of 70 patients with a history of ISSNHL and failure of hearing gain who receive intratympanic steroid injection or oral steroid as a second treatment modality.ResultsSeventy patients met inclusion criteria and were included in the study. The number of patients with improvement in pure tone average in the injection group was 12 (33%) compared with 6 (18%) in the oral group. Fifteen (41.7%) of the injected patients did have improvement in speech discrimination scores of greater than 15% compared with only 4 (11.8%) in the oral group.ConclusionPatients with ISSNHL who have failed oral steroid therapy can obtain better hearing results with intratympanic steroids injection in comparison to oral steroids.
Use of Image‐Guidance to Access the Endolymphatic Sac
Authors: Tsai Betty S. , Balachandran Ramya , Kahrs Lueder A. , Labadie Robert F. 
Published: February 2015

ObjectiveOne of the challenges in endolymphatic sac (ELS) decompression is the reliable identification of the ELS with minimal injury to surrounding structures. Here we propose to: 1) Demonstrate the feasibility of using imaging technology to identify the ELS. 2) Define a direct pathway from the lateral skull to the ELS.MethodThe location of the ELS was approximated in a CT scan using its anatomic relationship to nearby structures, and a linear path was manually selected from the mastoid cortex to the predicted ELS. The path was visually verified to determine its relationship to the actual location of the ELS.ResultsCT scans of 6 cadaveric temporal bones with bone‐implanted fiducial markers were analyzed. The location of the ELS was predicted using traditional surgical landmarks. A custom Microtable (microstereotactic frame) was manufactured for each bone to target the ELS via a linear path (selected manually by CT). The bone was drilled to decompress the ELS. The Microtable was then mounted on the fiducial markers and the drill bit passed through its target hole to determine the actual targeted path. The drill bit coincided with the ELS in all specimens and did not transect any critical structures along its pathway.ConclusionCurrent imaging technology allows for reliable identification of the ELS and generation of linear trajectories to reach the ELS without injury to adjacent structures. This work is the first step in the development of minimally invasive image‐guided techniques to safely access the ELS in the treatment of Ménière’s disease.
Ventilation Tube Treatment in Children with Otitis Media with Effusion
Authors: Ichihara Takahiro , Haginomori Shin‐Ichi , Mori Atsuko , Kanazawa Atsuko , Nishikado Akira , Kawata Ryo 
Published: February 2015

Objective1) Discuss the effects of ventilation tube placement on postoperative mastoid growth in children with otitis media with effusion (OME). 2) Show an incidence of postoperative complication, for example, spontaneous extrusion, permanent tympanic membrane perforation.MethodIn total, 177 tubes were inserted in 148 ears in 81 children with OME with a mean age of 5.5 years at our hospital from 2001 to 2009. Long‐term tubes were used: The T‐Tube (Goode) in 87 cases or the Type II tube (Paparella) in 90 cases.ResultsThe tubes fell out spontaneously in 46%: 61% in the T‐Tube group and 32% in the Type II tube group. Postoperative permanent tympanic membrane perforation occurred in 10%. No relationship was observed between the incidence of tympanic membrane perforation and tube type or duration of tube insertion. Postoperative mastoid growth compared to preoperative condition estimated from X‐rays was 42%, 55%, 59%, and 65% at 1, 2, 3, and 4 years after surgery, respectively. Retaining the tube in place for more than 3 years was more efficient than doing so for 1 year in terms of mastoid growth statistically.ConclusionThese results indicate that the mastoid air cells grow favorably in children with OME after ventilation tube insertion. The ventilation tube should be removed from the tympanic membrane 3 years or more after insertion from the viewpoint of the mastoid cells growth.
Vestibular Disorders in Childhood and Adolescence
Authors: Duarte Juliana A. 
Published: February 2015

Objective1) Assess diagnostic and therapeutic aspects in an neurotology ambulatory children’s department. 2) Assess diagnosis by age group, risk factors, previous related treatment given, and response to treatment.MethodRetrospective study, case series, held in otoneurology pediatric ambulatory children’s department through evaluated medical records of all patients seen from 2006 to 2010.ResultsEighty‐eight patients were included. The average age was 9.87 years. There were 46 girls (52.27%). The most prevalent diagnosis was VPBI in 48 (54.54%) cases, followed by vestibular cause metabolic syndrome (SVM), 21 (23.86%), and vestibular migraine in 10 (11.36%) patients. The majority (77.27%) had poor eating habits. The majority, 48 (54.54%), complained of vertigo. The vectoelectronystagmography (VENG) showed no changes in 22 (41.51%). In 30 (43.47%) patients improvement was noted with vestibular rehabilitation and dietary counseling, and dietary counseling alone was administered in 27 (39.13%) patients.ConclusionThere was a predominance of diagnostic VPBI. Its close relationship with a history of migraine and its benign nature of evolution were noted. We noted the importance of monitoring, dietary counseling, and the role of vestibular rehabilitation in childhood and adolescence dizziness.