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Pierre-Olivier Champagne, Michel W Bojanowski
OBJECTIVE: To our knowledge, there have not been any reported cases of a meningioma of the cranio-cervical region presenting solely with syncope as its initial symptom. Only one case of meningioma presenting with syncope has been published, but it was associated with hydrocephalus. We report two cases of syncope caused by a cranio-cervical junction meningioma, with syncope being the sole presenting symptom and without hydrocephalus. We discuss the possible pathophysiology as well as the clinical relevance of this type of presentation...
March 15, 2018: World Neurosurgery
Ryota Tamura, Ryosuke Tomio, Farrag Mohammad, Masahiro Toda, Kazunari Yoshida
OBJECTIVE The anterior transpetrosal approach (ATPA) was established in 1984 and has been particularly effective for petroclival tumors. Although some complications associated with this approach, such as venous hemorrhage in the temporal lobe and nervous disturbances, have been resolved over the years, the incidence rate of CSF leaks has not greatly improved. In this study, some varieties of air cell tracts that are strongly related to CSF leaks are demonstrated. In addition, other pre- and postoperative risk factors for CSF leakage after ATPA are discussed...
March 16, 2018: Journal of Neurosurgery
Alain Cunqueiro, Meir H Scheinfeld
Intracranial gas is commonly detected on neuroimaging. The recognition of this finding can at first blush be unsettling. Being able to localize this gas to a specific compartment: intraarterial, intravenous, intraparenchymal, subdural, epidural, subarachnoid and intraventricular, is the first step in determining the importance of the gas. Determination of the route of entry: through the skull, extension from a paranasal sinus or the mastoid air cells, via the spine, or trans-vascular, is the other important factor in determining potential consequences...
March 15, 2018: Emergency Radiology
Hylke F E van der Toom, Marc P van der Schroeff, Robert Jan Pauw
Importance: The ideal surgical treatment of cholesteatoma has been subject to discussion for years because both traditional surgical techniques (canal wall down [CWD] and canal wall up [CWU] tympanoplasty) have their own advantages and disadvantages. A more recently propagated surgical approach, to combine the CWD or CWU tympanoplasty technique with obliteration of the mastoid and epitympanum, is showing promising results. Objective: To systematically review the literature on recurrent and residual cholesteatoma rates after single-stage CWU and CWD tympanoplasty with mastoid obliteration...
March 15, 2018: JAMA Otolaryngology—Head & Neck Surgery
Shay Schneider, Joseph Kapelushnik, Mordechai Kraus, Sabri El Saied, Itai Levi, Daniel Michael Kaplan
PURPOSE: Otogenic lateral sinus thrombosis (OLST) is an intracranial, potentially life-threatening complication of acute and chronic otitis media. Since congenital thrombophilic disorders are risk factors for cerebral venous thrombosis, OLST may be related to thrombophilia. The aim of our study was twofold: to evaluate whether patients who suffered from OLST in childhood also have thrombophilia, and whether these patients experienced thromboembolic episodes in future years. STUDY DESIGN: Retrospective case series...
March 7, 2018: American Journal of Otolaryngology
J K Dierijck, A D Wright, J D Smirl, K Bryk, P van Donkelaar
Although balance control has been studied extensively following acute concussion, little is known regarding repetitive sub-concussive head impacts or chronic exposure to multiple concussive events. Quiet stance postural control was characterized in contact sport athletes at pre-season (n = 135) and post-season (n = 48) to evaluate the effects of subconcussive trauma to the head. To determine the impact of acute concussion on postural control, athletes diagnosed with a concussion during the season (n = 12) were tested at 72-h, 2-weeks, and 1-month post-injury...
March 8, 2018: International Journal of Psychophysiology
Samir Sorour Sorour, Nasser Nagieb Mohamed, Magdy M Abdel Fattah, Mohammad El-Sayed Abd Elbary, Mohammad Waheed El-Anwar
BACKGROUND: Canal wall down (CWD) mastoidectomy has many drawbacks including chronic otorrhea, granulations, dizziness on exposure to cold or hot water and tendency of debris accumulation in the mastoid cavity demanding periodic cleaning. Many of these problems can be solved by reconstruction of the posterior meatal wall (PMW). OBJECTIVES: To assess the results of PMW reconstruction after CWD mastoidectomy for cholesteatoma using bioactive glass (BAG) that is fabricated and built up intraoperatively...
March 6, 2018: American Journal of Otolaryngology
Jonathan W Wallace, Brandon G Rasman, Brian H Dalton
Maintaining standing balance involves multisensory processing and integration to produce dynamic motor responses. Electrical vestibular stimulation (EVS) delivered over the mastoid processes can be used to explore the vestibular control of balance. The purpose of this study was to determine whether intrinsic foot muscles exhibit vestibular-evoked balance responses and to characterize the traits associated with these responses. Electromyography (EMG) of the abductor hallucis, abductor digiti minimi and medial gastrocnemius and anterior-posterior (AP) forces were sampled while quietly standing participants were subjected to a random continuous EVS signal (peak-to-peak amplitude = ±3 mA)...
March 7, 2018: Neuroscience
Anup Singh, David Victor Kumar Irugu, Hitesh Verma, Alok Thakar
Tuberculosis involving mastoid and ear is an uncommon entity presenting with myriads of non-specific features and difficult to diagnose, being a paucibacillary condition. The involvement of otomastoid compartment is hypothesised to be of haematogenous origin. Rarely it can spread directly via tympanic membrane perforation or via reflux through eustachian tube. The usual picture of presentation tends to be one of indolent ear infection not responsive to usual antibiotic treatment and symptomatology being out of proportion to examination findings...
March 9, 2018: BMJ Case Reports
Michael Mather, Kate Musgrave, Nicholas Dawe
No abstract text is available yet for this article.
March 9, 2018: Laryngoscope
Tomoyasu Tachibana, Shin Kariya, Yorihisa Orita, Michihiro Nakada, Takuma Makino, Yasutoshi Komatsubara, Yuko Matsuyama, Yuto Naoi, Kazunori Nishizaki
OBJECTIVES: We reviewed surgical results of canal wall-down tympanoplasty (CWDT) with soft posterior meatal wall reconstruction (SWR) for acquired cholesteatoma (AC), and identified factors associated with surgical outcomes. METHODS: Results from 119 ears with AC (pars flaccida, n = 99; pars tensa, n = 20) that underwent CWDT with SWR were retrospectively reviewed. We defined postoperative balloon-like retraction (PBR) with web formation, which needed reoperation to clean accumulated cerumen, as postoperative deep retraction pocket (PDRP)...
March 8, 2018: Acta Oto-laryngologica
Hamed Sajjadi
Attic cholesteatoma with antral extension in tight sclerotic mastoid cavities is a common presentation that creates difficult decision-making intraoperatively. Drilling through a sclerotic and small mastoid cavity, keeping the canal wall intactis often difficult and increases the risk of serious injury. Consequently, a canal-wall-down mastoidectomy is often performed. The endoscopic transcanal modified canal-wall-down mastoidectomy approach allows the benefits of an open cavity for cholesteatoma resection and the benefits of a closed cavity for better long-term care and a more normal ear canal and middle ear reconstruction...
September 2017: World Journal of Otorhinolaryngology—Head and Neck Surgery
Natasha Pollak
The development of endoscopic ear surgery techniques promises to change the way we approach ear surgery. In this review paper, we explore the current evidence, seek to determine the advantages of endoscopic ear surgery, and see if these advantages are both measureable and meaningful. The wide field of view of the endoscope allows the surgeon to better visualize the various recesses of the middle ear cleft. Endoscopes make it possible to address the target pathology transcanal, while minimizing dissection or normal tissue done purely for exposure, leading to the evolution of minimally-invasive ear surgery and reducing morbidity...
September 2017: World Journal of Otorhinolaryngology—Head and Neck Surgery
Matteo Alicandri-Ciufelli, Matteo Fermi, Marco Bonali, Livio Presutti, Daniele Marchioni, Alessandra Todeschini, Lukas Aschuetz
OBJECTIVES: To describe facial sinus anatomy from an endoscopic perspective and present a radiologic classification. METHODS: Facial sinus was studied by endoscopy and high-resolution computed tomography (HRCT) scan in 39 temporal bones that underwent exclusive transcanal endoscopic approach. A radiomorphologic classification based on the relationship between the facial sinus and the mastoid portion of the facial nerve is created as follows. In type A facial sinus, the pneumatization of the facial sinus did not extend medially or posteriorly to the mastoid portion of the facial nerve...
March 7, 2018: Laryngoscope
Heinz Arnold, Maximilian Schulze, Stephan Wolpert, Bernhard Hirt, Anke Tropitzsch, Rainer Zimmermann, Andreas Radeloff, Hubert Löwenheim, Katrin Reimann
HYPOTHESIS: Anatomical and radiological evaluation improves safety and accuracy of the retrosigmoid approach for positioning a transcutaneous bone conduction implant and provides anatomical reference data for standardized, landmark-based implantation at this alternative site. BACKGROUND: The primary implantation site for the floating mass transducer of a novel bone conduction hearing implant is the mastoid. However, anatomical limitations or previous mastoid surgery may prevent mastoid implantation...
February 28, 2018: Otology & Neurotology
Jieun Kang, Se-Joon Oh, Hyun-Min Lee, Ki-Jae Jeong, Nari Shin, Il-Woo Lee, Jaebeom Lee
Many artificial materials have been used for mastoid cavity obliteration in canal wall down tympanomastoidectomy. Among the artificial materials, hydroxyapatite is most popular material for mastoid cavity obliteration. Hydroxyapatite is biostable and osteoconductive, but it has poor mechanical properties, especially brittleness. To overcome the limitation, hydroxyapatite has been combined with natural chitosan polymer, which is biocompatible and flexible, to produce a hydroxyapatite-chitosan patch via a sublimation-assisted compression process...
December 1, 2017: Journal of Biomedical Nanotechnology
David Carpenter, David Kaylie, Erin Piker, Dennis Frank-Ito
Purpose: This study assesses interaural differences in temporal bone anatomy in subjects with normal caloric findings. Method: Eligible patients included those referred to the Duke University Medical Center otology clinic complaining of dizziness, with a head computed tomography scan and caloric stimulation results within normal ranges (inter-ear difference ≤ 10% or < 25% unilateral weakness). Three-dimensional reconstructions of computed tomography scans in 11 patients were used to calculate the surface area and volume of lateral semicircular canals (LSCCs), mastoid airspaces, mastoid bones, and internal auditory canal diameter and circumference...
March 8, 2018: American Journal of Audiology
Hantai Kim, Ho Young Bae, Oak-Sung Choo, Yun-Hoon Choung
OBJECTIVES: Combined mastoidectomy is generally preferred to tympanoplasty alone when treating patients with chronic otitis media (COM), particularly when temporal bone computed tomography (TBCT) shows that the mastoid cavity contains opacification of soft tissue density. However, in cases with Eustachian tube dysfunction, a mastoid cavity volume may be a burden to its function. We hypothesized that tympanoplasty alone might be better than tympanoplasty combined with mastoidectomy because soft tissue in the mastoid cavity is a sequel to a protective physiological response...
March 2018: Clinical and Experimental Otorhinolaryngology
Selçuk Güneş, Mustafa Çelik, Ceylan Çolak, Burak Olgun
OBJECTIVE: The aim is to investigate the impact of degree of mastoid pneumatization on the affected side of Bell palsy (BP). STUDY DESIGN: Retrospective study in tertiary academic hospital. METHODS: In total, 52 patients who were diagnosed with as BP were included in the study. Each patient was staged using House-Brackmann (HB) staging system. All patients underwent temporal bone computed tomography imaging. House-Brackmann scores, side of the BP, and mastoid pneumatization of all of patients were evaluated in the present study...
February 26, 2018: Journal of Craniofacial Surgery
Theodoros Varakliotis, Gianluca Bellocchi, Alberto Eibenstein, Gilberto Acquaviva, Francesco Casorati
INTRODUCTION: Ossifying fibromixoid tumor of soft parts (OFMT) is a rare soft tissue and bone tumor. In its classic form, is considered benign, nevertheless aggressive clinical behaviour tumors with a different cytoarchitectural features of a malignant variant, have been described.The classification contains "typical", "atypical" and "malignant" variants. METHODS: A CT ear scan without contrast enhancement was carried out (October 2015), with coronal, sagittal and 3D reconstructions...
February 14, 2018: International Journal of Surgery Case Reports
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