Tolerable delay for speech production and perception: effects of hearing ability and experience with hearing aids.

Related Articles

Tolerable delay for speech production and perception: effects of hearing ability and experience with hearing aids.

Int J Audiol. 2017 Aug 24;:1-8

Authors: Goehring T, Chapman JL, Bleeck S, Monaghan JJM

Abstract
OBJECTIVE: Processing delay is one of the important factors that limit the development of novel algorithms for hearing devices. In this study, both normal-hearing listeners and listeners with hearing loss were tested for their tolerance of processing delay up to 50 ms using a real-time setup for own-voice and external-voice conditions based on linear processing to avoid confounding effects of time-dependent gain.
DESIGN: Participants rated their perceived subjective annoyance for each condition on a 7-point Likert scale.
STUDY SAMPLE: Twenty normal-hearing participants and twenty participants with a range of mild to moderate hearing losses.
RESULTS: Delay tolerance was significantly greater for the participants with hearing loss in two out of three voice conditions. The average slopes of annoyance ratings were negatively correlated with the degree of hearing loss across participants. A small trend of higher tolerance of delay by experienced users of hearing aids in comparison to new users was not significant.
CONCLUSION: The increased tolerance of processing delay for speech production and perception with hearing loss and reduced sensitivity to changes in delay with stronger hearing loss may be beneficial for novel algorithms for hearing devices but the setup used in this study differed from commercial hearing aids.

PMID: 28838277 [PubMed - as supplied by publisher]

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Endoscopic extradural supraorbital approach to the temporal pole and adjacent area: technical note.

Endoscopic extradural supraorbital approach to the temporal pole and adjacent area: technical note.

J Neurosurg. 2017 Aug 25;:1-7

Authors: Komatsu F, Imai M, Shigematsu H, Aoki R, Oda S, Shimoda M, Matsumae M

Abstract
The authors' initial experience with the endoscopic extradural supraorbital approach to the temporal pole and adjacent area is reported. Fully endoscopic surgery using the extradural space via a supraorbital keyhole was performed for tumors in or around the temporal pole, including temporal pole cavernous angioma, sphenoid ridge meningioma, and cavernous sinus pituitary adenoma, mainly using 4-mm, 0° and 30° endoscopes and single-shaft instruments. After making a supraorbital keyhole, a 4-mm, 30° endoscope was advanced into the extradural space of the anterior cranial fossa during lifting of the dura mater. Following identification of the sphenoid ridge, orbital roof, and anterior clinoid process, the bone lateral to the orbital roof was drilled off until the dura mater of the anterior aspect of the temporal lobe was exposed. The dura mater of the temporal lobe was incised and opened, exposing the temporal pole under a 4-mm, 0° endoscope. Tumors in or around the temporal pole were safely removed under a superb view through the extradural corridor. The endoscopic extradural supraorbital approach was technically feasible and safe. The anterior trajectory to the temporal pole using the extradural space under endoscopy provided excellent visibility, allowing minimally invasive surgery. Further surgical experience and development of specialized instruments would promote this approach as an alternative surgical option.

PMID: 28841120 [PubMed - as supplied by publisher]

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Pathogenesis of peri-tumoral edema in intracranial meningiomas.

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Pathogenesis of peri-tumoral edema in intracranial meningiomas.

Neurosurg Rev. 2017 Aug 24;:

Authors: Berhouma M, Jacquesson T, Jouanneau E, Cotton F

Abstract
Peri-tumoral edema in intracranial meningiomas occurs frequently and obviously impacts the morbidity and mortality of these predominantly benign neoplasms. Several causative factors (age, gender, volume, location…) have been unsuccessfully investigated. Despite recent progresses in metabolic imaging and molecular biology, the pathogenesis of peri-tumoral edema remains debated. Hypotheses include vascular endothelial growth factor, metalloproteinases and interleukins among many others. It is probable that this pathogenesis encompasses all these factors with different levels. The current review aims to shed the light on the investigated factors involved in the pathogenesis of peri-tumoral edema in meningiomas and identify the potential therapeutic targets.

PMID: 28840371 [PubMed - as supplied by publisher]

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Polyostotic craniofacial fibrous dysplasia with bizarre radiologic finding: Mandible, anterior skull base, frontal, temporal, parietal, and occipital bones involvement.

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Polyostotic craniofacial fibrous dysplasia with bizarre radiologic finding: Mandible, anterior skull base, frontal, temporal, parietal, and occipital bones involvement.

Surg Neurol Int. 2017;8:160

Authors: Tabibkhooei A, Taheri M, Rohani S, Azimi A

PMID: 28840064 [PubMed]

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Spindle cell/sclerosing rhabdomyosarcoma with intracranial invasion without destroying the bone of the skull base: a case report and literature review.

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Spindle cell/sclerosing rhabdomyosarcoma with intracranial invasion without destroying the bone of the skull base: a case report and literature review.

Acta Radiol Open. 2017 Aug;6(8):2058460117727316

Authors: Momosaka D, Togao O, Hiwatashi A, Yamashita K, Yoshimoto K, Mori M, Iwaki T, Honda H

Abstract
Spindle cell/sclerosing rhabdomyosarcoma (ssRMS) is a new subtype of rhabdomyosarcoma included in the World Health Organization soft tissue and bone tumor classification in 2013. Despite the increasing number of reported cases of ssRMS, the imaging characteristics of ssRMS are not established. Herein, we present the case of an elderly Japanese woman with ssRMS of the masticator space with intracranial invasion without destruction of the adjacent bone. Attention should be paid to the presence of intracranial infiltration that may indicate a worse prognosis. Tumor growth without bone destruction could be a key finding to differentiate ssRMSs from conventional subtypes of rhabdomyosarcoma.

PMID: 28839951 [PubMed]

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Progression-free survival and factors associated with postoperative recurrence in 126 patients with atypical intracranial meningioma.

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Progression-free survival and factors associated with postoperative recurrence in 126 patients with atypical intracranial meningioma.

World Neurosurg. 2017 Aug 21;:

Authors: Phonwijit L, Khawprapa C, Sitthinamsuwan B

Abstract
OBJECTIVE: Atypical meningioma has a higher recurrence rate than benign meningioma. The mainstay of treatment is surgery with or without radiation therapy (RT). The objective of this study was to investigate progression-free survival (PFS) and factors associated with postoperative recurrence in patients with atypical meningioma METHODS: Patients diagnosed with atypical menigioma who underwent surgery at Siriraj Hospital during the 2004 to 2014 study period were included. Features potentially associated with PFS and tumor recurrence from clinical records, operative records, and neuroimaging studies were evaluated and analyzed.
RESULTS: One hundred and twenty-six patients with mean age of 55 years were included. Median PFS was 55 months. Five-year and 10-year PFS rate was 72.5% and 32%, respectively. Median follow-up duration was 52 months. In multivariate analysis, tumor location (convexity, parasagittal/falcine, intraventricular, skull base) (p=0.003) and pial invasion (HR: 2.02; p=0.045) were significantly associated with tumor recurrence. Postoperative RT was associated with reduction in tumor recurrence in both univariate (OR: 0.48; p=0.039) and multivariate analysis (HR: 0.42; p=0.005).
CONCLUSIONS: Tumor location and pial invasion were significantly correlated with increased incidence of tumor recurrence, and postoperative RT was found to be significantly associated with decreased tumor progression and recurrence.

PMID: 28838877 [PubMed - as supplied by publisher]

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yOutcomes Following Endoscopic Endonasal Resection of Craniopharyngiomas in the Pediatric Population.

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yOutcomes Following Endoscopic Endonasal Resection of Craniopharyngiomas in the Pediatric Population.

World Neurosurg. 2017 Aug 21;:

Authors: Patel VS, Thamboo A, Quon J, Nayak JV, Hwang PH, Edwards M, Patel ZM

Abstract
BACKGROUND: Craniopharyngiomas have traditionally been treated via open, transcranial approaches. More recently, endoscopic, transsphenoidal approaches have been increasingly utilized; however very few case-series exist in the pediatric population.
METHODS: A retrospective review of patients (<18 years) undergoing endoscopic transsphenoidal resection of craniopharyngiomas between 1995 and 2016 was performed. Preoperative data included presenting symptoms, tumor size, location, and components. Postoperative outcomes included symptom resolution, visual outcomes, endocrine outcomes, disease recurrence, and major complications.
RESULTS: 16 pediatric patients with mean age of 11.0 (range = 5 - 15) were included. The median follow-up time was 56.2 months. Mean maximal tumor diameter was 3.98 cm. The majority of the tumors had suprasellar (93.8%) and intrasellar (68.8%) components. The gross-total resection rate was 93.8%. The most common presenting symptoms were vision changes (81.3%) and increased intracranial pressure (56.3%). The majority of patients (66.7%) had their presenting symptoms resolved by their first postoperative visit. Vision improved or remained normal in 69.2% of patients. Postoperatively, new incidence of panhypopituitarism or diabetes insipidus (DI) developed in 63.6% and 46.7% of patients respectively. New hypothalamic obesity developed in 28.6% of patients. The postoperative CSF leak rate was 18.8%. One patient died from intraventricular hemorrhage postoperatively. The major complication rate was 12.5%. Disease recurrence occurred in one patient with GTR (6.3%).
CONCLUSION: Endoscopic transsphenoidal resection for craniopharyngiomas can achieve high rates of total-resection with low rates of disease recurrence in larger tumor sizes than previously described. However, hypothalamic-pituitary dysfunction and CSF leak still remain significant postoperative morbidities.

PMID: 28838874 [PubMed - as supplied by publisher]

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Endoscopic Endonasal Interdural Middle Fossa Approach to the Maxillary Nerve: Anatomic Considerations and Surgical Relevance.

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Endoscopic Endonasal Interdural Middle Fossa Approach to the Maxillary Nerve: Anatomic Considerations and Surgical Relevance.

Oper Neurosurg (Hagerstown). 2017 Aug 01;13(4):522-528

Authors: Abhinav K, Panczykowski D, Wang WH, Synderman CH, Gardner PA, Wang EW, Fernandez-Miranda JC

Abstract
BACKGROUND: The maxillary nerve (V2) can be approached via the open middle fossa approach.
OBJECTIVE: To delineate the anatomy of V2 and its specific segments with respect to the endonasal landmarks. We present the endoscopic endonasal interdural middle fossa approach to V2 and its potential application for the treatment of perineural spread in sinonasal/skull base tumors.
METHODS: Five human head silicon-injected specimens underwent bilateral endoscopic endonasal transpterygoid approaches. V2 prominence and the maxillary strut were identified in the lateral recess along with paraclival carotid protruberance. The regions superior and inferior to V2 corresponding to the anteromedial and anterolateral triangles of the middle fossa were exposed.
RESULTS: V2 can be classified into 3 segments: interdural (from the Gasserian ganglion to the proximal part of the maxillary strut), intracanalicular (corresponding to the anteroposterior length of the maxillary strut), and pterygopalatine (distal to the maxillary strut and the site of its divisions). Endonasally, the average length of the interdural and the intracanalicular segments were approximately 9 and 4.4 mm, respectively. V2, following its division distal to the maxillary strut, was successfully dissected off the middle fossa dura and transected just distal to the Gasserian ganglion.
CONCLUSION: Endonasally, the interdural segment can be safely mobilized between the periosteal and meningeal dural layers while ensuring the integrity of the middle fossa dura. This allows transection of infiltrated V2 to facilitate tumor resection without entering the intradural/arachnoidal space. Posteriorly, this is limited by the Gasserian ganglion and superomedially by the dural envelope surrounding the cavernous sinus and the paraclival carotid artery.

PMID: 28838109 [PubMed - in process]

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The Infrazygomatic Segment of the Superficial Temporal Artery: Anatomy and Technique for Harvesting a Better Interposition Graft.

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The Infrazygomatic Segment of the Superficial Temporal Artery: Anatomy and Technique for Harvesting a Better Interposition Graft.

Oper Neurosurg (Hagerstown). 2017 Aug 01;13(4):517-521

Authors: Meybodi AT, Lawton MT, El-Sayed I, Davies J, Tabani H, Feng X, Benet A

Abstract
BACKGROUND: The superficial temporal artery (STA) is underutilized as an interposition graft because current techniques expose and harvest STA above the level of the zygoma. This technique yields a diminutive arterial segment in both length and diameter, which limits its use for extracranial-intracranial bypass.
OBJECTIVE: To introduce a safe and efficient technique for harvesting of the infrazygomatic segment of the STA.
METHODS: Scalp layers, STA, and the facial nerve were studied in 18 specimens. The length of the STA segment harvested below the superior border of the zygomatic arch was measured. Safety of this technique was assessed by measuring the distance between the facial nerve and the STA.
RESULTS: The galea and subgaleal fat pad were the only anatomical planes found between the facial nerve and the STA below the zygomatic arch. A dense subcutaneous band of galea contained the STA and allowed proximal dissection of the artery without exposing the facial nerve. The average length of the artery harvested between the zygomatic arch and the parotid gland was 20 mm.
CONCLUSION: Subcutaneous dissection within the galea below the level of the zygomatic arch and preservation of the dense subcutaneous band surrounding the STA avoids transecting the facial nerve branches while providing increased STA exposure. This anatomical knowledge may increase the use of STA as an interposition graft in cerebrovascular bypass procedures and reduce the need to harvest grafts through additional incisions at remote sites.

PMID: 28838108 [PubMed - in process]

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Subgaleal Retention Sutures: Internal Pressure Dressing Technique for Dolenc Approach.

Related Articles

Subgaleal Retention Sutures: Internal Pressure Dressing Technique for Dolenc Approach.

Oper Neurosurg (Hagerstown). 2017 Aug 01;13(4):448-452

Authors: Burrows AM, Rayan T, Van Gompel JJ

Abstract
BACKGROUND: Extradural approach to the cavernous sinus, the "Dolenc" approach recognizing its developing Dr. Vinko Dolenc, is a critically important skull base approach. However, resection of the lateral wall of the cavernous sinus, most commonly for cavernous sinus meningiomas, results commonly in a defect that often cannot be reconstructed in a water-tight fashion. This may result in troublesome pseudomeningocele postoperatively.
OBJECTIVE: To describe a technique designed to mitigate the development of pseudomeningocele.
METHODS: We found the Dolenc approach critical for resection of cavernous lesions. However, a number of pseudomeningoceles were managed with prolonged external pressure wrapping in the early cohort. Therefore, we incorporated subgaleal to muscular sutures, which were designed to close this potential space and retrospectively analyzed our results.
RESULTS: Twenty-one patients treated with a Dolenc approach and resection of the lateral wall of the cavernous sinus over a 2-year period were included. Prior to incorporation of this technique, 12 patients were treated and 3 (25%) experienced postoperative pseudomeningoceles requiring multiple clinic visits and frequent dressing. After incorporation of subgaleal retention sutures, no patient (0%) experienced this complication.
CONCLUSION: Although basic, subgaleal to temporalis muscle retention sutures likely aid in eliminating this potential dead space, thereby preventing patient distress postoperatively. This technique is simple and further emphasizes the importance of dead space elimination in complex closures.

PMID: 28838106 [PubMed - in process]

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Anterior Spinal Reconstruction to the Clivus Using an Expandable Cage After C2 Chordoma Resection Via a Labiomandibular Glossotomy Approach: A Technical Report.

Related Articles

Anterior Spinal Reconstruction to the Clivus Using an Expandable Cage After C2 Chordoma Resection Via a Labiomandibular Glossotomy Approach: A Technical Report.

World Neurosurg. 2016 Jun;90:372-379

Authors: Ozpinar A, Liu JJ, Whitney NL, Tempel ZJ, Choi PA, Andersen PE, Coppa ND, Hamilton DK

Abstract
INTRODUCTION: En bloc resection of high-cervical chordomas is a technically challenging procedure associated with significant morbidity. Two key components of this procedure include the approach and the method of spinal reconstruction. A limited number of reported cases of en bloc resection of high-cervical chordomas have been reported in the literature.
CASE PRESENTATION: We report a novel case using an expandable cage to reconstruct the anterior spinal column above C2 with fixation to the clivus. We also report a novel anterior approach to the high-cervical spine via a midline labiomandibular glossotomy. We detail the management of complications related to 2 instances of wound dehiscence and hardware exposure requiring two additional operations. The final surgical procedure involved explantation of the anterior cervical plate and use of a vascularized radial graft to close the posterior pharyngeal defect and protect the hardware. At 26-month follow-up, the patient remained disease free without any neurologic deficit.
DISCUSSION: We report the novel use of the midline labiomandibular glossotomy for surgical approach and reconstruction of the anterior column to the clivus with an expandable cage. The unique features of this operative strategy allowed the surgical team to tailor the construct intraoperatively, resulting in solid arthrodesis without significant neurologic sequelae.
CONCLUSIONS: Labiomandibular glossotomy for approach to high anterior cervical chordomas followed by craniospinal reconstruction to the clivus with an expandable cage represents a novel technique for managing high cervical chordomas.

PMID: 26968445 [PubMed - indexed for MEDLINE]

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Metastatic Gastrointestinal Stromal Tumor to the Skull.

Related Articles

Metastatic Gastrointestinal Stromal Tumor to the Skull.

World Neurosurg. 2016 May;89:725.e11-6

Authors: Gupta S, Bi WL, Dunn IF

Abstract
BACKGROUND: Gastrointestinal stromal tumors (GISTs) arising from the interstitial cells of Cajal along the gastrointestinal tract rarely metastasize to the central nervous system (CNS) but require aggressive multimodal therapies when they do. We present a case of recurrent GIST metastasis to the skull and review the literature on management, including the role of molecular profiling in determining adjuvant treatment.
CASE: A 64-year-old woman presented with an enlarging palpable mass over her right eye. Magnetic resonance imaging revealed an enhancing T1-hypointense, T2-hyperintense right frontal calvarial lesion with lytic features on computed tomography. Pathology confirmed metastatic GIST to the skull with dural involvement. Molecular profiling revealed a mutation in exon 11 of KIT in her primary tumor, while the skull metastasis harbored an additional mutation in exon 17 associated with acquired drug resistance.
CONCLUSION: We review the epidemiology of GIST metastases and discuss potential reasons for its rare presentation to the CNS. Additionally, we highlight the diagnostic and prognostic value of molecular profiling for metastatic GIST, as well as its influence in arbitrating targeted molecular inhibitor therapy. Evolving molecular signatures, associated with treatment resistance, may play a pivotal role in future integration with multimodality treatment strategies for CNS GIST.

PMID: 26805679 [PubMed - indexed for MEDLINE]

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Tolerable delay for speech production and perception: effects of hearing ability and experience with hearing aids.

Related Articles

Tolerable delay for speech production and perception: effects of hearing ability and experience with hearing aids.

Int J Audiol. 2017 Aug 24;:1-8

Authors: Goehring T, Chapman JL, Bleeck S, Monaghan JJM

Abstract
OBJECTIVE: Processing delay is one of the important factors that limit the development of novel algorithms for hearing devices. In this study, both normal-hearing listeners and listeners with hearing loss were tested for their tolerance of processing delay up to 50 ms using a real-time setup for own-voice and external-voice conditions based on linear processing to avoid confounding effects of time-dependent gain.
DESIGN: Participants rated their perceived subjective annoyance for each condition on a 7-point Likert scale.
STUDY SAMPLE: Twenty normal-hearing participants and twenty participants with a range of mild to moderate hearing losses.
RESULTS: Delay tolerance was significantly greater for the participants with hearing loss in two out of three voice conditions. The average slopes of annoyance ratings were negatively correlated with the degree of hearing loss across participants. A small trend of higher tolerance of delay by experienced users of hearing aids in comparison to new users was not significant.
CONCLUSION: The increased tolerance of processing delay for speech production and perception with hearing loss and reduced sensitivity to changes in delay with stronger hearing loss may be beneficial for novel algorithms for hearing devices but the setup used in this study differed from commercial hearing aids.

PMID: 28838277 [PubMed - as supplied by publisher]

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Comparison of porcine and bovine collagen dural substitutes in posterior fossa decompression for Chiari I malformation in adults.

Related Articles

Comparison of porcine and bovine collagen dural substitutes in posterior fossa decompression for Chiari I malformation in adults.

World Neurosurg. 2017 Aug 21;:

Authors: Lee CK, Mokhtari T, Connolly ID, Li G, Shuer LM, Chang SD, Steinberg GK, Gephart MH

Abstract
BACKGROUND: Posterior fossa decompression surgeries for Chiari malformations are susceptible to post-operative complications such as pseudomeningocele, external cerebrospinal fluid (CSF) leak, and meningitis. Various dural substitutes have been employed to improve surgical outcomes.
OBJECTIVE: This study examined whether the collagen matrix dural substitute type correlated with the incidence of post-operative complications following posterior fossa decompression in adult patients with Chiari I malformations.
METHODS: A retrospective cohort study was conducted on 81 adult patients who underwent an elective decompressive surgery for treatment of symptomatic Chiari I malformations, with duraplasty involving a dural substitute derived from either bovine or porcine collagen matrix. Demographics and treatment characteristics were correlated with surgical outcomes.
RESULTS: A total of 81 patients were included in the study. Compared to bovine dural substitute, porcine dural substitute was associated with a significantly higher risk of pseudomeningocele occurrence (OR 5.78, 95% CI 1.65-27.15; P = .01) and a higher overall complication rate (OR 3.70, 95% CI 1.23-12.71; P = .03) by univariate analysis. There was no significant difference in the rate of meningitis, repeat operations, or overall complication rate between the two dural substitutes. In addition, estimated blood loss was a significant risk factor for meningitis (P = .03). Multivariate analyses again demonstrated that porcine dural substitute was associated with pseudomeningocele occurrence, though the association with higher overall complication rate did not reach significance.
CONCLUSION: Dural substitutes generated from porcine collagen, compared to those from bovine collagen, were associated with a higher likelihood of pseudomeningocele development in adult patients undergoing Chiari I malformation decompression and duraplasty.

PMID: 28838875 [PubMed - as supplied by publisher]

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Endoscopic Endonasal Surgery for Cranial Base Chondrosarcomas.

Related Articles

Endoscopic Endonasal Surgery for Cranial Base Chondrosarcomas.

Oper Neurosurg (Hagerstown). 2017 Aug 01;13(4):421-434

Authors: Vaz-Guimaraes F, Fernandez-Miranda JC, Koutourousiou M, Hamilton RL, Wang EW, Snyderman CH, Gardner PA

Abstract
BACKGROUND: Microsurgical resection via open approaches is considered the main treatment modality for cranial base chondrosarcomas (CBCs). The use of endoscopic endonasal approaches (EEAs) has been rarely reported.
OBJECTIVE: To present the endoscopic endonasal experience with CBCs at our institution.
METHODS: Retrospective review of the medical records of 35 consecutive patients who underwent EEA for CBC resection between January 2004 and April 2013. Surgical outcomes and variables that might affect extent of resection, complications, and recurrence were analyzed.
RESULTS: Forty-eight operations were performed (42 EEAs and 6 open approaches). Gross-total resection was achieved in 22 patients (62.9%), near total (≥90% tumor resection) in 11 (31.4%). Larger tumors were associated with incomplete resection in univariate and multivariate analysis ( P = .004, .015, respectively). In univariate analysis, tumors involving the lower clivus and cerebellopontine angle were associated with increased number of complications, especially postoperative cerebrospinal fluid leak ( P = .015) and new cranial neuropathy ( P = .037), respectively. Other major complications included 2 cases of meningitis and deep venous thrombosis, and 1 case of hydrocephalus and carotid injury. Involvement of the lower clivus, parapharyngeal space, and cervical spine required a combination of approaches to maximize tumor resection ( P = .017, .044, .017, respectively). No predictors were significantly associated with increased risk of recurrence. The average follow-up time was 44.6 ± 31 months.
CONCLUSIONS: EEAs may be considered a good option for managing CBCs without significant posterolateral extension beyond the basal foramina and can be used in conjunction with open approaches for maximal resection with acceptable morbidity.

PMID: 28838112 [PubMed - in process]

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Meningocele and Meningoencephalocele of the Lateral Wall of the Sphenoid Sinus.

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Meningocele and Meningoencephalocele of the Lateral Wall of the Sphenoid Sinus.

World Neurosurg. 2016 May;89:703-4

Authors: Laws ER

PMID: 26732955 [PubMed - indexed for MEDLINE]

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Surgical treatment of vestibular schwannoma. Review of 420 cases.

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Surgical treatment of vestibular schwannoma. Review of 420 cases.

Acta Otorrinolaringol Esp. 2016 Jul-Aug;67(4):201-11

Authors: Arístegui Ruiz MÁ, González-Orús Álvarez-Morujo RJ, Oviedo CM, Ruiz-Juretschke F, García Leal R, Scola Yurrita B

Abstract
INTRODUCTION AND OBJECTIVES: Vestibular schwannoma is the most frequent cerebellopontine angle tumor. The aim of our study is to reflect our experience in the surgical treatment of this tumor
MATERIAL AND METHODS: Retrospective study of 420 vestibular schwannomas operated in our hospital between 1994-2014. We include tumor size, preoperative hearing, surgical approaches, definitive facial and hearing functional results, and complications due to surgery.
RESULTS: A total of 417 patients with 420 tumors were analyzed, 209 female (50.1%) and 208 male (49.9%). Mean age at diagnosis was 49.8±13.2 years. The majority of the tumors were resected through a translabyrinthine approach (80.2%). Total tumor removal was achieved in 411 tumors (98.3%), and anatomic preservation of facial nerve in 404 (96.2%). Definitive facial nerve outcome was House-Brackmann grade I and II in 69.9%, and was significantly better in tumors under 20mm. Surgical complications included cerebrospinal fluid leakage in 3 patients (0.7%) and retroauricular subcutaneous collection in 16 (3.8%), 5 cases of meningitis (1.2%), 4 patients with intracraneal bleeding (0.9%), and death in 3 patients (0.7%).
CONCLUSIONS: Surgery is the treatment of choice for vestibular schwannoma in the majority of patients. In our experience, the complication rate is very low and tumor size is the main factor influencing postoperative facial nerve function.

PMID: 26679233 [PubMed - indexed for MEDLINE]

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Treatment outcomes of recurrent respiratory papillomatosis : Retrospective analysis of juvenile and adult cases.

Treatment outcomes of recurrent respiratory papillomatosis : Retrospective analysis of juvenile and adult cases.

HNO. 2017 Aug 24;:

Authors: Papaioannou VA, Lux A, Voigt-Zimmermann S, Arens C

Abstract
BACKGROUND: Recurrent respiratory papillomatosis (RRP) is a rare, chronic disease of viral etiology which is characterized by multiple, recurrent growth of papillomas in the aerodigestive tract.
MATERIALS AND METHODS: The surgical outcomes and the recurrence rates of 106 patients with RRP of the larynx were analyzed. The patients were treated at the University of Magdeburg between 1983 and 2014. The surgical outcomes of conventional and laser surgery regarding time to relapse and complications were compared. In addition, the influence of the quadrivalent vaccine Gardasil® on the disease was analyzed in 10 patients.
RESULTS: Children with RRP had a statistically significant greater number of surgeries throughout their lifetimes compared to adult patients. There were no differences between the adult (n = 79) and juvenile (n = 27) groups in the time to relapse and the number of surgeries/year. The time to relapse and number of procedures/year were not influenced by the various surgical methods. Complications after conventional and laser surgery were not statistically different between the two groups. Serious complications and the need for a tracheotomy were only reported after conventional surgery. In the 10 patients who were immunized with Gardasil®, a statistically significant lower number of surgeries/year after vaccination was achieved.
CONCLUSION: RRP is a rare disease. Treatment requires experience and may be very difficult. The analysis of the course of the disease has shown that the treatment of choice is surgical excision with the CO2 laser combined with the quadrivalent or polyvalent vaccine. Consequent vaccination of both boys and girls has the potential to reduce the occurrence of RRP.

PMID: 28840259 [PubMed - as supplied by publisher]

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Subglottic infantile haemangioma: A rare but important consideration in young infants presenting with stridor.

Subglottic infantile haemangioma: A rare but important consideration in young infants presenting with stridor.

J Paediatr Child Health. 2016 Dec;52(12):1111-1113

Authors: Ting M, Roseby R, McAdam C

PMID: 27567008 [PubMed - indexed for MEDLINE]

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Cervical spondylodiscitis secondary to insertion of voice prosthesis.

Cervical spondylodiscitis secondary to insertion of voice prosthesis.

Acta Otorrinolaringol Esp. 2016 Jul-Aug;67(4):239-41

Authors: González-Paz T, Nehme-Paz AR, Rodríguez-Acevedo N, Arán-González I

PMID: 26593224 [PubMed - indexed for MEDLINE]

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