Outcomes of middle fossa craniotomy for the repair of superior semicircular canal dehiscence

Publication date: Available online 13 June 2017 Source:Journal of Clinical Neuroscience Author(s): Nolan Ung, Lawrance K. Chung, Carlito Lagman, Nikhilesh S. Bhatt, Natalie E. Barnette, Vera Ong, Quinton Gopen, Isaac Yang Superior semicircular canal dehiscence (SSCD) is a rare defect of the arcuate eminence that causes an abnormal connection between the superior semicircular canal and middle cranial fossa. Patients often present with a variety of auditory and vestibular symptoms. Trigger avoidance is the initial strategy, but surgery may be necessary in debilitating cases. We retrospectively reviewed SSCD patients undergoing repair via a middle fossa craniotomy between March 2011 and September 2015. Forty-nine patients undergoing 58 surgeries were identified. Autophony was the most common symptom at presentation (n =44; 90%). Mean follow-up was 10.9months, with 100% of patients reporting resolution of at least one symptom. Aural fullness was the most commonly resolved symptom following surgical repair (n =19/22; 86%). Hearing loss (n =11/25; 44%) and tinnitus (n =11/38; 29%) were the most common symptoms to persist following surgery. The most common symptom to develop after surgery was disequilibrium (n =4/18; 22%). Upon comparing the overall pre-operative and post-operative groups, the number of patients with autophony (p <0.0001), aural fullness (p =0.0006), hearing loss (p =0.0119), disequilibrium (p =0.0002), sound- and pressure-induced vertigo (p <0.0001), and tin...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research

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ConclusionOur study shows a reduced number of vertigo attacks and a positive effect on the discomfort generated by tinnitus and quality of life in patients with unilateral MD treated with SPC and when compared to patients treated with intravenous glycerol and dexamethasone. No effects on hearing thresholds were noted in both groups.
Source: European Archives of Oto-Rhino-Laryngology - Category: ENT & OMF Source Type: research
This article isolates the auditory and vestibular side effects of those drugs as reported by the drug's manufacturer as well as those side effects that could interfere with a balance assessment. Twenty of the 75 approved medications (26%) could have an auditory-related side effect. Hearing loss and tinnitus are not on the list. Only two, or just 3%, have vertigo and spinning as reported side effects (one each). More than 50% of the drugs will have some effect on a balance assessment. Audiologists who evaluate a patient with diabetes (PWD) are presented with symptoms that could be related to their diabetes medication. Altho...
Source: Seminars in Hearing - Category: Audiology Authors: Tags: Review Article Source Type: research
We present the case of a 39-year-old male presenting with headache, vertigo, tinnitus, hearing loss, and hoarseness. Neurological assessment showed facial paralysis House–Brackmann IV and lower cranial nerves deficits. Preoperative magnetic resonance imaging (MRI) demonstrated two large lesions, suggestive of a glomus jugulare, and carotid body paragangliomas. Considering worsening of the symptoms and the important mass effect of both lesions over the neurovascular structures, microsurgical excision was offered, after preoperative tumor embolization. We preferred to approach both lesions in the same operation, starti...
Source: Journal of Neurological Surgery Part B: Skull Base - Category: Neurosurgery Authors: Tags: Skull Base: Operative Videos Source Type: research
Conclusion: Vestibulocochlear symptoms such as SNHL, recurrent paroxysmal vertigo, or typewriter tinnitus can be precipitated from a neurovascular compression of the vestibulocochlear nerve by VBD. Because proper medical or surgical treatments may stop the disease progression or improve audio-vestibular symptoms in subjects with VBD, a high index of suspicion and meticulous radiologic evaluation are needed when vestibulocochlear symptoms are not otherwise explainable, and if VBD is confirmed to cause audiovestibular manifestation, a thorough oto-neurotologic evaluation should be performed before initial treatment. PMID...
Source: Clinical and Experimental Otorhinolaryngology - Category: ENT & OMF Tags: Clin Exp Otorhinolaryngol Source Type: research
Conclusion: Patients affected by ISSHL with associated vertigo show a higher likelihood of having a positive MR imaging, which, in turn, seems to predict an unfavorable outcome.
Source: Otology and Neurotology - Category: ENT & OMF Tags: SENSORINEURAL HEARING LOSS AND TINNITUS Source Type: research
Objective: Intratympanic (IT) steroid administration for sudden sensorineural hearing loss is offered as salvage to patients who failed systemic steroid treatment. Our objective was to study the audiometric and clinical outcomes of patients given salvage therapy with high-dose IT steroids instilled via ventilation tube. Study Design: Retrospective case review. Setting: Academic secondary medical center. Patients: One hundred three patients>18 years of age with sudden sensorineural hearing loss who failed systemic steroids and received IT treatment between 2010 and 2018. Intervention: Following ventilation ...
Source: Otology and Neurotology - Category: ENT & OMF Tags: SENSORINEURAL HEARING LOSS AND TINNITUS Source Type: research
CONCLUSIONS: Early grommet insertion with transtympanic steroid injection, combined with customised vestibular physiotherapy, may provide an alternative first-line strategy for MD, preventing further true MD attacks. In some patients, it may significantly improve hearing thresholds. PMID: 31508988 [PubMed - as supplied by publisher]
Source: Annals of the Royal College of Surgeons of England - Category: Surgery Authors: Tags: Ann R Coll Surg Engl Source Type: research
Conclusions and significance: Intratympanically administered dexamethasone is a potent agent to prevent the progression of hearing loss in MD. PMID: 31498001 [PubMed - as supplied by publisher]
Source: Acta Oto-Laryngologica - Category: ENT & OMF Authors: Tags: Acta Otolaryngol Source Type: research
Conclusion: SSNHL patient with ESRD often suffered a severe hearing loss with a high rate of accompanying tinnitus and vertigo. ITS may provide better audiological results for SSNHL with ESRD than OS. PMID: 31486695 [PubMed - as supplied by publisher]
Source: Acta Oto-Laryngologica - Category: ENT & OMF Authors: Tags: Acta Otolaryngol Source Type: research
Publication date: Available online 19 August 2019Source: Operative Techniques in Otolaryngology-Head and Neck SurgeryAuthor(s): Jenny X. Chen, Zizi Yu, Steven D. RauchMeniere's disease is characterized by idiopathic progressive fluctuating hearing loss, tinnitus, and episodic vertigo. Intratympanic gentamicin injection is the preferred therapeutic option for those who have failed conservative management including lifestyle modifications and oral medications. The procedure is simple and can be performed in the outpatient setting under local anesthesia with manageable recovery time. Patients may experience a disequilibrium s...
Source: Operative Techniques in Otolaryngology Head and Neck Surgery - Category: ENT & OMF Source Type: research
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