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Otology
Published in Adnan Darr, Karan Jolly, Jameel Muzaffar, ENT Vivas, 2023
Jameel Muzaffar, Chloe Swords, Adnan Darr, Karan Jolly, Manohar Bance, Sanjiv Bhimrao
Evidence: Meta-analysis: Jalali et al. Comparison of cartilage with temporalis fascia tympanoplasty: A meta-analysis of comparative studies. Laryngoscope 2017; 127(9): 2139–2148 Cartilage tympanoplasty favoured TF for integration rateHearing outcomes were the sameIn children: Depends on sxConventional wisdom has been that it is preferable to delay to age 10–12, but there is no statistical evidence to support this. However, it is potentially prudent to wait until the contralateral ear has normalised as this is associated with improved outcomes (Hardman et al. Tympanoplasty for chronic tympanic membrane perforation in children: systematic review and meta-analysis. Otology & Neurotology 2015; 36(5): 796–804) Improved ET functionHave to balance this with ages children keen to swim
Vestibular Migraine
Published in John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed, Paediatrics, The Ear, Skull Base, 2018
However, in neuro-otology and dizziness clinics, the majority of patients who describe dizziness and vertigo in association with migraine headaches and other migrainous phenomena, do not meet strict criteria for aura.2 This led to the proposal by Neuhauser in 2001 to define an entity they called migrainous vertigo. This definition was updated in 2012 in a joint statement by the International Headache Society and the Barany Society and termed vestibular migraine (VM) (Box 76.4, also in the Appendix section of ICHD-3 beta),1 which is the third type of migrainous disorder mentioned in the classification system. The validity of the diagnosis has been supported by long-term follow-up studies in which its stability has been demonstrated over a period of up to 9 years.4
An Overview of Position Documents
Published in Dale A. Stirling, Biomedical Organizations, 2012
<http://www.otology-neurotology.org/ANS/ans-main.html> Policy StatementsComponents of the Neurotologic ExaminationFacial Nerve MonitoringJoint Policy Statements: American Neurotologic Society and American Otologic SocietyCochlear ImplantsDynamic Posturography and Vestibular TestingEvaluation Prior to Hearing Aid FittingFacial Nerve MonitoringHearing AidsHearing ImpairmentImplantable Hearing DevicesInfant HearingInstitution-Based Audiology FacilitiesMedical Role in Cerumen Removal
Comparison between caloric and video-head impulse tests in Ménière’s disease and vestibular neuritis
Published in International Journal of Audiology, 2023
András Molnár, Stefani Maihoub, László Tamás, Ágnes Szirmai
A total of 109 patients (24 men, 85 women; mean age: 55.6 n = 26) and vestibular neuritis of the superior parts of the vestibular nerve (n = 27) were examined. Fifty-six patients with a normal vestibular system were also examined as controls. The latter group had been referred to neurotology for suspected sensorineural hearing loss and/or tinnitus without evidence of vertigo, dizziness, or other vestibular symptoms and had undergone a complete neurotological examination that failed to indicate any pathologies in vestibular function. In our clinical expertise, this group of patients always undergoes a detailed neurotological examination; therefore, sufficient clinical data were available to include them as a control group.
Cochlear implantation through intracochlear fibrosis: A comparison of surgical techniques
Published in Cochlear Implants International, 2023
Anne K. Maxwell, Jacob B. Kahane, Rahul Mehta, Moises A. Arriaga
Retrospective review of all patients who underwent cochlear implantation between 2009 and 2020 at a single University-based tertiary referral otology-neurotology practice was performed. Institutional Review Board approval (#19-971) was obtained as an exempt review. Patients found to have intracochlear fibrosis were identified. Those with bilateral profound SNHL met CI criteria with AzBio sentence testing in the best aided condition, while those with a unilateral profound SNHL met CI criteria for single-sided deafness with CNC word scores. Patient history, operative techniques, and type of implant used were examined. CT and MRI were performed preoperatively in all patients. Preoperative audiologic testing including pure tone average (PTA), speech reception threshold (SRT), and speech discrimination scores (SDS) were performed in the unaided condition. Postoperative audiologic testing was performed with the CI in place. PTA was calculated as an average of the air-conducted stimuli at 500-, 1000-, 2000-, and 4000-Hz. For calculations of means, when no response was obtained at a given frequency, 115 dB was substituted.
Cochlear implant indications: a review of third-party payers’ policies for standard and expanded indications
Published in Cochlear Implants International, 2021
Lindsey E. Moses, David R. Friedmann
Consensus statements from professional organizations regarding pediatric CI are even less prevalent. In 2011, the Government of Western Australia published guidelines supporting implantation in children under 12 months as well as bilateral implantation.28 No specific statement from the Academy of Otolaryngology, American Society of Pediatric Otolaryngology or American Neurotology Society exists regarding cochlear implantation in children. Among all of the scenarios evaluated here, perhaps most concerning is that criteria for children remain particularly conservative during a period of development when they are to be acquiring speech and language skills and that current policies emphasize audiometric detection most stringently rather than functional measures such as speech recognition. Consensus statements from more organizations based on data regarding the benefits of pediatric CI may provide stimulus to broaden the requirements for children and potentially lower the age for approval of implantation.