0000000000117523
AUTHOR
Mario Sanna
Management of chronic otitis by middle ear obliteration with blind sac closure of the external auditory canal.
Objective: Description of a technique of middle ear obliteration (MEO) with blind sac closure of the external auditory canal with discussion of the indications for its use in cases of recalcitrant chronic otitis and in far advanced disease. Patients: All patients underwent otologic examination and audiologic and radiologic assessments in a quaternary center. Results: Fifty-three cases of MEO were analyzed. For 9 patients, primary surgery was performed. One case of residual disease was identified. The minimum follow-up was 2 years. Conclusion: The decision to perform a MEO is one that is made only rarely. However, this is a technique that should be part of every otologist`s armamentarium. Wh…
Otoneurological management of petrous apex cholesterol granuloma
Objective: The aim of the study is to review the management of petrous apex cholesterol granuloma. The surgical approaches for drainage or total removal and the wait and see policy were analyzed, and outcomes were evaluated. Methods: Retrospective charts of 27 patients managed for petrous apex cholesterol granuloma with a minimum follow-up of 12 months were analyzed in a quartenary skull base center. Presenting symptoms and signs were recorded, and radiologic imaging was evaluated. Management options included wait and see policy and surgery by several approaches. Results: The mean age of patients affected by the lesion was 38.8 years. The mean follow-up was 56.7 months. Patients complained …
Decision making for solitary vestibular schwannoma and contralateral Meniere's disease.
The existence of dual inner ear pathology such as unilateral Meniere’s disease (MD) with a contralateral vestibular schwannoma (VS) is very rare, but provides the otologist with a significant management dilemma. In this study, we present 5 cases of unilateral disabling MD with a contralateral VS in the better hearing ear. Conservative management of the VS is mandated unless there are impending complications, with management directed toward controlling the vertigo attributed to MD. If and when the VS requires intervention, or the hearing in that ear deteriorates to unserviceable levels, cochlear implant of the ear affected by MD prior to addressing the VS provides optimal management.
Cystic vestibular schwannoma: classification, management, and facial nerve outcomes.
OBJECTIVE: Review of postoperative morbidity and facial nerve outcomes of cystic vestibular schwannoma (CVS) patients compared with solid vestibular schwannoma (SVS) patients and a proposal for a new CVS classification system. STUDY DESIGN: Retrospective review. SETTING: Tertiary care facility. PATIENTS: Ninety-six patients with surgically treated CVS (1998-2008). Outcomes were assessed in a subpopulation of 57 patients with greater than or equal to 1-year follow-up compared with 57 SVS patients. INTERVENTION: Fifty-six CVS patients underwent the enlarged translabyrinthine approach with transapical extension (Type I), and 1 patient underwent a transcochlear/transzygomatic approach. MAIN OUT…
Intratympanic gentamicin: a 1-day protocol treatment for unilateral Meniere's disease
Abstract Purpose The objective of this study was to assess the usefulness of low-dose intratympanic gentamicin administration in patients with Meniere's disease (MD). Materials and Methods We carried out a retrospective review of the charts of 55 patients with definite MD in accordance with the AAO-HNS (American Academy of Otolaryngology–Head and Neck Surgery) Diagnostic Scale who were treated at Gruppo Otologico (Piacenza, Rome, Italy). The treatment protocol consisted of 3 intratympanic injections of gentamicin at a 12-hour interval between each administration. Results Results were resumed in accordance with AAO-HNS criteria and showed complete control of vertigo spells in 60% (class A), …
Management of intralabyrinthine schwannomas
Abstract Objectives Our protocol to manage the intralabyrinthine schwannoma (ILS). Methods Retrospective chart review of 7 consecutive patients managed for ILS. Results Five patients underwent surgical removal of the lesions and none experienced significant complications or recurrent disease. One patient refused surgical treatment and was closely followed by serial MRI scans with no signs of tumor growth. One patient is presently managed conservatively due to a good hearing. Conclusions Diagnosis of ILS is based on high resolution MRI scans and should be included in the differential diagnosis of patients investigated for cochleovestibular symptoms. Treatment modality of ILS is controversial…