The objective of this study was to compare the hearing outcome using hydroxyapatite (HA) bone cement to bridge the incudostapedial gap versus incus remodelling for ossiculoplasty in case of incudostapedial discontinuity. A non-randomized retrospective study was conducted at a tertiary referral otologic centre. The intervention in 24 primary cases of conductive hearing loss was subsequent middle ear inspection where incudostapedial discontinuity was observed. HA bone cement was used in 10 consecutive cases, and incus remodelling was performed in 14 consecutive cases. Air-bone gap (ABG), bone-conduction (BC) thresholds, and air-conduction (AC) thresholds were evaluated preoperatively and at 3, 6 and 12 months postoperatively. No patients were lost to follow-up. Pure-tone averages were calculated according to the guidelines of the Committee on Hearing and Equilibrium for the evaluation of conductive hearing loss. The Amsterdam Hearing Evaluation Plots are presented. The postoperative ABG closure to within 20 and 10 dB at 12 months was, respectively, 80 and 40% in the HA bone cement group and 57.1 and 28.6% in the standard ossiculoplasty group (no statistically significant difference). However, we observed a statistically significant difference in ABG gain at 6 and 12 months favoring the HA bone cement cases. No short-term or intermediate-term adverse reactions were observed. Hydroxyapatite bone cement bridging ossiculoplasty offers a better intermediate-term ABG gain than standard ossiculoplasty. This new technique is a valuable alternative to conventional ossiculoplasty and presents the practical advantage of being easier and faster.

The objectives of the study were to determine the incidence of skin reactions and complications associated with bone-anchored hearing aid (BAHA) implantation. The study is a retrospective case review done in a tertiary referral center. One hundred thirty-eight consecutive patients between 1998 and 2008 underwent implantation of a BAHA and were regularly seen for follow-up. Indications included conductive or mixed hearing loss where a hearing aid cannot be used and since 2000 also had contralateral single-sided perceptive hearing loss. BAHA implantation was done by creating a pedicled flap using the skin flap dermatome technique. Postoperative incidence of skin reactions and complications were measured. Significant postoperative complications requiring revision surgery occurred 37 times in 30 patients. Normal skin healing was seen in 52 patients (63.4%), while abnormal skin healing occurred in 30 patients (36.6%). This study showed that skin problems occur more often than expected. Because of the skin problems with the skin flap technique, the authors have switched to the linear incision technique, hoping to decrease the incidence of skin problems.

In contrast to studies assessing CHAMP performance in Ménière patients and normal controls, the present study revealed this new test offers no discriminative value in differentiating Ménière's from non-MD subjects with otovestibular symptoms.

Requ le 3 janvier 1991 Accept6 le 8 mai 1991 VANDEWALLE, P., HAVARD, M., CLAES, G., et DE VREE, F. 1992. Mouvements des michoires pharyngiennes pendant la prise de nourriture chez le Serranus scriba (LinnC, 1758) (Pisces, Serranidae). Can. J. Zool. 70 : 145 -160. Par la morphologie de ses michoires pharyngiennes, le Serranus scriba peut etre situ6 au centre des Acanthopterygiens. Les michoires pharyngiennes infkrieures ne sont solidaires entre elles qu'en avant. Les michoires pharyngiennes sup6rieures, non articulkes sur le neurocrine, sont constitukes chacune des deuxieme et troisieme pharyngobranchiaux (ce dernier est bien dkveloppk), portant une plaque dentke, et d'une plaque dentke postkrieure auxquels sont associkes deux autres petites plaques dentkes portkes par les kpibranchiaux 2 et 3. La musculature branchiale est celle gknkralement observke chez les Perciformes. Elle anime les michoires pharyngiennes de mouvements cycliques variables qui assurent le transport de proies avec carapace ou tkgument uniquement, de la cavitk buccale a l'oesophage. I1 n'y a pas de mouvements sterkotypks de mastication comme chez les poissons plus kvoluks tels que les Labridae. Le transport des proies est le plus efficace lorsque les michoires pharyngiennes supkrieures et infkrieures reculent ensemble, simultankment ou dkcal6es les unes par rapport aux autres, ou quand elles sont en opposition de phase. Ces mouvements sont souvent accompagnks d'un dkplacement vers le bas des michoires supkrieures. Pendant ces mouvements de transport, les principaux constituants des michoires pharyngiennes supkrieures ne sont pas dkplacks d'une maniere identique : le second pharyngobranchial peut, par exemple, Etre tirk vers l'avant plus que le troisikme, ce dernier pouvant 1'Etre plus vers l'arriere, tandis que la plaque dentke postkrieure peut etre klevke ou abaisske diffkremment des autres pieces. Ces mobilitks particulieres seraient dues a des activites musculaires prkcises et (ou) a des changements dans la forme et la position de la proie. Les mouvements st6rkotypks dkcrits chez certaines especes leur permettent sans doute de rkpondre aux nkcessitks d'une prise de nourriture spkcialis6e. Au contraire, le S. scriba, par la diversitk de ses mouvements, devrait Etre capable de rkpondre des situations tres diffkrentes sans pour autant etre performant dans chacune d'elles.

Superiority could probably not be demonstrated because of insufficient sample size. Research addressing technical improvements in stapes surgery should agree on a base sample size able to detect the smallest difference that is clinically important or accept the null hypothesis. With data gathered in the Common Otology Database as basis, a sample size of at least 413 patients is needed in both the intervention and the control group. Other clinical outcome measures also should be explored.

Cichlids possess a complex pharyngeal jaw apparatus, the osteological components of which are two upper pharyngeal jaws, articulating with the neurocranial base, and a single lower pharyngeal jaw. Quantitative cinera-diography revealed that pharyngeal food processing in Oreochromis niloticus involves transport, mastication, and swallowing, effected by cyclical pharyngeal jaw movements. Transport and swallowing occur by simultaneous retractions of both upper pharyngeal jaws. Food reduction (mastication) is effected by lower jaw elevation (compression) and protraction (shear) during upper jaw retraction. Each movement cycle contains a transport, reduction, and swallowing component, although their relative importance may vary within a feeding sequence. The upper and lower pharyngeal jaws show opposite anteroposterior movements during most of the cycle. Variations in the amplitudes and the durations of the different movement components reflect the consistency and the size of the food.

Statistically significant findings have shown that the choice of a matching strategy is a major factor in the accuracy of computer navigation for ear, nose, throat surgery. Arch Otolaryngol Head Neck Surg. 2000;126:1462-1466

Using actual diagnostic criteria, the diagnosis of certain Menière's disease remains impossible during life without histopathologic confirmation. Assessing the value of a diagnostic test is difficult due to the lack of a gold standard. Recent studies reported on the use of MRI after intratympanic gadolinium injection to demonstrate endolymphatic hydrops in vivo. We evaluate whether MRI after intratympanic gadolinium administration is useful for predicting the effect and outcome of intratympanic gentamicin therapy. The correlation between transtympanic electrocochleographic (TT-ECoG) results and hydrops grade on MRI images is also investigated. Twelve definite Menière's disease patients with incapacitating vertigo attacks, not responding to drug and behavioral treatment, were selected for partial chemolabyrinthectomy with intratympanic gentamicin. All patients underwent transtympanic electrocochleography followed by surgical middle ear inspection, partial chemolabyrinthectomy (gentamicin solution 40 mg/ml applied during 60 min) and intratympanic gadolinium injection with clear exposure of the round window membrane. The MR images were reviewed and a hydrops grade was assigned. Correlation between the hydrops grade and the electrocochleographic data was assessed. Only 5 of 12 patients showed gadolinium enhancement in the inner ear. However, 6 of the 7 patients that did not show postoperative intracochlear or intralabyrinthine gadolinium distribution did report the clinical improvement after intratympanic gentamicin therapy. Hydrops grade correlated with the result of transtympanic electrocochleography in four of five cases that showed gadolinium enhancement. We conclude that the use of intratympanic gadolinium has no added value in predicting the clinical outcome of intratympanic gentamicin application. However, based on these data, a correlation between the result of TT-ECoG and hydrops grading on MRI images can be suggested.