Central skull base osteomyelitis (SBO) is a life-threatening disease originating from ear and from sinonasal infections. The intention of this study was to evaluate contemporary trends in etiology, diagnosis, management, and outcome of SBO and to draw the clinician's attention on this probably underestimated disease. Over a 6-year period we performed this systematic study in an academic quaternary medical care and skull base center including 20 patients (mean age 63.7 years) with central SBO, which is one of the largest series from a single center. In contrast to previous studies we explicitly excluded infections limited to malignant external otitis only but did not restrict central SBO to conditions unrelated to aural pathology. Fifteen patients had otogenic and five sinugenic SBO; four patients had fungal or mixed fungal infections. Pre-existing illnesses altering bone vascularization were detected in 70 % of the patients and had a negative effect on the improvement of cranial nerve palsies that were found in 14 patients. In relation, patients with otogenic SBO more often had local and systemic predisposing factors. Contrary to previous studies 16 patients (80 %) underwent surgical therapy and none of our patients died. A meta-analysis of five recent studies was done and compared with our own data and two previous meta-analyses. The present study highlights several important aspects with major implications for diagnosis and treatment of SBO that have not been adequately addressed as yet. In contrast to the restrictive attitude towards surgery in literature we recommend early and radical operative treatment to reduce its mortality.

The hypotension following TCR is a negative prognostic factor for hearing preservation in patients undergoing VS surgery. Patients' knowledge of this can be increased pre- and postoperatively. Further study of this phenomenon will advance the understanding of the underlying mechanisms and may help to improve hearing preservation by controlling the occurrence of the TCR.

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On the 18th of September 2009, a group of health care professionals and scientists involved in implantation of the auditory system attended a meeting convened by the Hacettepe Cochlear Implant Group. The aim of the meeting was to have a detailed discussion on the pressing and pertinent issues around auditory brainstem implantation (ABI) in children and in non-neurofibromatosis Type 2 (NF2) cases and to reach a consensus based on these discussions. surgery, experience of individual ABI centers, intraoperative issues, and rehabilitation with the final session devoted to discussion of the issues raised. The centers presented their experience of ABI in children who had hearing impairment because of congenital abnormalities or pathology where cochlear implantation (CI) was either contraindicated or the possibility of successful placement of the electrode was unlikely. Altogether, 61 children with various types of inner ear malformations, cochleovestibular nerve (CVN) anomalies, cochlear ossification, and bilateral cochlear fractures with cochlear nerve avulsion were presented by different groups. The following topics were discussed, and a consensus was obtained at the end of the meeting on the following issues. IN WHICH CHILDREN AND NON-NF2 PATIENTS IS THE ABI A VIABLE INTERVENTION?Two patient categories were identified: 1) Prelingual patients with inner ear malformations and cochlear nerve hypoplasia/aplasia. ABI provides auditory perception in most patients. The potential for speech and language acquisition in the longer term will depend on the age of implantation, the presence or absence of additional disabilities, and the other established factors seen in CI. It also was concluded that open set speech discrimination is possible in selected cases. In addition, prelingually deafened children because of meningitis with total ossification of both cochleas also should be included in this group. 2) Individuals deafened postlingually because of meningitis, temporal bone fractures with cochlear nerve avulsion, otosclerosis with gross cochlear destruction, or unmanageable facial nerve stimulation with CI. As with CI, the duration of severe or profound deafness is a prognostic indicator, and with short

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