No abstract

We can confirm the chance of achieving satisfactory results by CI even when the imaging of CVN is doubtful and the electrophysiological tests are disappointing. In our experience, a CI in Type IIb dysplasia of the CVN is a feasible option, provided that the candidate shows some responses at aided audiogram and at least minimal signs of language development. Adequate counseling is necessary for these children because the expected outcome is somewhat lower than that of their deaf peers with normal appearance of the nerves.

Currently, there are no studies assessing everyday use of cochlear implant (CI) processors by recipients by means of objective tools. The Nucleus 6 sound processor features a data logging system capable of real-time recording of CI use in different acoustic environments and under various categories of loudness levels. In this study, we report data logged for the different scenes and different loudness levels of 1,366 CI patients, as recorded by SCAN. Monitoring device use in cochlear implant recipients of all ages provides important information about the listening conditions encountered in recipients' daily lives that may support counseling and assist in the further management of their device settings. The findings for this large cohort of active CI users confirm differences between age groups concerning device use and exposure to various noise environments, especially between the youngest and oldest age groups, while similar levels of loudness were observed.

Internal jugular vein thrombosis may be a complication of acute otitis media, without involvement of the sigmoid sinus and with a starting point in the jugular bulb. Anticoagulation associated with antibiotic therapy can be considered a safe and effective treatment. Surgery should only be performed to eliminate the source of infection from the middle ear and mastoid.

Objectives: We sought to identify factors associated with anatomic and functional results of canal wall-down tympanoplasty. Methods: One hundred eighty-nine primary or relapsing cholesteatomas were consecutively operated on by a single surgeon. Cholesteatoma recurrence rates were evaluated. Predictive values of the patient, disease, and surgical characteristics on cholesteatoma recurrence were estimated. The effect of these variables on keratin pearl development, recurrent otorrhea or granulation tissue formation, and hearing function was tested. Results: The mean follow-up was 8 years (range, 4 to 15 years). The cholesteatoma relapse rate (±SE) estimated by the Kaplan-Meier method was 2.1% ± 1.1%. No variables were associated with relapsing disease. The log-rank test showed a significantly higher probability of keratin pearls in male patients (16.7% versus 2.1%; P =0.00 I), young patients (less than 16 years; 51.4% versus 6.2%; p =0.0001), patients with unencapsulated cholesteatomas (19.5% versus 5.3%; p =0.06), patients with petrous or accessory cellularity invasion (17.9% versus 7.1%; p =0.02), and patients with overlay myringoplasty (25% versus 7.9%; p =0.03). Recurrent otorrhea and granulation tissue were associated with homograft temporal is fascia myringoplasty (14.3% versus 3.8%; p =0.04). The overall postoperative air-bone gap was within 20 dB in 30.7%; it was within 20 dB in 43.9% (47/107) for intact or reconstructed ossicular chains and in 13.4% (11/82) for nonreconstructed, eroded ossicular chains (p =0.0001). The air-bone gap was within 20 dB in 42.6% (46/108) when the mucosa of the tympanic cavity was normal and in 14.8% (12/81) when there was granulation tissue within the tympanic cavity (p =0.0001). Conclusions: Single-stage canal wall-down tympanoplasty is an appropriate treatment for acquired tympanomastoid cholesteatoma.