The charts of 35 patients were reviewed retrospectively to determine the effects of embolization on glomus jugulare tumors. Eighteen patients underwent embolization; 17 did not. All tumors were removed with a type A infratemporal fossa approach. The charts were evaluated for operative blood loss, operative time, length of hospitalization, new postoperative cranial nerve deficits and recurrence of tumor. Embolized patients had significantly less operative blood loss and operative time. Embolization did not affect length of hospitalization or reduce the incidence of new postoperative cranial nerve deficits. The surgeon's experience also plays a central role in reducing operative blood loss and operative time. The potential risks of embolization must be considered in the treatment regimen of glomus jugulare tumors.

The purpose of this study was to evaluate and compare the results of stapedectomy in pediatric patients with otosclerosis and tympanosclerosis. A retrospective review of 14 patients (15 ears) who underwent stapedectomy from 1993 to 1995 was conducted. In 5 ears stapedectomy for tympanosclerosis was performed; 9 patients had otosclerosis and 1 had Treacher Collins syndrome. Patients were evaluated for preoperative and postoperative air-bone gaps, preoperative and postoperative speech reception thresholds, postoperative air conduction hearing improvement, and preoperative and postoperative speech discrimination. Children with otosclerosis who underwent stapedectomies had an average postoperative air-bone gap of 16 dB with an average air conduction hearing improvement of 17.6 dB. Children with tympanosclerosis who underwent stapedectomies had an average air-bone gap of 14 dB with an average air conduction hearing improvement of 28 dB. Stapedectomy is a safe and effective treatment for otosclerosis and tympanosclerosis in pediatric patients.

Children who underwent ossicular reconstruction with PORPs had slightly better postoperative hearing than did children with TORPs. Postoperative hearing was essentially unchanged in approximately 55% of both groups. Preoperative hearing levels may be the most important factor determining postoperative hearing in nonstaged surgery for children with chronic otitis media Long-term hearing results in children with single-stage surgery were not as good as those reported in the literature for staged surgery. Severe mucosal disease and eustachian tube dysfunction may contribute to poorer hearing results in children.

Mal de debarquement syndrome is defined by a persistent sensation of rocking and swaying commonly felt with sea travel that is first noted on return to land. Mal de debarquement syndrome is not to be confused with seasickness, which causes nausea, vomiting, diaphoresis, and headache. Four female patients with mal de debarquement syndrome are reviewed. Mal de debarquement is normally a short-lived phenomenon. The need for extensive evaluations may be avoided by an awareness of this entity.

Twenty-five patients with Bell's palsy were evaluated to assess the efficacy of gadolinium (Gd+)-enhanced MRI in determining: (1) the site of facial nerve enhancement, (2) the relationship between EMG findings and Gd+ MRIs, and (3) the usefulness of Gd+ MRI in predicting recovery of facial function. Eighteen of twenty-five patients had enhancement of the facial nerve during Gd+ MRI whereas seven did not. The most common areas of facial nerve enhancement were the labyrinthine, geniculate ganglion, and proximal tympanic segments of the facial nerve. EMGs were performed on ten patients who lost nerve excitability. The segments of facial nerve enhanced during Gd+ MRI varied in location and intensity in patients who maintained nerve excitability and in patients who lost nerve excitability. There was no correlation between EMG findings and location of facial nerve enhancement in patients who lost nerve excitability. The location of facial nerve enhancement during Gd+ MRI was not useful in predicting recovery of facial paralysis.