This newly introduced method of BET was found to be a feasible and safe procedure to inflate the ET. It significantly helped to improve ET function in our study group. However, larger long-term studies are necessary to fully evaluate the clinical value of BET.

This newly introduced method seems to be a feasible and safe procedure to dilate the Eustachian tube.

Objectives: Neurogenic tumors of the larynx are extremely rare. The goal of this report is to advert to this rare disease, to review and discuss diagnostics, differential diagnoses and treatment options. Study Design: Retrospective case report and review of the literature. Methods: Case report of a schwannoma of the supraglottic larynx and review of the English-and German-language literature regarding neurogenic tumors of the larynx. Results: Neurogenic laryngeal tumors typically involve the supraglottic larynx, rarely the glottis. They can course globus sensation, dysphagia, dysphonia and upper airway obstruction. Imaging does not yield a definite diagnosis. The only curative treatment option is complete surgical resection. Conclusions: A definite diagnosis can only be made histologically. Endoscopic (laser-) resection for smaller lesions and external approaches for larger lesions are recommended treatment options.

The initial long-term results suggest that BET is feasible and safe for the treatment of chronic obstructive eustachian tube dysfunction.

A 66-year-old female patient presented with a unilateral mixed hearing loss for several months. Otoscopy of the right ear revealed a white-colored sclerotic plaque under an intact and thickened tympanic membrane. The ear canal was without any pathologic finding. The provisional differential diagnosis was middle ear cholesteatoma. The patient's history did not reveal any significant predisposing factors for gout such as diuretic or aspirin usage, trauma, or acute illness. Our patient did not show any typical gouty symptoms such as severe joint pain, swelling, tenderness, or joint erythema. There were no clinical or laboratory signs of hyperuricemia.Clinical examination contained otoscopy by ear microscopy, pure-tone audiography, and tympanometry. Moreover, high-resolution computerized tomography of the temporal bone was done (Fig. 1). We performed a tympanoscopy of the patient's right ear in general anesthesia and removed semolina puddingYlike middle ear mass. Histopathology identified negatively birefringent crystals by light and polarized microscopy. Preoperative and postoperative pure-tone audiograms were examined after healing in a follow-up period of 3 months. Serologic analysis of urate was done according to a standard protocol. A musculoskeletal survey was performed by an orthopedic consultant. Because of the lack of any major joint symptoms, a joint fluid analysis (the gold standard for the diagnosis of gout) could not be obtained.The patient showed a combined hearing deafness with a conductive loss of 20 dB and normal tympanometry. Computed tomography of the petrous bone displayed a partial opacification of the middle ear with an almostnormal mastoid. During operation, we removed the middle ear masses that seemed semolina-like. The ossicular chain, chorda tympani, and tympanic membrane remained intact. Gout tophi were revealed on histopathologic examination by the identification of negatively birefringent monosodium urate crystals in the tophi by polarized Address correspondence and reprint requests to FIG. 1. Computerized tomography of the temporal bone showing a partly opacified middle ear. FIG. 2. Amorphous deposits within the tympanic membrane and subepithelial tissue. Needle-like deposits are also displaced within a fibrous stroma. Little inflammation is present. HE-staining, Â200.

In stapes surgery the step of fixation of the prosthesis onto the incus is critical. Implantation of the new Nitinol piston stapes prosthesis is facilitated due to the superelasticity and the design of the prosthesis. Crimping is not needed anymore. Postoperative hearing results are very good comparable to other Nitinol (shape memory) or titanium prostheses. Long-term results in a larger number of patients will be studied in the future.

Preoperative embolization for the treatment of juvenile nasopharyngeal angiofibroma was successfully accomplished with Onyx by intratumoral puncture for the first time. Extratumoral migration of Onyx particles was not observed, precluding the necessity to inflate the shield balloon. Postinterventional angiography showed complete occlusion of all supporting blood vessels. Transnasal surgery on the following day achieved complete resection of the angiofibroma without complications. Direct intratumoral embolization of juvenile nasopharyngeal angiofibromas appears to be a safe and effective preoperative method without complications. It could represent a new strategy for the treatment of JNA, as is already the case with other highly vascularized head and neck tumors. Moreover, it increases the likelihood of achieving complete resection.

This paper reviews the past and present developments in the treatment of chronic obstructive eustachian tube dysfunction. Alongside tube catheterization and bougie insertion, modern approaches such as laser eustachian tuboplasty and balloon eustachian tuboplasty (BET) are described. In BET, transnasal endoscopic insertion via the pharyngeal ostium places a balloon catheter in the cartilaginous portion of the eustachian tube. This is then dilated to a pressure of 10 bar for 2 min. Up until January 2013, 351 chronic obstructive eustachian tube dysfunction patients had been treated in our department using BET. The average preoperative eustachian tube score was 2.1 (± 1.8 standard deviation, SD); 12 months postoperatively it was 6.1 (± 2.6 SD). Of these patients, 87% expressed satisfaction with the improvement in chronic obstructive dysfunction. These results demonstrate that BET is a safe and effective treatment for improving eustachian tube function and ear ventilation.