October 26, 2011 Hüseyin Işıldak, MD, Metin Ibrahimov, MD, Mehmet Yilmaz, MD, Ozgun Enver, MD, and Sait Albayram, MD
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Abstract
Schwannomas arising from the cochlear nerve and confined to the internal auditory canal are rare. Clinically, a cochlear schwannoma can cause a progressive hearing loss. We report the case of a 56-year-old woman with a cochlear schwannoma that manifested as a slowly progressive hearing loss. The lesion was diagnosed by gadolinium-enhanced 3-Tesla magnetic resonance imaging.
July 13, 2011 Larry Lundy, MD and Selmin Karatayli-Ozgursoy, MD
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Abstract
In this article we describe a new method of cochlear implant receiver-stimulator fixation using a resorbable poly (D,L) lactic acid mesh. We conducted a retrospective case review at a tertiary referral center; 10 pediatric and 4 adult patients had undergone cochlear implantation during the period from February to October 2008. Resorbable poly (D,L) lactic acid mesh and pins were used for fixation of the cochlear implant receiver stimulator. The receiver stimulator was assessed for stability/migration, and the scalp flap/incision were evaluated for allergic reactions, infections, and healing problems. With an average follow-up of 17.2 months, no patients had migration of the receiver stimulator, and there was no evidence of infection, wound dehiscence, or allergic reaction. Early results indicate that fixation of a cochlear implant receiver stimulator using resorbable mesh is well tolerated and provides good stability without device migration. Resorbable mesh fixation of the receiver stimulator is a reasonable alternative technique for cochlear implantation.
December 1, 2009 Fernando Ribeiro, MD, Liciere Marotta, MD, and Claudia A. Eckley, MD
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Abstract
Modern magnetic resonance imaging has significantly improved the diagnosis of cochlear nerve deficiencies. A careful assessment of all clinical, imaging, and auditory data is of utmost importance in such cases in order to properly establish the site of the abnormality. We report the case of a 3-year-old girl with unilateral cochlear nerve aplasia, normal middle and inner ear anatomy, and an absence of otoacoustic emissions, all of which erroneously suggested cochlear damage. We also briefly review the embryogenesis of the inner ear and auditory pathway. A patient with similar findings in the setting of a bilateral hearing loss and insufficient imaging would be at risk of inappropriate cochlear implantation.
March 31, 2009 Fred Linthicum Jr., MD
May 31, 2008 Masoud Motasaddi Zarandy, MD
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Abstract
The standard transmastoid facial recess approach has become the popular technique for cochlear implantation. Although this approach has been used for implantation in patients with common cavity malformations, in patients with this anomaly and severe abnormalities of the middle ear, this approach may be technically difficult and makes the facial nerve vulnerable to injury. Using a direct approach to the common cavity through the mastoid cavity, we have successfully performed cochlear implantation in 1 patient with a common cavity malformation. This transmastoid labyrinthotomy approach to the common cavity is an effective and simple technique for placing the electrode array. It minimizes the risk to the facial nerve and may decrease postoperative cerebrospinal fluid leaks.
March 1, 2008 Matthew S. Pogodzinski, MD, Jon K. Shallop, PhD, Juraj Sprung, MD, PhD, Toby N. Weingarten, MD, Gilbert Y. Wong, MD, and Thomas J. McDonald, MD
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Abstract
A decrease in cerebrospinal fluid pressure may result in an endolymphatic hydrops through a patent cochlear aqueduct or through the fundus of the internal auditory canal. This hydrops typically leads to low-frequency sensorineural hearing loss. We describe the case of a man who presented with a subjective and objective hearing loss in addition to a headache 4 days after he had undergone a dural puncture. We treated him with a standard epidural blood patch. Immediately after treatment, his hearing improved and his headache resolved.
May 31, 2007 Joe Walter Kutz Jr., MD; William H. Slattery III, MD
July 31, 2005 Jane T. Siegal, PsyD; William Robiner, PhD; Sharon Smith, MS; Samuel C. Levine, MD
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Abstract
In view of the demanding instruction and training requirements associated with cochlear implantation, patients with cognitive impairments have typically been considered to be poor candidates for this procedure. This presumption persists in part because experience and research in this area are limited. We describe our experience with implanting cochlear devices in 2 patients who had significant psychological impairments; 1 patient had experienced a severe brain injury, and the other had paranoid schizophrenia. Nevertheless, both patients were able to follow the implant training program, and they experienced different degrees of improvement in their hearing. We discuss our preoperative evaluations of these patients and the key factors that led to our decision to proceed with surgery.
January 1, 2005 Henriëtte E. Westerlaan, MD; Linda C. Meiners, MD, PhD; Lourens Penning, MD, PhD
