No abstract

We present a case report of primary middle ear lipoma diagnosed in right ear of a 25-month-old girl with right otitis media. We identified injection and retraction at right ear drum. Impedance tympanometry of right ear was type B and temporal bone CT was suggestive of a congenital cholesteatoma. During the tympanoplasty, a mass of tissue obstructing the eustachian tube orifice was noted in the middle ear. We have treated a case of a lipoma that originated from the middle ear; only 5 such cases have been reported worldwide.

No abstract

) at a tertiary academic referral center including all patients diagnosed with ILS. RESULTS: Over the last decade, a total of 15 patients (11 females; mean follow-up 35.5 months) with ILS were evaluated at our institution. The mean age at diagnosis was 43.6 years (15-81 yrs) with an average 5.6 year delay from first onset of symptoms. Nine patients had isolated intracochlear tumors, three had intravestibular lesions, and three patients had tumor growth within both the cochlea and vestibule. Asymmetric sensorineural hearing (SNHL) loss was the most common symptom (100%) followed by tinnitus, unsteadiness, and intractable vertigo; no patients experienced facial nerve dysfunction. Three patients reported sudden SNHL and over 70% progressed to class D hearing. Eleven patients were observed with serial MRI and exam without evidence of tumor progression, three underwent surgical removal and one was treated with stereotactic radiotherapy. CONCLUSION: Intralabyrinthine schwannomas are rare tumors that may result in sudden or progressive asymmetric SNHL with or without vestibulopathy. Because of the often subtle radiographic findings, the diagnosis is often delayed. The majority of patients may be managed with simple observation and serial MRI. Those with clinical or radiographic tumor progression may require surgery or stereotactic radiotherapy; both of which appear to be well tolerated with low rates of complication. Intraoperative Monitoring of Hearing During OssiculoplastyKrzysztof Morawski, MD, PhD (presenter); Kazimierz Niemczyk, MD, PhD; Jacek Sokolowski, MD; Fred Telischi, MD OBJECTIVE: To evaluate the utility of electrocochleography recorded from the round window (RW-ECochG) and auditory brainstem responses (ABR) for assessment of hearing improvement during ossicular reconstruction performed during second look operation. METHOD: Twenty patients 18 to 50 years of age underwent two stage canal wall-up tympanoplasty and were followed for at least 6 months. During the second look operation, RWECochG and ABR were measured intraoperatively. Needle electrode for RW-ECochG was placed at RW niche via posterior tympanotomy. Various options of ossiculoplasty were evaluated. Auditory thresholds defined by N1-peak in RWECochG and ABR wave V were evaluated for various prostheses types and orientations. RESULTS: Intraoperatively measured thresholds demonstrated a good improvement for click and tone-bursts. RWECochG appeared more sensitive than ABR during ossicular prostheses manipulations. The largest changes in measurements occurred during TORP placement procedures. In two cases intraoperative bleeding from tympanic mucosa made effective testing impossible. For all the others, a good correspondence between intraoperative recordings and postoperative hearing results were achieved. CONCLUSION: Intraoperative evoked potentials using RWECochG and, to some extent, ABR were found to be good predictors of postoperative hearing after second stage ossicular reconstruction tool for intraoperative evaluation of ossicular reconstruction ...

No abstract