A reliable and valid patient-based system to measure impairment and disability in facial paralysis has been developed. This system appears to be better than traditional, physician-graded scales for evaluating quality-of-life issues affected by facial disability.

The modified Epley maneuver is an excellent treatment for BPPV.

Distortion product otoacoustic emissions (DPOAE) adapt after primary tone onset, with an approximately 100 ms time constant, due to feedback effects of medial olivocochlear (MOC) activity elicited by the primary tones. We tracked DPOAE postonset adaptation as a metric of MOC reflex strength, before during and after induction of anesthesia in guinea pigs. Reflex strength was significantly diminished by the barbiturate/neuroleptic anesthesia most commonly used in this species. The MOC reflex recovered more slowly than toe-pinch or startle reflexes, correlating better with recovery of general mobility. When individual anesthetic agents were assessed, the barbiturate (pentobarbital) significantly diminished MOC reflex strength, whereas fentanyl or droperidol did not. These results suggest that previous studies using anesthetized preparations may have underestimated the magnitude of sound-evoked responses in the OC pathway.

Fluid signal in the mastoid can be an incidental finding on T2-weighted magnetic resonance imaging and often is interpreted as mastoiditis by radiologists. This study examines 28 consecutive cases of such erroneously diagnosed “mastoiditis” and documents the presence or absence of otologic symptoms and clinical signs. We found a very low prevalence of otologic symptoms or pathology and no cases of mastoiditis in these patients, and we determined that magnetic resonance imaging is not an effective screening modality for mastoiditis. We also reviewed the literature on current diagnostic criteria for mastoiditis and propose alternative terminology to replace the use of excessively alarming terms such as “mastoiditis” unless they apply to that specific clinical diagnosis.

Objective Endolymphatic sac tumors are rare neoplasms originating in the endolymphatic sac. Current literature is limited to case reports and small case series. The objective of this study was to systematically review the literature to better describe clinical presentation, treatment options, and outcomes in endolymphatic sac tumors. Data Source PubMed, Embase, and Cochrane Library. Review Methods A systematic review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines describing human endolymphatic sac tumors. Risk of bias was assessed using a validated critical appraisal checklist for case series. Studies without inclusion of individual patient characteristics, corresponding treatments, and outcomes were excluded. Heterogeneity of data precluded meta-analysis. Results A total of 82 studies met inclusion criteria, and 253 discrete tumors were analyzed. A total of 23.4% of patients had von Hippel-Lindau disease. Von Hippel-Lindau–associated tumors affected females to males in a 2.4:1 ratio. Patients with von Hippel-Lindau disease displayed earlier average age at diagnosis compared to the sporadic cohort. Surgery was the primary treatment modality and was performed in 88.9% of cases. Adjuvant radiation therapy was employed in 18.7% of cases; 16.2% cases recurred, and 10.6% had progression of residual disease after treatment. Mean time to recurrence or progression was 53.1 ± 52.4 months with a range of 3 to 240 months. Conclusion Endolymphatic sac tumors require a high degree of suspicion for early diagnosis. Complete resection is the standard of care. No strong evidence supports routine use of adjuvant radiation therapy. Given the high rate of recurrence and wide-ranging time to recurrence, long-term follow-up is necessary.