The outcome of sudden hearing loss was unaffected by systemic disease, tinnitus or type of audiogram (except for midfrequency type). The following were poor prognostic factors in the outcome of sudden hearing loss: female gender, presence of vertigo, initiation of treatment more than seven days after onset of hearing loss, and >40 dB hearing loss on admission.

The adenoidal-nasopharyngeal ratio (ANR) was proposed as a convenient and practical method to evaluate adenoidal enlargement. We analyzed cephalometric radiographs of 150 children divided into 6 subgroups according to clinical assessment (possible adenoidectomy candidates [PACs] and controls) and age. Our purpose was to investigate the predictive reliability of different ANRs calculated on the same reference line. Each of the ANRs described in this study presented statistically significant differences between PACs and control groups, and highly significant correlations with clinical symptoms of nasal obstruction. Further, the mean adenoidal depth was significantly larger in PACs than in normals, and it was found that the adenoidal depth in PACs did not show a significant decrement with age. in contrast to normals. On the other hand, although nasopharyngeal depth was not different between PACs and normals, an age-dependent increment was observed in PACs, in contrast to normals. Thus, it could be said that the ANR is a more reliable method for determining whether adenoidal hyperplasia is clinically significant or not, rather than the size of the adenoid or nasopharynx.

Objective: To detail our experience in the management of cerebrospinal fluid (CSF) leak following posterior cranial fossa surgery by the retrosigmoid approach. Patients and Methods: 412 patients who underwent posterior cranial fossa surgery by the retrosigmoid approach for a variety of diseases were included in the study. Results: There were 32 CSF leaks (7.7%) in the 412 patients. Of these, 16 were leaks from the incision site (50%) and 16 (50%) were CSF rhinorrheas. The CSF leaks were documented in 22 of the vestibular schwannoma surgeries (68.7%) and 10 of the vestibular nerve sectioning surgeries (31.3%). No CSF leak was seen following microvascular decompression and auditory brain stem implantation surgeries. Ten patients could be treated conservatively. Twelve patients needed the placement of a lumbar drainage. Surgical reexploration was performed in 10 patients. Conclusions: Initially, a conservative treatment should be instituted in the case of a CSF leak. If the conservative treatment fails, the placement of a lumbar drainage should be considered. Patients that do not respond to lumbar drainage require surgical reexploration. The abovementioned algorithm represents the safest and best option in the presence of a CSF leak, as confirmed by the absence of recurrences or multiple revisions in this study.

Objective: MESNA is a synthetic sulfur compound that produces mucolysis by disrupting disulfide bonds. This study aimed to address indications and technique of MESNA application in otologic surgery, especially in retraction pockets and adhesive otitis media. Methods: MESNA application was performed in 42 ears of 39 patients. The diagnoses were retraction pockets fixed to incudostapedial joint, stapes or promontorium, and adhesive otitis media in 24 and 17 ears, respectively. Calculations were performed according to 24 ears of 23 patients with follow-up data. Results: One or more of the following surgical interventions were performed: MESNA application alone and ventilation tube insertion, reinforcement or mastoidectomy in addition to MESNA application. Sensorineural hearing loss was not encountered after MESNA application. The operation was successful in 79.2%. Overall revision surgery was needed in 20.8% of the ears. In 71.4% of the ears treated with MESNA alone, revision surgery was needed. Conclusion: In the light of our experience, we advocate the use of MESNA in atelectatic ears, because it makes the operation easy and safe by allowing elevation of the tympanic membrane by its mechanical and chemical actions.

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