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To find if patients experiencing postsurgical facial nerve stimulation caused by underlying disease process (ie, otosclerosis) can improve their hearing performance with their cochlear implant by reimplantation and by an optimal programming strategy. Design: Retrospective analysis. Setting: Academic tertiary referral center. Patients: Two cochlear otosclerosis patients with resistant facial nerve stimulation (FNS). Both patients were initially implanted with Nucleus 22 devices (Cochlear Corporation, Englewood, Colo) and they developed FNS after a period of use. Owing to the decreasing number of active electrodes, concurrent decreases in speech understanding occurred. Interventions: Various programming approaches were used to address the FNS. Both subjects ultimately received Nucleus 24 devices. One was reimplanted in the same ear, and the other was implanted in the opposite ear. Both have been followed up for 8 months following the reimplantation. Main Outcome Measures: Cochlear implant programming levels, cochlear implant performance, and facial nerve stimulation.

In this case presentation, three cases of labyrinthine concussion in the opposite ears of patients who had unilateral traumatic temporal bone fractures with facial paralysis are reported. The first patient was a 30-year-old male who had a right-sided longitudinal temporal bone fracture and labyrinthine concussion showing pure sensorineural hearing loss with a characteristic notch of 60 dB at 4000 Hz on the left side. The second patient was a 42-year-old male who had a right-sided traumatic facial paralysis owing to a mixedtype temporal bone fracture and labyrinthine concussion, demonstrating pure sensorineural hearing loss reaching its peak of 50 dB at 4000 Hz on the left. The third patient was a 19-year-old male who had a left-sided mixed-type temporal bone fracture and a right labyrinthine concussion exhibiting pure sensorineural hearing loss reaching 60 dB at 4000 Hz. For their facial paralyses, all three patients underwent middle cranial fossa or combined approach operations. The labyrinthine concussion in these patients was managed expectantly. At their 1-year follow-up, it was observed that the hearing loss owing to labyrinthine concussion persisted. Although labyrinthine concussion is not a rare complication of head injuries, it has rarely been reported in the medical literature. The main symptoms of labyrinthine concussion are hearing loss, tinnitus, and dizziness. The diagnosis mainly relies on audiometric tests, which reveal characteristic tracings reminiscent of acoustic trauma. SOMMAIRE Nous rapportons ici le cas de trois patients ayant subi une fracture unilaterale de I'os temporal causant une paralysie faciale et chez qui nous avons aussi diagnostique une commotion labyrinthine contralaterale. Les trois patients ont du subir une operation par approche de la fosse moyenne ou par approche combinee. La commotion labyrinthique a ete traitee de fa^on conservatrice chez ces patients. La surdite persistait a la visite annuelle. Bien que la commotion labyrinthique ne soit pas une complication rare du trauma cranien, elle n'est que rarement discutee dans la litterature scientifique. Les principaux symptomes sont une surdite, un acouphene et un etourdissement. Le diagnostic repose sur I'audiologie qui montre un trace qui rappelle le trauma acoustique.Key words: hearing loss, labyrinthine concussion, temporal bone trauma r he term labyrinthine concussion is used to describe high-frequency sensorineural hearing loss with or without vestibular symptoms following head trauma without a demonstrable labyrinthine fracture. The symptoms of labyrinthine concussion are sensorineural hearing loss with a characteristic notch in the 4 to 6 kHz range resembling acoustic trauma, tinnitus, and positional vertigo.' Although labyrinthine concussion is not a rare complication of head injuries, it has rarely been reported in the medical literature.In this case presentation, three cases of labyrinthine concussion in the opposite ears of patients who were treated surgically for traumatic temporal bone fractures resulting in facial...

Dual ectopic thyroid is very rare. We report a case of dual ectopic thyroid in the lingual and infrahyoid areas in a 20-year-old female patient with no thyroid gland in its normal anatomical location. On physical examination, there was a 7 x 5 cm anterior midline neck swelling just below the hyoid bone and a 2 x 2 cm mass in the base of the tongue. Triiodothyronine (T(3)), thyroxine (T(4)), and thyroid-stimulating hormone (TSH) levels were normal. A thyroid scan with technetium-99m sodium pertechnate confirmed dual ectopic thyroid with no iodine uptake in the normal anatomical location of the thyroid gland. The infrahyoid ectopic thyroid was surgically removed for cosmetic reasons, and the lingual thyroid, which was symptomatic, was left untouched. The importance of thyroid scanning in the evaluation of anterior midline neck swellings and treatment options are discussed.

Considering the cost of hyperbaric oxygen therapy and its inconvenience to patients, this treatment should only be considered in patients suffering sudden hearing loss if there are contraindications to standard medical treatment.