[Bone-anchored hearing aids and active middle ear implants].

This review is concerned with hearing implants, which are used in patients with hearing loss, who cannot be treated successfully with a conventional hearing aid. Among these implants, bone-anchored hearing systems (BAHS) can be used for conductive or mixed hearing loss, while active middle ear implants primarily are reserved for sensorineural hearing loss. For BAHS, active transcutaneous implants may replace percutaneous implants as a future first choice.

Cochlear MRI Signal Change Following Vestibular Schwannoma Resection Depends on Surgical Approach.

OBJECTIVE: Information on cochlear MRI signal change following vestibular schwannoma (VS) surgery by the retrolabyrinthine approach (RLA) is nonexisting, and information using the translabyrinthine approach (TLA) is scarce. We aimed to evaluate cochlear MRI fluid signal in patients with a unilateral VS, before and after surgery by the RLA or the TLA, that can have clinical importance for subsequent cochlear implantation feasibility. STUDY DESIGN: Retrospective cohort study. SETTING: University hospital. PATIENTS: One hundred one patients with a unilateral VS. INTERVENTION: VS resection by the TLA or the RLA. Pre- and postoperative T2-weighted MRI. MAIN OUTCOME MEASURE: Cochlear signal change using a semiquantitative system for grading cochlear asymmetry, with grades ranging from 1 (normal fluid signal both sides) to 4 (no fluid signal one side). RESULTS: Seventy-four patients were operated by the TLA and 27 by the RLA. The number of cochleas with grade 3 and 4 asymmetries postoperative was significantly higher than preoperative. The postoperative proportions of grade 1 (TLA 20%, RLA 56%) and grade 2-4 asymmetry (TLA 80%, RLA 44%) were significantly different between the two groups. In the TLA group, 46 patients (62%) demonstrated an increased asymmetry postoperatively, as compared with three patients (11%) in the RLA group. CONCLUSIONS: Postoperative decrease of cochlear MRI fluid signal is more likely to occur after translabyrinthine surgery (occurring in 62%), as compared with retrolabyrinthine surgery (occurring in 11%). The decrease of cochlear signal may be due to compromised vascularity or fibrosis.

Simultaneous Contralateral Vestibular Schwannoma and Glomus Tumor of the Temporal Bone- A Case Report.

INTRODUCTION: Presence of vestibular schwannoma and a simultaneous glomus jugulare tumor is an extremely rare event. There is only one case report regarding the incidence of a contralateral vestibular schwannoma, along with a glomus jugulare tumor. Herein, we present the second case with a contralateral tumor. CASE REPORT: A 69-year-old woman presented with a long history of bilateral hearing loss and a 2-year history of left-sided pulsatile tinnitus. The patient also suffered the itching of the left ear canal and mild vertigo; however, she had no recollection of middle ear infection, ear discharge, or ear pain. Magnetic resonance imaging (MRI) revealed a right-sided 8-mm extrameatal vestibular schwannoma and a left-sided almost purely extracranial glomus jugulare tumor of 18 mm. The pure-tone average values were 63 and 43 dB HL for the right and left ears, respectively. Speech audiometry showed a discrimination score of 76/88 (%). Caloric irrigation was performed and revealed a unilateral weakness of 81% towards the side of vestibular schwannoma. The patient was included in a watchful waiting regimen with annual MRI scans. CONCLUSION: Though vestibular schwannomas and glomus jugulare tumors are pathophysiologically different, they are similar in terms of symptomatology, growth pattern, diagnostic process, and therapeutic strategy. Based on this case report, it can be concluded that a vestibular evaluation demonstrates a unilateral vestibular weakness towards the side of the vestibular schwannoma, thereby facilitating clinical discrimination between the lesions.

[Christmas article. Scientific spam].

INTRODUCTION: Predatory publishing has led to an increasing amount of scientific spam mails addressed to medical researchers. This study aimed at characterising this spam further. METHODS: Prospective study of spam received during a three-month-period. RESULTS: A total of 137 spam e-mails with scientific contents were received. The majority (88%) was automatically led to the spam filter. The mails represented various invitations from journals (77%), conferences (19%) and other (4%). Most of the mails used titles, had opening lines or flattery contents, and spelling, grammar or layout errors were common. CONCLUSION: Since spam filters are not completely accurate, screening is often necessary, however, responding to unsolicited predatory scientific spam should be avoided.