Sphenoid Wing Meningioma Presenting as Sudden Sensorineural Hearing Loss: A Case Report and Literature Review.

Sphenoid wing meningiomas are tumors that typically present with vision deterioration and neurological changes due to their proximity to the sella, cavernous sinus, and other vital structures. Some unusual symptoms have also been described in the literature, such as cognitive dysfunction, parkinsonism, and intracerebral hemorrhage. In this report, we detail another unusual case of sphenoid wing meningioma in a 63-year-old female who presented with left sudden sensorineural hearing loss. A brief review of the literature is also included.

Modified endoscopic Denker approach in management of inverted papilloma of the anterior maxillary sinus.

BACKGROUND: Inverted papilloma (IP) is a benign epithelial tumor of the sinonasal cavity that is locally aggressive and has a propensity for recurrence. Tumors involving the anterior maxillary sinus can be challenging to reach endoscopically, and have historically been approached through a Caldwell-Luc or canine fossa trephination. We present a case series of 22 patients with maxillary IPs originating from the anterior wall, which were successfully resected using a modified endoscopic Denker (MED) procedure. This technique enables access to the entire maxillary sinus without the need for a separate transseptal or sublabial incision. METHODS: A retrospective chart review was performed on patients who underwent the MED approach for management of maxillary IPs involving the anterior wall from 2012 to 2018. The demographic data, clinical presentation, radiographic findings, pathology, and surgical outcomes were reviewed. RESULTS: Twenty-two patients were identified, including 13 males and 9 females. Eighteen of the 22 patients had prior surgery and all had Krouse stage 3 disease. After a mean follow-up of 24 (range, 4-63) months, only 1 patient (4.5%) developed a recurrence, which was treated successfully with endoscopic resection. Complications included 1 patient with preoperative epiphora who required dacryocystorhinostomy, epistaxis in another, and 1 patient with transient upper lip numbness. No patients developed alar notching or pyriform aperture stenosis. CONCLUSION: The MED technique is highly effective for surgical resection of primary and recurrent maxillary IPs involving the anterior wall, providing complete access to the entire maxillary sinus. In many cases, the MED can obviate the need for an adjunctive sublabial or transseptal incision, while also providing excellent exposure for postoperative surveillance.

Readmissions after endoscopic skull base surgery: associated risk factors and prevention.

BACKGROUND: Unplanned readmissions within 30 days of discharge is a quality measure introduced by the Centers for Medicare Services. This measure has been used to rate hospital quality and also to penalize hospitals for excess readmissions. It has been hypothesized that shorter hospital stays and fewer readmissions are associated with endoscopic skull base procedures. In this study we analyze endoscopic skull base procedures performed at our institution over a 10-year period to identify rates and factors associated with readmissions after endoscopic skull base surgery. METHODS: A retrospective chart review was performed at a tertiary care academic medical center identifying patients who underwent endoscopic skull base surgery over the past 10 years. Data on patient demographics and tumor variables, as well as patient variables such as body mass index (BMI), revision surgery, history of skull base radiation, medical comorbidities, intraoperative cerebrospinal fluid (CSF) leaks, and postoperative CSF leaks, were recorded. RESULTS: Eight hundred thirty-three patients were included in our study. Sixty-one patients (7.3%) were readmitted a total of 66 times within 30 days. The most common reasons were as follows: hyponatremia (n = 18); CSF leak (n = 17); epistaxis (n = 3); diabetes insipidus (n = 3); rhinorrhea (n = 3); as well as other reasons. Statistical analysis revealed that the presence of intraoperative CSF leak was the only statistically significant variable associated with increased rate of readmissions within 30 days of discharge (p < 0.001). CONCLUSION: Presence of intraoperative CSF leak was the only statistically significant variable associated with an increased risk for readmission after surgery. Other tumor and patient variables were not associated with an increased risk of readmission within 30 days.

Do abstracts in otolaryngology journals report study findings accurately?

OBJECTIVES: Although published abstracts have the advantage of being prominent and concise, their quality in the otolaryngology literature has not been studied. We sought to understand the limitations of relying on abstracts as the sole source of information about published research. In addition, we sought to identify specific opportunities for improving the quality of published articles and their associated abstracts. METHODS: Studies of original research published in four major otolaryngology journals from January 2008 to June 2008 were included. Each study article and abstract was reviewed separately for 12 domains relating to study design, results, and conclusions. Good inter-rater reliability was established as part of the validation process. RESULTS: Four hundred eighteen articles were identified for study, which included 75 percent clinical research and 25 percent basic science. The most common omissions in the abstract when compared with the complete article were study limitations (91% left out of abstract), geographic location (79%), confidence intervals (75%), dropouts or losses (62%), and harms and adverse events (44%). Conversely, the abstract often included information about research design (99%), sample size (92%), source of the data (81%), and quantitative results (67%). These results did not differ significantly with regard to article type, journal, or level of evidence. CONCLUSIONS: Readers of otolaryngology journals may form biased or inappropriate conclusions if they read only the abstract of a study, particularly with regard to study limitations, adverse events, and subject dropouts or losses. These results highlight the perils of using the abstract as a sole source of information.

Excision of laryngocele via transcervical midline approach.

Acute airway obstruction in the adult can be caused by a rapidly enlarging laryngeal cyst that may present unusually as a midline neck mass. In this case report we present a different surgical technique for the removal of a large combined laryngocele via midline transcervical approach that did not require laryngofissure. This technique allowed simple and fast access, excellent exposure and complete removal of the lesion without resection of thyroid cartilage or associated morbidities.