Late complications of cochlear implant: a case report of necrotizing meningoencephalitis similar to a CPA tumor.

OBJECTIVE: Report a case of localized necrotizing meningoencephalitis as the cause of functional hearing loss after cochlear implant (CI) surgery. CASE REPORT: A 12-year-old with bilateral CI presented to our quaternary center due to severe functional hearing loss after 11 years since left ear CI surgery. CT with contrast was conducted showing a CPA tumor-like mass. Pre-operative computed tomography (CT) scans and magnetic resonance imaging (MRI) performed at the age of 1 year showed no inner ear abnormalities and in particular no evidence of a tumor in the cerebellopontine angle (CPA). CONCLUSION: Following removal of the CI and the mass, histopathological, immunohistochemical and cultural examinations revealed a necrotizing meningoencephalitis, with the CI electrode as the focus.

Inside implant criteria or not? - Detection of non-organic hearing loss during cochlear implant assessment.

OBJECTIVES: The diagnosis of non-organic hearing loss (NOHL) is a difficult but important issue during the assessment process for cochlear implantation (CI). We aim to identify the key factors in identifying patients with NOHL during CI assessment and present our local screening protocol for NOHL. METHODS: A retrospective review of patients referred to the Yorkshire Auditory Implant Service (YAIS) between 2003 and 2015 who were subsequently diagnosed with NOHL during the assessment. Patient demographic data, audiological and functional assessments were assessed. RESULTS: Thirty-two patients were included in the study. Mean age was 43 years (range 14-82 years). Male to female ratio was 1:1.7. Indicators of possible NOHL included a sudden deterioration in hearing (n = 21; 66%), mismatches in observed behaviour and either pure-tone audiogram (PTA) (n = 27; 84%) or functional testing (n = 20; 80%) and stapedial reflexes below reported audiological thresholds (n = 12; 46%). A mismatch in functional hearing and PTA was seen in 72% of patients. Patients with suspected NOHL were referred for further objective testing. All 23 patients who underwent objective testing had better hearing levels compared to reported hearing thresholds thus placing them outside of implant criteria. Five candidates were found to have normal hearing thresholds. DISCUSSION: NOHL can present a significant challenge to the implant team, particularly in the subgroup with a pre-existing organic hearing loss with non-organic overlay. We discuss the common features in this cohort of patients. CONCLUSIONS: To facilitate the identification of patients with NOHL, the YAIS has developed a screening protocol.

[Stapedectomies. Retrospective study of 120 ears]. / Estapedectomías: estudio retrospectivo de 120 oídos.

This paper is a retrospective study of 120 stapedectomy cases with its outcomes and complications. With these technique we have achieved more than 80 percent of good results, being scarce the number of complications.

[A "double flap" technique in stabilization of the prostheses of the PORP and TORP type]. / Technika "podwójnego plata" w stabilizacji protezek typu PORP i TORP.

The authors described the stabilization method of prostheses type PORP and TORP in one and two steps hearing improvement surgery. The method is very simple and prevents the secondary tympanic membrane perforations.

Transmastoid labyrinthectomy: reliable surgical management of vertigo.

Transmastoid labyrinthectomy has continued to be an important part of the surgical armamentarium for patients with vertigo and nonserviceable hearing loss. Continuing experience substantiates our earlier impression that the vestibular system usually accommodates rapidly to complete unilateral surgical ablation, regardless of age or degree of residual vestibular activity in the ear (as measured by preoperative bithermal caloric testing). Although the symptom of vertigo is reliably treated by transmastoid labyrinthectomy, a patient questionnaire has demonstrated a significant incidence of mild to moderate persisting postoperative dysequilibrium. Although this dysequilibrium is usually not debilitating, this questionnaire has demonstrated its existence more precisely than a retrospective review of the patients' clinical records. This study reviews 110 patients who underwent labyrinthectomy between 1978 and 1985. We remain impressed at the efficacy of the transmastoid labyrinthectomy in relieving the symptom of vertigo.

[Functional surgery of major aplasia of the ear. Apropos of 109 patients]. / La chirurgie fonctionnelle de l'aplasie majeure de l'oreille. A propos de 109 patients.

Based on data from 109 patients operated upon for 125 major aplasias of ear, clinical and operative aspects and results of surgery are analysed. Functional prognosis is related essentially to the nature of the stapes, normal in 66% of cases, and the quality of healing of the newly formed canal. One auditive result out of four in cases of unilateral aplasia and one out of two in bilateral cases constituted the proportion of patients obtaining socially valuable postoperative auditive gain. Functional surgery for aplasia of ear should therefore be reserved mainly for bilateral forms because of the lack of any alternative to apparatus wearing.