Cases reported "Tinnitus"

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1/38. Reversible sensorineural hearing impairment induced by a carotid body tumor.

    A case of a 62-year-old Austrian man having a 25-year history of a right-sided carotid body tumor (CBT) is presented. Three months before being transferred to the University of Vienna for tumor resection the patient developed symptoms of tinnitus, progressive ipsilateral hearing loss and dysphagia. Pure-tone audiometry demonstrated a 50 dB right sensorineural hearing loss. A 6 x 6 x 4 cm firm, pulsatile mass was found in the right carotid triangle and extending towards the base of the skull. One week after radical tumor resection all preoperative symptoms disappeared and hearing of the right ear recovered. review of the available literature showed that hearing loss and tinnitus are unusual symptoms of a CBT. Our findings suggest that routine audiometric evaluations in such cases of CBT patients should be obtained in order to determine the real incidence of audiological disorders.
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2/38. Isolated metastases of adenocarcinoma in the bilateral internal auditory meatuses mimicking neurofibromatosis type 2--case report.

    A 56-year-old male with a history of lung cancer presented with isolated metastases of adenocarcinoma in the bilateral internal auditory meatuses (IAMs), mimicking the bilateral acoustic schwannomas of neurofibromatosis type 2, and manifesting as rapidly worsening tinnitus and bilateral hearing loss. magnetic resonance imaging showed small tumors in both IAMs with no sign of leptomeningeal metastasis. The preoperative diagnosis was neurofibromatosis type 2. Both tumors were removed and the histological diagnoses were adenocarcinoma. neuroimaging differentiation of a solitary metastatic IAM tumor from a benign tumor is difficult, although rapidly progressive eighth cranial nerve dysfunction suggests a malignant process. Metastases should be considered as a rare diagnostic possibility in a patient with small tumors in both IAMs.
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keywords = operative
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3/38. Vagal schwannoma of the cerebello-medullary cistern presenting with hoarseness and intractable tinnitus: a rare case of intra-operative bradycardia and cardiac asystole.

    Schwannomas arising from the lower cranial nerves (IX-XI) are rare, constituting only 3% of all intracranial schwannomas unassociated with neurofibromatosis. A great majority of these tumours present as jugular foramen lesions and less commonly they occur along the extracranial course of these nerves. An intracisternal location is extremely rare. We report a case of vagal schwannoma purely in the cerebello-medullary cistern causing distortion of the medulla oblongata. Total microsurgical excision of this tumor, arising from one of the rootlets of the vagus nerve, was achieved with preservation of the 9th, 10th and 11th cranial nerves.The intraoperative course was complicated by two episodes of complete cardiac asystole, each lasting for 4(s), and six episodes of severe bradycardia. The patient was relieved of his intractable tinnitus but continued to have a hoarse voice due to an ipsilateral partial vocal cord palsy.
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ranking = 5
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4/38. rupture of the round window membrane.

    A perilymph leak into the middle ear through a ruptured round window membrane results in the symptoms of hearing loss, tinnitus and vertigo, either singly or in combination. The case histories of thirteen patients with such a fistula are described, these patients having in common a predisposing incident which had led to a rise of C.S.F. pressure. Symptomatology and the results of investigation are analysed and operative technique and results discussed. While it appears that vertigo uniformly responds very satisfactorily to operative treatment the improvement in hearing loss and tinnitus is more difficult to predict.
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ranking = 2
keywords = operative
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5/38. Sonographic findings in glomus tympanicum tumor.

    A glomus tympanicum tumor that is associated with a visible retrotympanic mass is the most frequent cause of pulsatile tinnitus. The preoperative diagnostic approach to this lesion includes a meticulous physical examination as well as high-resolution CT, magnetic resonance angiography, and digital angiography, which can also be used for preoperative embolization. We report the use of color transcranial Doppler sonography in the evaluation of glomus tympanicum tumor in a 67-year-old woman with a 3-year history of left tinnitus. An otoscopic examination revealed a reddish pulsatile mass behind an intact tympanic membrane. No lesions were visualized on gray-scale sonography. Contrast-enhanced color transcranial Doppler sonography showed a vascular ovoid mass that measured 2 x 1 x 1 cm; spectral analysis of the lesion revealed arterial flow with a low resistance index. color transcranial Doppler sonography helped define the dimensions and vascular characteristics of the lesion.
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ranking = 2
keywords = operative
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6/38. Inverted papilloma of the sphenoid sinus presenting with auditory symptoms: a report of two cases.

    OBJECTIVES: The report aims to inform the reader of cases of inverted papilloma involving the sphenoid sinus presenting with auditory symptoms. STUDY DESIGN: Case series. methods: A retrospective medical record analysis was carried out to identify patients with inverted papilloma involving the sphenoid sinus that presented with a primary complaint of hearing loss or tinnitus, or both. Clinical records, including initial history and physical examination, audiologic and radiologic studies, and operative and histopathologic reports, were carefully examined. A complete literature review for relevant studies was performed to explore possible pathophysiologic factors and similar cases. RESULTS: Two patients with inverted papilloma presenting with primary auditory complaints were identified. One patient had roaring tinnitus and sensorineural hearing loss demonstrated with audiologic assessment, whereas the other had pulsatile tinnitus. Both patients had biopsy-proven inverted papilloma involving the sphenoid sinus, and both patients underwent endoscopic resection of the disease. No other cause or origin of their auditory symptoms was confirmed. The auditory symptoms of both patients improved markedly after excision of their inverted papillomas. CONCLUSIONS: tinnitus with or without hearing loss is an unusual presentation of inverted papilloma of the sphenoid sinus. Sphenoid tumors should be considered in the workup of these symptoms.
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keywords = operative
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7/38. Permanent sensorineural hearing loss following spinal anesthesia.

    A 25-year-old female developed permanent, fluctuating sensorineural hearing loss (SNHL), disabling vertigo, and tinnitus following an uneventful spinal anesthesia for cesarean section. At her first visit to the ear-nose-throat (ENT) department approximately 2 months postoperatively, pure-tone thresholds revealed profound SNHL on the right side whereas thresholds were within normal limits on the left side. The recruitment score (SISI) was 95% at 2000 Hz on the right side. Directional preponderance towards the right and the right canal paresis were evidenced by bithermal caloric testing. At follow ups the pure tone thresholds have shown some improvement, but fluctuating SNHL, disabling vertigo attacks, and tinnitus have remained. These findings imply a cochlear pathology causing endolymphatic hydrops possibly induced by lumbar puncture for spinal anesthesia.
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ranking = 1
keywords = operative
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8/38. Persistent inner ear injury after diving.

    OBJECTIVE: The purpose of this multiple case report was to discuss the occurrence and cause of sudden sensorineural hearing loss after diving. STUDY DESIGN: The study design was a retrospective case review. SETTING: The study was conducted at an academic tertiary referral center. patients: In this multiple case report, two teenagers with unilateral sudden sensorineural hearing loss after diving, one from a starting block and one from a 1-m board, while performing school swimsports were included. INTERVENTION: The patients underwent diagnostic tympanotomy with sealing of the round and oval window membranes and a vasoactive rheologic therapy combined with corticosteroid treatment. MAIN OUTCOME MEASURES: The average pure-tone bone-conduction thresholds were calculated. The appearance of nystagmus, vertigo, and tinnitus was analyzed. RESULTS: Both patients experienced unilateral sudden deafness after performing a headfirst pike-type dive into a swimming pool. None of the patients contacted with the bottom of the pool. In one patient, a rupture of the round window was found intraoperatively. In the other patient, no rupture of the round or oval window was seen intraoperatively. In spite of sealing of the round window and application of vasoactive rheologic therapy, hearing did not improve significantly in either of the patients. CONCLUSION: rupture of the round window may occur after diving even if the dive is performed from a low height into the water and the bottom of the pool is not contacted. Besides direct contusion to the external ear and barotrauma, other causes such as whiplash mechanism have to be considered.
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ranking = 2
keywords = operative
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9/38. Traumatic perilymphatic fistula: how long can symptoms persist? A follow-up report.

    In the past 18 years 68 ears (average 3.8 per year) were explored for perilymphatic fistula (PLF). A total of nine (13%) ears had a fistula identified at operation. patients with a previous history of otologic surgery were excluded from this review. The most common etiology for PLF was head trauma (4 of 9). Most patients had persistent symptoms lasting months (average 6.7). Eighty-three percent of all patients had sudden or fluctuating hearing loss, 77 percent had vertigo or dysequilibrium, and 61 percent had tinnitus. vertigo was the most commonly improved symptom postoperatively, and only 25 percent of patients had improved hearing. There were no major complications. The authors discuss indications for operation, criteria for diagnosis of PLF, and audiometric and electronystagmographic findings. This report agrees with other recent data indicating that exploration for fistula is an uncommon procedure performed by otologists.
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ranking = 1
keywords = operative
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10/38. vertigo and hearing disturbance as the first sign of a glioblastoma (world health organization grade IV).

    OBJECTIVE: To describe vertigo and hearing disturbance as a first sign of glioblastoma. STUDY DESIGN: Case report. SETTING: Ear, nose, and Throat Department of the University of Regensberg, germany. Primary Care Center. patients: A patient with a left temporal glioblastoma. RESULTS: A 67-year-old man presented with a 2-month history of vertigo and hearing disturbance. Radiological imaging revealed a left temporal tumor with dural inflation and erosion of the petrous bone and superior semicircular duct. The surgery involved total resection of the tumor and resurfacing of the gap in the superior canal. The histopathological examination revealed World Health Trade Organization IV glioblastoma. Postoperatively, the debilitating symptoms were relieved and the patient received radiation therapy. Tumor progression indicated a recraniotomy and a mastoidectomy. The tumor was only partially resected, and required chemotherapy. It subsequently developed otoliquorrhea and required a remastoidectomy. Histopathology of a pathological fracture of the X thoracic vertebra revealed a metastasis of the known glioblastoma. The patient died from respiratory distress syndrome. CONCLUSION: To the best of our knowledge, we are presenting the first case with transdural infiltration of bony structures by a glioblastoma at the moment of diagnosis. The transdural spread could be via the sinus petrosus and along the nervous petrosus major in the petrosal bone. Superior canal dehiscence syndrome should be considered in the differential diagnosis of vertigo and hearing disturbance. Two different processes for the etiology of the superior canal dehiscence syndrome are discussed previously in the literature; however, we present a new entity with a tumor-cause dehiscence of the bone overlying the superior canal.
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keywords = operative
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