Cases reported "Tinnitus"

Filter by keywords:



Filtering documents. Please wait...

11/38. Magnetic and electrical stimulation of the auditory cortex for intractable tinnitus. Case report.

    tinnitus is a distressing symptom that affects up to 15% of the population for whom no satisfactory treatment exists. The authors present a novel surgical approach for the treatment of intractable tinnitus, based on cortical stimulation of the auditory cortex. tinnitus can be considered an auditory phantom phenomenon similar to deafferentation pain, which is observed in the somatosensory system. tinnitus is accompanied by a change in the tonotopic map of the auditory cortex. Furthermore, there is a highly positive association between the subjective intensity of the tinnitus and the amount of shift in tinnitus frequency in the auditory cortex, that is, the amount of cortical reorganization. This cortical reorganization can be demonstrated by functional magnetic resonance (fMR) imaging. transcranial magnetic stimulation (TMS) is a noninvasive method of activating or deactivating focal areas of the human brain. Linked to a navigation system that is guided by fMR images of the auditory system, TMS can suppress areas of cortical plasticity. If it is successful in suppressing a patient's tinnitus, this focal and temporary effect can be perpetualized by implanting a cortical electrode. A neuronavigation-based auditory fMR imaging-guided TMS session was performed in a patient who suffered from tinnitus due to a cochlear nerve lesion. Complete suppression of the tinnitus was obtained. At a later time an extradural electrode was implanted with the guidance of auditory fMR imaging navigation. Postoperatively, the patient's tinnitus disappeared and remains absent 10 months later. Focal extradural electrical stimulation of the primary auditory cortex at the area of cortical plasticity is capable of suppressing contralateral tinnitus completely. transcranial magnetic stimulation may be an ideal method for noninvasive studies of surgical candidates in whom stimulating electrodes might be implanted for tinnitus suppression.
- - - - - - - - - -
ranking = 1
keywords = operative
(Clic here for more details about this article)

12/38. Jugular foramen tumors: diagnosis and treatment.

    OBJECT: Jugular foramen tumors are rare skull base lesions that present diagnostic and complex management problems. The purpose of this study was to evaluate a series of patients with jugular foramen tumors who were surgically treated in the past 16 years, and to analyze the surgical technique, complications, and outcomes. methods: The authors retrospectively studied 102 patients with jugular foramen tumors treated between January 1987 and May 2004. All patients underwent surgery with a multidisciplinary method combining neurosurgical and ear, nose, and throat techniques. Preoperative embolization was performed for paragangliomas and other highly vascularized lesions. To avoid postoperative cerebrospinal fluid (CSF) leakage and to improve cosmetic results, the surgical defect was reconstructed with specially developed vascularized flaps (temporalis fascia, cervical fascia, sternocleidomastoid muscle, and temporalis muscle). A saphenous graft bypass was used in two patients with tumor infiltrating the internal carotid artery (ICA). facial nerve reconstruction was performed with grafts of the great auricular nerve or with 12th/seventh cranial nerve anastomosis. Residual malignant and invasive tumors were irradiated after partial removal. The most common tumor was paraganglioma (58 cases), followed by schwannomas (17 cases) and meningiomas (10 cases). Complete excision was possible in 45 patients (77.5%) with paragangliomas and in all patients with schwannomas. The most frequent and also the most dangerous surgical complication was lower cranial nerve deficit. This deficit occurred in 10 patients (10%), but it was transient in four cases. Postoperative facial and cochlear nerve paralysis occurred in eight patients (8%); spontaneous recovery occurred in three of them. In the remaining five patients the facial nerve was reconstructed using great auricular nerve grafts (three cases), sural nerve graft (one case), and hypoglossal/facial nerve anastomosis (one case). Four patients (4%) experienced postoperative CSF leakage, and four (4.2%) died after surgery. Two of them died of aspiration pneumonia complicated with septicemia. Of the remaining two, one died of pulmonary embolism and the other of cerebral hypoxia caused by a large cervical hematoma that led to tracheal deviation. CONCLUSIONS: Paragangliomas are the most common tumors of the jugular foramen region. Surgical management of jugular foramen tumors is complex and difficult. Radical removal of benign jugular foramen tumors is the treatment of choice, may be curative, and is achieved with low mortality and morbidity rates. Larger lesions can be radically excised in one surgical procedure by using a multidisciplinary approach. Reconstruction of the skull base with vascularized myofascial flaps reduces postoperative CSF leaks. Postoperative lower cranial nerves deficits are the most dangerous complication.
- - - - - - - - - -
ranking = 6
keywords = operative
(Clic here for more details about this article)

13/38. Labyrinth dysfunction 8 months after cochlear implantation: a case report.

    OBJECTIVE: Investigate whether the cochleostomy is a possible port of entry for pneumolabyrinth and a resulting vertigo in patients provided with a cochlear implant. STUDY DESIGN: Retrospective case review. SETTING: Ludwig-Maximilians University of Munich, Hospital Grosshadern. PATIENT: 62-year-old patient who underwent implantation of a HiFocus II cochlear implant with positioner from Advanced bionics (CLARION). Eight months postoperatively, the patient reported rotatory vertigo and right-side tinnitus after he had blown his nose harder than usual during an episode of rhinitis. INTERVENTIONS: Preoperative and postoperative testing of both the petrosal bone with a CT scan and of balance function. MAIN OUTCOME MEASURE: air inclusion in the labyrinth. RESULTS: In contrast to the preoperative high resolution computed tomography (CT) scan, air inclusion was seen in the labyrinth during the episode of vertigo. At the same time, balance function tests with Frenzel glasses revealed both spontaneous and provoked horizontal nystagmus to the right side. At follow-up 8 weeks later, the level of vertigo had significantly decreased. Twelve months later, the control CT showed the cochlear implant positioned correctly and no visible air in the labyrinth. CONCLUSION: It is known that placement of the HiFocus II with Positioner from CLARION requires a relatively large cochleostomy of 1.5 mm. Moreover, in the connective tissue seal between the electrode and the positioner, the latter reaches into the tympanic cavity, and this is possibly the weak point. Further investigation will be needed to determine whether the large cochleostomy with the HiFocus II with positioner increases the predisposition to labyrinth dysfunction.
- - - - - - - - - -
ranking = 4
keywords = operative
(Clic here for more details about this article)

14/38. Glomangioma of the middle ear.

    A 62-year-old female was admitted to our clinic in October 1999 with a 6-year history of hearing loss, tinnitus and otorrhea in the right ear. physical examination showed a polypoid mass arising from the right middle ear and extending into the external auditory canal. Serohemorrhagic otorrhea was also observed. Serious hemorrhage occurred while taking a biopsy. The histopathologic diagnosis was a glomangioma. MRI demonstrated a hypervascular mass (10 x 15 mm(2)) completely filling the right middle ear. Preoperative embolization of the ascending pharyngeal artery was carried out. The tumor was completely resected via a transmastoid approach. No complications were observed postoperatively. At the most recent follow-up examination, 72 months after the operation, no sign of disease was present. The modified radical mastoidectomy approach used in this case proved to be a safe and efficacious method for removing the glomangioma.
- - - - - - - - - -
ranking = 2
keywords = operative
(Clic here for more details about this article)

15/38. Pulsatile tinnitus cured by mastoidectomy.

    tinnitus of venous origin is a rare occurrence. It represents roughly half of cases of vascular tinnitus. The choice of treatment is not easy, even when the diagnosis is certain. Reassurance of the patient is often sufficient. Nevertheless, a surgical treatment is sometimes performed--usually ligature of the internal jugular vein. We present the case of a patient with a right venous pulsatile tinnitus and a history of 5 years of ineffective medical and surgical treatments. Ligature of the internal jugular vein was not chosen in this case: a computed tomographic scan showed filled mastoid cells, and mastoidectomy was performed instead. The tinnitus disappeared immediately after surgery and has not recurred during a 2-year follow-up. The bilateral preoperative sensorineural and conductive hearing loss also disappeared. Pulsatile tinnitus of venous origin is usually treated with ligature of the internal jugular vein. Mastoidectomy is an interesting alternative in selected cases.
- - - - - - - - - -
ranking = 1
keywords = operative
(Clic here for more details about this article)

16/38. Tympanic electrocochleography for evaluation of endolymphatic hydrops.

    There has been increased interest in electrocochleography for the diagnosis and intraoperative monitoring of patients with endolymphatic hydrops. attention has been focused on the determination of the summating potential:action potential (SP:AP) ratio from alternating polarity clicks. review of this technique at the University of minnesota led to a reevaluation of the usual interpretation of these recordings. Separate examination of the rarefaction and condensation click recordings provides insight into abnormal response patterns. Cases are presented to illustrate a variety of normal and abnormal patterns including abnormal differences in the latency of condensation and rarefaction-click-generated action potentials, increased summating potential, uncanceled cochlear microphonic, and reduced action potential and summating potential amplitudes. These response categories may be useful in understanding the pathophysiology of Meniere's disease.
- - - - - - - - - -
ranking = 1
keywords = operative
(Clic here for more details about this article)

17/38. Objective pulsatile tinnitus: a video clip demonstration of the condition.

    Pulsatile tinnitus is an uncommon condition. We describe a case of pulsatile tinnitus and visually demonstrate a pulsating tympanic membrane caused by a postoperative cerebrospinal leak into the mastoid air cells following resection of a left temporal petrous meningioma. To our knowledge, this is the first case in the literature where an objective pulsatile tinnitus has been captured on video (see www.laryngoscope.com).
- - - - - - - - - -
ranking = 1
keywords = operative
(Clic here for more details about this article)

18/38. Benign osteoblastoma of the temporal bone: Case report and review of the literature.

    BACKGROUND: Benign osteoblastoma arising from the temporal bone is extremely rare in elderly patients. We reviewed the literature on benign osteoblastoma of the temporal bone and now propose a new classification of this pathologic entity based on its anatomical location in the temporal bone. CASE DESCRIPTION: A 68-year-old woman presented with tinnitus and hearing disturbance with a duration of 1 year. Her neurologic examination revealed mixed hearing disturbance and hypogeusia. Preoperative computed tomography showed a bony destructive isodensity mass with calcified component involving the temporal bone. The FDG-PET scan showed high uptake on the lesion. After preoperative embolization on the day before surgery, the patient underwent tumor removal via a left infratemporal approach under neuronavigated guidance. The pathologic examination revealed a benign osteoblastoma. CONCLUSION: We present the first case of FDG-PET showing high uptake on the lesion. Preoperative embolization is useful to reduce the amount of bleeding during the surgery.
- - - - - - - - - -
ranking = 3
keywords = operative
(Clic here for more details about this article)

19/38. Acoustic measurements of objective tinnitus.

    ear canal sound pressure levels were measured from a 38-year-old woman who had experienced objective tinnitus in her right ear for approximately 2 years. The tinnitus sounded like a series of "sighs" that were synchronous with her pulse rate. Because the level of the tinnitus fluctuated in a pulsing manner, it appeared to be of vascular origin. Psychoacoustically, the tinnitus behaved like a low-pass masker (cutoff frequency = 1.5 kHz) of about 40 dB SPL. This masking effect was manifested as a low-frequency hearing loss in the subject's right ear. A miniature microphone system was used to monitor the tinnitus before, during, and after a jugular-vein ligation. Because the cause of the tinnitus was only generally known, acoustically monitoring the sound as the jugular vein and/or its tributaries were systematically clamped and then released enabled the site of generation to be known exactly. By monitoring the tinnitus during surgery, the effectiveness of the corrective procedure could be immediately evaluated. Hearing sensitivity in the affected ear returned to normal limits following the elimination of the tinnitus. One year after the surgery, the tinnitus was barely audible to the woman, but only when she positioned her head a specific way. The level of the tinnitus measured in this head-turned condition was markedly lower than the level obtained preoperatively.
- - - - - - - - - -
ranking = 1
keywords = operative
(Clic here for more details about this article)

20/38. Pulsatile tinnitus and dural arteriovenous malformation.

    An unusual case of a patient presenting with left sided pulsatile tinnitus is presented. This was later shown to be due to a dural arteriovenous malformation involving the lateral venous sinus. The diagnosis was suspected by the presence of a bruit over the mastoid process and confirmed by a CT scan and angiography. Management involved pre-operative embolisation and neurosurgical excision. The differential diagnosis of pulsatile tinnitus and the management of a dural arterio venous malformation is discussed.
- - - - - - - - - -
ranking = 1
keywords = operative
(Clic here for more details about this article)
<- Previous || Next ->


Leave a message about 'Tinnitus'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.