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Cartilage myringoplasty to treat patulous eustachian tube dysfunction
Patulous eustachian tube (PET) dysfunction, where the eustachian tube is abnormally opened at rest, is a notoriously difficult condition to treat. Symptoms can mimic symptoms of superior semicircular canal dehiscence: autophony, aural fullness, hyperacusis and breathing synchronous tinnitus. Treatment has...
Lateral wall augmentation for patulous eustachian tube
The problem more commonly attributed to the eustachian tube is lack of its patency rather than it being unduly patulous. This lesser recognised condition is due to loss of peritubal fat volume resulting in concavity of the lateral wall and...
A new modified double-flap technique for cochlear implant surgery
The authors retrospectively assessed 342 implantees with a minimum of five years’ follow-up who had been implanted using a lazy S-shaped post auricular incision with a modified double-flap technique. From the notes, postoperative wound complications and any other adverse events...
A modification of the crescentic flap for nasal skin reconstruction
Non-melanoma skin cancers are the most frequent skin tumours and in over 25% of cases affect the nose. Following excision, the reconstruction may be challenging. Reconstruction aims to preserve the anatomical units, nasal functions and also an aesthetic final outcome....
To monitor or not to monitor
This is a report on an e-mail based survey of 1249 otologic surgeons on their practice regarding facial nerve monitoring during ear surgery. The response rate was very low (6.6%). The majority of responders (92%) stated that they did not...
Single surgery for repair of tegmen defects and superior semicircular canal dehiscence
This retrospective review of 34 patients undergoing repair of the temporal bone defect via the middle cranial fossa approach provides the author’s management strategy for two problems: superior semicircular canal dehiscence and tegmen defects. The incidence of both these pathologies...
Pulse synchronous tinnitus
This article reviews the most common neurosurgical causes of pulse synchronous tinnitus. Traditionally, tinnitus has been characterised as subjective vs. objective, or vascular vs. nonvascular. The authors observe that, in some cases, pulsatile tinnitus (PT) is not heard by examiners...
A twitch in time with a flicker of knowledge
The middle ear muscles can be seen as one of the ear’s safety mechanisms, and the interplay between eyes and ears has been established; think vestibular ocular reflex (VOR) or semi-circular canal dehiscence (SCCD). But can this protective mechanism be...
To scan or not to scan, otosclerosis
Otosclerosis can co-exist with other ear pathologies such as superior semicircular canal dehiscence (SSCD). Stapedectomy in this situation can lead to development of SSCD symptoms. Authors conducted an email-based survey involving active members of the American Neurotologic Society (ANS) and...
How can we treat a patient with aural fullness?
Aural fullness is a common complaint that we often come across in many of our otology patients. Management of this condition can be quite challenging. Common differentials include eustachian tube dysfunction, patulous eustachian tube dysfunction, otitic barotrauma, superior canal dehiscence...
Objective testing for Eustachian tube dysfunction
Eustachian tube dysfunction (ETD) is typically diagnosed based on subjective symptoms and examination leading to wide variation in its diagnosis and management. The search for an objective test has looked at ways of measuring the passage of air through the...
