Challenges in the Management of Symptomatic Fallopian Canal Meningoceles: A Multicenter Case Series and Literature Review.

OBJECTIVE: To describe the presentations, the diagnosis, our treatment approaches, and the outcomes for 11 patients with fallopian canal meningocele (FCM). STUDY DESIGN MULTICENTER: Retrospective case series. SETTING: Tertiary referral centers. PATIENTS: Patients (N = 11) with radiographically or intraoperatively identified, symptomatic FCM. INTERVENTIONS: Surgical repair of cerebrospinal fluid (CSF) leak and meningocele versus observation. MAIN OUTCOME MEASURES: Presentation (including symptoms, radiographic imaging, and comorbidities), management (including surgical approach, technique for packing, use of lumbar drain), clinical outcomes (control of CSF leak, meningitis, facial nerve function), and revision surgery. RESULTS: Patients presented with spontaneous CSF leak (n = 7), conductive (N = 11) and sensorineural hearing loss (n = 3), nonpositional intermittent vertigo (n = 3), headaches (n = 4), and recurrent meningitis (n = 1). Risk factors in our series included obesity (n = 4), Chiari 1 malformation (n = 1), and head trauma (n = 2). Noncontrast computed tomography of the temporal bone and magnetic resonance imaging were positive for FCM in 10 patients. Eight patients were managed surgically via a transmastoid approach (n = 4), combined transmastoid and middle fossa (N = 3), or middle fossa alone (n = 1); three were managed conservatively with observation. Postoperative complications included worsened facial nerve palsy (n = 1), recurrent meningitis (n = 1), and persistent CSF leak that necessitated revision (n = 1). CONCLUSIONS: Facial nerve meningoceles are rare with variable presentation, often including CSF otorrhea. Management can be challenging and guided by symptomatology and comorbidities. Risk factors for FCM include obesity and head trauma, and Chiari 1 malformation may present with nonspecific otologic symptoms, in some cases, meningitis and facial palsy. Layered surgical repair leads to high rates of success; however, this may be complicated by worsening facial palsy.

Music and Speech Perception in Prelingually Deafened Young Listeners With Cochlear Implants: A Preliminary Study Using Sung Speech.

PURPOSE: In the context of music and speech perception, this study aimed to assess the effect of variation in one of two auditory attributes-pitch contour and timbre-on the perception of the other in prelingually deafened young cochlear implant (CI) users, and the relationship between pitch contour perception and two cognitive functions of interest. METHOD: Nine prelingually deafened CI users, aged 8.75-22.17 years, completed a melodic contour identification (MCI) task using stimuli of piano notes or sung speech with a fixed timbre (same word for each note) or a mixed timbre (different words for each note), a speech perception task identifying matrix-styled sentences naturally intonated or sung with a fixed pitch (same pitch for each word) or a mixed pitch (different pitches for each word), a forward digit span test indexing auditory short-term memory (STM), and the matrices section of the Kaufman Brief Intelligence Test-Second Edition indexing nonverbal IQ. RESULTS: MCI was significantly poorer for the mixed timbre condition. Speech perception was significantly poorer for the fixed and mixed pitch conditions than for the naturally intonated condition. Auditory STM positively correlated with MCI at 2- and 3-semitone note spacings. Relative to their normal-hearing peers from a related study using the same stimuli and tasks, the CI participants showed comparable MCI at 2- or 3-semitone note spacing, and a comparable level of significant decrement in speech perception across three pitch contour conditions. CONCLUSION: Findings suggest that prelingually deafened CI users show similar trends of normal-hearing peers for the effect of variation in pitch contour or timbre on the perception of the other, and that cognitive functions may underlie these outcomes to some extent, at least for the perception of pitch contour. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.21217937.

Centralized Otolaryngology Research Efforts: Stepping-stones to Innovation and Equity in Otolaryngology-Head and Neck Surgery.

The Centralized Otolaryngology Research Efforts (CORE) grant program coordinates research funding initiatives across the subspecialties of otolaryngology-head and neck surgery. Modeled after National Institutes of Health study sections, CORE grant review processes provide comprehensive reviews of scientific proposals. The organizational structure and grant review process support grant-writing skills, attention to study design, and other components of academic maturation toward securing external grants from the National Institutes of Health or other agencies. As a learning community and a catalyst for scientific advances, CORE evaluates clinical, translational, basic science, and health services research. Amid the societal reckoning around long-standing social injustices and health inequities, an important question is to what extent CORE engenders diversity, equity, and inclusion for the otolaryngology workforce. This commentary explores CORE's track record as a stepping-stone for promoting equity and innovation in the specialty. Such insights can help maximize opportunities for cultivating diverse leaders across the career continuum.

Juvenile xanthogranuloma of the tympanic membrane: a case report.

Juvenile xanthogranuloma (JXG) is a benign, non-Langerhans cell histiocytic lesion that generally affects infants and children. These lesions characteristically appear as a solitary, yellow, cutaneous nodule of the head, neck, or trunk. Subcutaneous and extracutaneous forms can involve the gastrointestinal tract, kidney, lung, gonads, pericardium, central nervous system, temporal bone, larynx, and eye. We describe the clinical presentation, imaging, histochemical findings, and management of a solitary JXG of the tympanic membrane in a 17-month-old girl. The patient underwent surgical resection and was without disease several months following surgery and reconstruction of the defect. To the best of our knowledge, this is the first reported case of a JXG of the tympanic membrane.