A Case Report of Glomus Tympanicum Complicated With Facial Nerve Palsy.

Introduction: Generally, glomus tumors are considered tumors of the autonomic system arising from chromaffin cells of the parasympathetic paraganglia of the skull base and neck. Glomus tympanicum is the most common primary tumor of the middle ear cavity and it arises from the paraganglia of the middle ear. Case Report: We present a case of glomus tympanicum presented in a 70-year-old woman, complicated with facial nerve palsy which at first sight was misdiagnosed as cholesteatoma. Patient presented in our clinic because of otorrhea, pulsatile tinnitus and hearing loss in the right ear. However, facial nerve function was good in the first examination (40 days before the surgery). Eventually, she treated successfully with a canal wall down mastoidectomy. Technique had been chosen because of the mass size and the involvement of external auditory canal, after a discussion with the patient. Conclusions: Although histologically benign, glomus tympanicum is slow growing and destructs adjacent tissues potentially. The two most common complaints are hearing loss (conductive) and pulsatile tinnitus. These neoplasms are more common in women and they can be diagnosed by CT or MRI scan. It is of high importance physicians suspect a glomus tumor when patient 's clinical findings are hearing loss and pulsatile tinnitus and use an intravascular agent in imaging so that the differential diagnosis will be supported.

Cross-Cultural Adaptation and Validation of the Greek SPOT-25 Quality of Life Questionnaire in Patients with Otosclerosis.

Objective: To translate, adapt and validate in Greek the stapesplasty outcome test (SPOT)-25 quality of life questionnaire for patients with otosclerosis. Materials and methods:SPOT-25 was translated to Greek and completed by otosclerosis patients on the day of diagnosis, the day before surgery and three months postoperatively. Fifty controls without any otological history, symptom or finding also completed the questionnaire. Pure-tone average was obtained both preoperatively and three months postoperatively. Results:Test-retest evaluation on 56 patients was accepted. The Greek-SPOT-25 had an excellent internal consistency. All its items and subscales were significantly correlated between test and retest evaluation. Controls had significant lower SPOT-25 scores, and the postoperative scores were significantly lower than preoperative ones. Pure-tone average of four frequencies (PTA4) was significantly correlated to preoperative SPOT-25 total and subscales scores (P<0.001) before surgery and significantly correlated only with the "hearing function" subscale (p<0.05) postoperatively.

Role of the endoscope in cochlear implantation: A systematic review.

OBJECTIVE: To review the role of the endoscope in cochlear implantation (CI). METHODS: MEDLINE, ScienceDirect, Google Scholar and the Cochrane Library databases, as well as other sources, were searched by two independent reviewers. Studies including patients undergoing either exclusively endoscopic or endoscopically assisted CI were eligible for inclusion. Endoscopic CI approaches and postoperative complications were the primary outcomes. Secondary endpoints included the degree of round window (RW) microscopic visualisation according to St Thomas' Hospital classification and type of cochleostomy for electrode insertion in the scala tympani (ST). RESULTS: Fourteen studies met the inclusion criteria comprising 191 endoscopic or endoscopically assisted CI cases. The endoscope was used for better visualisation of the RW across all included studies, facilitated the insertion of the electrode in the ST and spared a mastoidectomy in a number of cases. No facial nerve palsy was reported in any of the studies. The most common complication was external auditory canal/tympanic membrane tear followed by chorda tympani injury. CONCLUSION: The microscopic CI approach is still the gold standard. The endoscope facilitates the recognition of the RW area and leads to successful and safe implantation, particularly in difficult anatomical scenarios, ear malformations and advanced otosclerosis. Endoscopically assisted CI procedures offer the opportunity to avoid a posterior tympanotomy and reduce the risk of facial nerve injury. To date, the lack of long-term data does not permit the widespread adoption of completely endoscopic CI procedures without a mastoidectomy.

Reactive C cell hyperplasia as an incidental finding after thyroidectomy for papillary carcinoma.

The biologic and clinical significance of reactive C cell hyperplasia (CCH), adjacent to differentiated thyroid cancers, remains unknown. Our aim was to investigate the presence of CCH in thyroidectomy specimens with papillary thyroid carcinomas (PTC) and discuss its epidemiology and histology. In total, 413 patients were prospectively included in the study (189 benign goiters, 224 PTC). Reactive CCH was observed in 9.8% of PTC cases (32% males, 68% females, mean age 48.3 ± 16.4 years) and usually ipsilateral to the primary tumor (91%). Histologically, CCH was either focal (91%) or diffuse (9%) and almost always (92%) found in the middle or upper thirds of the thyroid lobes. Patients with PTC/CCH were generally younger than patients with benign goiters (0.027). On the other hand, patients with PTC and with PTC/CCH did not differ in terms of age, gender, basal calcitonin levels, primary tumor size, multifocality, extrathyroidal invasion, or lymph node metastasis. Thyroiditis, however, was more frequent in cases with PTC/CCH compared to PTC alone. Reactive CCH is considered a physiological response of the C cells to various stimuli, differentiated thyroid cancer among others. It bears no malignant potential and requires no additional treatment, following thyroidectomy.