Early Elevation and Normalization of Electrode Impedance in Patients With Enlarged Vestibular Aqueduct Undergoing Cochlear Implantation.

OBJECTIVE: To characterize early changes in impedance in patients undergoing cochlear implantation with and without enlarged vestibular aqueducts (EVA). METHODS: Case-control retrospective study of patients undergoing cochlear implantation with and without EVA. Impedance was measured across all channels intraoperatively and within 24 hours of surgery. All patients received the same electrode array. RESULTS: Ten patients with EVA (and matched controls were identified). The average intraoperative impedance across all electrodes was significantly higher in patients with EVA (13.1 ±â€Š1.4 kΩ) than in controls (9.6 ±â€Š2.5 kΩ, p  < 0.001). At 24-hour activation, the average impedance across all electrodes was roughly equal in both groups (6.8 ±â€Š2.7 kΩ versus 6.5 ±â€Š2.1 kΩ, p  = 0.72). CONCLUSIONS: This study is the first identify differences in intraoperative impedance between patients with and without EVA. In addition, these data demonstrate rapid normalization within 24 hours of surgery. Such findings can give a window of insight into both the intracochlear microenvironment of patients with EVA and the important early electrode-fluid-tissue interface changes that occur within hours of surgery for all patients.

Dynamic pain after laser-assisted-Uvulo-palatoplasty (LAUP) can instantaneously be mitigated by topical regimens.

BACKGROUND AND OBJECTIVES: Kenalog application onto surgical wounds has been used to control dynamic pain following Laser-Assisted-Uvulo-Palatoplasty (LAUP) with good results in our department. When the effect was sub-optimal, insufficient ointment over the superior-lateral corner of wounds were always noted. Fulfilling the coating led to optimal results, and preliminary trials showed a good outcome of dynamic pain control as well by treating the corners only. The corners were thus named "sweet spots." This study aimed to verify the efficacy of applying Kenalog on "sweet spots" instead of whole surgical wounds to mitigate dynamic pain due to LAUP. STUDY DESIGN/MATERIALS AND METHODS: This is an outcomes research. Fifty-five subjects with primary snoring treated with LAUP were studied. By using Kenalog, local treatments were applied to sweet spots during the first postoperative week. A visual analogous scale was used to evaluate dynamic pain on the 1st, 2nd, 3rd, and 7th days after LAUP. RESULTS: Once sweet spots were treated, there was instant alleviation of dynamic pain; the average improvement level was ≥80% (P < 0.001, power = 100%). The area of sweet spots, in contrast to the significant relief in dynamic pain, occupied only about 30% of denuded mucosa. CONCLUSIONS: Dynamic pain after LAUP could immediately be mitigated by local treatments upon sweet spots using topical regimens. The large-scale relief of dynamic pain in contrast to the small area of sweet spots implies a congregation of free nerve endings there. Our finding invites further studies to correlate the neuroanatomy of the soft palate and dynamic pain caused by LAUP.