Cochlear implantation in neurofibromatosis type 2 after radiation therapy.

OBJECTIVE: To investigate the results of cochlear implantation in patients with neurofibromatosis Type 2 (NF2) who have previously been treated with radiation therapy to the vestibular schwannoma (VS) in their only hearing ear. STUDY DESIGN: A retrospective review of the Melbourne Cochlear implant database was undertaken to identify patients with NF2 undergoing cochlear implantation in whom previous radiation therapy had been performed to control their VS (ipsilateral tumor). Three patients were identified. A case note review was undertaken and data collected on preoperative and postoperative speech perception testing. SETTING: Melbourne Cochlear implant center. RESULTS: All 3 patients were daily cochlear implant users. There was improvement in speech perception scores in 2 cases, with the 3rd case unable, for unrelated medical reasons, to complete postoperative testing. Subjectively, the third patient reported a dramatic improvement in communication and is a daily user of his implant. CONCLUSION: Cochlear implantation results in improved hearing in a select group of NF2 patients who have undergone radiation treatment to control their VS.

Patients' use of the Internet for health related matters: a study of Internet usage in 2000 and 2006.

This prospective questionnaire study investigated access to the Internet and use of the Internet for health related information. Patients attending the senior author's ENT clinic (204 in 2000; 209 in 2006) were asked two questions: do you have access to the Internet? Have you used the Internet to find health related information? Access to the Internet rose from 43 per cent (88) in 2000 to 70 per cent (147) in 2006, a significant increase (p < 0.001). The Internet was used for health related information by only 32 patients (16%) in 2000 but by 114 (55%) in 2006, a dramatic and significant increase (p < 0.001). Clearly patients and their families are increasingly using the Internet to access and seek health information. Clinicians cannot overlook this aspect of health provision when seeking to facilitate the transmission of information to their patients.

Snoring: referral, investigation and treatment.

Snoring is a common problem and the incidence increases with age. The significance of snoring as a symptom of sleep disordered breathing must not be overlooked in assessing this complaint. This article aims to highlight some of the important aspects in the investigation and management of a snoring patient.

A case of herpes zoster presenting as orbital cellulitis.

We presented an unusual case of ophthalmic herpes zoster masquerading as orbital cellulitis, resulting in delay in appropriate treatment. A 65-year-old woman presented with left periorbital pain and swelling of a week duration. Examination revealed periorbital edema and inflammation but no proptosis. The erythema extended onto the brow. There was no change in visual acuity and cranial nerve function was normal. She was apyrexial and all other parameters were within normal limits. The patient was admitted with an initial diagnosis of sinusitis with orbital cellulitis/dacryocystitis and intravenous co-amoxiclav and a non-steroidal anti-inflammatory drug were administered. The following day, there was little change in her condition with the ocular movements being normal and vision remaining unaffected. She was apyrexial but the periorbital swelling persisted. Computed tomography of the sinuses did not show sinusitis or a periorbital collection. The third day after admission and 10 days after the initial appearance of pain, vesicles appeared on the left forehead, which enabled a diagnosis of herpes zoster of the ophthalmic branch of the trigeminal nerve. She was then treated with acyclovir with a good result.