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The article presents te case of an 80-year-old woman who was rushed to a tertiary care center due to a 2-year history of unilateral aural fullness and hearing loss to discuss the condition called amyloidosis presenting as mass abutting the tympanic membrane. Her medical history include end-stage renal disease (ESRD) secondary to polycystic kidney disease. Her amyloid was present in her external auditory canal (EAC).

Objective: The aim of this case series was to assess the impact of auditory rehabilitation with cochlear implantation on the cognitive function of elderly patients over time. Design: This is a longitudinal case series of prospective data assessing neurocognitive function and speech perception in an elderly cohort pre- and post-implantation. Setting: University cochlear implant center. Participants: The patients were post-lingually deafened elderly female (mean, 73.6 years; SD, 5.82; range, 67-81 years) cochlear implant recipients (n=7). Measurements: A neurocognitive battery of 20 tests assessing intellectual function, learning, short- and long-term memory, verbal fluency, attention, mental flexibility, and processing speed was performed prior to and 2-4.1 years (mean, 3.7) after cochlear implant (CI). Speech perception testing using Consonant-Nucleus-Consonant words was performed prior to implantation and at regular intervals postoperatively. Individual and aggregate differences in cognitive function pre- and post-CI were estimated. Logistic regression with cluster adjustment was used to estimate the association (%improvement or %decline) between speech understanding and years from implantation at 1 year, 2 years, and 3 years post-CI. Results: Improvements after CI were observed in 14 (70%) of all subtests administered. Declines occurred in five (25%) subtests. In 55 individual tests (43%), post-CI performance improved compared to a patient's own performance before implantation. Of these, nine (45%) showed moderate or pronounced improvement. Overall, improvements were largest in the verbal and memory domains. Logistic regression demonstrated a significant relationship between speech perception and cognitive function over time. Five neurocognitive tests were predictive of improved speech perception following implantation. Conclusion: Comprehensive neurocognitive testing of elderly women demonstrated areas of improvement in cognitive function and auditory perception following cochlear implantation. Multiple neurocognitive tests were strongly associated with current speech perception measures. While these data shed light on the complex relationship between hearing and cognition by showing that CI may slow the expected age-related cognitive decline, further research is needed to examine the impact of hearing rehabilitation on cognitive decline. [ABSTRACT FROM AUTHOR]

Objectives To identify measurable anatomical factors that may guide the surgical approach for posterior fossa selective vestibular neurectomy (SVN) and predict identification of the vestibulocochlear cleavage (VCC) plane. Study Design Dissection of fixed cadaveric heads through retrolabyrinthine and retrosigmoid-internal auditory canal (RSG-IAC) approaches with measurement of landmarks. Setting: Cadaveric dissection model. Main Outcome Measures Area of the Trautmann triangle (TT) and the distance from the posterior semicircular canal to the anterior border of the sigmoid along the posterior Donaldson line (pDL). VCC planes from each approach were calculated and compared. Results Overall mean pDL was 8.53 mm (range: 5-11.5 mm); mean TT area was 124 mm2 (range: 95-237 mm2). The VCC was identified in 63% of ears through the retrolabyrinthine (RVN) approach alone, whereas 37% of ears required the RSG-IAC approach. In ears requiring IAC dissection, the VCC was found within 1 to 2 mmdistal to the porus. The pDL (p < 0.05) and area of TT (p < 0.05) were significantly larger in the RVN group compared with the RSG-IAC group. Conclusion Ears amenable to the RVN approach had a greater pDL and TT area. These anatomical measurements may have a role in surgical planning and the choice of approach for SVN. [ABSTRACT FROM AUTHOR]

The article presents a study which aimed to determine if intraoperative transcranial motor-evoked potential (TCMEP) can predict immediate and long-term postoperative facial nerve function in patients undergoing cerebellopontine angle (CPA) tumor resection. The study found some factors that affect TCMEP monitoring, including anesthesia, use of muscle relaxants, and patient variation. Unsatisfactory postoperative paresis and complete paralysis was encountered in some patients after surgery.