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Abstract Objective Studies evaluating genetic sensorineural hearing loss (SNHL) in Hispanic and Latino populations using genomic technologies are lacking. Recent data has shown that Hispanic and Latino children display lower genetic diagnostic rates despite similar prevalence rates of SNHL to their Asian and White counterparts, thus negatively affecting their clinical care. Our objective was to determine the genetic contribution to SNHL in a population of Mexican children undergoing evaluation for cochlear implantation. Methods Pediatric patients from Mexico with severe to profound SNHL undergoing evaluation for cochlear implantation were recruited. Exome sequencing (ES) or hearing loss gene panel testing was performed. Variant pathogenicity was established in accordance to criteria established by the American College of Medical Genetics, and variants of interest were clinically confirmed via CLIA certified laboratory. Results Genetic evaluation was completed for 30 Mexican children with severe to profound SNHL. A genetic cause was identified for 47% (14) of probands, and 7% (2) probands had an inconclusive result. Of the diagnoses, 10 (71%) were syndromic or likely syndromic, and 4 (29%) were nonsyndromic. Eight probands (80% of all syndromic diagnoses) were diagnosed with a syndromic form of hearing loss that mimics a nonsyndromic clinical presentation at a young age and so could not be suspected based on clinical evaluation alone without genetic testing. Conclusion This is the largest study to date to use comprehensive genomic testing for the evaluation of Mexican children with severe to profound SNHL. A significant proportion of children in this cohort were diagnosed with syndromic hearing loss. Future study in a larger cohort of Mexican children with varying degrees of hearing loss is required to improve the efficacy of genetic testing and timely medical intervention within these ethnically diverse populations. Level of evidence Level 4 (cohort study).

BACKGROUND: There are only a few case studies describing the audio-vestibular symptoms related to COVID-19. A previous report shows a prevalence of tinnitus after COVID-19 disease in 14.8%, hearing loss in 7.6%, and vertigo in 7.2%. Most clinical cases worldwide reported a moderate-to-severe sensorineural hearing loss, mainly from high frequencies measured by pure tone audiometry. There is no consensus on a recommended treatment. Some case reports refer clinical improvement with the use of intratympanic steroids, while others advise the combination of intratympanic and systemic steroids. CLINICAL CASE: A 46-year-old male patient with profound bilateral sensorineural hearing loss after a severe COVID-19 disease, which required in-hospital care for 62 days. Many elements may have participated in the development of his hearing loss. A cochlear implant was placed in the left ear, one year and seven months after being diagnosed with COVID-19. CONCLUSIONS: This case report is the second showing the development of profound bilateral hearing loss after a COVID-19 infection and the results after cochlear implantation; the first one is only described in a letter to the editor. [ABSTRACT FROM AUTHOR]

Abstract Introduction Superior semicircular canal dehiscence syndrome was described by Minor et al in 1998. It is a troublesome syndrome that results in vertigo and oscillopsia induced by loud sounds or changes in the pressure of the external auditory canal or middle ear. Patients may present with autophony, hyperacusis, pulsatile tinnitus and hearing loss. When symptoms are mild, they are usually managed conservatively, but surgical intervention may be needed for patients with debilitating symptoms. Objective The aim of this manuscript is to review the different surgical techniques used to repair the superior semicircular canal dehiscence. Data Sources PubMed and Ovid-SP databases. Data Synthesis The different approaches are described and discussed, as well as their limitations. We also review the advantages and disadvantages of the plugging, capping and resurfacing techniques to repair the dehiscence. Conclusions Each of the surgical approaches has advantages and disadvantages. The middle fossa approach gives a better view of the dehiscence, but comes with a higher morbidity than the transmastoid approach. Endoscopic assistance may be advantageous during the middle cranial fossa approach for better visualization. The plugging and capping techniques are associated with higher success rates than resurfacing, with no added risk of hearing loss.

Abstract Introduction The endolymphatic sac is thought to maintain the hydrostatic pressure and endolymph homeostasis for the inner ear, and its dysfunction may contribute to the pathophysiology of Ménière's disease. Throughout the years, different surgical procedures for intractable vertigo secondary to Ménière's disease have been described, and though many authors consider these procedures as effective, there are some who question its long-term efficacy and even those who think that vertigo control is achieved more due to a placebo effect than because of the procedure itself. Objective To review the different surgical procedures performed in the endolymphatic sac for the treatment of Ménière's disease. Data Sources PubMed, MD consult and Ovid-SP databases. Data Synthesis We focus on describing the different surgical procedures performed in the endolymphatic sac, such as endolymphatic sac decompression, endolymphatic sac enhancement, endolymphatic sac shunting and endolymphatic duct blockage, their pitfalls and advantages, their results in vertigo control and the complication rates. The senior author also describes his experience after 30 years of performing endolymphatic sac surgery. Conclusions The endolymphatic sac surgery, with all its variants, is a good option for patients with incapacitating endolymphatic hydrops, providing a high percentage of vertigo control and hearing preservation.

Abstract Introduction Middle fossa approach has been suggested as an alternative for patients in whom other routes of electrode insertion are contraindicated. Even though there are temporal bone studies about the feasibility of introducing the cochlear implant through the middle fossa, until now, very few studies have described results when cochlear implant surgery is done through this approach. Objective The objective of this study is to review a series of temporal bone studies related to cochlear implantation through the middle fossa and the results obtained by different surgical groups after cochlear implantation through this approach. Data Sources PubMed, MD consult and Ovid-SP databases. Data Synthesis A total of 8 human cadaveric temporal bone studies and 6 studies reporting cochlear implant surgery through the middle fossa approach met the inclusion criteria. Temporal bone studies show that it is feasible to perform cochlear implantation through this route. So far, only two surgical groups have performed cochlear implantation through the middle fossa with a total of 15 implanted patients. One group entered the cochlea in the most upper part of the basal turn, inserting the implant in the direction of the middle and apical turns; meanwhile, the other group inserted the implant in the apical turn directed in a retrograde fashion to the middle and basal turns. Results obtained in both groups were similar. Conclusions The middle fossa approach is a good alternative for cochlear implantation when other routes of electrode insertion are contraindicated.

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Objective: To perform a descriptive analysis of treatment and evolution and infectious complications found in pediatric patients that received a cochlear implant at National Institute of Rehabilitation, Mexico. Material and method: A retrospective, descriptive, observational and analytical study that included 70 pediatric patients post-operated to cochlear implant, from November 2007 to June 2013, at National Institute of Rehabilitation, Mexico. It was made a descriptive statistical analysis by central and dispersion tendency measurements, with normality tests, besides logistic regression for identifying favorable responses with different antibiotics and treatment days and doses. Results: From 70 patients included, 34 had any infectious complication; from these, 17 had infection of upper airways and only 7 had acute otitis media. The first-choice antibiotic was amoxicilline-clavulanic acid in 16 patients. Longer number of days of treatment, better relieve of disease; besides, doses of 90 mg/kg/12 h showed better response of patients. Conclusions: Placement of cochlear implant is a safe and effective procedure, with a low rate of major complications. In case of suspicion of infection of upper airways, it is recommended the prescription of antibiotic. [ABSTRACT FROM AUTHOR]

Background: The application of a cochlear implant is a safe procedure eventhough it has a variable range of complications. Major and minor complications can happen in 2.1 to 11.7% of cases and 5.8 a 25.4% respectively acording to diferent series. Cochlear implantation is becoming more available every day as a treatment for bilateral profound deaffness in Mexico. Objective: To analyze the complications found during trans and postoperatory periods in pediatric patients who underwent cochlear implantation in a single tertiary referral center. Material and method: A retrospective analysis of treatment and evolution of short- and long-term complications of the cochlear implantation to 50 pediatric patients was done. The mean age at implantation was of 3.1 years, ranging from 1.6 to 7.8 years. Of these children, 22 (44%) had congenital deafness of unknown cause. The most common suspected causes were neonatal anoxia (n = 6, 12%) and aminoglycoside use in the first months of life (n = 6, 12%) followed by congenital cytomegalovirus infection (n = 3, 6%). The mean follow-up at the time of the study was 22 months (range, 6-48 months). Results: There were a total of 16 adverse events (32% in 50 patients) considered complications throughout the follow-up of these 50 patients. There was one major perioperative complication (2%) and 5 minor complications in the same period (10%). In the early postoperative period there was one major complication (2%) and one minor complication (2%) and in the late postoperative there were 4 major (8%) and 4 minor (8%) complications. Minor complications (e.g., eardrum perforation, hematoma, flap swelling, wound infection, temporary facial weakness) settled with conservative treatment or minor intervention. With regard to the major complications, these included a patient whose facial nerve was damaged during mastoidectomy, 2 patients with a tympanic perforation in the implanted ear secondary to acute suppurative otitis media in the postoperative period, a patient who developed a postauricular abscess after head trauma directly at the stimulator-receptor site, one patient who suffered a head trauma with irreparable damage to the receptor-stimulator, and a patient who developed an acute mastoiditis in the mastoid cavity of a previously implanted ear. Conclusions: Cochlear implantation is a relatively safe surgical procedure. Most surgical complications after cochlear implantation are minor and can be managed with conservative treatment or minor surgical intervention. However, an adequate preparation of the patient before surgery, meticulous attention to surgical detail and a long-term follow-up are of paramount importance in minimizing the incidence of surgical and infectious complications in implanted pediatric patients. [ABSTRACT FROM AUTHOR]

Osteomas are benign slow growing tumors characterized by proliferation of cancellous or compact bone. The ones that appear in the mandible are rare and their surgical excision is indicated when they interfere with proper maxillary function, when they cause symptoms because of compression of other structures or when they produce important facial deformity. We report a case of a posttraumatic osteoma in the inferior left angle of the mandible in a patient with deciduous teeth, as well as a revision of the literature. [ABSTRACT FROM AUTHOR]

For the last 40 years, bone anchored hearing aids have proved to be useful for the treatment of conductive or mixed unilateral or bilateral hearing loss, as well as for sensorineural unilateral hearing loss. Through these years, important improvements have been done in this type of implants, and one of them that presents some of the best features is the Alpha I model by Sophono, which has the advantage of not requiring an abutment, instead of it gets coupled by magnetism. In this article we report the case of a 61-yearold female with unilateral microtia-atresia syndrome, who gained an important hearing improvement with the use of one of this bone anchored devices. [ABSTRACT FROM AUTHOR]