Deep learning to predict risk of lateral skull base cerebrospinal fluid leak or encephalocele.

Purpose: Skull base features, including increased foramen ovale (FO) cross-sectional area, are associated with lateral skull base spontaneous cerebrospinal fluid (sCSF) leak and encephalocele. Manual measurement requires skill in interpreting imaging studies and is time consuming. The goal of this study was to develop a fully automated deep learning method for FO segmentation and to determine the predictive value in identifying patients with sCSF leak or encephalocele.

Outcomes of Near-Total and Subtotal Resection of Sporadic Vestibular Schwannoma: A Systematic Review and Meta-Analysis.

Objective: To evaluate tumor control and facial nerve outcomes after gross-total (GTR), near-total (NTR), and subtotal resection (STR) of sporadic vestibular schwannomas (VS).

Data Sources: PubMed, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus databases were searched in August 2021 through inception following PRISMA guidelines.

Review Methods: English language articles reporting tumor control and facial nerve outcomes of adults (≥18 years) with NTR and STR of VS were evaluated.

Multi-Disciplinary Approach to Skull Base Paragangliomas.

The treatment of skull base paragangliomas has moved towards the use of cranial nerve preservation strategies, using radiation therapy and subtotal resection in instances when aiming for gross total resection would be expected to cause increased morbidity compared to the natural history of the tumor itself. The goal of this study was to analyze the role of surgery in patients with skull base paragangliomas treated with CyberKnife stereotactic radiosurgery (SRS) for definitive tumor control. A retrospective review identified 22 patients (median age 65.

Management of Foreign Bodies in the Ear Canal.

Using the appropriate instruments and techniques for removing a foreign body from the external auditory canal facilitates the procedure and reduces the risk of complications. Most ear foreign bodies can be addressed on a nonurgent basis, but batteries and caustic materials warrant prompt removal. Referral to an otolaryngologist should be considered for difficult cases or after a failed attempt.

Older Adults with Vestibular Disorders and Hip Fractures Have High Rates of Meclizine Use.

Objectives: To examine the risk factors for hip fracture in patients with vestibular disorders and the association between antihistamine use and hip fracture in patients with vestibular disorders.

Study Design: Retrospective case series with chart review.

Setting: Tertiary academic medical center.

An Elusive Diagnosis: Delays in Treatment and Opportunities for Improvement in Temporal Encephalocele and CSF Leak.

Objective: Symptoms of temporal encephalocele or cerebrospinal fluid (CSF) leak causing middle ear effusion or otorrhea can be nonspecific and mistaken for other common diagnoses, leading to delays in diagnosis, failed treatments, and a risk of meningitis. This study sought to investigate the association between symptomatology and time to definitive surgical management.

Study Design: Retrospective cohort.

Frailty in middle cranial fossa approach for encephalocele or cerebrospinal fluid leak repair.

Objective: The modified 5-item frailty index (mFI-5) is a concise, comorbidity-based risk stratification tool that can predict adverse outcomes after surgery. The goal of this study was to understand the frailty of patients undergoing surgery for temporal encephalocele or cerebrospinal fluid (CSF) leak and the utility of mFI-5 for predicting increased post-operative outcomes.

Methods: A retrospective review of adults with temporal encephalocele or CSF leak who underwent middle cranial fossa (MCF) approach craniotomies with or without mastoidectomy from January 2015 through August 2021 at a tertiary care academic medical center was performed.

Expansion of the Foramen Ovale in Patients With Cerebrospinal Fluid Leak or Encephalocele.

Objective: Spontaneous cerebrospinal fluid (CSF) leaks are associated with elevated intracranial pressure and idiopathic intracranial hypertension (IIH). Skull base erosion and widening of the foramen ovale have been reported in patients with IIH. This study sought to investigate changes in the size of the foramen ovale and foramen spinosum in patients with IIH, spontaneous CSF leak, and encephalocele.

Systematic Review of CT Angiography in Guiding Management in Pediatric Oropharyngeal Trauma.

Objectives: Pediatric oropharyngeal trauma is common. Although most cases resolve uneventfully, there have been reports of internal carotid artery injury leading to devastating neurovascular sequelae. There is significant controversy regarding the utility of CT angiography (CTA) in children with seemingly minor oropharyngeal trauma.

Higher Readmission Rates After Hip Fracture Among Patients With Vestibular Disorders.

Objective: Falls in older adults are associated with high morbidity and mortality. Patients with vestibular disorders may have an increased risk. The purpose of this study was to examine the outcomes among patients with underlying vestibular disorders who have hip fractures and identify predictors of increased morbidity and mortality.

Population-based survival of pediatric rhabdomyosarcoma of the head and neck over four decades.

Objectives: Clinical trials have reported increases in the survival of pediatric rhabdomyosarcoma (RMS) from 25% in 1970 to 73% in 2001. The purpose of this study was to examine whether survival of pediatric patients with RMS of the head and neck improved at the US population level.

Methods: A population-based cohort of patients with rhabdomyosarcoma of the head and neck aged 0-19 years in the Surveillance, Epidemiology, and End Results (SEER) registry from 1973 to 2013 was queried.

Laryngotracheal Stenosis in Early vs Late Tracheostomy: A Systematic Review.

Objective: For critically ill patients undergoing long-term mechanical ventilation, to determine whether early conversion from endotracheal intubation to tracheostomy reduces the incidence of laryngotracheal stenosis.

Data Sources: MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, and the Cumulative Index to Nursing and Allied Health Literature.

Review Methods: A systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and an assessment of bias were performed.