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ImportanceReparative granuloma (RG) is a rare but severe complication of otosclerosis surgery, presenting with vertigo, tinnitus, and hearing loss. Surgical intervention may offer effective symptom relief.ObjectiveTo evaluate the effectiveness of surgical management for RG following otosclerosis surgery in alleviating vestibular symptoms and preserving hearing.DesignRetrospective cohort study (STROBE guidelines).SettingTertiary referral center.ParticipantsNineteen adult patients with histologically confirmed RG and persistent symptoms (vertigo and/or hearing loss) within 3 months of primary stapes surgery.InterventionRevision surgery included granuloma resection, prosthesis replacement, and corticosteroid-soaked graft placement as needed.Main Outcome MeasuresPostoperative relief of vestibular symptoms, hearing thresholds [pure-tone average (PTA)], and length of hospital stay.ResultsSymptoms developed on average 3.6 ± 3.9 days postoperatively. Revision surgery resolved vertigo in 18 of 19 patients (95%) by discharge (mean 4.8 ± 1.9 days). Audiometric improvement was limited, with 11 patients retaining serviceable hearing. Preoperative versus postoperative bone conduction PTA showed no significant change ( = .58).ConclusionsSurgical management effectively alleviates vestibular symptoms associated with RG but has minimal impact on hearing restoration.RelevanceThis study highlights the efficacy of revision surgery for RG in addressing vestibular symptoms. Further multicenter studies are warranted to better understand reparative granuloma and improve treatment strategies.
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http://dx.doi.org/10.1177/19160216251364762 | DOI Listing |
J Neurol
September 2025
SENSE Research Unit, Department of Clinical and Movements Neurosciences, UCL Institute of Neurology, 33 Queen Square, London, WC1N 3BG, UK.
Positional nystagmus is a frequently encountered yet often underappreciated clinical sign that provides critical insights into vestibular and central nervous system function. For the general neurologist, recognising and correctly interpreting positional nystagmus can significantly impact diagnostic accuracy and guide appropriate management of common and complex dizziness presentations. The current diagnostic framework for positional nystagmus disproportionately favours BPPV, underestimates central positional nystagmus (CPN), and over-relies on imaging.
View Article and Find Full Text PDFInt J Surg Case Rep
September 2025
Department of Otolaryngology, University Hospital Galway, Ireland; Discipline of Otorhinolaryngology, University of Galway, Ireland.
Introduction And Importance: While blunt trauma to the head is a well-recognized cause of middle ear injuries, penetrating traumas are far less common. Due to the close anatomical relations, the potential consequences of such injuries can be catastrophic.
Case Presentation: A man presented following a penetrating injury to the external auditory canal.
J Head Trauma Rehabil
September 2025
Author Affiliations: Hearing Center of Excellence, Joint Base San Antonio-Lackland Air Force Base, Texas (Dr Lambert); Advanced Exposures, Diagnostics, Interventions, and Biosecurity (AEGIS) Program, Joint Base San Antonio-Lackland Air Force Base, Texas (Dr Hoppes); Department of Orthopaedic Surgery
Objective: This study examined false-positive rates and associated factors on the Vestibular/Ocular Motor Screening (VOMS) in healthy US Army Special Operations Command (USASOC) personnel using the symptom provocation cutoff of ≥1 for any VOMS item as recommended in the Military Acute Concussion Evaluation 2 (MACE 2).
Setting: Military site.
Participants: Active-duty USASOC personnel aged 18 to 40 years with 20/20 vision, no duty limitations, and no recent concussion.
Objective: This study aims to evaluate long-term auditory outcomes in patients with inner ear malformations (IEMs) treated with cochlear or auditory brainstem implants (CI/ABI), and to assess the influence of anatomical subtype, electrode design, insertion depth, and genetic/syndromic background on hearing performance over a 10-year follow-up.
Methods: We conducted a prospective cohort study including patients with radiologically confirmed IEMs and bilateral severe-to-profound hearing loss, all of whom underwent implantation and completed at least 10 years of follow-up. Outcomes were assessed using pure-tone average (PTA) and speech recognition scores (SRS) at defined intervals.
JAMA Otolaryngol Head Neck Surg
September 2025
Department of Otolaryngology, Cambridge University Hospitals, Cambridge, England.
Importance: In the literature, there is a lack of data reporting tumor control rates after radiotherapy in actively growing vestibular schwannomas (VS). Data for this rarely studied population are needed.
Objective: To estimate tumor control rates in radiologically growing VS treated with first-line radiotherapy.