Search Our Scientific Publications & Authors

BMJ Case Rep 2022 Apr 15;15(4). Epub 2022 Apr 15.

Otolaryngology-Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA.

A woman in her late 40s who works as a veterinary technician represented to the emergency department with increasing headache, confusion, neck stiffness, subjective fevers and distorted hearing 2 days after diagnosis of viral infection at an outside emergency department.Diagnosis of was made from blood cultures and lumbar puncture. Intravenous ceftriaxone was administered for 21 days. Read More

J Neuroimaging 2022 May 20;32(3):400-411. Epub 2022 Mar 20.

Edward B. Singleton Department of Radiology, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA.

Tinnitus is defined as the perception of sound without an external source and can be categorized as either pulsatile or nonpulsatile (ie, continuous). A variety of etiologies have been reported to cause pediatric tinnitus, many with long-lasting implications due to hearing and concentration impairments. Therefore, imaging can be an essential part of the accurate and timely diagnosis of treatable etiologies. Read More

J Int Adv Otol 2021 Nov;17(6):500-507

Department of Otorhinolaryngology, Hacettepe University Faculty of Medicine, Ankara, Turkey.

Background: This study was planned (1) to evaluate long-term outcome after cochlear implantation in patients with post-meningitic deafness and (2) to compare the outcome measures with patients implanted for deafness due to other causes.

Methods: Records of 54 patients deafened as a sequel of bacterial meningitis and implanted at the largest university-based cochlear implant program in Turkey were retrospectively reviewed. Fifty-four age- and sex-matched patients with a similar interval of implant use were selected for controls. Read More

Ear Nose Throat J 2020 Nov 23:145561320974864. Epub 2020 Nov 23.

Department of Otorhinolaryngology, Otology, Neurotology and Cochlear Implant Unit, Christian Medical College, Vellore, Tamil Nadu, India.

Successful cochlear implantation in the setting of labyrinthitis ossificans is challenging. Various surgical techniques are described to circumvent the region of ossification and retrograde insertion of the electrode array is one such option. While reverse programming is often recommended in the case of retrograde electrode insertion, we present our experience of retrograde electrode insertion for labyrinthitis ossificans, where standard programming was adopted due to patient preference and provided satisfactory outcomes. Read More

J Radiol Case Rep 2020 May 31;14(5):1-6. Epub 2020 May 31.

Department of Radiology, University of Louisville Hospital, Kentucky, USA.

Labyrinthitis most commonly results from an infectious and less commonly from an inflammatory process of the inner ear, but it can be associated with temporal bone trauma, hemorrhage, or tumor. This inflammation (regardless of the etiology) disrupts the transmission of sensory information from the ear to the brain. Labyrinthitis ossificans is the pathological ossification of the membranous labyrinthine spaces in response to an insult to the inner ear involving membranous labyrinth or the endosteum of the otic capsule. Read More

Otolaryngol Head Neck Surg 2020 Dec 30;163(6):1281-1282. Epub 2020 Jun 30.

Department of Otolaryngology-Head and Neck Surgery, Augusta University, Augusta, Georgia, USA.

Otolaryngol Head Neck Surg 2021 01 30;164(1):175-181. Epub 2020 Jun 30.

Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, USA.

Objective: Labyrinthitis ossificans (LO) may occur following meningitis and, in cases where cochlear implantation is indicated, complicate electrode insertion. LO is critical to identify for successful cochlear implantation, and histopathology is more sensitive than imaging for identification of LO. Herein we utilize otopathologic techniques to study the timing and location of intracochlear tissue formation following meningitic labyrinthitis (ML). Read More

Laryngoscope Investig Otolaryngol 2020 Jun 6;5(3):506-510. Epub 2020 May 6.

Department of Ophthalmology, Otolaryngology and Head and Neck Surgery Ribeirão Preto Faculty of Medicine (FMRP-USP) Ribeirão Preto São Paulo Brazil.

Objective: To demonstrate the cochlear turns area changes among patients with a history of meningitis, through otopatologic study.

Methods: We performed an analysis of the area of the bony cochlear turns and the cochlear lumen of the horizontal sections containing the modiolus and the area of the basal turn at the level of round window, in temporal bones obtained from patients with a history of meningitis and compared to a nondiseased control group.

Results: The mean area of the bony walls and the lumen of all cochlear turns are reduced within the meningitis group. Read More

Otol Neurotol 2020 07;41(6):e695-e699

The Sydney Cochlear Implant Centre, Gladesville, NSW.

Objectives: To assess the effect on impedance levels of intraoperative reinsertion of a cochlear implant (CI) array compared with matched controls.

Study Design: Retrospective patient review.

Setting: Cochlear implant center. Read More

Laryngoscope Investig Otolaryngol 2020 Apr 14;5(2):256-266. Epub 2020 Feb 14.

Department of Otolaryngology Massachusetts Eye and Ear Boston Massachusetts.

Objective: While cochlear ossification is a common sequalae of meningitic labyrinthitis, less is known about the effects of meningitis on peripheral vestibular end organs. Herein, we investigate histopathologic changes in the peripheral vestibular system and cochlea in patients with a history of meningitic labyrinthitis.

Methods: Temporal bone (TB) specimens from patients with a history of meningitis were evaluated and compared to age-matched controls. Read More

Otol Neurotol 2020 06;41(5):e607-e614

Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, California.

Hypothesis: Endolymphatic hydrops (EH) associated with cochlear implantation are associated with vestibular dysfunction.

Background: Vestibular dysfunction is a known risk after cochlear implantation (CI). CI has been shown to cause cochlear hydrops due to fibrosis surrounding the ductus reuniens. Read More

Cureus 2019 Dec 3;11(12):e6279. Epub 2019 Dec 3.

Otolaryngology, Neurotology and Skull Base Surgery, King Saud University, Riyadh, SAU.

Background The selection of an appropriate imaging technique for assessment before cochlear implantation is critical for precise diagnosis and management. While magnetic resonance imaging (MRI) is used for the diagnosis of several conditions, such as labyrinthitis ossificans, cochlear nerve deficiency, and neoplasms, high-resolution computed tomography (HRCT) provides excellent details of the temporal bone. However, it remains unclear whether routine MRI provides any additional benefits over HRCT. Read More

Neuroradiology 2019 Sep 18;61(9):959-970. Epub 2019 Jul 18.

Radiology Department, Great Ormond Street Hospital, London, UK.

Purpose: Understanding the underlying pathophysiology and the patterns of disease spread is crucial in accurate image interpretation. In this pictorial review, the common and important inflammatory processes of the temporal bone in children will be discussed, and key computed tomography (CT) and magnetic resonance imaging (MRI) features described.

Methods: Inflammatory processes are categorized by anatomical location: the petrous apex and the inner, middle and outer ear. Read More

Otolaryngol Head Neck Surg 2019 10 7;161(4):658-665. Epub 2019 May 7.

Department of Otolaryngology, Massachusetts Eye and Ear, Boston, Massachusetts, USA.

Objective: Human otopathology following drill-out procedures for cochlear implantation (CI) in cases with labyrinthitis ossificans (LO) has not been previously described. This study uses the high sensitivity of histopathology to (1) evaluate surgical drill-out technique with associated intracochlear findings and (2) quantify spiral ganglion neuron populations in a series of patients with LO who underwent CI.

Study Design: Retrospective otopathology study. Read More

AJNR Am J Neuroradiol 2019 03 21;40(3):551-557. Epub 2019 Feb 21.

From the Departments of Radiology (K.B., B.B., A.F., M.M.Q., K.T., O.S.)

Background And Purpose: Our aim was to identify whether specific patterns of ossification in labyrinthitis ossificans are associated with the known risk factors. Labyrinthitis ossificans has been described as sequela of prior temporal bone trauma, prior infection, and other disorders including sickle cell disease. Specific patterns of mineralization in the membranous labyrinth associated with these risk factors has not been previously described. Read More

J Int Adv Otol 2019 Apr;15(1):156-159

Department of Otolaryngology, University of Pavia, IRCCS Policlinico "S. Matteo" Foundation, Pavia, Italy.

Polyarteritis nodosa (PAN) is a systemic vasculitis affecting the small- and medium-sized arteries that may present with hearing impairment. In rare cases, PAN may be associated with progressive labyrinthitis ossificans (LO), an otologic emergency requiring early cochlear implantation (CI) to restore hearing before the complete, irreversible cochlear ossification. We report the first case in the literature of a patient affected by PAN with bilateral sudden sensorineural hearing loss and rapid LO who underwent "emergency" bilateral simultaneous CI. Read More

Otol Neurotol 2018 12;39(10):e992-e995

Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University, Nashville, Tennessee.

Objective: To describe and characterize facial nerve stimulation (FNS) patterns in patients with labyrinthitis ossificans who underwent cochlear implantation (CI) for sensorineural hearing loss.

Patients: Five ears in four patients with labyrinthitis ossificans who underwent CI and subsequently developed FNS.

Interventions: CI, electrode mapping, and/or explantation to resolve FNS. Read More

Cochlear Implants Int 2019 01 20;20(1):47-50. Epub 2018 Sep 20.

a Department of Otorhinolaryngology , SMS Medical College and Hospitals , Jaipur , India.

Introduction: Beta-thalassemias are a group of hereditary blood disorders characterized by anomalies in the synthesis of the beta chains of hemoglobin. Iron overload occurs in thalassemia, with blood transfusion therapy being the major cause. Deferoxamine continues to be the mainstay of therapy to remove excess iron in patients requiring long-term transfusions. Read More

Comp Med 2018 Apr 12. Epub 2018 Apr 12.

Labyrinthitis is inflammation of the membranous and bony labyrinth of the inner ear. Typical portals of entry includehematogenous spread from the cochlear vasculature, passage of otitis media pathogens through the round window, and mostcommonly, meningogenic spread from the subarachnoid space. The sequela of chronic inner ear inflammation is labyrinthitisossificans, in which inner ear structures are replaced by fibrous and osseous tissues. Read More

Indian J Radiol Imaging 2017 Jul-Sep;27(3):274-281

Department of Otolaryngology, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt.

Objective: This study is concerned with clarification of radiological findings that should be addressed and reported in patients listed for cochlear implant (CI) operation. These findings may force a surgeon to consider modifications of the surgical approach by a CI surgeon.

Materials And Methods: The study was performed from January 2015 to January 2016. Read More

Int J Pediatr Otorhinolaryngol 2017 Aug 15;99:135-140. Epub 2017 Jun 15.

Department of Otolaryngology - Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA. Electronic address:

Objective: Describe the presentation, imaging characteristics, management, and outcomes of pediatric patients with Langerhans cell histiocytosis (LCH) of the temporal bone.

Methods: A retrospective chart review was performed between 2000 and 2014 at a single tertiary care children's hospital. Fourteen patients were identified with a diagnosis of LCH and involvement of the temporal bone. Read More

Otol Neurotol 2017 06;38(5):e21-e25

*Department of Otorhinolaryngology †Department of Radiology ‡Department of Clinical Genomics §Department of Audiology, Mayo Clinic, Rochester, Minnesota.

Objective: To describe a novel case of congenital profound bilateral sensorineural hearing loss in a patient with bilateral nodular internal auditory canal and labyrinthine enhancement and temporal bone dysplasia.

Patients: A 76-day-old female was referred to the authors' center for evaluation of congenital deafness. Behavioral observations and objective audiometric evaluation demonstrated bilateral profound sensorineural hearing loss and a comprehensive multidisciplinary evaluation identified compound heterozygous pathogenic variants in MYO7A, a gene associated with Usher Syndrome Type 1B or DFNB2. Read More

Ann Otol Rhinol Laryngol 2017 Feb 24;126(2):89-95. Epub 2016 Nov 24.

1 Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, USA.

Objective: To quantitatively assess the effect of serous labyrinthitis, suppurative labyrinthitis, and labyrinthitis ossificans on vestibular hair cells, dark cells, and transitional cells.

Methods: We examined human temporal bone specimens with serous labyrinthitis, suppurative labyrinthitis, and labyrinthitis ossificans, then compared them with age-matched control groups without labyrinthitis. We evaluated the density of type I and II vestibular hair cells, dark cells, and transitional cells in the peripheral sensorial organs. Read More

Int J Audiol 2016 7;55 Suppl 2:S77-87. Epub 2016 Jun 7.

a Department of Otolaryngology , The University of Melbourne , East Melbourne , Victoria , Australia.

Objective: To review the contemporary surgical issues in paediatric cochlear implantation (CI) based on published evidence.

Design: Narrative literature review.

Results: Surgical challenges in paediatric CI are discussed, with respect to post meningitic labyrinthitis ossificans; cochlear malformation; cochlear implantation in infants; auditory neuropathy and cochlear nerve deficiency; bilateral cochlear implantation; hearing preservation; otitis media; and device failure. Read More

Otolaryngol Head Neck Surg 2016 10 24;155(4):635-40. Epub 2016 May 24.

Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, USA

Objective: To quantitatively demonstrate and classify the histopathologic changes in the cochlea of the human temporal bones with labyrinthitis ossificans (LO).

Study Design: Comparative human temporal bone study.

Setting: Tertiary academic medical center. Read More

J Laryngol Otol 2016 Jul 23;130(7):691-5. Epub 2016 May 23.

Department of Otolaryngology,Tan Tock Seng Hospital,Singapore.

Background: Sensorineural hearing loss is a recognised complication of cryptococcal meningitis. The mechanism of hearing loss in patients with cryptococcal meningitis is different from that in bacterial meningitis.

Case Report: An immune-competent man with cryptococcal meningitis presented with sudden onset, bilateral, severe to profound sensorineural hearing loss and vestibular dysfunction. Read More

J Neurosci Rural Pract 2016 Apr-Jun;7(2):327-9

Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Otol Neurotol 2015 Dec;36(10):1633-7

*Department of Otolaryngology-Head and Neck Surgery, University of Texas at Southwestern Medical Center †Department of Pediatric Otolaryngology, Children's Health ‡Callier Center for Communication Disorders, University of Texas at Dallas §Department of Radiology, Children's Health ||Department of Radiology, University of Texas at Southwestern Medical Center, Dallas, Texas, U.S.A.

Objective: 1) To characterize pediatric cochlear implant performance in patients with hearing loss secondary to bacterial meningitis. 2) To evaluate performance differences in patients with and without labyrinthitis ossificans (LO).

Study Design: Retrospective case review. Read More

Laryngoscope 2016 07 4;126(7):1656-61. Epub 2015 Nov 4.

Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, U.S.A.

Objectives/hypothesis: To evaluate the effectiveness of cochlear measures obtained by high-resolution computed tomography (HRCT) scan in predicting depth of cochlear implant insertion.

Study Design: Retrospective case review.

Methods: Patients who underwent cochlear implantation in an academic referral center between 2010 and 2013 were considered. Read More

Ann Otol Rhinol Laryngol 2015 Aug 10;124(8):649-54. Epub 2015 Mar 10.

Department of Otolaryngology, Head & Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Denmark.

Introduction: It has been suggested that remodeling of the otic capsule is highly suppressed by the action of anti-resorptive signals emanating from structures of the inner ear space. Labyrinthitis ossificans (LO) is a severe complication to bacterial meningitis and is characterized by destruction of inner ear structures by the formation of new bone. The aim of this study was to explore the impact of LO on bone remodeling of the otic capsule. Read More