Overview of superior canal dehiscence syndrome

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PEDIATRIC AND ADULT AUDITORY BRAINSTEM IMPLANT (ABI) FDA CLINICAL TRIAL AT THE MASSACHUSETTS EYE AND EAR INFIRMARY AND MASSACHUSETTS GENERAL HOSPITAL

THE ABI CLINICAL TRIAL WILL INCLUDE INFANTS, CHILDREN AND ADULTS WHO ARE DEAF, DO NOT HAVE NEUROFIBROMATOSIS TYPE 2 AND ARE NOT CANDIDATES FOR THE COCHLEAR IMPLANT

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FOR CURRENT PATIENTS: Are you having surgery by Dr. Daniel Lee? - you can download your post-surgery instructions here.

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OCTOBER 31 TO NOVEMBER 3, 2013

ENDOSCOPIC EAR SURGERY AND ADVANCED OTOLOGY WORKSHOP

PRACTICAL ANATOMY AND SURGICAL EDUCATION, ST. LOUIS, MISSOURI.

Course Directors: Anthony Mikulec MD and Daniel Lee MD.

guest lecturers include:

Muaaz Tarabichi MD (Dubai)

David Pothier MD (Toronto)

Joao Flavio Nogueria MD (Brazil)

Daniele Marchioni MD (Italy)

This is a dedicated endoscopic ear surgery course for the first two days followed by a basic and advanced temporal bone course with whole skull dissection.

Participants will be able to use the latest surgical technology in the lab - including rigid endoscopes, drills from several manufacturers, middle ear implants and prostheses, KTP and CO2 lasers, and cochlear implant electrodes.

Inner ear surgery techniques, including minimally invasive cochlear implant surgery using the round window insertion approach, and transmastoid and middle fossa craniotomy approaches to repair / resurface superior canal dehiscence will also be presented.

The course takes place at the Practical Anatomy & Surgical Education, Center for Anatomical Science and Education, Saint Louis University School of Medicine, St. Louis, Missouri.

General otolaryngologists, pediatric otolaryngologists, otologists, and neurotologists are welcome.

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Pediatric and adult cochlear implants - an overview of clinical indications for cochlear implants, the multidisciplinary team based at the Massachusetts Eye and Ear Infirmary (MEEI), minimally invasive surgery, titanium screw fixation techniques to avoid tie down holes (especially when the skull is thin in patients 12 months of age or less), basic overview of CI surgery, and what to expect following surgery.

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IMPORTANT UPDATED 2012 GUIDELINES FROM THE CDC FOR COCHLEAR IMPLANT PATIENTS

Meningitis and cochlear implants - although a rare occurrence following CI surgery, it is important that all adult patients receive the correct PNEUMOCOCCAL vaccines and this includes both the Pneumovax and Prevnar 13.

See the CDC recommendations here

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Legislation to improve coverage of pediatric cochlear implant services - State Senator James Eldridge (Massachusetts)

Senator Jamie Eldridge teamed with Dr. Daniel Lee of MEEI and submitted S421 (formerly S469 and H3855), which would require health insurance plans to cover cochlear implant operations and post treatment services for children. Insurance is a major access factor to the CI technology. Please contact your legislator in support of this important piece of legislation to help deaf infants and children of the Commonwealth receive cochlear implant services.

Download the text of MA Senate Bill on pediatric CI coverage here (pdf file)

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NIH study: idiopathic sudden sensorineural hearing loss (SSNHL) multicenter treatment trial is now CLOSED BUT we are still actively caring for patients with sudden single-sided deafness with either high dose oral steroids or intratympanic steroid therapy. Learn more about sudden hearing loss here - www.suddendeafness.org

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superior semicircular canal dehiscence / superior canal dehiscence syndrome - known as Minor syndrome, superior canal dehiscence is a middle fossa skull base defect involving one of the vestibular (balance) organs. Specifically, a tiny hole in the superior (also known as anterior semicircular canal) in one or both ears can cause hearing loss AND/OR imbalance / dizziness, fullness of the involved ear and autophony (echo during self-vocalization). Superior semicircular canal dehiscence (SSCD) or superior canal dehiscence syndrome (SCDS) can result in many symptoms that resemble more common disorders of hearing loss and imbalance like otosclerosis, Eustachian tube dysfunction, patulous Eustachian tube, Menieres disease or BPPV.

Patients who need surgery can undergo repair of SCDS using either a transmastoid or middle fossa craniotomy surgery. The choice of the approach is based on the location of the dehiscence and presence of associated skull base defects.

Case 1 - 27 year old woman with left superior canal dehiscence syndrome (SCDS) who underwent middle fossa craniotomy and SCD repair (video)

Case 2 - 39 year old woman with left superior canal dehiscence syndrome (SCDS) who underwent middle fossa craniotomy and SCD repair (video)

Case 3 - 48 year old man with left superior canal dehiscence syndrome (SCDS) and meningoencephalocele who underwent middle fossa craniotomy, repair of tegmen defect, and repair of bony defect

Case 4 - 15 year old female patient with dizziness and right superior canal dehiscence syndrome (SCDS) from a prominent superior petrosal sinus who underwent transmastoid repair of this less common type of superior canal dehiscence

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