Otology, Neurotology, and Skull Base SURGERY Clinical Reference Guide
Theodore R. McRackan, MD Derald E. Brackmann, MD
Contents Foreword by Harold C. Pillsbury, MD xi Introduction xiii Acknowledgments xv About the Editors xvi Contributors xvii Section I
History of Neurotology
1
Chapter 1
History of Neurotology and Skull Base Surgery Lawrence R. Lustig
3
Section II
Embryology Anatomy Physiology
13
Chapter 2
Embryological Development of the Ear Theodore R. McRackan and George B. Wanna
15
Chapter 3
Anatomy and Physiology of the Auditory System Gregory J. Basura and Steven A. Telian
23
Chapter 4
Anatomy and Physiology of the Vestibular System Gregory T. Whitman and Timothy C. Hain
33
Section III
Evaluation
45
Chapter 5
The Neurotologic Examination Stanley Pelosi
47
Chapter 6
Hearing Assessment René H. Gifford
55
Chapter 7
Vestibular Testing Yuri Agrawal
67
Chapter 8
Intraoperative Monitoring Christopher K. Giardina and Oliver F. Adunka
75
Section IV
Common Otologic Symptoms
83
Chapter 9
Tinnitus Theodore R. McRackan and John C. Goddard
85
v
vi Otology, Neurotology, and Skull Base Surgery: Clinical Reference Guide
Chapter 10
Otalgia and Temporomandibular Joint Disorders Jason A. Beyea and Aaron C. Moberly
93
Section V
Hearing Loss
99
Chapter 11
Congenital and Genetic Hearing Loss Seiji B. Shibata and Richard J. Smith
101
Chapter 12
Otosclerosis Felipe Santos and Michael J. McKenna
111
Chapter 13
Presbycusis Simon I. Angeli
119
Chapter 14
Noise-Induced Hearing Loss Brian S. Chen and William M. Luxford
125
Chapter 15
Traumatic Injuries to the Ear Bradley W. Kesser
131
Chapter 16
Autoimmune Inner Ear Disease M. Jennifer Derebery
141
Chapter 17
Sudden Sensorineural Hearing Loss David S. Haynes and Jacob B. Hunter
149
Chapter 18
Ototoxicity Joseph T. Breen and Jeffrey T. Vrabec
157
Chapter 19
Rare Causes of Hearing Loss Oliver F. Adunka and Craig A. Buchman
169
Section VI
Otologic Infections
177
Chapter 20
Otitis Externa Theodore R. McRackan and Marc L. Bennett
179
Chapter 21
Otitis Media Sujana S. Chandrasekhar
187
Chapter 22
Cholesteatoma Brendan P. O’Connell and Ted A. Meyer
197
Chapter 23
Petrous Apicitis and Intracranial Infection Anthony Myint, Joel Lavinsky, John L. Go, and Rick A. Friedman
209
CONTENTS vii
Section VII
Hearing Rehabilitation
221
Chapter 24
Hearing Aids Monica M. Andriacchi and John W. House
223
Chapter 25
Implantable Hearing Devices Sohit Kanotra and Moises A. Arriaga
233
Chapter 26
Cochlear Implants Robert F. Labadie
247
Chapter 27
Auditory Brainstem Implants Daniel S. Roberts and Eric P. Wilkinson
259
Section VIII Skull Base Disorders
267
Chapter 28
Skull Base and Intracranial Anatomy C. Eduardo Corrales and Robert K. Jackler
269
Chapter 29
Vestibular Schwannoma Theodore R. McRackan and Derald E. Brackmann
281
Chapter 30
Meningiomas Colin L. W. Driscoll
291
Chapter 31
Neurofibromatosis Type II Brian S. Chen and William H. Slattery III
301
Chapter 32
Stereotactic Radiosurgery in Neurotology P. Ashley Wackym, Andrew Y. Kee, and Norman Jed Schroeder
309
Chapter 33
Temporal Bone Malignancy Paul W. Gidley
321
Chapter 34
Jugular Foramen Lesions Theodore R. McRackan and James L. Netterville
331
Chapter 35
Lesions of the Cerebellopontine Angle and Petrous Apex David R. Friedmann, J. Thomas Roland, Jr., and Sean O. McMenomey
341
Chapter 36
Cerebrospinal Fluid Leaks and Encephaloceles Jeffrey D. Sharon and Howard W. Francis
351
viii Otology, Neurotology, and Skull Base Surgery: Clinical Reference Guide
Chapter 37
Complications from Neurotologic Surgery Marc S. Schwartz
361
Section IX
Vestibular Disorders
371
Chapter 38
Bedside Vestibular Evaluation Evan Graboyes and Joel Goebel
373
Chapter 39
Ménière’s Disease Cameron C. Wick, Maroun T. Semaan, and Cliff A. Megerian
389
Chapter 40
Benign Paroxysmal Positional Vertigo Judith A. White
401
Chapter 41
Superior Semicircular Canal Dehiscence Syndrome 409 Heather M. Weinreich and John P. Carey
Chapter 42
Labyrinthitis and Vestibular Neuronitis Edward I. Cho
419
Chapter 43
Vestibular Migraine Michael Thomas Teixido
427
Chapter 44
Nonotologic Causes of Dizziness Timothy C. Hain and Marcello Cherchi
439
Chapter 45
Vestibular Therapy Elizabeth Grace Georgelos
449
Section X
Facial Nerve
459
Chapter 46
Embryology and Anatomy of the Facial Nerve Matthew L. Carlson and Alex D. Sweeney
461
Chapter 47
Electrodiagnostic Testing of the Facial Nerve Joseph P. Roche and Marlan R. Hansen
473
Chapter 48
Acute Facial Nerve Palsy Joseph P. Roche and Bruce J. Gantz
481
Chapter 49
Primary Facial Nerve Tumors Alejandro Rivas and Theodore R. McRackan
493
Chapter 50
Facial Nerve Rehabilitation Caroline A. Banks and Tessa A. Hadlock
501
CONTENTS ix
Section XI
Pediatric Otology
511
Chapter 51
Hearing Loss Syndromes Lourdes Quintanilla-Dieck and Steven Goudy
513
Chapter 52
Congenital Aural Atresia Paul R. Lambert
525
Section XII Other Otologic Considerations
531
Chapter 53
Otologic Manifestations of Systemic Disorders J. Eric Lupo
533
Chapter 54
External Auditory Canal Lesions Elliott D. Kozin and Daniel J. Lee
545
Chapter 55
On the Horizon Justin S. Golub and Ravi N. Samy
553
Index
563
Foreword This remarkable text, edited by Drs. McRackan and Brackmann, is a significant addition to our armamentarium of references in the field of otology, neurotology, and skull base surgery. The chapters are well-written and encompass the scope of the subspecialty. Each author is a well-recognized expert in their field and the format of the chapters by outline is extremely easy to follow. It is an outstanding reference for residents, fellows, and practicing otolaryngologists as well as neurotologists. The text is simplistic and easily addresses any question that may arise in the mind of the reader. This is clearly a reference guide. No attempts have been made to increase the prose to describe the topics, but that is not to say that the key issues are hard to assess using the format. The editors are to be commended in formulating a text that is extremely user-friendly to the reader. In these days where the majority of information we seek is available on the Internet, this particular book will be a completely different offering that will be a welcome addition to anyone’s library. I look forward to receiving my copy!!! — Harold C. Pillsbury, MD Professor and Chief Otolaryngology-Head and Neck Surgery The University of North Carolina at Chapel Hill
xi
Chapter
29 Vestibular Schwannoma Theodore R. McRackan and Derald E. Brackmann
Nomenclature . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 282 Epidemiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 282 Pathophysiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . 282 Presentation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 283 Diagnosis and Evaluation . . . . . . . . . . . . . . . . . . . . . . 284 Natural History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 285 Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 285 Observation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 286 Microsurgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 286 Radiosurgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 289 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 289
281
282 Otology, Neurotology, and Skull Base Surgery: Clinical Reference Guide
Nomenclature • Virchow named lesion neuroma due to parallel fibers on histology appear to be axons • Initially thought to be cochlear origin due to associated hearing loss • Murrey and Stout discovered origin cell to be Schwann cell • Preferred name is currently vestibular schwannoma (VS) although acoustic neuroma is still widely used
Epidemiology • Represent approximately 6% of all intracranial tumors • Prospective Denmark database estimate approximately 20 VS per 1 million population • Incidence increasing due to awareness and improved imaging access and quality 1. 7.8 VS/million 1976 to peak 23 VS/million year 2004 • Tumor size at time of diagnosis has decreased from 30 mm in mid1970s to current 10 mm • Mean age at diagnosis has also decreased from 58 years to 49 years
Pathophysiology • Arise from vestibular division of eighth cranial nerve 1. More commonly the inferior vestibular nerve • VS do not likely arise from Obersteiner-Redlich transition zone (glialschwannian junction) as initially thought 1. Most tumors form lateral to the Obersteiner-Redlich transition zone; oligodendrocytes produce myelin medial to junction and Schwann cells lateral 2. Greatest density of Schwann cells lies at Scarpa’s ganglion; VS likely arise from Schwann cell population associated with the Scarpa’s (vestibular) ganglion; like VS, Scarpa’s ganglion can lie near junction but also at various locations • Understanding of genetic origins of sporadic VS is still uncertain; tumor biology is mostly understood through studying Neurofibromatosis type II (see Chapter 31) • There are two histological patterns; Antoni A are densely packed cells with an organized whirled appearance (Verocay body); Antoni B are more loosely packed collection of vacuolated pleomorphic cells; Antoni B may occur more frequently in large tumors 1. Stain positive for S-100
CHAPTER 29
Vestibular Schwannoma 283
Presentation • Hearing loss is most common presenting symptom and present in 95% of patients 1. Typically gradual onset unilateral sensorineural hearing loss 2. During clinical course up to 26% of patients report sudden onset SNHL 3. Normal hearing patients are more likely to have tumors 50%
D
Any
