The American journal of otology
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A 12-channel cochlear implant (CI) for high-rate pulsatile stimulation strategies is presented. Symmetric biphasic current pulses can be generated up to a maximum pulse repetition rate of 18.18 kpulses/second. The stimulation pulse amplitude can be selected within 1.5 microA-1.5 mA. ⋯ Output capacitors for each channel are employed for safety reasons. A self-calibrating back telemetry system is included for estimating the channel impedances and field distribution along the electrode array. Dimensions of the ceramic package of the implant are only 33.50 x 23.40 x 3.95 mm3.
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Geniculate ganglion or nervus intermedius neuraigia is an unusual condition resulting in deep ear pain with or without signs of atypical trigeminal neuralgia, deep face, or throat pain. This article describes an experience with 14 patients who came to the neurosurgical service at the University of Pittsburgh Medical Center with a diagnosis of geniculate neuralgia. ⋯ Overall, good results (with excellent or partial relief) were found long term for 90% of patients in this series. The authors recommend microvascular decompression of cranial nerves V, IX, and X with nervus intermedius section for the treatment of geniculate neuralgia.
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Lyme disease must be included in the differential diagnosis of acute facial paralysis in endemic areas. When facial nerve palsy occurs as an isolated finding, the diagnosis of Lyme disease may not be readily apparent. The goal of the present study was to evaluate the frequency with which Lyme disease could be diagnosed based on clinical symptoms alone. ⋯ In endemic areas, Lyme disease should be suspected as a cause of acute facial nerve palsy even in the absence of other clinical symptoms. Cerebrospinal fluid serology is helpful in confirming the diagnosis and planning therapy. Central nervous system infection may be common in Lyme disease facial nerve palsy.
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To review the incidence of complications resulting from temporal bone fractures and analyze the outcomes from surgical and nonsurgical management. ⋯ Facial function following temporal bone fractures should be evaluated in the emergency room. If facial motion is noted at any time after the injury, surgical intervention is rarely indicated. Prophylactic antibiotics should be considered in temporal bone fractures when CSF fistulae are present. Surgical closure of a CSF fistula is indicated if it persists for > 7-10 days.
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Comparative Study
Prevention of headache after retrosigmoid removal of acoustic tumors.
To demonstrate a causal relationship between bone dust and the development of headache after retrosigmoid removal of acoustic neuromas. ⋯ Free circulation of bone dust into the posterior fossa during intradural drilling of the internal auditory canal may be the most important factor in the development of headache after this surgical procedure.