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Simultaneous use of soundbridge implantable hearing device and conventional hearing aid
Scientific Posters
struction of the mastoid. Magnetic resonance imaging showed enlarged lymph nodes in the left parotid gland and the left neck. A biopsy was performed and a basaloid squamous cell carcinoma was diagnosed. Results: The patient underwent an ablation of the left ear, a subtotal left parotidectomy and a selective, ipsilateral neck dissection (levels II-IV). The final histology revealed an EP. The margins of resection were free of tumor and there were no signs of parotideal tumor infiltration or lymph node metastases. Conclusion: Extensive surgical resection represents the therapy of choice for patients with eccrine porocarcinomas. Regional lymph node metastases are found in about 20% and distant metastases in about 10% of patients. On a small biopsy the accurate distinction between EP, SCC, and basal cell carcinoma may be impossible. The case presented highlights this diagnostic histopathologic challenge. Although extremely rare, EP should be included in the differential diagnosis of skin tumors in the head and neck. P172 Fibro-osseous Pseudotumor in the Neck: Report of a Case and Literature Review Brian James Baumgartner, MD (presenter); Eusterman, DDS MD; Charles Scott, MD Graham WA; Olympia WA; Tacoma WA
Vincent
D
Objectives: We present a case of fibro-osseous pseudotumor in an adolescent male with a 1-month history of a right posterior neck mass. We present the differential diagnosis, radiographic, clinical, surgical, and pathologic aspects, and a review of the medical literature for this rare and unusual fibro-osseous pseudotumor presenting in this location. Methods: Fibro-osseous pseudotumor is reported to occur in the digits, toes, and neural axis, falling under a diagnosis of myositis ossificans. This patient presented with a large fibroosseous pseudotumor in the neck that has not been identified in the medical literature. Results: Fibro-osseous pseudotumor is a benign soft tissue lesion that usually affects the digits but has also been known to occur in the neural axis. Fine needle aspiration was nondiagnostic and magnetic resonance imaging showed a large mass posterior to the carotid sheath and deep to the trapezius and splenius capitis muscles. Excisional biopsy demonstrated fibro-osseous pseudotumor. Conclusion: Fibro-osseous pseudotumor is benign, soft tissue growth that has not been previously reported in the neck. These tumors present as a poorly defined soft tissue mass with calcification or focal periosteal thickening but do not involve adjacent bone. This poster demonstrates a welldefined mass in a new location for fibro-osseous pseudotumor. It includes the differential diagnosis, radiographic, clinical, surgical, and pathologic aspects of this disease and a review the medical literature.
P173 Simultaneous Use of Soundbridge Implantable Hearing Device and Conventional Hearing Aid David Foyt, MD (presenter); Matthew Carfrae, MD; Juile HansonAmrao Albany NY; Albany NY; Albany NY
Objectives: The Vibrant Symphonix Soundbridge (VSB) middle ear hearing implant has proven to be an effective alternate treatment modality for patients with mild to moderate sensorineural hearing loss. The purpose of this study was to evaluate the audiologic performance of patients wearing the Soundbridge and a conventional hearing aid simultaneously in the same ear. This study was prompted by several Soundbridge patient reports that they obtained improved hearing with simultaneous use. Methods: Two patients who were audiologically marginal Soundbridge implant candidates reported marginal performance with their implants after surgery. These patients reported significant improvement with simultaneous use of a canal hearing aid and the Soundbridge. A full audiologic battery and subjective questionnaire was performed on these patients. Results: Both patients reported a significant subjective improvement in performance using both devices. Word discrimination score was significantly improved when both devices were worn. Conclusion: This is the first report of simultaneous use of an implantable hearing device and conventional hearing aid. This technique may be offered to patients who may be marginal candidates for either device separately and may be a benefit as an alternative to cochlear implantation.
P174 Expression of Cyclooxygenase in Laryngeal Granuloma Masahiko Higashikawa, MD (presenter); Ryo Kawata, MD; Sawako Hyo, MD; Hiroshi Takenaka, MD Osaka Japan; Takatsuki Japan; Takatsuki Japan; Takatsuki Japan
Objectives: The aim of this study was to elucidate the role of arachidonic acid metabolism in the growth of laryngeal granuloma via the cyclooxygenase pathway. Methods: We examined expression of cyclooxygenase-1 and -2 (COX-1 and COX-2) in laryngeal granuloma in 6 patients. For controls, normal vocal fold in 6 cases were examined in the same method that were obtained from the totally resected larynx because of noninflammatory diseases. Results: Expression of COX2 was observed in the epithelial cells of laryngeal granuloma, however, less expression of COX2 in epithelial cells of the vocal fold. Conclusion: Arachidonic acid metabolism may promote the growth of laryngeal granuloma. This evidence suggests
POSTERS
P296
Otolaryngology– Head and Neck Surgery August 2004
struction of the mastoid. Magnetic resonance imaging showed enlarged lymph nodes in the left parotid gland and the left neck. A biopsy was performed and a basaloid squamous cell carcinoma was diagnosed. Results: The patient underwent an ablation of the left ear, a subtotal left parotidectomy and a selective, ipsilateral neck dissection (levels II-IV). The final histology revealed an EP. The margins of resection were free of tumor and there were no signs of parotideal tumor infiltration or lymph node metastases. Conclusion: Extensive surgical resection represents the therapy of choice for patients with eccrine porocarcinomas. Regional lymph node metastases are found in about 20% and distant metastases in about 10% of patients. On a small biopsy the accurate distinction between EP, SCC, and basal cell carcinoma may be impossible. The case presented highlights this diagnostic histopathologic challenge. Although extremely rare, EP should be included in the differential diagnosis of skin tumors in the head and neck. P172 Fibro-osseous Pseudotumor in the Neck: Report of a Case and Literature Review Brian James Baumgartner, MD (presenter); Eusterman, DDS MD; Charles Scott, MD Graham WA; Olympia WA; Tacoma WA
Vincent
D
Objectives: We present a case of fibro-osseous pseudotumor in an adolescent male with a 1-month history of a right posterior neck mass. We present the differential diagnosis, radiographic, clinical, surgical, and pathologic aspects, and a review of the medical literature for this rare and unusual fibro-osseous pseudotumor presenting in this location. Methods: Fibro-osseous pseudotumor is reported to occur in the digits, toes, and neural axis, falling under a diagnosis of myositis ossificans. This patient presented with a large fibroosseous pseudotumor in the neck that has not been identified in the medical literature. Results: Fibro-osseous pseudotumor is a benign soft tissue lesion that usually affects the digits but has also been known to occur in the neural axis. Fine needle aspiration was nondiagnostic and magnetic resonance imaging showed a large mass posterior to the carotid sheath and deep to the trapezius and splenius capitis muscles. Excisional biopsy demonstrated fibro-osseous pseudotumor. Conclusion: Fibro-osseous pseudotumor is benign, soft tissue growth that has not been previously reported in the neck. These tumors present as a poorly defined soft tissue mass with calcification or focal periosteal thickening but do not involve adjacent bone. This poster demonstrates a welldefined mass in a new location for fibro-osseous pseudotumor. It includes the differential diagnosis, radiographic, clinical, surgical, and pathologic aspects of this disease and a review the medical literature.
P173 Simultaneous Use of Soundbridge Implantable Hearing Device and Conventional Hearing Aid David Foyt, MD (presenter); Matthew Carfrae, MD; Juile HansonAmrao Albany NY; Albany NY; Albany NY
Objectives: The Vibrant Symphonix Soundbridge (VSB) middle ear hearing implant has proven to be an effective alternate treatment modality for patients with mild to moderate sensorineural hearing loss. The purpose of this study was to evaluate the audiologic performance of patients wearing the Soundbridge and a conventional hearing aid simultaneously in the same ear. This study was prompted by several Soundbridge patient reports that they obtained improved hearing with simultaneous use. Methods: Two patients who were audiologically marginal Soundbridge implant candidates reported marginal performance with their implants after surgery. These patients reported significant improvement with simultaneous use of a canal hearing aid and the Soundbridge. A full audiologic battery and subjective questionnaire was performed on these patients. Results: Both patients reported a significant subjective improvement in performance using both devices. Word discrimination score was significantly improved when both devices were worn. Conclusion: This is the first report of simultaneous use of an implantable hearing device and conventional hearing aid. This technique may be offered to patients who may be marginal candidates for either device separately and may be a benefit as an alternative to cochlear implantation.
P174 Expression of Cyclooxygenase in Laryngeal Granuloma Masahiko Higashikawa, MD (presenter); Ryo Kawata, MD; Sawako Hyo, MD; Hiroshi Takenaka, MD Osaka Japan; Takatsuki Japan; Takatsuki Japan; Takatsuki Japan
Objectives: The aim of this study was to elucidate the role of arachidonic acid metabolism in the growth of laryngeal granuloma via the cyclooxygenase pathway. Methods: We examined expression of cyclooxygenase-1 and -2 (COX-1 and COX-2) in laryngeal granuloma in 6 patients. For controls, normal vocal fold in 6 cases were examined in the same method that were obtained from the totally resected larynx because of noninflammatory diseases. Results: Expression of COX2 was observed in the epithelial cells of laryngeal granuloma, however, less expression of COX2 in epithelial cells of the vocal fold. Conclusion: Arachidonic acid metabolism may promote the growth of laryngeal granuloma. This evidence suggests
POSTERS
P296
Otolaryngology– Head and Neck Surgery August 2004