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SP284 – Tai Chi as a form of vestibular rehabilitation
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Otolaryngology-Head and Neck Surgery, Vol 141, No 3S1, September 2009
disturbances (17%); less commonly facial nerve weakness (8%) and brainstem compression (8%) occurred. Four patients underwent a total of six decompression surgeries for aggressive disease and one additionally received cochlear implantation for profound bilateral SNHL. CONCLUSIONS: CED should be included in the differential diagnosis for patients with radiographic evidence of skull base thickening and synchronous cranial neuropathies (most commonly cochleovestibulopathy). In mild forms of disease, patients should be followed with serial examination, audiometric testing, and radiography. Those with more symptomatic skull base involvement benefit from wide decompression of involved neurovascular structures. SP327 – Subgaleal hematoma following cochlear implantation Mike Sheu (presenter); Daniel Zeitler, MD OBJECTIVES: 1) Present a unique case of a post-operative subgaleal hematoma following cochlear implantation. 2) Review of the literature regarding the management of post-operative hematoma in cochlear. METHODS: Case report and literature review. RESULTS: A 7-year-old girl with underwent left CI. On POD 3, she was noted to have increased swelling of the nasal dorsum and ipsilateral periorbital region that progressed over the following two days to involve her left forehead and temporoparietal skull. On POD 6, the patient was re-admitted with objective fevers and worsening edema over her left forehead and scalp without involvement of the post-auricular wound. Imaging revealed a large hematoma in the subgaleal space. The patient was started on antibiotics and taken to the operating room for hematoma evacuation. The patient discharged on hospital day three with no further complications. CONCLUSIONS: Subgaleal hematoma is typically associated with vacuum assisted birth and head trauma. This is the first reported case in the English literature of a subgaleal hematoma following CI, likely the result of unidentified bleeding from a branch of the superficial temporal artery beneath the temporoparietal fascia. A thorough review of the relevant anatomy can help the CI surgeon understand the etiology of a post-operative subgaleal hematoma, and assist in the management of this complication. SP297 – Surgical treatment of labyrinthine fistula caused by cholesteatoma Shan-Kai Yin, MD (presenter); Hai-Bo Shi, MD; Zheng-Nong Chen, MD; Akira Miyoshi, MD OBJECTIVES: To investigate the safety and efficacy of semicircular canal occlusion for surgical treatment of labyrinthine fistula caused by cholesteatoma. METHODS: Twenty-two patients with labyrinthine fistula,
who were treated surgically, were enrolled in the study. All patients were treated by completely removing the cholesteatoma matrix followed by semicircular canal occlusion. RESULTS: With a follow up of at least six months, there was no recurrent cholesteatoma in all patients. Vertigo disappeared in all the patients. Most patients presented no hearing detriment, and four of them demonstrated hearing improvement. No patient presented with surgery related deafness. CONCLUSIONS: Semicircular canal occlusion after completely removing cholesteatoma matrix for treatment of labyrinthine fistula is a safe and effective approach. SP284 – Tai Chi as a form of vestibular rehabilitation Paul S Lee, MD (presenter) OBJECTIVES: Evaluate the utility of Tai Chi in managing patients with vestibular symptoms who have failed conventional vestibular therapy. METHODS: This study aims to evaluate the utility of Tai Chi in managing patients with vestibular symptoms who have failed conventional vestibular therapy. We conducted a questionnaire study from April 2008 to March 2009 at an outpatient rehabilitation program utilizing the activities-specific balance confidence scale and dynamic gait index survey prior to therapy and at the conclusion of an eight-week course. Independent variables included compliance and medical co-morbidity. Mean improvement in ABC score was 7.3611.3 (p⬍ 0.05). Mean DGI score improved post intervention by 3.182. RESULTS: Total of 21 patients (18 females, three males) completed the study to date. Participants report subjective improvements in their vestibular symptoms, reflected by a mean improvement in their ABC score by 7.3611.3 (p⬍ 0.05). Mean DGI score also improved post Tai Chi intervention by 3.182 3.093 (p⬍0.05). Overall mean indices on ABC (N⫽21) and DGI (N⫽11) show statistically significant improvement after undergoing Tai Chi rehabilitation. CONCLUSIONS: Our study show benefits of using Tai Chi as an alternative form of vestibular rehabilitation in patients with vestibular symptoms based on both subjective and objective assessments. This may be based on the technique of Tai Chi promoting coordination through relaxation rather than muscular SP289 – Ten-year prognosis of low-frequency hearing loss Naoki Oishi, MD (presenter); Kaoru Ogawa, MD, PhD; Yasuhiro Inoue; Hideyuki Saito; Sho Kanzaki, MD, PhD OBJECTIVES: Investigate the clinical course of low-frequency hearing loss (LFHL), typically regarded as an effect of endolymphatic hydrops and postulated as a precursor of Me´-
Otolaryngology-Head and Neck Surgery, Vol 141, No 3S1, September 2009
disturbances (17%); less commonly facial nerve weakness (8%) and brainstem compression (8%) occurred. Four patients underwent a total of six decompression surgeries for aggressive disease and one additionally received cochlear implantation for profound bilateral SNHL. CONCLUSIONS: CED should be included in the differential diagnosis for patients with radiographic evidence of skull base thickening and synchronous cranial neuropathies (most commonly cochleovestibulopathy). In mild forms of disease, patients should be followed with serial examination, audiometric testing, and radiography. Those with more symptomatic skull base involvement benefit from wide decompression of involved neurovascular structures. SP327 – Subgaleal hematoma following cochlear implantation Mike Sheu (presenter); Daniel Zeitler, MD OBJECTIVES: 1) Present a unique case of a post-operative subgaleal hematoma following cochlear implantation. 2) Review of the literature regarding the management of post-operative hematoma in cochlear. METHODS: Case report and literature review. RESULTS: A 7-year-old girl with underwent left CI. On POD 3, she was noted to have increased swelling of the nasal dorsum and ipsilateral periorbital region that progressed over the following two days to involve her left forehead and temporoparietal skull. On POD 6, the patient was re-admitted with objective fevers and worsening edema over her left forehead and scalp without involvement of the post-auricular wound. Imaging revealed a large hematoma in the subgaleal space. The patient was started on antibiotics and taken to the operating room for hematoma evacuation. The patient discharged on hospital day three with no further complications. CONCLUSIONS: Subgaleal hematoma is typically associated with vacuum assisted birth and head trauma. This is the first reported case in the English literature of a subgaleal hematoma following CI, likely the result of unidentified bleeding from a branch of the superficial temporal artery beneath the temporoparietal fascia. A thorough review of the relevant anatomy can help the CI surgeon understand the etiology of a post-operative subgaleal hematoma, and assist in the management of this complication. SP297 – Surgical treatment of labyrinthine fistula caused by cholesteatoma Shan-Kai Yin, MD (presenter); Hai-Bo Shi, MD; Zheng-Nong Chen, MD; Akira Miyoshi, MD OBJECTIVES: To investigate the safety and efficacy of semicircular canal occlusion for surgical treatment of labyrinthine fistula caused by cholesteatoma. METHODS: Twenty-two patients with labyrinthine fistula,
who were treated surgically, were enrolled in the study. All patients were treated by completely removing the cholesteatoma matrix followed by semicircular canal occlusion. RESULTS: With a follow up of at least six months, there was no recurrent cholesteatoma in all patients. Vertigo disappeared in all the patients. Most patients presented no hearing detriment, and four of them demonstrated hearing improvement. No patient presented with surgery related deafness. CONCLUSIONS: Semicircular canal occlusion after completely removing cholesteatoma matrix for treatment of labyrinthine fistula is a safe and effective approach. SP284 – Tai Chi as a form of vestibular rehabilitation Paul S Lee, MD (presenter) OBJECTIVES: Evaluate the utility of Tai Chi in managing patients with vestibular symptoms who have failed conventional vestibular therapy. METHODS: This study aims to evaluate the utility of Tai Chi in managing patients with vestibular symptoms who have failed conventional vestibular therapy. We conducted a questionnaire study from April 2008 to March 2009 at an outpatient rehabilitation program utilizing the activities-specific balance confidence scale and dynamic gait index survey prior to therapy and at the conclusion of an eight-week course. Independent variables included compliance and medical co-morbidity. Mean improvement in ABC score was 7.3611.3 (p⬍ 0.05). Mean DGI score improved post intervention by 3.182. RESULTS: Total of 21 patients (18 females, three males) completed the study to date. Participants report subjective improvements in their vestibular symptoms, reflected by a mean improvement in their ABC score by 7.3611.3 (p⬍ 0.05). Mean DGI score also improved post Tai Chi intervention by 3.182 3.093 (p⬍0.05). Overall mean indices on ABC (N⫽21) and DGI (N⫽11) show statistically significant improvement after undergoing Tai Chi rehabilitation. CONCLUSIONS: Our study show benefits of using Tai Chi as an alternative form of vestibular rehabilitation in patients with vestibular symptoms based on both subjective and objective assessments. This may be based on the technique of Tai Chi promoting coordination through relaxation rather than muscular SP289 – Ten-year prognosis of low-frequency hearing loss Naoki Oishi, MD (presenter); Kaoru Ogawa, MD, PhD; Yasuhiro Inoue; Hideyuki Saito; Sho Kanzaki, MD, PhD OBJECTIVES: Investigate the clinical course of low-frequency hearing loss (LFHL), typically regarded as an effect of endolymphatic hydrops and postulated as a precursor of Me´-