Objective: This study aimed to describe the microscopic over-under cartilage tympanoplasty technique, provide hearing results and detail clinically significant complications.Method: This was a retrospective case series chart review study of over-under cartilage tympanoplasty procedures performed by the senior author between January 2015 and January 2019 at three tertiary care centres. Cases were excluded for previous or intra-operative cholesteatoma, if a mastoidectomy was performed during the procedure or if ossiculoplasty was performed. Hearing results and complications were obtained.Results: Sixty-eight tympanoplasty procedures met the inclusion criteria. The median age was 13 years (range, 3–71 years). The mean improvement in pure tone average was 6 dB (95 per cent confidence interval 4–9 dB;p <0.0001). The overall perforation closure rate was 97 per cent (n =66). Revision surgery was recommended for a total of 6 cases (9 per cent) including 2 post-operative perforations, 1 case of middle-ear cholesteatoma and 3 cases of external auditory canal scarring.Conclusion: Over-under cartilage tympanoplasty is effective at improving clinically meaningful hearing with a low rate of post-operative complications.

Background/Objectives: Congenital cytomegalovirus (cCMV) infection is a significant cause of pediatric hearing loss. However, the prevalence and characteristics of cCMV-related hearing loss remain unclear. Methods: A comprehensive search of major databases (PubMed, Scopus, and Web of Science) was conducted to identify studies and reviews published between 2000 and 2024 that investigated cCMV infection, testing for cCMV, and pediatric hearing loss. Studies were included if they reported on the prevalence, characteristics, current policies, and recommendations for universal cCMV testing in newborns. Results: This review highlights key issues: cCMV is a significant and treatable cause of pediatric hearing loss; most cCMV-related hearing loss cases presented with bilateral and profound hearing impairment; and cCMV testing is performed only for babies who fail newborn hearing screening. Conclusions: This narrative review highlights the significant association between cCMV infection and pediatric hearing loss. Currently, targeted cCMV testing is recommended for newborns who fail newborn hearing screening. Universal cCMV testing may facilitate early diagnosis and directed intervention and could be cost-effective in the long run.

This report describes the diagnosis and treatment of a patient with a rare fungal infection of the external ear, as well as a review of the literature. A 76-year-old Caucasian gentleman from rural southern United States with diabetes and hypertension was referred to our clinic for intractable left otalgia, otorrhea, headaches, and an exophytic lesion in the left external ear since five months. There was no pertinent travel history. Biopsy by an outside otolaryngologist was inconclusive. Repeat biopsy under anesthesia revealed morphological characteristics consistent with histoplasmosis. Intravenous amphotericin B and later oral antifungal agent voriconazole led to improvement in symptoms. The clinical presentation resembled a malignancy. A high index of clinical suspicion, histologic confirmation with deep tissue biopsy, and culture are essential for diagnostic confirmation followed by treatment with systemic antifungals. A multidisciplinary team approach is necessary to manage this rare condition.

Objective: Cochlear obliteration after vestibular schwannoma excision has been noted, with implications on cochlear implantation. Early postoperative cochlear enhancement with gadolinium on magnetic resonance imaging (MRI) has also been observed. Timing of enhancement and association with obliteration is described here. Study Design: Retrospective case review. Setting: Tertiary referral center, ambulatory. Patients: Patients receiving vestibular schwannoma excision surgery by the senior author performed at one institution between January 2015 and July 2017 with postoperative MRIs Intervention: Diagnostic. Main Outcome Measure(s): The imaging characteristics on postoperative MRIs examined were loss of fluid signal on postoperative T2 images and cochlear enhancement on gadolinium enhanced T1 images. In the patients receiving labyrinthine sparing procedures, presence of postoperative hearing was evaluated. Results: Of the 42 patients evaluated, 24 received the translabyrinthine approach and 18 received a labyrinth sparing surgery. Twenty-nine had evidence of cochlear enhancement on T1 with gadolinium contrast, and 27 had evidence of cochlear obliteration on T2 images. The odds ratio of patients with cochlear enhancement having obliteration was 30.0:1 (p < 0.0001). Intense cochlear enhancement (n = 21) appeared a median of 163 days after surgery, and complete or near complete obliteration (n = 18) appeared a median of 480 days after surgery, a statistically significant difference (p < 0.001). Within the labyrinth sparing group, there was no statistically significant association between hearing loss and cochlear obliteration or enhancement. Conclusions: Cochlear enhancement is correlated with cochlear obliteration and may precede it.