CURRENT ISSUE HIGHLIGHTS - JULY 2008

Main article: Cartilage ‘shoe': a new technique for stabilisation of titanium total ossicular replacement prosthesis at centre of stapes footplate

After tympanoplasty using a total ossicular replacement prosthesis, many unsatisfactory hearing results are due to dislocation of the prosthesis. A cartilage guide for stabilising the total ossicular replacement prosthesis in the oval window niche is described. Hearing results in 52 patients confirmed acoustically the effectiveness of this method of total ossicular replacement prosthesis stabilisation on the stapes footplate. Subsequent ‘second-look' surgery revealed stable ingrowth of the cartilage ‘shoe' into the oval niche. Such a cartilage shoe might address one of the causes of unsatisfactory hearing following ossicular chain reconstruction with a total ossicular replacement prosthesis.

Clinical Record: Embolisation of an extensive arteriovenous malformation of the temporal region as an alternate treatment: case report

Arteriovenous malformations of the head and neck usually occur intracranially; occurrence outside the cranium is rare. Although there have been single case reports and small clinical series of arteriovenous malformations involving the auricula and external auditory meatus, there has been no previous report of a case involving the temporal region so extensively. The rarity of such arteriovenous malformations limits systematic study. Their unpredictable behaviour renders prognosis difficult, and poor treatment results are common. Clinically, it is difficult to select treatment for such arteriovenous malformations which will maintain long-term success. ‘Superselective' embolisation may have a role, especially in palliation (i.e. for pain control, tinnitus or haemorrhage); it may also be used as primary therapy for surgically inaccessible arteriovenous malformations. 

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