A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

Petrous Bone Fractures Violating Otic Capsule

OBJECTIVE: This study presents our experience with a series of patients suffering from petrous bone fractures violating the otic capsule who underwent subtotal petrosectomy combined with eustachian tube, middle ear, and mastoid obliteration, with the goal of preventing cerebrospinal fluid (CSF) leak and meningitis. METHODS: This study enrolled 26 patients between 1997 and 2011. The clinical symptoms, otoscopy, and preoperative and postoperative audiometry and facial function, as well as CSF leak or meningitis, were evaluated in each patient. The entire group underwent a subtotal petrosectomy using the technique described in detail by Fisch. In addition, each patient was interviewed using a questionnaire to evaluate the impact on quality of life. RESULTS: Intraoperatively, we found significant CSF leaks in 14 patients (42.5%). No patient reported other episodes of CSF leak or meningitis after the surgery. The patients' responses of facial nerve function were slightly worse than the House-Brackmann evaluation (50% versus 42.3%; p < 0.05). The vast majority (88.5%) of the patients experienced no social impact. CONCLUSION: Our findings suggest the importance of not underestimating the risk for CSF leak in the petrous bone fractures violating the otic capsule.Preoperative counseling regarding the various troublesome complications must adequately motivate candidates to undergo surgery by pointing out the positive impact of the proposed treatment

Sebaceoma of the External Auditory Canal

Sebaceoma is a benign cutaneous neoplasm that typically presents as a nodule or plaque on the face or scalp. Sebaceomas may be associated with the Muir-Torre syndrome, in which they may be multiple and associated with other sebaceous neoplasms of the skin and multiple adenomatous polyps. We present the case of a young man affected by a sebaceoma of the external auditory canal (EAC). To our knowledge, this is the third reported case of sebaceoma localized in the ear canal. The differential diagnosis and clinical implications are also discussed

SELECTIVE VESTIBULAR NEUROLABYRINTHITIS OF THE LATERAL AND SUPERIOR SEMICIRCULAR CANAL AMPULLA AND AMPULLARY NERVES.

Objective: The diagnosis of vestibular neurolabyrinthitis is based on the sudden appearance of vertigo lasting for hours or days without associated cochlear or central nervous system signs or symptoms. The advent of the video head impulse test (vHIT), cervical vestibular evoked myogenic potentials (C-VEMPs) and ocular vestibular evoked myogenic potentials (O-VEMPs) has provided interesting clinical evidence for evaluating and monitoring the damage to specific compartments of the vestibular apparatus. These various modality of testing individual end-organ function may have a clinical impact on vestibular workup of the neurolabyrinthitis. Patients and Methods: This report describes three patients with acute vestibular neurolabyrinthitis in whom caloric tests, cervical vestibular evoked myogenic potentials (C-VEMPs), ocular vestibular evoked myogenic potentials (O-VEMPs) and the head impulse test (vHIT) led to a suspicion of peripheral vestibular deficits of the lateral or superior semicircular canals ampulla or ampullary nerves. Conclusion: To our knowledge, these are the first reported cases in which selective damage to the lateral and superior semicircular canals and their nerves caused by neurolabyrinthitis was demonstrated clinically. Our clinical results indicate that the damage can be selective for specific vestibular end organs