A Case of Cochlear Implantation in a Patient with Superficial Siderosis

Superficial siderosis is a disease in which iron from hemoglobin is deposited in the central nervous system, resulting in conditions such as progressive sensorineural hearing loss, cerebellar ataxia, dementia, and pyramidal signs. A 30-year-old man with superficial siderosis received a cochlear implant in the left ear, which had shown complete hearing loss. Good auditory responses were obtained at 14 days after implantation. The postoperative average hearing level with the cochlear implant was 56.7 dB at 3 months and 55.0 dB at 6 months. However, the patient showed gradual hearing loss, and the dynamic range changed each time the electrode parameters were adjusted. To assess residual hearing ability, single-photon emission computed tomography was performed together with an assessment of electrical auditory brainstem response, which showed a good response and increased blood flow in both the temporal lobes. Based on this result, we asked the patient to continue using the cochlear implant to see whether a perception of speech response would be obtained. However, the patient discontinued using the cochlear implant because he could not hear satisfactorily. Hearing outcomes after cochlear implant surgery for patients with superficial siderosis are not necessarily good. Therefore, the possibility of unsatisfactory Results should be fully explained before recommending this surgery to patients

Cellular Leiomyoma of the Nasal Cavity: Report of a Case and Review of Literature

We report a rare case of cellular leiomyoma in the nasal cavity. A 72-year-old Japanese woman was admitted to a hospital. A tumoral lesion was revealed in the left nasal cavity. Angiography showed tumor staining, and the tumor was endoscopically resected after the embolizaion of the feeding artery. At gross inspection, the tumor measured 1.0 × 1.5 × 2.0 cm. Microscopically, the tumor consisted of many spindled cells with blunt ended nuclei. Immunohistochemical examination revealed that the tumor cells were positive for vimentin, alpha smooth muscle actin. We diagnosed this case as cellular leiomyoma. To the best of our knowledge, there have been only 23 reported cases of nasal leiomyoma in English medical literature. We made a brief literature review of the occurrence of this tumor in the nasal cavity

A Case of Skull Base Chondrosarcoma with Intraoperative Trigemino-Cardiac Reflex

A 75-year-old female patient presented with a suspected recurrence of a clival chordoma. The tumor was resected using the infratemporal fossa type B and anterior petrosal approach with the help of a neurosurgeon. During cauterization of the trigeminal nerve, the patient developed cardiac arrest for approximately 10 seconds because of the trigemino-cardiac reflex (TCR). After several sternal compressions, there was return of spontaneous circulation. The operation was resumed after the circulatory dynamics stabilized. Subsequently, the surgery was completed with partial resection of the tumor without the recurrence of cardiac arrest. The pathological diagnosis was chondrosarcoma, and postoperative treatment with radiotherapy was started. Stimulation of the sensory branches of the trigeminal nerve induces TCR. There are reports of TCR developing in approximately 10% of skull base surgery cases in the absence of atropine administration. We report a rare case of TCR during the surgical procedure for the treatment of a skull base chondrosarcoma

Endolymphatic Sac Tumor, A Patient Report

Endolymphatic sac tumors are rare low malignant neoplasms of the petrous temporal bone, with symptoms referable to auditory, vestibular or facial nerves, which should be strictly discriminated from benign tumors of the temporal bone. Differential diagnosis between both at the early stages of checkup controls the treatment and prognosis. Complete surgical resection is the treatment of choice, which commonly provides long-term control. We have experienced a 48-year-old man with progressive hearing loss, unsteadiness and constant tinnitus. Computed tomography and magnetic resonance imaging (MRI) demonstrated a tumor invading the posterior petrous bone, extending to the posterior fossa. In the course of image diagnosis of his disease, we observed diagnostic efficacy of 3-tesla MRI, which showed excellent lesion visualization even in a small-size endolymphatic sac tumor. The intraoperative pathologic diagnosis was not available