Browsing by Subject "temporal bone"

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    Prevalence of Obstructive Sleep Apnea (OSA) in Spontaneous Cerebrospinal Fluid (CSF) Leaks: A Prospective Cohort Study
    (Wolters Kluwer, 2018-07) Rabbani, Cyrus; Saltagi, Mohamad; Manchanda, Shalini; Yates, Charles; Nelson, Rick; Otolaryngology -- Head and Neck Surgery, School of Medicine
    Objective: To determine the prevalence of obstructive sleep apnea (OSA) in a prospective cohort of patients with spontaneous CSF (sCSF) leaks of the temporal bone. Study Design: Prospective cohort study. Setting: Tertiary referral center. Patients: Consecutive sCSF leak patients (21) over a 3-year period. Four patients presented with a history of OSA and 17 patients were prospectively offered polysomnogram (PSG) testing during the initial clinic encounter. Intervention: Level I PSG. Main Outcome Measures: Patient characteristics (age, sex, body mass index), apnea hypopnea index (AHI), presence of snoring, and presence of hypoxia (oxygen saturation <88% for >5 min). OSA was defined as mild (AHI ≥5 and <15/h), moderate (AHI ≥15 and <30/h), and severe (AHI ≥30/h). Results: The prevalence of OSA in sCSF leak patients is 83.3%. PSG studies were performed on 18 of the 21 patients. There were 15 women and 6 men with an average age (standard deviation) of 56.3 (11.2) years and an average body mass index of 35.3 (7.7) kg/m2. Objectively, the AHI ranged from mild to severe (range = 5.7–92, median = 19.8). Snoring was present in 61% of patients and hypoxia was present in 39% of patients. sCSF leak patients with OSA were significantly older than sCSF leak patients without OSA (56.7 [8.3] versus 42.7 [14.5] yr, p = 0.03). Conclusions: OSA is highly prevalent among patients with sCSF leaks. All patients with sCSF leaks should undergo formal PSG testing. Future studies are needed to determine the role of OSA in the development of sCSF leaks.
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    Virtual, 3-Dimensional Temporal Bone Model and Its Educational Value for Neurosurgical Trainees
    (Elsevier, 2018) Morone, Peter J.; Shah, Kushal J.; Hendricks, Benjamin K.; Cohen-Gadol, Aaron A.; Neurological Surgery, School of Medicine
    Objective Learning complex neuroanatomy is an arduous yet important task for every neurosurgical trainee. As technology has advanced, various modalities have been created to aid our understanding of anatomy. This study sought to assess the educational value of a virtual, 3-dimensional (3D) temporal bone model. Methods The 3D temporal bone model was created with assistance of computer graphic designers and published online. Its educational value as a teaching was tool was assessed by querying 73 neurosurgery residents at 4 institutions and was compared with that of a standard, 2-dimensional (2D) temporal bone resource. Data were collected via a survey, and significance among responses was analyzed via a univariate chi-square test. Results The survey response rate was 37%. Greater than 90% of residents preferred to study with the 3D model compared with the 2D resource and felt that the 3D model allowed them understand the anatomy more realistically (P = 0.001). Moreover, >90% of residents believed that reviewing the 3D model before an actual surgery could lead to improved operative efficiency and safety (P = 0.001). Conclusions This study demonstrates the utility of a novel, 3D temporal bone model as a teaching tool for neurosurgery residents. The model contains accurate anatomic structures and allows user interaction via a virtual, immersive environment.