Moises Arriaga

Louisiana State University Health Sciences Center New Orleans | LSUHSC · Department of Neurosurgery

Objective: While the implications of ossification on cochlear implantation (CI) have been extensively described, there is a paucity of data regarding the fibrotic stage. We examined the outcomes of different insertion techniques for managing intracochlear fibrosis. Study design: Retrospective review of case series with case-control comparison....

As biomolecular approaches for hearing restoration in profound sensorineural hearing loss evolve, they will be applied in conjunction with or instead of cochlear implants. An understanding of the current state-of-the-art of this technology, including its advantages, disadvantages, and its potential for delivering and interacting with biomolecular h...

Objective Evaluate whether elevating the tympanic membrane from the malleus during endoscopic tympanoplasty may negatively affect postoperative hearing outcomes or perforation rates by comparing 2 similar endoscopic tympanoplasty techniques. Study Design Retrospective cohort. Setting Tertiary care center. Patients Endoscopic over-under cartilage...

Objectives Assesses whether preoperative functional testing can distinguish vestibular schwannomas from facial nerve schwannomas medial to the labyrinthine segment. Study Design Retrospective cohort. Methods Retrospectively review surgically managed intracranial facial and vestibular schwannomas between January 2015 and December 2019 at two terti...

Objective: Evaluate and compare the Dizziness Handicap Inventory with Activities-specific Balance Confidence scores shortly after vestibular schwannoma excision. Study design: Retrospective database review. Setting: Tertiary care center. Patients: Adults undergoing vestibular schwannoma excision between January 2015 and December 2019. Inter...

The COVID-19 pandemic has challenged every surgical discipline. Lessons learned from Hurricane Katrina have informed our department’s management of the current crisis. That experience impressed upon us a profound appreciation for shared decision making in the face of scarce resources, an evolving clinical context, and potential harm to patients and...

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 Jan...

Objectives To demonstrate the feasibility and efficacy for next-day loading of a percutaneous bone-anchored hearing device. Study Design Multicenter prospective cohort study. Setting Tertiary neurotologic referral centers. Subject and Methods In this multicenter prospective study, a 4.5-mm laser-etched bone-anchored hearing device was implanted...

Objective This study assesses the role of facial nerve monitoring (FNM) for intraoperative decision making during otologic surgery and possible benefits beyond protecting facial nerve integrity. Study Design This prospective study examines intraoperative FNM data and structured interviews collected during 52 otologic procedures. Setting Tertiary...

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: Retrospecti...

Objective To determine whether central findings from vestibular tests predict abnormal findings on magnetic resonance imaging. Method This study was a retrospective case series at a tertiary referral centre. The main outcome measure of this diagnostic intervention study was the positive predictive value of central vestibular findings in relation t...

Introduction: The techniques of facial reanimation are continually evolving in search of the ideal method for rehabilitating the paralyzed face. In the past, alternative cranial nerve motor nuclei have been used to power facial musculature. The trigeminal nerve is gaining popularity as a promising nerve to drive facial motion, particularly in the...

Objective: Cochlear implantation is routinely performed all over the world via the post-auricular, facial recess approach. Our case study describes the middle fossa approach for the management of bilateral profound sensorineural hearing loss in a female child with multiple external, middle and inner ear malformations. The middle fossa approach has...

We report our experience using the ultrasonic bone aspirator (UBA) for transcanal endoscopic “inside out” mastoidectomy. The UBA has irrigation, suction, and nonrotatory ultrasonic bone-removing technology in 1 handpiece, which makes it appropriate for bone removal during this procedure. The results of our study show that this technique is safe and...

Objective: Obstructive eustachian tube dysfunction (OETD) affects up to 5% of adults; however, available treatment strategies have limitations. It was previously reported that balloon dilation of the eustachian tube (BDET) with the eustachian tube balloon catheter + medical management (MM) results in a significantly higher proportion of subjects w...

Objective To assess the feasibility of non-contrast T2-weighted magnetic resonance imaging as compared to T1-weighted post-contrast magnetic resonance imaging for detecting acoustic neuroma growth. Methods Adult patients with acoustic neuroma who underwent at least three magnetic resonance imaging scans of the internal auditory canals with and wit...

Objective: To describe the use of electronic health records (EHR) among members of the American Neurotology Society (ANS). Study design: Cross-sectional. Setting: Active ANS members in November 2017. Intervention: Internet-based survey. Main outcome measure: Survey that assessed the use of EHR in practice, types of EHR programs, different...

Since the original carved Teflon stapes over vein graft, stapedectomy prostheses have undergone evolution. Prostheses shapes, materials, and surgical techniques for placement have reflected advances in biomaterials and surgical tools. The variability in prostheses has reflected alternative techniques of stapedectomy and stapedotomy and differing st...

Objectives/hypothesis: To assess balloon dilation of the Eustachian tube with Eustachian tube balloon catheter in conjunction with medical management as treatment for Eustachian tube dilatory dysfunction. Study design: In this prospective, multicenter, randomized, controlled trial, we assigned, in a 2:1 ratio, patients age 22 years and older wit...

Introduction: Ependymal cells are neuroglial cells that line the ventricular system and central canal of the spinal cord. Glioependymal cysts lined by ependymal cells are postulated to arise from ectopic rests of primitive neuroglial tissue. These cysts can occur anywhere along the neuraxis; however, the cerebellopontine angle is not a usual site f...

Outcome Objectives: Identify pediatric-specific considerations in neurotologic skull base surgery. Describe collaborative strategies in pediatric skull base surgery. Methods: In a retrospective chart review of a tertiary-care, Neurotology skull base surgery program, 247 consecutive skull base surgeries from 2011 to 2015 included seven pediatric pat...

Objective: To report the authors' experience with hydroxyapatite cement (HAC) cranioplasty and analyze the material's long-term safety and efficacy in repairing translabyrinthine skull-base defects by examining adverse events, specifically cerebrospinal fluid (CSF) leaks and surgical site infections. Study design: Retrospective case-control stud...

Otitis media is a prevalent condition that can be diagnosed and treated by primary care providers skilled in otoscopy. Previous analysis demonstrated that brief, intensive instruction at one site in rural Mexico improved the test scores of health care providers and changed long-term practices (Eavey R, et al. Otolaryngol Head Neck Surg 1993;109:895...

OBJECTIVE:: Can magnetic resonance imaging (MRI) diagnose abnormally thin and dehiscent superior semicircular canals (SSCs) that traditionally rely on evaluation by computed tomography (CT) imaging? STUDY DESIGN:: Retrospective clinical study. SETTING:: Tertiary referral center. PATIENTS:: Adults who underwent both MRI and CT of the temporal bones...

(1) Evaluate the effects of monopolar cautery on cochlear implant devices. (2) Determine whether voltage fluctuations within the cochlear implant adversely affect the cochlear implant devices STUDY DESIGN: Two Med-El cochlear implants modified to record voltage difference from the apical and proximal electrodes were implanted into an unembalmed, fr...

To determine if age affects radiographic incidence of superior semicircular canal dehiscence (SSCD) in pediatric patients. Retrospective case review. Tertiary children's hospital. Patients (0-18 yr) with high-resolution computed tomography (CT) temporal bone scans from April 2001 to February 2013. Diagnostic high-resolution CT temporal bone scans....

To compare subjective and objective findings between patients with true dehiscence versus thin bone over the superior semicircular canal (SSC). Retrospective case series. Tertiary referral center. All patients from our institution with true dehiscence or thin bone over the SSC on computed tomography temporal bone (oblique view) from 2007 to 2013. S...

Objectives/HypothesisAs cochlear implantation increases, surgeons are noting possible anatomical differences in pediatric population. Outcome objectives were to study pediatric temporal bone anatomy using high-resolution temporal bone imaging, and analyze the anatomical differences in group 1 (<12 months) versus group 2 (1–4 years) versus group 3 (...

Objectives Compare facial function at onset of skilled facial rehabilitation of patients with facial paresis performing unsupervised facial exercise routine and patients with no previous intervention. Methods Retrospective chart review at a tertiary referral center including all patients from our institution who had >1/6 House Brackman score and w...

Objectives Correlate the findings of preoperative magnetic resonance imaging (MRI) and computed tomography (CT) in temporal bone carcinoma with histopathological findings following lateral temporal bone resection. Methods In this retrospective review, 11 cases of temporal bone carcinoma over the past 3 years were reviewed at our institution. Preop...

Objectives (1) Examine the efficacy of quick-setting, hydrophilic formulation of hydroxyapatite cement (HAC) used in cranioplasty for the prevention of cerebrospinal fluid (CSF) leaks and long-term wound complications following translabyrinthine acoustic neuroma (TLAN) surgery. (2) Review evolution of HAC cranioplasty. Methods Retrospective case r...

Objective The types of otogenic cerebrospinal fluid (CSF) fistulae were previously classified into defects through, adjacent to, or distal to the otic capsule. This article presents cases of the three different types of spontaneous CSF fistulae and reviews pertinent literature. We examine the management of the different types of otogenic CSF leaks...

Background: Surgical treatment of carcinoma of the external auditory canal (EAC) and temporal bone involves a lateral temporal bone resection (LTBR) or more extensive sub-total or total temporal bone resection with some degree of parotidectomy or parotid margins. Involvement of the parotid gland or parotid nodes results in a higher pathologic stagi...

To determine the best method of removing hydroxyapatite cement from the temporal bone in the postoperative period. The advent of hydroxyapatite cement in neurotologic surgery of the temporal bone has dramatically decreased the rate of postoperative cerebrospinal fluid leaks. However, there is no literature currently available on how to manage these...

Objectives 1) Study pediatric temporal bone anatomy using high resolution temporal bone imaging. 2) Analyze the anatomical differences in infant (< 2 years old) versus toddler (2-5 years old) versus child (6-10 years old) versus preadolescent and adolescent (>10 years old) as it pertains to cochlear implantation Methods A retrospective chart and r...

Program Description This miniseminar, presented on behalf of the American Neurotology Society, is designed to provide the practicing general otolaryngologist with immediately useful clinical pearls in the evaluation and management of patients presenting with neurotologic emergencies. Five expert neurotologists will present the current state of the...

Importance The use of monopolar cautery has been widely regarded as a contraindication in the setting of a cochlear implant because of presumed risk to the implant device. There are very limited data to support this contraindication. Objectives (1) To evaluate the effects of monopolar cautery on cochlear implant devices. (2) To determine whether...

This article presents a comprehensive review of the translabyrinthine surgical approach for vestibular schwannoma. Additionally, it addresses the traditional labyrinthectomy and identifies a time-efficient version. Indications and outcomes of the approach are presented, along with detailed procedural technique from opening incision through closure....

Objective: Spontaneous otogenic CSF leak is a life-threatening problem. The types of spontaneous CSF fistulae have been previously classified into defects through, adjacent to, or distal to the otic capsule. This paper presents case reviews representative of these three different spontaneous CSF fistulae and reviews pertinent literature. The clinic...

To present a case of mucosal melanoma of the Eustachian tube with a focus on surgical technique and to review the literature on treatment of mucosal melanoma of the head and neck, and review cases involving the middle ear and/or Eustachian tube. A 67-year-old man was diagnosed with mucosal melanoma of the middle ear and Eustachian tube. The patient...

The opportunity to treat neurotologic patients when the patient and physician are in separate locations is an important clinical delivery mechanism. The authors developed their applications of neurotologic telemedicine in the aftermath of Hurricane Katrina and found this to be an effective way to deliver clinical care, develop a clinical neurotolog...

Objective: 1) Identify the different levels of sensitivity and specificity of electrocochleography (ECOG) in our laboratory setting as normal or abnormal SP/AP ratio; and 2) select the level of specificity as the desired parameter of the abnormal SP/AP ratio of ECOG. Method: This retrospective study reviews 61 patients undergoing ECOG in our vestib...

Since the early 1960s, microsurgical removal has been the standard for curative treatment of vestibular schwannomas and neurotologic skull base lesions. The narrow operative corridor with only one surgeon actively operating sometimes interferes with simultaneous application of standard surgical principles such as suction, counter tension, and disse...

1. Ménière’s disease is characterized by a triad of symptoms: fluctuating hearing loss, attacks of vertigo, and tinnitus. Some authors have included aural fullness. 2. Patients often seek treatment for the severe vertigo attacks, but may have had other otologic symptoms for some time prior to the onset of vertigo. 3. Tinnitus that occurs in Ménière...

This study aimed to assess the feasibility of using a 1.3 mm, semi-rigid, interventional salivary endoscope for middle-ear endoscopy, and as a trans-tympanic route for delivery of medication, in human cadaveric temporal bones. Human cadaveric study. Five temporal bones harvested from human cadavers were examined. A 1.3 mm, interventional sialendosc...

The objectives are to evaluate the applicability of the Pittsburgh staging system (PSS) (designed for primary temporal bone malignancies) to advanced periauricular cutaneous malignancies with temporal bone involvement and to study treatment outcomes and prognostic factors predicting recurrence-free survival. Ten patients with advanced periauricular...

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This study evaluates technical requirements, privacy and legal constraints, reimbursement considerations, and overall feasibility of a new telemedicine neurotologic patient care delivery model in post-Katrina, Southeast Louisiana. This study is a retrospective review of the first year of a telemedicine neurotology practice with limited on-site neur...

To review the clinical course of patients undergoing observation for their acoustic tumor with evaluation of the incidence and contributing variables to failure to follow-up. Case series with chart review and telephone interview. Single subspecialty practice. One hundred twenty-two patients underwent an observation period after their unilateral aco...

An abstract is unavailable. This article is available as HTML full text and PDF.

An abstract is unavailable. This article is available as HTML full text and PDF.

Otologic Surgery-the third edition of this invaluable surgical reference-has been thoroughly updated to reflect the latest advances in the field and covers all aspects of surgery of the ear and skull base. Derald E. Brackmann, MD, Clough Shelton, MD, and Moises A. Arriaga, MD bring you seven new chapters on the hot topics of Cartilage Tympanoplasty...

The retrosigmoid and middle fossa approaches to acoustic tumor excision allow for hearing preservation but differ in the angle of approach to the facial nerve. The authors comparatively examined facial nerve results of each approach. Case series with chart review. Multiple physician subspecialty practice. The authors reviewed facial nerve outcomes...

The aim of our study was to assess feasibility of using a 1.3mm semi-rigid interventional salivary endoscope for middle ear endoscopy and as a route for trans-tympanic delivery of medication in human cadaveric temporal bones. Five temporal bones harvested from human cadavers were examined. A 1.3mm diameter 0 degree. Marchal interventional sialendos...

Objective: To evaluate the applicability of the Pittsburgh staging system (designed for primary temporal bone malignancies) to advanced periauricular cutaneous malignancies of the temporal bone. To study treatment outcomes and prognostic factors predicting recurrence-free survival. Methods: An Institutional Review Board–approved retrospective char...