A Comparison of Indirect and Direct Methods for Estimating Transglottal Airflow Rate

Publication date: Available online 3 November 2017
Source:Journal of Voice
Author(s): Ashwini Joshi, Christopher R. Watts
ObjectiveThe purpose of this study was to compare indirect estimates of transglottal airflow rate using measures of phonation quotient with direct measures of mean airflow rate derived from a pneumotachograph.Study designThis study used prospective, repeated measures design.MethodsNineteen male and female participants, matched for age, completed tasks for maximum phonation time and vital capacity in addition to the comfortable sustained phonation protocol of the Phonatory Aerodynamic System (PAS), Model 6600. Phonation quotient was calculated from the vital capacity and phonation time measures, whereas actual transglottal airflow was obtained from the flow waveforms recorded on the PAS system. Statistical analyses compared transglottal airflow rate measures as a function of instrument and separately as a function of gender.ResultsStatistically significant differences were present only as a function of gender on airflow measures but not as a function of the instrument. There were no interaction effects present between instrument and gender.ConclusionsPhonation quotient can be used as an estimate of transglottal airflow in the absence of a pneumotachograph-based system.



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Effects of Vocal Function Exercises: A Systematic Review

Publication date: Available online 3 November 2017
Source:Journal of Voice
Author(s): Vrushali Angadi, Daniel Croake, Joseph Stemple
ObjectivesThe purpose of the present review was to systematically analyze the evidence for the effectiveness of vocal function exercises (VFEs) in improving voice production.MethodsA systematic literature search was performed by two independent reviewers using PubMed and EBSCOHost to access relevant databases and to locate outcome studies that used VFEs as an intervention. Articles that met inclusion criteria were appraised based on the American Speech-Language and Hearing Association's levels of evidence. Effect sizes for outcomes were calculated using Hedge's g. Voice outcomes were categorized according to the five domains of voice assessment: visual perceptual analysis, acoustic analysis, aerodynamic analysis, auditory-perceptual analysis, and patient self-report measures.ResultsTwenty-one articles were included for the final appraisal. All studies demonstrated positive effects of VFEs as demonstrated by effect sizes across selected voice parameters. Effect sizes across parameters ranged from −0.59 to 1.55. None of the included studies reported adverse voice outcomes as a result of VFEs.ConclusionsOutcome studies demonstrate that VFEs are efficacious in enhancing vocal function in individuals with normal and disordered voices, presbylaryngeus, and professional voice users. The available research suggests moderate to strong evidence to support the use of VFEs for a variety of voice disorders.



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Satisfaction With Communication Using Remote Face-to-Face Language Interpretation Services With Spanish-Speaking Parents: A Pilot Study

Effective communication in clinical encounters is dependent upon the exchange of accurate information between clinician and patient and the use of interpersonal skills that foster development of the patient-provider relationship and demonstrate understanding of the patient's social and cultural background. These skills are of critical importance in the diagnosis and management of hearing loss in children of Spanish-speaking families. While the provision of family friendly, culturally sensitive services to families of children with hearing loss can be challenging for audiologists and speech-language pathologists, the quality and satisfaction of these services is widely recognized as the cornerstone of patient satisfaction and improved outcomes. The purpose of this pilot study was to explore patient, audiologist, and interpreter satisfaction of the use of remote face-to-face language interpretation technologies in the context of audiology services. Parent participants rated each session regarding satisfaction with the communication exchange, audiology services, and the interpreting experience. Audiologists rated their satisfaction with the communication exchange, relationship with the parent, and experience with the interpreter. Interpreters rated their satisfaction with the logistics regarding the appointment, information exchange, and experience in working with the audiologist. Audiologists and interpreters were asked to identify what worked well and what challenges needed to be addressed. Data from this pilot study can be used to guide future efforts in providing high quality language interpretation services to Spanish-speaking families of young children who are at risk for or have been diagnosed with hearing loss.

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Phonological Awareness at 5 years of age in Children Who Use Hearing Aids or Cochlear Implants

Children with hearing loss typically underachieve in reading, possibly as a result of their underdeveloped phonological skills. This study addressed the questions of (1)whether or not the development of phonological awareness (PA) is influenced by the degree of hearing loss and (2) whether or not performance of children with severe-profound hearing loss differed according to the hearing devices used. Drawing on data collected as part of the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI, http://ift.tt/2hDgsG6) study, the authors found that sound-matching scores of children with hearing loss ranging from mild to profound degrees were, on average, within the normal range. The degree of hearing loss did not have a significant impact on scores, but there was a non-significant tendency for the proportion of children who achieved zero scores to increase with increase in hearing loss. For children with severe hearing loss, there was no significant group difference in scores among children who used bilateral hearing aids, bimodal fitting (a cochlear implant and a hearing aid in contralateral ears), and bilateral cochlear implants. Although there is a need for further prospective research, professionals have an important role in targeting PA skills for rehabilitation of young children with hearing loss.

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Coordinator's Column

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Language Outcomes in Children With Unilateral Hearing Loss: A Review

Unilateral hearing loss (UHL) in children is only recently beginning to be widely appreciated as having a negative impact. We now understand that simply having one normal-hearing ear may not be sufficient for typical child development, and leads to impairments in speech and language outcomes. Unfortunately, UHL is not a rare problem among children in the United States, and is present among more than 1 out of every 10 of adolescents in this country. How UHL specifically affects development of speech and language, however, is currently not well understood. While we know that children with UHL are more likely than their normal-hearing siblings to have speech therapy and individualized education plans at school, we do not yet understand the mechanism through which UHL causes speech and language problems. The objective of this review is to describe what is currently known about the impact of UHL on speech and language development in children. Furthermore, we discuss some of the potential pathways through which the impact of unilateral hearing loss on speech and language might be mediated.

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SIG 9 Perspectives Vol. 25, No. 2, September 2015: Earn 0.15 CEUs on This Issue

Download the CE Questions PDF from the toolbar, above. Use the questions to guide your Perspectives reading. When you're ready, purchase the activity from the ASHA Store and follow the instructions to take the exam in ASHA's Learning Center. Available until March 26, 18.

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Standardized Patients: Potential to Improve Student Training in Aural Rehabilitation

Hearing loss is a growing public health concern. The multifaceted consequences of hearing loss are far reaching and include reduced audibility, well-being, and quality-of-life. Audiologists require specific training to address the wide range of hearing loss (re)habilitation needs, including some of the psychosocial needs of patients. One instructional method that might provide valuable training for the next generation of clinicians is the use of simulated or standardized patients (SPs). Standardized patients (SPs) are actors who are recruited, trained, and typically paid to portray patients, family members, or healthcare team members in a standardized manner for purposes of training healthcare professionals. Advantages to using SPs as an instructional technique were identified through a review of the literature and through discussion with two focus groups of experienced educators in the field of audiology. Advantages included those inherent to SP scenarios (e.g., standardization, authenticity, and safety), as well as those inherent to the experience (e.g., student reflection, comprehensive feedback, etc.). Benefits to students can include increased student confidence and improved interpersonal skills. Although time and resource investments necessary for SP case implementation can be prohibitive for some programs, creative instructors can harness many of the benefits using alternative implementations of SP cases.

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Vocal Performance Teachers and Hearing Loss

Hearing thresholds and distortion product otoacoustic emissions were measured for teachers of vocal performance who were gathered for a national conference. Results showed mean audiometric thresholds to be consistent with noise induced hearing loss, more than what would be expected with normal aging. Years of instruction and age were considered as factors in the hearing loss observed. It was concluded that hearing conservation should be initiated with this group to help raise awareness and protect them from hearing loss due to occupational noise exposure.

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Editor's Column

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SIG 8 Perspectives Vol. 16, No. 1, November 2015: Earn 0.10 CEUs on This Issue

Download the CE Questions PDF from the toolbar, above. Use the questions to guide your Perspectives reading. When you're ready, purchase the activity from the ASHA Store and follow the instructions to take the exam in ASHA's Learning Center. Available until November 21, 2018.

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SIG Audiology Perspectives Vol. 7, No. 1, November 2011: Earn 0.3 CEUs on This Issue

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Improving the Quality of Auditory Training by Making Tasks Meaningful

Traditional auditory training (AT) typically includes activities that focus on the formal properties of sounds without requiring attention to meaning. After reviewing the psycholinguistic bases for requiring attention to meaning, the authors present a series of examples of how to modify purely form-oriented AT activities so that they become meaning oriented. For example, a purely form-oriented same–different task with /ba/–/pa/ or /ba/–/ba/ can be modified using minimal pairs such as /bear/–/pear/ or /bear/–/bear/ and by requiring listeners to identify appropriate picture pairs in order (i.e., pictures of a bear and then a pear, or of a bear and then another bear). The modified version requires attention to meaning, whereas the original version does not. The authors promote a nonhierarchical and interactive approach to AT in which activities at 3 linguistic levels (word, sentence, and discourse) are included from the beginning and throughout AT, but with activities that are carefully designed to be meaning oriented and in which comprehension is the central focus. In the Summary By Example section, the authors describe an AT program (I Hear What You Mean; Tye-Murray, Barcroft, & Sommers, in press) that was designed to be meaning oriented at the word, sentence, and discourse levels. Specific benefits of providing meaning-based AT, such as higher levels of participant engagement, are highlighted.

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Quality 101: What Every Audiologist and Speech-Language Pathologist Should Know But Is Afraid to Ask

The United States has the highest per capita health care costs of any industrialized nation in the world. Increasing costs are reducing access to care and constitute an increasingly heavy burden on employers and consumers. Yet as much as 20 to 30 percent of these costs may be unnecessary, or even counterproductive, to improved health (Wennberg, Brownless, Fisher, Skinner, & Weinstein, 2008). Addressing these unwanted costs is essential in the survival of providing quality health care. This article reviews 11 dimensions that should be considered when starting a quality improvement program as well as one quality improvement tool, the Juran model, that is commonly used in the healthcare and business settings. Implementing a quality management program is essential for survival in today’s market place and is no longer an option. While it takes time to implement a quality management program, the costs are too high not to.

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Coordinator’s Column

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Audiologists and Speech-Language Pathologists: Making Critical Cross-Disciplinary Connections For Quality Care in Early Hearing Detection and Intervention

Widespread realization of newborn hearing screening has made it possible to routinely identify hearing loss shortly after birth, expanding opportunities for children born with permanent hearing loss. For children to reach their full potential, high-quality comprehensive services need to be provided in a timely manner. Because the roles of the audiologist and speech-language pathologist vary significantly from family to family in an American Sign Language approach, this article focuses primarily on the roles these professionals serve within a listening and spoken language communication approach. An overview of components of quality assessment and intervention for audiology and speech-language pathology are discussed, as are the benefits and opportunities of interdisciplinary collaboration. Newborn hearing screenings, advanced hearing technology, and early education have the potential to affect the lives of children with hearing loss and their families; however, successful families and children rely on quality, collaborative intervention from their service providers. Together, speech-language pathologists and audiologists can better understand a child’s responses to sound, more effectively set hearing technology to maximize access to sound, and support parents in their ability to help their children reach their full potential.

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Healthy People 2020

The U.S. Department of Health and Human Services launched Healthy People 2020 in December 2010, announcing the new 10-year goals and objectives for health promotion and disease prevention. Healthy People is designed to improve the quality of the nation’s health and provide a framework for public health prevention priorities and actions. A newly redesigned website (http://ift.tt/17QFO9U) allows users to tailor information to individual or community needs and to explore evidence-based resources. A major principle states that national objectives and monitoring progress are critical factors in motivating action. An extensive feedback process was initiated by the Department of Health and Human Services to develop comprehensive objectives; previous topic areas were carried forward, and new areas were identified. Chief Technology Officer Todd Park stated, “This milestone in disease prevention and health promotion creates an opportunity to leverage information technology to make Healthy People come alive for all Americans in their communities and workplaces” (U. S. Department of Health and Human Services, 2011). Healthy People 2020 includes initiatives to hearing and communication disorders which are considered important to the overall well being of the population.

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Can Behavioral Speech-In-Noise Tests Improve the Quality of Hearing Aid Fittings?

The purpose of this article is to propose 4 dimensions for consideration in hearing aid fittings and 4 tests to evaluate those dimensions. The 4 dimensions and tests are (a) working memory, evaluated by the Revised Speech Perception in Noise test (Bilger, Nuetzel, & Rabinowitz, 1984); (b) performance in noise, evaluated by the Quick Speech in Noise test (QSIN; Killion, Niquette, Gudmundsen, Revit, & Banerjee, 2004); (c) acceptance of noise, evaluated by the Acceptable Noise Level test (ANL; Nabelek, Tucker, & Letowski, 1991); and (d) performance versus perception, evaluated by the Perceptual–Performance test (PPT; Saunders & Cienkowski, 2002). The authors discuss the 4 dimensions and tests in the context of improving the quality of hearing aid fittings.

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Satisfaction With Communication Using Remote Face-to-Face Language Interpretation Services With Spanish-Speaking Parents: A Pilot Study

Effective communication in clinical encounters is dependent upon the exchange of accurate information between clinician and patient and the use of interpersonal skills that foster development of the patient-provider relationship and demonstrate understanding of the patient's social and cultural background. These skills are of critical importance in the diagnosis and management of hearing loss in children of Spanish-speaking families. While the provision of family friendly, culturally sensitive services to families of children with hearing loss can be challenging for audiologists and speech-language pathologists, the quality and satisfaction of these services is widely recognized as the cornerstone of patient satisfaction and improved outcomes. The purpose of this pilot study was to explore patient, audiologist, and interpreter satisfaction of the use of remote face-to-face language interpretation technologies in the context of audiology services. Parent participants rated each session regarding satisfaction with the communication exchange, audiology services, and the interpreting experience. Audiologists rated their satisfaction with the communication exchange, relationship with the parent, and experience with the interpreter. Interpreters rated their satisfaction with the logistics regarding the appointment, information exchange, and experience in working with the audiologist. Audiologists and interpreters were asked to identify what worked well and what challenges needed to be addressed. Data from this pilot study can be used to guide future efforts in providing high quality language interpretation services to Spanish-speaking families of young children who are at risk for or have been diagnosed with hearing loss.

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Phonological Awareness at 5 years of age in Children Who Use Hearing Aids or Cochlear Implants

Children with hearing loss typically underachieve in reading, possibly as a result of their underdeveloped phonological skills. This study addressed the questions of (1)whether or not the development of phonological awareness (PA) is influenced by the degree of hearing loss and (2) whether or not performance of children with severe-profound hearing loss differed according to the hearing devices used. Drawing on data collected as part of the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI, http://ift.tt/2hDgsG6) study, the authors found that sound-matching scores of children with hearing loss ranging from mild to profound degrees were, on average, within the normal range. The degree of hearing loss did not have a significant impact on scores, but there was a non-significant tendency for the proportion of children who achieved zero scores to increase with increase in hearing loss. For children with severe hearing loss, there was no significant group difference in scores among children who used bilateral hearing aids, bimodal fitting (a cochlear implant and a hearing aid in contralateral ears), and bilateral cochlear implants. Although there is a need for further prospective research, professionals have an important role in targeting PA skills for rehabilitation of young children with hearing loss.

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Coordinator's Column

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Language Outcomes in Children With Unilateral Hearing Loss: A Review

Unilateral hearing loss (UHL) in children is only recently beginning to be widely appreciated as having a negative impact. We now understand that simply having one normal-hearing ear may not be sufficient for typical child development, and leads to impairments in speech and language outcomes. Unfortunately, UHL is not a rare problem among children in the United States, and is present among more than 1 out of every 10 of adolescents in this country. How UHL specifically affects development of speech and language, however, is currently not well understood. While we know that children with UHL are more likely than their normal-hearing siblings to have speech therapy and individualized education plans at school, we do not yet understand the mechanism through which UHL causes speech and language problems. The objective of this review is to describe what is currently known about the impact of UHL on speech and language development in children. Furthermore, we discuss some of the potential pathways through which the impact of unilateral hearing loss on speech and language might be mediated.

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SIG 9 Perspectives Vol. 25, No. 2, September 2015: Earn 0.15 CEUs on This Issue

Download the CE Questions PDF from the toolbar, above. Use the questions to guide your Perspectives reading. When you're ready, purchase the activity from the ASHA Store and follow the instructions to take the exam in ASHA's Learning Center. Available until March 26, 18.

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Standardized Patients: Potential to Improve Student Training in Aural Rehabilitation

Hearing loss is a growing public health concern. The multifaceted consequences of hearing loss are far reaching and include reduced audibility, well-being, and quality-of-life. Audiologists require specific training to address the wide range of hearing loss (re)habilitation needs, including some of the psychosocial needs of patients. One instructional method that might provide valuable training for the next generation of clinicians is the use of simulated or standardized patients (SPs). Standardized patients (SPs) are actors who are recruited, trained, and typically paid to portray patients, family members, or healthcare team members in a standardized manner for purposes of training healthcare professionals. Advantages to using SPs as an instructional technique were identified through a review of the literature and through discussion with two focus groups of experienced educators in the field of audiology. Advantages included those inherent to SP scenarios (e.g., standardization, authenticity, and safety), as well as those inherent to the experience (e.g., student reflection, comprehensive feedback, etc.). Benefits to students can include increased student confidence and improved interpersonal skills. Although time and resource investments necessary for SP case implementation can be prohibitive for some programs, creative instructors can harness many of the benefits using alternative implementations of SP cases.

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Vocal Performance Teachers and Hearing Loss

Hearing thresholds and distortion product otoacoustic emissions were measured for teachers of vocal performance who were gathered for a national conference. Results showed mean audiometric thresholds to be consistent with noise induced hearing loss, more than what would be expected with normal aging. Years of instruction and age were considered as factors in the hearing loss observed. It was concluded that hearing conservation should be initiated with this group to help raise awareness and protect them from hearing loss due to occupational noise exposure.

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Editor's Column

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SIG 8 Perspectives Vol. 16, No. 1, November 2015: Earn 0.10 CEUs on This Issue

Download the CE Questions PDF from the toolbar, above. Use the questions to guide your Perspectives reading. When you're ready, purchase the activity from the ASHA Store and follow the instructions to take the exam in ASHA's Learning Center. Available until November 21, 2018.

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Satisfaction With Communication Using Remote Face-to-Face Language Interpretation Services With Spanish-Speaking Parents: A Pilot Study

Effective communication in clinical encounters is dependent upon the exchange of accurate information between clinician and patient and the use of interpersonal skills that foster development of the patient-provider relationship and demonstrate understanding of the patient's social and cultural background. These skills are of critical importance in the diagnosis and management of hearing loss in children of Spanish-speaking families. While the provision of family friendly, culturally sensitive services to families of children with hearing loss can be challenging for audiologists and speech-language pathologists, the quality and satisfaction of these services is widely recognized as the cornerstone of patient satisfaction and improved outcomes. The purpose of this pilot study was to explore patient, audiologist, and interpreter satisfaction of the use of remote face-to-face language interpretation technologies in the context of audiology services. Parent participants rated each session regarding satisfaction with the communication exchange, audiology services, and the interpreting experience. Audiologists rated their satisfaction with the communication exchange, relationship with the parent, and experience with the interpreter. Interpreters rated their satisfaction with the logistics regarding the appointment, information exchange, and experience in working with the audiologist. Audiologists and interpreters were asked to identify what worked well and what challenges needed to be addressed. Data from this pilot study can be used to guide future efforts in providing high quality language interpretation services to Spanish-speaking families of young children who are at risk for or have been diagnosed with hearing loss.

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Phonological Awareness at 5 years of age in Children Who Use Hearing Aids or Cochlear Implants

Children with hearing loss typically underachieve in reading, possibly as a result of their underdeveloped phonological skills. This study addressed the questions of (1)whether or not the development of phonological awareness (PA) is influenced by the degree of hearing loss and (2) whether or not performance of children with severe-profound hearing loss differed according to the hearing devices used. Drawing on data collected as part of the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI, http://ift.tt/2hDgsG6) study, the authors found that sound-matching scores of children with hearing loss ranging from mild to profound degrees were, on average, within the normal range. The degree of hearing loss did not have a significant impact on scores, but there was a non-significant tendency for the proportion of children who achieved zero scores to increase with increase in hearing loss. For children with severe hearing loss, there was no significant group difference in scores among children who used bilateral hearing aids, bimodal fitting (a cochlear implant and a hearing aid in contralateral ears), and bilateral cochlear implants. Although there is a need for further prospective research, professionals have an important role in targeting PA skills for rehabilitation of young children with hearing loss.

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Coordinator's Column

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Language Outcomes in Children With Unilateral Hearing Loss: A Review

Unilateral hearing loss (UHL) in children is only recently beginning to be widely appreciated as having a negative impact. We now understand that simply having one normal-hearing ear may not be sufficient for typical child development, and leads to impairments in speech and language outcomes. Unfortunately, UHL is not a rare problem among children in the United States, and is present among more than 1 out of every 10 of adolescents in this country. How UHL specifically affects development of speech and language, however, is currently not well understood. While we know that children with UHL are more likely than their normal-hearing siblings to have speech therapy and individualized education plans at school, we do not yet understand the mechanism through which UHL causes speech and language problems. The objective of this review is to describe what is currently known about the impact of UHL on speech and language development in children. Furthermore, we discuss some of the potential pathways through which the impact of unilateral hearing loss on speech and language might be mediated.

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SIG 9 Perspectives Vol. 25, No. 2, September 2015: Earn 0.15 CEUs on This Issue

Download the CE Questions PDF from the toolbar, above. Use the questions to guide your Perspectives reading. When you're ready, purchase the activity from the ASHA Store and follow the instructions to take the exam in ASHA's Learning Center. Available until March 26, 18.

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Standardized Patients: Potential to Improve Student Training in Aural Rehabilitation

Hearing loss is a growing public health concern. The multifaceted consequences of hearing loss are far reaching and include reduced audibility, well-being, and quality-of-life. Audiologists require specific training to address the wide range of hearing loss (re)habilitation needs, including some of the psychosocial needs of patients. One instructional method that might provide valuable training for the next generation of clinicians is the use of simulated or standardized patients (SPs). Standardized patients (SPs) are actors who are recruited, trained, and typically paid to portray patients, family members, or healthcare team members in a standardized manner for purposes of training healthcare professionals. Advantages to using SPs as an instructional technique were identified through a review of the literature and through discussion with two focus groups of experienced educators in the field of audiology. Advantages included those inherent to SP scenarios (e.g., standardization, authenticity, and safety), as well as those inherent to the experience (e.g., student reflection, comprehensive feedback, etc.). Benefits to students can include increased student confidence and improved interpersonal skills. Although time and resource investments necessary for SP case implementation can be prohibitive for some programs, creative instructors can harness many of the benefits using alternative implementations of SP cases.

from #Audiology via ola Kala on Inoreader http://article/16/1/4/2480230/Standardized-Patients-Potential-to-Improve-Student
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Vocal Performance Teachers and Hearing Loss

Hearing thresholds and distortion product otoacoustic emissions were measured for teachers of vocal performance who were gathered for a national conference. Results showed mean audiometric thresholds to be consistent with noise induced hearing loss, more than what would be expected with normal aging. Years of instruction and age were considered as factors in the hearing loss observed. It was concluded that hearing conservation should be initiated with this group to help raise awareness and protect them from hearing loss due to occupational noise exposure.

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Editor's Column

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SIG 8 Perspectives Vol. 16, No. 1, November 2015: Earn 0.10 CEUs on This Issue

Download the CE Questions PDF from the toolbar, above. Use the questions to guide your Perspectives reading. When you're ready, purchase the activity from the ASHA Store and follow the instructions to take the exam in ASHA's Learning Center. Available until November 21, 2018.

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Intracranial melanotic schwannomas: a rare variant with unusual adherent features.

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Intracranial melanotic schwannomas: a rare variant with unusual adherent features.

J Neurooncol. 2017 Nov 02;:

Authors: Mahato D, Vivas-Buitrago T, Gassie K, Jentoft M, Tavanaiepour D, Quiñones-Hinojosa A

Abstract
Intracranial melanotic schwannomas (IMSch) are extremely rare nerve sheath tumors with features of Schwann cells that produce melanin. After a thorough review of the available literature since 1967, we report not only the 20th case of IMSch but a comprehensive modern-era analysis of radiographic and histological key-points to be considered when diagnosing and treating patients with this rare known entity. This is the case of a 43 years-old woman who presented with severe headaches 9 years ago (2008). At that time, MRI of the brain showed a 1.5 × 1.4 cm lesion at the level of the left cerebellar peduncle without any evidence of edema, mass effect or hydrocephalus. Given that the patient was neurologically intact, a conservative management with serial MRIs was recommended. Patient stopped following up due to the absence of symptoms. Over the course of the past year, patient noted mild left sided hearing loss and facial weakness, as well as some balance instability that progressed over the last 3 months. Given the presentation and progression of these signs and symptoms, a new MRI was performed in which considerable growth of the lesion was identified, measuring 2.5 × 2.8 × 2.6 cm with mass effect on the pons and the inferior fourth ventricle. She underwent a far lateral approach without a C1 hemilaminectomy for the resection of this lesion. Final pathology was consistent with a non-psammomatous melanotic schwannoma (NPMS) with areas of necrosis. Besides this case, only two other cases of IMSch with findings of necrosis have been reported in the literature, all of them reporting a subtotal resection. Evaluation of all previously reported cases of IMSch shows a male prevalence with a 1.6:1 male to female ratio. IMSch is radiographically T2 hypointense and can be differentiated from Schwannomas that are classically T2 hyperintense. In this case, only a subtotal resection was feasible due to the tumor's overwhelming inherent attachment to vital structures such as cranial nerves (CN), brainstem, and vasculature. While MSch is considered histologically benign, several factors including localization, surrounding structures, the rate of growth, tumor volume resection and histological necrosis should be considered in determining prognosis and further adjuvant treatment planning.

PMID: 29098570 [PubMed - as supplied by publisher]

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Intracranial melanotic schwannomas: a rare variant with unusual adherent features.

Related Articles

Intracranial melanotic schwannomas: a rare variant with unusual adherent features.

J Neurooncol. 2017 Nov 02;:

Authors: Mahato D, Vivas-Buitrago T, Gassie K, Jentoft M, Tavanaiepour D, Quiñones-Hinojosa A

Abstract
Intracranial melanotic schwannomas (IMSch) are extremely rare nerve sheath tumors with features of Schwann cells that produce melanin. After a thorough review of the available literature since 1967, we report not only the 20th case of IMSch but a comprehensive modern-era analysis of radiographic and histological key-points to be considered when diagnosing and treating patients with this rare known entity. This is the case of a 43 years-old woman who presented with severe headaches 9 years ago (2008). At that time, MRI of the brain showed a 1.5 × 1.4 cm lesion at the level of the left cerebellar peduncle without any evidence of edema, mass effect or hydrocephalus. Given that the patient was neurologically intact, a conservative management with serial MRIs was recommended. Patient stopped following up due to the absence of symptoms. Over the course of the past year, patient noted mild left sided hearing loss and facial weakness, as well as some balance instability that progressed over the last 3 months. Given the presentation and progression of these signs and symptoms, a new MRI was performed in which considerable growth of the lesion was identified, measuring 2.5 × 2.8 × 2.6 cm with mass effect on the pons and the inferior fourth ventricle. She underwent a far lateral approach without a C1 hemilaminectomy for the resection of this lesion. Final pathology was consistent with a non-psammomatous melanotic schwannoma (NPMS) with areas of necrosis. Besides this case, only two other cases of IMSch with findings of necrosis have been reported in the literature, all of them reporting a subtotal resection. Evaluation of all previously reported cases of IMSch shows a male prevalence with a 1.6:1 male to female ratio. IMSch is radiographically T2 hypointense and can be differentiated from Schwannomas that are classically T2 hyperintense. In this case, only a subtotal resection was feasible due to the tumor's overwhelming inherent attachment to vital structures such as cranial nerves (CN), brainstem, and vasculature. While MSch is considered histologically benign, several factors including localization, surrounding structures, the rate of growth, tumor volume resection and histological necrosis should be considered in determining prognosis and further adjuvant treatment planning.

PMID: 29098570 [PubMed - as supplied by publisher]

from #Audiology via ola Kala on Inoreader http://ift.tt/2A79pwa
via IFTTT