Otolaryngologist (ear, nose, throat)
25 years of experience
Video profile
Accepting new patients
Dearborn
Michigan Ear Institute
18181 Oakwood Blvd
Ste 201
Dearborn, MI 48124
248-865-4444
Locations and availability (5)

Education ?

Medical School Score Rankings
University of Michigan Medical School (1985)
  • Currently 4 of 4 apples
Top 25%

Awards & Distinctions ?

Appointments
Northwestern University, Feinberg School of Medicine - Chicago Il (1992 - 1997)
Assistant Professor
Wayne State University School Of Medicine - Detroit Mi (1997 - Present)
Assistant Professor
Associations
American Academy of Otolaryngology: Head and Neck Surgery
American College of Surgeons
American Board of Otolaryngology

Affiliations ?

Dr. Zappia is affiliated with 18 hospitals.

Hospital Affilations

Score

Rankings

  • Beaumont Hospital, Grosse Pointe
    Otolaryngology
    468 Cadieux Rd, Grosse Pointe, MI 48230
    • Currently 4 of 4 crosses
    Top 25%
  • Providence Hospital and Medical Center
    Otolaryngology
    16001 W 9 Mile Rd, Southfield, MI 48075
    • Currently 4 of 4 crosses
    Top 25%
  • University of Michigan Hospitals & Health Centers
    Otolaryngology
    1500 E Medical Center Dr, Ann Arbor, MI 48109
    • Currently 4 of 4 crosses
    Top 25%
  • Beaumont Hospital,Troy
    Otolaryngology
    44201 Dequindre Rd, Troy, MI 48085
    • Currently 4 of 4 crosses
    Top 25%
  • Beaumont Hospital, Royal Oak
    Otolaryngology
    3601 W 13 Mile Rd, Royal Oak, MI 48073
    • Currently 3 of 4 crosses
    Top 50%
  • Saint Joseph Mercy Hospital
    Otolaryngology
    505 E Huron St, Ann Arbor, MI 48104
    • Currently 3 of 4 crosses
    Top 50%
  • Oakwood Hospital and Medical Center
    Otolaryngology
    18101 Oakwood Blvd, Dearborn, MI 48124
    • Currently 3 of 4 crosses
    Top 50%
  • St. John Macomb-Oakland Hospital (Oakland Center)
    27351 Dequindre Rd, Madison Heights, MI 48071
    • Currently 3 of 4 crosses
    Top 50%
  • St John Detroit Riverview Hospital
    7733 E Jefferson Ave, Detroit, MI 48214
    • Currently 3 of 4 crosses
    Top 50%
  • Royal Oak (14 Years
  • Providence Park Hospital
    47601 Grand River Ave, Novi, MI 48374
  • Beaumont Affiliation & Years on StaffRoyal Oak
  • Oakwood Heritage Hospital
  • University of Michigan Health System
  • Hinsdale Hospital
  • Oakwood Hospital
  • Royal Oak
  • St. Joseph Ann Arbor Hospital
  • Publications & Research

    Dr. Zappia has contributed to 29 publications.
    Title Quality-of-life Assessment of Ménière's Disease Patients After Surgical Labyrinthectomy.
    Date February 2007
    Journal Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
    Excerpt

    OBJECTIVE: To examine the impact of surgical labyrinthectomy on quality of life of Ménière's disease patients. STUDY DESIGN: Cross-sectional survey. SETTING: Otology subspecialty referral center. PATIENTS: All patients with Ménière's disease who underwent surgical labyrinthectomy between 1998 and 2004 were selected. Fifty-three patients satisfied inclusion criteria. Completed questionnaires were obtained from 44 patients. INTERVENTION(S): The Ménière's Disease Outcomes Questionnaire is a disease-specific quality-of-life questionnaire. It was used to assess the quality of life of patients before and after surgical labyrinthectomy. The questionnaire encompasses physical, mental, and social well-being domains of quality of life. MAIN OUTCOME MEASURE(S): Change in total quality-of-life score was used to assess the overall impact of surgical labyrinthectomy on subjective patient outcome. Individual quality-of-life domains were also assessed. RESULTS: Forty-three of 44 respondents (98%) had improvement in total score after surgery. The one patient who demonstrated deterioration developed latent contralateral disease. Average preoperative and postoperative scores were 34 +/- 14 and 67 +/- 15, respectively (p < 0.001). All questions showed significant improvement with surgery (p < 0.001) except questions pertaining to memory (no change) and hearing loss (nonsignificant decrease in score). CONCLUSION: This study comprises the first patient-directed assessment of quality-of-life outcomes in Ménière's disease patients after labyrinthectomy. Despite the disadvantage of hearing loss, patients consistently reported significant improvement in all quality-of-life domains and do not report a significant loss of quality of life in terms of their hearing loss. Surgical labyrinthectomy remains a highly effective treatment for Ménière's disease patients.

    Title Success of Posterior Semicircular Canal Occlusion and Application of the Dizziness Handicap Inventory.
    Date April 2006
    Journal Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-head and Neck Surgery
    Excerpt

    OBJECTIVES: To determine the long-term efficacy and patient satisfaction of posterior semicircular canal occlusion (PSCO) as a treatment for intractable benign paroxysmal positional vertigo (BPPV). STUDY DESIGN AND SETTING: Retrospective analysis of patients with BPPV who underwent PSCO was conducted in a tertiary referral center. Demographic data, clinical records, and audiometric data were reviewed. Dix-Hallpike maneuver, dizziness handicap inventory (DHI), and a specific PSCO questionnaire (PCOQ) were used to measure outcome. RESULTS: Twenty-eight patients underwent PSCO. The mean follow-up time was 40 months. All patients had normalization of the Hallpike test. DHI scores of 20 patients were recorded. The mean preoperative score was 70 compared with postoperative mean of 13 (P < 0.001). Mild hearing loss was found in 1 patient. CONCLUSIONS AND SIGNIFICANCE: PSCO is highly successful. The DHI scores postoperatively show significant improvement. The PCOQ revealed an overall 85% patient satisfaction rate. PSCO is a safe and effective intervention for intractable BPPV with a high patient satisfaction rate. EBM rating: C-4.

    Title The Zb Mastoid Oscillation Protocol (zbmop) in Meniere's Disease and Ductolithiasis.
    Date December 2002
    Journal Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-head and Neck Surgery
    Title Round Window Gentamicin Absorption: an in Vivo Human Model.
    Date November 2002
    Journal The Laryngoscope
    Excerpt

    OBJECTIVE/HYPOTHESIS: Using a novel human labyrinthine sampling model, in vivo gentamicin absorption through the round window can be measured. STUDY DESIGN: A prospective study. METHODS: Gentamicin was delivered either transtympanically (preoperative) or through a facial recess approach (intraoperative). The lateral semicircular canal and vestibule were opened, and by means of a microsyringe, labyrinthine fluid was aspirated. A sample of serum was also drawn. In all patients cerebrospinal fluid was also drawn. The samples were analyzed using a standard chemistry analyzer. RESULTS: Intratympanic gentamicin diffused through the round window membrane and achieved concentrations in the labyrinthine fluid ranging from 0 to 16 mg/L. Intratympanic gentamicin was absorbed into the systemic circulation in 4 of 11 patients with serum levels ranging from 0.3 to 0.4 mg/L. No gentamicin was detected in the cerebrospinal fluid. CONCLUSIONS: Intratympanic gentamicin diffuses rapidly through the round window membrane and achieves significant levels in the inner ear. Thus, this new model can be used to assess round window permeability to clinically relevant medications such as steroids and ototopical antibiotics.

    Title Rethinking the Use of Auditory Brainstem Response in Acoustic Neuroma Screening.
    Date October 1997
    Journal The Laryngoscope
    Excerpt

    The ability of magnetic resonance imaging (MRI) to detect very small acoustic tumors has triggered many to rethink the use of auditory brainstem response (ABR) in the screening of acoustic tumors. To assess ABR accuracy, we conducted a retrospective study of 388 surgically treated patients. Of these patients, 111 had complete databases including both preoperative MRIs and ABRs. The ABR was abnormal by wave V interaural latency difference in 106 (95%) of the cases. Although our overall sensitivity was 95%, sensitivity varied according to tumor size. ABR was abnormal or absent for all tumors (100%) larger than 2 cm in diameter, for 98% of tumors 1.1 to 2 cm in diameter, and for only 89% of tumors less than or equal to 1 cm in diameter. Ramifications of this in the decision-making process are presented. Criteria for cut-off values are also discussed.

    Title Pitfalls in the Diagnosis of Hemifacial Spasm.
    Date May 1997
    Journal The Laryngoscope
    Excerpt

    Hemifacial spasm (HFS), a condition characterized by involuntary unilateral facial spasms, is a disabling disorder resulting in functional compromise, patient frustration, cosmetic deformity, and social embarrassment. Compression of the seventh nerve at the root entry zone via vascular loop is presently the most widely accepted causative theory. Although less common, there are other entities that can result in HFS. Basic evaluation, including a thorough history, physical examination, and magnetic resonance imaging (MRI) scan, is important to confirm the diagnosis and rule out other causes. The relation of vascular loop syndrome to HFS is well enough established that radiologic documentation of a vascular loop is probably not necessary in every case. Here we present 12 cases of HFS, 6 without VLS. The etiology and evaluation of HFS are reviewed.

    Title Posterior Semicircular Canal Occlusion for Benign Paroxysmal Positional Vertigo.
    Date January 1997
    Journal The American Journal of Otology
    Excerpt

    For the small group of patients with benign paroxysmal positional vertigo that does not resolve with time or conservative treatment measures, posterior semicircular canal occlusion is considered. In the past 2 years, eight patients have undergone posterior semicircular canal occlusion at the Chicago Otology Group. All patients noted resolution of their positional vertigo. No complications were observed, particularly no sensorineural hearing loss was noted. A several-week period of disequilibrium is typical and appears to be the most bothersome aspect of the surgery to the patient.

    Title Conservative Management of Patients with Small Acoustic Tumors.
    Date September 1995
    Journal The Laryngoscope
    Excerpt

    Of 432 patients referred for treatment of their cerebellopontine angle tumors, 53 with acoustic neuromas were managed initially without intervention but with adequate follow-up. Mean presenting tumor size in this subgroup of patients was 0.98 cm (range, 0.2 to 3.0 cm), and average growth rate was 0.16 cm per year. Twenty-one patients demonstrated tumor growth with a mean follow-up interval of 1.9 years. Of these 21 patients, 14 underwent microsurgical excision, 4 received radiation, 2 continued to be observed and 1 was lost to follow-up. The remaining 32 (60%) had no demonstrable growth with a mean follow-up of 2.13 years. Of these patients, 29 continue to be followed and 3 were lost to follow-up. Of the information evaluated, the only statistically significant relationship is with larger tumor size in elderly patients--most likely reflecting the propensity to opt for conservative treatment in elderly patients. Tumor growth rate was unrelated to presenting tumor size or patient age, which suggests that conservative treatment may be appropriate in selected patients.

    Title Congenital Cholesteatoma.
    Date January 1995
    Journal Archives of Otolaryngology--head & Neck Surgery
    Excerpt

    OBJECTIVE: To review the characteristics of congenital cholesteatomata. DESIGN: Case series. SETTING: Tertiary care (referral-based) private practice. PATIENTS AND OTHER PARTICIPANTS: Fourteen patients were included in the study. The diagnosis of congenital cholesteatoma was based on an intact tympanic membrane on physical examination; a history that excluded tympanic membrane perforation, otorrhea, or previous otologic procedure; and a documented cholesteatoma at the time of surgical removal. INTERVENTION: Surgical procedures including tympanotomy, atticotomy, and tympanotomy with mastoidectomy were performed on all patients. MAIN OUTCOME MEASURES: Removal of cholesteatoma. RESULTS: Four of the 14 patients had lesions isolated to the anterosuperior quadrant of the tympanum; the remainder had more extensive disease with notable posterior tympanic involvement. Three of the patients underwent surgery for recidivism; none were from isolated anterior lesions. One of these patients was referred at the time of recurrence, one had known residual cholesteatoma, and one had recurrence. CONCLUSIONS: Clinical presentation and surgical findings enable the differentiation of two separate sites of congenital cholesteatoma formation: the anterosuperior and posterior-superior regions of the tympanic cavity. Recidivism of the lesion appears more commonly with posterior-superior congenital cholesteatomas.

    Title Intraoperative Facial Nerve Monitoring: a Description of a Unique System.
    Date November 1994
    Journal The Journal of Laryngology and Otology
    Excerpt

    Intraoperative facial nerve monitoring has become an integral adjunct in facial nerve identification and preservation for patients undergoing cerebellopontine angle surgery. Since the first description of EMG monitoring of facial nerve activity intraoperatively, many systems have been developed. These systems often rely on unilateral monitoring of the facial nerve with auditory feedback to the surgeon, and it is difficult to distinguish between artifact and significant stimulation of the facial nerve. In this paper, we present the use of a bilateral, multialarm, facial nerve monitoring system that has multiple advantages over previous systems. Furthermore, we review our experience with this bilateral system, comparing a group of 50 monitored patients to a group of 50 unmonitored patients.

    Title Congenital Aural Atresia.
    Date November 1994
    Journal The Laryngoscope
    Excerpt

    Congenital aural atresia is an unusual anomaly that is difficult to surgically correct. Altered anatomical landmarks, especially of the facial nerve, and variability of the middle ear configuration, contribute to the difficulty of the procedure. In addition, the unpredictable healing process can make for variable outcomes. Choosing appropriate candidates for surgical repair minimizes risks and enhances patient care. This report reviews the outcome with evaluation and management of 17 patients with congenital aural atresia. Surgical techniques for repair, including use of a hydroxylapatite canal wall prosthesis to help reconstruct the posterior canal wall are described. As expected, patients with less severe anomalies had better postoperative hearing results. Lateralized tympanic membrane, canal stenosis, and meatal narrowing were complications encountered. The anatomy and embryology of the ear and facial nerve are reviewed to assist surgeons in safe, successful surgery.

    Title Titration Streptomycin Therapy in Menière's Disease: Current Concepts.
    Date April 1994
    Journal The American Journal of Otology
    Excerpt

    Soon after its discovery, streptomycin sulfate was found to be beneficial in the treatment of tuberculosis. However it also was found to have toxic effects, primarily vestibular and typically sparing the auditory nerve until higher doses were administered. The first reported use of streptomycin in the treatment of vertigo was in 1948. This was soon followed by its use for treating Menière's disease. Although excellent control of vertigo was achieved significant post-treatment oscillopsia was experienced by these completely ablated patients. A protocol of titration streptomycin therapy was established that effectively controls vertigo while decreasing the incidence of oscillopsia. This report presents three patients with Menière's disease treated with this protocol.

    Title Olfactory Neuroblastoma: the Results of Modern Treatment Approaches at the University of Michigan.
    Date June 1993
    Journal Head & Neck
    Excerpt

    A retrospective study was undertaken to review patterns of treatment and survival for patients with olfactory neuroblastomas at the University of Michigan since the introduction of craniofacial resection in the late 1970s. Recent results were compared to previous reports. Disease-free and overall survival for patients with Kadish stage B tumors were unchanged from prior years. Improvement in both disease-free intervals and overall survival was evident for patients with stage C tumors. Interestingly, in two patients with "unresectable" local disease, complete responses to induction chemotherapy followed by radiotherapy were noted.

    Title Branchiogenic Carcinoma.
    Date April 1993
    Journal The Journal of Otolaryngology
    Excerpt

    The validity of the diagnosis 'branchiogenic carcinoma' has been debated for many years. Recently, Micheau, et al recorded 21 cases of metastatic squamous carcinoma that presented with cystic masses in the neck and concluded that most, if not all of the reported cases of branchiogenic carcinoma, were in fact of similar origin. This report contains histological evidence of the origin of squamous cell carcinoma from a branchiogenic cyst in an otherwise healthy young man. Five similarly convincing reports from the literature are also reviewed.

    Title Cervical Metastatic Glioblastoma Multiforme.
    Date August 1992
    Journal Archives of Otolaryngology--head & Neck Surgery
    Excerpt

    Glioblastoma multiforme is an anaplastic neoplasm of glial origin. In spite of the aggressive histologic features and poor prognosis, metastasis outside the cranial vault is distinctly unusual. A patient with glioblastoma multiforme metastatic to the neck is presented. We also review the topic of metastatic intracranial tumors.

    Title Signet-ring Cell Adenocarcinoma Metastatic to the Maxillary Sinus.
    Date July 1992
    Journal Oral Surgery, Oral Medicine, and Oral Pathology
    Excerpt

    Signet-ring cell variant is a rare type of adenocarcinoma that has been reported in the paranasal sinuses and in other areas, most commonly the gastrointestinal tract. We describe a patient with signet-ring cell adenocarcinoma of the maxillary sinus who had dental and facial pain. Further evaluation revealed that the lesion was metastatic from an esophageal primary lesion. The unusual nature of this cell type and the importance of careful evaluation to exclude the possibility of these lesions representing metastatic lesions is discussed.

    Title Mucoepidermoid Carcinoma Associated with Acute Lymphoblastic Leukemia.
    Date June 1992
    Journal International Journal of Pediatric Otorhinolaryngology
    Excerpt

    As treatment and survival of acute leukemia as well as other types of pediatric cancer improve, the number of second malignancies in these treated patients will increase. Occurrence of these second malignancies in the head and neck is not frequently reported although it is known that radiation treatment, chemotherapy and sometimes the primary lesion itself are risk factors for neoplasia. Malignancies of the parotid gland in the pediatric population are known to be unusual. We discuss a mucoepidermoid carcinoma in a 10-year-old female who 7 years earlier had undergone successful treatment of acute lymphoblastic leukemia.

    Title Olfactory Neuroblastoma Associated with Kallman's Syndrome.
    Date May 1992
    Journal The Journal of Otolaryngology
    Excerpt

    Kallman's syndrome is an unusual clinical entity that includes anosmia and hypogonadotropic hypogonadism. We present a patient in whom an olfactory neuroblastoma was discovered during evaluation of his Kallman's syndrome. While other craniofacial abnormalities have been associated with this condition, to our knowledge this is the first report of its association with olfactory neuroblastoma.

    Title Evaluation of the Temporal Bones of a Multichannel Cochlear Implant Patient.
    Date January 1992
    Journal The Annals of Otology, Rhinology, and Laryngology
    Excerpt

    In this report we detail the temporal bone findings of a 57-year-old patient who underwent placement of a Nucleus 22-channel electrode 7 months prior to his death. Audiometric testing postoperatively demonstrated suprasegmental speech cue discrimination only. Histologic evaluation of the cochleas revealed significant sensorineural survival except in the region of the basal turn of the implanted cochlea adjacent to the implant. There was no significant pathologic condition attributable to the operation or the electrode in areas remote from the basal turn of the cochlea.

    Title Palatal Inclusion Cyst: an Unusual Complication of Uvulopalatopharyngoplasty.
    Date December 1991
    Journal Ear, Nose, & Throat Journal
    Excerpt

    Inclusion cyst formation after uvulopalatopharyngoplasty has not been previously reported. We describe a case of postoperative inclusion cyst in a 62-year-old man who presented with recurrent obstructive sleep apnea symptoms. Simple transoral excision of the cyst was curative. Careful eversion of the mucosal edges at the time of the original palatal surgery may have prevented this problem from occurring.

    Title Unilateral Multicentric Warthin's Tumors.
    Date July 1991
    Journal The Journal of Otolaryngology
    Excerpt

    Papillary cystadenoma lymphomatosum, or Warthin's tumor, is known to have a high rate of multicentricity. An incidence of 5-14% is suggested by the literature. We present a female patient with three discrete masses noted in the superficial lobe of the parotid gland at the time of surgical resection. The epidemiology, histology and pathophysiology of Warthin's tumor is discussed and the need for adequate surgical resection is emphasized.

    Title Primary Adenocarcinoma of the Temporal Bone. A Case with 40-year Follow-up.
    Date April 1991
    Journal Archives of Otolaryngology--head & Neck Surgery
    Excerpt

    Adenomatous tumors of the temporal bone are rare neoplasms. This article records the 40-year course of a patient with adenocarcinoma of the temporal bone and reviews the literature pertinent to the biologic behavior, histologic appearance, prognosis, and treatment of this group of tumors.

    Title Pathologic Quiz Case 2. Angiolymphoid Hyperplasia with Eosinophilia.
    Date February 1991
    Journal Archives of Otolaryngology--head & Neck Surgery
    Title Evaluation of a Silicon-substrate Modiolar Eighth Nerve Implant in a Guinea Pig.
    Date January 1991
    Journal Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-head and Neck Surgery
    Excerpt

    The availability of thin-film multichannel electrodes provides new possibilities for implantation and direct stimulation of the modiolar portion of the auditory nerve. Electrodes in direct contact with the auditory nerve should be functional at lower thresholds and might require fewer remaining neurons for stimulation compared to electrodes in the scala tympani. This strategy would also provide close contact with neural elements subserving a greater frequency range. Implantation of the eighth nerve may also be advantageous in profoundly deaf subjects who lack an implantable scala tympani. In this study we evaluated the effect of surgical implantation and chronic placement of a silicon substrate implant in the modiolar portion of the auditory nerve of the guinea pig. Of six chronically implanted ears, five showed changes limited to the loss of spiral ganglion cells in the canal of Rosenthal, immediately adjacent to the implant. The sixth ear showed more extensive cochlear alteration in a pattern suggestive of vascular injury. In separate acute experiments, implants were placed in the modiolar portion of the auditory nerve and electrophysiologic analysis was performed. Middle latency responses with good morphology were obtained at thresholds below those found with scala tympani implants. Input-output functions exhibited a plateau in response amplitude at stimulus levels below thresholds for seventh or vestibular portion of the eighth nerve. Further modifications of the modiolar portion of the auditory nerve electrode design will include development of an electrode interconnect that will allow chronic implantation with stimulation.

    Title Massive Ossifying Fibroma of the Temporal Bone.
    Date December 1990
    Journal Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-head and Neck Surgery
    Excerpt

    Ossifying fibromata are rare lesions of the temporal bone. Because the tumors tend to progress and can become clinically massive, early complete resection is advised whenever feasible to prevent clinically evident recurrences and potentially life-threatening complications.

    Title Facial Nerve Paresis As the Presenting Symptom of Leukemia.
    Date October 1990
    Journal International Journal of Pediatric Otorhinolaryngology
    Excerpt

    Leukemic involvement of the temporal bone is not uncommon and may present in a variety of ways including auricular or external canal skin lesions, red or thick tympanic membrane, middle ear effusions, otitis media, hearing loss or mastoiditis. Symptomatic facial nerve involvement, on the other hand, is extremely unusual. We discuss a pediatric patient whose sudden onset facial nerve paresis was the presenting symptom that led to her diagnosis of leukemia. At the time of mastoidectomy, a granulocytic sarcoma or chloroma was noted to be overlying the VIIth nerve.

    Title Evaluation of the Effect of Ototopical Neomycin on Spiral Ganglion Cell Density in the Guinea Pig.
    Date September 1989
    Journal Hearing Research
    Excerpt

    The development of a reproducible unilateral deafness animal model was the primary objective of this study. Because of its importance in the function of cochlear prostheses, the status of the VIIIth nerve was used as the measure of deafness. The effect of a concentrated neomycin solution applied locally to the middle ear of the guinea pig was evaluated. Spiral ganglion cell survival was quantitated at 1, 2, 4, 6 and 10 weeks after exposure. Although the intermediate time periods showed moderate inter-animal variability, by ten weeks, consistent spiral ganglion cell loss was seen with maximum cell loss at the extreme apex (18.8% of control) and base (30.3% of control) and maximum cell survival in the lower middle turns of the cochlear spiral (53% of control).

    Title Batch-fabricated Thin-film Electrodes for Stimulation of the Central Auditory System.
    Date August 1989
    Journal Ieee Transactions on Bio-medical Engineering
    Excerpt

    Silicon micromachining and thin-film technology have been employed to fabricate iridium stimulating arrays which can be used to excite discrete volumes of the central nervous system. Silicon multichannel probes with thicknesses ranging from 1 to 40 microns and arbitrary two-dimensional shapes can be fabricated using a high-yield, circuit-compatible process. Iridium stimulating sites are shown to have similar characteristics to iridium wire electrodes. Accelerated pulse testing with over 8 million 100 microA biphasic current pulses on 8000 microns 2 sites has demonstrated the long-term stability of iridium and activated iridium sites. In vivo tests have been performed in the central auditory pathways to demonstrate neural activation using the devices. These tests show a selective activation both as a function of site separation and site size.

    Title Selective Embolization of Glomus Jugulare Tumors.
    Date
    Journal Skull Base Surgery
    Excerpt

    Four patients with grade C or D(1) glomus jugulare tumors who underwent preoperative highly selective embolization followed by infratemporal fossa removal of their tumors were compared to three patients undergoing surgery alone with respect to intraoperative blood loss, operative time, cranial nerve palsy, length of hospitalization, and perioperative complications. Embolized patients demonstrated a marked reduction in blood loss (650 vs 1375 cc) compared with the nonembolized group. Operative time was shortened (by 51 minutes). Facial nerve function did not appear related to embolization but was directly related to intraoperative nerve manipulation. Hospital stay, perioperative complications, and lower cranial nerve palsies were not related to embolization.


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