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Chapter 24. Tumors of the Temporal Bone
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A 54-year-old woman presents with a 3-year history of progressive facial paralysis which has been complete for 18 months. A preoperative CT demonstrates a partially calcified 13-mm lesion centered in the geniculate ganglion abutting the descending basal cochlear turn. Preoperative audiometry shows normal hearing bilaterally. What is the preferred treatment modality for this patient?
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A. Continued observation with yearly MRI
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B. Subtotal excision with facial nerve preservation as intraoperative supramaximal labyrinthine facial nerve stimulation was absent
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C. Middle fossa approach with gross total excision with nerve grafting from labyrinthine to tympanic segment
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D. Mastoid approach with gross total excision with nerve grafting from intracanalicular to tympanic facial nerve
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Which of the following is correct regarding SDHA related head and neck paragangliomas?
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A. Higher incidence in vagal paraganglioma
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B. Low risk of pheochromocytoma
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C. High risk for multiple head and neck paraganglioma
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A 50-year-old woman presents with right profound hearing loss and episodic vertigo. MRI demonstrates a heterogeneously enhancing mass centered on the mid portion of the posterior fossa dura adjacent to the posterior semicircular canal. A CT shows irregular bone erosion that involves both the posterior and lateral semicircular canal. What is the best approach for obtaining a gross total excision of the tumor?
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A. Retrolabyrinthine transdural approach
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C. Infratemporal fossa approach with posterior re-routing of the facial nerve and overclosure of the ear canal
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D. Translabyrinthine approach
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What lesion in the IAC is hyperintense on a T1-weighted MRI without gadolinium contrast?
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What is an audiologic characteristic of a retrocochlear lesion?
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D. Preservation of speech discrimination scores