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Purpose: The objective of this study was to achieve uniform reporting of complications and failures in cochlear implantation, to analyze complications and failures and to identify risk factors for complications in a series of over 1300 cochlear implantations., Methods: In a retrospective chart review and observational study, data from all cochlear implantations from 1987 to 2015 were entered in a custom-made database. Complications were classified using the contracted form of the Clavien-Dindo system and risk factors were identified by statistical analysis., Results: A complication rate of 18.4% and a device failure rate of 2.9% were found. There was a higher rate of hematoma in patients with a clotting disorder and when a subtotal petrosectomy was performed, a higher rate of wound infections in patients who were not vaccinated against Streptococcus pneumoniae and a higher rate of meningitis in patients with an inner ear malformation., Conclusions: The use of a strict definition of a medical complication and device failure-in combination with the Clavien-Dindo classification system-enables uniform and objective registration of adverse events and prevents any tendency to downgrade complications. Complication and failure rates in this series are comparable to those reported in the literature. These results stress the need for pneumococcal vaccination, which may prevent general wound infections, but is especially important for patients with inner ear malformation, who have an increased risk of (postoperative) meningitis.

Background: A thyroglossal duct cyst is the most common form of congenital anomaly in the neck. Surgical removal is very effective. However, in some cases, a cyst recurs. The purpose of this study was to identify factors that predispose to recurrence of a thyroglossal duct cyst., Methods: A retrospective study was conducted of consecutive patients who underwent surgical resection for histologically confirmed thyroglossal duct cysts between 1998 and 2013 in a tertiary referral center., Results: Two hundred seven patients were included. The overall recurrence rate was 9.7%. The most important factor predicting recurrence was the type of resection: recurrence rate was 5.3% after the Sistrunk procedure, and 55.6% after plain excision (p < .001). The only other factor that was significantly associated with chance of recurrence was postoperative infection., Conclusion: The Sistrunk procedure is the treatment of choice for thyroglossal duct cysts because it yields low recurrence and morbidity. Postoperative infections, rather than preoperative infections, are associated with recurrence., (© 2014 Wiley Periodicals, Inc.)

Hypothesis: Image quality of low-dose multi-slice computed tomography (MSCT) after cochlear implantation is comparable to that of cone-beam computed tomography (CBCT)., Background: CBCT has been described as a low-dose alternative with superior image quality to MSCT for postoperative cochlear implant (CI) imaging, but to our knowledge, no dose-matched comparisons of image quality have been published., Materials and Methods: Five human cochleae were implanted with CI electrodes and scanned on two CBCT and two MSCT systems. Four independent observers rated aspects of image quality on a five-point scale. CBCT scans were compared to clinical and dose-matched MSCT scans. Declining-dose MSCT protocols were compared to the clinical protocol. CT phantoms were used to determine effective dose and resolution for each acquisition protocol., Results: Effective dose of the CBCT protocols was 6 to 16% of the clinical MSCT dose. Visibility of cochlear inner and outer walls and overall image quality were positively correlated with radiation dose on MSCT and image quality was better with clinical MSCT than with CBCT protocols. In other comparisons, differences between systems were found, but a distinction between CBCT and MSCT could not be made., Conclusion: CBCT and dose-matched MSCT are both suitable for postoperative CI imaging. Selecting a CT system and radiation dose depends on which cochlear structures need to be visualized.

Objective: To create a system for the uniform registration and classification of complications and failures in cochlear implant surgery, and apply it to all the patients who underwent implantation in our clinic., Method: The definition of a medical complication was established, and data for all cochlear implantations performed between 1987 and 2012 were entered into a custom-made database system., Results: One or more medical complications were registered in 19.0 per cent of 1003 cochlear implantations. The incidence of 'hard failure' was 2.3 per cent. Findings revealed a decrease in device failures over the years; the rate of medical complications remained constant., Conclusion: Our database system, which is available free of charge, enables fast and accurate data entry. There were a relatively high number of (minor) complications in our series, but comparison with the relevant literature is difficult. This emphasises the need for a uniform definition of 'complication' as it relates to cochlear implant surgery, and an appropriate classification system for such complications.

Objective: We report a unique case of inflammatory myofibroblastic tumour of the posterior wall of the hypopharynx., Method: We present the patient's case history, management and histopathological findings. A literature review of all cases localised to the larynx or pharynx is provided and discussed., Results: A 67-year-old man presented with airway obstruction due to a spherical mass in the hypopharynx originating from the posterior pharyngeal wall. The tumour was resected. Histopathological examination revealed an inflammatory myofibroblastic tumour. We found only five previously reported cases with pharyngeal localisation. Further treatment of the patient is described., Conclusion: Inflammatory myofibroblastic tumour of the pharynx is extremely rare. It is regarded as a neoplastic tumour of intermediate biological potential. In cases with extrapulmonary localisation, the incidence of local recurrence can be as high as 25 per cent. Radical surgery is the treatment of choice; no adjuvant therapy is necessary.