VSO Jeopardy

Overrated

100

The level of evidence supporting microvascular decompression for treatment of tinnitus & vertigo.

What is low ?  

DOI: 10.3171/2016.8.JNS16992

DOI: 10.3171/2016.2.JNS152913

200

The incidence of AICA vascular loops in both patients with localizing symptoms and patients with no symptoms.

What is between 1/4 and 1/5 ? 

DOI: 10.1097/MAO.0000000000000279

DOI: 10.1097/00005537-199811000-00027

DOI: https://doi.org/10.3174/ajnr.A8486

300

A 2016 systematic review found this diagnostic study to have little benefit in establishing a diagnosis of otosclerosis, and recommended it only for special cases or out of legal necessity.

What is a CT scan?

DOI: 10.1097/MAO.0000000000000924

Scandalous

200

The incidence of unmasking vestibular symptoms after stapedotomy in a person with otosclerosis and radiographic semicircular canal dehiscence.

What is 10-33% ?

DOI: 10.1097/MAO.0000000000002897 

DOI: 10.1097/MAO.0000000000003429

    

Hearing Loss

100

A 2022 meta-analysis found that the osteotome technique for exostosis surgery was associated with higher overall risk of tympanic membrane perforation, while drill canaloplasty was associated with 3-4% increased risk of stenosis and this complication.

What is sensorineural hearing loss?

DOI: 10.1177/00034894221147804

200

Ear pain and hearing loss can occur after pulling one's finger or a tight-fitting plug from the ear canal, typically caused by fractures of this ossicle. 

What is the malleus? 

DOI: 10.1002/lary.30962

300

Gene and cell-based approaches are transforming auditory regenerative medicine, with clinical validation of adeno-associated virus-mediated restoration of hearing after replacement of this single gene, which causes autosomal-recessive deafness 9 (DFNB9).

What is OTOFERLIN (OTOF) ? 

DOI: 10.1007/s00405-025-09957-x

DOI: 10.1002/advs.202306788

Meniere's

200

Comparative studies of surgical exposure with or without incision, and steroid application to this inner ear structure have found conflicting results.

What is the endolymphatic sac?

DOI: 10.1016/j.amjoto.2017.01.023

DOI: 10.1097/MAO.0000000000001810

300

A long-term (48 month) followup of subjects from a randomized, double-blinded comparative effectiveness trial of intratympanic gentamicin (40 mg/mL) versus methylprednisolone (62.5 mg/mL) found this drug to have superior vertigo control in subjects with medically-refractory Meniere's disease.

What is neither of the two ?

DOI: 10.1097/MAO.0000000000002108

DOI: 10.1016/S0140-6736(16)31461-1

(extra; DOI: 10.1007/s12070-024-04749-x)

VS

300

A 2024 systematic review found this number needed to treat (NNT) for vestibular schwannomas to benefit from radiosurgery, by comparing 10-year tumor control outcomes to untreated patients.

What is 4 (95% CI: 3.619-4.210).

The number was the same for vestibular schwannomas with documented linear growth prior to treatment: NNT= 4 (3.395, 95% CI: 2.966-3.968), with an absolute risk reduction of 29.4%.

DOI:  10.1093/noajnl/vdae191

400

This commonly prescribed antihyperglycemic agent with various pharamacologic effects may reduce the growth of vestibular schwannomas. 

What is metformin ? 

DOI: 10.1002/lary.30601