Background and Objectives: The widespread use of mobile phones and personal listening devices (PLDs) poses potential health risks, particularly noise-induced hearing loss. Among younger generations, high-volume PLD use is associated with auditory and vestibular system changes. Clinical vestibular testing, including vestibular-evoked myogenic potentials (VEMP) and the video head impulse test (vHIT), may reveal peripheral vestibular impacts from prolonged PLD exposure at volumes over 60%. This study examines VEMP and vHIT results in individuals with normal hearing who have had extended high-volume PLD exposure. Subjects and Methods: A cross-sectional comparative study was conducted on individuals aged 15-24 years. All the participants had normal pure tone thresholds with “A” type tympanogram, present acoustic reflexes, and history of PLD usage. Participants were divided into groups according to PLD exposure of <1 year (group A), 1.1-2 years (group B), 2.1-3 years (group C), and 3.1-4 years (group D). The output sound pressure level (dB SPL) near the tympanic membrane was measured. Furthermore, cervical VEMP, ocular VEMP, and vHIT were assessed. Results: The VEMP and vHIT findings were statistically analyzed and compared across groups. The peak-to-peak amplitudes of VEMP showed a statistically significant difference between groups A and D. Conclusions Potential subclinical damage to the otolith organs can be associated with increased PLD exposure. No damage to the semi-circular canals was observed as the participants used lower dBA values by the PLDs.

Background and Objectives: The widespread use of mobile phones and personal listening devices (PLDs) poses potential health risks, particularly noise-induced hearing loss. Among younger generations, high-volume PLD use is associated with auditory and vestibular system changes. Clinical vestibular testing, including vestibular-evoked myogenic potentials (VEMP) and the video head impulse test (vHIT), may reveal peripheral vestibular impacts from prolonged PLD exposure at volumes over 60%. This study examines VEMP and vHIT results in individuals with normal hearing who have had extended high-volume PLD exposure. Subjects and Methods: A cross-sectional comparative study was conducted on individuals aged 15-24 years. All the participants had normal pure tone thresholds with “A” type tympanogram, present acoustic reflexes, and history of PLD usage. Participants were divided into groups according to PLD exposure of <1 year (group A), 1.1-2 years (group B), 2.1-3 years (group C), and 3.1-4 years (group D). The output sound pressure level (dB SPL) near the tympanic membrane was measured. Furthermore, cervical VEMP, ocular VEMP, and vHIT were assessed. Results: The VEMP and vHIT findings were statistically analyzed and compared across groups. The peak-to-peak amplitudes of VEMP showed a statistically significant difference between groups A and D. Conclusions Potential subclinical damage to the otolith organs can be associated with increased PLD exposure. No damage to the semi-circular canals was observed as the participants used lower dBA values by the PLDs.

Background and Objectives: The widespread use of mobile phones and personal listening devices (PLDs) poses potential health risks, particularly noise-induced hearing loss. Among younger generations, high-volume PLD use is associated with auditory and vestibular system changes. Clinical vestibular testing, including vestibular-evoked myogenic potentials (VEMP) and the video head impulse test (vHIT), may reveal peripheral vestibular impacts from prolonged PLD exposure at volumes over 60%. This study examines VEMP and vHIT results in individuals with normal hearing who have had extended high-volume PLD exposure. Subjects and Methods: A cross-sectional comparative study was conducted on individuals aged 15-24 years. All the participants had normal pure tone thresholds with “A” type tympanogram, present acoustic reflexes, and history of PLD usage. Participants were divided into groups according to PLD exposure of <1 year (group A), 1.1-2 years (group B), 2.1-3 years (group C), and 3.1-4 years (group D). The output sound pressure level (dB SPL) near the tympanic membrane was measured. Furthermore, cervical VEMP, ocular VEMP, and vHIT were assessed. Results: The VEMP and vHIT findings were statistically analyzed and compared across groups. The peak-to-peak amplitudes of VEMP showed a statistically significant difference between groups A and D. Conclusions Potential subclinical damage to the otolith organs can be associated with increased PLD exposure. No damage to the semi-circular canals was observed as the participants used lower dBA values by the PLDs.

Renal angiomyolipomas, benign tumors composed of blood vessels, adipose tissue, and smooth muscle, affect approximately 70% to 80% of patients with tuberous sclerosis. Angiomyolipomas smaller than 4 cm are usually asymptomatic, whereas larger ones can cause lumbar pain, anemia, and hematuria. Contrary to its sporadic counterparts, tuberous sclerosis-associated angiomyolipomas often present at a young age, are multicentric and large, and carry a higher risk of life-threatening hemorrhage. Therapeutic strategies include selective tumor embolization, nephrectomy for severe cases, and medical treatment such as everolimus. Despite a correlation between tuberous sclerosis and renal angiomyolipomas and their described high complication rates in literature, disease awareness in clinical practice remains low. This case series describes the management and outcomes of three patients with tuberous sclerosis-associated renal angiomyolipomas treated with selective arterial embolization.

Renal angiomyolipomas, benign tumors composed of blood vessels, adipose tissue, and smooth muscle, affect approximately 70% to 80% of patients with tuberous sclerosis. Angiomyolipomas smaller than 4 cm are usually asymptomatic, whereas larger ones can cause lumbar pain, anemia, and hematuria. Contrary to its sporadic counterparts, tuberous sclerosis-associated angiomyolipomas often present at a young age, are multicentric and large, and carry a higher risk of life-threatening hemorrhage. Therapeutic strategies include selective tumor embolization, nephrectomy for severe cases, and medical treatment such as everolimus. Despite a correlation between tuberous sclerosis and renal angiomyolipomas and their described high complication rates in literature, disease awareness in clinical practice remains low. This case series describes the management and outcomes of three patients with tuberous sclerosis-associated renal angiomyolipomas treated with selective arterial embolization.

Renal angiomyolipomas, benign tumors composed of blood vessels, adipose tissue, and smooth muscle, affect approximately 70% to 80% of patients with tuberous sclerosis. Angiomyolipomas smaller than 4 cm are usually asymptomatic, whereas larger ones can cause lumbar pain, anemia, and hematuria. Contrary to its sporadic counterparts, tuberous sclerosis-associated angiomyolipomas often present at a young age, are multicentric and large, and carry a higher risk of life-threatening hemorrhage. Therapeutic strategies include selective tumor embolization, nephrectomy for severe cases, and medical treatment such as everolimus. Despite a correlation between tuberous sclerosis and renal angiomyolipomas and their described high complication rates in literature, disease awareness in clinical practice remains low. This case series describes the management and outcomes of three patients with tuberous sclerosis-associated renal angiomyolipomas treated with selective arterial embolization.

Renal angiomyolipomas, benign tumors composed of blood vessels, adipose tissue, and smooth muscle, affect approximately 70% to 80% of patients with tuberous sclerosis. Angiomyolipomas smaller than 4 cm are usually asymptomatic, whereas larger ones can cause lumbar pain, anemia, and hematuria. Contrary to its sporadic counterparts, tuberous sclerosis-associated angiomyolipomas often present at a young age, are multicentric and large, and carry a higher risk of life-threatening hemorrhage. Therapeutic strategies include selective tumor embolization, nephrectomy for severe cases, and medical treatment such as everolimus. Despite a correlation between tuberous sclerosis and renal angiomyolipomas and their described high complication rates in literature, disease awareness in clinical practice remains low. This case series describes the management and outcomes of three patients with tuberous sclerosis-associated renal angiomyolipomas treated with selective arterial embolization.

Renal angiomyolipomas, benign tumors composed of blood vessels, adipose tissue, and smooth muscle, affect approximately 70% to 80% of patients with tuberous sclerosis. Angiomyolipomas smaller than 4 cm are usually asymptomatic, whereas larger ones can cause lumbar pain, anemia, and hematuria. Contrary to its sporadic counterparts, tuberous sclerosis-associated angiomyolipomas often present at a young age, are multicentric and large, and carry a higher risk of life-threatening hemorrhage. Therapeutic strategies include selective tumor embolization, nephrectomy for severe cases, and medical treatment such as everolimus. Despite a correlation between tuberous sclerosis and renal angiomyolipomas and their described high complication rates in literature, disease awareness in clinical practice remains low. This case series describes the management and outcomes of three patients with tuberous sclerosis-associated renal angiomyolipomas treated with selective arterial embolization.

Isolated posterior communicating artery (PCoA) aneurysms are rare, predominantly fusiform in morphology, and rarely present with subarachnoid hemorrhage. Endovascular management of this pathology is technically challenging due to extreme tortuosity, the artery course in the subarachnoid space, sharp angulations at PCoA junctions with the parent artery, and, at times, associations with either internal carotid artery or basilar artery occlusions. We present a case of a ruptured fusiform PCoA at the junction of middle and distal third with concomitant proximal basilar artery occlusion. The PCoA reforms the posterior circulation, making it a vital artery. Stent-assisted coiling was performed with extreme difficulty in achieving distal positioning of the stents in the basilar artery/posterior cerebral artery/distal PCoA due to artery tortuosity. There was technical difficulty in the stent deployment. After changing strategies to a larger diameter laser-cut stent, endovascular treatment could be performed. There were good angiographic and clinical outcomes with stable occlusion at 6-month-follow-up.

Purpose: Choledochal cysts are congenital anomalies that occur as localized cystic or fusiform dilatations of the biliary tree. Reflux and stasis of pancreatic enzymes in the biliary duct may relate to the development of intestinal metaplasia which might be an important factor related to the carcinogenesis of choledochal cyst, thus the expression of beta-catenin in the metaplastic epithelium might be associated with malignant transformation of choledochal cyst epithelium. Methods: This study was conducted at a tertiary care pediatric center between October 2014 and March 2017. Forty patients were evaluated for epithelial lining, mural ulceration, fibrosis, inflammation, and metaplasia. Results: Out of 40, 12 cases (30.0%) were the infantile age group and 28 cases (70.0%) were in the classic pediatric group. Ulceration was classified as grade 0 (14 cases, 35.0%), grade 1 (17 cases, 42.5%), or grade 2 (nine cases, 22.5%). Inflammation was classified as grade 0 (2 cases, 5.0%), grade 1 (26 cases, 65.0%), or grade 2 (12 cases, 30.0%). Fibrosis was classified as grade 0 (five cases, 12.5%), grade 1 (11 cases, 27.5%), grade 2 (17 cases, 42.5%), or grade 3 (seven cases, 17.5%). Metaplasia was noted in five (12.5%) out of 40 cases. All choledochal cysts with metaplasia showed beta-catenin nuclear positivity on immunohistochemistry and were followed up. Conclusion This study emphasizes the importance of detailed histopathological examination and documentation of metaplastic changes. Metaplasia was associated with beta-catenin nuclear positivity. These findings suggest a potential role for beta-catenin as a marker of metaplastic changes in choledochal cysts.