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In addition to one of the neurotologists, 2 neurologists (one specializing in migraine and the other a neuro\u2010ophthalmologist), and a psychologist clinician\u2010investigator completed comprehensive evaluations. Neuropsychology test batteries included: the Millon Behavioral Medicine Diagnostic; Patient Health Questionnaire (PHQ\u20109) and Generalized Anxiety Disorder Screener (GAD\u20107); Adverse Childhood Experiences Scale; the Wide Range Assessment of Memory and Learning, including the 3 domains of verbal memory, visual memory, and attention\/concentration; Wechsler Adult Intelligence Scale; and the Delis\u2010Kaplan Executive Function System. The control cohort was comprised of 17 participants who previously underwent surgery for third window syndrome that resulted in the expected outcomes of resolution of their third window syndrome symptoms and cognitive dysfunction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was a high rate of psychological comorbidity (n\u2009=\u20096) in the outlier cohort; multiple traumatic brain injuries were also a confounding element (n\u2009=\u200910). One patient had elevated cerebrospinal fluid (CSF) pressure requiring ventriculoperitoneal shunting to control the recurrence of dehiscence and one patient with a drug\u2010induced Parkinson\u2010like syndrome and idiopathic progressive neurological degenerative process.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Components of the Millon Behavioral Medicine Diagnostic, PHQ\u20109 and GAD\u20107 results suggest that these instruments would be useful as screening tools preoperatively to identify psychological comorbidities that could confound outcomes. The identification of these comorbid psychological as well as other neurological degenerative disease processes led to alternate clinical management pathways for these patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>2b.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lio2.89","type":"journal-article","created":{"date-parts":[[2017,8,22]],"date-time":"2017-08-22T05:58:54Z","timestamp":1503381534000},"page":"225-253","source":"Crossref","is-referenced-by-count":17,"title":["Comorbidities confounding the outcomes of surgery for third window syndrome: Outlier analysis"],"prefix":"10.1002","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2904-5072","authenticated-orcid":false,"given":"P. 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