Journal of Otology最新文献

Objective

To determine whether cervical ultrasonography, magnetic resonance imaging (MRI), and magnetic resonance angiography (MRA) are useful in the differential diagnosis of etiology and understanding the pathophysiology in cases of apogeotropic direction-changing positional nystagmus (DCPN).

Methods

Thirty patients with apogeotropic DCPN were classified into 11 cases of central disease, seven cases of mixed central and peripheral disease, and 12 cases of peripheral disease by differential diagnosis based on various balance function, neuro-otological, and imaging tests.

Cervical ultrasonography using the cervical rotation method and MRI and MRA of the head and neck were performed in most patients with apogeotropic DCPN. We reviewed the presence of abnormal imaging findings according to the disease etiology.

Results

Of the 30 patients with apogeotropic DCPN, 23 showed vascular abnormalities or central lesions on imaging. Vascular lesions were found in six of the 12 patients with peripheral disease. Cervical ultrasonography with cervical rotation detected blood flow disturbance in the vertebral artery in eight patients in whom the disturbance could not be detected by MRI or MRA of the head and neck.

Discussion

We hypothesize that the causative disease of apogeotropic DCPN may be strongly associated with circulatory insufficiency of the vertebrobasilar and carotid arteries, and that impaired blood flow in these vessels may affect peripheral vestibular and central function. In patients with apogeotropic DCPN, examinations of vestibular function, central nervous system symptoms, and brain hemodynamics are valuable for differential diagnosis.

Purpose

Meniere's disease (MD), first introduced by Prosper Meniere, is characterized mainly by vertigo, tinnitus, aural fullness and sensorineural hearing loss. Though the exact pathophysiology of MD is unknown, immunologic and inflammatory interactions are possible underlying mechanisms involved in MD. This study is aimed to investigate the immunomodulatory and anti-inflammatory effect of Nigella sativa on MD as a therapeutic agent.

Methods

We divided 40 patients with definite MD into two groups of 20 cases. The study group received 1 g of Nigella sativa oil daily for three months and the control group received a placebo. Changes in hearing, tinnitus and vertigo were estimated by pure tone audiometry, tinnitus handicap inventory questionnaire and dizziness handicap inventory questionnaire, respectively.

Results

At the end of the study we did not observe any significant improvement in study's group hearing threshold, tinnitus and vertigo compared to the control group.

Conclusions

In this study, statistical analysis showed that Nigella sativa failed to improve signs and symptoms of MD. However, further investigations with a larger study population are needed to ascertain the current conclusion.

Background

The assessment and management of misophonia need a team approach, and audiologists are essential team members. However, the role of an audiologist in this condition is not well understood, and there is a lack of awareness even among professionals about their role in the assessment and management of misophonia.

Purpose

The main aim of our study is to document the present level of awareness and knowledge about misophonia assessment and management among audiologists in India.

Methods

A descriptive cross-sectional study was carried out among audiologists from all over India. Descriptive statistical procedures were measured based on the type of questions being addressed, and a non-parametric chi-square test was done to see the association among variables.

Results

The results show a lack of knowledge about misophonia even among audiologists, as only 15.3% of the audiologist reported being confident in handling cases with misophonia.

Conclusion

Although the exact assessment and management of misophonia is still the topic of debate, it is clear that audiologists are the team's key members. However, the results clearly show a lack of confidence in handling cases of misophonia among audiologists in India. This result shows the future need for Research in misophonia from an audiological perspective.

Intralabyrinthine schwannomas (ILS) are rare benign tumors, often responsible for hearing loss. MRI is important in establishing the diagnosis. We present the example of a 48-year-old lady who reported a 3-years history of right-sided sensorineural deafness. MRI demonstrated a loss of the normal hypersignal of the second turn of the right cochlea compatible with intracochlear schwannoma.

Background

Subjective measures of auditory development are equally important as objective measures to obtain a realistic image of the hearing status in infants and toddlers.

Objectives

The objectives of the current study were to translate and validate the LittleEARS questionnaire into the Hindi language, to calculate its psychometric properties and establish a regression curve of the scores obtained as a function of age, to calculate the inter-test and test retest reliability of the same. The secondary objectives were to compare the scores obtained by the normal hearing children and those with hearing impairment and to plot a regression curve of total scores obtained by the hearing-impaired children as a function of the duration of auditory training attended since their first fit of the device.

Materials and methods

The procedures involved conventional translation, reverse translation, and content validation before administering the questionnaire. The translated version was administered to parents of 59 children with normal hearing and 41 children with hearing impairment.

Results

The finalized version had good reliability and efficient internal consistency with a Cronbach alpha value of 0.96. The mean scores obtained by the normal hearing children showed a progressive pattern as a function of age.

Conclusion

The LittleEARS questionnaire has been successfully translated and validated into the Hindi language with excellent validity and reliability and can be used for screening and early identification of hearing impairment and in evaluating the outcome of audiological treatment approaches.

Background

Saccades are often observed on video head impulse tests (vHIT) in patients with Meniere's Disease (MD) and Vestibular Migraine (VM). However, their saccadic features are not fully described.

Objective

This study aims to identify the saccades characteristics of MD and VM.

Methods

75 VM patients and 103 definite unilateral MD patients were enrolled in this study. First raw saccades were exported and analyzed. The VM patients were divided into left and right based on their ears, while the MD patients were separated into affected and unaffected subgroups based on their audiograms and symptoms.

Results

The MD patients have more saccades on the affected side (85% vs. 69%), and saccade velocity is more consistent than the contralateral side (shown by the coefficient of variation). The saccades occurrence rates on both sides are similar in VM (77% vs. 76%), as are other saccadic parameters. The MD patients have more significant inter-aural differences than the VM patients, manifested in higher velocity (p-value 0.000), earlier arriving (p-value 0.010), and more time-domain gathered (p-value 0.003) on the affected side.

Conclusions

Bilateral saccades are commonly observed in MD and VM. In contrast to MD, saccades on VM are subtle, scattered, and late-arrived. Furthermore, the MD patients showed inconsistent saccadic distribution with more velocity-uniform saccades on the affected side.

Objective

We describe the first-year implementation experience of an Instrumented Sensory Integration Therapy Program in Audiological & Balance Center patients.

Design

This is a retrospective descriptive study. Participants included Seventy-three adults with diagnoses of acute, episodic, or chronic vestibular syndromes. They were classified into the following two groups: group 1 included 46 individuals treated with ISIT plus VRT, and group 2 included 27 individuals treated only with ISIT.

Results

The Sensory Organization Test (SOT) for both groups showed a statistical significance for all three sensory inputs; visual systems (G1: p = 0.0003; G2: p = 0.0337), vestibular system (G1: p < 0.0001; G2: p = 0.0003), and balance as demonstrated by compound balance score (G1: p < 0.0001; G2: p = 0.0035), and balance percentage deficit (G1: p < 0.0001; G2: p = 0.0078).

Conclusions

The severity and complexity of functional neurological disorders in the context of vestibular syndromes seem to require between 10 and 20 therapy sessions, and combined ISIT plus VRT appears to be more effective than ISIT as a monotherapy.

Background

Classic dichotic listening tests using speech stimuli result in right ear advantage, due to the dominant crossed pathway for speech and language. It is presumed that similar crossed dominance could exist for non-speech stimuli too. Hence, this is an attempt to develop and validate the dichotic non-speech test using environmental stimuli and explore the effect of focused attention on this test.

Materials and method

Three lists of dichotic stimuli were created using these sounds with fifteen tokens in each list. Four professionals and non-professionals validated these materials. Normative estimation was obtained by administering the newly developed test on 70 adults and 70 children using a free-recall and forced-recall condition.

Result

The results showed a significant difference between the left ear and right scores where the left ear score was better than the right, depicting left ear advantage (LEA) for free recall condition in both groups. In the forced recall condition, LEA was not seen; rather the mean score was significantly higher in the attended ear, irrespective of the stimuli presented to the right or left ear. The test-retest reliability in free recall was good in both the ears and moderate for forced right ear conditions.

Conclusion

The novel test consistently showed LEA with good reliability and can be used to assess the hemispheric asymmetry in normal subjects and also in test batteries for the clinical population.

Objective

It remains unknown whether calcium metabolism has any effect on the clinical presentation of superior semicircular canal dehiscence (SSCD). Our aim was to analyse the adjusted calcium and vitamin D levels in SSCD patients compared to a control group.

Methods

This was a prospective case-control study performed in a tertiary referral center, university teaching hospital in the UK. It included all new patients with SSCD seen in a dedicated skull base clinic over a 5-year period (2015–2019) compared to a gender and age matched control group. The main outcome of the study was adjusted calcium and Vitamin D levels between the two groups.

Results

A total of 31 SSCD patients were recruited with a matched number of control patients. The mean Vitamin D level on the SSCD group was 44.8 nmoL/l (SD: 20.8) compared to 47.5 nmoL/l (SD: 27.4) on the control group (p = 0.702). Mean Adjusted calcium level was 2.34 mmoL/l (SD: 0.7) for SSCD compared to 2.41 mmoL/l (SD: 0.11) for controls (p = 0.01), being within normal limits for both the SSCD and the control group.

Conclusion

Our study did not identify a link between Vitamin D levels and presence of SSCD. Normal adjusted calcium values were found in both groups. Despite that a statistically significant lower calcium level was found in the SSCD group which could indicate that suboptimal levels of calcium may affect the micro-environment of the otic capsule at the SSC region.