Pub Date : 2011-05-19DOI: 10.3109/1651386X.2011.580584
N. Kamal, H. Taha, E. Galal
Abstract Background: Laboratory vestibular tests are relatively expensive and may be not available in every clinic. On the other hand, office vestibular tests can be easily performed and are low-cost. Objectives: To measure the sensitivity of a proposed battery approach to be conducted as an office procedure to diagnose side and site of vestibular lesions. Methods: This study was conducted on 36 patients suffering from vertigo with a confirmed diagnosis of vestibular disorder by laboratory vestibular tests. These included a standard video nystagmography (VNG) test that entails recording of eye examination including gaze testing, saccadic eye movements and smooth pursuit together with positional and positioning examinations as well as bithermal calorics and Vestibular Evoked Myogenic Potential (VEMP) tests. Patients were evaluated independently by history, examination of eye movements and a battery of office vestibular tests that included the Head Shake nystagmus Test (HST), Head Thrust Test (HTT) and Fukuda Stepping Test as well as the Dix-Hallpike test. Audiological, radiological and laboratory tests were applied to establish aetiological diagnosis whenever indicated. Results and conclusions: One patient showed abnormal eye movements that were confirmed by full diagnostic work-up for vestibular disorders in keeping with a diagnosis of multiple sclerosis, and was excluded from forthcoming analysis. Sensitivity of the HST test with respect to results of the laboratory vestibular tests (VNG and VEMP) was 51.5% while that of HTT was 43%. Moreover, the Fukuda Stepping Test showed a sensitivity of 48.5% with non-significant correlation to the side of caloric weakness and a significant correlation to the side of abnormal VEMP response. The proposed battery of office vestibular tests proved to be a quick screening approach that was successful in helping to identify site and side of peripheral vestibular lesions in 77% of patients. On the other hand, normal office vestibular tests were obtained in patients with laboratory findings showing mild caloric weakness or with only an abnormal VEMP.
{"title":"Office vestibular tests: A battery approach to guide the diagnosis of dizzy patients","authors":"N. Kamal, H. Taha, E. Galal","doi":"10.3109/1651386X.2011.580584","DOIUrl":"https://doi.org/10.3109/1651386X.2011.580584","url":null,"abstract":"Abstract Background: Laboratory vestibular tests are relatively expensive and may be not available in every clinic. On the other hand, office vestibular tests can be easily performed and are low-cost. Objectives: To measure the sensitivity of a proposed battery approach to be conducted as an office procedure to diagnose side and site of vestibular lesions. Methods: This study was conducted on 36 patients suffering from vertigo with a confirmed diagnosis of vestibular disorder by laboratory vestibular tests. These included a standard video nystagmography (VNG) test that entails recording of eye examination including gaze testing, saccadic eye movements and smooth pursuit together with positional and positioning examinations as well as bithermal calorics and Vestibular Evoked Myogenic Potential (VEMP) tests. Patients were evaluated independently by history, examination of eye movements and a battery of office vestibular tests that included the Head Shake nystagmus Test (HST), Head Thrust Test (HTT) and Fukuda Stepping Test as well as the Dix-Hallpike test. Audiological, radiological and laboratory tests were applied to establish aetiological diagnosis whenever indicated. Results and conclusions: One patient showed abnormal eye movements that were confirmed by full diagnostic work-up for vestibular disorders in keeping with a diagnosis of multiple sclerosis, and was excluded from forthcoming analysis. Sensitivity of the HST test with respect to results of the laboratory vestibular tests (VNG and VEMP) was 51.5% while that of HTT was 43%. Moreover, the Fukuda Stepping Test showed a sensitivity of 48.5% with non-significant correlation to the side of caloric weakness and a significant correlation to the side of abnormal VEMP response. The proposed battery of office vestibular tests proved to be a quick screening approach that was successful in helping to identify site and side of peripheral vestibular lesions in 77% of patients. On the other hand, normal office vestibular tests were obtained in patients with laboratory findings showing mild caloric weakness or with only an abnormal VEMP.","PeriodicalId":88223,"journal":{"name":"Audiological medicine","volume":"9 1","pages":"79 - 84"},"PeriodicalIF":0.0,"publicationDate":"2011-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77300597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-05-19DOI: 10.3109/1651386X.2011.558688
Natalie Corless, B. Bardsley
Abstract Background: Bilateral vestibular hypofunction (BVH) is a disabling condition that may result in disequilibrium due to a diminished vestibulo-ocular reflex (VOR). For the majority of cases, the cause is unknown. Objective: The aim of this review paper is to evaluate all the current literature in order to consider whether or not vestibular rehabilitation (VR) is an efficient treatment for patients with BVH. The introduction of balance prostheses will also be considered as a suitable yet alternative treatment to VR for this patient group. Type of review: A narrative review was conducted of the publications relating to treatment of patients with BVH. Online databases: PubMed, Science Direct, and Web of Knowledge were used, supplemented by key words to identify literature published after 2000. Conclusion: This review concluded that VR is a useful treatment method for patients with BVH. However, further research is needed to investigate factors that influence success, such as the patient's clinical presentation, age, or compliance with the programme. The use of balance prosthesis is a developing field and, to date, positive outcomes in reducing postural sway in BVH patients have been documented. There are several disadvantages to this method of treatment; therefore, further developments are needed in the design of the sensory devices before they can be fully considered as an alternative treatment to VR.
背景:双侧前庭功能减退(BVH)是一种由于前庭-眼反射(VOR)减弱而导致不平衡的致残性疾病。对于大多数病例，病因不明。目的:本综述的目的是评估所有现有文献，以考虑前庭康复(VR)是否为BVH患者的有效治疗方法。平衡假体的引入也将被认为是一种合适的替代VR治疗的患者群体。综述类型:对与BVH患者治疗相关的出版物进行叙述性综述。利用PubMed、Science Direct和Web of Knowledge等在线数据库，辅以关键词对2000年以后发表的文献进行检索。结论:VR是治疗BVH的有效方法。然而，需要进一步的研究来调查影响成功的因素，如患者的临床表现、年龄或对该计划的依从性。平衡假体的使用是一个发展中的领域，迄今为止，BVH患者减少体位摇摆的积极结果已被记录。这种治疗方法有几个缺点;因此，感官设备的设计还需要进一步发展，才能被充分考虑作为VR的替代治疗方法。
{"title":"What is the most effective rehabilitation approach for patients with bilateral vestibular hypofunction?","authors":"Natalie Corless, B. Bardsley","doi":"10.3109/1651386X.2011.558688","DOIUrl":"https://doi.org/10.3109/1651386X.2011.558688","url":null,"abstract":"Abstract Background: Bilateral vestibular hypofunction (BVH) is a disabling condition that may result in disequilibrium due to a diminished vestibulo-ocular reflex (VOR). For the majority of cases, the cause is unknown. Objective: The aim of this review paper is to evaluate all the current literature in order to consider whether or not vestibular rehabilitation (VR) is an efficient treatment for patients with BVH. The introduction of balance prostheses will also be considered as a suitable yet alternative treatment to VR for this patient group. Type of review: A narrative review was conducted of the publications relating to treatment of patients with BVH. Online databases: PubMed, Science Direct, and Web of Knowledge were used, supplemented by key words to identify literature published after 2000. Conclusion: This review concluded that VR is a useful treatment method for patients with BVH. However, further research is needed to investigate factors that influence success, such as the patient's clinical presentation, age, or compliance with the programme. The use of balance prosthesis is a developing field and, to date, positive outcomes in reducing postural sway in BVH patients have been documented. There are several disadvantages to this method of treatment; therefore, further developments are needed in the design of the sensory devices before they can be fully considered as an alternative treatment to VR.","PeriodicalId":88223,"journal":{"name":"Audiological medicine","volume":"2 1","pages":"52 - 58"},"PeriodicalIF":0.0,"publicationDate":"2011-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78999181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-05-19DOI: 10.3109/1651386X.2011.570914
G. Andersson, Anita Keshishi, D. Baguley
Abstract Objective: Tinnitus is a common problem among persons with hearing loss and consequently also among hearing aid users. The aims of this study were 1) to assess the proportion of hearing aid recipients reporting tinnitus; 2) to investigate hearing aid benefit among hearing aid users with or without tinnitus; and 3) to assess the association between tinnitus distress and hearing aid benefit. Study design: This was a cross-sectional design with individuals who had been fitted with hearing aids one year earlier. A total of 160 individuals were approached and 85 returned the questionnaires. The main outcome measures were Swedish translations of the Abbreviated Profile of Hearing Aid Benefit (APHAB; Cox & Alexander, 1995) and the Tinnitus Handicap Inventory (Newman et al., 1996). Results: A total of 85 hearing aid users (mean age 67.4 years) participated, and of those 61% (52/85) reported tinnitus. Tinnitus patients reported more problems on the APHAB subscales Background Noise without a hearing aid, aversiveness with hearing aid, and less benefit from the hearing aid in aversive situations. Tinnitus distress was associated with less benefit on the APHAB subscales dealing with the aversiveness of sound and hearing in background noise. Conclusion: Tinnitus patients with hearing aids report slightly less benefit and more problems with their hearing aids, in particular in relation to background sounds and aversiveness of sounds.
摘要目的:耳鸣是听力损失人群和助听器使用者普遍存在的问题。本研究的目的是:1)评估助听器佩戴者报告耳鸣的比例;2)调查有无耳鸣的助听器使用者的助听器效益;3)评估耳鸣窘迫与助听器效益之间的关系。研究设计:这是一个横断面设计，研究对象是一年前安装助听器的个体。总共接触了160人，其中85人归还了问卷。主要的结局指标是瑞典语翻译的助听器获益简要概况(APHAB;Cox & Alexander, 1995)和耳鸣障碍量表(Newman et al, 1996)。结果:共有85名助听器使用者(平均年龄67.4岁)参与，其中61%(52/85)报告耳鸣。耳鸣患者在APHAB亚量表中报告了更多的问题，包括不带助听器的背景噪音，带助听器的厌恶，以及在厌恶的情况下助听器带来的好处较少。耳鸣窘迫与APHAB亚量表中处理声音厌恶和背景噪音听力的获益较少相关。结论:配戴助听器的耳鸣患者的受益程度略低，助听器的问题较多，特别是背景音和声音厌恶。
{"title":"Benefit from hearing aids in users with and without tinnitus","authors":"G. Andersson, Anita Keshishi, D. Baguley","doi":"10.3109/1651386X.2011.570914","DOIUrl":"https://doi.org/10.3109/1651386X.2011.570914","url":null,"abstract":"Abstract Objective: Tinnitus is a common problem among persons with hearing loss and consequently also among hearing aid users. The aims of this study were 1) to assess the proportion of hearing aid recipients reporting tinnitus; 2) to investigate hearing aid benefit among hearing aid users with or without tinnitus; and 3) to assess the association between tinnitus distress and hearing aid benefit. Study design: This was a cross-sectional design with individuals who had been fitted with hearing aids one year earlier. A total of 160 individuals were approached and 85 returned the questionnaires. The main outcome measures were Swedish translations of the Abbreviated Profile of Hearing Aid Benefit (APHAB; Cox & Alexander, 1995) and the Tinnitus Handicap Inventory (Newman et al., 1996). Results: A total of 85 hearing aid users (mean age 67.4 years) participated, and of those 61% (52/85) reported tinnitus. Tinnitus patients reported more problems on the APHAB subscales Background Noise without a hearing aid, aversiveness with hearing aid, and less benefit from the hearing aid in aversive situations. Tinnitus distress was associated with less benefit on the APHAB subscales dealing with the aversiveness of sound and hearing in background noise. Conclusion: Tinnitus patients with hearing aids report slightly less benefit and more problems with their hearing aids, in particular in relation to background sounds and aversiveness of sounds.","PeriodicalId":88223,"journal":{"name":"Audiological medicine","volume":"1 1","pages":"73 - 78"},"PeriodicalIF":0.0,"publicationDate":"2011-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89736368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-05-19DOI: 10.3109/1651386X.2011.558764
R. Santarelli, A. Starr, I. del Castillo, Taosheng Huang, P. Scimemi, Elona Cama, R. Rossi, E. Arslan
Abstract Objective: Our objective was to compare acoustically- and electrically-evoked potentials of the auditory nerve in patients with postsynaptic or presynaptic auditory neuropathy with underlying mutations in the OPA1 or OTOF gene. Study design: Transtympanic electrocochleography (ECochG) was recorded from two adult patients carrying the R445H OPA1 mutation, and from five children with mutations in the OTOF gene. Cochlear potentials to clicks or tone-bursts were compared to recordings obtained from 16 normally hearing subjects. Electrically-evoked neural responses recorded through the cochlear implant were also obtained. Results: The cochlear microphonic (CM) was recorded from all subjects, with normal amplitudes. After cancelling the CM, cochlear potentials were of negative polarity with reduced amplitude and prolonged duration compared to controls in both groups of patients. Prolonged negative responses were recorded as low as 50–90dB below behavioural threshold in subjects with OTOF mutations whereas in the OPA1 disorder the prolonged potentials were correlated with hearing threshold. A compound action potential (CAP) was superimposed on the prolonged activity at high stimulation intensity in two children with mutations in the OTOF gene while CAPs were absent in the OPA1 disorder. Electrically-evoked compound action potentials (e-CAPs) were only recorded from subjects with OTOF mutations following cochlear implantation. Conclusions: The findings are consistent with abnormal function of distal portions of auditory nerve fibres in patients carrying the OPA1 mutation whereas the low-threshold prolonged potentials recorded from children with mutations in the OTOF gene are consistent with abnormal neurotransmitter release resulting in reduced dendritic activation and impairment of spike initiation.
{"title":"Presynaptic and postsynaptic mechanisms underlying auditory neuropathy in patients with mutations in the OTOF or OPA1 gene","authors":"R. Santarelli, A. Starr, I. del Castillo, Taosheng Huang, P. Scimemi, Elona Cama, R. Rossi, E. Arslan","doi":"10.3109/1651386X.2011.558764","DOIUrl":"https://doi.org/10.3109/1651386X.2011.558764","url":null,"abstract":"Abstract Objective: Our objective was to compare acoustically- and electrically-evoked potentials of the auditory nerve in patients with postsynaptic or presynaptic auditory neuropathy with underlying mutations in the OPA1 or OTOF gene. Study design: Transtympanic electrocochleography (ECochG) was recorded from two adult patients carrying the R445H OPA1 mutation, and from five children with mutations in the OTOF gene. Cochlear potentials to clicks or tone-bursts were compared to recordings obtained from 16 normally hearing subjects. Electrically-evoked neural responses recorded through the cochlear implant were also obtained. Results: The cochlear microphonic (CM) was recorded from all subjects, with normal amplitudes. After cancelling the CM, cochlear potentials were of negative polarity with reduced amplitude and prolonged duration compared to controls in both groups of patients. Prolonged negative responses were recorded as low as 50–90dB below behavioural threshold in subjects with OTOF mutations whereas in the OPA1 disorder the prolonged potentials were correlated with hearing threshold. A compound action potential (CAP) was superimposed on the prolonged activity at high stimulation intensity in two children with mutations in the OTOF gene while CAPs were absent in the OPA1 disorder. Electrically-evoked compound action potentials (e-CAPs) were only recorded from subjects with OTOF mutations following cochlear implantation. Conclusions: The findings are consistent with abnormal function of distal portions of auditory nerve fibres in patients carrying the OPA1 mutation whereas the low-threshold prolonged potentials recorded from children with mutations in the OTOF gene are consistent with abnormal neurotransmitter release resulting in reduced dendritic activation and impairment of spike initiation.","PeriodicalId":88223,"journal":{"name":"Audiological medicine","volume":"98 4 1","pages":"59 - 66"},"PeriodicalIF":0.0,"publicationDate":"2011-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89211769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-02-22DOI: 10.3109/1651386X.2010.537121
M. Abou-Elew, M. Shabana, M. Selim, A. El-Refaei, S. Fathi, Marwa O. Fatth-Allah
Abstract Introduction: Patients with benign paroxysmal positional vertigo (BPPV) often experience postural instability as well as brief episodes of vertigo. Objective: To assess the effect of a canalith repositioning manoeuvre (CRM) on the improvement in postural instability in patients with idiopathic BPPV and to find factors that would predict this improvement. Methods: Nineteen patients with a diagnosis of BPPV of canalithiasis pathology participated in this study. After diagnosis, all patients were treated by CRM. Postural stability was assessed by a Sensory Organization Test (SOT) with six sensory conditions before and one week after successful CRM. Results: CRM improved postural instability in 36.8% (7/19) of patients. There was a statistically significant difference between pre- and post-repositioning SOT 4, 5, 6 and the composite score (CS). Compared to the control age-matched normative values, there was a statistically significant difference at SOT 4, 5, 6 and CS pre-repositioning and only a statistically significant difference at SOT 6 post-repositioning. Individually, some patients still had abnormal SOT scores. Residual imbalance was reported in about two-thirds of our series of patients (12/19) after successful CRM. Patients with right-sided BPPV significantly improved their SOT scores after repositioning, while females reported more residual imbalance. Conclusions: Successful CRM improved significantly postural instability in BPPV, but not in all patients. Better postural stability was encountered after CRM in patients with right-sided BPPV, which may be attributed to being the more commonly affected side or due to a more severe lesion.
{"title":"Residual postural instability in benign paroxysmal positional vertigo","authors":"M. Abou-Elew, M. Shabana, M. Selim, A. El-Refaei, S. Fathi, Marwa O. Fatth-Allah","doi":"10.3109/1651386X.2010.537121","DOIUrl":"https://doi.org/10.3109/1651386X.2010.537121","url":null,"abstract":"Abstract Introduction: Patients with benign paroxysmal positional vertigo (BPPV) often experience postural instability as well as brief episodes of vertigo. Objective: To assess the effect of a canalith repositioning manoeuvre (CRM) on the improvement in postural instability in patients with idiopathic BPPV and to find factors that would predict this improvement. Methods: Nineteen patients with a diagnosis of BPPV of canalithiasis pathology participated in this study. After diagnosis, all patients were treated by CRM. Postural stability was assessed by a Sensory Organization Test (SOT) with six sensory conditions before and one week after successful CRM. Results: CRM improved postural instability in 36.8% (7/19) of patients. There was a statistically significant difference between pre- and post-repositioning SOT 4, 5, 6 and the composite score (CS). Compared to the control age-matched normative values, there was a statistically significant difference at SOT 4, 5, 6 and CS pre-repositioning and only a statistically significant difference at SOT 6 post-repositioning. Individually, some patients still had abnormal SOT scores. Residual imbalance was reported in about two-thirds of our series of patients (12/19) after successful CRM. Patients with right-sided BPPV significantly improved their SOT scores after repositioning, while females reported more residual imbalance. Conclusions: Successful CRM improved significantly postural instability in BPPV, but not in all patients. Better postural stability was encountered after CRM in patients with right-sided BPPV, which may be attributed to being the more commonly affected side or due to a more severe lesion.","PeriodicalId":88223,"journal":{"name":"Audiological medicine","volume":"2 1","pages":"15 - 8"},"PeriodicalIF":0.0,"publicationDate":"2011-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86398122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-02-22DOI: 10.3109/1651386X.2010.537910
Yiqing Zheng, F. Zhao, M. Liang, B. Bardsley, Haidi Yang, Zhigang Zhang
Abstract Objective: To investigate the characteristics of auditory evoked cortical ERP components P1-N1-P2 and MMN and explore a practical way for ERP waveform identification and classification. Methods: Thirty right-handed normally hearing volunteers participated in the present study, age ranging from 20 to 40 years old, 14 males and 16 females. All the volunteers reported no history of auditory, neurological or mental disorder. The event related potential (ERP) components (i.e. P1-N1-P2 complex and mismatch negativity (MMN)) were measured using the 128-electrode channels EGI system. Results: Three different categories of ERP responses were classified on the basis of waveform configuration, size of the peak amplitude and the number of peaks together with scalp distribution of MMN. Ten participants (33.3%) had well defined ERP responses, 13 (43.3%) showed moderately defined ERP responses, and seven (23.3%) had poorly defined ERP responses. Although there were no significant differences in P1, P2, and MMN latencies, participants with the poorly defined ERP waves had significantly longer N1 latency than that in subjects with well defined ERP waves. In addition, significantly lower MMN amplitudes were also found in this group. Conclusion: Combining a waveform classification method and the MMN scalp distribution pattern, together with quantitative ERP response analysis, may provide more reliable and practical means for clinical application.
{"title":"Toward an understanding of auditory evoked cortical event-related potentials: Characteristics and classification","authors":"Yiqing Zheng, F. Zhao, M. Liang, B. Bardsley, Haidi Yang, Zhigang Zhang","doi":"10.3109/1651386X.2010.537910","DOIUrl":"https://doi.org/10.3109/1651386X.2010.537910","url":null,"abstract":"Abstract Objective: To investigate the characteristics of auditory evoked cortical ERP components P1-N1-P2 and MMN and explore a practical way for ERP waveform identification and classification. Methods: Thirty right-handed normally hearing volunteers participated in the present study, age ranging from 20 to 40 years old, 14 males and 16 females. All the volunteers reported no history of auditory, neurological or mental disorder. The event related potential (ERP) components (i.e. P1-N1-P2 complex and mismatch negativity (MMN)) were measured using the 128-electrode channels EGI system. Results: Three different categories of ERP responses were classified on the basis of waveform configuration, size of the peak amplitude and the number of peaks together with scalp distribution of MMN. Ten participants (33.3%) had well defined ERP responses, 13 (43.3%) showed moderately defined ERP responses, and seven (23.3%) had poorly defined ERP responses. Although there were no significant differences in P1, P2, and MMN latencies, participants with the poorly defined ERP waves had significantly longer N1 latency than that in subjects with well defined ERP waves. In addition, significantly lower MMN amplitudes were also found in this group. Conclusion: Combining a waveform classification method and the MMN scalp distribution pattern, together with quantitative ERP response analysis, may provide more reliable and practical means for clinical application.","PeriodicalId":88223,"journal":{"name":"Audiological medicine","volume":"44 1","pages":"16 - 25"},"PeriodicalIF":0.0,"publicationDate":"2011-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86792632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-02-22DOI: 10.3109/1651386X.2010.546954
P. Bergemalm, S. Hennerdal, Birger Persson
Abstract Objective: Progression of a sensorineural hearing loss (SNHL) is not an uncommon sequel after closed head injury (CHI). The mechanisms behind this progression are, however, unclear. The study objective was to search for specific radiological signs of inner ear pathology, such as fibrosis or sclerosis associated with progression of a trauma related SNHL. Could specific types of fractures and/or brain contusions be associated with progression? Methods: Eighteen subjects with a history of CHI, skull fracture and/or brain contusion, four to fifteen years prior to the present investigation were studied. All subjects had an initial trauma related SNHL. Thirteen subjects had a varying degree of SNHL progression. All subjects underwent otomicroscopy, standard audiological evaluation, CT and MRI. Results: No cochlear changes were demonstrated on MRI or CT in any of the 13 subjects with a trauma related SNHL progression, even in cases with extensive progression. However, in one subject with post-traumatic unilateral deafness an inner ear alteration was demonstrated on MRI. Conclusions: The observed progression of SNHL is probably due to processes at cellular level, not detectable using current radiological methodology. Furthermore, no specific type of fracture or localization of brain contusion seen on neuroimaging was found to indicate an increased risk for SNHL progression.
{"title":"Structural signs of progression of a sensorineural hearing loss after a closed head injury: A CT and MRI study","authors":"P. Bergemalm, S. Hennerdal, Birger Persson","doi":"10.3109/1651386X.2010.546954","DOIUrl":"https://doi.org/10.3109/1651386X.2010.546954","url":null,"abstract":"Abstract Objective: Progression of a sensorineural hearing loss (SNHL) is not an uncommon sequel after closed head injury (CHI). The mechanisms behind this progression are, however, unclear. The study objective was to search for specific radiological signs of inner ear pathology, such as fibrosis or sclerosis associated with progression of a trauma related SNHL. Could specific types of fractures and/or brain contusions be associated with progression? Methods: Eighteen subjects with a history of CHI, skull fracture and/or brain contusion, four to fifteen years prior to the present investigation were studied. All subjects had an initial trauma related SNHL. Thirteen subjects had a varying degree of SNHL progression. All subjects underwent otomicroscopy, standard audiological evaluation, CT and MRI. Results: No cochlear changes were demonstrated on MRI or CT in any of the 13 subjects with a trauma related SNHL progression, even in cases with extensive progression. However, in one subject with post-traumatic unilateral deafness an inner ear alteration was demonstrated on MRI. Conclusions: The observed progression of SNHL is probably due to processes at cellular level, not detectable using current radiological methodology. Furthermore, no specific type of fracture or localization of brain contusion seen on neuroimaging was found to indicate an increased risk for SNHL progression.","PeriodicalId":88223,"journal":{"name":"Audiological medicine","volume":"33 1","pages":"33 - 39"},"PeriodicalIF":0.0,"publicationDate":"2011-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77669056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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