The journal of international advanced otology最新文献

Different organs respond differently to cisplatin (CDDP)-induced toxicity. Oleuropein (OLE) is a natural phenolic antioxidant. The purpose of this study was to determine the potential protective effect of OLE against CDDP-induced ototoxicity by evaluating expression of genes associated with deoxyribonucleic acid (DNA) damage and repair in cochlear cells. House Ear Institute-Organ of Corti 1 (HEI-OC1) cells were treated using CDDP, OLE, and OLE-CDDP. The water-soluble tetrazolium salt assay was used for monitoring cell viability. Deoxyribonucleic acid damage in cells due to the CDDP, OLE, and combination treatments was determined using a flow-cytometric kit. The change in the expression of 84 genes associated with CCDP, OLE, and OLE-CDDP treatments that induced DNA damage was tested using the reverse transcription polymerase chain reaction array. Changes ≥3-fold were considered significant. House Ear Institute-Organ of Corti 1 cell viability was significantly reduced by CDDP. The OLE-CDDP combination restored the cell viability. Cisplatin increased the H2AX ratio, while OLE-CDDP combination decreased it. Some of the DNA damage-associated genes whose expression was upregulated with CDDP were downregulated with OLE-CDDP, while the expression of genes such as Gadd45g and Rev1 was further downregulated. The expression of DNA repair-related Abl1, Dbd2, Rad52, and Trp53 genes was downregulated with CDDP, whereas their expression was upregulated with OLE-CDDP treatment. In cochlear cells, the OLE-CDDP combination downregulated DNA damage-associated gene expression relative to that upregulated mainly by CDDP. The results revealed that OLE has a potential protective effect on CDDP-induced ototoxicity in cochlear cells by altering the expression of DNA damage-related genes.

Intralabyrinthine schwannomas are a rare subgroup of vestibular schwannomas located within the membranous labyrinth of the inner ear and are known for their variable clinical presentations and symptoms. In the present study, we report on a patient with a persistent history of dizziness and positional vertigo, who was misdiagnosed with posterior canalithiasis. As hearing loss was not developed until late in the disease course, the patient was not properly diagnosed until magnetic resonance imaging revealed an intralabyrinthine schwannoma, which was not discovered on earlier imaging. In addition to the unusual clinical presentation, we describe the audio-vestibular profile of our patient. We suggest that a thorough vestibular evaluation, including caloric testing and a careful examination of the inner ear on imaging, is warranted in cases of treatment of refractory vertigo, even in patients where a diagnosis seems certain.

Although advanced technologies and surgical procedures are used, cholesteatoma is a disease with the possibility of recurrence. The aim of this study was to determine the long-term effect of sodium 2-mercaptoethane sulfonate (MESNA) on cholesteatoma surgery. Patients who underwent cholesteatoma surgery between January 2009 and July 2014 by the same surgeon were divided into 2 groups: those where MESNA was used and those where it was not. Otomicroscopic examinations were performed to see the presence of cholesteatoma recurrence in the patients who had surgery at least 8 years ago. Pure-tone audiometry was performed to evaluate the hearing results. Sodium 2-mercaptoethane sulfonate was used in 23 patients and was not used in 39 patients who came to the control. In the MESNAused group, cholesteatoma was seen in only 1 of the patients who underwent a canal wall-down (CWD) mastoidectomy. In the MESNA non-used group, cholesteatoma was seen in 3 patients who underwent CWD. The difference was not statistically significant. Although there was no statistically significant difference, recurrence of cholesteatoma was seen less frequently in patients who received MESNA during surgery. Studies to be conducted in larger patient series may clarify this issue.

It is reported that sudden sensorineural hearing loss (SSNHL) is closely related to diabetes, hypertension, and hyperlipidemia. While the metabolic syndrome (MetS) is a multifactorial disease that includes diabetes, hypertension, dyslipidemia, and obesity, which are known to be associated with SSNHL. Weather conditions have long been known to affect the SSNHL. This study aimed to make a clear connection between MetS, or weather conditions, and the severity and prognosis of SSNHL. 127 SSNHL patients have been divided into the MetS group and the non-MetS group, and the demographic and clinical characteristics of the 2 groups have been analyzed retrospectively. There were 52 (40.9%) patients in the MetS group, while there were 75 (59.1%) patients in the non-MetS group. The rate of vertigo, hypertension, diabetes, lower high-density lipoprotein cholesterol (HDL-C) levels, high triglyceride (TG), and body mass index (BMI) ≥25 (kg/m2 ) were significantly higher in the MetS group than those in non-MetS group. Vertigo, hypertension, and Mets were linked to the severity of hearing loss. The rate of complete recovery and partial recovery in the MetS group was clearly lower than that in non-MetS group. According to the multivariate analysis, MetS was significantly associated with a poorer prognosis of SSNHL; a high ambient temperature difference at onset and hypertension were correlated with a poor prognosis. These results demonstrate that the severity and prognosis of SSNHL can be influenced by the MetS. High ambient temperature differences at onset and hypertension were indicators of a poor prognosis for SSNHL.

Temporal bone (TB) fractures are frequently accompanied by intracranial injury. This study aimed to analyze combined intracranial injuries in relation to functional changes in the inner ear, including those of the contralateral ear, in patients with TB fractures. Ninety-four patients (mean age: 35.6 ± 18.7 years, M : F=67 : 27) diagnosed with unilateral TB fracture were included. Bone conduction (BC) threshold, word recognition score (WRS), and changes in vestibular function were compared based on intracranial injuries, focusing on the contralateral side. Various types of intracranial injuries were observed (67.9%). Among these, a significant association between traumatic brain injury (TBI) and otic capsule-violating fractures was noted. The BC threshold on the fractured side significantly deteriorated in patients with TBI. Additionally, a significantly worse BC threshold was confirmed on the contralateral side in patients with TBI, intracranial hemorrhage (ICH), and contrecoup injury. The follow-up BC threshold did not improve or differ, regardless of high-dose steroid administration. The initial WRS and canal paresis in the bithermal caloric test were not significantly different in the presence of each intracranial injury. Concurrent fluctuations in the pressure of the cerebrospinal fluid space and perilymphatic space were speculated to be the potential underlying mechanisms. A significantly worse BC threshold was confirmed on the contralateral side of patients with TBI, contrecoup injury, ICH, and on fracture sides of patients with TBI.

This article evaluated the current status and focus areas in benign paroxysmal positional vertigo (BPPV) research in the world and to predict the direction of future research. Web of Science Core Collection were searched from January 1, 2002, to December 31, 2021. Bibliometric and statistical analysis were conducted to generate the basic information of the publications. A total of 1255 publications were identified, with an increasing trend in the number of annual number of publications from 2019 to 2021. Otology & Neurotology was the most productive journal. Kim J, Kim C, and Lee J from South Korea were the top 3 productive authors. Seoul National University is the most influential institution. The top 5 cited burst keywords include recurrence, osteoporosis, bone mineral density, vitamin D deficiency, and BPPV. The annual number of publications would continue to grow. The future research of BPPV will concentrate on osteoporosis and recurrence.

Middle ear neuroendocrine tumors (MeNETs) are an exceptionally rare occurrence. These benign tumors stem from the tympanic mucosa and can easily be misinterpreted by the clinician and the pathologist. Clinical characteristics, otoscopic findings and medical imaging in these cases are non-specific. We present a case of a 60-year-old male patient with bilateral hearing loss following recent coronavirus disease 2019 disease. Diagnostic work-up revealed a soft tissue neoplasm of the left middle ear. Surgical resection of the tumor mass with implantation of a partial ossicular replacement prosthesis (PORP) was the main modality of treatment. Middle ear neuroendocrine tumors was confirmed through positive immunohistochemistry for neuroendocrine tumor markers. Follow-up magnetic resonance imaging 12 months after the surgery reported no tumor recurrence or significant residual disease with a stable PORP. Our report highlights challenges in diagnosing and treating these rare tumors, while emphasizing surgical resection pitfalls and resulting improvement of quality of life of the patient. We recommend a through followup of patients with unclear soft tissue masses in the middle ear to obtain a definitive diagnosis.

Background:  Assessment of nystagmus fixation suppression can be used as an additional diagnostic tool for patients with an acute vestibular syndrome to distinguish between a central or peripheral cause. We investigated the ability of physicians to detect fixation suppression using a nystagmus simulation model.

Methods:  We used a nystagmus simulator to measure the accuracy of the nystagmus fixation suppression test. Fixation suppression was assessed randomly in 6170 trials by 20 otorhinolaryngologists and neurologists, segregated into 2 groups based on their neurootological experience, a beginner and an experienced group. The simulator presented random nystagmus slow velocity (SPV) reductions and presented 3 conditions with either changed nystagmus frequency, amplitude, or both.

Results:  The cutoff for the discernment of fixation suppression ranged from 1.2 to 14°/s nystagmus velocity difference. The more intense the baseline nystagmus was, the more difficult was the detection of fixation suppression. There was not significant difference (P >.05) in the cutoff values in the experts group compared to the novices for all 3 different conditions. Both, novices and experts, detected frequency changes easier than differences of the nystagmus amplitude. Test sensitivity was very low (19%-65%) for discernment of small nystagmus velocity differences of <2°/s by experts.

Conclusion:  In our study, there was no difference between experts and novices in detection of nystagmus suppression by visual fixation. The examiners could only detect large suppression effects at low-intensity baseline nystagmus. Overall, the sensitivity and accuracy of a clinical fixation suppression test is low and the assistance with a video-oculography device is highly recommended.

Background:  There may be confusion about which canal is involved in patients with benign paroxysmal positional vertigo (BPPV), especially with those that have subtle findings. The study aimed to determine if video head impulse testing may be used in such patients as a diagnostic tool. Symptom scoring and treatment efficiency in BPPV are essential parts of the process. Therefore, inventories like "Dizziness Handicap Inventory" may be useful in this regard.

Methods:  Patients with posterior and lateral canal BPPV were included. Video head impulse testing was performed prior to treatment and 1 week after treatment. Vestibuloocular reflex (VOR) gains were noted and compared to the opposite side. The presence of correction saccades was noted as well. Also, pretreatment and posttreatment Dizziness Handicap Inventory scores were compared.

Results:  Fifty-seven patients were diagnosed with posterior canal BPPV, and sixteen were with horizontal canal BPPV. In patients with posterior canal BPPV, there was no difference between the involved canal VOR gains and the other canals on the same side (P=.639). The involved horizontal canal did not differ from the opposite horizontal canal. Patients with lateral canal BPPV show more significant improvement after treatment compared to patients with posterior canal BPPV.

Conclusion:  Video head impulse testing may not be used to estimate the involved canal in BPPV; however, it may be used to evaluate the efficiency of the treatment, especially in the lateral canal.

Background:  Fibromyalgia syndrome (FMS) is a chronic pain condition that may be associated with dysfunction in the central nervous system.

Objective: The aim of this study was to assess the vestibulo-spinal reflex (VSR) and vestibulo-ocular reflex (VOR) in FMS using the cervical vestibular evoked myogenic potential (cVEMP) and ocular vestibular evoked myogenic potential (oVEMP) tests, respectively, and to evaluate their relation to disease severity.

Methods:  This study included 30 female FMS patients and 30 well-matched healthy controls. They underwent full history taking and assessment of the severity of dizziness/vertigo using the Dizziness Handicap Inventory; assessment of the severity of FMS symptoms using the Revised Fibromyalgia Impact Questionnaire; bedside examination of the dizzy patient; videonystagmography, cVEMP, and oVEMP tests; basic audiologic evaluation; and uncomfortable loudness level (UCL) testing.

Results:  Dizziness was reported in 46.6% and vertigo in 11.1% of patients. Abnormalities in cVEMP (50%) and oVEMP (63.3%) were mostly unilateral, irrespective of FMS severity. Disease duration affected only the oVEMP amplitude. Fibromyalgia syndrome patients had a statistically significant lower UCL and narrower dynamic range compared to controls.

Conclusion:  The VSR and VOR are commonly affected in FMS patients, and findings suggest central sensitization involving the brain stem. We recommend routine cVEMP and oVEMP testing to assess brainstem function in FMS patients.