Sensorineural Hearing Loss in Sickle Cell Disease: Case Reports

Sickle cell disease (SCD) is characterized by intermittent episodes of vascular occlusion and end-organ damage. It is believed that auditory impairment is associated because of sickling and slugging of blood in the cochlea. A prevalence of sensorineural hearing loss among patients with SCD has been reported. We present 2 patients with SCD with sudden sensorineural hearing loss. The goal is to detect hearing loss early and improve developmental and language outcomes. Understanding the need to screen for hearing loss in children with SCD will enable providers to maximize the quality of life of patients and improve school performance.     

Migraine: An Alternative in the Diagnosis of Unclassified Vertigo

SYNOPSIS
Vertigo and unsteadiness are frequent reasons for medical consultation. In some cases, these symptoms remain unclassified. The association of equilibrium disorders with migraine is often mentioned in literature.
Seventy-two cases of unclassified vertigo were studied in order to ascertain the prevalence of migraine in patients affected by recurring episodes of vertigo from undetermined causes, and attempting to establish a possible relationship with migraine. Characteristics of the vertigo and the headache, were evaluated by clinical history and examination, electronystagmogram (ENG), electroencephalogram (EEG), computerized tomography scanning (CT) and/or magnetic resonance imaging (MRI). In the group of patients studied 50% suffered from headache, and 32.8% fulfilled the diagnostic criteria of migraine. Results suggest that only a thorough clinical history would be able to give enough information to establish the diagnosis of migraine in these patients.
These observations imply an alternative diagnosis to be taken into account when a case of unclassified vertigo is evaluated.     

伪聋及夸大性耳聋患者听力检查的护理

目的 针对伪聋及夸大性耳聋患者心理特点进行护理，最终对其听力作出正确评估。方法 对初次检查结果可疑者，分析其行为动机，进行正确有效的思想疏导工作，使患者以积极的态度接受检查。结果 经说服教育和心理护理。所有病例均获得满意检查结果。确定初诊为伪聋者58例，夸大性耳聋者67例。动机包括为获取经济赔偿或诉讼优势；工伤评残或老兵退役评残；逃避工作或训练；医疗纠纷等。结论 伪聋和夸大性耳聋有其复杂的主观动机，通过正确引导和心理护理，最终均能获得真实听力结果。     

Relationship Between Basilar-Type Migraine and Migrainous Vertigo

Objective.— This study compared clinical manifestations and audiovestibular function tests among subjects of basilar-type migraine (BtM), definite and probable migrainous vertigo (dMV and pMV), in order to investigate the relationship between them.
Background.— Various diagnostic criteria such as BtM, dMV, and pMV have been proposed. However, a comparison between these diagnostic groups has not been conducted before.
Methods.— This study enrolled 77 subjects, including BtM in 15, dMV in 30, and pMV in 32 patients. All patients received structured interview of clinical presentations and underwent a battery of audiovestibular function tests.
Results.— Demographic features were similar between 3 groups, including age, gender, precipitating factors, and family preponderance. When considering the clinical manifestations, for example motion sickness, migrainous symptoms, and sequential relationship between headache and vertigo, BtM and dMV groups shared similar features, but differed from pMV group. As regards to differentiate between BtM and dMV patients, the former revealed higher occurrence rates than the latter in relation to the frequency of vertigo attacks, neurological symptoms, and saccadic dysmetria.
Conclusion.— The relationship between BtM, dMV, and pMV refers to a distribution of severity across the disease spectrum of migraine-related vertigo. Of them, BtM group presents the most severe form in clinical manifestation and brainstem involvement, followed by dMV, and pMV is the mildest form.     

SARS‐CoV‐2 infection with bilateral intralabyrinthine hemorrhage

A 47‐year‐old woman presented with the complaint of sudden hearing loss associated with vertigo. Serological testing was positive for IgM and negative for IgG COVID‐19 antibodies, with no other associated factors. Magnetic resonance imaging of the brain showed bilateral intralabyrinthine hemorrhage.     

Vestibular Pathways Involvement in Children With Migraine: A Neuro-Otological Study

( Headache 2010;50:71-76)
Objective.— To assess, during symptom free intervals, the clinical, audiological, and vestibular findings in a cohort of child migraine sufferers, with or without vertigo or dizziness or both.
Background.— In adults and children, dizziness and vertigo are frequently associated with migraine.
Methods.— Twenty-two child migraine sufferers with vestibular symptoms, aged 7-13 years (group A), and 18 child migraine sufferers without vestibular symptoms, aged 8-13 (group B) entered our study between January 2007 and June 2007. The characteristics of auditory functions and vestibular symptoms and signs were assessed and reviewed by a blinded physician.
Results.— The whole sample was found audiologically normal. In group A, 6 subjects had normal vestibular test results, whereas vestibular testing disclosed either peripheral or central sufferance or both, in the remaining 16 patients (73%). Twelve subjects from group B had normal vestibular test results whereas positive vestibular test results were reported in the remaining 6 subjects (33%).
Conclusions.— This single-blind work outlines the brain stem abnormalities in children with migraine in the form of direct involvement of peripheral or central vestibular pathways or both. Interestingly, some children with migraine but without vestibular symptoms also had abnormal results at vestibular testing. This could demonstrate a subclinical involvement of vestibular pathways without clinical presentation. The subjects are still being followed up to evaluate the evolution of symptomatology.     

眩晕症与听力学改变的关系

目的探讨眩晕症与听力学改变的关系。方法选择101例眩晕症患者（眩晕症组）和90例健康体检者（对照组）为研究对象。检测2组的纯音听阅、镫骨肌声反射阈,并对结果进行统计学分析。结果眩晕症组双耳250～4000Hz的气导和骨导纯音听阈与对照组相应的听阂值之间比较,差异均有统计学意义（P〈0．05）,双耳8000Hz的气导纯音听阚与对照组相对应的听阈值之间比较差异均无统计学意义（P〉0．05）。双耳各频率同、对侧镫骨肌声反射引出阳性例数比较。眩晕症组与对照组之间同、对侧500、1000Hz差异均有统计学意义（P〈0．05）。结论部分眩晕患者早期就在听力学上有所改变,作为临床耳鼻咽喉科医生应尽早干预,及早参与治疗。声反射衰减和重振试验可作为临床前庭功能检查的一种方法,提示眩晕的病变部位,为眩晕症的诊断提供一定的辅助价值。     

A pilot study to prevent hearing loss in farmers

OBJECTIVE: Determine the feasibility and outcome of a pilot program to increase farm workers' use of hearing protection when performing activities with high noise exposure. DESIGN: The study was a quasi-experimental study. SAMPLE: Eight intervention farmers and 17 comparison farmers participated in the study. MEASURES: Before and after the intervention, farmers completed a survey to identify their frequency of use of hearing protection, and their beliefs about hearing loss and use of hearing protection. INTERVENTION: The intervention consisted of noise assessments, educational sessions, mailed reminders with brochures, and placement of hearing protection on the farm. RESULTS: The intervention was effective in increasing the use of hearing protection 1 and 2 months after the implementation of the program. CONCLUSIONS: Hearing loss is a serious problem with farmers, and yet many farmers neglect to protect their hearing with the use of protection. The pilot study findings indicate that efforts to increase the use of hearing protection by farmers can be effective.     

儿童期分泌性中耳炎与语言发育迟缓的临床分析

目的探讨儿童期分泌性中耳炎所致感音神经性耳聋对语言、认知和交流能力的影响，及对分泌性中耳炎感音神经性耳聋患儿早期确诊、早期治疗、早期进行听力语言康复的重要性。方法根据26例语言发育迟缓的分泌性中耳炎患儿就诊情况及听力调查资料，分析高频听力损失和语言频率的关系以及对语言、认知和交流能力的影响。结果分泌性中耳炎所致感音神经性耳聋患儿对语言、认知和交流能力有影响，只有当高频听力损失达到一定程度，并波及到语频时，才会引起语言发育迟缓。早期发现分泌性中耳炎感音神经性耳聋儿童，早期确诊，早期进行听力语言康复非常必要，可以大大地减少因感音神经性耳聋所致的语言障碍。结论儿童期分泌性中耳炎所致的感音神经性耳聋可以引起患儿语言发育迟缓。对分泌性中耳炎患儿早期诊断、早期治疗可避免残余听力障碍对语言、认知和交流能力的影响。我们将病程超过3个月以上的儿童期分泌性中耳炎作为感音神经性耳聋的高危儿童，在儿童保健系统开展听力筛查，及早发现感音神经性耳聋儿童，可将此类儿童的早期诊断的确诊率、早期配戴助听器和早期开展听觉语言康复的年龄提前。