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1.
Background
Side-specific test procedures are mandatory in order to assess the function of peripheral vestibular receptors. Semicircular canals (SCC) and vestibulo-ocular reflex (VOR) can be tested by the Halmagyi and Curthoy head impulse test (HIT) and recently by means of the video head impulse test (vHIT). The vHIT procedure is a new method to measure eye and head velocity during brief and rapid head impulses. This method provides objective information of VOR and detects both overt and covert catch-up saccades.Materials and methods
As clinical experiences with vHIT are limited, in this study the horizontal VOR (hVOR) was examined by means of the vHIT in 142 consecutive patients with acute or chronic vestibular syndrome.Results
A total of 20 healthy volunteers served as a control group and exhibited a normal average VOR gain of 0.97?±?0.09 without re-fixation saccades. In patients, 47.6% showed a pathological vHIT whereas 52.4% revealed a normal test result. Covert catch-up saccades could be revealed in 13.7% by means of vHIT whereas in 86.3% overt catch-up saccades alone or in combination with covert catch-up saccades were found in the majority of catch-up saccades in peripheral vestibular disorders.Conclusions
By means of the vHIT it is possible to obtain a side-specific and quantitative assessment of hVOR. Video-head impulse test is a reliable tool for vestibular testing even in bedside examinations of patients suffering from dizziness. 相似文献2.
Objectives
The function of the semicircular canal receptors and the pathway of the vestibulo-ocular-reflex (VOR) can be diagnosed with the clinical head impulse test (cHIT). Recently, the video head impulse test (vHIT) has been introduced but so far there is little clinical experience with the vHIT in patients with peripheral vestibular disorders. The aim of the study was to investigate the horizontal VOR (hVOR) by means of vHIT in peripheral vestibular disorders.Methods
Using the vHIT, we examined the hVOR in a group of 117 patients and a control group of 20 healthy subjects. The group of patients included vestibular neuritis (VN) (n = 52), vestibular schwannoma (VS) (n = 31), Ménière's disease (MD) (n = 22) and bilateral vestibulopathy (BV) (n = 12).Results
Normal hVOR gain was at 0.96 ± 0.08, while abnormal hVOR gain was at 0.44 ± 0.20 (79.1% of all cases). An abnormal vHIT was found in VN (94.2%), VS (61.3%), MD (54.5%) and BV (91.7%). Three conditions of refixation saccades occurred frequently in cases with abnormal hVOR: isolated covert saccades (13.7%), isolated overt saccades (34.3%) and the combination of overt and covert saccades (52.0%).Conclusions
The vHIT detects abnormal hVOR changes in the combination of gain assessment and refixation saccades. Since isolated covert saccades in hVOR changes can only be seen with vHIT, peripheral vestibular disorders are likely to be diagnosed incorrectly with the cHIT to a certain amount. 相似文献3.
Objective
The objective of this study was to examine the effect of hypothyroidism on hearing function in patients surgically treated for differentiated thyroid cancer and subsequently experienced hypothyroidism during preparation for follow up I-131 scintigraphy scan by either recombinant human thyroid stimulating hormone (rhTSH) treatment or thyroid hormone withdrawal (THW).Methods
A total of 55 patients undergoing I-131 scintigraphy scan following surgeries for differentiated thyroid cancer were included in the study, including 25 patients prepared by administration of recombinant TSH (rhTSH Group) and 30 patients by thyroid hormone withdrawal (THW Group).Results
Air conduction thresholds at 1, 2 and 4?kHz for both ears were higher during hypothyroid period than during euthyroid period for patients in the THW group (p?<?0.05) but not for patients in the rhTSH group.Conclusion
Sensorineural hearing loss was detected, especially at low frequencies, in patients with DTC after surgical treatment whose hormone replacement therapy was withdrawn but not in those receiving rhTSH. It is therefore preferred to use rhTSH when preparing for I-131 scintigraphy scan in patients at risk for hearing loss. 相似文献4.
Objectives
The aim of our study is to examine vestibular-evoked myogenic potentials (VEMPs) elicited by the galvanic vestibular stimulation in the sternocleidomastoid muscle (SCM) in healthy subjects for clinical applications of auditory neuropathy or vestibular neuropathy in the future.Methods
We enrolled sixteen healthy subjects to record the average responses of SCM to galvanic vestibular stimulation (GVS) [current 3 mA; duration 1 ms] by electromyography (EMG). SPSS18.0 software was used to analyze the obtained data for mean and standard deviation.Results
In all healthy subjects mastoid-forehead galvanic vestibular stimulation produced a positive-negative biphasic EMG responses on SCM ipsilateral to the cathodal electrode. The latency of p13 was 11.7 ± 3.0 ms. The latency of n23 was 17.8 ± 3.4 ms. The amplitude of p13-n23 was 147.0 ± 69.0 μV. The interaural asymmetry ratio (AR) of p13, n23 latency and the amplitude was respectively 0.12 ± 0.09, 0.08 ± 0.08 and 0.16 ± 0.10.Discussions
Galvanic vestibular stimulation could elicit biphasic EMG responses from SCM via the vestibular nerve but not from the otolith organs. Galvanic stimulation together with air conducted sound (ACS) or bone conducted vibration (BCV) can elicit VEMPs and may enable the differentiation of retrolabyrinthine lesions from labyrinthine lesions in vestibular system. 相似文献5.
Objective
To evaluate High Resolution Computer Tomography (HRCT) in the diagnosis of external ear canal cholesteatoma.Methods
In this retrospective study, HRCTs of 27 patients with external ear canal cholesteatoma were reviewed. The changes in the external ear canal, tympanic membrane (TM), scutum, tympanum and mastoid were measured and categorized.Results
Fourteen patients showed no or mild destruction in the external ear canal (stage I group). Eight patients had obvious enlargement in the external ear canal (stage II group) but showed limited destructions of the mastoid bone and no damage of the tympanums. Five patients had serious destruction of the mastoid bone and damage of the tympanum (stage III group). All patients in the stage III group showed a compression of manubriums and TMs, with 3 having damages on ossicular chain. Bone destruction of the vertical section of facial nerve canal was discovered in one case in the stage III group.Conclusion
HRCT can provide detail information about the extent of external ear canal cholesteatoma. Such information can be used to identify special situations with serious complications and to differentiate external ear canal cholesteatoma from middle ear cholesteatoma. 相似文献6.
Objective
Infrared Tympanic Thermometer (ITT) is one of the most useful instruments for accurately measuring temperature. The effects of ear pathologies on ITT measurement remain unclear. The purpose of this study is to determine if tympanic membrane perforation (TMP) affects ITT measurements in adult patients.Material and methods
A total of 90 adult patients with monaural central TMP were enrolled in this study. Patients were categorized into three subgroups according to perforation size (1–3 mm, 4–7 mm, and 8–10 mm). The tympanic temperatures of the affected and unaffected sites, and subgroups were compared with each other.Results
This study contained 54 (60%) males and 36 (40%) females ranging from 20 to 58 years of age (mean age: 30.74 ± 9.61 years). The mean tympanic temperature of the side affected with TMP was 36.34oC ± 0.61oC. The mean tympanic temperature of the unaffected side with healthy and intact tympanic membrane was 36.33oC ± 0.6oC. The Pearson correlation score for the tympanic temperatures and the size of TMP was 0.22 which was not significant (r=–0.12).Conclusion
TMP and perforation size do not affect ITT measurements in adult patients. 相似文献7.
Introduction
The absence of vertigo during the caloric test, despite a robust response, has been suggested to represent a central vestibular system phenomenon. The purpose of this investigation was to determine the prevalence of absent caloric-induced vertigo perception in an unselected group of patients and to assess possible predicting variables.Methods
Prospective investigation of 92 unselected patients who underwent caloric testing. Inclusion criteria were that each patient generate a maximum slow phase velocity (maxSPV) ≥ 15 deg/sec and a caloric asymmetry of ≤10%. Following the caloric, patients were asked, “Did you have any sensation of motion?”Results
Results showed 75% of patients reported motion with a mean age of 56.51 years compared to a mean age of 66.55 in the 25% of patients reporting an absence of motion. A logistic regression was performed and the overall model was statistically significant accounting for 29% of the variance in caloric perception. The significant predictor variables were patient age and maxSPV of the caloric response. The effect size for both variables was small with an odds ratio of .9 for maxSPV and 1.06 for age.Conclusions
The current investigation showed that both age and maxSPV of the caloric response were significant predictors of vertigo perception during the caloric exam. However, the association between age and caloric perception is not conclusive. Although there is evidence to suggest that these findings represent age-related changes in the central processing of vestibular system stimulation, there are additional unmeasured factors that influence the perception of caloric-induced vertigo. 相似文献8.
Purpose
Vestibular migraine is a common cause of dizziness that lacks a known objective test. This study examined total eye speed on caloric testing as a diagnostic marker for vestibular migraine.Materials and methods
Retrospective chart review of patients seen in a tertiary otologic practice between 2004 and 2016 who had undergone caloric testing with water irrigation and had a diagnosis of vestibular migraine (n = 34). A group of patients with benign paroxysmal positional vertigo (n = 10) were used as a control group. Patients were grouped into quartiles based on total eye speed.Results
Only patients in the lowest quartile (total eye speed < 79) had a diagnosis of vestibular migraine. All other quartiles included a mix of control and vestibular migraine patients.Conclusion
Low total eye speed may be suggestive of a diagnosis of vestibular migraine, but most patients with vestibular migraine do not have low total eye speed. 相似文献9.
Liu Chenqing Ding Daxiong Zhu Yuhua Wang Hongyang Cheng Xiaoting Zhao Zhenhua Cao Juyang Zhai Suoqiang Yu Ning 《中华耳科学杂志(英文版)》2018,13(2):75-79
Objective
To report audiological characteristics in a group of noise-exposed crew members on board ships.Methods and materials
Clinical and audiological measurements including pure-tone thresholds, acoustic immittance results and tinnitus questionnaires were collected from both the ship crew members (study subjects) and their land based colleagues (controls).Results
1) Noise exposed crew members showed not only high frequency, but also low frequency hearing loss; 2) Hearing impairment increased with age, with 65.5% of crew members younger than 50 years showing normal hearing while only 14.9% of those older than 50 years had normal hearing; 3) hearing loss gradually increased with the extension of on board career time; and 4) Most study subjects reported high pitch tinnitus, significantly more than the control group although not significantly different among different age groups.Conclusion
Noise induced hearing impairment from working on board ships shows specific frequency and age characteristics. Understanding these characteristics is important for advancing relevant studies and for effective prevention of noise-induced hearing loss in ship crew members. 相似文献10.
Andrea Canale Federico Caranzano Michele Lanotte Alessandro Ducati Francesco Calamo Andrea Albera Michelangelo Lacilla Marco Boldreghini Sergio Lucisano Roberto Albera 《Auris, nasus, larynx》2018,45(6):1159-1165
Objective
Selective unilateral vestibular neurectomy (VN) is considered a reliable surgical treatment in case of recurrent vertigo in Menière’s disease (MD) because of hearing preservation and a minimally invasive posterior fossa retrosigmoid approach. The present study aimed to assess the quality of life and the long-term vestibular function in patients submitted to yearly follow-up after VN because of intractable MD.Methods
Retrospective series of 15 MD patients undergoing retrosigmoid VN for recurrent vertigo. Outcome measures included cVEMPs and oVEMPs (cervical and ocular vestibular evoked myogenic potentials), VHIT (Video Head Impulse Test) and caloric test, besides to DHI (Dizziness Handicap Inventory) and PTA (Pure Tone Audiometry).Results
Mean DHI score resulted within normal values in 74% of patients, significantly correlated to the duration of the follow-up. In the operated side, cVEMPs and oVEMPs have not been elicited respectively in 11 patients (73%) and 13 patients (87%), whereas it was not possible to evoke any response at bithermal caloric test in 4 cases. The gain of VOR from VHIT resulted always below normal values after VN except in one patient, who has also undergone an episode of posterior BBPV. The difference between average PTA threshold before and after VN resulted not significant.Conclusion
The vestibular outcomes prove VN to be an effective and safe surgery in MD; furthermore, the unexpected occurrence of BPPV after VN can justify the presence of neural anastomosis between the inferior vestibular nerve and the cochlear nerve, allowing to still perceive vestibular symptomatology despite of a proper neurectomy. 相似文献11.
Hypothesis
To determine the pharmacokinetics of sodium thiosulfate in the inner ear perilymph following middle ear application in Guinea pigs.Background
Cisplatin chemotherapy is often associated with a dose-dependent high frequency sensorineural hearing loss. Sodium thiosulfate has been shown to reduce cisplatin-induced ototoxicity when given intravenously, but this may limit the tumoricidal effects of the chemotherapy. Recent animal studies looking at middle ear application of sodium thiosulfate have shown prevention of outer hair cell and hearing loss, but the perilymph pharmacokinetics have not yet been established.Methods
Twenty Guinea pig ears were split into two groups and administered sodium thiosulfate to the middle ear at either a concentration of 250?mg/mL or 50?mg/mL for 30?min. Perilymph samples were then obtained serially through the round window over 6?h. Sodium thiosulfate concentrations were obtained using high-pressure liquid chromatography.Results
The 250?mg/mL group had a maximum perilymph concentration of 7.27?mg/mL (±0.83) that decreased to 0.94?mg/mL (±0.03) over 6?h. The 50?mg/mL group had an initial concentration of 1.63?mg/mL (±0.17) and was undetectable after 1?h. The half-life of sodium thiosulfate within perilymph was 0.74?h.Conclusions
and Relevance: The results of this study show that sodium thiosulfate is capable of diffusing through round window and into the inner ear perilymph. Peak levels decline over several hours after exposure. This has a potential application as a localized therapy in the prevention of cisplatin induced ototoxicity. 相似文献12.
Objective
We examined plastic changes in the vestibulo-ocular reflex (VOR) during low-frequency vertical head rotation, a condition under which otolith inputs from the vestibular system are essential for VOR generation.Methods
For adaptive conditioning of the vertical VOR, 0.02 Hz sinusoidal pitch rotation for one hour about the earth’s horizontal axis was synchronized with out-of-phase vertical visual stimulation from a random dot pattern.Results
A vertical VOR was well evoked when the upright animal rotated around the earth-horizontal axis (EHA) at low frequency due to the changing gravity stimulus and dynamic stimulation of the otoliths. After adaptive conditioning, the amplitude of the vertical VOR increased by an average of 32.1%.Conclusion
Our observations showing plasticity in the otolithic contribution to the VOR may provide a new strategy for visual-vestibular mismatch training in patients with otolithic disorders. This low-frequency vertical head rotation protocol also provides a model for investigating the mechanisms underlying the adaptation of VORs mediated by otolith activation. 相似文献13.
Objective
Evaluating the auditory function in patients with chronic hepatitis C treated with sofosbuvir and ribavirin.Methods
This study involved 80 patients with chronic hepatitis C who agreed to receive sofosbuvir and ribavirin. All participants were subjected to baseline otological and audiological assessment just before treatment. The audiological assessment included standard pure tone audiometry, extended high-frequency audiometry, immitancemetry and otoacoustic emissions (OAEs) (transient and distortion product). According to baseline hearing threshold measurements, the study population was divided into 2 groups. Group 1 included 42 patients with normal hearing sensitivity (250–8000?Hz), and Group 2 included 38 patients with sensorineural hearing loss. After 24 weeks of therapy, otological and audiological assessments were repeated and compared between the two groups and before and after therapy.Results
Post-treatment hearing threshold evaluation showed no significant difference from pretreatment evaluation at all tested frequencies. There was no statistically significant difference between pre and post-treatment otoacoustic emissions results.Conclusion
Therapy with sofosbuvir and ribavirin in chronic hepatitis C has no noticeable effects on cochlear functions. 相似文献14.
Na Yuan Shiwei Qiu Qian Wang Wei Zhuang Guoping Li Tiantian Sun Shiming Yang Yuehua Qiao Xi Shi 《中华耳科学杂志(英文版)》2018,13(4):131-134
Objective
To understand the crucial role of the klotho gene in hearing development in mouse models.Methods
PCR was used to identify CBA mice with different genotypes, i.e. WT, heterozygous (klotho?+/?) or homozygous (klotho??/?). Mice phenotype and weight were recorded postnatal 25 days (P-25) and auditory brainstem responses (ABR) were used to determine auditory function at P-60.Results
klotho??/? mice tended to have smaller size, lighter weight and higher ABR thresholds at P-60, showing early onset age-related hearing loss (ARHL).Conclusion
Heterozygous and homozygous klotho deficient mice exhibit different degrees of hearing loss at young age, with homozygous mice (klotho??/?) showing more severe hearing loss. Our results indicate that persisted expression of klotho protein in the inner ear may potentially delay the onset of ARHL and play an important role in the protection of auditory function. 相似文献15.
Objective
To investigate the feasibility of transcanal endoscopic myringoplasty in the hand of young beginner surgeons who had just completed the residency programme.Methods
In a three year period (August 2012 to August 2015), 44 ears in 42 patients were operated upon by a beginner surgeon through the transcanal endoscopic approach in a subdistrict level hospital located in the north western ranges of the Himalayan region.Results
Of the 42 patient, 19 were male and 23 female. The mean age was 26.23 years (range: 15–47 years). In 40 ears, complete perforation closure was achieved at six months (success rate: 90.9%). The mean air conduction PTA preoperatively was 40.84?dB HL and improved to 28.06?dB HL postoperatively (p?<?.001). The mean AB gap preoperatively was 22.40?dB, which improved to 9.1?dB postoperatively (p?<?.001).Conclusion
Endoscopic transcanal myringoplasty is safe and reliable even in young beginners' hands. Surgeons can consider endoscopic approach early in their careers without the fear of learning curve. The cost of endoscopic equipment is about one tenth as compared to open approach under a operating microscope, and an added advantage. 相似文献16.
Jianhui Li Hui Zhao Bangqing Huang Shanshan Zhang Kaihua Sun Xinying Jiang Fuxin Luan 《中华耳科学杂志(英文版)》2018,13(4):135-137
Objective
This study aimed to investigate hearing acuity of centenarians in Hainan Province and provide basis for interventional considerations.Method
Door-to-door follow-up was conducted to investigate hearing acuity of centenarians (aged 100 years or above) in Hainan Province. Physical examination, pure tone audiometry and acoustic impedance test were performed, and the results were analyzed.Result
A total of 460 centenarians (920 ears) were tested by pure tone audiometry. The rate of normal hearing was 0.2%, the rate of mild hearing loss was 1.5%, 12% for moderate hearing loss, 33.9% for moderate to severe hearing loss, 37.4% for severe hearing loss is and 15% for profound hearing loss. Acoustic impedance test was performed in 340 centenarians (668 ears). Tympanogram was type A in 41.2% of the ears, type As in 34.1% ears, type Ad in 6.4%, type B in 11.8%, and type C in 4.9% of the ears, while no response was elicited in 1.5% of the ears.Conclusion
Age related sensorineural hearing loss is prevalent among centenarians in Hainan Province. A probably beneficial intervention may be the use of hearing aids for effective communication. 相似文献17.
Objectives
This study examined the quality of life (QoL) of the parents and siblings of hearing-impaired children with cochlear implants (CIs).Design
This is a cross-sectional, questionnaire-based study. The questionnaire consists of three sub-domains - interaction, emotional well-being and support for the hearing-impaired child and the overall QoL -- and two open-ended questions for participants to provide comments and suggestions to enhance their family's QoL. A total of 63 questionnaires were e-mailed or mailed to families who met the inclusion criteria.Setting
The study was conducted under the Center for Rehabilitation & Special Needs, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur.Participants
A total of 79 parents and 23 siblings from 44 families of children with CI participated in this study.Main outcome measures
The mean score for each of the sub-domain and the overall QoL for both subject groups were computed. The answers for the open-ended questions were listed and organized into themes.Results
There were significant correlations between the overall QoL score and each of the test domains for the parents' group (p?<?0.01). For the siblings' group, only the interaction and support domains were significant. Interaction was the main sub-domain affecting the parents' QoL but for siblings, this could not be determined. A total of 60% of the pooled comments were classified as ‘concerns’. As for the suggestions, 38.7% requested some form of support, mainly financial (41.7%).Conclusions
Families with hearing impaired children with CI have numerous concerns that need to be addressed, even though, on average, they were satisfied with their overall QoL. 相似文献18.
19.
Roshan K. Verma Niveditha Damodharan Archana Angrup Jaimanti Bakshi Naresh K. Panda 《中华耳科学杂志(英文版)》2018,13(2):68-74
Objective
To study the bacteriological profile in a healing mastoid cavity.Methods
This study was a single centre prospective study. Culture swabs from granulations in the mastoid cavity were sent in 40 consecutive patients with squamosal chronic otitis media undergoing mastoidectomy. Cultures were processed for both aerobic and anaerobic bacteria.Results
Preoperatively: specimens from 26 out of 40 (60.5%) had growth on culture, with 22 (55%) showing only one organism while 4 showing multiple organisms. The commonest organism isolated was pseudomonas aeruginosa (n?=?15).At 1 month after mastoidctomy, 11 patients had sterile culture while 29 had growth, of which 26 had aerobic growth and 3 had anaerobic growth. Pseudomonas was seen in 22 patients and staphylococcus aureus in 2 patients. The mean Merchant score was 2.At 3 months: 29 patients (72.5%) had sterile culture from mastoid cavity while 11 patients (27.5%) had growth on culture. All positive cultures were aerobic, including pseudomonas (n?=?9) and proteus (n?=?2). The mean Merchant score was 1.03. Of the 40 patients, 16 (40%) had a different organism cultured postoperatively compared to preoperative swabs.Conclusion
Pseudomonas and proteus seem to be the most common organisms responsible for persistent otorrhea after mastoidectomy. Persistent sterile otorrhea was seen in 4 patients (10%) in this group at the end of 3 months. Sterile cultures of preoperative swab are more likely to remain sterile in the postoperative period. 相似文献20.