RESUMEN
A labyrinthine fistula is a severe complication of middle ear cholesteatoma that can cause profound sensorineural hearing loss and vertigo. However, there is no consensus regarding the transition to postoperative hearing. Although hearing deteriorates gradually with a delay in some cases of labyrinthine fistula, insufficient consideration has been given to this point. We examined perioperative changes in cases of middle ear cholesteatoma with labyrinthine fistulas. We retrospectively reviewed the medical records of 578 patients with middle ear cholesteatoma who underwent tympanoplasty at our hospital between 2016 and 2021. Patients with labyrinthine fistulas were selected; their perioperative bone-conduction hearing was assessed. Fistula depth was determined following the classification reported by Dornhoffer et al. The hearing was compared preoperatively, early postoperatively (3-6 months), and 1 year postoperatively. Forty-eight patients (8.3%) had labyrinthine fistulas. Regarding depth, 21 cases were type I, 14 were type IIa, 3 were type IIb, and 10 were type III. Preoperative bone-conduction hearing was significantly poor in invasion type IIb or deeper cases. Cases with type IIb or deeper fistulas, multiple fistulas, or vertigo deteriorated postoperatively. Type III cases or those with multiple fistulas deteriorated further from the early postoperative period to 1 year postoperatively. Concerning frequency, 500 and 2000 Hz showed a delayed deterioration. This is a valuable report of delayed hearing loss after surgery in patients with a labyrinthine fistula. This change is associated with the labyrinthine fistula's depth and multiple fistulas-this is important during preoperative counseling of patients undergoing surgery.
Asunto(s)
Colesteatoma del Oído Medio , Fístula , Enfermedades del Laberinto , Complicaciones Posoperatorias , Timpanoplastia , Humanos , Estudios Retrospectivos , Masculino , Femenino , Fístula/etiología , Fístula/cirugía , Persona de Mediana Edad , Adulto , Colesteatoma del Oído Medio/cirugía , Colesteatoma del Oído Medio/complicaciones , Enfermedades del Laberinto/cirugía , Enfermedades del Laberinto/etiología , Enfermedades del Laberinto/diagnóstico , Complicaciones Posoperatorias/etiología , Timpanoplastia/métodos , Pérdida Auditiva Sensorineural/etiología , Pérdida Auditiva Sensorineural/cirugía , Anciano , Adulto Joven , Conducción Ósea/fisiología , Vértigo/etiología , Adolescente , Audición/fisiologíaRESUMEN
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.
Asunto(s)
Imagen por Resonancia Magnética , Neuroma Acústico , Vértigo , Humanos , Diagnóstico Diferencial , Imagen por Resonancia Magnética/métodos , Neuroma Acústico/diagnóstico , Neuroma Acústico/diagnóstico por imagen , Vértigo/etiología , Vértigo/diagnóstico , Oído Interno/patología , Oído Interno/diagnóstico por imagen , Masculino , Mareo/etiología , Mareo/diagnóstico , Femenino , Persona de Mediana Edad , Neoplasias del Oído/diagnóstico , Neoplasias del Oído/diagnóstico por imagen , Neoplasias del Oído/patología , Enfermedades del Laberinto/diagnóstico , Errores Diagnósticos , Neurilemoma/diagnóstico , Neurilemoma/patología , Neurilemoma/diagnóstico por imagenAsunto(s)
Enfermedades Autoinmunes , Enfermedad de Meniere , Humanos , Enfermedad de Meniere/diagnóstico , Enfermedad de Meniere/inmunología , Masculino , Diagnóstico Diferencial , Enfermedades Autoinmunes/diagnóstico , Enfermedades Autoinmunes/inmunología , Femenino , Persona de Mediana Edad , Adulto , Oído Interno/inmunología , Audiometría de Tonos Puros , Anciano , Enfermedades del Laberinto/inmunología , Enfermedades del Laberinto/diagnóstico , Prueba de Impulso CefálicoRESUMEN
Systemic drug administration provides convenience and non-invasive benefits for preventing and treating inner ear diseases. However, the blood-labyrinth barrier (BLB) restricts the transport of drugs to inner ear tissues. Ultrasound can stimulate specific areas and penetrate tissues, with the potential to overcome physiological barriers. We present a novel strategy based on low-pressure pulsed ultrasound assisted by microbubbles (USMB) to transiently open the BLB and deliver therapeutics into the inner ear. A pulsed ultrasound device with adjustable pressure was established; the generated ultrasound was transmitted through the external auditory canal into the guinea pig's inner ear. We observed that the application of microbubbles allowed the use of safe and efficient ultrasound conditions to penetrate the BLB. We found that USMB-mediated BLB opening seemed to be associated with a reduced expression of the tight junction proteins zonula occludens-1 and occludin. Following intravenous administration, hydrophilic dexamethasone sodium phosphate (DSP), hydrophobic curcumin (CUR), as well as drug-loaded nanoparticles (Fe3O4@CUR NPs) could be efficiently delivered into the inner ear. We observed better drug accumulation in the perilymph of the inner ear, resulting in less drug (cisplatin)-induced ototoxicity. Furthermore, physiological, hematological, and histological studies showed that the modulation of the BLB by low-pressure USMB was a safe process without significant adverse effects. We conclude that USMB could become a promising strategy for the systematic delivery of therapeutics in the treatment of inner ear diseases.
Asunto(s)
Curcumina , Dexametasona , Oído Interno , Enfermedades del Laberinto , Microburbujas , Animales , Cobayas , Oído Interno/metabolismo , Dexametasona/administración & dosificación , Dexametasona/análogos & derivados , Curcumina/administración & dosificación , Curcumina/farmacocinética , Curcumina/química , Enfermedades del Laberinto/terapia , Ondas Ultrasónicas , Sistemas de Liberación de Medicamentos , Masculino , Nanopartículas/administración & dosificaciónAsunto(s)
Colesteatoma del Oído Medio , Fístula , Enfermedades del Laberinto , Canales Semicirculares , Humanos , Canales Semicirculares/patología , Canales Semicirculares/diagnóstico por imagen , Colesteatoma del Oído Medio/cirugía , Colesteatoma del Oído Medio/complicaciones , Colesteatoma del Oído Medio/patología , Fístula/cirugía , Enfermedades del Laberinto/patología , Enfermedades del Laberinto/diagnóstico por imagen , Enfermedades del Laberinto/etiología , Masculino , Femenino , Persona de Mediana EdadRESUMEN
Various inner ear diseases such as sensorineural deafness and Meniere's disease bring about problems such as speech communication disorders and decreased work efficiency, which seriously affect the life quality of patients. Due to the special anatomical structure and blood-labyrinth barrier in the inner ear, the current drug administration methods are often unable to achieve satisfactory results. Nanocarriers are the forefront and hot spot of nanotechnology research. In recent years, a lot of research progress has been made in the field of targeted delivery of the inner ear, which is expected to be eventually applied to the treatment of clinical diseases of the inner ear. This review focuses on the advantages, main research achievements and limitations of various nanocarriers in the targeted delivery of the inner ear, hoping to provide new ideas for related research.
Asunto(s)
Oído Interno , Pérdida Auditiva Sensorineural , Enfermedades del Laberinto , Enfermedad de Meniere , Humanos , Enfermedad de Meniere/tratamiento farmacológico , Calidad de VidaRESUMEN
Pneumo-membranous labyrinth is an almost unique condition, in which air extends into the membranous labyrinth, filling the endolymphatic sac through the vestibular aqueduct. In this manuscript, we describe and discuss a case of pneumo-membranous labyrinth, with air bubbles extending also to the endolymphatic sac, resulting in anacusis, following hyperbaric oxygen therapy for sudden sensorineural hearing loss. The patient was successfully rehabilitated with a cochlear implant, obtaining a pure-tone average of 30 dB, with a speech discrimination score of 100% at 70 dB. Laryngoscope, 134:3773-3777, 2024.
Asunto(s)
Pérdida Auditiva Sensorineural , Pérdida Auditiva Súbita , Oxigenoterapia Hiperbárica , Humanos , Oxigenoterapia Hiperbárica/métodos , Pérdida Auditiva Sensorineural/terapia , Pérdida Auditiva Súbita/terapia , Pérdida Auditiva Súbita/etiología , Masculino , Enfermedades del Laberinto/terapia , Persona de Mediana Edad , Femenino , Oído InternoRESUMEN
Autoimmune inner ear disease (AIED) is an organ-specific disease characterized by irreversible, prolonged, and progressive hearing and equilibrium dysfunctions. The primary symptoms of AIED include asymmetric sensorineural hearing loss accompanied by vertigo, aural fullness, and tinnitus. AIED is divided into primary and secondary types. Research has been conducted using animal models of rheumatoid arthritis (RA), a cause of secondary AIED. However, current models are insufficient to accurately analyze vestibular function, and the mechanism underlying the onset of AIED has not yet been fully elucidated. Elucidation of the mechanism of AIED onset is urgently needed to develop effective treatments. In the present study, we analyzed the pathogenesis of vertigo in autoimmune diseases using a mouse model of type II collagen-induced RA. Auditory brain stem response analysis demonstrated that the RA mouse models exhibited hearing loss, which is the primary symptom of AIED. In addition, our vestibulo-oculomotor reflex analysis, which is an excellent vestibular function test, accurately captured vertigo symptoms in the RA mouse models. Moreover, our results revealed that the cause of hearing loss and vestibular dysfunction was not endolymphatic hydrops, but rather structural destruction of the organ of Corti and the lateral semicircular canal ampulla due to an autoimmune reaction against type II collagen. Overall, we were able to establish a mouse model of AIED without endolymphatic hydrops. Our findings will help elucidate the mechanisms of hearing loss and vertigo associated with AIED and facilitate the development of new therapeutic methods.
Asunto(s)
Enfermedades Autoinmunes , Modelos Animales de Enfermedad , Hidropesía Endolinfática , Enfermedades del Laberinto , Animales , Ratones , Hidropesía Endolinfática/patología , Hidropesía Endolinfática/inmunología , Enfermedades Autoinmunes/patología , Enfermedades Autoinmunes/inmunología , Enfermedades del Laberinto/patología , Enfermedades del Laberinto/inmunología , Artritis Reumatoide/patología , Artritis Reumatoide/inmunología , Artritis Reumatoide/complicaciones , Vértigo/patología , Vértigo/etiología , Colágeno Tipo II/inmunología , Potenciales Evocados Auditivos del Tronco Encefálico , Femenino , Ratones Endogámicos C57BLRESUMEN
OBJECTIVE: To discuss the link between inner ear decompression sickness and patent foramen ovale. MATERIALS AND METHODS: Monocentric and retrospective study on decompression sickness of the inner ear requiring hyperbaric chamber treatment, from 2014 to 2021. RESULTS: Sixty-one patients of inner ear decompression sickness were included in this study. Twenty-four patients had vestibular injuries, 28 cochlear injuries and 9 cochleo-vestibular injuries. Compression chamber treatment was given, using an oxygen-helium mixture with oxygen partial pressure (PIO2) limited to 2.8 atmosphere absolute (ATA). All vestibular accidents completely recovered without clinical sequelae. For cochlear accident only 10 out of 37 patients (27%) recovered completely. A right-left shunt (patent foramen oval or intra-pulmonary shunt) was found in 31.1% of patients with inner ear decompression sickness (p > 0.05). CONCLUSION: The presence of patent foramen oval in patients with inner ear decompression was not statistically significant in our study. Understanding of the pathophysiology of decompression illness and the physiology and anatomy of the labyrinth would suggest a mechanism of supersaturation with degassing in intra-labyrinthine liquids.
Asunto(s)
Enfermedad de Descompresión , Foramen Oval Permeable , Humanos , Estudios Retrospectivos , Masculino , Femenino , Enfermedad de Descompresión/terapia , Adulto , Foramen Oval Permeable/complicaciones , Persona de Mediana Edad , Anciano , Oxigenoterapia Hiperbárica/métodos , Adulto Joven , Enfermedades del Laberinto , Oído Interno , AdolescenteRESUMEN
OBJECTIVE: Intratympanic injections are a safe, well tolerated procedure routinely performed by ENT's specialists. Intratympanic injections of gels have the potential to deliver therapeutics into the cochlea through the round window membrane prolonging the release of drugs in the inner ear compartment. Aim of the present review is to summarize clinical trials testing pharmacological treatments for inner ear pathologies through intratympanic gel formulations. DATA SOURCES: Online databases (Google scholar and PubMed) and registers (Clinicaltrials.gov and Euclinicaltrial) were used to identify clinical trials performed between 1990 and 2022. REVIEW METHODS: PRISMA criteria have been followed. Clinical trials testing gel formulations administered through local intratympanic injections and targeting inner ear disorders were included. All the reports were identified by the authors working in pairs sequentially selecting only studies respecting the inclusion criteria. RESULTS: A total of 45 clinical studies have been noticed; the gels for intratympanic injection are in the form of poloxamers or hyaluronic acid combinations; the trials found target different kind of inner ear disorders: acquired-stable SNHL, tinnitus, acute sudden SNHL, Meniere disease, cisplatin induced ototoxicity and hearing preservation in patients undergoing cochlear implant surgery. CONCLUSION: Few studies listed do not provide the specific kind of gel formulation used but only report the intratympanic delivery vehicle as "gel" or "thermogel". Multiple clinical studies have been targeting several forms of inner ear disorders by injecting different compounds through poloxamer and hyaluronic acid formulations. Larger and more advanced clinical stages are necessary to confirm the efficacy of these chemical compounds.
Asunto(s)
Geles , Inyección Intratimpánica , Enfermedades del Laberinto , Humanos , Enfermedades del Laberinto/tratamiento farmacológico , Ensayos Clínicos como AsuntoRESUMEN
A 30-year-old man presented with minute-long episodes of vertigo and severe autophony. CVEMP showed a decreased threshold when testing the left side, potentially indicating SSCD. A subsequent MRI demonstrated a multi-lobulated, cystic mass in the temporal bone and the radiological diagnosis at that time was ELST. Tumor excision was performed, and microscopic examination of the excised material revealed fibrovascular tissue without signs of papillary or cystic projections. The conclusion of the histological assessment rendered a diagnosis of angiofibroma. We were unable to find a previous report of ENA originating around the endolymphatic sac. Laryngoscope, 134:1897-1900, 2024.
Asunto(s)
Angiofibroma , Neoplasias Óseas , Neoplasias del Oído , Saco Endolinfático , Enfermedades del Laberinto , Masculino , Humanos , Adulto , Saco Endolinfático/cirugía , Saco Endolinfático/patología , Angiofibroma/diagnóstico por imagen , Angiofibroma/cirugía , Enfermedades del Laberinto/patología , Neoplasias del Oído/diagnóstico por imagen , Neoplasias del Oído/cirugía , Vértigo , Neoplasias Óseas/patologíaRESUMEN
OBJECTIVE: This study aimed to compare the pre- and post-operative vestibular and equilibrium functions of patients with cholesteatoma-induced labyrinthine fistulas who underwent different management methods. METHODS: Data from 49 patients with cholesteatoma-induced labyrinthine fistulas who underwent one of three surgical procedures were retrospectively analysed. The three management options were fistula repair, obliteration and canal occlusion. RESULTS: Patients underwent fistula repair (n = 8), canal occlusion (n = 18) or obliteration procedures (n = 23). Patients in the fistula repair and canal occlusion groups suffered from post-operative vertigo and imbalance, which persisted for longer than in those in the obliteration group. Despite receiving different management strategies, all patients achieved complete recovery of equilibrium functions through persistent efforts in rehabilitation exercises. CONCLUSION: Complete removal of the cholesteatoma matrix overlying the fistula is reliable for preventing iatrogenic hearing deterioration due to unremitting labyrinthitis. Thus, among the three fistula treatments, obliteration is the optimal method for preserving post-operative vestibular functions.
Asunto(s)
Colesteatoma del Oído Medio , Fístula , Enfermedades del Laberinto , Humanos , Colesteatoma del Oído Medio/complicaciones , Colesteatoma del Oído Medio/cirugía , Enfermedades del Laberinto/etiología , Enfermedades del Laberinto/cirugía , Estudios Retrospectivos , Audición , Fístula/etiología , Fístula/cirugíaRESUMEN
PURPOSE: Radiographic review of pathologies that associate with third window syndrome. METHODS: Case series and literature review. RESULTS: Eight unique third window conditions are described and illustrated, including superior, lateral, and posterior semicircular canal dehiscence; carotid-cochlear, facial-cochlear, and internal auditory canal-cochlear dehiscence, labyrinthine erosion from endolymphatic sac tumor, and enlarged vestibular aqueduct. CONCLUSION: The present study highlights the characteristic imaging features and symptoms to differentiate third window pathologies for expedient diagnosis and management planning.
Asunto(s)
Pérdida Auditiva Sensorineural , Enfermedades del Laberinto , Dehiscencia del Canal Semicircular , Acueducto Vestibular , Humanos , Enfermedades del Laberinto/diagnóstico por imagen , Enfermedades del Laberinto/patología , Pérdida Auditiva Sensorineural/patología , Acueducto Vestibular/patología , Cóclea/diagnóstico por imagen , Cóclea/patología , Canales Semicirculares/diagnóstico por imagen , Canales Semicirculares/patologíaRESUMEN
BACKGROUND: Manières disease (MD) is a chronic inner ear disease characterized by recurrent vertigo and fluctuation in auditory symptoms. Vertigo spells have a sudden onset and are difficult for patients to handle. Therefore, treating a patient with MD is still a challenge for clinicians. AIMS: This study aims to analyse the short-term effects of intratympanic dexamethasone (ITD) on the various symptoms of unilateral MD. MATERIALS AND METHODS: The study comprised 27 patients with unilateral MD and severe vertigo who failed medication therapy. Treatment was with ITD as an alternative to destructive therapy. Treatment is evaluated after four months. RESULTS: Significant improvements were measured with Dizziness Handicap Inventory (DHI), Tinnitus Handicap Inventory (THI), frequency of vertigo attacks longer than 20 min, Functional Level Scale (FLS), and tinnitus sensation measured by the Analog Visual Scale (AVS). Patients with severe symptoms grading with DHI and THI experienced the most improvement. Patients have achieved substantial vertigo control in 73%. CONCLUSION: ITD application shows improvement in controlling vertigo and tinnitus in patients under exacerbation in MD. SIGNIFICANCE: It is a promising non-destructive addition to the 'stepwise treatment concept' in MD and can be used as a first-line treatment in vertigo control.
Asunto(s)
Enfermedades del Laberinto , Acúfeno , Humanos , Acúfeno/tratamiento farmacológico , Mareo , Vértigo/tratamiento farmacológico , Vértigo/etiología , Dexametasona/uso terapéuticoRESUMEN
Delayed endolymphatic hydrops ï¼DEHï¼ is a rare disease that causes vertigo and is often misdiagnosed as other vertigo diseases. This article reports on a patient with vertigo who was easily misdiagnosed. The patient was a middle ear cholesteatoma complicated by labyrinthine fistula ï¼LFï¼; however, his vertigo was episodic vertigo, which could not be explained solely by LF causing labyrinthitis. The possibility of endolymphatic hydrops was suspected, which was confirmed by inner ear magnetic resonance gadolinium imaging. This is the first reported case of middle ear cholesteatoma complicated by LF and DEH. The patient underwent surgical resection of the cholesteatoma and three semicircular canal obstructions at the same time. During two years postoperative follow-up, the patient did not experience a recurrence of vertigo. When diagnosing vertigo diseases, a careful history of vertigo is of utmost importance.
Asunto(s)
Colesteatoma del Oído Medio , Hidropesía Endolinfática , Enfermedades del Laberinto , Humanos , Hidropesía Endolinfática/complicaciones , Hidropesía Endolinfática/diagnóstico , Colesteatoma del Oído Medio/complicaciones , Vértigo/complicaciones , Enfermedades del Laberinto/complicaciones , Imagen por Resonancia Magnética/efectos adversos , Canales SemicircularesRESUMEN
Introdução: A reabilitação vestibular (RV) surge como uma opção terapêutica em casos de tontura e desequilíbrio postural. O The Activities-specific Balance Confidence Scale (ABC Scale) é um questionário utilizado para avaliar a interferência destes sintomas vestibulares por meio do nível de confiança dos indivíduos em realizar atividades diárias que envolvem o equilíbrio postural. Objetivo: comparar o nível de confiança na realização de atividades diárias relacionadas ao equilíbrio corporal, pré e pós reabilitação vestibular (RV) em pacientes com disfunção vestibular. Método: Estudo primário, intervencional, clínico, longitudinal, prospectivo, analítico, não controlado. Participaram 14 indivíduos, do sexo feminino e masculino, portadores de vestibulopatia periférica. Foi aplicado o Activities-specific Balance Confidance Scale (ABC Scale) nas condições pré e pós RV. Os dados foram analisados de forma descritiva e inferencial, pelos testes Exato de Fisher, t-Sudent e o modelo linear de efeitos mistos. Resultados: A amostra se caracterizou por 78.57% do sexo feminino e 21.43% do sexo masculino, com média de idade de 59.21 anos. Observou-se diferença estatística quando comparados os resultados do ABC Scale nas condições pré e pós RV (p<0.0001). Não foi verificada diferença estatística entre os escores deste instrumento com as variáveis sexo, idade e número de sessões terapêuticas. Conclusão: Foi possível concluir que o nível de confiança dos pacientes dessa amostra modificou de baixo, na fase pré reabilitação, para alto, na fase final da intervenção, o que consolida a ocorrência do aumento no nível de confiança que acarretou melhoria na qualidade de vida. (AU)
Introduction: Vestibular rehabilitation (VR) appears as a therapeutic option in cases of dizziness and postural imbalance. The Activities-specific Balance Confidence Scale (ABC Scale) is a questionnaire used to assess the interference of these vestibular symptoms with the individuals' level of confidence to carry out daily activities involving postural balance. Objective: to compare the level of confidence to carry out daily activities related to body balance, before and after VR, in patients with vestibular dysfunction. Method: Primary, interventional, clinical, longitudinal, prospective, analytical, and noncontrolled study. The sample comprised 14 male and female individuals with peripheral vestibulopathy. The ABC Scale was applied before and after VR. Descriptive and inferential data analysis were performed, using Fisher's Exact test, Student's t-test, and the linear mixed-effects model. Results: The sample had 78.57% females and 21.43% males, with a mean age of 59.21 years. There was a statistical difference in ABC Scale results before and after VR (p < 0.0001). There was no statistical difference between its scores and sex, age, or the number of therapy sessions. Conclusion: It was concluded that this study patients' confidence level changed from low in the pre-rehabilitation phase, to high in the final phase of the intervention, which consolidates the increase in confidence level that led to an improvement of quality of life. (AU)
Introducción: La rehabilitación vestibular (RV) aparece como una opción terapéutica en casos de mareos y desequilibrio postural. La Escala de Confianza en el Equilibrio Específica de Actividades (Escala ABC) es un cuestionario utilizado para evaluar la interferencia de estos síntomas vestibulares a través del nivel de confianza de los individuos en la realización de actividades diarias que involucran el equilibrio postural. Objetivo: comparar el nivel de confianza en la realización de actividades cotidianas relacionadas con el equilibrio corporal, pre y post rehabilitación vestibular (RV) en pacientes con disfunción vestibular. Método: Estudio primario, intervencionista, clínico, longitudinal, prospectivo, analítico, no controlado. Participaron 14 individuos, hombres y mujeres y con vestibulopatía periférica. La Escala de Confianza del Equilibrio Específica de Actividades (Escala ABC) se aplicó en condiciones previas y posteriores a la RV. Los datos fueron sometidos a análisis descriptivo e inferencial mediante la prueba exacta de Fisher, t-Sudent y el modelo lineal de efectos mixtos. Resultados: La muestra se caracterizó por 78,57% del sexo femenino y 21,43% del masculino, con una edad media de 59,21 años. Hubo diferencia estadística al comparar los resultados de la Escala ABC en condiciones pre y post RV (p<0,0001). No hubo diferencia estadística entre los puntajes de este instrumento con las variables sexo, edad y número de sesiones terapéuticas. Conclusión: Fue posible concluir que el nivel de confianza de los pacientes de esta muestra pasó de bajo, en la fase de pre-rehabilitación, a alto, en la fase final de la intervención, lo que consolida la ocurrencia del aumento en el nivel de confianza que llevó a una mejora en la calidad de vida. (AU)
Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Actividades Cotidianas/psicología , Confianza/psicología , Vértigo/rehabilitación , Encuestas y Cuestionarios , Estudios Retrospectivos , Mareo/rehabilitación , Enfermedades del Laberinto/terapiaRESUMEN
Over the last several decades, both the academic and therapeutic fields have seen significant progress in the delivery of drugs to the inner ear due to recent delivery methods established for the systemic administration of drugs in inner ear treatment. Novel technologies such as nanoparticles and hydrogels are being investigated, in addition to the traditional treatment methods. Intracochlear devices, which utilize current developments in microsystems technology, are on the horizon of inner ear drug delivery methods and are designed to provide medicine directly into the inner ear. These devices are used for stem cell treatment, RNA interference, and the delivery of neurotrophic factors and steroids during cochlear implantation. An in-depth analysis of artificial neural networks (ANNs) in pharmaceutical research may be found in ANNs for Drug Delivery, Design, and Disposition. This prediction tool has a great deal of promise to assist researchers in more successfully designing, developing, and delivering successful medications because of its capacity to learn and self-correct in a very complicated environment. ANN achieved a high level of accuracy exceeding 0.90, along with a sensitivity of 95% and a specificity of 100%, in accurately distinguishing illness. Additionally, the ANN model provided nearly perfect measures of 0.99%. Nanoparticles exhibit potential as a viable therapeutic approach for bacterial infections that are challenging to manage, such as otitis media. The utilization of ANNs has the potential to enhance the effectiveness of nanoparticle therapy, particularly in the realm of automated identification of otitis media. Polymeric nanoparticles have demonstrated effectiveness in the treatment of prevalent bacterial infections in pediatric patients, suggesting significant potential for forthcoming therapeutic interventions. Finally, this study is based on a research of how inner ear diseases have been treated in the last ten years (2012-2022) using machine learning.
Asunto(s)
Infecciones Bacterianas , Oído Interno , Enfermedades del Laberinto , Otitis Media , Humanos , Niño , Inteligencia Artificial , Enfermedades del Laberinto/tratamiento farmacológico , Preparaciones FarmacéuticasRESUMEN
The literature review is devoted to the practical application of the method of recording vestibular evoked myogenic potentials (VEMPs) in the diagnosis of the inner ear diseases: superior semicircular canal dehiscence syndrome, Meniere's disease, benign paroxysmal positional vertigo (BPPV), vestibular neuritis. Registration of VMEP is an electrophysiological research method that allows to assess objectively the functional state of the otolith receptors (sacculus and utriculus) and their pathways, which expands the diagnostic capabilities in diagnosis of the inner ear diseases.