Otolithic functions in patients with residual dizziness after successful repositioning manoeuvres for unilateral posterior canal BPPV.

OBJECTIVE: To evaluate otolithic functions in patients with residual dizziness after successful canalith repositioning procedures (CRPs) for unilateral posterior canal benign paroxysmal positional vertigo (BPPV), and to investigate possible risk factors. METHODS: This case-control observational study included healthy controls and patients with residual dizziness after improvement following CRP for BPPV. All participants were subjected to full history taking, otoscopy, audiological basic evaluation, Dix-Hallpike test to search for posterior canal BPPV, residual dizziness screening, and vestibular evoked myogenic potential (VEMP) testing. Between-group differences were assessed and possible factors associated with residual dizziness were identified by univariate analysis. RESULTS: A total of 50 patients with residual dizziness (mean age, 56.53 ± 7.46 years [29 female: 21 male]) and 50 healthy controls (mean age, 58.13 ± 7.57 years [20 female: 30 male]) were included. A significant difference in VEMP latencies was found between the patient and control group (delayed in the patient group), with no significant between-group difference in amplitude in both ears. Aging, female sex, long duration of BPPV, number of CRPs, cervical VEMP and ocular VEMP abnormalities, and winter onset, were significantly associated with the risk of residual dizziness. CONCLUSIONS: Residual dizziness is a frequent sequel of BPPV that may relate to otolithic dysfunction. VEMP changes were revealed in the form of delayed latencies.

Can vaccination against pneumococci prevent otitis media with effusion?

The most common cause of hearing loss in early childhood is otitis media with effusion (OME). Prevention of OME in preschool children will improve quality of life. The authors aimed to determine, by the best available published evidence, whether vaccination against pneumococci effectively prevents OME. The study design was based on systematic review (SR) of randomized controlled trials (Level 1a evidence). The medical literature available through searching Medline database was reviewed using the following keywords "Otitis media with effusion," "secretory otitis media," or "glue ear," and "vaccination" limiting the search to randomized controlled trials (RCTs) conducted on children (0-18 years), published in English, in the last 10 years. Results of effects of vaccination on prevention of OME from the included RCTs were utilized to conduct a meta-analysis to find out the preventive value of antipneumococcal vaccination. Three RCTs were identified conforming to the inclusion criteria. Meta-analysis of results showed no significant preventive advantage for antipneumococcal vaccination. Based on the results it was confirmed that neither primary nor secondary prevention by antipneumococcal vaccination has a beneficial impact on OME. More RCTs should be conducted to study the effect of vaccination on OME.