The correlation of hearing prognosis and caloric test results in Meniere's disease: a follow up study.

BACKGROUND: Hearing loss is important in the diagnosis and treatment of Meniere's disease (MD). However, little is known about the factors associated with hearing changes in MD. AIMS/OBJECTIVES: This study aimed to investigate the correlation between hearing prognosis and caloric test (CT) results in MD. MATERIAL AND METHODS: Ninety consecutive patients diagnosed with unilateral definite MD underwent pure tone audiometry (PTA) and CT at initial visits, and were re-tested PTA at the 6-month follow-up. RESULTS: Fifty-three of ninety MD patients (58.89%) had abnormal CT results. The change of PTA (cPTA = initial PTA-last PTA) was negatively correlated with canal paresis (CP) values (overall association p = 0.032 and non-linear association p = 0.413). Multivariate linear model showed that as the CP value changed from 0 to 1, the cPTA decreased by -13.31 dB (95% CI: -24.03, -2.6) (p = 0.016). Stratified analysis found that the association was present in MD patients of Stage 1 and 2 (p < 0.05) but not in patients of Stage 3 and 4 (p > 0.05). CONCLUSIONS AND SIGNIFICANCE: Elevated CP values may be linked to worse hearing outcomes in MD, especially in Stage 1 and 2 patients. Conducting a caloric test at the initial consultation may aid in assessing hearing regression in MD.

A prospective cohort study on the association between new falls and balancing ability among older adults over 80 years who are independent.

OBJECTIVE: The purpose of this study was to prospectively investigate the relationship between new falls and the balancing ability of older adults aged ≥80 years who are independent and evaluate the validity of the assessment tools as a predictor of falls. METHODS: We enrolled a total of 160 participants (104 males and 56 females) aged 80 years or older. During the 12 months of observation, we investigated underlying diseases and drug use and performed a comprehensive geriatric assessment (including self-care ability, muscle strength, action ability, cognition, emotional state, and other aspects), as well as computerized dynamic posturography to assess balance and gait functions. We further analyzed the relationship between new falls and multiple internal risk factors. RESULTS: A total of 159 participants were included for statistical analysis, and there were 108 new falls among the 59 participants. Fall history and visual preference (PREF) scores on the sensory integration test showed a positive correlation with new falls. The composite equilibrium score (SOTcom), left total hip bone mineral density, left directional control, and end point deviation were all found to be negatively correlated with new falls (P < 0.05). The cut-off point of the timed "up and go" test (TUG) in predicting new falls in this cohort was >12.03 s, with a sensitivity of 78.0 %, a specificity of 51.5 %, and an AUC of 0.667 (P < 0.001, 95 % CI: 0.567-0.721). The cut-off point of SOTcom in predicting new falls was ≤52, with a sensitivity of 40.7 %, a specificity of 84.0 %, and an AUC of 0.606 (P = 0.028, 95 % CI: 0.525-0.682). CONCLUSIONS: The decline of balance sensory input function (mainly vestibular and visual sense), skeletal muscle motor function, and related postural control ability constituted the main risk factors for new falls in older adults who were independent. The combined use of TUG and SOT was useful in further improving the accuracy of predicting new falls in this population and providing a direction for effective intervention and rehabilitation measures.

Effective degradation of lindane and its isomers by dielectric barrier discharge (DBD) plasma: Synergistic effects of various reactive species.

Lindane is a broad-spectrum organochlorine insecticide which has been included in the persistent organic pollutants (POPs) list together with its two hexachlorocyclohexane (HCH) isomers. Due to its continuous use in the past decades, the environmental impacts of HCHs are still severe now. Therefore, in the present study, dielectric barrier discharge (DBD) plasma was used as an advanced oxidation process for the destruction of HCHs in water. The result indicated that in air-DBD system, over 95.4% of the initial 5 mg L-1 lindane was degraded within 60 min. Moreover, DBD plasma displayed high degradation efficiencies of other HCH isomers including α, ß, and δ-HCH. Electron spin resonance spectra, scavenging experiments and theoretical calculations revealed that the synergistic effects of various reactive species were the main reason for the high efficiency of DBD plasma. For instance, both hydroxyl radicals (•OH) and electrons (e-) could initiate the degradation of HCHs, while other reactive species such as 1O2 and ONOOH played important roles in the decomposition of intermediates. Therefore, the present study not only provided an effective approach for the treatment of HCHs, but also revealed the underlying mechanism based on in-depth experimental investigation and theoretical calculation.

Meniere Disease treated with transcutaneous auricular vagus nerve stimulation combined with betahistine Mesylate: A randomized controlled trial.

BACKGROUND: Meniere Disease is a clinical condition defined by hearing loss, tinnitus, and aural fullness symptoms, there are currently no any medications approved for its treatment. OBJECTIVE: To determine whether taVNS as an adjunctive therapy could relieve symptoms and improve the quality of life in patients with Meniere disease. METHODS: In this Single-center, single blind, randomized trial, participants were assigned to transcutaneous auricular vagus nerve stimulation (taVNS) group and sham taVNS group. The primary outcome measures comprised Tinnitus Handicap Inventory, Dizziness Handicap Inventory, Pure Tone Auditory, Visual analogue scale of aural fullness. Secondary outcome measures comprised the 36-Item Short Form Health Survey, video head impulse test, and the caloric test. RESULTS: After 12 weeks, the THI (-11.00, 95%CI, -14.87 to -7.13; P < 0.001), DHI (-47.26, 95%CI, -50.23 to -44.29; P < 0.001), VAS of aural fullness (-2.22, 95%CI, -2.95 to -1.49; P<0.01), and Pure Tone Thresholds (-7.07, 95%CI, -9.07 to -5.06; P<0.001) were significantly differed between the two groups. In addition, SF36(14.72, 95%CI, 11.06 to 18.39; P < 0.001), vHIT (RD, 0.26, 95 % CI, -0.44 to -0.08, RR, 0.43, 95 % CI, 0.22 to 0.83, P < 0.01), and the caloric test (RD, -0.24, 95 % CI, -0.43 to -0.04, RR, 0.66, 95 % CI, 0.44 to 0.95, P = 0.02) have significant difference between two group, respectively. CONCLUSIONS: These findings suggest that taVNS combined with Betahistine Mesylate relieve symptoms and improve the quality of life for patients with Meniere Disease. taVNS can be considered an adjunctive therapy in treatment of Meniere Disease. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05328895.

Caloric tests in clinical practice in benign paroxysmal positional vertigo.

Background: The value of caloric tests in benign paroxysmal positional vertigo (BPPV) patients is unclear. Objectives: To analyze the features and clinical significance of caloric tests in BPPV patients. Materials and methods: About 2192 patients (256 BPPV and 1936 non-BPPV) who complained of dizziness triggered by movement, accompanied by the symptom of hearing loss or a history of vertigo, participated in this prospective clinical study. All subjects received a caloric test, 213 BPPV patients underwent follow-up for at least 6 months after canalith repositioning procedures (CRPs). Results: (1) The abnormal canal paresis (CP) prevalence of BPPV was 57%. (2) The curative rate of single CRP decreased during follow-up from 90.1% after 7 days to 61% after 6 months and was significantly lower in patients with (54.1%) than in those without (70.1%) an abnormal CP at 6 months post-treatment (p = .01). (3) The recurrent rate was significantly higher in BPPV patients with abnormal CP (25.2%) than with normal CP (12.5%; p = .017). Conclusions and significance: Patients with abnormal CP needed more CRPs and were more prone to relapse. The value of the caloric test in treatment planning and predicting recurrence in BPPV patients should be emphasized.

[Investigation and analysis of the baseline data of 3432 patients with vertigo].

OBJECTIVE: To analyze the baseline data of outpatient clinical subjects with vertigo and study on the clinical characteristics of vertigo. METHOD: The questionnaires and clinical tests data of 3432 patients complained vertigo were retrospectively analyzed. RESULTS: All the patients received interview and vestibular function test. These patients aged 4-89 years with an average age of (40 +/- 18.6) years. Among them 1513 (44.09%) were male and 1919 (55.91%) were female, with a male:female ratio of 1:1.27. Vertigo patients increased according to age and reached its peak in the 41-60 years among all patients. The incidence might increase along with the increase of education level in urban populations. The onset of vertigo might correlate with the careers but differed among different populations. CONCLUSIONS: Vertigo attacks patients in all age spans, but vertigo is highly prevalent in the population aged 41-60 years. The onset of vertigo is related to many different factors.

[Acupuncture combined with oral western medication for Meniere's disease: a randomized controlled trial].

OBJECTIVE: To compare the effect difference between acupuncture combined with western medication and simple western medication for Meniere's disease. METHODS: Ninety-six patients with Meniere's disease were randomly assigned into a combination group (48 cases, 12 cases dropping) and a medication group (48 cases, 9 cases dropping). Betastatin mesylate tablets (once 12 mg, 3 times a day) and mecobalamin tablets (once 0.5 mg, 3 times a day) were prescribed orally in the two groups. Acupuncture was used in the combination group, twice a week, 20 min a time, and the acupoints were Baihui (GV 20), Fengchi (GB 20), Tinggong (SI 19), Hegu (LI 4), Quchi (LI 11), Zusanli (ST 36), Fenglong (ST 40), Taichong (LR 3), Taixi (KI 3) and Tianshu (ST 25). All the treatment was given for continuous 12 weeks. The symptoms were observed by dizziness handicap inventory (DHI), tinnitus handicap inventory (THI), pure tone audiometry score and stuffy ear visual analogue scale (VAS). The effects were compared in the aspects of dizziness, hearing and activity. RESULTS: The scores of DHI, THI, pure tone audiometry and VAS scores after treatment were lower than those before treatment in the two groups (all P<0.05), with lower scores of the above 4 indexes in the combination group after treatment (all P<0.05). The difference values before and after treatment of the 4 indexes in the combination group were higher than those in the medication group (all P<0.05). The effective rates of dizziness, hearing and activity in the combination group were 97.2% (35/36), 91.7% (33/36), 88.9% (32/36), which were better than 71.8% (28/39), 74.4% (29/39) and 69.2% (27/39) in the medication group (all P<0.05). CONCLUSION: Acupuncture combined with conventional medication achieve better effect than simple conventional medication.

[Analysis and evaluation of the balance function in patients with type 2 diabetes].

OBJECTIVE: Evaluation and analyze the characteristics of balance function in patients with type 2 diabetes, and to find out the importance of proprioception, vision and vestibular in postural control. METHOD: All subjects were divided into two groups, 37 normal individuals, 33 patients with type 2 diabetes mellitus. All were assessed by computerized posturography under six upright stance.conditions: including standing on the firm surface and foam with eyes open and closed. RESULT: (1) On anteroposterior,the scores of proprioception, vision and vestibular were 93.96 ± 7.95, 80.22 ± 16.24, 70.87 ± 20.99, the normal were 98.00 ± 2.18, 91.44 ± 6.01, 80.44 ± 7.81. There were significances between diabetes mellitus group and normal control group (P < 0.05) respectively. (2) On lateral, the scores of vision and vestibular were 80.39 ± 12.60, 73.96 ± 16.04, and the normal were 92.11 ± 4.50, 83.18 ± 9.45. There were significances with P < 0.05 between diabetes mellitus group and normal control group. However, there was no obvious difference in proprioception scores between the two groups. (3) The limit of stability of normal group were (176.47 ± 44.13) mm²; diabetic group was (143.13 ± 62.30) mm². There was statistical significance between the group with P < 0.05. (In diabetic patients, there was no significant difference between the no dizziness group and the dizziness group of the scores of proprioceptive, visual, vestibular as well as stable limits, P > 0.05. CONCLUSION: The balance function of patients with type 2 diabetes decreased. It is the main characteristic that the vision and vestibular decreased more significantly in the postural control.