Reliability of Pod Shape Diagram from Caloric Test in Vertigo Patients / 听力学及言语疾病杂志

Objective To understand the reliability of caloric test results through the analysis of the pod shape dia-gram types of caloric test and to provide a more accurate and reliable basis for vestibular system function evaluation.Meth-ods The results of caloric test in 528 patients from July 2021 to May 2022 in vertigo diagnosis and treatment center were analyzed.According to pod pattern and unilateral weakness(UW),the patients were divided into five groups:cold and warm test symmetrical group,left and right side asymmetry group,single value significant abnormal group,bilateral hypo-plasia group and pod morphology unable to be classified group.Unreliable data can be identified by comparing,explaining,and summarizing the results of UW of different groups,so as to reduce the interference of unreliable data to clinical diagno-sis and treatment.Results Cold and warm test symmetric group(n=439)included patients with symmetry of bilateral vestibular function(n=273)and decreased vestibular function of one side(n=166).Left and right symmetrical groups in-eluded pationts with bilateral symmetric vestibular function(n=11)and unilateral reduction(n=13).Single value signifi-cant abnormal group showed cases with unilateral vestibular function reduction(n=25)and bilateral symmetric vestibular function(n=11).Bilateral hypolasion group showed cases with bilateral symmetric vestibular function(n=25)and unilat-eral reduction(n=9).Pod morphology unclassified group(n=5)suggested varions interference factors.Conduson When the function of the peripheral vestibular is symmetrical and normal,we should be alert to the existence of temperature effect,and should consider the inspection of the perfusion apparatus and the calibration of the irrigation temperature.When the function of the peripheral vestibular shows unilateral weakness,repeating the irrigation is recommended when the single value of the caloric test significantly increases or decreases.If there is no change,repeating the irrigation at the same tem-perature in the other ear or even repeating the whole caloric test are recommended.The UW value could not truly reflect the state of peripheral vestibular function when the caoric test produces bilateral weakness.Therefore,water irrigation could be used to make a correct judgment based on the medical history and other auxiliary examinations.It is of great significance to judge the effectiveness of caloric test comprehensively by combining the morphology of pod diagram with UW value.

Expert consensus on the diagnosis of isolated otolith dysfunction / 临床耳鼻咽喉头颈外科杂志

Isolated otolith dysfunction(iOD) involves a group of unexplained vestibular syndromes that manifest clinically as a sense of translation, tilting or floating, and blurred vision with head movement, with normal semicircular canal function but abnormal otolith function on laboratory vestibular testing. As vestibular medicine has gained widespread popularity in recent years, increasing attention has also been paid to iOD and case reports, clinical studies and diagnostic criteria have been published. However, there is no consensus document to guide the diagnosis of this disease in China. In this context, the Special Committee on Vertigo of China Medical Education Association organized a group of domestic experts in vestibular medicine and formulated this diagnostic consensus after thorough discussion based on the latest evidence in China and abroad, in order to promote the best clinical practice for iOD.

Analysis of the risk factors of intravenous immunoglobin-resistant Kawasaki diseases / 临床儿科杂志

Objective To explore the early laboratory indicators for risk of intravenous immunoglobin-resistant Kawasaki diseases. Methods The clinical data were retrospectively analyzed in 881 Kawasaki disease patients (group A: 26 cases of intravenous immunoglobin-resistant; group B: 855 cases of intravenous immunoglobin-sensitive) from July 1, 2015 to June 30, 2016. After 1:3 matching with age and sex, the regression model for each of variables including sex, age, fever days, temperature, red blood cell count (RBC), white blood cell count (WBC), neutrophil (N), lymphocyte (L), platelet count (PLT) and C reactive protein (CRP), was constructed by conditional logistic regression analysis. Results Compared with group B, group A had significantly lower RBC count and higher PLT (P<0.05). Logistic regression analysis showed that, with the age, the regression model was Y=-2.87+0.01×PLT (PLT OR=1.01, 95％ CI: 1.00～1.01, P<0.01); with the sex, Y=-32.98+0.44×WBC+0.28× N+0.01×PLT (WBC OR=1.55, 95％ CI: 1.17～2.05, P<0.01; N％ OR=1.32, 95％ CI: 1.04～1.68, P<0.05; PLT OR=1.01, 95％ CI 1.00～1.01, P<0.01). Conclusion In case that abnormally high levels of PLT exist in confirmed Kawasaki disease, it should be aware of possibility of the intravenous immunoglobin-resistant Kawasaki disease.

Clinical Observation of Acupuncture-activating Method for Deglutition Disorder Due to Pseudobulbar Palsy After Cerebral Stroke / 上海针灸杂志

Objective To observe the clinical efficacy of ZHU Lian's acupuncture-activatingmethod in treating deglutition disorder due to pseudobulbar palsy after cerebral stroke.Method Sixty patients with deglutition disorder due to pseudobulbar palsy after cerebral stroke in acute stage were randomized into an observation group and a control group, 30 cases in each group. The two groups both received symptomatic neurological treatment. In the two groups, acupoints including Lianquan (CV23), Huiyan (Extra), Baihui (GV20), and bilateral Shuaigu (GB8), Wangu (GB12), Zhaohai (KI6), Lieque (LU7),and Yinlingquan (SP9) were selected. The observation group was intervened by ZHU Lian's acupuncture-activating method; the control group was intervened by ordinary needling method plus G6805 therapeutic appliance with sparse-dense wave for 20 min. Prior tothe treatment and after 10 treatment courses, the two groups were evaluated by using Videofluoroscopic Swallowing Study (VFSS) and Kubota's water drinking test for swallowing function.Result After 10 treatment courses, the total effective rate was 96.7%in the observation group versus 83.3% in the control group, and the between-group difference was statistically significant (P<0.05); the VFSS score in the observation group was significantly different from that in the control group (P<0.01); the water drinking test score in the observation group was significantly different from that in the control group (P<0.01). The results indicated that the therapeutic efficacy was more significant in the observation group compared to that in the control group.Conclusion ZHU Lian's acupuncture-activating method can produce a more significant efficacy in treating deglutition disorder due to pseudobulbar palsy after cerebral stroke in acute stage compared with sparse-dense-wave electroacupuncture.

Study on difference of vestibular damage of sudden deafness and vestibular neuritis / 中国耳鼻咽喉头颈外科

OBJECTIVE To explore the difference of vestibular damage between sudden deafness and vestibular neuritis.METHODS Patients in otolaryngology head and neck surgery eenterin PLA general hospital from February 25 in 2016 to July 20 in 2016 were included in this research.Among these patients,55 cases were diagnosed as sudden deafness group,including 39 cases With vertigo.And other 46 cases were diagnosed as vestibular neuritis.Vestibular bithermal caloric test,head impulse test(head impulse test,HIT),cervical vestibular evoked myogenic potentials(cervical vestibular evoked myogenic potential,cVEMP),ocular vestibular evoked myogenic potentials(ocular vestibular evoked myogenic potential,oVEMP) were performed to evaluate their vestibular function and were compared.RESULTS The abnormal rate of vestibular bithermal caloric test in sudden deafness group 25.45％,and 97.82％ in vestibular neuritis group.There was significant difference between two groups(x2=54.01,P＜0.001).HIT:the abnormal ratein sudden deafness groupwas 9.09％ and 32.61％ in vestibular neuritis group,there was significant difference between two groups(x2=8.72,P=0.003).VEMP:the abnormal rate of cVEMP in sudden deafness group was 69.10％ and 43.47％ in vestibular neuritis group,there was significant difference between two groups(x2=6.72,P=0.010).But the abnormal rate of oVEMP in sudden deafness group was 54.55％ and 63.04％ in vestibular neuritis group,and there was not statistically significant difference between two groups(x2=0.745,P=0.388).CONCLUSION The vestibular damage of sudden deafness with vertigo was more likely involved with saccule and inferior vestibular nerve,more close to the nerve terminal,and the injury was in a low frequency range;but the vestibular damage in vestibular neuritis was wider,and the injury involved a full band,the damaged part may be higher.

The Prevalence of BPPV in Patients with Meniere’s Disease / 听力学及言语疾病杂志

Objective To investigate the prevalence of BPPV in patients with Meniere’s Disease(MD),and to investigate the diagnostic and predictive values of VEMP in patients with MD and BPPV.Methods A total of 1 1 6 patients previously diagnosed MD were followed up through telephone about their BPPV-like attacks.We recorded the detailed history of BPPV-like attacks,and provided them with complete Dix-Hallpike and roll tests if patients were on their BPPV-like attacks.Results In all,4 patients'histories supported BPPV,and 4 patients were found with BPPV.The prevalence of BPPV in patients with MD was 3 .4%(4/1 1 6 ).Meniere's symptoms preceded the on-set of BPPV in 8 patients.In 4 confirmed BPPV patients with Meniere's disease,BPPV was limited to the same ear as the MD in 2 cases,and 1 had contralateral BPPV,and 1 was uncertain.Six histories supported or confirmed BP-PVpatients with high abnormal oVEMP rates (5/6).Four in this 5 (80%)had abnormal oVEMP of the same MD ear.The single repositioning procedures can improve vertigo and eliminated positional nystagmus in cases of BPPV associated with MD.Conclusion In the present study,the prevalence of BPPV in patients with MD was 3 .45%.De-tailed medical histories combined with Dix-Hallpike and roll tests and VEMP tests can identify BPPV in patients with MD.

Clinical characteristics of 100 vestibular migraine cases / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To analyze the characteristics of vestibular migraine (VM), in order to understand the auditory and vestibular function.@*METHOD@#One hundred cases of confirmed or suspected VM patients were observed. Routine examination including pure tone test, vestibular dual temperature test and vestibular evoked myogenic potential(VEMP) and video head impulse test(v-HIT) Were conducted.@*RESULT@#The incidence of male and female was about 1.00 : 2. 57. The average age of onset was 47 years, of which the youngest was 19 years old, and the oldest was 74 years old. Ninty-three cases of patients presented with vestibular sensitive performance, including photophobia, phonophobia,or motion sensitive. Fourty-two patients had migraine at the onset of the disease. Thirty-four patients had cochiear symptoms, including tinnitus, ear fullness, or epicophosis. In seventeen cases of fatigue, tension or poor sleep can cause vertigo. Nine patients had low blood pressure, 7 patients presented with hypertension. Two cases of vertigo were closely related to the change of position, and 1 case had visual aura. In the experiment, 94 patients had undergone VEMP test,with 44 cases of abnormal VEMP value. Seventy-nine patients had been examined v-HIT,of whom 2 patients were abnormal (both of which were reduced). Pure tone audiometry was abnormal in 35 cases. Five cases of patients showed abnormal vestibular-double temperature test.@*CONCLUSION@#Vestibular migraine is more prone to female, with young middle age, and can be accompanied by cochlear symptoms. Vestibular function tests (low frequency and high frequency) are normal.

Prevalence of bilateral abnormalities of unilateral Meniére disease / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To analyze the abnormal conditions of the affected ear and the contralateral ear of patients with unilateral Meniere's disease and the prevalence of bilateral abnormalities among these unilateral Meniere disease population, providing reference for the clinical treatment strategies for Meniére disease.@*METHOD@#A retrospective analysis of 106 Meni6re disease cases was performed, the abnormal incidence of the affected ears, the contralateral ears and the bilateral abnormalities were calculated, and the disease characteristics were analyzed.@*RESULT@#The bilateral ears abnormal incidence of unilateral Meniére disease was 35. 85% (38/106); the cochlear symptoms of the contralateral ears often occurred 2. 25 years later of the symptoms of Meni6re disease; contralateral cochlear symptoms included at least two symptoms of tinnitus, deafness and ear fullness; 39. 47%(15/38) patients with bilateral abnormalities would appear binaural hearing impairment.@*CONCLUSION@#This study showed that about one-third of unilateral Meniére diseases have binaural symptoms, among which about one-third would occur bilateral hearing loss. Therefore, it is necessary to consider the course of disease and the symptoms of the contralateral ear before taking damage or destructive method for treating Meniére's disease clinically.

Cinical and genetic characteristics of familial Meniere's disease: three families report / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical and genetic characteristics of three Chinese Meniere's disease (MD) families and decipher the mechanism of MD further.</p><p><b>METHODS</b>Personal and family medical evidence of hearing loss, vestibular symptoms, and other clinical abnormalities of the participants were identified, clinical and genetic features were analyzed. Targeted 307 genes capture and high-throughput sequencing were performed on the two ascertained members of family 1007184.</p><p><b>RESULTS</b>Eight patients from these three families showed post-lingual sensorineural hearing loss, six women and two men were involved. Age of onset in these affected members concentrated in the middle age, with the average age of 39.3 years old. Among them, patients from 1407278 were accompanied by migraine. All of the three probands presented as recurrent vertigo firstly, and then fluctuated hearing loss showed up, accompanying by tinnitus and ear fullness feeling. The hearing loss manifested as late-onset, low frequency-involved pattern, with subsequent gradual progression from moderate to severe level. Some of the patients progressed to severe level involving all frequencies at higher ages. In addition, most of the cases showed revitalization. Four cases received vestibular function tests, three of which had varying dysfunction of vestibular function, while the other one had normal vestibular function. Patients who had abnormal vestibular function showed much more severe hearing impairment. The three-generation family 1007193 had an autosomal recessive genetic characteristics, family 1007184 showed autosomal dominant inheritance of characteristics, family 1407278 were either autosomal dominant or X-linked dominant pattern. Through target genes capture high-throughput sequencing technology, we identified two candidate variants in the two members of family 1007184, named c. 2057G>A in EGFLAM and c. 1961C>T in ITGA8.</p><p><b>CONCLUSION</b>Meniere's disease has some genetic and familial aggregation in Chinese population, but its complex genetic pathogenic mechanisms need further study.</p>

Study of clinical characteristics and curative effects of sudden hearing loss patients with vertigo / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To analyze the clinical characteristics, prognosis and therapeutic effects of sudden sensorineural hearing loss (SSHL) patients associated with vertigo, and to investigate the strategy of diagnosis and treatment.</p><p><b>METHODS</b>We retrospectively analyzed the clinical characteristics of 240 patients diagnosed as SSHL with vertigo, who were treated in the Chinese PLA General Hospital from July 2008 to August 2012. Various factors affecting the therapeutic effects were analyzed, such as audiological features, vestibular function tests, genders, audiograms, lasting before seeing a doctor, courses of vertigo and vascular factors.</p><p><b>RESULT</b>Among the contemporaneous SSHL patients (873 cases), the cases with vertigo accounted for 27.49% (240/873). Among the 240 patients with vertigo, the cases with different hearing impaired degree of mild, moderate, severe and profound were 30, 13, 28 and 34, respectively, primarily by the profound cases. Detailed vestibular function tests were performed in 97 patients, with 54 cases having unilateral vestibular disfunction and 43 patients having normal vestibular function, among which 23 cases were diagnosed as benign paroxymal positional vertigo (BBPV). The relationship between vestibular function and different hearing impaired degrees or various audiogram types had no statistically significant difference. 219 cases had detailed records of the onset time of cochlear and vestibular symptoms, including 122 patients with cochlear symptoms and dizziness occurring simultaneously. After standardized drug treatment, the total effective rate was 46.67%, with recovery in 17 cases, excellent in 34 cases, better in 61 cases and poor in 128 cases, respectively. Statistical analysis showed that different genders, audiogram types, vertigo courses of time, the results of vestibular function and neck vascular ultrasounds were not related to the curative effects, while, the treatment time after onset was significantly associated with treatment effects.</p><p><b>CONCLUSIONS</b>SSHL with vertigo has a high incidence, primarily single side affected, with relatively severe hearing impairment, and total deafness and downslope hearing curve mainly. Vestibular function can be normal or low in SSHL patients with vertigo, with a higher incidence of BPPV. Vestibular and cochlear symptoms occur simultaneously in more than half of the patients. The detection rate of vestibular dysfunction gradually increased, as the degree of hearing loss increased, without statistical significance although. The therapeutic effects of sudden hearing loss with vertigo cases have no relationship with dizziness duration or vestibular function, while the disease course plays an important role in treatment.</p>

The study of clinical characteristics of sudden sensorineural hearing loss patients with tinnitus / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To analysis the characteristics of sudden sensorineural hearing loss (SSHL) patients with tinnitus, and explore the relationship of characteristics of tinnitus and audiology.@*METHOD@#Patients diagnosed as SSHL with tinnitus were studied in the research. All patients' clinical features were analyzed, such as tinnitus frequency, pure tone audiometry, tinnitus, hearing loss degree, results of residual inhibition test.@*RESULT@#Thirty cases were identified as mild degree hearing loss, 13 cases as moderate degree, 28 cases as severe degree and 34 cases as profound degree. And hearing impaired frequency of 13 cases was ascertained at low-frequency, 39 cases at middle-high-frequency, and 53 cases at full-range-frequency. The incidence of patients with low-frequency was about 41. 9% (44/105), and it was about 21. 9% (23/105) in those with middle-frequency. And it was 36. 2% (38/105) in cases of high-frequency tinnitus. The chi-square test show statistically significant differences between patients with the low-frequency, middle-frequency and high-frequency of the hearing loss (P<0. 05). In tinnitus residual inhibition test, positive rate of convergence type masking curve was about 72.0%, tinnitus separated type masking curve 20.0%, overlapping type was 57.9%, and the spacing type was 43.5%. There was a statistically significant difference among cases with different type masking curve (P<0. 05)with the spacing residual inhibition test positive rate.@*CONCLUSION@#There are individual differences of clinical characteristics among SSHL patients with tinnitus. Tinnitus frequency is consistent with the frequency of hearing loss. Patients had the more serious the degree of hearing loss, who had more serious tinnitus grading. Cases with the converged type curve will be fit for tinnitus masking. Therefore, combining the tinnitus detection with the audiological tests, we could obtain the clinical characteristics of SSHL patients with tinnitus.

The hearing and vestibular evoked myogenic potentials test in patients with primary benign paroxysmal positional vertigo / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the result of vestibular evoked myogenic potentials (VEMP) of primary benign paroxysmal positional vertigo(BPPV)and to identify the characteristics in VEMP examination of the primary BPPV and to observe the relevance of patients with primary BPPV and abnormal VEMP with hearing loss.@*METHOD@#Patients with primary BPPV were tested with pure tone audiometry, videonystagmograph and VEMPs test. We analyzed the difference in the two groups with normal hearing and hearing loss, discussed the etiology and pathogenesis.@*RESULT@#Primary BPPV comprised 23.0% with hearing lost, 77.0% hearing normal. The results of oVEMP were abnormal in 79. 7% (59/74) of the cases; and the results of cVEMP were abnormal in 66. 2% (49/74) of the cases; oVEMP and cVEMP differences to the diagnosis of primary BPPV (P<0. 05); oVEMP and cVEMP differences to the diagnosis primary BPPV with hearing lost (P<0. 05).@*CONCLUSION@#oVEMP detection positive rate of primary BPPV is higher than cVEMP,which may be due to otolithic particles falling from the utricle; positive rate of cVEMP in primary BPPV with hearing loss is higher than that of oVEMP, which may related to the cochlear and sacculus occured in the same embryonic tissue structure.

The roles of otolith organs in the recurrence primary benign paroxysmal positional vertigo / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the roles of otolith organs in the occurrence and recurrence of primary benign paroxysmal positional vertigo (BPPV) by vestibular evoked myogenic potential (VEMP) test.@*METHOD@#We enrolled 17 recurrent primary BPPV patients and 42 non-recurrent primary BPPV patients between September 2014 and November 2014. All patients underwent VEMP tests, including cervical vestibular evoked myogenic potential (cVEMP and ocular vestibular evoked myogenic potential (oVEMP) tests. The abnormal case was defined as non-elicitation or asymmetry rate between bilateral sides is larger than 29%.@*RESULT@#Significant difference was found in abnormal rate between cVEMP and oVEMP (P 0.05). No significant difference was found in sex and age between recurrent and non-recurrent groups (P > 0.05).@*CONCLUSION@#The impairment of otolith organs, especially the utricle, is related to primary BPPV. Dysfunction of utricle may play a role in recurrence of BPPV. Recurrence of BPPV is not correlated with sex and age.

The study of the pure tone audiometry characteristics and curative effect in sudden hearing loss patients with hypertension / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the pure tone audiometry characteristics and curative effect in sudden hearing loss patients with hypertension.@*METHOD@#One hundred and fifty-seven inpatients (168 ears) with hypertension suffered from sudden hearing loss were included in this study. We retrospectively analyzed the audiological index of these patients by comparing the pure tone audiometry (PTA) among patients in the aspects of gender, age, affected side, duration of hypertension, with or without inducement, concomitant symptoms and other combined diseases. The hearing threshold at different frequency was also compared, as well as the curative effect among patients with diverse audiological characteristics.@*RESULT@#Of the contemporaneous sudden hearing loss patients (874 cases), the prevalence of hypertension was 17.96%, where the male ones accounted for. 28.69% (103/359) and the female ones accounted for 19.42% (54/278) respectively with statistically significant difference between genders (P 0.05). The hearing threshold means of each frequency of unilateral hearing loss patients was significantly higher than that of bilateral hearing loss patients (P < 0.05). The hearing threshold means at 125 Hz, 250 Hz, 500 Hz and 1 kHz showed significant difference among patients with different duration of hypertension (P < 0.05). The total effective rate of sudden hearing loss in patients with hypertension was significantly lower than that in the sudden hearing loss patients without hypertension (19.64%, 61.57% respectively, P < 0.01). The total effective rate presented significant difference among patients with different duration of hypertension and different Cardiovascular Risk Stratification (P < 0.05).@*CONCLUSION@#The prevalence of sudden hearing loss in hypertension patients was higher in male than in female, which rose with age and combined disease. The hearing threshold means at mid-frequency and high-frequency were higher than that at low-frequency. The total effective rate of sudden hearing loss was relatively low in patients with hypertension. The longer the duration of hypertension and the higher the Cardiovascular Risk Stratification, the lower the total effective rate. Comprehensive understanding of audiological characteristics and hypertension condition plays a crucial role in type-specific treatment of sudden hearing loss.

Prevention and Treatment of Five Zang-organs Diseases with Twelve Temperaments Combining with Siqi Theory / 世界科学技术-中医药现代化

The study and treatment of the music therapy is very popular in Europe and America. While the Chi-nese traditional music therapy is still in the stage of excavation, both the theory and clinical practice are waiting for exploration and development. Through the formation of twelve temperaments and twelve temperaments system, this article discussed the twelve temperaments which reflect the yin and yang of twelve months, and the five in-ternal organs reflect the yin and yang of the four season . The author thinks that the twelve temperaments can pre-vent and treat diseases of five zang-organs, and puts forward the train of thought of prevention and treatment of five zang-organs diseases with twelve temperaments combining with Siqi theory.

The assessment of anxiety and depression state in Meniere's disease patients / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the incidence of anxiety and depression state in patients with Meniere's disease, to provide objective evidence for curing Meniere's disease effectively.@*METHOD@#Hamilton anxiety scale and Hamilton depression scale were used to quantitatively analyze the anxiety and depression state of 60 patients with untreated definite Meniere's disease and 20 normal controls.@*RESULT@#The scores of patients with Meniere's disease was significantly higher than that of normal controls (P 0.05).@*CONCLUSION@#Patients with Meniere's disease experienced high level of anxiety and depression. The treatment should not only focus on the physiological disorder but also the psychiatric and emotional problems.

Diagnosis and Treatment of Delayed Endolymphatic Hydrops / 听力学及言语疾病杂志

Objective To investigate the diagnosis and treatments of delayed endolymphatic hydrops(DEH).Methods A restrospective study was conducted in 37 cases of DEH.who were tested with pure tone threshold,vestibular evoked myogenic potentials,high stimulation rate auditory brainstem response audiometry and vestibular ruction test.Conservative drug therapy was the major treatment.Results All the 37 patients had sensorineural hearing loss up to the medium-severe degrees at least.Twenty-five had hearing loss and endolymphatic hydrops on the same side,nine had contralateral type and three bilateral type.Ten cases had abnormal horizontal semicircular canal(HSCC) hydrops and saccular hydrops.Nine cases had abnormal HSCC function and nomal saccular function.Fifteen cases had abnormal saccular function and normal HSCC function.Twenty-five abnomalVEMP showed of loss of p13-n23,prolonged latencies of p13 and depressed amplitude cases with of p13-n23.18 cases were completely relieved from vertigo in a week.17 cases improved until totally relieved in two weeks,while the rest 2 cases that were subject to chemistry labyrinthectomy free of vertigo attack.Conclusion Pure tone threshold,EcochG,bithermal caloric test and vestibular evoked myogenic potentials are important diagnosis methods of delayed endolymphatic hydrops.Consevative drug therapy,especially diuretics and vascular dilation may play a major role in the treatment of delayed endolymphatic hydrops.

Vertigo due to neurovascular cross-compression: diagnosis and treatment / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the clinical characteristics, pathological mechanism, diagnose, differential diagnosis and the treatment of vascular compressive vestibular neuropathy.@*METHOD@#The authors retrospectively studied 2 cases of vascular compressive vestibular neuropathy about clinical characteristics, auditory tests, vestibular tests and imaging examine results, pharmacotherapy results and reviewed the related documents.@*RESULT@#There were some common clinical characteristics: (1) Vertigo and disequilibrium could be elicited by any physical activity and head movement and abated with complete bed rest; (2) Symptoms and signs can't be improved by vestibular suppressant medications; (3) When taken Dix-Hallpike test, true vertigo or a spinning sensation appeared during head movement, when head skilled at any position,the symptoms disappeared; (4) The suffering lateral often showed high frequency sensorineural hearing loss ,the ABR of the suffering lateral showed prolonged inter wave latency of I-III wave; (5) Vestibular tests showed central lesion; (6) Occupying lesion can be ruled out by CT and MRI, MRI showed neurovascular compression of vestibular nerve; (7) Taking carbamazepine plus baclofen or only Tegretol orally can alleviate symptoms. A great deal of surgeries confirmed neurovascular compression of cranial nerve U as a disease entity, the offending artery mainly anterior inferior cerebellar artery. Microvascular decompression of cranial nerve VIII can successfully relieve vertigo.@*CONCLUSION@#Neurovascular compression of cranial nerve VIII is a disease entity beyond question. It's major characters were vertigo and disequilibrium which elicited by any physical activity and head movement, magnetic resonance tomographic angiography can give valuable information for diagnosis and treatment. Microvascular decompression can effectively relieve vertigo.

Meniere's disease in the elderly / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To focus on the prevalence of rare Meniere's disease in the elderly(> or = 60 yrs) and to investigate its clinical characteristics.@*METHOD@#To observe the elderly with Meniere's disease from 2004-01-2007-7 and to investigate its clinical manifestation, electrocochleography (ECoG), vestibular evoked myogenic potential (VEMP), caloric test and pure tone audiogram.@*RESULT@#There were 13 cases of Meniere's disease in the elderly. And the prevalence of Meniere's disease was 2.22% (13/586). The initial symptoms were as following: 2 cases with cochlear and vestibular symptoms, 9 cases with mere cochlear symptoms, 1 cases with mere spinning vertigo and 1 case with mere drop attack. The audiogram in the elderly were varied: low and high frequency hearing loss, flat, and high-frequency hearing loss. And the high frequency hearing loss had no relation with the duration of Meniere's disease. The results of vestibular function were varied. The percentage of positive result of ECoG was 63.6% (7/11, 2 cases not determined).@*CONCLUSION@#The prevalence of Meniere's disease in children was 2.22%. The initial symptoms was cochlear and vestibular symptoms, mere cochlear symptoms, mere spinning vertigo and mere drop attack, respectively. The audiogram showed prominent high frequency hearing loss. The percentage of positive result of ECoG was high. And the results of vestibular function tests were varied.

Differential diagnosis between vertigo of posterior circulation ischemia and migrainous vertigo / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To analyze two groups of patients with migrainous vertigo (MV )and vertigo resulting from posterior circulation ischemia (PCIV) and investigate the differential diagnosis between them.@*METHOD@#There were 60 patients with MV and 64 patients with PCIV. Clinical tests include high risk factors of posterior circulation ischemia (PCI), cerebral MRI, ocular motion and high stimulating rate ABR.@*RESULT@#Among 64 patients with PCIV, 29 had abnormal blood pressure and 14 had abnormal blood fat and/or pathoglycemia; 37 had abnormality in cervical vascular ultrasound; 14 suffered from amaurosis or dizziness upon fast getting up. Twenty two had abnormal high stimulating rate ABR and 4 had cerebral lacunar infarction in MRI. As for 60 patients with MV, 45 suffered from motion sickness; 20 were sensitive to motion; 32 had photophobia and (or) phonophobia; 45 had migraine; 16 had abnormal ocular motion function; 3 had abnormal cerebral MRI and 40 had abnormal results in high stimulating rate ABR. The percentage of abnormal high stimulating rate ABR in MV and PCIV were 53% (22/42) and 67% (40/60) respectively.@*CONCLUSION@#The mean age of MV is younger than that of PCIV. Female is more prone to MV than male (2.75 : 1. 00); the sex difference in PCIV is lesser (1.46 : 1.00). Motion sickness, motion sensitivity, photophobia and (or) phonophobia are principal differential highlights to MV. The major characteristics of PCIV include abnormal blood pressure, abnormal blood fat, pathoglycemia and arteriosclerosis. Vestibular function tests could not serve as a differential point; Cerebral MRI might be helpful to differential diagnosis. The results of high stimulating rate ABR is not a differential point between PCIV and MV, but it might play a role in differentiating other kinds of vertigo.