Evaluation of hearing organ in patients with Turner syndrome.

UNLABELLED: Hearing loss and middle ear diseases are often reported in some of Turner patients. In most of the reports hearing organ was evaluated with the use of subjective methods. The aim of the work was subjective and objective evaluation of hearing organ with an attempt to set the correlation between the results and the genotype of the patients with Turner syndrome (Ts). MATERIAL: 51 Ts patients aged 14.3 years on average. There were 29 girls with monosomy X and 22 having mosaicism. A detailed medical history was taken in each case with attention given to the hearing loss risk factors. METHOD: Physical ENT examination, hearing evaluation: pure tone audiometry, impedance audiometry, distortion products otoacoustic emissions (DPOAEs), brain auditory evoked potentials (BAEP). The control group consisted of 30 healthy patients. RESULTS: Recurrent acute otitis media was reported by 19.6% of Ts patients. Pure tone audiometry was improper in 36.3% ears; conductive hearing loss was present in 11.7% ears, mixed hearing loss in 5.9% ears and the moderate sensorineural hearing loss in 18.6% ears. Impedance audiometry was impaired in 14.7% of the cases. DPOAE disturbances were present in 41.4% of Ts patients, BAEP was improper in 52.0%. The percentage of the disturbances in DOPAEs and in BAEP in patients with mosaicism was 45.4 and 40.9% while in patients with monosomy 68.9 and 62%. CONCLUSIONS: Ts patients present predisposition to hearing disturbances. The disturbances seem to be connected with middle ear infections and with sensorineural hearing losses. Hearing loss in Ts women is not clinically apparent in most of the cases; this fact reflects the need of early evaluation and further monitoring of hearing organ in those patients. Sensorineural hearing loss seems to prevail in patients with 45,X genotype, so perhaps attention should be paid to this subgroup of Ts patients.

[Hearing organ function in children with nephrotic syndrome in the course of primary glomerulopathy]. / Stan czynnosciowy narzadu sluchu w zespole nerczycowym w przebiegu pierwotnej glomerulopatii u dzieci.

UNLABELLED: Nephrotic syndrome (NS) is connected with an increase of glomeral permeability. It generates numerous, reversible electrolic and biochemical disturbances. THE AIM of the work was complex evaluation of hearing organ in children in the course of NS. MATERIAL: 28 children aged from 7 to 17 years suffering from primary glomerulopathy, without renal failure and 28 healthy children in the relative age (control group). METHOD: In children with NS hearing tests (pure tone audiometry, impedance audiometry, BAEP, DPOAE) have been performed twice: in acute phase and in non-symptomic phase. Such parameters as total protein, albumines, globulins, cholesterol, sodium, potassium, calcium, magnesium were evaluated. RESULTS: In oedematous stage the concentration of total protein, albumines and calcium were significantly decreased and the concentration of cholesterol was increased. Children with NS presented much worse hearing than healthy subjects, even after the symptoms dissapeared in acute phase such parameters of BAEP as peak III latency and interpeak I-III interlatency were elongated and DPOAE values were decreased. In normal phase BAEP parameters were similar to those in normal group but DPOAE parameters were still much worse than in healthy children. Some of the biochemical parameters correlated with hearing results in children with NS. CONCLUSIONS: Hearing organ in children with NS in the course of chronic glomerulopathy is significantly worse than in healthy children. It is probably connected with repeated biochemical and electrolytic disturbances that cause partly reversible alterations in the cochlea, acoustic nerve and brain stem. It may be also caused by ototoxic drugs.

[Diversity of nasal polyps in microarray technology research]. / Zróznicowanie polipów nosa w badaniach technika mikromacierzy oligonukleotydowych.

UNLABELLED: Nasal polyps, according to many authors, generate as a result of chronic inflammation process with activation of cytokines, immunological reaction mediators that regulate proliferation, differentiation and cell apoptosis. Clarifying molecular mechanisms present in those disturbances may have diagnostic and prognostic value in evaluation of recurrence, dynamics and differentiation of nasal polyps as well as in their therapy. AIM: The aim of the work was an analysis of nasal polyps on the basis of molecular, histopathological and clinical picture as well as comparing differentiated genes transcription in nasal polyps and proper nasal mucosa. MATERIAL AND METHOD: Oligonucleotide array with HGU 133A - Affymetrix were used to analyze the expression of 22,283 genes in nasal polyp tissues from 17 patients. The control group consisted of 8 tissue samples from patients after nasal septoplasty surgery. RESULTS: All the samples could be classified to nasal polyps group or proper mucosa group, it reflected significant differences in genes profile expression in both groups. The evaluation of 22,283 genes transcriptions showed that in most cases nasal polyps tissue reflect classification connected with dominant inflammation cells infiltration. The data obtained let distinguish subgroups connected with clinical condition of the patients. The subgroup with massive nasal and sinus polyposis, eosinophilia and differentiated lower respiratory airways hyperactivity and the subgroup without eosinophilia infiltration may be distinguished. The data obtained suggest that molecular mechanisms may influence on the promotion and kind of inflammation process as well as the clinical course of nasal polyps.

Co-expression of the TGF-beta1 and TGF- beta2 isoforms in nasal polyps and in healthy mucosa.

BACKGROUND: The formation of nasal polyps is connected with a chronic inflammatory process with the activation of different cytokines. TGF-ss induces fibrosis and acts as a chemoattractant and proliferation factor for fibroblasts. The aim of the study was to evaluate the expression profiles of the genes coding TGF-ss isoforms in nasal polyps with predominately eosinophilic and neutrophilic infiltration and in healthy mucosa and to assess their mutual correlation with the levels of gene transcription. MATERIAL/METHODS: The study group consisted of 24 patients with nasal polyposis. On the basis of the histopathological evaluation there were 16 eosinophilic and 8 neutrophilic polyps. The control group constituted 9 healthy patients. The expression profiles of the genes coding the TGF-ss isoforms were detected using real-time RT-QPCR. RESULTS: TGF-beta1 and TGF-beta2 mRNAs were revealed in 10 patients with eosinophilic polyps. TGF-beta1 transcriptional activity was accompanied by TGF-beta2 transcriptional activity in nasal polyps. TGF-beta2 gene expression in tissues without mRNA for TGF-beta1 was silenced. There was positive correlation between the expressions of the TGF-beta1 and TGF-beta2 isoforms in nasal polyps. TGF-beta1 mRNA was present at higher levels in all control samples than in eosinophilic polyps. An increased TGF-beta1 mRNA expression was accompanied by an increased TGF-beta2 mRNA expression in healthy mucosa. TGF-beta3 showed the most intensive transcriptional activity among the TGF-ss isoforms in both nasal polyps and control tissues. There was no correlation between TGF-beta3 and TGF-beta1 nor between TGF-beta3 and TGF-beta2 transcriptional activity in nasal polyps and normal tissue.

[Vestibulo-cochlear disturbances in the course of vaso-neural conflict of vestibule-cochlear nerve--diagnostic and therapeutic problems]. / Zespól zaburzen przedsionkowo-slimakowych na podlozu konfliktu naczyniowo-nerwowego nerwu przedsionkowo-slimakowego--problemy diagnostyczno-terapeutyczne.

INTRODUCTION: Symptoms encompassing sensorineural hearing loss, tinnitus and vertigo occur in many diseases of various origin. The diagnostics in such cases is especially difficult and often requires interdisciplinary cooperation. Despite of that many cases remain unexplained. MATERIAL AND METHOD: The two cases with above mentioned symptoms (52 year-old woman and 46 year-old man) with differentiated clinical course were presented. The woman for one year experienced left sided, extreme tinnitus with paroxysmal vertigo and dizziness. The man with sudden monolateral hearing loss and tinnitus that disappeared after corticosteroid therapy, complained about recurrence of fluctuating hearing loss and tinnitus accompanied by chronic instability. The diagnostics of hearing and balance organs was performed (pure tone audiometry, impedance audiometry, DPOAE, ABR, ENG) complemented with computed tomography and Nuclear Resonance. RESULTS: Female patient presented bilateral mild sensorineural hearing loss, more intensive on the left side, male patient right sided sensorineural hearing loss in the frequencies from 250 to 1500 Hz. The elongation of some peak values in ABR test (with bilaterally proper otoacoustic emissions) as well as partial canal paresis on the hearing loss side suggested primary diagnosis of neoplasmatic process. It was an indication to perform radiological diagnostics. The radiologic findings revealed the contact of vestibulo-cochlear nerve with the loop of cerebellar inferior anterior artery within the internal acoustic canal. CONCLUSIONS: The course of the disease and diagnostic tests do not provide characteristic data that let diagnose neuro-vascular conflict. One has to be aware of such possibility in patients with intensive vertigo and dizziness that do not improve after treatment when other causes do not justify the symptoms.

[The profile of expression of transforming growth factor beta1 and TGFbetaRI, TGFbetaRII and TGFbetaRIII genes in nasal polyps]. / Profil ekspresji genów kodujacych TGF-beta1 i jego receptory TGFbetaRI, TGFbetaRII i TGFbetaRIII w polipach nosa.

BACKGROUND: Transforming growth factor beta (TGF-beta) plays an important role in cells proliferation and differentiation as well as in local immunological response. OBJECTIVES: An evaluation of genes expression profile for TGF-beta1 and its receptors TGF-betaRI, TGF-beta RII and TGF-beta betaRIII as well as their potential role in the pathogenesis of nasal polyps in eosynophilic and neutrophilic polyps and in normal nasal mucosa. MATERIAL: Material consisted of 22 patients. Nasal polyps were removed during standard polypectomy or FESS. In the histopathological evaluation there were 16 eosynophilic polyps and 5 neutrophilic ones. The control group consisted of 8 healthy patients from whom healthy nasal mucosa was taken during nasal septoplasty. METHODS: The expression of the genes coding TGF-beta and its receptors was evaluated with the use of RT-PCR technique. RESULTS: TGF-beta1 mRNA was present in 10 eosynophilic polyps out of 16. In neutrophilic polyps group (n = 6) mRNA TGFbeta-1 was present in 3 samples. TGFbeta-1 isoform was present in all the tissues of the control group. It was significantly larger expression of TGFbeta-1 gene in normal mucosa in comparison with eosinophilic and neutrophilic polyps (p < 0.05). The expression of genes coding TGFbetaRI, TGF-betaRII and TGF-betaRIII receptors was obtained in all the polyps and healthy tissues. There was no significant differences in the transcription activity of the receptors in polyps and in the healthy tissue. CONCLUSIONS: Considering regulative function of TGFbeta1 in inflammation processes, its low concentration in nasal polyps tissue may influence on migration and survival of inflammation cells. The high expression of genes coding TGFbetaRI, TGF-betaRII and TGF-betaRIII receptors in all the polyps and healthy tissues, show readiness to transduction of TGFbeta. It may suggest that, less intensive TGFbeta1 expression in nasal polyps may be connected with the presence of other than first TGFbeta isoforms. This problem needs further investigations to set precise role of individual TGFbeta isoforms and other growth factors in the pathogenesis of NSP as their interactions with local cytokines. It may help to work out more effective and specific therapeutic methods in nasal polyps therapy.

[Diagnostic and treatment in nasal polyps of children treated in Wroclaw ENT department in the years 1991-2001]. / Diagnostyka i leczenie polipów nosa u dzieci hospitalizowanych w Klinice otolaryngologii we Wroclawiu w latach 1991-2001.

BACKGROUND: Nasal polyposis is not often observed in children and usually follows general chronic diseases or disorders of cilliary structure or function and occurs mostly after 10 years of age. This is why in children clinical changes qualified as nasal polyposis should always be verified as congenital diseases or neoplasmatic changes. CASE REPORT: The population: of children treated in the years 1991-2001 in the Wroclaw ENT Department with initial diagnosis of nasal polyposis was presented. Material consisted of 52 children admitted in the years of 1991-2001 to Wroclaw ENT Department with already diagnosed nasal polyposis. In each case medical history was collected together with routine physical ENT examination complemented with fiberoendoscopic examination of the nose end epipharynx. In 7 children with initial diagnosis of nasal polyposis hypertrophy of pharyngeal tonsil with vasomotor rhinitis was diagnosed. Those children underwent adenectomy. Remaining group of 45 children aged from 2 to 16 years was analysed. Surgical treatment (polypectomy, FESS) was performed in 44 children. There was antrochoanal polyp in 10 cases (20,4%), monolateral choanal atresy in 1 case, foreign body of nasal cavity in 1 case and neoplasmatic tumour diagnosed in 5 cases. CONCLUSIONS: The diagnostic difficulties in nasal polyposis in children, except neoplasm, are reflected by the cases with initial diagnosis of nasal polyp and finally diagnosed as foreign body with inflammatory reaction or monolateral choanal atresy. Endoscopic examination of nasal cavity together with radiological diagnostic should be ordered routinely in the unclear cases.

[DPOAE in tinnitus patients with cochlear hearing loss considering hyperacusis and misophonia]. / Otoemisja DPOAE u osób z szumami usznymi i niedosluchem slimakowym z uwzglednieniem nadwrazliwosci na dzwieki i misophonii.

UNLABELLED: The most probable place generating tinnitus in auditory pathway are outer hair cells (OHC) inside cochlea. To asses their activity otoacoustic emission is used. The goal of the investigation was estimation the features of otoemission DPOAE in groups with tinnitus patients with cochlear hearing loss, estimation of diagnostic value of DPOAE parameters for analysis of function of the cochlea in investigated patients emphasizing DPOAE parameters most useful in localizing tinnitus generators and estimation of hypothetic influence of hyperacusis and misophony on parameters of DPOAE in tinnitus patients with cochlear hearing loss. The material of the study were 42 tinnitus patients with cochlear hearing loss. In the control group there were 21 patients without tinnitus with the same type of hearing loss. Then tinnitus patients were divided into three subgroups--with hyperacusis, misophony and without both of them, based on audiologic findings. METHOD: after taking view on tinnitus and physical examination in all the patients pure tone and impedance audiometry, supratreshold tests, ABR and audiometric average and discomfort level were evaluated. Then otoemission DPOAE was measured in three procedures. First the amplitudes of two points per octave were assessed, in second--"fine structure" method-- 16-20 points per octave (f2/f1 = 1.2, L1 = L2 = 70 dB). Third procedure included recording of growth rate function in three series for input tones of value f2 = 2002, 4004, 6006 Hz (f2/f1= 1.22) and levels L1=L2, growing by degrees of 5dB in each series. RESULTS: DPOAE amplitudes in recording of 2 points per octave and fine structure method are very valuable parameters for estimation of cochlear function in tinnitus patients with cochlear hearing loss. Decreasing of DPOAE amplitudes in patients with cochlear hearing loss and tinnitus suggests significant role of OHC pathology, unbalanced by IHC injury in generation of tinnitus in patients with hearing loss of cochlear localization. DPOAE fine structure provides us the additional information about DPOAE amplitude recorded in two points per octave, spreading the amount of frequencies f2, where differences are noticed in comparison of two groups--tinnitus patients and control. Function growth rate cannot be the only parameter in estimation of DPOAE in tinnitus patients with cochlear hearing loss, also including subjects with hyperacusis and misophony. Hyperacusis has important influence on DPOAE amplitude, increases essentially amplitude of DPOAE in the examined group of tinnitus patients.

[RANTES expression in nasal polyps fibroblasts; spontaneously and after stimulation with lipopolisaccharides (LPS) and phytohemagglutinin (PHA)]. / Ekspresja chemokiny RANTES w fibroblastach pochodzacych z polipów nosowych; samoistna i po stymulacji lipopolisacharydami (LPS) i fitohematoksylina (PHA).

INTRODUCTION: According to the results of research carried out by a number of authors, one of the main mechanisms of the generation of polyps is local inflammatory processes accompanied by immune system disorders. It has recently been shown that a number of differentiation factors and inflammatory mediators may be involved in the growth of nasal polyps. RANTES is a eosinophil chemoattractant factor likely could play an important role in a chronic inflammatory response in the nasal tissue that subsequently leads to the development of nasal polyps. OBJECTIVE: The objective of this study was detection of the chemokine RANTES in nasal polyps fibroblasts and researching influence of stimulation with lipopolisaccharides and phytohemagglutinin for RANTES expression in cultured nasal fibroblasts in vitro. METHODS: Nasal polyps were obtained from 17 subjects (9 atopic and 8 nonatopic) during polypectomy. RANTES was measured by immunofluorescence method. RESULTS: Intensive granular luminescence was observed in all cytoplasm of cells with the exception of nucleus. Immunoreactive RANTES was found to be present in 70% of cells. We not find increase percentage of positive RANTES fibroblasts after stimulation with lipopolisaccharides and phytohemagglutinin. RANTES expression was similar in the both: atopic and nonatopic polyps. CONCLUSIONS: This study demonstrates that cultured fibroblasts derived from both atopic and nonatopic patients release RANTES spontaneously and after stimulation with lipopolisaccharides and phytohemagglutinin. This observation and the finding that RANTES is present in nasal polyps fibroblasts suggest that this chemokine may be an important mediator of eosinophil in both atopic and nonatopic nasal polyposis. More research needs to expand on chemotactic factors such as RANTES and their interplay with other local cytokines.

Brain auditory evoked potentials in children with Down syndrome.

UNLABELLED: Researchers have been examining the condition of the auditory organ in people with Down syndrome for many years. The aim of this work was an objective evaluation of the hearing threshold and a functional evaluation of the hearing pathway in children with Down syndrome without any disturbances in the middle ear. MATERIAL: Seventy children with Down syndrome, aged from 2 months to 17 years. Brain auditory evoked potentials (BAEP) were performed. The peak latencies in children who had a normal BAEP pattern at 70 dB sHL were analysed. Peaks I-III and interpeak latencies I-III were significantly shortened in Down syndrome children up to the age of 1 year, as compared to older children with Down syndrome and to the control group. Peak III and interpeak latencies I-III were significantly longer in older children with Down syndrome in comparison to the control group. CONCLUSIONS: Hearing loss in children with Down syndrome is more frequent than in healthy children. The average latency values of BAEP established for healthy children should not be used as a reference for children with Down syndrome. The shortening of the latency values in BAEP results of children with Down syndrome under 1 year of age may be connected with accelerated maturation of the nervous system or anatomical and/or functional disturbances of the central nervous system. BAEP is a valuable method that allows for the objective evaluation of the hearing threshold and functional condition of the hearing pathway in subjects who do not cooperate during testing.

Middle-ear ceruminous adenoma as a rare cause of hearing loss and vertigo: case reports.

Middle-ear ceruminous adenomas are rare benign neoplasms arising from the epithelium of the middle ear. Progressive hearing loss, ear fullness and tinnitus are common symptoms of this tumour; facial nerve paresis and vestibular disturbances occur very infrequently. We present two cases of middle-ear ceruminous adenomas, one showed rapid unilateral hearing loss with aural fullness, followed by purulent aural discharge and vertigo. In the second case, the disease affected an already deaf ear and the only symptom of the disease was increasing vertigo. The clinical features, intraoperative findings, and histological and radiological findings are presented. The cases are compared to those described in the literature.

[Nasal glioma--case report]. / Glioma nasi--doniesienie o przypadku.

Benign congenital lesions resulting from the deficient regression of neuroglial tissue in normal embryonic development are called gliomas. They are usually located in the nasofrontal region and are diagnosed in the postnatal period. They are included in the differential diagnosis of nasofrontal midline masses. We present a case of the 9-year-old boy treated in the ENT Department of Wroclaw Medical University with the initial diagnosis of nasal polyposis or tumour which appeared to be glioma in the postoperative histological evaluation. The tumour was removed endoscopically. We present magnetic resonance imaging of the case together with the review of the literature concerning gliomas. We conclude that each doctor has to be aware of possible neoplasm even in the youngest groups of the patients.

Electrophysiological tests of the hearing organ in Hashimoto's disease.

Thyroid gland diseases resulting from an autoimmunological process may influence the hearing organ. The aim of this study was to assess peripheral and central parts of the hearing organ in children with Hashimoto's thyroiditis. Thirty children (mean age 14.9 years) with Hashimoto's thyroiditis were examined. Patients were euthyroid, and presented high blood concentration of antithyroperoxidase (ATPO) antibodies. Pure tone audiometry, tympanometry, otoacoustic emissions (DPOAEs), and brain auditory evoked potentials (BAEPs) were performed. None of the patients had any complaints about hearing acuity; pure tone audiometry, tympanometry, and DPOAEs were normal in all patients. There were considerable disturbances in auditory nerve and brainstem neural conduction in BAEPs. There was positive correlation between the blood concentration of ATPOA and the extent of the disturbances in the central part of the hearing organ. One should consider the possible presence of subclinical Hashimoto's encephalopathy affecting the central part of the auditory organ.

An evaluation of postural stability and the effects of middle-ear drainage on vestibulo-spinal reflexes of children with chronic otitis media with effusion.

OBJECTIVE: Many authors agree that chronic otitis media with effusion (OME) are the main causes of vertigo and balance disturbances in children. The aim of this work was the stabilometric evaluation of postural stability and the influence of middle ear drainage on vestibulo-spinal reflexes in children with OME. METHODS: Fifteen children with OME (5-14 years old, 13 males and two females) were selected for bilateral drainage of the middle ear after conservative treatment proved ineffective. The control group consisted of 15 healthy children of an analogous age range. Static and quasi-dynamic posturography was performed to evaluate balance. The tests were performed three times: 1 day before drainage, 1 day after drainage and 4 weeks after drainage. Parameters including the field of the developed area and the average velocity of body deflection were analysed. RESULTS: There was statistically significant elevation of stabilogram parameters in almost all the tests in children with OME as compared to the control group. The changes in the stabilogram parameters were analysed with reference to the timing of the evaluation. Significant improvement was noted after the fluid was removed from the ear, although recovery was not complete after 4 weeks. CONCLUSIONS: The presence of fluid in the middle ear impairs the functioning of the balance system in children. Postural stability and the quantity of vestibulo-spinal reflexes seem to depend on the functional condition of the middle ear. Prolonged cases of OME could potentially handicap a child's motor development.

[A case of Wegener's granulomatosis]. / Przypadek ziarniniaka Wegenera z manifestacja otologiczna.

We present a case of Wegener's granulomatosis in which otitis media symptoms masked the disease in first phases. Progressive, unilateral hearing loss, almost deafness, together with facial nerve paresis allowed us to make proper diagnosis and apply therapy.

[Two cases of hearing loss following Hashimoto disease]. / Dwa przypadki niedosluchu towarzyszacego chorobie Hashimoto.

UNLABELLED: Hearing loss accompanies some of thyroid gland diseases especially those with hypothyroidism. Some authors state it correlates with autoimmune background of certain thyroid gland disturbances. We present two cases of patients with Hashimoto disease accompanied by fluctuating cochlear hearing loss and peripheral vestibular loss in one of the cases. FIRST CASE: there was unilateral worsening of bilateral hearing loss diagnosed previously after gentamycine treatment in 16 year old female with Hashimoto disease. There was significant improvement confirmed in audiological tests when the child became euthyroid. Second case presenting hearing loss and vertigo: 16 year old female with hypothyroidism and diabetes mellitus type 1 with high blood concentration of anticytoplasmic immunoglobulins lasting for 2 years. Bilateral cochlear perceptive hearing loss was diagnosed. In summary an association of autoimmune process as well as thyroid hormones blood level with inner ear condition was suggested. Trying to find the reason of observed disturbances one should consider wide differential diagnostics in all the cases of perceptive seemingly idiopathic cochlear hearing loss. The presented problem needs to be further investigated in larger clinical material.

[Results of combined treatment for vestibular receptor impairment with physical therapy and Ginkgo biloba extract (Egb 761)]. / Wyniki skojarzonego leczenia uszkodzenia receptora przedsionkowego rehabilitacja ruchowa oraz wyciagiem z milorzebu japonskiego (Egb 761).

UNLABELLED: Vestibular receptor impairment causes symptoms called vestibular organ peripheral lesion syndrome. Subjective and objective symptoms of vestibular lesion diminish gradually in the process of vestibular compensation. Stimulating a patient to action is a basic factor that influences on the compensation process. The aim of our studies was an evaluation of treatment results in patients with vertigo of peripheral origin with the use of gingko biloba extract together with kinezytherapy. Ginkgo biloba extract shows vasoactive, rheologic, metabolic and neural effects. We have examined 45 persons aged between 35 and 48 years (38 on average, 35 female, 13 male) with clinical symptoms of peripheral vestibular lesion. In each case we performed as follows: ORL physical examination, pure tone audiometry, suprathreshold audiometry, electronystagmography (eyes open and closed nystagmus, cervical tests, caloric tests according to Hallpike), static and dynamic posturography. In all of the cases vestibular rehabilitation originally programmed in our Clinic was applied. N 23 cases (17 female and 6 male) chosen at random, kinezytherapy together with gingko biloba in tablet was applied: 2 tablets twice a day for 3 months. Control examination were performed on 30, 60 and 90 days of treatment. Treatment results evaluation was based on anamnesis, electronystagmography, static and dynamic posturography. CONCLUSIONS: 1. In almost all of the cases with peripheral lesion of vestibular organ, after 30 days of application of gingko biloba extract together with kinezytherapy and without gingko biloba there was vestibular compensation confirmed in electronystagmography but there were disturbances in static and dynamic posturography. 2. Control examination in the course of treatment revealed gradual improvement in vestibular tests in both group (with and without biloba extract). But in patients treated with gingko biloba extract the improvement was more clear and faster an dynamic posturography. It implies central effect of gingko biloba extract that allows to gain full vestibular compensation sooner.

[Vertigo in women in menopausal period]. / Zawroty glowy u kobiet w okresie menopauzy.

UNLABELLED: The aim of the work was an evaluation of vestibular organ as well as static and dynamic balance condition in menopausal women. We have examined 107 women aged 46 to 55 years, 47 among them with complaints of vertigo (Group I), 30 women aged 45 to 50 years with symptoms of menopause diagnosed in Outpatient of Endocrinology Clinic (Group II) and 30 healthy women aged 45-54 (control Group). Blood concentration of sexual hormones (estradiol, LH, FSH, progesterone), sodium and potassium blood level, electronystagmography (ENG), optokinesis, eye tracking test, static and dynamic posturography and radiography of cervical part of vertebral column were applied in each case. The intensification of the symptoms was assessed according to Blatt-Kupperman scale. RESULTS: There were disturbances of central type in ENG in 70% of the patients from Group I, in 12.7% of the patients from the Group I there were disturbances typical for cervical and (12,7%) positional origin. There were moderate qualitative disturbances in ENG in 50% of the patients from the Group II. No peripheral vestibular lesion as well as no disturbances in optokinesis and eye tracking test were diagnosed in any woman form all the groups. There was significant elevation of stabilogram parameters in the Group I (in comparison to the control Group) in the tests without vision control (static balance) and in all the tests in dynamic posturography. There was significant increase of the velocity of sways to the right and left in the test with eyes closed in the Group II (dynamic posturography). Vertigo in women in menopausal period are not connected with the lesion of the peripheral part of vestibular organ, they are mostly of central origin. Simultaneous posturographic tests reveal worse central co-ordination in vestibular organ, especially after vision control cancellation.

[Electrophysiologic tests of the auditory apparatus and vestibular organ in Usher syndrome]. / Badania elektrofizjologiczne narzadu sluchu i przedsionkowego w zespole Ushera.

Usher syndrome is a congenital autosomal dominant inherited disease characterised by hearing, balance and vision problems. The aim of the work was an evaluation of hearing and vestibular organ in the chosen group of patients with Usher syndrome diagnosed. Material consisted of 10 persons (5 males and 5 females) aged from 16 to 46 years with Usher syndrome diagnosed. All the patients have been in constant ENT and Ophthalmology Clinics' care. Complex hearing and balance organ, including posturography, as well as complex ophthalmologic examination were performed in each case. Medium or severe perceptive cochlear hearing loss, proper function of vestibular organ and slight elevation of stabilograms parameters were found in 6 cases. In 4 cases there were severe bilateral hearing loss, lack of vestibular function and considerable worsening of stabilograms parameters. In ophthalmologic examination in all the cases there was bilateral symmetrical dystrophy of the retina of various intensification. We concluded that hearing and balance organ examination in Usher syndrome can state accessory diagnostic aspect that might help to distinguish subtypes of the syndrome. In this way audiologic and otoneurologic tests could help to define prognosis of the disease in the individual cases. A necessity of close co-operation of genetics, ophthalmologists and ENT doctors as well as psychologists was stressed.

[The influence of metabolic disturbances present in diabetes mellitus type I on vestibulo-spinal reflexes in children and young adults]. / Wplyw zaburzen metabolicznych w cukrzycy typu 1 na odruchy przedsionkowo-rdzeniowe u dzieci i mlodych osób doroslych.

Diabetic neuropathy encompasses various disturbances concerning somatic and autonomic nervous system and has significant impact on prognosis and course of diabetes mellitus. The aim of the work is an evaluation of vestibulo-spinal reflexes in children and young adults suffering from diabetes mellitus type 1. Material--95 children and young adults aged from 6 to 28 years with diabetes mellitus type 1 diagnosed. The control group consisted of 44 otoneurologically healthy subjects aged from 6 to 28 years. After detailed medical history collection and physical ENT examination stato-posturography was performed in each case. Posturographer PE 62 Model 04 was applied in the studies. Static posturography as well as dynamic one (one leg standing test) was performed in each case. 6 patients belonging to diabetic group complained about vertigo or dizziness. There were worse stabilograms parameters in diabetic group in comparison to control one, statistically significant in younger children. There were better stabilogram parameters in diabetic patients with longer history of the disease. The parameters analysed were significantly worse in the subgroup with not compensated diabetes. The parameters were slightly better in relation to the presence of hypoglycaemic incidents. No apparent differences in stabilograms parameters were present in relation to the presence of diabetic complications. Diabetes mellitus type 1 with slight or without complications does not have significant influence on vestibulo-spinal reflexes and posture stability of the patients. Balance organ disturbances in diabetes mellitus type 1 in children and young adults despite their presence have subclinical course. Perhaps one should consider monitoring of those disturbances in the course of the disease.