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1.
Artigo em Chinês | MEDLINE | ID: mdl-38433689

RESUMO

Objective:To explore the effect of vestibular rehabilitation exercise platform based on browser server(BS) mode on vertigo symptoms, balance ability and anxiety of vertigo patients. Methods:The clinical data of 110 patients with vertigo in our hospital were retrospectively analyzed. The patients who received routine vestibular rehabilitation exercise from March 2019 to may 2020 were set as the control group (55 cases), and the patients who received vestibular rehabilitation exercise platform guidance based on BS mode from June 2020 to December 2021 were set as the study group (55 cases). The scores of Fugl Meyer balance assessment scale(FMA), hospital anxiety and Depression Scale(had), vertigo disorder scale(DHI), quality of life scale(SF-36), vertigo visual analog scale(VAS), Berg Balance Scale(BBS), rehabilitation treatment effect and rehabilitation exercise compliance were compared between the two groups. Results:before rehabilitation exercise, there was no significant difference in the scores of DHI, VAS, FMA, BBS, had and SF-36 between the two groups(P>0.05). After 3 months of exercise, the scores of DHI, had and vas in the study group were lower than those in the control group, and the scores of FMA, BBS and SF-36 in the study group were higher than those in the control group(P<0.05). The excellent and good rate of rehabilitation efficacy and treatment compliance rate in the study group were higher than those in the control group(P<0.05). Conclusion:The vestibular rehabilitation exercise platform based on CS mode can improve the limb movement and balance ability of patients with vertigo, reduce the vertigo symptoms and psychological anxiety, and improve the rehabilitation treatment effect and compliance of patients.


Assuntos
Ansiedade , Qualidade de Vida , Humanos , Estudos Retrospectivos , Tontura , Vertigem , Terapia por Exercício
4.
MMW Fortschr Med ; 166(4): 9, 2024 03.
Artigo em Alemão | MEDLINE | ID: mdl-38453831

Assuntos
Tontura , Vertigem , Humanos
5.
Sci Rep ; 14(1): 5774, 2024 03 09.
Artigo em Inglês | MEDLINE | ID: mdl-38459190

RESUMO

Little is known about a possible association of autoimmune inner ear disease among patients diagnosed with polymyositis (PM)/dermatomyositis (DM). This study aimed to explore differences in the prevalence of inner ear symptoms among patients with and without PM/DM using a nationwide population-based dataset. Data for this study were retrieved from the Taiwan National Health Insurance Research Database. The study sample included 1622 patients diagnosed with PM/DM and 8109 propensity-score matched comparison patients without PM/DM. We performed multivariate logistic regressions to calculate odds ratios (ORs) and 95% confidence interval (CI) for tinnitus, hearing loss, sudden deafness, and vertigo among patients with PM/DM versus comparison patients. Chi-square tests showed statistically significant differences between patients with PM/DM and comparison patients in the prevalence of tinnitus (16.1% vs. 12.7%, p < 0.001), non-conductive hearing loss (9.2% vs. 6.8%, p < 0.001), and vertigo (14.4% vs. 11.1%, p < 0.001). The adjusted ORs for tinnitus, non-conductive hearing loss, and vertigo, respectively, were 1.332 (95% CI = 1.147-1.547), 1.399 (95% CI = 1.154-1.696), and 1.374 (95% CI = 1.173-1.611) for patients with PM/DM when compared to comparison patients. Our study finds that patients with PM/DM have higher prevalence rates of tinnitus, non-conductive hearing loss, and vertigo than comparison patients.


Assuntos
Surdez , Dermatomiosite , Gastrópodes , Perda Auditiva Súbita , Polimiosite , Zumbido , Humanos , Animais , Dermatomiosite/complicações , Dermatomiosite/epidemiologia , Dermatomiosite/diagnóstico , Perda Auditiva Súbita/complicações , Perda Auditiva Súbita/epidemiologia , Zumbido/complicações , Zumbido/epidemiologia , Prevalência , Polimiosite/complicações , Polimiosite/epidemiologia , Polimiosite/diagnóstico , Surdez/complicações , Surdez/epidemiologia , Vertigem/complicações , Vertigem/epidemiologia
6.
BMJ Case Rep ; 17(3)2024 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-38453227

RESUMO

Diagnosing atrial myxoma in pregnancy is challenging because patients may present with non-specific symptoms that might be overlooked. The timing of non-obstetric operation usually depends on the nature of the disease, after careful consideration of feto-maternal safety, including the use of cardiopulmonary bypass and placental transfer of anaesthetic drug. A woman in her 30s at 18 weeks of pregnancy presented with recurring dizziness. She underwent successful myxoma excision at 20 weeks under general anaesthesia and cardiopulmonary bypass. The 6×5 cm myxoma was histologically confirmed as myxoma. Early detection of atrial myxoma in pregnancy is crucial, and a clinician has to consider the diagnosis of left atrial myxoma with mitral valve obstruction as a cause of severe dizziness. Optimal outcomes require multidisciplinary management. In this case, surgery during the second trimester of pregnancy enabled a full-term pregnancy with the patient's and foetal well-being and normal postprocedural echocardiography.


Assuntos
Neoplasias Cardíacas , Insuficiência da Valva Mitral , Mixoma , Feminino , Humanos , Gravidez , Tontura , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/cirurgia , Neoplasias Cardíacas/complicações , Neoplasias Cardíacas/diagnóstico por imagem , Neoplasias Cardíacas/cirurgia , Valva Mitral/diagnóstico por imagem , Valva Mitral/cirurgia , Insuficiência da Valva Mitral/cirurgia , Mixoma/complicações , Mixoma/diagnóstico por imagem , Mixoma/cirurgia , Recidiva Local de Neoplasia/complicações , Placenta , Vertigem , Adulto
7.
Zhonghua Yi Xue Za Zhi ; 104(12): 924-930, 2024 Mar 26.
Artigo em Chinês | MEDLINE | ID: mdl-38514340

RESUMO

In order to improve the awareness and understanding of hydropic ear disease, the Vertigo Committee of the Chinese Medical Education Association established an expert group and formed the expert recommendation on clinical diagnosis and treatment pathway of hydrochloric ear disease after repeated discussions, based on the existing medical evidence and clinical experience of experts. The article included the understanding process, characteristics, medical history collection and physical examination, diagnosis and clinical pathway of various treatment and rehabilitation methods in hydrochloric ear disease, aiming to promote standardized clinical work and research on hydropic ear disease.


Assuntos
Medicina , Vertigem , Humanos
8.
SEMERGEN, Soc. Esp. Med. Rural Gen. (Ed. Impr.) ; 50(2): [102114], Mar. 2024. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-231241

RESUMO

El vértigo es un síntoma común que puede tener diversas causas y requerir un enfoque integral para su diagnóstico y tratamiento desde atención primaria. Se propone un algoritmo de diagnóstico basado en la clasificación propuesta por la Comisión de Otoneurología de la SEORL-PCF, que facilita la clasificación de los diferentes tipos de vértigo y proporciona criterios de derivación de pacientes desde atención primaria hacia otras especialidades. Se realiza una revisión de los tratamientos disponibles basada en la causa subyacente para un manejo terapéutico adecuado. Se espera que este documento se convierta en una herramienta valiosa para los profesionales que atienden a pacientes con vértigo. El documento se basa en evidencia científica y en la experiencia de expertos en el campo de las diferentes especialidades médicas implicadas; y busca mejorar la comprensión y el abordaje clínico del vértigo agudo desde atención primaria.(AU)


Vertigo is a common symptom that can have various causes and may require a comprehensive approach for its diagnosis and treatment from primary care. A diagnostic algorithm based on the classification proposed by the Otoneurology Commission of the SEORL-PCF is suggested, which facilitates the classification of the different types of vertigo and provides referral criteria for patients from primary care to other specialties. A review of the available treatments based on the underlying cause is conducted for appropriate therapeutic management. This document is expected to become a valuable tool for professionals treating patients with vertigo. The document is based on scientific evidence and on the experience of experts in the field from various medical specialties; and seeks to improve the understanding and clinical approach to acute vertigo from primary care.(AU)


Assuntos
Humanos , Masculino , Feminino , Atenção Primária à Saúde , Algoritmos , Vertigem/diagnóstico , Vertigem/tratamento farmacológico , Otolaringologia
9.
J Integr Neurosci ; 23(2): 37, 2024 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-38419450

RESUMO

BACKGROUND: The purpose of this study was to determine the detailed characteristics of dizziness in patients with de novo Parkinson's disease (PD) and the clinical implications of dizziness. METHODS: Ninety-three people with de novo PD were enrolled between July 2017 and August 2022 for this retrospective study. Using each representative scale, various motor and non-motor symptoms were assessed. In addition, clinical manifestations of dizziness in those patients, including its presence, type, frequency, and duration of occurrence, were investigated. RESULTS: Thirty-nine patients with de novo PD reported dizziness, with presyncope being the most common (38%). The most common frequency was several times a week (51%). The most common duration was a few seconds (67%). Multivariable logistic regression analysis showed that dizziness was more common in women than in men {odds ratio (OR): 3.3601, 95% confidence interval (CI): 1.0820-10.4351, p = 0.0361}. Dizziness was significantly related to non-motor symptoms of low global cognition (OR: 0.8372, 95% CI: 0.7285-0.9622, p = 0.0123) and severe autonomic dysfunction (OR: 1.1112, 95% CI: 1.0297-1.1991, p = 0.0067). A post-hoc analysis revealed that dizziness was only associated with cardiovascular dysautonomia (adjusted OR: 10.2377, 95% CI: 3.3053-31.7098, p < 0.0001) among several domains of dysautonomia. CONCLUSIONS: About 42% of patients with de novo PD complained of dizziness. The occurrence of dizziness in those people was highly associated with female gender women, cognitive impairment, and cardiovascular dysautonomia. These results suggest that clinicians should pay close attention when patients with PD complain of dizziness.


Assuntos
Doenças do Sistema Nervoso Autônomo , Doença de Parkinson , Masculino , Humanos , Feminino , Tontura/epidemiologia , Tontura/etiologia , Estudos Retrospectivos , Doenças do Sistema Nervoso Autônomo/complicações , Vertigem
10.
Artigo em Chinês | MEDLINE | ID: mdl-38297869

RESUMO

Objective:To observe the results of dynamic visual acuity screening tests in patients with peripheral vertigo and explore its clinical significance. Methods:The number of 48 healthy volunteers were enrolled as control group and 25 peripheral vertigo patients as experimental group. In the experimental group, there are 12 patients with vestibular neuritis, 1 patient with Hunt syndrome, 5 patients with sudden deafness with vertigo and 7 patients with bilateral vestibular dysfunction. Horizontal and vertical dynamic visual acuity screening tests were performed on them. The number of lost rows of horizontal and vertical dynamic visual acuity was compared between the control group and the experimental group to figure out if there is a statistical difference. The number of lost rows of horizontal and vertical dynamic visual acuity was compared within the experimental group to figure out if there is a statistical difference. The two groups of 18 cases of unilateral vestibular function decline and 7 cases of bilateral vestibular function decline in the experimental group were compared with the control group, and figure out if there is a statistical difference. Results:The median number of lost rows of horizontal dynamic visual acuity in 48 healthy volunteers was 1.5 and median number of lost rows of vertical dynamic visual acuity was 1.0 in the control group. The median number of lost rows of horizontal dynamic visual acuity of 26 healthy volunteers was 6 and median number of lost rows of vertical dynamic visual acuity was 5 in the experimental group. Compared to the experimental group, the number of lost rows both have statistical significance in horizontal and vertical dynamic visual acuity(P<0.01). The comparison of horizontal and vertical lost rows within the test group also have statistical significance(P<0.01). Twenty five patients with exceptional vestibular disease in the experimental group were divided into unilateral vestibular function reduction group(n=18) and bilateral vestibular function reduction group(n=7). Compared with the control group, there was significant differences in the number of horizontal and vertical lost rows(P<0.01) within the three groups. After pairwise comparison, the number of lost rows of horizontal and vertical in the control group was significantly lower than that in the unilateral vestibular function reduction group and the bilateral vestibular function reduction group(P<0.01). There was a highly significant correlation between the number of horizontally lost rows of DVA and the mean vHIT values of bilateral horizontal semicircular canals in 25 patients(P<0.01); and a highly significant correlation between the number of vertically lost rows of DVA and the mean vHIT values of vertical semicircular canals in 4 groups bilaterally(P<0.01). Conclusion:The Dynamic Visual Acuity Screening Test is a useful addition to existing tests of peripheral vestibular function, particularly the vHIT test, and provides a rapid assessment of the extent of 2 Hz VOR impairment in patients with reduced vestibular function.


Assuntos
Doenças Vestibulares , Neuronite Vestibular , Humanos , Teste do Impulso da Cabeça/métodos , Vertigem/diagnóstico , Doenças Vestibulares/diagnóstico , Neuronite Vestibular/diagnóstico , Canais Semicirculares , Acuidade Visual , Reflexo Vestíbulo-Ocular
11.
Handb Clin Neurol ; 199: 389-411, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38307659

RESUMO

Dizziness is a common symptom among patients in primary care, general neurology, and headache clinic practices. Vestibular migraine is conceptualized as a condition of recurrent attacks of vestibular symptoms attributed to migraine. It is now considered the most common cause of spontaneous episodic vertigo. Persistent postural-perceptual dizziness (PPPD) has more recently been defined based on four previous clinical entities as a syndrome of chronic daily dizziness, unsteadiness, or nonspinning vertigo that fluctuates and is exacerbated by postural, motion, or visual factors. Although PPPD is more often precipitated by other conditions causing vertigo, unsteadiness, or dizziness, it is discussed at length in this chapter because vestibular migraine is among the most common triggers for development of PPPD. Pathophysiology of each is incompletely understood, and with lack of biomarkers, the diagnosis of each rests on consensus-derived, symptom-based criteria. Areas of uncertainty exist regarding some overlapping symptoms that may create potential diagnostic confusion between the conditions. This chapter provides a comprehensive review of the current state of vestibular migraine and PPPD, including diagnostic and management guidance for when they occur separately, together, or along with other common comorbidities.


Assuntos
Transtornos de Enxaqueca , Doenças Vestibulares , Humanos , Tontura/diagnóstico , Doenças Vestibulares/complicações , Doenças Vestibulares/diagnóstico , Vertigem/diagnóstico , Transtornos de Enxaqueca/complicações , Transtornos de Enxaqueca/diagnóstico , Confusão
12.
Medicine (Baltimore) ; 103(6): e36820, 2024 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-38335382

RESUMO

Combining traditional Chinese medicine theory and modern medical knowledge, this study explores the pathogenesis of sudden hearing loss in middle-aged and young people. Sixty-four young and middle-aged patients with sudden hearing loss who visited a public tertiary hospital in China are chosen as experimental objects. All experimental patients are broken into an experimental group (n = 32) and a control group (n = 32). The control group receive conventional Western medicine treatment regimen. The experimental group receive select acupoint acupuncture and bloodletting combined with Rosenthal effect for psychological intervention, and both groups have a treatment course of 14 days. The changes in the patient's condition before and after treatment are observed, and the differences in hearing threshold values, tinnitus, and dizziness clinical efficacy before and after treatment are observed and recorded. It evaluates the efficacy using the Anxiety, Depression Scale, and Hope Scale and statistically analyzes the data. The dizziness score of the experimental group decreased rapidly, the treatment onset time was shorter, and the improvement effect on dizziness symptoms was better (P < .05). After 1 month of intervention treatment, the intervention of the experimental group was better (P < .05). The hope level and self-efficacy of both groups of patients were raised in contrast with before treatment (P < .05). After 1 month, the intervention effect of the experimental group was more significant (P < .01). Both groups could improve patient ear blood circulation, but the experimental group had lower plasma viscosity, hematocrit, and red blood cell aggregation index, higher red blood cell deformation index, and more significant improvement effect (P < .05). The effective rates of improving hearing and tinnitus in the experimental group reached 87.5% and 81.5%, and the clinical treatment efficacy was better than that in the control group (P < .05). The level of depression and anxiety in the experimental group remained relatively stable, while that in the control group showed a significant rebound (P < .05). In conclusion, both groups had a certain effect in treating sudden deafness, both of which could effectively improve the patient's hearing. But in contrast with the control group, the experimental group had better clinical efficacy, higher safety, and better psychological intervention results, which is worthy of clinical promotion.


Assuntos
Terapia por Acupuntura , Perda Auditiva Neurossensorial , Perda Auditiva Súbita , Zumbido , Pessoa de Meia-Idade , Humanos , Adolescente , Perda Auditiva Súbita/tratamento farmacológico , Tontura/terapia , Zumbido/terapia , Intervenção Psicossocial , Vertigem , Resultado do Tratamento , Hemorragia , Perda Auditiva Neurossensorial/terapia
13.
JAMA Otolaryngol Head Neck Surg ; 150(3): 240-248, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38300591

RESUMO

Importance: Standard-of-care treatment proves inadequate for many patients with bilateral vestibular hypofunction (BVH). Vestibular implantation is an emerging alternative. Objective: To examine patient-reported outcomes from prosthetic vestibular stimulation. Design, Setting, and Participants: The Multichannel Vestibular Implant (MVI) Early Feasibility Study is an ongoing prospective, nonrandomized, single-group, single-center cohort study conducted at Johns Hopkins Hospital that has been active since 2016 in which participants serve as their own controls. The study includes adults with severe or profound adult-onset BVH for at least 1 year and inadequate compensation despite standard-of-care treatment. As of March 2023, 12 candidates completed the eligibility screening process. Intervention: The MVI system electrically stimulates semicircular canal branches of the vestibular nerve to convey head rotation. Main Outcomes and Measures: Patient-reported outcome instruments assessing dizziness (Dizziness Handicap Inventory [DHI]) and vestibular-related disability (Vestibular Disorders-Activities of Daily Living [VADL]). Health-related quality of life (HRQOL) assessed using the Short Form-36 Utility (SF36U) and Health Utilities Index Mark 3 (HUI3), from which quality-adjusted life-years were computed. Results: Ten individuals (5 female [50%]; mean [SD] age, 58.5 [5.0] years; range, 51-66 years) underwent unilateral implantation. A control group of 10 trial applicants (5 female [50%]; mean [SD] age, 55.1 [8.5] years; range, 42-73 years) completed 6-month follow-up surveys after the initial application. After 0.5 years of continuous MVI use, a pooled mean (95% CI) of within-participant changes showed improvements in dizziness (DHI, -36; 95% CI, -55 to -18), vestibular disability (VADL, -1.7; 95% CI, -2.6 to -0.7), and HRQOL by SF36U (0.12; 95% CI, 0.07-0.17) but not HUI3 (0.02; 95% CI, -0.22 to 0.27). Improvements exceeded minimally important differences in the direction of benefit (exceeding 18, 0.65, and 0.03, respectively, for DHI, VADL, and SF36U). The control group reported no mean change in dizziness (DHI, -4; 95% CI, -10 to 2), vestibular disability (VADL, 0.1; 95% CI, -0.9 to 1.1) or HRQOL per SF36U (0; 95% CI, -0.06 to 0.05) but an increase in HRQOL per HUI3 (0.10; 95% CI, 0.04-0.16). Lifetime HRQOL gain for MVI users was estimated to be 1.7 quality-adjusted life-years (95% CI, 0.6-2.8) using SF36U and 1.4 (95% CI, -1.2 to 4.0) using HUI3. Conclusions and Relevance: This cohort study found that vestibular implant recipients report vestibular symptom improvements not reported by a control group. These patient-reported benefits support the use of vestibular implantation as a treatment for bilateral vestibular hypofunction.


Assuntos
Tontura , Doenças Vestibulares , Adulto , Humanos , Feminino , Pessoa de Meia-Idade , Tontura/etiologia , Qualidade de Vida , Atividades Cotidianas , Estudos de Coortes , Estudos Prospectivos , Vertigem/diagnóstico , Doenças Vestibulares/diagnóstico
14.
JAMA Otolaryngol Head Neck Surg ; 150(3): 257-264, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38329761

RESUMO

Importance: Dizziness is a highly prevalent complaint with wide-ranging causes and resultant morbidity. Whether symptomatic dizziness and its various manifestations are associated with all-cause and cause-specific mortality is unknown. Objective: To examine the associations of symptomatic dizziness and its manifestations with all-cause and cause-specific mortality. Design, Setting, and Participants: This cohort study is a mortality follow-up study based on the 1999-2004 National Health and Nutrition Examination Survey. The study cohort included adults 40 years and older who completed questions about symptomatic dizziness, including problems with dizziness, balance, falling, and positional dizziness, within the past 12 months. Respondents were linked to mortality data through December 31, 2019. Data were analyzed from February to August 2023. Exposure: Self-reported symptomatic dizziness. Main Outcomes and Measures: All-cause and cause-specific (cardiovascular disease, diabetes, cancer, and unintentional injuries) mortality. Cox proportional hazard regression models were used to examine associations between symptomatic dizziness and all-cause and cause-specific mortality while adjusting for demographics and medical history. Results: In this nationally representative cohort of 9000 middle-aged and older US adults (mean [SD] age, 61.8 [13.8] years; 4570 [50.8%] female), prevalence of symptomatic dizziness was 23.8%. Specifically, 18.3% reported problems with dizziness, 14.5% reported problems with balance, 5.7% reported problems with falling, and 3.8% reported dizziness when turning in bed (positional dizziness). At a median (range) of 16.2 (0.1-20.6) years of follow-up, all-cause mortality for adults with symptomatic dizziness was higher than for those without (45.6% vs 27.1%). Symptomatic dizziness was associated with elevated risk for cause-specific mortality from diabetes (hazard ratio [HR], 1.66; 95% CI, 1.23-2.25), cardiovascular disease (HR, 1.33; 95% CI, 1.12-1.55), and cancer (HR, 1.21; 95% CI, 0.99-1.47) but not unintentional injuries (HR, 0.98; 95% CI, 0.51-1.88). Reporting problems with balance or falling was associated with increased all-cause mortality (balance: HR, 1.27; 95% CI, 1.17-1.39; and falling: HR, 1.52; 95% CI, 1.33-1.73), cardiovascular disease-specific mortality (balance: HR, 1.41; 95% CI, 1.20-1.66; and falling: HR, 1.49; 95% CI, 1.15-1.94), and diabetes-specific mortality risks (balance: HR, 1.74; 95% CI, 1.26-2.39; and falling: HR, 2.01; 95% CI, 1.26-3.18). There was no association between positional dizziness and mortality (HR, 0.98; 95% CI, 0.82-1.19). Conclusions and Relevance: In this cohort study, symptomatic dizziness was associated with increased risk for all-cause and diabetes-, cardiovascular disease-, and cancer-specific mortality. The imprecision of the effect size estimate for cancer-specific mortality prevents making a definitive conclusion. Future studies are needed to determine whether symptomatic dizziness indicates underlying health conditions contributing to mortality or if early intervention for imbalance and falls can reduce mortality risk.


Assuntos
Doenças Cardiovasculares , Diabetes Mellitus , Neoplasias , Adulto , Pessoa de Meia-Idade , Humanos , Feminino , Idoso , Masculino , Tontura , Doenças Cardiovasculares/epidemiologia , Estudos de Coortes , Causas de Morte , Seguimentos , Inquéritos Nutricionais , Vertigem , Neoplasias/complicações
15.
Acta Otolaryngol ; 144(1): 14-18, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38375677

RESUMO

BACKGROUND: Ménière's disease (MD) is a common idiopathic inner ear disorder in otorhinolaryngology characterized by recurrent episodes of vertigo, fluctuating sensorineural hearing loss, tinnitus and ear fullness. OBJECTIVE: To study the effects of low-sodium diet with adequate water intake on the clinical efficacy in MD. METHODS: Fifty patients diagnosed with stage-3 unilateral MD were randomly divided into control group(n = 25) and experimental group(n = 25). The control group was given routine medication therapy, and the experimental group was restricted to an sodium intake of 1500 mg/d and a water intake of 35 ml/kg/d based in addition to the routine medication therapy. The two groups were assessed using pure tone audiometry, electrocochleography, Tinnitus Handicap Inventory (THI), and Dizziness Handicap Inventory (DHI). RESULTS: The pure tone audiometry and electrocochleography showed better improvements after treatment in the experimental group than the control group (p < 0.05). The THI improved values in the experimental group were significantly higher than the control group (p < 0.001). The DHI improved values in the experimental group were significantly higher than the control group (p = 0.004). CONCLUSIONS AND SIGNIFICANCE: Low-sodium diet with adequate water intake improved the hearing and alleviated vertigo and tinnitus in MD patients.


Assuntos
Doença de Meniere , Zumbido , Humanos , Doença de Meniere/complicações , Doença de Meniere/tratamento farmacológico , Doença de Meniere/diagnóstico , Dieta Hipossódica , Ingestão de Líquidos , Vertigem , Tontura , Resultado do Tratamento
16.
Acta Otolaryngol ; 144(1): 7-13, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38375680

RESUMO

BACKGROUND: The treatment of refractory elderly Meniere's disease is a challenge. AIM: To investigate the efficacy of tympanostomy tube placement in elderly patients with Meniere's disease. METHODS: 31 patients over 60 years old with Meniere's disease who had failed medical treatment and underwent tympanostomy tube placement. Vertigo control, hearing level, tinnitus, and ear fullness were recorded and analyzed preoperatively and postoperatively. RESULTS: All patients completed a 6-month follow-up. At 6 months postoperatively,complete control, substantial control and limited control of vertigo were achieved in 10 (32%), 13 (42%), and 6 (19%) patients respectively. Two patients (6%) reported no substantial improvement. Twelve patients completed a 2-year follow-up. At 2 years postoperatively, complete control, substantial control and limited control of vertigo were achieved in 3 (25%), 5 (42%), and 1 (8%) patients respectively. Three (25%) patients showed no significant improvement in vertigo. The majority of patients reported significant improvement in the functional level scale, the Dizziness Handicap Inventory scores, and ear fullness at 6 months and 2 years postoperatively. CONCLUSIONS AND SIGNIFICANCE: Tympanostomy tube placement may reduce vertigo attacks and improved the quality of life in elderly patients with Meniere's disease.


Assuntos
Doença de Meniere , Zumbido , Humanos , Idoso , Pessoa de Meia-Idade , Doença de Meniere/complicações , Doença de Meniere/cirurgia , Ventilação da Orelha Média , Qualidade de Vida , Vertigem/cirurgia , Zumbido/cirurgia
17.
Sci Rep ; 14(1): 3701, 2024 02 14.
Artigo em Inglês | MEDLINE | ID: mdl-38355682

RESUMO

Usher Syndrome classification takes into account the absence of vestibular function but its correlation with genotype is not well characterized. We intend to investigate whether video Head Impulse Test (vHIT) is useful in screening and to differentiate Usher Syndrome types. 29 Usher patients (USH) with a genetically confirmed diagnosis and 30 healthy controls were studied with vHIT and dizziness handicap inventory questionnaire (DHI). Statistical significant differences between USH1, USH2 and controls were found in the vestibulo-ocular-reflex (VOR) gain of all SCCs, with USH1 patients consistently presenting smaller gains. VOR gain of the right lateral SCC could discriminate controls from USH1, and USH2 from USH1 with an overall diagnostic accuracy of 90%. USH1 DHI correlated with VOR (ρ = - 0,971, p = 0.001). Occurrence rate of covert and overt lateral semicircular canals refixation saccades (RS) was significantly different between groups, being higher in USH1 patients (p < 0.001). USH1 peak velocity of covert and overt saccades was higher for lateral semicircular canals (p < 0.05 and p = 0.001) compared with USH2 and controls. Covert saccades occurrence rate for horizontal SCCs could discriminate USH1 from USH2 patients and controls with a diagnostic accuracy of 85%. vHIT is a fast and non-invasive instrument which allowed us to screen and distinguish Usher patients from controls with a high precision. Importantly, its use allowed further discrimination between USH1 from USH2 groups. Moreover, VOR gain seems to correlate with vertigo-related quality of life in more severe phenotypes.


Assuntos
Reflexo Vestíbulo-Ocular , Síndromes de Usher , Humanos , Qualidade de Vida , Síndromes de Usher/diagnóstico , Síndromes de Usher/genética , Vertigem , Teste do Impulso da Cabeça , Movimentos Sacádicos
18.
Brain Behav ; 14(2): e3389, 2024 02.
Artigo em Inglês | MEDLINE | ID: mdl-38391108

RESUMO

OBJECTIVES: Persistent postural-perceptual dizziness (PPPD) is a chronic functional vestibular disorder for which the Bárány Society has established diagnostic criteria. This nationwide multicenter study aims to investigate the clinical features of individuals with definite PPPD and clinical variant PPPD who do not fully meet the diagnostic criteria, with a particular focus on visual exaggeration. METHODS: Between September 2020 and September 2021, a total of 76 individuals with definite PPPD and 109 individuals with clinical variant PPPD who did not meet all three exacerbating factors outlined in Criterion B were recruited from 18 medical centers in South Korea. The study gathered information on demographic factors, clinical manifestations, balance scales, and personality assessments. RESULTS: Comparative analysis between groups with definite PPPD and clinical variant with visual exacerbation revealed no significant differences in sociodemographic characteristics, clinical course, dizziness impact, and specific precipitants. Only disease duration was significantly longer in definite PPPD compared with variant with visual exacerbation. However, the variant without visual exacerbation displayed significantly reduced rates of panic disorder, diminished space-motion discomfort, lesser impact of dizziness, and decreased prevalence of depression when compared with the definitive PPPD. CONCLUSION: This is the first comprehensive nationwide study examining clinical features of both definite PPPD patients and its clinical variants, considering visual exacerbating factors. Differences in dizziness and personality traits emerged between definite PPPD and its potential variant without visual issues. Our results highlight the possibility of a distinct clinical variant of PPPD influenced by visual dependency.


Assuntos
Tontura , Doenças Vestibulares , Humanos , Tontura/diagnóstico , Tontura/epidemiologia , Estudos Transversais , Vertigem , Doenças Vestibulares/diagnóstico , Doenças Vestibulares/epidemiologia , República da Coreia/epidemiologia
19.
Otol Neurotol ; 45(3): e177-e185, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38361298

RESUMO

OBJECTIVE: To determine the utility of the motion sensitivity quotient (MSQ) in diagnosing pediatric vestibular migraine (VM) and to characterize the role of motion sensitivity and headache control on vestibular rehabilitation (VR) outcomes in pediatric VM. STUDY DESIGN: Retrospective cohort analysis. SETTING: Pediatric tertiary referral center. PATIENTS: Children (≤18 years old) with dizziness who completed vestibular testing from January 2016 to August 2022, diagnosed with either VM or another vestibular disorder. INTERVENTIONS: VR, which included MSQ testing. MAIN OUTCOME MEASURES: Initial MSQ, number and duration of vestibular physical therapy (PT) sessions, PT goals met, and posttreatment MSQ. RESULTS: Two hundred fifty-seven patients met study criteria. MSQ was not a reliable diagnostic marker in pediatric VM as there was no difference in initial MSQ between VM and non-VM patients (9.4 vs. 7.8 in non-VM, p = 0.014). Both VM (n = 116) and non-VM (n = 141) patients demonstrated significant improvement in MSQ after VR (p = 0.004). However, VM patients tended to be less likely to meet at least one PT goal (60 vs. 77% in non-VM, p = 0.016, d = 0.37), although not significant. VM patients with more frequent headaches had significantly higher initial MSQ (p = 0.008). VM patients with more frequent headaches or higher initial MSQ tended to require increased number and longer duration of VR (small/medium effect size although not statistically significant after Bonferroni correction). CONCLUSION: VR is an effective treatment for both VM and non-VM pediatric patients. VM patients, especially those with severe motion sensitivity or poorly controlled headaches, may be less responsive to VR and may require increased frequency and duration of VR. Our findings propose the importance of counseling pediatric patients with severe motion sensitivity or uncontrolled migraines regarding realistic expectations of their VR course.


Assuntos
Transtornos de Enxaqueca , Doenças Vestibulares , Humanos , Criança , Adolescente , Estudos Retrospectivos , Vertigem , Transtornos de Enxaqueca/complicações , Transtornos de Enxaqueca/diagnóstico , Doenças Vestibulares/complicações , Doenças Vestibulares/diagnóstico , Tontura/etiologia , Cefaleia , Resultado do Tratamento
20.
PLoS One ; 19(2): e0297100, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38300969

RESUMO

The purpose of this study was to explore the characteristics of and risk factors for otological symptoms after contracting COVID-19. We invited 468 participants who had been infected with COVID-19 to participate in a survey. 310 (66.2%) were women and 158 (33.8%) were men. The mean age is 38.73 (12.21) years. The questionnaire included their basic information, symptoms and symptom duration after SARS-CoV-2 infection, number of vaccine doses received, and details regarding otological symptoms. In total, 106/468 (22.6%) participants experienced tinnitus, 66/468 (14.1%) hearing loss, 103/468 (22.0%) aural fullness, and 71/468 (15.2%) dizziness. Women were more prone to experience tinnitus (P = 0.022) and dizziness (P = 0.001) than men. The group with hearing loss were older (P = 0.025), and their initial COVID-19 symptoms lasted longer (P = 0.028) than those of patients without. Patients with aural fullness were more likely to experience fatigue than patients without (P = 0.002). Patients experiencing dizziness were more likely to experience pharyngalgia (P = 0.040) and fatigue (P = 0.005) than those without. The number of vaccine doses was positively associated with the resolution of otological symptoms (P = 0.035). Multiple logistic regression analysis revealed that sex was an independent risk factor for tinnitus (odds ratio [OR], 1.802; 95% confidence interval [CI], 1.099-2.953; P = 0.020), the duration of initial COVID-19 symptoms for hearing loss (OR, 1.055; 95% CI, 1.008-1.105; P = 0.023), and sex for dizziness (OR, 2.870; 95% CI, 1.489-5.535; P = 0.002). Sex, age, COVID-19-related fatigue, and the duration of initial COVID-19 symptoms may affect the occurrence of otological symptoms, and vaccines may aid their resolution.


Assuntos
COVID-19 , Surdez , Perda Auditiva , Zumbido , Vacinas , Masculino , Humanos , Feminino , Adulto , Zumbido/epidemiologia , Zumbido/etiologia , Tontura/etiologia , Tontura/complicações , COVID-19/complicações , COVID-19/epidemiologia , SARS-CoV-2 , Perda Auditiva/etiologia , Perda Auditiva/complicações , Vertigem/complicações , Fatores de Risco
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