HMGB1 Carried by Small Extracellular Vesicles Potentially Plays a Role in Promoting Acquired Middle Ear Cholesteatoma.

Cholesteatoma is a specific medical condition involving the abnormal, non-cancerous growth of skin-like tissue in the middle ear, potentially leading to a collection of debris and even infections. The receptor for advanced glycation (RAGE) and its ligand, high-mobility box 1 (HMGB1), are both known to be overexpressed in cholesteatoma and play a potential role in the pathogenesis of the disease. In this study, we investigated the role of small extracellular vesicles (sEVs) in carrying HMGB1 and inducing disease-promoting effects in cholesteatoma. No significant differences in the concentration of isolated sEVs in the plasma of cholesteatoma patients (n = 17) and controls (n = 22) were found (p > 0.05); however, cholesteatoma-derived sEVs carried significantly higher levels of HMGB1 (p < 0.05). In comparison to sEVs isolated from the plasma of controls, cholesteatoma-derived sEVs significantly enhanced keratinocyte proliferation and IL-6 production (p < 0.05), potentially by engaging multiple activation pathways including MAPKp44/p42, STAT3, and the NF-κB pathway. Thus, HMGB1(+) sEVs emerge as a novel factor potentially promoting cholesteatoma progression.

Change in the Characteristics of Patients Qualified for Hearing Aids over the Last 25 Years in Poland.

Hearing loss is one of the most common causes of disability worldwide. The aim of the study was to compare the demographic structure and the results of hearing tests in people qualified for hearing aids over the last 25 years. The material covered 1246 patients qualified for hearing aids in the years 1996-2001 and 2016-2021. Patients were divided into two groups according to the time of qualifying for hearing aids. Group 1 (G1) consisted of 759 people qualified in the years 1996-2001, and Group 2 (G2) comprised 487 people qualified in the years 2016-2021. Statistical analysis was performed on the results of pure tone threshold audiometry and the demographic structure in both groups. Patients in G1 had statistically significantly elevated hearing thresholds (HT) in the air conduction range at frequencies from 2000 to 8000 Hz in relation to G2 patients. The opposite situation was observed for the bone conduction threshold. G2 patients had significantly elevated bone conduction HT at frequencies from 250 to 1000 Hz compared to G1 patients. The age structure in both groups was similar; however, the gender distribution was statistically significantly different. In G1 women accounted for 40%, and in G2, they became the dominant gender (53%). Over the last twenty years, there has been a change in the structure of patients qualified for hearing aids. Although the age has remained similar, today, patients decide to use hearing aids at an earlier stage of hearing loss than 25 years ago. Modern women began to use hearing aids much more often.

The Impact of the Angular Head Movement's Velocity during Diagnostic Maneuvers on Proper Benign Positional Paroxysmal Vertigo Diagnosis and Therapy.

Based on the current state of the BPPV field, there are no guidelines that specify an angular head movement's velocity (AHMV) during diagnostic maneuvers of BPPV. The aim of this study was to evaluate the impact of AHMV during diagnostic maneuvers on proper BPPV diagnosis and therapy. The analysis covered the results obtained in 91 patients with a positive result of the Dix-Hallpike (D-H) maneuver or the roll test. The patients were divided into four groups based on values of AHMV (high 100-200°/s and low 40-70°/s) and the BPPV type (posterior: PC-BPPV or horizontal: HC-BPPV). The parameters of the obtained nystagmuses were analyzed and compared to AHMV. There was a significant negative correlation between AHMV and latency of nystagmus in all study groups. Furthermore, there was a significant positive correlation between AHMV and both maximum slow phase velocity and average frequency of nystagmus in the PC-BPPV groups, whereas it was not observed in the HC-BPPV patients. Complete relief of symptoms was reported after 2 weeks and was better in patients diagnosed with maneuvers performed with high AHMV. High AHMV during the D-H maneuver allows the nystagmus to be more visible, increasing the sensitivity of diagnostic tests and is crucial for a proper diagnosis and therapy.

Treatment Results of Endoscopic Transnasal Orbital Decompression for Graves' Orbitopathy-A Single-Center Retrospective Analysis in 28 Orbits of 16 Patients.

Graves' orbitopathy (GO) is an extrathyroidal manifestation of Graves' disease (GD), which can be associated with corneal ulcerations or optic neuropathy in severe forms. Transnasal endoscopic orbital decompression (TEOD) is a surgical procedure performed in order to decrease the intraorbital pressure by removing part of its bony borders in cases with excessive mass in orbit. The aim of this study was to present the results and evaluate the efficacy of TEOD for GO. The retrospective study included 28 orbits (16 patients) who underwent TEOD from 2017 to 2020. Outcome was evaluated based on visual acuity improvement, clinical activity score (CAS) decrease, proptosis, and intraocular pressure (IOP) reduction. A preoperative best-corrected visual acuity (BCVA) increased from 0.69 ± 0.385 (mean ± standard deviation) to 0.74 ± 0.332 (p = 0.17) postoperatively. CAS decreased in 15 orbits postoperatively. Proptosis decreased from 22.89 ± 1.873 mm to 21.25 ± 2.053 mm (p < 0.05). IOP decreased from a preoperative 16.11 ± 3.93 mmHg to 14.40 ± 3.27 mmHg (p < 0.05) postoperatively. In addition, postoperative relief of exposure keratitis was observed. The analysis of development of iatrogenic diplopia revealed increasing in degree of diplopia. TEOD shows rare complications, but significant improvements in BCVA, CAS, proptosis, and IOP.

Dysfunctions of the vestibular organ in patients with migrainous vertigo in the results of objective tests of the equilibrium system.

<b>Introduction:</b> Migrainous vertigo (MV) is one of the most common causes of episodic vertigo. Diagnostic criteria for MV are described in the appendix to the third edition of the International Classification of Headache Disorders (Beta Version). The dysfunction exerts its impact on certain peripheral and central structures within the vestibular system. </br></br> <b>Aim:</b> The aim of the study was to assess the function of the central and peripheral vestibular system in patients with MV based on the results of objective clinical tests including videonystagmography (VNG) and cervical vestibular evoked myogenic potentials (cVEMP) depending on the duration of the disease. </br></br> <b>Material and methods:</b> A query of the medical records of patients receiving vertigo treatment at the Department of Otolaryngo-logy of the Centre of Postgraduate Medical Education over the last four years returned a total of 84 cases of patients diagnosed with MV; the patients were assigned to either of the following two groups: study group I (SG1) - 42 patients with MV in whom the symp-tom onset had occurred within one year prior to hospital admission, and study group II (SG2) - 42 patients who had been suffering from vertigo for about 10 years. </br></br> <b>Results:</b> Patients in both groups (SG1 and SG2) were diagnosed with all three types of vestibular dysfunction (central, peri-pheral and mixed), with peripheral vestibular dysfunction being the predominant finding. A thorough analysis of the dura-tion of vestibular attacks revealed that the patients suffering from MV for a longer period of time (SG2) suffered from vertigo attacks which were longer than those in the patients with the shorter lasting-disorder (SG1). The duration of vertigo episodes was also estimated to be prolonged in peripheral and mixed types of vestibular disorders. The percentage of individuals with peripheral and mixed vestibular disorders increased significantly with increasing MV episode durations.

RAGE and HMGB1 Expression in Orbital Tissue Microenvironment in Graves' Ophthalmopathy.

Graves' ophthalmopathy (GO) is a chronic autoimmune inflammatory disorder involving orbital tissues. A receptor for advanced glycation end products (RAGE) and its ligand high mobility group box 1 (HMGB1) protein trigger inflammation and cell proliferation and are involved in the pathogenesis of various chronic inflammatory diseases. This study was aimed to evaluate RAGE and HMGB1 expression in GO to determine its potential clinical significance. To the best of our knowledge, this is the first study showing RAGE and HMGB1 expression in orbital tissue using immunohistochemistry. Sections of orbital adipose tissue obtained from patients diagnosed with GO (23 patients; 36 orbits) and normal controls (NC) (15 patients; 15 orbits) were analyzed by immunohistochemistry for RAGE and HMGB1 expression. Expression profiles were then correlated with clinical data of the study group. RAGE and HMGB1 expression were elevated in GO patients in comparison with NC (p = 0.001 and p = 0.02, respectively). We observed a correlation between RAGE expression and occurrence of dysthyroid optic neuropathy (DON) (p = 0.05) and levels of TSH Receptor Antibodies (TRAb) (p = 0.01). Overexpression of RAGE and HMGB1 might be associated with GO pathogenesis. In addition, RAGE and HMGB1 proteins may be considered as promising therapeutic targets, but this requires further research.

Immunological Aspects of Graves' Ophthalmopathy.

The body's autoimmune process is involved in the development of Graves' disease (GD), which is manifested by an overactive thyroid gland. In some patients, autoreactive inflammatory reactions contribute to the development of symptoms such as thyroid ophthalmopathy, and the subsequent signs and symptoms are derived from the expansion of orbital adipose tissue and edema of extraocular muscles within the orbit. The autoimmune process, production of antibodies against self-antigens such as TSH receptor (TSHR) and IGF-1 receptor (IGF-1R), inflammatory infiltration, and accumulation of glycosaminoglycans (GAG) lead to edematous-infiltrative changes in periocular tissues. As a consequence, edema exophthalmos develops. Orbital fibroblasts seem to play a crucial role in orbital inflammation, tissue expansion, remodeling, and fibrosis because of their proliferative activity as well as their capacity to differentiate into adipocytes and myofibroblasts and production of GAG. In this paper, based on the available medical literature, the immunological mechanism of GO pathogenesis has been summarized. Particular attention was paid to the role of orbital fibroblasts and putative autoantigens. A deeper understanding of the pathomechanism of the disease and the involvement of immunological processes may give rise to the introduction of new, effective, and safe methods of treatment or monitoring of the disease activity.

[Endoscopic decompression of orbit in Graves' orbitopathy]. / Endoskopowa dekompresja oczodolu w orbitopatii tarczycowej.

Graves' orbitopathy (GO) is an extrathyroidal manifestation of Graves' disease (GD). The majority of patients has mild form of the disease, with no need of additional treatment. A few percent of patients can have a severe or very severe course of disease. In severe forms of GO there might occur considerable exophthalmos complicated in some cases with corneal ulceration or pressure on optic nerve leading to neuropathy (DON, dysthyroid optic neuropathy). In therapy of severe forms of GO different types of treatment are used depending on diagnosis and activity of disease. The pharmacological (among the others very high doses of intravenous methylprednisolone) and surgery treatment (orbit decompression) are used. The orbital decompression is a procedure performed in order to decrease the intraorbital pressure by removing part of its bony borders in cases with excessive mass in orbit. For decades many external approaches have been used. With the progress of the endoscopic techniques the endoscopic orbit decompression has become the first line treatment. The lack of facial incisions is connected with many benefits for patients. In our article endoscopic decompression technique in GO was described, as well as available medical literature concerning this technique and its outcomes was performed.

Marcus Gunn (jaw-winking) phenomenon in pediatric otorhinolaryngology practice.

Marcus Gunn phenomenon (MGP) is a rare form of congenital facial synkinesis known as jaw-winking or pterygoid-levator synkinesis. The MGP is the raising of the affected eyelid is synchronous and proportionate to the opening of the mouth. The etiology is unclear. Most authors claim that a branch of trigeminal nerve has been congenitally misdirected into position of the oculomotor nerve which supplies the levator muscle of the upper lid. The MGP deals with number of problems which have to be manage by ENT doctors, but they are not well­documented. We describe the first time Marcus Gunn phenomenon associated with an olfactory nerve disturbance. We have especially emphasized laryngological aspect of MGP diagnosis and the need for deeper interdisciplinary diagnostics in each child with olfactory dysfunction.

Tympanometric evaluation of Eustachian tube function in Polish scuba divers.

BACKGROUND: Scuba divers are subjected to relatively high ambient pressures while descending. Equalizing maneuvers (e.g., Valsalva) are necessary to open the Eustachian tube (ET) and allow air into the middle ear (ME) cavity. Insufficient opening of the ET leads to ME barotrauma, which is the most common injury related to scuba diving. The study aims were to assess the incidence of ME barotrauma and to compare tympanometric parameters and stapedial reflexes in scuba divers and non-diving individuals. MATERIAL AND METHODS:: 60 scuba divers participated in the study; control consisted of 90 non-diving volunteers without a history of otolaryngologic problems. All participants were examined with the use of otoscopy and tympanometry with evaluation of ipsilateral stapedial reflexes. The group studied was surveyed regarding occurrence of ME barotrauma and diving competence. RESULTS: 51.7% of the divers experienced ME barotrauma, the most common symptoms being earache and hearing loss. Comparison of the group studied and control revealed significantly lower ME pressure and compliance in scuba divers. In scuba divers with ME barotrauma, longer time from injury correlates directly with greater ME pressure and compliance, indicating tissue recovery. At 4,000Hz 100dB percentage of present stapedial reflexes among scuba divers was significantly lower than in controls; moreover, a greater number of dives correlated inversely with percentage of present stapedial reflexes at 4000Hz 100dB. The reduced thresholds at high intensities suggest a negative effect of scuba diving on hearing. CONCLUSIONS: ME pressure and compliance, however still within the norm, are significantly lower in scuba divers than in non-diving healthy volunteers. This may be attributed to a subclinical form of barotrauma.

Kallmann syndrome in pediatric otorhinolaryngology practice - Case report and literature review.

BACKGROUND: Kallmann syndrome (KS) is an isolated form of hypogonadotrophic hypogonadism (HH) in combination with a defect in olfactory function. The diagnosis of KS before maturation is often difficult to make due to the broad spectrum of presentation and genetic heterogeneities. ENT examination including smell test is essential for proper diagnosis of olfactory disturbances and non olfactory abnormalities in craniofacial region which may also be existent in KS. CASE: A 17-year-old girl admitted to ENT Department because of the olfactory sense disturbances since two years. The patient reported also amenorrhea caused by primary HH. A diagnostic work-up using double-checked Sniffin' Sticks test and 6-items olfactory test confirmed serious hyposmia and identified the presence of KS. CONCLUSION: Usually anosmia is not recognized by the affected individuals, so it is recommended to perform olfactory screening tests and obligatory ENT examination in the event of a HH even when patient reports a normal sense of smell. It leads to early diagnosis of KS and will benefit the relevant patient care.The KS diagnosis should be done at an early stage, but symptoms and clinical manifestations are not always evident both in ENT and pediatric field. In this article we would like to highlight the need for a multidisciplinary assessment and awareness for KS symptoms in pediatric practice as a hole.

The correlation of TAS2R38 gene variants with higher risk for chronic rhinosinusitis in Polish patients.

BACKGROUND: Bitter taste receptors (T2Rs), especially T2R38s appear as innovative regulators of innate immunity in the respiratory system. The single nucleotide polymorphisms (SNPs) in TAS2R38 gene may contribute to individual differences in susceptibility to respiratory infections especially chronic rhinosinusitis (CRS). TAS2R38 genotypes distribution varies by geographic region, race and ethnicity. The aim of the preliminary study was the identification of SNPs in TAS2R38 encoding genes in Polish patients with CRS and finding potential correlation with CRS phenotypes. MATERIAL AND METHODS: The preliminary study contained 20 CRS patients undergoing functional endoscopic sinus surgery (FESS). Fresh sinus mucosa (SM) was obtained during FESS in CRS patients. Patients were genotyped for TAS2R38 using Sanger method and the genotype occurrences of the clinically recalcitrant CRS cohort was evaluated. Analysis of TAS2R38 expression in SM of CRS patients was performed using immunohistochemistry (IHC). RESULTS: T2R38 was highly expressed in SM of CRS patients. Patients with CRS demonstrated both common genotypes PAV, AVI. The heterozygotes frequency (AVI/PAV) was the highest. The protective genotype (PAV/PAV) was noticed in the lowest frequency and connected with lower average value of CT score compare to AVI/AVI genotypes (p=0.01). CONCLUSIONS: The work presented in this study provides the hypothesis that airway bitter T2Rs are an innovative sphere of human respiratory innate protection. TAS2R38 polymorphism may influence the susceptibility to CRS. The AVI haplotypes are an independent risk factors for CRS. Additionally, the bitter taste receptors and related signalling pathways might create an unique group of therapeutic targets to treat CRS.

Clinical evaluation of balloon dilation Eustachian tuboplasty in the Eustachian tube dysfunction.

The development of minimally invasive procedures such as the balloon dilation Eustachian tuboplasty (BET) is an alternative to the grommet tympanum membrane. BET is applied in the cases where, after elimination of all factors influencing the ET and middle ear functioning, no sufficient improvement is observed. The aim of this study was to present the therapeutic benefits of the BET method in the treatment of ETD caused by disorders in the middle ear ventilation. The BET procedure was offered to four patients (3 men and 1 woman) after subjective, physical, otorhinolaryngological and audiometric examinations including pure tone audiometry, tympanometry and pressure-swallow test. As the method was novel, preinterventional CT angiography of the carotid arteries was performed in all patients. Any complications were noticed during and after the procedure (bleeding or damage of regional mucosa) in any patients. Our clinical studies assessed the feasibility and safety of the BET during a short-term period--only a 6-week observation. Although patients revealed a significant improvement of ET score, longer long-term studies are necessary to determine whether this method will demonstrate lasting benefits and safety in the treatment of chronic Eustachian tube dysfunction. In other investigations, improvement was found to be time dependent.

[Comparable efficacy between twice and three times daily for treatment of balance system disturbances]. / Porównanie skutecznosci betahistyny podawanej dwa i trzy razy dziennie w leczeniu zaburzén ukladu równowagi.

UNLABELLED: In spite of detailed examinations it is impossible to find reasons for balance system disturbances in more than 25 per cent of patients. Therefore doctors have to treat symptoms but not the reasons for balance system disturbances. One of the most frequently administered medicine in treatment of both central and peripheral balance system disturbances is betahistine dihydrochloride (Betaserc). The aim of the study was to evaluate the influence of Betaserc an balance system disturbances with reference to dosage. MATERIAL AND METHODS: Patients were divided into two groups. The first group (Group I) was treated with Betaserc three times a day: 16 mg for minimum 4 weeks and 8 mg for minimum 8 weeks. The second group (Group II) was treated with Betaserc twice a day: 24 mg for maximum 4 weeks and next 12 mg for minimum 8 weeks. The data from interviews and additional examinations (videonystagmography and posturography) were considered. RESULTS: The latter group more often showed smaller balance system disturbances and vertigo than the first group both after 4 and 12 weeks. After 12 weeks of treatment more patients from the second group reported "a complete disappearance" of the symptoms. A substantial improvement of results was observed in videonystagmography and posturography examinations. CONCLUSION: The treatment with 24 mg for 4 weeks and 12 mg for 8 weeks twice daily was better tolerated and gave higher positive effects than the treatment three times a day with 16 mg for 4 weeks and 8 mg for 8 weeks.

[Case of paraganglioma of the originally numerous location in the 24 year old male]. / Przypadek klebczaka o pierwotnie mnogim umiejscowieniu u 24-letniego mezczyzny.

INTRODUCTION: Paragangliomas, in other words chemodectomas were bening tumors arising from the paragangliomas cells of the parasympathetic system. There are four kinds of paragangliomas: carotic artery baroreceptors (glomus caroticum), tympanic cavity (glomus tympanicum), internal jugular vein (glomus jugulare) and placed along vagal nerve (glomus vagale). Overall 5-10% of all paragangliomas are malignant. The bening lorms paragangliomas, of the originally numerous location are rare described. MATERIAL AND METHODS: The authors describe the rare case of 24 yrs old male, of the bening form paraganglioma of the originally numerous location - glomus tympanicum on the left site, glomus caroticum on the right site. RESULTS: The patient was successfuly treated surgicaly. CONCLUSIONS: The first choice of treatment is surgery. The diagnosis of a suspected paraganglioma can be confirmed with USG, CT, Angio CT, Angiography and MRI. Radiation therapy may be usefull in those cases in which the residual tumor was known to be left.

[A large emphysema as complication of sinus puncture]. / Rozlegla odma jako powiklanie punkcji zatoki szczekowej.

Acute sinusitis including maxillary sinusitis is one of the most common complications of acute upper respiratory tract infections. The "gold standard" in the diagnostics and treatment in cases at positive interview, positive results of rhinoscopy, X-ray examination and negative pharmacological treatment is sinus puncture. Method is cheap, simple but charged minimal risk of complications, so, not recommended as method from choice for practice diagnostics of first cast. The paper presents case of intramuscular, subcutaneous, retropharyngeal region and in front of vertebral column regions emphysema in 61-year-old man after maxillary sinus puncture.

[The hearing organ men assessment on basis of judgments of committee recruits in 2001-2003 years]. / Ocena narzadu sluchu mezczyzn na podstawie orzeczen komisji poborowych w latach 2001-2003.

In spite of a considerable progress in research techniques, assessment of health state of large social groups still poses a problem. The most extensive and complete information can be obtained from examinations of recruits. 1 092 506 recruits were examined by medical boards between 2001 and 2003. There were analyzed health certificates with the clause 21 comprising various disorders of the hearing organ (excluding inflammatory illnesses) and defining the recruits' health categories as "D"--unqualified for military service at peace as well as the category "E"--unqualified for military service at peace and in the case of mobilization or at war referring to the level of hearing. 6836 certificates of laryngological illnesses, 5057 certificates with the clause 21, 2684 certificates of the "D" category and 2088 certificates of the "E" category were issued. The certificates given by recruitment commissions refer to a homogeneous group as regards sex and age. They are issued for a short period of time and based on equal criteria. This also refers to laryngological illnesses including estimation of the hearing organ.

[Evaluation of hyperbaric oxygen and pharmacological therapy in sudden hearing loss]. / Ocena wyników leczenia naglej gluchoty idiopatycznej z zastosowaniem terapii tlenem hiperbarycznym.

UNLABELLED: Treatment of idiopathic sudden hearing loss (SHL) is still a big problem for the otolaryngologists, due to the still unexplained etiopathogenesis of the illness. The aim of this study was to evaluate effectiveness of pharmacotherapy combined with the hyperbaric oxygen (HBO) in idiopathic sudden sensorineural hearing loss treatment. Patients who received HBO and medical treatment in the Department of Otolaryngology of Military Institute of Health Service and Warsaw Center for Hyperbaric Therapy and Wounds Treatment were studied. MATERIAL AND METHODS: Nine patients, with idiopathic sudden hearing loss--patients treated in 2007 year were studied. There were 5 women and 4 men involved in our study--mean age: 41 years old. Patients with sensorineural hearing loss of minimum 15 dB at 0.25-8 kHz and tinnitus were included in the treatment group. Improvement of hearing of minimum 10 dB at 0.25-8 kHz in pure tone audiometry and decrease in the intensity of tinnitus was considered as an improvement. RESULTS: Statistically significant difference in Pure Tone Audiometry results obtained before and after the treatment was noted in 500 Hz, 1 kHz, 2 kHz, 3 kHz, 4 kHz and 8 kHz. Statistically significant difference was noted in 500 Hz, 2 kHz, 3 kHz when treatment was started within 6 days since the acoustic trauma. No side effects of therapy were observed. CONCLUSIONS: Hyperbaric oxygen therapy is the unique method of increasing concentration of oxygen in the inner ear fluids thus facilitates the regeneration process. Hyperbaric oxygen therapy combined with steroids is an effective method of sensorineural hearing loss treatment. Important is to start the therapy quickly after hearing loss.

[A case report of fibrous dysplasia in right temporal bone]. / Przypadek zwyrodnienia wlóknistego kosci skroniowej prawej.

The authors describe the rare case of fibrous dysplasia in temporal bone. Dysplasia fibrosa is a benign osseous condition that may involve one or more bones in the cranial and extracranial skeleton. Temporal bone involvement occurs in 18 per cent of craniofacial diseases. Clinical, radiographic and histologic examinations are essential to confirm the diagnosis of fibrous dysplasia. Treatment of illness depends on the associated symptoms.

[Assessment of betahistine dihydrochloride effectiveness in the treatment of vertigo of a different aetiology based on videonystagmography test results]. / Ocena zastosowania dichlorowodorku betahistyny w leczeniu zawrotów glowy o róznej etiologii na podstawie badan wideonystagmograficznego.

UNLABELLED: Comprehensive medical history and videonystagmography (VNG) testing play very important role in balance assessment especially when dealing with balance disorders occurring occasionally. VNG in many clinical situations is performed as an initial test before complete otoneurological examination is carried out. Betahistine dihydrochloride (betahistine) a synthetic histamine analogue is one of many drugs used in the treatment of balance disorders of central or peripheral etiology. The aim of our work was to analyze, using the VNG test, effectiveness of betahistine treatment and to compare it with the control group treated with different drugs. MATERIAL AND METHODS: 42 patients suffering from vertigo were evaluated before and after the treatment with betahistine. Treatment results were compared with the results of 20 vertigo sufferers treated during the same period of time with different drugs. In effort to standardize asked questions, interviews with patients were completed with specially structured questionnaire. In 54% of patients, decreased intensity and severity of vegetative symptoms was observed after the treatment with betahistine, in 45.2% of patients (30% of the control group) decreased frequency of attacks was noted. RESULTS: In 69.1% of patients treated with betahistine and in 50% of the control group improved results of the VNG test were noted. In 9.5% of patients (4 patients) treated with betahistine and in 20% of patients from the control group, the VNG test results were worse. Quantitative and qualitative features of the VNG test were best improved in parts of the test showing features of its central origin. In 50% of patients improvement of the symmetry in Optokinetic testing, decrease or stop of vertical component of positional nystagmus was noted. In 38.1% of patients decrease of directional predominance of nystagmus in Caloric Testing was noted. None of all examined patients exhibited features of worsening of VNG test results and no new symptoms were noted. Radiological investigations showed no new pathologies. CONCLUSION: Betahistine dichloride is one of the basic drugs used in the treatment of vertigo of different etiology.