Diagnostic Criteria for Meniere's Disease / 대한평형의학회지

This paper presents diagnostic criteria for Meniere's disease jointly formulated by the Classification Committee of the Barany Society, The Japan Society for Equilibrium Research, the European Academy of Otology and Neurotology, the Equilibrium Committee of the American Academy of Otolaryngology-Head and Neck Surgery, and the Korean Balance Society. The classification includes two categories: definite Meniere's disease and probable Meniere's disease. The diagnosis of definite Meniere's disease is based on clinical criteria and requires the observation of an episodic vertigo syndrome associated with low- to medium- frequency sensorineural hearing loss and fluctuating aural symptoms (hearing, tinnitus and/or fullness) in the affected ear. Duration of vertigo episodes is limited to a period between 20 minutes and 12 hours. Probable Meniere's disease is a broader concept defined by episodic vestibular symptoms (vertigo or dizziness) associated with fluctuating aural symptoms occurring in a period from 20 minutes to 24 hours.

Experimentally induced deep cervical muscle pain distorts head on trunk orientation.

PURPOSE: We wanted to explore the specific proprioceptive effect of cervical pain on sensorimotor control. Sensorimotor control comprises proprioceptive feedback, central integration and subsequent muscular response. Pain might be one cause of previously reported disturbances in joint kinematics, head on trunk orientation and postural control. However, the causal relationship between the impact of cervical pain on proprioception and thus on sensorimotor control has to be established. METHODS: Eleven healthy subjects were examined in their ability to reproduce two different head on trunk targets, neutral head position (NHP) and 30° target position, with a 3D motion analyser before, directly after and 15 min after experimentally induced neck pain. Pain was induced by hypertonic saline infusion at C2/3 level in the splenius capitis muscle on one side (referred to as "injected side"). RESULTS: All subjects experienced temporary pain and the head repositioning error increased significantly during head repositioning to the 30° target to the injected side (p = 0.011). A post hoc analysis showed that pain interfered with proprioception to the injected side during acute pain (p < 0.001), but also when the pain had waned (p = 0.002). Accuracy decreased immediately after pain induction for the 30° target position to the side where pain was induced (3.3 â†’ 5.3°, p = 0.033), but not to the contralateral side (4.9 â†’ 4.1°, p = 0.657). There was no significant impact of pain on accuracy for NHP. A sensory mismatch appeared in some subjects, who experienced dizziness. CONCLUSIONS: Acute cervical pain distorts sensorimotor control with side-specific changes, but also has more complex effects that appear when pain has waned.

Hearing impairment after platinum-based chemotherapy in childhood.

BACKGROUND: Chemotherapy is used in the treatment of children and adolescents with malignant diseases. Some of the chemotherapeutic agents are highly toxic and may cause a number of side effects. The primary objective of this study was to evaluate the long-term effects on hearing in cancer survivors who had received platinum-based chemotherapy in childhood or adolescence. PROCEDURE: Medical records of 297 patients, who had received treatment for cancer at the Children's Hospital, Landspitali University Hospital in Iceland between 1981 and 2006, were retrospectively reviewed. Fifteen subjects fulfilled the eligibility criteria for the study and underwent an extended audiometric evaluation. RESULTS: The results showed that three of the subjects had a high frequency hearing loss. In one subject, we observed a hearing recovery just after the completion of chemotherapy, but the hearing deteriorated again some years later. Nine of the 15 subjects (60%) had tinnitus after the cancer treatment. An evaluation of subjective hearing disability and handicap (The Hearing Measurements Scale) revealed that some subjects had great difficulties with hearing in certain situations. The Hearing Measurement Scale showed that the pure-tone audiogram findings were only partly associated with the apparent hearing difficulties. CONCLUSION: Regular follow-up hearing examinations, which include both pure-tone audiogram investigations and subjective hearing disability assessments, should be performed during and after chemotherapy to identify subjects who require particular attention. This will ensure that hearing impaired individuals are provided with the most suitable listening devices, to promote good speech and social development.