Vestibulo-Ocular Reflex in the Aging Population.

Objectives: The aim of this study was to evaluate vestibulo-ocular reflex (VOR) of individuals over 60 years of age who have not been diagnosed with a specific vestibular pathology. Methods: Bilateral six-semicircular canal video head impulse test (vHIT), Dizziness Handicap Inventory and European Evaluation of Vertigo scales were applied to participants. Results: In total, 103 participants were included in the study (75 male, 28 female), and the mean age was 69.35 ± 7.41 years. The mean age of 7th decade group was 64.32±3.12 (59 participants; 38 male, 21 female), and the mean age of 8th decade and older group was 76.11±5.93 (44 participants; 37 male, 7 female). No significant differences were found between the VOR gains of the lateral or vertical semicircular canals between the 7th decade and 8th decade and older groups (p>0.05). In the 8th decade and older group, the presence of right lateral semicircular canal corrective saccade and left posterior semicircular canal corrective saccade showed a positively moderate correlation with VOR gains of the same semicircular canals (r=0.455, p=0.002, and r=0.518, p=0.001, respectively). No significant correlation was found between age and VOR gain in the 7th decade group, however, there was a negatively weak correlation between age and left lateral semicircular canal VOR gain (r=-0.366, p=0.017) in the 8th decade and older group. Conclusion: While assessing the age-related changes in VOR using vHIT, it must be considered that the changes related to aging of the vestibular system begin to emerge in the population over 70 years of age, and corrective saccade findings may be more informative than VOR gains in revealing these changes.

Bone-Anchored Hearing Implants: Surgical and Audiological Comparison of Different Surgical Techniques

Abstract Introduction The bone-anchored hearing implant system (BAHS) is an effective amplification system that transmits the sounds received by an external operating system to the inner ear by bypassing the middle ear placed in the temporal bone. Objective This study compares the results of patients who underwent bone-anchored hearing implant system (BAHS) surgery using two different surgical methods in terms of preoperative and postoperative complications, surgical time, audiological findings, and patient satisfaction. Methods The results of 22 patients who underwent BAHS were evaluated retrospectively from video records and audiological results, The Turkish Version of the Glasgow Benefit Inventory (GBI) questionnaire were evaluated. Two different surgical approaches were used for implantation: the linear incision technique (n = 9) and the punch technique (n = 13). Results Mean surgical durations were 9.67 ± 2.85 and 47.65 ± 6.13 minutes for Groups A and B, respectively, and these were significantly different (p < 0.001). There were no significant differences between the groups' speech recognition scores for a signal-to-noise ratio (SNR) of +5 (p = 0.173), SNR of 0 (p = 0.315), or SNR of -5 (p = 0.360) and results of the GBI scores. Conclusion The punch technique has a significant advantage due to a shorter surgery duration without increased surgical complications. Additionally, the punch technique showed no significant difference in hearing performance or satisfaction compared with linear incision.

Investigation of the Relationship between Vestibular Disorders and Sleep Disturbance

Abstract Introduction Vestibular pathologies cause physical and psychological symptoms, as well as cognitive problems. Objective To evaluate the deterioration in sleep quality associated with vestibular pathologies. Methods The Dizziness Handicap Inventory (DHI), the Beck Depression Inventory (BDI), the Pittsburgh Sleep Quality Index (PSQI), and the Limits of Stability test (LOS) were applied to the participants. Results We included 25 patients with Meniere's disease (MD), 22 patients with benign paroxysmal positional vertigo (BPPV), 21 patients with unilateral peripheral vestibular loss (UPVL), 23 patients with vestibular migraine (VM), and 43 controls. The total PSQI scores of the controls were better than those of the MD (p = 0.014), VM (p < 0.001), BPPV (p = 0.003), and UPVL (p = 0.001) groups. The proportion of poor sleepers in the MD (p = 0.005), BPPV (p = 0.018), and UPVL (p < 0.001) groups was significantly higher than that of the controls. The highest total DHI score (45.68 ± 25.76) was found among the MD group, and it was significantly higher than the scores of the BPPV (p = 0.007) and control (p < 0.001) groups. The highest BDI score was obtained in the VM group, and it was significantly higher than the scores of the BPPV (p = 0.046) and control (p < 0.001) groups. Moreover, the BDI scores of the MD (p = 0.001) and UPVL groups were also significantly worse than the score of the controls (p = 0.001). Conclusion The present study showed that presents with vestibular symptoms have physical and functional complaints, as well as increased psychosocial stress and decreased sleep quality. Evaluating multiple parameters of quality of life may contribute to a better understanding of vestibular physiology and symptoms, and may help establish a more effective therapeutic approach.

Bone-Anchored Hearing Implants: Surgical and Audiological Comparison of Different Surgical Techniques.

Introduction The bone-anchored hearing implant system (BAHS) is an effective amplification system that transmits the sounds received by an external operating system to the inner ear by bypassing the middle ear placed in the temporal bone. Objective This study compares the results of patients who underwent bone-anchored hearing implant system (BAHS) surgery using two different surgical methods in terms of preoperative and postoperative complications, surgical time, audiological findings, and patient satisfaction. Methods The results of 22 patients who underwent BAHS were evaluated retrospectively from video records and audiological results, The Turkish Version of the Glasgow Benefit Inventory (GBI) questionnaire were evaluated. Two different surgical approaches were used for implantation: the linear incision technique ( n = 9) and the punch technique ( n = 13). Results Mean surgical durations were 9.67 ± 2.85 and 47.65 ± 6.13 minutes for Groups A and B, respectively, and these were significantly different ( p < 0.001). There were no significant differences between the groups' speech recognition scores for a signal-to-noise ratio (SNR) of +5 ( p = 0.173), SNR of 0 ( p = 0.315), or SNR of -5 ( p = 0.360) and results of the GBI scores. Conclusion The punch technique has a significant advantage due to a shorter surgery duration without increased surgical complications. Additionally, the punch technique showed no significant difference in hearing performance or satisfaction compared with linear incision.

Investigation of the Relationship between Vestibular Disorders and Sleep Disturbance.

Introduction Vestibular pathologies cause physical and psychological symptoms, as well as cognitive problems. Objective To evaluate the deterioration in sleep quality associated with vestibular pathologies. Methods The Dizziness Handicap Inventory (DHI), the Beck Depression Inventory (BDI), the Pittsburgh Sleep Quality Index (PSQI), and the Limits of Stability test (LOS) were applied to the participants. Results We included 25 patients with Meniere's disease (MD), 22 patients with benign paroxysmal positional vertigo (BPPV), 21 patients with unilateral peripheral vestibular loss (UPVL), 23 patients with vestibular migraine (VM), and 43 controls. The total PSQI scores of the controls were better than those of the MD ( p = 0.014), VM ( p < 0.001), BPPV ( p = 0.003), and UPVL ( p = 0.001) groups. The proportion of poor sleepers in the MD ( p = 0.005), BPPV ( p = 0.018), and UPVL ( p < 0.001) groups was significantly higher than that of the controls. The highest total DHI score (45.68 ± 25.76) was found among the MD group, and it was significantly higher than the scores of the BPPV ( p = 0.007) and control ( p < 0.001) groups. The highest BDI score was obtained in the VM group, and it was significantly higher than the scores of the BPPV ( p = 0.046) and control ( p < 0.001) groups. Moreover, the BDI scores of the MD ( p = 0.001) and UPVL groups were also significantly worse than the score of the controls ( p = 0.001). Conclusion The present study showed thatpatients with vestibular symptoms have physical and functional complaints, as well as increased psychosocial stress and decreased sleep quality. Evaluating multiple parameters of quality of life may contribute to a better understanding of vestibular physiology and symptoms, and may help establish a more effective therapeutic approach.

The effect of different types of convergent strabismus on horizontal eye movements.

PURPOSE: To investigate the effect of different types of convergent strabismus on horizontal eye movements and compare data with healthy control subjects. MATERIALS AND METHODS: This prospective, cross-sectional study included 38 patients with convergent strabismus (16 fully accommodative, 13 partially accommodative and 9 non-accommodative esotropia) and 19 age-matched control subjects. All of the participants had a detailed ophthalmological examination including visual acuity assessment, cover-uncover prism test, slit lamp, and indirect ophthalmoscopy examination. Videonystagmography (VNG) was used for the evaluation of horizontal eye movements such as saccadic accuracy, velocity, latency, and smooth pursuit velocity gain. RESULTS: The saccadic accuracy in the rightward direction was lower in the fully accommodative esotropia group compared to the partially accommodative esotropia group in the right eye (p = 0.002). The saccadic latency in the rightward direction was longer in the fully accommodative esotropia group compared to the control group (p = 0.008) and smooth pursuit velocity gain in the leftward direction was lower in the partially and non-accommodative esotropia group compared to the control group in binocular recording (p = 0.004, p = 0.001, respectively). There was no difference in the saccadic velocity among the study groups (p > 0.05). Finally, asymmetry of saccadic velocity and latency was observed between right- and leftward directions in the partially accommodative esotropia group in the right eye (p = 0.003, p = 0.008, respectively). CONCLUSION: This study demonstrated that horizontal eye movements may vary in different types of convergent strabismus. VNG may be an auxiliary tool to the clinical examination in differentiating fully or non-accommodative esotropia.

Vestibulo-ocular reflex evaluation of the children with acquired esotropia.

OBJECTIVES: This study aims to evaluate the effects of acquired esotropia on vestibulo-ocular reflex (VOR) gain in children using video (vHIT) and functional head impulse (fHIT) tests. METHODS: A total of 62 children aged 6-18 years, with acquired esotropia and normal vision, were evaluated in the study. The patients were divided into two sub-groups: accommodative and non-accommodative. VOR gains were analyzed by performing lateral canal vHIT and fHIT with monocular and binocular recordings by a single examiner. RESULTS: Seventeen (10 male, 7 female) children with accommodative esotropia, 24 (14 male, 10 female) children with non-accommodative esotropia, and 21 (8 male and 12 female) healthy controls were included in this study. The vHIT findings did not differ between the groups (p˃.05). In the non-accommodative esotropia group, the location of the camera in both binocular and monocular vHIT recordings made a significant difference in the left VOR gain (p = .025, z = -2.243, p = .032, and z = -2.143, respectively), but no difference was observed in the right VOR gain. In the accommodative esotropia group, while the camera was on the left there was a significant difference in the right VOR gain between binocular and monocular recordings (p = .016, z = -2.413) but no difference was observed in the left VOR gain. No overt or covert saccade was detected in any group. CONCLUSIONS: The statistical differences found in vHIT and fHIT in acquired esotropia patients are thought to be sporadic and based on the results of this study no correction or change in recording technique is required for vHIT or fHIT in children with acquired esotropia.

Evaluation of the Effect of Musical Perception Activities on Speech Perception in Adult Cochlear Implant Users.

Objective: This study aimed to evaluate clinical musical perception, analyze the relationship between speech recognition and music perception, and investigate the effects of a three-month musical perception activities on these parameters in adult cochlear implant (CI) users with post-lingual hearing loss. Methods: Free-field hearing and speech tests in a quiet environment, the Turkish matrix test, and the Turkish version of the clinical assessment of musical perception test were performed on 18 adult unilateral CI users before and after the three-month music training. Results were compared with those of 18 healthy controls. Results: Prior to the musical perception activities, word recognition scores, Turkish matrix test results, and 500, 1000, and 6000 Hz free-field hearing thresholds were significantly correlated with the clinical assessment of musical perception test scores in the CI group (p<0.047). Timbre recognition scores (p=0.019) had improved significantly in the CI group after the three-month musical perception activities. On the other hand, timbre recognition scores had significantly affected the Turkish matrix test results (R2adjusted=0.56). Conclusion: Our study showed that speech perception in noise and clinical musical perception measurements affected each other in CI users. The inclusion of musical perception activities to support an auditory rehabilitation program may contribute to increased speech recognition skills in noise.

Effect of Korean Red Ginseng on Noise-Induced Hearing Loss.

OBJECTIVE: Noise-induced hearing loss (NIHL) is one of the most important problems affecting both social and professional life of patients. There is no treatment method considered to be successful on the hearing loss that has become a permanent nature. Aim of this study is to evaluate protective effect of Korean Red Ginseng (KRG) against NIHL in an animal model. METHODS: Twenty-eight rats were separated into four groups [control saline (group I), control KRG (group II), saline + noise (group III), KRG + noise (group IV)]. Rats in the saline and KRG groups were fed via oral gavage with a dose of 200 mg/kg/day throughout for 10 days. Fourteen rats (group III and IV) were exposed to 4 kHz octave band noise at 120 dB SPL for 5 hours. Hearing levels of rats were evaluated by distortion product otoacoustic emissions (DPOAE) and auditory brainstem responses (ABR) at 4, 8, 12, 16 and 32 kHz frequencies prior to and on days 1, 7 and 10 after the noise exposure. Rats were sacrificed on 10th day, after the last audiological test. Cochlea and spiral ganglion tissues were evaluated by light microscopy. RESULTS: Audiological and histological results demonstrated that after noise the group IV showed better results than group III. In the noise exposed groups, the most prominent damage was seen at the 8 kHz frequency region than other regions. After the noise exposure, DPOAE responses were lost in 1st, 7th and 10th measurements in both group III and IV. Thus, we were not able to perform any statistical analyses for DPOAE results. CONCLUSION: Our findings suggest that KRG seems to be an efficient agent against NIHL. There is need for additional research to find out about the mechanisms of KRG's protective effect.

Analysis of winter thermal comfort conditions: street scenarios using ENVI-met model.

Rapid migration to cities and the increasing demand for housing negatively affect living areas. Furthermore, uncontrolled population growth, industrialization, urbanization, narrowing of urban areas, and expansion of cities cause physical boundaries. Urbanization growth and the cold climate restrict pedestrian mobility in the city. Therefore, hourly microclimate data of the city center streets were collected 1.5 m above ground level in the winter period of 2019-2020. Then, different landscape design scenarios on pedestrian roads were investigated extensively using the ENVI-met V.4.4.2 winter model to determine the outdoor thermal comfort level. The RayMan model was utilized to generate the sky view factor (SVF) and analyze the mean values of the microclimate data. The proposed landscape design scenarios were as follows; (1) hard-covered street, (2) complete street coverage with a canopy, (3) street coverage with a semi-canopy, (4) sage of a combination of different plant species (30% deciduous, 30% coniferous, 30% bush), and (5) usage of ornamental pools in streets. The time period when pedestrians used the outdoor space was taken into consideration in evaluating and interpreting the analysis results. The findings of this study generally indicated that the semi-open canopy design provided roads with high thermal comfort such that people can walk and cycle in winter time. In conclusion, the thermal comfort condition of a street design, which is important for achieving sustainable urbanization, can be changed by making appropriate plan decisions. The findings of this study will help improve the outdoor thermal comfort in the first stage of urban planning and landscape street design for more livable and effective cities. This study emphasizes that a multidisciplinary team should work together to establish a healthy, sustainable, and livable urbanized area with thermal comfort in the streets.

Street design scenarios using vegetation for sustainable thermal comfort in Erzurum, Turkey.

Urbanization models that do not comply with the planning criteria are affecting human lives. In urban areas, street trees have positive contributions to the ecosystem and human thermal comfort. In this study, the thermal comfort of the main streets that connect people to each other and provide access and transportation has been thermally explored. Cumhuriyet Street, which is one of the vibrant streets in Erzurum, was selected as a case study scenario in the winter and summer periods in 2018 by using the ENVI-met V. 4.4.2 winter model. A different green scenario is proposed, and the best thermal comfort scenario in both seasons is determined. The results show that, in the summer period, the air temperature of the greener street scenario is about 1.0 °C cooler than the existing condition and about 2.0 °C warmer in the winter period. Physiological equivalent temperature (PET) value was better in narrow canyon streets in winter months, but in wide canyon streets in summer months. The green scenarios of wide canyon streets positively affect the outdoor thermal comfort in both seasons. These results clearly imply that green streets are an appropriate strategy for city streets that suffer from discomfort levels in cold winter and hot summer periods. It has been concluded that it is possible to increase thermal comfort through improvement in the open space in street and more suitable plant preferences for livable urbanization. Planning streets in a new city characterized by summer and winter seasons should take into consideration an accurate decision for providing a thermal comfort level and healthy urbanization.

Evaluation of Interexaminer Variability in Video Head Impulse Test Results.

OBJECTIVE: The video head impulse test (vHIT) is a diagnostic tool to assess the function of the semicircular canals and branches of the vestibular nerve. The aim of this study was to analyze the interexaminer variability of vHIT results in healthy subjects. MATERIALS AND METHODS: A total of 21 healthy participants were included in the study. vHIT responses were collected by four clinicians. Variability of the vHIT results between examiners was analyzed statistically. RESULTS: The vestibulo-ocular reflex (VOR) velocity regression values were from 0.99 to 1.09 degrees per second for the lateral canals. For the vertical canals, VOR velocity regression values were from 0.87 to 1.21 degrees per second. According to repeated measures analysis of variance, the normality assumptions for the velocity regression of the left lateral canal (p = 0.002) and the right anterior canal (p < 0.01) were met and the differences were statistically significant. The normality assumptions were not met for 40, 60, and 80 ms median gain of the right lateral canal (p = 0.016, p = 0.038, and p = 0.001, respectively); 40 and 60 ms median gain of the left lateral canal (p < 0.001 and p = 0.008, respectively); and the velocity regression of the left posterior canal (p < 0.00). These differences were found to be statistically significant by using the Friedman test. CONCLUSION: The interexaminer differences of the VOR gain values for the vHIT were statistically significant. Serial vHIT testing should be performed by the same examiner to reduce the effects of interexaminer variability.

Comparison of Cortical Auditory Evoked Potential Findings in Presbycusis with Low and High Word Recognition Score.

BACKGROUND: Deteriorated speech understanding is a common complaint in elderly people, and behavioral tests are used for routine clinical assessment of this problem. Cortical auditory evoked potentials (CAEPs) are frequently used for assessing speech detection and discrimination abilities of the elderly, and give promise for differential diagnosis of speech understanding problems. PURPOSE: The aim of the study was to compare the P1, N1, and P2 CAEP latencies and amplitudes in presbycusis with low and high word recognition score (WRS). RESEARCH DESIGN: A cross-sectional study design was used forthe study. Two groups were formed from the patients with presbycusis based on their scores on the speech recognition test. STUDY SAMPLE: Fifty-seven elderly volunteers participated in the study. The first group composed of 27 participants with high WRS, the other group composed of 30 participants with low WRS. DATA COLLECTION AND ANALYSIS: The CAEP waves were recorded from these participants using speech signals. Latencies and amplitudes of P1 -N1-P2 waves of the two groups were compared with the f-test statistic. RESULTS: There were significant prolongation of P1 and N1 latencies in presbycusis with low WRS when compared with presbycusis with a relatively high word score (p < 0.05). CONCLUSION: According to the result of the research, P1 and N1 latencies of presbycusis with low WRS were longer than the participants with high WRS. Factors affecting peripheral auditory system, such as stimulus sensation level, might be responsible for P1 and N1 latency prolongation of the low WRS group.

Examination and Comparison of Electrically Evoked Compound Action Potentials and Electrically Evoked Auditory Brainstem Response Results of Children with Cochlear Implantation without Inner Ear Anomaly.

OBJECTIVE: To investigate the relationship between electrically evoked compound action potentials (ECAP) and electrically evoked auditory brainstem responses (EABR) in children with cochlear implants (CI) without inner ear anomalies. METHODS: Sixteen children between the ages of two and six years who were CI users participated in the study. ECAP thresholds were recorded from one electrode in the basal, medial, and apical regions of the cochlear implant. EABRs were recorded from electrodes whose ECAP thresholds were determined. The latency-intensity functions, amplitude and morphological analyzes of the eIII and eV waves at 200 and 180 current unit (CU) excitation levels were performed. The data obtained were analyzed statistically. RESULTS: ECAP thresholds were found to be 171.5±11.38, 169.69±20.32 and 160.81±20.03 CU at the basal, medial and apical electrodes, respectively. EABR thresholds were also found to be 169.69±12.17, 165.62±16.41 and 160±15.49 CU in basal, medial and apical electrodes, respectively. There was a strong positive correlation between ECAP and EABR thresholds in apical, medial and basal electrodes (p<0.05). EABR threshold levels were not significantly different between basal, medial and apical region electrodes (p>0.05), and ECAP threshold values were significantly different between apical and basal region electrodes (p=0.002). When the significance values of EABR eV wave latencies were analyzed in terms of electrode region, the difference between basal and apical regions was found to be significant (p=0.03). CONCLUSION: Consistency was found between ECAP and EABR recordings. However, it was concluded that one could not be preferred over the other because the data quality of the two tests was different. In future studies, ECAP and EABR recordings may be recommended by selecting more electrodes for stimulation.

Comparison of Cortical Auditory Evoked Potential Findings in Presbycusis with Low and High Word Recognition Score.

BACKGROUND: Deteriorated speech understanding is a common complaint in elderly people, and behavioral tests are used for routine clinical assessment of this problem. Cortical auditory evoked potentials (CAEPs) are frequently used for assessing speech detection and discrimination abilities of the elderly, and give promise for differential diagnosis of speech understanding problems. PURPOSE: The aim of the study was to compare the P1, N1, and P2 CAEP latencies and amplitudes in presbycusis with low and high word recognition score (WRS). RESEARCH DESIGN: A cross-sectional study design was used for the study. Two groups were formed from the patients with presbycusis based on their scores on the speech recognition test. STUDY SAMPLE: Fifty-seven elderly volunteers participated in the study. The first group composed of 27 participants with high WRS, the other group composed of 30 participants with low WRS. DATA COLLECTION AND ANALYSIS: The CAEP waves were recorded from these participants using speech signals. Latencies and amplitudes of P1-N1-P2 waves of the two groups were compared with the t-test statistic. RESULTS: There were significant prolongation of P1 and N1 latencies in presbycusis with low WRS when compared with presbycusis with a relatively high word score (p < 0.05). CONCLUSION: According to the result of the research, P1 and N1 latencies of presbycusis with low WRS were longer than the participants with high WRS. Factors affecting peripheral auditory system, such as stimulus sensation level, might be responsible for P1 and N1 latency prolongation of the low WRS group.

A Case with Brown-Vialetto-Van Laere Syndrome: A Sudden Onset Auditory Neuropathy Spectrum Disorder.

The Brown-Vialetto-Van Laere syndrome (BVVLS) is a rare neurological disorder that may present at all ages with sensorineural hearing loss, bulbar palsy and respiratory compromise. We describe a 6-year-old male patient who suffered bilateral sudden onset severe hearing loss for two years. Audiological investigations revealed sudden onset auditory neuropathy spectrum disorder bilaterally. He also had neurological complaints. During riboflavin therapy an improvement in hearing loss and the benefit of hearing aids were observed. In BVVLS, it is difficult to plan and apply auditory rehabilitation interventions and the results vary from patient to patient. In audiological evaluation, it should be borne in mind that subjective and objective tests are complemental. Early medical intervention and regular audiological follow-up are very important for effective hearing rehabilitation in the patients with BVVLS.

The Reliability and Validity of "Dokuz Eylül University Meniere's Disease Disability Scale".

OBJECTIVE: Ménière's Disease (MD) is a chronic, non-life threatening inner ear disease, with attacks of disabling vertigo, progressive hearing loss, and tinnitus as the major symptoms. All three symptoms, separately or in combination, cause great distress and have a considerable impact on the quality of life of the patients. The aims of this study were to develop a disease-specific quality of life survey for patients with MD and to analyze the relationships between the audiovestibular findings and the survey. MATERIALS AND METHODS: Following Ear-Nose-Throat examination and audiovestibular tests, the Dokuz Eylül University Meniere's Disease Disability Scale (DEU-MDDS) and Turkish version of the Dizziness Handicap Inventory (DHI-T) were administered to 93 patients with definite MD. Reliability and validity analyses of the scale were performed. RESULTS: There were 45 (48.4%) male and 48 (51.6%) female patients and the mean age was 48.9±12.1 years. Cronbach's alpha was 0.92 and intraclass correlation coefficients of the DEU-MMDS were significant (p<0.001). Results of the Goodness of Fit Statistics showed that the expression levels of the items were high and the correlation coefficients of each item with the scale were sufficient. There was a statistically significant correlation between DHI-T scores and MDDS. DEU-MDDS was not related to the vestibular tests, age or gender (p>0.05). CONCLUSION: The MDDS is a valid and reliable scale as a disease-specific quality of life questionnaire for patients with MD.

Comparison of Audiological Findings in Patients with Vestibular Migraine and Migraine.

OBJECTIVE: The aim of this study was to investigate and compare the auditory findings in vestibular migraine (VM) and migraine patients without a history of vertigo. METHODS: This study was conducted on 44 patients diagnosed with definite VM and 31 patients diagnosed with migraine who were followed and treated between January 2011 and February 2015. Also, 52 healthy subjects were included in this study as a control group. All participants underwent a detailed otorhinolaryngological examination followed by audiological evaluation, including pure tone audiometry, speech reception threshold, speech recognition score, and acoustic immitancemetry. RESULTS: In the VM group, there were 16 patients (36.4%) with tinnitus, while in the other groups we did not observe any patients with tinnitus. The rate of tinnitus in the VM group was significantly higher in comparison to other groups (p<0.05). None of the groups had any patients with permanent or fluctuating sensorineural hearing loss. CONCLUSION: We conclude that patients with VM should be closely and longitudinally followed up for the early detection of other otological symptoms and possible occurrence of sensorineural hearing loss in the long term.

Validity and Reliability of the Diagnostic Tests for Ménière's Disease.

Ménière's disease is defined as an idiopathic syndrome characterized by endolymphatic hydrops. Various tests and measurement methods have been employed for the diagnosis of Ménière's disease. These include audiological, vestibular, radiological, clinical, and biochemical tests. However, the lack of a definitive or gold standard diagnostic test sometimes complicates the process of diagnosis. Hence, the clinician should be well-experienced in deciding when to perform a test and how to interpret the results of the test. Furthermore, having the knowledge of the validity and reliability of these tests plays a critical role. This review particularly emphasizes on remarking the validity and reliability of each test performed for the diagnosis of Ménière's disease and discussing the results according to the up-to-date literature.