[Labyrinth hydrops and its diagnosis]. / Gidrops labirinta i ego diagnostika.

The article deals with the basic theories of maze and labyrinth hydrops, which are often used in clinical practice for its diagnosis according to the world literature. Tonal threshold, suprathreshold audiometry, broadband thympanometry, ultrasound tests, test for determination of lateralization of loud sounds, dehydration test, extra-timbanical electrocochleography, method of registration of evoked vestibular myogenic potentials, study of vestibular function (video pulse test, caloric sample), CT of temporal bones with gadolinium, MRI, and other methods are considered. None of these study methods gives an accurate confirmation of the presence of maze hydrops. Only taking into account the history, complaints of the patient, clinical manifestations of the disease and a comprehensive evaluation of the results of all the above methods of study can we speak with confidence about hydropse.

[Bilateral vestibulopathy in elderly patients]. / Dvustoronnyaya vestibulopatiya u patsientov pozhilogo vozrasta.

Balance disorders and recurring falls are the most frequent causes of medical treatment in old age. Chronic cerebral vascular insufficiency is considered to be the cause of instability in most of these cases, and its role in the development of postural instability in old age is likely to be greatly overrated. At the same time, the role of chronic peripheral vestibular disorders, by contrast, is underestimated. The emergence in recent years of sensitive, specific and, at the same time, relatively accessible methods of diagnosing peripheral vestibulopathies has led to a much more frequent diagnosis of peripheral vestibulopathies, and their role in the development of postural instability in elderly patients is being revisited. This review considers current approaches to the diagnosis and treatment of bilateral vestibulopathy.

[Tinnitus - current trends and prospects]. / Sub''ektivnyi ushnoi shum: sovremennye tendentsii i perspektivy.

Tinnitus is described as the perception of any sound or noise in the absence of real acoustic stimulation. Numerous investigations have been tried for this potentially debilitating, heterogeneous symptom. The authors overview the current concepts of the management of the suffering tinnitus patients. The review contains modern views on the mechanisms of generation, etiology and pathogenesis of tinnitus. Classifications for practical management of patients are presented. The review of medical and physical methods of therapy and rehabilitation of a tinnitus patients given. The review includes the most clinically reliable and common methods of treatment and rehabilitation.

[The compensation of the vestibulo-ocular reflex during rehabilitation of the patients presenting with vestibular neuritis]. / Kompensatsiia vestibulookuliarnogo refleksa pri reabilitatsii u patsientov s vestibuliarnym neironitom.

AIM: The objective of the present study was to elucidate the mechanisms behind the compensation of the vestibular ocular reflex and evaluate the effectiveness of vestibular rehabilitation in the patients presenting with vestibular neuritis (VN) with the application of the video head-impulse test (vHIT) and the dynamic visual acuity test (DVAT). METHODS: The study included 26 patients with vestibular neuritis whose condition was assessed by scoring based on the dizziness handicap inventory, the dynamic visual acuity test, and the video head-impulse test with the evaluation of saccades and the degree of eye-head movement coordination (gain) before and after the course of vestibular rehabilitation. RESULTS: The study has demonstrated that the course of vestibular rehabilitation of the patients presenting with vestibular neuritis resulted in a significant decrease in the scores of dizziness estimated based on the dizziness handicap inventory and an improvement of dynamic visual acuity in the case of the complete gain recovery as well as in the case of persisting impairment of the gain and the development of sufficient 'covert' saccade. Vestibular rehabilitation was unsuccessful in the patients with persistereduced gain and simultaneous development of 'covert' and 'overt' saccades.

[Pseudohypoacusis associated with Munchausen's syndrome]. / Psevdogipoakuziia pri sindrome Miunkhgauzena.

The authors describe a rare clinical case of psychogenic hearing loss in a female patient presenting Munchausen's syndrome with special reference to the objective and subjective methods designed to evaluate the hearing ability and used for diagnostics of this condition.

[Benign paroxysmal positional vertigo: modern concepts of its etiology and pathogenesis]. / Dobrokachestvennoe paroksizmal'noe pozitsionnoe golovokruzhenie: sovremennye predstavleniia ob étiologii i patogeneze.

The objective of the present review of the literature is the analysis of the currently available data concerning etiology and pathogenesis of benign paroxysmal positional vertigo (BPPV). The special emphasis is placed on the modern hypotheses of BPPV formation that collectively account for not more than 15% of all known cases of this condition. The best explored are the following causes of benign paroxysmal positional vertigo: vestibular neuronitis, head injuries, and disorders in the middle ear. During the recent years, much attention has been given to the role of disturbances of calcium metabolism and osteoporosis in etiology of benign paroxysmal positional vertigo. It is supposed that pathogenesis of vertiginous attacks can be explained in terms of the canalolithiasis and cupulolithiasis theories.

[The efficacious algorithm for the diagnostics and treatment of benign paroxysmal positional vertigo].

The objective of the present study was to elucidate the prevalence of various forms of benign paroxysmal positional vertigo (BPPV) among the patients with the complaints of dizziness who had applied for the medical aid. The secondary objective was to evaluate the effectiveness of the newly developed algorithm for the diagnostics and treatment of various forms of the disease. A total of 195 patients with the verified BPPD diagnosis were available for the examination. The fraction of the patients visiting the otoneurologist's office with complaints of this conditions is estimated at 17.8%. It was shown that the women suffer from benign paroxysmal positional vertigo 1.8 times more frequently than the men. The mean age of the patients of either sex experiencing this problem is above 50 years. Most of them have idiopathic pathology. The relationship between benign paroxysmal positional vertigo and vascular neurological disorders or inner and middle ear diseases remains to be elucidated. The present study also included the assessment of the effectiveness of the combination of various repositioning maneuvers, self-assisted vestibular gymnastics in the domestic environment, and training in long lying on the unaffected side.

[Combined dizziness: a difficult case of diagnostics].

The present article is focused on the detailed analysis of the history of a patient suffering from combined dizziness including the entire course of the disease, the complicating complex of complaints, and the increasing number of abnormal components of the patient's condition. The specific features of various nosological forms of the disease are described as arising from different clinical entities causing vertigo. The special emphasis is laid on the diagnostic algorithm for the elucidation of these disorders.

[The application of ultrasound for diagnostics of middle ear pathologies].

The objective of the present work was to summarize the results of the application of ultrasound tests for differential diagnostics of various diseases and lesions affecting the middle ear. Almost 7.000 threshold and suprathreshold studies were carried out in the patients presenting with various forms of sensorineural impairment of hearing. The ultrasound investigations were conducted with the use of the EKHOTEST-02 apparatus (Giperion, Moscow). The results of determination of threshold hearing sensitivity to ultrasound and lateralization of its threshold and suprathreshold values suggest their significance for the detection of even such a minimal disturbance in the cochlear function as the phenomenon of accelerated increase in loudness and the associated enhancement of the severity of the damage to the peripheral sensory system.

[The ototoxic action of cisplatin on the middle ear].

The objective of the present study was to elucidate the mechanisms underlying the ototoxic action of cisplatin after its single administration using an experimental model (white mice). Short latency acoustically evoked potentials (SAEP) and distortion-product otoacoustic emissions (DPOAE) were recorded for the purpose. The results of the study confirm the possibility of using the proposed model for the estimation of the cisplatin-induced loss of hearing. It was shown that a single cisplatin dose causes hearing impairment in the mice within 7 days after its administration; with the maximum effect becoming apparent on day 30.

[Complex types of vertigo: diagnostic possibilities].

OBJECTIVE: To study diagnostic possibilities of a complex vestibular examination of patients with hard curable vertigo. MATERIAL AND METHODS: We studied 312 patients with complex types of vertigo. Neurologic and othoneurologic examination and some audio- and vestibulometry tests were carried out. RESULTS: The high frequency of comorbid lesions of the vestibular analyzer and coordination system was identified. CONCLUSION: Diagnostic and therapeutic approaches to hard curable vertigo are discussed.

[Basilar type migraine: clinical features, differential diagnosis].

The work is devoted to the description of neurological, vestibulometric and audiologic data obtained in the examination of 11 patients with basilar type migraine. The features of the disease (neck injuries before the disease, prolonged aura, protracted attacks, similarity with the clinical picture of stroke, occipital pain, cervical root syndrome, muscle-tonus phenomena and others) are described. A role of cervical pathology and labyrinthine hydrops in the disease pathogenesis as well as difficulties of differential diagnosis with Ménière's disease and Barre-Lieou syndrome are discussed.

[Cochleovestibular disorders in the patients suffering from migraine of the basilar type].

The objective of the present study was to improve diagnostics of basilar type migraine (BTM) based on the results of neurological, vestibulometric, and audiological studies of 11 patients. Peculiarities of the clinical picture of this disease and the medical histories of these patients are described. The pathogenetic role of labyrinthine hydrops and the difficulties encountered in diagnostics of Meniere's disease are discussed.

[Diagnostics of endolymphatic hydrops].

The objective of the present work was to analyse the methods for diagnostics of endolymphatic hydrops associated with Miniere's disease most frequently employed in clinical practice using both the data from the world scientific literature and our own 25-30 year experience based on the observation of more than 500 patients. Camertonal studies of hearing acuity estimated from the results of air conduction measurements and relevant acoumetric curves were considered. The main methods of research are discussed including such as tonal threshold audiometry, ultrasound testing, loud sound lateralization, dehydration test, extratympanic electrocochleography, otoacoustic emission, and functional computed stabilometry. It is concluded that none of the above methods is as reliable as to yield the comprehensive information being sought. All the data obtained by the application of these techniques need to be supplemented by the medical history data, the patients' complaints, clinical signs and symptoms of the disease if the definitive diagnosis of endolymphatic hydrops is to be made.