Surgical Outcomes of Bilateral Inferior Rectus Muscle Recession for Restrictive Strabismus Secondary to Thyroid Eye Disease.

This retrospective, observational study examined the surgical outcomes of bilateral inferior rectus (IR) recession in thyroid eye disease. Twelve patients who underwent bilateral IR muscle recession were included in the study. Surgical success was defined as patient achievement of the following conditions: (1) a postoperative angle of vertical ocular deviation of ≤3°; (2) a postoperative cyclotropic angle of ≤2°; (3) postoperative binocular single vision, including the primary position; and (4) postoperative enlargement of the field of binocular single vision. Linear regression analyses were performed to analyze the relationship between postoperative changes in the vertical and torsional ocular deviation angles and the amount of IR muscle recession and nasal transposition. Consequently, 9 out of 12 patients were deemed to have had successful surgical outcomes. There was a positive correlation between a change in the vertical deviation angle and a side-related difference in the amount of IR muscle recession in successful cases (crude coefficient, 2.524). A positive correlation was also found between a change in the torsional deviation angle and the amount of IR recession (crude coefficient, 1.059) and nasal transposition (crude coefficient, 5.907). The results will be helpful to more precisely determine the amount of recession and nasal transposition of the IR muscle in patients with thyroid-related bilateral IR myopathy.

Temporal virtual reality-guided, dual-task, trunk balance training in a sitting position improves persistent postural-perceptual dizziness: proof of concept.

BACKGROUND: Persistent postural-perceptual dizziness (PPPD) is a newly defined disorder characterized by functional dizziness. Due to its recent discovery, definitive treatment for PPPD has not been established; therefore, this study aimed to assess the effectiveness of virtual reality (VR)-guided, dual-task, trunk balance training for the management of PPPD using the mediVR KAGURA system. METHODS: We analyzed data of patients who presented with PPPD from January 1, 2021, to February 28, 2021. The VR group included patients who underwent mediVR KAGURA-guided training for 100 tasks (10 min). Patients with PPPD who received standard treatment and rehabilitation were assigned to the control group. Equilibrium tests were performed at baseline and immediately after mediVR KAGURA-guided training to examine its effectiveness in improving static and dynamic balance. Additionally, clinical questionnaires related to balance disorders were administered at baseline and 1 week after mediVR KAGURA-guided training to examine its effects on balance-related symptoms. The primary outcome was improvements in static and dynamic balance and Niigata PPPD Questionnaire (NPQ) scores. RESULTS: VR-guided training using mediVR KAGURA improved objective outcomes, including static and dynamic postural stability, after a single 10-min training session. Additionally, mediVR KAGURA-guided training improved scores on the Hospital Anxiety and Depression Scale and NPQ 1 week after the 10-min training session. CONCLUSION: VR-guided training using mediVR KAGURA represents a viable method for managing balancing ability, anxiety, and symptoms in patients with PPPD. Such training provides a safe and cost-effective solution for PPPD management. Further studies are required to evaluate the clinical efficacy of this strategy. TRIAL REGISTRATION: Institutional Ethics Committee of Kitano Hospital, approval number: 1911003. Registered 18 December 2019, https://kitano.bvits.com/rinri/publish_document.aspx?ID=426 .

Hearing Outcomes and Complications of Cochlear Implantation in Elderly Patients over 75 Years of Age.

OBJECTIVE: Populations are aging in many countries, and the proportion of elderly people with severe to profound hearing loss is increasing in parallel with the increasing average life span. The objective of this study was to investigate the outcomes of cochlear implant (CI) surgery in elderly patients compared to those in younger patients. METHODS: The outcomes of CI surgery were retrospectively investigated for 81 adults (32 men and 49 women) who underwent CI surgery at our hospital. They were divided according to age at the time of implantation into the younger group (<75 years of age; n = 49) or elderly group (≥75 years of age; n = 32). RESULTS: The mean sentence recognition score on the CI-2004 Japanese open-set test battery (±standard deviation) was 82.9% ± 24.1 in the younger group and 81.9% ± 23.2 in the elderly group, with no significant difference between the groups (Mann-Whitney U test). The incidence of major complications that required surgical treatment was not significantly different between the groups (4.1% vs. 6.2%, respectively). Thus, there were no severe complications that could affect general health status in either group. Three patients in each group died for reasons unrelated to CI surgery during follow-up. The proportion of patients who were alive and continued to use the CI five years after surgery was 92.8% and 91.5%, respectively. CONCLUSION: Our results show good speech recognition and a low incidence of major complications in elderly patients. This comprehensive report on the outcomes of CI surgery in elderly patients will be helpful to the elderly with severe to profound hearing loss when deciding whether to undergo CI surgery.