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2.
Cochlear Implants Int ; 23(6): 358-360, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36065491

RESUMO

BACKGROUND: Intractable benign paroxysmal positional vertigo (BPPV) may be treated by plugging the affected semicircular canal (SCC). A cochlear implant (CI) can diminish subjective symptoms of tinnitus. We present a case with intractable BPPV and incapacitating tinnitus who underwent surgery, simultaneously plugging his posterior SCC (PSCC) and implanting an ipsilateral CI. CASE: A 50-year-old male experienced single-sided deafness (SSD) with severe ipsilateral tinnitus, and intractable BPPV related to the ipsilateral PSCC. Two years earlier, he had been treated with a bone anchored hearing system (BAHS) for his single-sided hearing loss, but his tinnitus and BPPV persisted. The patient was elected for surgical plugging of the affected SCC and was offered a simultaneous ipsilateral CI to treat his hearing loss and reduce his disabling tinnitus. The procedure was initially clinically and subjectively successful, but the tinnitus worsened, following an MRI despite regular precautions. CONCLUSION: This is the first case presentation of cochlear implantation performed concurrent to plugging of the ipsilateral PSCC. The outcome of the procedure was overall successful.


Assuntos
Implante Coclear , Perda Auditiva , Zumbido , Vertigem Posicional Paroxística Benigna/cirurgia , Perda Auditiva/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Canais Semicirculares/cirurgia , Zumbido/etiologia , Zumbido/cirurgia
3.
Otol Neurotol ; 43(8): 889-893, 2022 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-35970153

RESUMO

OBJECTIVE: Histologic characterization of labyrinthitis ossificans (LO) has mostly been limited to postmortem samples. In this report, we describe the histology of LO from a surgical specimen obtained from a patient undergoing labyrinthectomy with simultaneous cochlear implantation. PATIENT: A 38-year-old woman initially presenting to the emergency room with acute vertigo, left-sided hearing loss, tinnitus, and aural fullness. INTERVENTIONS: Contrast-enhanced magnetic resonance imaging (MRI) and computerized tomography (CT) were performed for the patient before labyrinthectomy and cochlear implantation. Audiometric testing was performed before and after surgical intervention. Histologic analysis was performed on a specimen obtained from the left lateral semicircular canal (SCC) during surgery. MAIN OUTCOME MEASURES: Preoperative CT and MRI findings, preoperative and postoperative hearing thresholds via air conduction and bone conduction, hematoxylin and eosin (H&E) stain of the surgical sample, and CD45 immunostain of the surgical sample. RESULTS: Preoperative CT and MRI confirmed the diagnosis of isolated LO of the left lateral SCC. Audiometric testing revealed significant improvement in hearing after labyrinthectomy and cochlear implantation. H&E stain demonstrated fibrosis and ossification in the left lateral SCC, and CD45 immunostain was negative. CONCLUSIONS: Histopathology of LO based on a surgical sample is comparable to heterotopic ossification (HO) seen in other human tissue. Given the similarities between LO and HO, agents effective in preventing HO may have utility in preventing LO.


Assuntos
Implante Coclear , Perda Auditiva , Labirintite , Ossificação Heterotópica , Adulto , Feminino , Perda Auditiva/etiologia , Perda Auditiva/patologia , Perda Auditiva/cirurgia , Humanos , Labirintite/patologia , Labirintite/cirurgia , Ossificação Heterotópica/complicações , Ossificação Heterotópica/diagnóstico por imagem , Ossificação Heterotópica/cirurgia , Canais Semicirculares/cirurgia , Vertigem/cirurgia
4.
Artigo em Chinês | MEDLINE | ID: mdl-36036064

RESUMO

Objective:To summarize gain characteristics of three pairs of semicircular canals in head impulse paradigm (HIMP) and suppression head impulse paradigm (SHIMP) in healthy young Chinese population. Methods:HIMP and SHIMP tests were performed on 40 healthy young volunteers enrolled as study group, by using EyeseeCam examiantion system (Interacoustics,Denmark). The elicitation rates and gain values of the two saccades were recorded, and the gain values were compared and analyzed. Results:The results of 40 healthy young people were as follows: in HIMP, the instantaneous gain at 60 ms of the horizontal semicircular canals were 1.11±0.07 on the left side and 1.08±0.07 on the right side; the regression gain of the horizontal semicircular canals were 1.09±0.06 on the left side and 1.10±0.06 on the right side; the regression gain of the vertical semicircular canals were 1.08±0.12 on the right anterior, 1.07±0.11 on the left posterior, 1.41±0.16 on the right posterior and 1.42±0.16 on the left anterior. So in HIMP, no significant difference could be found between left and right side in both horizontal and vertical semicircular canal conjugate plane regarding regression gain (P>0.05), except that 60 ms instantaneous gain on the left horizontal semicircular canals was slightly higher than that on the right side (P<0.05).The instantaneous gain values of the horizontal semicircular canal at 60 ms in SHIMP were 1.08±0.08 on the left side and 1.06±0.07 on the right side; the regression gain in horizontal semicircular canals were 1.06±0.07 on the left side and 1.07±0.06 on the right side, respectively; the regression gains of vertical semicircular canal were 1.06±0.13, 1.08±0.16, 1.49±0.16, 1.39±0.15, on the right anterior, left posterior, right posterior, and left anterior side. So in SHIMP, no significant difference could be found in 60 ms instantaneous gain in horizontal conjugate plane, regression gain in horizontal conjugate plane and regression gain in right anterior left posterior conjugate plane (P>0.05), while the regression gain of the left anterior right posterior conjugate plane in the right was found slightly higher than that of the left (P<0.05).Both 60 ms instantaneous gain and regression gain in horizontal conjugate plane in HIMP were slightly higher than that of SHIMP (P<0.05), while no significant difference could be found in vertical conjugate planes (P>0.05). In both HIMP and SHIMP tests, gains of the left anterior right posterior conjugate plane was slightly higher than that of both horizontal plane and the right anterior left posterior conjugate plane (P<0.05), while no significant difference could be found in gains between horizontal and the right anterior left posterior conjugate plane (P>0.05). Conclusion:Gain values of HIMP and SHIMP were slightly different among different semicircular canals conjugate planes.It is suggested that each examination center should establish normal values for their own and make correction regularly.


Assuntos
Teste do Impulso da Cabeça , Reflexo Vestíbulo-Ocular , Adolescente , China , Humanos , Movimentos Sacádicos , Canais Semicirculares
5.
Artigo em Chinês | MEDLINE | ID: mdl-36036066

RESUMO

Objective:To understand the occurrence of horizontal semicircular canal functional impairment in patients with common vestibular diseases and to explore the characteristics and clinical value of different evaluation methods of horizontal semicircular canal. Methods:From July 2013 to December 2016, patients who attended the vertigo clinic of the First Affiliated Hospital of Dalian Medical University and completed more than three horizontal semicircular canal function tests were retrospectively analyzed. A total of 396 patients diagnosed as vestibular migraine (VM), Ménière's disease (MD), benign paroxysmal positional vertigo (BPPV), vestibular neuritis (VN) and 104 patients with unknown diagnosis were enrolled. The results of caloric test (CT), rotation test (RT), head-shaking nystagmus test (HSN) and video head impulse test (vHIT) were collected and the abnormal detection rates of different detection methods were calculated. The sensitivity, specificity and coincidence rate of various detection methods were statistically analyzed using CT as the gold standard. Results:①The abnormal rates of the four evaluation methods from high to low were HSN, CT, RT, vHIT (51.20%, 50.80%, 25.76%, 19.74%, respectively); ②Taking CT as the gold standard, among these four common vestibular diseases, the sensitivity and specificity of vHIT were 0.13-0.41 and 0.69-1.00, the sensitivity and specificity of HSN were 0.44-0.76 and 0.29-0.69, and the sensitivity and specificity of RT were 0.25-0.45 and 0.50-0.84;③According to statistical analysis, only HSN and CT results showed no statistically significant difference in the 4 diseases. There was no significant difference between RT and CT in VM and BPPV, and vHIT and CT in BPPV. Conclusion:The abnormal rate of HSN results in common vestibular diseases is highest, and it could be recommended as a routine vestibular function screening item. The specificity of vHIT is highest and worthy of promotion. CT is still an irreplaceable method to evaluate the function of horizontal semicircular canal.


Assuntos
Transtornos de Enxaqueca , Doenças Vestibulares , Vertigem Posicional Paroxística Benigna , Teste do Impulso da Cabeça , Humanos , Estudos Retrospectivos , Canais Semicirculares
6.
Artigo em Chinês | MEDLINE | ID: mdl-36036071

RESUMO

Objective:The three-dimensional direction feature of torsional nystagmus induced by posterior semicircular canal canalithasis (PSC-Can) was recorded and analyzed using three-dimensional video nystagmography (3D-VNG). Methods:Sixty patients (22 on the left side and 38 on the right side) with PSC-Can were enrolled for torsional nystagmus evoked by Dix-Hallpike test in the affected-side head-hanging and sitting positions, and the direction characteristics of the horizontal, vertical and torsional components were analyzed. Results:Vertical torsional nystagmus was induced in 60 PSC-Can patients in the head-hanging and sitting positions evoked by Dix-Hallpike test, respectively. Horizontal, vertical, and torsional components of were presented in the 3D-VNG. In the head-hanging position, the direction of horizontal component in the left/right PSC-Can nystagmus was contralateral in 46 cases(the other 14 cases were ipsilateral), the vertical component was upward, and the torsional component was upward/downward, respectively. The intensity of nystagmus induced in the three components in the sitting position is weaker than in the head-hanging position, and the direction of nystagmus was reversed in both vertical and torsional components compared with the head-hanging position. However, the direction of the horizontal component was reversed in 39 cases and not reversed in 21 cases in the sitting position. Conclusion:The horizontal, vertical and torsional components of the torsional nystagmus in PSC-Can patients recorded by 3D-VNG, which provided more comprehensive and objective information for the analysis of PSC-Can and the study of semicircular canal physiological function.


Assuntos
Nistagmo Patológico , Canais Semicirculares , Face , Cabeça , Humanos , Nistagmo Fisiológico
7.
Artigo em Chinês | MEDLINE | ID: mdl-36036072

RESUMO

Objective: To explore the value of adding 1 kHz cervical vestibular evoked myogenic potential(cVEMP) and ocular vestibular evoked myogenic potential(oVEMP) in the auxiliary diagnosis of unilateral vestibular hypofunction. Methods:A retrospective analysis of 84 patients with unilateral vestibular hypofunction receiving two or more vestibular function tests was conducted,29 cases of unilateral Ménière's disease, 27 cases of benign paroxysmal positional vertigo (BPPV), 8 cases of idiopathic sudden sensorineural hearing loss (ISSHL) with vertigo, and 20 cases of ISSHL without vertigo were included. SPSS 25.0 software was used for statistical analysis to observe the difference of frequency amplitude ratio (FAR) at 500 Hz/1 kHz of cVEMP and oVEMP between the experimental and control groups. Results:①The cVEMP elicitation rates were 95.24% (80/84) and 98.81% (83/84) for 500 Hz and 1 kHz, respectively; and the oVEMP elicitation rates were 78.57% (66/84) and 91.67% (77/84) for 500 Hz and 1 kHz, respectively. ②Except for the lateral difference of FAR in oVEMP of the posterior semicircular canal BPPV group and cVEMP of the horizontal semicircular canal BPPV group (P<0.05), no significant lateral difference was observed in the other disease groups (P>0.05). Conclusion:In patients with unilateral vestibular hypofunction, cVEMP and oVEMP showed different frequency tuning changes in different semicircular canal BPPV groups. Additionally, 1 kHz cVEMP and oVEMP as regular stimulation frequencies in clinical test, which has certain clinical reference significance for determining the diagnosis and prognosis of BPPV on the weak ear and in different semicircular canal involvement.


Assuntos
Perda Auditiva Neurossensorial , Perda Auditiva Súbita , Potenciais Evocados Miogênicos Vestibulares , Vertigem Posicional Paroxística Benigna , Humanos , Estudos Retrospectivos , Canais Semicirculares , Testes de Função Vestibular
8.
PLoS One ; 17(8): e0262788, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35969602

RESUMO

Spider morph ball pythons are a frequently-bred designer morph with striking alterations of the skin color pattern. We created high-resolution µCT-image series through the otic region of the skulls, used 3D-reconstruction software for rendering anatomical models, and compared the anatomy of the semicircular ducts, sacculus and ampullae of wildtype Python regius (ball python) with spider morph snakes. All spider morph snakes showed the wobble condition (i.e., twisting movements of the head, impaired locomotion, difficulty striking or constricting prey items). We describe the inner ear structures in wildtype and spider morph snakes and report a deviant morphology of semicircular canals, ampullae and sacculus in the latter. We also report about associated differences in the desmal skull bones of spider morph snakes, which were characterized by wider semicircular canals, ampullae widened and difficult to discern in µCT, a deformed crus communis, and a small sacculus with a highly deviant X-ray morphology as compared to wildtype individuals. We observed considerable intra- and interindividual variability of these features. This deviant morphology in spider morph snakes could easily be associated with an impairment of sense of equilibrium and the observed neurological wobble condition. Limitations in sample size prevent statistical analyses, but the anatomical evidence is strong enough to support an association between the wobble condition and a malformation of the inner ear structures. A link between artificially selected alterations in pattern and specific color design with neural-crest associated developmental malformations of the statoacoustic organ as known from other vertebrates is discussed.


Assuntos
Boidae , Aranhas , Animais , Boidae/anatomia & histologia , Orelha , Canais Semicirculares , Crânio/anatomia & histologia
9.
Otol Neurotol ; 43(9): e984-e991, 2022 Oct 01.
Artigo em Alemão, Inglês | MEDLINE | ID: mdl-36006776

RESUMO

OBJECTIVE: To determine the prevalence of endolymphatic hydrops (EH) in cochlear implant (CI) candidates with idiopathic profound sensorineural hearing loss (SNHL) and its influence on the preservation of audiovestibular function after cochlear implantation. STUDY DESIGN: Prospective case series. SETTING: Tertiary referral center. PATIENTS: CI candidates with idiopathic progressive SNHL, but without classic EH-associated symptoms. INTERVENTIONS: Delayed intravenous gadolinium-enhanced inner ear fluid-attenuated inversion recovery magnetic resonance imaging as well as pure-tone audiograms, video head impulse tests, and vestibular evoked myogenic potentials before and 4 weeks after cochlear implantation. MAIN OUTCOME MEASURES: Prevalence of EH before cochlear implantation, audiovestibular function before and after surgery in hydropic and nonhydropic ears. RESULTS: Thirty-two ears in 16 CI candidates were included. Nine ears (28%) with EH were detected. Although preoperative hearing thresholds, utricular function, and semicircular canal function were not different between the two groups, saccular function was reduced in hydropic ears. Ten subjects received a unilateral CI. Of these, 3 (30%) showed EH on the implanted side. There was no difference regarding postoperative hearing loss between the two groups, but the results point toward a higher vulnerability of hydropic ears with respect to loss of otolith function after cochlear implantation. CONCLUSIONS: This is the first study showing that EH can be assumed in about one third of CI candidates with idiopathic profound SNHL, but no classic EH-associated symptoms. Preliminary results suggest that EH has no influence on the preservation of cochlear function but could be a risk factor for loss of otolith function after cochlear implantation.


Assuntos
Implante Coclear , Implantes Cocleares , Hidropisia Endolinfática , Perda Auditiva Neurossensorial , Hidropisia Endolinfática/diagnóstico por imagem , Hidropisia Endolinfática/epidemiologia , Hidropisia Endolinfática/cirurgia , Gadolínio , Perda Auditiva Neurossensorial/epidemiologia , Perda Auditiva Neurossensorial/cirurgia , Humanos , Imageamento por Ressonância Magnética/métodos , Prevalência , Canais Semicirculares
10.
J Int Adv Otol ; 18(4): 334-339, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35894530

RESUMO

BACKGROUND: Both the Dix-Hallpike test and the supine head-roll test can provoke positional nystagmus in a group of benign paroxysmal positional vertigo patients, including but not limited to those with multiple canal involvement. This study aimed to determine the incidence and interpret the clinical significance of positional nystagmus provoked by both the Dix-Hallpike and the supine head-roll tests. METHODS: The results of video-nystagmography sessions recorded in the computer database that included both the Dix-Hallpike and the supine head-roll tests were examined. RESULTS: The records belonging to 2880 video-nystagmography sessions of 2387 patients were examined. Nystagmus was detected in both the Dix-Hallpike and the supine head-roll tests of 131 (5.5%) patients. The video images belonging to 142 session records of 122 patients were accessed and further analyzed. The diagnosis was posterior canal BPPV in 9.0%, and lateral canal BPPV in 62.3%. More than one canal was involved in 3.3%, one rehabilitation maneuver was performed in 75.0%, and recurrence was observed in 7.4% of those patients. CONCLUSION: In both geotropic and apogeotropic variants of lateral canal BPPV, nystagmus can be observed during the Dix-Hallpike test in addition to the supine head-roll test. In patients with posterior canal benign paroxysmal positional vertigo, nystagmus can also be observed in the head-roll test. To reach a correct and comprehensive diagnosis and apply appropriate treatment in benign paroxysmal positional vertigo, the Dix-Hallpike test and the head-roll test should be completely performed on both sides, and the results of those tests must be interpreted concomitantly.


Assuntos
Vertigem Posicional Paroxística Benigna , Nistagmo Patológico , Vertigem Posicional Paroxística Benigna/diagnóstico , Vertigem Posicional Paroxística Benigna/terapia , Humanos , Nistagmo Patológico/diagnóstico , Nistagmo Fisiológico , Canais Semicirculares , Testes de Função Vestibular
11.
Artigo em Chinês | MEDLINE | ID: mdl-35822358

RESUMO

Objective:To compare the diagnostic performance of the rapid axial roll test(RART) and the traditional roll test(SRT)in determining the responsible semicircular canal for horizontal canal benign paroxysmal positional vertigo(HC-BPPV). Methods:A total of 400 patients diagnosed with HC-BPPV from January 2020 to December 2020 were collected and randomly divided into two groups. Among them, there were 202 cases in the RART group and 198 cases in the SRT group. The patients in the two groups performed corresponding positional test respectively, and the following treatment was based on the types of induced nystagmus. The patients with typical HC-BPPV nystagmus underwent two rounds of modified Barbecure procedure. The diagnostic accuracies of the two positional tests in locating the responsible semicircular canal were evaluated by the elicitation rate of typical nystagmus. Finally, the effects of the two tests were evaluated by comparing the recovery rate of nystagmus between the two groups after repositioning procedures. Results:The elicitation rate of nystagmus in HC-BPPV patients by RART was significantly higher than that by SRT(χ²=10.73,P<0.01 ). The effectiveness of repositioning procedure by RART in HC-BPPV patients was significantly higher than that of SRT(χ²=6.08,P<0.05). Conclusion:RART could significantly improve the accuracy in determining the responsible semicircular canal in HC-BPPV, and future studies are warranted.


Assuntos
Vertigem Posicional Paroxística Benigna , Nistagmo Patológico , Vertigem Posicional Paroxística Benigna/diagnóstico , Humanos , Nistagmo Patológico/diagnóstico , Canais Semicirculares
12.
Acta Otorhinolaryngol Ital ; 42(3): 281-286, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35880368

RESUMO

Objective: The aim of this study is to evaluate vestibular functions with video head impulse test (VHIT) and to understand the value of VHIT in differential diagnosis in patients with vestibular migraine (VM) during dizziness attack. Materials and methods: Two groups were enrolled in this study. The first consisted of 84 vestibular migraine patients, and second group of 74 healthy subjects. VHIT was applied to patients with VM during vertigo attack and the results were compared with the VHIT values applied to subjects in the control group. Results: The mean vestibulo-ocular reflex (VOR) in all semicircular canals in the VM group was lower than healthy individuals, but the results were not statistically significant. Refixation saccades were found in 52.3% of VM patients and in 10.2% of healthy individuals. Conclusions: When patients with VM were evaluated with VHIT during vertiginous attack, VOR gain values were not different from healthy individuals, but the number of catch-up saccades were higher in VM patients, which indicates peripheral vestibular involvement. For differential diagnosis in patients with VM, vestibular tests should be performed during the vertigo attack. When evaluating VHIT results, the presence of refixation saccades should also be evaluated.


Assuntos
Teste do Impulso da Cabeça , Transtornos de Enxaqueca , Teste do Impulso da Cabeça/métodos , Humanos , Transtornos de Enxaqueca/complicações , Transtornos de Enxaqueca/diagnóstico , Reflexo Vestíbulo-Ocular , Canais Semicirculares , Vertigem/diagnóstico , Vertigem/etiologia
13.
Acta Otorhinolaryngol Ital ; 42(3): 287-292, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35880369

RESUMO

Objective: A mono-positional persistent, direction-fixed apogeotropic nystagmus (MPosApoNy) is very challenging for the neuro-otologist. MPosApoNy can be found in patients suffering from a partially compensated acute unilateral vestibulopathy; with a normal caloric test, one can speculate the presence of "trapped" otolithic debris located close to the ampulla of the horizontal semicircular canal. Methods: Among 957 patients suffering from vertigo and dizziness, we selected 53 cases of MPosApoNy. Results: In 28 patients, caloric test showed a canal paresis on the same side of the MPosApoNy. In the remaining 25 cases, MPosApoNy was the only clinical finding. We hypothesised the presence of horizonal canal lithiasis and patients were treated with a Gufoni manoeuvre, followed by a forced prolonged position. Conclusions: Performing bedside examination in a patient suffering from vertigo, the presence of MPosApoNy may be due to: a) facilitation of a subclinical nystagmus due to the mechanism of apogeotropic reinforcement; b) horizontal canal lithiasis with 'trapped' otoliths close to the ampulla. The disappearance of MPosApoNy following a repositioning manoeuvre or conversion in a typical form of canalolithiasis may represent the best method to confirm this hypothesis.


Assuntos
Litíase , Nistagmo Patológico , Vertigem Posicional Paroxística Benigna/diagnóstico , Humanos , Nistagmo Patológico/diagnóstico , Nistagmo Fisiológico , Canais Semicirculares , Vertigem/diagnóstico
14.
Otol Neurotol ; 43(7): 835-839, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35878641

RESUMO

OBJECTIVE: To investigate the prevalence of vestibular migraine (VM) in a cohort of patients with radiologic confirmation of superior canal dehiscence (SCD) and to compare management of superior canal dehiscence syndrome (SCDS) in patients with and without comorbid VM. STUDY DESIGN: Retrospective review of a SCD database. SETTING: University-based tertiary medical center. PATIENTS: Ninety-one patients identified with SCD from 2009 to 2017. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Coincidence of VM and SCD, and resolution of symptoms. RESULTS: Ninety-one patients with SCD met the inclusion and exclusion criteria. VM was diagnosed in 36 (39.6%) patients. Of those receiving medical therapy for VM alone, five (45.5%) reported symptom resolution, five (45.5%) reported partial improvement, one (9.1%) had no change, and none worsened. Fifteen patients (41.7%) were treated with both surgery (for SCD) and medical therapy (for VM). Seven (46.7%) reported symptom resolution, seven (46.7%) reported partial improvement, and one (6.7%) worsened. There was no statistically significant difference in symptom resolution between SCD + VM patients who were treated medically compared with those treated with medical therapy and surgery (p = 0.951). There was no significant difference in symptom resolution after surgery between SCD + VM and SCD-only cohorts (p = 0.286). CONCLUSIONS: This is the first study describing the incidence of VM in a cohort of patients with SCDS. The symptoms of VM confound those of SCDS and unrecognized or undertreated VM may contribute to surgical failure in SCDS. Therefore, we recommend a high index of suspicion for VM in patients with SCDS and a trial of medical therapy in the setting of suspected VM.


Assuntos
Transtornos de Enxaqueca , Deiscência do Canal Semicircular , Humanos , Transtornos de Enxaqueca/complicações , Transtornos de Enxaqueca/terapia , Estudos Retrospectivos , Canais Semicirculares/cirurgia , Vertigem/etiologia
18.
Vestn Otorinolaringol ; 87(3): 99-106, 2022.
Artigo em Russo | MEDLINE | ID: mdl-35818953

RESUMO

The article provides a brief overview of the epidemiology, diagnosis, clinical manifestations and surgical methods of treatment of labyrinthine fistulas (LF) in patients with chronic suppurative otitis media (CSOM) with cholesteatoma. The efficacy of various LF treatment techniques, their complications, and the principles of prevention of cochleovestibular disorders during surgical treatment are described. The prognostic criteria for the deterioration of bone conduction thresholds during LF surgery, which include a large LF size, the opening of the membranous labyrinth, and the extent of damage to the structures of the inner ear, are presented. A clinical case of surgical treatment of widespread LF in CSOM with cholesteatoma is presented, which proves the possibility of preserving the auditory and vestibular functions while observing the stages of sanitation, manipulations on the LF and obliteration of semicircular canals defects with auto tissues. Combined surgery of such a plan must certainly be accompanied by local instillation of solutions of hormonal preparations in case of a deficiency of perilymphatic fluid in the labyrinth and postoperative antibacterial and hormonal therapy.


Assuntos
Colesteatoma da Orelha Média , Fístula , Doenças do Labirinto , Otite Média Supurativa , Doenças Vestibulares , Colesteatoma da Orelha Média/cirurgia , Fístula/diagnóstico , Fístula/etiologia , Fístula/cirurgia , Audição , Humanos , Doenças do Labirinto/complicações , Doenças do Labirinto/diagnóstico , Otite Média Supurativa/complicações , Otite Média Supurativa/diagnóstico , Otite Média Supurativa/cirurgia , Estudos Retrospectivos , Canais Semicirculares , Doenças Vestibulares/complicações
19.
Artigo em Chinês | MEDLINE | ID: mdl-35822378

RESUMO

Objective:To investigate the characteristics of habitual sleeping position and triggered movement in patients with benign paroxysmal positional vertigo(BPPV). Methods:The patients with idiopathic tubulitic BPPV who the symptoms were relieved after repositioning were enrolled in this study. The relationship between the side, the tube of otolith detachment and habitual sleeping position and triggered movement was analyzed. Results:①Among the 446 patients, female gender predominated(319 cases, 71.5%), 41-60 years old group accounted for the highest proportion(192 cases, 43.0%), and posterior semicircular canal patients accounted for the highest proportion(289 cases, 64.8%); ②The affected side was associated with habitual sleep postion(P<0.05, ES=0.392), ipsilateral ear was more common in left or right decubitus; ③There were statistically significant differences in the triggered movement in different types of BPPV(P<0.05, ES=0.380), BPPV of multiple semicircular canals. Horizontal semicircular canals and posterior semicircular canals were more likely to induce vertigo and nystagmus. Conclusion:Habitual sleeping position and triggered movement could be collected during the diagnosis of BPPV, to predict the affected side and tube. The combination of Roll test and Dix-Hallpike test is more conducive to accurately distinguish the location of otolith shedding.


Assuntos
Vertigem Posicional Paroxística Benigna , Nistagmo Patológico , Adulto , Vertigem Posicional Paroxística Benigna/diagnóstico , Feminino , Humanos , Pessoa de Meia-Idade , Nistagmo Patológico/diagnóstico , Membrana dos Otólitos , Canais Semicirculares , Sono
20.
Exp Brain Res ; 240(7-8): 2017-2025, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35716191

RESUMO

This study aimed to test the role of the otolithic system in self-motion perception by examining adaptive responses to asymmetric off-axis vertical rotation. Self-movement perception was examined after a conditioning procedure consisting of prolonged asymmetric sinusoidal yaw rotation of the head on a stationary body with hemicycle faster than the other hemicycle. This asymmetric velocity rotation results in a cumulative error in spatial self-motion perception in the upright position that persists over time. Head yaw rotation conditioning was performed in different head positions: in the upright position to activate semicircular canals and in the supine and prone positions to activate both semicircular canals and otoliths with the phase of otolithic stimulation reversed with respect to activation of the semicircular canals. The asymmetric conditioning influenced the cumulative error induced by four asymmetric cycles of whole-body vertical axis yaw rotation. The magnitude of this error depended on the orientation of the head during the conditioning. The error increased by 50% after upright position conditioning, by 100% in the supine position, and decreased by 30% in the prone position. The enhancement and reduction of the perceptual error are attributed to otolithic modulation because of gravity influence of the otoliths during the conditioning procedure in supine and prone positions. These findings indicate that asymmetric velocity otolithic activation induces adaptive perceptual errors such as those induced by semicircular canals alone, and this adaptation may be useful in testing dynamic otolithic perceptual responses under different conditions of vestibular dysfunction.


Assuntos
Percepção de Movimento , Membrana dos Otólitos , Gravitação , Humanos , Movimento (Física) , Membrana dos Otólitos/fisiologia , Reflexo Vestíbulo-Ocular/fisiologia , Canais Semicirculares/fisiologia
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