scholarly journals Clinical and pathophysiological study of patients with vertigo at SAIMS, Indore

Author(s):  
Digant Patni ◽  
Alok Tyagi ◽  
Vishal R. Munjal

<p class="abstract"><strong>Background:</strong> This was a prospective, descriptive study performed by collecting and analyzing the results of vestibular exams, evoked myogenic potential tests, pure tone audiometry test and impedence test performed in the Otorhinolaryngology Department of Sri Aurobindo Institute of Medical Sciences, Indore.</p><p class="abstract"><strong>Methods:</strong> This was a prospective, descriptive study performed by collecting and analyzing the results of vestibular exams, evoked myogenic potential tests, pure tone audiometry test and impedence test performed in the Otorhinolaryngology Department of Sri Aurobindo Institute of Medical Sciences, Indore.  </p><p class="abstract"><strong>Results:</strong> In age group of 20 to 60, maximum number of patients were in group of 31-40 (16), followed by 51-60 (15), followed by 20-30 (24.) Maximum positive seen in Romberg (07), followed by nystagmus (06), followed by Dix-Hallpike (06). The patients in our study (30 out of 50) were suffering from hypertension. Two patients were of Meniere’s disease and rest 16 were of SNHL, 08 were of SNHL and BPPV combined. The rest of the cases were of mixed hearing loss and other central hearing loss causes will have be ruled out.</p><p class="abstract"><strong>Conclusions:</strong> The main aim of study is to study clinicopathological aspects in patients with vertigo. We also studied incidence of SNHL in our study. It has been established by this study that hypertension is one the major causes of vertigo in patients whereas VEMP has not proven to be very beneficial in our study to see peripheral vertigo patients. Most of the patients with BPPV also had a normal cVEMP which showed that it was not a very reliable instrument in BPPV.</p>

2015 ◽  
Vol 2 (1) ◽  
pp. 4
Author(s):  
Devashri Uday Patil ◽  
Kiran S. Burse ◽  
Shreeya Kulkarni ◽  
Vandana Sancheti ◽  
Chaitanya Bharadwaj

Chronic suppurative otitis media is one of the common otological conditions in India for which patients seek advice from an otorhinolaryngologist. Chronic suppurative otitis media is recurrent and progressive disease which is characterized with tympanic membrane perforation and suppurative discharge. Pure tone audiometry is the most common test used to evaluate auditory sensitivity. Since hearing loss is a common complication of chronic suppurative otitis media, we designed this study to evaluate preoperative pure tone audiometry findings in patients with chronic suppurative otitis media and its correlation with the intra-operative findings. <strong>Aims and Objectives:</strong> 1] To assess the intra-operative findings in patients with chronic suppurative otitis media. 2] To evaluate the correlation between the preoperative pure tone audiometry findings and intra-operative findings in patients with chronic suppurative otitis media. 3] To assess the type of hearing loss and degree of hearing loss in patients with chronic suppurative otitis media. <strong>Materials and Methods:</strong> This is an Observational study carried over a period of 3 years from August 2011 to August 2013. Total number of patients included in this study was 100. <strong>Result:</strong> Out of 100 patients studied 69 % of patients had Tubo-Tympanic type of CSOM, 31 % of patients had Attico-antral type of CSOM. In patients of Safe CSOM; Central perforation was seen in maximum cases 46.4 %, anterior central perforations was seen in 8.7 % cases, posterior central perforations seen in 20.2 % cases, and subtotal perforations seen in 24.63 % cases. In patients of Unsafe CSOM posterosuperior cholesteatoma was seen in maximum cases 67.74 %, and attic cholesteatoma was seen in 32.2 % cases. In safe CSOM patients all ossicles were intact and mobile whereas in unsafe CSOM patients only 4 patients had intact ossicular chain, while maximum patients had ossicular defect. <strong>Conclusion:</strong> Hearing loss depends on size of perforation. Hearing loss increases as the size of perforation increases. Average air conduction threshold and air bone gap did not differ significantly between various groups of ossicular defect. This shows us that neither air conduction nor air bone gap are reliable parameters on basis of which we can predict ossicular status preoperatively.


2016 ◽  
Vol 130 (11) ◽  
pp. 1059-1063 ◽  
Author(s):  
A T Sayit ◽  
H P Gunbey ◽  
B Fethallah ◽  
E Gunbey ◽  
E Karabulut

AbstractObjective:To inform on the incidence of high jugular bulb and dehiscent high jugular bulb, and the symptoms related to these vascular anomalies.Methods:A retrospective analysis was performed of temporal bone computed tomography scans of 3285 patients who attended our clinic with various symptoms. The medical records of patients with high jugular bulb and dehiscent high jugular bulb were analysed, and the clinical findings reviewed. Patients with dehiscent high jugular bulb were evaluated for hearing loss with pure tone audiometry.Results:High jugular bulb was evident in 730 patients (22 per cent) (510 right-sided, 220 left-sided; p < 0.01). Twenty-six high jugular bulb patients had dehiscent high jugular bulb. Ten of these 26 patients had vertigo, 15 had tinnitus and 1 had hearing disturbance. Ten dehiscent high jugular bulb patients had undergone pure tone audiometry: seven patients had conductive hearing loss, two had sensorineural hearing loss and one had mixed hearing loss.Conclusion:The incidences of high jugular bulb and dehiscent high jugular bulb were 22 per cent and 3.5 per cent, respectively. Tinnitus was the most common symptom of all patients. Dehiscent high jugular bulb was associated with various degrees of hearing loss, but not hearing disturbance.


2018 ◽  
Vol 132 (5) ◽  
pp. 457-460 ◽  
Author(s):  
H R F Powell ◽  
I Pai ◽  
H Ghulam ◽  
D Jiang

AbstractObjective:To report a novel management strategy for mixed hearing loss in advanced otosclerosis.Methods:A 50-year-old male was referred to St Thomas’ Hearing Implant Centre with otosclerosis; he was no longer able to wear conventional hearing aids because of recurrent otitis externa. The patient underwent short process incus vibroplasty (using the Med-El Vibrant Soundbridge device), followed at a suitable interval (six weeks) by stapes surgery. The main outcome measures were: pure tone audiometry, functional gain and monosyllabic word recognition scores.Results:Post-operative pure tone audiometry showed a reduction of the mean air–bone gap from 55 dB HL to 20 dB HL. The residual mixed hearing loss was rehabilitated with the Vibrant Soundbridge, with an average device gain of 32 dB. The monosyllabic word recognition scores in quiet at 65 dB improved from 37 to 100 per cent when using the Vibrant Soundbridge at six months after switch-on of the device.Conclusion:Stapedotomy in conjunction with incus short process vibroplasty (i.e. inner-ear vibroplasty) is a safe and promising procedure for managing advanced otosclerosis with mixed hearing loss in selected patients.


Author(s):  
Prakash S. Handi ◽  
Mallikarjun N. Patil ◽  
K. R. Prasenkumar

<p class="abstract"><strong>Background:</strong> Hearing loss associated with the CSOM affects the patients’ communication with others and results in poor quality of life. Degree and type of hearing loss can be assessed by pure tone audiometry, which helps in predicting the status of tympanic membrane, ossicular chain, and inner ear and also helps in preoperative planning.</p><p class="abstract"><strong>Methods:</strong> Patients with CSOM aged 10 years and above were included in the study. All patients underwent pure tone audiometry. With the help of air and bone conduction threshold, the degree and type of hearing loss in each ear was determined. The data collected was evaluated and results are reported as rates and proportions (%).  </p><p class="abstract"><strong>Results:</strong> Most of the ears (83%) had mild to moderate hearing loss. Average ABG observed was 31 dB. Maximum ABG observed was 55dB on right side and 50 dB on the left side. There was mixed hearing loss in 10.9% cases.</p><p class="abstract"><strong>Conclusions:</strong> This study reinforces the idea of using preoperative pure tone audiometry, which not only helps in planning surgery but also helps in documenting the preoperative status of patients’ sensorineural hearing loss, if present.</p>


2013 ◽  
Vol 118 (4) ◽  
pp. 719-724 ◽  
Author(s):  
Tingting Ying ◽  
Parthasarathy Thirumala ◽  
Aalap Shah ◽  
Tara Nikonow ◽  
Kelley Wichman ◽  
...  

Object The primary aim of this study was to evaluate the incidence and discuss the pathogenesis of high-frequency hearing loss (HFHL) after microvascular decompression (MVD) for hemifacial spasm (HFS). Methods Preoperative and postoperative audiogram data and brainstem auditory evoked potentials (BAEPs) from 94 patients who underwent MVD for HFS were analyzed. Pure tone audiometry at 0.25–2 kHz, 4 kHz, and 8 kHz was calculated for all individuals pre- and postoperatively ipsilateral and contralaterally. Intraoperative neurophysiological data were reviewed independently. An HFHL was defined as a change in pure tone audiometry of more than 10 dB at frequencies of 4 and 8 kHz. Results The incidence of HFHL was 50.00% and 25.53% ipsilateral and contralateral to the side of surgery, respectively. The incidence of HFHL adjusted for conductive and nonserviceable hearing loss was 26.6% ipsilaterally. The incidence of HFHL at 4 and 8 kHz on the ipsilateral side was 37.23% and 45.74%, respectively, and it was 10.64% and 25.53%, respectively, on the contralateral side. Maximal change in interpeak latency Waves I–V compared with baseline was the only variable significantly different between groups (p < 0.05). Sex, age, and side did not increase the risk of HFHL. Stepwise logistic regression analysis did not find any changes in intraoperative BAEPs to increase the risk of HFHL. Conclusions High-frequency hearing loss occurs in a significant number of patients following MVD surgery for HFS. Drill-induced noise and transient loss of CSF during surgery may impair hearing in the high-frequency ranges on both the ipsilateral and contralateral sides, with the ipsilateral side being more affected. Changes in intraoperative BAEPs during MVD for HFS were not useful in predicting HFHL. Follow-up studies and repeat audiological examinations may be helpful in evaluating the time course and prognosis of HFHL. Prospective studies focusing on decreasing intraoperative noise exposure, as well as auditory shielding devices, will establish causation and allow the team to intervene appropriately to decrease the risk of HFHL.


2018 ◽  
Vol 132 (11) ◽  
pp. 1039-1041 ◽  
Author(s):  
J Suzuki ◽  
Y Takanashi ◽  
A Koyama ◽  
Y Katori

AbstractObjectivesSodium bromate is a strong oxidant, and bromate intoxication can cause irreversible severe-to-profound sensorineural hearing loss. This paper reports the first case in the English literature of bromate-induced hearing loss with hearing recovery measured by formal audiological assessment.Case reportA 72-year-old woman was admitted to hospital with complaints of profound hearing loss, nausea, diarrhoea and anuria after bromate ingestion in a suicide attempt. On admission, pure tone audiometry and auditory brainstem responses showed profound bilateral deafness. Under the diagnosis of bromate-induced acute renal failure and sensorineural hearing loss, continuous haemodiafiltration was performed. When dialysis was discontinued, pure tone audiometry and auditory brainstem responses showed partial threshold recovery from profound deafness.ConclusionSevere-to-profound sensorineural hearing loss is a common symptom of bromate intoxication. Bromate-induced hearing loss may be partially treated, and early application of continuous haemodiafiltration might be useful as a treatment for this intractable condition.


2013 ◽  
Vol 60 (1) ◽  
Author(s):  
Samantha Marlanie Govender ◽  
Cyril Devdas Govender ◽  
Glenda Matthews

Objective: To evaluate cochlear functioning in patients (18 - 45 years old) with varying stages of chronic kidney disease (CKD). Using purposive sampling, 50 participants, 10 in each of the 5 stages of CKD, were selected and underwent pure tone audiometric testing and distortion product otoacoustic emissions (DPOAEs).Results: Significant differences (p<0.05) were found between pure tone audiometry and DPOAEs in detecting early cochlear dysfunction in the high-frequency range in stages 3 (6 000/5 000 Hz; p=0.00), 4 (6 000/5 000 Hz; p<0.03) and 5 (4 000/3 333 Hz; p<0.01, 8 000/6 667 Hz:p<0.05) with DPOAEs being more sensitive in identifying early cochlear dysfunction. Patients in stages 1 and 2 presented with normal puretone thresholds and DPOAEs, suggesting that cochlear functioning in these patients was normal. Early cochlear dysfunction, thereby indicating a subclinical hearing loss, was identified in stages 3, 4 and 5 by DPOAE testing. In addition, blood test results, drug intake and concomitant conditions were recorded and analysed which suggested a relationship between reduced cochlear functioning and increased electrolyte levels, treatment regimens and concomitant conditions.Conclusion: Participants in the later stages of CKD presented with early cochlear dysfunction, presenting with subclinical hearing loss. It was postulated that this subclinical hearing loss resulted from a combination of electrolytic, urea and creatinine imbalances, together with concomitant medical conditions and ototoxic drug intake. It was concluded that audiological monitoring be included in the management of patients with CKD and that DPOAEs be introduced as part of the test battery to monitor cochlear function in patients with varying degrees of CKD.


10.2196/23047 ◽  
2020 ◽  
Vol 8 (11) ◽  
pp. e23047
Author(s):  
Heng-Yu Haley Lin ◽  
Yuan-Chia Chu ◽  
Ying-Hui Lai ◽  
Hsiu-Lien Cheng ◽  
Feipei Lai ◽  
...  

Background Sudden sensorineural hearing loss (SSNHL) is an otologic emergency that warrants urgent management. Pure-tone audiometry remains the gold standard for definitively diagnosing SSNHL. However, in clinical settings such as primary care practices and urgent care facilities, conventional pure-tone audiometry is often unavailable. Objective This study aimed to determine the correlation between hearing outcomes measured by conventional pure-tone audiometry and those measured by the proposed smartphone-based Ear Scale app and determine the diagnostic validity of the hearing scale differences between the two ears as obtained by the Ear Scale app for SSNHL. Methods This cross-sectional study included a cohort of 88 participants with possible SSNHL who were referred to an otolaryngology clinic or emergency department at a tertiary medical center in Taipei, Taiwan, between January 2018 and June 2019. All participants underwent hearing assessments with conventional pure-tone audiometry and the proposed smartphone-based Ear Scale app consecutively. The gold standard for diagnosing SSNHL was defined as the pure-tone average (PTA) difference between the two ears being ≥30 dB HL. The hearing results measured by the Ear Scale app were presented as 20 stratified hearing scales. The hearing scale difference between the two ears was estimated to detect SSNHL. Results The study sample comprised 88 adults with a mean age of 46 years, and 50% (44/88) were females. PTA measured by conventional pure-tone audiometry was strongly correlated with the hearing scale assessed by the Ear Scale app, with a Pearson correlation coefficient of .88 (95% CI .82-.92). The sensitivity of the 5–hearing scale difference (25 dB HL difference) between the impaired ear and the contralateral ear in diagnosing SSNHL was 95.5% (95% CI 87.5%-99.1%), with a specificity of 66.7% (95% CI 43.0%-85.4%). Conclusions Our findings suggest that the proposed smartphone-based Ear Scale app can be useful in the evaluation of SSNHL in clinical settings where conventional pure-tone audiometry is not available.


2021 ◽  
pp. 1-24
Author(s):  
Fiona Höbler ◽  
Katherine S. McGilton ◽  
Walter Wittich ◽  
Kate Dupuis ◽  
Marilyn Reed ◽  
...  

Background: Hearing loss is highly prevalent in older adults, particularly among those living with dementia and residing in long-term care homes (LTCHs). Sensory declines can have deleterious effects on functioning and contribute to frailty, but the hearing needs of residents are often unrecognized or unaddressed. Objective: To identify valid and reliable screening measures that are effective for the identification of hearing loss and are suitable for use by nursing staff providing care to residents with dementia in LTCHs. Methods: Electronic databases (Embase, Medline, PsycINFO, CENTRAL, and CINAHL) were searched using comprehensive search strategies, and a stepwise approach based on Arksey & O’Malley’s scoping review and appraisal process was followed. Results: There were 193 scientific papers included in the review. Pure-tone audiometry was the most frequently reported measure to test hearing in older adults living with dementia. However, measures including self- or other-reports and questionnaires, review of medical records, otoscopy, and the whisper test were found to be most suitable for use by nurses working with older adults living with dementia in LTCHs. Conclusion: Although frequently used, the suitability of pure-tone audiometry for use by nursing staff in LTCHs is limited, as standardized audiometry presents challenges for many residents, and specific training is needed to successfully adapt test administration procedures and interpret results. The whisper test was considered to be more suitable for use by staff in LTCH; however, it yields a limited characterization of hearing loss. There remains an urgent need to develop new approaches to screen hearing in LTCHs.


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