{"title":"A Prospective Study to Evaluate Role of Middle Ear Risk Index in Tympanoplasty with Mastoidectomy as a Prognostic Parameter","authors":"Archana Mathri, Niya Joseph Neelamkavi","doi":"10.1055/s-0043-1761402","DOIUrl":"https://doi.org/10.1055/s-0043-1761402","url":null,"abstract":"Abstract Introduction Chronic otitis media (COM) is an otological challenge in the developing countries as it is a persistent disease causing severe destruction of middle ear with irreversible sequalae. To assess Middle Ear Risk Index (MERI) score and study its prognostic effect in postoperative outcome following mastoidectomy with tympanoplasty. To evaluate MERI score with respect to graft uptake and A-B gap closure. Materials and Methods This prospective study comprised 25 patients suffering from COM who presented to the Department of ENT, HSK Hospital, Bagalkot, over a period of 1 year from November 2020 to November 2021. The patients underwent tympanoplasty with mastoidectomy. MERI 2001 was used in the current study, and risk factors were assessed based on pre- and intra-operative findings to obtain the MERI score. Patients were segregated into those with mild (1–3), moderate (4–7), and severe (8–15) MERI. They were evaluated at 1 month follow-up visit. Results and Conclusion The study reveals the degree to which MERI score can predict the extent of disease and indicate outcome of surgery. In the present study, patients with lower MERI score benefitted more favorably in terms of graft uptake and hearing improvement as compared with success rate of severe MERI score. MERI index is in fact a very reliable predictor of graft uptake and audiological alteration in patients undergoing tympanoplasty with mastoidectomy surgeries for COM.","PeriodicalId":108664,"journal":{"name":"Annals of Otology and Neurotology","volume":"74 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132424641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Epley versus Semont Maneuver in the Treatment of Benign Paroxysmal Positional Vertigo","authors":"Aravind Karuppan Muthu, K. Bongale, V. Bhat","doi":"10.1055/s-0043-1761405","DOIUrl":"https://doi.org/10.1055/s-0043-1761405","url":null,"abstract":"Abstract Introduction Benign paroxysmal positional vertigo (BPPV) is characterized by brief but violent attacks of paroxysmal vertigo provoked by certain positions of the head. This study aimed to compare the outcomes of Epley and Semont maneuvers for the relief of vertigo in posterior semicircular canal BPPV. Materials and Methods This was a prospective comparative study conducted in a tertiary referral hospital over 1 year. Among 70 cases of BPPV, 35 were treated with Epley and 35 with Semont maneuver. Follow-up was done at 1 week, 1 month, and 3 months to assess symptomatic improvement using visual analogue scale. Results Out of 70 patients of BPPV, 62 patients responded very well to the maneuvers and got relief from vertigo. Thirty-two patients (91.4%) in the Epley group and 30 (85.7%) patients in the Semont group had a significant improvement post-therapy and the balance was the same in both groups. At 1 month, there was no significant statistical difference in mean visual analogue score (VAS) score between both groups. Conclusion Majority of cases showed symptomatic improvement with both maneuvers. However, patients treated with Epley maneuver showed earlier relief from vertigo than those treated with the Semont maneuver.","PeriodicalId":108664,"journal":{"name":"Annals of Otology and Neurotology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125751461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Silvestina Winston Furtal, Amith Thomas, K. Yerraguntla
{"title":"A Systematic Review of Vestibular Evoked Myogenic Potential in Individuals with Motion Sickness","authors":"Silvestina Winston Furtal, Amith Thomas, K. Yerraguntla","doi":"10.1055/s-0043-1764173","DOIUrl":"https://doi.org/10.1055/s-0043-1764173","url":null,"abstract":"Abstract The otolith of vestibular system in the human body helps in maintaining the static balance. Travelling can cause defect in static balance that may lead to motion sickness. The evidence showing the relation between vestibular evoked myogenic potential (VEMP) that assesses otolith function and motion sickness is contrasting. The current systematic review is aimed to understand outcomes of published articles in reporting association between vestibular evoked myogenic in individuals with motion sickness. For this study, the database used is PubMed, Scopus, ProQuest, CINHAL, and Web of Science. The data is extracted from the final articles where VEMP is done on individuals with and without motion sickness. The total articles included are 125 out of which five articles used for the systematic review. In this study, motion sickness susceptibility questionnaire is used to assess individuals with and without motion sickness. The latency and amplitude of both cervical VEMP (cVEMP) and ocular (oVEMP) of individuals with and without motion sickness are normal. However, the review indicates a significant change in the interaural asymmetry ratio of both cVEMP and oVEMP results in individuals with motion sickness. This shows that there might be a variation in the functional asymmetry in the otoliths. From the review, it is clear that there might be otolith changes due to motion sickness that can have a smaller impact on the interaural asymmetry ratio in VEMP. These findings can be further applied for the diagnostic purpose in individuals with motion sickness.","PeriodicalId":108664,"journal":{"name":"Annals of Otology and Neurotology","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133827734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Awareness and Experience of Tinnitus in Nepalese Young Adult Population","authors":"Sajana Aryal, Prabuddha Bhatarai, P. Prabhu","doi":"10.1055/s-0043-1764177","DOIUrl":"https://doi.org/10.1055/s-0043-1764177","url":null,"abstract":"Abstract Introduction The prevalence of tinnitus is increasing in younger adult rapidly. It is increasing mainly because of increased daily noise levels due to the unrestrained usage of recreational devices like mobile phones, MP3s, iPods, and other personal stereos. The aim of this study is to describe awareness and experience of tinnitus among younger adult with respect to the existence, cause, effects, and management. Methods A descriptive cross-sectional study was conducted in 205 young adult Nepalese population between the age ranges between 20 and 40 years through online survey mode. Statistical analyses were carried out using SPSS 25.0 software. Data were analyzed using the descriptive statistics. Results Result showed more than half of the participants (59.2%) were aware about the existence of tinnitus; however, only 16.1% of participants were aware about the effect of tinnitus. The incidence of tinnitus was found to be high (11.71%) in Nepalese population. Conclusion Even though most of the participants were found to be aware about existence of tinnitus, most of them were not aware about the effect of tinnitus and its cause. This result has implications for audiologist who are involved in hearing health care program across the various age groups. As per this study, since most of the participants pointed to the Internet as their source of awareness, that could be further tapped on to provide awareness in these age groups.","PeriodicalId":108664,"journal":{"name":"Annals of Otology and Neurotology","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129317856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sidra Khan, R. Agrawal, S. Nivsarkar, Shrikant Phatak, A. Sikdar
{"title":"Video Occulography-Assisted Diagnosis of BPPV and Comparison of Pre- and Post-Intervention Dizziness Handicap Inventory Score","authors":"Sidra Khan, R. Agrawal, S. Nivsarkar, Shrikant Phatak, A. Sikdar","doi":"10.1055/s-0043-1761403","DOIUrl":"https://doi.org/10.1055/s-0043-1761403","url":null,"abstract":"Abstract Benign paroxysmal positional vertigo (BPPV) is a commonly recognized vestibular disorder which is characterized by brief periods of vertigo and a characteristic nystagmus. The nystagmus is often difficult to appreciate with naked eyes and hence video oculography is a helpful tool. Dizziness Handicap Inventory is an objective way to assess the impact of vertigo on quality of life. Objective Our study here aims at diagnosing undiagnosed, difficult and missed cases of BPPV using video-oculography and managing it with repositioning manoeuvre. This study also aims at measuring Dizziness Handicap Inventory Scores pre and post repositioning manoeuvre. We also observed the association between Vitamin D levels and the occurrence of BPPV. Methods and Materials One hundred and twenty-six patients were enrolled in the age group of 18-70 years. After recognizing patients with BPPV, vertigo evaluation was performed. Those patients with suggestive history and suspicion of multiple canal involvement were taken for video-oculography. Results Forty-four patients were in age group of 50-60 years, having female predominance. 35.71% cases which were missed on clinical examination were correctly diagnosed using video-oculography. The mean pre-intervention DHI was 41.29 ± 15.90 which lowered down to 14.84 ± 11.52 in post-intervention period. The highest DHI scores were seen in multi-canal BPPV involving lateral and posterior semi-circular canals. Conclusion With the help of vide-oculography we could diagnose more cases of anterior and multi canal BPPV which are often missed. Maximum number of participants had insufficient levels of Vitamin-D and in our opinion correcting it would reduce the occurrence and recurrence rate..","PeriodicalId":108664,"journal":{"name":"Annals of Otology and Neurotology","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124856550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Vaccine-Induced Tinnitus: A New Consequence of COVID-19","authors":"A. Raza, Dilli Raj Paudel, P. Prabhu","doi":"10.1055/s-0043-1761407","DOIUrl":"https://doi.org/10.1055/s-0043-1761407","url":null,"abstract":"","PeriodicalId":108664,"journal":{"name":"Annals of Otology and Neurotology","volume":"87 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121349628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Physical Therapy for the Horizontal Semicircular Cupulolithiasis: A Prospective Interventional Case Series from an Otoneurology Center in South Rajasthan, India","authors":"A. Vats, J. K. Sharma, G. Ramchandani","doi":"10.1055/s-0041-1735990","DOIUrl":"https://doi.org/10.1055/s-0041-1735990","url":null,"abstract":"Abstract Objective This article aims to study the effect of physical therapy in patients of horizontal semicircular cupulolithiasis with results audited in the short term. Design Nonrandomized prospective interventional study. Study Sample Four patients with horizontal semicircular cupulolithiasis. Results All four patients in whom diagnostic supine roll test (carried at least thrice to look for the sustainability as well as the polarity of the nystagmus) elicited apogeotropic horizontal positional nystagmus lasting more than 1 minute were subjected to therapeutic head-shaking maneuver (HSM). The results were audited immediately after the physical therapy, and at 1 hour. Follow-up by telephonic interviews for 4 weeks was done in all patients. Three out of four patients responded to HSM alone. One patient who did not respond to HSM was successfully treated with four other sequent physical therapies. Conclusion The response of physical therapy for horizontal semicircular cupulolithiasis occasionally indicates the side of the cupula to which otoconial debris is adherent (Cup-U or Cup-C). Occasionally, Cup-C variant of horizontal semicircular cupulolithiasis can be transformed by physical therapy to long posterior arm horizontal semicircular canalolithiasis—a disorder with better established treatment options.","PeriodicalId":108664,"journal":{"name":"Annals of Otology and Neurotology","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122767049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Unilateral Multicanalicular Vestibular Lithiasis of Right Horizontal and Posterior Semicircular Canals: An Unusual Case","authors":"A. Vats","doi":"10.1055/s-0041-1735989","DOIUrl":"https://doi.org/10.1055/s-0041-1735989","url":null,"abstract":"Abstract Vestibular lithiasis (canalolithiasis as well as cupulolithiasis) commonly exists in monocanalicular forms involving one of the three semicircular canals, frequent posterior, less frequent horizontal, and very rarely anterior. It is treated with canal clearing maneuvers intended to reposition the otoconia from the semicircular canal (where they have inappropriately entered) through the utricular exit in the nonampullary arm of the semicircular canal to the utricle (where they normally remain as a part of utricular gelatinous matrix). The cases of multicanalicular vestibular lithiasis with the involvement of more than one semicircular canal require meticulous identification of the involved canals and multiple different canal-clearing maneuvers for effective treatment. A 70-year-old male patient with no significant history of previous medical or otologic illnesses or head trauma presented with a 1-day history of vertigo with positional aggravation. A one-time performed diagnostic supine head roll test elicited three different patterns of positional nystagmus, each with an accurate localizing and lateralizing value. Diagnosis of unilateral multicanalicular vestibular lithiasis of right horizontal and posterior semicircular canals was entertained based on the pattern of the elicited positional nystagmi on the supine roll test. The upbeating torsional nystagmus that localizes the involvement to the posterior semicircular canal was paradoxically elicited by supine head roll test and not by the Dix–Hallpike test. As horizontal semicircular canalolithiasis causes severe symptoms, its treatment preceded that of concurrent posterior semicircular canalolithiasis. The patient was successfully treated with multiple sessions of canalith repositioning maneuvers (CRMs) spread over 24 hours. It is important to perform both positional tests, namely Dix–Hallpike maneuver, and supine head roll test, in cases suspected to have multicanalicular vestibular lithiasis. The positionings may need to be repeated several times to unveil multiple nystagmi, each with different localizing and lateralizing values. Identifying treatment priorities with CRM for the individual semicircular canals is crucial, and the canal that is liable to cause severe symptoms needs early clearance of the otoconial debris. If a CRM fails to clear a semicircular canal, an alternative maneuver may need to be executed. Clinicians involved in the care of cases with multicanalicular vestibular lithiasis should be well versed with all possible backup maneuvers for clearing each of the three semicircular canals.","PeriodicalId":108664,"journal":{"name":"Annals of Otology and Neurotology","volume":"229 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124530197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Young Patient with Horizontal Semicircular Cupulolithiasis with Immediate Response to the Therapeutic Head-Shaking Maneuver (HSM)","authors":"A. Vats","doi":"10.1055/s-0041-1736344","DOIUrl":"https://doi.org/10.1055/s-0041-1736344","url":null,"abstract":"Abstract The apogeotropic variant of horizontal semicircular canal benign paroxysmal positional vertigo is attributed to either short anterior ampullary arm canalolithiasis or to the cupulolithiasis with the otoconial debris adhering to the cupula on utricular (Cup-U) or canal side (Cup-C), rendering it heavy and gravity sensitive. The treatment options for horizontal semicircular cupulolithiasis are not very well defined. A 25-year-old female patient with 8 days history of vertigo on rolling to either of the lateral recumbent position presented in the first week of November 2019. The supine roll test (SRT) on yawing head maximally to the right as well as to the left elicited an apogeotropic horizontal positional nystagmus lasting more than 1 minute, which was stronger on the right side and indicated a diagnosis of left horizontal semicircular cupulolithiasis. Two short-term follow-ups at 1 and 24 hours after head-shaking maneuver (HSM), with verifying SRT, were undertaken. During either of the two follow-ups, neither the previously elicited horizontal positional nystagmus was observed, nor did the patient have vertigo on rolling to lateral recumbent positions. She was telephonically questioned weekly regarding the recurrence of rotational vertigo for the next 4 weeks, and it was confirmed that she remained symptom free till then. The therapeutic HSM, owing to the inertial forces generated, can detach the otoconial debris from the cupula that renders it heavy and gravity sensitive. Successful offloading of cupula by HSM brings immediate cure in the Cup-U variant of the horizontal semicircular cupulolithiasis.","PeriodicalId":108664,"journal":{"name":"Annals of Otology and Neurotology","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131585902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Primary Malignant Melanoma Limited to the External Auditory Canal: A Rare Presentation","authors":"D. Samal, C. Preetam, A. Sahoo","doi":"10.1055/s-0041-1735991","DOIUrl":"https://doi.org/10.1055/s-0041-1735991","url":null,"abstract":"Abstract Malignant melanoma limited to the external auditory canal is very rare. These patients present relatively late as compared with melanoma involving other subsites of external ear. However, the tumor is slow-growing but shows aggressive behavior with a poor prognosis when presented late. We have a 44-year-old female who presented with a blackish lesion, which was bleeding on and off from her left ear. She was managed with wide local excision, preserving maximum part of external auditory canal cartilage. The histopathology of the lesion was suggestive of malignant melanoma. After a thorough evaluation, she was kept under close follow-up. Malignant melanoma of external auditory canal shows poor prognosis usually, mainly because of late presentation. Thus, early diagnosis is crucial, as in our case, where wide local excision was sufficing, and the patient is disease-free after 4 years of follow-up.","PeriodicalId":108664,"journal":{"name":"Annals of Otology and Neurotology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130521559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}