Annals of Otology and Neurotology最新文献

{"title":"Comparison of Speech Perception Abilities of Children using Bimodal Hearing with Children using Cochlear Implant Alone","authors":"G. Belsare, Sharda A. Sarda, P. Bhardwaj, Sai Belsare","doi":"10.1055/s-0040-1715930","DOIUrl":"https://doi.org/10.1055/s-0040-1715930","url":null,"abstract":"Abstract Introduction There are very few studies comparing speech perception abilities of children using bimodal hearing over monaural cochlear implant and factors related to benefit of bimodal hearing. The aim of this study is to compare speech perception abilities of children using bimodal fitting versus children using cochlear implant alone and explore factors related to benefit of bimodal hearing. Materials and Methods In the present study, 20 cochlear implantees with the hearing age range of 3 to 8 years were included. Speech perception performance was assessed by means of Parent’s Evaluation of Aural/Oral Performance of Children scale and early speech perception (ESP) test: Pattern Perception Words, Monosyllabic Words, Bisyllabic, and Trisyllabic Words Identification test. ESP test was carried out in two conditions cochlear implant with hearing aid in opposite ear (CIHA), bimodal, and cochlear implant (CI) alone. Aided audiometry was also carried out in above mentioned two conditions. Results and Discussion On aided audiometry test, aided thresholds were improved by 5 to 6 dB in CIHA condition as compared to CI alone condition in 14 out of 20 children. Whereas on speech perception test, there was a significant improvement of 15 to 20% on domains of ESP test in these children. Factors such as implant age, chronological age, and number of hours of hearing aid usage were not significantly associated with benefit. Nevertheless aided threshold at 4,000 Hz was found to be significantly associated with bimodal benefit. Conclusion Bimodal hearing is beneficial in most of the children than monaural hearing through cochlear implant.","PeriodicalId":108664,"journal":{"name":"Annals of Otology and Neurotology","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126943399","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":"Role of Free Radicals, Glutamate Toxicity, Glutathione Depletion in Apoptosis of Cochlear Hair Cells, Neuronal Cells among Patients with Sensorineural Hearing Loss","authors":"Vithal D. Udagatti, Rajendran Dinesh Kumar, A. Samorekar, Vaibhavi Kr","doi":"10.1055/s-0041-1724220","DOIUrl":"https://doi.org/10.1055/s-0041-1724220","url":null,"abstract":"Abstract Introduction Hearing loss may lead to depression, decreased quality of life, reduced functional status and social isolation. The glutathione-S transferase (GSTS) is an antioxidant scavenging enzyme. Decreased glutathione and GSTS activity levels lead to an increase in susceptibility of hair-cell damage leading to sensorineural hearing loss. The cumulative effect of oxidative stress and mitochondrial damage by free radicals results in the mutation/deletion of deoxyribonucleic acid, leading to decline in mitochondrial function, which in turn plays an important role in inducing apoptosis of the cochlear cells. Other risk factors also include noise exposure, genetic predisposition, health comorbidities, ototoxic drugs, infections, and immune-mediated inflammation of auditory cells. Study Design Prospective, non-comparative, metacentric clinical study. Materials and Methods The study was carried out in 30 patients from 6/5/2016 to 10/1/2018. Total of 30 patients of sensorineural hearing loss were enrolled (17 males, 13 females). Clinical history, ENT examination, and audiogram were done, treatment duration of 8 weeks for each patient and followed up to 3 outpatient visits. The patient was administered rebamipide 100 mg, alpha lipoic acid 100 mg, and acetylcysteine 100 mg capsules twice a day for a total period of 8 weeks. Wherever giddiness was an added symptom, Cinnarizine 20mg with Diaminehydrate 40 mg combination twice a day was added up to complete relief of symptoms, thereafter once a day as maintenance dose over a period of 8 weeks. Wherever tinnitus was an added symptom, deflazacort 6 mg twice a day was added and tapered up to 1 month. If the symptom of tinnitus persisted, intratympanic steroid injection was given. During every visit, clinical assessment and audiogram were repeated. Results Our study demonstrated greater improvement in hearing at higher frequencies with 8 weeks of rebamipide 100 mg + alpha lipoic acid 100 mg + acetylcysteine 100 mg administration in 30 patients with twice-daily dosing. Conclusion Synthesis of free radicals in the inner ear may play an important part in the pathogenesis of sensory hearing loss. The combination of rebamipide 100 mg + alpha lipoic acid 100 mg + acetylcysteine 100 mg is effective prophylaxis in sensorineural hearing loss that addresses both factors of inhibiting the cochlear cell damage and enhancing cochlear cell preservation.","PeriodicalId":108664,"journal":{"name":"Annals of Otology and Neurotology","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124961481","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":"Study of Hearing Impairment in School-Going Children of Ghaziabad","authors":"Sushil Gaur, Udita Arora, Vandana Singh","doi":"10.1055/s-0040-1721898","DOIUrl":"https://doi.org/10.1055/s-0040-1721898","url":null,"abstract":"Abstract Introduction Hearing is one of the traditional five senses that is also the fastest sense. Inadequate hearing acuity especially during early age has serious effects on the development of a child’s personality. According to World Health Organization, around 466 million people worldwide have disabling hearing loss and of these ~34 million are children. Hearing loss in children may occur due to several reasons, but ~60% of childhood hearing loss occurs from preventable causes. An early detection of these conditions plays an important role in reduction in magnitude of this problem. Aims and Objectives The motive of this study is to estimate the prevalence of hearing impairment among school-going children in Ghaziabad on the basis of otological findings and tuning fork tests. Materials and Methods A random sample of 500 school-going children between the ages of 6 to 14 years was selected from children attending ENT OPD in Santosh Hospital, Ghaziabad, over a period of 8 months from July 2019 till February 2020. Results and Conclusion Prevalence rate encountered in this study was 13%, with unilateral hearing loss being more common than bilateral. The commonest cause was found to be cerumen. A higher prevalence was found in children from semiurban and low socioeconomic background. Since the commonest cause is preventable and readily correctable by proper management, early detection can reduce the burden of this disability.","PeriodicalId":108664,"journal":{"name":"Annals of Otology and Neurotology","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133380758","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":"Meniere’s Disease: New Frontiers in Management for Better Results","authors":"A. Velusamy, A. Anand, S. Janarthanan","doi":"10.1055/s-0041-1724221","DOIUrl":"https://doi.org/10.1055/s-0041-1724221","url":null,"abstract":"Abstract Introduction Meniere's disease (MD) remains a difficult disease to diagnose, especially in the early stages when not all of the symptoms may be present. Sensorineural hearing loss, tinnitus, and recurrent vertigo constitute the hallmark symptoms of MD. Endolymphatic hydrops (EH) has been described as the responsible pathology in MD. Since that description, the medical and surgical treatment of MD have been directed at reducing the volume of endolymph. Unfortunately, these approaches have had equivocal success in the control of vertigo and recovery of hearing. So, a routine treatment directed at resolution of EH may not be suitable for all patients. Treatment has to be directed at the cause of EH whenever possible. Objectives The aim of this study was to define new findings in clinical tests and modes of treatment in MD, to determine the outcome of vertigo and hearing in patients after treatment, and to describe treatment which will prevent long term deterioration of hearing. Materials and Methods Forty-six new patients with a diagnosis of MD were treated with antiviral drugs or diuretics. Drugs were used based on nature of dehydration test. Hearing test including pure tone average (PTA) and speech discrimination (SD) was performed prior to treatment and at 1 to 2 months, 6 months, and 1 year after initiation of treatment. Effect on dizziness was recorded at each evaluation; hearing was judged to be improved, if PTA was lowered by at least 10 to 15 dB or an increase in SD > 20%. Results The antiviral approach has virtually eliminated the use of various surgical methods used in the past. Dehydration test-based treatment protocol with diuretics and antivirals and antimigraine prophylaxis when needed has led to remission of disease in 93.5% of patients. With prompt treatment, inner ear damage can be prevented. Conclusion Orally administered antiviral drugs should be considered in the treatment of MD. Migraine-associated MD patients need migraine prophylaxis and this will lead to improvement in Meniere’s symptoms also. If Intratympanic therapy is considered, then targeted low-dose delivery method of using Gelfoam instillation of gentamicin is preferable according to our study to prevent any significant hearing loss.","PeriodicalId":108664,"journal":{"name":"Annals of Otology and Neurotology","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134598756","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":"Comparative Study on Method of Threshold Estimation: Distortion Product Threshold Test versus Pure Tone Threshold Test","authors":"Gunjan Mehta, A. Neupane, Abhishek Mistri, Hiral B Joshi, Nirmita Shah","doi":"10.1055/s-0041-1724218","DOIUrl":"https://doi.org/10.1055/s-0041-1724218","url":null,"abstract":"Abstract Introduction Distortion product otoacoustic emissions (DPOAEs) can be helpful in estimating the hearing thresholds by extrapolating the DPOAE input/output function with the help of scissor paradigm, and thus the following study aims at assessing its reliability by comparing DPOAE thresholds with those obtained by behavioral responses at pure tones on various frequencies. Materials and Methods Fifty participants having normal hearing sensitivity were included in the study. Pure tone (PT) audiometry was carried out on all participants to determine PT thresholds in both ears. DPOAE threshold test was administered and thresholds at 1, 2, 4, and 8 kHz were compared accordingly. Results The result indicated significant difference between the two methods of threshold estimation where the mean difference was found to be 3 decibel (dB) and 4 dB for left and right ears, respectively. Shapiro-Wilk test revealed normal distribution (p > 0.05) of the data. Hence, parametric paired t-test was performed, which revealed significant difference between PT and distortion product thresholds. Conclusion Study concludes as having good clinical applicability in assessing neonates and infants.","PeriodicalId":108664,"journal":{"name":"Annals of Otology and Neurotology","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127313429","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":"The Clinical Spectrum of Patients of Horizontal Semicircular Canal Benign Paroxysmal Positional Vertigo Attending an Otoneurology Center in South Rajasthan, India and Their Response to Appropriate Repositioning Maneuvers at a Short-Term Follow-Up","authors":"A. Vats","doi":"10.1055/s-0040-1715533","DOIUrl":"https://doi.org/10.1055/s-0040-1715533","url":null,"abstract":"Abstract Introduction This article aims to study the clinical spectrum of 20 consecutive patients diagnosed with horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV) attending an otoneurology center in Udaipur, Rajasthan, India, over a period of 11 months and their response to appropriate repositioning maneuvers evaluated at short-term follow-up of 1 hour and 24 hours. Study Design This is a nonrandomized prospective interventional study. Materials and Methods Twenty patients with unilateral HSC-BPPV were treated with a session of an appropriate repositioning maneuver (Gufoni maneuver or barbecue roll maneuver for the geotropic variant of HSC-BPPV [geo-HSC-BPPV]; Appiani maneuver or barbecue roll maneuver or head-shaking maneuver for the apogeotropic variant of the HSC-BPPV [apo-HSC-BPPV]). Patients were followed up twice (at 1 hour and 24 hours) and audited by a supine roll test with questioning for the absence or presence of concomitant vertigo. Results At the 1-hour follow-up, 78.57% (11/14) patients of geo-HSC-BPPV treated with Gufoni maneuver recovered, and 66.67% (4/6) patients of apo-HSC-BPPV treated with some form of physical therapy recovered. The recovery was maintained at 24 hours’ follow-up in both groups. Conclusion To the best of the author’s knowledge, no such study on patients of HSC-BPPV has been reported from India hitherto. Gufoni maneuver is an effective and safe treatment for the geo-HSC-BPPV with a recovery rate of 78.57% (11/14) at a short-term follow-up. The physical therapy for the apo-HSC-BPPV must be tailored according to the purported site of pathology which cannot be precisely predetermined most of the times.","PeriodicalId":108664,"journal":{"name":"Annals of Otology and Neurotology","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131824245","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 Case of Right Apogeotropic Posterior Semicircular Canal BPPV that Initially Emulated as Left Anterior Semicircular Canal BPPV","authors":"A. Vats, S. Kothari, A. Biswas","doi":"10.1055/s-0040-1715532","DOIUrl":"https://doi.org/10.1055/s-0040-1715532","url":null,"abstract":"Abstract In any patient with a history of rotational vertigo triggered by changes in the position of head relative to the gravity, whose oculomotor patterns elicit a positional downbeating nystagmus (p-DBN), the localization could be either central in the brainstem, midline cerebellum, or at the craniocerebral junction; or else peripheral due to one of the rare variants of benign paroxysmal positional vertigo of vertical semicircular canals. Most serious causes of central vertigo in patients with p-DBN can be diagnosed by magnetic resonance imaging of the posterior fossa and craniovertebral junction. However, the peripheral p-DBN could be either due to anterior semicircular canal benign paroxysmal positional vertigo (ASC-BPPV) or a recently described apogeotropic variant of posterior semicircular canal BPPV (apo-PSC-BPPV) and the two are almost impossible to differentiate initially. The usual clinical scenario in apo-PSC-BPPV is diagnosing it initially as ASC-BPPV. However, following diagnostic or therapeutic positioning maneuvers for the purported ASC-BPPV, the positional oculomotor pattern changes to an upbeating nystagmus with the reversal in the direction of the torsion as well, localizing it to the contralateral PSC with respect to the ASC initially diagnosed. The initial oculomotor pattern observed on the right Dix–Hallpike test in this patient, of a short latency downbeating left torsional (from the patient’s perspective) positional nystagmus suggested a diagnosis of left ASC-BPPV, which was accordingly treated with multiple sessions of reverse Epley maneuvers daily for a week. At the end of the week, a verifying right Dix–Hallpike test elicited an upbeating right torsional (from the patient’s perspective) positional nystagmus. It is extremely unlikely that this patient had resolution of her initial left ASC-BPPV with the daily sessions of reverse Epley maneuvers carried over a week and immediately suffered from commoner geotropic variant of the right PSC-BPPV (geo-PSC-BPPV). It is plausible to interpret that this patient suffered from the right apo-PSC-BPPV from the very outset, and the reverse Epley maneuver performed for the ostensive left ASC-BPPV led to an intracanal shift of otoconial debris from its nonampullary to the ampullary arm resulting in right geo-PSC-BPPV. The reasons why situations like this outwit the clinician resulting in inaccurate localization as well as lateralization is discussed. The patient was successfully treated with right Epley maneuver after transformation to geo-PSC-BPPV and was asymptomatic at follow-up for 4 weeks. A peripheral p-DBN with torsional component in any patient with a history of positionally triggered vertigo can be either ASC-BPPV or apo-PSC-BPPV. A very close follow-up at a short interval of time with meticulously executed positional tests is the only definitive way to differentiate the two conditions.","PeriodicalId":108664,"journal":{"name":"Annals of Otology and Neurotology","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124736563","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":"Lack of Torsion in the Type-III Duane Retraction Syndrome (DRS-III) Affected Left Eye During Dix -Hallpike Test","authors":"A. Vats","doi":"10.1055/s-0040-1708073","DOIUrl":"https://doi.org/10.1055/s-0040-1708073","url":null,"abstract":"Abstract Background Duane retraction syndrome (DRS) is a congenital cranial dysinnervation disorder (CCDD) of ocular movements, characterized by deficits in horizontal duction associated with narrowing of palpebral fissure, retraction of eye globe on attempted adduction and occasionally accompanied by upshoot or downshoot of the eye globe. It is caused by congenital absence of sixth cranial nerve, which results in fibrotic changes in the extraocular muscles leading to an abnormal ocular motility--a concept known as CCDD. Depending on whether only abduction/adduction or both are affected, DRS has been classified into three types designated as type-I, type-II and type-III. The torsional movements of the affected eye in DRS have not been reported to be deficient hitherto, which could be due to difficulties in the routine bedside evaluation of such movements. Case Presentation An unusual case of a patient of left unilateral type-III DRS is reported, who presented with a short history of vertigo on getting up from supine to sitting position and on assuming right lateral recumbent position. The diagnostic right Dix-Hallpike test (DHT) revealed upbeating torsional geotropic positioning nystagmus in the normal right eye and upbeating positioning nystagmus without torsional component in the abnormal left eye and this clinical finding was video recorded. Conclusion The observed lack of incyclotorsion of the left eye, affected with DRS-III during right Dix-Hallpike positioning, is primarily due to the absence of initial slow-phase excyclotorsional component. If the slow phase of VOR does not occur, then the fast-phase VOR, which is a refixation saccade, will be lacking too. An anastomosis, either in the lateral wall of the cavernous sinus or within the orbit, between the trochlear nerve and fibers of the oculomotor nerve can lead to simultaneous co-contraction of the inferior and superior oblique muscles. This is the most probable explanation for such finding of asymmetrical absence of torsional component in the left eye affected by DRS-III, during right Dix -Hallpike positioning. Thus, the recording of eye movements (voluntary and involuntary) opened a window into the brain to conceptualize neural and mechanical factors influencing the human eye movements.","PeriodicalId":108664,"journal":{"name":"Annals of Otology and Neurotology","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132172290","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":"Vestibular Paroxysmia with Trigeminal Neuralgia: Simultaneous Occurrence of Two Compression Syndromes: A Rare Case Report","authors":"A. Bhandari, Shiva Sharma","doi":"10.1055/s-0040-1703972","DOIUrl":"https://doi.org/10.1055/s-0040-1703972","url":null,"abstract":"Abstract Neurovascular compression syndromes are compression of cranial nerves by blood vessels leading to troublesome symptoms. They mostly occur due to a single vessel loop compression. Here, we report two rare cases with simultaneous fifth and eighth nerve compression by anterior inferior cerebellar artery and superior cerebellar artery loops together.","PeriodicalId":108664,"journal":{"name":"Annals of Otology and Neurotology","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121127059","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":"Goldenhar Syndrome Presenting As Squamosal Chronic Otitis Media","authors":"Ravi Ambewadi, V. Bhat, Prajna L Salian","doi":"10.1055/s-0040-1715292","DOIUrl":"https://doi.org/10.1055/s-0040-1715292","url":null,"abstract":"Abstract Goldenhar syndrome is a rare congenital anomaly involving the eye, ear, vertebra, and the mandible. This anomaly presenting primarily to the ENT outpatient clinic with ear discharge and cholesteatoma is still rarer. Here we describe one such rare case that was a challenge to diagnose as well as manage. We also discuss the various problems in the management and highlight the need for a multispecialty approach to tackling the various pathologies in such a case.","PeriodicalId":108664,"journal":{"name":"Annals of Otology and Neurotology","volume":"121 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122151048","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}