Audiology and Neuro-Otology最新文献

{"title":"Temporal Bone Meningoencephalocele Associated with Cholesteatoma: Systematic Literature Review and a Case Series.","authors":"Amit Wolfovitz, Omer Shaked, Idit Tessler","doi":"10.1159/000546748","DOIUrl":"https://doi.org/10.1159/000546748","url":null,"abstract":"<p><strong>Background: </strong>Temporal bone meningoencephalocele (TB-MEC) diagnosed with or following cholesteatoma is a rare yet complex neurotological scenario. This study aims to characterize the clinical features and treatment strategies to facilitate clinicians' decision-making and patients' counseling.</p><p><strong>Methods: </strong>We conducted a retrospective case series with a systematic literature review of the past 3 decades. For the literature review, PRISMA guidelines were followed, with articles sourced from PubMed and EMBASE. The study examined demographics, clinical aspects, imaging findings, surgical approaches, and postoperative outcomes.</p><p><strong>Results: </strong>We identified 75 cases (n=72 from the literature and n=3 original). The majority of the patients with TB-MEC had prior cholesteatoma surgeries (79%), mostly canal wall down (CWD) mastoidectomy, with a relatively high complication rate (15%) at presentation. TB-MECs were incidentally discovered intraoperatively in 39.5% of the cases. Most (65%) of the preoperatively diagnosed had major defects (>1cm). Tegmen mastoidum was involved in 68%. Surgical treatment employed trans-mastoid approach in 72%, including minor and major defects, whereas middle fossa or combined approaches were reserved for major defects only. Autologous grafts, mainly temporalis fascia, were the primary choice for reconstruction (98%), regardless of defect sizes or surgical approach. Single surgery was mostly sufficient, irrespective of defect size (100% and 93% for minor and major defects), and complications were minimal.</p><p><strong>Conclusions: </strong>Despite advancements in imaging, TB-MED are still discovered intraoperatively at a substantial rate. High-risk cases are patients with prior complications and multiple past surgeries, mainly CWD. Although previously described complications were ominous, today, a single-stage procedure yields positive outcomes.</p>","PeriodicalId":55432,"journal":{"name":"Audiology and Neuro-Otology","volume":" ","pages":"1-19"},"PeriodicalIF":1.6,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EVALUATION OF SACCADIC ABNORMALITIES IN MULTIPLE SCLEROSIS USING A NOVEL CLINICAL SACCADOMETRY TEST.","authors":"Zahra Polat, Ahmet Alperen Akbulut, Sema Satıcı, Reyhan Sürmeli, Mehmet Sürmeli","doi":"10.1159/000546670","DOIUrl":"https://doi.org/10.1159/000546670","url":null,"abstract":"<p><strong>Introduction: </strong>The clinical saccadometry test is an ocular motor test that provides a functional assessment of the brain regions and circuits involved in the generation of saccadic eye movements. Clinical saccadometry is thought to be more sensitive to concussions and neurodegenerative disorders. The aim of our study was to compare healthy individuals with individuals diagnosed with relapsing-remitting multiple sclerosis (RRMS) using a saccadometry test, and to evaluate pro-saccade and anti-saccade performances.</p><p><strong>Methods: </strong>The study included 32 patients (mean age: 41±11.88 years) between the ages of 18-60 years with relapsing remitting multiple sclerosis (RRMS), and a healthy control group of 28 individuals (mean age: 37.3±12.2 years). Spontaneous nystagmus, gaze, random saccade, pursuit, optokinetic and saccadometry tests included in the videonystagmography (VNG) test battery were performed for all participants.</p><p><strong>Results: </strong>There were no significant differences in random saccade (RS) latencies between the groups (p>0.05). However, the pro-saccade and anti-saccade latencies were significantly prolonged in the multiple sclerosis (MS) group (p<0.05). There were no statistically significant differences between the groups in peak velocity and accuracy for random saccades, pro-saccades and anti-saccades (p>0.05). Directional error rates in the pro-saccade and anti-saccade tests were significantly different between the MS and control groups (p<0.05).</p><p><strong>Conclusion: </strong>The findings of our study show that there are significant differences in saccadometry test results between MS patients and healthy subjects. Therefore, the clinical saccadometry test, which is newly added to the VNG test battery and offers short and non-invasive evaluation, could be included in the vestibular test battery for neurodegenerative diseases such as MS.</p>","PeriodicalId":55432,"journal":{"name":"Audiology and Neuro-Otology","volume":" ","pages":"1-19"},"PeriodicalIF":1.6,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiologically Assessed Stapes Footplate Thickness and Audiologic Outcomes in Patients with Otosclerosis.","authors":"Justus Müller-Goebel, Rahel Bertschinger, Nathalie Nierobisch, David Bächinger, Flurin Pfiffner, Christof Röösli, Alexander Huber, Adrian Dalbert","doi":"10.1159/000545673","DOIUrl":"10.1159/000545673","url":null,"abstract":"<p><strong>Introduction: </strong>Otosclerosis is a known cause of particularly conductive hearing loss of a variable extent. Radiological examination reveals footplate thickening in addition to heterogeneously distributed hypodense foci. The objective of this study was to investigate the correlation between a thickened stapes footplate and its association with perioperative audiometric findings and postoperative complications.</p><p><strong>Methods: </strong>This was a retrospective data analysis conducted at a single tertiary referral center on 63 surgically confirmed otosclerotic ears from 56 patients. Stapes footplate thickness was measured in the stapes axial plane of a preoperative computed tomography scan. Measured stapes footplate thickness was assessed regarding its relationship between pre- and postoperative audiometric data and vestibulocochlear complications associated with stapedotomy.</p><p><strong>Results: </strong>Radiological assessment of stapes footplate thickness demonstrated considerable variation between otosclerotic ears, with a mean value of 0.85 mm (range 0.5-1.37 mm). No statistically significant correlation was identified between pre- and postoperative audiometric data for air-bone gap, air conduction, and bone conduction in the overall population or within subgroups. One case showed postoperative inner ear hearing loss (PTA-BC 26.3-37.5 dB HL), resulting in severe combined hearing loss, occurring 40 days after uneventful surgery (footplate thickness 0.79). Regardless of footplate thickness, no further cases of postoperative sensorineural hearing loss were reported. Postoperative vertigo was observed in 20 patients, none of whom showed pathological findings in clinical head impulse testing or exhibited spontaneous nystagmus, without association with footplate thickness (t(61) = 0.83, p = 0.41). Significant improvements regarding the air-bone gap (26.45 dB HL, SD 9.24 to 7.70 dB HL, SD 5.69, p < 0.0001), as well as air-conduction (48.65 dB HL, SD 14.24-26.29 dB HL, SD 10.24, p < 0.0001) and bone-conduction (22.20 dB HL, SD 9.20-18.13 dB HL, SD 10.11, p < 0.0001) pure-tone average thresholds, were observed from last pre- to last postoperative audiometric data after stapedotomy. Comparison of first to last postoperative audiometric data revealed significant improvement in air-bone gap (10,74 dB HL, SD 7.20-7.70 dB HL, SD 5.691, p = 0.0002), as well as air conduction (31.63 dB HL, SD 12.30-26.29 dB HL, SD 10.24, p < 0.0001) and bone conduction (20.08 dB HL, SD 10.26-18.13 dB HL, SD 20.11, p = 0.011), at a mean postoperative follow-up time of 12.6 months, SD 9 months (2.4-37.3 months).</p><p><strong>Conclusion: </strong>Stapes footplate thickness in otosclerosis cases is not correlated with presurgical or postoperative hearing, nor with the incidence of postoperative complications. Stapedotomy can be performed safely regardless of the thickness of the stapes footplate.</p>","PeriodicalId":55432,"journal":{"name":"Audiology and Neuro-Otology","volume":" ","pages":"1-8"},"PeriodicalIF":1.6,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to oral steroids for sudden sensorineural hearing loss: considerations of age, time to treatment, and degree of hearing loss.","authors":"Erin Harvey, Grace Callan, Neil Osafo, David Friedland, Michael Harris, Jazzmyne Adams, Kristen Osinski, Ling Tong, Jake Luo","doi":"10.1159/000545672","DOIUrl":"https://doi.org/10.1159/000545672","url":null,"abstract":"<p><strong>Introduction: </strong>Compare outcomes of oral steroids (OS) to intratympanic (IT) steroids for treatment of idiopathic sudden sensorineural hearing loss (ISSNHL) in a retrospective cohort study at a tertiary academic center.</p><p><strong>Methods: </strong>Patients diagnosed with ISSNHL receiving at least one course of OS between January 2009 and February 2022 were reviewed. OS patients were compared to a previously reported cohort of 74 patients who underwent IT treatment.</p><p><strong>Interventions: </strong>OS or IT steroid therapy for ISSNHL. Full, partial or no recovery rates of hearing thresholds stratified by modality of treatment, age, degree of hearing loss, and time to initiation of treatment were measured.</p><p><strong>Results: </strong>There were 96 patients treated with OS and 74 patients treated with IT steroid. Full recovery was more frequent in patients who underwent oral steroid therapy (43.8%) compared to IT therapy (25.68%, p=0.017). For patients under 40 years old, full recovery rates were similar between OS (60.0%) and IT (61.5%). In patients over 40 years old, however, full recovery was seen in 40.7% of patients on OS and 18% for IT. Further, while those over 65 years had the worst rates of full recovery to IT steroid (<20%), this age group had a 50% full recovery rate with oral steroids. Additional factors correlating with response to both OS and IT treatment included degree of hearing loss and time to starting steroids.</p><p><strong>Conclusion: </strong>Oral steroid therapy was associated with greater likelihood of full recovery in all patient age groups compared to those treated with IT steroid alone, in combination with oral steroid, or for salvage. A significant difference in response was seen in those over 65 years raising consideration of age stratification in decision making for steroid modality in treatment of ISSNHL.</p>","PeriodicalId":55432,"journal":{"name":"Audiology and Neuro-Otology","volume":" ","pages":"1-19"},"PeriodicalIF":1.6,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Comorbidities on Cochlear Implantation Outcomes in Adults Under 60.","authors":"Jamie A Schlacter, Christine Schremp, Allen Khudaverdyan, Emily R Spitzer, Susan B Waltzman","doi":"10.1159/000546569","DOIUrl":"https://doi.org/10.1159/000546569","url":null,"abstract":"<p><strong>Introduction: </strong>Prior studies have demonstrated that comorbid conditions can negatively impact cochlear implantation (CI) outcomes in elderly patients, but few have examined how comorbidities affect younger adult CI recipients. This study examines the relationship between comorbidities and CI outcomes in adults under 60 years old.</p><p><strong>Methods: </strong>We reviewed all CI recipients between 20 to 60 years old from 2015-2019 at a tertiary academic medical center. Patient data were collected including comorbidities, demographics, etiology, and length of deafness (LOD). Patients' Charlson Comorbidity Index (CCI) was calculated. The primary outcome was speech perception scores at 1-year on the consonant-nucleus-consonant (CNC) word test.</p><p><strong>Results: </strong>There were 118 patients who underwent CI (15% 20-29 years, 22% 30-39, 21% 40-49, 42% 50-60), averaging 1.8 comorbidities. Mean LOD was 19.7 years, and most etiologies were unknown (53.4%). 34% had no comorbidities, and the most frequent comorbidities were hypertension (14%), asthma (10%), anxiety (8%), acoustic neuroma (8%), and arthritis (7%). Comorbidity frequency was similar across ages, but cardiovascular comorbidities varied by patient decade (50-60 yrs: 41% vs. 20-49 yrs: 12-22%, p = 0.004). Compared to studies on elderly CI outcomes, our cohort had fewer comorbidities with reduced cardiac events and neurological conditions. We did not find differences in 1-year CNC scores or complications based on the number of comorbidities or any single comorbidity. However, there was a difference in individual improvement in CNC word scores by age group (p = 0.024). Patients' CCI did not correlate to post-op scores.</p><p><strong>Conclusion: </strong>Subjects showed improved speech understanding post-CI. The number and type of comorbidities were not meaningful predictors of 1-year speech perception scores, suggesting adult CI users under 60 years with comorbidities can expect comparable outcomes to those without comorbidities.</p>","PeriodicalId":55432,"journal":{"name":"Audiology and Neuro-Otology","volume":" ","pages":"1-17"},"PeriodicalIF":1.6,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Balance performance in children who are deaf and hard of hearing.","authors":"Adam C King, Abby Frazier, Krystal L Werfel, Emily Lund","doi":"10.1159/000545482","DOIUrl":"https://doi.org/10.1159/000545482","url":null,"abstract":"<p><strong>Introduction: </strong>Hearing loss impacts children's ability to learn language and motor skills. This study examined the postural control differences between children who are deaf and hard of hearing (DHH) and typical hearing (TH), who differ in language and literacy performance, across diverse balance tasks.</p><p><strong>Methods: </strong>Thirty-three children between the ages of six and 13 performed a battery of balance tasks evaluating postural control and mobility. Twenty-six children were classified as DHH, while seven were TH children. Children participated in an extended battery of language and literacy measures, not unlike an intense academic day schedule. Assessments of postural control were conducted during a pre- and post-fatigue state.</p><p><strong>Results: </strong>Children who are DHH exhibited lower degrees of balance than TH children across the clinical, static, and dynamic balance evaluations.</p><p><strong>Conclusions: </strong>Our findings provide evidence of robust balance impairments for children who are DHH beyond standard clinical evaluations. Fatigue effects induced by testing had a greater impact on TH than DHH children, which may be related to chronic fatigue traits in DHH children. Overall, the results underscore the importance of characterizing balance impairments of children with hearing loss and determining the degree of impact on activities like academics.</p>","PeriodicalId":55432,"journal":{"name":"Audiology and Neuro-Otology","volume":" ","pages":"1-17"},"PeriodicalIF":1.6,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adults Implanted as Children: Long-Term Educational, Occupational, and Speech Perception Outcomes.","authors":"Emily R Spitzer, Alexandria Juliet Lichtl, Susan B Waltzman","doi":"10.1159/000545788","DOIUrl":"10.1159/000545788","url":null,"abstract":"<p><strong>Introduction: </strong>This study investigates factors that relate to long-term educational and occupational outcomes of adults who received cochlear implants (CIs) during childhood.</p><p><strong>Methods: </strong>A retrospective chart review was conducted on 109 adults who received a CI before the age of 15 between 2000 and 2012 at a US tertiary medical center. Demographic variables, speech perception scores, and educational and vocational achievements were analyzed. Current US Census and Bureau of Labor Statistics data were used for comparison.</p><p><strong>Results: </strong>The median age at implantation was 2.81 years, and the median age at data collection was 27.30 years. Most subjects were unilaterally implanted (63.3%) and used an oral communication approach (89.0%). Educational outcomes showed that 17% completed a high school diploma or less, and 9% completed an associates or technical degree. Seventy-two percent of the subjects achieved a bachelor's degree or higher, significantly higher than the general US population (37.9%). Occupational outcomes indicated that subjects were employed across various job categories, with a higher proportion in jobs requiring considerable preparation (job zone 4) compared to the general population. There was a significant negative correlation between age at implantation and speech perception scores. Better word recognition scores were also associated with better educational and occupational outcomes.</p><p><strong>Conclusions: </strong>Adults who received CIs as children demonstrate excellent educational and occupational outcomes, surpassing those of the general US population. Early implantation and the absence of additional disabilities positively influence these outcomes. Continued investigation of nonspeech outcomes and the factors that influence them is essential to provide better support services for future cohorts.</p>","PeriodicalId":55432,"journal":{"name":"Audiology and Neuro-Otology","volume":" ","pages":"1-10"},"PeriodicalIF":1.6,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12119057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of auditory temporal processing in individuals with subjective tinnitus using gap detection and forward masking tests.","authors":"Hatice Kübra Bozkurt, Emine Aydin, F Ceyda Akin Öcal, Songül Aksoy, Bülent Satar","doi":"10.1159/000546372","DOIUrl":"https://doi.org/10.1159/000546372","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to investigate auditory temporal processing skills and word discrimination performance in noise among individuals with subjective tinnitus and normal hearing.</p><p><strong>Methods: </strong>Fifty-five individuals were included: 27 individuals with chronic subjective tinnitus in the study group and 28 healthy individuals in the control group. Interventions included the Word-in-Noise Discrimination Test (WIND), auditory temporal processing tests (Gap Detection Test (GDT) and Forward Masking Test (FMT)), the Standardized Mini Mental Test for cognitive assessment, and the Tinnitus Handicap Inventory to evaluate the impact of tinnitus.</p><p><strong>Results: </strong>In the GDT and FMT results, both right and left ear values were significantly higher in the study group (p<0.05). A significant difference was observed between the study and control groups in terms the WIND test results (p<0.05). However, when the study group was divided into two subgroups based on the presence or absence of WIND problems, no significant difference was found between the groups regarding the auditory temporal processing tests (p>0.05).</p><p><strong>Conclusion: </strong>Tinnitus poses a significant burden for patients; thus, assessing its impact on daily activities and quality of life is essential.</p>","PeriodicalId":55432,"journal":{"name":"Audiology and Neuro-Otology","volume":" ","pages":"1-20"},"PeriodicalIF":1.6,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Analysis of Hearing Status and Hearing Healthcare Utilization of English-Speaking Expatriates in Thailand.","authors":"Shade Avery Kirjava, Amornphat Kitro, Ratana Sapbamrer, Pheerasak Assavanopakun, Rungnapa Malasao, Pimbucha Rusmevichientong, Michele M Wood","doi":"10.1159/000545789","DOIUrl":"10.1159/000545789","url":null,"abstract":"<p><strong>Objective: </strong>This study seeks to assess the prevalence of hearing difficulties and hearing healthcare system utilization among English-speaking migrants living in Thailand.</p><p><strong>Design, setting, and participants: </strong>A cross-sectional survey was digitally distributed to online forums and communities for English-speaking migrants living in Thailand. Ninety participants were included in the study.</p><p><strong>Results: </strong>Seventy-seven percent of men and 75.8% of women reported at least some hearing difficulty. People who reported hearing loss were more likely to be white, and people who reported greater social disruption due to hearing difficulty were more likely to be younger or transgender. Though people with more hearing loss had received hearing testing more recently than peers with less hearing loss, very few participants treated their hearing loss with hearing aids and no participants received their hearing healthcare services in Thailand.</p><p><strong>Conclusion and relevance: </strong>This study shows that English speaking migrants living in Thailand may have hearing difficulty and low rates of hearing healthcare utilization. These results highlight the need for additional research to understand the hearing healthcare needs of this population.</p>","PeriodicalId":55432,"journal":{"name":"Audiology and Neuro-Otology","volume":" ","pages":"1-11"},"PeriodicalIF":1.6,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Migraine Abortive Drugs on Benign Paroxysmal Positional Vertigo Odds: A Database Analysis.","authors":"Marwin Li, Claire Ceriani, Hongyan Li","doi":"10.1159/000545977","DOIUrl":"10.1159/000545977","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with migraine may be more susceptible to benign paroxysmal positional vertigo (BPPV) than the general population. Although the underlying pathophysiology remains uncertain, it has been postulated that recurrent vasospasms associated with migraine attacks may cause inner ear ischemia and changes in endolymph pressure. Currently, there are no specific recommendations for preventing BPPV in this vulnerable patient population. Among commonly used migraine abortive drugs, triptans, which are selective serotonin agonists, are known to be vasoconstrictive, whereas calcitonin gene-related peptide (CGRP) antagonists are not. This population-based study uses a federated electronic medical record (EMR) database to characterize the prevalence of BPPV among migraine patients and its relevance to their choice of abortive drug.</p><p><strong>Methods: </strong>In this case-control study, EMR data from the TriNetX US Collaborative Network were queried for subjects who were seen at a participating healthcare organization for a vestibular disorder (ICD10: H81) between 2019 and 2024. Subjects must also have a concomitant, pre-existing diagnosis of migraine (G43). These patients were stratified by age (18-44, 45-64, 65+ years) and sex. The resulting cohorts were then divided into those with and without a BPPV diagnosis (H81.1). Patients with prior documented head trauma (S02, S06, S09), middle or inner ear surgery, or vitamin D deficiency (E55) were excluded. The prevalence of pre-existing triptan and CGRP antagonist use of each BPPV cohort was compared against the non-BPPV cohort of the same age and sex using χ2 analysis.</p><p><strong>Results: </strong>As expected, the female subject population had significantly higher prevalence of migraine (17.06% vs. 7.26%, p < 0.0001) than the males. Among migraine patients of all ages and sexes, triptan use was significantly more common among BPPV patients than non-BPPV patients (30.90% vs. 25.35%, p < 0.0001). Conversely, CGRP antagonists were more commonly used by non-BPPV patients than by BPPV patients (3.17% vs. 2.45%, p = 0.0005).</p><p><strong>Conclusion: </strong>This study shows that, among patients with vestibular disorders, migraine patients with BPPV are more often exposed to triptans, and less to CGRP antagonists, than those without BPPV. Triptans may increase the prevalence of BPPV by potentiating vasoconstriction during migraine attacks, which may result in inner ear ischemia and alterations of endolymphatic pressure, while CGRP antagonists do not. Therefore, CGRP antagonists may be preferable over triptans for preventing BPPV in migraine patients.</p>","PeriodicalId":55432,"journal":{"name":"Audiology and Neuro-Otology","volume":" ","pages":"1-8"},"PeriodicalIF":1.6,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}