[Genesis of vestibulo-autonomic disorders under weightless conditions].
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The ototoxicity of cisplatin and a comparison of the ototoxicity between cisplatin and kanamycin had been studied by morphological and biochemical methods. The results showed that the ototoxic effects of both drugs were similar, mainly affecting the cochlea, and next the vestibule. Lesions developed from the periphery to the center. The stria vascularis, the spiral ligament and the secretory epithelium of the vestibule were slightly injured by cis-platin. The K+ and Na+ concentrations of cochlear perilymph changed after the administration of both drugs. The ototoxicity of cis-platin appeared to be accumulated. So, while using cisplatin clinically, we stress the need for careful monitoring of the cochlear and vestibular functions.
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In 258 patients, neurological symptoms of otogenic leptomeningitis and diagnostic importance of the meningeal symptom-complex in the clinical development of other intracranial complications and sepsis were investigated. Otogenic leptomeningitis was characterized by the meningeal syndrome, rigidity of occipital muscles combined with Brudzinski's sign and Kernig's sign, albumin-cytologic dissociation in the cerebrospinal fluid, and, frequently, unilateral lesion of cranial nerves. Meningeal symptoms in the case of cerebrum and cerebellum abscesses did not always indicate leptomeningitis. Kernig's sign and its combination with occipital muscle rigidity can be an indication of cerebrum abscesses. With leptomeningitis and cerebrum abscesses, the rigidity of occipital muscles rarely occurs as a separate symptom, which emphasizes its importance in the topical diagnosis of subtentorial abscesses.
Clinical aspects of sudden deafness and sudden vestibular loss. The cases of sudden deafness and/or sudden vestibular loss are 90% idiopathic. Initially they can be overlooked but they can be responsible for an important sensorial impairment. In 65% of cases, and within the first two weeks, there may be a relevant or complete recovery or functional compensation. Etiology and pathogenesis are considered to be pluri-factorial; multiple virus infection including the Herpesvirus family, is the most relevant and better documented cause. Such an infection is responsible for a derangement of inner ear microcirculation, ions imbalance at labyrinthine fluids level, reduction of receptors and nervous supply function. Therapy is essentially symptomatic and therefore the most widely used drugs are cortisonics and heparin. In the Author's opinion also dextran 40, by slow endovenous drip, and carbogen (O2 95% + CO2 5%), by inhalations, are very effective with only rare contraindications. The occurrence of an important number of spontaneous improvements or even recoveries does not authorize therapeutic abstension especially in severe or delayed cases.
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