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At least 379 records · Page 21Linked to original sources

[Clinical characteristics and diagnostic criteria of the onset of multiple sclerosis].

The study of initial symptoms of disseminated sclerosis in 250 patients showed the disease to manifest mostly by one, less frequently by two or more symptoms. The following symptoms occurred earlier and more frequently than others: locomotor disorders (transient mono- or parapareses); limited paresthesias, hypesthesias and pains; retrobulbar neuritis, transient pareses of ocular muscles; while vestibular, cerebellar and vesicular disorders were encountered less frequently. A definite correlation between the type of onset (mono- or polysymptomatic) and a further clinical course was established. The following criteria are offered for the first attack diagnosis; unsteadiness and reversibility of initial symptoms, frequent detection of clinical dissociations in the initial symptoms structure, spontaneous remissions of different duration between the first and recurrent attacks.

Cerebellar Diseases↗

[Approach to cochleovestibular tolerability of aminoglycosides in man. Demonstration of a methodology apropos of a controlled comparative trial of dibekacin versus gentamicin].

A controlled trial comparing the effects of dibekacin and gentamicin in 30 patients has enabled us to standardise the most commonly used vestibulocochlear tests. None of the patients treated with dibekacin showed any auditory disturbance. The only abnormality detected was on vocal audiometry in 7 patients treated with gentamicin. Could vocal audiometry be the first paraclinical test capable of detecting aminoglycoside ototoxicity?

Clinical Trials as Topic↗

[Evaluation of cochlear and vestibular functions of patients treated by dibekacin in an E.N.T. unit].

Cochlear and vestibular ototoxicity of dibekacin was evaluated in 27 patients treated with aminoglycoside after surgery on head and neck cancer. The treatment was administered intramuscularly or intravenously during 13 days at the schedule of 3 mg/kg per day. Cochlear and vestibular functions were tested by audiometry and electronystagmography before the administration of the antibiotic and on the 14th, 30th day, and for certain patients on the 4th month after the start of the treatment. No cochlear ototoxicity was found after the dibekacin treatment. On the other hand, the dibekacin treatment produced minor abnormalities of ENG (irritative pattern).

Adult↗

The evaluation of dizziness in children.

A child with symptoms that relate to the balance mechanism can be a complex diagnostic problem. Often an adequate history is difficult to obtain because of the child's age and limitation of expression. Psychosomatic illness can frequently present as dizziness in children; however, this should not preclude a thorough evaluation. It is the purpose of this paper to outline these possibilities and the characteristics unique to each. The differential diagnosis can be grouped into central (central nervous system) and peripheral (otologic) categories, with a few miscellaneous conditions. A basic evaluation should include a complete neurotologic examination, audiogram and electronystagmogram. An electroencephalogram is frequently a valuable diagnostic adjunct. Further testing should be decided on the basis of the patient's history, examination and prior results. The records of children admitted to Boston City Hospital over a one-year period were reviewed. Of 2,088 pediatric patients, 238 had discharge diagnoses pertinent to the balance mechanism. Of these, 14 had a presenting symptom of dizziness. These cases are analyzed.

Central Nervous System Diseases↗

[Paralayrinthine cholesteatoma and tympanoplasty (author's transl)].

Closed tympanoplasty techniques greatly increase the risk of recurrent cholesteatoma. This is obvious as many surgeons using these methods insist on a necessary obligatory control operation as a "second look". In this paper cholesteatomata are classified according to their tendency to extend within the petrous pyramid and the subsequent danger of invading semicircular canals, cochlea or cranial fossae. The predisposition to this type of growth is present in the well defined "medial" type of epitympanic cholesteatoma, and more in the anteriorly than the posteriorly placed ones. As infection becomes less prominent in countries with advanced medical services, especially otology, the cholesteatoma hidden behind a small dry epitympanic perforation and those even with no perforation termed "hidden primary cholesteatoma" become more frequent. They cause their own special symptomatology, not infrequently a slowly progressive facial palsy. Every cholesteatoma requires mandatory prophylactic surgery. This means the complete exposure of the danger area, the epitympanum, and nowadays the possibility of the syncronous complete reconstruction of a normal middle ear and external canal, i.e. osteoplastic epitympanotomy.

Cholesteatoma↗

Clinical diagnoses associated with histologic findings of fibrotic tissue and new bone in the inner ear.

Fibrotic tissue or new bone occurs following inner ear inflammation, fracture, or surgery. The prevalence is unknown and was investigated using the National Temporal Bone, Hearing and Balance Pathology Resource Registry database. A search yielded 264 temporal bones with diagnoses of otosclerosis, tumor, Meniere's disease, meningitis, labyrinthitis, chronic otitis media, autoimmune disease, temporal bone fracture, or sensorineural hearing loss. All autoimmune cases contained some new bone, whereas only 20% to 30% of the labyrinthitis/meningitis cases were reported to contain new bone. Otosclerosis, Meniere's disease, and otitis media had relatively few cases containing new bone. Although new bone may derive from surgical trauma, it is also likely to be a result of the disease process. It seems that all these disease processes may contain a common feature that acts as a stimulus to induce fibrosis or bone growth in the inner ear.

Autoimmune Diseases↗