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Otosclerosis and vestibular dysfunction.

Vestibular dysfunction associated with otosclerosis has been observed for many years. In a recent clinical study of patients exhibiting progressive sensorineural hearing loss of unknown origin, it was demonstrated that approximately 50% of the cases had cochlear otosclerosis/otospongiosis as the most probable cause for the hypacusis. Of these, approximatley 55% had vestibular symptoms. In the present study, the effect of sodium fluoride therapy in this group of patients is analyzed. It will be demonstrated that such therapy is beneficial not only in controlling the progressive sensorineural hearing loss but also the symptoms of vestibular dysfunction in patients with cochlear otosclerosis (otospongiosis).

Adult↗

Sound localization. Part II: a clinical procedure.

Difficulty in localizing sound has been shown to be associated with severe unilateral hearing impairment, middle-ear conditions and lesions of the cerebello-pontine angle. This was in contrast to the performance of subjects with cochlear lesions and certain brain conditions who had mainly normal ability to localize sound. The investigation appeared to indicate that a sound localization test in the horizontal plane using low frequency stimuli may be a useful addition to the test battery employed in the differential diagnosis of cochlear and retrocochlear lesions involving the cerebello-pontine angle.

Adolescent↗

Cisplatin vestibular ototoxicity: preliminary report.

Sixteen patients were monitored for vestibular ototoxicity while receiving cisplatin in dosages of 180 mg/M2. The incidence of preexisting vestibular functional abnormalities (31%) was higher than the incidence of ototoxicity (18%). Although the number of patients was not large enough for meaningful statistical comparison, the incidence of vestibular ototoxicity from cisplatin was low for the dosage levels employed. Based upon the results of this study, the following recommendations are made for monitoring cisplatin vestibular ototoxicity. 1. All patients should receive vestibular tests prior to cisplatin administration. 2. Subjects, who have reduced (or asymmetric) vestibular function upon pretherapy testing, should be monitored at least weekly for any change in function while receiving cisplatin. 3. Subjects who are normal prior to therapy need to be tested only when cumulative doses exceed 400 mg. The severe nausea and vomiting associated with cisplatin chemotherapy is not related to vestibular ototoxicity.

Adult↗

[Diagnostic value of the second phase nystagmus].

The aim of our work was the presence of the second phase nystagmus after rotatory, caloric and optokinetic irritation; estimation of this nystagmus magnitude and the clinical application of the second phase nystagmus. The investigation was performed in 30 healthy subjects and 65 cases of the peripheral and central vestibular pathology. Our results show that the second phase nystagmus appears more often after strong vestibular or visual irritation; the largeness of this reaction is bigger than the first reaction nystagmus. Only the asymmetry of the second phase nystagmus has the clinical apply. Labyrinthine disorders has the influence on the formation of the post-optokinetic reaction.

Adult↗

Hearing disorders after Haemophilus influenzae meningitis. Comparison of different drug regimens.

Of 131 children with bacteriologically verified Haemophilus influenzae meningitis, 75 were treated with ampicillin sodium and 45 with a combination of chloramphenicol, sulfonamides, and penicillin G sodium during the first 72 hours. Audiological and neuro-otologic examinations performed 1 to 15 years later showed that 3 patients were totally deaf, 11 had moderate and 15 minimal hearing losses, and 6 had vestibular disorders. All three deaf children and all those with recognized vestibular disorders had been treated with ampicillin. The severe sequelae, both otologic and nonotologic, tended to occur in children of the lower social groups. There were 15 ears with moderate hearing loss; the lesion was cochlear in nine and retrocochlea in four; it could not be localized in two. Ampicillin was given in relatively low dosage, but the results strongly support the value of chloramphenicol of "triple therapy" as weapons against H influenzae meningitis.

Ampicillin↗

Progress in otology.

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Audiometry↗

[Neuropharmacology of the autonomic vestibular syndrome].

It was found during studies on man and experiments on animals that various neuromediator systems of the organism (M-cholinergic, H1-histaminergic, dopaminergic, and opioidergic) are involved in the genesis of VVS. In addition, animal experiments showed that of great importance in the process are different regulatory peptides, in particular, substance P and beta-endorphin. The findings indicate that some neuropeptides may be used in the future in man for VVS prevention. At neuronal level the role of opioid peptides in realization of vestibulovegetative reactions is decoded and a number of possible mechanisms of their action is established. The study of the human hormonal status in VVS revealed complex neuroendocrine changes occurring in the organism. Based on the knowledge of some neurohormonal and neurochemical mechanisms of VVS pathogenesis, a new drug prevention and therapy of seasickness was proposed, efficacy of opioid antagonists naloxone and nalorphine was shown.

Adult↗

Autoimmune vestibular dysfunction: preliminary report.

Since 1981, 28 patients have been diagnosed with autoimmune inner ear disease. This preliminary, retrospective study reviews clinical and laboratory manifestations of autoimmune vestibular dysfunction. Sixteen of 28 patients presented with dizziness (7 vertigo, 8 lightheadedness, 1 ataxia). Twelve of these patients presented with Meniere's syndrome. Seven of 16 dizzy patients underwent formal vestibular testing. Five had reduced vestibular response in the involved ear(s); one patient had positional nystagmus only; and one had normal results. Of 17 patients with adequate follow-up, 11 presented with dizziness. Hearing improved and dizziness resolved in two patients following treatment. Hearing stabilized and dizziness resolved in two. Hearing stabilized but lightheadedness (without vertigo) persisted in five. Hearing was lost and oscillopsia resulted in two patients. Preliminary conclusions are vestibular dysfunction in autoimmune inner ear disease is nonspecific; bilateral vestibular dysfunction is more common; Meniere's syndrome is relatively common; medical management usually is helpful; surgery at this time does not seem appropriate; vestibular treatment results tend to parallel auditory treatment results.

Adolescent↗