摘要:

Objective:To evaluate long-term hearing results and quality of life in patients with Meniere's disease.Study Design:Detailed audiometric evaluation and disease specific as well as global health quality evaluation of patients with Meniere's disease.Setting:Ambulatory evaluation was conducted in a large multispecialty clinic.Patients:Meniere's disease in only one ear, were at least 1 year posttreatment, were <65 years of age, had no neurologic or psychologic disorders, and lived within driving distance of the ambulatory clinic.Main Outcome Measures:Audiometry, the Hearing Handicap Inventory, Dizziness Handicap Inventory, Tinnitus Handicap Handicap Inventory, and SF-36 Health Survey.Results:No statistically significant differences in long-term hearing results were detected from natural history in medically or surgically treated patients with Meniere's disease. A significant disease-specific symptom handicap was detected. The global health handicap was greater for emotional disability than for physical disability.Conclusions:Medical and surgical treatment does not significantly influence hearing results in Meniere's disease. Patients with Meniere's disease have a greater emotional disability than a physical disability.

ISSN:0192-9763    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Hypothesis:We have theorized that surgical occlusion of all three semicircular canals (TCO) may be an effective means to treat vestibular pathology limited to semicircular canal dysfunction while preserving hearing and otolithic function.Background:A procedure that would eliminate vertigo while preserving hearing and minimizing postoperative dysequilibrium would be desirable.Methods:Staged bilateral TCO was performed on four cats and compared to staged bilateral labyrinthectomy in four cats. Balance and gait analysis were performed for 3 weeks after each surgical procedure—a total of 6 weeks of testing.Results:Balance testing, gait analysis, and righting reflex were found to be better among the cats undergoing TCO compared to labyrinthectomy.Conclusions:Compared to labyrinthectomy in the cat, TCO appears to have advantages for vestibular compensation after unilateral and contralateral surgery.

ISSN:0192-9763    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Background:Legislation for reporting unfit-to-drive patients by physicians varies dramatically among U.S. states and Canadian provinces. The impact of vestibular disease on driving safety is not well described in the literature.Objectives:(1) to learn more about the critical issues and current practices of neurotologists regarding reporting of vestibular patients and (2) to make recommendations for reporting patients with vestibular disorders.Study Design:A mailed census of members of the American Neurotology Society using a questionnaire based on a modified Dillman Total Design Survey Method.Results:Most respondents are aware of the potential safety risks of patients who drive with vestibular diseases, most notably those with Tumarkin's attacks. Although many have counselled patients (94%) and considered reporting vestibular patients (75%), few actually have (14%). There was no consensus of opinion on a method of reporting unfit-to-drive patients. Only 18.9% of respondents supported mandatory physician reporting. Respondents who live in states where reporting is not mandatory and who are aware of this fact are (a) more satisfied with their state's legislation (χ2=60,1, p=0.001) and (b) less likely to report patients who they consider unfitto- drive (χ2=10.6, p=0.03).Conclusions:In that there is no general consensus amongst respondents and the relative safety risks seem low in comparison to other disorders, at present we do not advocate mandatory reporting of patients with vestibular disorders.

ISSN:0192-9763    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Hypothesis:The saccule provides important input for the otolith spinal reflex during sudden falls in the cat.Background:Previous studies on cats have identified two distinct components of muscle activity in response to sudden falls: an early otolith-dependent component (OSR) and a later nonlabyrinthine component associated with landing. The presence of an otolith-dependent reflex suggests a discrete role of the otolith organs in the control of posture and locomotion.Methods:The influence of saccular input on the OSR during sudden falls was studied by simultaneous video and electromyographic (EMG) recordings obtained from saccular-deficient deaf white cats and white cats with normal hearing.Results:A total of 628 sudden falls from five cats (two normal, one unilaterally deaf and two bilaterally deaf) were studied. Normal cats had a total of 337 drops, 276 of which (82%) were acceptable; a unilaterally deaf cat had a total of 79 drops, 56 of which (71%) were acceptable; deaf cats had a total of 212 drops, 177 of which (83%) were acceptable. The earliest of five observed behavioral events was that of forelimb extension which had a mean latency of 98 ± 32 msec in normal cats and 139 ± 28 msec in deaf cats (p <0.0001). The mean latency of early EMG activity in normal cats was 19 ± 7 msec and in deaf cats was 30 ± 13 msec (p <0.0001). The unilaterally deaf cat exhibited behavior and early EMG responses that were similar to those of normal cats. Deaf cats displayed poor body control during landings that improved with experience.Conclusions:These data demonstrate that the saccule provides important input for the otolith spinal reflex in the cat, and cats that lack both saccules have discernible behavioral and EMG differences in response to sudden falls, when compared with normal cats.

ISSN:0192-9763    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Summary:Multiple sclerosis (MS) is a chronic, debilitating disease characterized by multiple areas of focal demyelination that develop throughout the white matter of the central nervous system at varying times. Most patients report disequilibrium at some point in the course of their disease. When balance disturbance occurs early in the course of the disease prior to diagnosis, the patient may present to the otolaryngologist for evaluation. Are there any patterns of balance dysfunction that might suggest the diagnosis to the evaluating physician? An evaluation often patients with known early MS suggests that platform posturography and ENG is the test most likely to provide useful diagnostic information in patients with early MS.

ISSN:0192-9763    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Summary:The objective of this study was to investigate the effects of endolymphatic sac obliteration for stabilization of progressive hearing loss in patients with the large vestibular aqueduct syndrome. This was a retrospective case review conducted at a private neurootologic office in a metropolitan area. Seven ears in six patients were subjected to surgery for obliteration of the endolymphatic sac in an effort to stabilize progressive hearing loss associated with the large vestibular aqueduct syndrome. The study population was composed of four boys and two girls 4—17 years of age. The large vestibular aqueduct was unilateral in two patients and bilateral in four patients. All seven ears demonstrated progressive sensorineural hearing loss preoperatively. Surgical tissue obliteration was performed via a transmastoid approach in seven ears. The main outcome measure was comparison of pre- and postoperative hearing levels and stability. Magnetic resonance imaging also was performed in all cases at least 6 months postoperatively to determine patency of the endolymphatic sac and vestibular aqueduct. Six of seven ears maintained stable hearing during the follow-up period, which ranged from 6 months to 6 years (mean 3.2 years). One patient showed continued progression of hearing loss postoperatively. All seven ears demonstrated continued obliteration on postoperative imaging studies. Surgical obliteration of the endolymphatic sac may stabilize hearing in patients with the large vestibular aqueduct syndrome and progressive hearing loss. These results support the theory of pressure or fluid reflux into the labyrinth as a cause of progressive hearing loss in these patients.

ISSN:0192-9763    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0192-9763    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0192-9763    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0192-9763    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0192-9763    

出版商:OVID    

年代:1997

数据来源: OVID