1
|
Casile M, Thivat E, Giraudet F, Ginzac A, Molnar I, Biau J, Brehant J, Lourenco B, Avan P, Durando X. Non-invasive intracranial pressure monitoring for high-grade gliomas patients treated with radiotherapy: results of the GMaPIC trial. Front Oncol 2024; 14:1302977. [PMID: 38919520 PMCID: PMC11196594 DOI: 10.3389/fonc.2024.1302977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 05/29/2024] [Indexed: 06/27/2024] Open
Abstract
Introduction Patients with high-grade gliomas are at risk of developing increased intracranial hypertension (ICHT) in relation to the increase in volume of their tumor. ICP change cannot be measured by invasive method but can be estimated by using routine clinical signs, in combination with a standard imaging method, magnetic resonance imaging (MRI). A non-invasive monitoring of ICP could be of interest in high-grade glioma, in particular after radiotherapy treatment with as major side effect a cerebral oedema. Patients and Methods This prospective clinical study aimed to compare the ICP changes (estimated by a non-invasive method based upon distortion product otoacoustic emissions (DPOAE) monitoring) with volume changes observed on MRI in patients with high-grade gliomas treated with radiotherapy. DPOAE measurements were performed one month after the end of radiotherapy and then every 3 months for one year. At each visit, the patient also underwent MRI as well as an evaluation of clinical signs. Results The variation in the estimate of intracranial pressure readout measured at each follow-up visit (in absolute value with respect to the baseline measurements) was significantly associated with the variation of T2/FLAIR volume (n=125; p<0.001) with a cut off value of change ICP readout of 40.2 degrees (e.i. an estimated change of 16 mm Hg). Discussion The GMaPIC trial confirm the hypothesis that the ICP change estimated by DPOAEs measurement using a non-invasive medical device is correlated with the change of the tumor or edema in high grade glioma after radiotherapy. The device could thus become an easy-to-use and non-invasive intracranial pressure monitoring tool for these patients. Clinical Trial Registration Clinicaltrials.gov, identifier (NCT02520492).
Collapse
Affiliation(s)
- Mélanie Casile
- INSERM U1240 IMoST, University of Clermont Auvergne, Clermont-Ferrand, France
- UMR 501, Clinical Investigation Centre, Clermont-Ferrand, France
- Clinical Research and Innovation Department, Centre Jean Perrin, Clermont-Ferrand, France
| | - Emilie Thivat
- INSERM U1240 IMoST, University of Clermont Auvergne, Clermont-Ferrand, France
- UMR 501, Clinical Investigation Centre, Clermont-Ferrand, France
- Clinical Research and Innovation Department, Centre Jean Perrin, Clermont-Ferrand, France
| | - Fabrice Giraudet
- INSERM 1107, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Angeline Ginzac
- INSERM U1240 IMoST, University of Clermont Auvergne, Clermont-Ferrand, France
- UMR 501, Clinical Investigation Centre, Clermont-Ferrand, France
- Clinical Research and Innovation Department, Centre Jean Perrin, Clermont-Ferrand, France
| | - Ioana Molnar
- INSERM U1240 IMoST, University of Clermont Auvergne, Clermont-Ferrand, France
- UMR 501, Clinical Investigation Centre, Clermont-Ferrand, France
- Clinical Research and Innovation Department, Centre Jean Perrin, Clermont-Ferrand, France
| | - Julian Biau
- Radiation Oncology Department, Centre Jean Perrin, Clermont-Ferrand, France
| | - Julien Brehant
- Radiology Department, Centre Jean Perrin, Clermont-Ferrand, France
| | - Blandine Lourenco
- INSERM 1107, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Paul Avan
- INSERM 1107, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Xavier Durando
- INSERM U1240 IMoST, University of Clermont Auvergne, Clermont-Ferrand, France
- UMR 501, Clinical Investigation Centre, Clermont-Ferrand, France
- Clinical Research and Innovation Department, Centre Jean Perrin, Clermont-Ferrand, France
- Oncology Department, Centre Jean Perrin, Clermont-Ferrand, France
| |
Collapse
|
2
|
Pascaud J, Redon S, Elzière M, Donnet A. Real-life study of the use of oto-acoustic emissions in the diagnosis of intracranial hypotension. Rev Neurol (Paris) 2024; 180:154-162. [PMID: 37827931 DOI: 10.1016/j.neurol.2023.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/07/2023] [Accepted: 07/18/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND The diagnosis of spontaneous or post-traumatic intracranial hypotension (IH) mainly relies on clinical features and neuro-imaging. However, the results of brain and spine magnetic resonance imaging are not always contributive. There is an interest for other non-invasive procedures, able to confirm or refute the diagnosis. The use of oto-acoustic emissions (OAE) was previously reported on isolated cases of IH associated with endolymphatic hydrops (ELH). The aim of this study was to assess the real-life utilization of this electrophysiological method in a larger population of suspected IH. METHODS A retro-prospective cohort study was conducted from November 2013 to July 2022 in patients with a suspected or doubtful diagnosis of IH. They were assessed for ELH by recording bilateral distortion product of oto-acoustic emissions (DPOAE) in sitting then in supine position. RESULTS Among the 32 patients assessed, the diagnostic of IH was confirmed in 18 patients. An ELH was shown in 15 of them (83%), but also in seven other patients. They had several differential diagnoses: chronic migraine, Chiari malformation, rebound intracranial hypertension and perilymph fistula. CONCLUSIONS This procedure seems to be insufficient to exclude differential diagnosis when intracranial hypotension is suspected.
Collapse
Affiliation(s)
- J Pascaud
- Department of Evaluation and Treatment of Pain, FHU INOVPAIN, CHU Timone, AP-HM, Marseille, France
| | - S Redon
- Department of Evaluation and Treatment of Pain, FHU INOVPAIN, CHU Timone, AP-HM, Marseille, France.
| | - M Elzière
- Vertigo Center, European Hospital, Marseille, France
| | - A Donnet
- Department of Evaluation and Treatment of Pain, FHU INOVPAIN, CHU Timone, AP-HM, Marseille, France; INSERM U-1107, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| |
Collapse
|
3
|
Tian C, Yang Y, Wang R, Li Y, Sun F, Chen J, Zha D. Norepinephrine protects against cochlear outer hair cell damage and noise-induced hearing loss via α 2A-adrenergic receptor. BMC Neurosci 2024; 25:5. [PMID: 38291397 PMCID: PMC10829207 DOI: 10.1186/s12868-024-00845-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 01/16/2024] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND The cochlear sympathetic system plays a key role in auditory function and susceptibility to noise-induced hearing loss (NIHL). The formation of reactive oxygen species (ROS) is a well-documented process in NIHL. In this study, we aimed at investigating the effects of a superior cervical ganglionectomy (SCGx) on NIHL in Sprague-Dawley rats. METHODS We explored the effects of unilateral and bilateral Superior Cervical Ganglion (SCG) ablation in the eight-ten weeks old Sprague-Dawley rats of both sexes on NIHL. Auditory function was evaluated by auditory brainstem response (ABR) testing and Distortion product otoacoustic emissions (DPOAEs). Outer hair cells (OHCs) counts and the expression of α2A-adrenergic receptor (AR) in the rat cochlea using immunofluorescence analysis. Cells culture and treatment, CCK-8 assay, Flow cytometry staining and analysis, and western blotting were to explore the mechanisms of SCG fibers may have a protective role in NIHL. RESULTS We found that neither bilateral nor unilateral SCGx protected the cochlea against noise exposure. In HEI-OC1 cells, H2O2-induced oxidative damage and cell death were inhibited by the application of norepinephrine (NE). NE may prevent ROS-induced oxidative stress in OHCs and NIHL through the α2A-AR. CONCLUSION These results demonstrated that sympathetic innervation mildly affected cochlear susceptibility to acoustic trauma by reducing oxidative damage in OHCs through the α2A-AR. NE may be a potential therapeutic strategy for NIHL prevention.
Collapse
Affiliation(s)
- Chaoyong Tian
- Department of Otolaryngology Head and Neck Surgery, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi, 710032, China
| | - Yang Yang
- Department of Otolaryngology Head and Neck Surgery, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi, 710032, China
| | - Renfeng Wang
- Department of Otolaryngology Head and Neck Surgery, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi, 710032, China
| | - Yao Li
- Department of Otolaryngology Head and Neck Surgery, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi, 710032, China
| | - Fei Sun
- Department of Otolaryngology Head and Neck Surgery, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi, 710032, China
| | - Jun Chen
- Department of Otolaryngology Head and Neck Surgery, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi, 710032, China
| | - Dingjun Zha
- Department of Otolaryngology Head and Neck Surgery, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi, 710032, China.
| |
Collapse
|
4
|
Inagaki K, Yoshida T, Kobayashi M, Sugimoto S, Fukunaga Y, Hara D, Naganawa S, Sone M. Impact of endolymphatic hydrops on DPOAE in subjects with normal to mild hearing loss. Laryngoscope Investig Otolaryngol 2023; 8:262-268. [PMID: 36846415 PMCID: PMC9948569 DOI: 10.1002/lio2.998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/22/2022] [Accepted: 12/04/2022] [Indexed: 12/27/2022] Open
Abstract
Objective The increased endolymph volume affects a shift in the organ of Corti and basilar membrane in ears with endolymphatic hydrops (EH), which might affect distortion-product otoacoustic emissions (DPOAE) by altering the operating point of the outer hair cells. We investigated how changes in DPOAE are related to the distribution site of EH. Study Design Prospective study. Methods Among 403 patients with hearing or vestibular symptoms who underwent contrast-enhanced magnetic resonance imaging (MRI) for the diagnosis of EH and subsequent DPOAE testing, subjects whose hearing levels on pure tone audiometry were ≤35 dB at all frequencies were included in this study. In patients with EH on MRI, the presence and amplitude of DPOAE were evaluated between groups with hearing levels of ≤25 dB at all frequencies versus hearing levels of >25 dB at one or more frequencies. Results There were no differences in the distribution of EH between groups. The amplitude of DPOAE had no clear correlation with the presence of EH. However, in both groups, there was a significantly higher probability of the presence of a DPOAE response from 1001 to 6006 Hz in cases with EH in the cochlea. Conclusion Among patients whose hearing levels were ≤35 dB at all frequencies, better responses on DPOAE testing were found in subjects with EH in the cochlea. Alteration of DPOAEs in the early stages of hearing impairment could indicate morphological changes in the inner ear with altered basilar membrane compliance due to EH. Level of Evidence 4.
Collapse
Affiliation(s)
- Kei Inagaki
- Department of OtorhinolaryngologyNagoya University Graduate School of MedicineNagoyaJapan
| | - Tadao Yoshida
- Department of OtorhinolaryngologyNagoya University Graduate School of MedicineNagoyaJapan
| | - Masumi Kobayashi
- Department of OtorhinolaryngologyNagoya University Graduate School of MedicineNagoyaJapan
| | - Satofumi Sugimoto
- Department of OtorhinolaryngologyNagoya University Graduate School of MedicineNagoyaJapan
| | - Yukari Fukunaga
- Department of RehabilitationNagoya University Graduate School of MedicineNagoyaJapan
| | - Daisuke Hara
- Department of RehabilitationNagoya University Graduate School of MedicineNagoyaJapan
| | - Shinji Naganawa
- Department of RadiologyNagoya University Graduate School of MedicineNagoyaJapan
| | - Michihiko Sone
- Department of OtorhinolaryngologyNagoya University Graduate School of MedicineNagoyaJapan
| |
Collapse
|
5
|
Wang X, Zhu M, He Y, Liu Z, Huang X, Pan H, Wang M, Chen S, Tao Y, Li G. Usefulness of phase gradients of otoacoustic emissions in auditory health screening: An exploration with swept tones. Front Neurosci 2022; 16:1018916. [PMID: 36325482 PMCID: PMC9619081 DOI: 10.3389/fnins.2022.1018916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 09/26/2022] [Indexed: 11/13/2022] Open
Abstract
Otoacoustic emissions (OAEs) are low-level sounds generated by the cochlea and widely used as a noninvasive tool to inspect cochlear impairments. However, only the amplitude information of OAE signals is used in current clinical tests, while the OAE phase containing important information about cochlear functions is commonly discarded, due to the insufficient frequency-resolution of existing OAE tests. In this study, swept tones with time-varying frequencies were used to measure stimulus frequency OAEs (SFOAEs) in human subjects, so that high-resolution phase spectra that are not available in existing OAE tests could be obtained and analyzed. The results showed that the phase of swept-tone SFOAEs demonstrated steep gradients as the frequency increased in human subjects with normal hearing. The steep phase gradients were sensitive to auditory functional abnormality caused by cochlear damage and stimulus artifacts introduced by system distortions. At low stimulus levels, the group delays derived from the phase gradients decreased from around 8.5 to 3 ms as the frequency increased from 1 to 10 kHz for subjects with normal hearing, and the pattern of group-delay versus frequency function showed significant difference for subjects with hearing loss. By using the swept-tone technology, the study suggests that the OAE phase gradients could provide highly sensitive information about the cochlear functions and therefore should be integrated into the conventional methods to improve the reliability of auditory health screening.
Collapse
Affiliation(s)
- Xin Wang
- CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen, China
- Guangdong-Hong Kong-Macao Joint Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Mingxing Zhu
- School of Electronics and Information Engineering, Harbin Institute of Technology, Shenzhen, China
| | - Yuchao He
- CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- Guangdong-Hong Kong-Macao Joint Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Zhenzhen Liu
- Surgery Division, Epilepsy Center, Shenzhen Children’s Hospital, Shenzhen, China
| | - Xin Huang
- Department of Otorhinolaryngology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Hongguang Pan
- Department of Otolaryngology, Shenzhen Children’s Hospital, Shenzhen, China
| | - Mingjiang Wang
- School of Electronics and Information Engineering, Harbin Institute of Technology, Shenzhen, China
| | - Shixiong Chen
- CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- Guangdong-Hong Kong-Macao Joint Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- *Correspondence: Shixiong Chen,
| | - Yuan Tao
- Department of Otorhinolaryngology, Peking University Shenzhen Hospital, Shenzhen, China
- Yuan Tao,
| | - Guanglin Li
- CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- Guangdong-Hong Kong-Macao Joint Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| |
Collapse
|
6
|
Abstract
Audiological tests in patients with Menière's disease reveal abnormal patterns relevant for diagnostic purposes with some success. Electrocochleography, otoacoustic emissions and immittance measurements share a moderate sensitivity but a good specificity. Their potential for monitoring the patients suggests means to understand the characteristic time course of Menière's disease and the pathophysiology behind its attacks. Besides, magnetic resonance imaging now allows direct evaluation of endolymphatic hydrops. One issue is now to understand the links between volume inflation of endolymphatic spaces, which sometimes remains asymptomatic, and the functional signs, in the hope that a better understanding of what triggers the attacks may guide future treatments. This article provides a short review of the possible biophysical significance of audiological tests of Menière's disease, and of the attempts to make sense of functional and imaging data and of the patterns they form when combined.
Collapse
Affiliation(s)
- Paul Avan
- Neurosensory Biophysics, INSERM, University Clermont Auvergne, Clermont-Ferrand, France.,Centre Jean Perrin, Clermont-Ferrand, France.,Institut de l'Audition, Centre Institut Pasteur, Paris, France
| | - Idir Djennaoui
- Neurosensory Biophysics, INSERM, University Clermont Auvergne, Clermont-Ferrand, France.,University Hospital, ENT Department, Strasbourg, France
| |
Collapse
|
7
|
Yücel E, Ardıç FN, Tümkaya F, Kara CO, Topuz B. Detecting Intralabyrinthine Pressure Increase by Postural Manipulation with Wideband Tympanometry and Distortion Product Otoacoustic Emissions. Turk Arch Otorhinolaryngol 2021; 58:203-207. [PMID: 33554193 DOI: 10.5152/tao.2020.5530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 09/15/2020] [Indexed: 01/21/2023] Open
Abstract
Objective Intracranial pressure increase is known to affect inner ear pressure through the cochlear and vestibular aqueducts. This finding forms a good model for inner ear pressure studies. Standard techniques used to detect this pressure increase are neither reliable nor easily repeatable or cheap. Studies with immitancemetry and otoacoustic emissions have been giving hopeful results. This study aims to confirm the results in the literature with wideband tympanometry and add a new parameter of otoacoustic emissions to inner ear pressure testing. Methods Wideband tympanometry (WBT) and distortion product otoacoustic emissions (DPOAE) tests were applied to 40 healthy participants in sitting, supine, and Trendelenburg positions. DPOAE were measured under ambient or peak pressure. Resonance frequency, tympanic peak pressure, 1000, 1500, 2000, 3000, 4000, and 6000 Hz frequencies in DPOAE were measured. Results The increase in the tympanic peak pressure and the decrease in resonance frequency (RF) due to position change were found statistically significant (p<0.01). Signal noise ratio (SNR) decrease at 1 kHz frequency and SNR increase at 2, 3, 6 kHz in the normal protocol, SNR decrease at 1 kHz in the pressurized protocol were found statistically significant (p<0.01). Conclusion RF in WBT and 1 kHz DPOAE SNR parameters were found useful in supporting the diagnosis in pathologies that increase intracranial pressure and inner ear pressure. Future research may ease their widespread use in clinical practice as they are non-invasive and rapidly applicable.
Collapse
Affiliation(s)
- Emrah Yücel
- Department of Otolaryngology, Pamukkale University School of Medicine, Denizli, Turkey
| | - Fazıl Necdet Ardıç
- Department of Otolaryngology, Pamukkale University School of Medicine, Denizli, Turkey
| | - Funda Tümkaya
- Department of Otolaryngology, Pamukkale University School of Medicine, Denizli, Turkey
| | - Cüneyt Orhan Kara
- Department of Otolaryngology, Pamukkale University School of Medicine, Denizli, Turkey
| | - Bülent Topuz
- Department of Otolaryngology, Pamukkale University School of Medicine, Denizli, Turkey
| |
Collapse
|
8
|
Thai-Van H, Bakhos D, Bouccara D, Loundon N, Marx M, Mom T, Mosnier I, Roman S, Villerabel C, Vincent C, Venail F. Telemedicine in Audiology. Best practice recommendations from the French Society of Audiology (SFA) and the French Society of Otorhinolaryngology-Head and Neck Surgery (SFORL). Eur Ann Otorhinolaryngol Head Neck Dis 2020; 138:363-375. [PMID: 33097467 PMCID: PMC7575454 DOI: 10.1016/j.anorl.2020.10.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Objectives Access to diagnosis and treatments for auditory disorders and related pathologies has regressed in France during the COVID-19 pandemic, posing a risk to the patient's chance of recovery. This best practice recommendations guide aims to list the existing technological solutions for the remote examination of a patient with hearing complaint, and to outline their benefits and, where applicable, their limitations. Methods The recommendations were developed both from the clinical experience of the medical experts who drafted the guide, and from an extensive review of the literature dealing with clinical practice recommendations for tele-audiology. Tele-audiometry solutions were identified on the basis of a search engine query carried out in April 2020, prior to verification of their availability on the European market. Results Video otoscopy solutions allow for the teletransmission of images compatible with a high-quality diagnosis, either by connecting via internet to a tele-health platform or using a smartphone or a tablet with an iOS or Android operating system. Using the same telecommunication methods, it is possible to remotely conduct a pure-tone audiometry test in accordance with standard practice, a speech-in-quiet or a speech-in-noise audiometry test, as well as objective measures of hearing. Clinical and paraclinical examinations can be accessed by the physician to be interpreted on a deferred basis (asynchronous tele-audiology). Examinations can also be conducted in real time in a patient, at any age of life, as long as a caregiver can be present during the installation of the transducers or the acoumetry. Tele-audiology solutions also find application in the remote training of future healthcare professionals involved in the management of deafness and hearing impairment. Conclusion Under French law, tele-otoscopy is a medical procedure that is either a tele-expertise (asynchronous adive) or a teleconsultation act (synchronous advice). Subjective and objective evaluation of the patient's hearing functions can be done remotely provided that the listed precautions are respected.
Collapse
Affiliation(s)
- H Thai-Van
- Department of Audiology and Otoneurological Evaluation, Edouard-Herriot Hospital, HCL (hospices civils de Lyon), 69003 Lyon, France; Claude-Bernard University Lyon 1, 69100 Villeurbanne, France; Inserm (French National Institute of Health and Medical Research) U1120, Hearing Institute-Paris, Research Centre of Institut Pasteur, 75012 Paris, France.
| | - D Bakhos
- Faculty of Medicine, University of Tours, 10, boulevard Tonnellé, 37000 Tours, France; Inserm U1253, ibrain, 37044 Tours, France
| | - D Bouccara
- Department of ENT and Head & Neck Oncology, Georges-Pompidou European Hospital, Paris Ouest University Hospitals, AP-HP, 75015 Paris, France; SOFRESC (French Society of Sensory and Cognitive Research), 92130 Issy-les-Moulineaux, France
| | - N Loundon
- Department of ENT & Maxillofacial Surgery, Necker Children's University Hospital, 75015 Paris, France; Inserm U587, Genetics of Deafness Unit, IMAGINE, 75015 Paris, France
| | - M Marx
- Department of Otology, Otoneurology, and Paediatric Otorhinolaryngology, Pierre-Paul-Riquet Hospital, Toulouse Purpan University Hospital, 31000 Toulouse, France; Brain and Cognition Laboratory, UMR 5549, Toulouse III University, 31000 Toulouse, France
| | - T Mom
- Department of Otorhinolaryngology and Head & Neck Surgery, Gabriel-Montpied University Hospital, 63000 Clermont-Ferrand, France; Inserm UMR 1107, Sensorineural Biophysics Laboratory, Clermont-Auvergne University, 63000 Clermont-Ferrand, France
| | - I Mosnier
- Functional unit for auditory implants and audiovestibular testing, Department of Otorhinolaryngology, île de France reference centre for cochlear and brainstem implants in adults, Pitié-Salpêtrière Hospital Group, Sorbonne University, AP-HP, 75013 Paris, France
| | - S Roman
- Department of ENT, Timone Children's Hospital, AP-HM (Assistance publique-Hôpitaux de Marseille), 13385 Marseille cedex 5, France; La Timone Faculty of Medicine, UMR 1106, The institut de neurosciences des systèmes, 13005 Marseille, France
| | - C Villerabel
- Department of ENT & Maxillofacial Surgery, Gui-de-Chauliac University Hospital, 34000 Montpellier, France; Inserm U1051, Institute for Neurosciences of Montpellier, University of Montpellier, 34000 Montpellier, France
| | - C Vincent
- Department of Otology and Otoneurology, Salengro Hospital, University of Lille, 59000 Lille, France
| | - F Venail
- Department of ENT & Maxillofacial Surgery, Gui-de-Chauliac University Hospital, 34000 Montpellier, France; Inserm U1051, Institute for Neurosciences of Montpellier, University of Montpellier, 34000 Montpellier, France
| |
Collapse
|
9
|
Loiselle AR, de Kleine E, van Dijk P, Jansonius NM. Intraocular and intracranial pressure in glaucoma patients taking acetazolamide. PLoS One 2020; 15:e0234690. [PMID: 32555666 PMCID: PMC7302490 DOI: 10.1371/journal.pone.0234690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 05/30/2020] [Indexed: 11/18/2022] Open
Abstract
The alternative mechanical theory of glaucoma, in which an increased pressure difference across the lamina cribrosa (difference between intraocular and intracranial pressure; IOP and ICP), rather than solely an elevated IOP, leads to structural and functional vision loss, is still controversial. If the theory is true, a drug that simultaneously lowers both the IOP and ICP may be ineffective. The aim of this study was to determine how acetazolamide (AAZ; a drug prescribed in glaucoma that aims to lower the IOP) affects both IOP and ICP in glaucoma patients and to compare the magnitude and time course of the induced pressure changes with those of healthy subjects not taking AAZ. IOP and noninvasive ICP (measured through emissions from the ear) were measured in 20 glaucoma patients taking 125 mg of AAZ twice daily. Measurements were taken for 30 minutes before taking the drug and for 2 hours post-ingestion. Comparisons were made with 13 age-similar controls. After 12 hours with no anti-glaucoma medication, AAZ did not further reduce IOP in glaucoma patients compared to controls (P = 0.58) but did reduce ICP compared to controls (P = 0.035), by approximately 4 mmHg. Our findings suggest that there are periods during the day when the pressure difference across the lamina cribrosa is larger in case of AAZ use. Future studies should focus on improving the noninvasive ICP testing, different doses and dosing schedules of AAZ, and the time course of IOP in glaucoma patients not taking AAZ.
Collapse
Affiliation(s)
- Allison R. Loiselle
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Emile de Kleine
- Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Pim van Dijk
- Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Nomdo M. Jansonius
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- * E-mail:
| |
Collapse
|
10
|
Abstract
OBJECTIVE In this review the authors discuss evidence from the literature concerning vitamin D and temporal bone diseases (benign paroxysmal positional vertigo [BPPV], Menière's disease [MD], vestibular neuritis, idiopathic facial paralysis, idiopathic acute hearing loss). Common features shared by Menière's disease, glaucoma, and the possible influence by vitamin D are briefly discussed. DATA SOURCES, STUDY SELECTION Publications from 1970 until recent times have been reviewed according to a keyword search (see above) in PubMed. CONCLUSIONS MD, BPPV, vestibular neuritis, idiopathic facial paralysis, idiopathic acute hearing loss may all have several etiological factors, but a common feature of the current theories is that an initial viral infection and a subsequent autoimmune/autoinflammatory reaction might be involved. Additionally, in some of these entities varying degrees of demyelination have been documented. Given the immunomodulatory effect of vitamin D, we postulate that it may play a role in suppressing an eventual postviral autoimmune reaction. This beneficial effect may be enhanced by the antioxidative activity of vitamin D and its potential in stabilizing endothelial cells. The association of vitamin D deficiency with demyelination has already been established in other entities such as multiple sclerosis and experimental autoimmune encephalitis. Mice without vitamin D receptor show degenerative features in inner ear ganglia, hair cells, as well as otoconia. The authors suggest further studies concerning the role of vitamin D deficiency in diseases of the temporal bone. Additionally, the possible presence and degree of demyelination in these entities will have to be elucidated more systematically in the future.
Collapse
|
11
|
Redon S, Elzière M, Kaphan E, Donnet A. Contribution of Otoacoustic Emissions for Diagnosis of Atypical or Recurrent Intracranial Hypotension. A Cases Series. Headache 2019; 59:1374-1378. [DOI: 10.1111/head.13621] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2019] [Indexed: 01/03/2023]
Affiliation(s)
- Sylvain Redon
- Department of Evaluation and Treatment of Pain FHU INOVPAIN, CHU Timone, AP‐HM Marseille France
| | - Maya Elzière
- Centre des vertiges Hôpital Européen Marseille France
| | - Elsa Kaphan
- Pôle de Neurosciences Cliniques CHU Timone, AP‐HM Marseille France
| | - Anne Donnet
- Department of Evaluation and Treatment of Pain FHU INOVPAIN, CHU Timone, AP‐HM Marseille France
- INSERM U‐1107 CHU de Clermont‐Ferrand Clermont‐Ferrand France
| |
Collapse
|
12
|
Relationship Between Audio-Vestibular Functional Tests and Inner Ear MRI in Meniere's Disease. Ear Hear 2019; 40:168-176. [PMID: 29698363 DOI: 10.1097/aud.0000000000000584] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Meniere's disease is an inner ear disorder generally attributed to an endolymphatic hydrops. Different electrophysiological tests and imaging techniques have been developed to improve endolymphatic hydrops diagnosis. The goal of our study was to compare the sensitivity and the specificity of delayed inner ear magnetic resonance imaging (MRI) after intravenous injection of gadolinium with extratympanic clicks electrocochleography (EcochG), phase shift of distortion product otoacoustic emissions (shift-DPOAEs), and cervical vestibular-evoked myogenic potentials (cVEMP) for the diagnosis of Meniere's disease. DESIGN Forty-one patients, with a total of 50 affected ears, were included prospectively from April 2015 to April 2016 in our institution. Patients included had definite or possible Meniere's disease based on the latest American Academy of Otolaryngology-Head and Neck Surgery guidelines revised in 2015. All patients went through delayed inner ear MRI after intravenous injection of gadolinium (three dimension-fluid attenuated inversion recovery sequences), pure-tone audiometry, extratympanic clicks EcochG, shift-DPOAEs, and cVEMP on the same day. Endolymphatic hydrops was graded on MRI using the saccule to utricle ratio inversion defined as when the saccule appeared equal or larger than the utricle. RESULTS Abnormal EcochG and shift-DPOAEs in patients with definite Meniere's disease (DMD) were found in 68 and 64.5%, respectively. The two methods were significantly associated in DMD group. In DMD group, 25.7% had a positive MRI. The correlation between MRI versus EcochG and MRI versus shift-DPOAEs was not significant. MRI hydrops detection was correlated with hearing loss. Finally, 22.9% of DMD group had positive cVEMP. CONCLUSIONS EcochG and shift-DPOAEs were both well correlated with clinical criteria of Meniere's disease. Inner ear MRI showed hydrops when hearing loss was higher than 35 dB. The shift-DPOAEs presented the advantage of a rapid and easy measurement if DPOAEs could be recorded (i.e., hearing threshold <60dB). In contrast, EcochG can be performed regardless of hearing loss. In combination with shift-DPOAEs, it enhances the chances to confirm the diagnosis with a better confidence.
Collapse
|
13
|
Loiselle AR, de Kleine E, van Dijk P, Jansonius NM. Noninvasive intracranial pressure assessment using otoacoustic emissions: An application in glaucoma. PLoS One 2018; 13:e0204939. [PMID: 30273407 PMCID: PMC6166960 DOI: 10.1371/journal.pone.0204939] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 09/16/2018] [Indexed: 01/01/2023] Open
Abstract
The theory that glaucoma patients have a lower intracranial pressure (ICP) than healthy subjects is a controversial one. The aim of this study was to assess ICP noninvasively by determining the relationship between distortion product otoacoustic emission (DPOAE) phase and body position and to compare this relationship between patients with primary open angle glaucoma (POAG), patients with normal tension glaucoma (NTG), and controls. The relationship was also calibrated using published data regarding invasive measurements of ICP versus body position. DPOAEs were measured in 30 controls and 32 glaucoma patients (17 POAG, 15 NTG) at the following body positions (assuming 90° as upright): 45, 30, 20, 10, 0 (supine), -10, and -20°. DPOAE phase had a clear, nonlinear relationship with body position. The mean DPOAE phase shifts between the two most extreme body positions (45 to -20°) were 73.6, 80.7, and 66.3° for healthy, POAG, and NTG, respectively (P = 0.73), and the groups showed the same, nonlinear behaviour. This indicates that there is no evidence that glaucoma patients have a reduced ICP. When calibrated with invasive data, ICP and DPOAE phase were linearly related over an ICP of 3 mmHg. This suggests that, more broadly, DPOAEs could be used in the future to monitor changes in ICP in a clinical setting and to measure dynamic changes in ICP such as diurnal fluctuations or changes induced by certain medications.
Collapse
Affiliation(s)
- Allison R. Loiselle
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Graduate School of Medical Sciences (Research School of Behavioural and Cognitive Neurosciences), University of Groningen, Groningen, The Netherlands
| | - Emile de Kleine
- Graduate School of Medical Sciences (Research School of Behavioural and Cognitive Neurosciences), University of Groningen, Groningen, The Netherlands
- Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Pim van Dijk
- Graduate School of Medical Sciences (Research School of Behavioural and Cognitive Neurosciences), University of Groningen, Groningen, The Netherlands
- Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Nomdo M. Jansonius
- Department of Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Graduate School of Medical Sciences (Research School of Behavioural and Cognitive Neurosciences), University of Groningen, Groningen, The Netherlands
- * E-mail:
| |
Collapse
|
14
|
A Comparison of Distortion Product Otoacoustic Emission Properties in Ménière’s Disease Patients and Normal-Hearing Participants. Ear Hear 2018; 39:42-47. [DOI: 10.1097/aud.0000000000000461] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
15
|
Ciorba A, Skarżyński PH, Corazzi V, Bianchini C, Aimoni C, Hatzopoulos S. Assessment Tools for Use in Patients with Ménière Disease: An Update. Med Sci Monit 2017; 23:6144-6149. [PMID: 29282350 PMCID: PMC5753749 DOI: 10.12659/msm.905166] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 06/06/2017] [Indexed: 11/28/2022] Open
Abstract
A number of electrophysiological tests have been proposed for the initial diagnostic assessment or for the follow-up phase of patients affected by Ménière disease. The most common are: (i) vestibular evoked myogenic potentials (VEMPs); (ii) electrocochleography (ECochG); and (iii) otoacoustic emissions (OAEs). This paper presents the latest clinical developments with these 3 testing modalities. The PubMed, Embase, and Cinahl databases were searched from 2006 to December 2016. Full-text articles were obtained in cases where the title, abstract, or key words suggested that the study may be eligible for this review. The medical subject heading (MeSH) terms included the following: Ménière, hearing threshold, vestibule, otoacoustic emissions, inner ear, ECochG, VEMPs. There were 368 identified papers, out of which 87 were eligible for inclusion. Overall the data in the literature are still limited and the recommended procedures have not reached an international consensus. From the available data, one can conclude that none of the electrophysiological tests could be considered as pathognomonic, for the diagnosis of Ménière disease: presently, the tests could be mostly used in a supportive role to the clinical diagnosis. Hopefully, in the future, improved technology in electrophysiological testing could contribute to the development of better strategies for the diagnosis of Ménière disease.
Collapse
Affiliation(s)
- Andrea Ciorba
- Clinic of Audiology and ENT, University of Ferrara, Ferrara, Italy
| | - Piotr Henryk Skarżyński
- World Hearing Center, Warsaw, Poland
- Department of Heart Failure and Cardiac Rehabilitation, Medical University of Warsaw, Warsaw, Poland
- Institute of Sensory Organs, Kajetany, Poland
| | - Virginia Corazzi
- Clinic of Audiology and ENT, University of Ferrara, Ferrara, Italy
| | - Chiara Bianchini
- Clinic of Audiology and ENT, University of Ferrara, Ferrara, Italy
| | - Claudia Aimoni
- Clinic of Audiology and ENT, University of Ferrara, Ferrara, Italy
| | | |
Collapse
|
16
|
Bakhos D, Marx M, Villeneuve A, Lescanne E, Kim S, Robier A. Electrophysiological exploration of hearing. Eur Ann Otorhinolaryngol Head Neck Dis 2017; 134:325-331. [PMID: 28330595 DOI: 10.1016/j.anorl.2017.02.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Electrophysiologic hearing tests have been developed since the 1960s to determine hearing thresholds objectively. They are now implemented in newborn hearing screening. While they determine thresholds, interpretation requires subjective pure-tone and speech audiometry to determine the type of hearing loss. Each examination tests a different anatomic region, enabling the auditory system to be explored from the organ of Corti to the auditory cortex. Thus, the various objective audiometric examinations are complementary.
Collapse
Affiliation(s)
- D Bakhos
- ENT department, université François-Rabelais de Tours, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours, France; Équipe 1, CNRS ERL 3106, UMRS imagerie et cerveau, Inserm U930, université François-Rabelais de Tours, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours, France.
| | - M Marx
- Service d'otologie-otoneurologie, CHU de Toulouse, hôpital Purpan, place du Docteur-Baylac, 31059 Toulouse, France; Laboratoire CerCo, université Paul-Sabatier, 31059 Toulouse, France
| | - A Villeneuve
- ENT department, université François-Rabelais de Tours, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours, France
| | - E Lescanne
- ENT department, université François-Rabelais de Tours, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours, France; Équipe 1, CNRS ERL 3106, UMRS imagerie et cerveau, Inserm U930, université François-Rabelais de Tours, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours, France
| | - S Kim
- ENT department, université François-Rabelais de Tours, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours, France; Équipe 1, CNRS ERL 3106, UMRS imagerie et cerveau, Inserm U930, université François-Rabelais de Tours, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours, France
| | - A Robier
- ENT department, université François-Rabelais de Tours, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours, France
| |
Collapse
|
17
|
Sakka L, Chomicki A, Gabrillargues J, Khalil T, Chazal J, Avan P. Validation of a noninvasive test routinely used in otology for the diagnosis of cerebrospinal fluid shunt malfunction in patients with normal pressure hydrocephalus. J Neurosurg 2016; 124:342-9. [DOI: 10.3171/2015.1.jns142142] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT
Ventriculoperitoneal shunting is the first-line treatment for normal pressure hydrocephalus. Noninvasive auditory tests based on recorded otoacoustic emissions were assessed, as currently used for universal neonatal hearing screenings, for the diagnosis of cerebrospinal fluid shunt malfunction. The test was designed based on previous works, which demonstrated that an intracranial pressure change induces a proportional, characteristic, otoacoustic-emission phase shift.
METHODS
Forty-four patients with normal pressure hydrocephalus (23 idiopathic and 21 secondary cases) were included in this prospective observational study. The male:female sex ratio was 1.44, the age range was 21–87 years (mean age 64.3 years), and the range of the follow-up period was 1–3 years (mean 20 months). Patients were implanted with a Sophy SU8 adjustable-pressure valve as the ventriculoperitoneal shunt. The phase shifts of otoacoustic emissions in response to body tilt were measured preoperatively, immediately postoperatively, and at 3–6 months, 7–15 months, 16–24 months, and more than 24 months postoperatively. Three groups were enrolled: Group 1, 19 patients who required no valve opening-pressure adjustment; Group 2, 18 patients who required valve opening-pressure adjustments; and Group 3, 7 patients who required valve replacement.
RESULTS
In Group 1, phase shift, which was positive before surgery, became steadily negative after surgery and during the follow-up. In Group 2, phase shift, which was positive before surgery, became negative immediately after surgery and increasingly negative after a decrease in the valve-opening pressure. In Group 3, phase shift was positive in 6 cases and slightly negative in 1 case before revision, but after revision phase shift became significantly negative in all cases.
CONCLUSIONS
Otoacoustic emissions noninvasively reflect cerebrospinal fluid shunt function and are impacted by valve-opening pressure adjustments. Otoacoustic emissions consistently diagnosed shunt malfunction and predicted the need for surgical revision. The authors’ diagnostic test, which can be repeated without risk or discomfort by an unskilled operator, may address the crucial need of detecting valve dysfunction in patients with poor clinical outcome after shunt surgery.
Collapse
Affiliation(s)
- Laurent Sakka
- 1Service de Neurochirurgie, Hôpital Gabriel Montpied, Centre Hospitalier Universitaire de Clermont-Ferrand
- 2Equipe IGCNC, EA 7282, ISIT, UMR 6284, CNRS, Université d’Auvergne
| | - Alexandre Chomicki
- 4Laboratoire de Biophysique Sensorielle, Faculté de Médecine, Université d’Auvergne; and
| | - Jean Gabrillargues
- 3Service de Neuroradiologie, Hôpital Gabriel Montpied, Centre Hospitalier Universitaire de Clermont-Ferrand
| | - Toufic Khalil
- 1Service de Neurochirurgie, Hôpital Gabriel Montpied, Centre Hospitalier Universitaire de Clermont-Ferrand
- 2Equipe IGCNC, EA 7282, ISIT, UMR 6284, CNRS, Université d’Auvergne
| | - Jean Chazal
- 1Service de Neurochirurgie, Hôpital Gabriel Montpied, Centre Hospitalier Universitaire de Clermont-Ferrand
- 2Equipe IGCNC, EA 7282, ISIT, UMR 6284, CNRS, Université d’Auvergne
| | - Paul Avan
- 4Laboratoire de Biophysique Sensorielle, Faculté de Médecine, Université d’Auvergne; and
- 5Biophysique Médicale, Centre Jean Perrin, Clermont-Ferrand, France
| |
Collapse
|
18
|
Abnormal fast fluctuations of electrocochleography and otoacoustic emissions in Menière's disease. Hear Res 2015; 327:199-208. [PMID: 26232527 DOI: 10.1016/j.heares.2015.07.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 07/10/2015] [Accepted: 07/23/2015] [Indexed: 12/25/2022]
Abstract
The responses of cochlear hair cells to sound stimuli depend on the resting position of their stereocilia bundles, which is sensitive to the chemical and mechanical environment. Cochlear hydrops, a hallmark of Menière's disease (MD), which is likely to come with disruption of this environment, results in hearing symptoms and electrophysiological signs, such as excessive changes in the cochlear summating potential (SP) and in the postural shifts of distortion-product otoacoustic emissions (DPOAEs). Here, SP from the basal part of the cochlea and DPOAEs from the apical part of the cochlea were recorded concomitantly in 73 patients with a definite MD, near an attack (n = 40) or between attacks with no clinical symptoms (n = 33), to compare their sensitivities to posture and evaluate their stability. The phase of the 2f1-f2 DPOAEs was monitored during body tilt, with stimuli f1 = 1 kHz and f2 = 1.2 kHz at 72 dB SPL. Extratympanic electrocochleography was performed in response to 95-dBnHL clicks. The normal limits of the DPOAE phase shift with body tilt, [-18°, +38°], and of the SP to action-potential (AP) ratio, <0.40, were exceeded in 75% and 60% of patients, respectively, near an attack. In these patients, but not in the asymptomatic ones, both tests reveal fluctuating cochlear responses from one data sample to the next. They emphasize how hydrops hinders normal hair-cell operation and may generate fast fluctuations in inner-ear functioning. If these fluctuations also occur on shorter time scales, it might explain the imperfect diagnostic sensitivity of SP and DPOAE tests, as averaging procedures would tend to level out transient fluctuations characteristic of hydrops.
Collapse
|
19
|
Measurement of endolymphatic pressure. Eur Ann Otorhinolaryngol Head Neck Dis 2015; 132:81-4. [DOI: 10.1016/j.anorl.2014.05.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Revised: 05/18/2014] [Accepted: 05/21/2014] [Indexed: 11/20/2022]
|
20
|
Lütkenhöner B, Basel T. Reappraisal of the glycerol test in patients with suspected Menière's disease. BMC EAR, NOSE, AND THROAT DISORDERS 2014; 14:12. [PMID: 25866475 PMCID: PMC4392460 DOI: 10.1186/1472-6815-14-12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 11/17/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND Recent advances in magnetic resonance imaging make it possible to visualize the presumed pathophysiologic correlate of Menière's disease: endolymphatic hydrops. As traditional diagnostic tests can provide only indirect evidence, they are hardly competitive in this respect and need to be rethought. This is done here for the glycerol test. METHODS The data of a previous retrospective analysis of the glycerol test in patients with suspected Menière's disease are reinterpreted using a simple model. The mean threshold reduction (MTR) in the frequency range from 125 to 1500 Hz (calculated from audiograms obtained immediately before and four hours after the glycerol intake) is used as the test statistic. The proposed model explains the frequency distribution of the observed MTR by the convolution of a Gaussian probability density function (representing measurement errors) with a template representing the frequency distribution of the true MTR. The latter is defined in terms of two adjustable parameters. After fitting the model to the data, the performance of the test is evaluated using receiver operating characteristic (ROC) analysis. RESULTS The cumulative frequency distribution of the observed MTR can be explained almost perfectly by the model. According to the ROC analysis performed, the capability of the currently used audiometric procedure to detect a glycerol-induced threshold reduction corresponds to a diagnostic test of rather high accuracy (area under the ROC curve greater than 0.9). Simulations show that methodological improvements could further enhance the performance. CONCLUSIONS Owing to their ability to reveal functional aspects without an obvious morphological correlate, traditional test for Menière's disease could be decisive for defining the stage of the disease. A distinctive feature of the glycerol test is that it is capable of determining, with high accuracy, whether the pathophysiologic condition of the inner ear is partially reversible. Prospectively, this could help to estimate the chances of specific therapies.
Collapse
Affiliation(s)
| | - Türker Basel
- ENT Clinic, Münster University Hospital, Münster, Germany
| |
Collapse
|
21
|
Abstract
To enhance weak sounds while compressing the dynamic intensity range, auditory sensory cells amplify sound-induced vibrations in a nonlinear, intensity-dependent manner. In the course of this process, instantaneous waveform distortion is produced, with two conspicuous kinds of interwoven consequences, the introduction of new sound frequencies absent from the original stimuli, which are audible and detectable in the ear canal as otoacoustic emissions, and the possibility for an interfering sound to suppress the response to a probe tone, thereby enhancing contrast among frequency components. We review how the diverse manifestations of auditory nonlinearity originate in the gating principle of their mechanoelectrical transduction channels; how they depend on the coordinated opening of these ion channels ensured by connecting elements; and their links to the dynamic behavior of auditory sensory cells. This paper also reviews how the complex properties of waves traveling through the cochlea shape the manifestations of auditory nonlinearity. Examination methods based on the detection of distortions open noninvasive windows on the modes of activity of mechanosensitive structures in auditory sensory cells and on the distribution of sites of nonlinearity along the cochlear tonotopic axis, helpful for deciphering cochlear molecular physiology in hearing-impaired animal models. Otoacoustic emissions enable fast tests of peripheral sound processing in patients. The study of auditory distortions also contributes to the understanding of the perception of complex sounds.
Collapse
Affiliation(s)
- Paul Avan
- Laboratory of Neurosensory Biophysics, University of Auvergne, School of Medicine, Clermont-Ferrand, France; Institut National de la Santé et de la Recherche Médicale (INSERM), UMR 1107, Clermont-Ferrand, France; Centre Jean Perrin, Clermont-Ferrand, France; Department of Otolaryngology, County Hospital, Krems an der Donau, Austria; Laboratory of Genetics and Physiology of Hearing, Department of Neuroscience, Institut Pasteur, Paris, France; Collège de France, Genetics and Cell Physiology, Paris, France
| | - Béla Büki
- Laboratory of Neurosensory Biophysics, University of Auvergne, School of Medicine, Clermont-Ferrand, France; Institut National de la Santé et de la Recherche Médicale (INSERM), UMR 1107, Clermont-Ferrand, France; Centre Jean Perrin, Clermont-Ferrand, France; Department of Otolaryngology, County Hospital, Krems an der Donau, Austria; Laboratory of Genetics and Physiology of Hearing, Department of Neuroscience, Institut Pasteur, Paris, France; Collège de France, Genetics and Cell Physiology, Paris, France
| | - Christine Petit
- Laboratory of Neurosensory Biophysics, University of Auvergne, School of Medicine, Clermont-Ferrand, France; Institut National de la Santé et de la Recherche Médicale (INSERM), UMR 1107, Clermont-Ferrand, France; Centre Jean Perrin, Clermont-Ferrand, France; Department of Otolaryngology, County Hospital, Krems an der Donau, Austria; Laboratory of Genetics and Physiology of Hearing, Department of Neuroscience, Institut Pasteur, Paris, France; Collège de France, Genetics and Cell Physiology, Paris, France
| |
Collapse
|
22
|
Braun M. High-multiple spontaneous otoacoustic emissions confirm theory of local tuned oscillators. SPRINGERPLUS 2013; 2:135. [PMID: 23638405 PMCID: PMC3636430 DOI: 10.1186/2193-1801-2-135] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Accepted: 03/21/2013] [Indexed: 12/03/2022]
Abstract
Understanding the origin of spontaneous otoacoustic emissions (SOAEs) in mammals has been a challenge for more than three decades. Right from the beginning two mutually exclusive concepts were explored. After 30 years this has now resulted in two well established but incompatible theories, the global standing-wave theory and the local oscillator theory. The outcome of this controversy will be important for our understanding of inner ear functions, because local tuned oscillators in the cochlea would indicate the possibility of frequency analysis via local resonance also in mammals. A previously unexploited opportunity to gain further information on this matter lies in the occasional cases of high-multiple SOAEs in human ears, which present a large number of adjacent small frequency intervals. Here, eight healthy ears of four subjects (12 to 32 SOAEs per ear) are compared with individually simulated ears where frequency spacing was random-generated by two different techniques. Further, a group of 1000 ears was simulated presenting a mean of 21.3 SOAEs per ear. The simulations indicate that the typical frequency spacing of human SOAEs may be due to random distribution of emitters along the cochlea plus a graded probability of mutual close-range suppression between adjacent emitters. It was found that the distribution of frequency intervals of SOAEs shows no above-chance probability of multiples of the preferred minimum distance (PMD) between SOAEs and that the size of PMD is related to SOAE density. The variation in size between adjacent small intervals is not significantly different in random-generated than in measured data. These three results are not in agreement with the global standing-wave theory but are in line with the local oscillator theory. In conclusion, the results are consistent with intrinsic tuning of cochlear outer hair cells.
Collapse
Affiliation(s)
- Martin Braun
- Neuroscience of Music, Gansbyn 14, Värmskog, S-66492 Sweden
| |
Collapse
|
23
|
Gázquez I, Moreno A, Requena T, Ohmen J, Santos-Perez S, Aran I, Soto-Varela A, Pérez-Garrigues H, López-Nevot A, Batuecas A, Friedman RA, López-Nevot MA, López-Escamez JA. Functional variants of MIF, INFG and TFNA genes are not associated with disease susceptibility or hearing loss progression in patients with Ménière's disease. Eur Arch Otorhinolaryngol 2012. [PMID: 23179933 DOI: 10.1007/s00405-012-2268-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Variability in acute immune response genes could determine susceptibility or prognosis for Ménière's disease (MD). The cytokines tumor necrosis factor α (TNFα), macrophage migration inhibitory factor (MIF) and interferon γ (INFγ) are proinflammatory cytokines of the innate immune response. These cytokines mediate inflammation and have been previously associated with the inflammatory process in several autoimmune diseases. We investigated the association between functional allelic variants of MIF (rs35688089), IFNG (rs2234688) and TNFA (rs1800629) in patients with MD. In addition to testing these variants for an association with disease, we also tested for an association with clinical aspects of disease progression, such as persistence of vertigo and the sensorineural hearing loss. A total of 580 patients with diagnosis of definite MD, according to the diagnostic scale of the American Academy of Otolaryngology-Head and Neck Surgery, and 552 healthy controls were included. DNA samples from a set of 291 American patients were used to confirm the results obtained in the MIF gene in our Spanish cohort. Although we found a significant association with the allele containing five repeats of CATT within the MIF gene in patients with MD in the Spanish cohort [corrected p = 0.008, OR = 0.69 (95 % CI, 0.54-0.88)], this finding could not be replicated in the American set. Moreover, no genetic associations for variants in either the TNFA or IFNG genes and MD were found. These results support the conclusion that functional variants of MIF, INFG, and TFNA genes are not associated with disease susceptibility or hearing loss progression in patients with MD.
Collapse
Affiliation(s)
- Irene Gázquez
- Otology and Neurotology Group CTS495, Centro de Genómica e Investigación Oncológica Pfizer-Universidad de Granada-Junta de Andalucía (GENyO), Avda. de la Ilustración, 114, 18014 Granada, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|