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Vainutienė V, Ivaška J, Dadonienė J, Beleškienė V, Ivaškienė T, Lesinskas E. Audiological Manifestations in Patients with Granulomatosis with Polyangiitis. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:267. [PMID: 38399554 PMCID: PMC10890050 DOI: 10.3390/medicina60020267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 01/30/2024] [Accepted: 02/01/2024] [Indexed: 02/25/2024]
Abstract
Background and Objectives: Granulomatosis with Polyangiitis (GPA) is a rare, autoimmune, multisystemic disease characterized by vasculitis and necrotizing granuloma that commonly affects the upper and lower respiratory tract and kidneys. Audiovestibular dysfunction in GPA diseases may have different clinical presentations. The aim of the present study was to evaluate hearing function in patients with GPA and to compare the results with a healthy control group. Materials and Methods: A total of 34 individuals participated in the study. The GPA group consisted of 14 participants, and the control group was composed of 20 healthy participants with no signs or symptoms of ear disease. The ages ranged from 18 to 65 years old, with a mean age of 43.8 years. The participants underwent a complete audiological evaluation using otoscopy, impedance audiometry, pure tone audiometry, speech audiometry-evaluation of speech thresholds, and speech recognition in quiet. Both ears were tested. All of the participants of the study were native Lithuanian speakers. Data were statistically analyzed using the Statistical Analysis System software SAS® Studio 3.8. A p value < 0.05 was regarded as statistically significant. Results: 92.85% of patients from the GPA group reported hearing-related symptoms: hearing loss, tinnitus, and fullness in the ears. The arithmetic means of all hearing thresholds at frequencies from 125 Hz to 8000 Hz were significantly higher in the GPA group. The results revealed statistically significant differences between the two groups in the Speech Detection Threshold, Speech Recognition Threshold, Speech Discomfort level, and Word Recognition Scores. Conclusions: The frequency of hearing loss, the average hearing thresholds, and speech thresholds were higher in GPA patients than in healthy individuals. The most common type of hearing loss was sensorineural. Audiological assessments should be considered during the routine evaluation of patients with GPA disease to prevent hearing-related disabilities.
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Affiliation(s)
- Vija Vainutienė
- State Research Institute Centre for Innovative Medicine, Santariškių str. 5, LT-08406 Vilnius, Lithuania; (J.D.); (T.I.)
| | - Justinas Ivaška
- Clinic of Ear, Nose, Throat and Eye Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, M.K. Čiurlionio str. 21, LT-03101 Vilnius, Lithuania; (J.I.); (V.B.); (E.L.)
| | - Jolanta Dadonienė
- State Research Institute Centre for Innovative Medicine, Santariškių str. 5, LT-08406 Vilnius, Lithuania; (J.D.); (T.I.)
- Department of Public Health, Faculty of Medicine, Vilnius University, M.K. Čiurlionio str. 21, LT-03101 Vilnius, Lithuania
| | - Vilma Beleškienė
- Clinic of Ear, Nose, Throat and Eye Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, M.K. Čiurlionio str. 21, LT-03101 Vilnius, Lithuania; (J.I.); (V.B.); (E.L.)
| | - Tatjana Ivaškienė
- State Research Institute Centre for Innovative Medicine, Santariškių str. 5, LT-08406 Vilnius, Lithuania; (J.D.); (T.I.)
| | - Eugenijus Lesinskas
- Clinic of Ear, Nose, Throat and Eye Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, M.K. Čiurlionio str. 21, LT-03101 Vilnius, Lithuania; (J.I.); (V.B.); (E.L.)
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Shah S, Chidarala S, Jeong S, Zhang K, Nguyen SA, Wilkinson R, Ward C, Rizk H. Secondary autoimmune immune ear disease (AIED): a systematic review and meta-analysis on vestibular manifestations of systemic autoimmune and inflammatory disorders. Clin Rheumatol 2023; 42:2747-2759. [PMID: 37380912 DOI: 10.1007/s10067-023-06674-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 06/07/2023] [Accepted: 06/10/2023] [Indexed: 06/30/2023]
Abstract
Secondary autoimmune inner ear disease (AIED) is often bilateral and asymmetric in patients presenting with audiovestibular symptoms due to a systemic autoimmune disease. This systematic review and meta-analysis are aimed at identifying and highlighting patterns in prevalence of vestibular dysfunction, symptom presentation, and diagnostic methods in extant literature by combining clinical context from case reports with quantitative analyses from cohort studies. Screening of articles by title, abstract, and full text was completed by four reviewers (K.Z., A.L., S.C., and S.J.). In this study, we grouped secondary AIED and systemic autoimmune diseases by pathophysiologic mechanism: (1) connective tissue disease (CTD), (2) vasculitides (VAS), (3) systemic inflammatory disorders (SID), and (4) other immune-mediated disorders (OIMD). The search for AIED disease identified 120 articles (cohorts and case reports) that met the final inclusion criteria. All 120 were included in the qualitative review, and 54 articles were included for meta-analysis. Of these 54 articles, 22 included a control group (CwC). Ninety individual cases or patient presentations from 66 articles were included for analysis in addition to the 54 cohort articles. Secondary AIED does not have a diagnostic algorithm for managing vestibular symptoms. The management of audiovestibular symptoms requires close collaboration between otolaryngologists and rheumatologists to preserve end-organ function of the ear. To improve our ability to understand the impact on the vestibular system, vestibular clinicians need to develop a standardized reporting method. Clinical presentation should frequently be paired with vestibular testing to contextually investigate symptom severity and provide higher quality care.
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Affiliation(s)
- Sunny Shah
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Shreya Chidarala
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Seth Jeong
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Kathy Zhang
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Shaun A Nguyen
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Rachel Wilkinson
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Celine Ward
- Department of Rheumatology, Medical University of South Carolina, Charleston, SC, USA
| | - Habib Rizk
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA.
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Wang Y, Tang S, Shao C, Liu Y. Cogan's syndrome is more than just keratitis: a case-based literature review. BMC Ophthalmol 2023; 23:212. [PMID: 37173630 PMCID: PMC10176949 DOI: 10.1186/s12886-023-02966-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 05/05/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Cogan's syndrome (CS) is a rare autoimmune disorder characterized by non-syphilitic interstitial keratitis (IK) and Menière-like cochlear vestibular symptoms, which may also have systemic effects. Corticosteroids are first-line treatment. DMARDs and biologics have been used to treat ocular and systemic symptoms of CS. CASE PRESENTATION This is a case of a 35-year-old female who reported hearing loss, eye redness and photophobia. Her condition progressed to a sudden sensorineural hearing loss, tinnitus, and constant vertigo accompanied by cephalea. CS was diagnosed after excluding other diseases. The patient still developed bilateral sensorineural hearing loss after receiving hormone, methotrexate, cyclophosphamide, and a variety of biological agents. Joint symptoms were relieved after treatment with a JAK inhibitor (tofacitinib), and hearing did not deteriorate further. CONCLUSIONS CS should be involved in the differential diagnosis of keratitis. Early identification and intervention of this autoimmune disease can minimize disability and irreversible damage.
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Affiliation(s)
- Yanqing Wang
- Department of Rheumatology and Immunology, Tongren Hospital, Shanghai JiaoTong University School of Medicine, No. 1111 Xianxia Road, Changning District, Shanghai, 200336, China
| | - Shichao Tang
- Department of Rheumatology and Immunology, Tongren Hospital, Shanghai JiaoTong University School of Medicine, No. 1111 Xianxia Road, Changning District, Shanghai, 200336, China
| | - Chong Shao
- Department of Rheumatology and Immunology, Tongren Hospital, Shanghai JiaoTong University School of Medicine, No. 1111 Xianxia Road, Changning District, Shanghai, 200336, China
| | - Yu Liu
- Department of Rheumatology and Immunology, Tongren Hospital, Shanghai JiaoTong University School of Medicine, No. 1111 Xianxia Road, Changning District, Shanghai, 200336, China.
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The Prevalence of Hearing Impairments in Women with Silicone Breast Implants. Diseases 2023; 11:diseases11010031. [PMID: 36810545 PMCID: PMC9945132 DOI: 10.3390/diseases11010031] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/28/2023] [Accepted: 02/06/2023] [Indexed: 02/12/2023] Open
Abstract
Many women with silicone breast implants (SBIs) report non-specific complaints, including hearing impairments. Hearing impairment appears to be associated with a number of autoimmune conditions. The current study aimed to evaluate the prevalence and severity of hearing impairments among women with SBIs and to explore potential improvements in their hearing capability following implant removal. Symptomatic women with SBIs (n = 160) underwent an initial anamnestic interview, and women who reported hearing impairments were selected for the study. These women completed self-report telephone questionnaires regarding their hearing difficulties. Some of these women underwent subjective and objective hearing tests. Out of 159 (50.3%) symptomatic women with SBIs, 80 reported hearing impairments, including hearing loss (44/80; 55%) and tinnitus (45/80; 56.2%). Five out of seven (71.4%) women who underwent an audiologic evaluation exhibited hearing loss. Of women who underwent silicone implant removal, 27 out of 47 (57.4%) reported the improvement or resolution of their hearing complaints. In conclusion, hearing impairment is a frequent complaint among symptomatic women with SBIs, and tinnitus was found to be the most common complaint. A significant reduction in hearing difficulties was observed following silicone implant removal. Further studies using larger populations are needed to verify the occurrence of hearing impairments in these women.
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Grundfast KM, Jamil TL. Evaluation and Management of Tinnitus: Are There Opportunities for Improvement? Otolaryngol Head Neck Surg 2023; 168:45-58. [PMID: 35349391 DOI: 10.1177/01945998221088286] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 03/02/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To review current information about diagnosis and management of tinnitus aiming to identify opportunities for achieving a cost-effective, efficient, evidence-based approach that meets the needs of tinnitus sufferers. DATA SOURCES PubMed/MEDLINE. REVIEW METHODS In total, 249 relevant published reports were reviewed. Pertinent keywords and MeSH terms identified reports via PubMed and EMBASE. Acknowledged experts were consulted on ways to improve tinnitus management. CONCLUSIONS There may be opportunities to improve evaluation and management of patients with tinnitus using modern modes of communication and a multidisciplinary therapeutic approach. IMPLICATIONS FOR PRACTICE Tinnitus can adversely affect quality of life while being time-consuming and costly to evaluate and manage. Based on both personal experience and the reports of others, patients with tinnitus who choose to see a physician primarily want to know two things: (1) that the tinnitus that is so distressing will not remain at the same level of severity forever and (2) that something can be done to help cope with the tinnitus that is so annoying. Recent advancements in internet communications, social media, information technology, artificial intelligence, machine learning, holistic medical care, mind-body integrative health care, and multidisciplinary approaches in medical therapeutics may be possibly making new ways of meeting the needs of patients with tinnitus.
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Affiliation(s)
- Kenneth M Grundfast
- Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Otolaryngology-Head and Neck Surgery, Boston Medical Center, Boston, Massachusetts, USA
- Otology Service, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Taylor L Jamil
- Boston University School of Medicine, Boston, Massachusetts, USA
- Boston University School of Public Health, Boston, Massachusetts, USA
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De Fontcuberta P, Vandenhende MA, Laux M, Tourbier B, Paz R, Bonnet F, Meriglier E. [Hearing loss in giant cell arteritis: A case report]. Rev Med Interne 2023; 44:31-34. [PMID: 35752483 DOI: 10.1016/j.revmed.2022.05.008] [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: 04/15/2022] [Revised: 05/17/2022] [Accepted: 05/23/2022] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Hearing loss is a rare manifestation in giant cell arteritis. The different types of deafness are possible with a predominance of sensorineural deafness. CASE REPORT We report a 75-year-old woman who presented with typical manifestations of giant cell arteritis associated concomitantly with the occurrence of bilateral mixed hearing loss confirmed on the audiogram. Corticosteroids allowed a rapidly favorable clinical and biological outcome. The follow-up audiogram at 3 months was markedly improved and showed a decrease in sensorineural hearing loss and disappearance of conductive hearing loss. CONCLUSION Any rapid onset deafness in an inflammatory context in the elderly should lead to a search for giant cell arteritis. The diagnosis can be difficult in the absence of other typical manifestations, especially since the biopsy of the temporal artery most often comes back negative. Corticosteroids are usually effective.
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Affiliation(s)
- Pedro De Fontcuberta
- Service de médecine interne et post-urgences, hôpital Pellegrin, CHU de Bordeaux, hôpital Pellegrin, place Amélie Raba Léon, 33000 Bordeaux, France
| | - Marie-Anne Vandenhende
- Service de médecine interne et post-urgences, hôpital Pellegrin, CHU de Bordeaux, hôpital Pellegrin, place Amélie Raba Léon, 33000 Bordeaux, France; Université de Bordeaux, Talence, France
| | - Miranda Laux
- Service de médecine interne et post-urgences, hôpital Pellegrin, CHU de Bordeaux, hôpital Pellegrin, place Amélie Raba Léon, 33000 Bordeaux, France
| | - Benjamin Tourbier
- Service de médecine interne et post-urgences, hôpital Pellegrin, CHU de Bordeaux, hôpital Pellegrin, place Amélie Raba Léon, 33000 Bordeaux, France
| | - Rafael Paz
- Service de médecine interne et post-urgences, hôpital Pellegrin, CHU de Bordeaux, hôpital Pellegrin, place Amélie Raba Léon, 33000 Bordeaux, France
| | - Fabrice Bonnet
- Université de Bordeaux, Talence, France; Service de médecine interne et maladies infectieuses, hôpital Saint-André, CHU de Bordeaux, Bordeaux, France
| | - Etienne Meriglier
- Service de médecine interne et post-urgences, hôpital Pellegrin, CHU de Bordeaux, hôpital Pellegrin, place Amélie Raba Léon, 33000 Bordeaux, France; Université de Bordeaux, Talence, France.
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7
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Brisse M, Fernández-Alarcón C, Huang Q, Kirk N, Schleiss MR, Liang Y, Ly H. Hearing loss in outbred Hartley guinea pigs experimentally infected with Pichinde virus as a surrogate model of human mammarenaviral hemorrhagic fevers. Virulence 2022; 13:1049-1061. [PMID: 35758052 PMCID: PMC9794012 DOI: 10.1080/21505594.2022.2087948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Lassa fever (LF) is a neglected tropical disease that is caused by Lassa virus (LASV), a human hemorrhagic fever-causing mammarenavirus. A notable sequela of LF is sensorineural hearing loss (SNHL) that can develop in about 33% of the patients. Animal models of LF-associated SNHL have been limited in size and scope because LASV is a biosafety level 4 (BSL4) pathogen that requires its handling in a high biocontainment laboratory. In this report, we describe the development of an alternative arenavirus hearing loss model by infecting outbred Hartley guinea pigs with a virulent strain (rP18) of the Pichinde virus (PICV), which is a guinea pig-adapted mammarenavirus that has been used as a surrogate model of mammarenaviral hemorrhagic fevers in a conventional (BSL2) laboratory. By measuring auditory brainstem response (ABR) throughout the course of the virulent rP18 PICV infection, we noticed that some of the animals experienced an acute but transient level of hearing loss. Cochleae of hearing-impaired animals, but not of controls, had demonstrable viral RNA by quantitative RT-PCR, indicating the presence of virus in the affected inner ear with no overt histopathological changes. In contrast, neither the outbred Hartley guinea pigs infected with a known avirulent strain (rP2) of PICV nor those that were mock-infected showed any evidence of hearing loss or viral infection of the inner ear. This is the first report of an immunocompetent small animal model of mammarenavirus-induced hearing loss that can be used to evaluate potential therapeutics against virus-induced hearing impairment under a conventional laboratory setting.
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Affiliation(s)
- Morgan Brisse
- Biochemistry, Molecular Biology and Biophysics Graduate Program, University of Minnesota, Twin Cities, Minnesota, USA,Department of Veterinary and Biomedical Sciences College of Veterinary Medicine, University of Minnesota, Twin Cities, Minnesota, USA
| | | | - Qinfeng Huang
- Department of Veterinary and Biomedical Sciences College of Veterinary Medicine, University of Minnesota, Twin Cities, Minnesota, USA
| | - Natalie Kirk
- Comparative and Molecular Biosciences Graduate Program, University of Minnesota, Twin Cities, Minnesota, USA,Department of Veterinary and Biomedical Sciences College of Veterinary Medicine, University of Minnesota, Twin Cities, Minnesota, USA
| | - Mark R. Schleiss
- Department of Pediatrics, School of Medicine University of Minnesota, Twin Cities, Minnesota, USA
| | - Yuying Liang
- Department of Veterinary and Biomedical Sciences College of Veterinary Medicine, University of Minnesota, Twin Cities, Minnesota, USA
| | - Hinh Ly
- Biochemistry, Molecular Biology and Biophysics Graduate Program, University of Minnesota, Twin Cities, Minnesota, USA,Comparative and Molecular Biosciences Graduate Program, University of Minnesota, Twin Cities, Minnesota, USA,Department of Veterinary and Biomedical Sciences College of Veterinary Medicine, University of Minnesota, Twin Cities, Minnesota, USA,CONTACT Hinh Ly
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Chevet B, Cornec D, Casal Moura M, Cornec-Le Gall E, Fervenza FC, Warrington KJ, Specks U, Berti A. Diagnosing and treating ANCA-associated vasculitis: an updated review for clinical practice. Rheumatology (Oxford) 2022; 62:1787-1803. [PMID: 36315063 DOI: 10.1093/rheumatology/keac623] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 09/14/2022] [Accepted: 10/05/2022] [Indexed: 03/29/2023] Open
Abstract
Abstract
ANCA-associated vasculitides (AAV) are a group of rare, primary, systemic necrotizing small-vessel vasculitides. Granulomatosis with polyangiitis and microscopic polyangiitis account for ∼80–90% of all AAV. Exposure to silica dust, farming and chronic nasal Staphylococcus aureus carriage are associated with increased risk of developing AAV. When a diagnosis of AAV is suspected, as in patients with multisystem organ dysfunction or those with features such as chronic recurrent rhinosinusitis, cavitated lung nodules, palpable purpura or acute kidney injury, then appropriate further investigations are needed, including ANCA testing. In this scenario, a structured clinical assessment should be conducted, evaluating all the organs possibly involved, and tissue biopsy may be necessary for confirmation of the diagnosis. Therapeutic algorithms vary based on the severity of AAV, the clinical diagnosis/ANCA specificity, and the patient’s age, weight, comorbidities and prognosis. Recent data favour rituximab as a preferable option for both induction and maintenance of remission. In addition, regimens with less glucocorticoids are equally effective and safer in inducing remission compared with conventional regimens, and avacopan is an effective glucocorticoid-sparing option. In contrast, there is not compelling evidence to support the routine use of plasma exchange in addition to standard remission-induction therapy in AAV. ANCA and other biomarkers can be helpful in association with clinical assessment to guide diagnosis and treatment decisions. Patients should be frequently evaluated during follow-up for possible disease relapses or treatment-related morbidity, and for monitoring damage accrual, especially metabolic and cardiovascular damage.
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Affiliation(s)
- Baptiste Chevet
- LBAI, UMR1227, Univ Brest, Inserm, Labex IGO, CHU de Brest, Brest, France
| | - Divi Cornec
- LBAI, UMR1227, Univ Brest, Inserm, Labex IGO, CHU de Brest, Brest, France
| | - Marta Casal Moura
- Department Division of Pulmonary and Critical Care Medicine, Department of Medicine, and Thoracic Research Disease Unit, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | | | | | | | - Ulrich Specks
- Department Division of Pulmonary and Critical Care Medicine, Department of Medicine, and Thoracic Research Disease Unit, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - Alvise Berti
- Rheumatology, Santa Chiara Regional Hospital, APSS Trento, and Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Italy
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9
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Marini K, Garefis K, Skliris JP, Chatziavramidis A, Nikolaidis V, Zarachi A, Tsetsos N, Poutoglidis A, Markou K. Granulomatosis with Polyangiitis: Multiple Cranial Nerve Manifestations and Nasopharyngeal Pseudotumor. EAR, NOSE & THROAT JOURNAL 2021:1455613211069925. [PMID: 34961395 DOI: 10.1177/01455613211069925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024] Open
Affiliation(s)
- Katerina Marini
- 2nd Academic ORL, Head and Neck Surgery Department, Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki, Greece
| | - Konstantinos Garefis
- 2 Academic ORL, Head and Neck Surgery Department, Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki, Greece
| | | | - Angelos Chatziavramidis
- 2 Academic ORL, Head and Neck Surgery Department, Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki, Greece
| | - Vasilios Nikolaidis
- 2 Academic ORL, Head and Neck Surgery Department, Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki, Greece
| | - Athina Zarachi
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Nikolaos Tsetsos
- Department of Otorhinolaryngology-Head and Neck Surgery, "G. Papanikolaou" General Hospital, Thessaloniki, Greece
| | - Alexandros Poutoglidis
- Department of Otorhinolaryngology-Head and Neck Surgery, "G. Papanikolaou" General Hospital, Thessaloniki, Greece
| | - Konstantinos Markou
- 2 Academic ORL, Head and Neck Surgery Department, Aristotle University of Thessaloniki, Papageorgiou Hospital, Thessaloniki, Greece
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10
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Warnecke A, Giesemann A. Embryology, Malformations, and Rare Diseases of the Cochlea. Laryngorhinootologie 2021; 100:S1-S43. [PMID: 34352899 PMCID: PMC8354575 DOI: 10.1055/a-1349-3824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Despite the low overall prevalence of individual rare diseases, cochlear
dysfunction leading to hearing loss represents a symptom in a large
proportion. The aim of this work was to provide a clear overview of rare
cochlear diseases, taking into account the embryonic development of the
cochlea and the systematic presentation of the different disorders. Although
rapid biotechnological and bioinformatic advances may facilitate the
diagnosis of a rare disease, an interdisciplinary exchange is often required
to raise the suspicion of a rare disease. It is important to recognize that
the phenotype of rare inner ear diseases can vary greatly not only in
non-syndromic but also in syndromic hearing disorders. Finally, it becomes
clear that the phenotype of the individual rare diseases cannot be
determined exclusively by classical genetics even in monogenetic
disorders.
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Affiliation(s)
- Athanasia Warnecke
- Klinik für Hals-, Nasen- und Ohrenheilkunde, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30625 Hannover.,Deutsche Forschungsgemeinschaft Exzellenzcluster"Hearing4all" - EXC 2177/1 - Project ID 390895286
| | - Anja Giesemann
- Institut für Neuroradiologie, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30625 Hannover
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11
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Weiss NM. Rare Diseases of the Middle Ear and Lateral Skull Base. Laryngorhinootologie 2021; 100:S1-S30. [PMID: 34352901 PMCID: PMC8354576 DOI: 10.1055/a-1347-4171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Otalgia, otorrhea and hearing loss are the most common ear-related symptoms that lead to the consultation of an otolaryngologist. Furthermore, balance disorders and affections of the cranial nerve function may play a role in the consultation. In large academic centres, but also in primary care, the identification of rare diseases of the middle ear and the lateral skull base is essential, as these diseases often require interdisciplinary approaches to establish the correct diagnosis and to initiate safe and adequate treatments. This review provides an overview of rare bone, neoplastic, haematological, autoimmunological and infectious disorders as well as malformations that may manifest in the middle ear and the lateral skull base. Knowledge of rare disorders is an essential factor ensuring the quality of patient care, in particular surgical procedures. Notably, in untypical, complicated, and prolonged disease courses, rare differential diagnoses need to be considered.
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Affiliation(s)
- Nora M. Weiss
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie
„Otto Körner“ der Universitätsmedizin Rostock,
Deutschland
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12
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Dlugaiczyk J. Rare Disorders of the Vestibular Labyrinth: of Zebras, Chameleons and Wolves in Sheep's Clothing. Laryngorhinootologie 2021; 100:S1-S40. [PMID: 34352900 PMCID: PMC8363216 DOI: 10.1055/a-1349-7475] [Citation(s) in RCA: 4] [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] [Indexed: 02/08/2023]
Abstract
The differential diagnosis of vertigo syndromes is a challenging issue, as many - and in particular - rare disorders of the vestibular labyrinth can hide behind the very common symptoms of "vertigo" and "dizziness". The following article presents an overview of those rare disorders of the balance organ that are of special interest for the otorhinolaryngologist dealing with vertigo disorders. For a better orientation, these disorders are categorized as acute (AVS), episodic (EVS) and chronic vestibular syndromes (CVS) according to their clinical presentation. The main focus lies on EVS sorted by their duration and the presence/absence of triggering factors (seconds, no triggers: vestibular paroxysmia, Tumarkin attacks; seconds, sound and pressure induced: "third window" syndromes; seconds to minutes, positional: rare variants and differential diagnoses of benign paroxysmal positional vertigo; hours to days, spontaneous: intralabyrinthine schwannomas, endolymphatic sac tumors, autoimmune disorders of the inner ear). Furthermore, rare causes of AVS (inferior vestibular neuritis, otolith organ specific dysfunction, vascular labyrinthine disorders, acute bilateral vestibulopathy) and CVS (chronic bilateral vestibulopathy) are covered. In each case, special emphasis is laid on the decisive diagnostic test for the identification of the rare disease and "red flags" for potentially dangerous disorders (e. g. labyrinthine infarction/hemorrhage). Thus, this chapter may serve as a clinical companion for the otorhinolaryngologist aiding in the efficient diagnosis and treatment of rare disorders of the vestibular labyrinth.
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Affiliation(s)
- Julia Dlugaiczyk
- Klinik für Ohren-, Nasen-, Hals- und Gesichtschirurgie
& Interdisziplinäres Zentrum für Schwindel und
neurologische Sehstörungen, Universitätsspital Zürich
(USZ), Universität Zürich (UZH), Zürich,
Schweiz
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Tugizova M, Feng H, Tomczak A, Steenerson K, Han M. Case series: Hearing loss in neuromyelitis optica spectrum disorders. Mult Scler Relat Disord 2020; 41:102032. [PMID: 32155460 DOI: 10.1016/j.msard.2020.102032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 02/25/2020] [Accepted: 02/26/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Aquaporin 4 (AQP4)- and myelin oligodendrocyte glycoprotein (MOG)-associated neuromyelitis optica spectrum disorders (NMOSD) are thought to primarily affect the central nervous system (CNS). However, emerging evidence suggests that there are extra-CNS manifestations of NMOSD, including myopathies, gastrointestinal dysfunction, renal involvement and adverse pregnancy outcomes.1 METHODS: Three patients who reported hearing loss during a NMOSD relapse were identified through a retrospective case review. RESULTS In this article, we discuss two AQP4-IgG positive NMOSD cases, each presenting with conductive and sensorineural hearing loss, and a case of MOG-IgG-associated NMOSD presenting with sensorineural hearing loss. CONCLUSION Hearing loss may be present as a relapse in patients with NMOSD. Early recognition and timely treatment are essential to prevent irreversible hearing loss.
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Affiliation(s)
- Madina Tugizova
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, United States
| | - Haojun Feng
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, United States
| | - Anna Tomczak
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, United States
| | - Kristen Steenerson
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, United States; Department of Otolaryngology - Head and Neck Surgery, Stanford University, Stanford, CA, United States
| | - May Han
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, United States; Neuroimunology Division, Multiple Sclerosis Center, Stanford University, Stanford, CA, United States.
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