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Kirbac A, Kaya E, Incesulu SA, Carman KB, Yarar C, Ozen H, Pinarbasli MO, Gurbuz MK. Differentiation of peripheral and non-peripheral etiologies in children with vertigo/dizziness: The video-head impulse test and suppression head impulse paradigm. Int J Pediatr Otorhinolaryngol 2024; 179:111935. [PMID: 38574650 DOI: 10.1016/j.ijporl.2024.111935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 03/14/2024] [Accepted: 03/26/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVES To identify the etiology of vertigo/dizziness and determine the effectiveness of the video-head impulse test (vHIT) and the suppression head impulse paradigm (SHIMP) tests in distinguishing between peripheral and non-peripheral etiologies in children who presented to the otolaryngology department with complaints of vertigo/dizziness. METHODS The vHIT and SHIMP tests were applied to the children. The vestibulo-ocular reflex (VOR) gain and saccade parameters were compared. RESULTS In 27 children presenting with vertigo/dizziness, the most common etiological factor was inner ear malformation (IEM) (n = 6/27, 22.2%), followed by cochlear implant surgery (11.1%) and migraine (11.1%). Vestibular hypofunction was indicated by the vHIT results at a rate of 60% (9/15 children) and SHIMP results at 73.3% (11/15 children) among the children with a peripheral etiology, while these rates were 8.3% (1/12 children) and 25% (3/12 children), respectively, in the non-peripheral etiology group. SHIMP-VOR and vHIT-VOR gain values had a moderate positive correlation (p = 0.01, r = 0.349). While there were overt/covert saccades in the vHIT, anti-compensatory saccade (ACSs) were not observed in the SHIMP test (p = 0.041). The rates of abnormal vHIT-VOR gain (p = 0.001), over/covert saccades (p = 0.019), abnormal vHIT response (p = 0.014), ACSs (p = 0.001), and abnormal SHIMP response (p = 0.035) were significantly higher in the peripheral etiology group. CONCLUSIONS IEM was the most common etiological cause, and the rate of vestibular hypofunction was higher in these children with peripheral vertigo. vHIT and SHIMP are effective and useful vestibular tests for distinguishing peripheral etiology from non-peripheral etiology in the pediatric population with vertigo/dizziness. These tests can be used together or alone, but the first choice should be the SHIMP test, considering its short application time (approximately 4-5 min) and simplicity.
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Affiliation(s)
- Arzu Kirbac
- Eskişehir Osmangazi University, Faculty of Health Sciences, Department of Audiology, 26480, Eskisehir, Turkiye.
| | - Ercan Kaya
- Eskişehir Osmangazi University, Faculty of Medicine, Department of Otolaryngology, 26480, Eskisehir, Turkiye
| | - Saziye Armagan Incesulu
- Eskişehir Osmangazi University, Faculty of Medicine, Department of Otolaryngology, 26480, Eskisehir, Turkiye
| | - Kursat Bora Carman
- Eskişehir Osmangazi University, Faculty of Medicine, Department of Pediatric Neurology, 26480, Eskisehir, Turkiye
| | - Coskun Yarar
- Eskişehir Osmangazi University, Faculty of Medicine, Department of Pediatric Neurology, 26480, Eskisehir, Turkiye
| | - Hulya Ozen
- University of Health Sciences, Gulhane Faculty of Medicine, Department of Medical Informatics, 06018 Ankara, Turkiye
| | - Mehmet Ozgur Pinarbasli
- Eskişehir Osmangazi University, Faculty of Medicine, Department of Otolaryngology, 26480, Eskisehir, Turkiye
| | - Melek Kezban Gurbuz
- Eskişehir Osmangazi University, Faculty of Medicine, Department of Otolaryngology, 26480, Eskisehir, Turkiye
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Gualberto IJN, Medeiros GA, Santos MV, da Silva Lopes L, Machado HR, Sbragia L. Is there a role in the central nervous system development for using corticosteroids to treat meningomyelocele and hydrocephalus? Childs Nerv Syst 2022; 38:1849-1854. [PMID: 35907004 DOI: 10.1007/s00381-022-05615-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 07/23/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Myelomeningocele (MMC) is the most frequent neural tube defect and is frequently associated (around 80% of cases) with hydrocephalus (HC). Both diseases can have severe clinical consequences, insomuch as they require surgical treatment whose complications are not negligible, either when performed in utero or after birth. Therefore, clinical therapies that could have an impact on the incidence and progression of MMC and HC would be certainly valuable; however, this is not the current picture, and there are no effective pharmacological treatments for such patients to this day. AIM AND METHODS Therefore, knowing that an inflammatory process comes associated with these disorders, mostly due to nervous tissue distension, the present article aimed at reviewing the role of corticosteroids in reducing inflammation and thus improving the outcome of patients with HC and MMC, considering the well-established anti-inflammatory effects of CS. RESULTS The systematic review performed herein has found varying results regarding the role of steroids (even though a positive trend was observed) on the treatment and prevention of hydrocephalus, whereas for MMC. CONCLUSION There are many reports demonstrating beneficial effects of CS therapy, from a clinical and histopathological point of view.
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Affiliation(s)
- I José Nogueira Gualberto
- Bauru Medical School, Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - G Araújo Medeiros
- Bauru Medical School, Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - M Volpon Santos
- Division of Pediatric Neurosurgery, Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - L da Silva Lopes
- Division of Pediatric Neurosurgery, Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - H Rubens Machado
- Division of Pediatric Neurosurgery, Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - L Sbragia
- Division of Pediatric Surgery, Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes 3900, 10th floor, Ribeirão Preto, São Paulo, Brazil.
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Paccola ECM, Costa Filho OA, Jacob RTS. Frequency Modulation System and Bone Conduction Hearing Aid: Electroacoustic Verification. Int Arch Otorhinolaryngol 2020; 25:e483-e489. [PMID: 34737817 PMCID: PMC8558960 DOI: 10.1055/s-0040-1714128] [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: 12/13/2019] [Accepted: 06/02/2020] [Indexed: 10/28/2022] Open
Abstract
Introduction A protocol has not yet been developed to perform electroacoustic measurements and behavioral tests to fit the frequency modulation (FM) system in bone conduction hearing aid (BCHA) users. Electroacoustic verification, with "FM transparency" achieved, ensures user audibility of FM transmitter and hearing aid signals. Objective To propose and validate a protocol for electroacoustic verification of the FM system coupled to the BCHA. Method Twenty-four sets of FM system and BCHA were submitted to electroacoustic verification, using a receiver and a plastic adapter to connect the BCHA to a 2cc coupler in the hearing instrument analyzer. The measurements were performed in the acoustic box, at 65 dB sound pressure level (SPL), with International Speech Test Signal (ISTS), first to the BCHA microphone and then to the FM system microphone, to determine the transparency, in which equivalent inputs for both microphones result in equivalent outputs. The FM gain or volume has been adjusted to try to gain transparency for the outputs of the two input devices. Results Transparency was achieved for all sets evaluated, but in some combinations, adjustments to the FM receiver gain over the manufacturer's default setting were required. Conclusion The proposed protocol proved to be effective for the electroacoustic verification of the FM system coupled to the BCHA.
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Affiliation(s)
- Elaine Cristina Moreto Paccola
- Division of Hearing Health, Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo, Bauru, SP, Brazil
| | - Orozimbo Alves Costa Filho
- Department of Speech Therapy, Faculdade de Odontologia de Bauru, Universidade de São Paulo, Bauru, SP, Brazil
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Matos ILD, Ferreira MC, Mondelli MFCG. Analysis of speech perception with amplification devices in subjects with ear malformation and unilateral hearing loss. Codas 2020; 32:e20190047. [PMID: 32756855 DOI: 10.1590/2317-1782/20202019047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 09/17/2019] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To verify the speech perception in subjects with ear malformation and unilateral hearing loss, fitted with two types of amplification as follows: conventional hearing aids and softband (band with vibrator bone). METHOD The study included fifteen subjects of both sexes who presented congenital malformation of the middle or outer ear, diagnosed with unilateral conductive or mixed hearing loss, moderate to severe hearing loss, age range between 15 to 25 years and, prescription from a specialist doctor for hearing device fitting. We performed the speech perception assessment without amplification after the hearing aid and softband fitting, with the hearing aid linked to the bone vibrator (conventional) and the softband (band with the bone vibrator). The subjects were evaluated using the Hearing in Noise Test (HINT), in silence and in noise. RESULTS Seven subjects with unilateral ear malformation were evaluated, 57.1 % had impairment in the right ear and 42.9 % in the left ear. Regarding the type and the level of hearing loss, 71 % of all subjects included in the sample presented moderate conductive hearing loss. The assessment of speech perception was performed during silence, frontal noise, lateral noise and, during three specifics situations: no amplification, with conventional hearing aid and with the softband. The results with the amplification devices were positive in all evaluated conditions. CONCLUSION Evaluated subjects presented improvement in speech perception, in silence, frontal noise and lateral noise situations, regardless of the type of amplification; however, the difference was not statistically significant.
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Kaya Ş, Çiçek Çınar B, Özbal Batuk M, Özgen B, Sennaroğlu G, Genç GA, Sennaroğlu L. Wideband tympanometry findings in inner ear malformations. Auris Nasus Larynx 2019; 47:220-226. [PMID: 31540740 DOI: 10.1016/j.anl.2019.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 08/21/2019] [Accepted: 09/01/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The deficits in the cochlea which is at the one end of the ear sound transfer system, may effect middle ear functions. Wideband typanometry (WBT) is frequently used to evaluate these transfer functions which play a crucial role in setting the impedance matching between the external ear and the cochlea. To this end, the aim of this study was to investigate the ear transfer functions in inner ear malformations via WBT, and to question whether these functions change depending on the types of inner ear malformation. METHODS This prospective case-control study was conducted in a university hospital. One hundered-fifty-seven ears (aged 3-37 years) under the groups of cochlear hypoplasia, incomplete partition I, incomplete partition II, cochlear aplasia and complete labyrinthine aplasia were evaluated. In the control group, 30 ears with normal hearing were enrolled and WBT was carried out. Tympanometric peak pressure, equivalent middle ear volume, static admittance, tympanogram width, resonance frequency, average wideband tympanometry and absorbance measurements were analyzed. RESULTS The inner ear malformation groups demonstrated statistically significant differences than the control group and from each other in terms of traditional tympanometric parameters and WBT test parameters (p<0.05). The most remarkable difference was between the group of complete labyrinthine aplasia and the control group, most probably because of complete labyrinthine aplasia's structural effects. However, on some parameters, incomplete partition II and the control group showed similarities. In absorbance measurements, there was significant difference between all patient groups and the control group, especially at high frequencies (p<0.05). The largest difference was between the control group and the group of complete labyrinthine aplasia which has revealed the lowest absorbance values (p<0.05). In averaged-wideband tympanogram analysis, all patient groups obtained a lower amplitude peak than the control group; complete labyrinthine aplasia group had the flattest peaked amplitude, while the incomplete partition II group had a near-normal curve. CONCLUSION The results of the study revealed the distinctive effects of inner ear malformations in middle ear transfer functions. It is concluded that the absence of inner ear structures causes negative effects on energy absorbance and the other transfer functions of the middle ear. WBT may provide additional information on diagnosis of patients with inner ear malformations.
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Affiliation(s)
- Şule Kaya
- Ankara Yildirim Beyazit University, Faculty of Health Sciences, Audiology Department, Ankara, Turkey.
| | - Betül Çiçek Çınar
- Hacettepe University, Faculty of Health Sciences, Audiology Department, Ankara, Turkey
| | - Merve Özbal Batuk
- Hacettepe University, Faculty of Health Sciences, Audiology Department, Ankara, Turkey
| | - Burçe Özgen
- Hacettepe University, Medical Faculty, Radiology Department, Ankara, Turkey
| | - Gonca Sennaroğlu
- Hacettepe University, Faculty of Health Sciences, Audiology Department, Ankara, Turkey
| | - Gülsüm Aydan Genç
- Hacettepe University, Faculty of Health Sciences, Audiology Department, Ankara, Turkey
| | - Levent Sennaroğlu
- Hacettepe University, Medical Faculty, ENT Department, Ankara, Turkey
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Mondelli MFCG, Mariano TCB, Honório HM, Brito RVD. Vibrant Soundbridge and Bone Conduction Hearing Aid in Patients with Bilateral Malformation of External Ear. Int Arch Otorhinolaryngol 2015; 20:34-8. [PMID: 26722343 PMCID: PMC4688002 DOI: 10.1055/s-0035-1566155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 07/14/2015] [Indexed: 12/01/2022] Open
Abstract
Introduction Hearing loss is the most common clinical finding in patients with malformation of the external ear canal. Among the possibilities of treatment, there is the adaptation of hearing aids by bone conduction and the adaptation of implantable hearing aids. Objective To assess speech perception with the use of Vibrant Soundbridge (VBS - MED-EL, Innsbruck, Austria) associated with additional amplification in patients with bilateral craniofacial malformation. Method We evaluated 11 patients with bilateral malformation over 12 years with mixed hearing loss or bilateral conductive. They were using the Softband (Oticon Medical, Sweden) and bone conduction hearing aid in the ear opposite the one with the VSB. We performed the evaluation of speech perception using the Hearing in Noise Test. Results Participants were eight men and three women with a mean of 19.5 years. The signal / noise ratio presented significant results in patients fitted with VSB and bone conduction hearing aid. Conclusion The results of speech perception were significantly better with use of VBS combined with bone conduction hearing aids.
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Affiliation(s)
| | | | - Heitor Marques Honório
- Department of Phonoaudiology, Faculdade de Odontologia de Bauru, Universidade de São Paulo - USP, Bauru, SP, Brazil
| | - Rubens Vuono de Brito
- Department of Otolaryngology, Universidade de São Paulo, São Paulo, São Paulo, Brazil
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