Audiological and Vestibular Measurements in Chronic Renal Failure Patients Receiving Hemodialysis Treatment

BACKGROUND

The aim was to evaluate the changes in the audiovestibular system in adult patients with the diagnosis of chronic renal failure who were treated with hemodialysis.

METHODS

Thirty-five patients diagnosed with chronic renal failure and receiving hemodialysis treatment 3 days a week and 35 healthy individuals were tested with pure tone audiometry, video head impulse test, and post-head shake nystagmus test. Dizziness Handicap Inventory was applied to all participants.

RESULTS

The Dizziness Handicap Inventory scores of the patient groups are higher than the control groups (P=.001). In the video head impulse test, there is no statistically significant difference between the patient and control groups in terms of gain asymmetry. 17.1% of the patients had both left and right lateral saccades (P=.03). A statistically significant difference was also found after the post-head shake test (P=.025). In the patient group, an inverse relationship between the presence of left anterior right posterior saccades and blood urea nitrogen-creatinine ratio and a direct relationship between the presence of right anterior left posterior saccades and creatinine elevation were determined. The presence of saccades in the video head impulse test increased significantly as the disease duration of hemodialysis patients increased.

CONCLUSION

It was determined that the overt and covert saccades in the video head impulse test increased significantly as the creatinine increased and the duration of the disease increased in the patients with chronic renal failure. The common clinical usage of video head impulse test in monitoring the vestibular side effects of creatinine elevation and disease duration in chronic renal failure patients may be possible with future studies.

A comparison of the video head impulse test and the functional head impulse test in chronic unilateral vestibular loss

OBJECTIVE

To examine the correlation of video head impulse test, functional head impulse test and Dizziness Handicap Inventory results in patients with chronic unilateral vestibular loss, and to compare the results with healthy controls.

METHODS

Forty-eight patients diagnosed with chronic unilateral vestibular loss and 35 healthy individuals, aged 18-65 years, were included. The video head impulse test, functional head impulse test and Dizziness Handicap Inventory were administered.

RESULTS

A significant positive correlation was found between functional head impulse test and video head impulse test results for the study group in all semicircular canals (p < 0.05). There was no significant correlation between Dizziness Handicap Inventory, functional head impulse test and video head impulse test results (p > 0.05). The functional head impulse test and video head impulse test results of the control group were significantly higher than those of the study group in all semicircular canals planes (p < 0.05).

CONCLUSION

In chronic unilateral vestibular loss patients, with high head accelerations, the functional head impulse test indicates deterioration in vestibulo-ocular reflex functionality. It would be beneficial to include the video head impulse test and functional head impulse test in clinical practice as complementary tests in vestibulo-ocular reflex evaluation.

Evaluation of Mental Rotation Ability in Patients with Unilateral Benign Paroxysmal Positional Vertigo

BACKGROUND

Our study aims to determine whether there are differences in mental rotation abilities between unilateral benign paroxysmal positional vertigo patients and healthy controls using object-based mental rotation tasks.

METHODS

Our study included 17 unilateral posterior canal benign paroxysmal positional vertigo patients and 20 healthy adults. Spontaneous nystagmus test, saccade test, and dynamic positional tests with videonystagmography and object-based mental rotation test with 2-dimensional images of cubes rotated at certain angles in 3-dimensional space were performed on the participants. The mental rotation test response time and the number of correct answers were compared between patients and controls. We also evaluated whether there was a relationship between saccade test parameters and mental rotation test parameters in our study.

RESULTS

No significant relationship was found between benign paroxysmal positional vertigo patients and controls on any of the dependent measures (P -gt; .05). When we evaluated the relationship between saccadic latency and accuracy and mental rotation test response time and number of correct answers in benign paroxysmal positional vertigo patients, no significant relationship was found (P -gt; .05).

CONCLUSION

Our findings show that unilateral, posterior canal benign paroxysmal positional vertigo does not affect object-based mental rotation performance. In our study, no correlation was found between saccadic function and mental rotation ability in unilateral benign paroxysmal positional vertigo patients.

Evaluation of Auditory Functions in Patients with Psoriasis

Our study aims to evaluate the functions of the middle and inner ear and the efferent auditory system in psoriasis. Hearing thresholds, resonance frequency, otoacoustic emission amplitudes with and without contralateral acoustic stimulation, contralateral suppression levels were evaluated in 35 psoriasis patients and 40 controls. The air-conduction hearing thresholds of the patients were significantly higher than the controls at 125, 250, 500, 1000, 2000, 4000, and 12,000 Hz frequencies in the left ear, and 125, 250, 500, 1000, 2000, and 4000 Hz frequencies in the right ear, and the bone-conduction hearing thresholds of the patients were found to be significantly higher than the controls at all frequencies in the left ear, and 250, 500, 1000 and 2000 Hz in the right ear (p < 0.05). The resonance frequencies of patients were found to be significantly lower than the controls (p < 0.001). The emission amplitudes obtained with contralateral acoustic stimulation were significantly lower than without contralateral acoustic stimulation at 1 kHz frequency in both groups (p < 0.01). There was no significant difference in contralateral suppression levels of the two groups (p > 0.05). Our findings indicate that middle ear mechanics can be affected by psoriasis. There was no significant difference between psoriasis patients and healthy controls in terms of efferent auditory functions. There was a significant difference at limited frequency in hearing thresholds and emission amplitudes between the groups.

Comparison of Compressed High-Intensity Radar Pulse and Tone Burst Stimulation in Vestibular Evoked Myogenic Potentials in Acute Peripheral Vestibular System Pathologies

BACKGROUND

It is ascertained that the compressed high-intensity radar pulse (CHIRP) is an effective stimulus in auditory electrophysiology. This study aims to investigate whether Narrow Band Level Specific Claus Elberling Compressed High-Intensity Radar Pulse (NB LS CE-CHIRP) stimulus is an effective stimulus in the vestibular evoked myogenic potentials test.

METHODS

A case-control study was designed. Fifty-four healthy participants with no vertigo complaints and 50 patients diagnosed with acute peripheral vestibular pathology were enrolled in this study. Cervical and ocular vestibular evoked myogenic potential tests (cervical vestibular evoked myogenic potentials and ocular vestibular evoked myogenic potentials) with 500 Hz tone burst and 500 Hz Narrow Band Level Specific CE-CHIRP stimulations were performed on all participants. In addition, cervical vestibular evoked myogenic potentials and ocular vestibular evoked myogenic potentials tests with 1000 Hz tone burst and 1000 Hz Narrow Band Level Specific CE-CHIRP were performed on 24 Meniere's disease patients. P1 latency, N1 latency, amplitude, threshold, and the asymmetry ratio of responses were recorded.

RESULTS

In healthy participants, with CHIRP stimulus, shorter P1 latency (P < .001), shorter N1 latency (P < .001), and lower threshold (P = .003) were obtained in the cervical vestibular evoked myogenic potentials test; shorter P1 latency (P < .001), shorter N1 latency (P < .001), higher amplitude (P < .001), and lower threshold (P < .001) were obtained in ocular vestibular evoked myogenic potentials test. In symptomatic ears of patients, with CHIRP stimulus, shorter P1 latency (P < .001), shorter N1 latency (P < .001), and lower threshold (P=.013 in cervical vestibular evoked myogenic potentials; P=.015 in ocular vestibular evoked myogenic potentials) were obtained in cervical vestibular evoked myogenic potentials and ocular vestibular evoked myogenic potentials tests. In asymptomatic ears of patients, with CHIRP stimulus, shorter P1 latency (P < .001) and shorter N1 latency (P < .001) were obtained in the cervical vestibular evoked myogenic potentials test; shorter P1 latency (P < .001), shorter N1 latency (P < .001), higher amplitude (P < .001), and lower threshold (P=.006) were obtained in ocular vestibular evoked myogenic potentials test.

CONCLUSION

Our results suggest that due to higher response rates, shorter latencies, higher amplitude, and lower threshold values, the Narrow Band Level Specific CE-CHIRP stimulus is an effective stimulus for both cervical vestibular evoked myogenic potentials and ocular vestibular evoked myogenic potentials tests.

The relationship between functional head impulse test and age in healthy individuals

BACKGROUND

fHIT is an easily applicable test battery that indirectly evaluates the vestibulo-ocular reflex (VOR) from a functional perspective.

AIMS/OBJECTIVES

The aim of this study was to Individuals determine the correlation between age and the percentage of correct answers (% CA) obtained in the functional head impulse test (fHIT) in healthy individuals.

MATERIAL AND METHODS

A total of 105 volunteers, 50 males and 55 females, between the ages of 18 and 70 years, participated in the study. A Beon Solution fHIT system (Zero Branco (TV), Italy) was used in the study.

RESULTS

In our study, a decrease in the mean % CA was observed in all semicircular canals (SCCs) with increasing age. Between age and mean % CA, a significant negative moderate (-0.311) correlation was observed in lateral SCCs, and a significant negative low (-0.257) correlation was observed in posterior SCCs (p <  0.05). In anterior SCCs, there was no statistically significant relationship between age and mean % CA (p >  0.05).

CONCLUSIONS

The present study performed in a healthy population will be helpful in terms of making comparisons in studies to be conducted in various vestibular diseases. It will also be a guide for identifying pathological consequences in vestibular diseases.

Does the Efferent Auditory System Have a Role in Children with Specific Learning Disabilities?

Objective

This study aimed to compare the baseline transient otoacoustic emission (t-OAE) amplitudes and medial olivo-cochlear (MOC) efferent activity in children with specific learning disability (SLD) and children with normal development.

Methods

The study was conducted in two groups. The patient group included 30 children aged 6 to 10 years and diagnosed with SLD, and the control group included 30 children in the same age range without SLD. The patient group included eight males and 22 females, and the control group included 14 females and 16 males. t-OAE and contralateral suppression test were performed in both groups.

Results

In the first t-OAE measurements, a statistically significant difference was observed between the patient and the control group at frequencies of 1400, 2000, 2800, and 4000 Hz, but no such difference was observed at 1000 Hz frequency. In the control group, significantly better emission amplitudes were observed. No differences were found at any frequency between the patient and the control groups after suppression. When the subjects in the two groups were compared among themselves, there was a statistically significant difference between the before and after suppression scores in the patient group except at 4000 Hz. Likewise, an important difference was also observed in all frequencies in the control group.

Conclusion

This study shows that suppression effects of t-OAE on children diagnosed with SLD and children with no SDL are not significantly different.

Submandibular Gland Surgery: Our Clinical Experience

Objective

The aim of this study was to assess the demographic findings and surgical results of patients who underwent submandibular gland excision at a tertiary care center.

Methods

The clinical characteristics and histopathological results of 45 patients who had undergone submandibular gland excision between 1997 and 2014 were evaluated in detail.

Results

Twenty-eight (62.2%) and 17 (37.8%) patients presented with a complaint of a painful mass and painless mass, respectively. Histopathologic investigation of the surgical specimens revealed sialolithiasis in 14 patients (31.1%), chronic sialadenitis in 16 (35.6%), benign tumor in 12 (26.7%), malignant tumor in two (4.4%), and mucocele extravasation in one. As complications, permanent paralysis of the marginal mandibular branch of the facial nerve was seen in one patient (2.2%), temporary paralysis of the marginal mandibular branch of the facial nerve was seen in seven (15.6%), orocutaneous fistula was seen in one (2.2%), and temporary paralysis of the hypoglossal nerve was seen in one (2.2%).

Conclusion

This study revealed that in patients presenting with complaints of a submandibular gland mass, sialolithiasis, sialadenitis, and benign masses were the mostly diagnosed disorders. Transcervical submandibular gland excision is a satisfactory procedure with low complication and recurrence rates when it is performed on selected patients and obeyed to surgical techniques.

[Ocular vestibular evoked myogenic potentials in response to bone-conducted sound stimuli: results of measurements in healthy adults]

OBJECTIVES

This study aims to determine the normal values of ocular vestibular evoked myogenic potentials (oVEMP) in response to bone-conducted sound stimuli in healthy adults.

PATIENTS AND METHODS

The study included 42 healthy adult volunteers (18 males, 24 females; mean age 39.7±11.2 years; range 20 to 60 years) (84 ears) with pure tone mean thresholds better than 20 dB, no detected nystagmus during positional tests, and no complaint involving the ear. The participants were performed otorhinolaryngologic examination, audiologic evaluation, and positional tests. Ocular vestibular evoked myogenic potentials were measured using air-conducted and bone-conducted sound stimuli and results were compared.

RESULTS

No statistically significant difference was detected between the side of the ear tested and sex in terms of the latency and amplitude values (p>0.05). There was no correlation between n1, p1 latency and amplitude values with age and (p>0.05). Mean n1 latency was 9.9±1.87 milliseconds and p1 latency was 12.75±1.41 milliseconds. Mean amplitude was 5.06±1.97 µV. Interaural asymmetry ratios were 4±3% for p1, 4±3% for n1, and 8±6% for amplitude.

CONCLUSION

Data obtained in this study may be accepted as normal values for healthy adults and used as reference in oVEMP studies with bone-conducted sound stimuli.