Complete recovery following hyperbaric oxygen therapy in idiopathic sudden sensorineural hearing loss--a report of two cases.

Complete recovery following hyperbaric oxygen therapy in idiopathic sudden sensorineural hearing loss--a report of two cases.

Undersea Hyperb Med. 2016 Mar-Apr;43(2):161-6

Authors: Agrawal S, Sharma N

Abstract
Idiopathic sudden sensorineural hearing loss (ISSHL), a common otologic emergency, presents mostly as an abrupt onset unilateral hearing loss, aural fullness, often with vertigo and tinnitus, usually upon awakening in the morning. Its etiopathogenesis is multifactorial, so a number of different therapeutic regimens are in practice, hyperbaric oxygen (HBO2) therapy being an effective yet underutilized one. Not all cases recover completely even after treatment. Here we describe two cases of ISSHL, diagnosed on the basis of clinical examination and pure-tone audiometry, who had a complete recovery following administration of HBO2 therapy in addition to medical treatment. These cases are reported to highlight the effectiveness of this modality in a physician's armamentarium.

PMID: 27265993 [PubMed - in process]

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Endolymphatic sac surgery versus tenotomy of the stapedius and tensor tympani muscles in the management of patients with unilateral definite Meniere's disease.

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Endolymphatic sac surgery versus tenotomy of the stapedius and tensor tympani muscles in the management of patients with unilateral definite Meniere's disease.

Eur Arch Otorhinolaryngol. 2015 Dec;272(12):3645-50

Authors: Albu S, Babighian G, Amadori M, Trabalzini F

Abstract
This study aims to compare the outcomes of patients with Meniere's disease submitted to either endolymphatic mastoid shunt (ES) or tenotomy of the stapedius and tensor tympani muscles (TSTM). This is a retrospective chart review of patients treated with ES or TSTM between 2000 and 2010 and followed up for at least 12 months. The main outcomes were represented by: (1) vertigo class, hearing stage and functional level according to the American Academy of Otolaryngology-Head and Neck Surgery criteria; (2) adjustment of dizziness handicap inventory (DHI) and (3) complete and substantial vertigo control using the Kaplan-Meier survival method. Sixty-three patients met the inclusion criteria: 34 underwent ES and 29 TSTM. The baseline demographic characteristics, the hearing stage, the functional level, the DHI and hearing levels were not different between the two groups. No significant difference in vertigo class was demonstrated: 66 % of TSTM patients attained class A compared to 44 % in the ES group (p = 0.14). Kaplan-Meier survival curves specific to class A showed significant differences, favoring TSTM (log-rank test, p = 0.022). TSTM patients demonstrated significantly improved functional level (p = 0.0004) and improved DHI scores (p = 0.001). Eight ES patients (25 %) demanded a second surgical attempt compared to none in the TSTM. Aural fullness was significantly improved in TSTM group (p = 0.01), while the difference in tinnitus improvement was non-significant. Hearing preservation was significantly better in TSTM group (p = 0.001). TSTM is a safe surgical procedure, with significant vertigo control rates, and important hearing preservation rates. More patients and longer follow-up are needed to support our preliminary findings.

PMID: 25488280 [PubMed - indexed for MEDLINE]

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Deconvolution of the vestibular evoked myogenic potential using the power spectrum of the electromyogram.

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Deconvolution of the vestibular evoked myogenic potential using the power spectrum of the electromyogram.

Theor Biol Med Model. 2015;12:21

Authors: Lütkenhöner B

Abstract
BACKGROUND: The vestibular evoked myogenic potential (VEMP) can be modelled reasonably well by convolving two functions: one representing an average motor unit action potential (MUAP), the other representing the temporal modulation of the MUAP rate (rate modulation). It is the latter which contains the information of interest, and so it would be desirable to be able to estimate this function from a combination of the VEMP with some other data. As the VEMP is simply a stimulus-triggered average of the electromyogram (EMG), a supplementary, easily accessible source of information is the EMG power spectrum, which can be shown to be roughly proportional to the squared modulus of the Fourier transform of the MUAP. But no phase information is available for the MUAP so that a straightforward deconvolution is not possible.
METHODS: To get around the problem of incomplete information, the rate modulation is described by a thoughtfully chosen function with just a few adjustable parameters. The convolution model is then used to make predictions as to the energy spectral density of the VEMP, and the parameters are optimized using a cost function that quantifies the difference between model prediction and data.
RESULTS: The workability of the proposed approach is demonstrated by analysing Monte Carlo simulated data and exemplary data from patients who underwent VEMP testing as part of a clinical evaluation of their dizziness symptoms.
CONCLUSIONS: The approach is suited, for example, to estimate the duration of the inhibition causing the VEMP or to disentangle a VEMP consisting of more than one component.

PMID: 26438301 [PubMed - indexed for MEDLINE]

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