1/12. What inner ear diseases cause benign paroxysmal positional vertigo?Benign paroxysmal positional vertigo (BPPV) originating from the posterior semicircular canal (pSCC) is a common vestibular disorder that is easy to diagnose and usually easy to treat. The majority of patients with BPPV have no known inner ear disease; they have "primary" or "idiopathic" BPPV. However, a minority does have objective evidence of an inner ear disease on the same side as the BPPV and this group has "secondary" or "symptomatic" BPPV. Previous publications differ on the prevalence of secondary BPPV and about the types of inner ear diseases capable of causing it. In order to determine what proportion of patients have secondary as opposed to primary BPPV and which inner ear diseases are capable of causing secondary BPPV, we searched our database for the 10-year period from 1988 to 1997 and found a total of 2847 patients with BPPV. Of these, 81 (3%) had definite pSCC-BPPV secondary to an ipsilateral inner ear disease. Sixteen had Meniere's disease, 24 had an acute unilateral peripheral vestibulopathy, 12 had a chronic unilateral peripheral vestibulopathy, 21 had chronic bilateral peripheral vestibulopathy and 8 had unilateral sensorineural hearing loss. It seems that any inner ear disease that detaches otoconia and yet does not totally destroy pSCC function can cause BPPV and that a case can be made for audiometry and caloric testing in all patients with BPPV.- - - - - - - - - - ranking = 1keywords = vertigo (Clic here for more details about this article) |
2/12. rupture of the round window membrane.A perilymph leak into the middle ear through a ruptured round window membrane results in the symptoms of hearing loss, tinnitus and vertigo, either singly or in combination. The case histories of thirteen patients with such a fistula are described, these patients having in common a predisposing incident which had led to a rise of C.S.F. pressure. Symptomatology and the results of investigation are analysed and operative technique and results discussed. While it appears that vertigo uniformly responds very satisfactorily to operative treatment the improvement in hearing loss and tinnitus is more difficult to predict.- - - - - - - - - - ranking = 0.4keywords = vertigo (Clic here for more details about this article) |
3/12. Unilateral deafness with subsequent vertigo.The association between the characteristic clinical picture of endolymphatic hydrops and pre-existent profound sensori-neural hearing loss of long duration, has not been previously reported. Several cases are reported to illustrate this clinical syndrome. Labyrinthectomy was found to be curative. A plea is made for better recognition of this clinical entity.- - - - - - - - - - ranking = 0.8keywords = vertigo (Clic here for more details about this article) |
4/12. Traumatic perilymphatic fistula: how long can symptoms persist? A follow-up report.In the past 18 years 68 ears (average 3.8 per year) were explored for perilymphatic fistula (PLF). A total of nine (13%) ears had a fistula identified at operation. patients with a previous history of otologic surgery were excluded from this review. The most common etiology for PLF was head trauma (4 of 9). Most patients had persistent symptoms lasting months (average 6.7). Eighty-three percent of all patients had sudden or fluctuating hearing loss, 77 percent had vertigo or dysequilibrium, and 61 percent had tinnitus. vertigo was the most commonly improved symptom postoperatively, and only 25 percent of patients had improved hearing. There were no major complications. The authors discuss indications for operation, criteria for diagnosis of PLF, and audiometric and electronystagmographic findings. This report agrees with other recent data indicating that exploration for fistula is an uncommon procedure performed by otologists.- - - - - - - - - - ranking = 0.2keywords = vertigo (Clic here for more details about this article) |
5/12. Complicated cholesteatomas: CT findings in inner ear complications of middle ear cholesteatomas.patients with facial palsy and middle ear disease, which may be chronic but clinically occult, may have a cholesteatoma with extension medially along the facial canal. In two patients, axial computed tomographic (CT) scans demonstrated involvement of the medial petrous bone. patients with vertigo and chronic middle ear disease may have a cholesteatoma with a "fistula" between the middle and inner ears. Although the fistula usually involves the lateral semicircular canal, the cholesteatoma may pass through the oval window. In two patients, coronal CT scans showed extension to the oval window in one and through it in the other.- - - - - - - - - - ranking = 0.2keywords = vertigo (Clic here for more details about this article) |
6/12. Generalized argyrosis in man: neurotological, ultrastructural and X-ray microanalytical findings.Generalized argyrosis can produce a number of abnormalities, including skin discoloration, liver and kidney dysfunction. We describe a patient with generalized argyrosis following long-term self-treatment with oral silver intake, in whom skin discoloration, progressive taste and smell disorders, vertigo and hypesthesia were observed. These findings were confirmed by chemosensory tests and electrophysiological investigations. The development of hypogeusia was assessed by subjective tests, while the progression of hyposmia was followed by recording olfactory evoked cortical potentials. light and electron microscopy of tissue samplings demonstrated electron-dense mineral deposits in basal membranes, in macrophages, in the perineurium of peripheral nerves, along elastic and collagenous fibers, and in necrotic cells of the oral submucosa. silver and sulfur deposits in affected tissues could be defined by X-ray microanalysis. The quantitative ratio between silver and sulfur in involved tissues was similar to that of an inorganic silver-sulfide (Ag2S) standard. The minute increase in the sulfur content when compared to the inorganic standard suggested a sulfur containing organic matrix of the tissue precipitates. Our findings indicate that the affinity of silver for membrane and neuronal structures and the deposition of silver as an insoluble compound (Ag2S) induce the progression of clinical disease.- - - - - - - - - - ranking = 0.2keywords = vertigo (Clic here for more details about this article) |
7/12. hearing loss resulting from perilymph fistula. A presentation of two cases.Two cases of perilymph fistula in the oval window are presented. In such cases hearing loss may be severe and vertigo may or may not be present. Early surgical intervention is recommended, but one should not hesitate to explore a suspected ear, even if considerable time has elapsed.- - - - - - - - - - ranking = 0.2keywords = vertigo (Clic here for more details about this article) |
8/12. Underrated neurotologic symptoms.patients present themselves with neurotologic symptoms which may be early and subtle indicators of active vestibular pathology. The frequently slighted complaints of light-headedness, imbalance and a floating sensation are as important as "true rotatory vertigo." Ear fullness, the most underinvestigated of neurotologic complaints may be a cardinal symptom. Occipital headaches are a frequent complaint of the dizzy patient. Blurred vision, and, in some severe peripheral disorders, diplopia are symptoms referrable to oculovestibular interaction. Visual stimulation intensifies vestibular symptoms. Stress may precipitate or increase dizziness in patients who have partially compensated for a vestibular deficit. anxiety, fatigue and systemic illness are exemplary. Patient histories are presented to emphasize clinical relevance and therapeutic modalities.- - - - - - - - - - ranking = 0.2keywords = vertigo (Clic here for more details about this article) |
9/12. Meniere's disease and endolymphatic hydrops: clinical-histopathological correlations.The clinical-histopathological correlation between Meniere's disease and endolymphatic hydrops was done to explain, as much as possible, causes of symptoms of Meniere's disease. Twenty-three temporal bones with endolymphatic hydrops from 17 patients were reviewed and clinical and histopathological findings were correlated. Histopathological examination revealed frequent, severe deformities in the labyrinthine walls and permanent changes in Reissner's membranes. Evidence of rupture was difficult to assess. Of 21 ears of patients with the clinical diagnosis of Meniere's disease, 93% had endolymphatic hydrops. A statistical correlation between increased area of the cochlear duct and hearing loss was found. Some correlation was also found between frequency of vertigo and results of electronystagmography with histopathological findings. Consequently, the mechanical effect of endolymphatic hydrops seems to have greater significance in the production of symptoms of Meniere's disease than the biochemical effect of ruptures. In a review of ten unusual cases from this series of 17 patients, traumatic neuromas or remnants of vestibular structures were found after an incomplete labyrinthectomy. Histopathological findings of four patients who had undergone endolymphatic subarachnoid shunt surgery are described.- - - - - - - - - - ranking = 0.2keywords = vertigo (Clic here for more details about this article) |
10/12. Otoneurological observation and classification of Harada's disease presenting with aural symptoms, especially vertigo.Harada's disease is an uncommon autoimmune disease affecting melanocytes located in the uvea, inner ear, skin, hair, and meninges. A classification of Harada's disease presenting with aural symptoms, especially vertigo, was devised on the basis of otoneurological findings. Peripheral vestibular dysfunction, such as staggering in the stepping test, rotato-horizontal or horizontal nystagmus, and diminished labyrinthine function in the caloric nystagmus test, was observed in the vast majority of these patients. Harada's disease with such features was designated as the peripheral type, and was further divided into vestibular, cochleo-vestibular, and cochlear subtypes. patients only rarely presented with symptoms or signs of central nervous system involvement, and Harada's disease with such features was designated as the central type.- - - - - - - - - - ranking = 1keywords = vertigo (Clic here for more details about this article) |
| | Next -> |