Cases reported "Tinnitus"

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21/26. Low-frequency sensorineural hearing loss. Brainstem response, speech and high-frequency audiometry.

    Four cases of acquired, unilateral sensorineural hearing loss are presented. The low-frequency octave threshold changes are considered compatible with the low-frequency tails of neurons with characteristic frequencies of 2, 4 and 9 kHz. Zero speech discrimination was found in two patients with high-frequency threshold preservation at and above 4 kHz. Normal auditory brainstem responses were obtained in the two patients with low-frequency hearing loss confined to the frequency bands below 2 and 4 kHz respectively. Only wave I could be reliably identified in the two patients with single frequency threshold preservation at 2 and 9 kHz, while both presented a second, low amplitude wave with latency corresponding to our normative values for wave V. The latter may represent a delayed and pathological wave III.
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ranking = 1
keywords = speech discrimination, discrimination, speech
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22/26. An algorithm for neurotologic disorders.

    In the evaluation of patients with complaints of dizziness, hearing loss, and/or tinnitus, the primary objective is to determine the site of the lesion. An accurate localization of the lesion is important for selecting the most appropriate radiologic study. The information obtained from the vestibular and audiometeric evaluations identifies the site of the lesion accurately. For the vestibular evaluation we use photoelectric nystagmography (PENG) and the Torok monothermal differential caloric test. The initial audiometeric evaluation consists of a pure-tone audiogram and speech discrimination scores. Additional audiometric site-of-lesion tests and ABR are used selectively as the diagnostic yield of these tests does not significantly add to the information already obtained from the vestibular evaluation. If the lesion is suspected to lie in the middle ear or internal auditory canals, we use pluridirectional tomography. For further delineation of lesions confined to the internal auditory canal we use pneumo-CT. For suspected morphologic lesions of the posterior fossa we use thin-section CT with enhancement. review has proved useful in defining petrous apex and skull base lesions. CT-rBBC studies have proved valuable in objectively demonstrating a deficient perfusion of the brain. The vascularity of certain lesions such as glomus tumors can be satisfactorily confirmed by this technique.
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ranking = 0.99115560671089
keywords = speech discrimination, discrimination, speech
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23/26. Unusual presentations of acoustic tumours.

    A series of 238 consecutive patients with acoustic neuromas, operated on in paris has been studied to identify unusual presentations and varied symptomatology. The most common history was that of a progressive unilateral hearing loss (in 68.1%), with tinnitus (in 49.1%) or disequilibrium (in 49.1%) or both. Sudden hearing loss (in 14.7%) or fluctuating hearing loss (in 6.3%), and a single or repeated episodes of acute vertigo (in 8.8%) were seen less commonly. Headaches occurred as an associated symptom in 10.5%, tinnitus was the sole symptom in 2.8% and other uncommon symptoms included otalgia, facial nerve palsy, facial or ocular pain, altered sensation in the face or eye, or tingling of the tongue. Some 11.3% of patients presented with normal pure tone auditory thresholds and a 100% speech discrimination score and of these patients acoustic reflex thresholds were normal in 53% and brainstem auditory evoked responses were suggestive of the retro-cochlear abnormality in only 76.2%. Amongst the less common presentations, the initial symptoms mimicked such diagnoses as Meniere's disease, benign positional vertigo, vertebro-basilar migraine, vertebro-basilar insufficiency, Bell's palsy and trigeminal neuralgia. overall, 20.6% of patients had unusual initial presenting symptoms, 36.5% of the symptoms were unusual and these were found in isolation in 11.8% of patients. An awareness of the spectrum of more subtle symptoms of acoustic tumours may lead to the correct diagnosis at an earlier stage.
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ranking = 0.99115560671089
keywords = speech discrimination, discrimination, speech
(Clic here for more details about this article)

24/26. Vascular-decompression surgery for severe tinnitus.

    Vascular compression of the eighth cranial nerve is increasingly recognised as a possible cause of incapacitating audiovestibular symptoms. There have been few reports of the efficacy of surgical microvascular decompression for tinnitus, and the practise is controversial. During the last 6 years, investigation by air computed tomography (CT) cisternography initially, and fast spin-echo magnetic resonance imaging (MRI) latterly has resulted in the diagnosis of cochlear nerve vascular compression in nine patients with a primary complaint of severe tinnitus who have subsequently undergone vascular-decompression surgery. The duration of symptoms ranged between 1 and 10 years, whilst their subjective tinnitus perception varied between 30 to 60 dB above threshold. Microvascular decompression was carried out by a retrolabyrinthine approach in four and by a retrosigmoid approach in the remaining five cases, with a postoperative follow-up of 1.3 to 5 years. tinnitus was completely abolished in three (33%), very significantly improved to a sensation level of < or = 10 dB in four (33%), significantly improved to a level of 15 dB in one (11%), and unchanged in two (22%). Both failures had had tinnitus for 6 years and had transient abolition for 10 days after surgery. Subsequent revision decompression surgery was also unsuccessful. This small study suggests that cochleovestibular vascular compression may result in severe tinnitus, which can often be ameliorated surgically.
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ranking = 0.0042316134326939
keywords = perception
(Clic here for more details about this article)

25/26. Audio-vestibular manifestations of Chiari malformation and outcome of surgical decompression: a case report.

    Sensorineural hearing loss, tinnitus, dizziness and ataxia are recognised symptoms associated with Chiari malformations but they are rarely the presenting complaints. patients with such symptoms are frequently referred to otolaryngologists and audiological physicians. We report a case of a 13-year-old girl who presented complaining of tinnitus and impaired hearing, and was subsequently diagnosed as having a type I Chiari malformation. Pure tone audiogram showed a mild hearing impairment on the left side and the speech audiogram was normal. Auditory brain stem responses and the electronystagmography were abnormal. The patient underwent posterior fossa decompression following which her tinnitus disappeared, the hearing problem recovered and some of the abnormal electrophysiological parameters were corrected.
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ranking = 0.0022110983222785
keywords = speech
(Clic here for more details about this article)

26/26. Reversible pitch perception deficit due to carbamazepine.

    carbamazepine (CBZ) is a drug frequently used to treat variety of neurological diseases or symptoms. Among its adverse effects, auditory disturbance is described rarely. In the present report, we describe an 18-year-old girl who noted false lowering of perceived pitch after starting CBZ treatment for epilepsy, and review the literature reporting CBZ-associated abnormal pitch perception.
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ranking = 0.02115806716347
keywords = perception
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