122 research outputs found
Intratympanic prednisolone therapy for sudden sensorineural hearing loss: A new protocol
No full textConclusion: Intratympanic administration of prednisolone at a dose of 62.5 mg/ml performed every day for 3 consecutive days is more efficacious than the therapeutic approaches described so far in the literature. Objectives: The aim of the study was to evaluate the overall success rate, morbidity, and prognostic factors of a new protocol of intratympanic steroid administration as a means of primary therapy for idiopathic sensorineural hearing loss. Methods: Overall, 34 patients presenting sudden unilateral sensorineural hearing loss of at least 30 dB over three frequencies that had developed within 72 h were treated once a day for 3 consecutive days with a single intratympanic injection of prednisone diluted in saline solution. Results: Following intratympanic therapy with prednisone, 16 patients (47%) reported complete recovery of sudden sensorineural hearing loss, with a pure tone average that returned within 25 dB; 11 patients (32.3%) showed improvement in hearing of more than 30 dB; 4 patients presented improvement in pure-tone average between 10 and 30 dB. Only three patients failed to improve following intratympanic injection. © 2010 Informa Healthcare
DELAYED RETROAURICOLAR CEREBROSPINAL FLUID (CSF) COLLECTION IN COCHLEAR IMPLANTATION
No full textIn the literature, this is the first description of a delayed retroauricular cerebrospinal fluid (CSF) collection in a child after 18 months of cochlear implantation. During surgical revision, anomalous thinning of the dura and leakage of CSF was found beneath the receiver, requiring local sealing and repositioning. Exposure of the dura is a procedure usually performed during housing of the receiver to avoid excessive protrusion of the implant in subjects with insufficient bone thickness. In most cases, this has proved to be a safe procedure. However, in some cases, as in children, exposure of the dura should be undertaken with care
“Riabilitazione estetico funzionale e camouflage nelle II Classi dentoscheletriche”
No full textPoster Collegio dei Docenti di Odontoiatria 16-19 Marzo 200
Pneumolabyrinth after intratympanic steroid injection in patient with prosthesis of the stapes: A case report
No full textThe aim of this study is to present a patient who developed a pneumolabyrinth following
intratympanic steroid injection performed one year after stapes surgery. The patient started
a medical treatment but since no improvement of his symptoms occurred, 10 days after the
intratympanic injection a surgical treatment was proposed. An exploratory tympanotomy
showed a displacement of the stapes prosthesis from the platinotomy, a dislocation of the
incus long process, a fracture of the footplate and a depression into the vestibule. The
fragment of the broken footplate was removed, a new prosthesis was located. Nausea,
vertigo and nystagmus resolved immediately following surgery with a hearing threshold
unchanged. In the present case report, the pathogenesis of pneumolabyrinth may be
connected to an IT steroid injection proposed to the patient for the onset of sudden
sensorineural hearing loss. To our knowledge, no case of a pneumolabyrinth provoked by
intratympanic steroid injection has been previously described
Utilization of Bioalcamid in Reconstructive Surgery of the maxillo-Facial District
No full textXVII Congress of the European Association for Cranio Maxillo facial
Surgery
Inner Ear Active Hearing Device in Non-Otosclerotic, Severe, Mixed Hearing Loss
No full textOBJECTIVE:
To verify the efficacy of a powerful active hearing device in a patient different from far-advanced otosclerosis, specifically when the stapes footplate is mobile.
PATIENT:
A patient with severe-to-profound mixed hearing loss, who was not benefiting from the use of a conventional hearing aid, was selected for an inner ear active implant. This was justified by a bone conductive threshold above 60 dB, which had discouraged any other rehabilitative solutions such as a bone conductive implant, or an active middle ear implant (AMEI).
INTERVENTION:
The hearing device was surgically applied using a combined transmastoid/transcanal approach. During surgery, a mobile stapes were found and was perforated for the insertion of a piston prosthesis, crimped on the new-incus of the device.
MAIN OUTCOME MEASURE:
The bone conduction threshold was assessed postoperatively to identify any possible surgery-related hearing deterioration. Pure tone audiometry was conducted in a sound field, and a speech reception threshold test was performed with the contralateral ear masked. The hearing outcome was assessed soon after the implant activation (6 weeks after surgery), and 6 months after surgery.
RESULTS:
Upon activation of the device, a PTA of 45 dB was obtained (at 0.5, 1, 2 and 4 kHz). At 6 months after surgery, the speech discrimination score reached 90% at 80 dB SPL.
CONCLUSION:
The application of the Codacs device has shown to be compatible with a mobile stapes footplate, as demonstrated in this report. The footplate perforation did not cause any further hearing deterioration, and has allowed to achieve a favorable auditory outcome
The role of cochlear implantation in alleviating Tumarkin drop attacks of Meniere's disease; a case report
No full textMénière's disease (MD) patients may suffer episodes of sudden falls, named Tumarkin drop attacks (DAs). This fall occurs abruptly and without warning or loss of consciousness. DAs usually aggravate the clinical picture of MD and are challenging to manage. The present report describes a case treated by cochlear implantation (CI) due to concomitant deafness and offers some clinical considerations for this condition. A male patient aged 48 years with a 10-year history of definite bilateral MD had profound SNHL on the right and severe SNHL on the left side. He suffered from intermittent attacks of vertigo, ear fullness, and tinnitus and, in the last year, had developed DAs and experienced 14 episodes in the previous six months. The preoperative category of acoustic performance was 3. The Dizziness Handicap Inventory (DHI) questionnaire showed a total score of 46, which indicated a moderate degree of disability. A CI was planned for the right side. The patient did not report any further DAs episode for two years since then. The postoperative category of acoustic performance became 11, and the postoperative DHI questionnaire showed a decrease in the total score (from 46 to 19), which indicated a mild disability. Unilateral CI effectively alleviated the DAs associated with bilateral MD. Our report proposes a new modality for managing vertiginous symptoms in cases of MD with hearing loss without the need for more aggressive surgical interventions with the need for clinical trials to confirm our results
Intratympanic steroid therapy in moderate sudden hearing loss: A randomized, triple-blind, placebo-controlled trial
No full textObjectives/Hypothesis: To investigate the efficacy of an intratympanic steroid as a first-line therapy in patients affected by moderate idiopathic sudden sensorineural hearing loss (ISSNHL). Study Design: Prospective, randomized, triple-blind, placebo-controlled trial. Methods: Fifty patients presenting with moderate idiopathic sudden sensorineural hearing loss involving all frequencies from 250 Hz to 8,000 Hz (a flat audiogram) were enrolled. Patients were randomized into two groups of 25 each. The first group (intratympanic steroid) underwent a daily intratympanic administration of prednisolone for 3 consecutive days. Subjects in the second group (control) received a daily intratympanic injection of a saline solution for 3 consecutive days. Audiometric tests were performed at day 7 after the beginning of therapy (T1), and then 10 and 30 days after T1. The patients in both groups who did not show a complete recovery at T1 were treated with oral prednisone at a tapering dose. Results: In the intratympanic steroid group, 19 out of 25 patients presented at T1 complete recovery (76%), whereas in the control group the number patients who recovered completely at T1 was five out of 25 (20%). The mean pure-tone average (PTA) recorded at T1 shows a statistically significant improvement in the hearing threshold of the first group compared to the control group (P <.01). Conclusions: The mean PTA recorded after the first-line approach (T1) demonstrated a significant therapeutic action of the short-duration intratympanic steroid therapy on moderate ISSNHL, with a flat audiogram shape, compared to the natural course of the disease and the placebo effect at that time point. Laryngoscope, 2013 Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc
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