1,721,056 research outputs found
The influence of systemic circulation on hearing: The reliability of a different impact of microcirculatory defects and atherosclerosis
No full textThe extension of the dependence of hearing acuity from circulatory factors has been widely evaluated in the literature, without reaching an univocal conclusion. In our opinion, a precise distinction between acute/fluctuating disorders and progressive hearing loss must be made in order to identify the possible circulatory causes. Actually, it is conceivable to hypothesize that an acute lack of perfusion plays a major role in the inner ear microcirculation, and may be responsible for acute hearing damages; on the other hand, systemic atherosclerosis may coexist with good hearing provided that a sufficient local perfusion is maintained.This distinction, supported by our findings over the year, appears logical considering the autoregulatory properties of the cochlea and the differences between large/middle vessels and microvasculature; moreover, it can explain the finding of both people with no cardiovascular risk factors and (usually) unilateral inner ear affections and people with diffuse atherosclerosis and well preserved hearing, not exceptionally occurring in daily practice
Dehiscence of the superior semicircular canal: A review of the literature on its possible pathogenic explanations
No full textThe dehiscence of superior semicircular canal is a well-known affection which is able to explain some cases of hearing loss, tinnitus and/or vertigo unexpectedly presenting in adults without previous otologic affections. Although a diagnostic algorithm has been assessed and a surgical therapy has been indicated, the review of the literature shows that a completely satisfactory explanation for the reason why symptoms of a supposed congenital condition only occur in adulthood is still lacking. A pathogenic hypothesis based on the slow metabolism of the bony labyrinth, which could in time result in a prevalence of bone re-absorption on new bone formation leading to a dehiscence, despite some controversial findings could represent a the most reliable explanation for the question
Stapedotomy versus stapedectomy: an ancient match considered from another point of view
No full textPurpose: Analysis of the differences in inner ear admittance achieved by a large fenestra in comparison with a small fenestra and its effect on bone conduction in stapes surgery. Materials and methods: Description of an interesting case of bilateral otosclerosis with an atypical and symmetrical behaviour of bone conduction, treated with a stapedotomy on the right ear some years before, and recently submitted to stapedectomy on the left year. Results: Concerning the left side, the first complete audiometry was made 15 days after stapedectomy and confirmed a bone conduction improvement, that subsequently increased until almost to the normality 42 days after surgery. The mean postoperative bone conduction difference was 13 dB considering all frequencies; when considering the frequencies between 500 and 2000 Hz the mean difference raised to 20 dB. Conclusions: The reported case, in which the stapedectomy was not scheduled as the first option, but derived from a particular intraoperative situation thus resulting in an almost obligatory choice, permits some interesting conceptual considerations
Idiopathic acute labyrinthine diseases and Ménière’s disease : The necessit y of a multidisciplinary approach.
No full textAssent
Primary vascular dysregulation syndrome: Possible implications for inner ear acute diseases?
No full textPrimary vascular dysregulation syndrome has been reported as a possible cause for different eye diseases. Signs or symptoms of this syndrome not only may consist in a series of ocular disorders, as they possibly concern or are associated to various systemic conditions; even the damage of another terminal sensory organ as the inner ear is reported among the possible associations. Herein, the analogies between eye and inner ear are outlined, analyzing the PVD profile that well corresponds to our widely described model of subject without organic cardiovascular impairment but prone to inner ear acute disturbances. Actually, in absence of a recognized cause the latter can be due to a systemic dysregulation like the described one concerning ocular disorders
Inner ear symptoms: can we use them to approach cardiovascular diseases?
No full textSensory organs are programmed to detect external stimuli, and inform about possible threats. In general, they are characterized by a complex architecture, a highly energy-requiring function, a peripheral location and a vascular supply depending on a terminal circulation usually under systemic control. Their function may be highly sensitive to more general disorders primarily involving other organs or physiological systems. Consequently, the onset of transient or persistent symptoms of impairment of sensory organs might be the expression of abnormalities in the integrity of more general systems, especially in the elderly population. In the otologic area, despite the availability of evidence supporting the negative impact of some systemic conditions negatively affecting the local blood supply at the labyrinth level, the possibility that the inner ear can reveal the presence of sub-clinical, non-otologic disorders has never been the topic of a constructive investigation. The present review summarizes the preliminary available evidence suggesting a possible negative impact of early systemic hemodynamic changes on the function of the inner ear, as well as the possibility that some audiological symptoms may play some role in the early detection of cardiovascular diseases. In particular, we hypothesize that some cardiovascular diseases may cause an impairment in correct labyrinthine function as a result of a negative interaction between systemic hemodynamic changes, a reflex activation of the autonomic nervous system, and a local vascular response. A multidisciplinary approach to the interpretation of inner ear disorders may increase the possibility of an earlier recognition and understanding of systemic dysfunctions in clinical practice
Comparison of two different epidemiological profiles of otorhinolaryngology emergencies
Full text linkAudiovestibular loss of a vascular cause: A distinction should be made between cochlear and vestibular symptoms
No full textLetter to Edito
Perilymphatic fistula: an often unrecognized occupational handicap? A review of the literature and some consequent remarks.
No full textPerilymphatic fistula is an abnormal communication between inner and middle ear, usually through the oval or the round window, with a leakage of perilymph in the middle ear. It can present with fluctuating and generally progressive hearing loss, frequently associated to dizziness and/or vertigo, aural fullness and tinnitus that can occur without a precise pattern. Despite the potential danger derived from the persistence of a perilymphatic fistula in some categories of workers, the necessity to protect potentially affected subjects is often underestimated: for this reason, a review of the literature seemed useful in order to assess the overall awareness of the problem and help avoiding the exposure of these subjects to uncontrolled risks
Superior canal dehiscence and ‘near-dehiscence’ syndrome: clinical and instrumental aspects.
No full textEven though superior canal dehiscence syndrome (SCDS) has already been
widely studied from a clinical, etiopathogenetic and therapeutic point of view,
some diagnostic aspects have yet to be clarified. It is well-known that highresolution
CT (HRCT) scan tends to overestimate the prevalence of the bony
defect requiring the detection of lowered thresholds of air-conducted (AC) VEMPs
to confirm the diagnostic suspect. The most recent definition of the so-called
near-dehiscence syndrome (NDS), in which an extremely thinned bony roof of
the superior canal results in the onset of a symptomatological scenario overlapping
SCDS, has allowed to explain most cases of incongruence between imaging
analyses and electrophysiological data. Moreover, no univocal explanation to
the wide symptomatological and semeiological variability of SCDS has been
offered yet. The aim of this paper is to face the diagnostic dilemma offered by
the complexity of this two-fold syndrome (SCDS vs NDS) reviewing the clinical
and instrumental data and submitting to statistical analyses a subsample of
100 patients (193 ears) selected from a group of 242 patients (114 M, 128 F,
mean age 56.8 y, range 8-88 y) showing a dehiscence or a an extreme thinning
of the superior canal at least from one side at HRCT scans. Firstly, we
verified the effectiveness and the diagnostic accuracy of imaging in confirming
electrophysiological data, considering the threshold lowering of AC cervical
VEMPs as the gold standard in diagnosing an increased inner-ear admittance
due to SCD and we offered physiopathogenetic explanation for those cases of
incongruence between results. Secondly, we sought among instrumental set (AC
and BC cervical and ocular VEMPs, video head impulse test) the test allowing
the best diagnostic criteria for ‘near dehiscence’ and the parameter correlating
most significantly with the size of dehiscence in case of SCDS. While mostly
all data collected can reliably differentiate SCDS from NDS, from this study
emerges that ocular VEMPs represent an effective method to detect the ‘neardehiscent’
condition among the normal cases
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