
Research Articles| December 30 2009 Hearing in Ménière's Disease Subject Area: Audiology and Speech Otto H. Meurman; Otto H. Meurman From the Oto-laryngological University Clinic, Helsinki [Head: Prof. Y. Meurman, M.D.] Search for other works by this author on: This Site PubMed Google Scholar Bertel Grahne Bertel Grahne From the Oto-laryngological University Clinic, Helsinki [Head: Prof. Y. Meurman, M.D.] Search for other works by this author on: This Site PubMed Google Scholar Practica Oto-Rhino-Laryngologica (1956) 18 (6): 365–376. https://doi.org/10.1159/000274005 Article history Published Online: December 30 2009 Content Tools Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn Email Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Otto H. Meurman, Bertel Grahne; Hearing in Ménière's Disease. Practica Oto-Rhino-Laryngologica 1 June 1956; 18 (6): 365–376. https://doi.org/10.1159/000274005 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll JournalsPractica Oto-Rhino-Laryngologica Search Advanced Search Article PDF first page preview Close Modal This content is only available via PDF. 1956Copyright / Drug Dosage / DisclaimerCopyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements. You do not currently have access to this content.
Mandibular angle fractures are frequently observed. Not only the angle is a weak transition region, but the presence of impacted third molar tooth also plays an important role in the development of mandibular angle fractures. Fractures of the mandibular angle are usually isolated, whereas bifocal mandibular fractures usually involve a different region, such as symphysis or condyle. In fact, mandibular fractures involving both mandibular angles are rare. The aim of the present article was to present a case report of a Biangular Mandibular Fracture, along with its characteristics and surgical management.
Oncocytic lipoadenoma is an extremely rare benign tumor of the salivary glands; less than 20 cases have been reported in literature, since the first report in 1998. We are presenting a case of a 73-year-old man with a slowly growing painless parotid mass; ultrasound and magnetic resonance imaging enhanced with gadolinium showed a lesion with benign features and heterogeneous content. Fine needle aspiration biopsy was suggestive for a Warthin’s tumor. Surgical approach was a classic lateral parotidectomy with facial nerve identification and preservation. Histology revealed a well-capsulated mass with mixed components, including oncocytes (70%) and mature adipocytes (30%), consistent with oncocytic lipoadenoma. The results of immunohistochemical staining supported this diagnosis. Main characteristics of this neoplasm are reviewed and briefly discussed, along with the differential diagnostic elements of more common lesions. The knowledge and the awareness of this entity could be helpful when evaluating a patient with a salivary gland tumor.
Viral infections have become an increasingly worsening threat, SARS-Cov-2 is the third coronavirus that emerged during the past twenty years. The contagion can also occur by inhalation of aerosolized viruses, capable of floating in the air for long times (in closed spaces) and traveling unknown distances. A lesson from history shows that exclusive infectious disease hospitals with multiple building are still a modern architectural choice. Individual spaces are needed and this is an important way to reduce the viral load. Nowadays, the restrictions should involve not only the interpersonal relationships but also environmental measures.
Mandibular fractures are frequent, and it is common to observe multiple mandibular fractures. Bifocal bilateral fractures are usually diagnosed because of the trauma dynamics and mandibular anatomy. Instead, bifocal unilateral fractures are a rare entity, thus presenting a free mandibular segment without anterior and posterior support. The aim of this article is to present and discuss the characteristics and surgical management of a bifocal unilateral mandibular fracture.
article: Universal screening of preoperative cases for COVID-19. Is this the way forward post-pandemic? A surgeon’s perspective - Otorinolaringologia 2020 December;70(4):159-60 - Minerva Medica - Journals
There is currently a great interest in the study of Ménière’s disease using imaging. Magnetic resonance imaging (MRI) with delayed acquisition provides a powerful means to characterize endolymphatic hydrops noninvasively by using the properties of contrast media on inner ear perilymph. Despite their popularity and widespread use, there are a number of practical considerations that must be considered in order to increase the robustness of endolymphatic hydrops evaluation in Ménière’s disease patients. Besides endolymphatic hydrops, other imaging biomarkers have more recently proven to be useful in Ménière’s disease patients characterization and follow-up, such as blood-labyrinthine barrier impairment or an absence of visible saccule. The progressive ossification of the vestibular aqueduct in both temporal bones of Ménière’s disease patients have also been described, including using nonenhanced CT/cone beam CT scans to rule out the presence of endolymphatic hydrops. This article describes what we consider as major findings of imaging Ménière’s disease patients using MRI scan (first part) and CT/CBCT scan (second part), with particular emphasis on technical considerations that can have an important impact in the results. The recommendations here are intended to inform healthcare providers on potential important shortcomings of their current imaging protocols, as well as to guide future physicians on some of the key issues and decisions that must be faced when doing the imaging report. Finally, we will provide perspectives on what could be expected for Ménière’s disease imaging in the next few years, based on machine learning new developments (last part).
BACKGROUND: Ménière’s disease (MD) is a complex illness characterized by the typical association of acute onset of vertigo lasting less than 12-24 hours and low-frequency sensorineural fluctuating hearing loss. In our cohort of patients, MD manifested immediately as its definite form in about 35% of cases whereas in the remaining 75% of cases the pathology started as a monosymptomatic form.METHODS: In order to determine the temporal relationship among these two forms, we evaluated the clinical history on 283 patients affected by definite MD.RESULTS: The very first symptom of MD resulted more frequently the hearing loss. The average time delay between the onset of the first and the second symptom resulted within one year. The risk of onset of the definite form after the first symptom was about 80% within 5 years. The transition from the monosymptomatic form the definite form was quicker in case of vertigo happened as the first symptom.CONCLUSIONS: In conclusion the most frequent layout of onset of MD is a unilateral low-frequency sensorineural fluctuating hearing loss followed by the appearance of vertigo within 5 years. According to the MD guidelines proposed in 1995, all patients referring such kind of hearing loss should be treated as MD, in order to prevent the subsequent occurrence of vertigo.
BACKGROUND: Skull vibration induced nystagmus test (SVINT) also named Dumas’s test uses bone conducted vibrations applied to the cranium to reveal a vibration induced nystagmus (VIN) related to a vestibular asymmetry in unilateral vestibular lesions (UVL). VIN is relevant from a global canal (predominant) and otolith structures contribution. The aim of this work was to find out in Ménière’s disease (MD) SVIN possible characteristics when compared to those in other acute vestibular disorders, such as vestibular neuritis (VN), and describe its interest among other common vestibular explorations.METHODS: Thirty-two MD (60±18 yo) and 47 VN (59±13yo) patients were included. Each mastoid was stimulated at 100Hz for 10 seconds. The SVIN slow phase velocity (SPV) was measured in °/s and recorded with a VNG 3 D. All MD patients had on the same day an audiogram and SVINT, 23 had a caloric test (CaT) and HST, 18 a VHIT, 9 a subjective visual vertical (SVV) and 10 a VEMPs.RESULTS: SVIN was positive in 21/32 MD (66%) and 40/47 VN (85%), usually beating away from the lesion side. A VIN beating toward the lesion was observed in 3/21 (14%) MD and 1/42 (2%) VN. In VN, SVINT Sensitivity (Se) was equivalent to CaT (Se (83%) and VHIT (Se=88%) and in MD it was not different from CaT (Se=52%) but different from VHIT (Se=11%). SVIN-SPV was significantly higher in VN (7.3±4.9°/s) than in MD (3.89±3.9°/s) (P=0.001). SVIN-SVP horizontal component was correlated with results of the tests exploring the horizontal canal (Caloric-hypofunction and L-VHIT % asymmetry) in VN and only CaT in MD.CONCLUSIONS: SVINT is a sensitive first line examination test to reveal a vestibular asymmetry in peripheral vertiginous patients during the acute, subacute or chronic period. It is more often modified and with a higher SVIN-SPV in VN than in MD. SVIN is usually beating toward the intact side but is more often beating toward the lesion in MD than in VN. CaT, VHIT, HST, SVIN results are well correlated in VN but often discordant in MD. SVINT Se is equivalent to CaT to reveal MD or VN, but SVINT is more sensitive than VHIT in MD. In acute cases of vestibular syndromes its positivity associated with a negative VHIT suggests usually strongly a MD.
The diagnosis of Ménière disease (MD) is based primarily on clinical symptoms and there is no single feature or subset of features from the history, clinical examination or instrumental tests that are able to establish a certain diagnosis. Identification of diagnostic markers that can discriminate MD more accurately, and also that are reliable, reproducible and easy-to-obtain, could be useful. The pathophysiology of MD is complex and debated. Starting from the pathophysiological hypotheses of the disease, different approaches have been used in order to find useful biomarker candidates for diagnosis. We will present the main results in the literature and our personal experience in the field of molecular diagnostics applied to MD, and specifically of proteomics studies.
Cholesterol granuloma is a granulomatous tissue reaction consisting of cholesterol cleft surrounded by foreign body giant cells, foam cells and macrophages filled with hemosiderin pigments. It commonly occurs within the middle ear cavity and temporal bone. We report a case of right antrochoanal polyp which turned out to be a sinonasal cholesterol granuloma in an elderly female patient who presented with a one-month history of unilateral blood-stained nasal discharge. Patient underwent surgical excision of the nasal mass successfully with no complications or recurrence. Albeit rare, cholesterol granuloma should be considered as a differential diagnosis of sinonasal mass.
Foreign body entrapment in the nasal cavity is one of the common sequels of oro nasal fistulae in patients operated for cleft palate. Rarely these foreign bodies or malposed teeth in cleft patients may undergo dystrophic calcification presenting as rhinoliths. Often these rhinoliths are quiescent but rarely lead to nasal obstruction with associated complications. The purpose of our paper is to present a case of rhinolith with concomitant oronasal fistula in an adolescent girl operated for cleft palate.