ObjectivesTo evaluate audiological and vestibular functions via basic audiological evaluation, otoacoustic emissions and videonystagmography (VNG) in vitiligo patients.Material and methods30 vitiligo patients (8 acrofacial and 22 mixed types) as the study group and 30 normal healthy adults as the control group were included in the study. All participants were submitted to basic audiological evaluation, transient and distortion product otoacoustic emmisions (TEOAEs and DPOAEs), vestibular assessment including history taking, office tests and videonystagmography (VNG) and dermatological assessment to determine type, percent of body surface area involvement and duration of vitiligo.ResultsThis study showed statistically significant difference between control and study groups in pure tone audiometry (PTA) and otoacoustic emissions results. Fifty percent of vitiligo patients had peripheral vestibular disorders (10 vestibular neuritis and 5 posterior canal benign paroxysmal positional vertigo.ConclusionThe results in this study showed that 50% of vitiligo patients suffered from peripheral vestibular disorders in addition to auditory affection. Vitiligo patients require routine monitoring for auditory and vestibular functions for early identification and monitoring of changes as the disease progress.

Patients with ‘far-advanced’ or ‘very far-advanced’ otosclerosis have a profound bilateral hearing loss, with apparently no cochlear reserve measured by standard clinical audiometers. These patients have no benefit from a powerful hearing aid, have severe feedback problems and the cochlear implant may be the only solution. A total of 12 stapedotomies were performed in 8 patients with far-advanced or very far-advanced otosclerosis, with satisfactory results, improved air conduction thresholds and improved cochlear function and speech discrimination. Stapedotomy is a useful procedure for patients with far-advanced otosclerosis which improves patient’s hearing to levels where they can benefit from less powerful hearing aids with fewer feedback problems, compared to no measurable preoperative hearing aid benefit. It also spares those patients being submitted to cochlear implantation.

For atraumatic CI, precise and easy localization of the site of cochleostomy play a pivotal role in preserving intracochlear structures. Accurate setting of the vertical and horizontal orientations is mandatory before choosing the site of cochleostomy. The facial nerve and the margins of the RWM offer a very helpful clue for such localization; meanwhile, it is readily identifiable in the surgical field.

OBJECTIVE:Noise has been recognized as a major cause of cochlear damage resulting in both tinnitus and hearing loss. On the other hand, damage to the vestibular system, especially the saccule, can be considered as a potential problem. The cervical vestibular-evoked myogenic potentials (cVEMPs) have been established as a clinical test of measuring both sac cular and inferior vestibular nerve function. Therefore, it is thought to be sensitive to the noise-induced damage to the vestibular system. Accordingly, this study was designed to assess the vestibular system in subjects exposed to noise during work by using cVEMPs. MATERIALS and METHODS:This study was performed in over 60 adult males who were divided into a study group (consisting of 40 adult males) with history of chronic occupational noise exposure and with variable degree of hearing levels and a control group consisting of 20 healthy adults with normal peripheral hearing, with no history of noise exposure and no vestibular complaints. cVEMP recordings were elicited using 95dB nHL click stimuli. RESULTS:There was statistically significant prolonged cVEMP latency of the P13 and N23 waves of the study versus the control groups. As regard to the sense of imbalance, there were significant prolonged cVEMPs latencies in present versus absent sense of imbalance. However, there were statistically insignificant reduced cVEMP amplitudes in present versus absent sense of imbalance. CONCLUSION:Chronic noise exposure damages the vestibular system especially the saccule in addition to cochlear damage.

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