BACKGROUND: The management strategy for functional recovery after vestibular neuritis (VN) has not yet been established. Therapeutic choices involve corticosteroids, vestibular rehabilitation therapy (VRT) and the combination of corticosteroids with VRT. OBJECTIVE: The present study aimed to compare the efficacy of corticosteroids, vestibular rehabilitation, and combination of them in terms of subjective and objective improvement in patients with VN. METHODS: A prospective randomized study was conducted on 60 patients with acute vestibular neuritis within 3 days after symptom onset. The patients were divided into three groups; steroid group treated with corticosteroids (n = 20), VRT group (n = 20) managed with vestibular rehabilitation exercises and combination group (n = 20) received combined (corticosteroids and vestibular exercises). Groups were compared by caloric lateralization, vestibular myogenic potential amplitude asymmetry and Dizziness Handicap Inventory scores, both at presentation and up to 12 months. RESULTS: The study found no statistically significant difference between the three groups of the study at the end of the follow up period. CONCLUSION: Corticosteroids and VRT seem to be equivalently effective in patients with VN. The study proposes that corticosteroids may accelerate the recovery of VN, with no more beneficial role in the long-term prognosis of the disease.

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.

Few studies have been conducted in the Eastern Mediterranean region on chronic hepatitis C virus (HCV) infection with reference to genotypes. We investigated the response to standard combination therapy (pegylated interferon/ribavirin) of different genotypes of HCV in Kuwaiti patients and factors that could be associated with sustained virological response (SVR). The records of all Kuwaiti patients treated for chronic HCV between January 2003 and May 2009 were retrospectively identified and reviewed. Of 108 patients studied, 27.8% were infected with genotype 1, 25.0% with genotype 3 and 47.2% with genotype 4. Overall, 64.8% of patients achieved SVR, 25.9%, were non-responders and 9.3% were relapsers. Baseline viral load and alanine aminotransferase level in addition to early virological response to pegylated interferon-based therapy may serve as a decision tool for clinicians to identify patients who are unlikely to achieve SVR. Traitement par peginterféron alfa-2b et ribavirine chez des patients koweïtiens atteints d'infection chronique par le virus de l'hépatite CRÉSUMÉ Peu d'études ont été conduites dans la région de la Méditerranée orientale sur l'infection chronique par le virus de l'hépatite C rapportée aux différents génotypes. Nous avons étudié la réponse à une association médicamenteuse classique (interféron pégylé/ribavirine), de différents génotypes du virus de l'hépatite C chez des patients koweïtiens, et les facteurs qui pourraient être associés à une réponse virologique prolongée. Les dossiers de tous les patients koweïtiens traités pour une infection par le virus de l'hépatite C entre janvier 2003 et mai 2009 ont été recherchés et examinés. Parmi 108 patients étudiés sur dossier, 27,8 % d'entre eux étaient infectés par le génotype 1, 25,0 % par le génotype 3, et 47,2 % par le génotype 4. Globalement, 64,8 % des patients ont présenté une réponse virologique prolongée, 25,9 % étaient non-répondeurs et 9,3 % ont rechuté. La charge virale de référence et le taux d'alanine aminotransférase, associés à une réponse virologique précoce au traitement à base d'interféron pégylé sont des critères qui pourraient servir d'aide à la décision pour les cliniciens afin d'identifier les patients qui ne sont pas susceptibles de présenter une réponse virologique prolongée.

ObjectiveEvaluating the auditory function in patients with chronic hepatitis C treated with sofosbuvir and ribavirin.MethodsThis study involved 80 patients with chronic hepatitis C who agreed to receive sofosbuvir and ribavirin. All participants were subjected to baseline otological and audiological assessment just before treatment. The audiological assessment included standard pure tone audiometry, extended high-frequency audiometry, immitancemetry and otoacoustic emissions (OAEs) (transient and distortion product). According to baseline hearing threshold measurements, the study population was divided into 2 groups. Group 1 included 42 patients with normal hearing sensitivity (250–8000 Hz), and Group 2 included 38 patients with sensorineural hearing loss. After 24 weeks of therapy, otological and audiological assessments were repeated and compared between the two groups and before and after therapy.ResultsPost-treatment hearing threshold evaluation showed no significant difference from pretreatment evaluation at all tested frequencies. There was no statistically significant difference between pre and post-treatment otoacoustic emissions results.ConclusionTherapy with sofosbuvir and ribavirin in chronic hepatitis C has no noticeable effects on cochlear functions.

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Objective: This study was designed to evaluate the effectiveness of intratympanic dexamethazone (ITD) for the treatment of ipsilateral delayed endolymphatic hydrops (DEH). Methods: Forty-one patients were diagnosed with ipsilateral DEH. Only 37 patients completed this study. Patients were randomly divided into 2 groups. Group A (n = 16) received oral medication, and group B (n = 21) received ITD once weekly for 4 consecutive weeks. Results: In group A, 6 patients showed improvement in their vertigo. Four patients (25%) showed complete vertigo control, and 2 patients (12.5%) showed substantial vertigo control. In group B, 21 patients showed improvement in their vertigo, 11 patients (52%) showed complete vertigo control, and 10 patients (47%) showed substantial vertigo control. Only 1 case did not show any improvement in their vertigo. Conclusion: ITD is proven to be a valuable and promising alternative modality for the management of ipsilateral DEH.

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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