Source of funding: None other than the author's own institution. 1 Incidence, seasonality and comorbidity in vestibular neuritis AbstractAims of the present study were: 1) to assess the incidence of vestibular neuritis (VN) in the adult population in two cities in Croatia, 2) to identify distribution of new VN cases in the different months and seasons by years, and 3) to identify comorbidities associated with VN. This is a prospective, population-based study conducted in the cities of Zagreb and Velika Gorica, Croatia in the 2011-2012 period. All diagnoses were confirmed either with caloric test or vestibular evoked myogenic potentials within 7 days of symptom onset. Following clinical parameters were collected from all patients: age, gender, side of the lesion, month and season of symptoms onset and comorbidities. We identified 79 new cases of VN (34 in 2011VN (34 in , 45 in 2012. The male to female ratio was 1.1:1. The mean age at the onset of the disease was 52.3 (range 20-86) years. The average annual incidence was 11.7 per 100,000 (95% CI 7,8 -15,6) in the 2011 period and 15.5 per 100,000 (95% CI 11,0 -20,0) in the 2012 period.For both years there was no statistically significant uneven distribution in the different months or seasons by years. The most frequent comorbidities present in VN patients were hypertension (30.4%), diabetes mellitus (8.9%), hyperlipidemia (7.5%) and hypothyreosis (6.3%). Our study has shown higher incidence of VN than previously reported. We have found no evidence of seasonality of VN and significant proportion of VN patients older than 50 years who had vascular risk factors present.
This study evaluates the recovery of vestibular nerve function after vestibular neuritis (VN) by vestibular-evoked myogenic potentials (VEMPs). Twenty-six patients with the diagnosis of VN were included. All patients underwent ocular VEMP (oVEMP) and cervical VEMP (cVEMP) recordings, at 6 days and 6 months from the onset of the symptoms. Of the 26 patients, 14 showed improvement on oVEMP at month 6 (group 1), and 12 showed no change or worsening on oVEMP at 6 months (group 2). At the same time, there was no change in the amplitudes of the cVEMP on either healthy or affected sides in both groups. Inability to perform the Fukuda test, and chronic white matter supratentorial lesions present on brain magnetic resonance imaging (MRI) were more frequent in patients with worse outcome on oVEMP (P = 0.044 and 0.045, respectively). Although involvement of the inferior branch of the vestibular nerve was not associated with oVEMP outcome, oVEMP latencies (N10 and P13) were associated with improvement or worsening in oVEMP amplitudes, showing that prolonged latencies correlate with 6-month improvement in oVEMP amplitudes (Pearson correlation -0.472, P = 0.041 and -0.580, P = 0.009, respectively). This study identified clinical, MRI and neurophysiological predictors of recovery in patients with superior VN, and offers additional insight into, and better understanding of, the role of VEMP in diagnosis and prognosis of patients with VN. Further studies are needed to validate this diagnostic procedure and to assess its clinical usefulness in VN management.
Hearing was tested in 18 patients with Pierre Robin syndrome (PRS). These results were compared with those obtained for 243 patients with either cleft lip or cleft palate, or both. None of the PRS group patients had middle ear or inner ear malformations, or sensorineural hearing loss in speech frequencies. Hearing loss in PRS is usually conductive, bilateral, and more frequent in PRS patients (30 ears or 83.33%) than in patients who do not have PRS (290 ears or 59.67%). A significantly higher (p < .01) mean of hearing loss for air conduction in speech frequencies (MHLSF = 24.5 dB) was found in PRS patients than in patients without PRS (MHLSF = 17.8 dB). The ears of the PRS patients with hearing loss were examined, revealing middle ear effusion. In all cases, hearing was restored to a normal level through suction and the use of ventilation tubes.
Hearing was tested in 18 patients with Pierre Robin syndrome (PRS). These results were compared with those obtained for 243 patients with either cleft lip or cleft palate, or both. None of the PRS group patients had middle ear or inner ear malformations, or sensorineural hearing loss in speech frequencies. Hearing loss in PRS is usually conductive, bilateral, and more frequent in PRS patients (30 ears or 83.33%) than in patients who do not have PRS (290 ears or 59.67%). A significantly higher (p < .01) mean of hearing loss for air conduction in speech frequencies (MHLSF = 24.5 dB) was found in PRS patients than in patients without PRS (MHLSF = 17.8 dB). The ears of the PRS patients with hearing loss were examined, revealing middle ear effusion. In all cases, hearing was restored to a normal level through suction and the use of ventilation tubes.
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