Unilateral peripheral vestibular disorder (UPVD) causes deficient locomotor responses to novel environments due to a lack of accurate vestibular sensory information, increasing fall risk. This study aimed to examine recovery response (stability recovery actions) and adaptive feedback potential in dynamic stability of UPVD‐patients and healthy control subjects during perturbed walking. 17 UPVD‐patients (>6 months since onset) and 17 matched healthy control participants walked on a treadmill and were subjected to eight unexpected perturbations during the swing phase of the right leg. For each perturbation, the margin of stability (MS; state of body's centre of mass in relation to the base of support), was determined at touchdown of the perturbed leg and during the following six recovery steps. The first perturbation caused a reduced MS at touchdown for the perturbed leg compared to baseline, indicating an unstable position, with controls requiring five recovery steps to return to MS baseline and UPVD‐patients not returning to baseline level within the analyzed six recovery steps. By the eighth perturbation, control subjects needed two steps, and UPVD‐patients required three recovery steps, both thereby improving their recovery response with practice. However, MS at touchdown of the perturbed leg increased only for the controls after repeated perturbations, indicating adaptive feedback‐driven locomotor improvements for the controls, but not for the UPVD‐patients. We concluded that UPVD‐patients have a diminished ability to control dynamic gait stability during unexpected perturbations, increasing their fall risk, and that vestibular dysfunction may inhibit the neuromotor system adapting the reactive motor response to perturbations.

Preserving upright stance requires central integration of the sensory systems and appropriate motor output from the neuromuscular system to keep the centre of pressure (COP) within the base of support (BoS). Unilateral peripheral vestibular disorder (UPVD) causes diminished stance stability. The aim of this study was to determine the limits of stability and to examine the contribution of multiple sensory systems to upright standing in UPVD patients and healthy subjects. We hypothesised that closure of the eyes and Achilles tendon vibration during upright stance will augment the postural sway in UPVD patients more than in healthy subjects. Seventeen UPVD patients and 17 healthy subjects performed six tasks on a force plate: forwards and backwards leaning, to determine limits of stability, and upright standing with and without Achilles tendon vibration, each with eyes open and closed (with black out glasses). The COP displacement of the patients was significantly greater in the vibration tasks than the controls and came closer to the posterior BoS boundary than the controls in all tasks.Achilles tendon vibration lead to a distinctly more backward sway in both subject groups.Five of the patients could not complete the eyes closed with vibration task. Due to the greater reduction in stance stability when the proprioceptive, compared with the visual, sensory system was disturbed, we suggest that proprioception may be more important for maintaining upright stance than vision. UPVD patients, in particular, showed more difficulty in controlling postural stability in the posterior direction with visual and proprioceptive sensory disturbance.

We describe five patients with cervical spondylosis and large anterior osteophytes causing pharyngeal compression. All had dysphagia, two had obstructive sleep apnoea and another two had dyspnoea and stridor on inspiration. One, with perforation of the pharynx, required emergency tracheostomy. Only three had pain in the neck or arm. Compression of the retroglottic space was confirmed in all patients by pharyngoscopy and in all the symptoms were relieved by excision of the osteophytes. Three also underwent intervertebral fusion. One had some persistent sleep apnoea.

Considerable sound levels are produced in primary schools by voices of children and resonance effects. As a consequence, hearing loss and mental impairment may occur. In a Cologne primary school, sound levels were measured in three different classrooms, each with 24 children, 8-10 years old, and one teacher. Sound dosimeters were positioned in the room and near the teacher's ear. Additional measurements were done in one classroom fully equipped with sound-absorbing materials. A questionnaire containing 12 questions about noise at school was distributed to 100 children, 8-10 years old. Measurements were repeated after children had been taught about noise damage and while "noise lights" were used. Mean sound levels of 5-h per day measuring period were 78 dB (A) near the teacher's ear and 70 dB (A) in the room. The average of all measured maximal sound levels for 1 s was 105 dB (A) for teachers, and 100 dB (A) for rooms. In the soundproofed classroom, Leq was 66 dB (A). The questionnaire revealed certain judgment of the children concerning situations with high sound levels and their ability to develop ideas for noise reduction. However, no clear sound level reduction was identified after noise education and using "noise lights" during lessons. Children and their teachers are equally exposed to high sound levels at school. Early sensitization to noise and the possible installation of sound-absorbing materials can be important means to prevent noise-associated hearing loss and mental impairment.

Attention diversion is an important method for decreasing tinnitus-related distress. Patients should be instructed to use not only auditory but also visual and thermal sensations in order to distract attention away from their tinnitus.