Introduction Dysphagia is a relevant symptom in Parkinson disease (PD), and its pathophysiology is poorly understood. To date, researchers have not investigated the effects of combined motor tasks on swallowing. Such an assessment is of particular interest in PD, in which patients have specific difficulties while performing two movements simultaneously.
Objective The present study tested the hypothesis that performing concurrent tasks could decrease the safety of swallowing in PD patients as visualized using fiberoptic endoscopic evaluation of swallowing (FEES).
Methods A total of 19 patients and 19 controls matched by age, gender, and level of schooling were compared by FEES under two conditions: isolated swallowing and dual task (swallowing during non-sequential opposition of the thumb against the other fingers). The two tasks involved volumes of food of 3 mL and 5 mL. The PD subjects were classified according to the Hoehn & Yahr (H&Y) Scale, the Mini Mental State Examination (MMSE), and the Montreal Cognitive Assessment (MoCA). The FEES assessment was performed according to the Boston Residue and Clearance Scale (BRACS).
Results The data showed a significant worsening of swallowing in the dual task assessment for both volumes (3 mL: p ≤ 0.001; 5 mL: p ≤ 0.001) in the PD group. A correlation between the MoCA and dual-task swallowing of 3 mL was also found.
Conclusion These findings suggest that additional tasks involving manual motor movements result in swallowing impairment in patients with PD. Moreover, these data highlight the need to further evaluate such conditions during treatment and assessment of PD patients.
The Vibrant Soundbridge (VSB) system helps hearing impaired people who, for various reasons, are unable to use conventional hearing aids. This study presents our experience and outcomes with the first eight patients we implanted with this device. Method: Eight patients were implanted with a VSB in our department from 2006 to 2010. Seven of them had sensorineural hearing loss, while one case involved otosclerosis with mixed hearing loss. All patients received a VSB from Med-El.
Poster PresentationsP213 1, 2, 3, 4 kHz) the preoperative and postoperative air-bone gap were analyzed in order to ascertain whether the preoperative ABG could act as a predictor. Having not passed normality testing, Wilcoxon matched paired signed rank test and Spearman rank coefficient were used for analysis.Results: Throughout the statistical analysis, preoperative ABG correlated most strongly with net difference in postoperative ABG (P < .0001). For each commonly tested frequency assessed this demonstrated a "very strong" positive correlation. As such, the greater the preoperative ABG, the greater the closure obtained through stapedectomy in this series.Conclusions: In performing stapedectomy for otosclerosis, our series suggested the preoperative ABG may have a role in preoperative patient counseling and consent but is unable to predict success in stapedectomy surgery.
P229Results: Varying degrees of EH were observed in 14 of the 16 ears. Episodes of acute sensorineural hearing loss or vertigo occurred in 4 ears with severe EH in the cochlea and 3 ears with severe EH in the vestibules. Overall, 12 of 14 ears with EH did not undergo stapes surgery. Ears without EH showed no postoperative complications, but one ear with mild EH in the vestibule showed severe vertigo following the surgery.
Conclusions:The presence of EH in cases with otosclerosis was clearly visualized, and the degree of EH was correlated with the clinical findings in most patients. Such preoperative MRI evaluation could provide useful information to prevent complications following stapes surgery.
POSTERSteams should be created to develop surgical expertise and competence in the treatment of the disease in order to offer the best options to these patients.
Otology/NeurotologyHearing Loss and Cochlear Pathology in a Type II Diabetic Mouse Model Sean Miller, MD (presenter); Flint Boettcher; Grady Phillips; Michael Anne Gratton, PhDObjective: 1) Determine whether a type II diabetic mouse model demonstrates hearing loss. 2) Examine cochlear ultrastructure of a type II diabetic mouse model for evidence of pathology.
Method:The Lepr db /Lepr db (db/db) mouse has a leptin receptor point mutation which manifests as polyphagia, hyperglycemia, and obesity, mimicking type II diabetes. Db/db and wild type mice from the parent strain underwent auditory brainstem response measurements followed by cochlear ultrastructure analysis using scanning and transmission electron microscopy.Results: At 12 weeks of age, the mutant animals demonstrate a profound hearing loss from 8 to 32 kHz, which is in contrast to published data of a 10 dB shift at 8 kHz and 30 dB shift at 16 to 32 kHz for age-matched, wild type C57BL/6J counterparts. In addition, fine structure analysis reveals evidence of morphological alterations in multiple locations within the cochlea, including loss of neuron density in the spiral ganglion, stria vascularis edema, and endothelial abnormalities within strial capillaries. Agematched controls are without similar ultrastructural changes. Scanning electron microscopy reveals no evidence of hair cell loss or other identifiable abnormalities.Conclusion: This is the first demonstration of cochlear pathophysiology in a genetically derived type II diabetic mouse model. Use of the db/db mouse provides an opportunity to investigate the underlying mechanism of type II diabetes associated hearing loss.
Otology/Neurotology Hearing Loss as Factor That Influences the Quality of Life in Tinnitus PatientsLetícia Petersen Schmidt Rosito, MD (presenter); Bruna Vanni; Konrado Deutsch;
Vanessa de Brito BellineObjective: Tinnitus is a sensation of noise. In most cases it is accompanied by hearing loss, but it can be an independent symptom occurring in patients with normal hearing. We want to compare the impact of tinnitus on quality of life in patients with or without associated hearing loss.
Method:We selected patients with chronic and disturbing tinnitus. They underwent audiometry and answered the Tinnitus Handicap Inventory (THI) in order to evaluate and quantify the impact of tinnitus. The criterion defined as the threshold of hearing loss records was less than 25 dB at all frequencies in either ear.Results: From January 2005 to January 2011, 308 patients were included. The patients were divided into 2 groups: 1) with hearing loss (n = 272), and 2) with normal hearing (n = 34). Among patients with normal hearing, the average score on the THI was 33.8, whereas among patients with hearing loss, the average was 42.33, P = .04 (t test).
Conclusion:Patients with hearing loss have a mean THI significantly higher than patients with n...
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