This study showed altered OAE in patients with tinnitus and normal hearing. It also demonstrated a positive correlation between the annoyance of tinnitus and anxiety and depression in normal-hearing patients.

Mean age did not differ between groups (study group: 51.5 ± 0.7 years; control: 52.9 ± 0.6 years). No significant differences in wave latencies, or interpeak intervals were observed between the two groups (p > 0.05).

ORAL PRESENTATIONSamong those with pathological cVEMP (N = 4 in the pathological VEMP group too small to allow statistical analysis). 14 (58%) patients had recurrent PCBPPV (rPCBPPV). Twelve (86%) of the subjects with rPCBPPV had normal and 2 (14%) had pathological cVEMP. The proportions of subjects having abnormal cVEMP did not differ significantly between the recurrence and non-recurrence groups (Fisher exact test). Conclusion:Most patients suffering from PCBPPV had normal cVEMP. Reduced symptomatology as quantified by the DHI score was found when the cVEMP was pathological. This finding suggests that functional integrity of the inferior vestibular nerve is required for the complete clinical picture of PCBPPV to take place. Otology/NeurotologyThe Socioeconomic impact of Revision Otologic Surgery Sahar Nadimi, MD (presenter); John P. Leonetti, MD Objective: To estimate the socioeconomic impact of revision canal wall down (CWD) mastoidectomy.Method: Retrospective chart analysis from our tertiary care medical center that evaluated all adult patients who underwent CWD mastoidectomy by the senior surgeon between 2006 to 2011. Institutional charges and collections for all patients were extrapolated to estimate the overall healthcare cost of revision surgery at state (Illinois) and national levels. Results:One hundred eighty-nine CWD mastoidectomies were reviewed, of which 89 were primary and 100 were revision procedures. The total charge for this group of revision cases was $2,783,700, and the net reimbursement (collections) was $843,245. Using Illinois Hospital Consortium data, the estimated cost of reimbursement for revision CWD mastoidectomy for 387 cases in FY 2011 was nearly $3.3 million. An additional $2160 per patient in lost wages was predicted to have been related to time away from work. The 9214 patients who underwent revision CWD mastoidectomy in the U.S. represented a national healthcare cost of roughly $80 million. Conclusion:Known causes for failed CWD mastoidectomy include inadequate meatoplasty, high facial ridge, and residual or recurrent cholesteatoma. A better understanding of these factors can reduce the need for revision surgery, thereby resulting in a positive impact on the socioeconomic strain related to this procedure at local, state, and national levels. Method: This case-control study was performed in 2 groups of normal hearing patients: study group (SG): 68 patients with tinnitus; and control group (CG): 46 patients without tinnitus. Patients were submitted to otoacoustic emissions tests, to THI evaluation, and to anxiety and depression search by Beck Scale. Otology/NeurotologyResults: Seventy-five ears (67.0%) in SG showed abnormal TOAE versus 18 ears (19.6%) in CG (P < .0001). Sixty-eight ears (65.2%) had abnormal DPOAE in SG versus 46 ears (50%) in the CG (P < .029). There was no correlation between THI and the results of TOAE (P = .799) and DPOAE (P > .7) tests. SG had 44.1% (N = 30) individuals with anxiety versus 17.4% (N = 8) in CG (P < .003). There was a statistical difference betw...

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Objectives: 1) Compare electroneuronography (ENoG) values in patients with facial palsy using two different methods, the midline method that records compound muscle action potentials (CMAPs) from the orbicularis oris muscle (the standard muscle for facial ENoG) and five electroneurogram recordings that records five CMAPs from five different facial muscles. 2) Reveal whether the ENoG value obtained with the midline method reflects entire facial nerve degeneration.Methods: Forty patients with facial palsy were enrolled. CMAPs were recorded using the midline method, in which the anode was placed on the mental protuberance and the cathode was placed on the philtrum. Additionally, five electroneurogram recordings were obtained by placing the anode on the skin of the parietal region and five cathodes on the skin over five facial muscles (frontalis, orbicularis oculi, nasalis, orbicularis oris, and depressor anguli oris muscles). ENoG values recorded using the two methods were compared. Results:The ENoG values of the five facial muscles did not differ from those obtained using the midline method. The total ENoG value calculated by summing five CMAPs from five facial muscles, which is considered to reflect total facial nerve degeneration, was not significantly different from that using midline methods; moreover, a strong positive correlation coefficient (r = 0.87) was found between them. Conclusions:The midline ENoG method that records CMAP from the orbicularis oris muscle reflects entire facial nerve degeneration. The ENoG value calculated from the orbicularis oris muscle might be suitable to evaluate the total prognosis of facial palsy.Objectives: Tinnitus is more common in patients with some degree of hearing loss, but may be present in approximately 10-20% of people with normal hearing. There is evidence of involvement of the central auditory nervous system and interrelation with various parts of the nervous system, which may be involved in the mechanism of central processing of auditory signals. We aimed to analyze the annoyance of tinnitus in patients without hearing loss and to correlate the findings with auditory brainsteam response (ABR). Methods:We selected 84 patients with tinnitus and 47 patients without tinnitus, with ages ranging from 18 to 48 years old and hearing threshold less than or equal to 25 dB at frequencies between 500 and 8000Hz. We conducted the evaluation of tinnitus annoyance with the Tinnitus Handicap Inventory (THI), and examination of ABR.Results: Among the 84 patients in the study group, we found 35.7% of abnormal tests in at least one of the seven parameters tested, however, only the difference in the interaural wave V latency in patients with unilateral tinnitus was significant difference between the study and control group. Most patients in the study group had mild or very mild tinnitus. The discomfort of tinnitus showed no correlation with the results of ABR results.