This retrospective study evaluates the outcome of 38 patients with intractable Ménière’s disease with a minimum of 7 years follow-up. Twenty underwent endolymphatic-mastoid shunt (EMS) and 18 were offered surgery but declined (natural history, NH, group). At the last control, 85% of the patients who were operated on (EMS group) and 74% of the NH patients had complete or substantial control of vertigo. The difference between the two groups was not significant. However, it was significant at 2 and 4 years follow-up. At 2 years, EMS patients had complete or substantial control of vertigo in 65% of the cases, at 4 and 6 years in 85% of the cases. Only 32% of the NH patients had complete or substantial control of vertigo at 2 years. This percentage rose to 50% at 4 years and to 74% at 6 years. Hearing results in the two groups were not significantly different. Tinnitus disappeared or decreased in 56% of the EMS patients and in 18% of the NH patients. Sixty-seven percent of the EMS patients and 29% of the NH patients reported that their aural fullness was abolished. In conclusion, over the years, approximately 8 out of 10 of our patients with Ménière’s disease achieved complete or substantial control of vertigo; however, this reduction was observed earlier in EMS patients than in those who declined surgery.

No abstract

Deglutition disorders (dysphagia) are common symptoms of a large number of diseases and can lead to severe deterioration of the patient’s quality of life. The clinical evaluation of this problem involves an invasive screening, whose results are subjective and do not provide a precise and quantitative assessment. To overcome these issues, alternative possibilities based on wearable technologies have been proposed. We explore the use of ultrathin, compliant, and flexible piezoelectric patches that are able to convert the laryngeal movement into a well-defined electrical signal, with extremely low anatomical obstruction and high strain resolution. The sensor is based on an aluminum nitride thin film, grown on a soft Kapton substrate, integrated with an electrical charge amplifier and low-power, wireless connection to a smartphone. An ad-hoc designed laryngeal motion simulator (LMS), which is able to mimic the motions of the laryngeal prominence, was used to evaluate its performances. The physiological deglutition waveforms were then extrapolated on a healthy volunteer and compared with the sEMG (surface electromyography) of the submental muscles. Finally, different tests were conducted to assess the ability of the sensor to provide clinically relevant information. The reliability of these features permits an unbiased evaluation of the swallowing ability, paving the way to the creation of a system that is able to provide a point-of-care automatic, unobtrusive, and real-time extrapolation of the patient’s swallowing quality even during normal behavior.

No abstract

Quaranta A, Scaringi A, Sallustio V, Quaranta N. Cochlear function in ears with immunomediated inner ear disorder. Acta Otolaryngo l 2002; Suppl 548: 15 -19.The aim of the presen t study was to evaluat e the performance of ears with inner ear disorder , responsive to immunosupp ressive drugs, in advanced tests designed to assess primary cochlea r functions (temporal integration, frequency selectivity, cochlear mechanics). The results of this study suggest that immunomedia ted inner ear disease results, in the acute clinical stage, in the developmen t of endolymphat ic hydrops, which increases the stiffness of the vibrating structures within the inner ear and causes dysfunction s of the outer hair cells. Our patients presented with upsloping or at sensorineura l hearing loss, absence of evoked otoacoustic emissions and distortion-product otoacoustic evoked emissions and abnorma l temporal integration, frequency selectivity and cochlea r mechanics. F ollowing immunosupp ressive treatment, hydrop s recovered , hearing subsequently returned to normal, the audiometr ic curve became at at low-to-middle frequencies and primary cochlea r function tended to normalize. This study seems to suppor t the usefulness of testing primary cochlea r function s in order to monitor the clinical course of immunomediated inner ear disorders.