Vestibular Manifestations In Retrocochlear Tumoral Pathology

Introduction Retrocohlear tumoral pathology is dominated by the vestibular schwannoma (VS). The VS involve the vestibular division of the 8th cranial nerve and grows slowly leading to a gradual installation of the unilateral vestibular impairment allowing simultaneous achievement of central compensation process. Sometimes only a careful history will reveal a slow imbalance, a tendency to move towards to a certain lateral part. Remarkable progress has been made in the VS early diagnosis so that treatment can take place earlier with good results. Materials and methods A representative case is presented. Beside general, neurological and ENT examination, the diagnostic workup comprised of computerized dynamic posturography, videonystagmography, pure tone audiometry, auditory brainstem evoked response, MRI brainstem evaluation. Results In VS computerized dynamic posturography allows an overall of the vestibular function with polymorphic results. Bithermal caloric testing is, combined to auditory brainstem responses a good tool to diagnose and evaluate unilateral vestibular impairment in vestibular schwannoma. Discussion Detailed history, careful exploration of vestibular and cochlear function can lead to the conclusion of possible retrocochlear injury. For confirmation of its existence and its nature contrast-enhanced CT or MRI are necessary. Conclusion Any unilateral cochlear or vestibular symptoms (unilateral or asymmetric sensorineural hearing loss, unilateral tinnitus, unilateral vestibular impairment of any degree with central compensation or not) should raise suspicion of possible VS

Auditory Function Recovery In Sudden Sensorineural Hearing Loss: 3-Year Study

Objectives: The goal of this study was to assess the post-therapeutic rehabilitation for a group of patients in order to evaluate the conventional treatment of sudden sensorineural hearing loss. Materials and methods: 45 patients diagnosed with sudden sensorineural hearing loss, where clinically examined. A careful examination is needed to exclude life threatening causes such as vascular events and malignant diseases. Conventional treatment that include corticosteroids, antiviral drugs, vasoactive and vitamins (B1, B6) was administered to patients. Results: Post-treatment rehabilitation degree varies. The greatest recovery of hearing has been shown when corticosteroids are started within the first 1—2 weeks after symptom onset. About 45% of patients show good recovery, usually in about 2 weeks. Patients in whom there is no change within 2 weeks are unlikely to show much recovery. Conclusions: In most cases the cause is not identified, although various infective, vascular, and immune causes have been proposed. It is recommended that patients with sudden sensorineural hearing loss with no clear underlying cause after investigation are treated with a short course of oral prednisolone started within 2 weeks after onset. There is much to learn about pathogenesis of sudden sensorineural hearing loss and more clinical trials are needed to establish evidence-based management