Simultaneous Presentation of Benign Paroxysmal Positional Vertigo and Meniere’s Disease – Case Report

BACKGROUND: Benign paroxysmal positional vertigo (BPPV) is one of the most common clinical entities, which develops spontaneously in most of the cases, but it can be secondary as a result of different conditions such as head injuries, viral neurolabyrinthitis, Meniere’s disease and vertebrobasilar ischemia. The aim of presenting this case is to point out to the need of taking a precise clinical history and performing Dix-Hallpike manoeuvre in all patients who complain about vertigo regardless of the previously diagnosed primary disease of the inner ear. CASE PRESENTATION: A 63-year-old female patient presented with the classical triad of symptoms for Meniere’s disease (fluctuating sensorineural hearing loss in the right ear, tinnitus and fullness in the same ear and rotary vertigo), two years later complained of brief episodes of vertigo linked to changes in head position relative to gravity. Dix-Hallpike manoeuvre showed a classical response in the head-hanging right position. Benign paroxysmal positional vertigo (BPPV) in the same ear was diagnosed in this patient. After treatment with Epley’s canal repositioning manoeuvre for a few days, the symptoms of positional vertigo resolved. CONCLUSION: The authors recommend complete audiological and otoneurological evaluation in all patients with vertigo for timely recognition/diagnosis of any inner ear associated pathology

RISKY FACTORS, IMPROVING DIAGNOSTIC ACCURACY AND PREVENTION OF OTITIS MEDIA WITH EFFUSION-IN EARLY CHILDHOOD

Otitis media with effusion (OME) is the leading cause of hearing loss in children and it is associ­ated with delayed language and speech develop­ment.The aim of the study was to improve the diagnostic accuracy, understanding the difference between the OME and other forms of middle ear infections

NASAL SEPTUM DEVIATION AND CONDUCTIVITY HEARING LOSS IN CHILDREN

The human respiratory system is extremely com­plicated and it has been extensively investigated, yet the system has not been fully recognized. De­viation of the nasal septum, which changes the airflow in this part of the res­piratory tract, can af­fect the state of the paranasal sinuses as well as the functions of the auditory tube. It can also cause hypertrophy of adenoids. In the available literature on skeletal deviations of the nasal septum and their influ­ence on the state of hearing and, particularly, on the state of the auditory tube and middle ear, there are no uniform views

The Pillars of the Nose-Crura Shortening for Over Projected Nose

BACKGROUND: The over projected nose, commonly referred to as the "Pinocchio" nose is a significant challenge to the rhinoplasty surgeon. Firstly, we speak about a very large nose, and secondly, we speak about the correction of nasal cartilages (alar and triangular). Surgical correction of the over projected nose is the most difficult and least predictable component of rhinoplasty surgery. AIM: By performing rhinoseptoplasty we aimed to achieve an ideal landmarks position according to concepts of nasal projection as well as by making preoperative analyses to determine the ideal position for the nasal tip after having understood and defined the ideal position for the nasion. METHODS: We performed a retrospective study of patients who were admitted to ENT University Clinic, University Campus “St. Mother Theresa†Skopje, the Republic of Macedonia in the period 2011-2019. A total of 70 patients were enrolled in the study; 46 women (33%) and 24 men (33%). Operative technique rhinoseptoplasty was realised in 70 patients. All of the 70 (100%) patients underwent preoperative and postoperative evaluation during this period regularly to record the effects of various approaches on nasal projection, rotation, need for revision, and patient satisfaction. RESULTS: All patients used one or more of the preferred methods to treat over projection. Patients who had undergone 2 previous rhino/septoplasty procedures were excluded from the study, and hence, a total of 70 patients were evaluated. Full-transfixion incisions were made in all patients. From 2011 to 2019, in 72 cases, 1 or more of the preferred methods were used to treat over projection. CONCLUSION: The crural anatomy of the nasal tip relates to the size and shape of the lower lateral cartilages (LLC) and their relationship with the caudal septum and upper lateral cartilages (ULC). Modification of nasal tip rotation and projection should attempt to preserve or reconstruct major tip mechanisms

Speech Perception Outcomes after Cochlear Implantation in Children with GJB2/DFNB1 associated Deafness

Background: Cochlear implants (CI) for the rehabilitation of patients with profound or total bilateral sensorineural hypoacusis represent the initial use of electrical fields to provide audibility in cases where the use of sound amplifiers does not provide satisfactory results. Aims: To compare speech perception performance after cochlear implantation in children with connexin 26-associated deafness with that of a control group of children with deafness of unknown etiology. Study Design: Retrospective comparative study. Methods: During the period from 2006 to , cochlear implantation was performed on 26 children. Eighteen of these children had undergone genetic tests for mutation of the Gap Junction Protein Beta 2 (GJB2) gene. Bi-allelic GJB2 mutations were confirmed in 7 out of 18 examined children. In order to confirm whether genetic factors have influence on speech perception after cochlear implantation, we compared the post-implantation speech performance of seven children with mutations of the GBJ2 (connexin 26) gene with seven other children who had the wild type version of this particular gene. The latter were carefully matched according to the age at cochlear implantation. Speech perception performance was measured before cochlear implantation, and one and two years after implantation. All the patients were arranged in line with the appropriate speech perception category (SPC). Non-parametric tests, Friedman ANOVA and Mann-Whitney’s U test were used for statistical analysis. Results: Both groups showed similar improvements in speech perception scores after cochlear implantation. Statistical analysis did not confirm significant differences between the groups 12 and 24 months after cochlear implantation. Conclusion: The results obtained in this study showed an absence of apparent distinctions in the scores of speech perception between the two examined groups and therefore might have significant implications in selecting prognostic indicators of speech perception following cochlear implantation