Inner ear pathology - a perpetual confrontation

Introduction: Benign Paroxysmal Positional Vertigo is the most common type of vertigo in adults. In the literature we found the coexistence of BPPV with other ear pathologies and the most commonly recognized conditions are head trauma and infections.Methods: This report of a 51 years old man diagnosed before with neurocysticercosis summerise a possible association between otosclerosis and BPPV. Otosclerosis is a progressive disease that affects middle and inner ear; it has been associated with an increase incidence of vestibular symptoms but in its vestibular McCabe form. BPPV is a mechanical peripheral vestibular disorder, idiopathic or secondary. The most commonly recognized conditions are head trauma or infections, Meniere's disease and post-surgery.Secondary BPPV is often underdiagnosed because dizziness is usually attributed to the primary inner ear pathology.Results: The complete neurootological and audiological evaluation were performed; we recognized the associated pathology (otosclerosis left ear and BPPV-left posterior semi-circular canal).The positional vertigo developed after two years of conductive hearing loss, but in the same time(aprox two weeks) with ipsilateral tinnitus. Usually, recurrence is present more in secondary BPPV than in idiopathic cases but in this situation the canalith repositioning maneuver Epley was immediately successful.Conclusion: Unfortunately, the clinical differences between idiopathic and secondary BPPV are limited. This clinical case suggest that otosclerosis could be an underlying condition for BPPV. A search of the literature reveals that neurocysticercosis as a trigger factor for BPPV represents a unique case.Keywords: BPPV, otosclerosis, neurocysticercosis.Der Erstautor gibt keinen Interessenkonflikt an

Tinnitus in the elderly - Comorbidities, impact on life quality and enhanced treatment strategies

Introduction: Tinnitus is a common sensation that affects between 7-32% of the population. In elderly population there are many causes of tinnitus: age - hearing loss related and other otologic problems, neurologic and cardiovascular conditions, some medications or rheumatologic problems. The purpose of this study was to determine the possible causes of tinnitus in elderly population and the psychosocial implications resulted. Material and methods: Our clinical study was a retrospective on 590 patients hospitalized in our ENT service aged up to 60 years during 1 year. All subjects were assessed only for subjective tinnitus and for different comorbidities. For the patients diagnosed with subjective tinnitus we prescribed medical therapy and alternative medicine treatments. Tinnitus severity was assessed using the tinnitus handicap inventory - screening version.Results: Tinnitus was reported at 28% patients with no significant difference related to sex, origin, drinking or smoking, but a significant association with risk factors - exposure to noise, cardiovascular problems, diabetes and associated auricular pathology. Regarding the treatment, the 2 groups were compared in relation to the intensity of tinnitus, the degree of depression and the treatment benefits. In 2/3 of the cases patients treated with alternative medicine treatments or with electronic devices showed an improvement in life quality compared with those who received medical treatment.Conclusion: Although tinnitus isn't a condition in itself but a symptom, it represents a common problem of the elderly population. Its association with treatable conditions reduces the quality of life and argues the necessity of using complementary strategies.Keywords: Tinnitus, treatment, quality of lifeDer Erstautor gibt keinen Interessenkonflikt an

Hearing loss - non genetic etiology of newborns diagnosed in Neonatal Intensive Care Unit

Objectives: The purpose of this study is to assess the newborns hospitalized in The Neonatal Intensive Care Unit Emergency County Clinical Hospital Oradea with positive screening for hearing loss and to identify non-genetic causes of the hearing loss.Materials and Methods: This prospective study was presented in NICU in the period January 2008 to June 2012, on a number of 139 newborns with positive screening for hearing loss at the second test (AABR+TEOAE). Were excluded from the study newborns with genetic etiology for hearing loss ( craniofacial anomalies, genetic syndromes and family history for hearing loss). Therefore, 126 patients with positive screening for hearing loss were evaluated. Every patient was evaluated according to the data provided by the Declaration of principles and guidelines for detection and early intervention for hearing loss at newborns, issued by The Joint Committee on Infant Hearing in 2007. All infants identified with congenital and postnatal infections were evaluated clinically and paraclinical by serological laboratory examination, through ophtalmological examination and transfontanelar ultrasound. Results: Of the 126 newborns with positive screening for hearing loss 12 patients were from positive mothers for TORCH test. 50% of intrauterine infections were given by CMV, followed by herpes simplex, toxoplasma and rubella. Conclusions: Diagnosis of hearing loss was found in 3,17% of infants hospitalized in NICU with positive screening for hearing loss, respectively 2 patients with cytomegalovirus infection, one with toxoplasmosis and one with congenital rubella, which corresponds to the statistical data from the literature: 2 - 4 / 100 newborns.Keywords: newborn, hearing screening, sensorineural hearing loss, TORCH.Der Erstautor gibt keinen Interessenkonflikt an