Vestibular evoked myogenic potentials testing for diagnosing Sudden Sensorineural Hearing Loss

Sudden sensorineural hearing loss is an emergency condition in otolaryngology. In most cases it manifests as a unilateral reduction in hearing. In addition to hearing loss in one ear, patients often have symptoms such as vertigo and/or tinnitus. The follow-up of patients with sudden sensorineural hearing loss should include not only testing of the hearing system but also diagnosis of the vestibular apparatus. VEMP is an objective method for assessment of the vestibular function through the reaction of the reflex muscle in response to high-intensity acoustic stimulation.Materials and methods: The subject of study are 12 patients with sudden hearing loss where 5 of the followed patients also complaining of vertigo and instability. After taking a history, the following are performed: examination of ENT organs, pure-tone audiometry, OAE, tympanometry with acoustic reflex, otoneurological examination, VEMP tests, CT (MRI).Results: Patients with severe sudden hearing loss have deviations in their VEMP tests. The hearing recovery percentage is lower with abnormal VEMP than in those with normal VEMP. Conclusion: Patients with deviations in VEMP tests can have vestibular disorders in addition to lesions in the organ of Corti, including stria vascularis and the tectorial membrane. There is an association between pathological VEMP and the level of hearing reduction. Abnormal VEMP can be used to predict subsequent incomplete hearing recovery

A Case of Familial External Auditory Canal Atresia

Introduction: Congenital аural аtresia (CAA) can occur as an isolated congenital malformation or as part of a monogenic and chromosomal syndromes. CAA can be associated with several syndromes. An 18q deletion is frequently seen in CAA. The subject of the study are three individuals from one family (mother, son and daughter). Methods:After taking a detailed history, an examination of ENT organs, tone audiometry testing, auditory brain stem responses, brain CT, external auditory canal and middle ear were performed. Results: The conducted tone audiometry testing and auditory brain stem response found bilateral sound conduction hearing loss.Conclusion: Bilateral atresia is treated surgically. Surgical treatment is difficult and not always successful, it is preferable to perform it at age 4-5

COMPARATIVE STUDIES OF THE LIPIDS AND ACID MUCOPOLYSACCHARIDES IN THE WALL OF AORTA AND PULMONARY TRUNK IN EXPERIMENTAL ATHEROSCLEROSIS IN RABBITS

No abstrac

The Bonebridge system – Our clinical experience /Case report/

Introduction: Bone conduction implants are a standard treatment option for patients with conductive or mixed, hearing loss. The Bonebridge system was introduced by MED-EL in 2012, and two years after its debut, it was used in more than 200 centers worldwide (6). For the first time the Bonebridge system was implanted in Bulgaria in 2015 by associated professor P. Rouev. The main audiological criteria for placement is conductive hearing loss, which is caused by atresia of the auditory canal or diseases of the middle ear with preserved bone conduction (below 45 dB), as well as unilateral hearing loss above 70 dB (contralateral hearing loss not more than 20 dB). The system does not penetrate the skin and consists of an internal part - an implant, which is placed completely under the skin, and an external part - a processor. The acoustic signal from the environment is transformed into mechanical vibrations that are transmitted to the mastoid bone. The expected results are an improved hearing threshold and better hearing in noisy environments.Methods: Our clinical experience with the Bonebridge system is based on three operated patients aged between 56 and 73 years. All three patients had evidence of bilateral conductive hearing loss. Here we present one of these cases.Results: Test results showed significant improvement in hearing sensitivity especially in frequencies round 1000 Hz.Conclusions: Bone conduction implants such as the Bonebridge system are an excellent treatment option for patients with bilateral conductive deafness. Bonebridge has good hearing results, relative simplicity, and low rate of complications. Experience has shown that the Bonebridge system is easy to use and highly reliable. The use of Bonebridge conduction implant system leads to a significant improvement in the quality of life

Size Dependence of Electrical Conductivity and Thermoelectric Enhancements in Spin-Coated PEDOT:PSS Single and Multiple Layers

This work reveals that the electrical conductivity σ of a poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate) (PEDOT:PSS) film can be significantly increased by spin-coating multiple thin layers onto a substrate. Generally, σ can be improved by more than fourfold for multiple layers, as compared to a single thicker one. A gradual enhancement is observed for pristine PEDOT:PSS films (up to 2.10 ± 0.26 S cm–1 for five-layered films), while a plateau in σ at around 200 S cm–1 is reached after only three layers, when using a PEDOT:PSS solution with 5 vol% dimethyl sulfoxide. By contrast, only a small change in σ is observed for single layers of varying thickness. Accordingly, the thermoelectric power factor is also increased by up to 3.4 times for the multiple layers. Based on atomic force microscopy, X-ray photoelectron spectroscopy, UV–vis, and Raman spectroscopy measurements, two mechanisms are also proposed, involving an increase in percolation by inclusion of smaller grains within the existing ones, respectively, a reorganization of the PEDOT:PSS chains. These findings represent a direct strategy for enhancing the thermoelectric performance of conductive polymer films without additional reagents, while the mechanistic insights explain existing literature results

High Frequency Audiometry and its importance for the hearing loss early diagnosis

High Frequency Audiometry (9000 до 20000 Hz) is available and can be useful for early diagnosis of hearing impairments and their management and therapy, besides the conventional one (125 до 8000 Hz). The use of high frequency audiometry (HFA) is particularly important for early detection of hearing deviations connected with noise exposure, ototoxic drug treatment, unclear hearing dysfunction – noisy environment speech misunderstanding.The authors present different patient cases with hearing loss etiology,revealed by high frequency audiometry testing, with or without hearing loss diagnosed by conventional audiomerty (125 – 8000 Hz). Based on the published referent threshold values for high frequency audiometry, age divided into groups, we evaluate the obtained results and HFA changes in different hearing disorders – tinnitus, noisy environment speech misunderstanding, hearing loss. That group includes etiologically patients with acute acoustic trauma, noisy occupational environment, treated by chemotherapy, and patients with normal hearing without hearing disorders.The aim of our study is to identify the importance of high frequency audiometry deviations, for the early diagnosis of hearing disorders

Importance of Auditory Brainstem Response for Detection of Hearing Impairment in Early Childhood

Цел: Целта на настоящата презентация е да докаже ролята на слуховите стволови евокирани потенциали (ССЕП) в ранната диагностика на слуховите увреди при деца.Материали и методи: Изследвани са над 120 деца със слухови нарушения на възраст между 6 месеца и 5 години. Използвани са следните аудиометрични изследвания: тонална прагова аудиометрия, тимпанометрия, рефлексометрия, ССЕП.Резултати: Резултатите от ССЕП категорично доказват значимостта на изследването за диагностициране на слуховото състояние – има ли нарушение или не в слуховото възприятие при деца в ранна детска възраст.Изводи: Правим изводи, че ССЕП са единствен, обективен и надежден метод за диагностика на слуховите увреди в ранна детска възраст.-----------------------------------------------Aim: The aim of the present study is to prove the importance of Auditory brainstem response (ABR) in early diagnosis of hearing impairment in children. More than 120 kids from 6 months to 5 year old were tested in a period of 5 years.Material and methods: During the period of the study the following methods were used: Tonal audiometry, tymponometry, reflexometry and Auditory brainstem response.Results: The results clearly show the importance of the testing for evaluation of the hearing condition – is there an impairment present or not in sound perception in early childhood.Conclusion: We conclude that ABR a sole and objective method for diagnosing hearing impairment in early childhood

Balloon Dilatation Eustahian Tuboplasty (BET) (Case report)

Introduction: Eustachian tube dysfunction, particularly the obstructive type means inability for proper ventilation of the middle ear through it. This common disease affects 0,9% of adults and almost 40% of children up to age of 10 years. This lack of middle ear ventilation may lead to recurrent serous otitis media, chronic otitis media with retraction and even cholesteatoma, perforation of the tympanic membraneр ossicular erosion, etc.Aim: To be used modern method for Eustachian tube dysfunction managing – balloon dilatation Eustachian tuboplasty(BET). Material and Method: We present you the first two patients who underwent BET in UMHAT “St. George” Plovdiv.Results: Patients were discharged with improvement of the symptoms but the control tests at the 30th day after the intervention showed results similar to that before BET.Conclusions: Balloon dilatation Eustachian tuboplasty is a new micro invasive method for treatment of the Eustachian tube dysfunction in cases with no improvement of the conservative treatment

Auditory Brainstem Response Results in Children with Disturbance of the Neuropsychological Development

Цел: Целта на проучването е да се представят резултатите от слуховите стволови евокирани потенциали (ССЕП) при деца с невропатии, аутизъм, ментална ретардация, при които има отклонения в говора, познавателните способности и социалното развитие. Предвид зависимостта на говорната функция от слуховата определяме оценката на слуха като важна и необходима предпоставка за подпомагане на социалната адаптация на тези деца.Материали и методи: Основни методи за изследването са: ССЕП, тонална аудиометрия, тимпанометрия и рефлексометрия.Резултати: Изследвали сме над 20 деца със смущения в нервно-психическото развитие, при които има проблеми с комуникацията, развитието на говора и социализацията, и резултатите показаха, че при голям процент от децата се установи социално адекватен слух, само при 4 деца има данни за намален слух.Изводи: Изводът е, че ССЕП е задължително изследване при всички деца с нарушения в комуникацията, отклонения или неразвитие на говор, с цел ранната им диагностична и клинична оценка, с цел бъдещата им социална интеграция и говорна рехабилитация.------------------------------------------------Aim: To present the results from Auditory brainstem response (ABR) of children with neuropathy, autism and mental retardation who have speech, cognitive abilities and social-emotional development anomalies.The correlation between hearing and speech is well established and we define the evaluation of the hearing abilities as an important and necessary prerequisite for the social-emotional adaptation.Materials and methods: The methods that we used for the study were Auditory brainstem response (ABR), complimented by tonal audiometry testing, tympanometry and reflexometry.Results: We tested more than 20 kids with disturbance in the neuropsychological development and speech and in the larger number there is socially acceptable hearing and only in 4 cases there was significant hearing loss.Conclusion: The results clearly show that ARB is obligatory for all children with abnormal communication and anomalies in or with non developed speech and is of fundamental importance for early diagnostic and clinical evaluation to help their social integration and speech rehabilitation