Ramsay Hunt syndrome: Clinical analysis of 15 cases

The Ramsay Hunt syndrome (RHS) is characterized by acute facial nerve paresis and/or paralysis accompanied by a herpetic lesion on the external ear. Fifteen patients were evaluated and treated for RHS. After a detailed history was obtained, clinical examination was performed, and treatment was initiated based on steroids and acyclovir. The House-Brackmann grading system (HB I-VI) was used to evaluate the facial nerve function; this was further electrophysiologically assessed with the nerve excitability test (NET) and electro-neurography. In RHS cases, the most common accompanying findings were the cochleovestibular symptoms (73%) and in particular vertigo and balance disorder. The combined treatment of acyclovir with steroids resulted in satisfactory facial nerve function (HB I-II) in 75% of cases. The recovery was satisfactory in all the cases in which the NET was normal or diminished. In 4 cases in which the recovery was non-satisfactory (ΗΒΙΙΙ-V) no response was initially obtained in NET. In RHS, the possible neuritis and the inflammatory process which occur into the internal auditory canal may result in facial nerve dysfunction and cochleovestibular symptoms. The combined therapy of the antiviral agent acyclovir with the anti-inflammatory effect of steroids is recommended for the treatment of RHS. The NET was proved as the most useful method in the prognostication of RHS.The Ramsay Hunt syndrome (RHS) is characterized by acute facial nerve paresis and/or paralysis accompanied by a herpetic lesion on the external ear. Fifteen patients were evaluated and treated for RHS. After a detailed history was obtained, clinical examination was performed, and treatment was initiated based on steroids and acyclovir. The House-Brackmann grading system (HB I-VI) was used to evaluate the facial nerve function; this was further electrophysiologically assessed with the nerve excitability test (NET) and electro-neurography. In RHS cases, the most common accompanying findings were the cochleovestibular symptoms (73%) and in particular vertigo and balance disorder. The combined treatment of acyclovir with steroids resulted in satisfactory facial nerve function (HB I-II) in 75% of cases. The recovery was satisfactory in all the cases in which the NET was normal or diminished. In 4 cases in which the recovery was non-satisfactory (ΗΒΙΙΙ-V) no response was initially obtained in NET. In RHS, the possible neuritis and the inflammatory process which occur into the internal auditory canal may result in facial nerve dysfunction and cochleovestibular symptoms. The combined therapy of the antiviral agent acyclovir with the anti-inflammatory effect of steroids is recommended for the treatment of RHS. The NET was proved as the most useful method in the prognostication of RHS

Hydrotherapy (Project Hydriades)

Natural resources are being used for the maintenance of health. According to the Law 3498/2006 of the Greek Parliament the natural health spas must be validated for their therapeutic properties. The Association of Municipalities and Communities of Health Springs of Greece signed a contract with the Research Committee of the Aristotle University of Thessaloniki, Greece, in order to conduct the research programme: ‘Study for the documentation of the therapeutic properties of the thermomineral waters’. The main aim of the project is: (1) the study of biological and therapeutic parameters of the natural health sources, (2) the identification of the indications and contraindications of hydrotherapy. Aims parallel to the main ones have been also set

Utility of otoacoustic emissions and olivocochlear reflex in predicting vulnerability to noise-induced inner ear damage

Aim: The aim of the present study was to explore the possible utility of otoacoustic emissions (OAEs) and efferent system strength to determine vulnerability to noise exposure in a clinical setting. Materials and Methods: The study group comprised 344 volunteers who had just begun mandatory basic training as Hellenic Corps Officers Military Academy cadets. Pure-tone audiograms were obtained on both ears. Participants were also subjected to diagnostic transient-evoked otoacoustic emissions (TEOAEs). Finally, they were all tested for efferent function through the suppression of TEOAEs with contralateral noise. Following baseline evaluation, all cadets fired 10 rounds using a 7.62 mm Heckler & Koch G3A3 assault rifle while lying down in prone position. Immediately after exposure to gunfire noise and no later than 10 h, all participants completed an identical protocol for a second time, which was then repeated a third time, 30 days later. Results: The data showed that after the firing drill, 280 participants suffered a temporary threshold shift (TTS) (468 ears), while in the third evaluation conducted 30 days after exposure, 142 of these ears still presented a threshold shift compared to the baseline evaluation [permanent threshold shift (PTS) ears]. A receiver operating characteristics curve analysis showed that OAEs amplitude is predictive of future TTS and PTS. The results were slightly different for the suppression of OAEs showing only a slight trend toward significance. The curves were used to determine cut points to evaluate the likelihood of TTS/PTS for OAEs amplitude in the baseline evaluation. Decision limits yielding 71.6% sensitivity were 12.45 dB SPL with 63.8% specificity for PTS, and 50% sensitivity were 12.35 dB SPL with 68.2% specificity for TTS. Conclusions: Interestingly, the above data yielded tentative evidence to suggest that OAEs amplitude is both sensitive and specific enough to efficiently identify participants who are particularly susceptible to hearing loss caused by impulse noise generated by firearms. Hearing conservation programs may therefore want to consider including such tests in their routine. As far as efferent strength is concerned, we feel that further research is due, before implementing the suppression of OAEs in hearing conservations programs in a similar manner