Effects of customized vestibular rehabilitation on static balance among adults with benign paroxysmal positional vertigo

The aim of this study was to detemine the effectiveness of Customized vestibular rehabilitation (CVR) in addition to the standard Canalith repositioning maneuver (CRM) on static balance among adults with posterior canal Benign Paroxysmal Positional Vertigo (BPPV). In this randomised controlled trial, 28 adults with idiopathic unilateral posterior canal BPPV were randomized to either the control or experimental group. The experimental group (n=14, mean age: 50.71±9.88 years) received CVR in addition to CRM, and the control group (n=14, mean age: 54.36±8.55 years) received only CRM for 6 weeks. Measurements of static balance (postural sway) using a portable kinematic sensor were performed at baseline, four and six weeks after treatment for both groups while standing on firm and foam surface with eyes open (EO) and closed (EC). Only standing on foam surface with EC was observed to have a significant interaction effect, F (2, 52) =5.28, p<0.05. This suggest that the groups were affected differently by the intervention and greater improvement was demonstrated in the experimental group. Post hoc test showed that a significant difference (p<0.05) in static balance was shown between baseline and 6th week after intervention. The results of our study indicate that CVR in addition to CRM improved static balance in adults with UPC BPPV at 6th week after intervention for persons with BPPV

Effect of stimulus sweep direction on distortion product otoacoustic emission fine structure

The purpose of this study was to examine the effect of stimulus sweep direction on the fine structure of the 2f1-f2 distortion product otoacoustic emission (DPOAE). It was hypothesised that the DPOAE fine structure could be shifted if the stimulus sweep changed from one direction to the other. In the present study, ascending, descending and random frequency sweeps were used, with f2 frequency varying between 992 Hz and 2496 Hz and f2/f1 fixed at 1.22. DPOAE fine structure was recorded at 16 Hz intervals. Screening, spontaneous otoacoustic emission (SOAE) and DPOAE measurements were carried out on 19 ears of 19 subjects aged between 22 and 30 years. Data from 14 ears that had at least one significant peak or valley in their DPOAE fine structure were included in the main analysis. Of these, five ears showed at least one occurrence of SOAE over the frequency span 600 Hz to 2500 Hz. Data for ears with and without SOAEs were grouped and analysed separately. The results showed no effect of sweep direction on DPOAE fine structure. No significant differences were observed in peak or valley frequencies, peak height or valley depth between the three stimulus sweep conditions (p > 0.05). There was also no significant effect of stimulus sweep direction on DPOAE level at the point at which SOAE frequency equalled DPOAE frequency (p > 0.05). In conclusion, the study found no effect of stimulus sweep direction on the fine structure of the 2f1-f2 DPOAE, either in ears with or without SOAEs.Therefore, future measurements of this fine structure may use either sweep direction

Which is the best method of sterilization for recycled bone autograft in limb salvage surgery: a radiological, biomechanical and histopathological study in rabbit

Background: Limb salvage surgery is a treatment of choice for sarcomas of the extremities. One of the options in skeletal reconstruction after tumour resection is by using a recycled bone autograft. The present accepted methods of recycling bone autografts include autoclaving, pasteurization and irradiation. At the moment there is lack of studies that compare the effectiveness of various sterilization methods used for recycling bone autografts and their effects in terms of bone incorporation. This study was performed to determine the effects of different methods of sterilization on bone autografts in rabbit by radiological, biomechanical and histopathological evaluations. Methods: Fresh rabbit cortical bone is harvested from the tibial diaphysis and sterilized extracorporeally by pasteurization (n = 6), autoclaving (n = 6), irradiation (n = 6) and normal saline as control group (n = 6). The cortical bones were immediately reimplanted after the sterilization process. The subsequent process of graft incorporation was examined over a period of 12 weeks by serial radiographs, biomechanical and histopathological evaluations. Statistical analysis (ANOVA) was performed on these results. Significance level (Α) and power (Β) were set to 0.05 and 0.90, respectively. Results: Radiographic analysis showed that irradiation group has higher score in bony union compared to other sterilization groups (p = 0.041). ANOVA analysis of 'failure stress', 'modulus' and 'strain to failure' demonstrated no significant differences (p = 0.389) between treated and untreated specimens under mechanical loading. In macroscopic histopathological analysis, the irradiated group has the highest percentage of bony union (91.7 percent). However in microscopic analysis of union, the pasteurization group has significantly higher score (p = 0.041) in callus formation, osteocytes percentage and bone marrow cellularity at the end of the study indicating good union potential. Conclusions: This experimental study shown that both irradiation and pasteurization techniques have more favourable outcome in terms of bony union based on radiographic and histopathological evaluations. Autoclaving has the worst outcome. These results indicate that extracorporeal irradiation or pasteurization of bone autografts, are viable option for recycling bone autografts. However, pasteurization has the best overall outcomes because of its osteocytes preservation and bone marrow cellularity