Audiovestibular and radiological findings in patients with migrainous vertigo

Objective:To describe the audiological, vestibular and radiological profile of patients with migrainous vertigo. Methods: This is a prospective descriptive study of patients who presented with migrainous vertigo in a tertiary care institute over one year.All patients between the ages of twenty to sixty who presented between 2013 and 2014 with migrainous vertigo diagnosed according to Neuhauser’s criteria were included in this study. The diagnostic intervention was audiovestibular tests and magnetic resonance imaging (MRI) of brain with gadolinium. The main outcome measures were types and degree of auditory and vestibular deficits; MRI findings in migrainous vertigo, and whether age at presentation and duration of symptoms affected these findings.Results:Of the 112 patients recruited, the overall female-to male ratio was 1.7: 1. On pure tone audiogram, 18 (16%) patients had sensorineural hearing loss and this was similar in age groups40 years. Caloric abnormalities were seen in 64 (61.5%) patients and there was no significant difference in the younger versus older age groups. MRI abnormality was present in 24% and the commonest finding was deep white matter hyperintensities in the brain. In the 7 years with MRI abnormalities, and this difference was statistically significant (Chi sq 4.14, p=0.041). Conclusions:Both audiological and vestibular abnormalities were seen in migrainous vertigo patients and older age did not appear to be an additional risk factor for the presence of theseabnormalities. Deep white matter hyperintensities were the commonest abnormality found on MRI scans and longer headache duration was associated with higher chances of MRI abnormalities in younger people.

Nasalance in Cochlear Implantees

OBJECTIVES: Speech intelligibility is severely affected in children with congenital profound hearing loss. Hypernasality is a problem commonly encountered in their speech. Auditory information received from cochlear implants is expected to be far superior to that from hearing aids. Our study aimed at comparing the percentages of nasality in the speech of the cochlear implantees with hearing aid users and also with children with normal hearing. METHODS: Three groups of subjects took part in the study. Groups I and II comprised 12 children each, in the age range of 4-10 years, with prelingual bilateral profound hearing loss, using multichannel cochlear implants and digital hearing aids respectively. Both groups had received at least one year of speech therapy intervention since cochlear implant surgery and hearing aid fitting respectively. The third group consisted of age-matched and sex-matched children with normal hearing. The subjects were asked to say a sentence which consisted of only oral sounds and no nasal sounds ("Buy baby a bib"). The nasalance score as a percentage was calculated. RESULTS: Statistical analysis revealed that the children using hearing aids showed a high percentage of nasalance in their speech. The cochlear implantees showed a lower percentage of nasalance compared to children using hearing aids, but did not match with their normal hearing peers. CONCLUSION: The quality of speech of the cochlear implantees was superior to that of the hearing aid users, but did not match with the normal controls. The study suggests that acoustic variables still exist after cochlear implantation in children, with hearing impairments at deviant levels, which needs attention. Further research needs to be carried out to explore the effect of the age at implantation as a variable in reducing nasality in the speech and attaining normative values in cochlear implantees, and also between unilateral versus bilateral implantees.