ABSTRACT
Vestibular paroxysmia is the name given to the syndrome caused by vascular compression of the vestibulocochlear nerve. The main symptoms of vestibular paroxysmia are recurrent, spontaneous, brief attacks of spinning, non-spinning vertigo or positional vertigo that generally last less than one minute, with or without ear symptoms (tinnitus and hypoacusis). Prior to attributing a patient's symptoms to vestibular paroxysmia, however, clinicians must exclude common conditions like benign paroxysmal positional vertigo, Menière's disease, vestibular neuritis and vestibular migraine. This is usually possible with a thorough history and bedside vestibular/ocular motor examination. Herein, we describe a patient with vestibular paroxysmia that mimicked resolved BPPV with a literature review.
Subject(s)
Humans , Benign Paroxysmal Positional Vertigo , Carbamazepine , Ear , Migraine Disorders , Neuritis , Vertigo , Vestibular Diseases , Vestibulocochlear NerveABSTRACT
BACKGROUND AND OBJECTIVES: To investigate the effectiveness of fine needle aspiration (FNA) conducted by the otolaryngologists, we compared the ultrasound (US)-guided FNA results conducted by a radiologist (RD-US), the US-guided FNA results (ENT-US), and the palpation guided FNA results (ENT-palpation) conducted by an otolaryngologist. SUBJECTS AND METHOD: 1646 patients who underwent FNA were classified according to the site and periods of investigation (2007-2015), and their sampling adequacy was retrospectively reviewed. They were also divided into three groups (ENT-US, ENT-palpation, and RD-US); each group was then investigated for sampling adequacy. Results of further surgical excisional biopsy were compared with the those of the FNA results to investigate the diagnostic accuracy of all three groups. RESULTS: The sampling adequacy identified by the groups showed the result of ENT-US at 87.9%, ENT-palpation at 87.1% and RD-US at 91.3%. The periodical inadequacy rate failed to show any significant differences between the groups. The sensitivity of ENT-palpation was lower than other two groups. Diagnostic accuracy identified by the groups showed the result of ENT-US at 95.2%, ENT-palpation at 93.6%, and RD-US at 97.4%. CONCLUSION: FNA performed by otolaryngologists demonstrates the effectiveness of diagnosis and treatment, and that doing so would improve economic efficiency. Therefore, it is recommended that well-trained otolaryngologists conduct FNA actively.
Subject(s)
Humans , Biopsy , Biopsy, Fine-Needle , Diagnosis , Methods , Palpation , Retrospective Studies , UltrasonographyABSTRACT
Middle ear cholesteatoma is considered to be congenital in origin when there is an intact tympanic membrane with no prior history of otorrhea, tympanic perforation or otologic procedure. However, congenital cholesteatoma is a relatively rare disease entity for which a variety of theories regarding its pathogenesis have been suggested as follows: epidermoid formation, migration of squamous epithelium, implantation, metaplasia, and acquired inclusion theory. However, the pathogenesis of congenital cholesteatoma remains unclear. There are two pathologic types of congenital cholesteatoma, "closed" and "open". We present a rare case of congenital cholesteatoma arising from middle ear cavity in a condition of two completely isolated closed congenital cholesteatomas, which were successfully removed via transcanal approach. Also we review the literature and discuss the theories on the development of two separate congenital cholesteatomas.