Prevalence of canal paresis and associated disorders in benign paroxysmal positional vertigo patients

The purpose of this work was to study the prevalence of canal paresis and associated abnormalities in patients with posterior canal benign paroxysmal positional vertigo [BPPV]. Retrospective study of patients with BPPV attending the outpatient clinics of ENT and hearing and balance at DSFH, Jeddah, K.S.A. The study group consisted of 108 patients, 63 females and 45 males with unilateral posterior canal benign paroxysmal positional vertigo examined between March 2005, and November 2005. Their age ranged from 27 to 79 years. In this study the male to female ratio was 1: 1.4. The patients had a mean age of 48.6 +/- 12.4 years. Sixty nine patients [63.8%] were idiopathic BPPV and 39 patients [36.2%] had associated disorders with BPPV. The results of caloric test for patients with posterior canal benign paroxysmal positional vertigo revealed that 36 patients [33.3%] had caloric abnormalities, 21 patients [19.4%] had canal paresis, and 15 patients [13.8%] had directional preponderance. Primary BPPV with no associated disorders is more common than BPPV with associated disorders. BPPV is more common in females. Canal paresis may be found in patients with BPPV either on the same side or on the other unaffected side. Consequently, ENG test battery should be a routine test for evaluation of BPPV to detect other associated abnormalities

Middle ear functional changes associated with bilateral anterior nasal packing

Objective: the purpose of this study was to investigate the middle ear functional changes that associate with bilateral anterior nasal packing

Study Design: prospective study group consisted of thirty-eight consenting patients with bilateral anterior nasal packs, twenty males and eighteen females. Their age ranged from 18 to 50 years. The tymapanometric results of 76 ears that underwent bilateral anterior nasal packing after endoscopic nasal operations for chronic sinusitis were measured. The measurement was done before, during, and after nasal packing

Results: type A tympanogram was observed in 31 ears [40%] during bilateral anterior nasal packing and 59 ears [77%] after removal of the pack. While 34 ears [44 %] had type C tympanogram during bilateral anterior nasal packing and only 12 ears [15 %I had type C tympanogram after removal of the pack. Discussion: In this study, there was significant statistical difference between both middle ear functions before and after removal of the bilateral anterior nasal packing. However, there was no significant statistical dr8erence between the right and left ears affliction during the packing or after its removal by one week

Conclusions: this study revealed that there was a high incidence of Eustachian tube dysfunctions in patients with bilateral anterior nasal packs. However, with removal of the pack the middle ear pressure improves towards the pre-nasal pack condition with restoration of the middle ear physiological function after its removal