Identification of cochlear and Retro cochlear causes in patients with tinnitus

This study was designed to identify the possible underlying site of lesion in patients with tinnitus through using Transient Evoked otoacoustic Emissions [TEOAEs], Auditory Brainstem Response [ARR] and Electrocochleography [ECOchG]. Forty subjects complaining of tinnitus were examined. The control group consisted of'24 ears with normal hearing sensitivity not involved with tinnitus. The study group comprised of 36 ears with hearing loss and 20 ears with normal hearing thresholds. TEOAEs revealed that 88.8% of tinnitus ears with hearing loss partially passed or failed to pass the emissions. Interestingly, 20% of tinnitus ears with normal hearing full in the fail to pass category. There was statistically significant difference between control amid study group for absolute latency of wave 1. In ABR test. EcochG results showed that there was no statistically significant difference of the summation potential [SP], action potential [AP] and SP/AP ratio. On individual analysis, two subjects showed increased SP/AP ratio who were finally diagnosed as having Meniere's disease. One subject revealed manifestations of retrocochlear lesion in ABR test results and proved later to have cerebello-pontine angle mass. The combination of TEOAEs, ABR and EcochG is useful to identify site of lesion in tinnitus subjects. EcochG is valuable in diagnosis of endolymphatic subjects. EcochG is valuable in diagnosis of endolymphatic hydrops, ABR for detection of retrocochlear lesion while TEOAEs is very promising for early detection of hidden cochlear pathology

study of balance disorders in old patients

This work studied 50 cases and 20 control patients complaining of dizziness and balance problems. The study also included 20 normal volunteer subjects to detect the 5th percentile of the used score. Each patient was diagnosed depending on history, examination and audiological and balance investigations. Semiquantitative clinical measures of equilibrium and subjective improvement were studied in patients and control groups before and after therapy. It was found that there was statistically highly significant improvement of mean score in clinical static and dynamic equilibrium after completing the vestibular rehabilitation regimen. There was a highly significant difference between the patient and the control groups in static assessment, but a insignificant difference in dynamic assessment. It was found that the static equilibrium score is more accurate than the dynamic one. There was a negative correlation between age and the degree of improvement in both static and dynamic assessment in patients and control groups. It was found that the vestibular subgroup of patients showed a statistically significant better improvement than the non-vestibular and the unknown subgroups. The benefit of vestibular rehabilitation therapy [VRT] was also found to be limited in patients with multiple medical problems. 62% of the patients' group and 15% of the control group achieved major improvement after VRT