ABSTRACT
OBJECTIVE@#To find out the clinical characteristics of Meniere's disease in flight aircrew and discuss relevant principles of clinical aviation medicine, in order to summarize experience in medical evaluation of aircrew.@*METHOD@#Collect the data of 35 cases that were diagnosed with Meniere's disease from 1966 to 2011 in our hospital and analyze the clinical characteristics, diagnosis and flight conclusion of them.@*RESULT@#Among the 35 cases, 34 patients complained of vertigo. 27 patients complained of tinnitus and 21 patients complained of hearing loss. (1) 18 cases manifested typical symptoms of Meniere's disease (paroxysmal vertigo, fluctuating neurosensory hearing loss, tinnitus and ear fullness); (2) 7 patients showed the symptoms of vertigo and tinnitus, not complaining of significant hearing loss (after inspection. 4 of them proved the low-frequency hearing loss); (3) 7 patients only manifested as vertigo; (4) 2 patients manifested as tinnitus and hearing loss. 1 patients manifested only hearing loss. On the basis of the diagnostic criteria of Meniere's disease formulated hy Committee on Hearing and Equilibrium of the American Academy of Otolaryngology-Head and Neck Surgery. 22 patients were diagnosed with definite Meniere's disease, 2 patients were diagnosed with probable Meniere's disease, 11 patients were diagnosed with possible Meniere's disease. For patients with definite Meniere's disease and probable Meniere's disease, the phases of the disease were: 11 cases of phase I, 7 case of phase II and 6 case of phase III. The flight conclusion of all the 35 patients was permanent grounding. The time from the attack of the disease to receiving the conclusion of permanent grounding fluctuated from three months to 11 years.@*CONCLUSION@#The diagnosis of Meniere's disease of flight aircrew must he cautious. For patients with atypical symptoms of Meniere's disease, the diagnosis should be made in the case of completely ruling out other possible diseases. Once be diagnosed, a patient should normally be flight unqualified. The flying waiver would he recommended only under exceptional circumstances. The criterion of waiver condition need to be further explored in the future.
Subject(s)
Adult , Humans , Male , Middle Aged , Aerospace Medicine , Methods , Meniere Disease , DiagnosisABSTRACT
Objective To evaluate the hearing function of pilots under physical examination for modification to equipment of high performance aircraft,using pure tone audiometry(PTA) and distortion product otoacoustic emission(DPOAE).Methods Analyzed were all the results of PTA and DPOAE of 75 pilots (150 ears) which accepted physical examination for modification to equipment of high performance aircraft in our department from March 2008 to February 2009.75 cases were divided into two groups according to their flight time.The difference between these two groups was studied.Results According to the Equipments of Physical Constitution for Flying Persons of Air force,PLA,all 75 pilots passed the ENT assessments as being qualified for flying.Of all 150 ears,abnormal DPOAEs were obviously higher than that of abnormal PTA tests.128 ears had normal PTA results.92 ears had normal DPOAE results.36 ears (27.6&) showed abnormal DPOAEs at one or more frequencies,especially at 1,3 and 4 kHz.22 ears had abnormal PTA results.20 ears had noticeable V or U shaped thresholds at 3 kHz and/or 4 kHz.The DPOAE amplitudes showed similar curves.The other two ears showed depressions at all frequencies,in both PTA and DPOAE tests.No statistically significant difference was found between the two groups in DPOAE.But statistical difference was found in DPOAE at 4 kHz compared with other frequencies.No statistically significant differences were found between the two groups in DPOAE amplitudes at 1,2,3 and 4 kHz.but at 6 and 8 kHz.Conclusion The application of DPOAE test helped find pilots who were on the early stage of noise-induced hearing loss.These pilots were the most important objects for us to follow up.