Limitation of High Pitch Sound Perception in Nontumor Patients with Auditory Brainstem Implantation / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Auditory brainstem implantation (ABI) is another option for hearing rehabilitation in non-neurofibromatosis type 2 patients who cannot undergo cochlear implantation (CI). However, the average performance of ABI is worse than that of CI. We analyzed the psycho-electrical parameters of each electrode and psycho-acoustic response to different frequency sounds in nontumor patients with ABI. SUBJECTS AND METHOD: Sixteen patients with ABI from July 2008 to May 2013 were included in the study. They were followed up for 4 to 56 months. Among them, 12 were prelingual deaf with a narrow internal auditory canal or cochlear ossification. The remaining four were post-lingual deaf adults with severely ossified cochleae. We analyzed the electrical parameters [impedance, threshold level (T level), and dynamic range] of each of the 12 electrodes. We also evaluated the sound field pure-tone threshold, Ling 6 sound detection-identification test (Ling 6 test), and pitch ranking data of these patients. RESULTS: The impedance, T level, and dynamic range did not significantly differ among electrodes. However, the pure-tone threshold to sound field stimulation was elevated in the high tone area, where more variables were found than in the low frequency area. Patients could not identify /S/ and /Sh/ sounds in the Ling 6 test. The mean T level and the dynamic range of the three highest pitch-perceiving electrodes in each patient was higher and narrower, respectively, than those of the three lowest pitch-perceiving electrodes. CONCLUSION: The nontumor patients with ABI have difficulty perceiving high pitch sound. More sophisticated penetrating type electrodes and, if possible, bimodal stimulation with CI, could be considered.

Results of otolith reposition therapy in posterior semicircular canal BPPV

BACKGROUND AND OBJECTIVES: Benign paroxysmal positional vertigo (BPPV) has been well controlled with otolith reposition therapy. Posterior canal is known as the most common site of BPPV. The purpose of this study was to study the therapeutic result of reposition therapy in posterior canal BPPV, to investigate the unusual cases such as recurred cases and type changed cases during the reposition maneuver, and to figure out the therapeutic strategy. MATERIALS AND METHODS: One hundred and ten patients diagnosed posterior canal BPPV were included in this study. Epley maneuver was performed once a day until nystagmus disappeared. We analyzed the number of treatment, changing type, recurrence and the relationship between recurrence and age or sex of patients. RESULT: All cases except 2 were recovered by Epley maneuver. In 11 cases, the type of disease was changed, and the treatment of these cases were changed according to new type and origin. Overall recurrence rate was 15%, and they were completely treated with reposition therapy. There was no correlation between recurrence and age, sex of patients. CONCLUSION: All most cases were cured with Epley maneuver. The type of the disease was possibly changeable. Recurrence rate was relative high, and close follow up was required.

Treatments of Lateral Semicircular Canal BPPV / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Benign paroxysmal positional vertigo (BPPV) is a common vestibular disease. The theories of can-alolthiasis and cupulolithisis of posterior semicircular canal are commonly accepted in BPPV. Recently, not only posterior canal but also lateral canal BPPV were reported. The purposes of this study are to analyze the result of lateral canal BPPV treatment and to introduce effective schedule of reposition maneuvers and follow up. MATERIALS AND METHODS: Sixty two patients who were diagnosed as lateral semicircular canal BPPV were included in this study. Supine head turning test was done and eye movement was documented with videonystagmography. In the canalolithiasis type, barbecue rotation maneuver was performed and in the cupulolithiasis type, cupulolith reposition maneuver was performed. In each type of BPPV, we analyzed the number of treatment until nystagmus was disappeared, recurrence rate and relationship between recurrence and age, sex of patients. RESULTS: Canalolithiasis type was 55% and cupulolithiasis type was 37%. Eight percents of patients showed combined type. All except 2 cases (congenital malformation) were healed by the reposition maneuver. Vertigo recurred in about 30% of patients, and they were retreated with the reposition maneuver. There was no correlation between recurrence and age, sex of patients. CONCLUSION: In lateral semicircular canal BPPV, the reposition maneuver was a effective treatment method. The reposition maneuver was recommended to perform continuously once a day until nystagmus disappeared. Because recurrence rate was about 30%, continuous follow-up was needed.

Results of Otolith Reposition Therapy in Various Types of BPPV / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Benign paroxysmal positional vertigo (BPPV) has been well controlled with otolith reposition maneuver. The purpose of this study was to investigate the incidence of various forms of BPPVs such as type change during the reposition maneuver, combined type and recurred cases, to study the therapeutic result of physical therapy in various forms of BPPVs, and to figure out the therapeutic strategy. MATERIALS AND METHOD: One hundred and twenty-seven patients who were diagnosed with BPPV were included in this study. Reposition maneuver was performed once a day until nystagmus disappeared. In the case of posterior canal BPPV, Epley maneuver was performed. In the case of lateral canal BPPV, barbecue rotation maneuver was performed in canalolithiasis type, and cupulolith reposition maneuver in cupulolithiasis type. In each type of BPPV, we analyzed the number of treatment, recurrence, changing type, and the relationship between recurrence and age or sex of patients. RESULTS: Posterior canal origin was more common than lateral canal origin. All cases except 2 were recovered by reposition maneuver. In 8 cases, the type of disease was changed, and the treatment of these cases were changed according to new type and origin. Overall recurrence rate was 14%, and they were completely treated with reposition maneuver. There was no correlation between recurrence and origin, type, age or sex of patients. CONCLUSION: Patients showed various origin, type and recurrence. Type of the disease was possibly changeable. Almost all the cases were cured with suitable reposition maneuver. Recurrence rate was relatively high, and the close follow up is required.