Clinical features of vestibular syncope associated with tumarkin attacks in delayed endolymphatic hydrops / 中华耳鼻咽喉头颈外科杂志

Objective: To analyze the clinical characteristics of vestibular syncope (VS) associated with drop attacks (DA) in delayed endolymphatic hydrops (DEH). Methods: DEH cases with complete data were retrospectively analyzed, including three DEH cases with DA and VS (VS group), and six DEH cases without DA or VS (control group). The clinical profile, the results of neurotological examinations [such as pure tone audiometry, electrocochleography (EcochG), caloric test, vestibular evoked myogenic potentials (VEMP), and video head impulse test (vHIT)] and treatment outcomes were analyzed. Results: (1) In the VS group, there were three cases of ipsilateral DEH; in the control group, there were six cases of ipsilateral type. One case in each group had a history of migraine. (2) The prevalence of abnormal results in caloric test, vHIT, cervical VEMP, and ocular VEMP in the VS group was 3/3, 1/3, 2/2, and 2/2, respectively, and in the control group was 3/6, 0/3, 1/6, and 4/6, respectively. Two cases in each group underwent EcochG, and no identifiable waveform was elicited on the affected side, and-SP/AP ratio of unaffected side was less than 0.4. (3) Patients in both groups were initially treated with conservative medication. Two cases in the VS group subsequently received intratympanic injections of dexamethasone. No DA or VS occurred during a follow-up period lasting over one year. All patients achieved good control of vertigo during the follow-up period. Conclusions: VS may occur in the patients with DEH. The differential diagnosis of syncope in patients with otogenic vertiginous disease can help improve clinical diagnosis and treatment.

Electrocochleography for Ménière's disease: is it reliable?, / Eletrococleografia na doença de Ménière: é confiável?,

Introduction: Endolymphatic hydrops, the histopathological substrate of Ménière's disease, is an almost universal finding in postmortem studies of patients with this disease. The cause of hydrops is still unknown, as is the mechanism by which it causes progressive dysfunction of the sensory organs of inner ear. The fluctuating course of the disease complicates the interpretation of certain tests, such as electrocochleography; thus, for some authors its diagnostic value is questionable. Objective: The aim of this study was to analyze the clinical applicability of electrocochleography in the diagnosis of hydrops. It is a valuable tool, but still generates conflicting opinions among otolaryngologists. Methods: Systematic review of the literature on electrocochleography in patients diagnosed with endolymphatic hydrops. Results: A total of 34 articles regarding the use of electrocochleography in patients with hydrops, from the year 2000 onwards, were selected. Of these, 15 were excluded from the review as they were not observational studies. Only one cross-sectional study addressing the clinical use of electrocochleography by otolaryngologists was included. Conclusion: Electrocochleography is a valuable tool in the diagnosis of hydrops, as it is a non-invasive, easy to handle procedure, which offers new techniques to increase the sensitivity of the test, and thereby assists otolaryngologists in the management of Ménière's disease. .

Introdução: A hidropisia endolinfática é o substrato histopatológico e achado quase universal nos estudos post-mortem de pacientes com doença de Ménière. A causa da hidropisia ainda é desconhecida, assim como o mecanismo pelo qual causa disfuncção progressiva dos órgãos sensitivos da orelha interna. O curso flutuante da doença dificulta a interpretação de exames como a eletrococleografia, que apresenta, para alguns autores, valor diagnóstico controverso. Objetivos: O objetivo deste estudo é analisar a aplicabilidade clínica da eletrococleografia no diagnóstico da hidropisia endolinfática, sendo uma ferramenta de uso comum e que ainda gera opiniões conflitantes entre os otorrinolaringologistas. Método: Revisão sistemática da literatura sobre eletrococleografia em pacientes com diagnóstico de hidropisia endolinfática. Resultados: Foram selecionados 34 artigos sobre o uso da eletrococleografia em pacientes portadores de hidropisia endolinfática a partir do ano 2000; 15 artigos foram excluídos da revisão por não se tratarem de estudos observacionais, com inclusão de somente um estudo transversal que trata sobre o uso clínico da eletrococleografia entre os otorrinolaringologistas. Conclusão: A eletrococleografia é uma importante ferramenta no diagnóstico da hidropisia endolinfática, por ser não invasiva, de fácil mensuração, e por oferecer novas técnicas capazes de aumentar a sensibilidade do exame e auxiliar o otorrinolaringologista no tratamento da Doenca de Ménière. .

Doença de Ménière - Parte III / Ménière's disease - Parte III

Os autores fazem estudo do estado atual de conhecimentos sobre a doença de Ménière. Tecem considerações sobre o exame do aparelho vestibular, o que quer dizer, o estudo dos sistemas vestíbulo-espinhal e vestíbulo-oculomotor. Fazem referência a doença de Ménière não idiopática e apreciação sobre as causas, exames subsidiários e diagnóstico diferencial. Foram estudados 83 casos