Vestibular dysfunction in patients with post-mumps sensorineural hearing loss.

OBJECTIVE: To study the possible damage to the vestibular system in patients with post-mumps sensorineural hearing loss. METHODS: Nineteen patients with recent mumps infection participated in the study. All patients had unilateral profound sensorineural hearing loss or total hearing loss. Patients were subjected to video-nystagmography and vestibular-evoked myogenic potential testing. RESULTS: Eight patients (42.1 per cent) had normal video-nystagmography results and intact vestibular-evoked myogenic potentials on both sides, whereas the other 11 patients (57.9 per cent) had vestibular lesions in the form of marked canal weakness and absent vestibular-evoked myogenic potential responses on the same side as hearing loss. The overall findings indicated a peripheral site for the lesions. CONCLUSION: The majority of patients with post-mumps sensorineural hearing loss had peripheral vestibular pathology in the same ear as hearing loss. Further research should be directed to saving the inner ear following mumps infection.

Use of the nine-step inflation/deflation test and resting middle-ear pressure range as predictors of middle-ear barotrauma in aircrew members.

OBJECTIVE: To explore the role of the nine-step inflation/deflation tympanometric test and resting middle-ear pressure range as predictors of barotrauma in aircrew members. METHODS: A prospective, non-randomised study was conducted on 100 aircrew members. Resting middle-ear pressure was measured and the nine-step inflation/deflation test performed on all subjects before flights. Subjects were allocated to two groups according to resting middle-ear pressure range (group A, within the range of +26 to +100 and -26 to -100 mmH2O; group B, -25 to +25 mmH2O). All aircrew members were assessed after flights regarding the presence and the grade of barotrauma. RESULTS: In both groups, the sensitivity and specificity values of the entire post-inflation/deflation test were close to those of the post-deflation part of the test. The post-deflation test had a higher negative predictive value than the post-inflation test. Ears with resting middle-ear pressure lower than -55 mmH2O experienced barotrauma, regardless of good or poor post-inflation or post-deflation test results. CONCLUSION: In an aircrew member, a resting middle-ear pressure within the range of -55 and +50 mmH2O, together with good post-deflation test results, are considered reliable predictors for fitness to fly.