A comparison of the video head impulse test and the functional head impulse test in chronic unilateral vestibular loss.

OBJECTIVE: To examine the correlation of video head impulse test, functional head impulse test and Dizziness Handicap Inventory results in patients with chronic unilateral vestibular loss, and to compare the results with healthy controls. METHODS: Forty-eight patients diagnosed with chronic unilateral vestibular loss and 35 healthy individuals, aged 18-65 years, were included. The video head impulse test, functional head impulse test and Dizziness Handicap Inventory were administered. RESULTS: A significant positive correlation was found between functional head impulse test and video head impulse test results for the study group in all semicircular canals (p < 0.05). There was no significant correlation between Dizziness Handicap Inventory, functional head impulse test and video head impulse test results (p > 0.05). The functional head impulse test and video head impulse test results of the control group were significantly higher than those of the study group in all semicircular canals planes (p < 0.05). CONCLUSION: In chronic unilateral vestibular loss patients, with high head accelerations, the functional head impulse test indicates deterioration in vestibulo-ocular reflex functionality. It would be beneficial to include the video head impulse test and functional head impulse test in clinical practice as complementary tests in vestibulo-ocular reflex evaluation.

Evaluation of vestibulo-ocular reflex with functional head impulse test in healthy individuals: normative values.

Objectives: This study aimed to determine the normative values of the functional head impulse test (fHIT) test in healthy young adults. Materials and methods: The study included 100 individuals, 58 females and 42 males, aged 20-25 years. Beon Solution Zero Branco (TV) fHIT test was applied to all participants. FHIT results were analyzed in terms of lateral-posterior-anterior semicircular canals (SSCs), gender, and right-left ear. Results: In the fHIT test, for the lateral SSC the mean percent correct answer (%CA) values for 4,000-6,000°/s2 and 1,000-7,000°/s2 were 88.52 ± 9.04 and 89.91 ± 6.95, respectively; for the posterior SSC, the mean %CA values for SSC 3000-6,000°/s2 and 1,000-7,000°/s2 were 90.63 ± 8.69 and 91.16 ± 7.42, respectively; for the anterior SSC, the mean %CA values for 3,000-6,000°/s2 and 1,000-7,000°/s2 were 91.21 ± 7.96 and 91.49 ± 7.13, respectively. There was no statistically significant difference between the right and left ear in %CA values at all accelerations in all SSCs (p > 0.05). There was a statistically significant difference between genders in the mean %CA values for 6,000-7,000°/s2, 4,000-6,000°/s2, and 1,000-7,000°/s2 in the lateral SSC and 3,000-6,000°/s2 in the anterior SSC (p < 0.05). Conclusion: The FHIT is a noninvasive test battery that functionally evaluates the VOR of the six semicircular canals. In clinical use, the determination of normative values at all accelerations (1,000-7,000 degrees/s2) constitutes an important database for future studies to distinguish pathologic results.

Evaluation of Mental Rotation Ability in Patients with Unilateral Benign Paroxysmal Positional Vertigo.

BACKGROUND: Our study aims to determine whether there are differences in mental rotation abilities between unilateral benign paroxysmal positional vertigo patients and healthy controls using object-based mental rotation tasks. METHODS: Our study included 17 unilateral posterior canal benign paroxysmal positional vertigo patients and 20 healthy adults. Spontaneous nystagmus test, saccade test, and dynamic positional tests with videonystagmography and object-based mental rotation test with 2-dimensional images of cubes rotated at certain angles in 3-dimensional space were performed on the participants. The mental rotation test response time and the number of correct answers were compared between patients and controls. We also evaluated whether there was a relationship between saccade test parameters and mental rotation test parameters in our study. RESULTS: No significant relationship was found between benign paroxysmal positional vertigo patients and controls on any of the dependent measures (P -gt; .05). When we evaluated the relationship between saccadic latency and accuracy and mental rotation test response time and number of correct answers in benign paroxysmal positional vertigo patients, no significant relationship was found (P -gt; .05). CONCLUSION: Our findings show that unilateral, posterior canal benign paroxysmal positional vertigo does not affect object-based mental rotation performance. In our study, no correlation was found between saccadic function and mental rotation ability in unilateral benign paroxysmal positional vertigo patients.

Evaluation of Auditory Functions in Patients with Psoriasis.

Our study aims to evaluate the functions of the middle and inner ear and the efferent auditory system in psoriasis. Hearing thresholds, resonance frequency, otoacoustic emission amplitudes with and without contralateral acoustic stimulation, contralateral suppression levels were evaluated in 35 psoriasis patients and 40 controls. The air-conduction hearing thresholds of the patients were significantly higher than the controls at 125, 250, 500, 1000, 2000, 4000, and 12,000 Hz frequencies in the left ear, and 125, 250, 500, 1000, 2000, and 4000 Hz frequencies in the right ear, and the bone-conduction hearing thresholds of the patients were found to be significantly higher than the controls at all frequencies in the left ear, and 250, 500, 1000 and 2000 Hz in the right ear (p < 0.05). The resonance frequencies of patients were found to be significantly lower than the controls (p < 0.001). The emission amplitudes obtained with contralateral acoustic stimulation were significantly lower than without contralateral acoustic stimulation at 1 kHz frequency in both groups (p < 0.01). There was no significant difference in contralateral suppression levels of the two groups (p > 0.05). Our findings indicate that middle ear mechanics can be affected by psoriasis. There was no significant difference between psoriasis patients and healthy controls in terms of efferent auditory functions. There was a significant difference at limited frequency in hearing thresholds and emission amplitudes between the groups.

Comparison of Compressed High-Intensity Radar Pulse and Tone Burst Stimulation in Vestibular Evoked Myogenic Potentials in Acute Peripheral Vestibular System Pathologies.

BACKGROUND: It is ascertained that the compressed high-intensity radar pulse (CHIRP) is an effective stimulus in auditory electrophysiology. This study aims to investigate whether Narrow Band Level Specific Claus Elberling Compressed High-Intensity Radar Pulse (NB LS CE-CHIRP) stimulus is an effective stimulus in the vestibular evoked myogenic potentials test. METHODS: A case-control study was designed. Fifty-four healthy participants with no vertigo complaints and 50 patients diagnosed with acute peripheral vestibular pathology were enrolled in this study. Cervical and ocular vestibular evoked myogenic potential tests (cervical vestibular evoked myogenic potentials and ocular vestibular evoked myogenic potentials) with 500 Hz tone burst and 500 Hz Narrow Band Level Specific CE-CHIRP stimulations were performed on all participants. In addition, cervical vestibular evoked myogenic potentials and ocular vestibular evoked myogenic potentials tests with 1000 Hz tone burst and 1000 Hz Narrow Band Level Specific CE-CHIRP were performed on 24 Meniere's disease patients. P1 latency, N1 latency, amplitude, threshold, and the asymmetry ratio of responses were recorded. RESULTS: In healthy participants, with CHIRP stimulus, shorter P1 latency (P < .001), shorter N1 latency (P < .001), and lower threshold (P = .003) were obtained in the cervical vestibular evoked myogenic potentials test; shorter P1 latency (P < .001), shorter N1 latency (P < .001), higher amplitude (P < .001), and lower threshold (P < .001) were obtained in ocular vestibular evoked myogenic potentials test. In symptomatic ears of patients, with CHIRP stimulus, shorter P1 latency (P < .001), shorter N1 latency (P < .001), and lower threshold (P=.013 in cervical vestibular evoked myogenic potentials; P=.015 in ocular vestibular evoked myogenic potentials) were obtained in cervical vestibular evoked myogenic potentials and ocular vestibular evoked myogenic potentials tests. In asymptomatic ears of patients, with CHIRP stimulus, shorter P1 latency (P < .001) and shorter N1 latency (P < .001) were obtained in the cervical vestibular evoked myogenic potentials test; shorter P1 latency (P < .001), shorter N1 latency (P < .001), higher amplitude (P < .001), and lower threshold (P=.006) were obtained in ocular vestibular evoked myogenic potentials test. CONCLUSION: Our results suggest that due to higher response rates, shorter latencies, higher amplitude, and lower threshold values, the Narrow Band Level Specific CE-CHIRP stimulus is an effective stimulus for both cervical vestibular evoked myogenic potentials and ocular vestibular evoked myogenic potentials tests.

The relationship between functional head impulse test and age in healthy individuals.

BACKGROUND: fHIT is an easily applicable test battery that indirectly evaluates the vestibulo-ocular reflex (VOR) from a functional perspective. AIMS/OBJECTIVES: The aim of this study was to Individuals determine the correlation between age and the percentage of correct answers (%CA) obtained in the functional head impulse test (fHIT) in healthy individuals. MATERIAL AND METHODS: A total of 105 volunteers, 50 males and 55 females, between the ages of 18 and 70 years, participated in the study. A Beon Solution fHIT system (Zero Branco (TV), Italy) was used in the study. RESULTS: In our study, a decrease in the mean %CA was observed in all semicircular canals (SCCs) with increasing age. Between age and mean %CA, a significant negative moderate (-0.311) correlation was observed in lateral SCCs, and a significant negative low (-0.257) correlation was observed in posterior SCCs (p < 0.05). In anterior SCCs, there was no statistically significant relationship between age and mean %CA (p > 0.05). CONCLUSIONS: The present study performed in a healthy population will be helpful in terms of making comparisons in studies to be conducted in various vestibular diseases. It will also be a guide for identifying pathological consequences in vestibular diseases.

Does the Efferent Auditory System Have a Role in Children with Specific Learning Disabilities?

OBJECTIVE: This study aimed to compare the baseline transient otoacoustic emission (t-OAE) amplitudes and medial olivo-cochlear (MOC) efferent activity in children with specific learning disability (SLD) and children with normal development. METHODS: The study was conducted in two groups. The patient group included 30 children aged 6 to 10 years and diagnosed with SLD, and the control group included 30 children in the same age range without SLD. The patient group included eight males and 22 females, and the control group included 14 females and 16 males. t-OAE and contralateral suppression test were performed in both groups. RESULTS: In the first t-OAE measurements, a statistically significant difference was observed between the patient and the control group at frequencies of 1400, 2000, 2800, and 4000 Hz, but no such difference was observed at 1000 Hz frequency. In the control group, significantly better emission amplitudes were observed. No differences were found at any frequency between the patient and the control groups after suppression. When the subjects in the two groups were compared among themselves, there was a statistically significant difference between the before and after suppression scores in the patient group except at 4000 Hz. Likewise, an important difference was also observed in all frequencies in the control group. CONCLUSION: This study shows that suppression effects of t-OAE on children diagnosed with SLD and children with no SDL are not significantly different.

The protective effect of metformin against the noise-induced hearing loss.

OBJECTIVE: To test the protective effect of metformin against noise-induced hearing loss. METHODS: 24 rats were included in the study. The first group was exposed to noise only, the second group took metformin, the third group was exposed to noise and took metformin, and the fourth group was neither exposed to noise nor took metformin as control group. After measurement of baseline DPOAE and ABR of rats, the metformin group and the metformin + noise group received 300 mg/kg/day metformin via gavage for 10 days. On the 11th day, group 1 and group 3 were exposured to white noise at 105 dB SPL for 15 h. After noise exposure, DPOAE and ABR measurements of all rats were repeated on days 1st, 7th, and 21st. At the end of the study, all animals were sacrificed and cochlear tissues were separated for immunohistochemical assessments. RESULTS: ABR threshold values and DPAOE measurements of groups 1 and 3 were deteriorated on the 1st day after noise, while deterioration in group 1 continued on 7th and 21st days, but normalized on 7th day in group 3. After immune staining, a significant immunoreaction was observed in the noise group, while the reaction in the noise + metformin group was close to the control group. CONCLUSION: Metformin has a protective effect on noise-induced hearing loss in rats. As a conclusion, it is determined that metformin protects from permanent threshold shift in rats. It can be considered a good alternative for protecting noise-induced hearing loss.

[Ocular vestibular evoked myogenic potentials in response to bone-conducted sound stimuli: results of measurements in healthy adults]. / Kemik iletimli ses uyarilarina yanit olarak elde edilen oküler vestibüler uyarilmis miyojenik potansiyeller: Saglikli eriskinlerdeki ölçüm sonuçlari.

OBJECTIVES: This study aims to determine the normal values of ocular vestibular evoked myogenic potentials (oVEMP) in response to bone-conducted sound stimuli in healthy adults. PATIENTS AND METHODS: The study included 42 healthy adult volunteers (18 males, 24 females; mean age 39.7±11.2 years; range 20 to 60 years) (84 ears) with pure tone mean thresholds better than 20 dB, no detected nystagmus during positional tests, and no complaint involving the ear. The participants were performed otorhinolaryngologic examination, audiologic evaluation, and positional tests. Ocular vestibular evoked myogenic potentials were measured using air-conducted and bone-conducted sound stimuli and results were compared. RESULTS: No statistically significant difference was detected between the side of the ear tested and sex in terms of the latency and amplitude values (p>0.05). There was no correlation between n1, p1 latency and amplitude values with age and (p>0.05). Mean n1 latency was 9.9±1.87 milliseconds and p1 latency was 12.75±1.41 milliseconds. Mean amplitude was 5.06±1.97 µV. Interaural asymmetry ratios were 4±3% for p1, 4±3% for n1, and 8±6% for amplitude. CONCLUSION: Data obtained in this study may be accepted as normal values for healthy adults and used as reference in oVEMP studies with bone-conducted sound stimuli.

Submandibular Gland Surgery: Our Clinical Experience.

OBJECTIVE: The aim of this study was to assess the demographic findings and surgical results of patients who underwent submandibular gland excision at a tertiary care center. METHODS: The clinical characteristics and histopathological results of 45 patients who had undergone submandibular gland excision between 1997 and 2014 were evaluated in detail. RESULTS: Twenty-eight (62.2%) and 17 (37.8%) patients presented with a complaint of a painful mass and painless mass, respectively. Histopathologic investigation of the surgical specimens revealed sialolithiasis in 14 patients (31.1%), chronic sialadenitis in 16 (35.6%), benign tumor in 12 (26.7%), malignant tumor in two (4.4%), and mucocele extravasation in one. As complications, permanent paralysis of the marginal mandibular branch of the facial nerve was seen in one patient (2.2%), temporary paralysis of the marginal mandibular branch of the facial nerve was seen in seven (15.6%), orocutaneous fistula was seen in one (2.2%), and temporary paralysis of the hypoglossal nerve was seen in one (2.2%). CONCLUSION: This study revealed that in patients presenting with complaints of a submandibular gland mass, sialolithiasis, sialadenitis, and benign masses were the mostly diagnosed disorders. Transcervical submandibular gland excision is a satisfactory procedure with low complication and recurrence rates when it is performed on selected patients and obeyed to surgical techniques.

[Idiopathic spontaneous tonsillar hemorrhage]. / Idiopatik spontan tonsil kanamasi.

Since the advent of antibiotics, major spontaneous tonsillar hemorrhage is extremely rare. The majority of the spontaneous tonsillar hemorrhage events is associated with acute or chronic tonsillitis, coagulopathies, or tonsillar cancer. A 36-year-old female patient was admitted to the otolaryngology department with the complaint of tonsillar hemorrhage. The patient had no history of prior trauma, coagulopathy, malignancy and infection sign. Preoperatively, carotid angiography was performed to detect any arteriovenous malformation of tonsillar vessels. The carotid angiography results were within normal ranges. The patient underwent tonsillectomy and no perioperative complication was occurred. Management of idiopathic spontaneous tonsillar hemorrhage may be challenging for the clinician and may require tonsillectomy.