ABSTRACT
We present a group of 50 patients with retrocochlear pathology, divided on 41 (82 per 100) non tumoral and 9 (18 per 100) tumoral: 8 cerebello-pontine angle meningiomas and 1 intracranial cholesteatoma. The retrocochlear diagnosis of the pathology is assessed by the results of the audiovestibular explorations, specially the electrophysiology (early auditory evoked response, electrocochleography). The neuroradiologic explorations (TAC, MNR) define the tumoral or non tumoral nature of the pathology. We review some technical aspects of the common electrocochleographic practice, as actually is realised by the Bordeaux group; also, the different parameters of a retrocochlear pathologic response. In this group, the electrocochleography was necessary on 64 per 100 of the cases to obtain an electrophysiologic retrocochlear diagnostic.
Subject(s)
Audiometry, Evoked Response , Cranial Nerve Diseases/diagnosis , Labyrinth Diseases/diagnosis , Acoustic Impedance Tests , Adult , Audiometry , Cerebellar Neoplasms/complications , Cerebellar Neoplasms/diagnosis , Cerebellar Neoplasms/physiopathology , Cerebellopontine Angle , Cholesteatoma/complications , Cholesteatoma/diagnosis , Cholesteatoma/physiopathology , Cranial Nerve Diseases/etiology , Cranial Nerve Diseases/physiopathology , Electrodiagnosis/methods , Female , Humans , Labyrinth Diseases/etiology , Labyrinth Diseases/physiopathology , Male , Meningioma/complications , Meningioma/diagnosis , Meningioma/physiopathology , Middle AgedABSTRACT
The authors study the different parameters of the stapedius reflex on a 55 patients group with retrocochlear and non tumoral diagnostic is assess by electrophysiologic (BERA, Electrocochleography) and neuroradiologic explorations (TAC), Meato-cisternography, NMR). We realise an comparative study between the results of this group and the results of 2 other groups (98 acoustic neuromas and 104 endocochlear diseases). The test has a moderate sensibility and none specificity in this kind of pathology, because the high percent of false negative (30%), and the positivity on 95% of acoustic neuromas and on 74% of endocochlear diseases.
Subject(s)
Hearing Disorders/diagnosis , Reflex, Acoustic , Vestibulocochlear Nerve Diseases/diagnosis , Acoustic Impedance Tests , Audiometry , Audiometry, Evoked Response , Cochlear Diseases/diagnosis , Diagnosis, Differential , Electrophysiology , Female , Humans , Male , Neuroma, Acoustic/diagnosis , Vertigo/diagnosisABSTRACT
The authors present a case of a cochleovestibular syndrome with a scanner showing a calcified dolico-ektasis of the basilar truncus and the left vertebral artery. The patient had typical Ménière's disease symptomatology. A retrolabyrinthic diagnosis with substantial recruitment was indicated by the results of the audio-vestibular explorations (stapedius reflex, electroculography, early brainstem evoked response, electrocochleography). The electrocochleography with glycerol test indicated labyrinthic hydrops. Finally, some reflections on the role of neurovascular problems in the pathogeny of some cochleovestibular syndromes are put forward.
Subject(s)
Basilar Artery/abnormalities , Cochlear Diseases/etiology , Vertebral Artery/abnormalities , Vestibular Diseases/etiology , Aged , Humans , Male , SyndromeABSTRACT
The authors present 55 cases of non-tumoral retrocochlear impairment, studied over the period between 1984 and 1988 in the ENT University Clinic of Bordeaux. Deafness was the most frequent symptom leading patients to come for consultation (89%). The stapedial reflex was pathological in 70% of the cases. No conclusion could be drawn from electro-occulography. Only the early auditory evoked responses made it possible to reach the diagnosis of retrocochlear impairment in 35% of the cases. Electrocochleography was required in 65% of the cases to establish the topographic diagnosis. The neuro-radiological examination proved to be negative in 48 cases, and positive in 7 cases (6 atrophic symptoms, 1 left vertebral dolichoartery). Among the other etiologies, we noted 14 cases of auditory trauma, 12 vascular pathologies, 9 neurological pathologies, 7 cases of Ménière's disease, and 7 sudden onsets of deafness. The incidence of vasculo-nervous conflict reported by other authors appears very low in this series (with only 1 case).
Subject(s)
Audiometry, Evoked Response , Auditory Diseases, Central/physiopathology , Vestibulocochlear Nerve Diseases/physiopathology , Evoked Potentials, Auditory , Female , Humans , Male , Middle AgedABSTRACT
The Galen's anastomosis connects superior and recurrent laryngeal nerves and its anatomy and physiology still remain unknown. In humans it can be found in 30 to 60% of cases, according to classical anatomy books. In this study the authors report the anatomy of 47 fresh half-larynx. They have demonstrated the invariable existence of an anastomosis between superior and recurrent laryngeal nerves, either as a single nerve, or as a plexus.
