Ocular vestibular evoked myogenic potential testing for the prognosis of Bell's palsy.

CONCLUSION: oVEMP could be a useful tool for predicting the prognosis of Bell's palsy comparable to ENoG and H-B grade. OBJECTIVES: Several previous studies have reported cases of Bell's palsy with vestibular function disorder. The basic hypothesis behind this effect lies in the close proximity of the vestibular and facial nerves in the internal auditory canal (IAC). Therefore, the aim of this study was to investigate the correlation between Bell's palsy prognosis and ocular vestibular evoked myogenic potentials (oVEMPs). METHODS: Total 104 consecutive patients who were diagnosed with Bell?s palsy from January 2012 to December 2014 were enrolled. Patients were divided into complete recovery group and incomplete recovery group. All of patients underwent oVEMP recordings within 1 week after disease onset. For the evaluation of correlation between H-B grades, ENoG, oVEMP and Recovery of Bell?s palsy, logistic regression analysis was performed. RESULTS: The mean value of ocular vemp asymmetry was significantly higher in the incomplete recovery group than the complete recovery group (p < 0.05). No association was found between the ipsilesional PTA threshold, caloric test, and rate of abnormal EMG and recovery state. However, the initial state of ENoG, initial H-B grade, and oVEMP abnormal findings (Latency & Amplitude symmetry ratio) were significantly correlated with the rate of recovery (p = 0.025, p = 0.013, and p < 0.005, respectively).

Evaluation of functional rhinoplasty using the Modified Cottle test in Asian patients.

CONCLUSION: MCT is a useful tool to pre-operatively determine whether internal nasal valve (INV) narrowing affects a nasal obstruction. Functional rhinoplasty seemed to produce better results than septoplasty in Asian patients with a nasal obstruction, due to INV narrowing. OBJECTIVE: This study compared pre-operative modified Cottle test (MCT) findings and post-operative clinical improvement according to surgical approach in an Asian population. METHODS: One-hundred and sixty-four patients who underwent septal surgery were enrolled. The clinical symptoms, radiological findings, and paranasal computed tomography (PNS CT) scan results were compared and analyzed between the MCT-positive and -negative groups, focusing on internal nasal valve narrowing. Post-operative clinical improvement were also compared based on whether septoplasty or functional rhinoplasty was performed. RESULTS: The MCT-positive group had significantly higher pre-operative visual analog scale scores for nasal obstruction and rhinorrhea than those in the negative group. The MCT-positive group had a significantly higher percentage of highly deviated septa on PNS CT and endoscopic findings than those in the MCT-negative group. The functional rhinoplasty group had a significantly higher MCT conversion rate (positive to negative) and improvement in nasal obstruction than those in the septoplasty group.

The prognostic value of electroneurography of Bell's palsy at the orbicularis oculi versus nasolabial fold.

OBJECTIVES/HYPOTHESIS: We compared the prognostic value of different placements measured by electroneurography (ENoG) in Bell's palsy, especially among patients with poor results on ENoG. STUDY DESIGN: Retrospective study using electrodiagnostic data and medical chart review from August 2006 to June 2013 was performed of patients who were diagnosed with Bell's palsy. METHODS: We included 81 patients treated from August 2006 to June 2013. Initial and final facial function was established clinically by the House-Brackmann scale. Final state of facial palsy was estimated after 6 months from onset of facial palsy. Patients with less than 10% of ENoG response (more than 90% degeneration) were divided into three groups according to ENoG response by electrode placement as follows: group A, ENoG for orbicularis oculi (oculi) ≥ 10% and ENoG for nasolabial fold (NLF) < 10%; group B, ENoG (oculi) < 10% and ENoG (NLF) ≥ 10%; and group C, ENoG (oculi) < 10% and ENoG (NLF) < 10%. RESULTS: There were no differences in demographic data among the three groups in terms of age, gender, initial paralysis, and days from the onset to ENoG. The complete/nearly complete recovery rates were the following: group A, 49.9%; group B, 75%; group C, 32%. The overall incomplete recovery rate in groups A and C was significantly worse than group B, and group C was the worst (P < 0.05). CONCLUSION: The results suggest that ENoG of the NLF has more prognostic value in the outcomes of Bell's palsy than ENoG of the oculi, with poorest results in patients with the NLF < 10%. LEVEL OF EVIDENCE: 4. Laryngoscope, 126:1644-1648, 2016.

Comparison of clinical characteristics in patients with bilateral and unilateral tinnitus.

CONCLUSION: Discomfort from bilateral tinnitus was more frequent and severe than that from unilateral tinnitus. Also, patients with bilateral tinnitus were significantly older and tended to have a longer duration of tinnitus than those with unilateral tinnitus. Background and subjects: Although bilateral tinnitus differs from unilateral tinnitus, their treatment is identical. Clinical characteristics associated with tinnitus, including tinnitograms, were retrospectively examined in 105 patients with unilateral tinnitus and 102 with bilateral tinnitus evaluated in the center between January 2012 and January 2014. This study compared the two groups to assess the characteristics differentiating their treatment. RESULTS: Mean age was significantly higher in patients with bilateral than unilateral tinnitus (p = 0.04), but gender distribution and duration of tinnitus were similar in the two groups. Both tinnitus handicap index (THI) and Beck depression index (BDI) values were significantly higher in patients with bilateral than unilateral tinnitus (p < 0.05 each). Rates of hyperacusis (p = 0.23), ear fullness (p = 0.16), and vertigo (p = 0.31) did not differ significantly between the two groups. Also, audiology test results, including tinnitograms, showed no significant differences.