[Side effects and patients expectations after vestibular tests]. / Effets secondaires et expectatives des patients après tests vestibulaires.

OBJECTIVE: Patients satisfaction and side effects assessment after vestibular tests. MATERIALS AND METHODS: Questionnaires were sent to 150 patients after vestibular testing in 2006. Forty-two questionnaires were sent back to us. On each questionnaire there were 5 questions regarding patient expectations, 4 questions about side effects after vestibular tests and one question was related to follow-up medical attention. RESULTS: Most of the patients think that the delay between clinical consultation and vestibular test was not too long. Information patients received beforehand regarding vestibular tests aim, duration, possible side effects and diagnostic expectations are good enough for most of the patients. However patient's assessment of the informed consent document and location of vestibular tests is diverse. The vast majority of patients feel "very important" to receive information about vestibular tests results on the same day. For most of the subjects caloric test is the most disconfortable tests. In the following days, more than half of the subjects feel vestibular symptoms. The most frequent suggestion we received from patients is to give them a phone calls after vestibular tests. CONCLUSION: It is worth mentioning the importance of informing the patient about vestibular test results upon completion. Our aim is to make some changes on the informed consent document given to patients and to make a phone call to patients after vestibular tests.

Hearing loss and vestibular function correlation in Menière's disease patients.

OBJECTIVES: To analyse the correlation between vestibular dysfunction and hearing level of patients diagnosed with Menière's disease. METHODS: Retrospective study on the correlation between hearing level and unilateral weakness in 100 Menière's disease patients. In order assess the effect of disease severity in such correlation, the study group included 50 patients who subsequently were treated with oral medication and 50 who later received intratympanic gentamicin to control their symptoms. Audiogram and caloric tests were performed before beginning both of the treatments. Patients were classified according to the AAO-HNS guidelines. Handicap was assessed with the Functional Level of the AAO-HNS and the Dizziness Handicap Inventory. RESULTS: No correlation was found between pure tone average and canal paresis neither when patients were analysed as a whole nor when correlation was controlled for the treatment installed afterwards. Nevertheless, when they were grouped by hearing loss AAO-HNS stages, we found a greater canal paresis in those with a higher hearing loss (groups 3 and 4). CONCLUSION: No correlation was found between hearing loss and canal paresis of patients diagnosed with Menière's disease. However patients with a higher amount of hearing damage have a tendency to abnormal caloric results.

Progressive cochleo-vestibular labyrinthitis.

OBJECTIVE: We report a rare case of sudden deafness and benign paroxysmal positional vertigo (BPPV) corresponding to a canalithiasis of the ipsilateral left posterior semicircular canal (PSC). CASE REPORT: The initial examination showed intact lateral semicircular canal (LSC) function. Cerebral MRI results were normal. However evoked otoacoustics emissions were absent in the left ear. The patient developed, in the course of one week, symptoms and signs of an acute unilateral vestibulopathy in the same ear. However there were no change in hearing loss after it. CONCLUSION: The association of BPPV acute vestibulopathy and sudden deafness is uncommon but usually the former develops well after the second and third. This case is best explained by a vestibulocochlear labyrinthitis.

[Salivary gland choristoma (hamartoma) of the middle ear: a case report]. / Cas clinique : choristome de glande salivaire au niveau de l'oreille moyenne.

OBJECTIVE: Middle ear salivary gland choristoma are extremly rare. We report a case, describe the clinical management and review the literature. CLINICAL CASE: A 12 year old boy presented with unilateral conductive hearing loss associated with a large inferior retraction pocket on otoscopy. CT scan demonstrated a large mass in the left middle ear cavity. The incus was absent and the stapes was partially eroded. Middle ear exploration demonstrated an 8 mm yellow/red mass in the region of the fallopian canal. This mass was comptly removed and histopathology confirmed salivary gland choristoma. CONCLUSION: These lesions result from an abnormal development of the second branchial arch. It is important to consider these lesions as part of the differential diagnosis for any unilateral hearing loss associated with a middle ear mass in children.

[Immediate acoustic effect of the cochlear fistula in a guinen pig]. / Efecto acústico inmediato de la fístula coclear en el cobaya.

INTRODUCTION AND OBJECTIVES: To Evaluate objectively the effect that cochleostomy has in the cochlea as well as the exposition of the estria vascularis, through acoustic otoemissions immediatly after surgery. MATERIAL AND METHODS: Submandibular approach to the guinea pig's middle ear and cochlea. Triming of the timpanic and vestibular first turns and wide exposition of the estria vascularis in the first and second turns. Study of cochlear function through acoustic otoemissions of distortion products. CONCLUSIONS: Guinea Pig is a perfect experimentation animal for surgical work when monitoring functional state of the cochlea. Its acoustic response is similar to the one found in other mammals thoug its response is lower than that reported in other papers. The lack of intracochlear manipulation ensures the lower decrease hearing loss deterioration regarding the findings in the different methods of studying the acousting distortion. RESULTS: There is a decrease of amplitud in the audiograms of distortion for specific frequencies (4 and 6 KHz), located tonotopically near the cochleostomies carried out in the first turn (at the level of scala vestigularis and timpanic). Approadring the cochlea without intracochlear manipulation does not modify greathy the results of audiograms of distortion neither the growth slopes of the response. A lateral approach of the estric vascularis minimising the aggression to labrynth did not cause a significant acoustic deterioration.

[Postural analysis of the test "timed-up-and-go" in patients with vertigo]. / Análisis postural de la prueba "timed-up-and-go" en pacientes con vértigo.

INTRODUCTION AND OBJECTIVES: To characterize and analyze the "Timed-up-and-go" test in non-fallers patients with peripheral vertigo. To assess if turning to the side of the lesion induces a more intense instability. MATERIAL AND METHODS: The test was performed after carefully explanation to the patient who was allowed to do some attempts. Postural measurements were the angle and angular speed of trunk sway in roll and pitch. It was done with a special device adapted to the trunk with two sensors specially built for that purpose. CONCLUSIONS: Dizzy, non-fallers patients perform this test in a period of time considered as normal. Canal paresis influences in roll trunk sway when the patient performs the TUG only when turning to the normal side.

[Antitumoral effect of HSV-tk suicide gene associated with ganciclovir in an experimental model of head and neck epidermoid carcinoma]. / Efecto antitumoral del gen suicida HSV-tk y ganciclovir en un modelo experimental de carcinoma epidermoide de cabeza y cuello.

INTRODUCTION: We studied the transfection by adenoviral vectors and the antitumoral effect of HSV-tk gene associated with ganciclovir (AdCMVtk/GCV) in KB human oral cavity squamous cell carcinoma, in vitro and in vivo. MATERIALS AND METHODS: Transfection was assessed by the X-gal stain. It was used in cell cultures and tumoral sections previously exposed to adenoviral vector AdCMVlacZ. In vitro, in order to study the antitumoral effect of AdCMVtk/GCV, survival of cell cultures exposed to AdCMVtk/GCV and to AdCMVlacZ/GCV was compared. In vivo, necrotic volume as a percentage of total tumoral volume, was compared between AdCMVtk/GCV treated group and AdCMVlacZ/GCV exposed group. Hepatic and renal toxicities were assessed. RESULTS: In vitro, survival of cell cultures treated with AdCMVtk/GCV was less than AdCMVlacZ/GCV exposed cells. In vivo, necrotic volume was larger in AdCMVtk/GCV treated group than in AdCMVlacZ/GCV exposed group. No toxicity was found (hepatic, renal). CONCLUSIONS: KB cells are transfected by adenoviral vectors and are killed by AdCMVtk/GCV, both in vitro and in vivo (no toxicity was found in the animal model).

[Laryngeal metastasis from colloid adenocarcinoma of the colon: report of a case]. / Metástasis laríngea de adenocarcinoma coloide de colon: a propósito de un caso.

Metastatic involvement of the laryngeal is very rare, with around 150 cases reported to the literature. In eight of these cases, the primary tumor was a colon adenocarcinoma. We report the case of a 80 year-old woman treated of a colloid adenocarcinoma of 7 years earlier, referred to us for chronic and progressive dyspnea. Endoscopic examination showed a subglottic spherical mass, which caused an important compromise of the respiratory airway. Tomographic studies revealed also a thyroid mass. The patient was treated with a tracheostomy, resection of the subglottic mass (with intraoperative diagnosis of "mucin producing tumor"), and total thyroidectomy. The final pathologic diagnosis of the subglottic mass was a metastasis of colloid adenocarcinoma of the colon. In the literature reviewed there are no previous reports of metastatic involvement of the larynx with this type of colon adenocarcinoma. We discuss the clinical and radiological findings, and therapeutic options for metastasis to the larynx, as well as pathological differential diagnosis.