Effectiveness of the combined hearing and masking devices on the severity and perception of tinnitus: a randomized, controlled, double-blind study.

OBJECTIVE: The aim of this study was to evaluate the effect of combined hearing and tinnitus masking devices that are appropriately programmed for acoustic stimulations using wide-band noise over the specific frequency range of tinnitus. MATERIAL AND METHODS: A total of 21 patients were randomly divided into 2 groups. Group I (12 patients) was managed with betahistine dihydrochloride (2HCl) and fitted either with a combined hearing aid or a sound generator, and group II (9 patients) was treated with betahistine 2HCl for 3 months. Audiological tests, pitch matching to determine the frequency of tinnitus, an assessment of tinnitus severity, and subjective scores (visual analog scale, VAS; Mini-Tinnitus Questionnaire) were used to assess the patients in both groups, and a loudness scale was also analyzed in group I. The results were evaluated in a double-blinded manner. RESULTS: Significant decreases in the severity of tinnitus, Mini-Tinnitus Questionnaire score and VAS were observed in both groups. No significant differences were obtained in pitch-matched frequency of tinnitus in the two groups. CONCLUSION: The findings obtained using either the combined devices or the masking devices with wide-band masking demonstrate that these devices are an effective tinnitus treatment alternative.

Benign paroxysmal positional vertigo following septorhinoplasty.

We present 2 cases of benign paroxysmal positional vertigo (BPPV) following septorhinoplasty. Benign paroxysmal positional vertigo following septorhinoplasty is an unusual entity. Two young women who had difficulty in breathing and nasal deformity underwent septorhinoplasty. On the second and the third postoperative days, the patients experienced vertigo that was induced by position changes. Both patients had neither preexisting ear disease nor vertigo before the surgery. All the examinations were normal. With Dix-Hallpike maneuver, which is the criterion-standard test, the characteristic nystagmus was observed. Right posterior canal BPPV was diagnosed, and they were both treated with Epley canalith repositioning maneuver. Publications related to postsurgical vertigo are available in literature, but it is still an underdiagnosed disorder. We would like to mention about this rare entity and inform the surgeons that they must keep in mind that a patient who is complaining about vertigo or dizziness after the surgery should be observed and investigated for BPPV.

Are thiazides effective on hypertensive vertigo? A preliminary study.

OBJECTIVES: In this study, we aimed to investigate whether the symptoms of vertigo related to hypertension resulted from endolymphatic hydrops and the efficacy of the thiazides in the treatment. PATIENTS AND METHODS: A total of 24 vertigo patients without peripheric or central vestibular pathologies or hyperlipidemia were included. The study group comprised 15 patients with hypertension, including nine with regulated non-insulin-dependent diabetes mellitus (DM). The control group comprised nine patients without hypertension or DM. The patients in the study group received hydrochlorothiazide treatment. The European Evaluation of Vertigo Scale (EEVS) and Vertigo Handicap Questionnaire (VHQ), puretone audiometry, tympanometry, electronystagmography (ENG) for nystagmus tests, oculomotor tests, and caloric test were carried out initially and at three weeks for both groups. The results of the study group were compared to those of the control group. RESULTS: There was a statistically significant decrease in the scores of EEVS and VHQ at three weeks in the study group, compared to the baseline scores (for both groups p≤0.01). CONCLUSION: Our study results showed that thiazides alleviated vertigo symptoms in hypertensive patients, as measured by qualitative methods (i.e. EEVS, VHQ), but not with quantitative measurements (i.e. ENG).

Laryngeal dysfunction and oral hygiene: Any relation?

OBJECTIVE: The purpose of this study is to establish a relation between poor oral hygiene and laryngeal dysfunction. METHODS: 43 adult patients were divided into two groups according to caries activity and oral hygiene. 18 patients with oral hygiene index score (OHI-S) 0-1 were grouped as the control group (good oral hygiene). 25 patients with OHI-S 2-3 were grouped as the study group (poor oral hygiene). Larygostroboscopic examination, aerodynamic measures by defining maximum phonation time (MPT) and s/z ratio and the pitch level measurements were done. Patients with gastroesophageal reflux disease (GERD), laryngopharyngeal reflux (LPR), previously confirmed laryngeal diseases or pathologies, systemic other diseases, or smokers were excluded from this study. RESULTS: The average MPT values of the study group were found to be statistically very significantly lower than those of the control group (p<0.01). In the stroboscopic findings, the proportion of normal closure levels were meaningfully higher in the control group than in the study group (p<0.05). The supraglottic involvement was found statistically meaningfully higher in the study group than in the control group (p<0.05). The proportion of normal closure phase incidences were meaningfully higher in the control group than in the study group (p<0.05). CONCLUSION: So, our findings of high glottic closure impairment, supraglottic involvement and low MPT scores in the poor oral hygiene group correlate with LPR findings such as muscle tension dysphonia. Poor oral hygiene may aggravate potential LPR in people.

Could Riedel's thyroiditis be subacute thyroiditis? A case report.

Our purpose in this paper is to make a case for the need to question whether Riedel's thyroiditis is in fact a rare variety of subacute thyroiditis. Total thyroidectomy was performed on a patient with a huge thyroid mass. The histopathological diagnosis was Riedel's thyroiditis with classical lymphoplasmacytic infiltration destroying thyroid tissue and invading perithyroidal soft tissue. However, in addition, histopathology showed epithelioid granulomas containing multinuclear giant cells. The existence of these giant cells led us to place this case somewhere between Hashimoto's thyroiditis and subacute thyroiditis (de Quervain's). Since giant cells are seen in the histopathology of subacute thyroiditis, we propose that the possibility of Riedel's thyroiditis being a form of subacute thyroiditis be observed and studied.