Quality of Life Following Cochlear Implantation in Patients With Menière's Disease.

Background: Menière's disease (MD) is a disorder characterized by auditory and vestibular dysfunction that significantly deteriorates patients' quality of life (QoL). In addition to the management of vestibular symptoms, some patients with bilateral hearing loss meet criteria for cochlear implantation (CI). Objectives: (1) To assess hearing results and QoL outcomes following CI in patients with MD. (2) To compare these results to a matched control group of patients who had undergone CI. (3) To analyse differences in MD patients who have undergone simultaneous or sequential labyrinthectomy or previous neurectomy. Methods: A retrospective analysis of a study group of 18 implanted patients with MD and a matched control group of 18 implanted patients without MD, who had CI at a tertiary referral center. Hearing and speech understanding were assessed via pure-tone audiometry (PTA) and disyllabic perception tests in quiet. QoL was assessed via the Nijmegen Cochlear Implant Questionnaire (NCIQ), the Glasgow Benefit Inventory (GBI), the Speech, Spatial and Qualities of Hearing Scale (SSQ12), and the Hearing Implant Sound Quality Index (HISQUI19). The impact of MD ablative surgeries was analyzed in the study group (MD group). Results: Mean pre-operative PTA thresholds were significantly lower in the MD group (103 vs. 121 dB). A significant improvement in hearing outcomes was observed following CI in both groups (p < 0.001), with a maximum Speech Discrimination Score of 64 and 65% disyllables at 65 dB for the MD and control group, respectively. Subjective outcomes, as measured by the NCIQ, GBI, SSQ12, and HISQUI19 did not significantly differ between groups. In the MD group, despite achieving similar hearing results, QoL outcomes were worse in patients who underwent simultaneous CI and labyrinthectomy compared to the rest of the MD group. Post-operative NCIQ results were significantly better in patients who had undergone a previous retrosigmoid neurectomy when compared to those who had undergone only CI surgery in the subdomains "basic sound perception" (p = 0.038), "speech" (p = 0.005), "activity" (p = 0.038), and "social interactions" (p = 0.038). Conclusion: Patients with MD and severe hearing loss obtain hearing results and QoL benefits similar to other CI candidates. Delayed CI after labyrinthectomy or vestibular neurectomy can be performed with similar or better results, respectively, to those of other cochlear implanted patients. Patients who undergo simultaneous CI and labyrinthectomy may achieve similar hearing results but careful pre-operative counseling is needed.

[Analysis of the otorhinolaryngological doctoral theses submitted in Spain between 1976 and 2005]. / Análisis de las tesis doctorales en otorrinolaringología presentadas en España en el período 1976-2005.

INTRODUCTION AND OBJECTIVE: The importance of otorhinolaryngology as a separate branch of medicine has grown in the last decades. The objective of this work is to analyze the doctoral theses in ENT presented in Spain between 1976 and 2005. METHODS: The TESEO database was searched for theses on otorhinolaryngology produced in Spain between 1976 and 2005. The search criteria used were the terms "Otorhinolaryngology," "Ear, nose, and throat surgery," "Hearing physiology," "Vestibular physiology," "Hearing physics," and "Bioacoustics". RESULTS: 468 theses were found (15.6 theses/year). Of these, 343 (73.6 %) were submitted by otorhinolaryngologists. The Universities of Valencia (Estudi General) (49), Complutense of Madrid (42), Salamanca (39), Barcelona (35), and Autònoma of Barcelona (31) accounted for most of the theses. The name of the supervisor was listed in 376 of the 468 theses (80.4 %); 286 of them had only 1 supervisor (76.1 %) and 90 had 2 (23.9 %). The most frequent topics were otology and audiology (35.1 %). CONCLUSIONS: Otorhinolaryngology in Spain has produced a similar number of theses as other areas of knowledge evaluated. The supervision of theses has tended to be shared in the most recent years studied. The number of theses submitted each year did not have only academic influences but also non-academic reasons.

Análisis de las tesis doctorales en otorrinolaringología presentadas en España en el período 1976-2005 / Analysis of the otorhinolaryngological doctoral theses submitted in Spain between 1976 and 2005

Introducción y objetivo: La importancia de la otorrinolaringología como disciplina independiente ha crecido en las últimas décadas. El objetivo de este trabajo es analizar las tesis doctorales defendidas sobre el tema en España entre 1976 y 2005. Métodos: Mediante la base de datos TESEO se obtuvieron los registros de las tesis doctorales sobre otorrinolaringología elaboradas en España entre 1976 y 2005. Como criterios de búsqueda empleamos los descriptores: “otorrinolaringología”, “cirugía de garganta, nariz y oídos”, “fisiología de la audición”, “fisiología del equilibrio”, “física de la audición” y “bioacústica”. Resultados: Se identificaron 468 tesis (15,6 tesis/año). Del total de ellas, 343 (73,6 %) fueron leídas por otorrinolaringólogos. Las universidades donde se leyeron más tesis fueron: Valencia (Estudi General) (49), Complutense de Madrid (42), Salamanca (39), Barcelona (35) y Autónoma de Barcelona (31). El director de la tesis pudo ser identificado en 376 (80,4 %) registros; de ellos 286 (76,1 %) tenían un solo director y 90 (23,9 %) estaban codirigidas por 2 directores. Los temas más frecuentemente abordados son los de otología y audiología (35,1 %). Conclusiones: La otorrinolaringología en España genera un número de tesis similar a las de otras áreas de conocimiento evaluadas. Su dirección tiende a ser compartida en los últimos años estudiados. El número anual de tesis presentadas está influido no sólo por motivos académicos, sino también por razones coyunturales extraacadémicas

Introduction and objective: The importance of otorhinolaryngology as a separate branch of medicine has grown in the last decades. The objective of this work is to analyze the doctoral theses in ENT presented in Spain between 1976 and 2005. Methods: The TESEO database was searched for theses on otorhinolaryngology produced in Spain between 1976 and 2005. The search criteria used were the terms “Otorhinolaryngology,” “Ear, nose, and throat surgery,” “Hearing physiology,” “Vestibular physiology,” “Hearing physics,” and “Bioacoustics”. Results: 468 theses were found (15.6 theses/year). Of these, 343 (73.6 %) were submitted by otorhinolaryngologists. The Universities of Valencia (Estudi General) (49), Complutense of Madrid (42), Salamanca (39), Barcelona (35), and Autònoma of Barcelona (31) accounted for most of the theses. The name of the supervisor was listed in 376 of the 468 theses (80.4 %); 286 of them had only 1 supervisor (76.1 %) and 90 had 2 (23.9 %). The most frequent topics were otology and audiology (35.1 %). Conclusions: Otorhinolaryngology in Spain has produced a similar number of theses as other areas of knowledge evaluated. The supervision of theses has tended to be shared in the most recent years studied. The number of theses submitted each year did not have only academic influences but also non-academic reasons

Hemangioma capilar telangiectásico de membrana timpánica / Vestibular myogenic evoked potentials in patients with benign paroxysmal positional vertigo

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Kaposiform hemangioendothelioma of the external auditory canal in an adult.

BACKGROUND: Kaposiform hemangioendothelioma is an uncommon vascular tumor initially reported to occur exclusively in children. METHODS: The presentation, pathologic evaluation, and management of an unusual case of kaposiform hemangioendothelioma is presented and discussed. RESULTS: A 27-year-old HIV-negative man was initially seen with a reddish nodule located in the outer third of the external auditory canal. Histologically, the tumor was composed of spindle-shaped cells arranged in short fascicles associated with small endothelial-like vascular spaces, similar in appearance to Kaposi's sarcoma. The lesion was locally excised but recurred 1 month later; then radiation therapy was performed. The patient remains well at 5-year follow-up. CONCLUSIONS: Recognition of kaposiform hemangioendothelioma is important to avoid possible confusion with a variety of vascular neoplasms with different biologic potential. This case presented some diagnostic difficulty because of the age of the patient and the unusual location of the lesion and had to be mainly distinguished from Kaposi's sarcoma.