Vestibular stimulation after cochlear implantation in common cavity deformity.
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Biomedical subjects
Publications and source records attributed to G Sennaroglu.
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OBJECTIVE: To compare the efficacy of intratympanic dexamethasone (ID), intratympanic gentamicin (IG), and decompression of the endolymphatic sac (ESD) for intractable vertigo in Meniere's disease. STUDY DESIGN AND SETTING: This prospective study was conducted at Hacettepe University Medical Faculty, a tertiary care center. Dexamethasone was applied through a ventilation tube in 24 patients, intratympanic gentamicin (also through a ventilation tube) to 16 patients, and 25 patients underwent ESD. RESULTS: Satisfactory control of vertigo was 72%, 75%, and 52%, respectively for the ID, IG, and ESD. Two patients in the gentamicine group had total hearing loss. In the dexamethasone group, hearing level remained the same in 46% of the patients with 16% increase and 38% decrease (30% 10dB and 8% 20 dB). CONCLUSION: If the vertiginous symptoms still persist after 6 months of medical treatment, ID can be started. If there is no further improvement after 3 months with ID, patients with profound sensorineural hearing loss undergo treatment with IG, ESD is reserved for patients with good hearing. If ESD also fails, patients with good hearing may undergo vestibular nerve section; patients with nonservicable hearing become candidates for labyrinthectomy.
OBJECTIVE: Etiopathogenesis of Ménière's disease has not been resolved. The principal histopathologic finding in this disease is endolymphatic hydrops. The majority of radiologic and histopathologic studies demonstrated a narrow vestibular aqueduct in Ménière's disease. There is no study in the literature investigating the relationship between inner ear pressure and vestibular aqueduct dimensions. Static acoustic compliance is a noninvasive procedure that is thought to measure perilymphatic pressure at the footplate. An increase in mechanical fluid pressure in the inner ear is transmitted to the footplate of the stapes. This causes a reduction in the compliance at the drum. The aim of this study is to investigate the relationship between vestibular aqueduct dimensions and static acoustic compliance in Ménière's disease and the normal population. STUDY DESIGN: Prospective study. METHODS: Forty patients with Ménière's disease and 40 healthy individuals with no otolaryngologic disorders were the subjects of this study. Each group was further divided into two according to static compliance value (normal and low static compliance). In these four groups dimensions of vestibular aqueduct were determined radiologically by high-resolution computerized tomography and correlated with normal and low static acoustic compliance values (normal and high perilymphatic pressure). RESULTS: The results demonstrated that vestibular aqueduct is narrower in patients with Ménière's disease than the normal population. However, there is no relationship between vestibular aqueduct dimensions and inner ear pressure obtained by static acoustic compliance measurements.
OBJECTIVE: The aim of this study was to determine the dimensions of cochlear aqueduct radiologically in patients with Ménière's disease and in normal subjects, and to correlate these findings with normal and low static acoustic compliance (SAC) (high and normal perilymphatic pressure) to see whether the dimensions of the cochlear aqueduct play any role in the perilymphatic pressure in normal individuals and patients with Ménière's disease. STUDY DESIGN: Prospective double-blind study. SETTING: The study was conducted at Hacettepe University Medical Faculty, a tertiary care center. PATIENTS: Forty patients with Ménière's disease with bilateral involvement, diagnosed by vertigo attacks, fluctuating hearing loss, tinnitus, fullness in the ear, and cochlear sensitivity constituted the patient group. Forty healthy individuals with no otolaryngologic symptoms constituted the control group. INTERVENTIONS: All individuals underwent SAC measurement in terms of equivalent volume in milliliters, based on two volume measurements. To measure the dimensions of the cochlear aqueduct, high-resolution computed tomography of the temporal bone in the axial plane was performed. RESULTS: There was no statistically significant difference in the width of the cochlear aqueduct between patients with Ménière's disease and normal subjects. When SAC measurements were also taken into account, there was no difference in cochlear aqueduct dimensions between individuals with normal and low SAC values in the two groups. CONCLUSION: The dimensions of cochlear aqueduct are not significantly different in Méniére's disease patients and normal individuals. Also, the cochlear aqueduct does not appear to play a significant role in normal and low SAC values in the two groups of individuals.
OBJECTIVE: To determine the relationship between stimulation rate and adaptation in cochlear implant users. STUDY DESIGN: A prospective clinical study. SETTING: This study was conducted at Hacettepe University Medical Faculty, which is a tertiary care and cochlear implant center in Ankara, Turkey. PATIENTS: Seven patients (three women, four men) who were using Nucleus CI 24 M cochlear implants (Cochlear Corp., Lane Cove, NSW, Australia). Two of them had become deaf after developing language skills, and five had congenitally deafness. RESULTS: Six patients demonstrated no tone decay. Only one patient, who had congenital hearing loss, demonstrated tone decay at stimulation rates of 250, 500, 720, 900 pulses per second. There is no statistically significant relationship between the stimulation rate and the selected electrode. CONCLUSION: The majority of the cochlear implant patients sustained the perception of a continuous electrical signal for 1 minute at 5 to 10 current levels above threshold.
This investigation was carried out in the Audiology and Speech Pathology Section of the Department of Otorhinolaryngology of Hacettepe University. The pregnant group comprised of 20 women followed by the Department of Gynaecology and Obstetrics of the same university; 18 non-pregnant women comprised the control group. The aim of this investigation was to study the relationship between hormonal changes in pregnancy and cochlear functions. All subjects underwent ENT examination, audiologic and acoustic immitance measurements and auditory brain stem response (ABR) tests. Results from each trimester and post-partum period of the pregnant group were compared. These results demonstrated that there was a decrease in hearing levels for 125 Hz, beginning in the first trimester and increasing in the second and third trimesters. Hearing returned to normal in the post-partum period. Similar findings were also obtained for 250 and 500 Hz; however, frequencies higher than 500 Hz demonstrated no significant correlation. Uncomfortable loudness was statistically significant between the third trimester and post-partum period. ABR tests did not reveal any differences. In conclusion, there is a low-frequency hearing loss and tolerance problem in pregnancy mimicking cochlear pathology. However, this hearing loss did not reach pathologic levels in any case and returned to normal in the post-partum period.
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