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At least 253 records · Page 14Linked to original sources
PubMed1986

Noninvasive recordings of cochlear evoked potentials in Meniere's disease.

Noninvasive meatal electrocochleography simultaneously recorded with brain stem auditory evoked potentials were performed on 24 adult patients with unilateral Meniere's disease. Data from the affected ear were compared with those of the nonaffected ear and with those of ten healthy normally hearing adults. The most striking finding was the significant deviation from the norm of the nonaffected ears' action potential duration. The combination of simultaneously recorded surface meatal electrocochleography and brain stem auditory evoked potentials complement the diagnostic battery of Meniere's disease in ruling out retrocochlear involvement, indicating cochlear involvement of the affected ear, and revealing subclinical changes in the contralateral ears.

Adult↗
PubMed2000

Modeling nonstationary longitudinal data.

An important theme of longitudinal data analysis in the past two decades has been the development and use of explicit parametric models for the data's variance-covariance structure. A variety of these models have been proposed, of which most are second-order stationary. A few are flexible enough to accommodate nonstationarity, i.e., nonconstant variances and/or correlations that are not a function solely of elapsed time between measurements. We review five nonstationary models that we regard as most useful: (1) the unstructured covariance model, (2) unstructured antedependence models, (3) structured antedependence models, (4) autoregressive integrated moving average and similar models, and (5) random coefficients models. We evaluate the relative strengths and limitations of each model, emphasizing when it is inappropriate or unlikely to be useful. We present three examples to illustrate the fitting and comparison of the models and to demonstrate that nonstationary longitudinal data can be modeled effectively and, in some cases, quite parsimoniously. In these examples, the antedependence models generally prove to be superior and the random coefficients models prove to be inferior. We conclude that antedependence models should be given much greater consideration than they have historically received.

Analysis of Variance↗
PubMed1992

Cochleovestibular nerve compression syndrome. II. Vestibular nerve histopathology and theory of pathophysiology.

The present study was undertaken to systematically examine and characterize pathological changes in vestibular nerve specimens obtained at surgery in patients with symptomatic cochleovestibular nerve compression syndrome (CNCS). Vestibular nerves were obtained in six cases of CNCS and were intermingled with vestibular nerves obtained in cases of Meniere's disease. All of the nerve specimens were coded and reviewed microscopically in a blind-study fashion by the neuropathologist. The vestibular nerves obtained from CNCS cases showed significant endoneurial fibrosis, compared to controls (specimens from patients with Meniere's disease). Based on observations in this study, as well as the clinical symptoms and audiovestibular test findings in these patients, a theory of pathophysiology in CNCS of the cochleovestibular nerve is proposed. The implications of this theory are discussed with respect to the diagnosis of CNCS.

Axons↗
PubMed1995

Middle ear imaging in neurotological work-up.

Middle ear imaging constitutes a homogeneous test battery for evaluation of neurotological disease. The imaging comprises infra-sound fistula test, ABR, tympanoscopy, ECoG, and trans-promontiorial cochlear blood flow measurement. We used a fistula test with infra-sound loading on posturography. In tympanoscopy we used 5 degrees and 25 degrees endoscopes with a diameter of 1.9 mm and length of 125 mm. In blood flow measurement we used laser-Doppler system with a stainless steel tip placed on the basal turn against stira vascularis. The flux was analyzed with a computer with custom-made software. In ECoG, a silver ball electrode was placed on the round window. In 64 cases evaluated we were not able to verify a spontaneous PLF by tympanoscopy. Symptoms typical for spontaneous PLF with positive fistula test turned out to be caused by endolymphatic hydrops. Sudden deafness usually did not show reduced cochlear blood flow, but often an endolymphatic hydrops. Fistula test was positive in about 25% of cases with endolymphatic hydrops. Tympanoscopy caused very few complication. The procedure takes about one hour and is done ambulatorily.

Adolescent↗
PubMed1993

Imaging of otosclerosis.

Imaging studies play an important role in the diagnosis of otosclerosis and in the clinical management of this disease. CT scanning at present is the tool of choice for the assessment of the labyrinthine windows and cochlear capsules. MR imaging thus far has had limited applications in the examination of the cochlear capsules but has been more useful in the assessment of the cochlear lumen prior to cochlear implant in patients with profound bilateral hearing loss.

Absorptiometry, Photon↗
PubMed1996

[Noninvasive determination of pressure relations of intracranial and intracochlear fluid spaces during the glycerol test in normal probands and patients with Menière's disease].

BACKGROUND: The cochlear aqueduct is a route for direct pressure transfer between intracranial and intracochlear fluids. In patients with Menière's disease, intracochlear pressure is presumably disturbed. The "Tympanic Membrane Displacement Analyser (TDA)" is a new system which provides a useful noninvasive method of detecting intracranial and intracochlear pressure changes. PATIENTS: In this study TDA measurements in combination with a glycerol test were performed in nine patients with Menière's disease and in seven normal persons. RESULTS: Before ingestion of glycerol, no significant difference in pressure was found between the two groups. After ingestion of glycerol a temporary decrease in intracochlear pressure was detected in both groups without any significant difference between the two groups. CONCLUSION: These results show that the combination of glycerol testing and TDA measurements does not seem to be helpful for the differential diagnosis of Menière's disease.

Adult↗
PubMed1998

Focal damage to cochlear microcirculation measured using a non-contact laser blood flowmeter in guinea pigs.

The focal microcirculation damage induced by a photochemical reaction in the stria vascularis (SV) of the guinea pig cochlea was evaluated using a non-contact laser blood flowmeter (NCLBF) and the endocochlear potential (EP). Focal degeneration, including vascular thrombosis in the SV produced by the systemic infusion of rose bengal, and the illumination of green light in the second cochlear turn were observed with scanning and transmission electron microscopy. The NCLBF probe was placed at a position 10 mm from the cochlear surface, and the diameter of the laser light was focused to 1 mm in the green light illumination area. The change in NCLBF values induced by the loading of anoxia and administration of epinephrine agreed very well with those obtained with a conventional contact-type laser Doppler flowmeter. Significant decreases in the cochlear blood flow (CBF) (p < 0.01) and EP (p < 0.01) were observed at the site of the photochemical injury compared with the values at the non-illuminated area. CBF gradually decreased (82.0+/-7.3% at 10 min, 71.2+/-5.5% at 20 min, 64.3+/-11.2% at 30 min from the baseline, n=7), but blood pressure was stable. The EP values also decreased gradually during the first 13 min (79.9+/-3.7 mV at pre-illumination, 11.4+/-10.7 mV at 13 min, n=7). The gradual decline in the EP was comparable to the changes in the CBF. The NCLBF was useful for evaluating the haemodynamic properties of the cochlear microcirculation disorders, and this animal model is expected to be suitable for studying the pathology of focal cochlear vascular disease.

Animals↗
PubMedDate not supplied

[Use of monotreane in the treatment of patients with cochleovestibular disorders].

Patients with cochleovestibular disorders of central and peripheral origin were treated with monothreane (produced by Luitpold Werk, FRG). The drug was given to 70 patients (19 men and 51 women) at the age of 28 to 64 years, 28 patients of which had disorders of peripheral origin and 42 patients disorders of mixed origin. The patients were examined by clinical methods and special tests and hypertension was diagnosed in 32 patients. The therapy yielded good effects in 61 patients: complete recovery of vestibular disorders was seen in 28 patients and relief of headaches in 42 subjects. Side effects were observed in nine patients who showed reduction of perception thresholds which disappeared after drug withdrawal. Monothreane had a beneficial effect on the course of the hypertensive disease.

Adult↗
PubMed2005

Distortion product otoacoustic emissions after intratympanic gentamicin therapy for unilateral Ménière's disease.

The treatment of patients with Ménière's disease that do not respond to conventional therapy becomes complicated, particularly when taking into account the issue of hearing damage as well as the control of vertigo. Treatment often involves the intratympanic administration of gentamicin, for which different protocols are used. Hence, it is important that we better understand how this treatment influences hearing, beyond mere audiometric assessments. The aim of this prospective study was to evaluate the effect of intratympanic gentamicin treatment for Ménière's disease on cochlear function, as assessed by otoacoustic emissions. The 41 patients included in the study had been diagnosed with unilateral Ménière's disease as defined by the American Academy of Otolaryngology-Head and Neck Surgery guidelines (1995), and had been refractory to medical treatment for at least 1 year. Intratympanic injections of gentamicin at a concentration of 27 mg/ml were performed at weekly intervals until indications of vestibular hypofunction appeared in the treated ear. Before beginning the treatment and 3 months after ending it, pure tone and speech audiometry tests were performed and the results are expressed in terms of the pure tone average (0.5, 1, 2, and 3 kHz) and the speech discrimination score, respectively. At the same time, a distortion product otoacoustic emission (DPOAE) study was performed and the results are expressed in terms of its presence or absence, and as the amplitude and threshold of the emission. When analyzed 3 months after the treatment had terminated, hearing loss was seen in 13 patients (31.7%). However, no significant change in the threshold and/or amplitude of otoacoustic emissions was observed in any of the patients. Neither were changes in the audiometric stage, number of injections required or the existence of DPOAE before treatment detected. Hence, the treatment method used here for patients with intractable unilateral Ménière's disease can be considered as having a low risk on auditory function, as assessed both audiometrically and with otoacoustic emissions, and can be considered as subablative for hearing function.

Anti-Bacterial Agents↗
PubMed1999

Stress electrocochleography.

Electrocochleographic recordings after changes of middle-ear and intracranial pressure were studied in a group of otologically normal subjects and in patients with suspected Ménière's disease. Electrocochleography performed under these conditions was called stress electrocochleography. It was useful to distinguish among Ménière's disease, benign positional vertigo, and a round-window fistula. Changes of middle-ear pressure, whether positive or negative, always resulted in a rise of the SP/AP ratio. Raised intracranial pressure after Trendelenburg positioning showed fluctuations of the SP/AP ratio in both normal subjects and symptomatic patients. However, in normal subjects, a congruent pattern of these fluctuations was apparent, whereas symptomatic patients exhibited a discordant pattern. The discordant pattern, typical for Ménière's disease, showed an increase of the SP voltage, whereas the AP voltage decreased. In benign positional vertigo, the SP voltage decreased, and the AP voltage increased, once during Trendelenburg positioning and again at the end of the test when starting position was resumed. During raised intracranial pressure after the Queckenstedt maneuver, round-window fistulas showed an increase of the SP voltage, whereas the AP voltage decreased considerably. At our clinic, stress electrocochleography has become an important neurootological test in the differential diagnosis of Ménière's disease.

Action Potentials↗
PubMed2026

Cochlear Implantation in Sickle Cell Disease: A Systematic Review of Feasibility and Outcomes.

INTRODUCTION: Sickle cell disease (SCD) is associated with systemic complications, including sensorineural hearing loss (SNHL) from microvascular occlusion and chronic inflammation. Although reports link SCD to higher rates of SNHL, current evidence is limited by small sample size, varied audiologic methods, and lack of standardized screening. This systematic review summarizes available literature on SNHL and cochlear implantation (CI) in SCD. METHODS: A literature search of PubMed MEDLINE, Embase, Scopus, Web of Science, and CINAHL identified 79 citations. After removal of duplicates, 35 records were screened in Rayyan. Studies published between January 1, 2000, and June 30, 2025, were eligible if they reported patients with SCD who developed hearing loss and underwent CI. Nine full texts were reviewed, and 4 met the inclusion criteria. Screening and review were performed independently by 2 authors per PRISMA guidelines. RESULTS: Across 4 case reports, a total of 5 patients with SCD underwent CI, ranging in age from 2 to 42 years. Four presented with bilateral severe-to-profound SNHL and one with unilateral loss. Implantation was technically feasible in all cases, including patients with cochlear fibrosis or ossification requiring modified insertion techniques. Postoperative outcomes were favorable: all patients demonstrated reliable device function and low impedances. Only 60% showed meaningful auditory benefit, characterized by improved functional speech perception in 2 patients (40%) and access to the speech frequency range with hearing testing going from moderate/profound hearing loss to mild hearing loss in 3 patients (60%). Complications occurred in 2 patients (40%): one developed unilateral middle ear infection leading to meningitis, and another experienced a postoperative pulmonary embolism requiring anticoagulation. The remaining 3 patients (60%) had uncomplicated recoveries with reported improved hearing from moderate/profound hearing loss to mild hearing loss post implantation. CONCLUSION: While CI appears feasible in SCD, our findings suggest that additional data are needed to assess its effectiveness in this patient population. However, evidence is limited to case reports, and complications such as thromboembolism and rapid cochlear fibrosis highlight the need for close perioperative management. More comprehensive studies with larger sample size are required to define surgical risk, optimize management, and establish best practices for timely implantation in this population.

Humans↗