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   2016| April-June  | Volume 32 | Issue 2  
    Online since April 25, 2016

 
 
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REVIEW ARTICLE
Bilateral vestibulopathy treatment: Update and future directions
Mohamed Fawzy, Ahmed Khater
April-June 2016, 32(2):83-92
DOI:10.4103/1012-5574.181082  
Bilateral vestibulopathy or BVH is a disorder of both labyrinths and/or vestibular nerves which have various etiologies. BVH is most often a chronic condition in which patients can suffer from blurred vision (oscillopsia), impaired spatial orientation and postural instability. Moreover, there is no continuing distressing vertigo, spontaneous nystagmus, or postural falls, which are typical signs of a vestibular tone imbalance caused by acute unilateral lesions. Those symptoms lead to an important decrease in physical activity, social functioning and vitality that dramatically impact the patients' quality of life. The treatment options for various forms of BVH could be one of the following four lines of treatment: (a) Preventive treatment through prevention of ototoxicity, (b) therapeutic treatment through medical treatment of the causative underlying disease, (c) rehabilitative treatment through the vestibular rehabilitation therapy, (d) future directions through sensory substitution devices (balance prostheses technology). The prognosis of BVH is poor and more than 80% of the patients do not improve. The aim of this study was to discuss the update and the future directions in the treatment of the bilateral vestibular hypofunction (BVH).
  11,303 728 1
ORIGINAL ARTICLES
Sensorineural hearing loss following tympanoplasty surgery: A prospective cohort study
Fatma H Al Anazy, Fahad A Alobaid, Wala S Alshiha
April-June 2016, 32(2):93-97
DOI:10.4103/1012-5574.181083  
Objectives Sensorineural hearing loss (SNHL) subsequent to middle-ear surgery is an important yet under-reported complication. Our aim is to assess the prevalence of this complication and to identify the risk factors for SNHL after type 1 tympanoplasties. Materials and methods In this prospective cohort study, a total of 312 patients with tubotympanic chronic suppurative otitis media and pure conductive hearing loss were included. The patients were evaluated using case histories, clinical examinations, preoperative and postoperative (3, 6, and 12 months) audiograms, and laboratory investigations. All patients underwent type 1 tympanoplasties, the surgical details were noted, and the prevalence of SNHL as a consequence of the surgical procedure was recorded. Results Sixteen patients (5.1%) developed SNHL. Fifteen operations were performed by residents, and one was performed by a consultant. Conclusion We concluded that the most important factor in the development of SNHL after a type 1 tympanoplasty is the surgeon's experience.
  5,437 403 2
CASE REPORTS
Removal of superglue from the external ear using acetone: A case report
Shweta Gogia, Alok Agarwal
April-June 2016, 32(2):116-117
DOI:10.4103/1012-5574.181105  
Foreign bodies in ear are a common occurrence and are commonly seen in the practice. But some foreign bodies require special attention. We here describe a unique situation of cynoacrylate glue or superglue in the external auditory canal which was removed using acetone solution. Acetone solution instilled in the ear canal enabled complete removal of the glue while preserving the anatomy of the ear canal and tympanic membrane.
  3,720 178 1
ORIGINAL ARTICLES
Auditory short-term memory in children with cochlear implant
Shazly Mohamed, Abdel-Hamid Asmaa, Fawzy Aisha, Mahmoud Heba
April-June 2016, 32(2):98-104
DOI:10.4103/1012-5574.181084  
Objective The aim of this study was to assess short-term auditory memory in children with cochlear implant and to assess the possible correlation of their language ages with their memory scores to consider memory training during rehabilitation program for cochlear-implanted patients. Patients and methods Sixty-one Egyptian children were included in this study. Thirty prelingual deaf children implanted with the nucleus multichannel cochlear implant were included. Their ages at the time of implantation ranged from 4 years to 4 years 11 months. All of the children had normal intellectual abilities. All cases were selected from Wadi El Neel Hospital where they received their aural-oral rehabilitation program for 1 year. A total of 31 normal children of matched sex and age were selected as a control group. A battery of auditory short-term memory assessments for Arabic-speaking children were applied to all children. An Arabic language test was also applied. Results A significant defect in short-term auditory memory in cochlear-implanted children as compared with controls was proven. A positive correlation between short-term auditory memory and their language ages was found. Conclusion The study revealed defective short-term auditory memory in cochlear-implanted children. This defect is more evident in cochlear-implanted children with poor language skills.
  2,790 213 -
Sudden sensorineural hearing loss in adults - Our experience with a multidrug high-dose steroid regimen at a tertiary care hospital
Vivek Gupta, Abhineet Jain, Praveer K Banerjee, Sonam Rathi
April-June 2016, 32(2):105-109
DOI:10.4103/1012-5574.181085  
Introduction Sudden sensorineural hearing loss is a confusing and controversial issue in our practice since no standard definition, evaluation method and treatment protocol exists. It is more a symptom than a disease entity. It is an otological emergency with narrow golden period of treatment. Objective To establish the early diagnosis, treatment and study the outcome of treatment. Design and method It is a prospective study, including patients >18 year age who had presented with sudden sensorineural hearing loss in ENT opd. Patients underwent general systemic and ENT examination, pure tone audiometry, impedance audiometry and necessary imaging. After diagnosis patients were treated with i.v. methylprednisolone 2 gm loading dose on day 1 followed by 1 gm BD for 2 days. and then tab. Prednisolone (1 mg/kg/day) for 5 days, gradually tapered over next 10 days along with tab. pentoxyfylline 400 mg TDS for 14 days with inj.methylcobalamine i.m. OD for 3 days. Pure tone audiogram was repeated on 4th day, 3 week, and 6 weeks after diagnosis. Results The study group included 37 patients who were diagnosed and treated. 56.76% of patients had sudden SNHL of < 72 hrs. duration, while 43.24% had sudden SNHL of >72 hrs. duration. The majority i.e. 35.14% had severe hearing loss (71-90 db) followed by 29.73% with moderate hearing loss (41-55 db). Tinnitus was noted as commonest associated symptom in 78.38% followed by tinnitus & vertigo in 21.62%. As per etiology, idiopathic cause (64.86%) was followed by acoustic trauma (24.32%) and head trauma (10.81%) in study group .In terms of recovery, 35.14% patients had complete recovery while 40.54% and 24.32% patients had partial and no recovery respectively. Conclusion The diagnosis of sudden SNHL is easily obtained by audiometry. Exact etiology often remains unknown so early diagnosis by avoiding unnecessary investigations and prompt treatment in <72 hrs. still carry good prognosis.
  2,634 218 -
CASE REPORTS
Intermediate-grade mucoepidermoid carcinoma arising from Warthin's tumour of parotid gland
Arsheed H Hakeem, Imtiyaz H Hakeem, Fozia J Wani
April-June 2016, 32(2):113-115
DOI:10.4103/1012-5574.181087  
Warthin's tumour (WT), also known as the adenolymphoma, is the second common benign neoplasm that mostly occurs in the parotid gland. Malignant transformation of the epithelial or lymphoid component of the WT has been rarely reported. We describe a case of a 73-year-old woman who underwent total radical parotidectomy with modified neck dissection on the left side. The case was diagnosed as intermediate-grade mucoepidermoid carcinoma developed in the setting of WT based on histomorphologic findings. Clinical presentation, pathogenesis, differential diagnosis and management of the rare malignancy have been discussed briefly.
  2,061 133 -
ORIGINAL ARTICLES
Central mucoepidermoid carcinoma of the mandible: A rare case report with diagnostic dilemma and review of the literature
Praveer K Banerjee, Abhineet Jain, Sonam Rathi
April-June 2016, 32(2):110-112
DOI:10.4103/1012-5574.181086  
Introduction Primary central mucoepidermoid carcinoma of jaws is a rare lesion comprising 2-3% of all mucoepidermoid carcinomas reported in the literature. It affects the mandible as unilocular or multilocular radiographic lesions. Case report The case presented here is that of a 55-year-old woman with expansile osteolytic lesion of the mandible who was managed with en-bloc resection considering ameloblastoma as preoperative diagnosis. Conclusion Mucoepidermoid carcinoma of the jaw is a rare tumour. The speculation on its aetiopathogenesis is mainly centered on the pluripotential capabilities of the epithelial lining of odontogenic cysts.
  1,818 162 -