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[PMID]:27881797
[Au] Autor:Kaya S; Schachern PA; Tsuprun V; Paparella MM; Cureoglu S
[Ad] Endereço:1 Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, USA.
[Ti] Título:Deterioration of Vestibular Cells in Labyrinthitis.
[So] Source:Ann Otol Rhinol Laryngol;126(2):89-95, 2017 Feb.
[Is] ISSN:1943-572X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To quantitatively assess the effect of serous labyrinthitis, suppurative labyrinthitis, and labyrinthitis ossificans on vestibular hair cells, dark cells, and transitional cells. METHODS: We examined human temporal bone specimens with serous labyrinthitis, suppurative labyrinthitis, and labyrinthitis ossificans, then compared them with age-matched control groups without labyrinthitis. We evaluated the density of type I and II vestibular hair cells, dark cells, and transitional cells in the peripheral sensorial organs. RESULTS: The mean density of type I vestibular hair cells in the maculae of the saccule significantly differed between the serous labyrinthitis group and its control group. The loss of type I and II vestibular hair cells in all of the peripheral sensorial organs was significantly higher in the suppurative labyrinthitis group than in its control group. The mean density of dark cells in the lateral and posterior semicircular canals was significantly lower in the suppurative labyrinthitis group than in its control group. The mean density of type I and II vestibular hair cells, dark cells, and transitional cells was significantly lower in the labyrinthitis ossificans group than in its control group. CONCLUSION: The loss of vestibular hair cells and degenerative changes in dark cells and transitional cells could affect vestibular function in patients with labyrinthitis.
[Mh] Termos MeSH primário: Células Ciliadas Vestibulares/patologia
Labirintite/patologia
[Mh] Termos MeSH secundário: Máculas Acústicas/patologia
Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Cadáver
Contagem de Células
Criança
Pré-Escolar
Feminino
Seres Humanos
Lactente
Labirintite/classificação
Masculino
Meia-Idade
Sáculo e Utrículo/patologia
Osso Temporal/patologia
Vestíbulo do Labirinto/patologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170206
[Lr] Data última revisão:
170206
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161125
[St] Status:MEDLINE
[do] DOI:10.1177/0003489416675356


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[PMID]:27866146
[Au] Autor:Tarasidis GS; Wiggins RH; Gurgel RK
[Ad] Endereço:1 Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Utah, Salt Lake City, Utah, USA.
[Ti] Título:Hearing Preservation After Penetrating Cochlear Injury.
[So] Source:Ann Otol Rhinol Laryngol;126(2):163-165, 2017 Feb.
[Is] ISSN:1943-572X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To share results and recommendations for management of penetrating cochlear injury. METHODS: A patient underwent repair of a penetrating cochlear injury after a projectile led to a traumatic cochleostomy with a narrow miss of the facial nerve and intracranial carotid artery. RESULTS: Postoperatively, the patient's audiogram demonstrated a pure tone average of 47.5 dB for air conduction and 35 dB for bone conduction, worse in the high frequencies, with a Word Recognition Score of 76%. CONCLUSIONS: Hearing loss from a penetrating cochlear injury can be mitigated with early repair, minimizing inner ear trauma, and steroid use to treat posttraumatic labyrinthitis.
[Mh] Termos MeSH primário: Cóclea/lesões
Traumatismos Cranianos Penetrantes/cirurgia
Perda Auditiva/cirurgia
Perfuração da Membrana Timpânica/cirurgia
[Mh] Termos MeSH secundário: Corticosteroides/uso terapêutico
Adulto
Audiometria de Tons Puros
Cóclea/diagnóstico por imagem
Cóclea/cirurgia
Feminino
Traumatismos Cranianos Penetrantes/complicações
Traumatismos Cranianos Penetrantes/diagnóstico por imagem
Traumatismos Cranianos Penetrantes/fisiopatologia
Perda Auditiva/etiologia
Seres Humanos
Labirintite/etiologia
Labirintite/prevenção & controle
Tomografia Computadorizada por Raios X
Perfuração da Membrana Timpânica/complicações
Perfuração da Membrana Timpânica/fisiopatologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Adrenal Cortex Hormones)
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170206
[Lr] Data última revisão:
170206
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161121
[St] Status:MEDLINE
[do] DOI:10.1177/0003489416676186


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[PMID]:28091469
[Au] Autor:Mileshina NA; Kurbatova EV; Bondarenko ES; Orlovskaya SS; Vafina KY
[Ad] Endereço:National Research Center for Audiology and Hearing Rehabilitation, Russian Medico-Biological Agency, Moscow, Russia, 117513.
[Ti] Título:[The role of computer and magnetic resonance imaging in patients with deafness].
[Ti] Título:Rol' komp'yuternoi i magnitno-rezonansnoi tomografii u patsientov s glukhotoi..
[So] Source:Vestn Otorinolaringol;81(6):13-16, 2016.
[Is] ISSN:0042-4668
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:The objective of the present study was to evaluate the potential of CT and MRI for diagnostics of congenital and acquired pathology of the inner ear in the deaf patients. Two groups of the patients were examined. The first group consisted of 75 patients with congenital or acquired deafness etiology. The second group was comprised of 75 patients with deafness associated with acute bacterial meningitis suffered in the preceding period. All the patients were examined by CT and MRI of temporal bones. The results of the study provided a basis for the development of indications for the application of CT and MRI to examine the patients presenting with hearing loss and deafness. CONCLUSION: CT and MRI make it possible to identify individual features of the temporal bone structure significant for the surgical treatment. MRI appears to have an advantage over CT for diagnostics of early obliteration of the cochlea. Both CT and MRI are the optional methods for the examination of the patients with deafness developing after meningitis.
[Mh] Termos MeSH primário: Surdez/diagnóstico
Doenças do Labirinto/diagnóstico
Labirintite/diagnóstico por imagem
Imagem por Ressonância Magnética/métodos
Tomografia Computadorizada por Raios X/métodos
[Mh] Termos MeSH secundário: Adulto
Criança
Surdez/etiologia
Feminino
Seres Humanos
Lactente
Doenças do Labirinto/etiologia
Doenças do Labirinto/fisiopatologia
Labirintite/fisiopatologia
Masculino
Reprodutibilidade dos Testes
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170621
[Lr] Data última revisão:
170621
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170117
[St] Status:MEDLINE
[do] DOI:10.17116/otorino201681613-16


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[PMID]:27937029
[Au] Autor:Sandhu JS; Rea PA
[Ad] Endereço:Neurotology Clinical Research Fellow and Clinical Scientist (Audiology), Ear Nose and Throat Department, Royal Hallamshire Hospital, Sheffield Teaching Hospitals, Sheffield S10 2JF.
[Ti] Título:Clinical examination and management of the dizzy patient.
[So] Source:Br J Hosp Med (Lond);77(12):692-698, 2016 Dec 02.
[Is] ISSN:1750-8460
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Dizziness is the commonest reason for a GP appointment over the age of 75 years and many dizzy patients will end up in hospital. This article introduces the range of vestibular disorders commonly seen in hospital practice with a symptom-based approach and discusses the range of treatments that might be considered.
[Mh] Termos MeSH primário: Tontura/diagnóstico
Labirintite/diagnóstico
Exame Neurológico/métodos
Doenças Vestibulares/diagnóstico
[Mh] Termos MeSH secundário: Vertigem Posicional Paroxística Benigna/diagnóstico
Vertigem Posicional Paroxística Benigna/terapia
Infarto Encefálico/complicações
Infarto Encefálico/diagnóstico
Infarto Encefálico/terapia
Gerenciamento Clínico
Tontura/etiologia
Tontura/terapia
Teste do Impulso da Cabeça
Seres Humanos
Labirintite/complicações
Labirintite/terapia
Doença de Meniere/diagnóstico
Doença de Meniere/terapia
Transtornos de Enxaqueca/diagnóstico
Transtornos de Enxaqueca/terapia
Exame Físico
Vertigem/diagnóstico
Vertigem/terapia
Doenças Vestibulares/complicações
Doenças Vestibulares/terapia
Testes de Função Vestibular
Neuronite Vestibular/diagnóstico
Neuronite Vestibular/terapia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170309
[Lr] Data última revisão:
170309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161213
[St] Status:MEDLINE


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[PMID]:27368464
[Au] Autor:Sommerfleck PA; González Macchi ME; Weinschelbaum R; De Bagge MD; Bernáldez P; Carmona S
[Ad] Endereço:Otorhinolaryngology Department, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Argentina. Electronic address: p.sommerfleck@gmail.com.
[Ti] Título:Balance disorders in childhood: Main etiologies according to age. Usefulness of the video head impulse test.
[So] Source:Int J Pediatr Otorhinolaryngol;87:148-53, 2016 Aug.
[Is] ISSN:1872-8464
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:UNLABELLED: Balance disorders are common in adult patients but less usual in the pediatric population. When this symptomatology appears in children it is a cause for concern, both for parents and health-care professionals. OBJECTIVES: To explain the balance disorders in children describing a case series and to discuss the main etiologies found according to age. STUDY DESIGN: A retrospective, observational, descriptive, and cross-sectional study was conducted. POPULATION: Patients aged 1-18 years who consulted because of balance disorders at the otolaryngology department of a pediatric tertiary-care hospital between March 2012 and July 2015. RESULTS: Two hundred and six patients were included in the study. Median age was 10 years. The most common diagnoses were vestibular migraine in 21.8% of the children, ataxia in 9.22%, benign paroxysmal vertigo of childhood in 7.77%, and post-traumatic vertigo in 6.31%.Overall, 61 videonystagmographies- of which 46 were normal - and 55 video head impulse tests - which were normal in 45 and showed abnormalities in the vestibulo-ocular reflex gain in 10 - were performed. CONCLUSIONS: In a child with balance disorders, the medical history and neurotological examination are essential. Vestibular migraine is the most commonly found disorder in every age group, and most of the patients have a family history of migraine. Ancillary studies, especially the video head-impulse test, provide important data to confirm the diagnosis.
[Mh] Termos MeSH primário: Ataxia/fisiopatologia
Vertigem Posicional Paroxística Benigna/fisiopatologia
Neoplasias do Sistema Nervoso Central/fisiopatologia
Labirintite/fisiopatologia
Transtornos de Enxaqueca/fisiopatologia
Otite Média com Derrame/fisiopatologia
Equilíbrio Postural
Transtornos das Sensações/fisiopatologia
[Mh] Termos MeSH secundário: Adolescente
Ataxia/complicações
Vertigem Posicional Paroxística Benigna/complicações
Neoplasias do Sistema Nervoso Central/complicações
Criança
Pré-Escolar
Estudos Transversais
Feminino
Teste do Impulso da Cabeça
Seres Humanos
Lactente
Labirintite/complicações
Masculino
Transtornos de Enxaqueca/complicações
Otite Média com Derrame/complicações
Reflexo Vestíbulo-Ocular
Estudos Retrospectivos
Transtornos das Sensações/etiologia
Vertigem/complicações
Vertigem/fisiopatologia
Doenças Vestibulares
Testes de Função Vestibular
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160703
[St] Status:MEDLINE


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[PMID]:27221575
[Au] Autor:Kaya S; Paparella MM; Cureoglu S
[Ad] Endereço:Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, USA Department of Otolaryngology-Head and Neck Surgery, Gebze Fatih State Hospital, Gebze, Turkey.
[Ti] Título:Pathologic Findings of the Cochlea in Labyrinthitis Ossificans Associated with the Round Window Membrane.
[So] Source:Otolaryngol Head Neck Surg;155(4):635-40, 2016 Oct.
[Is] ISSN:1097-6817
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To quantitatively demonstrate and classify the histopathologic changes in the cochlea of the human temporal bones with labyrinthitis ossificans (LO). STUDY DESIGN: Comparative human temporal bone study. SETTING: Tertiary academic medical center. SUBJECTS AND METHODS: We compared 23 temporal bone specimens from 19 deceased donors with LO associated with the round window membrane (RWM) and 27 age-matched specimens from 20 deceased donors without any otologic diseases. We focused on the location of LO in the inner ear, the intensity of endolymphatic hydrops, the number of spiral ganglion cells and cochlear hair cells, and the areas of the stria vascularis and spiral ligament. In addition, we created a new pathologic grading system for temporal bone specimens from deceased donors with LO associated with the RWM. RESULTS: We most often observed LO in the scala tympani of the basal cochlear turn. In the LO group (as compared with the control group), the intensity of endolymphatic hydrops was significantly increased; the number of spiral ganglion cells was significantly decreased in all segments; the loss of outer and inner hair cells was significantly increased in all turns of the cochlea; the atrophy of the stria vascularis was significantly greater in all turns of the cochlea; and atrophy of the spiral ligament was significantly greater in the basal and middle cochlear turn. CONCLUSION: LO was associated with significant cochlear damage (to the spiral ganglion cells, cochlear hair cells, stria vascularis, and spiral ligament) and with increased intensity of endolymphatic hydrops.
[Mh] Termos MeSH primário: Cóclea/patologia
Labirintite/patologia
Osso Temporal/patologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Cadáver
Criança
Pré-Escolar
Feminino
Células Ciliadas Auditivas/patologia
Seres Humanos
Masculino
Meia-Idade
Minnesota
Janela da Cóclea/patologia
Gânglio Espiral da Cóclea/patologia
Estria Vascular/patologia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170718
[Lr] Data última revisão:
170718
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160526
[St] Status:MEDLINE
[do] DOI:10.1177/0194599816651245


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[PMID]:27115607
[Au] Autor:Nomura K; Takano K; Yamamoto K; Abe A; Takahashi N; Okuni T; Himi T
[Ti] Título:Pneumolabyrinth with Labyrinthitis as the Suspected Cause.
[So] Source:Adv Otorhinolaryngol;77:23-6, 2016.
[Is] ISSN:1662-2847
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:Pneumolabyrinth is a rare condition with air bubbles existing in the vestibule and/or cochlea. We report a case of pneumolabyrinth without trauma that was suspected to be caused by labyrinthitis. A 65-year-old man presented with vertigo and hearing loss in the left ear after catching a cold. Computed tomography performed after there had been no improvement in the patient's symptoms showed the presence of air bubbles in the vestibule, semicircular canals and cochlea. The patient was transferred to our hospital with suspected perilymphatic fistula. Bacterial infection was suspected after the laboratory tests had indicated a severe inflammatory response, and the patient was treated with antibiotics. However, no bacteria were detected in a bacterial culture of the otorrhea. An exploratory tympanotomy was performed to improve the patient's staggering gait and to examine the middle ear, with no obvious fistula being observed. Subsequent fenestration of the round window revealed a white mass that appeared to contain bacteria which was collected from the cochlea and submitted for analysis and bacterial culture. However, no bacteria were detected and the mass contained white blood cells. We suspected pneumolabyrinth following labyrinth infection. However, the cause of air bubble formation remains unclear and needs to be validated with further research.
[Mh] Termos MeSH primário: Doenças do Labirinto/etiologia
Labirintite/diagnóstico
Tomografia Computadorizada por Raios X/métodos
Vestíbulo do Labirinto/diagnóstico por imagem
[Mh] Termos MeSH secundário: Idoso
Diagnóstico Diferencial
Seres Humanos
Doenças do Labirinto/diagnóstico
Labirintite/complicações
Masculino
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170207
[Lr] Data última revisão:
170207
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160427
[St] Status:MEDLINE
[do] DOI:10.1159/000441866


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[PMID]:27052132
[Au] Autor:Dommaraju S; Perera E
[Ti] Título:An approach to vertigo in general practice.
[So] Source:Aust Fam Physician;45(4):190-4, 2016 Apr.
[Is] ISSN:0300-8495
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Dizziness is a common and very distressing presentation in general practice. In more than half of these cases, the dizziness is due to vertigo, which is the illusion of movement of the body or its surroundings. It can have central or peripheral causes, and determining the cause can be difficult. OBJECTIVE: The aim of this article is to provide a clear framework for approaching patients who present with vertigo. A suggested approach to the assessment of vertigo is outlined. DISCUSSION: The causes of vertigo may be central (involving the brainstem or cerebellum) or peripheral (involving the inner ear). A careful history and physical examination can distinguish between these causes. The most common causes of vertigo seen in primary care are benign paroxysmal positional vertigo (BPPV), vestibular neuronitis (VN) and Ménière's disease. These peripheral causes of vertigo are benign, and treatment involves reassurance and management of symptoms.
[Mh] Termos MeSH primário: Medicina Geral/métodos
Vertigem/etiologia
Vertigem/terapia
[Mh] Termos MeSH secundário: Seres Humanos
Labirintite/complicações
Anamnese
Doença de Meniere/complicações
Exame Físico
Vertigem/diagnóstico
Neuronite Vestibular/complicações
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1701
[Cu] Atualização por classe:170127
[Lr] Data última revisão:
170127
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160408
[St] Status:MEDLINE


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[PMID]:26987015
[Au] Autor:Kaya S; Tsuprun V; Hizli Ö; Paparella MM; Cureoglu S
[Ad] Endereço:Department of Otolaryngology, University of Minnesota, Minneapolis2Department of Otolaryngology-Head and Neck Surgery, Gebze Fatih State Hospital, Gebze, Kocaeli, Turkey.
[Ti] Título:Quantitative Assessment of Cochlear Histopathologic Findings in Patients With Suppurative Labyrinthitis.
[So] Source:JAMA Otolaryngol Head Neck Surg;142(4):364-9, 2016 Apr.
[Is] ISSN:2168-619X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:IMPORTANCE: Better understanding of the effects of suppurative labyrinthitis (SL) on cochlear elements will aid the development of new approaches to treat its sequelae and complications in the ear. OBJECTIVE: To quantitatively evaluate the effects of SL on cochlear elements in humans. DESIGN, SETTING, AND PARTICIPANTS: A comparative study was conducted at a tertiary academic medical center from October 20, 2014, to January 3, 2015, of the histopathologic characteristics of 28 archived human temporal bone samples from 19 deceased patients with SL and 20 temporal bone samples from 14 deceased, age-matched controls. EXPOSURES: Evaluation of archived human temporal bone samples. MAIN OUTCOMES AND MEASURES: The locations of SL in the inner ear and the degree of endolymphatic hydrops were noted; the area of the stria vascularis and the spiral ligament in all turns of the cochlea at the midmodiolar level and in the adjacent 2 sections were measured; and the number of remaining outer and inner hair cells of the cochlea were counted to calculate the loss of both types of cells. To evaluate the loss of fibrocytes in the spiral ligament, a rating scale in each cochlear turn was used. For each segment of the cochlea, the number of spiral ganglion cells was determined. Outcomes between the group with SL and the control group were compared. RESULTS: Of the 28 temporal bone samples from the 19 deceased patients (16 men and 3 women; mean [SD] age, 23.1 [24.6] years) with SL, all showed SL in the scala tympani of the basal turn. In the group with SL vs the control group, the mean (SD) loss of outer hair cells was significantly higher in the lower (28.6% [11.4%] vs 12.4% [6.2%]; P = .02) and upper (22.3% [9.7%] vs 8.8% [3.2%]; P = .01) basal cochlear turn, the mean (SD) loss of inner hair cells was significantly higher in the lower (15.4% [6.7%] vs 2.6% [1.1%]; P = .02) and upper (10.6% [4.6%] vs 2.2% [0.7%]; P = .03) basal cochlear turn, the mean (SD) total number of spiral ganglion cells (28,132 [2068] vs 30,358 [2036]; P = .001) and the mean (SD) number of spiral ganglion cells in segment I (3554 [847] vs 4223 [649]; P = .003) was significantly decreased, the mean (SD) degree of atrophy of the stria vascularis in the lower (8455 [924] vs 9368 [1049] µm2; P = .003) and upper (7911 [837] vs 8474 [813] µm2; P = .02) basal cochlear turn was significantly greater, and the degree of endolymphatic hydrops was significantly greater (10 bone samples [36%] vs 1 [5%]; P = .006). No significant differences were found between the 2 groups in the number of fibrocytes and in the presence of atrophy of the spiral ligament in any cochlear turn. CONCLUSIONS AND RELEVANCE: This study demonstrates that SL can lead to cochlear damage, especially in the basal turn of the cochlea. These pathological observations have formed the basis for clinical findings of hearing loss and tinnitus detected in those patients with SL.
[Mh] Termos MeSH primário: Cóclea/patologia
Labirintite/patologia
[Mh] Termos MeSH secundário: Adulto
Cadáver
Feminino
Seres Humanos
Masculino
Reprodutibilidade dos Testes
Estudos Retrospectivos
Gânglio Espiral da Cóclea/patologia
Estria Vascular/patologia
Supuração/patologia
Osso Temporal/patologia
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1609
[Cu] Atualização por classe:160422
[Lr] Data última revisão:
160422
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:160318
[St] Status:MEDLINE
[do] DOI:10.1001/jamaoto.2015.3803


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[PMID]:26961517
[Au] Autor:Olusesi AD; Abubakar J
[Ad] Endereço:Department of Ear, Nose and Throat, National Hospital Abuja, Plot 132, Central area, Garki (Phase II), Abuja, Nigeria. drbiodunolusesi@gmail.com.
[Ti] Título:10 years of Vertigo Clinic at National Hospital Abuja, Nigeria: what have we learned?
[So] Source:Eur Arch Otorhinolaryngol;273(11):3567-3572, 2016 Nov.
[Is] ISSN:1434-4726
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:The clinician's major role in management of the dizzy patient involves determining what dizziness is vertigo, and what vertigo is of central or peripheral origin. These demand attention to details of history, otolaryngological workup including vestibular assessment, and often use of diagnostic and management algorithms. There is paucity of published reports of the management outcomes of peripheral vestibular diseases from Africa. Two tertiary care otologist-led dedicated vertigo clinics are located in Abuja, Nigeria. A prospective, non-randomized study of patients presenting with features of peripheral vestibular diseases attending the National Hospital Abuja Nigeria (between May 2005 and April 2014) and CSR Otologics Specialist Clinics (May 2010 to April 2014) was carried out. Both institutions adopted the same diagnostic and management protocols. Data extracted from anonymized databases created for this study include age, sex, vertigo duration (acute <12 weeks, chronic >12 weeks), dizziness handicap inventory score at presentation and at subsequent visits, otological and vestibular findings, ice-water caloric testing results, other investigation outcomes, treatments offered and outcomes. 561/575 (97.5 %) of the cases recorded had peripheral vestibular disease. The male-to-female ratio was 290:271. The mean age of the subjects was 44.7 years. Duration of vertigo at presentation was acute in 278 subjects and chronic in 283 subjects. Identifiable clinical diagnostic groups include BPPV (n = 200), Meniere's disease (n = 189), cervicogenic vertigo (n = 35), labyrinthitis (n = 32), Migraine-associated vertigo (MAV) (n = 32), cholesteatoma/perilymph Fistula (n = 10), climacteric vertigo (n = 8) and unclassified vertigo (n = 55). Migraine-associated vertigo recorded the highest DHI score (95 % CI 75 ± 4.3), followed by cholesteatoma/perilymph fistula (95 % CI 72 ± 6.1) and labyrinthitis (95 % CI 62 ± 1.9). Pure tone audiometry (95 % CI 67.3 ± 3.43), followed by thyroid function tests (95 % CI 66.7 ± 23.55) and ice-water caloric testing (95 % CI 59.7 ± 2.69) were investigations with the highest yields. 86.5 % of cases were treated by either vestibular suppressant medications alone (n = 285) and/or particle repositioning maneuver (n = 200) with improvement in vertigo control (95 % CI 63.63 to 74.37 % and 62.59 to 75.41 %, respectively). Peripheral vestibular diseases constitute majority of cases of self-reported vertigo seen in our setting. Migraine-associated vertigo seen in our setting all have peripheral vestibular signs. Dedicated vertigo clinics could significantly improve the diagnostic and treatment yield in a resource-constrained setting like ours. Most cases can be managed using non-operative measures.
[Mh] Termos MeSH primário: Vertigem/etiologia
[Mh] Termos MeSH secundário: Adulto
Colesteatoma da Orelha Média/complicações
Colesteatoma da Orelha Média/diagnóstico
Feminino
Seres Humanos
Labirintite/complicações
Labirintite/diagnóstico
Masculino
Doença de Meniere/complicações
Doença de Meniere/diagnóstico
Meia-Idade
Transtornos de Enxaqueca/complicações
Transtornos de Enxaqueca/diagnóstico
Nigéria
Ambulatório Hospitalar
Estudos Prospectivos
Vertigem/diagnóstico
Vertigem/terapia
Doenças Vestibulares/complicações
Doenças Vestibulares/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170928
[Lr] Data última revisão:
170928
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160311
[St] Status:MEDLINE



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