Based on the current state of the BPPV field, there are no guidelines that specify an angular head movement’s velocity (AHMV) during diagnostic maneuvers of BPPV. The aim of this study was to evaluate the impact of AHMV during diagnostic maneuvers on proper BPPV diagnosis and therapy. The analysis covered the results obtained in 91 patients with a positive result of the Dix-Hallpike (D-H) maneuver or the roll test. The patients were divided into four groups based on values of AHMV (high 100–200°/s and low 40–70°/s) and the BPPV type (posterior: PC-BPPV or horizontal: HC-BPPV). The parameters of the obtained nystagmuses were analyzed and compared to AHMV. There was a significant negative correlation between AHMV and latency of nystagmus in all study groups. Furthermore, there was a significant positive correlation between AHMV and both maximum slow phase velocity and average frequency of nystagmus in the PC-BPPV groups, whereas it was not observed in the HC-BPPV patients. Complete relief of symptoms was reported after 2 weeks and was better in patients diagnosed with maneuvers performed with high AHMV. High AHMV during the D-H maneuver allows the nystagmus to be more visible, increasing the sensitivity of diagnostic tests and is crucial for a proper diagnosis and therapy.
Background: Hearing loss (HL) among older adults is a major global health concern. Hearing aids (HAs) offer an effective solution to manage HL and enhance the quality of life. However, the adoption and the consistent use of HAs remain low, making non-use a significant barrier to successful audiological rehabilitation. The aim of the study was to assess the benefit of HAs among patients with different degrees of HL and to determine the profiles of patients who have the least benefit from HAs. Methods: the HA benefits were assessed by using the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire. Participants were assigned to the study groups based on the pure-tone audiometry. This paper presents the results obtained by using HAs in various listening environments among 167 patients. Results: The majority of individuals benefited from HAs in a noisy environment while a reverberant environment provided the lowest benefit. It was observed that the degree of HL had a statistically significant impact on the benefits of HAs in terms of the communication ease, the reverberation, the background noise, and the global score. A moderately positive correlation was observed between the unaided APHAB and the HL degree. The subjects’ APHAB scores ranged from the 50th to the 65th percentile. Additionally, women had a significantly better improvement than men. Conclusions: HAs improved communication in everyday life situations among 91.6% of HA users. The degree of HL influences APHAB scores. Patients with a severe degree of HL achieved the greatest APHAB scores while male patients with mild HL received the lowest benefits of HAs. Both HL and the age, gender, and HA type are factors that also play important roles. The APHAB questionnaire is a reliable screening test for patients with hearing difficulties.
Objectives: Even though BPPV is one of the most common causes of vertigo, it is often underdiagnosed and omitted in the diagnosis of patients reporting vertigo. The aim of the study was to establish a diagnostic pattern useful in patients admitted due to vertigo, based on the most common clinical characteristics of patients suffered from posterior canal BPPV (PC-BPPV), horizontal canal BPPV with geotropic (HCG-BPPV) and apogeotropic nystagmus (HCA-BPPV). Methods: The analysis covered the results obtained in 105 patients with a positive result of the Dix-Hallpike maneuver or the supine roll test. The patients were divided into 3 groups based on the BPPV type: gr.1:PC-BPPV (60%); gr.2: HCG-BPPV (27%); gr.3: HCA-BPPV (13%). Patients before the diagnostic maneuvers filled the questionnaire concerning their symptoms and previous diseases. Results: Almost all patients had vertigo during turning over in bed and the character of the symptoms was paroxysmal. The answers to questions about the type of head movement evoked vertigo and how long vertigo lasted were differentiating. The percentages of correct diagnosis speculated by the combined answers were 69.6% in PC-BPPV, 61.8% in HCG-BPPV, and 80% in HCA-BPPV. Conclusions: Basing on those observations there is presented the diagnostic schedule which could be useful in dizziness examination. The above results indicate that a properly collected interview with the patient allows for a high percentage of accurate diagnosis.
Reconstructive surgery after surgical treatment of neoplasms in the head and neck region is always a challenge. Many factors are responsible for the success of reconstruction. The anatomy of the facial region is complex, which significantly influences the aesthetic effect of the reconstruction. Moreover, many patients undergo postoperative radiotherapy after surgical treatment, which affects the range of reconstructive techniques. The aim of this study is to review current reconstructive methods in the craniofacial region, using bone-anchored implants to attach nasal prostheses. The article also comprises the authors’ own experience with successful single-stage, Vistafix 3 osseointegrated implants for the attachment of an external nasal prosthesis in a 51-year-old man after surgical removal of squamous cell carcinoma of the nose and paranasal sinuses. The literature search for articles regarding implants in craniofacial reconstructions was performed using the three following databases: Scopus, Web of Science and MEDLINE (through PubMed), and follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA). A systematic literature search was set for 2018–2023 and retrieved 92 studies. From them, 18 articles were included in the review.
31 March 2023 in Polski Przegląd Otorynolaryngologiczny
Introduction: Idiopathic intracranial hypertension (IIH) is a rare disease entity that most often occurs in obese patients. Although it was first described in the 1930s until now, its etiology is unknown. Moreover, the diagnostic criteria and treatment guidelines for IIH are being still modified. Aim: The aim of the study was to review the current medical knowledge on IIH and to present our own clinical experience regarding this disease entity. Materials and methods: Scientific publications on the Pubmed platform were reviewed using keywords. Time descriptors had been set for 2013–2023. The paper also presents a clinical case of a 35-year-old female patient diagnosed with IIH. Results: Patients with IIH may first come to an ENT specialist because of tinnitus, dizziness or hearing loss. IIH mimics many disease entities, including Ménière’s disease, vestibular migraine and other peripheral and central balance disorders. An example of an atypical clinical picture of IIH is a 35-year-old patient admitted to the Otolaryngology Department due to diz- ziness and sudden hearing loss, who was diagnosed with IIH as a result of extended diagnostics. Conclusions and significance: IIH is a rare disease, a careful differential diagnosis is crucial to make the correct, early diagno- sis, that can protect the patients from serious consequences of IIH, such as significant visual impairment or even loss of vision
Hearing loss is one of the most common causes of disability worldwide. The aim of the study was to compare the demographic structure and the results of hearing tests in people qualified for hearing aids over the last 25 years. The material covered 1246 patients qualified for hearing aids in the years 1996–2001 and 2016–2021. Patients were divided into two groups according to the time of qualifying for hearing aids. Group 1 (G1) consisted of 759 people qualified in the years 1996–2001, and Group 2 (G2) comprised 487 people qualified in the years 2016–2021. Statistical analysis was performed on the results of pure tone threshold audiometry and the demographic structure in both groups. Patients in G1 had statistically significantly elevated hearing thresholds (HT) in the air conduction range at frequencies from 2000 to 8000 Hz in relation to G2 patients. The opposite situation was observed for the bone conduction threshold. G2 patients had significantly elevated bone conduction HT at frequencies from 250 to 1000 Hz compared to G1 patients. The age structure in both groups was similar; however, the gender distribution was statistically significantly different. In G1 women accounted for 40%, and in G2, they became the dominant gender (53%). Over the last twenty years, there has been a change in the structure of patients qualified for hearing aids. Although the age has remained similar, today, patients decide to use hearing aids at an earlier stage of hearing loss than 25 years ago. Modern women began to use hearing aids much more often.