Incidence Of Vertigo Research Articles

Relationship between Sleep Quality and Vertigo Incidence in College Students

One-third of adults are affected by poor sleep quality. Sleep problems are not only experienced by adults. Knowing the relationship between sleep quality and the incidence of vertigo is very important and urgent because of its very broad impact on health, understanding pathophysiology, clinical development, improving quality of life, as well as education and awareness in the community, especially students. In Indonesia, the prevalence of sleep disorders in adolescents is 62.9%. This study aims to determine the relationship between sleep quality and the incidence of vertigo in students. Literature review using Google Scholar, National Center for Biotechnology Information (NCBI) & Research Science found 9 journals based on inclusion & exclusion criteria. The results of the research is the relationship between sleep quality and vertigo involves a complex interaction between physiological and psychological factors. Physiological effects include disorientation and instability, motor coordination, and physiological stress responses such as cortisol. The psychological effects that can occur are anxiety, depression, decreased concentration, decreased cognitive function, and increased psychological discomfort. Lack of sleep in students makes vertigo symptoms worse. Lack of sleep will make vertigo symptoms worse. It is best to arrange the right sleeping position so that symptoms of vertigo do not occur, because vertigo can occur even in people who have never experienced it. The conclusion is there is a relationship between sleep quality and the incidence of vertigo in students.

Factors Associated with the Incidence of Vertigo in Konawe Distric

Background: Based on data obtained from the Konawe District Health Office, it is known that there are still many women affected by Vertigo and each year it has increased. There were 2,460 cases recorded in 2020, in 2021 there were 2,770 cases, while in 2022 month 6 there were 2,890 cases. The purpose of this study was to analyze the factors associated with the incidence of vertigo in Konawe District.
 Methods: This research was a quantitative observation with using a Cross Sectional Study design. This research was carried out from October to November 2022. The research population was all people suffering from disabled neurological diseases at the Konawe district health office living in the Konawe district in 2021 totaling 698 cases with the sample is 97 respondents.
 Results: The results showed that the results of the chi-square test on the work fatigue variable obtained an X2 hit value = 23.642, stress obtained an X2 hit value = 25.630, and sleep patterns obtained an X2 hit value = 26.085.
 Conclusion: The conclusion was that there is a relationship between work fatigue, stress and sleep patterns with the incidence of vertigo in Konawe Regency, the most dominant variable associated with the incidence of vertigo is sleep pattern variable.

Predictive Factors for Subjective Vertigo Following Cochlear Implantation: A Regional Multicenter Cohort Study of 395 Patients.

Cochlear implantation (CI) is generally accepted as having a low rate of postoperative complications, but between 9.3% and 13% of cases experience vertigo postoperatively. This study aimed to examine patient, surgical, and device factors contributing toward the risk of postoperative vertigo. A retrospective review was conducted of adult patients who underwent cochlear implant in a regional area of New South Wales from 2007 to 2018. A total of 395 cochlear implant cases were included in the final study. The overall incidence of vertigo at 3 months of follow-up was 7.1% (n = 28/395). No difference was identified in this study between rates of postoperative vertigo between device factors, including implant make (Cochlear vs. Med-El), electrode shape (perimodiolar vs. straight), and electrode model. No significant difference was found also for surgical factors such as the number of electrode rings inserted, side of implantation, or surgical approach of tympanic ramp (round window insertion vs. cochleostomy).A higher percentage of patients with preoperative vertigo experienced vertigo postoperatively (18.4%, n = 7/38), compared with the population without preoperative vertigo (6.0%, n = 21/352) (p = 0.005). Patients with previous mastoid surgery also reported a higher rate of postoperative vertigo (20%, n = 9/45) compared with those who had not had mastoid surgery (5.43%, n = 19/350) (p = 0.006). The mean age of patients experiencing postoperative vertigo was higher than the population without postoperative symptoms (67 vs. 63). This study of a large multicenter population outlines that patient factors are more critical than surgical or device factors when considering risk factors for vertigo post-cochlear implant.

A comparative analysis of the clinical symptoms of benign paroxysmal positional vertigo between older and young and middle-aged patients

Objective: To compare the differences in clinical symptoms and the time required for diagnosis of benign paroxysmal positional vertigo (BPPV) between older patients and young and middle-aged patients in the structured inquiry of dizziness history. Methods: The medical records of 6 807 patients diagnosed with BPPV from the Vertigo Database of Vertigo Clinical Diagnosis, Treatment, and Research Center of Beijing Tiantan Hospital, Capital Medical University, between January 2019 and October 2021 were retrospectively analyzed. The data included basic demographic information, clinical symptoms in a structured medical history questionnaire, and the time interval from the appearance of BPPV symptoms to diagnosis consultation. The patients were divided into the young and middle-aged group (<65 years old) and the older group (≥65 years old). The differences in clinical symptoms and consultation time were compared between these two groups. Categorical variables were represented by numbers (%), and compared using Chi-squared tests or Fisher's exact probability test for analysis; whereas, continuous variables conforming to normal distribution were represented by mean±standard deviation. Both data groups were compared and analyzed by Student's t-test. Results: The mean age of the older group was 65-92 (71±5) years, while the mean age of the middle-aged group was 18-64 (49±12) years. The incidence of vertigo (42.5% vs. 49.1%, χ2=23.69, P<0.001); vertigo triggered by changes in position of the head or body (52.4% vs. 58.7%, χ2=22.31, P<0.001); and autonomic symptoms (10.1% vs. 12.4%, χ2=7.09, P=0.008) were lower, but hearing loss (11.8% vs. 7.8%, χ2=27.36, P<0.001) and sleep disorders (18.5% vs. 15.2%, χ2=11.13, P=0.001) were higher in the older group than in the young and middle-aged group. The time from the appearance of dizziness to diagnosis was commonly longer in the older patient group than the other group (55.0% vs. 38.5%, χ2=55.95, P<0.001). Conclusions: Older patients with BPPV have more atypical symptoms and complex concomitant symptoms than young and middle-aged patients. For older patients with dizziness, positional testing is needed to confirm the possibility of BPPV even if the clinical symptoms are atypical.

Impact of environmental noise exposure as an inducing factor on the prognosis of sudden sensorineural hearing loss: a retrospective case-control study.

The study aimed to evaluate the clinical characteristics and prognostic factors associated with unilateral sudden sensorineural hearing loss (SSNHL) related to environmental noise exposure before its onset. A total of 50 unilateral SSNHL patients exposed to environmental noise before onset (case group) and 924 unilateral SSNHL patients without any exposure to obvious inducing factors before onset (control group) were enrolled between January 2018 and October 2022. We retrospectively analyzed differences between both groups using the chi-square test, Fisher's exact tests, independent t-tests, and Mann-Whitney U-tests as appropriate before and after propensity score matching (PSM) based on sex, age, and initial pure-tone average (PTA). Prognostic factors for the case group were analyzed using univariate and multivariate logistic analyses between the effective and ineffective groups. Before PSM, significant differences were noted in age, sex, time to treatment, the proportion of combined diabetes mellitus, initial PTA, hearing gain, the incidence of vertigo or aural fulness, the rate of vestibular dysfunction or inner ear MRI abnormalities, the effective rate, the glucose and homocysteine levels, and the proportion of audiogram curve types (P < 0.05) between both groups. After PSM, compared to the control group, a longer time to treatment (Z= -3.02, P < 0.05), higher final PTA (Z= -2.39, P < 0.05), lower hearing gain (Z= -3.46, P < 0.05), lower rate of vestibular dysfunction (χ2 = 55.1, P < 0.001), and lower effective rate (χ2 = 4.87, P < 0.05) were observed in the case group. There was a significant difference between the audiogram curve types in both groups (χ2 = 14.9, P < 0.05). Time to treatment (95% confidence interval: 0.692-0.965, P < 0.05) and final PTA (95% confidence interval: 0.921-0.998, P < 0.05) were associated with the clinical outcomes for the case group. Unilateral SSNHL patients exposed to environmental noise triggers before onset showed a poorer effective rate and a lower rate of vestibular dysfunction than those who were not. The time to treatment and final PTA were associated with the prognosis of these patients.

Research Progress of Chinese and Western Medicine in the Pathogenesis and Treatment of Vertigo

In recent years, with the progress of society and the change of lifestyle, the incidence of vertigo is gradually increasing. However, the current understanding of the pathogenesis and treatment of vertigo is limited, which leads to poor clinical diagnosis and treatment effect. The author analyzed the pathogenesis and treatment methods of vertigo from the perspectives of Western medicine and traditional Chinese medicine respectively, and summarized the related factors of vertigo, the research progress of traditional Chinese and western medicine treatment methods of vertigo, and the latest application research status of new ideas and new ideas for vertigo treatment. Based on the incidence types of vertigo, the overall concept and dialectical thinking of traditional Chinese medicine are put forward to guide the clinical treatment. The objective is to explore the advantages and disadvantages of Western medicine and traditional Chinese medicine in the treatment of vertigo, and integrate their advantages and disadvantages, in order to provide the best treatment plan for more vertigo patients, so as to improve the quality of life of patients.

Bone-turnover biomarkers as potential prognostic factors in sudden sensorineural hearing loss: A prospective cohort study.

ObjectivesThis study aims to explore the relationship between bone-turnover biomarkers and the recovery of SSNHL to provide clues for further improvements in etiological research and predictors.MethodsThe medical history, hearing thresholds, biomarkers of bone-turnover, and related hormones of 117 SSNHL patients were collected prospectively between August 2018 and December 2021. Linear correlation and logistic regression models were applied to examine the association between bone-turnover biomarkers and the prognosis of SSNHL.ResultsAge, the incidence of vertigo, pure tone average of the impaired frequencies (PTAimpairedfre), and the levels of bone turnover [including alkaline phosphatase (ALP), β-carboxy terminal crosslinked telopeptide of type 1 collagen (β-CTX), and N-terminal-midfragment of osteocalcin (N-MID)] were higher in the nonresponders than responders (P < 0.05). Logistic regression showed that the age (OR = 1.035, P = 0.027), time to treatment (OR = 1.157, P = 0.038), PTAimpairedfre (OR = 1.031, P = 0.008), and β-CTX (OR = 1.004, P = 0.001) were independent risk factors for the prognosis of SSNHL. In the women SSNHL subgroup, age, postmenopause percentage, PTAimpairedfre, the activity of ALP, levels of β-CTX, and N-MID were significantly higher in the nonresponders than the responders (P < 0.05). Compared to the men SSNHL subgroup, β-CTX has a higher correlation coefficient and predictive efficiency in the women SSNHL subgroup, and logistic regression showed that β-CTX (OR = 1.004, P = 0.004) was an independent risk factor for the women SSNHL.ConclusionsBone-turnover biomarkers are risk factors for poor prognosis in SSNHL, especially β-CTX. The differences were significant in women SSNHL, which may be related to the rapid regression of estrogen after menopause that leads to the occurrence of osteoporosis with a high conversion rate.

Relationship Between Atypical Symptoms of Degenerative Cervical Myelopathy and Segments of Spinal Cord Compression: Retrospective Observational Study

Patients with degenerative cervical myelopathy (DCM) often present with atypical symptoms such as vertigo, headache, palpitations, tinnitus, blurred vision, memory loss, and abdominal discomfort. This study aims to investigate the relationship between atypical symptoms of DCM and the segments of spinal cord compression. The 166 DCM patients with atypical symptoms admitted to our institution from 2019 to 2020 were divided into vertigo, headache, blurred vision, tinnitus, and palpitations groups according to their atypical symptoms, while the typical group was 214 DCM patients with typical symptoms only. Differences in segments of compression were compared among the groups. Results of more than 1-year of follow-up were further summarized for nonsurgical and surgical treatment of DCM patients with atypical symptoms. The incidence of vertigo, headache, blurred vision, tinnitus, and palpitations of all DCM patients was 37%, 18%, 15%, 11%, and 11%, respectively. Compared with the typical group, patients in the blurred vision and tinnitus group were older (P < 0.05) and the incidence of spinal cord compression at C3-5 in the vertigo group, C4-5 in the headache group, and C6-7 in the palpitation group was higher (P < 0.05). The scores of vertigo, headache, and palpitations decreased after surgical decompression (P < 0.05), whereas only vertigo and headache scores decreased after nonsurgical treatment (P < 0.05). Atypical symptoms were common in patients with DCM, and the segments of spinal cord compression might be associated with specific atypical symptoms. Surgical treatment is effective in relieving some of the atypical symptoms.

Vertigo Associated With Cochlear Implant Surgery: Correlation With Vertigo Diagnostic Result, Electrode Carrier, and Insertion Angle.

Objective: Vertigo is a common side effect of cochlear implant (CI) treatment. This prospective study examines the incidence of postoperative vertigo over time and aims to analyze influencing factors such as electrode design and insertion angle (IA).Study Design and Setting: This is a prospective study which has been conducted at a tertiary referral center (academic hospital).Patients: A total of 29 adults were enrolled and received a unilateral CI using one of six different electrode carriers, which were categorized into “structure-preserving” (I), “potentially structure-preserving” (II), and “not structure-preserving” (III).Intervention: Subjective vertigo was assessed by questionnaires at five different time-points before up to 6 months after surgery. The participants were divided into four groups depending on the time of the presence of vertigo before and after surgery. Preoperatively and at 6 months postoperatively, a comprehensive vertigo diagnosis consisting of Romberg test, Unterberger test, subjective visual vertical, optokinetic test, video head impulse test, and caloric irrigation test was performed. In addition, the IA was determined, and the patients were divided in two groups (<430°; ≥430°).Main Outcome Measures: The incidence of vertigo after CI surgery (group 1) was reported, as well as the correlation of subjective vertigo with electrode array categories (I–III) and IA.Results: Among the participants, 45.8% experienced new vertigo after implantation. Based on the questionnaire data, a vestibular origin was suspected in 72.7%. The results did not show a significant correlation with subjective vertigo for any of the performed tests. In group 1 with postoperative vertigo, 18% of patients showed conspicuous results in a quantitative analysis of caloric irrigation test despite the fact that the category I or II electrodes were implanted, which are suitable for structure preservation. Average IA was 404° for the overall group and 409° for group 1. There was no statistically significant correlation between IA and perceived vertigo.Conclusions: Though vertigo after CI surgery seems to be a common complication, the test battery used here could not objectify the symptoms. Further studies should clarify whether this is due to the multifactorial cause of vertigo or to the lack of sensitivity of the tests currently in use. The proof of reduced probability for vertigo when using atraumatic electrode carrier was not successful, nor was the proof of a negative influence of the insertion depth.

Endoscopic Stapedotomy: Overcoming Limitations of Operating Microscope

The study is aimed to assess the scope of endoscopic stapedotomy in overcoming technical challenges faced during conventional stapedotomy using operating microscope. Sixty-four patients with clinical and audiological diagnosis of otosclerosis were randomly assigned into one of the 2 groups-one underwent conventional stapedotomy using operating microscope, while the other group underwent endoscopic stapedotomy, the operating surgeon being the same for both groups, for all cases. The 2 groups were observed in terms of extent of the postero-superior canal bone curettage/drilling, chorda tympani repositioning, visualization of footplate area, surgical time from first incision to ear packing, post-operative morbidity in terms of post-operative pain, vertigo, hearing outcome, and changes in taste sensation. It was observed that irrespective of the width of the external auditory canal, endoscopic approach offered better access to the footplate area requiring lesser bone removal and chorda tympani repositioning. The operating time, post-operative pain, and changes in taste sensation were significantly less in the endoscopic group. However, no difference was noted in terms of the post-operative hearing outcome and incidence of vertigo. Endoscopic stapedotomy has clear advantages in terms of the technicality and accessibility to the working area as well as faster recovery.

Comorbid Symptoms Occurring During Acute Low-Tone Hearing Loss (AHLH) as Potential Predictors of Menière's Disease.

Acute low-tone sensorineural hearing loss (ALHL) is a type of idiopathic sudden sensorineural hearing loss. ALHL is rarely a solitary condition but rather co-occurs with vertigo and tinnitus, being an element of contemporary diagnostic criteria for Menière's disease (MD). The goal of our present study was to determine the value of ALHL for the early diagnosis of MD in patients presenting in the emergency room with ALHL as a main complaint. The files of 106 patients with ALHL who were admitted to the emergency room over the period of 7 years and 104 patients with acute high- tone sensorineural hearing loss (AHHL) from the same period were included in this retrospective study. Forty ALHL patients presented with recurrent episode of hearing loss and 66 remaining patients presented with ALHL for the first time. Of the latter group, 25 patients gave consent for the follow-up. First, we analyzed the difference in the occurrence of tinnitus and vertigo between the ALHL and AHHL groups. In patients with ALHL, the incidence of vertigo with tinnitus and the number of recurrent episodes were statistically higher than in patients with AHHL. Next, we focused on the ALHL follow-up group (25 patients). In that group, two patients had all MD symptoms at presentation, 18 had ALHL and tinnitus and five ALHL only. Of 18 patients with ALHL and tinnitus at admission, five developed vertigo and thus the triad of Menière's disease. None of the five patients with AHLH as a sole symptom developed MD during the follow-up time but four of them have developed tinnitus. Patients with recurrent ALHL had significantly higher incidence of MD than the patients with first episode. We conclude that some patients who present with ALHL and concomitant tinnitus or have recurrent episodes of ALHL are more likely to develop Menière's disease than these patients, who present with ALHL as a sole symptom. Nonetheless, we recommend otological follow-up for all patients presenting with ALHL.

The technique of retaining part of the external auditory canal posterior wall with epitympanoplasty in soft wall reconstruction treating middle ear cholesteatoma

Objective:To investigate the surgical treatment of cholesteatoma of the middle ear. Method:A retrospective analysis of patients from June 2013 to July 2016 diagnosed as cholesteatoma. 137 ears were divided into A group (retaining part of the external auditory canal posterior wall with epitympanoplasty in soft wall reconstruction for 75 ears) and B group (canal wall down mastoidotympanoplasty for 62 ears). the extent and damage of cholesteatoma were observed, comparing the time of dry ear and epithelial postoperative, the incidence of complications such as dizziness and hearing changes. Result:compared with B group, the postoperative dry ear time, epithelial time and hearing improvement in the A group were obviously improved, and the incidence of vertigo after operation was decreased, and the anatomical and physiological functions of the external auditory canal were protected. Conclusiont:The technique of retaining part of the external auditory canal posterior wall with epitympanoplasty in soft wall reconstruction is conductive to the removal of lesions and normal anatomical and physiological protection to external auditory canal, can prevent the forming of the abstraction pocket effectively and the recurrence of cholesteatoma, has clinical and practical value.

Mechanoreceptors in Diseased Cervical Intervertebral Disc and Vertigo.

We collected the samples of cervical intervertebral discs from patients with vertigo to examine the distribution and types of mechanoreceptors in diseased cervical disc. The aim of this study was to determine whether mechanoreceptors are distributed more abundantly in cervical discs from patients with cervical spondylosis, and whether they are related to vertigo. Previous limited studies have found that normal cervical intervertebral discs are supplied with mechanoreceptors that have been considered responsible for proprioceptive functions. Several clinical studies have indicated that the patients with cervical spondylosis manifested significantly impaired postural control and subjective balance disturbance. We collected 77 samples of cervical discs from 62 cervical spondylosis patients without vertigo, 61 samples from 54 patients with vertigo, and 40 control samples from 8 cadaveric donors to investigate distribution of mechanoreceptors containing neurofilament (NF200) and S-100 protein immunoreactive nerve endings. The immunohistochemical investigation revealed that the most frequently encountered mechanoreceptors were the Ruffini corpuscles in all groups of cervical disc samples. They were obviously increased in the number and deeply ingrown into inner annulus fibrosus and even into nucleus pulposus in the diseased cervical discs from patients with vertigo in comparison with the discs from patients without vertigo and control discs. Only three Golgi endings were seen in the three samples from patients with vertigo. No Pacinian corpuscles were found in any samples of cervical discs. The diseased cervical discs from patients with vertigo had more abundant distribution of Ruffini corpuscles than other discs. A positive association between the increased number and ingrowth of Ruffini corpuscles in the diseased cervical disc and the incidence of vertigo in the patients with cervical spondylosis was found, which may indicate a key role of Ruffini corpuscles in the pathogenesis of vertigo of cervical origin. 1.

Vertebrobasilar system computed tomographic angiography in central vertigo

The incidence of vertigo in the population is 20% to 30% and one-fourth of the cases are related to central causes. The aim of this study was to evaluate computed tomography angiography (CTA) findings of the vertebrobasilar system in central vertigo without stroke.CTA and magnetic resonance images of patients with vertigo were retrospectively evaluated. One hundred twenty-nine patients suspected of having central vertigo according to history, physical examination, and otological and neurological tests without signs of infarction on diffusion-weighted magnetic resonance imaging were included in the study. The control group included 120 patients with similar vascular disease risk factors but without vertigo. Vertebral and basilar artery diameters, hypoplasias, exit-site variations of vertebral artery, vertebrobasilar tortuosity, and stenosis of ≥50% detected on CTA were recorded for all patients. Independent-samples t test was used in variables with normal distribution, and Mann–Whitney U test in non-normal distribution. The difference of categorical variable distribution according to groups was analyzed with χ2 and/or Fisher exact test.Vertebral artery hypoplasia and ≥50% stenosis were seen more often in the vertigo group (P = 0.000, <0.001). Overall 78 (60.5%) vertigo patients had ≥50% stenosis, 54 (69.2%) had stenosis at V1 segment, 9 (11.5%) at V2 segment, 2 (2.5%) at V3 segment, and 13 (16.6%) at V4 segment. Both vertigo and control groups had similar basilar artery hypoplasia and ≥50% stenosis rates (P = 0.800, >0.05).CTA may be helpful to clarify the association between abnormal CTA findings of vertebral arteries and central vertigo.This article reveals the opportunity to diagnose posterior circulation abnormalities causing central vertigo with a feasible method such as CTA.

Pediatric Modified Radical Mastoidectomy: Open Cavity versus Periosteal-Temporofascial Flap Obliteration: An Analysis

Obliteration of the mastoid cavity leaves a smaller cavity with quicker as well as better healing. Chances of developing cavity granulations or infection are also reduced. Protection of the lateral semicircular canal by soft tissue obliteration also prevents vertigo episodes on exposure to cold air. This prospective study was to compare the results of pediatric modified radical mastoidectomy (MRM) in open mastoid cavities and cavities obliterated with periosteal-temporofascial swing flap at Manipal Teaching Hospital, Pokhara; a tertiary referral centre. The cohort comprised of 40 pediatric patients who underwent MRM between January 2012 and December 2014. They were divided into group 1 where mastoid cavity was kept open and group 2 where mastoid cavity was obliterated with periosteal-temporofascial swing flap plus medicated bone dust. Results in the 2 groups were assessed by comparing the time taken for mastoid cavity to become dry, incidence of vertigo on exposure to cold air, tympanic membrane graft status, mastoid cavity status and change in the pre-operative to post-operative pure tone average after 6 months. Statistical analysis was done with Statistical Package for Social Sciences (SPSS) version 16.0. Statistical significance was set at p<0.05. Group 1 vs. Group 2 results were as follows: Mean time taken for mastoid cavity to dry was 81.8 days vs. 30.1 days. Vertigo on exposure to cold air was present in 77.3% vs. 0%. Tympanic membrane graft status was intact in 72.7% vs. 100%. Mastoid cavity epithelialization was complete in 68.2% vs. 94.4%. Mastoid cavity granulations were present in 36.4% vs. 5.6%. Mastoid cavity healing rates were 63.6% vs. 94.4%. Residual cholesteatoma was seen in 4.5% vs. 0%. Excessive wax & keratin debris was present in 36.4% vs. 5.6%. External auditory canal opening was adequate in 86.4% vs. 94.4%. The mean post-operative pure tone average was 37.61 dB vs. 25.97 dB. Mean gain in pure tone average was 8.94 dB vs. 19.84 dB. None of the patients developed intra-cranial complications. Periosteal-temporofascial swing flap plus medicated bone dust obliteration of pediatric MRM cavity provides a dry and healed cavity in less time with better hearing when compared to an open MRM cavity.

Incidence of Vertigo and Dizziness Disorders at a University Hospital

Subjects were 626 patients reporting vertigo or dizziness seen at the University Hospital Department of Otolaryngology from April 2001 to September 2003. Patients were diagnosed based on diagnostic criteria prescribed by the Japan Society for Equilibrium Research. The most common peripheral vestibular disorder was benign paroxysmal positional vertigo (32%), followed by Meniere's disease (12%). All peripheral vestibular disorders accounted for 65%. Central vestibular disorder accounted for 7%, of which space-occupying lesions in the posterior fossa accounted for 1.0% and cerebral infarction 1.9%. Dizziness due to orthostatic hypotension accounted for 4.0%. Among past reports on clinical statistics of vertigo, the incidence of vertigo and dizziness disorders differed greatly, but our research and the past 2 reports based on diagnostic criteria prescribed by the Japan Society for Equilibrium Research showed almost the same incidence, i.e., BPPV of 30-40%, Meniere's disease of 7-10%, other peripheral vestibular disorders of 15-20%, and central vestibular disorder of 6-8%. Unified diagnostic criteria are thus important in the statistical analysis of vertigo disorders.

慢性中耳炎手術症例における迷路ろう孔の検討

Twenty cases of labyrinthine fistula have been reviewed. From 1988 to 1993, surgery was performed on 384 ears with chronic otitis media, and 20 of these cases had a labyrinthine fistula (incidence 5.2%). All twenty cases had a lateral semicircular canal fistula and one case had an additional superior semicircular canal fistula. There was no relationship between the size of the labyrinthine fistula and the incidence of vertigo or fistula symptoms. Also there was no relationship between the size of the labyrinthine fistula and preoperative bone conduction thresholds. All twenty cases were characterized by chronic otitis media with cholesteatoma, and the matrix of the cholesteatoma was completely removed in all patients with the exception one case where the cholesteatoma was enormous. Preoperative bone conduction hearing was preserved after removal of the cholesteatoma matrix in all cases except the latter.These results suggest that lesions over the lateral semicircular canal fistula should be completely removed, at best with care, when they are discovered during chronic ear surgery. This policy rarely causes lateral semicircular canal fistula bone conduction hearing to become worse.

"Vertigo" in Old People's Home and the Pathological Study of SHR Rats Suffering from "Vertigo"

Questionnaires were sent to homes for the elderly in Shimane prefecture, inquiring about the incidence of vertigo, its characteristics, duration and associated symptoms. Otological examination of 20 patients revealed probable Meniere's disease in 10.The medulla oblongata and temporal bones of 6 SHR rats with a kind of vertigo were examined. These SHR rats tilted their heads to one side, and when held, they circled around their tails. Their systolic blood pressures were 200-300 mmHg. In two rats, degenerating neurons which stained deeply with Luxol-Fast blue were observed in the reticular formation of the medulla oblongata. In the temporal bones of all 6 rats, the cochlear structures of the affected side were destroyed and replaced by fibrotic cells. Further study is needed to evaluate these pathological findings.

最近の突発性難聴 教室１５年間の検討から

Six hundred patients with sudden deafness visiting Kitasato University Hospital during the past 15 years were divided into two groups: group I, 150 seen in the past three years and group II, 450 seen in the previous 12 years.There was no statistically significant difference in sex or incidence of vertigo between the two groups. Younger and older patients were significantly more numerous in group I. The interval between onset of symptom and first hospital visit was longer in group I than in group II. The average hearing level was equal in patients who visited our hospital within four days after the onset of symptom, but among patients whose first visit was later, the average hearing level was better in group I than in group II. These facts point to the improvement of diagnosis and treatment of sudden deafness among general otologists, as a result of research and information about sudden deafness by the Intractable Diseases Research Commitee of the Ministry of Health and Welfare of Japan. It is now easy for most general otologists to diagnose and treat this desease, so patients receive primary care for several days before being referred to our hospital for secondary treatment.The number of cured and definitely improved patients has increased significantly. On the other hand, 20% of the patients in both groups did not show improvement. We must continue to work to improve the rate of cure and to define the cause and pathology of this disease.

高齢めまい患者の平衡機能

Equilibrium examinations were performed in 133 patients over 60 years of age who complained of vertigo and/or dizziness.1. The incidence of vertigo or dizziness due to central nervous system lesions (central disorders) increased with age, while that of peripheral vestibular lesions (peripheral disorders) fell with age.2. Elderly patients with peripheral disorders had a incidence of abnormal caloric response (36.6%) compared with those with central disorders.3. The eye tracking test of patients with central disorders indicated that smooth pursuit eye movement tended to be more difficult.4. Nystagmus tests showed abnormal nystagmus in those with cerebellar and brain stem lesions.