Englische Zusammenfassungen der Kapitel 1–9

ZusammenfassungAs a whole the effect of an explorative tympanoscopy with sealing the round/oval window(s) in cases of a profound idiopathic unilateral sudden hearing loss (ISSNHL) has been analyzed (data: own study cases and review of literature) and the results have been compared to that of intratympanal steroid injections published elsewhere. In detail the topics of the chapters focused on: Comparison of epidemiologic data, anamnestic and clinical findings including hearing results of our study group with those published Time course of hearing improvement after explorative tympanoscopyand sealing of the round/oval window Compilation of parameters influencing the extent of the initial hearing loss and the hearing gain after surgical therapy Perilymphatic fistulas as an etilogical factor causing a sudden profound hearing loss Comparison of those cases which have been treated by obliteration of the round/oval window with and without corticoid-soaked connective tissue Comparison of patients (data sampled by literature and own cases) treated with intratympanal corticoid injections on the one side or explorative tympanscopy with sealing of the round/oval window on the other side.

Bilateral Sudden Hearing Loss Caused by Basilar Artery Dissection: A Case Report

Bilateral sudden sensorineural hearing loss (SNHL) is rare, but a possible symptom of vertebrobasilar ischemia. A 69-year-old female patient with hypertension and atrial fibrillation presented with bilateral sudden hearing loss and vertigo without other neurological symptoms. On examination, she had left-beating horizontal nystagmus with positive head impulse on the left side. Pure tone audiometry revealed severe SNHL on both sides. Brain computed tomography angiography showed a dissection in the proximal portion of the basilar artery (BA) with occlusion of the mid-BA and bilateral anterior inferior cerebellar arteries (AICA), which confirmed on transfemoral cerebral angiography (TFCA). Left common carotid angiography demonstrated retrograde blood flow into the BA and right AICA via the left posterior communicating artery. During TFCA, her right hearing loss dramatically improved. Nine days later, follow-up TFCA showed an improvement of antegrade flow of the BA and AICA. We suggest that vertebrobasilar ischemia can be suspected in patients with bilateral sudden SNHL who present with risk factors for stroke.

The Relationship Between Sudden Sensorineural Hearing Loss, Vestibular Neuritis, and Infection With COVID-19

Introduction: This study aimed to investigate the relationship between sudden sensorineural hearing loss, vestibular neuritis, and infection with COVID-19. Materials and Methods: In this study, a total of 56 Iranians (32 females and 24 males) with a Mean±SD age of 45.12±14 years were studied in Tehran City, Iran. Individuals diagnosed with Sudden Sensorineural Hearing Loss (SSNHL) or vestibular neuritis based on definitive diagnostic criteria were included in the study. The methodology comprised four sections of underlying Sudden Hearing Loss,, auditory and vestibular inspection, SARS-CoV-2 Reverse Transcription-Polymerase Chain Reaction (RT-PCR) test, and statistical analysis. Also, the videonystagmography test was used in participants with vertigo to diagnose vestibular neuritis. Pure tone audiometry confirmed SSNHL in some patients with a complaint of hearing loss. Furthermore, tuning fork, Rinne and Weber tests were also performed. Results: The results of SARS-CoV-2 RT-PCR in 56 subjects showed that eight subjects (22.2%) with vestibular neuritis and two with SSNHL (10%) had a positive RT-PCR test. The Chi- square and Fisher exact-tests with a 95% confidence interval revealed no statistically significant (P>0.05) relationship between COVID-19 infection and vestibular neuritis or SSNHL. Conclusion: The present study showed no statistically significant relationship between audiovestibular disorders and positive SARS-CoV-2 RT-PCR test. However, the possibility of this relationship cannot be ruled out, and there is a need for studies with larger sample sizes.

Multiple sclerosis in the otoneurology outpatient clinic: interdisciplinary cooperation between otoneurologist and neurologist

Summary Introduction: Multiple sclerosis (MS) is a chronic multifocal inflammatory disease affecting the CNS, with autoimmune and neurodegenerative processes involved in its pathogenesis. Otoneurology outpatient clinic patients presenting with hearing loss, tinnitus, and vertigo may eventually be newly dia­gnosed MS patients. An otoneurologist specialist may be the first physician to suspect MS and refer the patient for an MRI and neurological examination. Early dia­gnosis and subsequent treatment of MS can delay permanent disability. Aim: Analysis of the incidence of MS patients in an otoneurological outpatient clinic during a twenty-year period. To increase the otoneurologists’ awareness of MS dia­gnosis. Methods and materials: Of 6,000 patients, who were newly examined in an otoneurology outpatient clinic between 2000 and 2021, data of 11 patients (0,18%) (5 male/6 female, aged 25–58 years) with MS or suspected of MS were retrospectively evaluated. Results: In 11 patients, MS was suspected or ongoing. In 4 of those patients, otoneurological examination contributed to the first detection of MS by an otoneurologist. The first MS symptoms included hearing loss, tinnitus, instability, and post-infection visual disorder. Conclusion: The otoneurologist must consider that sudden hearing loss, tinnitus, and vertigo may be the first manifestations of MS. Early dia­gnosis of MS increases the likelihood that with treatment, the progression of the disease will be slowed. Interdisciplinary cooperation between the otoneurologists and neurologists is very important for the dia­gnosis of MS. Key words multiple sclerosis – sensorineural hearing loss – tinnitus – vertigo – otoneurology

A clinical study of traumatic tympanic membrane perforation

<p><strong>Background:</strong> Tympanic membrane (TM) which forms the partition between external auditory canal and middle ear may be ruptured by trauma. Traumatic TM perforation is a commonly observed condition. Though, several therapeutic interventions have been described, conservative follow-up until spontaneous complete recovery is the most common choice.</p><p><strong>Methods:</strong> It was a prospective cohort study conducted during a period of 10 months from July 2020 to April 2021, carried out in 30 patients who presented to outpatient department of ENT and casualty of Hassan institute of medical sciences hospital with traumatic TM perforation. After taking informed consent, detailed history was taken, thorough examination of ear was performed and characteristics of perforation were noted. Pure tone audiometry (PTA) was conducted, data was statistically analysed.</p><p><strong>Results:</strong> Mean age group was 33.1 years and 73.3% were males. Ear pain was the commonest symptom with accidental trauma being the most common cause. 70% of them had left TM perforation and posteroinferior quadrant was mostly involved.</p><p><strong>Conclusions:</strong> Traumatic TM perforation is commonly seen in young adults following accidental trauma and assault. Earache, sudden hearing loss and tinnitus are the common symptoms. Most of the cases heal spontaneously with conservative management.</p>