RESUMEN
A 20 year-old man presented with pain and swelling of the left submandibular area. Neck sonography revealed enlargement of the submandibular gland, coarsening of its echotexture with a few calculi and a multiloculated cystic lesion. Doppler sonography revealed venous flow within the cystic lesion and aneurysmal dilatation of the adjacent facial vein. CT angiography confirmed the facial vein aneurysm. We hypothesize that inflammation of the gland had weakened the wall of the adjacent facial vein, causing aneurysmal dilatation.
Asunto(s)
Aneurisma/etiología , Venas Braquiocefálicas , Cara/irrigación sanguínea , Enfermedades Vasculares Periféricas/etiología , Sialadenitis/complicaciones , Glándula Submandibular , Aneurisma/diagnóstico por imagen , Diagnóstico Diferencial , Estudios de Seguimiento , Humanos , Masculino , Enfermedades Vasculares Periféricas/diagnóstico por imagen , Sialadenitis/diagnóstico , Tomografía Computarizada por Rayos X , Ultrasonografía Doppler , Adulto JovenRESUMEN
OBJECTIVES: Physiological studies with experimental models of endolymphatic hydrops in Meniere's disease demonstrate some pressure changes at the level of round and oval window. Interestingly, conductive type hearing loss was observed in some patients during Meniere episodes. A close auditory follow-up of these patients may provide a better understanding of hydrodynamic changes of the hydrops and micromechanics of the inner ear. PATIENTS AND METHODS: Eighty-four patients (mean age 34.3 years; range 17 to 77 years) with Meniere's disease were enrolled in the study. Duration of Meniere symptoms ranged between six months to 22 years (mean 6.2 years). Longitudinal follow-up of patients was planned for three years. Bone and air conduction thresholds were averaged and the differences between the thresholds were calculated. RESULTS: Twenty-four patients (28.4%) demonstrated air-bone gap at least at one frequency, the differences being 18.3, 11.8, 2.8, and 11.1 dB at 0.5, 1, 2, and 4 kHz, respectively. The average air-bone gap was 11.5 dB. The difference was the greatest at 0.5 kHz and the least at 2 kHz. CONCLUSION: Low-frequency conductive hearing loss may be detected in Meniere's disease, which is apparently not indicative of middle ear pathology. High incidence of conductive involvement in patients who have had a recent episode of vertigo may indicate a distortion of vibratory movement of the stapes.
Asunto(s)
Pérdida Auditiva Sensorineural/epidemiología , Pérdida Auditiva Sensorineural/fisiopatología , Enfermedad de Meniere/epidemiología , Enfermedad de Meniere/fisiopatología , Adolescente , Adulto , Anciano , Audiometría , Femenino , Pérdida Auditiva Sensorineural/complicaciones , Humanos , Masculino , Enfermedad de Meniere/complicaciones , Persona de Mediana Edad , Estudios Prospectivos , Turquía/epidemiologíaRESUMEN
OBJECTIVE: Case reports indicate that abnormal location of the jugular bulb (JB) may result with some vestibular and audiological symptoms. The aim of this study is to analyze the correlation between the radiological view of the JB and audiovestibular findings and to clarify its possible role for Meniere-like problems. METHOD: Fifty-six patients, who had abnormal view of the JB on computerized tomography (CT) were selected to the study in this prospective case review. They were classified in three groups (Group-I; Lateral, Group-II; Intermediate and Group-III; Medial), according to the location of the JB. Patients were subjected to audiogram and vestibular tests (Dix-Hallpike maneuver, fistula test, vestibulospinal tests, electronystagmography (ENG)). RESULTS: JB was compressing on the cochlear aqueduct (CA) in two patients in group-II. Seventeen out of 25 patients in group-III had radiological evidence of obstruction of vestibular aqueduct (VA). 19 patients had neurosensorial and four patients had conductive hearing loss. All of the patients in group-I and nine of the patients in group-II gave normal caloric response to stimulation. Twelve of 19 patients in group-III demonstrated canal paresis ranging from 22 to 80%. CONCLUSION: Present study points out that there is a high correlation between HJB and vestibular problems in symptomatic cases. In patients who have HJB without classic vertigo attacks subclinical involvement of the vestibular system has been observed on ENG recordings. These findings imply that radiological existence of HJB may be a predisposing factor for Meniere-like complaints.
Asunto(s)
Pérdida Auditiva Conductiva/etiología , Pérdida Auditiva Sensorineural/etiología , Venas Yugulares/anomalías , Enfermedades Vestibulares/diagnóstico , Enfermedades Vestibulares/etiología , Electronistagmografía , Pérdida Auditiva Conductiva/diagnóstico , Pérdida Auditiva Conductiva/fisiopatología , Pérdida Auditiva Sensorineural/diagnóstico , Pérdida Auditiva Sensorineural/fisiopatología , Humanos , Venas Yugulares/diagnóstico por imagen , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Tomografía Computarizada por Rayos X , Acueducto Vestibular/diagnóstico por imagen , Acueducto Vestibular/fisiopatología , Enfermedades Vestibulares/fisiopatologíaRESUMEN
Intratympanic administration of gentamicin for the treatment of intractable Menière's disease can achieve relief of vertigo. However, the effect of gentamicin on tinnitus has been less well identified. and conflicting results have been reported. Intratympanic gentamicin therapy was given to 25 patients with Menière's disease for the control of vertigo, and the effect of the therapy on tinnitus was evaluated by a 10-point scale and a modified tinnitus questionnaire. It was found that the tinnitus decreased in four patients (16%) and disappeared in three patients (12%) at follow-up. The effect of gentamicin on tinnitus presented intersubject variability, and no correlation was found between the amount of gentamicin injected and its effect on tinnitus.
Asunto(s)
Antibacterianos/uso terapéutico , Gentamicinas/uso terapéutico , Enfermedad de Meniere , Acúfeno/tratamiento farmacológico , Administración Tópica , Adolescente , Adulto , Anciano , Antibacterianos/administración & dosificación , Femenino , Gentamicinas/administración & dosificación , Humanos , Masculino , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Acúfeno/diagnóstico , Resultado del TratamientoRESUMEN
OBJECTIVE: Abnormal aeration of the petrous bone, which may be responsible for some clinical symptoms, is an incidental radiological finding. It has been reported that people with abnormal aeration at the petrous bone are more prone to develop complications. In an attempt to make clear the clinical importance of a giant air cell at the petrous apex or abnormal aeration of this region, a prospective analysis has been planned. METHOD: 430 temporal bone CTs taken for diagnostic imaging only between 1992-2000 have been reviewed and 12 cases with petrous air cell were selected. Aeration was measured on computer basis. Patients were invited for interview and subjected to complete audilogical and ENG testing Symptoms of the patients were reviewed and the possible link with the radiological findings has been discussed. RESULTS: The internal distance of the air cell was ranging between 1.6 to 2.5 cm at transverse axis and between 2.0 to 4.2 cm at longitudinal axis. It was noted that all patients with large air cell at the apex also had extensive mastoid and temporal bone aeration. The degree of temporal bone aeration and the size of air cell was the same in both sexes. Four patients had balance problems. One patient had sudden hearing loss. Two patients had Bell's palsy. Two patients were asymptomatic. Six patients had normal hearing level. Five patients demonstrated ENG abnormality. CONCLUSIONS: It was found that these patients had some ear symptoms which were usually vague and nonlocalizing. It was unlikely to attribute these symptoms to a giant apical air cell or abnormal aeration of the petrous bone.