The "Barbed Roman Blinds" technique: a step forward

Laryngoscope, 2003

Objective To compare the effectiveness and complications of our adaptation of the canalith repositioning procedure (CRP) with the expectation treatment for benign paroxysmal positional vertigo.Study Design A randomized, controlled trial in the setting of a neurotological clinic in Thailand.Methods Fifty-eight patients with posterior benign paroxysmal positional vertigo were randomly assigned to treatment and control groups using a block of four. The treatment group was treated with the modified CRP technique until the nystagmus disappeared. A mastoid oscillator was not used, nor were any instructions given for patients after the maneuver. Both groups recorded the daily grading of symptoms and the amount of anti-vertiginous drugs (cinnarizine) taken. Objective and subjective assessments were made weekly until the nystagmus disappeared or until 4 weeks had passed since treatment began.Results The rates of effectiveness of CRP treatment and the control treatment for benign paroxysmal positional vertigo were 75.9% and 48.2%, respectively. There was a significant difference in the treatment outcomes of the CRP and control groups (P = .03). The CRP group used significantly fewer drugs than the control group (P = .001). Complications in the CRP group, such as lateral canalithiasis and fainting, were observed in 13.8% of the patients.Conclusions The CRP was more effective than the expectation treatment for benign paroxysmal positional vertigo insofar as it provided faster recovery and required less dependence on medication. Complications of CRP were limited to 13.8% of patients.

The Journal of Laryngology & Otology, 2013

2015

Autonomized flaps in secondary head and neck reconstructions L’utilizzo dei lembi locoregionali autonomizzati nelle ricostruzioni cervico-facciali

Laryngoscope, 1979

2016

Acoustic stimulation effect on temporal processing skills in elderly subjects before and after hearing aid fitting

Frontiers in Neurology, 2023

Background and objectives: Patients with benign paroxysmal positional vertigo of the posterior canal (pc-BPPV) exhibit BPPV fatigue, where the positional nystagmus diminishes with the repeated performance of the Dix-Hallpike test (DHt). BPPV fatigue is thought to be caused by the disintegration of lumps of otoconial debris into smaller parts and can eliminate positional nystagmus within a few minutes [similar to the immediate e ect of the Epley maneuver (EM)]. In this study, we aimed to show the non-inferiority of the repeated DHt to the EM for eliminating positional nystagmus after week. Methods: This multicenter, randomized controlled clinical trial was designed based on the CONSORT guidelines. Patients who had pc-BPPV were recruited and randomly allocated to Group A or Group B. Patients in Group A were treated using the EM, and patients in Group B were treated using repeated DHt. For both groups, head movements were repeated until the positional nystagmus had been eliminated (a maximum of three repetitions). After week, the patients were examined to determine whether the positional nystagmus was still present. The groups were compared in terms of the percentage of patients whose positional nystagmus had been eliminated, with the non-inferiority margin set at %. Results: Data for a total of patients were analyzed ( patients per group). Positional nystagmus had been eliminated in . % of the patients in Group A compared with . % in Group B. The upper limit of the % confidence interval for the di erence was . %, which was lower than the non-inferiority margin. Discussion: This study showed the non-inferiority of repeated DHt to the EM for eliminating positional nystagmus after week in patients with pc-BPPV and that even the disintegration of otoconial debris alone has a therapeutic e ect for Frontiers in Neurology frontiersin.org Imai et al. . /fneur. . pc-BPPV. Disintegrated otoconial debris disappears from the posterior canal because it can be dissolved in the endolymph or returned to the vestibule via activities of daily living. Classification of evidence: This study provides Class II evidence of the non-inferiority of repeated DHt to the EM for eliminating positional nystagmus after week. Registration number: UMIN .

International Archives of Otorhinolaryngology, 2019

Introduction Posterior tympanotomy through facial recess (FR) is the conventional and most preferred approach to facilitate cochlear implantation, especially when the electrode is inserted through the round window. The complications of the FR approach can be minimized by proper understanding of the anatomy of the FR. Objective The present study was undertaken to assess the various parameters of FR and round window visibility, which may be of relevance for cochlear implant surgery. Methods Thirty-five normal wet human cadaveric temporal bones were studied by dissection for anatomy of FR and posterior tympanum. Photographs were taken with an 18 megapixels digital camera, which were then imported to a computer to determine various parameters. Results The mean distance from the take-off point/crotch of the chorda tympani nerve (CTN) to the stylomastoid foramen was 4.08 ± 0.8 mm (range of 2.06 - 5.5 mm). The variations in the course of the CTN included origin at the level of the lateral ...

Revista Brasileira de Otorrinolaringologia, 2008

A Reabilitação Vestibular visa melhorar o equilíbrio global, a qualidade de vida e orientação espacial dos pacientes com tontura. OBJETIVOS: Traçar o perfil dos pacientes atendidos no Ambulatório de Reabilitação Vestibular do Setor de Otoneurologia de um hospital universitário e verificar os resultados obtidos no período de novembro/2000 a dezembro/2004. MATERIAL E MÉTODO: Levantamento de dados contidos nas fichas dos 93 pacientes submetidos à Reabilitação Vestibular no período. FORMA DE ESTUDO: Clínico retrospectivo. RESULTADOS: A média etária dos pacientes foi de 52,82 anos, 56 do sexo feminino e 37 do sexo masculino. O número médio de atendimentos foi 4,3, sendo maior para os pacientes com distúrbios otoneurológicos centrais (média de 5,9). Dentre os pacientes que concluíram o tratamento proposto, 37 (60,7%) obtiveram melhora significativa, 14 (22,9%) tiveram melhora parcial e 10 (16,4%) não referiram benefícios significativos. Os pacientes que mais se beneficiaram com a Reabilit...

Medicinski pregled, 2017