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1

Diagnostic evaluation of neck torsion test in objective examination in patients with vertigo and/or hearing impairment

100%

Niewiadomski P., Bielińska M., Pietkiewicz P., Olszewski J.

Polish Journal of Otolaryngology

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2017

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vol. 71

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issue 5

18-28

EN

Introduction. The aim of the study was to evaluate the neck torsion test in objective examinations of patients with vertigo and/or hearing loss. Material and methods. The study was conducted in 100 patients, including 54 women and 46 men aged 17–79 years, who were divided into two groups: I – 50 patients, including 30 women and 20 men aged 17–79 years (mean age 49.92 years) with dizziness and/or hearing impairments, and confirmed asymmetry of intracranial vessels, II – 50 patients – the control group, including 24 women and 26 men aged 20–71 years without dizziness and/or hearing disorders and without disturbance in the construction of intracranial vessels. For each patient, the following tests were carried out: subjective, objective otorhinolaryngological, Doppler ultrasound specifying the diameter of vertebral and carotid arteries and the velocity of blood flow in these vessels, audiological diagnostics, including the examination of latency of waves I, III, V of the auditory evoked potentials of the brain stem, otoneurological diagnostics with used the neck torsion test. Results. It appears from the analysis of the material presented that the application of the neck torsion test in the Doppler ultrasound results in the fact that the difference in the mean systolic velocity of blood flow in vertebral artery is higher on the side opposite to the turning of the neck, and the increase in the average diastolic blood flow velocity in the vertebral artery on the side of the test being performed and its reduction on the opposite side in the study group, when compared to the control group. The value of the wave I, II, V latency in the ABR test during the neck torsion test is extended more in the study group than in the controls, on the side of the performed test. The performed neck torsion test in the VNG test increases the occurrence of both, square waves and nystagmus (much higher in the study group than in the controls). Conclusion. The application of the neck torsion test in the Doppler ultrasound, ABR and VNG test in patients with vertigo and/or hearing loss means that these tests become functional, thereby increasing their diagnostic value and may be used to monitor the rehabilitation of inner ear disorders.

2

Comparative evaluation of the diagnostic value of the VHIT and Dix-Hallpike test in patients with balance system disorders in out-patient healthcare practice and expertise preparation

100%

Karawani K., Bielinska M., Nowosielska-Grygiel J., Pietkiewicz P., Kusmierczyk K., Kolary K., Olszewski J.

Otolaryngologia Polska

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2018

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vol. 72(6)

37-43

EN

Introduction: This study aimed to perform comparative analysis of the diagnostic value of the Video Head Impulse Testing (VHIT) Ulmer I and Dix-Hallpike Test in patients with balance system disorders in outpatient healthcare practice and medical jurisdiction. Material and methods: The study included 63 patients, aged 20–79, 28 women (20–72 years) and 35 men (23–79 years), divided into two groups: group I (study group) – 33 patients with vertigo of mixed origin (on the basis of the Fitzgerald-Hallpike caloric test during the VNG), and group II (reference group) – 30 healthy subjects. After the ENT interview and physical examination, exclusion of pathological lesions in the external acoustic meatus and middle ear, each patient underwent the Fitzgerald-Hallpike caloric test in VNG as well as the VHIT and Dix-Hallpike test, with the evaluation of eyeball reaction during head rotation. Results: In the group of patients with mixed origin vertigo (group I), the Fitzgerald-Hallpike caloric test showed unilateral labyrinth disturbances in 90.9% of the patients (mean 41.8%) and relative directional preponderance of the mean value of 19.0%, whereas in 9.1% of the patients, the detected values of labyrinth excitability were normal. Benign paroxysmal positional vertigo was diagnosed in 9.1% of all the examined vertigo cases. This diagnosis was based on the positive response to the Dix-Hallpike maneuver and indicative of damage to the posterior semicircular canal in VHIT (without signs of deficiency in VNG). Conclusion: VHIT and the Dix-Hallpike test enable quick and precise detection of benign paroxysmal positional vertigo in outpatient healthcare practice and medical jurisdiction.

3

Diagnostic evaluation of neck torsion test in objective examination in patients with vertigo and/or hearing-impairment

100%

Niewiadomski P., Bielińska M., Pietkiewicz P., Olszewski J.

Otolaryngologia Polska

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2017

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vol. 71(3)

20-30

EN

Introduction. Introduction. The aim of the study was to evaluate the neck torsion test in objective examinations of patients with vertigo and/or hearing loss. Material and methods. The study was conducted in 100 patients, including 54 women and 46 men aged 17–79 years, who were divided into two groups: I – 50 patients, including 30 women and 20 men aged 17–79 years (mean age 49.92 years) with dizziness and/or hearing impairments, and confirmed asymmetry of intracranial vessels, II – 50 patients – control group, including 24 women and 26 men aged 20–71 years without dizziness and/or hearing disorders and without disturbance in the construction of intracranial vessels. For each patient, the following tests were carried out: subjective, objective otorhinolaryngological, Doppler ultrasound specifying diameter of vertebral and carotid arteries and the velocity of blood flow in these vessels, audiological diagnostics, including the examination of latency of waves I, III, V of the auditory evoked potentials of the brain stem, otoneurological diagnostics with used the neck torsion test. Results. It appears from the analysis of the material presented that the application of the neck torsion test in the Doppler ultrasound results in the fact that the difference in the mean systolic velocity of blood flow in vertebral artery is higher on the side opposite to the turning of the neck, and the increase in the average diastolic blood flow velocity in the vertebral artery on the side of the test being performed and its reduction on the opposite side in the study group, when compared to the control group. The value of the wave I, II, V latency in the ABR test during the neck torsion test is extended more in the study group than in the controls, on the side of the performed test. The performed neck torsion test in the VNG test increases the occurrence of both, square waves and nystagmus (much higher in the study group than in the controls). Conclussion. The application of the neck torsion test in the Doppler ultrasound, ABR and VNG test in patients with vertigo and/or hearing loss means that these tests become functional, thereby increasing their diagnostic value and may be used to monitor the rehabilitation of inner ear disorders.

4

An analysis of causes and results of VNG examinations in patients with vertigo and balance disorders in private ENT practice

100%

Polaczkiewicz L., Olszewski J.

Otolaryngologia Polska

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2020

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vol. 74(2)

23-30

EN

Introduction: The aim of the study was to attempt to analyze the most common causes leading to dizziness, vertigo and balance disorders according to gender and age. Material and methods: Analysis of medical records and evaluation of VNG tests were performed on 608 patients of the private ENT practice “VERTIGO” in Opole between 2011 and 2017, including 404 women and 204 men. The patients’ age was in the range from 18 to 85 years, average age 49.88 years. The following parameters were taken into account in the analysis: the result of the subjective examination and the basic ENT and otoneurological examination, videonystagmographic examination, hearing assessment (tonal and impedance audiometry) and imaging tests (head MRI/CT and cervical spine x-ray), assessment of doppler ultrasound examination of vertebral arteries flow. Results: In examinations patients dizziness and vertigo were more common in women (66.45%) than men (33.55%), the most numerous was group of patients over 60 years, i.e. 30, 76%, systemic ver-tigo predominated (61.02%). Hypertension was the most common chronic disease in the entire popu-lation of patients with dizziness, vertigo and balance disorder and its frequency increases with age, which translates into an increase in the frequency of non-systemic and mixed dizziness reported by patients. The frequency of lipid metabolism disorders increases statistically significantly with age, while thyroid dysfunction as well as migraines and frequent headaches are significantly more com-mon in women reporting dizziness, vertigo and balance disorder than in men. In doppler ultrasound examination, while with age the frequency of bilateral disorders in vertebral artery flow increases significantly. The percentage of individual diagnoses in the examined patients was as follows: ves-tibular disorder (35.86%), benign paroxysmal positional vertigo (18.9%), mixed vertigo (16.12%), cervical vertigo (5.42%), Méniére's disease and its suspicion (5.1%), vertigo and dizziness of central origin (3.78%), vascular vertigo (2.8%), vestibular neuritis (2.3%), post-traumatic dizziness (1.32%) and the cerebellopontine angle tumors (0.16%). In the VNG study: in visual-oculomotor tests an in-crease in the percentage of pathology with age between 51 and 60 years old. Conclusions: The structure of diagnoses made in private practice differs from public health care. This results from the fact that the patient with acute symptoms first goes or is transported to the hospital emergency department. The second reason is the cost of diagnostics in the private sector which is not affordable to every patient.

5

An analysis of causes and results of VNG examinations in patients with vertigo and balance disorders in private ENT practice

100%

Polaczkiewicz L., Olszewski J.

Polish Journal of Otolaryngology

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2020

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vol. 74

|

issue 2

23-30

EN

Introduction: The aim of the study was to attempt to analyze the most common causes leading to dizziness, vertigo and balance disorders according to gender and age. Material and methods: Analysis of medical records and evaluation of VNG tests were performed on 608 patients of the private ENT practice “VERTIGO” in Opole between 2011 and 2017, including 404 women and 204 men. The patients’ age was in the range from 18 to 85 years, average age 49.88 years. The following parameters were taken into account in the analysis: the result of the subjective examination and the basic ENT and otoneurological examination, videonystagmographic examination, hearing assessment (tonal and impedance audiometry) and imaging tests (head MRI/CT and cervical spine x-ray), assessment of doppler ultrasound examination of vertebral arteries flow. Results: In examinations patients dizziness and vertigo were more common in women (66.45%) than men (33.55%), the most numerous was group of patients over 60 years, i.e. 30, 76%, systemic ver-tigo predominated (61.02%). Hypertension was the most common chronic disease in the entire popu-lation of patients with dizziness, vertigo and balance disorder and its frequency increases with age, which translates into an increase in the frequency of non-systemic and mixed dizziness reported by patients. The frequency of lipid metabolism disorders increases statistically significantly with age, while thyroid dysfunction as well as migraines and frequent headaches are significantly more com-mon in women reporting dizziness, vertigo and balance disorder than in men. In doppler ultrasound examination, while with age the frequency of bilateral disorders in vertebral artery flow increases significantly. The percentage of individual diagnoses in the examined patients was as follows: ves-tibular disorder (35.86%), benign paroxysmal positional vertigo (18.9%), mixed vertigo (16.12%), cervical vertigo (5.42%), Méniére's disease and its suspicion (5.1%), vertigo and dizziness of central origin (3.78%), vascular vertigo (2.8%), vestibular neuritis (2.3%), post-traumatic dizziness (1.32%) and the cerebellopontine angle tumors (0.16%). In the VNG study: in visual-oculomotor tests an in-crease in the percentage of pathology with age between 51 and 60 years old. Conclusions: The structure of diagnoses made in private practice differs from public health care. This results from the fact that the patient with acute symptoms first goes or is transported to the hospital emergency department. The second reason is the cost of diagnostics in the private sector which is not affordable to every patient.

6

Porównanie częstości występowania objawów współistniejących w grupie pacjentów z zawrotami głowy

100%

Šichnárek J., Vyskotová J., Macháčková K., Mrázková E.

Otolaryngologia Polska

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2017

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vol. 71(1)

34-39

EN

BACKGROUND: Dizziness is the second most frequent symptom that make patients seek specialized examination. The effective solution of dizzy conditions requires treatment in cooperation with different branches of medicine. OBJECTIVE: To analyze data from the database of patients with vertigo examined in the Hearing and Balance Disorder Centre in Ostrava, to find out whether, and in what factors, the sets of patients with diagnosed central and peripheral vestibular syndrom differ from each other. METHODS: Retrospective study that was carried out from October 2012 to February 2013. The data was gathered from documentation of all vertiginous patients who were examined by an otoneurologist. RESULTS: The statistically significant difference between the two sets was found in: occurrence of hypertension and mild obesity, impaired hearing and otitis media, stabilometric testing CONCLUSIONS: There was a statistically significant difference between the sets with the central and peripheral vestibular syndrome in the frequency of occurrence of hypertension, impaired hearing, otitis media, in mild obesity categorization and in balance disorders. There was not any statistically significant difference found in the other observed factors. The results confirm the need of a multidisciplinary approach to patients with vertigo.

7

Vertigo in cerebellopontine angle tumor Patients

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Zarębska-Karpieszuk P., Bartoszewicz R., Pierchała K., Niemczyk K.

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2015

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vol. 4(4)

27-31

EN

Cerebellopontine angle tumors are a group of tumors that originate from the posterior cranial fossa. Most of them are acoustic neuromas arising from the Schwann cell sheath of the vestibular branch of VIII cranial nerve. Those benign tumors usually present with unilateral hearing loss (53–57%), tinnitus (79–82%), and vertigo/imbalance (18–50%). The objective of this study was documentation-based evaluation of 53 out of 96 patients that received surgical treatment in the ENT Department of Medical University in Warsaw during the period from May 2012 to May 2014, with special consideration of vertigo/imbalance in relation to other symptoms. Statictical analysis has shown larger frequency of vertigo/imbalance in patients with mild to moderate hearing loss and positive corelation between the largest diameter of the tumor and the vestibular deficit in VNG (videonystagmography). The corelation of vestibular deficit in VNG and imbalance symptoms was only estabilished in the group with intrameatal localization of the tumor (T1).

8

Comparison of the incidence rates of coincident symptoms in a group of patients with Vertigo

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Šichnárek J., Vyskotová J., Macháčková K., Mrázková E.

Otolaryngologia Polska

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2017

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vol. 71(1)

34-39

PL

ÚVOD: Závrať je druhým nejčastějším příznakem. kvůli kterému pacienti musí vyhledat lékaře. Efektivní léčba závrativých stavů vyžaduje spolupráci mnoha lékařských odvětní. CÍL: Cílem bylo analyzovat údaje z databáze pacientů s vertigem vyšetřených v Centru pro poruchy sluchu a rovnováhy v Ostravě – Porubě, zjistit, zda a v jakých faktorech se od sebe odlišují soubory pacientů s diagnostikovaným centrálním a periferním vestibulárním syndromem. METODIKA: výzkum byl proveden formou retrospektivní studie, která probíhala od října 2012 do února 2013. Data byla sbírána z dokumentace všech pacientů, kteří byli vyšetřeni otoneurologem na základě potíží s vertigem. VÝSLEDKY: Statisticky významný rozdíl byl nalezen mezi soubory s centrálním a periferním vertigem ve výskytu hypertenze, poruchy sluchu, zánětů středního ucha, mírné obezity a výsledky stabilometrického vyšetření. ZÁVĚR: Rozdíl mezi soubory s periferním a centrálním souborem jsou zmíněny výše. Mezi ostatními hledanými příznaky nebyl nalezen rozdíl. Výsledky potvrzují nutnost multioborového přístupu k pacientům s vertigem.

100%

Bujak K., Kasacka I.

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EN

Vestibular neuritis is a group of symptoms resulting from a sudden unilateral vestibular dysfunction. It seldom occurs in children (approximately 7%). Its etiology and pathogenesis are unknown, although most researchers consider viral infection to be a causative factor. The clinical symptoms appear rapidly, exacerbate within a few hours and include vertigos, accompanied by nausea, vomiting and paralytic nystagmus, which intensifies with head movements. This is a case of a 15-year-old boy, so far healthy and with normal psychomotor development, who was admitted to the hospital ward due to exacerbating vertigos accompanied by nausea and balance disorders.

15

Benign paroxysmal vertigo of childhood

88%

Mierzwiński J., Polak M., Dalke K., Burduk P., Kaźmierczak H., Modrzyński M.

Otolaryngologia Polska

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2007

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vol. 61(3)

307-310

EN

Objective. To relate the authors’ experience to the diagnosis and follow-up of patients with benign paroxysmal vertigo of childhood (BPV) who were followed-up at the Children’s Hospital of Bydgoszcz between 1999 and 2004, and to review and discuss controversial issues regarding the disease. Methods. Among 124 children suffering from vertigo 14 were classified as having BPV. All the children were submitted to differential diagnosis protocol which consisted of meticulous history, otolaryngological, ophthalmological, psychological, neurological examination, biochemical tests and standard neurootological examination including caloric tests. The children were followed-up and the tests were repeated if no improvement was observed. Results. All the children suffered from episodic vertigo of variable intensity and frequency. All of them were neurologically intact. In 8 patients pathologic ENG results were found, only 1 patient with canal paresis could be considered as having peripheral lesion, 7 patients had central/mixed pathology. The follow-up was favorable in majority of patients. Six of them recovered completely, in 6 an improvement was noted and in 2 no improvement was observed. Three patients after remission of BPV attacks developed migraine. One child before development of BPV attacks suffered from paroxysmal torticollis of infancy. Conclusions. Childhood BPV is a disorder of vestibular system with the onset occurring mainly in preschoolers aged 1–7. Older children with the onset of BPV - like symptoms should be suspected for functional background of the disease. There are no typical ENG features for BPV. The only objective evidence of vestibular dysfunction is the presence of nystagmus during the attack. The disease is probably of vascular origin and there is strong evidence for close relationship between spasmodic torticollis, BPV and migraine.

88%

Niemczyk K., Jasińska A., Pierchała K.

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EN

We present an overview of current diagnostic and therapeutic guidelines on Ménière’s disease. Over the last five years, several guidelines and studies on this subject have been published, including The International consensus (ICON) on treatment of Méniere’s disease of 2018, The European Position Statement on Diagnosis, and Treatment of Ménière’s Disease, The Diagnostic and therapeutic strategy in Menière’s disease. Guidelines of the French Otorhinolaryngology-Head and Neck Surgery Society (SFORL) of 2017 . Consequently, also the “American Academy of Otorhinolaryngology, Head and Neck Surgery” (AAO-HNS) published updated recommendations on the subject in April 2020. On the basis of these studies and a literature review, the main treatment methods used in Ménière’s disease and an assessment of their effectiveness were presented. The current recommendations, as well as own experience of the Clinic of Otorhinolaryngology, Head and Neck Surgery of the Medical University of Warsaw, gave grounds for proposing a therapeutic scheme.

20

Intratympanic injection of dexamethasone for Menière’s disease. What relief can be expected? A case-series study

88%

Plainfossé O., El Yagoubi M., Puechmaille M., Mom T.

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vol. 10(1)

9-17

EN

Introduction: In patients suffering from Menière’s disease (MD), after failure of oral medical treatment, intratympanic in-jections (IT) may be achieved, among which, IT with dexamethasone (DXM). IT DXM has been reported to be effective on vestibular symptoms but very few reports focus on auditory symptoms. Aim: Here we assessed its efficacy both in vestibular and auditory symptoms.Patients and method: Twenty-seven MD patients who suffered from auditory and vestibular symptoms despite previous sys-temic medical treatment, underwent at least one series of five daily consecutive IT DXM. Auditory and vestibular assessment were achieved before IT DXM, and four months afterwards. Patients were ranked according to the vestibular functional level scale of the American Academy of Otolaryngology Head Neck society (1995) at the same periods. A specifically designed qu-estionnaire, focused on auditory symptoms was administered after IT DXM. Comparisons used a Chi-2 test for paired series, with p ≤ 0.05 considered significant.Results: The vestibular functional level shifted significantly towards lower levels, the median shifting from level 4 to 3. There was no complication but two persistent tympanic membrane perforation. Twelve patients (44.4%) had recurrent symptoms, on average 7 months after IT DXM and required additional treatment. Tonal and speech audiometry did not improve, neither the objective auditory and vestibular assessment. Based on the questionnaire, IT DXM was effective on auditory symptoms, at least on tinnitus in 9 cases (33.3%), mainly by lowering its intensity.Conclusion: IT DXM confirmed its capacity to relieve vestibular and auditory symptoms, in particular tinnitus, even though transiently.

Refine search results

Diagnostic evaluation of neck torsion test in objective examination in patients with vertigo and/or hearing impairment

Comparative evaluation of the diagnostic value of the VHIT and Dix-Hallpike test in patients with balance system disorders in out-patient healthcare practice and expertise preparation

Diagnostic evaluation of neck torsion test in objective examination in patients with vertigo and/or hearing-impairment

An analysis of causes and results of VNG examinations in patients with vertigo and balance disorders in private ENT practice

An analysis of causes and results of VNG examinations in patients with vertigo and balance disorders in private ENT practice

Porównanie częstości występowania objawów współistniejących w grupie pacjentów z zawrotami głowy

Vertigo in cerebellopontine angle tumor Patients

Comparison of the incidence rates of coincident symptoms in a group of patients with Vertigo

Diagnostic evaluation of neck torsion test in objective examination in patients with vertigo and/or hearing impairment

Comparison of the incidence rates of coincident symptoms in a group of patients with Vertigo

Comparative evaluation of the diagnostic value of the VHIT and Dix-Hallpike test in patients with balance system disorders in out-patient healthcare practice and expertise preparation

Porównanie częstości występowania objawów współistniejących w grupie pacjentów z zawrotami głowy

Diagnostic evaluation of neck torsion test in objective examination in patients with vertigo and/or hearing-impairment

Vestibular neuritis – a case description

Benign paroxysmal vertigo of childhood

Łagodne napadowe zawroty głowy typu dziecięcego

Analysis and interpretation of air-conducted ocular vestibular-evoked myogenic potentials (AC-oVEMP) – our experience in healthy adults

Benign paroxysmal vertigo of childhood

Ménière’s disease pt. 2. Treatment options and therapeutic strategies. Commentary to the current recommendations and own experience

Intratympanic injection of dexamethasone for Menière’s disease. What relief can be expected? A case-series study