The aim of this study was to examine, in elderly subjects, a possible association between age-related hearing impairment and vitamin B12 or folic acid status. Ninety-one consecutive subjects with pure age-related hearing impairment, 35 males and 56 females, with a median age of 78 years, range 67-88 years, were included in the investigation. All subjects underwent a thorough evaluation, including pure-tone, speech and impedance audiometry. Blood samples were drawn for determination of B12, folic acid and homocysteine and analysed by routine laboratory measurements. No significant differences in the blood parameters as a function of gender could be demonstrated and no correlations were found between B12 or folic acid and hearing levels averaged across the range 0.5-4 kHz. A weak correlation between hearing levels and homocysteine (r = 0.03; correlation coefficient 0.004) was found; however, a comparison of the hearing levels between those with increased and normal homocysteine failed to show any significant differences. In addition, no association between B12 and the speech recognition score could be found. This investigation therefore fails to demonstrate any association between hearing level and vitamin B12 or folic acid in elderly subjects.

A brief history of the vestibular neurectomy is given. This treatment modality was introduced in Denmark by us, using the experiences obtained by the use of translabyrinthine treatment modality for vestibular schwannoma surgery. This paper presents our experiences with this type of surgery (translabyrinthine, retrolabyrinthine and retrosigmoid vestibular nerve section) from 1980 to 1996, including 43 operations in 42 patients. The patients had all been treated with conventional methods without success and were all severely handicapped by their attacks of vertigo. The mean age was 51 years, postoperative observation time between 2 and 15 years, with a mean of 6.4 years. The vertigo was controlled in 88% of the patients, while postoperative imbalance occurred in 14 patients, mainly due to the ablation of the vestibular labyrinth and not by episodic vertigo. A total of 39 patients indicated that they were satisfied with the operation. Six patients were deaf before surgery and 92% of the remaining patients retained their preoperative hearing. Postoperative complications were few, including two re-operations for CSF leaks, one patient with a slight transient facial nerve paresis and one transient VI nerve paresis. The results compare favorably with results from other authors. Retrosigmoid vestibular nerve section is an effective treatment modality to be offered to patients in whom other modalities have failed. Information about the efficacy and leniency of the treatment should be given to the patient's organization in order to diminish the fear of an intracranial intervention. Surgical experience is necessary in order obtain good results, the number of patients needing the operation is small and centralization of the treatment is mandatory.

Coronal CT of the paranasal sinuses and the ostiomeatal complex (OMC) was performed before and 12 months after bilateral functional endoscopic sinus surgery (FESS) in 30 patients with sinusitis and 12 patients with nasal polyposis. The extent of sinus mucosal thickening was graded, and the patency of the OMC was evaluated. After FESS, the percentage of open OMCs had increased from 42% to 83% in the sinusitis group, and from 8% to 45% in the polyposis group. There was only a small improvement in mucosal score in sinuses with opened OMC, so that the overall extent of sinus opacification before and after FESS was almost the same. Despite this, 91% of the patients reported clinical relief of symptoms. Preoperative coronal CT of the paranasal sinuses serves as an anatomical map for the surgeon, but there is no benefit of routine postoperative CT.