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Clinical HIT, either performed by an emergency specialist or neurologist is equivalent to vHIT gain and gain asymmetry analysis as conducted by neuro-otologist in the diagnosis of PCS, albeit mislabeling about 20% of VN patients. vHIT does not appear to yield additional diagnostic information. These findings indicate the strength of clinical HIT. Pure gain-based vHIT analysis seems limited and needs to be incorporated with saccade analysis.

Laryngopharyngeal reflux (LPR), which is defined as the backflow of gastric contents into the upper aerodigestive tract, is a relatively common disorder. However, its diagnosis still poses many problems. Twenty-four-hour double-probe pH monitoring is currently the diagnostic test of choice, but it has many disadvantages. Thus, an empiric trial of antireflux therapy has been suggested as an alternative method for diagnosis. The purpose of this article is to evaluate the validity of this alternative method in the management of LPR. The study group consisted of 36 patients with symptoms and physical findings suggesting LPR. The control subjects were 23 healthy adults. Twenty-four-hour double-probe pH monitoring was performed both in the study group and the control group, and the results were compared. In addition, the symptoms and physical findings in the study group was scored by the modified reflux symptom index (MRSI) and reflux finding score (RFS) at four intervals: before the start of therapy and at the second, fourth and sixth months of the therapy. The results of the 24-hour double-probe pH monitoring showed no significant difference between the study and the control groups (p>0.05). In the study group, the MRSI before the therapy was 13.6+/-4.4. This index improved significantly to 4.3+/-1.9 at the second month; to 1.5+/-0.6 at the fourth month, and to 0.5+/-0.2 at the sixth month of the therapy (p<0.05). The RFS before the start of the therapy was 14.8+/-3.8; and it improved significantly to 7.7+/-3.8 at the second month; to 4.5+/-2.3 at the fourth month, and to 1.4+/-0.9 at the sixth month of the therapy (p<0.05). The significant improvement in the MRSI and the RFS during the course of proton pump inhibitor therapy relates the patients' symptoms and physical findings to LPR. This implies the validity of the method, not only in the treatment of LPR, but in the diagnosis of this disorder, as well. Unfortunately, 24-hour double-probe pH monitoring has failed to differentiate LPR patients from healthy individuals.

The aim of this study was to compare the audiologic outcomes of the patients who underwent endoscopy on one ear and microscopic tympanoplasty on the other, and to investigate the operative time, graft success, postoperative pain and health status. This prospective randomized controlled study was carried out in Ege University ENT Department between February 2015 and September 2016. The patients who had bilateral chronic otitis media, normal middle ear mucosa and a hearing loss difference of 10 dB or less between the two ears randomly underwent microscopic tympanoplasty in one ear and endoscopic tympanoplasty in the contralateral ear, with 6-month intervals. 13 patients were included in the study with a mean age of 36.17 ± 3.61 years (range 17-53 years, 7 female, 6 male). The improvement in air-bone gap for groups 1 (endoscopic) and 2 (microscopic) was 9.48 ± 5.23 and 9.89 ± 2.79 dB, respectively. The duration of the surgery in group 1 was significantly lower than that in group 2 (p < 0.01). VAS scores were 2.15 ± 0.37 and 3.76 ± 1.64 cm for groups 1 and 2, respectively (p = 0.006). The endoscopic approach for type 1 tympanoplasty offers shorter surgery time, better health status and lower postoperative pain than microscopic surgery. In addition, endoscopic surgery offers comparable improvement in air-bone gap and similar graft success. The endoscopic approach has comparable audiological and morphological graft outcomes with the microscopic one. The endoscopic approach yielded better health and pain status for the same patients. Level of evidence This is an individual randomized controlled trial. The level of evidence is 1b.

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