OBJECTIVE:Benign paroxysmal positional vertigo (BPPV) is a common type of vertigo caused by the peripheral vestibular system. The majority of cases are accepted as idiopathic. Calcium metabolism also plays a primary role in the synthesis/absorption of otoconia made of calcium carbonate and thus might be an etiological factor in the onset of BPPV. In this study, we aimed to investigate the role of osteoporosis and vitamin D in the etiology of BPPV by comparing BPPV patients with hospital-based controls. MATERIALS and METHODS:This is a case-control study comparing the prevalence of osteoporosis and vitamin D deficiency in 78 BPPV patients and 78 hospital-based controls. The mean T-scores and serum vitamin D levels were compared. The risk factors of osteoporosis, physical activity, diabetes mellitus, body mass index, and blood pressure were all compared between the groups. To avoid selection bias, the groups were stratified as subgroups according to age, sex, and menopausal status. RESULTS:In this study, the rates of osteoporosis and vitamin D deficiency detected in BPPV patients were reasonably high. But there was no significant difference in mean T-scores and vitamin D levels, osteoporosis, and vitamin D deficiency prevalence between the BPPV group and controls. CONCLUSION:The prevalence of osteoporosis and vitamin D deficiency is reasonably high in the general population. Unlike the general tendencies in the literature, our study suggests that osteoporosis and vitamin D deficiency are not risk factors for BPPV; we conclude that the coexistence of BPPV with osteoporosis and vitamin D deficiency is coincidental.

Overlaps can be seen between vestibular migraine (VM) Ménière's Disease (MD) and diagnosis is difficult if hearing is normal. We aimed to investigate the sacculo-collic pathway in VM patients, MD patients, and healthy controls to define the diagnostic role of cervical VEMP (cVEMP). VEMP testing in response to 500 Hz and 1000 Hz air-conducted tone burst (TB) stimulation was studied prospectively in 22 subjects with definite VM (according to Bárány nomenclature), 30 subjects with unilateral definite MD, and 18 volunteers matched healthy controls. In VM subjects, response rate, p13 and n23 latencies were similar to healthy controls, but peak-to-peak amplitudes were bilaterally reduced at 500 Hz TBs (p= 0.005). cVEMP differentiated MD patients from VM and healthy controls with asymmetrically reduced amplitudes on affected ears with low response rates at 500 Hz TBs, and alteration of frequency dependent responses at 500 and 1000 Hz TBs. These findings suggest that cVEMP can be used as a diagnostic test to differentiate MD from VM. On the other hand, VEMP responses are symmetrically reduced on both sides in VM patients, suggesting that otolith organs might be affected by migraine-induced ischemia.

OBJECTIVE:Although there has been a wide consensus on the mechanism of nystagmus and clinical presentation of benign paroxysmal positional vertigo (BPPV), the neuroepithelial pathophysiology of BPPV still remains unclear. In this study, we aimed to clarify the pathophysiology of BPPV by evaluating the cervical vestibular-evoked myogenic potential (cVEMP) findings of patients. MATERIALS and METHODS:Thirty-six BPPV patients and 20 healthy volunteers were included. Bilateral cVEMP tests were performed on all participants. The participants were divided into the following three groups: those with a BPPV-affected ear, those with a BPPV-unaffected ear, and the healthy control group. RESULTS:There were no significant differences regarding the latencies of the first positive (p1) and negative (n1) peaks among the three groups. The mean normalized amplitude asymmetry ratio also did not differ between the BPPV and control groups. However, the normalized amplitudes of the BPPV patients (with both affected and unaffected ears) were significantly lower than those of the healthy control group. CONCLUSION:We detected that the cVEMP data of the affected and unaffected ears of the BPPV patients was similar and that their normalized amplitudes significantly differed from those of the healthy controls. Eventually, we concluded that even if the symptoms of BPPV were unilateral, the findings suggest that the bilateral involvement of the macular neuroepithelium is important in understanding the pathophysiology of BPPV. This finding supports the conclusion that the pathophysiological process starts with neuroepithelial membrane degeneration and continues with otoconia separation.

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Kısa süreli endotrakeal entübasyonun ses kalitesi ve aralığına etkisi The effect of short term endotracheal intubation on voice quality and range Amaç: Kısa süreli Endotrakeal Entübasyon (EE) sonucu oluşan vokal kord hasarının ses kalitesi ve ses aralığına olan etkisi incelenmiştir. Gereç ve Yöntem: Araştırma Sağlık Bakanlığı Üniversitesi Haseki Eğitim ve Araştırma Hastanesi KBB Kliniği'nde yürütüldü. Hastaların ameliyat öncesi ses kayıtları alındı. Hastaların aralıkları hesaplandı. Ölçümler postoperatif 24. saatte tekrarlandı. Sonuçlar istatistiksel olarak karşılaştırıldı. Bulgular: Çalışmaya 24'ü (%60) kadın, 16'ı (%40) erkek 40 hasta dahil edildi. Hastaların yaş ortalaması 33.70 (17-55) idi. Hastaların operasyon sonrasındaki Bazal Frekans (F0) değerlerinin, en tiz ses frekansının ve ses aralıklarının operasyon öncesi değerlere göre istatistiksel olarak anlamlı olarak daha az olduğu saptanmıştır. Jitter, Shimmer ve Harmonik-Gürültü oranında ise anlamlı değişiklik saptanmamıştır. Sonuç: EE'un invaziv bir girişim olması nedeni ile vokal kordlar üzerinde belli etkileri olmaktadır. Bu etkiler genelde kısa sürede gerilemektedir. Ses profesyonellerinin bu dönemde seslerini daha güvenli kullanmaları önerilmektedir. Anahtar Sözcükler: Endotrakeal entübasyon; vokal kord hasarı. Introduction: To evaluate the voice quality and range after vocal fold trauma due to Endotracheal Intubation (EI). Methods: The research had been processed in Ministry of Health University Haseki Education and Research Hospital Otolaryngology Head and Neck Clinic. The voice samples of patients were recorded preoperatively. The voice ranges of patients were calculated. The recordings were repeated at 24h after operation. The results were statistically compared. Results: The research was undergone with 24 (60%) female, 16 (40%) male, total 40 patients. The mean age was 33.70 (17-55). Postoperative acoustic analysis revealed that the fundamental frequency (F0), highest level of voice and vocal range were a statistically significant decreased from preoperative levels. Jitter, Shimmer and Harmonic-to-Noise ratios did not changed significantly. Discussion and Conclusion: The EI is an invasive process and has some effects on vocal cords. These effects usisally resolve in a short time. The voice professionals need to use their voice more precautiously during this period.