Cochlear EH was present in 3.3% of 30 ears of 15 controls, 6.3% of 32 contralateral (contra) ears of 32 uMDs, 62.5% of 32 affected ears of 32 uMDs, and 55.6% of 18 affected ears of nine bMDs. Vestibular EH was observed in 6.7% of control ears, 3.1% of contra-uMD ears, 65.6% of affected uMD ears, and in 55.6% of affected bMD ears. Either cochlear or vestibular EH was present in 10.0% of control ears, 6.3% of contra-uMD ears, 81.3% of affected uMD ears, and 44.4% of affected bMD ears.

Prostaglandin E(1) (PGE(1)), a vasodilator and an inhibitor of platelet aggregation, has been used for the treatment of idiopathic sudden sensorineural hearing loss, despite the fact that its effectiveness has not been proven. Furthermore, it is rapidly metabolized in the lungs, which makes it difficult to use clinically. In an attempt to prevent this, PGE(1) was coated with a 0.2-microg lipid microsphere produced by beans; this was designated lipo-PGE(1). This coating protects PGE(1) from being rapidly metabolized. In this study, the effectiveness of the intravenous administration of lipo-PGE(1) was compared with that of PGE(1) by investigating the effects on systemic blood pressure (SBP) and cochlear blood flow (CBF) in guinea pigs with normal ears. The results of both drugs showed a dose-dependent decrease in SBP and the maintenance of CBF despite the decrease in SBP. However, no significant increase in CBF was observed for either drug. In comparing the effects of PGE(1) and lipo-PGE(1), no obvious differences in the effects on SBP and CBF were observed in this study.

Objectives The aim of the present study was to assess head‐position management for intractable idiopathic benign paroxysmal positional vertigo (BPPV) when lying down. We hypothesized that head‐up sleep (HUS) could prevent free‐floating otoliths from entering the semicircular canals. Study Design A prospective two‐arm multicenter randomized controlled trial. Methods BPPV was diagnosed in 611 patients (611/1,520; 40.2%) according to the 2015 diagnostic guidelines issued by the International Classification of Vestibular Disorders. Among them, 201 patients were intractable (201/611; 32.9%), 88 of whom were idiopathic and subsequently enrolled in the study. Patients randomly received intervention with HUS at greater than 45° (n = 44) or head‐down sleep (HDS; n = 44) when lying down. Before treatment, they completed several examinations, including subjective visual vertical (SVV). The specific diagnoses for the 88 patients with BPPV included horizontal type cupula (n = 40), horizontal type canal (n = 13), posterior type (n = 26), and probable and/or atypical BPPV (n = 9). Results Patient backgrounds did not differ significantly between the HUS and HDS groups. Visual analog scale (VAS) scores of vertiginous sensation were significantly lower in the HUS group than in the HDS group at both the third month and sixth month post‐treatment. Positional/positioning nystagmus observed just before treatment disappeared significantly more often in the HUS group than in the HDS group until the sixth post‐treatment month. Further, especially in HUS group, VAS scores in SVV− group (n = 24) were significantly lower than those in the SVV+ group (n = 20) sixth month post‐treatment. Conclusions Controlling free‐floating otoliths is not easy due to aging of the otolith organs. Repeatedly returning the endless free‐floating debris from the canals to the utricle through physical means is not a good strategy. Therefore, HUS when lying down at home could be recommended as an initial treatment for patients with intractable idiopathic BPPV. Level of Evidence 1b

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