BackgroundVestibular vertigo is associated with substantially reduced quality of life. Betahistine is effective in improving vertigo-associated symptoms, with longer treatment periods leading to greater improvements; however, it is not known whether these effects persist after treatment cessation.MethodsVIRTUOSO was a prospective, multinational, non-comparative, post-marketing observational programme investigating the effectiveness of betahistine (48 mg/day) and the course of vertigo after the discontinuation of treatment. Patients with vestibular vertigo who were prescribed 48 mg/day betahistine were enrolled in Russia and Ukraine. Treatment duration was up to 2 months, and patients were followed up for 2 months after discontinuation of betahistine. Efficacy endpoints included clinical response (assessed by change in vertigo severity), monthly attack frequency, and physician and patient grading of overall clinical response and improvement of vertigo-associated symptoms.ResultsOverall, 309 patients were enrolled and 305 completed the study. Clinical response was rated as good, very good or excellent in 74.1% of patients at end of treatment, with vertigo severity significantly decreased from baseline (p < 0.001). Monthly vertigo attack frequency decreased significantly during the 2 months of treatment (p < 0.001 from baseline) and further decreased during the 2-month follow-up (p < 0.001 from end of treatment). Overall, clinical response was graded as good or excellent by 94.4% of physicians and 95.4% of patients. Clinical improvement was considered either good or excellent by 82.6–90.5% of physicians and patients for nausea, vomiting and faintness. Only one adverse event was reported, with no serious adverse events.ConclusionOur findings suggest that betahistine (48 mg/day) therapy is effective in treating vertigo in routine clinical settings. The observed effects persisted for 2 months after treatment cessation, suggesting that betahistine may facilitate lasting vestibular compensation.

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Posturography provides valuable information about the balance. Wii Balance Board is inexpensive and when used with specially designed software is a potentially effective tool for instrumental balance assessment. Objective: To study the main outcome variables of postural balance in healthy children using the Wii Balance Board platform. Methods: Postural balance parameters of 38 children with normal hearing and without vestibular complaints were recorded using Wii Balance Board and Wii Posturografie software. Way, Area, Lat, Ant-Post, AP/Lat parameters in position with eyes opened and closed were measured. Romberg Way, Romberg Area parameters were calculated. Results: Numerical values of postural balance in children significantly increased with closed eyes position. The parameter Area, obtained during the study in open eyes, was improving with increasing the children age. The parameters of postural balance Way, Area, AP, obtained during the study with eyes closed, were likely to be decreased with increasing age of a child. Conclusion: This paper describes the quantitative data of postural balance in healthy children obtained with the Wii Balance Board platform and Wii Posturografie software.

Topicality: Long-term and pronounced psychoemotional tension leads to negative changes in the human body. Many aspects of cochleovestibular changes caused by psychoemotional stress are not studied enough to date. Aim: to increase the diagnostic efficiency of auditory and vestibular disorders in patients of active working age after exposure to stress. Materials and methods: 95 patients of active working age with dizziness, which manifested under stress, and 10 persons of control group were studied. The following tests were performed to all patients: survey with the questionnaire "Comprehensive stress assessment", pure tone and speech audiometry, measurement with filtered speech discrimination tests, assessment of the auditory adaptation level, impedancemetry, registration of auditory brainstem responses (ABR), computed static posturography, vestibular testing. Results and discussion: All subjects were divided into three groups according to the results of the survey with the questionnaire "Comprehensive stress assessment": Group 1 included 21 patients with moderate stress, Group 2 included 35 persons with severe stress that could not be compensated and Group 3 included 39 persons under severe stress, moreover 10 of them were on the verge of exhaustion of adaptive capacities. 60 (63.2 %) patients had normal hearing. 24 (25.2 %) subjects had statistically significant (P <0.05) hearing impairment in the high frequency zone compared with the control group, a statistically significant difference in hearing impairment was detected in the entire frequency range in 11 (11.6 %) persons. Central auditory processing disorders were detected in more than half of patients (according to various tests – from 29 (30.5 %) to 49 (51.6 %) persons). Central vestibular syndrome of varying severity was diagnosed in all 95 patients. The most pronounced disorders of balance according to posturography have been reported in patients with severe stress with vision deprivation in the position with closed eyes. Conclusions: An integrated approach allowed to identify and select, besides traditional research methods, supplementary diagnostic measures for optimal assessment of cochleovestibular changes in patients of active working age after exposure to stress, to detect cochleovestibular disorders and differential topical diagnostics of disorders of the central or peripheral portions of the auditory and vestibular analyzers. These included psychological testing, a test battery to determine central auditory processing disorders – hearing adaptation with load, filtered speech discrimination tests, registration of ABR, registration of postural balance using the Wii Balance Board platform, vestibular testing.

Topicality: Despite the fact that during cochlear implantation can have negative impact on the peripheral part of the vestibular analyzer, in most clinics that perform CI, there is no routine examination of vestibular function in the pre- and postoperative periods. Aim: to study the condition of the peripheral vestibular analyzer in children with sensorineural deafness before and after cochlear implantation through the analysis of quantitative characteristics of the rotational test. Material and methods: The prospective study included 30 children with normal hearing and no vestibular complaints (control group), 34 children with sensorineural deafness, 65 children with sensorineural deafness after unilateral cochlear implantation. All children were tested on a rotatory chair according to the standard method, the average speed of the slow phase of post-rotation nystagmus was determined by stimulation of the left and right labyrinths. Results: In children with sensorineural deafness, labyrinthine areflexia was detected on the right in 17.6% and on the left in 20.6% of cases. Bilateral labyrinthine areflexia was observed in 17.6% of subjects. Vestibular asymmetry was found in 29.4% of cases. In the remote period after unilateral cochlear implantation, labyrinthine function was within normal limits on the right in 38.5%, on the left in 44.6% of children, areflexia of the right labyrinth was detected in 20%, left - in 26.2% of children, bilateral areflexia in 18,5% of subjects, asymmetric impression was found in 30.8% of cases. Labyrinthine areflexia on the implanted ear was recorded in 32.7% after cochlear implantation on the right, a difference statistically significant compared with the group of unimplanted children with sensorineural deafness.