Background: The subjective visual vertical (SVV) is a measure of otolith-mediated verticality perception. The aim of this study was to test otolith function using the SVV in patients with posterior canal (PC) benign paroxysmal positional vertigo (BPPV) before and after Epley’s Canalith repositioning maneuver (CRM). Methodology: This study included 20 PC BPPV patients and 20 healthy control subjects. SVV was tested using special equipment, at the time of BPPV diagnosis, then after CRM, and then 1 week after the resolution of vertigo and nystagmus. SVV was determined from clockwise (CW) and counter-clockwise (CCW) directions. The absolute average and the conventional numerical average was calculated. Results: Using the conventional method, there was no statistically significant difference between BPPV and their controls regarding either the CW or the CCW-SVV or the average slope. There was no statistically significant difference between CW and CCW-SVV in the patients. There was no statistically significant difference in the mean SVV values or the distribution of normal and abnormal results or the distribution of the SVV tilt between both-sided BPPV. Using the absolute average, SVV tilt was significantly higher in the patients than the controls. The preset angle affected the result. The mean SVV was significantly lower after resolution of BPPV than before treatment. Conclusion: Absolute SVV average was more accurate than numerical SVV average. There was a reduction of the SVV tilt after the CRM in BPPV patients. So, the SVV test can be used as a prognostic test for BPPV improvement after treatment.

Background: Auditory steady-state responses (ASSRs) are periodic scalp potentials that arise in response to auditory stimuli. Narrow-band (NB) CE-Chirps stimuli have been developed to combine the advantages of compensation for the cochlear traveling wave delay and frequency specificity. Objectives: To measure the hearing threshold objectively using ASSR in adults with normal behavioural hearing thresholds and adult patients with different degrees of sensorineural hearing loss (SNHL) and its comparison to the behavioural thresholds. Methods: In the present study, 35 subjects (70 ears) were enrolled. Ears were grouped according to the level of hearing obtained by pure tone audiometry (PTA) into 7 equal groups. NB-CE-Chirp ASSR was done for all groups by means of auditory-evoked potential device. Results: The estimated ASSR audiograms configuration matched the behavioural curves. ASSR was equally accurate at all frequencies tested except for 1 kHz in the normal-hearing group who showed less accuracy compared to 500 and 4000 Hz in air conduction (AC) and in bone conduction (BC). Although the AC estimation was not equal among the different degrees of hearing compared to the BC estimation, the AC PTA-ASSR thresholds difference range was small. BC PTA-ASSR threshold difference was statistically significantly less than AC at all tested degrees of hearing loss, in most of the frequencies; which reflects that the ASSR was more accurate in estimating BC than the AC thresholds. There was a negative correlation regarding behavioural BC PTA thresholds with PTA-ASSR threshold difference and PTA-estimated audiograms threshold difference at all tested frequencies. Conclusion: ASSR using either AC or BC NB-CE-Chirp is a reliable objective method in estimating the behavioural threshold in normal hearers and patients with various degrees of SNHL, so it can be used in difficult-to-test cases where accurate behavioural thresholds could not be obtained.

Background: In benign paroxysmal positional vertigo (BPPV), the otoconia are dislodged from their usual position within the utricle and migrated into one of the semicircular canals. Utricular dysfunction in BPPV has been reported. Residual dizziness (RD) is common after the treatment. Objective: To assess the utricular function in patients with posterior canal BPPV after canalith repositioning maneuver (CRM) using ocular vestibular evoked myogenic potential (oVEMP) and to correlate the findings with any RD after CRM. Methods: Thirty adult patients with posterior canal BPPV (6 males and 24 females) were compared to well-matched controls. The oVEMP and Dizziness Handicap Inventory (DHI) Questionnaire were administrated before and after successful CRM. Results: Before CRM, the affected ear showed a significant delay in latency of N1 in the affected ear oVEMP and a significantly decreased in N1–P1 amplitude compared to controls and to the non-affected ears. After CRM their amplitudes were comparable. The BPPV group had a greater interaural amplitude difference percent (IAAD%) compared to controls before and after CRM. The non-affected ear showed only decrease in N1–P1 amplitude compared to controls. After CRM the affected ear amplitude increased and became comparable to the controls. The IAAD% was larger in RD group than non-RD group before and after CRM. The dizziness handicap severity decreased after CRM. But the occurrence of RD could not be predicted from DHI scores. Conclusion: Utricular function measured by oVEMP in the affected ear improved after CRM, and contralateral ear showed sub-clinical affection. Persistent VEMP abnormality reflecting persistent utricular dysfunction was related to residual dizziness.

Background: Vitiligo is a common chronic disease of pigmentation, which may be accompanied by audiological abnormalities. Material and methods:The aim of this study was to assess vitiligo patients in terms of hearing thresholds using conventional pure tone audiometry (0.25 to 8 kHz), high frequency pure tone audiometry (10 and 12.5 kHz), as well as Transient Evoked Otoacoustic Emissions (TEOAEs). We correlated the audiometric findings with vitiligo duration and severity. The study included 75 subjects with a mean age of 29.7 ± 8.6 years. There were 50 vitiligo patients and 25 age and gender matched healthy controls who had never had any audiological condition or exposed to excessive noise.Results: Only 24% of vitiligo patients had high frequency sensorineural hearing loss (SNHL) using conventional audiometry and the majority (76%) had bilaterally normal hearing. The majority (90%) of vitiligo patients had SNHL in extended high frequency audiometry. There was a statistically significant difference between the cases and controls regarding TEOAE SNR at 5 kHz, and nearly half of the normal hearers had an abnormal TEOAE. Vitiligo patients were found to have subclinical inner ear dysfunction compared with the controls. There was a statistically significant correlation between PTA and age of the patients but not with vitiligo duration or severity. Conclusions:The audiometric findings of the vitiligo group and the statistically significant differences from the control group suggest a subclinical involvement of the cochlea, probably related to the vitiligo condition, but not affected by vitiligo duration or severity. We therefore recommend the use of extended high frequency audiometry and otoacoustic emission tests for early detection of inner ear involvement in vitiligo.

EnAbstract Participants and methods This study included 20 dizzy children, who were compared with 10 healthy children, aged 6–12 years. Assessment of history taking was carried out using an Arabic dizziness questionnaire, for which a scoring system was designed to include a thorough evaluation of the different systems involved in balance control; a comparison with the results of referral was carried out. Objective To categorize the causes of dizziness into diagnostic categories and to determine the ability of the scoring system to direct to a certain referral for diagnosing the cause of dizziness. Results The questionnaire’s diagnostic categories matched the diagnosis on referral in 75% of cases. Its sensitivity in diagnosing vestibular category was 88.89%. The scoring was applied to the present history, but relevant data in the past medical and family histories were taken into consideration. Conclusion The questionnaire seems to be a reasonable anamnesis for use in training, with a scoring system that can categorize dizzy children by the system/systems affected. It provides questions that a trainee needs to be considering when managing balance disorders in the clinic.