Objectives: Persistent postural-perceptual dizziness (PPPD) represents an important category of vertigo. Medical treatment and psychotherapy provide convenient control of symptoms. However, these management strategies can have inconvenient side effects and short-term relief, respectively. Vestibular rehabilitation therapy (VRT) is a self-conducted habituation program that can be personalized to the subject’s needs to give adequate symptom relief without side effects. The present study aims to test the effect of VRT on patients with PPPD. Methods: Participants were diagnosed as having PPPD by the exclusion of organic vestibular lesions. The study involved 2 groups with PPPD: Group I, treated with the VRT, and Group II, treated with the VRT plus placebo. The Dizziness Handicap Inventory (DHI), a self-assessment scale, was used to evaluate the VRT outcomes. Results: There was a significant decrease in functional, physical, and total scores on the DHI in both groups after VRT. Adding the placebo did not have supplementary outcomes. The patients who did not benefit from the VRT had a significantly longer duration of PPPD, more complex aggravating factors, more composite VRT exercises, and a higher DHI score than the patients who benefited from VRT. Conclusions: Customized VRT adequately reduced symptoms and improved quality of life in subjects with PPPD.

Introduction Cochlear or neural mechanisms of tinnitus generation may affect auditory temporal resolution in tinnitus patients even with normal audiometry. Thus, studying the correlation between tinnitus characteristics and auditory temporal resolution in subjects with tinnitus may help in proper modification of tinnitus management strategy. Objective This study aims to examine the relationship between the psychoacoustic measures of tinnitus and the auditory temporal resolution in subjects with normal audiometry. Methods Two normal hearing groups with ages ranging from 20 to 45 years were involved: control group of 15 adults (30 ears) without tinnitus and study group of 15 adults (24 ears) with tinnitus. Subjective scaling of annoyance and sleep disturbance caused by tinnitus, basic audiological evaluation, tinnitus psychoacoustic measures and Gaps in Noise test were performed. Data from both groups were compared using independent sample t-test. Psychoacoustic measures of tinnitus and Gaps in Noise test parameters of the tinnitus group were correlated with Pearson's correlation coefficient. Results Significantly higher hearing threshold, higher approximate threshold and lower correct Gaps in Noise scores were observed in tinnitus ears. There was no significant correlation between psychoacoustic measures of tinnitus and Gaps in Noise test parameters of the tinnitus group. Conclusion Auditory temporal resolution impairment was found in tinnitus patients, which could be attributed to cochlear impairment or altered neural firing within the auditory pathway. It is recommended to include temporal resolution testing in the tinnitus evaluation battery to provide a proper management planning.

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Objective: The present study aimed to describe and compare the vestibular profile of a random sample of patients with type 1 and type 2 diabetes mellitus (DM). Study design: Forty-five adult patients with DM were divided into three groups; group I: type 1 DM (n = 15), group II: type 2 DM treated with oral hypoglycaemic (n = 15), and group III: type 2 DM treated with insulin (n = 15). Diagnosis of vestibular disorders based on detailed history, Dizziness Handicap Inventory, clinical, and laboratory vestibular evaluation using videonystagmography test battery, electrocochleography, and cervical vestibular-evoked myogenic potential test. The study addressed the vestibular test results of the three diabetic groups and compared them. It also clarified the effect of different diabetic characteristics (clinical and laboratory) on the outcome of vestibular testing. Results: Vestibular disorders prevalence of 64.4% was estimated in diabetic patients with a higher prevalence was found in diabetic group III (86.7%) followed by group I (66.7%) then group II (40%). Vestibular function was significantly impaired in the insulin controlled DM compared to the orally controlled, and in the dizziness complainers compared to the non-complainers. Conclusions: A relatively high prevalence of vestibular dysfunctions were detected in DM. Diabetic patients treated with insulin, mainly those with type 2 DM, exhibited more involvement of the vestibular system owing to the long standing hyperglycemia with subsequent degenerative insults, microvascular lesions, and electrolyte imbalance. These changes could happen longtime prior to the onset of vestibular manifestations. Thus, early and routine vestibular assessment in diabetic patients is recommended even in absence of dizziness.