A correct diagnosis is essential to ensure adequate treatment and attain an acceptable balance between cost and effectiveness.

Only a few studies have investigated vestibular function in diabetes mellitus (DM), showing contradictory results. We have performed an electronystagmographic (ENG) evaluation of 46 individuals with type I DM and 37 healthy controls. No patient reported subjective vestibular symptoms. Duration of caloric-induced nystagmus (DN) was significantly lower (2.1 ± 0.7 vs. 2.6 ± 0.4 min, p < 0.01), and central nystagmus frequency of caloric response also nonsignificantly tended to be decreased (37.4 ± 16.5 vs. 41.7 ± 12.7 beats/30 s, p = 0.21) in DM patients, as compared to controls. The latter comparison achieved significance after exclusion of newly diagnosed diabetic patients (33.4 ± 16.1 vs. 41.6 ± 12.7 beats/s, p < 0.05). Depressed caloric reactions were seen in 21.8% of patients. DN was lower in patients with microalbuminuria and retinopathy, but this was not observed after exclusion of newly diagnosed diabetic patients, all of whom had normal ENG responses and no chronic diabetic complications. The existence of a lower DN and central nystagmus frequency should be borne in mind when interpreting ENG tracings in patients with long duration type I diabetes mellitus.

No abstract

The results of the audiological evaluation of 47 diabetics are presented. The patients were divided into two groups: A (17/47), type I early diabetics, and B (30/47), type I chronic diabetics. The evaluation included puretone audiometry, high-frequency audiometry and auditory brainstem response. There was a control group consisting of 30 healthy subjects. In group 1 the audiological assessment was normal in all cases. In group 2 hearing loss was found in 30% of cases (9/30). Hearing loss was significantly correlated with age (p = 0.0019) and duration of diabetes (p = 0.0143), but not with diabetic microangiopathy (p = 0.1506). The authors conclude that hearing loss is not a usual feature in diabetic patients. When present, hearing loss should be attributed to the effect of diabetes on the age-related physiological impairment of the inner ear. The pathogenic mechanisms remain obscure.

A study has been carried out to assess the mucociliary function of nasal mucosa in 30 patients: 16 had undergone surgery due to larynx malignancy and the remaining 14 were divided in two groups. The first group was composed of seven patients suffering from larynx cancer but not operated, and the second group of seven had pathology not related to the airways (control group). The method used a 99mtechnetium sulphur colloid drop deposited on the nasal mucosa of one nostril. To calculate the rate of transport, a new method of quantification has been introduced, based on the formation of a parametric image. The mean velocity in laryngectomees was 3.6 mm/min (range 1.1-6.4). It was compared with the group of 14 patients without tracheostomy (mean 5.3, range 3.3-8.2). An impaired Student's-t-test gave a significant difference between both groups (P less than 0.005). The comparison between patients with nonoperated larynx cancer and normals gave a nonsignificant difference. The 16 operated patients were arbitrarily divided into two groups as per the time elapsed from laryngectomy; seven were studied within the first 3 years of operation and seven other patients after this term. The comparison between them was not significant.