Objective: Compare hearing outcome for vestibular schwannoma patients following stereotactic radiosurgery (SRS) or conservative management. Study Design: Retrospective review. Setting: University Hospital. Patients: Patients with small-or medium-sized sporadic vestibular schwannoma (intracanalicular or with CPA component <2 cm) who were managed conservatively or underwent SRS with available clinical, radiological, and audiometric data from the time of presentation (or just before radiotherapy for the SRS group) and most recent follow-up; with the two sets of data to be compared being at least 3 years apart (minimum follow-up period). Interventions: SRS or observation. Main Outcome Measure: Pure-tone averages, speech discrimination scores, and corresponding hearing classifications. Results: Two hundred forty-seven patients met our inclusion criteria; 140 were managed conservatively with a mean follow-up period of 5.9 AE 1.6 years and 107 underwent SRS with a mean follow-up period of 7.1 AE 1.9 years. There was significant deterioration of hearing measures for both groups; with the SRS group displaying consistently worse measures. SRS patients showed worse mean pure-tone averages and speech discrimination scores decline rates by 2.72 dB/yr and 2.98 %/yr, respectively, when compared with conservatively managed patients. Stratifying patients according to Tokyo's hearing classification revealed that 68.75% of conservatively managed patients who had baseline serviceable hearing preserved their hearing throughout the studied period compared with only 15.38% of the SRS patients. Conclusion: Based on our data we conclude that patients with small-and medium-sized tumors will have a better hearing outcome if managed via an initial conservative approach with radiotherapy reserved for those demonstrating disease progression.

Background. Vitiligo is characterized by the destruction of functional melanocytes in the skin. This destruction can target melanocytes anywhere in the body, in turn affecting the function of the organs in which the affected melanocytes reside. Melanocytes in the skin, uveal tract and ear are similar in their physiology and morphology, and share a common embryological origin. Aim. To study the association of vitiligo with ocular and auditory abnormalities. Methods. This case-control study was carried out on 40 patients with vitiligo and 20 healthy controls (HCs). All patients and HCs underwent auditory examination (otoscopic examination and immittance audiometry to assess middle ear pressure and exclude tympanic membrane perforation; pure tone audiometry to assess peripheral hearing sensitivity; and transient evoked otoacoustic emissions to assess central hearing ability) and standard ocular examination including visual acuity test, slit lamp biomicroscopy and optical coherence tomography. Results. Compared with controls, there was a significantly higher prevalence of hearing loss and ocular abnormalities in patients with vitiligo but no significant difference in visual acuity. Conclusion.Vitiligo is a systemic disease that can be associated with impairment of melanocyte function organs other than the skin, including the eyes and ears. The function of auditory melanocytes is related to the hearing process and thus their destruction could lead to hearing impairment. By contrast, ocular melanocytes do not play a direct role in detection or transfer of visual information, and thus should not affect vision. Vitiligo may be associated with ocular abnormalities and hearing loss.

Introduction:This study aims to compare the binaural interaction component of auditory brainstem response (ABR-BIC) between children with stuttering and normal peers, and to correlate ABR-BIC parameters with stuttering severity instrument -3. Patients and Methods: Twenty Stuttering children, diagnosed according to the criteria of stuttering severity instrument -3, and 20 normal age and gender matched peers were included. Click evoked ABRs were recorded through right monaural, left monaural and binaural stimulation at 80 dBnHL in both study groups. ABR-BIC was calculated as the difference between the binaurally evoked ABR response and the algebraic sum of the left and right monaural responses, and ABR-BIC parameters were measured. Results: ABR-BIC latency and duration were significantly prolonged in the stuttering group compared to the control group, while ABR-BIC amplitude and area under the curve (AUC) were comparable. Also, ABR-BIC amplitude and AUC were significantly correlated with stuttering severity. Conclusion:The results of this study point to impaired timing and reduced overall magnitude of binaural interaction at the brainstem level in stuttering children.

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