Background: The aim of this study was to evaluate endolymphatic hydrops using the 3T temporal bone magnetic resonance imaging (MRI), performed according to the chosen protocol, and determine whether it could be applied as an objective diagnostic tool for Menière's disease. Methods: 105 participants diagnosed with probable (n = 50) and definite (n = 55) Menière's disease were included in this prospective study at Vilnius University Hospital, Santaros Clinics. Audiometry, vestibular function tests, videonystagmography, and computer posturography were performed before MRI. The 3T MRI with gadolinium contrast was performed to evaluate the endolymphatic hydrops. Imaging protocol consisted of 3D-FLAIR and 3D T2DRIVE sequences. Vestibular endolymphatic sac was interpreted as enlarged if occupied more than 50% of the vestibular area. Results: 78.1% of subjects had abnormal MRI findings other than hydrops, and it was more than 90% (50/55) of patients in the definite MD group (p < 0.001). Changes in caloric test were observed in 63.8% of subjects in general, and in 76.4% of patients with a definite Menière's disease. The side of the endolymphatic hydrops observed on MR imaging corresponded to the clinical diagnosis of the Menière's disease based on the results of audiometry (p < 0.001) and unilateral weakness (p < 0.001). Endolymphatic hydrops on MRI and directional preponderance in caloric test were two independent predictors of the definite Menière's disease. Conclusions: Temporal bone 3T MRI with gadolinium contrast is clinically superior to confirm the diagnosis of Menière's disease. Grade II endolymphatic hydrops on MRI, directional preponderance, and unilateral weakness on caloric test were independent predictors for the definite Menière's disease.

ObjectivesThe aim of this study was to establish the rate variation of sonotubometric measurements using a specific broadband class of signals, the so-called perfect sequences (PSEQ) among healthy adults and to identify an optimal and technically simple test to provoke Eustachian tube (ET) openings.MethodsSonotubometry was performed on 105 healthy adult subjects. Three different consecutive maneuvers were performed for ET opening: dry swallowing, water swallowing (a small [2 mL] and a large [5 mL] water bolus). Values of the amplitude and duration of each measured ET opening were calculated.ResultsA total of 6,300 measurements were performed. Sonotubometric ET openings were detected for all subjects but not for each measurement. In 6,180 of 6,300 measurements (98.1%), objective ET openings were registered. In 11 of 105 subjects (10.5%) at least one sonotubometric ET opening was not detected. The mean ET opening duration time and the mean sound amplitude similar for all performed test and were 270 (SD, ±96) msec, 13.48 (SD, ±6.57) dB.ConclusionSonotubometry based on PSEQ stimuli is a reliable methodology to assess the ET opening function in healthy subjects. Mean ET opening duration time and the mean sound wave amplitude performed similarly in all analysed tests, hence it might be concluded that dry (saliva) and water swallowing are reliable sonotubometric maneuvers and may be used when examining ET opening function. The size of a sip during water swallowing does not affect the sonotubometry result. All maneuvers can be equally used as the optimal test, and water swallow is most comfortable for the subject.

Reikšminiai žodžiai: ausies trimito tyrimai, sonotubometrija, pasunkėjęs kvėpavimas per nosį. Sonotubometrija yra vienas objektyvių ausies trimito ventiliacinės funkcijos tyrimo metodų, kai funkcijai įvertinti naudojamas garsas ir jo intensyvumo pokyčiai atsiveriant ausies trimitui. Darbo tikslas – įvertinti sonotubometrijos tyrimo rezultatus naudojant idealios sekos dažnius asmenims su nosies pertvaros iškrypimu ir pasunkėjusiu kvėpavimu per nosį bei nustatyti veiksnius, galinčius turėti įtakos gaunamiems rezultatams. Ištirta 42 asmenys, kurie gydėsi dėl pasunkėjusio kvėpavimo per nosį, bei 37 sveiki kontrolinės grupės asmenys. Buvo renkama tiriamųjų anamnezė, atliekama otoskopija, rinoskopija, timpanometrija, Valsalvos testas. Nosiaryklės videoendoskopijos metu vertinti nosiaryklės ir ausies trimito angos morfologiniai požymiai, angos atsidarymo kokybė. Sonotubometrijai naudota plačiajuostė radijo signalų sistema (idealios sekos dažniai), 15 sekunžių 71 dB intensyvumo garsas. Mėginiui įvertinti tiriamųjų buvo prašoma ryti seiles 5 kartus. Ausies trimito atsidarymas sonotubometriškai užregistruotas 65,5 proc. tiriamųjų (kontrolinė grupė – 93,2 proc., p &lt; 0,001). Vidutinė ausies trimito atsidarymo trukmė buvo 260 ms (SD ± 151), garso intensyvumo pokytis 10,59 dB (SD ± 4,78). Pasunkėjusio kvėpavimo per nosį ir sveikų asmenų grupėse buvo skirtingų sonotubogramų tipų. Ausies trimito fiksuoto atsidarymo rezultatai buvo blogesni asmenims su pasunkėjusiu kvėpavimu per nosį, stipriai išreikštu nosies pertvaros iškrypimu, apatinių nosies kriauklių edema, taip pat tais atvejais, kai fiksuota nosiaryklės ir ausies trimito ryklinės angos gleivinės edema limfoidinio audinio perteklius.

Conclusion:Theatre staff report an initial challenging learning curve with EES. With time however the theatre team satisfaction levels are higher due to greater awareness and involvement with the surgical procedure.Learning points: The theatre team shows high levels of satisfaction with EES. Objectives: The aim of this study was to establish the rate variation of sonotubometric measurements using a specific broadband class of signals, the so-called perfect sequences (PSEQ) among healthy adults and to identify an optimal and technically simple test to provoke Eustachian tube (ET) openings.Methods: Sonotubometry was performed on 105 healthy adult subjects. Three different consecutive maneuvers were performed for ET opening: dry swallowing , water swallowing (a small (2 ml) and a large (5 ml) water bolus). Values of the amplitude and duration of each measured ET opening were calculated. Results:6,300 measurements were performed. Sonotubometric ET openings were detected for all subjects but not for each measurement. 6,180/6,300 measurements (98.1%) objective ET openings were registered. Mean ET opening duration time and the mean sound amplitude were similar for all performed test and are 270 (SD ± 96) ms, 13.48 (SD ± 6.57) dB.Conclusion: sonotubometry based on PSEQ stimuli is a reliable methodology to assess the Eustachian Tube opening function in healthy subjects. Mean ET opening duration time and the mean sound wave amplitude were similar performing all analysed tests, hence might be concluded, that dry (saliva) and water swallowing are a reliable sonotubometric maneuvers and may be used examining ET opening function. Size of a sip during water swallowing does not affect the sonotubometry result. All maneuvers can be equally used as the optimal maneuver, and we think that water swallow is most comfortable for the subject. The hearing loss in patients with history of Cholesteatoma,have multifarious features that depend either by the damaging disease activity or by the result of the surgery. The majority of them suffer from conductive hearing losses because the ossicles have been destroyed by the disease or surgically removed. The hearing has to be restored, reconstructing the ossicular chain(ossiculoplasty)or, in other cases, with hearingimplants. Frequently patients with previous cholesteatoma, show a mixed hearing loss, due to the aging or toxicity of the disease. A limited number presents a profound deafness, or anacusis due to a cholesteatoma's invasion into the labyrinth or by iatrogenic damage during the surgery. All these outcomes can be corrected with auditory implants inserted either in the middle ear or in the cochlea. Subjects that have CWU and CWD tympanoplasty done and good bone hearing threshold were treated with BONEBRIDGE device in the retro-sigmoid site, in order to avoid any future contamination in case of a disease recurrence or infections in the middle ear. In mixed hearing losses, a Vibrabt Soundbridge system has been preferred to place the FMT over the stapes, if present, or onto the footplate...

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