Objective: We aimed to report audiological and vestibular test results in patients with vestibular migraine (VM ) . We used a retrospective analysis study design in the setting of a tertiary referral neuro-otology center. Patients and methods: Data from 55 patients with the diagnosis of vestibular migraine were enrolled into the study. Comprehensive audiometry, electronystagmography (ENG) and vestibular myogenic evoked potentials (VEMP) were the interventions and main outcome measures were the degree and profi le of hearing loss, speech discrimination, oculomotor gaze, saccades and pursuit abnormalities, as well as the presence of spontaneous, post head-shake and positional nystagmus. We also measured the caloric response peak slow phase velocity, asymmetry, failure of fi xation suppression, and VEMP p12-n23 latency response. Results: Sensorineural hearing loss was present in 71% (39/55) of patients; 53% (29/55) had bilateral symmetrical loss, 9% (5/55) had bilateral asymmetrical loss and 9% (5/55) had unilateral loss. The pattern of hearing loss was fl at in 44% (24/55) of patients, low frequency in 3% (2/55) and high frequency in 24% (13/55). The degree of hearing loss was 10 -25dB HL in 62% (34/55) of patients and Ͼ 25dB HL in 9% (5/55). Word discrimination scores were Ն 90% in 97% (53/55) of patients and Ͻ 90% (84 -88%) in only 3% (2/55) of patients. Abnormal vestibular fi ndings were present in 87% (48/55). Oculomotor saccades, pursuit, and gaze tests were normal in all patients. Abnormal nystagmus was present in 58% (32/55) of patients; 15% (8/55) had spontaneous nystagmus, 31% (17/55) had post head-shake nystagmus, and 36% (20/55) had non-paroxysmal positional nystagmus. None of the patients had benign paroxysmal positional nystagmus. Caloric responses were normal and symmetrical in 57% (31/55) of patients and showed unilateral weakness in 33% (18/55) of patients. No bilateral weakness was present. Caloric hyperactivity (caloric response Ͼ 40 o /s) was present in 10% (6/55) of patients. All patients showed normal fi xation suppression index. VEMP response (p13n23) was present in 66% (33/50) of patients with normal latency and absent in 34% (17/55) of patients. Conclusions: Sixty-two percent (34/55) of the vestibular migraine patients in this study had sensorineural hearing loss ( Ͼ 10 -25dB HL), 58% (32/55) abnormal nystagmus, 10% (6/55) hyperactive caloric response, 33% (18/55) caloric asymmetry and 34% (17/55) absent VEMP. The patients in this study did not have central vestibular abnormalities.

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Background Hearing loss is one of the most common health problems affecting people in the developing countries so our aim of the “Save The Hearing Project” was to combat deafness by training local doctors for ear surgery in order to treat their local patients with low cost as possible. The project was done as ear surgery campaigns in peripheral areas in Egypt, Yemen, and other countries, to train young ENT specialists and to treat patients there. Our plan was put according to the frequency of different causes of deafness as shown by previous surveys. We used the previous local and evidence-based researches to make our protocols of management of different diseases. These protocols were further evaluated during our work. The project has five stages. The first stage included management of sudden sensory neural hearing loss (SSNHL), otitis media with effusion (OME), and local anesthesia for the ear surgery—cartilage tympanoplasty and ossiculoplasty. The second stage included mastoidectomy cholesteatoma surgery and otoendoscopy. The third stage included more advanced surgery as stapedectomy and tympanosclerosis. The fourth stage included combating SNHL mainly through audiology and rehabilitation program, beside referral for cochlear implants to specialized centers. The fifth stage was only a plan for doing stem cell research in management of hearing loss. Results Our teams did about 42 campaigns only and the data of 31 were recorded. There were 259 attendants, 70 had hands on training, and 35 were well trained and became trainers. We did 270 tympanoplasties, 52 mastoidectomies, and cholesteatoma surgery beside 16 operations of stage III. Conclusion Training an ear surgeon is a tedious and long process, but it is at the end very fruitful and useful for the community. Most causes of HL are preventable. We think that our project plan to combat HL is very suitable to be applied in developing countries in Africa and the Middle East.

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