-
A Case of Sensorineural Hearing Loss and Vertigo during Epidural Nerve Block
-
Byeong Min Lee, Jin hong Noh, Seong Ki Ahn, Hyun Woo Park
-
Res Vestib Sci. 2018;17(4):170-174. Published online December 21, 2018
-
DOI: https://doi.org/10.21790/rvs.2018.17.4.170
-
-
 Abstract
 PDF
- Epidural anesthesia has significantly advanced in neuraxial anesthesia and analgesia. It is used for surgical anaesthesia and treatment of chronic pain. Hearing loss during or after epidural anesthesia is rare, and it is known to occur by the change of the intracranial pressure. Cerebrospinal fluid is connected with perilymph in the cochlear and vestibule that is important to hearing and balance. If the intracranial pressure is abruptly transferred to the inner ear, perilymph can be leak, that called perilymphatic fistula, dizziness, and hearing loss can occur suddenly. We report a 65-year-old woman who presented with acute onset dizziness and hearing loss during the epidural nerve block for back pain, wherein we speculated a possibility of perilymphatic fistula as the mechanism of hearing loss and dizziness. The mechanism of dizziness and hearing loss was suspected with perilymphatic fistula.
-
Incidence of Progression into Ménière Disease from Idiopathic Sudden Sensorineural Hearing Loss: Midterm Follow-up Study
-
Byeong Min Lee, Jin Hyun Seo, Hyun Woo Park, Hyun Jin Lee, Dong Gu Hur, Seong Ki Ahn
-
Res Vestib Sci. 2018;17(3):95-101. Published online September 18, 2018
-
DOI: https://doi.org/10.21790/rvs.2018.17.3.95
-
-
Abstract
PDF
- Objectives
Ménière disease is a clinical syndrome characterized by the four major symptoms of episodic vertigo, sensorineural hearing loss, tinnitus, and aural fullness. Sensorineural hearing loss, especially low frequency, is the characteristic type of audiogram in Ménière's disease. However, it is difficult to distinguish idiopathic sudden sensorineural hearing loss (ISSNHL) with vertigo from the first attack of Ménière disease. The purpose of this study was to investigate the incidence of progression into Ménière Disease from low frequency ISSNHL.
Methods
Two hundred eighty-three patients were included in this study. We classified the patients with ISSNHL according to the hearing loss in audiogram and analyzed how many of them actually progressed to Ménière disease based on diagnosis criteria.
Results
Among the 240 patients, 37.1% (89 patients) were confirmed low frequency ISSNHL and 14.6% (13 patients) of them were diagnosed with Meniere disease.
Conclusions
This study showed that the progression from low frequency ISSNHL to Ménière disease was higher than other frequency ISSNHL, as in other studies.
-
A case of sensorineural hearing loss and vertigo during epidural nerve block
-
Byeong min Lee, Jin hong Noh, Seong ki Ahn, Hyun woo Park
-
Received October 11, 2018 Accepted December 4, 2018 Published online December 4, 2018
-
[Accepted]
-
-
Abstract
- Epidural anesthesia has significantly advanced in neuraxial anesthesia and analgesia. It is used for surgical anaesthesia and treatment of chronic pain. Hearing loss during or after epidural anesthesia is rare, and it is known to occur by the change of the intracranial pressure. Cerebrospinal fluid is connected with perilymph in the cochlear and vestibule that is important to hearing and balance. If the intracranial pressure is abruptly transferred to the inner ear, perilymph can be leak, that called perilymphatic fistula, dizziness and hearing loss can occur suddenly. We report a 65-year-old women who presented with acute onset dizziness and hearing loss during the epidural nerve block for back pain, wherein we speculated a possibility of perilymphatic fistula as the mechanism of hearing loss and dizziness. The mechanism of dizziness and hearing loss was suspected with perilymphatic fistula.
-
Long-Term Results of CyberKnife Radiosurgery for Vestibular Schwannoma
-
Ho Joong Lee, Chae Dong Yim, Hyun Woo Park, Dong Gu Hur, Ho Jin Jeong, Seong-Ki Ahn
-
Res Vestib Sci. 2017;16(1):23-28. Published online March 15, 2017
-
DOI: https://doi.org/10.21790/rvs.2017.16.1.23
-
-
Abstract
PDF
- Objective: Since the 2000s, CyberKnife radiosurgery (CKRS) is either a primary or an adjunct management approach used to treat patients with vestibular schwannoma (VS). The goals of CKRS are prevention of tumor growth, preservation of cranial nerve function and prevention of new neurologic deficiencies. The aim of this study was to assess the efficacy and safety of CKRS, in terms of tumor control, hearing preservation, and complications.
Methods
Forty patients with VS underwent CKRS as a treatment modality for from January 2010 to February 2016. The long term results of 32 patients were evaluated who received CKRS as primary treatment. 8 patients presented with previously performed surgical resection. Information related to clinical history, Brain MRI and outcomes of patients with VS collected retrospectively by reviewing patient’s chart and telephone survey.
Results
The mean tumor volume was 3.3 cm3 and the mean follow-up was 41 months. The most recent follow-up showed that tumor size decreased in 17 patients (42.5%), displayed no change in 19 patients (47.5%), and increased in 4 patients (10%). Progression-free survival rates after CKRS at 1, 3, and 5 years were 95%, 90%, and 90%. After CKRS, 13 patients experienced hearing degradation. The overall rate of preservation of serviceable hearing at the long-term follow-up was 60%. Vertigo, ataxia, and headache were improved after CKRS compared with pretreated status. But, facial weakness, trigeminal nerve neuropathy, and tinnitus were worsen.
Conclusion
CKRS provide an excellent tumor control rate and a comparable hearing preservation rate in VS patients. Also CKRS is associated with low rate of cranial neuropathy, other complications.
-
Multicenter Randomized Study on the Efficacy of Isosorbide in Patients with Mèniére's Disease
-
Hyun Woo Park, Won Ho Chung, Sung Huhn Kim, Kyu Sung Kim, Jong Woo Chung, Sung Won Chae, Ja Won Koo, Bo Gyung Kim, Eui Kyung Goh, Gyu Cheol Han
-
Res Vestib Sci. 2016;15(2):44-50. Published online June 15, 2016
-
-
-
Abstract
PDF
- Objective: Mèniére's disease is one of the most common causes of episodic vestibular syndrome that shows symptom complexes of recurrent vertigo, hearing loss, tinnitus and ear fullness. Isosorbide (Isobide) is a osmotic diuretics which has been used for Meniere's disease to reduce the endolymphatic pressure. The purpose of this study was to evaluate the efficacy of isosorbide in the treatment of Mèniére's disease by comparing the combined therapy of isosorbide and betahistine (Meniace) to betahistine only.
Methods
Among 220 patients enrolled with Mèniére's disease from 9 centers, 187 patients completed this clinical study. Patients were randomly subjected either to betahistine alone therapy at dose of 6 mg three times a day (n=97) or to combined therapy with isosorbide (dose of 30 mL three times a day) and betahistine (n=90) for 12 weeks. Two groups were compared at 4 and 12 weeks after treatment on frequency of vertigo, hearing level (pure tone audiometry, speech audiometry), electocochleography (ECoG), tinnitus (Tinnitus Handicap Inventory, THI) and quality of life (Korean functional level scale, Korean dizziness handicap inventory).
Results
During first 4 weeks after treatment, the frequency of vertigo was not reduced in either betahistine alone therapy group or combined therapy group. However, between 8 and 12 weeks, the frequency of vertigo was significantly reduced in either group, and in the combined group frequency of vertigo was more significantly reduced than in the betahistine alone therapy group (p=0.041). The hearing level, ECoG, tinnitus and quality of life was not significantly different between two groups.
Conclusion
Isosorbide and betahistine combined therapy were more effective for vertigo control than betahistine alone therapy. Isosorbide is an effective diuretic in vertigo control in definite Mèniére's disease.
|
KBS
