Bibliographic identification IŠTOKOVÁ, Lucie. The influence of cochlear implant on vestibular function in adult patients. Prague: Charles University, 2nd Faculty of Medicine, Department of Rehabilitation and Sports Medicine, 2020. 58 p., Appendices. Thesis supervisor Mgr. Klára Kučerová. Abstract Severe hearing loss is standardly treated by cochlear implantation. Considering the anatomical proximity and interconnection to the vestibulocochlear nerve, it is possible to influence vestibular functions. The aim of this diploma thesis is to evaluate the effect of unilateral cochlear implantation on postural stability and vestibular function in adult patients with severe hearing loss caused postlingually. Eleven patients aged 28-72 were examined the day before surgery, the day after surgery, and on average 25 days after surgery. The evaluation consisted of short-form Dizziness Handicap Inventory (DHI), Timed Up and Go testing (TUG), static stabilometry and the perception of the subjective visual vertical (SVV) static and dynamic. Significant deterioration of TUG and SVV was recorded particularly immediately after surgery. In dynamic SVV, especially, when the field of view rotated to the left. Considerable results in stabilometry were only when standing on a hard surface with eyes closed. Improvements in TUG, SVV...

The Epidemiology of Hearing Loss Study (EHLS) conducted in Beaver Dam, Wisconsin, was a population-based study that focused on the prevalence of hearing loss among 3,753 participants between 1993 and 1995. This article reports the results of several auditory measures from 999 veteran and 590 nonveteran males 48 to 92 years of age included in the EHLS. The auditory measures included pure tone thresholds, tympanometry and acoustic reflexes, word recognition in quiet and in competing message, and the Hearing Handicap Inventory for the Elderly-Screening (HHIE-S) version. Hearing loss in the auditory domains of pure tone thresholds, word recognition in quiet, and word recognition in competing message increased with age but were not significantly different for the veterans and nonveterans. No significant differences were found between participant groups on the HHIE-S; however, regarding hearing aid usage, mixed differences were found.

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Dizziness and other vestibular symptoms affect around five percent of the general population. As one grows older the risk for dizziness increases and the symptoms become more severe and frequent. Studies have shown that digital tools can be used effectively when treating these symptoms. By developing and implementing digital tools in healthcare, the effectiveness in healthcare can be improved and the work for healthcare professionals facilitated. YrselTräning is an application developed to help patients with rehabilitation of acute dizziness. The aim of this study was to evaluate the usability of the application. We wanted to investigate how the usability of the prototype for the acute dizziness application can be improved based on users tests, cognitive theories and design principles. Five participants, two males and three females in the ages of 50-65, participated in the study. Qualitative data was obtained by conducting semi-structured interviews with direct observations, where the participants were asked to use the think-aloud-method. Quantitative data was collected with the lite version of the likert scale Usability metric for user experience (UMUX-LITE). The results showed that YrselTräning is an application with relatively good usability. The main concerns were regarding a lack of, or unclear instructions and feedback. A new design of the application was created that for example included added functions and modified instructions to improve the usability. Further research is required to evaluate and improve the new design of the application. / Yrsel och andra vestibulära symptom drabbar ungefär fem procent av populationen. Med åldern ökar risken för yrsel och symptomen förvärras och sker mer frekvent. Studier har visat att vestibulära symptom kan behandlas på ett effektivt sätt med hjälp av digitala verktyg. Genom att utveckla och implementera digitala verktyg i sjukvården, kan effektiviteten inom vården förbättras och arbetet för vårdpersonal förenklas. YrselTräning är en applikation utvecklad för att hjälpa patienter med rehabilitering av akut yrsel. Syftet med denna studie var att utvärdera användbarheten av applikationen. Det vi avsåg att undersöka var hur användarvänligheten av en prototyp av applikationen för akut yrsel kan förbättras baserat på användartester, kognitiva teorier och designprinciper. Fem deltagare, två män och tre kvinnor i åldrarna 50-65 deltog i studien. Kvalitativ data samlades in via semistrukturerade intervjuer med direkta observationer där deltagarna uppmanades att använda sig av tänka-högt-metoden. Kvantitativ data samlades in via en lite version av en likertskala, Usability metric for user experience (UMUX-LITE). Resultatet visade att YrselTräning är en relativt användarvänlig applikation. De huvudsakliga problemen gällde brist på och otydliga instruktioner samt feedback. Ett nytt designförslag skapades där till exempel nya funktioner implementeras och instruktioner modifierades för att förbättra användarvänligheten. Vidare forskning behövs för att utvärdera och förbättra det nya designförslaget av applikationen.

Le vertige (V), l'étourdissement (E) et l'instabilité (I) sont des symptômes fréquents, traditionnellement considérés comme ayant des étiologies vestibulaires et extra-vestibulaires différentes. La prévalence de chaque symptôme et la manière dont ils sont liés entre eux ainsi qu'avec la migraine, l'agoraphobie, la susceptibilité au mal des transports (SMT), le malaise vagal (MV), l'anxiété/dépression (AD) et la prise de médicaments, ont été l'objet de cette étude. Un questionnaire auto-administré a été complété par 2897 adultes de la population lorraine, âgés de 18 à 86 ans, dont 1471 femmes. La prévalence sur un an du V était de 48,3%, celle de l'I de 39,1% et celle de l'E de 35,6%. Les VEI étaient corrélés entre eux et apparaissaient en général en diverses combinaisons (69,4%) ; 90% des épisodes de VEI avaient une durée inférieure ou égale à 2 mn et une fréquence < 1/mois. Les trois symptômes étaient similaires concernant leur prédominance féminine, le profil temporaire des épisodes et le lien avec les chutes et les nausées. Les VEI augmentaient avec le nombre de médicaments indépendamment de l'âge. Chaque VEI était corrélé avec chaque co-morbidité. Les facteurs de risque étaient pour l'agoraphobie : AD>sexe féminin>VEI, pour la SMT : sexe féminin > AD > migraine. En ajustant sur les trois VEI entre eux, le V reste un facteur de risque significatif pour chaque co-morbidité, suggérant que le V est un symptôme aussi peu spécifique que les deux autres et que les VEI représentent un spectre de symptômes résultant de diverses causes / Vertigo (V), dizziness (D) and unsteadiness (U) are common symptoms traditionally considered to result from different kinds of vestibular and non-vestibular dysfunctions. The prevalence of each symptom and how they relate to each other and to migraine, agoraphobia, motion sickness susceptibility (MSS), vaso-vagal episodes (VVE) and anxiety-depression (AD) was the object of this population-based study in north-eastern France. A self-administered questionnaire was returned by 2987 adults (age span 18-86 years, 1471 women). The 1-year prevalence for V was 48.3%, for U 39.1% and for D 35.6%. The VDU symptoms were correlated with each other, occurred mostly (69.4%) in various combinations rather than in isolation, less than once per month, and 90% of episodes lasted < or = 2 minutes and occurred < 1/month. The three symptoms were similar in terms of female predominance, temporary profile of the episodes and their link to falls and nausea. Symptom associations including I and symptom episodes of >1 hour increased the risk of falls. The number of drugs taken increased VDU even when controlling for age. Each VDU symptom was correlated with each co-morbidity. The risk factors were for agoraphobia: AD>female gender>VDU; for MSS: female gender>AD>migraine. Logistic regressions controlling for each vestibular symptom showed that V correlated with each co-morbidity, suggesting that V is a symptom as unspecific as the other two and that the three symptoms represent a spectrum resulting from a range of mechanisms or disorders

INTRODUÇÃO: O consumo mundial de açúcar triplicou nos últimos 50 anos e a sua ingesta abusiva é responsável pela resistência periférica à insulina, que origina a síndrome metabólica - obesidade, diabetes melito, hipertensão arterial e doenças coronarianas . Motivados pelo elevado número de pacientes que nos procuram com queixas vestibulares associadas aos distúrbios de metabolismo da glicose (DMG) resolvemos avaliar de forma objetiva, a influência dos DMG nas disfunções labirínticas e o efeito da dieta restritiva de carboidratos como forma de tratamento. OBJETIVO: Observar o impacto da dieta fracionada e restritiva de carboidratos na qualidade de vida dos pacientes portadores de distúrbios do equilíbrio corporal e DMG por meio da posturografia dinâmica computadorizada (PDC), do disability index (DI) e da escala análogo-visual (EAV). CASUÍSTICA E METODOLOGIA: Este estudo foi desenhado como um ensaio clínico prospectivo controlado randomizado realizado no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. A amostra foi constituída de 51 pacientes divididos em dois grupos: Grupo Dieta (GD): indivíduos tratados com comprimidos de placebo e dieta fracionada com restrição de glicose, Grupo Controle (GC): receberam apenas placebo. Os pacientes realizaram PDC, DI e EAV no primeiro e trigésimo dias do estudo. RESULTADOS: A amostra mostrou-se homogêna quando comparados os grupos e observou-se melhora, estatísticamente comprovada nas condições posturográficas avaliadas quando comparados GD e GC. Observou-se ainda melhora clínica do GD na análise da EAV. CONCLUSÃO: A dieta fracionada e restritiva de carboidratos mostrou-se eficaz no tratamento da nossa amostra de pacientes portadores de disfunções vestibulares associadas a DMG. / INTRODUCTION: World sugar consumption has tripled in the last 50 years and its abusive ingestion is responsible for peripheral insulin resistance, which leads to metabolic syndrome - obesity, diabetes mellitus, hypertension and coronary heart disease. Because of the high number of patients with vestibular complaints and with glucose metabolism disorders (GMD) we decided to objectively evaluate the effect of glucose restrictive and fractionated diet as a option of treatment in these patients. OBJECTIVE: To evaluate the impact of the glucose restrictive and fractionated diet on the Computerized Dynamic Posturography (CDP), disability index (DI) and the visual analogue scale (VAS) in patients with balance disorders and disorders of glucose metabolism. SAMPLES AND METHODOLOGY: Randomized controlled trial. Sample of 51 patients divided into two groups: Diet Group (DG) treated with placebo pills and glucose restrictive and fractionated diet and Control Group (CG) with only placebo. The individuals performed CDP, DI and VAS at first and thirtieth days of study. RESULTS: The sample groups were homogeneous before the study. There were significant improvement of DG on CDP conditions 4, 5, 6 and composite score. There was, also, significant improvement of VAS analysis on DG after intervention. CONCLUSION: The glucose restrictive and fractionated diet was effective in the treatment of patients with vestibular dysfunction associated with glucose metabolism disorders

Purpose: The purpose of this study was to evaluate the effectiveness of triaging patients with motion-provoked dizziness into a benign paroxysmal positional vertigo (BPPV) clinic. Method: A retrospective chart review was performed of veterans who were tested and treated for BPPV in a triaged BPPV clinic and veterans who were tested and treated for BPPV in a traditional vestibular clinic. Results: The BPPV triage clinic had a hit rate of 39%. On average, the triaged BPPV clinic reduced patient wait times by 23 days relative to the wait times for the traditional vestibular clinic while also reducing patient costs. Conclusion: Triaging patients with BPPV is one method to improve access to evaluation and treatment and a mechanism for the effective use of clinic time and resources.

Young adults are more likely to suffer blast injury and traumatic brain injury (TBI) than other age groups. This article reviews the literature on the vestibular consequences of blast exposure and TBI and concussion. In addition, the vestibular test findings obtained from 31 veterans with a history of blast exposure and/or mild TBI are presented. The authors discuss loss of horizontal semicircular canal function and postural instability related to head injury. Preliminary data suggest the novel theory that otolith organs are uniquely vulnerable to head injury and blast exposure.

Vestibular evoked myogenic potentials (VEMPs) are short-latency electromyograms evoked by high-level acoustic stimuli recorded from surface electrodes over the tonically contracted sternocleidomastoid (SCM) muscle. These responses are presumed to originate in the saccule. The purpose of this preliminary report is to provide an overview of our initial experience with the VEMP by describing the responses obtained in five subjects. Click-evoked VEMPs were present at short latencies in two normal-hearing subjects, one patient with profound congenital sensorineural hearing loss, and one patient with a severe sensorineural hearing loss due to Meniere's disease. Additionally, VEMPs were absent in a patient with profound sensorineural hearing loss following removal of a cerebellopontine angle tumor. The amplitude of the VEMP was influenced by the amount of background activity of the SCM muscle, stimulus level, and stimulus frequency. Tone-burst evoked responses showed an inverse relationship between stimulus frequency and response latency. VEMPs may prove to be a reliable technique in the clinical assessment of vestibular function.

INTRODUÇÃO: O consumo mundial de açúcar triplicou nos últimos 50 anos e a sua ingesta abusiva é responsável pela resistência periférica à insulina, que origina a síndrome metabólica - obesidade, diabetes melito, hipertensão arterial e doenças coronarianas . Motivados pelo elevado número de pacientes que nos procuram com queixas vestibulares associadas aos distúrbios de metabolismo da glicose (DMG) resolvemos avaliar de forma objetiva, a influência dos DMG nas disfunções labirínticas e o efeito da dieta restritiva de carboidratos como forma de tratamento. OBJETIVO: Observar o impacto da dieta fracionada e restritiva de carboidratos na qualidade de vida dos pacientes portadores de distúrbios do equilíbrio corporal e DMG por meio da posturografia dinâmica computadorizada (PDC), do disability index (DI) e da escala análogo-visual (EAV). CASUÍSTICA E METODOLOGIA: Este estudo foi desenhado como um ensaio clínico prospectivo controlado randomizado realizado no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. A amostra foi constituída de 51 pacientes divididos em dois grupos: Grupo Dieta (GD): indivíduos tratados com comprimidos de placebo e dieta fracionada com restrição de glicose, Grupo Controle (GC): receberam apenas placebo. Os pacientes realizaram PDC, DI e EAV no primeiro e trigésimo dias do estudo. RESULTADOS: A amostra mostrou-se homogêna quando comparados os grupos e observou-se melhora, estatísticamente comprovada nas condições posturográficas avaliadas quando comparados GD e GC. Observou-se ainda melhora clínica do GD na análise da EAV. CONCLUSÃO: A dieta fracionada e restritiva de carboidratos mostrou-se eficaz no tratamento da nossa amostra de pacientes portadores de disfunções vestibulares associadas a DMG. / INTRODUCTION: World sugar consumption has tripled in the last 50 years and its abusive ingestion is responsible for peripheral insulin resistance, which leads to metabolic syndrome - obesity, diabetes mellitus, hypertension and coronary heart disease. Because of the high number of patients with vestibular complaints and with glucose metabolism disorders (GMD) we decided to objectively evaluate the effect of glucose restrictive and fractionated diet as a option of treatment in these patients. OBJECTIVE: To evaluate the impact of the glucose restrictive and fractionated diet on the Computerized Dynamic Posturography (CDP), disability index (DI) and the visual analogue scale (VAS) in patients with balance disorders and disorders of glucose metabolism. SAMPLES AND METHODOLOGY: Randomized controlled trial. Sample of 51 patients divided into two groups: Diet Group (DG) treated with placebo pills and glucose restrictive and fractionated diet and Control Group (CG) with only placebo. The individuals performed CDP, DI and VAS at first and thirtieth days of study. RESULTS: The sample groups were homogeneous before the study. There were significant improvement of DG on CDP conditions 4, 5, 6 and composite score. There was, also, significant improvement of VAS analysis on DG after intervention. CONCLUSION: The glucose restrictive and fractionated diet was effective in the treatment of patients with vestibular dysfunction associated with glucose metabolism disorders