Audiological Medicine

Francesca Forli

Susanna Passetti

Emanuele Neri

Donato Gianfelice

Stefano Berrettini

A rare association between neurofibromatosis type I and Cogan's syndrome: Case report

神经纤维瘤病I型与Cogan综合征的罕见关联：病例报告

This paper describes the vision of networked balance testing centres as set out in the Balance Good Practice Guide published in 2009. It provides examples of room design and enabling works. A suggestion for hardware and software specifications for a supra-specialist balance centre is provided. How to design, evaluate and commission such a laboratory will be covered, including brief descriptions of the qualitative and quantitative balance tests used in assessing vestibular function in children, maintenance and training issues. The appendix provides guidance on making a business case, applying for capital bids, option appraisal, writing equipment specifications, bid evaluation, and procurement.

Paul Radomskij

Ewa Raglan

John Veness

Setting up a paediatric vestibular testing laboratory

建立儿科前庭功能测试实验室

Vinaya K. C. Manchaiah

The hearing sciences

听觉科学

With recent increased interest in paediatric balance disorders it has become apparent that there is need for more paediatric vestibular services in the UK. This paper explores the rationale underpinning service development, and the evidence that supports this. The need for these services to be set up within a child orientated clinical setting is emphasized, as is the importance of a well trained and experienced multidisciplinary paediatric team.

Katherine Harrop-Griffiths

Setting up a paediatric vestibular service

建立儿科前庭功能服务

Sketches of otohistory. Edited by Hawkins JE and Schacht J. Basel, Karger, 2008, pp. vi + 74. (CHF 39; Euros 28; $US 39) ISBN 978-3-8055-8364-0. This attractive little book brings together a number...

Dafydd Stephens

Sketches of otohistory

耳科历史素描

Rosalyn A. Davies

Simon Dafydd Glyn Stephens, Professor of Audiological Medicine

西蒙·达菲德·格林·斯蒂芬斯，听力医学教授

Betahistine, a histamine H1 agonist and H3 antagonist, has been used for the pharmacotherapy of Menière's disease for many decades. Earlier its mode of action and efficacy, in particular in low dosages, were the subject of controversy mainly because valid experimental or clinical data were not available. Recent animal studies, however, showed that betahistine increases cochlear blood flow in a sigmoid dose-dependent way, thus supporting the hypothesis that it may act by improving cochlear microcirculation. In terms of its clinical efficacy, two studies demonstrated that a high-dose (at least 48 mg t.i.d.) and long-term treatment (at least six to 12 months) have a significant prophylactic effect on the occurrence of attacks in Menière's disease.

Michael Strupp

Eike Krause

Franziska Lezius

Martin Canis

Fritz Ihler

Robert Gürkov

Betahistine for Menière's disease

倍他司汀用于梅尼埃病

According to our model, the primum movens for the onset of Ménière's disease should be represented by a haemodynamic imbalance. From this starting point, the principal therapeutic approach should concern the necessity of achieving and maintaining a stable blood perfusion to the inner ear; this involves a number of different factors ranging from cardiac pump activity to vasomotor regulation that in turn exert an influence on membrane and cell integrity. A simple, alternative or coadjuvant and almost risk-free treatment can thus be represented by antioxidants such as melatonin, especially through its modulating activity on the autonomic nervous system, and mostly by omega-3 polyunsaturated fatty acids (omega-3 PUFAs); the latter, owing to their capability of improving myocardial function and arterial compliance, modulating blood pressure, and stabilizing cell and organelle membrane structure and function could theoretically fulfil all the requirements. When considering a resort to more strictly pharmacological principles, the hypothesis of some possible benefit deriving from commercially available proton pump inhibitors has been advanced. Moreover, an aspect that in our opinion deserves some interest, is the role of angiogenesis; a series of analogies permits the hypothesis of a similar role for the eye and the ear, thus opening a matter of debate on the possibility to apply to the labyrinth the same principles that have proved useful in treating degenerative retinopathy.

Antonio Pirodda

Claudio Borghi

Is it possible to consider non-conventional proposals for treating Ménière's disease?

治疗梅尼埃病是否可能考虑非常规方案？

Since it was first described in the 19th century, Meniere's disease (MD) has presented with a series of fundamental aspects the basis of which still remain unclear. It is commonly accepted that an ...

Ménière's disease: Is it time to approach it from another point of view?

梅尼埃病：是否到了从另一个角度看待它的时候？

Background: The model of explanation for the pathogenesis of Ménière's disease (MD) proposed by our group postulates a crucial role for the maintained activity of the labyrinthine gastric-type proton pump under ischaemic conditions. Thus, the administration of the common proton pump inhibitors (PPI) could exert a favourable influence on MD symptoms. Method: In order to help assess the validity of this hypothesis a questionnaire was administered to a selected population of sufferers from MD; the aim was to verify the percentage of PPI users and the incidence of MD symptoms among users and non-users. Results: These showed a higher prevalence of PPI users in the selected sample compared to an unselected large series in the literature; the difference was statistically significant in all cases. In contrast, no statistically significant differences between users and non-users were found regarding the incidence of symptoms in the previous six months, even though the group of PPI users had a slightly better performance. Conclusion: Despite these inconclusive findings and the consequent need for further studies to eventually propose PPI as a therapy for MD, some physiological and pharmacological aspects seem to support a possible positive influence of this category of drugs on the inner ear.

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