Costs and health effects of screening and delivery of hearing aids in Tamil Nadu, India: an observational study

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Clinical and Audio Vestibular Profile of Meniere’s Disease in a Tertiary Care Centre in India

The aims of this study are to determine the frequency of patients presenting with Meniere’s Disease(MD) in an Indian setting, using the American Academy of Otolaryngology-Head and Neck Surgery (AAO) diagnostic criteria, and to describe the clinical and audio vestibular profiles of these patients. The study was based on prospective case series design in the settings of a tertiary referral hospital. The study included all consecutive patients aged between 5 and 75 years presenting with the history of hearing loss, vertigo, tinnitus and or aural fullness as participants, satisfying inclusion and exclusion criteria for MD (AAO 1995) recruited over a 12 month period. Main outcome measures comprised the evaluation of epidemiological profile, clinical features, and results of audio vestibular investigations like Pure Tone Audiometry with and without glycerol, Impedance Audiometry, Electrocochleography (ECohG), Distortion Product Otoacoustic Emission and Electronystagmography (ENG). The results of the study are as follows: The frequency of MD was 15.6%, being commoner in males than females (2.6:1) and occurring more in the age group 40–49  years among males and 30–39 years among females. High frequency tinnitus was commoner than low frequency tinnitus. Extra tympanic ECohG had a positive predictive value of 76% for endolymphatic hydrops. ENG was useful for demonstrating canal paresis pattern of nystagmus in 61%. Indian patients with MD commonly present to tertiary care at the functional level scale of 3. The results of this study revealed that the frequency of MD is not as low in the Indian ENT setting as earlier believed. There is a high chance of missing cases in the routine ENT outpatient clinic setting unless a structured proforma incorporating the AAO 1995 diagnostic criteria is used

Subjective Visual Vertical and Horizontal Abnormalities in a Patient with Lateral Medullary Syndrome-A Case Report

Introduction: Evaluation of persistent vertigo in post infarct patients is very important as the management depends on whether the cause is purely of central origin or due to associated vestibular affliction.   Case Report: A patient with left sided dorsolateral medullary syndrome and persistent vestibular symptoms was evaluated. Vestibular test battery showed abnormal smooth pursuit, bilateral hyperactive caloric responses, and abnormal dynamic subjective visual vertical and dynamic subjective visual horizontal tests.   Conclusion:  Dorsolateral medullary infarctions (Wallenberg’s syndrome) typically cause a central vestibular tonus imbalance in the roll plane with ipsilateral deviations of perceived vertical orientation. The SVV and SVH tests may have a role in localizing the pathology in a patient with lateral medullary syndrome

Giant Intracranial Arachnoid Cyst Mimicking Benign Paroxysmal Vertigo of Childhood: Case Report with Review of Literature

ABSTRACTArachnoid cysts constitute 1% of all intracranial space-occupying lesions. These typically produce vague and nonspecific symptoms. However, a subset of these lesions can produce constellation of signs and symptoms indistinguishable from those causing peripheral vertigo. We discuss the presentation of a giant arachnoid cyst which presented with dizziness and mimicked benign paroxysmal vertigo of childhood (BPVC).</jats:p