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This report presents the case of a patient with forceful eyelid closure syndrome (FECS) who did not have an otologic history of facial paresis. The patient was an 11-year-old girl. She complained of a click noise in the left ear simultaneous with eyelid closure and was referred to our department. A microphone in the external auditory canal captured a click noise simultaneously with eye blinking. Impedance audiometry of the left ear showed a slight compliance reduction simultaneously with eye blinking, whereas a pure-tone audiogram, tympanogram, computed tomography (CT), magnetic resonance imaging (MRI), and movement of the palate and pharynx were normal. Her previous otologic history was unremarkable and did not include facial paresis. She was diagnosed with FECS due to contraction of the tensor tympanic muscle. Treatment with an anticonvulsant for 2 months showed no effects on her tinnitus and she was bothered by her drowsiness and dizziness. Behavioral therapy (BT) was started, and the tinnitus was remarkably reduced in 7 months. BT for patients with muscular tinnitus, including FECS, may be a preferred choice rather than surgical procedure and medication including an anticonvulsant and muscle relaxant.Cochlear implantation is a reliable and safe tool to rehabilitate patients with severe-to-profound sensorineural hearing loss, who get limited benefits from traditional hearing aids. Electrode misplacement is a rare but significant problem that fails to provide benefits and may cause injury to the nearby structures. We present a case that underwent mastoidectomy first to remove cholesteatoma, followed by cochlear implantation with electrode misplacement into the petrous area, with sustained hearing benefits and without any injury to the surrounding structures.Primary intraosseous cavernous hemangiomas (PICHs) in the temporal bone are very rare. Most treated cases are in adult patients, and there are very few reports involving children. To our knowledge, no cases reported have ever actually adopted embolization in children, although several reports recommend preoperative embolization of the feeding arteries. Here, we present a case of a child with a large cavernous hemangioma developing in the temporal bone. The patient was an 11-year-old girl whose chief complaints were hearing loss, aural fullness, and otalgia. Based on imaging, a lymphoma was initially suspected, but extensive arterial bleeding occurred during biopsy under local anesthesia. Angiography was performed to evaluate the blood flow in the tumor, and revealed the middle meningeal artery as a main feeding artery to the tumor. A huge PICH at the temporal bone was successfully resected following preoperative embolization of the feeding artery.As for other vestibular schwannomas, intralabyrinthine schwannomas commonly cause a sensorineural hearing loss, contrary to more lateral ear pathology that can cause conductive or mixed hearing loss. This case report features a patient that presented with a mixed and thus partly pseudo-conductive hearing loss due to an intracochlear schwannoma, a finding that is very rare. As a result, the patient was initially misdiagnosed as having otosclerosis and a stapedotomy was performed, without hearing improvement. We discuss the clinical implications of this atypical presentation, which illustrates the importance of performing supplementary audiological testing (e.g., the Gellé test), and the importance of considering vestibular system testing when otosclerosis is suspected. In addition, the importance of imaging and considering differential diagnoses in cases of conductive hearing loss is stressed.Self-Contained Underwater Breathing Apparatus (SCUBA) diving is a popular sport. However, improper diving may injure different organs. BAY 1217389 order The majority of dive-related disorders concern otolaryngology, and may include hearing loss, tinnitus, aural fullness, disequilibrium, and vertigo. Three main inner ear pathological conditions can occur underwater inner ear barotrauma (IEB), inner ear decompression sickness (IEDS), and alternobaric vertigo (AV). IEB results from inappropriate equalization of middle ear pressure and consequent inner ear injury produced by pressure changes within the middle ear; IEDS is characterized by the formation of gas bubbles within the vessels of the inner ear during rapid ascent; AV typically develops while ascending or performing the Valsalva maneuver and can follow asymmetrical equalization of middle ear pressure transmitted via the oval and round window membranes. The clinical pictures of these pathological conditions are partly superimposable, even if they have specific peculiarities. Before starting SCUBA diving, a fit-to-dive assessment is recommended. It should include an otolaryngologic examination with audiological assessment to evaluate nasal, middle ear, and tubal patency and to minimize the risk of IEB, IEDS, and AV. It is of utmost importance to identify individual risk factors and predisposing pathological conditions that favor inner ear injury before diving, to prevent acute events and preserve auditory and vestibular functions in SCUBA divers. This review aims to provide an overview of the pathological conditions characterized by inner ear injury in SCUBA divers, discussing their pathogenetic mechanisms, diagnostic work-up, and prevention.
This study aimed to examine the individual differences and factors affecting balance and gait control during walking (i.e., dynamic equilibrium) in healthy young adults subjected to unilateral caloric vestibular stimulation (CVS).
Sixty-six participants completed questionnaires related to motion sickness. All participants were subjected to the head-up tilt test (HUT), which assesses orthostatic dysregulation, followed by inner ear stimulation with cold water (20°C) for 60 s. Subsequently, all participants performed a 6 m walking test with their eyes open.
CVS resulted in horizontal nystagmus. The measured distance of sway from the centerline on the goal line ranged from 0 to 600 cm. Both motion sickness and orthostatic dysregulation (OD) were associated with the distance of sway from the centerline.
Autonomic dysfunction affects the dynamic equilibrium and might cause individual gait differences. Further study is warranted to quantify the autonomic function and clarify individual variations in dynamic equilibrium, after unilateral CVS.