Journal reading Putri Melati Fk Trisakti, THT

1. Research Article

A Balance Test for Chronic Perilymph Fistula

Perilymph fistula is defined as a leak of perilymph at the oval or round window. It excludes

other conditions with “fistula” tests due to a dehiscent semicircular canal from cholesteotoma

and the superior canal dehiscence syndrome. First recognized as a complication of

stapedectomy, it then became apparent that head trauma and barotraumatic trauma from

flying or diving could be a cause. Descriptions of “spontanenous” perilymph fistulas with no

trauma history followed. It is likely that most perilymph fistula patients have a congential

potential weakness of the otic capsule at the round or oval window. The vestibular symptoms

have been assumed to be due to endolymphatic hydrops, but there is poor evidence. Their

unilateral disequilibrium, nausea, and subtle cognitive problems suggest they are due to

otolith disfunction and that these patients have a specific balance abnormality, unlike

subjects with unilateral vestibular hypofuction. In this series of twenty patients with a

confirmed fistula a logical simplification of Singleton’s “eyes-closed turning” test predicted a

PLF in twelve with a trauma history. In four no cause was found. In three a prior traumatic

event was later recalled, but one patient had concealed it.

2. Research Article

Acute-Phase Inflammatory Response in Idiopathic SuddenDeafness: Pathogenic ImplicationsThe acute-phase inflammatory response in the peripheral bloodstream can be an expression of

transient cerebral ischaemia in idiopathic sudden deafness. For this, a neurological and

otorhinolaryngological examination of each patient, performing tests on audiometry, and

tympanometry, haemogram, and cranial magnetic resonance were performed. The acute-

phase inflammatory response manifests as an increased neutrophil/lymphocyte ratio that is

detected 48–72 hours after the appearance of sudden deafness. This study shows that there is

an acute-phase response in the peripheral bloodstream with an increased

neutrophil/lymphocyte ratio as an expression of an inflammatory process that can be caused

by transient cerebral ischaemia in sudden deafness. In addition, the increased

neutrophil/lymphocyte ratio can rule out a viral origin of sudden deafness, since a viral

infection lowers the neutrophil count and increases the lymphocyte count, thus reducing the

neutrophil/lymphocyte ratio. These findings aid in understanding the pathogenic mechanisms

involved in sudden deafness and offer better treatment to the patient.

3. Research ArticleInvestigation of Tinnitus Patients in Italy: Clinical and Audiological Characteristics

Objective. 312 tinnitus sufferers were studied in order to analyze: the clinical characteristics

of tinnitus; the presence of tinnitus-age correlation and tinnitus-hearing loss correlation; the

impact of tinnitus on subjects’ life and where possible the etiological/predisposing factors of

tinnitus. Results. There is a slight predominance of males. The highest percentage of tinnitus

results in the decades 61–70. Of the tinnitus sufferers, 197 (63.14%) have a hearing deficit

(light hearing loss in 37.18% of cases). The hearing impairment results of sensorineural type

in 74.62% and limited to the high frequencies in 58.50%. The tinnitus is referred as unilateral

in 59.93%, a pure tone in 66.99% and 10 dB above the hearing threshold in 37.7%. It is

limited to high frequencies in 72.10% of the patients with sensorineural hearing loss (SNHL)

while the 88.37% of the patients with high-frequency SNHL have a high-pitched tinnitus (χ2

= 66.26;P < .005). Conclusion. Hearing status and age represent the principal tinnitus

related factors; there is a statistically significant association between high-pitched tinnitus

and high-frequency SNHL. There is no significant correlation between tinnitus severity and

tinnitus loudness confirming the possibility that neural connection involved in evoking

tinnitus-related negative reactions are governed by conditioned reflexes.