Long-Term Follow-Up of Intratympanic Methylprednisolone Versus Gentamicin in Patients With Unilateral Menière's Disease.

Objectives: To determine whether long term (>48 months) symptomatic vertigo control is sustained in patients with Menière's disease from a previous comparative trial of intratympanic methylprednisolone versus gentamicin, and if the two treatments remain nonsignificantly different at long-term follow-up.

Study Design: Mail survey recording vertigo frequency in the previous one and six months, further intratympanic treatment received, and validated symptom questionnaires.

Setting: Outpatient hospital clinic setting.

Impact of vertigo and spatial disorientation on concurrent cognitive tasks.

Disorientation may draw attention from other activities and its impact on cognition may cause pilot error and problems of concentration in dizzy patients. Tasks used to study the impact of disorientation include number processing, intelligence scales and Brookes matrices (reproduction of 2xD patterns of numbers vs. nonsensical sentences), and Stroop tasks to probe selective effects on spatial versus verbally-loaded tasks.

Adaptation of ventilation to 'buffeting' in vehicles.

Objectives: Short exposures to buffeting in a vehicle driving over rough terrain induce an increase in the frequency of respiration resulting in hyperpnoea and hypocapnia. The present study investigates the adaptation to buffeting-induced hyperpnoea.

Methods: We monitored ventilation and cardiovascular function in nine healthy young adults prior to, throughout and post a 30 minute simulation of buffeting.

Cognitive impairment by spatial disorientation.

Introduction: Maintaining spatial orientation is a biological imperative. When orientation is threatened, attention resources are diverted to regaining orientation, possibly to the detriment of attention required by concurrent tasks. Hence, a factor in aviation mishaps may be the negative impact of disorientation on concurrent performance, such as interpreting instruments.

Tachypnea and hypocapnia are induced by 'buffeting' in vehicles.

Normal physiological responses to vehicular buffeting were studied during a 5 minute mild 'off road' exposure in a motion simulator. The ride provoked an initial increase in heart rate and blood pressure and a significant hypocapnia of P(ET) CO(2) 34 mm Hg caused by tachypnea, which took 5 minutes to recover. Motion induced hypocapnia could be a source of distress for vulnerable subjects and patients when travelling.