Clinical, oculographic and vestibular test characteristics of Ménière's disease.

Seventy Ménière's disease (MD) patients with spontaneous vertigo (100%), unilateral aural fullness (57.1%), tinnitus (78.6%), and subjective hearing loss (75.

The Clinical Uses of Electrocochleography.

The clinical uses of electrocochleography are reviewed with some technical notes on the apparatus needed to get clear recordings under different conditions. Electrocochleography can be used to estimate auditory thresholds in difficult to test children and a golf club electrode is described. The same electrode can be used to obtain electrical auditory brainstem responses (EABR).

Cochlear Implant Outcomes in Cochlea Nerve Aplasia and Hypoplasia.

Objective: To assess cochlear implant (CI) outcomes, and factors affecting outcomes, for children with aplasia/ hypoplasia of the cochlea nerve. We also developed a new grading system for the nerves of the internal auditory meatus (IAM) and cochlea nerve classification.

Study Design: Retrospective patient review.

CHARGE syndrome and Cochlear implantation: difficulties and outcomes in the paediatric population.

Objectives: CHARGE syndrome is a complex cluster of congenital abnormalities, these children may have absent or hypoplastic auditory nerves. Our objective was to assess preoperative factors and outcomes for paediatric cochlear implant recipients with CHARGE syndrome, to enable better surgical preparation and family counselling.

Methods: The Sydney Cochlear Implant Centre database was searched for children with CHARGE syndrome who had received a cochlear implant at ages 16 and less.

Pediatric cochlear implantation: associated with minimal postoperative pain and dizziness.

Objective: To prospectively document the surgical pain, assessing analgesia use as a proxy, and postoperative dizziness in children over the first week after cochlear implantation.

Study Design: Prospective.

Setting: Tertiary referral hospital and cochlear implant program.

Impedance, neural response telemetry, and speech perception outcomes after reimplantation of cochlear implants in children.

Objective: To compare mean impedance levels, neural response telemetry (NRT), and auditory perception after initial and explant-reimplant pediatric cochlear implants.

Study Design: Retrospective case review.

Setting: Tertiary referral hospital and cochlear implant program.

Pediatric cochlear implants: additional disabilities prevalence, risk factors, and effect on language outcomes.

Objective: To determine the prevalence of additional disabilities in a pediatric cochlear population, to identify medical and radiologic conditions associated with additional disabilities, and to identify the effect of additional disabilities on speech perception and language at 12 months postoperatively.

Study Design: Retrospective case review.

Setting: Tertiary referral center and cochlear implant program.

Augmented ocular vestibular evoked myogenic potentials to air-conducted sound in large vestibular aqueduct syndrome.

Objective: To demonstrate the value of recording air-conducted ocular Vestibular Evoked Myogenic Potentials (oVEMP) in a patient with bilaterally enlarged vestibular aqueducts.

Design: Cervical VEMP and oVEMP were recorded from a patient presenting with bilateral hearing loss and imbalance, attributable to large vestibular aqueduct syndrome. The stimuli were air-conducted tone bursts at octave frequencies from 250 to 2000 Hz.

Cochlear implants and magnetic resonance scans: A case report and review.

Objective And Importance: Traditionally, magnetic resonance imaging (MRI) was contraindicated for patients with cochlear implants (CIs), due to concern about device displacement, overheating of the device or tissues, or direct damage to the device electrode. In addition, image artifact from the device magnet gave poor imaging information in the cranial and upper cervical spine region. Today, MRI is increasingly required in patients who have undergone cochlear implantation, and CI design and MRI protocols have therefore changed to allow implanted patients to safely enter the MRI field, in some cases without removal of the CI internal magnet.

Assessment of intracochlear trauma caused by the insertion of a new straight research array.

Objective: To assess the degree of intracochlear trauma using the Cochlear™ Straight Research Array (SRA). This electrode has recently been released by Cochlear™ on the CI422 implant.

Background: Electroacoustic stimulation (EAS) enables recipients to benefit from cochlear implantation while retaining their natural low-frequency hearing.

Vestibular evoked myogenic potentials to sound and vibration: characteristics in vestibular migraine that enable separation from Meniere's disease.

Objectives: It can be difficult to distinguish vestibular migraine (VM) from Menière's disease (MD) in its early stages. Using vestibular-evoked myogenic potentials (VEMPs), we sought to identify test parameters that would help discriminate between these two vestibular disorders.

Methods: We first recorded ocular and cervical VEMPs (oVEMP/cVEMP) to air-conducted clicks and bone-conducted vibration in 30 control participants, 30 participants with clinically definite VM and 30 participants with clinically probable VM.

Intra-individual assessment of speech and music perception in cochlear implant users with contralateral Cochlear™ and MED-EL™ systems.

Conclusion: Whilst objective testing on music perception showed no individual differences between cochlear implant (CI) devices, subjective music perception was found to be superior with the MED-EL device in the majority of cases evaluated.

Objective: To compare speech and music perception through two different CI systems in the same individuals.

Methods: Six post-lingually deaf patients, who had been implanted with a Cochlear™ Nucleus(®) device in one ear and a MED-EL SONATATI(100) on the contralateral side were evaluated.

On the differential diagnosis of Ménière's disease using low-frequency acoustic biasing of the 2f1-f2 DPOAE.

We have cyclically suppressed the 2f1-f2 distortion product otoacoustic emission (DPOAE) with low-frequency tones (17-97 Hz) as a way of differentially diagnosing the endolymphatic hydrops assumed to be associated with Ménière's syndrome. Round-window electrocochleography (ECochG) was performed in subjects with sensorineural hearing loss (SNHL) on the day of DPOAE testing, and from which the amplitude of the summating potential (SP) was measured, to support the diagnosis of Ménière's syndrome based on symptoms. To summarize and compare the cyclic patterns of DPOAE modulation in these groups we have used the simplest model of DPOAE generation and modulation, by assuming that the DPOAEs were generated by a 1st-order Boltzmann nonlinearity so that the magnitude of the 2f1-f2 DPOAE resembled the 3rd derivative of the Boltzmann function.

Imaging of endolymphatic hydrops in Meniere's disease at 1.5 T using phase-sensitive inversion recovery: (1) demonstration of feasibility and (2) overcoming the limitations of variable gadolinium absorption.

Endolymphatic hydrops is the primary histopathological finding in Meniere's disease. We demonstrate the feasibility of imaging endolymphatic hydrops at 1.5 T using phase-sensitive inversion recovery (PS-IR) MRI following intratympanic injection of gadolinium (Gd).

The vestibular evoked-potential profile of Ménière's disease.

Objective: To define the ocular and cervical vestibular evoked myogenic potential (oVEMP and cVEMP) profile in Ménière's Disease (MD), we studied air-conducted (AC) sound and bone-conducted vibration (BCV)-evoked responses in 77 patients and 35 controls.

Methods: oVEMPs were recorded from unrectified infra-orbital surface electromyography (EMG) during upward gaze. cVEMPs were recorded from rectified and unrectified sternocleidomastoid EMG during head elevation against gravity.

Hypothetical mechanism for vertigo in Meniere's disease.

Past theories that have been proposed to account for the attacks of vertigo during the course of Meniere disease are reviewed. In the past, vascular theories and theories of perilymph and endolymph mixing due to ruptures or leakages were proposed. Recent research concerning the basic mechanisms of the inner ear anatomy and function cast doubt on these theories.

Changes in audiometric thresholds before, during and after attacks of vertigo associated with Meniere's syndrome.

Conclusion: No significant changes in hearing thresholds were observed during vertigo attacks associated with Meniere's disease.

Objectives: To determine if the hearing alters during the period of the attacks of vertigo in Meniere's disease.

Patients And Methods: The study group consisted of patients who had a clinical diagnosis of definite Meniere's syndrome according to the AAOOHNS criteria, a score on the Gibson scale of 7 or over and an enhanced negative summating potential on transtympanic electrocochleography.

A comparison of two methods of using transtympanic electrocochleography for the diagnosis of Meniere's disease: click summating potential/action potential ratio measurements and tone burst summating potential measurements.

Conclusion: Transtympanic electrocochleography (TT ECochG) is helpful for the confirmation of Meniere's disease using tone burst stimuli to measure the amplitude of the frequency specific summating potentials (SP) but not when using the click evoked summating potential versus action potential ratio (SP/AP).

Objectives: To evaluate the effectiveness of TT ECochG as a means of confirming the clinical diagnosis of Meniere's disease.

Patients And Methods: A total of 2,717 patients were referred for TT ECochG between August 1998 and September 2008.

Grading of endolymphatic hydrops using magnetic resonance imaging.

Conclusion: Grading of endolymphatic hydrops in the vestibule and the cochlea using magnetic resonance imaging (MRI) is proposed (2008 Nagoya scale).

Objective: To standardize the evaluation of endolymphatic hydrops in both the vestibule and the cochlea using MRI.

Patients And Methods: The endolymphatic space was evaluated after intratympanic gadolinium injection using three-dimensional fluid attenuated (3D-FLAIR) MRI and three-dimensional real inversion recovery (3D-real IR) MRI.

The use of intra-operative electrical auditory brainstem responses to predict the speech perception outcome after cochlear implantation.

Electrically evoked auditory brainstem responses (EABR) were obtained intra-operatively from children receiving full insertion of Cochlear CI24 implant. The EABR waveform was quantified according to the presence or absence of waves (eII-eV). Each trace was scored from 0-3 providing a maximum score for all 22 electrodes of 66 in the monopolar mode.

The association of codeine, macrocytosis and bilateral sudden or rapidly progressive profound sensorineural deafness.

Conclusions: Codeine shows a similar association with profound deafness to other opiates. Good cochlear implant outcomes suggest a sensory disorder. Although macrocytosis could be due to confounding factors, the lack of other consistent findings may signify a vascular pathology.

Cochlear implantations in children with Waardenburg syndrome: an electrophysiological and psychophysical review.

Waardenburg syndrome presents with dystopia canthorum, pigmentary abnormalities of hair, iris and skin (often a white forelock and heterochromia iridis) and sensorineural deafness. The authors review the electrophysiological and psychophysical findings of implanted children with Waardenburg syndrome at the Sydney Cochlear Implant Centre. Twenty children with Waardenburg syndrome received cochlear implants between 1985 and 2001.

Trans-tympanic electric auditory brainstem response (TT-EABR): the importance of the positioning of the stimulating electrode.

Trans-tympanic electric auditory brainstem response (TT-EABR) is an established pre-operative investigation in cochlear implantation surgery. Various techniques have been employed to obtain electrical responses but there has been no universal agreement on the exact positioning of the stimulating electrode on the medial wall of the mesotympanum. The authors investigate the relationship of the positioning of the electrode and the brainstem response.