Otolaryngology - Science topic

It seems to me that are 2 possible problems

An error in data transformation. The solution is to use logistic regression directly which is where the logit transform takes you. The other possibility is rare events, which I suspect is common in your application. The approach here is to use Firth logistic regression. All of this is available in R. Best wishes David Booth

1. audiological and radiological findings in children with CSOM ( cholesteatoma).

2. long term consequences of CSOM in children

3. hearing management and attitudes of patients towards amplification

4. health outcomes in children following adenoidectomy

5. attitude and knowledge of patients towards care and maintenance of vocal prosthesis post laryngectomy.

Dear experts. What are the treatments for Miniera? What are the treatments and herbs? Thanks

A loupe with at least 3 to 3.5x magnification should suffice.

Definite MD

A. Two or more spontaneous episodes of vertigo(1,2), each lasting 20 minutes to 12 hours(3).

B. Audiometrically documented low- to mediumfrequency sensorineural hearing loss(4,5) in one ear, defining the affected ear on at least one occasion before, during or after one of the episodes of vertigo(6,7).

C. Fluctuating aural symptoms (hearing, tinnitus or fullness) in the affected ear(8). D. Not better accounted for by another vestibular diagnosis(9).

Hi,

Here are few of the refeences:

Vasenina EE, Levin OS. Narushenie rechi i trevoga: mekhanizmy vzaimodeistviya i vozmozhnosti terapii [Speech disorders and anxiety: interaction mechanisms and therapy potential]. Zh Nevrol Psikhiatr Im S S Korsakova. 2020;120(4):136-144. Russian. doi: 10.17116/jnevro2020120041136

Lowe R, Menzies R, Onslow M, Packman A, O'Brian S. Speech and Anxiety Management With Persistent Stuttering: Current Status and Essential Research. J Speech Lang Hear Res. 2021 Jan 14;64(1):59-74. doi: 10.1044/2020_JSLHR-20-00144

Bergamaschi MM, Queiroz RH, Chagas MH, de Oliveira DC, De Martinis BS, Kapczinski F, Quevedo J, Roesler R, Schröder N, Nardi AE, Martín-Santos R, Hallak JE, Zuardi AW, Crippa JA. Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients. Neuropsychopharmacology. 2011 May;36(6):1219-26. doi: 10.1038/npp.2011.6

Have a look at this useful link.

Please see the following attached document.

Polysomnography can be used to perform accurate diagnosis regarding the presence and severity of apnea in children. However, the other aids mentioned above such as tonsil size, behaviour issues, noctural enuresis, etc. can help to screen the patients.

Sharpness and Durability should be considered. We look more into cavities and we sometimes have to carry out long procedures

The reason for bleeding in the majority of cases is misdirection of the spray towards the septum, active management in the first instance is stop the spray for a few days and use aseptic or a local lubricating spray. Either lubrication should be applied with the 'non-touch' technique as patients often use their finger or a cotton bud to install the ointment which defeats the purpose.

Prevention is best especially if the intranasal steroids are necessary so I advise the use of the X-Factor approach which is directing the spray laterally towards the medial cants of the eye on the same side thus optimising delivery of the medication to the turbinates and avoiding the septal mucosa as much as possible. This advice which is liked by children was based on a clinical nugget that I received from an experienced German ORL college some year ago which was to present the spray to the right nostril with the left hand and vice versa. This method by crossing fingers for the nose while instructing her led to one of my adolescent patients first suggesting the X-Factor

Probably affect facial nerve and glossopharyngeal nerve in the pons and medulla oblongata?

I agree with Japneet Kaur. The problem in the cilia of olfactory sensory neurons. The myofibrilar myopathy is a genetic disease that associated with the primary ciliary dyskinesia. The primary ciliary dyskinesia resulted in defective cilia and olfactory receptors.

Attached, please find the article describing both myofibrilar myopathy and primary ciliary dyskinesia.

In adults main cause is DNS or Turbinate pathology

For headache where no pathogenesis, as suggested by you, is found, proper treatment can’t be taken up. The author, in his new research, found that some NTM infection is the cause of it. The modified treatment akin to the treatment of mycobacterial infections gives definite success – cure or arrest of aggravation.

Donna, I have two Qs. Firstly, how can I know the rationale behind the contraindications? Is there any draft that explains so? Because I'd like to know if the contraindication in Q can be managed or it is absolutely not. Secondly, can I rephrase what you said with regard to dizziness? You mean that if the patient used carbamide peroxide while he is suffering tymanic membrane perforation, will suffer vertigo? Is that the rationale behind the contraindication?

Thanks a lot for great help

Hemangioma

With this population, we will look at using the CDP technology and the mismatch of surface versus visual dependency with these patients as often they become highly visually dependent. We then apply a sensory re-weighting load technique to balance out the visual versus surface dependency to allow the patient to maximize the use of each efficiently - it is amazing how well they do despite no vestibular function.

Interestingly, we have dabbled with the VOXX socks and orthotics group as their technology, albeit a little pseudo-science, has demonstrated increased somatosensory balance score on the SOT on the CDP with repeated testing suggesting the sock improve somatosensory cues and thus improve balance performance.

medication "noncompliance" or "noncompliant" are readily understood in the USA.

Dear Mostafa!

The therapy is a one thing. I agree with Shan. But: does the shortness of breath the Fluticasone or the preservative of the nasal spray? And what is in the bath or in the bathroom? Allergens, parfums, or mycetes (Aspergillus, Alternaria, etc)?- she has perennial rhinitis. She needs a rescue inhaler(SABA) and vs ICS.

Dear Mostafa,

No matter what guidelines you chose to use, there is no guideline that could escape the following principles of the treatment of allergic rhinitis.

1). Work on prevention - Avoid exposure to allergen(s) as much as you can. Even, change a life style might help, like taking bath daily in the allergy season.

2). Medical treatment - you may start with a non-sedating anti-histamine. If it fails to work, follow it with the use of corticosteroid nose spray.

3). For a long term solution, if 1) and 2) failed to achieve a satisfactory result, you may consider an allergy desensitization, or immunotherapy treatment (it would be recommended for age 6 and above)

Shih-Wen Huang, MD

Hi

in Harrison text book of internal medicine in Cardinal manifestation of disease chapter, it shows a very nice approach to cough step by step. I would recommend that algorithM.

Regards

In threshold comparison method, the subject has to decide when he stopped hearing. This may not be accurate many of the times or it may become difficult to execute in old, too young or less co-operative subjects.

On the other hand, loudness comparison is more straight forward in comparing which one is louder; thats all.

So, I think, this may be the reason why loudness comparison method is better than threshold comparison method.

You can read my article about the subject:

The key differences as I believe are:

1. Laterality of the diseases: unilateral in Meniere's disease while bilateral in Autoimmune disease

2. Middle age group affection in Meniere's disease while there is all age groups might be affected in Autoimmune disease

3. Other autoimmune diseases in Autoimmune disease

4. Low frequency SNHL in Meniere's disease while high frequency hearing loss in Autoimmune disease on pure tone audiogram

5. Autoimmune antibodies were found in Autoimmune disease

6. SP/AP>0.5 on cochleography in Meniere's disease

7. Steroid is an effective treatment for Autoimmune disease

My present research on PIL (pauciballary indeterminate leprosy indicates that F.D. may be one manifestation. Pl. get a detail investigation & needful before progress of deafness. Thanks.

Streptococcal infection is susceptible to natural penicillins. Oropharingeal candidiasis could be a complication of antibiotics therapy, if there is no any other reason( Hiv, inhailed corticosterroids, immune suppressive agents). Anyway there is no need for macrolides  (they are not active against Candida infection and they can cause diarrhea) gastric acid suppression by PPi  can make conditions for candida growth. What's the aim of antihistamines prescription? For candidiasis antifungal drug should be used: fluconasole or nystatin  ( if regisrered) . Second one acts locally on mucosa membrane because it's not absorbed from git. 

Good clinical examination of ear nose and oral cavity to rule out other pathology in this area with combination of otoscopic, tympanometry, OAE with regular follow up weekly Will will give good results.

Eosinophilic ulcer (EU) is a rare self-limiting chronic benign lesion of the oral mucosa. The ulceration has been most frequently found in tongue and it is characterized by the presence of mildly indurated borders which may resemble malignancies, traumatic ulcerations and some infections such as deep fungal infections, tuberculosis and primary syphilis). EU also has been referred as traumatic ulcerative granuloma with stromal eosinophilia, traumatic eosinophilic granuloma, traumatic granuloma and ulcerative eosinophilic granuloma. In infants, usually on the ventral surface of the anterior tongue secondary to trauma from newly erupted primary teeth, EU is referred as Riga-Fede disease. The pathogenesis of the EU is still unclear, however the lesion is thought to be reactive since trauma has been implicated as initiating factor, nevertheless trauma cannot be demonstrated in many cases. Histopathological findings consist of eosinophil-rich mixed infiltrates involving the superficial mucosa and the deeper muscle layer, accompanied by a population of large mononuclear cells that may correspond either to histiocytic cells, myofobroblastic cells or activated lymphoid cells.

he has been hospitalized in intensive care unit for few days because of loss of consciousness due to an  obstruction , he reported also a chronic dyspnea in last few years

Dear Parelker, you should extract the relevant portions of your thesis and make it in an article format, concise for wider audience within the Otolaryngology circles and send to a journal for publication. Journal of Laryngology and Otology (JLO) accepts otology articles, and it is an indexed journal. Alternatively, some editors may ask you to contribute a chapter in a book, or even assist you to publish the thesis as a book.

Best Wishes.

Abdullahi Kirfi, Kaduna Nigeria

We had made the keel using easily available components. Have described it in the article I have written. 

I am working on a case report  regarding an anterior glottic web which we treated with a laryngeal keel in a 10 year old patient. Wanted suggestions for publishing that in a pubmed indexed journal .....

No. For a perforation to heal there must be active healing process, and so you have to trigger it by freshening the edges (unless it is a very recent perforation).

Hi Kartil

Great question. The umbo has the fibrous layer tightly applied so this needs to be cut if the TM is to removed entirely from the malleus. I regularly do this but I take care to make sure the squamous layer remains intact. I have not yet had an implantation cholesteatoma using this technique.

I hope this helps!

Regards

DP

nasal adhesions (synechiae) according to nayak etal 1998; type a  at middle turbinate attachment to lateral nasal wall, type b partial synechiae  at the caudal end /inferior border of middle turbinate to lateral wall, type c complete synechiae at caudal end, type d adhesion between inferior/ middle turbinate and septum. 

I hope this can help

Sir the patient had intermittent unilateral discharge over a number of years,it wasn't profuse. She did not have earache or any symptoms which were relieved on discharge. Also she had no idea what could have set it off. 

The research that was the basis for my M.S.(1968) was looking to see the ideal place for injection of polytetrafluoroethylene (PTFE) to treat patulous Eustachian tubes. 

I developed a method for measuring ET patency in anesthetized dogs using an air flow system through a myringotomy. The back flow in a manometer would show the opening pressure of the ET. There were two possible places for the injection. 1. behind the torus tubarius  2.in front into the tensor veli palatini. The tensor injection reduced the patency without causing serous otitis media. The behind the torus injection did not change the patency as expected but produced serous otitis media in all dogs. The latter revealed that ET obstruction was not a necessary etiology for serous otitis media.

Clinically the PTFE injection was effective, but its exact placement in the human was difficult and lead to at least two deaths and was subsequently abandoned.

Clinically, now when expected, the diagnosis is confirmed with the ET insufflation of a boric acid/salicylic acid powder. If confirmed the patient can be instructed in self ET catheterization with insufflation of the powder as necessary. In some instances presumably by producing some chronic inflammation of the ET mucosa the symptom disappears.

Dennis Poe has been performing the leading edge endonasal contemporary surgical management.

Thank you for the answers. Béatrice Marianne Ewalds-Kvist the article was very informative.

But can anyone tell me the difference between the blood supply of the first tracheal ring and rest of the rings? 

Anecdotal reports state that temporalis fascia and tragal perichondrium both are equally effective as graft materials, depending on the route of tympanoplasty (postaural vs permeatal).

Here are a few studies evaluating their role, with some stating both to be equivalent, and others suggesting that tragal perichondrium might be a better graft material (with or without use of cartilage along with the perichondrium):

IT glucocorticoids are not only to be considered n patients who have a contra-indication for oral corticoids, but also have a place for rescue therapy (when oal corticoids dod not improve sudden hearing loss).

Dear Colleague,

I suppose there was a misunderstanding : We study the "covert path" which is electric and comes from collagen fibers piezoelectricity, for reaching through gap junctions the Deiters-cells/OHC complex at the level of the reticular lamina. We then describe the "trickystor" as a kind of Field Effect Transistor. It would interfere with the accepted mecano-electrical transduction by stereociliae, toward the inner aspect of the OHC cuticle and the prestinic structures of the OHC.

see https://www.google.fr/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=0CCEQFjAAahUKEwiu8sfc_ofJAhVDshQKHaoWCmY&url=http%3A%2F%2Farxiv.org%2Fabs%2F1310.7182&usg=AFQjCNGDWyAN8cuTNdOhI4vGCCyop5iI8Q&sig2=X_Sf8xnxfqr5rf6wzQXAlA

So, what is your thoughts about these observations ?

I agree we start with otoscopy, and might add the better lighting and close-up view of video otoscopy. It is possible to obtain a false negative (Type A, but more likely Shallow A) as OME is a transitory condition and fluctuates throughout the day. We might catch the condition at any point of the cycle and not realize its longer term implications.  

As mentioned by Leonard Silva this is a rare condition. I have only seen one patient over 40 years with localised amyloid in the tongue. This was excised with sufficient margins mainly for histological diagnosis. Patient had no recurrence for a period of 10 years of follow up.

I have however seen 3 cases of amyloidosis of the larynx.

Instruments that assess quality of life allow the measurement of the individual's perception about effect of an illness on their personal, social and professional relations .Somtimes a sigle tool like V-RQOL  many not be sufficient to assess the impact specific illnessess as  it is has been observed V-RQOL  has  lot  of significace in the assessment of patients following thyroplasty for unilateral vocal cord paralysis but not significant  in assessment alayngeal population So multiparameters like V-RQOL, VHI, VAPP can be used  for individuals with different vocal problems

please see the attached files

J Otolaryngol Head Neck Surg. 2008 Apr;37(2):E49-54.

[Paranasal sinus localization of Rosai Dorfman disease: long-term evolution and importance of magnetic resonance imaging].

[Article in French]

Daoud R1, Malinvaud D, Meatchi T, Rahman HA, Halimi P, Bonfils P.

Hi Paul, Signs of pulmonary oxygen toxicity are irritating cough,  a sternal burning sensation etc. Neurological oxtox is very rare and manifests itself as a in chamber convulsion.  This sounds more like a patient who depends on his hypoxic drive for ventilation. One HBOT session will give a huge pO₂ that will cause hypoventilation long enough to develop hypercapnia that may have resulted in a coma. I would say that HBOT is contraindicated in this case. Interesting problem. 

division of tensor palati tendin appear to help

Yes-that is exactly what I suggest.

the first rule is to look for the thyroid capsule and to stay close to it,  look for parathyroids (yellow mustard) and save them with the vascular pedicle, I find very helpful to use a loupe 2.5 magnifications

Dear Dr. Irfan,

Thank you so much for the information. We had some experience with the Diode laser in cordectomy for bilateral VC palsy too, and the results are encouraging; though we are yet to write about it. For the patient selection in the early laryngeal cancer, i quite agree with you because the outcome matters alot to both the patient, the surgeon and the system at large. My regards.

Dr. Kirfi, AM

Nigeria

If you have a reason to expect a certain set of match-ups, then simply look at those select few. For instance, suppose you were using the SCL-90 as an outcome measure. You might have some theoretical rationale for expecting that empathic interventions like reflection of feelings would have an effect on "feeling that others don't understand you or are unsympathetic," but that relaxation training would have more of an effect on "feeling tense or keyed up."

The thing to be wary about is the "buckshot" approach of simply correlating every type of intervention with every item on your outcome measures. If your rating system captures 20 different therapist behaviors and you have 90 outcome items, that would be 1,800 correlations - of which at least 50-100 will be statistically significant even if there's nothing "really" there. Of course, sometimes we don't know what to expect ahead of time. If you must correlate everything with everything, then I'd recommend having a cross-validation sample: anything that doesn't hold up in both groups is probably junk.

Another option is to set your alpha level higher - probably a good idea, but in my opinion the widely used Bonferroni correction goes way too far. When you have a lot of analyses, it demands impossibly large effect sizes.

I recently read the guidelines for treatment of acute bacterial sinusitis in Choosing wisely I found this a useful and sensible approach.

You may like to check this.

salam,thank you for your answer

Immunotherapy has a place in some head and neck cancer.

Very interesting topic to follow. I hope that other scholars add their opinion & experience.  

Seek and apply for summer research opportunities where there is someone working in the field you are interested in. In the USA many Medical Students interested in research take a year off between their 3rd and 4th year of medical school to work in a mentored research arrangement.  I don't know what is available in your location but in the USA there are many Academic Institutions here that have funded programs available to facilitate this. 

You can refer an article published in Ear and Hearing for the Methodology. It is done on children and also on adults as controls. They have used a sound method for localisation and lateralization measures. Please find the link.

Wish it was useful.

Warm Regards,

Prashanth

I am a 21 year multichannel cochlear implant user that is profoundly deaf bilaterally. I was severely hearing impaired at age three from a double case of mumps, and as a result of physicians using aminoglycoside antibiotics repeatedly for my recurring rhuematic fever I lost all of our hearing--every bit of it over time and balance in my vestibular organ. I was somewhat of a child prodigy, studied hard, and utilized speechreading (trained by the United Way Speechreading Program in Denver, Colorado in the early 1960s), all of which enabled me to attend hearing schools and to remain on the Dean's Honor Roll throughout school, and later college. Because of the cochlear implant, I was able to regain some footing after my speech severely degraded in my lecturing and went back to school to earn four more advanced degrees. I credit this technology as saving both my peronal and professional life, without which I would just have been another deaf man highlly and utterly dependent on society, instead of building enterprises that cumulatively employed thousands and brought many innovations and knowledge to the healthcare field, and also to the field of music, where I still perform and work to inspire kids everywhere to use music to overcome learning disabilities. Graham Clark's and  others' innovation of the cochlear implant has made possible nearly all that has transpired good in my life these past more than two decades. I will be forever grateful for this technology coming out at a time of my life when the lights were about to go out, and my life. personally and professionally, would have been severely limited.     

Thanks much Dr. Vincent for your sharing. Are there any recent experience in your institute regarding steroid nasal irrigation & what is the protocol of use & outcome?

Dear Matti,

I suggest all participants to read our paper: Mladina R, Skitarelić N, Casale M. Two holes syndrome (THS) is present in more than half of the postnasal drip patients? Acta Otolaryngol 2010;130:1274-1277.

I think this issue is one of those areas open to debate. That could be due to insufficient sample size due to difficulty of finding cases. In my recent literature review, I have come across two distinct problems: (1) definitions of symptoms with respect to Head and Neck cancer could be differing from study to study. While some studies are looking at pain per se, others investigate a cluster of symptoms. (2) definition of Head and Neck cancers can differ in the literature, depending on the anatomical site of surgery/tumor, metastase, etc. This complicates studies because then it becomes quite difficult to standardize. Case definitions are very important in observational studies. Pain and symptoms such as pain, which are usually patient-reported outcomes, are valuable to report if they are followed up in time, if they show good internal and external validity, and if precision and reliability are shown as well. Unfortunately, we are not at that particular stage in symptom research area to demonstrate precision and validity, we can only talk about Cronbach alpha, correlation, perhaps ppa, etc but these are not exactly the same things as validity. Long story short, it depends on your observational design. Do not get overwhelmed with what the literature says, focus on your sample population. It will benefit you much the more comparable your controls are to your cases and if they are both assessed the same on the exposure: the underlying disease, the underlying therapy should be the same or very similar. I don't know how to accomplish this with head and neck cancers...

One also has to keep in mind that the opinion about the status of the brain as immune-privileged organ is going to change. There is increasing evidence that even in the "normal" brain without any damage of the blood-brain-barrier some lymphocytes patrol the organ to search for pathogenic invaders. If this is prevented, e.g. by pharmacological blockade of the BBB by anti-VLA4-antibodies, lethal opportunistic infections of the brain were observed. Thus, even if the brain is definitively not to compare with other organs concerning the status of patrolling lymphocytes, the "immune privilege" is not absolute, but at least some basic immunological events are going on.

Glenn Griffin, Cheryl A Flynn

Antihistamines and/or decongestants for otitis media with effusion (OME) in children

Cochrane Database of Systematic Reviews, September 2011

Hi, a few years ago I'v seen and heard presentation of prof Kukwa Andrzej - ENT from Poland, Warsaw - about cranial nervs action during sleep. it was a symposium for snorring and OSAS. He reported and showed in his study - electrical potentials of several cranial nervs including vagus - X nerv - you can proove electr. potentials of muscles nerved by cranial nervs. There is phisiological vocal fold activity during a sleep - abduction during brath take, and adduction during exhaust. As well as phisiological activity of the nervs V,VII, IX, XII that helps us breath well during sleep.

Patophysiology of this activity can provide to snoring and sleep apneas, besides hole others typical causes. It is very important and amazing to discover and know physiology when you deal with OSAS patients.

both conditions may be microvascular complications of Diabetes. therfore the correlation appears to be quite obvious;-)

Hi ,

Stroboscopy will give the information on the mucosal wave

If you have a Bell's palsy dx or even if the dx is Ramsey Hunt's sindrom it has the same mehcanism which is: inhbition of the motor neural cell in the VII cranial nerv nucleus, produced by the interneural cell (gabaergic) located at the lenticular nucleus, which is functioning in excess because the cortex motor neural cell is been also inhbited. In one word facial nerve palsy has been produced through a disbalance between excitatory and inhibitory neurotransmitters, now you can restore the neurotransmitters equilibrium through differents neuroprotectors but I'll only mention one which is pirirdoxine (vitamine B6), which can be administered by mouth or parenterally, but because it is needed an enough dosis is better to use the intravenously via. It will also produce excellent efects on the fetus brain. If you want deeper information, please e mail me: ramiro.vergara@funda-cyt.com. This is new knowledge generated at Fundacyt.

May be my following article may be of help to you.

Numbness Over the Distribution of Trigeminal NerveVTrigeminal Trophic Syndrome or Viral Neuritis: A Diagnostic Dilemma!

Pankaj Patil, MDS, Sanjay Chandan, Þ Vikram Singh, Þ Kiran Gadre, Þ Rajshekhar Halli, Þ Pushkar Gadre, BDS, MDSþ

Journal of Craniofacial Surgery (impact factor: 0.82). 07/2013; 24(4). DOI:10.1097/SCS.0b013e3182942dff

Numbness and ulceration of the face, particularly erosion

of ala of the nose, sometimes occur after sensory denervation in the

territory of the divisions of the trigeminal nerve. The incidence is uncertain

and usually follows surgical treatments for trigeminal neuralgia.

Such condition is known as trigeminal trophic syndrome (TTS),

although some authors believe it to be a special form of dermatitis

artefacta. Trigeminal trophic syndrome most commonly affects adults,

after iatrogenic, vascular, viral, or neoplastic damage to the trigeminal

nerve.We present a rare case of TTS in a 32-year-old woman whowas

referred to us with progressive numbness in the right upper and lower

lip region.

Regards

Kiran

SD was not considered, there is no contraction while talking. The patient suffered a myopathy due to medical treatment of HIV that affects some other muscles or regions. His voice was breathy due to lack of volume of the vocal folds and mild separation between vocal cords in sustained phonation. We do not considered Radiesse for laryngoplasty medialization but goretex doing the external approach seeking for more volume and medialization, that was achieved, but withour any vocal results. I think there is no vibration in both vocal folds, since the patient can only whisper now that there is no glottic gap.

Has anyone experience with similar cases and what to do ?

See this article by RGacek and consider writing to him:

ORL J. Otorhinolaryngol. Relat. Spec., 2008 vol. 70(1) pp. 6-14; discussion 14-5

Evidence for a viral neuropathy in recurrent vertigo

Gacek, RR

The concept that reactivation of latent neurotropic viruses (i.e. Herpesviridae group) in the vestibular ganglion is responsible for recurrent vestibulopathies is presented. A similar histopathologic degeneration of vestibular ganglion cells in vestibular neuronitis (VN), Ménière's disease and benign paroxysmal positional vertigo is presented to support this concept. The clinical response (relief of vertigo) to the administration of antiviral medication in these syndromes provides practical evidence of a viral neuropathy in patients with recurrent vertigo. Relief of vertigo after this treatment was 90% in VN, Ménière's disease and VN. The relief of positional vertigo (benign paroxysmal positional vertigo) was 66%.

(c) 2008 S. Karger AG, Basel

Address: Department of Otolaryngology-Head and Neck Surgery, University of Massachusetts Medical School, Worcester, MA 01655, USA. GacekR@ummhc.org