E. Filipponi

Auditory brainstem responses (ABR) in normal hearing adult subjects with Down's syndrome

BACKGROUND Auditory brainstem responses (ABRs) have been previously investigated in subjects with Downs syndrome (DS), but the published data are generally from children with hearing loss. The aim of this study was to evaluate the hearing pathway in normal hearing adult DS patients. METHODS We used ABRs to analyze absolute and interpeak latencies in 19 adult DS patients aged 18-45 years whose pure tone audiometry (PTA) test results indicated thresholds within normal limits, and 19 normal controls. RESULTS The DS sample showed statistically significant gender-related differences in interpeak interval III-V (p = 0.015). The latencies of waves III and V, and interpeak intervals III-V and I-V, were significantly shortened in the DS patients than in the controls. CONCLUSIONS Our findings may be due to the smaller brain sizes and simpler afferent auditory pathways of DS subjects.

Ménière disease and gluten sensitivity: Recovery after a gluten-free diet

We report the case of a 63-year-old female with definite unilateral Ménière disease, osteoarthritis of the distal finger joints with mucous cysts and Heberdens nodes, and constipation with recurrent abdominal pain whose symptoms remitted after 6months of a restrictive gluten-free diet.

Auditory late potentials in normal-hearing adult subjects with Down's syndrome.

Objective Several studies have demonstrated that adult subjects with Down’s syndrome (DS) and hearing impairments show significantly delayed latencies in auditory late potentials (ALPs). The aim of this study was to investigate whether the differences were still present in ALPs in an adult DS population with normal hearing, taking into consideration sex, handedness, and head size. Study Design Prospective study. Setting Audiology unit of the hospital Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy. Patients Sixteen normal-hearing adult DS subjects referred to the health monitoring program for DS patients of Vivi Down Onlus Association in Milan, Italy (7 male subjects with a mean age of 26 ± 7.74 yr and 9 female subjects with a mean age of 28 ± 8.63 yr) and 16 controls (7 male subjects with a mean age of 26 ± 7.74 yr and 9 female subjects with a mean age of 28 ± 8.86 yr) matched for sex, age, and handedness. Main Outcome Measure The 2 negative peaks, N1 and N2, and the 2 positive peaks, P1 and P2, of ALP. Results ALP N1 and P2 components were well defined in all subjects. The P1 and N2 components were less evident than the others. There were significant delayed latencies in the DS group with respect to the control subjects for P1, N1, P2, and N2 components. Conclusion Our study demonstrated that ALP longer latencies are present in adult DS participants even when they have a normal hearing threshold, regardless of handedness and head size.

The occlusal imaging and analysis system by T-scan III in tinnitus patients.

Background Several studies have demonstrated that the prevalence of temporomandibular disorders (TMDs) in tinnitus patients ranges from 7% to 95%, and it is reported in literature that idiopathic tinnitus patients should be referred to a dentist to define whether or not the tinnitus is associated with TMD. However, the possible pathophysiological relation between TMDs and tinnitus is not generally investigated in clinical practice. Methods The patterns and forces of occlusal contacts have been studied by means of T-scan III in 47 tinnitus patients (23 suffering from idiopathic tinnitus and 24 affected by Ménière disease [MD]) and 13 healthy subjects. Results The center of force target was offset in the opposite direction in 15/23 idiopathic tinnitus and in 7/24 MD patients (p = 0.026). No significant variation was found in the occlusal force. Conclusions Our data suggest that a diagnostic screening method for occlusal stability in the intercuspidal position might be clinically useful in idiopathic tinnitus patients.

Benign paroxysmal positional vertigo and tinnitus.

INTRODUCTION In our clinical experience, some of the patients affected by benign paroxysmal positional vertigo (BPPV) reported the onset of tinnitus shortly before or in association with the positional vertigo. OBJECTIVES The aim of this study was to describe the prevalence and the clinical patterns of tinnitus episodes which occurred in association with BPPV and to suggest possible interpretative hypotheses. METHODS 171 normal hearing patients affected by BPPV (50 males and 122 females; age range: 25-77 years; mean age 60.3 years ± 14.9) underwent pure tone audiometry, immittance test and a clinical vestibular evaluation before and after repositioning manoeuvers. Those suffering from tinnitus were also assessed using visual analogue scales and tinnitus handicap inventory. RESULTS 19.3% of the patients reported the appearance of tinnitus concurrently with the onset of the positional vertigo. It was mostly unilateral, localized on the same ear as the BPPV, slight in intensity and intermittent. Tinnitus disappeared or decreased in all patients except two, either spontaneously, before performing the therapeutic manoeuvers, or shortly after. CONCLUSIONS A possible vestibular origin of tinnitus determined by the detachment of macular debris into the ductus reuniens and cochlear duct is discussed.