Verónica Rodríguez Rivera

Comportamiento del acúfeno en la enfermedad de Ménière

INTRODUCTION Ménières disease is characterised by vertigo, hearing loss and tinnitus. Various studies assess the problem of vertigo and audition deficit in Ménières disease, but only a few of these relate to the clinical characteristics of tinnitus, the aim of this study. MATERIAL AND METHODS A transversal descriptive study of the behaviour of tinnitus in 88 patients in different stages of Ménières disease treated in a tertiary hospital was carried out. The different characteristics of disease were analysed: intensity was evaluated with an analogue-visual scale, subjective tonality through tonal shade references, the impact on the patients quality of life was tested by a self-appraisal questionnaire, and competence level was evaluated with the Tinnitus Handicap Inventory. Epidemiologic factors, personal records, hearing thresholds and evolution in the number of vertiginous crises in the previous six months were also taken into account. RESULTS The average time of evolution of the disease was 15.4 years. The results evidence the development of tinnitus of moderate intensity (5/10) and low frequency (46%), with a slight impact on quality of life. Worsening in the quality of life related to hearing affectation and/or advanced stages of the disease was also observed. We identified high frequency tonality, a medical record of depression and youth as unfavourable prognostic factors. There was no relationship found with the years of evolution of the disease or with the number of vertigo crises. CONCLUSION In large samples of long evolution Ménières disease, patients do not perceive tinnitus as a problem that produces serious impairment in their quality of life.

[Clinical characteristics of tinnitus in Ménière's disease].

Abstract Introduction Menieres disease is characterised by vertigo, hearing loss and tinnitus. Various studies assess the problem of vertigo and audition deficit in Menieres disease, but only a few of these relate to the clinical characteristics of tinnitus, the aim of this study. Material and methods A transversal descriptive study of the behaviour of tinnitus in 88 patients in different stages of Menieres disease treated in a tertiary hospital was carried out. The different characteristics of disease were analysed: intensity was evaluated with an analoguevisual scale, subjective tonality through tonal shade references, the impact on the patients quality of life was tested by a self-appraisal questionnaire, and competence level was evaluated with the Tinnitus Handicap Inventory. Epidemiologic factors, personal records, hearing thresholds and evolution in the number of vertiginous crises in the previous six months were also taken into account. Results The average time of evolution of the disease was 15.4 years. The results evidence the development of tinnitus of moderate intensity (5/10) and low frequency (46%), with a slight impact on quality of life. Worsening in the quality of life related to hearing affectation and/or advanced stages of the disease was also observed. We identified high frequency tonality, a medical record of depression and youth as unfavourable prognostic factors. There was no relationship found with the years of evolution of the disease or with the number of vertigo crises. Conclusion In large samples of long evolution Menieres disease, patients do not perceive tinnitus as a problem that produces serious impairment in their quality of life.

Pulsatile Tinnitus From Bovine Aortic Arch Variant

When synchronous with arterial pulse, pulsatile tinnitus often has a vascular origin. It may be due to different causes, including vascular malformations, venous angiomas, vascular tumours (glomus), increased intracranial pressure and blood flow alterations, among others. Magnetic resonance angiography is the test of choice for the diagnosis of most arterial alterations. We report the case of a 50-year-old woman who presented pulsatile, chronic tinnitus in the right ear with over 25 years evolution, which increased with physical activity and decreased with cervical compression at the level of the carotid region. She did not suffer hearing loss, vestibular or neurological symptoms. Physical examination was unremarkable, with audiometry revealing a normal otoscopy and bilateral normoacusis. Magnetic resonance angiography (Fig. 1) showed a bovine aortic arch variant of the left common carotid which stemmed from a right arterial trunk and elongation of the basilar artery. The normal anatomical configuration of the aortic arch consists of 3 major vessels originating from this arch: innominate artery (brachiocephalic trunk), left common carotid artery and left subclavian artery. The so-called bovine aortic arch variant is a congenital anomaly of the aortic arch, whereby the brachiocephalic trunk and left common carotid artery arise from a common trunk which stems from the aortic arch. It is the most

Evolución de la hipoacusia neurosensorial bilateral en el síndrome de Vogt Koyanagi Harada

Vogt-Koyanagi-Harada syndrome is an autoimmune multisystem disease, characterized by the association of ocular inflammatory manifestations (uveitis and retinal detachment) and extraocular lesions such as meningismus and tegumentary or auditory findings. We report the case of a Hispanic woman with this syndrome.

Respuesta a «Tratamiento de la mastoiditis aguda en niños con implante coclear»

Agradecemos su contribución y suscribimos la importancia de subsanar los errores en las publicaciones que pueden generar equivocaciones futuras, como señala el autor. En efecto, se trata de una confusión, repetida en el texto, de la ceftazidima por la cefuroxima que, como es sabido, se trata de cefalosporinas con características y presentación diferentes. El tratamiento en los casos publicados de mastoiditis en niños con implante coclear fue con ceftriaxona intravenosa durante el ingreso hospitalario hasta su mejoría y con cefuroxima en presentación oral de forma ambulatoria unas 3 semanas. Es una equivocación que involuntariamente ha pasado todos los filtros hasta su publicación y solo en la tabla 2 aparece escrita de forma correcta. El cambio de Streptococcus por Staphylococcus en la tabla 2 es un error de imprenta, ya que en el original se utilizó la nomenclatura S. pyogenes, por lo que debió cambiarse posteriormente. No obstante, en la introducción se especificaba que la etiología más frecuente era debida a gérmenes de vías respiratorias superiores citando en concreto el grupo de Streptococcus.