This article presents the case of an adolescent with asymptomatic coronavirus disease 2019 infection who had vestibular neuronitis symptoms.

The new coronavirus disease 2019 demonstrates neurotropic properties, apart from airway symptoms. Early in the pandemic, coronavirus disease 2019 infection had been associated with olfactory disturbances. Accumulative evidence supports that both the infection with coronavirus disease 2019 and the vaccination against the virus may induce a condition of vestibular hypofunction, known as vestibular neuronitis. Coronavirus disease 2019 may directly affect the vestibular organs and ganglia, or indirectly damage them via immune-mediated mechanisms. In most cases, complete recovery is achieved with the typical therapeutic approaches for vestibular neuronitis, consisting of supportive measures and corticosteroids.

Physicians may expect an increased incidence of vestibular neuronitis during the coronavirus disease 2019 pandemic. Conversely, coronavirus disease 2019 infection should be considered in patients with sudden vestibular symptoms.

There are currently no guidelines for simultaneous vestibular schwannoma surgery and cochlear implantation. This paper therefore provides our experience and our results regarding predictive parameters of good hearing.

Morphological appearance of the cochlear nerve after tumour resection was used as the main criterion for implantation in the case series. Patients were then divided into responders and non-responders to cochlear implantation, and potential outcome predicting factors were evaluated in the two groups.

Nine of the 16 patients showed a response to cochlear implantation. Pre-surgery serviceable hearing was significantly more common in the responder group, while no difference was found in the two groups for other variables.

This study highlights how the morphological appearance of the cochlear nerve can be useful to predict the hearing outcome and indicates that satisfactory hearing results are closely related to pre-surgery serviceable hearing.

To determine the short- and long-term outcomes of triple semicircular canal occlusion as a potential alternative for patients with intractable Ménière's disease.

A retrospective case series was performed in university settings, enrolling patients with intractable Ménière's disease with previous maximum treatment, who underwent transmastoid, triple semicircular canal occlusion. The study documented: pre- and post-operative Dizziness Handicap Inventory scores at six weeks and one year post-treatment, pure tone audiometry, and surgical aspects.

Two female patients, aged 42 and 65 years, underwent unilateral three-semicircular-canal occlusion. Their respective Dizziness Handicap Inventory scores improved from 88 to 68 and 54 to 30 at six weeks post-operatively, with scores of 66 and 0 at one year post-treatment. The one patient with pre-existing functional hearing maintained her hearing threshold post-operatively.

Triple semicircular canal occlusion is a safe, hearing-preserving, extracranial alternative technique that can control rotatory vertigo in patients with intractable Ménière's disease, when other measures have failed.

To summarise published research investigating maximal temperatures associated with endoscopes used in otology. Possible thermal issues surrounding the use of endoscopes in middle-ear surgery are discussed, and recommendations regarding the safest ways to use endoscopes in endoscopic ear surgery are made.

A non-systematic review of the relevant literature was conducted, with descriptive analysis and presentation of the results.

There are currently no reports of any temperature-related deleterious effects in patients having undergone endoscopic ear surgery. There is debate regarding heat issues in endoscopic ear surgery, with a limited body of work documenting potential negative impacts of middle-ear heat exposure from endoscopes. The diameter of endoscope, type of light source used, distance from endoscope tip and duration of exposure are highlighted potential factors for high temperatures in endoscopic ear surgery.

There is a trend towards endoscopes being used routinely in ear surgery. Simple practice points are recommended to minimise potential thermal risks.

Histopathological anomalies of inner-ear structures in individuals with Down syndrome have been well documented; however, few studies have examined the radiological features.

A retrospective study was conducted of temporal bone computed tomography images in 38 individuals (75 ears) with Down syndrome to evaluate the prevalence of inner-ear abnormalities and assess vestibular aqueduct widths.

Inner-ear anomalies were identified in 20 of the 38 individuals (52.6 per cent). Seven of the 75 temporal bones (9.3 per cent) were found to have higher than previously reported. A dilated internal auditory canal and vestibule were more common among the present study group, while prior studies have demonstrated internal auditory canal stenosis and decreased vestibule size.

Down syndrome patients exhibit a high prevalence of dysplastic inner-ear features that confer substantial risk of sensorineural hearing loss. Computed tomography is a useful screening aid to detect inner-ear abnormalities, particularly enlarged vestibular aqueducts, which cause preventable sensorineural hearing loss in this population.

This study aimed to determine whether there was any relationship between tinnitus and mean platelet volume.

This retrospective study was conducted between January 2013 and January 2014 in Ankara Atatürk Hospital and Ondokuz Mayıs University Hospital, Turkey, on a study group of 86 patients with tinnitus and a control group of 84 healthy subjects. Mean platelet volume was recorded and comparisons were made between the two groups.

Mean (± standard deviation) platelet volume was 7.67 ± 0.83 μm3 in the study group and 7.28 ± 0.56 μm3 in the control group. There was a statistically significant difference in mean platelet volume between the tinnitus patients and the healthy subjects (p < 0.05).

The clinical findings indicated that tinnitus patients had a higher mean platelet volume than the healthy control subjects; however, the pathophysiological mechanism remains unclear.

This study aimed to review the current advances in superior semicircular canal dehiscence syndrome and to ascertain its aetiology, whether dehiscence size correlates with symptoms, signs and investigation results, the best investigations, and its surgical management.

A literature search using the key words ‘superior semicircular canal dehiscence’ was performed using the Allied and Complementary Medicine Database and the Embase, Health Management Information Consortium, Medline, PsycINFO, British Nursing Index, Cinahl and Health Business Elite databases for the period January 2009 to May 2014. Systematic reviews, meta-analyses, randomised controlled trials, prospective and retrospective case series, case reports, and observational studies were included.

Of the 205 papers identified, 35 were considered relevant.

The aetiology of superior semicircular canal dehiscence syndrome is unclear. Dehiscence size significantly affects the air–bone gap and ocular vestibular evoked myogenic potential thresholds. Computed tomography evaluation has a high false positive rate. The middle cranial fossa approach is the surgical standard for treating this syndrome; however, the transmastoid approach is gaining popularity.

Vestibular evoked myogenic potentials are short latency electrical impulses that are produced in response to higher level acoustic stimuli. They are used clinically to diagnose sacculocollic pathway dysfunction.

This study aimed to compare the vestibular evoked myogenic potential responses elicited by click stimuli and short duration tone burst stimuli, in normal hearing individuals.

Seventeen subjects participated. In all subjects, we assessed vestibular evoked myogenic potentials elicited by click and short duration tone burst stimuli.

The latency of the vestibular evoked myogenic potential responses (i.e. the p13 and n23 peaks) was longer for tone burst stimuli compared with click stimuli. The amplitude of the p13–n23 waveform was greater for tone burst stimuli than click stimuli. Thus, the click stimulus may be preferable for clinical assessment and identification of abnormalities as this stimulus has less variability, while a low frequency tone burst stimulus may be preferable when assessing the presence or absence of vestibular evoked myogenic potential responses.

Endothelin has many biological activities, including regulation of the functions of the cochlear lateral wall. The present study aimed to analyse the expression of endothelin receptors in the cochlear lateral wall, and to investigate the significance of such receptors in maintaining the homeostatic environment of the cochlea.

The cochleae of healthy guinea pigs were fixed, decalcified, embedded in paraffin and serially sectioned. Expression of the endothelin receptor subunits A and B in the cochlear lateral wall was examined using an immunohistochemical technique.

Different degrees of endothelin receptor subunit A and endothelin receptor subunit B like activity were found distributed in the cells of the cochlear lateral wall.

These findings support the theory that endothelin, via its receptors, plays an important role in maintaining the homeostatic environment of the cochlea.

To determine the efficacy of vestibular rehabilitation with the electrotactile vestibular substitution system, as a new treatment modality in patients with bilateral vestibular disorders.

Nineteen patients with bilateral, chronic, idiopathic vestibulopathy were studied prospectively. Patients were divided to two groups. Patients in the first group were rehabilitated with the electrotactile vestibular substitution system, while patients in the second group were treated with standard vestibular rehabilitation therapy. The sensory organisation test and dizziness handicap inventory were used to compare the pre- and post-training results of both rehabilitative treatments.

All group one patients in the standardised testing subset demonstrated improved results for both the composite sensory organisation test and for the functional transfer aspect of the dizziness handicap inventory, after five days' training with the electrotactile vestibular substitution system. In contrast, group two patients showed no significant improvement in their composite sensory organisation test or dizziness handicap inventory scores after eight weeks of therapy, compared with pre-treatment levels.

These preliminary results indicate the efficacy of the electrotactile vestibular substitution system in improving patients' symptoms of vestibulopathy, and constitute evidence of successful sensory substitution.

We describe a case of benign paroxysmal positional vertigo which occurred after use of a whole-body vibration training plate.

Case report and literature review concerning the secondary causes of benign paroxysmal positional vertigo and the physiological effects of whole-body vibration training plates.

A 44-year-old woman was referred with classic symptoms of benign paroxysmal positional vertigo following use of a whole-body vibration training plate, a popular form of fitness equipment widely used in sports, rehabilitation and beauty treatments. The condition resolved spontaneously after several days. There have been reports of negative side effects in users of this equipment, such as dizziness, headache and a sensation of imbalance; however, there have been no reported cases involving vertigo. Based on a literature review, this equipment may cause side effects, including vertigo, by generating forces that can increase the original amplitude of internal organs, which may potentially cause labyrinthine trauma or dislocation of otoconia, leading to benign paroxysmal positional vertigo.

We suggest that whole-body vibration training plates may potentially induce benign paroxysmal positional vertigo. Manufacturers may need to make users of this equipment aware of this risk, and remind them to use it with caution.

Prospective, case–control study.

The study included 26 randomised patients with systemic lupus erythematosus (52 ears) and 30 healthy control subjects (60 ears). Pure tone audiometry was performed at 250 and 500 Hz and at 1, 2, 4, 6, 8, 10, 12, 14 and 16 kHz. Distortion product otoacoustic emissions and transient evoked otoacoustic emissions were measured using Biologic System equipment with Scout Acoustic Emissions System software.

The distortion product otoacoustic emission signal responses were significantly different only at 750 Hz, while the distortion product otoacoustic emission signal–noise ratios were significantly different at 750 Hz and 6 kHz (p < 0.05), comparing patients and controls. The transient evoked otoacoustic emission signal–noise ratios were significantly different at 2 and 3 kHz, comparing patients and controls (p < 0.05). The transient evoked otoacoustic emission total signal–noise ratios were significantly different, comparing patients and controls (p < 0.05). In addition, the pure tone audiometry thresholds were significantly different at 250 and 500 Hz and at 1, 2, 10 and 12 kHz, comparing patients and controls (p < 0.05).

Our findings do not completely agree with those of previous temporal bone histopathological studies. However, our results do support a general picture of low frequency hearing loss in systemic lupus erythematosus patients. We consider these results to be related to endolymphatic and cochlear hydrops, and we suggest that electrocochleography could be performed in further studies for clarification of this subject.

The auditory brainstem response consists of fast and slow waves. The acoustically evoked, short latency negative response is a large, negative deflection with a latency of 3 milliseconds which has been reported in patients with profound hearing loss. It may be of vestibular, particularly saccular, origin, as is the vestibular evoked myogenic potential.

To assess the presence of acoustically evoked, short latency negative responses in children with severe to profound sensorineural hearing loss.

Twenty-three children (46 ears) with sensorineural hearing loss underwent audiological evaluation and auditory brainstem response, vestibular evoked myogenic potential and caloric testing.

An acoustically evoked, short latency negative response was present in 30.43 per cent of ears and absent in 69.57 per cent. Vestibular evoked myogenic potentials were recorded in all ears in the former group, but in only 53.13 per cent in the latter group. Caloric testing was normal in 82.6 per cent of the total ears tested.

The presence of an acoustically evoked, short latency negative response is dependent not on residual hearing but on normal saccular function. This response can be measured in patients who cannot contract their neck muscles.

To present the theory that large vestibular aqueduct syndrome (i.e. the recognised existence of an enlarged vestibular aqueduct with progressive sensorineural hearing loss) and endolymphatic hydrops are due to a common primary dysfunction of inner-ear fluid homeostasis.

Case report and review of the world literature concerning large vestibular aqueduct syndrome and endolymphatic hydrops.

We report a family in which one sibling suffered from large vestibular aqueduct syndrome while the other had classic Ménière's disease. This suggests that large vestibular aqueduct syndrome and endolymphatic hydrops, in some cases, may be due to a common primary dysfunction of inner-ear fluid homeostasis.

To our knowledge, this is the first report in the world literature to postulate that variation in the relative compliance of inner-ear membranes could be the factor that determines the manifestation of the disorder as either endolymphatic hydrops or large vestibular aqueduct syndrome.

To analyse the possible impact of low and extremely low frequency electromagnetic fields on the outer hairs cells of the organ of Corti, in a guinea pig model.

Electromagnetic fields of 50, 500, 1000, 2000, 4000 and 5000 Hz frequencies and 1.5 µT intensity were generated using a transverse electromagnetic wave guide. Guinea pigs of both sexes, weighing 100–150 g, were used, with no abnormalities on general and otic examination. Total exposure times were: 360 hours for 50, 500 and 1000 Hz; 3300 hours for 2000 Hz; 4820 hours for 4000 Hz; and 6420 hours for 5000 Hz. One control animal was used in each frequency group. The parameters measured by electric response audiometer included: hearing level; waves I–IV latencies; wave I–III interpeak latency; and percentage appearance of waves I–III at 90 and 50 dB sound pressure level intensity.

Values for the above parameters did not differ significantly, comparing the control animal and the rest of each group. In addition, no significant differences were found between our findings and those of previous studies of normal guinea pigs.

Prolonged exposure to electromagnetic fields of 50 Hz to 5 KHz frequencies and 1.5 µT intensity, produced no functional or morphological alteration in the outer hair cells of the guinea pig organ of Corti.

Although most studies on animal ototoxicity employ scanning electron microscopy, all cochlear structures may be identified with light microscopy. This paper describes a simple method of histological assessment of cisplatin-induced ototoxicity in rats, and relates morphological changes to functional changes in hearing detected by distortion product evoked otoacoustic emissions.

Male Wistar rats were injected with 8 mg/kg/day cisplatin, or with an equivalent volume of saline solution, for three consecutive days. They underwent distortion product evoked otoacoustic emission testing at baseline and at 24 or 48 hours after the last administration. At the end of the experiment, the animals were sacrificed and their cochleae were retrieved and prepared for haematoxylin and eosin staining.

A four-point scoring system was used to grade injury to the external ciliated cells, as indicated by the number of cells absent from the basal turn of the cochlear duct. A four-point scoring system was also used to grade stria vascularis injury, as indicated by the degree of shrinkage of the intermediate cells. Scores were significantly higher in groups treated with cisplatin compared with controls. Morphological changes were confirmed by decreased distortion product evoked otoacoustic emission amplitudes in animals treated with cisplatin.

This method is simple to perform with routine histology equipment and is appropriate for the study of acute, cisplatin-induced ototoxicity in rats.

To evaluate the effectiveness of hyperbaric oxygen therapy in the management of sudden hearing loss.

Patients with sudden hearing loss were divided into study and control groups. The 36 patients in the study group were treated with hyperbaric oxygen therapy in addition to standard medical therapy, whereas the 21 patients in the control group were treated with only standard medical therapy.

Both groups were treated with standard therapy, comprising prednisolone starting at a dose of 1 mg/kg and reducing over three weeks. Patients in the study group received hyperbaric oxygen therapy in addition to standard drug therapy.

Success rates were 78.95 per cent in the study group and 71.30 per cent in the control group. However, this difference was not statistically significant (p > 0.05).

Considering the cost of hyperbaric oxygen therapy and its inconvenience to patients, this treatment should only be considered in patients suffering sudden hearing loss if there are contraindications to standard medical treatment.