Several surgical techniques have been documented for approaching and repairing superior semicircular canal dehiscence syndrome (SCDS). These techniques encompass the trans-middle cranial fossa, transmastoid, endoscopic approaches, and round window reinforcement (RWR). RWR entails the placement of connective tissue with or without cartilage and around the round window niche, restricting the round window\'s movement to minimize the 3rd window effect and restore the bony labyrinth closer to its normal state. We employed the multilayer RWR technique, resulting in significant postoperative improvement and long-lasting effects for 3.7 years in 2 cases. Here, we present the clinical findings, surgical procedures, and the effectiveness of multilayer RWR. This technique can be the initial choice for surgical treatments of SCDS due to its high effectiveness, longer-lasting effect, and minimal risk of surgical complications.

UNASSIGNED: The present study was conducted to generate data on awareness and incidence of sickle cell disease (SCD) and also to adduce the widespread myths peddled about SCD.
UNASSIGNED: Students studying in the Department of Nursing were recruited. A pretested, self-administered sickle cell assessment questionnaire was distributed electronically through WhatsApp group to collect necessary data. Participants were screened for malaria by thin blood smear analyses, and their hemoglobin (Hb) contents (g/dL) were determined by Sahli\'s haemoglobinometer. Statistical analyses were done using Origin (version 8.1, USA). A reliability study was performed for the validity of questionnaire data.
UNASSIGNED: Study participants had significantly high awareness regarding SCDs (89.9%, P < 0.001). Most participants (96.3%) were aware about government policy regarding premarital screening for genetic disorders and replied that the government has strict health policies backed by equally robust laboratory diagnostics. Moreover, none of the participants had SCDs, although their parents had a consanguineous marriage. Thin blood smear analyses of participants did not reveal any cases of Plasmodium falciparum. However, significant percentages (33.1%) were found to be anemic, probably due to their dietary habits and lifestyles, as has been reflected by questionnaire analyses. Furthermore, a very less number of students had knowledge about genetic variations that might occur in malaria-endemic regions after long exposure to offer protection from malaria. Knowledge about management practices was also lacking among study participants (29%).
UNASSIGNED: This research points to the necessity that the nursing study plan should focus on providing specific training on management skills and preventive measures for SCDs, which is of paramount importance.

暂无摘要。

BACKGROUND: Vestibular-evoked myogenic potential (VEMP) is commonly conducted with air-conducted (AC) stimuli whose intensity may exceed the prudential levels of acoustic exposure in susceptible subjects.
OBJECTIVE: To determine the diagnostic accuracy of AC VEMP for superior canal dehiscence syndrome (SCDS) at lowered acoustic stimulation levels.
METHODS: VEMP was tested in 10 SCDS patients and in 10 age/sex matched control subjects. VEMP were recorded on cervical muscles (cVEMP) and extraocular muscles (oVEMP) in response to short AC tone bursts at 500, 1000 and 2000 Hz delivered at 80 dB nHL (103 dB peSPL). Parameters of interest were the response amplitude and the frequency tuning.
RESULTS: VEMP evoked by AC stimuli at safe acoustic stimulation levels did effectively separate SCDS patients from healthy controls. The separation was optimal at all the frequencies tested, however 500 Hz resulted the best VEMP tuning frequency, especially at oVEMP.
CONCLUSIONS: Lowering the AC stimulation to the levels compatible with testing of patients susceptible to acoustic exposure didn\'t affect the VEMP diagnostic properties for SCDS.
CONCLUSIONS: SCDS may be screened by VEMP even among subjects susceptible for acoustic exposure.

The objective of this study is to report the surgical outcome after middle fossa approach (MFA) plugging in patients suffering from a superior semi-circular canal dehiscence (SCD) syndrome. This is a retrospective case review. Tertiary referral center. Sixteen ears in 13 patients with a SCD syndrome suffering from severe and disabling vestibular symptoms with a bony dehiscence on CT scan >3 mm and decreased threshold of cervical vestibular evoked potentials (cVEMPs). We assessed preoperatively: clinical symptoms, hearing, cVEMPs threshold, size of dehiscence and videonystagmography (VNG) with caloric and 100 Hz vibratory tests. Postoperatively, we noted occurrences of neurosurgical complication, evolution of audiological and vestibular symptoms, and evaluation of cVEMP data. Tullio\'s phenomenon was observed in 13 cases (81.3 %) and subjectively reported hearing loss in seven (43.7 %). All patients were so disabled that they had to stop working. No neurosurgical complications were observed in the postoperative course. In three cases (16.6 %), an ipsilateral and transitory immediate postoperative vestibular deficit associated with a sensorineural hearing loss (SNHL) was noted, which totally resolved with steroids and bed rest. All patients were relieved of audiological and vestibular symptoms and could return to normal activity with a mean follow-up of 31.1 months (range 3-95). No patient had residual SNHL. cVEMPs were performed in 14 ears postoperatively and were normalized in 12 (85.7 %). Two of the three patients operated on both sides kept some degree of unsteadiness and oscillopsia. MFA plugging of the superior semi-circular canal is an efficient and non-hearing deteriorating procedure.

暂无摘要。

OBJECTIVE: Venous thrombembolism is a significant cause of mortality in patients after subarachnoid hemorrhage (SAH). After screening a cohort of SAH for this complication, we proposed a refinement for risk stratification of venous thromboembolism.
METHODS: Our retrospective study included patients admitted to our academic medical center (2005-2007) for SAH from ruptured aneurysm and having survived beyond 72 hours. The 196 patients then underwent screening (i.e., duplex scans of the lower extremities) for deep vein thrombosis (DVT). Ultrasound scans were obtained when there was a clinical suspicion of DVT. Patient demographics and clinical variables were assessed as risk factors for DVT by logistic regression analysis.
RESULTS: Among 196 patients, the incidence of DVT was 9.7% and pulmonary embolism was 2%. In univariate analysis, factors significantly associated with DVT were absence of tobacco smoking, black race, male gender, poor admission Glasgow Coma Scale or World Federation of Neurological Surgeons grading scale for SAH, tall height, long hospital stay, and heavier body weight (P< 0.05). In multivariate analysis, only smoking, race, and length of stay were significant independent predictors of DVT. Aneurysm securing method and hypertension had no association with DVT.
CONCLUSIONS: Finding our SAH patients to be the largest group screened for DVT on the basis of our literature review, we confirmed many known risk factors for DVT and observed that smokers who abruptly quit lowered their risk of DVT. Our findings may be used for risk stratification when determining DVT chemoprophylaxis after SAH.