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Case Review |
Clinical
Radiograph of The Week |
An 59-year old male presented with sudden onset of
vertigo of 12 days duration associated with left sided tinnitus and
hearing loss. He had no associated otalgia or otorrhoea. He was treated
for Left sided Ramsay-Hunt syndrome 16 years earlier with incomplete
resolution of facial palsy. Examination revealed left ptosis, left
incomplete facial palsy (House-Brackman grade 3), Normal Otoscopy
with lateralization of Weber's test to right ear. CT-scan of brain was
negative. CT-scan of the neck revealed the features demonstrated in this
radiograph.
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What is the Diagnosis? |

1. 110th
American Academy of ORL, Head & Neck Surgery Annual Meeting & OTO EXPO, September
17-20, 2006; Toronto, Canada.
2.
42nd
South African ENT Congress joint meeting with the British Association of
Otolaryngology - Head & Neck Surgery, October 8 - 11, 2006; Cape Town,
South Africa. Click
HERE for More Info
3.
16th Annual oto-rhino-laryngological society of Nigeria (ORLSON) General Meeting
& Scientific Conference; November 22nd - 25th, 2006; Kaduna, Nigeria

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This study from Athens, Greece (Xenellis J. et al,
J Laryngol Otol. 2006 Jul 19;:1-7. )
examined the prognostic factors in idiopathic sudden sensorineural
hearing loss and concluded that identification of wave V on ABR within
first month of medical treatment might be significant prognostic
factor. Abstract: Objectives: Sudden sensorineural hearing
loss (SSHL) remains a challenge for the clinician. In the majority of
cases, no definite cause can be found and the prognosis is variable.
Methods: The present study assessed 114 patients suffering from
idiopathic SSHL, with regard to the prognostic value of demographic,
epidemiologic, neurotologic and audiometric factors. In addition, the
relationship between the identification of wave V in auditory brainstem
responses and the final hearing outcome was investigated. All patients
received 75 mg/day intravenous prednisolone, divided into three daily
doses, for 10 days, with gradual tapering of the dose over the next 10
days. Results: The results (after one year follow up) revealed
the following factors to be related to a better hearing outcome:
younger age; male sex; less time elapsed between the onset of hearing
loss and the beginning of treatment; and an upward-sloping or cupeloid
audiogram contour. The detection of wave V early in recovery and within
the first month of medical treatment might also constitute a
significant favourable factor in respect to hearing recovery.
Conclusions: The present study revealed that there are certain
factors that affect prognosis in idiopathic SSHL. This is very
important in counselling patients and may affect current clinical
practice.
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Journal Watch :
The Edwin Smith Papyrus: the birth of analytical
thinking in medicine and otolaryngology - Stiefel, Shaner & Schaefer, 2006
1. Reviewers
wanted for otolaryngology news journal's watch page. If you are an
Otolaryngologist in Africa and will like to be our journal reviewer, please feel
free to email orl-mailer@otolaryngologyinafrica.net
2. DODA
2006, capable of advanced hearing measure, and also paediatric hearing
assessment is being developed. If you requested for and got a free copy of DODA,
you may also look out for this latest version dubbed DODA-i, as well as for an
additional page on outcome of hearing assessment using DODA.
3. A subweb of this site, dedicated to online
publications of otorhinolaryngological grand round presentations across
Institutions all over Africa will soon take off. The subweb once active can be
accessed at http://www.otolaryngologyinafrica.net/grandround/ . Watch out, and please take
advantage of this to send in your grand round presentations. Also watch out for
online discussion forum for discussion of issues concerning otolaryngologists,
but not really of clinical nature at
http://otolaryngologyinafrica.net/discussionforum/
Till Next Week,
Biodun
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© Copyright Dr 'Biodun Olusesi, 2005 - 2006
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