Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo of peripheral origin. The lateral semicircular canal (LSCC) follows the posterior semicircular canal (PSCC) as the site of pathology in the majority of patients. Therapy, aiming at relocating particles causing aberrant LSCC stimulation has been applied by forced prolonged positioning, barbecue, and particle repositioning maneuvers. Results of the different techniques are variable. This systematic review/meta-analysis aimed to find out which therapy technique yields higher cure rates. MedLine database provided at National Library of Medicine was searched for randomized controlled trials comparing results of different therapeutic techniques for patients with LSCC BPPV. For studies included in qualitative analysis/synthesis, the following were collected independently by the author: number of participants, count of patients with geotropic and apogeotropic LSCC in each treatment group, and resolution of vertigo/nystagmus assessed by symptomatic improvement and negative supine roll test 1&#x2013;24 hours following intervention considering the type of LSCC BPPV (geotropic/apogeotropic). Level Ia evidence (systematic review of RCTs) shows superiority of Gufoni maneuver over sham for both geotropic and apogeotropic LSCC BPPV. Comparisons between different therapeutic maneuvers for LSCC BPPV based on results of published RCTs could not be set.

Aly M. Nagy El-Makhzangy

Benign Paroxysmal Positional Vertigo of Lateral Semicircular Canal: A Systematic Review and Meta-Analysis

Objective. To elucidate the incidence of cisplatin induced ototoxicity in adult patients, with a focus on an adult population. Study Design. IRB approved retrospective study. Methods. The charts of patients who underwent cisplatin therapy from 1995 to present were reviewed. Inclusion criteria were (1) cisplatin as the primary chemotherapeutic agent and (2) hearing evaluation performed prior to and after treatment. Audiometric thresholds were measured by presenting pure-tone stimuli at 0.25 to 10.0&#x2009;kHz. Criteria for hearing loss were based on the Chang criteria. Cochlear radiation doses were also calculated in patients with primary tumors in their head and neck or brain. Results. There were 1565 patients that had undergone therapy with cisplatin from 1995 to 2014, which 30 met inclusion criteria. Eight were patients treated for head and neck or brain cancer. Evaluation with ANOVA testing identified statistically significant decline in audiometric scores for WRS and pure tone frequencies 500, 2000, 4000, 6000, and 8000&#x2009;Hz in the right ear. Overall, hearing loss was noted with 63&#x25; incidence and in patients who received radiation to their cochlea and cisplatin. Conclusion. The incidence of cisplatin induced ototoxicity was significant and even more prevalent in those patients receiving both cisplatin and radiation to their cochlea.

Joshua B. Greene

Robert Standring

Farzan Siddiqui

Syed F. Ahsan

Incidence of Cisplatin Induced Ototoxicity in Adults with Head and Neck Cancer

Voice disorders exert a dramatic influence on patients&#x2019; quality of life (QOL). The physical, functional, and emotional impact can be accurately assessed using the conventional questionnaire of &#x201c;voice handicap index&#x201d; (VHI) or its shorter version, the VHI-10. We evaluated the VHI scores of patients suffering from obstructive Reinke&#x2019;s edema, a benign laryngeal disorder, before and after endoscopic treatment. Comparison of pre- and postoperative VHI scores showed the treatment efficacy. The scores achieved were similar to asymptomatic individuals (control group), thus improving their quality of life. Furthermore, both VHI and VHI-10 tests yielded similar scores. We suggest routine systematic incorporation of the VHI-10 test for pre- and postoperative routine evaluation of patients with Reinke&#x2019;s edema. The results are faster and reliable.

Bassel Hallak

Fr&#xe9;d&#xe9;ric Olivier

Pedro S. Teiga

Salim Bouayed

Sonia von Wihl

Kishore Sandu

Subjective Voice Assessment after Endoscopic Surgery for an Obstructive Reinke Edema Using Voice Handicap Index

People with residual hearing in the low frequencies and profound hearing loss in the high frequencies often do not benefit from acoustic amplification. Focus on this group of patients led to the development of the combined electric-acoustic stimulation (EAS) systems which can provide users with greater speech perception than can cochlear implant (CI) alone or acoustic hearing alone. EAS users wear a combined speech processor that incorporates a behind-the-ear audio processor that sits with an ear hook on the user&#x2019;s pinna and a hearing aid, which sits in the ear canal. However, with the introduction of single-unit processors, which combine the audio processor, coil, control unit, and battery pack into a single device that sits on the implant site, therefore off the ear, simultaneous electric (CI) and acoustic (hearing aid) stimulation is not currently possible with a combined processor. To achieve EAS with a single-unit processor, a CI user must also wear a hearing aid. This study seeks to determine if experienced users of combined EAS speech processors could also benefit from using a combination of a single-unit speech processor that sits off the ear and an in-the-ear hearing aid.

Dayse T&#xe1;vora-Vieira

Stuart Miller

The Benefits of Using RONDO and an In-the-Ear Hearing Aid in Patients Using a Combined Electric-Acoustic System

Cervical vestibular evoked myogenic potential (cVEMP) and cochlear hydrops analysis masking procedure (CHAMP) have both shown sensitivity in identifying Meniere&#x2019;s disease. However none of the previous reports have compared the two tests for their relative efficacy in identifying Meniere&#x2019;s disease. Hence the present study aimed to compare the efficiency of cVEMP and CHAMP in evaluating Meniere&#x2019;s disease. The study included 58 individuals with unilateral definite Meniere&#x2019;s disease and an equal number of age and gender matched healthy individuals. cVEMP corresponding to 500&#x2009;Hz tone burst was recorded from ipsilateral sternocleidomastoid muscle and CHAMP was acquired from the conventional electrode sites for single channel auditory brainstem response recording using a default protocol of the Biologic Navigator Pro evoked potential system. Both cVEMP and CHAMP showed statistically significant differences between the groups (<svg xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg" style="vertical-align:-0.6617603pt" id="M1" height="9.65971pt" version="1.1" viewBox="-0.0498162 -8.99795 46.7259 9.65971" width="46.7259pt"><g transform="matrix(.0135,0,0,-0.0135,0,0)"><path id="g113-81" d="M600 480C600 590 528 650 384 650H143L137 622C222 614 225 607 210 531L130 127C113 41 106 36 23 28L17 0H294L300 28C204 36 195 42 212 127L243 284L314 263C327 263 339 263 352 264C465 271 600 337 600 480ZM508 481C508 351 402 304 329 304C289 304 265 311 250 317L295 559C302 594 310 606 323 611C335 616 350 619 367 619C455 619 508 573 508 481Z"/></g><g transform="matrix(.0135,0,0,-0.0135,12.15,0)"><path id="g117-91" d="M512 -3V55L134 254V256L512 456V514L75 281V230L512 -3Z"/></g><g transform="matrix(.0135,0,0,-0.0135,23.887,0)"><path id="g113-49" d="M241 635C89 635 35 457 35 312C35 153 89 -12 240 -12C390 -12 443 166 443 312C443 466 390 635 241 635ZM238 602C329 602 354 454 354 312C354 172 330 22 240 22C152 22 124 173 124 313S148 602 238 602Z"/></g><g transform="matrix(.0135,0,0,-0.0135,30.39,0)"><path id="g113-47" d="M113 -12C146 -12 170 11 170 46C170 78 146 103 114 103S58 78 58 46C58 11 82 -12 113 -12Z"/></g><g transform="matrix(.0135,0,0,-0.0135,33.48,0)"><use xlink:href="#g113-49"/></g><g transform="matrix(.0135,0,0,-0.0135,39.983,0)"><path id="g113-54" d="M153 550H386L412 615L406 623H120L82 318C104 327 142 338 184 338C294 338 347 275 347 187C347 112 305 39 221 39C160 39 119 71 97 89C88 97 80 96 71 90C59 80 50 67 49 57C48 45 52 36 66 23C80 9 123 -12 169 -12C221 -11 288 15 342 59C403 109 431 165 431 225C431 308 366 395 238 395C212 395 165 379 127 364L153 550Z"/></g></svg>). The receiver operating curves revealed 100&#x25; sensitivity and specificity for CHAMP as against 70.7&#x25; sensitivity and 100&#x25; specificity for cVEMP in identifying Meniere&#x2019;s disease. Therefore, CHAMP appears to be the test of choice provided the degree of hearing loss does not exceed a moderate degree. cVEMP could be used for all degrees of hearing losses, but with slight constraint on the sensitivity.

Niraj Kumar Singh

Rahul Krishnamurthy

Priya Karimuddanahally Premkumar

Relative Efficiency of Cochlear Hydrops Analysis Masking Procedure and Cervical Vestibular Evoked Myogenic Potential in Identification of Meniere&#x2019;s Disease

Follow-up program in squamous cell carcinoma of head and neck district is crucial to detect locoregional recurrence and second primary tumors and to manage treatment toxicities. The choice of the appropriate frequency of visits and imaging modality can be troublesome. Details of timing surveillance and type of diagnostic procedure are still not well defined. This review highlights the problem from a clinician&#x2019;s point of view.

Francesca De Felice

Daniela Musio

Vincenzo Tombolini

Follow-Up in Head and Neck Cancer: A Management Dilemma

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Advances in Otolaryngology