| Conscientiousness
in patients with Ménière's disease.
Otol Neurotol. 2007 Apr;28(3):365-8.
OBJECTIVE:
To assess whether a conscientious personality profile is more
prevalent in patients with Ménière's disease (MD) in comparison
with other vertigo patients. Second, to investigate a sex effect and
compare the obtained conscientiousness scores with published
normative values. PATIENTS: A total of 108 patients were included
and subdivided into one of five pathology groups: MD, benign
paroxysmal positional vertigo, vestibular neuritis, vestibular
schwannoma, and posttraumatic nonbenign paroxysmal positional
vertigo. INTERVENTION: The conscientiousness domain of the
self-reporting NEO Five-Factor Inventory questionnaire. MAIN OUTCOME
MEASURE: Conscientiousness score. RESULTS: There was no significant
difference between the diagnostic groups or a sex effect. MD
patients had a higher score than published normal values.
CONCLUSION: As assessed with the NEO Five-Factor Inventory
questionnaire, MD patients do not demonstrate a higher conscientious
personality profile in comparison with other vertigo patients.
Therefore, this limits the clinical use of the personality profile
to discriminate between patient groups.
Otosclerosis
associated with Ménière's disease: a histological study. Adv
Otorhinolaryngol. 2007;65:50-2.
A
histological study of a pair of temporal bones was performed in a
case of Menière's disease. A severe endolymphatic hydrops and
extensive capsular otosclerosis bilaterally was found. Severe
endolympathic hydrops results from otosclerotic endolympahtic duct
occlusion. Our unique histopathological findings show that a causal
association exists between these two entities.
Non-specific immunological determinations in Meniere's disease:
any role in clinical practice? Eur Arch Otorhinolaryngol 2007
Jan;264(1):15-9. Epub 2006 Oct 11.
Several
studies supported the hypothesis that an autoimmune response may be
a pathogenetic factor in Meniere's disease occurrence. It has been
demonstrated that the endo-lymphatic sac has an important role in
the immuno-mediated reaction and it has also become evident that an
immunological mechanism may be involved in the development of endo-lymphatic
hydrops. The present study was carried out in order to analyse the
validity of serological non-specific immune tests in determining the
possible role of immune pathology in 200 Meniere's suffering
patients. The immune activity was investigated determining the
erythrocyte sedimentation rate (ESR), the C-reactive protein levels,
the rheumatoid factor, the serum immunoglobulin levels by group, the
complement levels, the lymphocyte sub-populations, the
cryoglobulines, the circulating immune complexes (CIC), organ and
non-organ auto-antibodies. Levels of Ig, ESR, C-reactive protein,
rheumatoid factor, complement fractions and cryoglobulines were
either negative or non-significant in the considered cohort of
Meniere's disease suffering patients. On the other hand, in more
than half of the sample group high values of CIC were found. Data
concerning T-lymphocyte sub-population indicates a clear increase in
T-helper compared to T-cytotoxic cells, with an increase in the
CD4/CD8 ratio. The datum of particular interest concerns analysis of
T-cells activation complexes. Our present findings show that early
activated T-lymphocytes change and in particular changes occur in
the expression of the interleukin-2 receptor. Moreover, it seems to
be possible to correlate the alteration of the immunological tests
and the phase of the disease. Present data showed that the
immunological factor should be considered a relevant element in most
of the cases of Menière's disease.
Ménière's
disease review 2005. J Am Acad Audiol. 2006 Jan;17(1): 16-26.
Ménière's
disease (MD) is a complex, multifactorial disorder of the inner ear
that is the most common cause of the syndrome of episodic vertigo
combined with fluctuating hearing loss. In spite of a century of
investigation, the etiology and pathophysiology of MD remain
controversial and incompletely understood. Among the factors that
have contributed to these controversies are the absence of (1) a
validated clinical test, (2) an appropriate animal model, and (3) a
specific treatment. Nonetheless, physicians are able to assist MD
patients with a variety of tailored, symptom-specific medications
and therapies. Given that the vertigo induced by MD, in general, is
self-limited, the long-term outlook for balance function is good.
The same cannot be said for the hearing dysfunction of MD.
Diameter of the
cochlear nerve in endolymphatic hydrops: implications for the
etiology of hearing loss in Ménière's disease. Laryngoscope.2005
Sep;115(9):1525-35.
OBJECTIVE/HYPOTHESIS:
Endolymphatic hydrops (ELH) is an important histopathological
hallmark of Ménière's disease. Experimental data from human
temporal bones as well as animal models of the disorder have
generally failed to determine the mechanism by which ELH or related
pathology causes hearing loss. Hair cell and spiral ganglion cell
counts in both human and animal case studies have not, for the most
part, shown severe enough deterioration to explain associated severe
sensorineural hearing loss. However a limited number of detailed
ultrastructural studies have demonstrated significant reductions in
dendritic innervation densities, raising the possibility that
neurotoxicity plays an important role in the pathology of
Ménière's disease (MD) as well as experimental endolymphatic
hydrops (ELH). This study tests the hypothesis that neurotoxicity is
an important primary mediator of injury to the hydropic ear and is
reflected in measurable deterioration of the cochlear nerve in the
animal model of ELH. This study also explores the previously
presented hypothesis that cochlear injury in ELH is mediated through
the actions of nitric oxide (NO) by evaluating whether hearing loss
or various measures of cochlear damage can be ameliorated by
administration of an agent that limits excess production of NO.
STUDY DESIGN: Part one of the project involves the surgical
induction of endolymphatic hydrops and correlation of long term
hearing loss with histological parameters of ELH severity as well as
cochlear nerve and eighth cranial nerve diameter measurements. In
part two, aminoguanidine is administered orally to a separate set of
hydropic animals in an attempt to limit cochlear injury presumably
mediated by NO. METHODS: Guinea pigs are subjected to surgical
induction of unilateral endolymphatic hydrops after establishing
baseline ABR thresholds at 2, 4, 8, 16, and 32 kHz. Threshold shifts
are established prior to sacrifice at 4 to 6 months and temporal
bones processed for light microscopy. Measurements of cochlear nerve
and eighth cranial nerve maximal diameters as well as average
maximal diameters are carried out and correlated to hearing loss and
a semi-quantitative measure of hydrops severity. The identical
experiments are carried out in animals treated with aminoguanidine,
an inhibitor of inducible nitric oxide synthase. RESULTS:: The mean
maximal diameter (n = 14) of the hydropic cochlear nerve was
significantly reduced (432.14 +/- 43.18 vs. 479.28 +/- 49.22
microns, P = .0025) as compared to the control nerve. This was also
seen in measures of the eighth cranial nerve (855.71 +/- 108.82 vs.
929 +/- 81.53 microns, P = 0.0003). Correlation studies failed to
show correlation between hydrops severity and a cochlear nerve
deterioration index (r = -0.0614, P = .8348). Similarly, hearing
loss severity failed to correlate with cochlear nerve deterioration
(r = 0.1300, P = .6577). There was a significant correlation between
hearing loss and hydrops severity (r = 0.6148, P = .0193).
Aminoguanidine treated animals (n = 5) also sustained nerve
deterioration to the same degree as non-treated animals and there
appeared to be no protective effect (at the dosage administered)
against ELH related hearing loss, hydrops formation, or nerve
deterioration. CONCLUSION: ELH results in significant deterioration
of cochlear nerve and eighth cranial nerve maximal diameters in the
guinea pig model. These findings are in accord with previous studies
which detected ultrastructural evidence of dendritic damage and
indicate that neural injury is of sufficient severity to result in
light microscopic evidence of cochlear nerve and eighth cranial
nerve deterioration. These data support the concept that the
principle pathological insult in ELH is a form of neurotoxicity,
especially in light of previous studies which indicate relative
preservation of hair cells at similar points in time. The lack of
correlation between the severity of hydrops and nerve deterioration
suggests that nerve deterioration is independent of hydrops
severity.
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