1
|
Celis-Aguilar E, Mayoral-Flores HO, Torrontegui-Zazueta LA, Medina-Cabrera CA, León-Leyva IC, Dehesa-López E. Effectiveness of Brandt Daroff, Semont and Epley maneuvers in the treatment of Benign Paroxysmal Positional Vertigo: A Randomized Controlled Clinical Trial. Indian J Otolaryngol Head Neck Surg 2022; 74:314-321. [PMID: 36213465 PMCID: PMC9535051 DOI: 10.1007/s12070-021-02516-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 03/15/2021] [Indexed: 11/28/2022] Open
Abstract
The aim was to compare the effectiveness of Brandt-Daroff, Semont and Epley maneuver in BPPV resolution. A Single Blind RCT in a Secondary Care Center was performed. Inclusion criteria were: patients with unilateral rotatory nystagmus on Dix-Hallpike Maneuver (DHM). Exclusion criteria: other causes of peripheral or central vertigo. Patients were randomized into 4 groups: Brandt-Daroff, "sham", Semont and Epley. Patients underwent allocation, 1st visit (at 1 week with reprise of original maneuver if persistent nystagmus) and 2nd visit (2 to 4 weeks) with repetitions of both DHM and DHI. Main Outcome Measures: Absence of nystagmus on DHM at 1st and 2nd visit evaluations and DHI score. Resolution was defined as the abscence of nystagmus. We included 34 patients (25 females, 9 males). Patients were randomized to Brandt-Daroff (n = 9), "sham" (n = 7), Semont (n = 9) and Epley (n = 9) group. Overall mean age was 59.85 years (SD ± 13.10). A total of 47.06% patients (n = 16) had negative DHM at 1st visit. Resolution for Brandt-Daroff was 22.22%, "sham" 28.57%, Semont 44.44% and Epley 88.88% (p = 0.024); at 2nd visit follow up, Epley achieved 100% resolution (other maneuvers: 42.86%, 16.67%, 44.44%, respectively. P = 0.006). The DHI improvement at 2nd visit for Brandt-Daroff was 21.17 points, "sham" 8.05, Semont 14.67 and Epley 61.78 (p = 0.001). Epley maneuver was superior to Brandt Daroff, "sham" and Semont maneuvers on nystagmus resolution and DHI improvement in patients with BPPV.
Collapse
Affiliation(s)
- Erika Celis-Aguilar
- Department of Otorhinolaryngology and Head and Neck Surgery, Center of Research and Teaching in the Health Sciences (CIDOCS), Civil Hospital of Culiacan, Autonomous University of Sinaloa, Eustaquio Buelna #91, 80030 Culiacan, Sinaloa Mexico
| | - Homero Oswaldo Mayoral-Flores
- Center of Research and Teaching in the Health Sciences (CIDOCS), Civil Hospital of Culiacan, Autonomous University of Sinaloa, 80030 Culiacan, Mexico
| | - Luis Alejandro Torrontegui-Zazueta
- Center of Research and Teaching in the Health Sciences (CIDOCS), Civil Hospital of Culiacan, Autonomous University of Sinaloa, 80030 Culiacan, Mexico
| | - Cindy Anahí Medina-Cabrera
- Center of Research and Teaching in the Health Sciences (CIDOCS), Civil Hospital of Culiacan, Autonomous University of Sinaloa, 80030 Culiacan, Mexico
| | - Ivonne Carolina León-Leyva
- Center of Research and Teaching in the Health Sciences (CIDOCS), Civil Hospital of Culiacan, Autonomous University of Sinaloa, 80030 Culiacan, Mexico
| | - Edgar Dehesa-López
- Department of Statistics, Center of Research and Teaching in the Health Sciences (CIDOCS), Civil Hospital of Culiacan, Autonomous University of Sinaloa, 80030 Culiacan, Mexico
| |
Collapse
|
2
|
Celis-Aguilar E, Obeso-Pereda A, Castro-Bórquez KM, Dehesa-Lopez E, Vega-Alarcon A, Coutinho-De Toledo H. Multiple Audiometric Analysis in the Screening of Vestibular Schwannoma. Cureus 2022; 14:e21492. [PMID: 35103228 PMCID: PMC8783613 DOI: 10.7759/cureus.21492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2022] [Indexed: 01/14/2023] Open
Abstract
Introduction Asymmetric sensorineural hearing loss is the main early symptom of retrocochlear lesions, hence its importance in screening for vestibular schwannomas. Currently, there is no consensus regarding its definition. The objective was to identify the audiometric pattern that would serve as a predictor for vestibular schwannoma in patients with asymmetric hearing loss. Materials and methods A cross-sectional study was conducted that included patients with asymmetric hearing loss attending a secondary care center and a tertiary care center. Clinical, audiometric and imaging (MRI with gadolinium) variables were collected. Asymmetric hearing loss was defined as a difference of 15 dB in one or more frequencies between both ears. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of different audiometric patterns were analyzed. Results A total of 107 patients were studied and divided into two groups: group 1 without vestibular schwannoma (n=98); and group 2 with vestibular schwannoma (n=9). No significant difference in demographic characteristics or audiometric patterns was found in patients with and without vestibular schwannoma. The audiometric pattern with the best sensitivity as a screening test was a difference >20 dB in the 4,000 Hz frequency, with a sensitivity of 77.78%, specificity of 30.61%, PPV of 8.33%, NPV of 93.75% and accuracy of 34.50%. Conclusion The audiometric pattern with the best results was a difference >20 dB in the 4,000 Hz frequency range; however, patients with asymmetric hearing loss could not be differentiated from patients with retrocochlear lesions based only on audiometry. Asymmetrical hearing loss must be studied with MRI.
Collapse
|
3
|
Espinoza-Valdez A, Celis-Aguilar E, Torres-Gerardo F, Cantú-Cavazos N, Dehesa-Lopez E. In Search of a Neurotologic Profile in COVID-19 — A Study in Health Care Workers. Cureus 2022; 14:e21015. [PMID: 35028241 PMCID: PMC8747973 DOI: 10.7759/cureus.21015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction COVID-19 is an emerging disease and the neurotologic symptoms are still not well understood. Furthermore, the development of a neurotological profile and its associated factors can help the clinician in the diagnosis and treatment of this disease. The objective is to determine the neurotologic manifestations experienced by COVID-19 positive health care workers and their associated factors. Methods A symptoms survey was administered to health care workers who were positive to COVID-19 from September to October 2020. An informed consent form was digitally signed and Google Forms software was used for the survey. Frequencies and percentages were used for categorical variables, and associated clinical features were reported with odds ratios. Results We included 209 COVID-19 positive health care workers, 55.5% (n = 116) were women, and 44.5% (n = 93) were men. Fifty-three percent of patients were 20 to 30 years old and 56.4% had at least one comorbidity. The prevalence of neurotological manifestations was 18.6% (n = 39/209), the most frequent symptoms were vertigo (61.5%, n = 24/39), tinnitus (43.5%, n = 17/39), imbalance (43.5%, n = 17/39), and one case of facial paralysis (2.5%, n = 1/39). Neurotological manifestations were associated predominantly with asthenia (p = 0.021), loss of smell (p = 0.002) and taste dysfunction (p = 0.002). Conclusion The most common neurotological manifestations were vertigo, tinnitus and imbalance. Clinical features associated with a neurotologic profile were asthenia, hyposmia and dysgeusia.
Collapse
|
4
|
Celis-Aguilar E, Medina-Cabrera CA, Torrontegui-Zazueta LA, Núñez-Millán BX, García-Valle CG, Ochoa-Miranda CA. Adaptation and validation of the chronic otitis media questionnaire 12 (COMQ-12) in the Mexican Spanish language (COMQ-12-Mx). Acta Otolaryngol 2020; 140:450-455. [PMID: 32125212 DOI: 10.1080/00016489.2020.1730438] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Background: Chronic otitis media (COM) questionnaire 12 (COMQ-12) is a specific-disease tool that evaluates COM patients.Objective: To validate COMQ-12 in the Mexican Spanish language (COMQ-12-Mx).Materials and methods: Mexican Spanish-speaking healthy volunteers and COM patients who attended a Secondary Care Center from May 2019 to October 2019. The COMQ-12 in Mexican Spanish was obtained by translation and back translation from an English-Spanish translator. All participants completed the COMQ-12-Mx questionnaire. COM patients were included regardless of their COM status. Control group completed the questionnaire twice. Participants were categorized into three groups: group 1 (COM), group 2 (volunteers first test) and group 3 (volunteers retest). Cronbach's alpha was used for internal consistency, Spearman's rank correlation coefficient was used for test-retest reliability and Mann-Whitney U test compared groups.Results: We included 78 Mexican Spanish-speaking participants (COM n = 37, healthy volunteers n = 41), 51 females and 27 males, mean age was 39.67 years (SD ± 18.32). Group 1 COMQ-12-Mx score was 22.108 ± 11.79, group 2 score was 3.561 ± 4.399 (p ≤ .001) and group 3 score was 3.683 ± 4.435. Cronbach's alpha was 0.828 and test-retest reliability achieved a 0.928 outcome.Conclusions: COMQ-12-Mx is a valid and reliable tool to evaluate quality life in Mexican Spanish-speaking patients with COM.
Collapse
Affiliation(s)
- Erika Celis-Aguilar
- Department of Otolaryngology and Neurotology, Center of Research and Teaching in Health Sciences, Civil Hospital of Culiacán, Autonomous University of Sinaloa, Sinaloa, Mexico
| | - Cindy Anahí Medina-Cabrera
- Department of Otolaryngology and Neurotology, Center of Research and Teaching in Health Sciences, Civil Hospital of Culiacán, Autonomous University of Sinaloa, Sinaloa, Mexico
| | - Luis Alejandro Torrontegui-Zazueta
- Department of Otolaryngology and Neurotology, Center of Research and Teaching in Health Sciences, Civil Hospital of Culiacán, Autonomous University of Sinaloa, Sinaloa, Mexico
| | - Blanca Xóchitl Núñez-Millán
- Resident of Otolaryngology, Center of Research and Teaching in Health Sciences. Civil Hospital of Culiacán, Autonomous University of Sinaloa, Sinaloa, Mexico
| | - César Guillermo García-Valle
- Department of Otolaryngology and Neurotology, Center of Research and Teaching in Health Sciences, Civil Hospital of Culiacán, Autonomous University of Sinaloa, Sinaloa, Mexico
| | - Carlos Andrey Ochoa-Miranda
- Department of Otolaryngology and Neurotology, Center of Research and Teaching in Health Sciences, Civil Hospital of Culiacán, Autonomous University of Sinaloa, Sinaloa, Mexico
| |
Collapse
|
5
|
Jimenez-Garcia L, Celis-Aguilar E, Díaz-Pavón G, Muñoz Estrada V, Castro-Urquizo Á, Hernández-Castillo N, Amaro-Flores E. Efficacy of topical clotrimazole vs. topical tolnaftate in the treatment of otomycosis. A randomized controlled clinical trial. Braz J Otorhinolaryngol 2020; 86:300-307. [PMID: 30826311 PMCID: PMC9422661 DOI: 10.1016/j.bjorl.2018.12.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 11/14/2018] [Accepted: 12/11/2018] [Indexed: 11/29/2022] Open
Abstract
Introduction Otomycosis, an infection of the ear canal by fungi, is prevalent in hot and humid weather. Nevertheless, there is not sufficient evidence for the effectiveness of different topical antifungal treatments. Tolnaftate, is a topical antifungal agent described to be effective in the treatment of otomycosis. Currently there are not sufficient studies that prove its efficacy. Objectives To compare the efficacy of clotrimazole and tolnaftate administration in the treatment of otomycosis. Material and methods A controlled, randomized and open clinical trial included patients diagnosed with fungal external otitis who were treated with topical antifungals, randomized into two treatment groups: (1) clotrimazole cream; (2) tolnaftate solution. They were microscopically evaluated at one and two weeks of treatment to determine resolution of disease. Recurrence and complications were recorded. Demographic and clinical variables were collected and analyzed. Follow-up and final outcomes (absence of infection) were compared between groups. Results Forty eight patients were included, 28 in the clotrimazole group and 20 in the tolnaftate group. Spring was the weather most commonly associated with otomycosis, while otic manipulation was the risk factor more common in both groups. Predominant symptoms were itching and otic fullness. Aspergillus niger organism was isolated most frequently. Treatment with clotrimazole resulted in 75% resolution vs 45% resolution with treatment with tolnaftate at one week of treatment (p = 0.007). The Tolnaftate treatment group demonstrated higher recurrence rates and treatment failures, 20% and 15% respectively. Conclusions Clotrimazole cream treatment is more effective than tolnaftate for uncomplicated otomycosis. More studies are needed to corroborate our results.
Collapse
Affiliation(s)
- Lesly Jimenez-Garcia
- Universidad Autónoma de Sinaloa, Centro de Investigación y Docencia en Ciencias de la Salud, Otolaryngology Department, Culiacán, Mexico
| | - Erika Celis-Aguilar
- Universidad Autónoma de Sinaloa, Centro de Investigación y Docencia en Ciencias de la Salud, Otolaryngology Department, Culiacán, Mexico.
| | - Gaudencio Díaz-Pavón
- Universidad Autónoma de Sinaloa, Centro de Investigación y Docencia en Ciencias de la Salud, Otolaryngology Department, Culiacán, Mexico
| | - Victor Muñoz Estrada
- Universidad Autónoma de Sinaloa, Centro de Investigación y Docencia en Ciencias de la Salud, Mycology Department, Culiacán, Mexico
| | - Ángel Castro-Urquizo
- Universidad Autónoma de Sinaloa, Centro de Investigación y Docencia en Ciencias de la Salud, Otolaryngology Department, Culiacán, Mexico
| | - Nemiliztli Hernández-Castillo
- Universidad Autónoma de Sinaloa, Centro de Investigación y Docencia en Ciencias de la Salud, Otolaryngology Department, Culiacán, Mexico
| | - Ernesto Amaro-Flores
- Universidad Autónoma de Sinaloa, Centro de Investigación y Docencia en Ciencias de la Salud, Otolaryngology Department, Culiacán, Mexico
| |
Collapse
|
6
|
Celis-Aguilar E, Burgos-Páez A, Villanueva-Ramos N, Solórzano-Barrón J, De La Mora-Fernández A, Manjarrez-Velázquez J, Verdiales-Lugo S, Escobar-Aispuro L, Becerril P, Valdez-Flores A, Merino-Ramírez FJ, Caballero-Rodríguez CB. An Emergent Entity: Indolent Mucormycosis of the Paranasal Sinuses. A Multicenter Study. Int Arch Otorhinolaryngol 2018; 23:92-100. [PMID: 30647791 PMCID: PMC6331311 DOI: 10.1055/s-0038-1667005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Accepted: 05/23/2018] [Indexed: 12/20/2022] Open
Abstract
Introduction
Indolent or chronic mucormycosis is a rare entity that affects both immunosuppressed and immunocompetent individuals. Additionally, its clinical evolution is nonspecific and there is no standardized treatment for this condition.
Objective
To describe the clinical characteristics and management of patients with indolent mucormycosis.
Methods
In the project of study with chart review in the Interinstitutional secondary care centers, patients with evidence of indolent mucormycosis, defined as pathological confirmation of nasal/paranasal sinus mucormycosis for more than 1 month, were included. All patients underwent complete laboratory workup, imaging studies, surgical treatment and adequate follow-up. No evidence of disease status was defined when patient had subsequent biopsies with no evidence of mucormycosis.
Results
We included seven patients, three female and four male subjects. The mean age was 53.14 years. Four patients were immunosuppressed and three immunocompetent. Among the immunosuppressed patients three had diabetes and one had dermatomyositis. The symptoms were nonspecific: facial pain/headache, mucoid discharge and cacosmia were the ones most frequently reported. Maxillary sinus involvement was present in all patients. Two immunosuppressed subjects received amphotericin. Posaconazole was the only treatment in one immunosuppressed patient. All immunocompetent patients had single paranasal sinus disease and received only surgical treatment. All patients are alive and free of disease.
Conclusion
Indolent mucormycosis is a new and emerging clinical entity in immunosuppressed and immunocompetent patients. Single paranasal sinus disease is a frequent presentation and should not be overlooked as a differential diagnosis in these patients. Immunocompetent patients should only be treated surgically.
Collapse
Affiliation(s)
- Erika Celis-Aguilar
- Department of Otolaryngology, Centro de Investigación y Docencia en Ciencias de la Salud (CIDOCS) de la Universidad Autónoma de Sinaloa, Culiacán, Sinaloa, México
| | - Alan Burgos-Páez
- Department of Otolaryngology, Centro de Investigación y Docencia en Ciencias de la Salud (CIDOCS) de la Universidad Autónoma de Sinaloa, Culiacán, Sinaloa, México
| | - Nadia Villanueva-Ramos
- Department of Otolaryngology, Centro de Investigación y Docencia en Ciencias de la Salud (CIDOCS) de la Universidad Autónoma de Sinaloa, Culiacán, Sinaloa, México
| | - José Solórzano-Barrón
- Department of Otolaryngology, Centro de Investigación y Docencia en Ciencias de la Salud (CIDOCS) de la Universidad Autónoma de Sinaloa, Culiacán, Sinaloa, México
| | - Alma De La Mora-Fernández
- Department of Otolaryngology, Centro de Investigación y Docencia en Ciencias de la Salud (CIDOCS) de la Universidad Autónoma de Sinaloa, Culiacán, Sinaloa, México
| | | | - Sergio Verdiales-Lugo
- Department of Otolaryngology, Centro de Investigación y Docencia en Ciencias de la Salud (CIDOCS) de la Universidad Autónoma de Sinaloa, Culiacán, Sinaloa, México
| | - Lucero Escobar-Aispuro
- Department of Otolaryngology, Centro de Investigación y Docencia en Ciencias de la Salud (CIDOCS) de la Universidad Autónoma de Sinaloa, Culiacán, Sinaloa, México
| | - Perla Becerril
- Department of Otolaryngology, General Hospital Regional No. 1 "Ignacio García Téllez" del IMSS, Mérida, Yucatán, México
| | - Ana Valdez-Flores
- Department of Pathology, Centro de Investigación y Docencia en Ciencias de la Salud (CIDOCS), Universidad Autónoma de Sinaloa, Culiacán, Sinaloa, México
| | - Francisco Javier Merino-Ramírez
- Department of Pathology, Centro de Investigación y Docencia en Ciencias de la Salud (CIDOCS), Universidad Autónoma de Sinaloa, Culiacán, Sinaloa, México
| | - Carmen Beatriz Caballero-Rodríguez
- Department of Pathology, Centro de Investigación y Docencia en Ciencias de la Salud (CIDOCS), Universidad Autónoma de Sinaloa, Culiacán, Sinaloa, México
| |
Collapse
|
7
|
Abstract
OBJECTIVE To determine and interpret the range of normal deviation of the bucket test in healthy subjects Subjects and methods: Study design: Cross-sectional study in a secondary care center. INCLUSION CRITERIA subjects ≥18 years old with no otologic or neurologic symptoms and normal complete neuro-otological examination. The subjective visual vertical was evaluated binocularly using the bucket test. Five measurements were made on the clockwise direction and five on the counterclockwise direction. The examiner selected the starting point, the patient then manipulated the bucket and it stopped when the volunteer considered the line reached the vertical position. RESULTS Fifty healthy volunteers were included, 16 (32%) were men, and 34 (68%) women with a mean age of 34 years. The mean value found clockwise was 1.93° ± 2.26° and counterclockwise sense was of 0.86° ± 2.44°. Mean normal values ranged from 1.4° ± 1.9°. CONCLUSIONS The bucket test is easy and quick to perform; we recommend to use a range of -1.0° to +3.0° as normal values in the healthy population.
Collapse
Affiliation(s)
- Erika Celis-Aguilar
- Department of Otolaryngology, Hospital Civil de Culiacán, CIDOCS, Autonomous University of Sinaloa, Culiacan, Mexico
| | - Angel Castro-Urquizo
- Department of Otolaryngology, Hospital Civil de Culiacán, CIDOCS, Autonomous University of Sinaloa, Culiacan, Mexico
| | | |
Collapse
|
8
|
Celis-Aguilar E, Escobar-Aispuro L, Alarid-Coronel J, Burgos-Paez A. A therapeutic approach of isolated suppurative labyrinthitis complicated by meningitis. Indian J Otol 2018. [DOI: 10.4103/indianjotol.indianjotol_94_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
9
|
Alarid-Coronel J, Celis-Aguilar E, Escobar-Aispuro L, Muñoz-Estrada V. Otomycosis in immunocompetent patients: Clinical and mycological features. Our experience with 40 cases. Clin Otolaryngol 2017; 43:373-377. [PMID: 28834405 DOI: 10.1111/coa.12966] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2017] [Indexed: 11/27/2022]
Affiliation(s)
- J Alarid-Coronel
- Center of Research and Teaching of Health Sciences, Universidad Autónoma de Sinaloa, Culiacan, Mexico
| | - E Celis-Aguilar
- Department of Otolaryngology, Center of Research and Teaching of Health Sciences, Universidad Autónoma de Sinaloa, Culiacan, Mexico
| | - L Escobar-Aispuro
- Center of Research and Teaching of Health Sciences, Universidad Autónoma de Sinaloa, Culiacan, Mexico
| | - V Muñoz-Estrada
- Department of Dermatology, Center of Research and Teaching of Health Sciences, Universidad Autónoma de Sinaloa, Culiacan, Mexico
| |
Collapse
|
10
|
Celis-Aguilar E, Hinojosa-González R, Vales-Hidalgo O, Coutinho-Toledo H. Refractory episodic vertigo: role of intratympanic gentamicin and vestibular evoked myogenic potentials. Braz J Otorhinolaryngol 2016; 82:668-673. [PMID: 27068887 PMCID: PMC9444736 DOI: 10.1016/j.bjorl.2015.11.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2015] [Revised: 11/11/2015] [Accepted: 11/29/2015] [Indexed: 11/28/2022] Open
Abstract
Introduction Even today, the treatment of intractable vertigo remains a challenge. Vestibular ablation with intratympanic gentamicin stands as a good alternative in the management of refractory vertigo patients. Objective To control intractable vertigo through complete saccular and horizontal canal vestibular ablation with intratympanic gentamicin treatment. Methods Patients with refractory episodic vertigo were included. The inclusion criteria were: unilateral ear disease, moderate to profound sensorineural hearing loss, and failure to other treatments. Included patients underwent 0.5–0.8 mL of gentamicin intratympanic application at a 30 mg/mL concentration. Vestibular ablation was confirmed by the absence of response on cervical vestibular evoked myogenic potentials and no response on caloric tests. Audiometry, electronystagmography with iced water, and vestibular evoked myogenic potentials were performed in all patients. Results Ten patients were included; nine patients with Meniere's disease and one patient with (late onset) delayed hydrops. Nine patients showed an absent response on vestibular evoked myogenic potentials and no response on caloric tests. The only patient with low amplitude on cervical vestibular evoked myogenic potentials had vertigo recurrence. Vertigo control was achieved in 90% of the patients. One patient developed hearing loss >30 dB. Conclusions Cervical vestibular evoked myogenic potentials confirmed vestibular ablation in patients treated with intratympanic gentamicin. High-grade vertigo control was due to complete saccular and horizontal canal ablation (no response to iced water in electronystagmography and no response on cervical vestibular evoked myogenic potentials).
Collapse
Affiliation(s)
- Erika Celis-Aguilar
- Universidad Autónoma de Sinaloa, Centro de Investigación y Docencia en Ciencias de la Salud (CIDOCS), Departamento de Otorrinolaringología, Culiacán, Sinaloa, Mexico.
| | - Ramon Hinojosa-González
- Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Department of Neurotology, Ciudad de México, Mexico
| | - Olivia Vales-Hidalgo
- Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Department of Neurotology, Ciudad de México, Mexico
| | | |
Collapse
|
11
|
Celis-Aguilar E, Hinojosa-González R, Vales-Hidalgo O, Coutinho-Toledo H. Total Vestibular Ablation and VEMPs after Intratympanic Gentamicine in Patients with Intractable Vertigo. Otolaryngol Head Neck Surg 2014. [DOI: 10.1177/0194599814541629a293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: Even today, treatment of intractable vertigo remains a challenge. The objective of this study was to control intractable vertigo through complete vestibular ablation with intratympanic gentamicin treatment. Complete vestibular ablation was confirmed by zero response on ice water (ENG) and an absent response on vestibular evoked myogenic potentials (VEMPs). Methods: Retrospective case study design in a tertiary care center. Subjects were patients with refractory episodic vertigo. The inclusion criteria were unilateral ear disease, moderate to profound sensorineural hearing loss, and failure to respond to other treatments. Included patients underwent 0.5-0.8 mL of gentamicin intratympanic application at a 30 mg/mL concentration. Audiometry, electronystagmography with ice water, and vestibular evoked myogenic potentials were performed in all patients. Outcome measurements: VEMPs response and vertigo control. Results: Ten patients were included; 9 patients with Ménière’s disease and 1 patient with delayed endolymphatic hydrops. Nine patients showed an absent response on VEMPs. The only patient with low amplitude on VEMPs had vertigo recurrence. Vertigo control was achieved in 90% of the patients. One patient developed hearing loss >30 dB. Conclusions: VEMPs confirmed complete vestibular ablation. High-grade vertigo control was due to total vestibular ablation.
Collapse
|
12
|
Celis-Aguilar E, Burgos-Paez A, Mayoral-Flores HO, Bernal-Espinoza YM, López-Ramos EG. Hyperbaric Oxygen Therapy for Sudden Hearing Loss after Failure of Intratympanic and Oral Corticosteroid Therapy. Otolaryngol Head Neck Surg 2014. [DOI: 10.1177/0194599814541629a224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives: Determine the efficacy of hyperbaric oxygen therapy (HBOT) in idiopathic sudden sensorineural hearing loss (ISSHL) after unsuccessful treatment with oral and intratympanic corticosteroids. The current treatment for ISSHL remains controversial. Systemic and intratympanic steroids are usually prescribed; unfortunately, only 61% of patients achieve full recovery. Recently, hyperbaric oxygen therapy has emerged as a new possible treatment. Methods: Case series at a secondary care center. Patients were included from March 2013 to July 2013. Inclusion criteria: age >18 years, failure to systemic and intratympanic corticosteroids. Ten sessions of HBOT were conducted, 60 minutes each, at 2 atmospheres. All patients underwent audiometry before and after treatment. Pure tone average (PTA) was defined as the average of the frequencies of 500, 1000, 2000, and 4000 Hz. Results: We included 4 female patients, mean age 51 years. The mean time from onset of illness to HBOT was 108.75 days. Initial mean PTA was 55.31 dB, final PTA was 54.6875 dB ( P = .958). Mean hearing gain was 0.625 dB. One patient had complete hearing recovery, 2 patients slight improvement (recovery of 3.75 dB), and 1 patient worsened. Two patients reported subjective improvement of dizziness. Although hearing gain was observed at low frequencies in 2 patients (25 dB and 20 dB), no statistical significance was achieved ( P = .817). No complications were reported. Conclusions: The use of HBOT in patients who fail steroid therapy did not demonstrate a beneficial hearing effect in ISSHL patients. However, symptoms such as dizziness improved subjectively. More studies are needed to corroborate our results.
Collapse
|
13
|
Celis-Aguilar E, Lassaletta L, Roda JM, Gavilán J. End-to-Side Interposed Donor Grafting as a Facial Nerve Reinforcement Technique after Vestibular Schwannoma Surgery. Ann Otol Rhinol Laryngol 2013; 122:520-3. [DOI: 10.1177/000348941312200807] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: This retrospective case review was performed to determine the facial function outcome of an end-to-side interposed donor grafting technique in patients who had a nonresponsive and partially injured facial nerve during a translabyrinthine approach for vestibular schwannoma resection. Methods: The study included patients with silent electrophysiological tests after partial injury of the facial nerve during translabyrinthine schwannoma resection surgery in a tertiary referral hospital. The patients underwent end-to-side interposed donor grafting as a facial nerve reinforcement technique, and we evaluated their facial function after 1 year of follow-up. Results: Four cases with intact preoperative facial function were included (3 men and 1 woman). All patients had a lack of electrical response from the facial nerve and partial anatomic injury after a translabyrinthine approach. An end-to-side interposed donor grafting technique was performed. The donor grafts used were the sural nerve (2 patients), superior vestibular nerve (1 patient), and greater auricular nerve (1 patient). All patients achieved a good House-Brackmann grade. Ocular adjuvant procedures were performed in all patients. Conclusions: Immediate repair of the facial nerve with an interposed donor graft may provide better facial function in patients who have no electrical response from a partially injured facial nerve after vestibular schwannoma surgery.
Collapse
|
14
|
Celis-Aguilar E. Commentary. J Neurosci Rural Pract 2013. [DOI: 10.1055/s-0039-1696831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- Erika Celis-Aguilar
- Department of Otolaryngology (Neurotology), Centro de Investigación y Docencia en Ciencias de la salud, Universidad Autónoma de Sinaloa, Culiacán, Sinaloa, Mexico
| |
Collapse
|
15
|
Celis-Aguilar E. Commentary. J Neurosci Rural Pract 2013; 4:355-6. [PMID: 24250187 PMCID: PMC3821440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- Erika Celis-Aguilar
- Department of Otolaryngology (Neurotology), Centro de Investigación y Docencia en Ciencias de la salud, Universidad Autónoma de Sinaloa, Culiacán, Sinaloa, Mexico,Address for correspondence: Dr. Erika Celis-Aguilar, Eustaquio Buelna No. 91 Col. Gabriel Leyva, C.P. 80030, Culiacán, Sinaloa, Mexico. E-mail:
| |
Collapse
|
16
|
Celis-Aguilar E, Macias-Valle L, Coutinho-De Toledo H. Auditory Neuropathy Secondary to Cryptococcal Central Nervous System Infection in 2 Immunocompromised Patients. Otolaryngol Head Neck Surg 2012; 147:597-8. [DOI: 10.1177/0194599812442488] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Erika Celis-Aguilar
- Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suarez, México DF
| | | | | |
Collapse
|
17
|
Celis-Aguilar E, Lassaletta L, Torres-Martín M, Rodrigues FY, Nistal M, Castresana JS, Gavilan J, Rey JA. The molecular biology of vestibular schwannomas and its association with hearing loss: a review. Genet Res Int 2012; 2012:856157. [PMID: 22567403 PMCID: PMC3335540 DOI: 10.1155/2012/856157] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Revised: 10/08/2011] [Accepted: 11/03/2011] [Indexed: 01/16/2023]
Abstract
Hearing loss is the most common symptom in patients with vestibular schwannoma (VS). In the past, compressive mechanisms caused by the tumoral mass and its growth have been regarded as the most likely causes of the hearing loss associated with VS. Interestingly, new evidence proposes molecular mechanisms as an explanation for such hearing loss. Among the molecular mechanisms proposed are methylation of TP73, negative expression of cyclin D1, expression of B7-H1, increased expression of the platelet-derived growth factor A, underexpression of PEX5L, RAD54B, and PSMAL, and overexpression of CEA. Many molecular mechanisms are involved in vestibular schwannoma development; we review some of these mechanisms with special emphasis on hearing loss associated with vestibular schwannoma.
Collapse
Affiliation(s)
- Erika Celis-Aguilar
- Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suarez, 14269 Ciudad de México, DF, Mexico
| | - Luis Lassaletta
- Department of Otolaryngology, “La Paz” University Hospital, 28046 Madrid, Spain
| | - Miguel Torres-Martín
- Unidad de Investigación, Laboratorio Oncogenetica Molecular, “La Paz” University Hospital, 28046 Madrid, Spain
| | - F. Yuri Rodrigues
- Department of Pathology, “La Paz” University Hospital, 28046 Madrid, Spain
| | - Manuel Nistal
- Department of Pathology, “La Paz” University Hospital, 28046 Madrid, Spain
| | - Javier S. Castresana
- Brain Tumor Biology Unit, CIFA, University of Navarra School of Sciences, 31009 Pamplona, Spain
| | - Javier Gavilan
- Department of Otolaryngology, “La Paz” University Hospital, 28046 Madrid, Spain
| | - Juan A. Rey
- Department of Pathology, “La Paz” University Hospital, 28046 Madrid, Spain
| |
Collapse
|
18
|
Pascual-Ramos V, Hernández-Hernández C, Soto-Rojas AE, Celis-Aguilar E, Sánchez-Guerrero J. Association between dental caries and pneumonia in patients with systemic lupus erythematosus. J Rheumatol 2006; 33:1996-2002. [PMID: 16960926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
OBJECTIVE To establish the association between oral pathology and pneumonia in patients with systemic lupus erythematosus (SLE). METHODS Thirty women with SLE, consecutively admitted for hospitalization because of pneumonia, and 60 noninfected controls with SLE (30 hospitalized and 30 ambulatory), matched by age, sex, and date of hospitalization to the cases, were enrolled. At entry, information about sociodemographic variables, traditional infection risk factors, SLE characteristics, treatment, and comorbidity was gathered by medical chart review. In every patient, one rheumatologist performed a complete physical examination, and assessed disease activity and chronic damage using validated indices; and one periodontist performed a standardized oral health evaluation including the use of 6 international oral health indices. RESULTS Twenty-eight patients with community-acquired and 2 patients with nosocomial pneumonias were included. Age of the total study population was 38.8 +/- 14.6 years, mean number of SLE criteria 6.3 +/-1.95, and disease duration 6.6 +/- 7.2 years, with no differences among the 3 groups. Cases had greater disease activity and damage, and were taking higher doses of prednisone than ambulatory controls (p <or= 0.03). Cases accrued more traditional infection risk factors than ambulatory controls and had lower levels of serum albumin than both control groups (p <or= 0.04). Oral health was worse among the cases, including more periapical lesions, cervical and third-grade caries, and a higher mean number of caries/patient than controls (p <or= 0.05). In the multivariate analysis, third-grade caries (odds ratio 7.5, 95% CI 2.05-27.3, p = 0.002) was strongly associated with pneumonia. CONCLUSION Poor oral hygiene and third-grade caries are common in patients with SLE who develop pneumonia.
Collapse
Affiliation(s)
- Virginia Pascual-Ramos
- Department of Immunology and Rheumatology and the Dentistry Service, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
| | | | | | | | | |
Collapse
|
19
|
Sánchez-Guerrero J, Pérez-Dosal MR, Celis-Aguilar E, Cárdenas-Velázquez F, Soto-Rojas AE, Avila-Casado C. Validity of screening tests for Sjögren's syndrome in ambulatory patients with chronic diseases. J Rheumatol 2006; 33:907-11. [PMID: 16541477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
OBJECTIVE To determine the validity of screening tests for Sjogren's syndrome (SS) in ambulatory patients with chronic diseases. METHODS Three hundred randomly selected patients from the rheumatology and internal medicine clinics of a tertiary care center were assessed for SS according to the American-European Consensus Group criteria. During the screening phase, an interview, the European questionnaire for sicca symptoms, Schirmer-I test, and the wafer test were carried out in all patients. Patients with positive screening had confirmatory tests including fluorescein staining test, nonstimulated whole salivary flow, and autoantibody testing. Confirmatory tests were also done in 13 patients with negative screening. During the last phase, lip biopsy was proposed to patients who met preestablished criteria. RESULTS Women made up 79% of the study population. Mean age of subjects was 42.8+/-15.7 years. Two hundred twenty patients (73%) had positive screening. The distribution of positive test results was: xerophthalmia 118 (39%), xerostomia 103 (34%), Schirmer-I test 101 (34%), and wafer test 187 (62%) patients. Forty (13%) patients met criteria for SS. All screening tests were useful for identifying patients with SS; however, the model composed of at least one positive response to the European questionnaire (EQ1), Schirmer-I test, and wafer test showed the best performance. CONCLUSION Use of the European questionnaire, Schirmer-I test, and wafer test in parallel was useful for identifying patients with SS among ambulatory patients with chronic diseases.
Collapse
Affiliation(s)
- Jorge Sánchez-Guerrero
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencas Medicas y Nutricion Salvador Zubiirdan, UNAM, Mexico, DF Mexico.
| | | | | | | | | | | |
Collapse
|
20
|
Sánchez-Guerrero J, Pérez-Dosal MR, Cárdenas-Velázquez F, Pérez-Reguera A, Celis-Aguilar E, Soto-Rojas AE, Avila-Casado C. Prevalence of Sjogren's syndrome in ambulatory patients according to the American-European Consensus Group criteria. Rheumatology (Oxford) 2004; 44:235-40. [PMID: 15509625 DOI: 10.1093/rheumatology/keh455] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To estimate the prevalence of Sjögren's syndrome (SS) in ambulatory patients attending a tertiary care centre, according to the American-European Consensus Group criteria, using a structured approach. METHODS Three hundred patients from rheumatology and internal medicine clinics were randomly chosen. During the screening phase, a face-to-face interview, a screening questionnaire, a Schirmer-I test and a wafer test were carried out in all patients. During the second phase, patients with positive screening had confirmatory tests including fluorescein staining test, non-stimulated whole salivary flow and autoantibody testing. Confirmatory tests were also done in 13 patients with negative screening. In the last phase, lip biopsy was proposed to those patients who met pre-established criteria. RESULTS Females constituted 79% of the study population. The mean age of the subjects was 42.8+/-15.7 yr. Two hundred and twenty patients (73%) had positive screening. Fifty-five (27%) out of 204 patients evaluated showed keratoconjunctivitis sicca and 28 (13%) out of 215 patients xerostomia. One hundred and sixty-eight patients met criteria for lip biopsy and it was performed in 80 subjects who accepted the procedure. Focal sialoadenitis was demonstrated in 39 patients (49%), but only 28 of them met criteria for SS. In total, 40 patients were classified as SS. The minimum prevalence of SS in the population studied was 13.3% (95% CI 9.5-17.1%). The structured approach used in this study allowed 24 (60%) undiagnosed cases of SS to be identified. CONCLUSION SS is common among ambulatory patients attending a tertiary care centre and in most of them it is undiagnosed.
Collapse
Affiliation(s)
- J Sánchez-Guerrero
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, 14000 México, D.F. Mexico.
| | | | | | | | | | | | | |
Collapse
|