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Query: UMLS:C0012833 (dizziness)
 9,689 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Surgery for cochlear prosthesis insertion exposes the patient to several potential risks. We review the surgical complication experience with cochlear implants in the United States. There have been no deaths attributable to these devices, few serious major complications, and relatively few minor complications. Major complications usually have to do with surgical technique and include flap necrosis, improper electrode placement, and rare facial nerve problems. Minor complications include dehiscence of incisions, infection, facial nerve stimulation, dizziness, and pedestal problems with the Ineraid device. Complications were less frequent in children than adults and were more likely to occur in the younger children than those above the age of 7 years. Complications were still fewer in groups of patients operated on within tightly controlled protocols. There was no increased incidence of otitis media in children who received the Nucleus Mini-22 device, and no reported sequelae from such otitis when it occurred.
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PMID:Complications of cochlear implant surgery in adults and children. 195 60

Nine cases of tuberculous otitis media were treated by us over the past 10 years. Six patients presenting with large tympanic membrane perforations were treated for suppurative otitis media at various ENT clinics. The remaining three patients presented without perforation. Intractable otorrhoea, aggravation of hearing loss, dizziness, and in one case facial palsy, resulted in eventual referral to us. Histological examination revealed a tuberculous granulation, confirming the diagnosis in most cases. CT in four cases with profound sensorineural hearing loss showed bone destruction of the otic capsule around the oval window and the promontory. Changes noted included a notch in one case, disappearance of the bony contour around the hook in two cases, and a distinct fistula in the final case. A cochlear fistula seemed to be characteristic of advanced tuberculous otitis media.
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PMID:Computed tomography of the temporal bone in tuberculous otitis media. 793 Sep 28

Although much has been written about the central nervous system infectious complications of otitis media, little has been written about intracranial extension of cholesteatoma in chronic otitis media. The records of 13 patients from the House Ear Clinic with chronic otitis media and cholesteatoma extending into the middle fossa and/or the posterior fossa are reviewed. Preoperatively, symptoms included hearing loss (100%), dizziness (61%), facial weakness (46%), and headache (31%). All 13 patients had previously undergone at least one mastoidectomy procedure for removal of cholesteatoma. The neurotologic approaches used included the middle fossa, translabyrinthine, and transcochlear operations. Eradication of cholesteatoma was accomplished with one neurotologic procedure, in 11 of 13 patients with two neurotologic procedures in one patient, and without surgery in one patient. Audiologic findings and facial nerve results are discussed.
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PMID:Neurotologic treatment of acquired cholesteatoma. 858 49

This discussion has focused primarily on the history and physical examination of the patient with dizziness which, in fact, are the two most important elements in the evaluation process. To perform the examination expeditiously and completely, a broad differential diagnosis of dizziness must be kept in mind. The clinician should also keep in mind two basic objectives: first, to identify serious pathology (e.g., central nervous system lesion, brainstem ischemia, cardiac arrhythmia); and second, to recognize diseases that can be specifically treated, such as an endocrine abnormality, middle ear infection, Meniere's disease, or a drug reaction. Reassurance and/or vestibular rehabilitation are the mainstays of therapy for the patients not falling into the above two categories.
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PMID:Evaluation of the dizzy patient. 936 Jul 99

Vertigo and dizziness are not common complaints in childhood, but probably present more often than has been thought. These symptoms, caused mainly by otitis media (OM) and middle ear effusion (MEE), are 2 of the most common diseases in children, and until recently had long been neglected in the literature and in practice. We determined objectively the incidence of balance-related symptoms in children with long-lasting MEE, and resolution following insertion of ventilation tubes (VT). 36 children, aged 4-9 years, were studied using electronystagmography (ENG) and the Bruininks-Oseretsky tests for motor proficiency, before and after ventilation of the middle ear. Results were compared to those in 74 healthy children with no history of middle ear disease. Abnormal ENG findings were found in 58%, and 71% had low Bruininks-Oseretsky (BO) test scores. The ENG was abnormal in only 3 of the controls, 1 of whom also had low BO test scores. The symptoms and signs of balance disturbances resolved in 96% following VT insertion. These results indicate that balance-related symptoms often encountered in young children may result from chronic MEE, and that they resolve following evacuation of the effusion and ventilation of the middle ear.
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PMID:[Balance disturbances in children with middle ear effusions]. 945 89

Criteria used to establish ideal skeletal position of the maxilla and mandible relative to the cranial base is exacting. It must first enhance facial esthetics and facial profile. Secondly, it must improve TMJ health; and finally, it must improve physiologic harmony. Physiologic harmony include alleviation of many medical symptoms such as migraine headaches, neck-shoulder-back pain, myalgia, mouth breathing, otitis media, ringing in the ear, dizziness, vertigo, etc. The Skeletal Archial Analysis is a powerful diagnostic aid. Once the skeletal landmarks are learned, it takes clinicians less than 5 minutes to trace and diagnose. This is because it uses visual references rather than columns of angles and linear measurements. How powerful and accurate is this analysis? If done correctly, patients treated to their anterior arc and correct vertical arc will often times achieve significant facial esthetics, TMJ health, and physiologic harmony. Both the Skeletal Archial Analysis and the Skeletal Classification System indicate whether the disharmony is in the maxilla, mandible, or both. They clearly show in which direction these skeletal structures must be moved to enhance facial appearance and health. In all cases, the direction is to move these structures as close to skeletal Type I, Normal, as physiologically possible. Figure 8 shows a 21-year-old female individual with this skeletal classification. She has ideal maxillary and mandibular A-P position and ideal lower facial height. As can be seen, she has an attractive facial profile and she has no clinical symptoms of temporomandibular disorder or other medical problems. Conversely, patients with facial disharmony often seem to have various medical problems, including premenstrual syndrome and infertility. Once clinicians become adept at using the Skeletal Archial Analysis, they will begin to see many more types of facial disharmonies than previously thought. It then becomes a verbal challenge to accurately describe the multitude of different types of skeletal malpositions. In light of this, it is important that a universal Skeletal Classification System be established to promote better understanding in the diagnosis and treatment of facial-skeletal problems.
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PMID:Skeletal classification of maxillary and mandibular malpositions. 956 80

Vertigo and dizziness are not common in childhood, but are probably present more often than was formerly thought. These symptoms caused mainly by otitis media and middle ear effusion, two of the most common diseases in children, have been neglected for a long time, both in the literature and in practice, until recently. The purpose of this study was to determine objectively the incidence of balance-related symptoms in children with long-lasting middle ear effusion and to discover whether these symptoms resolve after the insertion of ventilation tubes. One hundred thirty-six children, ages 4 to 9 years, were given electronystagmographic tests and the Bruininks-Oseretsky tests for motor proficiency before and after tube ventilation of the middle ear. The results were compared with those in 74 healthy children with no history of middle ear diseases. Pathologic findings were found in 58% of the children with chronic middle ear effusion, as compared with only 4% of the control group. The symptoms and signs of balance disturbances resolved in 96% of the children after ventilation tube insertion. The results of this study indicate that balance-related symptoms often encountered in young children may result from chronic middle ear effusion and that these symptoms will resolve after evacuation of the effusion and ventilation of the middle ear.
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PMID:Effects of middle ear effusion on the vestibular system in children. 985 53

Some complications of otitis media with effusion (OME) are not obvious and not always associated with otitis media by physicians and patients; the authors propose to call them 'unusual complications', although they may be quite frequent. Complications such as dizziness, clumsiness and behavioural disorders are classified in this group. Other complications are rare and uncommon such as sensorineural hearing loss and cholesteatoma. Some of these sequelae are structural, others more functional. The impact of OME on complex functions such as language, learning or behaviour is still controversial but seems to have been underestimated until now. Not only withholding treatment in children with OME may cause complications but also the treatment of OME may lead to sequelae, although serious side effects caused by the treatment of OME are rare. In this literature review, the epidemiology, importance and diagnosis of the uncommon and unusual complications of OME will be discussed.
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PMID:Uncommon and unusual complications of otitis media with effusion. 1057 89

During the period between 1992 and 1997, there was an increase in levels of methyl tertiary butyl ether (MTBE) in gasoline in the Philadelphia, Pennsylvania, area. In this study, the authors analyzed billing records from clinical practices that were extensions of the University of Pennsylvania. The authors based their selections on the International Classification of Diseases-9 diagnostic codes, which were determined from (1) previous studies of methyl tertiary butyl ether conducted by the Centers for Disease Control; (2) respiratory symptoms, including asthma and wheezing; and (3) symptoms associated anecdotally with methyl tertiary butyl ether levels in gasoline. The authors normalized all data by the total number of office visits. The incidences of headache, throat irritation, allergic rhinitis, cough, nausea, dizziness, upper respiratory infections, wheezing, otitis media, skin rash, anxiety, insomnia, palpitations, generalized allergy, and malaise were increased during the period studied. Large increases occurred during the winters of 1993-1994 and 1994-1995 (during which there were high levels of MTBE), but not in the preceding summers (during which there were low levels of MTBE). This was especially true for asthma and wheezing. During the summers of 1995, 1996, and 1997, the incidences of the aforementioned symptoms increased greatly.
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PMID:Visits to physicians after the oxygenation of gasoline in Philadelphia. 1219 59

Among the otolaryngologic subspecialties, otology has historically been at the forefront of outcomes research in our specialty. Many traditional outcomes reporting tools have been consistently employed in the study of otologic disease and treatment outcomes including standardized reporting schemes for Meniere's disease and facial nerve dysfunction. However, recent interest has surfaced in disease-specific quality-of-life outcomes measures for many otologic diseases such as sensorineural hearing loss, conductive hearing loss and suppurative otitis media. Several reliable and validated outcomes tools are available for the assessment of the impact on quality of life and treatment outcomes for common otologic afflictions that carry with them significant quality-of-life burdens. Furthermore, similar outcomes tools have been developed that allow a scientific appraisal of disease status and quality of life for dizziness and tinnitus, which have been traditionally difficult to quantify. Increasing familiarity with these outcomes tools will allow investigators to accurately assess and compare treatments for these otologic diseases and justify treatment initiatives in the future.
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PMID:Outcomes research in otology. 1546 47


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