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Eustachian Tube Dysfunction
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Matthew Smith, James R. Tysome
ETD provides a diagnostic challenge, as the presenting symptoms are non-specific and similar to many otological conditions, as well as temporomandibular joint disorders, and even chronic rhinosinusitis. It is important to note that autophony can be caused by other disorders, such as superior canal dehiscence. Furthermore, patient symptoms correlate poorly with the underlying ET function and should not be used in isolation when deciding on management.1
Vertigo
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Christopher C. Glisson, Jorge C. Kattah
The clinical features of conductive hearing loss, noise-induced vertigo associated with nystagmus or conjugate ocular torsion or Valsalva- and cough-related oscillopsia, nystagmus, and (less frequently) drop attacks are caused by congenital aplasia/dysplasia or an acquired thinning of the roof of the superior canal. Absence or thinning of the roof of the superior SCC creates a heightened response to sound and to inner ear pressure changes, and it may contribute to awareness of one's own voice (autophony) and oscillopsia.
ENT
Published in Keith Hopcroft, Instant Wisdom for GPs, 2017
Andrew Bath, John Phillips, Peter Tassone, Stephanie Cooper
Patients present around the age of 45 with autophony in the affected ear (they can hear their own voice more loudly and will sometimes describe the phenomenon of hearing their own eyeballs move), and tinnitus, which may be associated with loud noises and hyperacusis (sensitivity to sound). This has a gradual onset and is due to a thinning or absence of bone over the superior semicircular canal. If the symptoms are severe, surgical repair may be warranted.
Teprotumumab for the treatment of thyroid eye disease
Published in Expert Opinion on Biological Therapy, 2023
Poupak Fallahi, Francesca Ragusa, Sabrina Rosaria Paparo, Giusy Elia, Eugenia Balestri, Valeria Mazzi, Armando Patrizio, Chiara Botrini, Salvatore Benvenga, Silvia Martina Ferrari, Alessandro Antonelli
All events of alopecia were mild in severity, except for one event of moderate severity. 23% of menstruating women experienced menstrual disorders (amenorrhea, metrorrhagia, dysmenorrhea). Teprotumumab may increase blood sugar (10%), so it is necessary to evaluate glycemia before the start of the treatment, and glycemic levels should be tracked during the treatment. However, hyperglycemia might be transient and can recover after the end of the treatment, or with a specific therapy. Another possible side effect is related to hearing problems, that are present in about 10% of patients and in some cases can persist after the end of the treatment. Hearing impairment includes deafness, eustachian tube dysfunction, hyperacusis, hypoacusis, and autophony. A case of a woman with chronic teprotumumab-associated sensorineural hearing loss has been recently reported [67]. The patient had chronic TED with proptosis and diplopia. After three doses of teprotumumab she developed tinnitus, followed by hearing loss after five doses. The audiogram showed bilateral mild to moderate-severe hearing loss, significantly worse with respect the baseline audiogram. Teprotumumab was immediately interrupted, however 6 weeks later the audiogram showed no amelioration. Due to the potentially irreversible sensorineural hearing loss, close monitoring with regular audiometric tests before, during and after treatment with teprotumumab is recommended, and it may be important to consider potential treatment to recover from any hearing problems [67].
Video-head impulse test in superior canal dehiscence
Published in Acta Oto-Laryngologica, 2021
Payal Mukherjee, Elodie Chiarovano, Kai Cheng, Leonardo Manzari, Leigh A. McGarvie, Hamish G. MacDougall
This was a retrospective study of 8 patients with 11 SCDs. Data was collected between 2011 and 2019. The sample consisted of 11 ears of 8 patients (3 patients had bilateral unoperated SCD) aged from 34 to 80 years. There were 6 females and 2 males with 5 left and 6 right sided SCD. The size of the defects ranged from 1.5 to 5.7 mm (Table 1). Patients had undergone high resolution petrous temporal bone CT scan including helical CT (0.5 mm) and cone beam CT (125 µm). All subjects also underwent audiogram, cervical and ocular VEMPs and vHIT. Patients presented with a range of symptoms from tullio phenomenon to autophony only. All patients had unambiguous SCD on CT and typical SCD type results on air-conducted VEMP testing: enhanced amplitude and/or decreased threshold of response [6,9]. Patients who had previous ear surgery were excluded.
Silicone plug insertion for treatment of refractory patulous eustachian tube after irradiation
Published in Acta Oto-Laryngologica Case Reports, 2020
Her hearing in her left ear had deteriorated, predominantly affecting the low-frequencies (Figure 1(A)). This deterioration would have been potentially irreversible if it had been caused by damage to the middle ear and cochlea due to irradiation [12]. However, her hearing improved considerably after surgery (Figure 1(C)). Hearing loss was considered to have been caused not only by middle and inner ear damage but also by PET. Voice and breathing autophony can disturb hearing. The damage is known to predominantly affect the low-frequency area, a characteristic which has been used in an audiological test for PET [13]. In the present case, it was assumed that tubal plugging could decrease noise transduction via the ET, followed by hearing improvement. That means that hearing may be recovered in post-radiation cases if the patient has PET.