nasrin yazdani

The present study aimed to evaluate the impact of vitamin D supplementation as an adjuvant therapy on tinnitus and vertigo in individuals diagnosed with Meniere’s disease.

The study was conducted from November 2021 to October 2022 at Tehran University Hospital, Tehran, Iran. This clinical trial involved 60 individuals diagnosed with Meniere’s disease and vitamin D deficiency. Participants were randomly allocated to receive either vitamin D (50,000 IU weekly) or a placebo for eight weeks. The study assessed the frequency, intensity, and duration of vertigo attacks, as well as several measures of dizziness and tinnitus, both before and after the intervention.

No significant change was observed in the number of vertigo attacks (P = 0.85), the duration (P = 0.52), or the severity of vertigo (P = 0.33) in the vitamin D group compared to the placebo group at the end of the trial. Additionally, vitamin D supplementation did not significantly affect the results of various dizziness and tinnitus indices at the study’s conclusion (P > 0.05). As expected, serum levels of vitamin D were significantly higher in the intervention group compared to the placebo group at the trial's endpoint (P < 0.001).

Vitamin D supplementation did not significantly affect vertigo and tinnitus in patients with Meniere’s disease. Further clinical trials with larger sample sizes and longer durations are recommended to confirm these findings.

Wideband acoustic immittance (WBT) is a new method for assessing middle ear status by using a wide spectrum stimulus instead of the traditional 226 Hz probe tone. This study focuses on establishing normative data for WBT in the Iranian young adults. We aim to provide clinicians with specific norms for the Iranian population to enhance accuracy in diagnosing middle ear conditions and diseases. 

The research involved 20 healthy Iranian young adults who underwent WBT measurements. 

Results showed differences in the WBT parameters compared to other populations, emphasizing the importance of using ethnicity-specific norms in clinical evaluations. 

The findings can help in diagnosing various middle ear disorders and monitoring treatment progress.

Changes in signals and parameters of time-signal intensity curve (TIC) resulting from dynamic MRI have been considered for determining malignancy. However, the specific diagnostic criteria of TIC for detecting malignancy in various organs, such as lymph nodes, are not yet well-established.

This study aimed to evaluate the role of some TIC parameters in identifying malignant cervical lymph nodes. Patients and

In this case-control study, patients with cervical lymphadenopathy were examined by dynamic contrast-enhanced MRI (DCE-MRI) before excisional biopsy. They were then divided into malignant and benign groups based on histopathology. Malignant patients were considered as the case group, while benign cases were considered as the control group. The TIC parameters included the signal intensity (SI) at 45 seconds, 90 seconds, 120 seconds, 5 minutes, and 10 minutes, as well as maximum signal intensity (SImax), the time at which the maximum signal intensity occurs (Tmax), the peak signal intensity (SI peak), and the time at which the peak signal intensity occurs (T peak). Additionally, the enhancement slope (ES), washout ratio (WR), and washout slope (WS) were evaluated at 5 and 10 minutes.

A total of 63 patients were enrolled in the study, including 31 (49.2%) patients with benign lymphadenopathies and 32 (50.8%) patients with malignant lymphadenopathies. Among the variables under study, significant differences were observed between the malignant (M) group and the benign (B) group in terms of the SI-5 min, SI-10 min, WR-5 min, WR-10 min, and WS-5 min (SI-5 min: 124.4 ± 145 (B) vs. 219.2 ± 93.8 (M), P=0.003; SI-10 min: 109.9 ± 134.6 (B) vs. 188.9 ± 83.7 (M), P = 0.007; WR-5 min: 0.58 ± 0.38 (B) vs. 0.15 ± 0.13 (M), P < 0.001; WR-10 min: 0.63 ± 0.36 (B) vs. 0.26 ± 0.17 (M), P < 0.001; and WS-5 min: 0.93 ± 1.20 (B) vs. 1.40 ± 4.44 (M), P = 0.001). In the ROC curve analysis, WS-5 min showed specificity of 29.1%, 75%, 90%, and 95% and sensitivity of 88.2%, 70.6%, 47.1%, and 47.1% at cutoff points of 0.1, 0.37, 0.57, and 0.66, respectively.

The WR-5 min can be considered as a potential TIC index in DCE-MRI for the diagnosis of malignant cervical lymphadenopathies.

Vestibular Rehabilitation (VR) is a well-accepted treatment for Unilateral Vestibulopathy (UVP). Since noisy Galvanic Vestibular Stimulation (nGVS) improves the processing of vestibular inputs, we assessed the synergistic effects of adding nGVS to vestibular rehabilitation for the treatment of UVP.

Patients with UVP were randomly assigned into two groups receiving either VR for four weeks (VR group, n=12) or VR for four weeks combined with nGVS for three sessions (VR+nGVS group; n=12). Outcome measurements were postural control parameters measured with eyes open/closed conditions on hard/soft surfaces, Vestibulo-Ocular Reflex (VOR) gain, and Dizziness Handicap Inventory (DHI) scores that were assessed at baseline and after four weeks.

All postural control parameters, mean total and subscale scores of DHI, and mean VOR gain in directions of affected canals significantly improved in both groups after interventions (p<0.05) except mean mediolateral displacement in conditions with eyes closed on hard surface and with eyes open on soft surface, mean mediolateral velocity in conditions with eyes closed on hard surface, ability to stance with eye closed condition on soft surface and mean emotional subscale of DHI in VR group. Improvements were significantly higher in postural control outcomes measured in stances with eyes closed on hard surface and with eyes open and closed on soft surface, mean VOR gains in directions of affected horizontal and anterior canals, and mean total, physical, and functional scores of DHI in VR+nGVS group (p<0.05).

When combined with VR, nGVS shows additional therapeutic effects in UVP patients.

Despite more affordable and advanced technologies for early detection of congenital hearing loss, unilateral hearing loss is the prevalent form of hearing loss affecting school-aged children. This study aimed to examine the impact of Words-in-Noise (WIN) training on speech perception of noise in children with unilateral hearing loss.

Thirteen children aged 8 to 12 years with unilateral hearing loss underwent a WIN training program in noise. The participants were tested before and after training on word identification in noise and cortical auditory evoked potentials.

A comparison of the mean signal-to-noise ratio 50% between pre- and post-training indicated that signal-to-noise ratio 50% score decreased after training sessions. WIN training reduced the latency in N1 and P2 waves in the Fz electrode and the N1 wave in the Pz electrode and increased the amplitude of the waves in the Fz and Pz electrodes. The observed data suggest that all participants’ performance improved on word identification in noise and some electrophysiological parameters. Cortical auditory evoked potentials components changes did not correlate with the WIN scores.

The Persian version of the WIN training improved speech perception ability in the presence of competitive noise in children with unilateral hearing loss. Therefore, this software solution can partially solve speech comprehension problems with noise in these children.

The Acceptance Noise Level (ANL) which determines the tolerable noise level while listening to running speech, is related to factors such as hearing loss and speech presentation level. This study aims to investigate the effect of speech presentation level on the ANL in people with unilateral Meniere’s Disease (MD) compared to the normal-hearing people.

In this study, 33 people aged 32–60 years with unilateral MD and 38 normal-hearing people aged 20–46 years participated. The ANL growth was evaluated unilaterally at four different speech presentation levels: Most Comfortable Level (MCL), –10 dB lower than the MCL, +10 dB higher than the MCL, and a range between MCL and uncomfortable level.

In MD patients, the ANL of the affected ear was significantly different from that of the contralateral ear (p<0.010). Compared to the normal-hearing people, the pattern of ANL growth in MD patients was significantly different, but the ANL growth patterns were similar between the affected and contralateral ears.

ANL and its growth pattern are different between the affected and contralateral ears of patients with unilateral MD, but are similar compared to normal-hearing people. Despite the apparently normal hearing thresholds, the performance of the contralateral ear in noise at various speech presentation levels in patients with unilateral MD seems to be similar to that of the affected ear.

Rhinosinusitis involves inflammation within the paranasal sinuses and the nasal mucosa. It is a very common chronic health condition. This paper performs a validation process on the Persian translation of the rhinosinusitis quality-of-life questionnaire (RhinoQOL), for use in clinical assessment of chronic rhinosinusitis (CRS) patients. The Lund-Mackay score is also used widely in assessing CRS, and this study aims to describe its relationship to RhinoQOL.

The Persian RhinoQOL adaptation was carried out on 110 CRS patients. A follow-up questionnaire was completed two weeks later. Psychometric properties were determined by statistical analysis (reliability, reproducibility, validity, responsiveness). A total of 45 patients were included for radiologic score calculation. The Spearman’s test was used for assessing the correlation between the RhinoQOL scores and Lund-Mackay score.

Internal reliability was excellent for the impact scale (Cronbach’s alpha=0.92). Cronbach’s alpha was 0.63 and 0.55 for frequency and irritation scales, which reflects lower internal consistency values. Temporal stability or Test-retest reliability was excellent across all three scales. ICC was 0.96, 0.97, and 0.99 for RhinoQOL frequency, irritation, and impact scales. No significant correlation was observed between the Lund-Mackay score and RhinoQOL scores in terms of frequency, irritation and impact scales.

The Persian version of RhinoQOL appears to be as reliable, valid, and sensitive to change as the English version.

Meniere’s disease (MD) is known as a rare chronic disorder of the inner ear with elevated serum levels of proinflammatory cytokines like tumor necrosis factor (TNF)α, Interleukin (IL)1, and IL6. This study aims to evaluate genes polymorphism in some proinflammatory cytokines in a group of Iranian MD patients compared to the healthy controls. In this casecontrol study, 25 MD patients and 139 healthy controls were enrolled. DNA was extracted from blood samples, and single nucleotide polymorphisms were detected using polymerase chain reaction with sequencespecific primers assay. MD patients and controls were examined in terms of allele, genotype, and haplotype frequency of proinflammatory cytokine genes. Only the frequencies of alleles A/G at position 238 in the promoter of the TNFα gene differed significantly between MD patients and healthy controls. G to A allele ratio was 23 and 3.6 in MD and controls, respectively. In individuals with MD, genotype GG was found to be significantly more prevalent at position 238 of the TNFα gene promoter sequence. In addition, the heterozygote AG variant of 238 A/G TNFα gene polymorphism was lower in MD patients than controls. Compared to the control group, the haplotype TNF (308, 238) AG was higher in MD patients, although not statistically significant. This is the first study that we know of that evaluates the frequencies of proinflammatory cytokine genes in an Iranian MD sample. This study shows the association between TNFα and susceptibility to MD.

Noise tolerance and performance in noisy environments are influential factors of hearing aid use in people with hearing loss. One of the causes of hearing loss is Meniere’s disease (MD), which affects speech perception in noise. Acceptable noise level (ANL) is a test that measures the maximum tolerated background noise level (BNL) while listening to the running speech. Since the effect of MD on ANL needs further study, the present study aims to examine the ANL test results in people with unilateral MD, and compare the results between the two ears.

This cross sectional study conducted on 33 individuals with unilateral MD (21 females and 12 males) aged 32–60 years who had the disease for at least one year, who participated in this study. Their most comfortable level (MCL), BNL, and ANL in both ears were then evaluated.

The mean MCL and BNL were significantly different between the two ears, where they were higher in the affected ear than in the contralateral ear. There was also a significant difference in the ANL results between the two ears. In the affected ear, a statistically significant relationship was reported between the ANL and the average hearing thresholds at frequencies of 250, 500, and 1000 Hz.

MD affects the ANL in the affected ear and causes a deterioration in its level and speech perception in noise.

This study aimed to investigate the relationship between sudden sensorineural hearing loss, vestibular neuritis, and infection with COVID-19.

In this study, a total of 56 Iranians (32 females and 24 males) with a Mean±SD age of 45.12±14 years were studied in Tehran City, Iran. Individuals diagnosed with Sudden Sensorineural Hearing Loss (SSNHL) or vestibular neuritis based on definitive diagnostic criteria were included in the study. The methodology comprised four sections of underlying Sudden Hearing Loss,, auditory and vestibular inspection, SARS-CoV-2 Reverse Transcription-Polymerase Chain Reaction (RT-PCR) test, and statistical analysis. Also, the videonystagmography test was used in participants with vertigo to diagnose vestibular neuritis. Pure tone audiometry confirmed SSNHL in some patients with a complaint of hearing loss. Furthermore, tuning fork, Rinne and Weber tests were also performed.

The results of SARS-CoV-2 RT-PCR in 56 subjects showed that eight subjects (22.2%) with vestibular neuritis and two with SSNHL (10%) had a positive RT-PCR test. The Chi-square and Fisher exact-tests with a 95% confidence interval revealed no statistically significant (P>0.05) relationship between COVID-19 infection and vestibular neuritis or SSNHL.

The present study showed no statistically significant relationship between audiovestibular disorders and positive SARS-CoV-2 RT-PCR test. However, the possibility of this relationship cannot be ruled out, and there is a need for studies with larger sample sizes.

Two sibling cases with a temperature-sensitive form of auditory neuropathy from a consanguineous marriage of Iranian descent have been described. They complained about the temporary loss of hearing and compromised speech comprehension after a slight fever or elevating the body temperature by vigorous exercises. A series of tests including brain MRI, pure-tone audiometry, speech audiometry in quiet and noise, tympanometry, reflexometry, TEOAEs, cochlear microphonic, and ABR were performed in a 24-hours interval at both febrile and afebrile states, and results are reported here. This report is the first example of temperature-sensitive auditory neuropathy in this geographical region.

Squamous cell carcinoma (SCC) accounts for 85% of laryngeal cancers. In some cases, lymph nodes do not show any specific symptoms despite being involved by cancer. Previous studies showed that patients undergoing selective neck lymph node dissection (SND) had significantly lower recurrence rates. We investigated the prevalence of occult neck lymph node involvement in patients with laryngeal SCC, and this is an important step in performing targeted selective neck lymph node dissection (SND) in these patients.

This is a descriptive, retrospective, cross-sectional study involving the clinical records of patients with laryngeal carcinoma referred to Amir Alam Hospital from 2012 to 2017. Clinical and radiologic data showed that 66 patients had laryngeal SCC and were in the N0 stage. This group of patients was considered as the statistical sample of the study. A number of patients with similar status were excluded because of incomplete case data. Data analysis was done with SPSS v.22 software.

Of the total number of patients 29(44%), were diagnosed with glottic cancer, 29 (44%) with supraglottic cancer and 8 (12%) with subglottic cancer. 26 (39.5%) of these patients had lymph node metastasis (occult metastasis approved by post-operative pathology report). No metastasis in lymph nodes was found in 40(60.5%) patients. Of the 66 targeted patients, only 13 underwent radiotherapy before surgery. Of the 26 patients who had lymph node metastasis, 11 were diagnosed with glottic cancer and 13 patients with supraglottic cancer and 2 cases with subglottic cancer.

Considering the nearly 20% prevalence of occult lymph node metastasis in patients with laryngeal squamous cell carcinoma who are in the N0 stage, it is recommended to selectively excise the neck lymph nodes in addition to the tumor surgery as this will reduce the recurrence rate of the disease.

Pre-operative differentiation of benign from malignant cervical adenopathies remains a challenge. Several studies indicate parameters to discriminate between benign and malignant lymph nodes, which has not yet been enough.

The aim of the current study was to assess the diagnostic efficacy of DWI to differentiate benign from malignant cervical lymph nodes. Patients and

In all patients, we assessed axial and coronal fast spin echo T2 and T1-weighted images and T1-weighted after contrast injection. DWI sequences were implemented before contrast injection, in axial and coronal planes (b factor of 50, 500 and 1000 s/mm2 ) and the apparent diffusion coefficient (ADC) maps were reconstructed. Data were assessed in mixed model analysis and results were compared with postoperative histopathologic findings.

Thirty seven subjects were enrolled, 10 with benign lymphadenopathy and 27 patients with malignant lymphadenopathies before treatment. The mean ADC of the benign neck lymph nodes was (1.00 ± 0.34) × 10-3 mm2 /s, while it was (0.76 ± 0.16) × 10-3 mm2 /s in malignant ones (P = 0.058). The mean ADC of the metastatic nodes was (0.81 ± 0.14) × 10-3 mm2 /s, while it was (0.56 ± 0.04) × 10-3 mm2 /s in lymphoma (P < 0.001). The mean ADC of weakly differentiated metastatic nodes was significantly lower than that of good and moderately differentiated ones [(0.86 ± 0.13) × 10-3 mm2 /s vs. (0.66 ± 0.02) × 10-3 mm2 /s respectively; P = 0.001]. The area under the ROC curve of ADC was 0.69 [95%CI = 0.52 - 0.83]. Considering cut off points of 0.6 × 10-3, 0.95 × 10-3, and 1.2 × 10-3 yielded sensitivities were 15%, 92.5%, and 100%, respectively; while, in these cutoff points, specificities were 80%, 50%, and 40%, respectively.

DWI could be considered as an important diagnostic tool to differentiate enlarged cervical lymphadenopathies.