The evaluation of tinnitus and auditory brainstem response in benign paroxysmal positional vertigo accompanied by tinnit
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OTOLOGY
The evaluation of tinnitus and auditory brainstem response in benign paroxysmal positional vertigo accompanied by tinnitus Ece Kocabaş1 · Ahmet Kutluhan2 · Banu Müjdeci3 Received: 26 June 2020 / Accepted: 29 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose The aim of this study is to investigate auditory brainstem response (ABR) in patients with benign paroxysmal positional vertigo (BPPV) accompanied by tinnitus and to suggest possible interpretative hypotheses. Methods Ninety individuals were included in the study. Individuals were separated into three groups: patients reporting tinnitus with BPPV (Group I), patients with BPPV (Group II), and a control group. The ABR test was applied at a low and at a high rate. Results For patients reporting tinnitus with BPPV, tinnitus was found to be localized in the ear affected by BPPV. Tinnitus disappeared after therapeutic interventions in 23 individuals with tinnitus. The difference between the V. wave = false Wave V = true latency at high rate and V. wave = false Wave V = true latency at a low rate in the affected ears of all individuals with BPPV (Groups I and II) was significantly long. In the affected ears of all BPPV patients, at a high rate of ABR, the absolute latency of the Wave III was found to be significantly longer than for the control group. Conclusions Individuals with BPPV showed prolonged latencies in affected ears in a high rate of ABR without the effect of tinnitus. High rate of ABR in individuals with BPPV can be used to obtain preliminary information in cases where ischemia in the auditory pathways is suspected in BPPV formation. Keywords Tinnitus · Auditory brainstem response · Dizziness · Ischemia · BPPV
Introduction Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibular disease seen in adults [1]. Although its causes are still debated, the most widely accepted hypothesis is the presence of abnormal particles in the semicircular canals (SCC) (canalolithiasis) [2] or on the cupula (cupulolithiasis) [3]. BPPV is treated with * Banu Müjdeci [email protected] Ece Kocabaş [email protected] Ahmet Kutluhan [email protected] 1
Department of Auditory Rehabilitation, Su Special Training and Rehabilitation Center, Ankara, Turkey
2
Faculty of Medicine, Department of Otorhinolaryngologyó, Ankara Yıldırım Beyazıt University, Ankara, Turkey
3
Faculty of Health Science, Department of Audiology, Ankara Yıldırım Beyazıt University, Ankara, Turkey
repositioning maneuvers aimed at returning the particles back to the utricle. In some patients, tinnitus of vestibular origin may occur [4] and it may be observed that tinnitus disappears immediately after repositioning maneuvers. The mechanism behind the formation of tinnitus, which can be seen in many pathological conditions, is still unclear. The presence of anatomical connections between the vestibular and cochlear systems may explain the involvement of auditory pathways and the formation of tinnitus sec
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