HSC Section 8_April 2017

T ABLE OF C ONTENTS Selected Recent Materials - Reproduced in this Study Guide

SECTION 8: OTOLOGY and NEUROTOLOGY APRIL 2017

ADDITIONAL REFERENCE MATERIAL .....................................................................................i - iv CYCLE 2016-2017 INDEX ...................................................................................... I-1 - I-18

I.

Vestibular Disorders

A. Migraine and vertigo Chang TP, Lin YW, Sung PY, et al. Benign paroxysmal positional vertigo after dental procedures: a population-based case-control study. PLOS One . 2016; 11(4):e0153092. EBM level 3..........................................................................................................................................1-8 Summary : This is a population-based study using case-control design to look at the prevalence of benign paroxysmal positional vertigo (BPPV) in patients who had a recent dental procedure as compared to age- and gender-matched controls. It showed a significant increased odds ratio for BPPV after certain dental procedures. Summary : This is a narrative review of diagnosis and management of vestibular migraine. It discusses the diagnostic criteria and main differential diagnosis, and reviews the various medications and treatment options for vestibular migraine. Friedland DR, Tarima S, Erbe C, Miles A. Development of a statistical model for the prediction of common vestibular diagnoses. JAMA Otolaryngol Head Neck Surg . 2016; 142(4):351-356. EBM level 4............................................................................................................................17-22 Summary : This report details a statistical model based on utility of four to five variables for diagnosis of most common peripheral vestibular disorders, including Ménière’s disease, benign paroxysmal positional vertigo (BPPV), and vestibular migraine. Based on an intake questionnaire, the study showed that there was good sensitivity and specificity for diagnosis of BPPV and Ménière’s disease but less specificity for vestibular migraine. This information can help otological practices in terms of efficient management of patients referred for dizziness. B. Ménière’s disease Crowson MG, Patki A, Tucci DL. A systematic review of diuretics in the medical management of Ménière’s disease. Otolaryngol Head Neck Surg . 2016; 154(5);824-834. EBM level 3......................................................................................................................................23-33 Summary : This is systematic review of all articles from 1962 to 2012 with level 4 evidence or higher discussing the use of oral diuretics in the medical management of Ménière’s disease. The 19 articles selected investigated isosorbide, hydrochlorothiazide, acetazolamide, chlorthalidone, betahistine, HCTZ-triamterene, and nimodipine. Forty-two percent of studies reported hearing improvement and 79% reported vertigo improvement. In 53% of reports there were no side effects, but 21% noted abdominal discomfort. Dieterich M, Obermann M, Celebisoy N. Vestibular migraine: the most frequent entity of episodic vertigo. J Neurol . 2016; 263 Suppl 1:S82-S89. EBM level 5.................................9-16