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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.
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
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.