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Otolaryngology, ENT & Sinus News Provided by the California Sinus CentersA New Dynamic Visual Acuity Test to Assess Peripheral Vestibular Function [Original Article]July 1, 2010, 12:00 pm by Archives of Otolaryngology Head & Neck SurgeryObjective To evaluate a novel test for dynamic visual acuity (DVA) that uses an adaptive algorithm for changing the size of Landolt rings presented during active or passive head impulses, and to compare the results with search-coil head impulse testing. Design Prospective study in healthy individuals and patients with peripheral vestibular deficits. Setting Tertiary academic center. Participants One hundred neuro-otologically healthy individuals (age range, 19-80 years) and 15 patients with bilateral (n = 5) or unilateral (n = 10) peripheral vestibular loss (age range, 27-72 years). Interventions Testing of static visual acuity (SVA), DVA during active and passive horizontal head rotations (optotype presentation at head velocities >100°/s and >150°/s), and quantitative horizontal head impulse testing with scleral search coils. Main Outcome Measure Difference between SVA and DVA, that is, visual acuity loss (VA loss), gain of the high-acceleration vestibulo-ocular reflex. Results Passive head impulses and higher velocities were more effective than active impulses and lower velocities. Using passive head impulses and velocities higher than 150°/s, the DVA test discriminated significantly (P < .001) among patients with bilateral vestibulopathy, those with unilateral vestibulopathy, and normal individuals. The DVA test sensitivity was 100%, specificity was 94%, and accuracy was 95%, with search-coil head impulse testing used as a reference. In healthy individuals, VA loss increased significantly with age (P < .001; R2 = 0.04). Conclusion Dynamic visual acuity testing with Landolt rings that are adaptively changed in size enables detection of peripheral vestibular dysfunction in a fast and simple way.
More from Archives of Otolaryngology Head & Neck Surgery Professional Burnout Among Microvascular and Reconstructive Free-Flap Head and Neck Surgeons in the United States [Original Article] Archives of Otolaryngology Head & Neck Surgery: August 16, 2010, 12:00 pm Objectives To determine the prevalence of professional burnout among microvascular free-flap (MVFF) head and neck surgeons and to identify modifiable risk factors with the intent to reduce MVFF surgeon burnout.Design A cross-sectional, Iguazu Falls [About the Cover] Archives of Otolaryngology Head & Neck Surgery: August 1, 2010, 12:00 pm About This Journal [About This Journal] Archives of Otolaryngology Head & Neck Surgery: August 1, 2010, 12:00 pm The Learning Curve of Sialendoscopy With Modular Sialendoscopes: A Single Surgeon's Experience [Original Article] Archives of Otolaryngology Head & Neck Surgery: August 1, 2010, 12:00 pm Objective To assess the learning curve of sialendoscopy with modular endoscopes based on operative parameters and a postoperative performance rating. Design Prospective study, case series. Setting Tertiary referral hospital. Patients The study included 50 consecutive Dexamethasone Administration and Postoperative Bleeding Risk in Children Undergoing Tonsillectomy [Original Article] Archives of Otolaryngology Head & Neck Surgery: August 1, 2010, 12:00 pm Objective To assess whether administration of dexamethasone during tonsillectomy is associated with a dose-dependent increased rate of postoperative tonsillectomy hemorrhage. Design Retrospective review of 2788 children and adolescents who underwent tonsillectomy with or
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