Jean Philippe Guyot Livres

Bilateral vestibular loss often goes unrecognized by doctors and, as a result, many patients consult a variety of specialists before finally getting the correct diagnosis. This special topic issue provides new insights into this disorder and includes encouraging data on the development of a vestibular prosthesis. The publication starts with a discussion of the difficulties patients face until a total vestibular deficit is identified. The focus then turns to the development of a balance-restoring implant which is a neuro-prosthesis conceptually similar to a cochlear implant. Two of the three worldwide teams involved in developing this therapy provide exclusive updates on research in animal models and the first applications in humans. So far, demonstrations have shown that at least partial restoration of vestibular function is possible. Because of the myriad possible symptoms and the difficulties in diagnosis, patients may consult general practitioners, internists, neurologists, ophthalmologists, and/or otorhinolaryngologists. This publication is meant to enhance the awareness of those professionals and bring them up to date on the latest research and results.

There are various theories regarding the source of tinnitus. Different therapeutic concepts which are based on these theories have gained popularity throughout the last years and are applied worldwide, some with an obvious benefit for the patient. But is this sufficient to proof the physiological basis of the concept? In this controversial issue the most popular theories are critically discussed. Renowned experts were invited to contribute, and the manuscripts were then submitted to the other invited authors for comment. The commentaries are published along with the original contribution. Hoping to open an exciting and inspiring debate the editors expect that readers will contribute as well and that additional comments will come forward. They will be published in the next issue of ORL.

The possible causes of vertigo and dizziness are multiple, the symptoms are nonspecific, and some typical features of a particular syndrome may be absent for a long period of time. In addition, the case history may be confusing as it often includes somatic as well as psychological elements. Moreover, all generally used diagnostic tests are severely limited. Facing these difficulties, the clinician has two options. The first is to systematically perform an extensive otoneurological workup including audiological, vestibular and radiological tests. In this case, he risks to perform unnecessary examinations, or to have difficulties in interpreting inconsistent results, which reflect the limitations of the diagnostic tests. On the other hand, the clinician may choose to limit the investigation to the minimum, risking to miss information indispensable to the diagnosis.

Although sudden deafness is common, its etiology and pathology are still hypothetical, and the efficiency of treatment remains questionable. The intention of this issue is to help clarify knowledge on the etiology, pathology and efficiency of the treatment of sudden deafness. Invited experts discuss the hypothetical etiology and pathology of sudden deafness and the treatment efficacy, and each article is followed by a discussion between these experts. They point out that no treatment has yet been proven efficient, that sudden deafness is not considered a therapeutic emergency, and that abstention of treatment represents a correct choice from an ethical point of view. This issue should prove interesting to any physician facing a serious clinical situation where no treatment exists.

Perilymphatic fistula - tears or defects of the thin membranes between the middle and inner ear are the object of numerous reports in the literature. Results often remain controversial and a source of confusion for the readers. The purpose of this issue is to raise the many unresolved aspects of 'perilymphatic fistula', such as pathophysiology, pathogenesis, diagnosis and treatment. An extensive knowledge of the many unresolved questions should help the clinician to understand why the conclusions of reports he may have read are still controversial. As renowned experts cannot agree on this topic, each practitioner shares in the responsibility to improve our understanding of the problem. This issue is of interest not only to ENT specialists but also to audiologists, neurologists and general practitioners involved in the diagnosis and treatment of patients with dysequilibriums, vertigo and hearing loss.

Otitis media is the object of numerous reports in the literature. Results and conclusions often remain controversial and a source of confusion for the reader. This issue of 'Oto-Rhino-Laryngologia Nova' is devoted to 'Otitis media in children' with the purpose to promote discussions and critical thinking on currently controversial aspects concerning diagnostics, pathogenesis and treatment. Recognized experts selected for their first-hand knowledge of the subject had been invited to prepare a manuscript which was then submitted for comments to the other authors and an invited expert in the field. All commentaries are published together with the invited papers. Some of the opinions expressed in this issue will raise additional comments among readers. These comments will be published in the next issue of 'Oto-RhinoLaryngologia Nova'. This will hopefully open a debate which will be an exciting intellectual venue for the field. It should also help readers to understand why the conclusions of reports they may have read in the many journals are still controversial. This issue will be of interest not only for ENT specialists but also for pediatricians and general practitioners concerned with the treatment of otitis media.