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Author: admin | 06.01.2015 | Category: Relieve Tinnitus

Correspondence Address:Zhang QuanbinDepartment of Neurosurgery, Shanghai 10th People's Hospital, Tongji University School of Medicine, No. Dagmara Hering,Markus Schlaich Current Hypertension Reports.
Presbyacusis (age related hearing loss) is probably the commonest cause of hearing loss and is essentially due to degeneration of the specialised hearing nerves and hearing organ that is nicely protected in a tough bone around the ear. Noise induced hearing loss may be occupational from being exposed to excessive noise for prolonged periods without ear protection.
Some people develop a sudden severe hearing loss usually in one ear with no apparent cause. Other cause of hearing loss include viruses, trauma, some medications, congenital causes and more rarely brain tumours. These pages contain medical information on the ears, nose, throat, conditions of the head and neck, and on facial plastic and cosmetic surgery. Material on this site is for information purposes only and is not a substitute for medical advice.
These patient information leaflets have been written in accordance with CNST guidelines and advice, and have been reviewed by the Royal College of Surgeons Patient Liaison Group.
This leaflet may be freely reproduced in its entirety by photocopying, print, electronic publishing or any other means on condition that no additions, deletions or any other alterations are made to the text and that the text is circulated for the benefit of patients. Herpes Zoster which is the virus that causes shingles produces a rash around the ears and often a facial paralysis. A patient who has had a laryngectomy is inserting a Blom Singer valve to the throat, which will allow him to talk normally.
The patient underwent surgical exploration of the posterior cranial fossa, and a gross left vertebral artery was identified as the offending vessel. A single microvascular decompression surgery cures a patient with trigeminal neuralgia, hemifacial spasm, tinnitus, hypertension, and paroxysmal supraventricular tachycardia caused by the compression of a vertebral artery.
Subsequent investigations have indicated that several other clinical syndromes, such as trigeminal neuralgia, deafness, tinnitus, vertigo, hemifacial spasm, glossopharyngeal neuralgia, and even neurogenic hypertension, can be due to the vascular compression of the trigeminal nerve, cochlear nerve, vestibular nerve, facial nerve, glossopharyngeal nerve, and vagus nerve, as well as the root entry zone (REZ) of these nerves.


Microvascular decompression on patients with trigeminal neuralgia caused by ectaticvertebrobasilar artery complex: Technique notes. It usually takes a careful history of the hearing loss and related factors along with other ear symptoms coupled with an examination to arrive at a diagnosis. Most patients would require a hearing test which helps to quantify and characterise the hearing loss. The neurovascular conflicts were associated with the cranial nerves V, VII, VIII, IX, and X. The clinical syndromes noted above may appear alone, but two or three can also occur together, [1] although four types of symptoms appearing together is rare. Unfortunately presbyacusis is irreversible but hearing aids help to amplify sounds to be heard. Moreover, paroxysmal supraventricular tachycardia (PSVT) caused by vascular compression had never been reported.
People with presbyacusis complain of being unable to hear properly when there is background noise or complain of other people not being clear enough when speaking. Probably this is the first report of a single microvascular decompression, having cured such a high number of syndromes, including paroxysmal supraventricular tachycardia. The patient with five types of diseases mentioned above was cured successfully by a single microvascular decompression (MVD) surgery. Hearing aid technology has come a long way with digital hearing aids now in routine use in many parts of the world. The hemifacial spasm was limited to the area around the left eye, and the patient was experiencing paroxysms of electric shock-like pain that involved the third left trigeminal branch. Additionally, she had experienced tinnitus in the left ear and paroxysmal palpitations for several months.
Preoperative computed tomography angiography showed bilateral vertebral arteries (Vas), with the left artery, in particular, deflected to the left and flexed abnormally [Figure 1]a-c. Magnetic resonance imaging (MRI) showed a VA in the left side of the ventral brain stem [Figure 1]d-f. During the MVD operation, after removing the arachnoid, the left VA was distended and flexed abnormally, and it compressed, from the left rostral ventrolateral medulla (RVLM) to the tentorium of the cerebellum, the VII, VIII, IX, and X cranial nerves and their REZ [Figure 2]a.


The surgery proceeded from the proximal part of the VA, and involved lifting the VA from the REZ of IX and X (the position of the left RVLM) and insertion of a Teflon pad [Figure 2]c.
The offending vessel was also affixed to the dura mater of the petrosa with glue [Figure 2]d.
Thus, the REZ of the facial nerve was completely decompressed, and the offending vessel was transposed [Figure 3]a.
A Teflon pad was also spread between VA and VII, VIII cranial nerves on the cistern segment [Figure 3]b.
Next, the trigeminal nerve was explored; because the strength of flexion of the vertebral arteries had squeezed this nerve to the tentorium tightly, the nerve had become only a thin sheet [Figure 3]c. The surgeons attempted to push the VA away, and a thick Teflon pad was inserted to shield the nerve [Figure 3]d (video clip). The symptoms, including neuralgia, spasm, tinnitus, and paroxysmal palpitations, disappeared immediately. It is necessary that the offending vessel be displaced from the REZ of the facial nerve at the proximal region, as was performed in this case. Because the VA was gross and curved with high bending tension, the offending vessel may reset, causing recurrence.
In this case, after decompression, the Teflon was affixed with glue to the dura mater of the petrosa, and the Teflon pad inserted into the neurovascular conflict was thick to diffuse the pressure.After Annette and Gendell reported that a glossopharyngeal neuralgia patient with hypertension was cured by MVD surgery, [3] Morimoto subsequently confirmed that neurogenic hypertension may be caused by the compression of the posterior fossa vasculature in the left side of the RVLM.
This case, in which PSVT was cured by MVD surgery, may be associated with the neurovascular compression of the nuclei of the cardiovascular center in the medulla or with effects on the excitation of the vagus nerve.




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