pubmed_pdfs.csv

,Unnamed: 0,sr,Journal,Citation,Source,f_selection,f_rejection,Type_of_exclusion,reason_for_exclsuion,Comment,final_selection,titles,abstracts,dois,pdfs
0,2,3,Ann Otol Rhinol Laryngol Suppl,S. M. Abel and H. O. Barber Measurement of optokinetic nystagmus for otoneurological diagnosis 1981,PubMed,0.0,1.0,Outcome,Not included symptoms,,0.0,Measurement of optokinetic nystagmus for otoneurological diagnosis,"Abstract
Optokinetic nystagmus was recorded and measured in 101 subjects comprising six diagnostic categories: 1) normal, screened for otologic disease, 2) chronic unilateral labyrinthectomy, 3) unilateral Menière's disease, 4) neurologically confirmed focal brainstem lesion, 5) brainstem-cerebellar syndrome, and 6) focal unilateral supratentorial lesion. For the OKN test, each subject looked at a translucent screen onto which a field of parallel black and white bars was back-projected. The array of bars could be projected vertically or horizontally to allow for study of nystagmus beating right and left or up and down. The speed of movement of the bars varied over a range from 20 to 140 degrees/sec of visual angle, in each axis for both directions. An analysis of the slow phase velocity of OKN indicated that patients with brainstem disease produced significantly lower eye speeds than did normal subjects or patients with chronic peripheral vestibular disease. The latter groups could not be distinguished. The responses of patients with cortical lesions fell midway between these two extremes and were significantly different from those of the brainstem group. Directional preponderance of nystagmus proved to be significantly related to the side of lesion for both the labyrinthine and cortical groups. However, the absolute value of the difference in slow phase velocity for nystagmus beating toward or away from the side of lesion was no greater than the difference between right and left-beating nystagmus in normal subjects. While the results provide statistical confirmation for the findings of earlier investigations, it is noted that for purposes of clinical diagnosis, the test is of value only in the context of the otoneurological test battery. Distribution of results for individuals in the various groups overlap considerably. The designation of a numerical cutoff for differential diagnosis leads to error rates far in excess of what may be confidently attributed to chance.",doi: 10.1177/00034894810901s201.,abel1981.pdf
1,4,5,Eur Arch Otorhinolaryngol,"G. O. Acar, E. Acioğlu, O. Enver, C. Ar and S. Sahin Unilateral sudden hearing loss as the first sign of chronic myeloid leukemia 2007",PubMed,0.0,1.0,Population,,,0.0,Unilateral sudden hearing loss as the first sign of chronic myeloid leukemia,"Abstract
Chronic myeloid leukemia (CML) is one of the etiologic causes of sudden hearing loss and vertigo. However, deafness in association with vestibular symptoms rarely occurs in CML as the first sign. In this article, a 50-year-old male with CML whose first signs and symptoms were unilateral sudden hearing loss and tinnitus in the right ear, vertigo and nausea was presented. Aetiopathogenetic mechanisms, clinical and radiological aspects and therapeutic options for CML with deafness and vertigo were discussed reviewing the literature.",doi: 10.1007/s00405-007-0382-1.,acar2007.pdf
2,6,7,Rev Laryngol Otol Rhinol (Bord),"W. Adjibabi, F. Avakoudjo, O. Biaou, S. L. Afouda, S. Hounkpatin, S. Alamou, Y. Hounkpe and D. Stoll Seven cases of inverted nasosinusal papilloma treated at Cotonou 2011",PubMed,0.0,1.0,Population,Unilateral nasal obstruction,,0.0,[Seven cases of inverted nasosinusal papilloma treated at Cotonou],"Abstract
Objective: Sinonasal inverted papilloma is a rare benign tumor with a high recurrence rate and potential malignant transformation. The purpose of this study was to analyze the clinical and radiological aspects and to identify the suitable surgical approaches to be used in developing countries.
Methodology: In 3 years, 7 cases have been analyzed in a retrospective study. Patients presented with unilateral nasal obstruction and epitasis, a whitish unilateral polypoid mass, sinonasal opacity with osteolysis on CT scan or on sinus X-ray. Using these data we adopted the Krouse staging which classifies the disease in four stages and accordingly the appropriate surgical approach was used. The diagnosis was confirmed by histological examination of the biopsied specimen.
Results: Average age 48.28 years, predominant sex male. Symptom: unilateral nasal obstruction 5, bilateral nasal obstruction 1, epistaxis 5. The average time-delay before consultation was 73 months. The combined endonasal endoscopic and vestibular was the most commonly used approach (4 cases). The results were satisfying. After a minimal follow up of 2 years, one case of recurrence was detected after 4 years.
Conclusion: CT scan is an essential tool for the diagnosis and detecting the extension of sinonasal inverted papillomas. Better results were obtained with a surgical approach that combined a vestibular approach and an endonasal endoscopic approach in our region.",Not Found,No pdf
3,8,9,J Clin Neurosci,"S. H. Ahn, J. E. Shin and C. H. Kim Final diagnosis of patients with clinically suspected vestibular neuritis showing normal caloric response 2017",PubMed,1.0,,,,,0.0,Final diagnosis of patients with clinically suspected vestibular neuritis showing normal caloric response,"Abstract
Vestibular neuritis is one of the most common peripheral causes of acute vestibular syndrome, of which the diagnosis is generally based on a comprehensive interpretation of clinical and laboratory findings following reasonable exclusion of other disorders. This study aimed to investigate the final diagnosis of patients admitted to hospital under the clinical impression of vestibular neuritis who showed no unilateral caloric paresis. Forty-five patients who visited the emergency department with isolated acute spontaneous vertigo were included. Among them, six patients (13%) developed definitive spontaneous vertigo lasting longer than 20min again after discharge from hospital, accompanied by hearing loss, which was audiometrically documented, leading to a final diagnosis of definite Ménière's disease. Nine patients (20%) revisited our clinic with recurrent episodic vertigo without any documented hearing loss or auditory symptoms such as hearing loss, tinnitus or ear fullness, which led to a final diagnosis of possible Ménière's disease. In four patients (9%), initial spontaneous vertigo and nystagmus changed to positional vertigo and nystagmus on the second hospital day. In 26 patients (58%), neither another episode of vertigo nor auditory symptoms developed during follow-up period (7-92months), a condition to which the authors gave an arbitrary diagnosis of ""mild unilateral vestibular deficit"". In conclusion, patients admitted to hospital under clinical impression of vestibular neuritis may have various final diagnoses, and ""mild unilateral vestibular deficit"" was the most common final diagnosis among patients who did not meet the diagnostic criteria of vestibular neuritis.
Keywords: Benign paroxysmal positional vertigo; Caloric test; Ménière’s disease; Vertigo; Vestibular neuritis.",doi: 10.1016/j.jocn.2017.02.064.,ahn2017.pdf
4,9,10,J Surg Case Rep,"Y. Aladham, O. Ahmed, S. A. S. Hassan and E. Francis-Khoury Traumatic superior semicircular canal dehiscence syndrome: case report and literature review 2021",PubMed,0.0,1.0,Population, Superior SSC dehissance,,0.0,Traumatic superior semicircular canal dehiscence syndrome: case report and literature review,"Abstract
Superior semicircular canal dehiscence (SSCD) syndrome was first reported in 1998 by Minor et al. and comprises a spectrum of auditory and vestibular symptoms as a result of 'mobile third window' mechanism. The aetiology of SSCD is debated, but persistent infantile microstructure of the temporal bone was suggested. However, some authors related a 'second event', such as closed head trauma, temporal bone fracture and sudden increase in the intracranial pressure to the precipitation of its symptoms. In this article, we report a patient with a closed head trauma who developed unilateral auditory symptoms. High-resolution computed tomography images were obtained and confirmed bilateral SSCD with the normal middle ear structure. The patient was provided with a monaural hearing aid. Literature was searched for similar case reports or series where head trauma precipitated the symptoms of SSCD in anatomically susceptible individuals.
Keywords: SSCD; head trauma; traumatic superior semicircular canal dehiscence.",doi: 10.1093/jscr/rjaa592.,aladham2021.pdf
5,10,11,Acta Otorhinolaryngol Ital,"A. Albera, M. Boldreghini, A. Canale, R. Albera and C. F. Gervasio Vertigo returning to the sitting position after the Semont manoeuvre. Is it a prognostic symptom? 2018",PubMed,1.0,,,,,0.0,Vertigo returning to the sitting position after the Semont manoeuvre. Is it a prognostic symptom?,"Abstract in English, Italian
Benign paroxysmal positional vertigo (BPPV) is a frequent benign vestibular condition usually managed with particle repositioning manoeuvres, such as Semont manoeuvre (SM). Since few authors have described prognostic aspects of liberatory manoeuvres, the purpose of the present study was to investigate the possibility of considering vertigo in the final sitting position of the SM as a prognostic symptom in the outcome of posterior BPPV. One hundred and thirteen patients with diagnosis of unilateral posterior BPPV were taking into account in our retrospective cohort study: 41 men and 72 women, aged 22 to 85 years. All were submitted to one repositioning SM and afterwards controlled 3 to 5 days later by means of an additional Dix-Hallpike manoeuvre. The main outcomes investigated were the occurrence of Ny and vertigo in the different phases of the SM, as well as their characteristics in relation to outcome of the disease. Among all patients, 75 (66%) presented both orthotropic Ny and vertigo in the second SM position and 72% obtained a complete resolution of the disease after the liberatory manoeuvre. Contrarily, 17 subjects (15%) manifested vertigo in the final sitting position of the SM and among these, only 7 (41%) completely recovered from BPPV. According to our data, in case of sudden vertigo returning to the final sitting position of the SM, the failure rate of the liberatory manoeuvre was higher, even though not statistically significant: therefore, it can be considered as a negative prognostic factor of posterior BPPV after SM.
Keywords: BPPV; BPPV outcomes; Positional vertigo; Semont manoeuvre •Semont prognostic factors.",doi: 10.14639/0392-100X-1815.,albera2018.pdf
6,11,12,Acta Otolaryngol,P. L. Albernaz Unusual cases of delayed endolymphatic hydrops 2007,PubMed,1.0,,,,4 of the patients were unilaterally delayed endolymphatic hydrops ,0.0,Unusual cases of delayed endolymphatic hydrops,"Abstract
The objective of this report is to emphasize the clinical features of delayed endolymphatic hydrops in comparison with Ménière's disease. Four cases were selected from a series of 16 examined between the years 1993 and 2005, due to their unusual characteristics. A short clinical history and significant tests are presented for each of the four cases. The cases of delayed endolymphatic hydrops discussed in this article suggest that hydrops is the most important underlying pathology that causes the hearing loss and the vestibular symptoms both in the better ear and in the ear with severe hearing loss. They also suggest that this condition probably occurs in patients with congenitally sensitive ears that make them prone to the development of the late hydrops.",doi: 10.1080/00016480601113729.,luizmangabeiraalbernaz2007.pdf
7,12,13,J Vet Intern Med,"M. Aleman, M. Spriet, D. C. Williams and J. E. Nieto Neurologic Deficits Including Auditory Loss and Recovery of Function in Horses with Temporohyoid Osteoarthropathy 2016",PubMed,0.0,1.0,Population,Animal study,,0.0,Neurologic Deficits Including Auditory Loss and Recovery of Function in Horses with Temporohyoid Osteoarthropathy,"Abstract
Background: Auditory loss is a common deficit in horses with temporohyoid osteoarthropathy (THO), however, recovery of function is unknown.
Hypothesis/objectives: To investigate neurologic function with emphasis in audition in horses with THO after treatment. To describe anatomical alterations of the petrous temporal bone that might result in auditory loss.
Animals: Twenty-four horses with a clinical diagnosis of THO.
Methods: Prospective study. A brainstem auditory evoked response (BAER) study was done as part of the criteria for inclusion in horses with a clinical diagnosis of THO from the years of 2005 to 2014. Physical and neurologic status and BAER findings were recorded. Brainstem auditory evoked response variables were compared by using Wilcoxon sign test. Fisher's exact test was also used. Significance was set at P < 0.05.
Results: The most common signs included auditory loss (100% of horses), vestibular and facial nerve dysfunction (83%), and exposure ulcerative keratitis (71%). Concurrent left laryngeal hemiparesis was observed in 61% of horses through endoscopy. Auditory dysfunction was bilateral in 50% of the cases (complete and partial), and unilateral affecting more commonly the right ear (R = 8, L = 4). Short- and long-term follow-up revealed persistent auditory loss in all horses based on abnormal response to sound, and further confirmed through a BAER in 8 horses.
Conclusions and clinical importance: Auditory dysfunction appears to be a permanent neurologic deficit in horses diagnosed with THO despite overall neurologic improvement.
Keywords: Brainstem auditory evoked response; Deafness; Equine; Hearing.",doi: 10.1111/jvim.13654.,aleman2015.pdf
8,13,14,Gait Posture,"J. H. Allum, A. L. Adkin, M. G. Carpenter, M. Held-Ziolkowska, F. Honegger and K. Pierchala Trunk sway measures of postural stability during clinical balance tests: effects of a unilateral vestibular deficit 2001",PubMed,0.0,1.0,Population,Central dizziness,,0.0,Trunk sway measures of postural stability during clinical balance tests: effects of a unilateral vestibular deficit,"Abstract
This research evaluated whether quantified measures of trunk sway during clinical balance tasks are sensitive enough to identify a balance disorder and possibly specific enough to distinguish between different types of balance disorder. We used a light-weight, easy to attach, body-worn apparatus to measure trunk angular velocities in the roll and pitch planes during a number of stance and gait tasks similar to those of the Tinetti and CTSIB protocols. The tasks included standing on one or two legs both eyes-open and closed on a foam or firm support-surface, walking eight tandem steps, walking five steps while horizontally rotating or pitching the head, walking over low barriers, and up and down stairs. Tasks were sought, which when quantified might provide optimal screening for a balance pathology by comparing the test results of 15 patients with a well defined acute balance deficit (sudden unilateral vestibular loss (UVL)) with those of 26 patients with less severe chronic balance problems caused by a cerebellar-pontine-angle-tumour (CPAT) prior to surgery, and with those of 88 age- and sex-matched healthy subjects. The UVL patients demonstrated significantly greater than normal trunk sway for all two-legged stance tasks especially those performed with eyes closed on a foam support surface. Sway was also greater for walking while rotating or pitching the head, and for walking eight tandem steps on a foam support surface. Interestingly, the patients could perform gait tasks such as walking over barriers almost normally, however took longer. CPAT patients had trunk sway values intermediate between those of UVL patients and normals. A combination of trunk sway amplitude measurements (roll angle and pitch velocity) from the stance tasks of standing on two legs eyes closed on a foam support, standing eyes open on a normal support surface, as well as from the gait tasks of walking five steps while rotating, or pitching the head, and walking eight tandem steps on foam permitted a 97% correct recognition of a normal subject and a 93% correct recognition of an acute vestibular loss patient. Just over 50% of CPAT patients could be classified into a group with intermediate balance deficits, the rest were classified as normal. Our results indicate that measuring trunk sway in the form of roll angle and pitch angular velocity during five simple clinical tests of equilibrium, four of which probe both stance and gait control under more difficult sensory conditions, can reliably and quantitatively distinguish patients with a well defined balance deficit from healthy controls. Further, refinement of these trunk sway measuring techniques may be required if functions such as preliminary diagnosis rather than screening are to be attempted.",doi: 10.1016/s0966-6362(01)00132-1.,allum2001.pdf
9,14,15,Annu Int Conf IEEE Eng Med Biol Soc,"J. H. Allum, M. G. Carpenter, B. C. Horslen, J. R. Davis, F. Honegger, K. S. Tang and P. Kessler Improving impaired balance function: real-time versus carry-over effects of prosthetic feedback 2011",Pubmed,1.0,,,,,0.0,Improving impaired balance function: real-time versus carry-over effects of prosthetic feedback,"Abstract
This study investigated whether training with realtime prosthetic biofeedback (BF) of trunk sway induces a carry-over improvement in balance control once BF is removed. 12 healthy older adults and 7 uncompensated unilateral vestibular loss patients were tested. All participants performed a battery of 14 balance and gait tasks (pre-test) upon their initial lab visit during which trunk angular sway was measured at L1-3. They then received balance BF training on a subset of 7 tasks, three times per week, for two consecutive weeks. BF was provided using a multi-modal biofeedback system with graded vibrotactile, auditory, and visual cues in relation to subject-specific angular displacement thresholds. Performance on the battery of the 14 balance and gait tasks (without BF) was re-assessed immediately after the 2 week training period, as well as 1 week later to examine BF carry-over effects. Significant reductions in trunk angular displacement were observed with the real-time BF, compared to the pre-test trials. The effects of BF persisted when BF was removed immediately after the final training session. BF carry-over effects were less evident at one week post-training. This evidence supports the potential short-term effects of BF training in a limited number of tasks after the BF is removed in healthy elderly subjects and those with vestibular loss. However, the prospect for longer term (>1 week) effects of prosthetic training on balance control remains currently unknown.",doi: 10.1109/IEMBS.2011.6090309.,allum2011.pdf
10,15,16,J Vestib Res,J. H. Allum and F. Honegger Recovery times of stance and gait balance control after an acute unilateral peripheral vestibular deficit 2016,PubMed,1.0,,,,,0.0,Recovery times of stance and gait balance control after an acute unilateral peripheral vestibular deficit,"Abstract
Background: Acute unilateral peripheral vestibular deficit (aUPVD) patients have balance deficits that can improve after several weeks. Determining differences in vestibulo-spinal reflex (VSR) influences on balance control and vestibular ocular reflex (VOR) responses with peripheral recovery and central compensation would provide insights into CNS plasticity mechanisms. Also, clinically, knowing when balance control is approximately normal again should contribute to decisions about working ability after aUPVD. Usually VORs are employed for this purpose, despite a lack of knowledge about correlations with balance control. Given this background, we examined whether balance and VOR measures improve similarly and are correlated. Further whether balance improvements are different for stance and gait.
Methods: 26 patients were examined at onset of aUPVD, and 3, 6 and 13 weeks later. To measure balance control and thereby assess the contribution of VSR influences during stance and gait, body-worn gyroscopes mounted at lumbar 1-3 recorded the angular velocity of the lower trunk in the roll (lateral) and pitch (anterior-posterior) directions. These signals were integrated to yield angle deviations. To measure VOR function, rotating chair (ROT) tests were performed with triangular velocity profiles with accelerations of 20°/s(2) and 5°/s(2), and caloric tests with bithermal (44 and 30°C) water irrigation of the external auditory meatus. Changes in average balance and VOR measures at the 4 examination time points were modelled with exponential decays. Improvements were assumed to plateau when model values were to within 10% of steady state.
Results: Balance improvement rates were task and direction dependent, ranging from 3-9 weeks post aUPVD, similar to the range of ROT VOR improvement rates. Stance balance control improved similarly in the pitch and roll directions. Both reached steady state at 7.5 weeks. However, changes in visual and proprioceptive influences on stance sway velocities continued to decrease in favour of vestibular influences for over 10 weeks with the visual influence being correlated with ROT deficit side responses (R= 0.475). Spontaneous nystagmus and stance roll velocity were weakly correlated (R= 0.24). Pitch control during gait tests improved faster than roll. Gait speed was slower and only recovered normal velocity at 6-9 weeks. Pitch velocity when walking eyes closed was correlated (R= 0.38) with ROT asymmetry. Other balance and VOR measures were more weakly correlated (R< 0.2) even if these had similar improvement rates.
Conclusions: These results indicate that balance control for stance improves equally fast in the pitch and roll directions. For gait, pitch control improves faster than roll. On average, stance and gait tests show normal balance control at 6-9 weeks post aUPVD onset. As few balance measures are correlated with those of VOR function and then with low (R< 0.5) coefficients, we suggest that VOR tests should not be used to assess improvements in balance control after aUPVD. The lack of strong correlations between balance and VOR measures included in this study during peripheral recovery and central compensation of aUPVD supports the hypothesis that recovery of balance function after an aUPVD involves different CNS pathways and neural plasticity mechanisms.
Keywords: Unilateral vestibular loss; balance control; gait; recovery rates; stance.",doi: 10.3233/VES-150561.,allum2016.pdf
11,16,17,Ear Nose Throat J,"L. M. Almond, K. Patel and D. Rejali Transient auditory dysfunction: a description and study of prevalence 2013",PubMed,0.0,1.0,Design,Not related to subject ,,0.0,Transient auditory dysfunction: a description and study of prevalence,"Abstract
Transient auditory dysfunction (TAD) is a previously undescribed symptom complex of unknown cause. It is characterized by short-lasting sensorineural hearing loss (unilateral or bilateral), it is associated with tinnitus, it resolves completely within minutes, and it is not accompanied by vestibular symptoms. We conducted a cross-sectional prospective study to define TAD, find its prevalence, and discuss its significance. Two hundred healthy subjects between the ages of 16 and 49 years were surveyed using a questionnaire. Of these subjects, 41 (20.5%) reported experiencing symptoms of TAD. The mean number of episodes was 5.9 times per month, the mean duration was 41 seconds, and 80% experienced concomitant tinnitus. We conclude that TAD is a common finding in a healthy population. This may have implications for the pathogenesis of sudden-onset sensorineural hearing loss. Further longitudinal studies and detailed audiologic evaluation of patients with TAD are required to ascertain the significance, etiology, and pathophysiology of this condition.",doi: 10.1177/014556131309200809.,almond2013.pdf
12,17,18,Arch Ital Biol,"P. Andre, O. Pompeiano, D. Manzoni and P. D'Ascanio Muscarinic receptors in the cerebellar vermis modulate the gain of the vestibulospinal reflexes in decerebrate cats 1992",PubMed,0.0,1.0,Population,Animal study,,0.0,Muscarinic receptors in the cerebellar vermis modulate the gain of the vestibulospinal reflexes in decerebrate cats,"Abstract
1. The Purkinje (P)-cells of the cerebellar vermis, which exert a prominent influence on posture as well as on the gain of vestibulospinal (VS) reflexes, are under the control not only of the classic mossy fibers and climbing fibers which liberate excitatory amino acids as neurotransmitter, but also of cholinergic afferents. The role of these afferents was investigated in precollicular decerebrate cats by using the method of local microinjection of cholinergic agents into appropriate areas of the cerebellar cortex. 2. Unilateral injection into the vermal cortex of the culmen of the non-selective cholinergic agonist carbachol (0.25 microliters at 0.5 micrograms/microliters saline) produced a postural asymmetry, characterized by a slight decrease of the extensor tonus in the ipsilateral forelimb and an increased tonus in the contralateral forelimb. Moreover, the gain of the EMG responses of the ipsilateral and the contralateral triceps brachii to animal tilt increased significantly, while no significant changes in the phase angle of the responses were observed. These effects started 5-10 min after the injection and persisted for at least 2 hours before disappearing. Similar but smaller effects were obtained after injection of eserine, an inhibitor of acetylcholinesterase. Thus, the effects could be produced by increasing the naturally present amount of acetylcholine (ACh). 3. The changes in posture and gain of the VS reflexes described above utilized in part at least muscarinic receptors, since effects similar to those induced by carbachol injection were also obtained after unilateral microinjection into the vermal cortex of the culmen of the muscarinic agonist bethanechol (0.25 microliters at 0.1 micrograms/microliters). On the other hand opposite effects, characterized by an increased postural activity in the ipsilateral forelimb associated with a decreased activity in the contralateral forelimb, as well as by a reduced gain of the EMG responses of the triceps brachii of both sides to animal tilt were observed in other experiments after local microinjection of the muscarinic antagonist scopolamine (0.25 microliter at 4-8 micrograms/microliters saline). Evidence for muscarinic supersensitivity was obtained following repetitive injections of scopolamine into the cerebellar vermis. 4. The area which upon injection of the cholinergic agents modified the postural activity as well as the gain of the VS reflexes was located within the third and/or the fourth folium rostral to the fissura prima (culmen), at the laterality of 1.4-1.8 mm with respect to the midline.(ABSTRACT TRUNCATED AT 400 WORDS)",Not Found,No pdf
13,23,24,Acta Otolaryngol,"Y. Asama, F. Goto, T. Tsutsumi and K. Ogawa Objective evaluation of neck muscle tension and static balance in patients with chronic dizziness 2012",PubMed,1.0,,,,The study included 26 patients with chronic dizziness caused by unilateral vestibular deficit,0.0,Objective evaluation of neck muscle tension and static balance in patients with chronic dizziness,"Abstract
Conclusion: Increase in the average value of bilateral neck muscle tension (ANT) indicates the increase in neck muscle tension to stabilize static posture resulting from vestibular compensation. Asymmetry of neck muscle tension was closely related to postural imbalance.
Objective: Patients with dizziness often complain of neck symptoms with stiff neck. This study was conducted to clarify the pathophysiological mechanism of neck symptoms in patients with dizziness.
Methods: We objectively measured bilateral trapezius muscle tension in patients with chronic dizziness and determined its relationship with static postural perturbation. The study included 26 patients with chronic dizziness caused by unilateral vestibular deficit and 24 healthy controls. The tension of bilateral trapezius muscles was objectively measured using a neck muscle tension meter. ANT and the ratio (right/left) of the bilateral neck muscle tension (RNT) were calculated. Static posturography was performed to measure total length of path (LNG).
Results: ANT was negatively correlated to LNG under the eyes closed (EC) condition only in the case of the patients (r = -0.44, p < 0.05). In the case of both the controls and the patients with a unilateral vestibular deficit, RNT was positively correlated to LNG under the EC condition.",doi: 10.3109/00016489.2012.699197.,asama2012.pdf
14,26,27,Exp Brain Res,"S. T. Aw, G. M. Halmagyi, I. S. Curthoys, M. J. Todd and R. A. Yavor Unilateral vestibular deafferentation causes permanent impairment of the human vertical vestibulo-ocular reflex in the pitch plane 1994",PubMed,1.0,,,,,0.0,Unilateral vestibular deafferentation causes permanent impairment of the human vertical vestibulo-ocular reflex in the pitch plane,"Abstract
Rapid, passive, unpredictable, low-amplitude (10-20 degrees), high-acceleration (3000-4000 degrees/s2) head rotations were used to study the vertical vestibulo-ocular reflex in the pitch plane (pitch-vVOR) after unilateral vestibular deafferentation. The results from 23 human subjects who had undergone therapeutic unilateral vestibular deafferentation were compared with those from 19 normals. All subjects were tested while seated in the upright position. Group means and two-tailed 95% confidence intervals are reported for the pitch-vVOR gains in normal and unilateral vestibular deafferented subjects. In normal subjects, at a head velocity of 125 degrees/s the pitch-vVOR gains were: upward 0.89 +/- 0.06, downward 0.91 +/- 0.04. At a head velocity of 200 degrees/s, the pitch-vVOR gains were: upward 0.92 +/- 0.06, downward 0.96 +/- 0.04. There was no significant up-down asymmetry. In the 15 unilateral vestibular deafferented subjects who were studied more than 1 year after unilateral vestibular deafferentation, the pitch-vVOR was significantly impaired. At a head velocity of 125 degrees/s, the pitch-vVOR gains were: upward 0.67 +/- 0.11, downward 0.63 +/- 0.07. At a head velocity of 200 degrees/s, the pitch-vVOR gains were: upward 0.67 +/- 0.07, downward 0.58 +/- 0.06. There was no significant up-down asymmetry. The pitch-vVOR gain in unilateral vestibular deafferented subjects was significantly lower (P < 0.05) than the pitch-vVOR gain in normal subjects at the same head velocities. These results show that total, permanent unilateral loss of vestibular function produces a permanent symmetrical 30% (approximately) decrease in pitch-vVOR gain. This pitch-vVOR deficit is still present more than 1 year after deafferentation despite retinal slip velocities greater than 30 degrees/s in response to head accelerations in the physiological range, indicating that compensation of pitch-vVOR function following unilateral vestibular deafferentation remains incomplete.",doi: 10.1007/BF00232444.,aw1994.pdf
15,27,28,Acta Otolaryngol Suppl,"S. T. Aw, G. M. Halmagyi, D. V. Pohl, I. S. Curthoys, R. A. Yavor and M. J. Todd The effect of unilateral posterior semicircular canal inactivation on the human vestibulo-ocular reflex 1995",PubMed,0.0,1.0,Outcome,"No symptom, signs",,0.0,The effect of unilateral posterior semicircular canal inactivation on the human vestibulo-ocular reflex,"Abstract
The responses to rapid, passive, unpredictable, low amplitude (10-20 degrees), high acceleration (3,000-4,000 degrees/s2) head rotations were used to study the human vestibulo-ocular reflex (VOR) in pitch and yaw plane after unilateral posterior semicircular canal occlusion (uPCO) in 10 subjects. The results from these 10 uPCO subjects were compared with those from 18 normal subjects. The VOR gains at a head velocity of 200 degrees/s in the uPCO subjects were: pitch upward = 0.62 +/- 0.06, pitch downward = 0.87 +/- 0.11, yew ipsilesion = 0.78 +/- 0.06, yaw contralesion = 0.79 +/- 0.10 and in normal subjects were: pitch upward = 0.92 +/- 0.06, pitch downward = 0.96 +/- 0.04, yaw right = 0.88 +/- 0.05, yaw left = 0.91 +/- 0.12 (group means +/- twotailed 95% confidence intervals). The results showed that the pitch-vVOR gain was significantly (p < 0.05) decreased in response to upward head impulses whereas in response to downward, ipsilesion and contralesion head impulses were not significantly different (p > 0.05) from the normals. This study shows that there is 30% permanent residual deficit of the upward pitch-vVOR with an up-down asymmetry in pitch-vVOR gain following inactivation of a single posterior semicircular canal and that compensation of pitch-vVOR function is incomplete.",doi: 10.3109/00016489509125243.,aw1995.pdf
16,28,29,Acta Otolaryngol,"S. T. Aw, J. S. Magnussen, M. J. Todd, S. McCormack and G. M. Halmagyi MRI of the vestibular nerve after selective vestibular neurectomy 2006",PubMed,1.0,,,,"Of the seven patients only one was asymptomatic (totally free of vertigo); six had continued to experience vertigo attacks, albeit not as long or as severe as before VNx.",0.0,MRI of the vestibular nerve after selective vestibular neurectomy,"Abstract
Conclusion: In patients with Ménière's disease and persisting vertigo attacks after vestibular neurectomy (VNx) MRI of the vestibulocochlear nerve can identify residual vestibular nerve fibres that could be responsible for the vertigo attacks.
Objective: To test if MRI of the vestibulocochlear nerve can corroborate the presence of residual vestibular nerve fibres in patients with persisting vertigo attacks and residual vestibular function after VNx.
Materials and methods: Vestibulocochlear nerve bundles of seven post-VNx unilateral Ménière's patients were imaged using 1.5 Tesla MRI with steady state free precession (SSFP) sequences. Reformatted MR images orthogonal to the vestibulocochlear nerve axis in internal auditory canal were compared on the VNx and intact sides. Vestibular function was assessed with caloric tests, three-dimensional head impulse tests and vestibular evoked myogenic potentials. Of the seven patients only one was asymptomatic (totally free of vertigo); six had continued to experience vertigo attacks, albeit not as long or as severe as before VNx.
Results: On the VNx side, MRI showed intact facial and cochlear nerves in all seven patients. In the six symptomatic patients, although superior and inferior vestibular nerve bulk and signal were reduced, residual bulk suggestive of inferior vestibular nerve was evident, correlating with evidence of residual posterior canal function on impulsive testing in all six symptomatic patients. In the asymptomatic patient, superior and inferior vestibular nerves were absent on MRI and impulsive testing revealed no residual posterior canal function.",doi: 10.1080/00016480600606657.,aw2006.pdf
17,30,31,Am J Otolaryngol,"C. Badaracco, F. S. Labini, A. Meli and D. Tufarelli Oscillopsia in labyrinthine defective patients: comparison of objective and subjective measures 2010",PubMed,1.0,,,,chronic dizziness: 18 with unilateral vestibular hypofunction,0.0,Oscillopsia in labyrinthine defective patients: comparison of objective and subjective measures,"Abstract
Objective: To compare the oscillopsia sensation in vestibular defective patients, using a specific handicap questionnaire and a specific Visual Analog Scale, with objective measure of the vertical vestibulo-ocular reflex efficiency in the pitch plane, using the computerized Dynamic Visual Acuity (DVA) test and Gaze Stabilization Test (GST).
Design: Controlled retrospective study.
Setting: Day hospital in ENT Rehabilitation Unit.
Subjects: Sixty-five subjects: 35 controls (12 men and 23 women; mean age, 50.77 ± 13.39 years) and 30 patients with chronic dizziness: 18 with unilateral vestibular hypofunction (7 men and 11 women; mean age, 55.50 ± 12.72 years) and 12 with bilateral hypofunction (7 men and 5 women; mean age, 57.25 ± 9.18 years).
Main measures: Computerize vertical DVA and GST; subjective Visual Analog Scale, Oscillopsia Score questionnaire.
Results: Instrumental tests had different means between subject groups; vertical DVA results and subjective measures were significantly correlated.
Conclusions: Vertical DVA and GST test in up and down direction are able to separate healthy and vestibular patients. Moreover, the DVA test in down direction differentiates patients with unilateral vestibular hypofunction and with bilateral vestibular hypofunction. These results show that vertical DVA test can be used for the assessment of the visual field instability referred to as disabling.",doi: 10.1016/j.amjoto.2009.06.002.,badaracco2010.pdf
18,36,37,J Neurophysiol,N. H. Barmack and V. E. Pettorossi Effects of unilateral lesions of the flocculus on optokinetic and vestibuloocular reflexes of the rabbit 1985,PubMed,0.0,1.0,Population,Animal study,,0.0,Effects of unilateral lesions of the flocculus on optokinetic and vestibuloocular reflexes of the rabbit,"Abstract
The horizontal optokinetic reflex (HOKR) and the horizontal vestibuloocular reflex (HVOR) were tested in 21 rabbits before and after unilateral lesions were made in the left cerebellar flocculus. The immediate effect, observed within 15 min following placement of a floccular lesion, was a conjugate nystagmus with the slow phase toward the side opposite to the lesion when the animal was placed in total darkness. This spontaneous nystagmus lasted from several hours to two days depending on the extent of damage to the flocculus. It was reversed in sign if the subjacent vestibular nuclei or vestibular nerve were damaged by the operation, and it was totally absent if the unilateral floccular lesions were made in rabbits that had been bilaterally labyrinthectomized. The spontaneous drift of the eyes observed immediately postoperatively caused a bias in measurement of the HVOR that was dependent on the frequency of vestibular stimulation. When measured 50 days postoperatively the HVOR had a normal gain and normal bias. When measured 50 days postoperatively the monocular HOKR (posteroanterior stimulation of the left eye) was significantly reduced in gain at stimulus velocities below 5 degrees/s. A quantitative anatomical analysis of the degeneration of inferior olivary neurons caused by lesions of the flocculus demonstrated contralateral cell loss of as much as 65% of the dorsal cap neuronal population. These data reveal a permanent deficit in the HOKR, but not the HVOR, following unilateral floccular lesions and are consistent with the idea that the flocculus contributes to the regulation of the low-velocity eye movements through the inhibitory modulation of the activity of the subjacent vestibular nuclei.",doi: 10.1152/jn.1985.53.2.481.,barmack1985.pdf
19,37,38,Int Tinnitus J,"S. Barozzi, F. Di Berardino, E. Arisi and A. Cesarani A comparison between oculomotor rehabilitation and vestibular electrical stimulation in unilateral peripheral vestibular deficit 2006",PubMed,1.0,,,,,0.0,A comparison between oculomotor rehabilitation and vestibular electrical stimulation in unilateral peripheral vestibular deficit,"Abstract
Rehabilitation therapy is proved to be effective in reducing disability in patients with persistent symptoms of disequilibrium after acute unilateral peripheral vestibular deficit. The aim of this study was to evaluate the effects of oculomotor rehabilitation (group 2) on static balance and a dizziness handicap and to compare those with the effects to vestibular electrical stimulation (group 1). Before and after therapy, we tested 28 patients, using static posturography and.the dizziness handicap inventory short form. After therapy, all subjects reported a reduction of symptoms (p = .00019). In group 1, the reductions seen in eyes-opened length of the oscillations and eyes-opened and eyes-closed surface of the body sway were statistically significant, respectively (p = .04; p = .02; p = .02). Group 2 patients revealed better stability on all parameters, and the reductions of eyes-opened length and of eyes-opened correlation function between length and surface were statistically significant (p = .01 and p = .01, respectively). Analysis of the equilibrium system subcomponents did not show any variation. Oculomotor exercises,employed in most rehabilitative protocols and including head movements to improve vestibular adaptation, have proved to reduce the perceived overall impairment and postural sway in patients with recent unilateral vestibular disorders, even though the disorders are not associated with head movements. Comparison of our two study groups did not show any significant difference, revealing that both forms of therapy are effective.",Not Found,No pdf
20,40,41,J Int Adv Otol,"M. Bassiouni, H. Olze and P. Arens Bilateral Hearing Loss Due to Metastatic Gastric Signet Cell Adenocarcinoma Involving the Internal Auditory Canal and Cerebellopontine Angle 2021",PubMed,0.0,1.0,Population,Bilateral loss,,0.0,Bilateral Hearing Loss Due to Metastatic Gastric Signet Cell Adenocarcinoma Involving the Internal Auditory Canal and Cerebellopontine Angle,"Abstract
Intracranial metastases of stomach cancers are very rare and are associated with a poor prognosis. Of those, metastases of gastric cancers in the internal auditory canal and cerebellopontine angle represent an extremely rare subgroup. Such metastatic lesions may be indistinguishable from vestibular schwannomas in imaging studies and clinical presentation. In this report, we describe a case of gastric signet cell adenocarcinoma metastasizing to the internal auditory canal and cerebellopontine angle bilaterally and causing bilateral hearing loss, including a unilateral sudden deafness. Due to the co-detection of multiple other intracranial masses in the magnetic resonance imaging scan, the suspected diagnosis of leptomeningeal metastatic disease was clear, and the patient was referred to palliative whole brain radiotherapy. The case further highlights the importance of prompt diagnosis and treatment of metastatic cerebellopontine angle lesions to prevent permanent neurological sequelae. Metastatic tumors should therefore be considered in the differential diagnosis of cerebellopontine angle lesions, especially in patients with a known history of malignant disease.",doi: 10.5152/iao.2020.8415.,No pdf
21,41,42,Iran J Otorhinolaryngol,A. Bayat and N. Saki Effects of Vestibular Rehabilitation Interventions in the Elderly with Chronic Unilateral Vestibular Hypofunction 2017,PubMed,1.0,,,,In the full text there are symptoms,0.0,Effects of Vestibular Rehabilitation Interventions in the Elderly with Chronic Unilateral Vestibular Hypofunction,"Abstract
Introduction: Although vestibular rehabilitation therapy (VRT) methods are relatively popular in treating patients with body balance deficits of vestibular origin, only limited studies have been conducted into customized exercises for unilateral vestibular hypofunction (UVH). Furthermore, very little evidence is available on the outcomes of VRT in the elderly population with chronic UVH.
Materials and methods: A total of 21 patients, aged 61 to 74 years, with UVH participated in this study. The dizziness handicap inventory (DHI) was performed immediately before, and 2 and 8 weeks after treatment.
Results: All patients showed a reduction in DHI scores during the study. The average decrease in DHI score was 25.98 points after 2 weeks' intervention (P<0.001) and 32.54 points at the end of the study. This improvement was observed in all DHI subscores, and was most profound in the functional aspect. The correlation between the degree of final recovery and canal paresis was not significant (P>0.05). There were no relationships between the scores and gender.
Conclusion: Our study demonstrates that VRT is an effective method for the management of elderly patients with UVH, and shows maximal effect on functional aspects.
Keywords: Elderly; Rehabilitation; Vestibular.",Not Found,No pdf
22,43,44,PLoS One,"S. Becker-Bense, H. G. Buchholz, B. Baier, M. Schreckenberger, P. Bartenstein, A. Zwergal, T. Brandt and M. Dieterich Functional Plasticity after Unilateral Vestibular Midbrain Infarction in Human Positron Emission Tomography 2016",PubMed,0.0,1.0,Outcome,"No symptom, signs",,0.0,Functional Plasticity after Unilateral Vestibular Midbrain Infarction in Human Positron Emission Tomography,"Abstract
The aim of the study was to uncover mechanisms of central compensation of vestibular function at brainstem, cerebellar, and cortical levels in patients with acute unilateral midbrain infarctions presenting with an acute vestibular tone imbalance. Eight out of 17 patients with unilateral midbrain infarctions were selected on the basis of signs of a vestibular tone imbalance, e.g., graviceptive (tilts of perceived verticality) and oculomotor dysfunction (skew deviation, ocular torsion) in F18-fluordeoxyglucose (FDG)-PET at two time points: A) in the acute stage, and B) after recovery 6 months later. Lesion-behavior mapping analyses with MRI verified the exact structural lesion sites. Group subtraction analyses and comparisons with healthy controls were performed with Statistic Parametric Mapping for the PET data. A comparison of PET A of acute-stage patients with that of healthy controls showed increases in glucose metabolism in the cerebellum, motion-sensitive visual cortex areas, and inferior temporal lobe, but none in vestibular cortex areas. At the supratentorial level bilateral signal decreases dominated in the thalamus, frontal eye fields, and anterior cingulum. These decreases persisted after clinical recovery in contrast to the increases. The transient activations can be attributed to ocular motor and postural recovery (cerebellum) and sensory substitution of vestibular function for motion perception (visual cortex). The persisting deactivation in the thalamic nuclei and frontal eye fields allows alternative functional interpretations of the thalamic nuclei: either a disconnection of ascending sensory input occurs or there is a functional mismatch between expected and actual vestibular activity. Our data support the view that both thalami operate separately for each hemisphere but receive vestibular input from ipsilateral and contralateral midbrain integration centers. Normally they have gatekeeper functions for multisensory input to the cortex and automatic motor output to subserve balance and locomotion, as well as sensorimotor integration.",doi: 10.1371/journal.pone.0165935.,becker-bense2016.pdf
23,44,45,Brain Struct Funct,"S. Becker-Bense, M. Dieterich, H. G. Buchholz, P. Bartenstein, M. Schreckenberger and T. Brandt The differential effects of acute right- vs. left-sided vestibular failure on brain metabolism 2014",PubMed,0.0,1.0,Population,Midbrain infarction,,0.0,The differential effects of acute right- vs. left-sided vestibular failure on brain metabolism,"Abstract
The human vestibular system is represented in the brain bilaterally, but it has functional asymmetries, i.e., a dominance of ipsilateral pathways and of the right hemisphere in right-handers. To determine if acute right- or left-sided unilateral vestibular neuritis (VN) is associated with differential patterns of brain metabolism in areas representing the vestibular network and the visual-vestibular interaction, patients with acute VN (right n = 9; left n = 13) underwent resting state (18)F-FDG PET once in the acute phase and once 3 months later after central vestibular compensation. The contrast acute vs. chronic phase showed signal differences in contralateral vestibular areas and the inverse contrast in visual cortex areas, both more pronounced in VN right. In VN left additional regions were found in the cerebellar hemispheres and vermis bilaterally, accentuated in severe cases. In general, signal changes appeared more pronounced in patients with more severe vestibular deficits. Acute phase PET data of patients compared to that of age-matched healthy controls disclosed similarities to these patterns, thus permitting the interpretation that the signal changes in vestibular temporo-parietal areas reflect signal increases, and in visual areas, signal decreases. These data imply that brain activity in the acute phase of right- and left-sided VN exhibits different compensatory patterns, i.e., the dominant ascending input is shifted from the ipsilateral to the contralateral pathways, presumably due to the missing ipsilateral vestibular input. The visual-vestibular interaction patterns were preserved, but were of different prominence in each hemisphere and more pronounced in patients with right-sided failure and more severe vestibular deficits.",doi: 10.1007/s00429-013-0573-z.,becker-bense2013.pdf
24,49,50,Otol Neurotol,"R. W. Bergmark, R. S. Semco, D. Abdul-Aziz and S. D. Rauch Transmastoid Labyrinthectomy for Menière's Disease: Experience and Outcomes 2020",PubMed,0.0,1.0,Outcome,chronic symptomst? Not determined,,0.0,Transmastoid Labyrinthectomy for Menière's Disease: Experience and Outcomes,"Abstract
Objective: To characterize presurgical symptoms and treatment history and postoperative course in patients with medically recalcitrant Menière's disease undergoing transmastoid labyrinthectomy in the post-intratympanic gentamicin era.
Study design: Retrospective case series.
Setting: Tertiary academic medical center.
Patients: All patients who underwent transmastoid labyrinthectomy for medically recalcitrant Menière's disease in 2003 to 2019 by the senior author.
Interventions: Review of patients' medical records for: preoperative history of drop attacks, gentamicin injections, endolymphatic sac decompression or vestibular neurectomy, preoperative audiograms, length of hospital stay, postoperative complications, and persistent symptoms or challenging recovery.
Main outcome measures: Presurgical clinical history and proximal postoperative outcomes.
Results: Seventy-two patients with a mean age of 56.7 (standard deviation [SD] 10.7) were included. All cases were unilateral. Forty-three patients (59.7%) suffered from drop attacks. Sixty-two (86.1%) had failed sufficient symptom control with gentamicin injections. The mean preoperative word recognition score was 36.4% (SD 23.7) versus 95.1% (SD 8.5) in the contralateral ear. The mean pure-tone average (PTA) of the ipsilateral ear before surgery was 65.5 dB (SD 18.0) versus 16.2 (SD 13.5) for the contralateral ear. Mean hospital stay was 2.0 days (SD 0.87 days, range of 1-5 d). Three patients (4.2%) had prolonged postoperative vertigo.
Conclusions: Transmastoid labyrinthectomy at our center is performed for unilateral Menière's disease, generally when intratympanic gentamicin has failed. A majority of surgical patients suffer from drop attacks preoperatively. Hospital stay is typically brief.",doi: 10.1097/MAO.0000000000002805.,No pdf
25,50,51,Acta Otorhinolaryngol Belg,"S. Berrettini, P. Bruschini, S. Sellari Franceschini, L. Mita, I. Olivieri and G. Gemignani Sudden deafness and Behçet's disease 1989",PubMed,0.0,1.0,Population,Behcet disease,,0.0,[Sudden deafness and Behçet's disease],"Abstract
Behçet's disease is a multisystemic vasculitis of unknown aetiology. Generally, it is characterized by recurrent aphthous stomatitis, recurrent genital ulcers, uveitis with hypopion. Recently some authors reported that patients with Behçet's disease show frequently audio-vestibular involvement. We observed a 40 year-old man (case A) and a 66 year-old woman (case B) affected by Behçet's disease for more than 10 years, showing a sudden deafness occurring during an exacerbation of the disease. In both cases there was a sensorineural hearing-loss, unilateral or bilateral. One patient received early high-dose cortisone therapy. General symptoms and audiovestibular function, both have completely recovered.",Not Found,No pdf
26,52,53,Eur Arch Otorhinolaryngol,"P. Bertholon, P. Reynard, Y. Lelonge, R. Peyron, F. Vassal and A. Karkas Hearing eyeball and/or eyelid movements on the side of a unilateral superior semicircular canal dehiscence 2018",PubMed,0.0,1.0,Outcome,"No symptom, signs",,0.0,Hearing eyeball and/or eyelid movements on the side of a unilateral superior semicircular canal dehiscence,"Abstract
Hearing of eyeball movements has been reported in superior semicircular canal dehiscence (SSCD), but not hearing of eyelid movements. Our main objective was to report the hearing of eyeball and/or eyelid movements in unilateral SSCD. Our secondary objective was to access its specificity to SSCD and discuss the underlying mechanism. Six patients with SSCD who could hear their eyeball and/or eyelid movements were retrospectively reviewed. With the aim of comparisons, eight patients with an enlarged vestibular aqueduct (EVA), who share the same mechanism of an abnormal third window, were questioned on their ability to hear their eyeball and/or eyelid movements. Three patients with SSCD could hear both their eyeball and eyelid movements as a soft low-pitch friction sound. Two patients with SSCD could hear only their eyelid movements, one of whom after the surgery of a traumatic chronic subdural hematoma. The latter remarked that every gently tapping on the skin covering the burr-hole was heard in his dehiscent ear as the sound produced when banging on a drum, in keeping with a direct transmission of the sound to the inner ear via the cerebrospinal fluid. One patient with SSCD, who could hear only his eyeball movements, had other disabling symptoms deserving operation through a middle fossa approach with an immediate relief of his symptoms. None of the eight patients with EVA could hear his/her eyeball or eyelid movements. Hearing of eyeball and/or eyelid movements is highly suggestive of a SSCD and do not seem to occur in EVA. In case of radiological SSCD, clinicians should search for hearing of eyeball and/or eyelid movements providing arguments for a symptomatic dehiscence. The underlying mechanism is discussed particularly the role of a cerebrospinal fluid transmission.
Keywords: Blink; Bone conduction; Cerebrospinal fluid; Enlarged vestibular aqueduct; Eyeball movements; Eyelid movements; Superior semicircular canal dehiscence; Surgical repair; Third window.",doi: 10.1007/s00405-017-4781-7.,bertholon2017.pdf
27,53,54,Biomed Res Int,"J. Betka, E. Zvěřina, Z. Balogová, O. Profant, J. Skřivan, J. Kraus, J. Lisý, J. Syka and M. Chovanec Complications of microsurgery of vestibular schwannoma 2014",PubMed,0.0,1.0,Outcome,chronic symptomst? Not determined,,0.0,Complications of microsurgery of vestibular schwannoma,"Abstract
Background: The aim of this study was to analyze complications of vestibular schwannoma (VS) microsurgery.
Material and methods: A retrospective study was performed in 333 patients with unilateral vestibular schwannoma indicated for surgical treatment between January 1997 and December 2012. Postoperative complications were assessed immediately after VS surgery as well as during outpatient followup.
Results: In all 333 patients microsurgical vestibular schwannoma (Koos grade 1: 12, grade 2: 34, grade 3: 62, and grade 4: 225) removal was performed. The main neurological complication was facial nerve dysfunction. The intermediate and poor function (HB III-VI) was observed in 124 cases (45%) immediately after surgery and in 104 cases (33%) on the last followup. We encountered disordered vestibular compensation in 13%, permanent trigeminal nerve dysfunction in 1%, and transient lower cranial nerves (IX-XI) deficit in 6%. Nonneurological complications included CSF leakage in 63% (lateral/medial variant: 99/1%), headache in 9%, and intracerebral hemorrhage in 5%. We did not encounter any case of meningitis.
Conclusions: Our study demonstrates that despite the benefits of advanced high-tech equipment, refined microsurgical instruments, and highly developed neuroimaging technologies, there are still various and significant complications associated with vestibular schwannomas microsurgery.",doi: 10.1155/2014/315952.,betka2014.pdf
28,54,55,Audiol Neurootol,A. G. Beule and J. H. Allum Otolith function assessed with the subjective postural horizontal and standardised stance and gait tasks 2006,PubMed,1.0,,,,,0.0,Otolith function assessed with the subjective postural horizontal and standardised stance and gait tasks,"Abstract
If otolith function is essential to maintain upright standing while moving along slanted or uneven surfaces, subjects with an otolith deficit should have difficulty judging whether the inclination of the surface on which they are standing is tilted or not. We tested this judgement and compared it with the ability to control trunk sway during standardised stance and gait tests. Thirteen patients with unilateral vestibular nerve neurectomy at least 6 months prior to testing and 39 age-matched controls were asked to move a dynamic posturography platform on which they were standing back to their subjective 'horizontal' position after the platform had been slowly tilted at 0.4 degrees/s to 5 degrees in 8 different directions. Normal subjects left the platform deviated in pitch (forwards-backwards) at about 0.7 degrees on describing the platform as levelled off for all directions of tilt. Patients showed larger deviations of about 1.3 degrees in pitch with significant differences for forward right tilt (1.58+/-0.73 degrees compared to 0.73+/-0.11 degrees for normals; mean and SEM) and for forward left. Roll (lateral) deviations were about 0.4 degrees for normals and 0.5 degrees larger for the patients (for example, for backward left, 1.13+/-0.24 degrees compared to 0.4+/-0.07 degrees in normals). Except for a tendency towards greater deviations to the lesion side of patients with eyes closed, no differences were noted between tests under eyes open and closed conditions. However, for backward and roll tilts patients needed to steady themselves first by grasping a handrail when tested with eyes closed. Stance tests on foam showed increases in roll and pitch trunk sway with respect to controls. Patients had significantly larger trunk roll sway deviations during 1-legged stance tests and during gait trials. For stance trials, the patients lost their balance control prior to the end of the standard 20-second recording time. We conclude that a unilateral loss of otolith inputs due to nerve resection permanently impairs the ability to judge whether the support surface is horizontal, and leads to excessive trunk sway when standing on a compliant surface as well as excessive trunk roll sway during gait.",doi: 10.1159/000091412.,beule2006.pdf
29,55,56,Otol Neurotol,"J. A. Beyea, R. S. Instrum, S. K. Agrawal and L. S. Parnes Intratympanic Dexamethasone in the Treatment of Ménière's Disease: A Comparison of Two Techniques 2017",PubMed,0.0,1.0,Outcome,chronic symptomst? Not determined,,0.0,Intratympanic Dexamethasone in the Treatment of Ménière's Disease: A Comparison of Two Techniques,"Abstract
Objective: To assess the efficacy and safety of two different intratympanic dexamethasone (IT Dex) injection protocols for intractable unilateral Ménière's disease.
Study design: Prospective case series.
Setting: Tertiary neurotology clinic.
Patients: One hundred six consecutive adult patients with definite unilateral Ménière's disease who had failed medical management were studied for an average of 1,061 days. None had previous oral steroid, IT steroid, or ablative treatment.
Interventions: Two different IT Dex regimes, either a single injection or a series of four injections, that were subsequently repeated as indicated.
Main outcome measure: Requirement for subsequent ablative therapy in the form of intratympanic gentamicin, vestibular nerve section, or labyrinthectomy. Hearing outcomes were measured using pure-tone average of 0.5, 1, 2, and 3 kHz on standard audiometry.
Results: The number of intratympanic dexamethasone injections per patient ranged from 1 to 29 (median = 4). Using the Kaplan-Meier method, predicted survival (patients not requiring ablative therapy) at 2 and 4 years after initial treatment was 83.9 and 79.3%, respectively. The injection series protocol ultimately yielded 5% better survival than the single injection protocol, but this was not statistically significant. Injections did not protect against hearing loss, and the most recent pure-tone averages declined compared with pretreatment values by an average of 8.27 dB (p < 0.05). The treatments did not result in any acute hearing losses, permanent tympanic membrane perforations, or other significant adverse events.
Conclusion: Intratympanic dexamethasone injections were successful in controlling vertigo insofar as they were able to obviate ablative therapy in the majority of Ménière's disease patients in this study. The injection series protocol may have been more beneficial compared with the single injection, although the difference between the two protocols was nonsignificant. Hearing mildly declined over the treatment course, which likely represents natural disease progression. The lack of adverse events suggests that IT Dex may be a nonablative option for patients with bilateral disease or only hearing/vestibular ears.",doi: 10.1097/MAO.0000000000001437.,beyea2017.pdf
30,56,57,Nervenarzt,"S. Biedert, H. Weidauer and R. Reuther Differential diagnosis of tinnitus and vertigo. A review 1985",PubMed,0.0,1.0,Design,Review,,0.0,[Differential diagnosis of tinnitus and vertigo. A review],"Abstract
Tinnitus and vertigo, two common neurological complaints, often challenge the physician's ability with respect to possible etiology. Objective tinnitus can result from an abnormally patent eustachian tube, from tetanic contractions of the muscles of the soft palate, or from vascular abnormalities within the head or neck. Subjective tinnitus refers to lesions involving the external ear canal, tympanic membrane, ossicles, cochlea, auditory nerve, brainstem, and cortex. As many as 50% of patients with tinnitus do not exhibit associated hearing loss; in these patients, the cause of the tinnitus is rarely identified. An illusion of movement is specific for vestibular system disease--a peripheral or central location depending upon associated audiologic and neurologic symptoms, respectively. However, a presyncopal, light-headed sensation is most commonly associated with diffuse cerebral ischemia: in the young patient, this may be caused by a hyperventilation syndrome; in the aged individual, this can result from diffuse atherosclerotic cerebrovascular disease and decreased cardiac output. Postural and gait imbalance associated with acute vertigo indicates a unilateral peripheral vestibular or a central vestibular lesion; if vertigo is absent, either a cerebellar, proprioceptive, or bilateral peripheral vestibular lesion is likely. Transient oscillopsia suggests unilateral peripheral vestibular lesions. Permanent oscillopsia indicates a bilateral peripheral vestibular lesion or--in the absence of severe vertigo--brainstem or cerebellar damage.",Not Found,No pdf
31,57,58,Case Rep Otolaryngol,"A. C. Binetti, A. X. Varela, D. L. Lucarelli and D. H. Verdecchia Unilateral Head Impulses Training in Uncompensated Vestibular Hypofunction 2017",Pubmed,1.0,,,, she developed migraine symptoms during the treatment with associated chronic dizzy sensations and blurred vision,1.0,Unilateral Head Impulses Training in Uncompensated Vestibular Hypofunction,"Abstract
The aim of this paper is to report a case of a young woman with unilateral vestibular chronic failure with a poorly compensated vestibuloocular reflex during rapid head rotation. Additionally, she developed migraine symptoms during the treatment with associated chronic dizzy sensations and blurred vision. Her report of blurred vision only improved after she completed a rehabilitation program using fast head impulse rotations towards the affected side for 5 consecutive days. We discuss why we elected this form of treatment and how this method may be useful for different patients.",doi: 10.1155/2017/2145173.,binetti2017.pdf
32,59,60,Brain,"A. R. Bisdorff, C. J. Wolsley, D. Anastasopoulos, A. M. Bronstein and M. A. Gresty The perception of body verticality (subjective postural vertical) in peripheral and central vestibular disorders 1996",PubMed,1.0,,,,Patients with chronic unilateral peripheral vestibular lesions and those with position-independent vertical nystagmus had normal sensitivities,0.0,The perception of body verticality (subjective postural vertical) in peripheral and central vestibular disorders,"Abstract
The perception of body verticality (subjective postural vertical, SPV) was assessed in normal subjects and in patients with peripheral and central vestibular lesions and the data were compared with conventional neuro-otological assessments. Subjects were seated with eyes closed in a motorized gimbal which executed cycles of tilt at low constant speed (1.5 degrees s-1), both in the frontal (roll) and sagittal (pitch) planes. Subjects indicated with a joystick when they entered and left verticality, thus defining a sector of subjective uprightness in each plane. The mean angle of tilt (identifying a bias of the SPV) and the width of the sector (defining sensitivity of the SPV) were then determined. In normal subjects, the angle of the ""verticality' sector was 5.9 degrees for pitch and roll. Patients with bilateral absence of vestibular function, patients with vertigo, i.e. acute unilateral lesions, benign paroxysmal positional vertigo (BPPV) and Ménière's disease, and patients with positionally modulated up-/downbeat nystagmus all had enlarged sectors (i.e. loss in sensitivity). Mean sector angle in these groups ranged from 7.8 to 11 degrees and the abnormality was present both in pitch and roll, regardless of the direction of nystagmus or body sway. Patients with chronic unilateral peripheral vestibular lesions and those with position-independent vertical nystagmus had normal sensitivities. No significant bias of the SPV was found in any patient group, not even those with acute unilateral vestibular lesions who had marked tilts of the subjective visual vertical (SVV). Complementary experiments in normal subjects tested under galvanic vestibular or roll-plane optokinetic stimulation also failed to show biases of the SPV. In contrast, a significant bias in the SPV could be induced in normal subjects by asymmetric cycles of gimbals tilt, presumably by proprioceptive adaptation. The following conclusions can be drawn. (i) The perception of body verticality whilst seated is mainly dependent on proprioceptive/contact cues but these are susceptible to tilt-mediated adaptation. (ii) Vestibular input improves the sensitivity of the SPV, even in vestibular disorders, as long as the abnormality is stable. (iii) There can be marked dissociation between vestibulo-motor (ocular and postural) phenomena and the perception of body verticality, and between the SPV and SVV. (iv) The postural sway asymmetries in patients with peripheral and central vestibular lesions, like those induced by galvanic or optokinetic stimulation in normal subjects, are not consequences of changes of the SPV.",doi: 10.1093/brain/119.5.1523.,bisdorff1996.pdf
33,64,65,Neurophysiol Clin,"L. Borel, C. Lopez, P. Péruch and M. Lacour Vestibular syndrome: a change in internal spatial representation 2008",PubMed,0.0,1.0,Design,Review,,0.0,Vestibular syndrome: a change in internal spatial representation,"Abstract
The vestibular system contributes to a wide range of functions from reflexes to spatial representation. This paper reviews behavioral, perceptive, and cognitive data that highlight the role of changes in internal spatial representation on the vestibular syndrome. Firstly, we review how visual vertical perception and postural orientation depend on multiple reference frames and multisensory integration and how reference frames are selected according to the status of the peripheral vestibular system (i.e., unilateral or bilateral hyporeflexia), the environmental constraints (i.e., sensory cues), and the postural constraints (i.e., balance control). We show how changes in reference frames are able to modify vestibular lesion-induced postural and locomotor deficits and propose that fast changes in reference frame may be considered as fast-adaptive processes after vestibular loss. Secondly, we review data dealing with the influence of vestibular loss on higher levels of internal representation sustaining spatial orientation and navigation. Particular emphasis is placed on spatial performance according to task complexity (i.e., the required level of spatial knowledge) and to the sensory cues available to define the position and orientation within the environment (i.e., real navigation in darkness or visual virtual navigation without any actual self-motion). We suggest that vestibular signals are necessary for other sensory cues to be properly integrated and that vestibular cues are involved in extrapersonal space representation. In this respect, vestibular-induced changes would be based on a dynamic mental representation of space that is continuously updated and that supports fast-adaptive processes.",doi: 10.1016/j.neucli.2008.09.002.,borel2008.pdf
34,65,66,Rhinology,"P. Bossolesi, L. Autelitano, R. Brusati and P. Castelnuovo The silent sinus syndrome: diagnosis and surgical treatment 2008",PubMed,0.0,1.0,Population,Sinus syndrome,,0.0,The silent sinus syndrome: diagnosis and surgical treatment,"Abstract
The silent sinus syndrome consists of painless facial asymmetry characterized by unilateral enophthalmos. Reabsorbed bone with displacement of the orbital floor is a constant finding. It is secondary to chronic maxillary sinus atelectasis. The onset of symptoms is usually slightly progressive but can be brisk due to sudden collapse of the orbital thin bony floor. The diagnosis is suggested by clinical findings including endonasal endoscopic examination and confirmed on the basis of computed tomography and magnetic resonance imaging. The restitution treatment of the silent sinus syndrome involves functional endoscopic sinus surgery and plastic reconstruction of the floor of the orbit via transconjunctival approach; an additional vestibular incision may be necessary to treat the malar region. Four cases of this rare and therefore relatively unknown disease are fully discussed.",Not Found,No pdf
35,67,68,Curr Opin Neurol,T. Brandt and M. Dieterich 'Excess anxiety' and 'less anxiety': both depend on vestibular function 2020,PubMed,0.0,1.0,Design,Review,,0.0,'Excess anxiety' and 'less anxiety': both depend on vestibular function,"Abstract
Purpose of review: To present evidence of a functional interrelation between the vestibular and the anxiety systems based on a complex reciprocally organized network. The review focuses on the differential effects of various vestibular disorders, on psychiatric comorbidity, and on anxiety related to vertigo.
Recent findings: Episodic vertigo syndromes such as vestibular migraine, vestibular paroxysmia, and Menière's disease are associated with a significant increase of psychiatric comorbidity, in particular anxiety/phobic disorders and depression. Chronic unilateral and bilateral vestibulopathy (BVP) do not exhibit a higher than normal psychiatric comorbidity. Anxiety related to the vertigo symptoms is also increased in episodic structural vestibular disorders but not in patients with chronic unilateral or bilateral loss of vestibular function. The lack of vertigo-related anxiety in BVP is a novel finding. Several studies have revealed special features related to anxiety in patients suffering from BVP: despite objectively impaired postural balance with frequent falls, they usually do not complain about fear of falling; they do not report an increased susceptibility to fear of heights; they do not have an increased psychiatric comorbidity; and they do not report increased anxiety related to the perceived vertigo. Subtle or moderate vestibular stimulation (by galvanic currents or use of a swing) may have beneficial effects on stress or mood state in healthy adults, and promote sleep in humans and rodents. The intimate structural and functional linkage of the vestibular and anxiety systems includes numerous nuclei, provincial and connector hubs, the thalamocortical network, and the cerebellum with many neural transmitter systems.
Summary: The different involvement of emotional processes and anxiety - to the extent of 'excess anxiety' or 'less anxiety' - in structural vestibular disorders may be due to the specific dysfunction and whether the system activity is excited or diminished. Both psychiatric comorbidity and vertigo-related anxiety are maximal with excitation and minimal with loss of peripheral vestibular function.",doi: 10.1097/WCO.0000000000000771.,brandt2019.pdf
36,68,69,Clin Neurophysiol,T. Brandt and M. Strupp General vestibular testing 2005,PubMed,0.0,1.0,Design,Review,,0.0,General vestibular testing,"Abstract
A dysfunction of the vestibular system is commonly characterized by a combination of phenomena involving perceptual, ocular motor, postural, and autonomic manifestations: vertigo/dizziness, nystagmus, ataxia, and nausea. These 4 manifestations correlate with different aspects of vestibular function and emanate from different sites within the central nervous system. The diagnosis of vestibular syndromes always requires interdisciplinary thinking. A detailed history allows early differentiation into 9 categories that serve as a practical guide for differential diagnosis: (1) dizziness and lightheadedness; (2) single or recurrent attacks of vertigo; (3) sustained vertigo; (4) positional/positioning vertigo; (5) oscillopsia; (6) vertigo associated with auditory dysfunction; (7) vertigo associated with brainstem or cerebellar symptoms; (8) vertigo associated with headache; and (9) dizziness or to-and-fro vertigo with postural imbalance. A careful and systematic neuro-ophthalmological and neuro-otological examination is also mandatory, especially to differentiate between central and peripheral vestibular disorders. Important signs are nystagmus, ocular tilt reaction, other central or peripheral ocular motor dysfunctions, or a unilateral or bilateral peripheral vestibular deficit. This deficit can be easily detected by the head-impulse test, the most relevant bedside test for the vestibulo-ocular reflex. Laboratory examinations are used to measure eye movements, to test semicircular canal, otolith, and spatial perceptional function and to determine postural control. It must, however, be kept in mind that all signs and ocular motor and vestibular findings have to be interpreted within the context of the patient's history and a complete neurological examination.",doi: 10.1016/j.clinph.2004.08.009.,brandt2005.pdf
37,69,70,Neurosurgery,"C. N. Breivik, R. M. Nilsen, E. Myrseth, P. H. Pedersen, J. K. Varughese, A. A. Chaudhry and M. Lund-Johansen Conservative management or gamma knife radiosurgery for vestibular schwannoma: tumor growth, symptoms, and quality of life 2013",PubMed,1.0,,,,hearing was lost in 54 of 71 (76%) (CM) and 34 of 53 (64%) (GKRS) patients during the study period,0.0,Not Found,Not Found,Not Found,No pdf
38,70,71,Laryngoscope,"P. E. Brookhouser, D. W. Worthington and W. J. Kelly Fluctuating and/or progressive sensorineural hearing loss in children 1994",PubMed,0.0,1.0,Population,children,,0.0,Not Found,Not Found,Not Found,No pdf
39,71,72,Cochlear Implants Int,"S. J. Broomfield, J. Murphy, D. C. Wild, S. R. Emmett and G. M. O'Donoghue Results of a prospective surgical audit of bilateral paediatric cochlear implantation in the UK 2014",PubMed,0.0,1.0,Population,children,,0.0,Results of a prospective surgical audit of bilateral paediatric cochlear implantation in the UK,"Abstract
Background: Following the approval of bilateral paediatric cochlear implantation in 2009, the prospective multi-centre UK National Paediatric Cochlear Implant Audit was established to collect a large dataset of paediatric implantations. The aim of the surgical part of the audit, reported here, was to collect data on surgical practice, outcomes and complications.
Methods: Data from 14 surgical centres was collected prospectively, including simultaneous and sequential bilateral as well as unilateral implantations. Data collected included age at implantation, aetiology of deafness, implant type, duration of surgery, the use of electrophysiological testing, and the use of pre- and post-operative imaging. Details of major and immediate minor complications were also recorded.
Results: 1397 CI procedures in 961 CI recipients were included; 436 bilateral simultaneous, 394 bilateral sequential, 131 unilateral. The overall major complication rate was 1.6% (0.9% excluding device failure) and was similar following bilateral CI compared to sequential and unilateral CI.
Conclusion: This prospective multi-centre audit provides evidence that bilateral paediatric CI is a safe procedure in the UK, thus endorsing its role as a major therapeutic intervention in childhood deafness.
Keywords: Audit; Cochlear Implant; Complications; Pediatric.",doi: 10.1179/1467010013Z.000000000126.,broomfield2013.pdf
40,72,73,Br J Neurosurg,S. J. Broomfield and G. M. O'Donoghue Self-reported symptoms and patient experience: A British Acoustic Neuroma Association survey 2016,PubMed,1.0,,,,,0.0,Self-reported symptoms and patient experience: A British Acoustic Neuroma Association survey,"Abstract
Objective: To assess patient-reported outcomes and experience of vestibular schwannoma (VS) management.
Study design: Survey of members of the British Acoustic Neuroma Association (BANA).
Methods: Members of the BANA were invited to complete an online survey. Questions were divided into five areas: Demographic details; symptoms at diagnosis; level of information received; treatment after-effects; and overall experience of diagnosis and/or treatment.
Demographics: 598 (58%) BANA members completed the survey. 77.1% of respondents were aged between 41 and 70 years. Symptoms at diagnosis: hearing loss (84%), unilateral tinnitus (40%) and imbalance (51%) were commonest. Isolated tinnitus and imbalance occurred in 2% and 6%, respectively. Information received: 39% stated they were given 'just the right amount of information about all management options', and 32% 'not enough information'. Treatment after-effects: Overall quality of life was classified as 'a lot better' (11%), 'a little better' (7%), 'unchanged' (25%), 'a little worse' (38%) and 'a lot worse' (19%). 61% respondents continued in the same job. Return to social life, hobbies and sports was impaired in 65%. Overall experience: Experience of treatment was graded as 'much better than expected' (20%), 'a little better' (15%), 'about the same' (27%), 'a little worse' (22%) and 'much worse' (16%).
Conclusion: Quality of life measures are important in assessing VS management outcomes, and will increasingly inform clinical decision-making. Further examination of how patients with VS perceive their disease, cope with illness and use social support networks may also help to inform future practice and the creation of decision analytical models.
Keywords: acoustic neuroma; outcome; treatment; vestibular schwannoma.",doi: 10.3109/02688697.2015.1071323.,broomfield2015.pdf
41,73,74,Exp Brain Res,"D. M. Broussard, J. K. Bhatia and G. E. Jones The dynamics of the vestibulo-ocular reflex after peripheral vestibular damage. I. Frequency-dependent asymmetry 1999",PubMed,0.0,1.0,Population,Animal study,,0.0,The dynamics of the vestibulo-ocular reflex after peripheral vestibular damage. I. Frequency-dependent asymmetry,"Abstract
Accurate performance by the vestibulo-ocular reflex (VOR) is necessary to stabilize visual fixation during head movements. VOR performance is severely affected by peripheral vestibular damage; after one horizontal semicircular canal is plugged, the horizontal VOR is asymmetric and its amplitude is reduced. The VOR recovers partially. We investigated the limits of recovery by measuring the VOR's response to ipsilesional and contralesional rotation after unilateral peripheral damage in cats. We found that the VOR's response to rotation at high frequencies remained asymmetric after recovery was complete. When the stimulus was a pulse of head velocity comprising a dynamic overshoot followed by a plateau, gain was partially restored and symmetry completely restored within 30 days after the plug, but only for the plateau response. The overshoot in eye velocity remained asymmetric. The asymmetry was independent of stimulus velocity throughout the known linear velocity range of primary vestibular afferents. Sinusoidal rotation at 0.05-8 Hz revealed that, within this range, the persistent asymmetry was significant only at frequencies above 2 Hz. Asymmetry was independent of the peak head acceleration over the range of 50-500 degrees/s2. When both horizontal canals were plugged, a small residual VOR was observed, suggesting residual signal transduction by plugged semicircular canals. However, transduction by plugged canals could not explain the enhancement of the VOR gain, at high frequencies, for rotation away from the plugged side compared with rotation toward the plug. Also, the high-frequency asymmetry was present after recovery from a unilateral labyrinthectomy. These results suggest that high-frequency asymmetry after unilateral damage is not due to residual function in the plugged canal. The findings are discussed in the context of a bilateral model of the VOR that includes central filtering.",doi: 10.1007/s002210050691.,broussard1999.pdf
42,74,75,Laryngoscope,"C. A. Buchman, J. Joy, A. Hodges, F. F. Telischi and T. J. Balkany Vestibular effects of cochlear implantation 2004",PubMed,0.0,1.0,Population,Cochlear implant,,0.0,Vestibular effects of cochlear implantation,"Abstract
Objectives/hypothesis: Cochlear implantation (CI) carries with it the potential risk for vestibular system insult or stimulation with resultant dysfunction. As candidate profiles continue to evolve and with the recent development of bilateral CI, understanding the significance of this risk takes on an increasing importance.
Study design: Between 1997 to 2001, a prospective observational study was carried out in a tertiary care medical center to assess the effects of unilateral CI on the vestibular system.
Methods: Assessment was performed using the dizziness handicap inventory (DHI), vestibulo-ocular reflex (VOR) testing using both alternate bithermal caloric irrigations (ENG) and rotational chair-generated sinusoidal harmonic accelerations (SHA), and computerized dynamic platform posturography (CDP) at preoperative, 1-month, 4-month, 1-year and 2-year postimplantation visits. CI was carried out without respect to the preoperative vestibular function test results.
Results: Specifically, 86 patients were entered into the study after informed consent. For the group as a whole, pair wise comparisons revealed few significant differences between preoperative and postoperative values for VOR testing (ENG and SHA) at any of the follow-up intervals. Likewise, DHI testing was also unchanged except for significant reductions (improvements) in the emotional subcategory scores at both the 4-month and 1-year intervals. CDP results demonstrated substantial improvements in postural sway in the vestibular conditions (5 and 6) as well as composite scores with the device ""off"" and ""on"" at the 1-month, 4-month, 1-year, and 2-year intervals. Device activation appeared to improve postural stability in some conditions. Excluding those patients with preoperative areflexic or hyporeflexic responses in the implanted ear (total [warm + cool] caloric response <or= 15 deg/s), substantial reductions (>or=21 deg/s maximum slow phase velocity) in total caloric response were observed for 8 (29%) patients at the 4-month interval. These persisted throughout the study period. These changes were accompanied by significant low frequency phase changes on SHA testing confirming a VOR insult. Of interest, no significant changes were detected in the DHI or CDP, and there were no effects of age, sex, device manufacturer, or etiology of hearing loss (HL) for these patients.
Conclusions: Unilateral CI rarely results in significant adverse effects on the vestibular system as measured by the DHI, ENG, SHA, and CDP. On the contrary, patients that underwent CI experienced significant improvements in the objective measures of postural stability as measured by CDP. Device activation in music appeared to have an additional positive effect on postural stability during CDP testing. Although VOR testing demonstrated some decreases in response, patients did not suffer from disabling vestibular effects following CI. The mechanism underlying these findings remains speculative. These findings should be considered in counseling patients about CI.",doi: 10.1097/00005537-200410001-00001.,buchman2004.pdf
43,76,77,J Clin Neurosci,"A. Burston, S. Mossman, B. Mossman and M. Weatherall Comparison of the video head impulse test with the caloric test in patients with sub-acute and chronic vestibular disorders 2018",PubMed,1.0,,,,"caloric tests in patients with sub-acute and chronic vestibular symptoms, especially if the vHIT is norma",0.0,Comparison of the video head impulse test with the caloric test in patients with sub-acute and chronic vestibular disorders,"Abstract
The aim of this prospective register-based study was to compare video Head Impulse Tests (vHIT) with caloric tests on 173 patients assessed by a tertiary Neurology referral centre who had been referred for investigation of dizziness or vertigo and whose symptom duration was one month or longer. Abnormal vHIT was defined as angular velocity gain (peak eye velocity/peak head velocity) less than 0.79 at 80 ms and 0.75 at 60 ms, which was two standard deviations below our institutions' lower limit of normal; together with refixation saccades. Abnormal bi-thermal caloric testing defined unilateral hypofunction as a 25% difference using Jongkee's formula and bilateral hypofunction was defined by the sum of the peak slow phase velocities over the four irrigations being <20°/s. Sixty patients had abnormal results on one or both tests, of whom 51 had unilateral and nine bilateral hypofunction. With caloric testing considered as the gold standard, the sensitivity (95% CI) of the vHIT was 18/52, 34.6% (22.0-49.1), and the specificity (95% CI) was 113/121, 93.4% (87.4-97.1). However vHIT was more sensitive in the nine patients with bilateral hypofunction with 100% abnormal vHIT results while only 4/9, 44% had abnormal caloric results. In conclusion these results support the continued use of both vHIT and caloric tests in patients with sub-acute and chronic vestibular symptoms, especially if the vHIT is normal.
Keywords: Caloric test; Vestibular dysfunction; Video head impulse test.",doi: 10.1016/j.jocn.2017.10.040.,burston2018.pdf
44,78,79,Otol Neurotol,"L. Califano, G. Iorio, F. Salafia, S. Mazzone and M. Califano Hyperventilation-induced nystagmus in patients with vestibular schwannoma 2015",PubMed,1.0,,,,Hyperventilation-induced,0.0,Hyperventilation-induced nystagmus in patients with vestibular schwannoma,"Abstract
Main objective: To determine the utility of the hyperventilation test (HVT) in the diagnosis of vestibular schwannoma (VS).
Study design: A retrospective analysis of hyperventilation-induced nystagmus (HVIN) in 45 patients with unilateral VS.
Setting: A tertiary referral center.
Patients: Forty-five patients with VS; 30 patients with chronic vestibular neuritis; 20 healthy subjects with normal hearing and without symptoms or a history of vertigo, migraine, or neurological diseases (control group).
Interventions: Audiological and vestibular examination; ""side-stream"" measurement of end-tidal CO2 pressure (P(EtCO2)) to standardize the procedure; magnetic resonance imaging (MRI) centered on the cerebellopontine angle.
Main outcome measures: An analysis of HVIN, its patterns, and its appearance threshold via the measurement of P(EtCO2) correlations with the tumor size.
Results: HVIN was observed in 40 of 45 cases (88.9%) in the schwannoma group and in 12 of 30 cases (40%) in the chronic vestibular neuritis group; HVIN was not observed in the control group (0/20 cases) (p < 0.001). In the schwannoma group, HVIN was evoked at a mean P(EtCO2) value of 16.5 ± 1.15 mm Hg. The hypofunctional labyrinth was identified with high sensibility and specificity through caloric test, head shaking test, and head thrust test. The excitatory pattern, which included HVIN with slow phases that beat toward the hypofunctional side, and the paretic pattern, which included HVIN with slow phases that beat toward the hypofunctional side, were not significantly associated with VS size (19.04 ± 10.56 mm for the excitatory pattern and 19.06 ± 11.01 mm for the paretic pattern). The difference in the VS size in HVIN+ (19.05 ± 10.60 mm) and HVIN- (8.40 ± 2.19 mm) cases was significant (p = 0.009).
Conclusions: A 60-second hyperventilation event causes metabolic changes in the vestibular system and reveals a latent vestibular asymmetry. The presence of an excitatory pattern is the major criterion that suggests VS in patients with signs of unilateral vestibular deficit.",doi: 10.1097/MAO.0000000000000699.,califano2015.pdf
45,79,80,J Physiol,S. A. Cameron and M. B. Dutia Lesion-induced plasticity in rat vestibular nucleus neurones dependent on glucocorticoid receptor activation 1999,PubMed,0.0,1.0,Population,Animal study,,0.0,Lesion-induced plasticity in rat vestibular nucleus neurones dependent on glucocorticoid receptor activation,"Abstract
1. We have recently shown that neurones in the rostral region of the medial vestibular nucleus (MVN) develop a sustained increase in their intrinsic excitability within 4 h of a lesion of the vestibular receptors of the ipsilateral inner ear. This increased excitability may be important in the rapid recovery of resting activity in these neurones during 'vestibular compensation', the behavioural recovery that follows unilateral vestibular deafferentation. In this study we investigated the role of the acute stress that normally accompanies the symptoms of unilateral labyrinthectomy (UL), and in particular the role of glucocorticoid receptors (GRs), in the development of the increase in excitability in the rostral MVN cells after UL in the rat. 2. The compensatory increase in intrinsic excitability (CIE) of MVN neurones failed to occur in animals that were labyrinthectomized under urethane anaesthesia and kept at a stable level of anaesthesia for either 4 or 6 h after UL, so that they did not experience the stress normally associated with the vestibular deafferentation syndrome. In these animals, 'mimicking' the stress response by administration of the synthetic GR agonist dexamethasone at the time of UL, restored and somewhat potentiated CIE in the MVN cells. Administration of dexamethasone in itself had no effect on the intrinsic excitability of MVN cells in sham-operated animals. 3. In animals that awoke after labyrinthectomy, and which therefore experienced the full range of oculomotor and postural symptoms of UL, there was a high level of Fos-like immunoreactivity in the paraventricular nucleus of the hypothalamus over 1.5-3 h post-UL, indicating a strong activation of the stress axis. 4. The GR antagonist RU38486 administered at the time of UL abolished CIE in the rostral MVN cells, and significantly delayed behavioural recovery as indicated by the persistence of circular walking. The mineralocorticoid receptor (MR) antagonist spironolactone administered at the time of UL had no effect. 5. Vestibular compensation thus involves a novel form of 'metaplasticity' in the adult brain, in which the increase in intrinsic excitability of rostral MVN cells and the initial behavioural recovery are dependent both on the vestibular deafferentation and on the activation of glucocorticoid receptors, during the acute behavioural stress response that follows UL. These findings help elucidate the beneficial effects of neuroactive steroids on vestibular plasticity in various species including man, while the lack of such an effect in the guinea-pig may be due to the significant differences in the physiology of the stress axis in that species.",doi: 10.1111/j.1469-7793.1999.0151r.x.,cameron1999.pdf
46,80,81,Auris Nasus Larynx,"A. Canale, F. Caranzano, M. Lanotte, A. Ducati, F. Calamo, A. Albera, M. Lacilla, M. Boldreghini, S. Lucisano and R. Albera Comparison of VEMPs, VHIT and caloric test outcomes after vestibular neurectomy in Menière's disease 2018",PubMed,1.0,,,,some symptoms were written,1.0,"Comparison of VEMPs, VHIT and caloric test outcomes after vestibular neurectomy in Menière's disease","Abstract
Objective: Selective unilateral vestibular neurectomy (VN) is considered a reliable surgical treatment in case of recurrent vertigo in Menière's disease (MD) because of hearing preservation and a minimally invasive posterior fossa retrosigmoid approach. The present study aimed to assess the quality of life and the long-term vestibular function in patients submitted to yearly follow-up after VN because of intractable MD.
Methods: Retrospective series of 15 MD patients undergoing retrosigmoid VN for recurrent vertigo. Outcome measures included cVEMPs and oVEMPs (cervical and ocular vestibular evoked myogenic potentials), VHIT (Video Head Impulse Test) and caloric test, besides to DHI (Dizziness Handicap Inventory) and PTA (Pure Tone Audiometry).
Results: Mean DHI score resulted within normal values in 74% of patients, significantly correlated to the duration of the follow-up. In the operated side, cVEMPs and oVEMPs have not been elicited respectively in 11 patients (73%) and 13 patients (87%), whereas it was not possible to evoke any response at bithermal caloric test in 4 cases. The gain of VOR from VHIT resulted always below normal values after VN except in one patient, who has also undergone an episode of posterior BBPV. The difference between average PTA threshold before and after VN resulted not significant.
Conclusion: The vestibular outcomes prove VN to be an effective and safe surgery in MD; furthermore, the unexpected occurrence of BPPV after VN can justify the presence of neural anastomosis between the inferior vestibular nerve and the cochlear nerve, allowing to still perceive vestibular symptomatology despite of a proper neurectomy.
Keywords: Menière’s disease; Neural anastomosis; Recurrent vertigo; Vestibular neurectomy; Vestibular neurectomy outcomes.",doi: 10.1016/j.anl.2018.04.006.,canale2018.pdf
47,81,82,BMC Med Genet,"G. Cappuccio, A. Rossi, P. Fontana, E. Acampora, V. Avolio, G. Merla, L. Zelante, A. Secinaro, G. Andria and D. Melis Bronchial isomerism in a Kabuki syndrome patient with a novel mutation in MLL2 gene 2014",PubMed,0.0,1.0,Population,Kabuki syndrome,,0.0,Not Found,Not Found,Not Found,No pdf
48,82,83,Laryngoscope,"M. L. Carlson, N. M. Tombers, C. L. W. Driscoll, J. J. Van Gompel, J. I. Lane, A. Raghunathan, K. D. Flemming and M. J. Link Clinically significant intratumoral hemorrhage in patients with vestibular schwannoma 2017",PubMed,0.0,1.0,Outcome,Not included symptoms,,0.0,Clinically significant intratumoral hemorrhage in patients with vestibular schwannoma,"Abstract
Objectives: The frequency of intratumoral hemorrhage (ITH) in vestibular schwannoma (VS) remains undefined.
Methods: Retrospective case series of all patients diagnosed with hemorrhagic VS between 2003 and 2015 at a single tertiary academic skull base center.
Results: Five patients with ITH were evaluated, representing 0.4% of all newly diagnosed VS evaluated at the authors' center during this time. The median age at time of diagnosis was 66 years (range 39-83), four of five cases occurred in men, and all had sporadic unilateral tumors. The frequency of ITH among patients receiving anticoagulation was 5.6% (2 of 36), compared to only 0.2% (3 of 1356) in non-anticoagulated patients (P = 0.006), representing a 25-fold increase. At time of hemorrhage, all patients had acute onset of headache, disequilibrium, and progression of hearing loss; three reported trigeminal symptoms, and two exhibited acute moderate facial paresis. The median tumor size at diagnosis of hemorrhage was 3.1 cm (range 2.4-4.2 cm), and three patients had radiological evidence of hydrocephalus. All patients underwent microsurgical resection. There were no perioperative deaths. At a median follow-up of 25 months (3-70 months), no patient has experienced tumor recurrence.
Conclusion: Tumor-associated hemorrhage in VS occurs in 0.4% of cases and commonly presents with acute neurological change. The risk of clinically significant hemorrhage is greater in patients receiving anticoagulation compared to the general VS population. Prompt microsurgical resection should be pursued when possible since tumor removal may improve neurological symptoms, relieve brainstem compression, and reduce the risk of repeat hemorrhage.
Level of evidence: 4. Laryngoscope, 127:1420-1426, 2017.
Keywords: Vestibular schwannoma; acoustic neuroma; anticoagulation; hemorrhage; intratumoral hemorrhage; microsurgery; skull base surgery; subarachnoid hemorrhage; warfarin.",doi: 10.1002/lary.26193.,carlson2016.pdf
49,84,85,Otolaryngol Head Neck Surg,"A. Casani, D. Nuti, S. S. Franceschini, E. Gaudini and I. Dallan Transtympanic gentamicin and fibrin tissue adhesive for treatment of unilateral Menière's disease: effects on vestibular function 2005",PubMed,1.0,,,,patients suffer from frequent and serious vertigo spells with vomiting,1.0,Transtympanic gentamicin and fibrin tissue adhesive for treatment of unilateral Menière's disease: effects on vestibular function,"Abstract
Objective: To determine the effects of transtympanic injections, with a mixture composed of gentamicin and fibrin tissue adhesive (FTA), on vestibular function of patients with intractable unilateral Menière's disease.
Study design: This was an open, prospective study.
Setting and patients: The study was performed at 2 tertiary referral centers. Twenty-six patients affected by ""definite"" unilateral Menière's disease, unresponsive to medical therapy for at least 6 months, were enrolled.
Intervention: A buffered gentamicin solution mixed with FTA was injected in the middle ear until the development of bedside vestibular hypofunction signs and/or caloric weakness in the treated ear.
Main outcome measure: Vestibular function was evaluated by 3 bedside vestibular tests (observation of spontaneous nystagmus, head shaking test, and head thrust test) and by a caloric test. Tests were performed on days 10 and 30 after completion of treatment. Tests were also performed 3, 6, and 12 months from completion of the gentamicin-FTA protocol. The effects of treatment were also assessed in terms of hearing levels, control of vertigo, and disability status.
Results: In 22 of the 26 patients, only 1 gentamicin-FTA injection was necessary to obtain 1 or more signs indicating a reduction of the vestibular function in the treated ear. Four patients needed another treatment because of the persistence of their incapacitating symptoms during the follow-up. Four patients needed more than 1 injection to obtain a vestibular hypofunction. None of the patients who received 1 or 2 injections presented hearing loss in direct temporal relationship to the treatment.
Conclusions: A mixture of gentamicin and fibrin glue makes it possible to considerably reduce the number of administrations in patients with intractable unilateral Menière's disease. Spontaneous nystagmus, post head shaking nystagmus, and a head thrust sign are the clinical signs that indicate onset or progression of unilateral vestibular hypofunction. These signs were obtained with only 1 injection in 81% of patients.",doi: 10.1016/j.otohns.2005.07.033.,casani2005.pdf
50,87,88,Otolaryngol Head Neck Surg,"N. Cerchiai, E. Navari, S. Sellari-Franceschini, C. Re and A. P. Casani Predicting the Outcome after Acute Unilateral Vestibulopathy: Analysis of Vestibulo-ocular Reflex Gain and Catch-up Saccades 2018",PubMed,1.0,,,,,0.0,Predicting the Outcome after Acute Unilateral Vestibulopathy: Analysis of Vestibulo-ocular Reflex Gain and Catch-up Saccades,"Abstract
Objectives (1) To describe the relationships among the main instrumental features characterizing an acute unilateral vestibulopathy and (2) to clarify the role of the video head impulse test in predicting the development of chronic vestibular insufficiency. Study Design Case series with chart review. Setting Tertiary referral center. Subjects and Methods Sixty patients suffering from acute unilateral vestibulopathy were retrospectively analyzed: 30 who recovered spontaneously (group 1) and 30 who needed a vestibular rehabilitation program (group 2). The main outcome measures included Dizziness Handicap Inventory score, canal paresis, high-velocity vestibulo-oculomotor reflex gain, and catch-up saccade parameters. The tests were all performed between 4 and 8 weeks from the onset of symptoms. Results The high-velocity vestibulo-oculomotor reflex gain correlated with the Dizziness Handicap Inventory score ( P = .004), with the amplitude of covert and overt saccades ( P < .001), and with the prevalence of overt saccades ( P < .001). Patients in need for vestibular rehabilitation programs had a significantly lower gain ( P < .001) and a higher prevalence and amplitude of overt saccades ( P = .002 and P = .008, respectively). Conversely, we found no differences in terms of response to the caloric test ( P = .359). Conclusions Lower values of high-velocity vestibulo-oculomotor reflex gain and a high prevalence of overt saccades are related to a worse prognosis after acute unilateral vestibulopathy. This is of great interest to clinicians in identifying which patients are less likely to recover and more likely to need a vestibular rehabilitation program.
Keywords: acute unilateral vestibulopathy; caloric test; chronic vestibular insufficiency; dizziness; prognosis; vertigo; vestibular compensation; vestibular rehabilitation; video head impulse test.",doi: 10.1177/0194599817740327.,cerchiai2017.pdf
51,88,89,Neurol Sci,"A. Cesarani, D. Alpini, B. Monti and G. Raponi The treatment of acute vertigo 2004",PubMed,0.0,1.0,Design,Review,,0.0,The treatment of acute vertigo,"Abstract
Vertigo and dizziness are very common symptoms in the general population. The aim of this paper is to describe the physical and pharmacological treatment of symptoms characterized by sudden onset of rotatory vertigo. Acute vertigo can be subdivided into two main groups: (1) spontaneous vertigo and (2) provoked vertigo, usually by postural changes, generally called paroxysmal positional vertigo (PPV). Sudden onset of acute vertigo is usually due to acute spontaneous unilateral vestibular failure. It can be also fluctuant as, e.g., in recurrent attacks of Ménière's disease. Pharmacotherapy of acute spontaneous vertigo includes Levo-sulpiride i.v., 50 mg in 250 physiologic solution, once or twice a day, methoclopramide i.m., 10 mg once or twice a day, or triethilperazine rectally, once or twice a day, to reduce neurovegetative symptoms; diazepam i.m., 10 mg once or twice a day, to decrease internuclear inhibition, sulfate magnesium i.v., two ampoules in 500 cc physiological solution, twice a day, or piracetam i.v., one ampoule in 500 cc physiological solution, twice a day, to decrease vestibular damage. At the onset of the acute symptoms, patients must lie on their healthy side with the head and trunk raised 20 degrees. The room must be quiet but not darkened. If the patient is able to swallow without vomiting, it is important to reduce nystagmus and stabilize the visual field with gabapentine, per os, 300 mg twice or three times a day. The first step of the physical therapy of acute vertigo is vestibular electrical stimulation, that is to say, a superficial paravertebral electrical stimulation of neck muscles, aimed to reduce antigravitary failure and to increase proprioceptive cervical sensory substitution. PPV is a common complaint and represents one of the most common entities in peripheral vestibular pathology. While the clinical picture is well known and widely described, the etiopathogenesis of PPV is still a matter of debate. Despite the different interpretation of PPV etiopathogenesis, the maneuvers described by Semont, Epley, or Lempert and their modifications are undoubtedly effective. For this reason the first therapeutic approach in acute provoked vertigo must be by means of one of these kinds of treatments.",doi: 10.1007/s10072-004-0213-8.,cesarani2004.pdf
52,89,90,J Otolaryngol,"D. A. Charles, H. O. Barber and H. F. Hope-Gill Blood glucose and insulin levels, thyroid function, and serology in Ménière's disease, recurrent vestibulopathy, and psychogenic vertigo 1979",PubMed,1.0,,,,recurrent vestibulopathy (diagnostic criteria in text of paper),0.0,"Blood glucose and insulin levels, thyroid function, and serology in Ménière's disease, recurrent vestibulopathy, and psychogenic vertigo","Abstract
Nineteen patients with unilateral Ménière's disease, 20 with psychogenic dizziness, and 20 with recurrent vestibulopathy (diagnostic criteria in text of paper) were found to have normal five hour glucose tolerance tests, serum thyroxine and effective thyroid indices, and serologic tests for syphilis. Hypothyroidism and hypoglycemia were absent in all groups. An unexplained finding of each diagnostic group was significant increase of fasting blood glucose and insulin levels, and elevated insulin:glucose ratios, compared to a control group. There appears to be no diagnostic indication for performing these chemical and serologic studies in patients with unilateral Ménière's disease, psychogenic vertigo, or recurrent vestibulopathy. Reasons are given to support the view that recurrent vestibulopathy may be a specific vestibular disturbance.",Not Found,No pdf
53,91,92,Surg Endosc,"Y. H. Chen, H. Y. Kim, A. Anuwong, T. S. Huang and Q. Y. Duh Transoral robotic thyroidectomy versus transoral endoscopic thyroidectomy: a propensity-score-matched analysis of surgical outcomes 2020",PubMed,0.0,1.0,Population,Transoral robotic thyroidectomy,,0.0,Transoral robotic thyroidectomy versus transoral endoscopic thyroidectomy: a propensity-score-matched analysis of surgical outcomes,"Abstract
Background: Transoral endoscopic thyroidectomy vestibular approach (TOETVA) has been shown to be safe and has similar outcomes as open thyroidectomy for selected patients. It is not clear if transoral robotic thyroidectomy (TORT) may extend transoral endoscopic thyroidectomy to more complex thyroid operations. The study aimed to compare the safety and outcomes of TORT with those of TOETVA.
Methods: We retrospectively reviewed all patients who had TORT and TOETVA performed by a single surgeon from June 2017 to May 2019. Intrathoracic goiter and combined operations were excluded. Surgical outcomes were compared after propensity score matching. Learning curves, as measured by operating time, were evaluated.
Results: A total of 150 patients underwent 154 transoral (55 TORT and 99 TOETVA) thyroidectomy. Of the 154 operations, 28 (18.2%) were bilateral total thyroidectomy and 126 (81.8%) were unilateral thyroid lobectomy. After propensity score matching, we found a longer operative time (median [interquartile range]) for TORT (n = 53) than for the TOETVA (308 [284-388] vs 228 [201-267] min, P < 0.001). Blood loss and visual analog scale scores for pain were not significantly different between the two groups. Central neck lymph node dissection was performed more frequent in the TORT group (28 of 53 [52.8%] vs 10 of 53 [18.9%], P = 0.001), and when performed, the numbers of total and positive lymph nodes did not differ significantly between the two groups. The rates of hypoparathyroidism and recurrent laryngeal nerve injury did not differ significantly between the two groups. There was no conversion to open thyroidectomy, mental nerve injury, or surgical site infection. The learning curve for TORT was 25 cases, but no obvious learning curve was observed for TOETVA.
Conclusions: TORT requires a longer operative time, but is as safe as TOETVA and may be useful for more complex thyroid operations.
Keywords: TOETVA; TORT; Transoral endoscopic thyroidectomy; Transoral robotic thyroidectomy.",doi: 10.1007/s00464-020-08114-1.,10.1007@s00464-020-08114-1.pdf
54,93,94,J Neurol Sci,"J. H. Choi, K. Y. Cho, S. Y. Cha, J. D. Seo, M. J. Kim, Y. R. Choi, S. H. Kim, J. S. Kim and K. D. Choi Audiovestibular impairments associated with intracranial hypotension 2015",PubMed,0.0,1.0,Population,patients with intracranial hypotension,,0.0,Audiovestibular impairments associated with intracranial hypotension,"Abstract
Objective: To investigate the patterns and mechanisms of audiovestibular impairments associated with intracranial hypotension.
Methods: We had consecutively recruited 16 patients with intracranial hypotension at the Neurology Center of Pusan National University Hospital for two years. Spontaneous, gaze-evoked, and positional nystagmus were recorded using 3D video-oculography in all patients, and the majority of them also had pure tone audiometry and bithermal caloric tests.
Results: Of the 16 patients, five (31.3%) reported neuro-otological symptoms along with the orthostatic headache while laboratory evaluation demonstrated audiovestibular impairments in ten (62.5%). Oculographic analyses documented spontaneous and/or positional nystagmus in six patients (37.5%) including weak spontaneous vertical nystagmus with positional modulation (n=4) and pure positional nystagmus (n=2). One patient presented with recurrent spontaneous vertigo and tinnitus mimicking Meniere's disease, and showed unidirectional horizontal and torsional nystagmus with normal head impulse tests during the attacks. Bithermal caloric tests were normal in all nine patients tested. Audiometry showed unilateral (n=6) or bilateral (n=1) sensorineural hearing loss in seven (53.8%) of the 13 patients tested.
Conclusions: Intracranial hypotension frequently induces audiovestibular impairments. In addition to endolymphatic hydrops and irritation of the vestibulocochlear nerve, compression or traction of the brainstem or cerebellum due to loss of CSF buoyancy may be considered as a mechanism of frequent spontaneous or positional vertical nystagmus in patients with intracranial hypotension.
Keywords: Audiovestibular impairment; CSF hypovolemia; Dizziness; Hearing loss; Intracranial hypotension; Nystagmus.",doi: 10.1016/j.jns.2015.07.002.,choi2015.pdf
55,94,95,Neurology,"K. D. Choi, J. S. Kim, H. J. Kim, J. W. Koo, J. H. Kim, C. Y. Kim, C. W. Oh and H. J. Kee Hyperventilation-induced nystagmus in peripheral vestibulopathy and cerebellopontine angle tumor 2007",PubMed,0.0,1.0,Population,,,0.0,Hyperventilation-induced nystagmus in peripheral vestibulopathy and cerebellopontine angle tumor,"Erratum in
Neurology. 2010 Nov 30;75(22):2046",doi: 10.1212/01.wnl.0000271378.54381.6a.,choi2007.pdf
56,95,96,Neurology,"S. Y. Choi, J. Y. Jang, E. H. Oh, J. H. Choi, J. Y. Park, S. H. Lee and K. D. Choi Persistent geotropic positional nystagmus in unilateral cerebellar lesions 2018",PubMed,0.0,1.0,Population,Cerebellar lesion,,0.0,Persistent geotropic positional nystagmus in unilateral cerebellar lesions,"Abstract
Objective: To determine the prevalence of central lesions in persistent geotropic positional nystagmus, and characteristics and anatomical substrates of the nystagmus in cerebellar lesions.
Methods: We prospectively recruited 58 patients with persistent geotropic positional nystagmus at the Dizziness Clinic of Pusan National University Hospital. Seven patients with unilateral cerebellar lesions were subjected to analysis of clinical characteristics, oculographic data, and MRI lesions. For comparison, we studied 37 cases of peripheral persistent geotropic positional nystagmus.
Results: The prevalence of central lesions in persistent geotropic positional nystagmus was 12% (7/58). Persistent geotropic positional nystagmus in cerebellar lesions was mostly asymmetrical. Horizontal nystagmus changed in direction during the bow-and-lean test with null positions. All patients showed impaired horizontal smooth pursuit bilaterally, and 3 of them also had positional downbeat nystagmus. The peak intensity and asymmetry of persistent geotropic positional nystagmus did not differ between central and peripheral groups (p > 0.05), while there was a difference in the maxima. Lesion overlays revealed that damage to the cerebellar tonsil was responsible for the generation of persistent geotropic positional nystagmus.
Conclusion: Although persistent geotropic positional nystagmus in cerebellar lesions shares the characteristics of nystagmus measures with peripheral cases, accompanying central oculomotor signs can aid in differentiation. In tonsillar lesions, compensatory rotational feedback due to erroneous estimation of the direction of gravity may generate constant horizontal geotropic positional nystagmus.",doi: 10.1212/WNL.0000000000006167.,choi2018.pdf
57,96,97,J Vestib Res,"S. Y. Choi, H. J. Kee, J. H. Park, H. J. Kim and J. S. Kim Combined peripheral and central vestibulopathy 2014",PubMed,0.0,1.0,Population,Combined peripheral and central,,0.0,Combined peripheral and central vestibulopathy,"Abstract
Diagnosis of central vestibulopathy remains a challenge when it is associated with peripheral vestibular dysfunction because neurotological findings from peripheral vestibulopathy may overshadow those from central vestibular involvements. To define the characteristics of disorders involving both peripheral and central vestibular structures, we classified the combined vestibulopathies into four types according to their vestibular manifestations, and describe a typical case in each subtype. Infarction involving the territory of anterior inferior cerebellar artery is the most common cause of acute unilateral cases, whereas tumors involving the cerebellopontine angle should be of prime suspicion in patients with chronic unilateral ones. Wernicke encephalopathy was most common in patients with acute bilateral combined vestibulopathy while degenerative disorders should be considered in chronic bilateral ones. Since the head impulse test (HIT) is mostly positive in combined vestibulopathy, signs of central vestibular dysfunction other than negative HIT should be sought carefully even in patients with obvious clinical or laboratory features of peripheral vestibulopathy.
Keywords: Vertigo; Wernicke encephalopathy; infarction; tumor; vestibular disorders.",doi: 10.3233/VES-140524.,choi2014.pdf
58,97,98,J Neurol Sci,"S. Y. Choi, H. J. Kim and J. S. Kim Chasing dizzy chimera: Diagnosis of combined peripheral and central vestibulopathy 2016",PubMed,0.0,1.0,Population,Central,,0.0,Chasing dizzy chimera: Diagnosis of combined peripheral and central vestibulopathy,"Abstract
Diagnosis of combined peripheral and central vestibulopathy remains a challenge since the findings from peripheral vestibular involvements may overshadow those from central vestibular disorders or vice versa. The aim of this study was to enhance detection of these intriguing disorders by characterizing the clinical features and underlying etiologies. We had recruited 55 patients with combined peripheral and central vestibulopathy at the Dizziness Clinic of Seoul National University Bundang Hospital from 2003 to 2013. Peripheral vestibular involvement was determined by decreased caloric responses in either ear, and central vestibulopathy was diagnosed with obvious central vestibular signs or the lesions documented on MRIs to involve the central vestibular structures. Combined peripheral and central vestibulopathy could be classified into four types according to the patterns of vestibular presentation. Infarctions were the most common cause of acute unilateral cases while cerebellopontine angle tumors were mostly found in chronic unilateral ones. Wernicke encephalopathy and degenerative disorders were common in acute and chronic bilateral disorders. Twenty five (45.5%) patients showed only vestibular findings with or without auditory involvements, but association with gaze-evoked nystagmus, impaired smooth pursuit or central types of head shaking nystagmus indicated a central vestibular involvement in most of them (23/25, 92.0%). Given the requirements for urgent treatments and potentially grave prognosis of combined vestibulopathy, central signs should be sought even in patients with clinical or laboratory features of peripheral vestibulopathy. Scrutinized bedside evaluation, however, secured the diagnosis in almost all the patients with combined vestibulopathy.
Keywords: Head impulse test; Infarction; Tumor; Vertigo; Vestibular disorder; Vestibulopathy; Wernicke's encephalopathy.",doi: 10.1016/j.jns.2016.09.063.,choi2016.pdf
59,98,99,Biomed Res Int,"M. Chovanec, E. Zvěřina, O. Profant, Z. Balogová, J. Kluh, J. Syka, J. Lisý, I. Merunka, J. Skřivan and J. Betka Does attempt at hearing preservation microsurgery of vestibular schwannoma affect postoperative tinnitus? 2015",PubMed,0.0,1.0,Outcome,"No symptom, signs",elimination of tinnitus in 66% but also new-onset of the symptom in 14% of case,0.0,Does attempt at hearing preservation microsurgery of vestibular schwannoma affect postoperative tinnitus?,"Abstract
Background: The aim of this study was to analyze the effect of vestibular schwannoma microsurgery via the retrosigmoid-transmeatal approach with special reference to the postoperative tinnitus outcome.
Material and methods: A prospective study was performed in 89 consecutive patients with unilateral vestibular schwannoma indicated for microsurgery. Patient and tumor related parameters, pre- and postoperative hearing level, intraoperative findings, and hearing and tinnitus handicap inventory scores were analyzed.
Results: Cochlear nerve integrity was achieved in 44% corresponding to preservation of preoperatively serviceable hearing in 47% and useful hearing in 21%. Main prognostic factors of hearing preservation were grade/size of tumor, preoperative hearing level, intraoperative neuromonitoring, tumor consistency, and adhesion to neurovascular structures. Microsurgery led to elimination of tinnitus in 66% but also new-onset of the symptom in 14% of cases. Preservation of useful hearing and neurectomy of the eighth cranial nerve were main prognostic factors of tinnitus elimination. Preservation of cochlear nerve but loss of preoperative hearing emerged as the main factor for tinnitus persistence and new onset tinnitus. Decrease of THI scores was observed postoperatively.
Conclusions: Our results underscore the importance of proper pre- and intraoperative decision making about attempt at hearing preservation versus potential for tinnitus elimination/risk of new onset of tinnitus.",doi: 10.1155/2015/783169.,chovanec2015.pdf
60,99,100,Eur Arch Otorhinolaryngol,"M. Chovanec, E. Zvěřina, O. Profant, J. Skřivan, O. Cakrt, J. Lisý and J. Betka Impact of video-endoscopy on the results of retrosigmoid-transmeatal microsurgery of vestibular schwannoma: prospective study 2013",PubMed,0.0,1.0,Outcome,"No symptom, signs",,0.0,Impact of video-endoscopy on the results of retrosigmoid-transmeatal microsurgery of vestibular schwannoma: prospective study,"Abstract
Endoscopy-assisted microsurgery represents modern trend of treatment of the cerebellopontine angle (CPA) pathologies including vestibular schwannoma (VS). Endoscopes are used in adjunct to microscope to achieve better functional results with less morbidity. Angled optics, magnification and illumination enable superior view in the operative field. Consecutive 89 patients with untreated unilateral sporadic vestibular schwannoma undergoing tumor resection via a retrosigmoid approach during 2008-2010 were prospectively analysed. Endoscopy-assisted microsurgical (EA-MS) removal was performed in 39 cases (Grade 1: 2, Grade 2: 5, Grade 3: 9, Grade 4: 22, Grade 5: 1) and microsurgical (MS) removal was performed in 50 cases (Grade 1: 1, Grade 2: 3, Grade 3: 9, Grade 4: 34, Grade 5: 3). Minimally invasive approach with craniotomy ≤ 2.5 cm was employed for small tumors (Grade 1 and 2) in the EA-MS group. Endoscopic technique was used for monitoring of neuro-vascular anatomy in CPA, during dissection of the meatal portion of tumors, assessment of radicality and for identification of potential pathways for CSF leak formation. All cases in MS group were deemed as radically removed. In the EA-MS group, residual tumor tissue in the fundus of internal auditory canal not observable with microscope was identified with endoscope in four cases. Such cases were radicalized. Tumor recurrence was not observed during the follow-up in EA-MS group. There is a suspicious intrameatal tumor recurrence on the repeated MRI scan in one patient in the MS group. Neither mortality nor infection was observed. The most common complication was pseudomeningocele (EA-MS 20 cases; MS 23). It was managed with aspiration with or without tissue-gluing in all cases without the need for any surgical revision. Adjunctive use of endoscope in the EA-MS group identified potential pathways for CSF leak formation, which was not observable with the microscope in five patients. Improved cochlear nerve (EA-MS: 22, MS: 14; p = 0.012), brainstem auditory evoked potentials (EA-MS: 3 of 8, MS: 0 of 4) and hearing (EA-MS: 14 of 36, MS: 4 of 45; p = 0.001) preservation were observed in EA-MS group. Despite the trend for better useful hearing (Gardner-Robertson class 1 and 2) preservation (EA-MS: 8 of 26, MS: 1 of 16) there were no significant differences in the postoperative hearing handicap inventory in both groups. There were no differences in the postoperative tinnitus in both groups. Better facial nerve preservation (EA-MS: 39, MS: 44; p = 0.027) and excellent-very good (House-Brackmann 1 or 2) facial nerve function (EA-MS: 31, MS: 29; p = 0.035) were observed in EA-MS group. Postoperative compensation of vestibular lesion, symptoms typical for VS, patients assessed by dizziness handicap inventory, facial disability index were comparable in both studied groups. Adjunctive use of endoscope during the VS surgery due to its magnification and illumination enable superior view in the operative field. It is valuable for assessment of radicality of resection in the region of internal auditory meatus. Improved information about critical structures and tumor itself helps the surgeon to preserve facial nerve and in selected cases also hearing. These techniques can help to decrease incidence of postoperative complications.",doi: 10.1007/s00405-012-2112-6.,chovanec2012.pdf
61,100,101,N Engl J Med,"M. R. Chow, A. I. Ayiotis, D. P. Schoo, Y. Gimmon, K. E. Lane, B. J. Morris, M. A. Rahman, N. S. Valentin, P. J. Boutros, S. P. Bowditch, B. K. Ward, D. Q. Sun, C. Treviño Guajardo, M. C. Schubert, J. P. Carey and C. C. Della Santina Posture, Gait, Quality of Life, and Hearing with a Vestibular Implant 2021",PubMed,0.0,1.0,Population,Bilateral vestibular hypofunction,,0.0,"Posture, Gait, Quality of Life, and Hearing with a Vestibular Implant","Abstract
Background: Bilateral vestibular hypofunction is associated with chronic disequilibrium, postural instability, and unsteady gait owing to failure of vestibular reflexes that stabilize the eyes, head, and body. A vestibular implant may be effective in alleviating symptoms.
Methods: Persons who had had ototoxic (7 participants) or idiopathic (1 participant) bilateral vestibular hypofunction for 2 to 23 years underwent unilateral implantation of a prosthesis that electrically stimulates the three semicircular canal branches of the vestibular nerve. Clinical outcomes included the score on the Bruininks-Oseretsky Test of Motor Proficiency balance subtest (range, 0 to 36, with higher scores indicating better balance), time to failure on the modified Romberg test (range, 0 to 30 seconds), score on the Dynamic Gait Index (range, 0 to 24, with higher scores indicating better gait performance), time needed to complete the Timed Up and Go test, gait speed, pure-tone auditory detection thresholds, speech discrimination scores, and quality of life. We compared participants' results at baseline (before implantation) with those at 6 months (8 participants) and at 1 year (6 participants) with the device set in its usual treatment mode (varying stimulus pulse rate and amplitude to represent rotational head motion) and in a placebo mode (holding pulse rate and amplitude constant).
Results: The median scores at baseline and at 6 months on the Bruininks-Oseretsky test were 17.5 and 21.0, respectively (median within-participant difference, 5.5 points; 95% confidence interval [CI], 0 to 10.0); the median times on the modified Romberg test were 3.6 seconds and 8.3 seconds (difference, 5.1; 95% CI, 1.5 to 27.6); the median scores on the Dynamic Gait Index were 12.5 and 22.5 (difference, 10.5 points; 95% CI, 1.5 to 12.0); the median times on the Timed Up and Go test were 11.0 seconds and 8.7 seconds (difference, 2.3; 95% CI, -1.7 to 5.0); and the median speeds on the gait-speed test were 1.03 m per second and 1.10 m per second (difference, 0.13; 95% CI, -0.25 to 0.30). Placebo-mode testing confirmed that improvements were due to treatment-mode stimulation. Among the 6 participants who were also assessed at 1 year, the median within-participant changes from baseline to 1 year were generally consistent with results at 6 months. Implantation caused ipsilateral hearing loss, with the air-conducted pure-tone average detection threshold at 6 months increasing by 3 to 16 dB in 5 participants and by 74 to 104 dB in 3 participants. Changes in participant-reported disability and quality of life paralleled changes in posture and gait.
Conclusions: Six months and 1 year after unilateral implantation of a vestibular prosthesis for bilateral vestibular hypofunction, measures of posture, gait, and quality of life were generally in the direction of improvement from baseline, but hearing was reduced in the ear with the implant in all but 1 participant. (Funded by the National Institutes of Health and others; ClinicalTrials.gov number, NCT02725463.).",doi: 10.1056/NEJMoa2020457.,No pdf
62,101,102,J Psychosom Res,"M. R. Clark, L. J. Heinberg, J. A. Haythornthwaite, A. L. Quatrano-Piacentini, M. Pappagallo and S. N. Raja Psychiatric symptoms and distress differ between patients with postherpetic neuralgia and peripheral vestibular disease 2000",PubMed,0.0,1.0,Population,patients with  postherpetic neuralgia,,0.0,Psychiatric symptoms and distress differ between patients with postherpetic neuralgia and peripheral vestibular disease,"Abstract
Objective: No previous studies have investigated the psychiatric characteristics of patients with postherpetic neuralgia (PHN). Similarly, no studies have been performed on patients with different chronic somatic symptoms due to a defined medical disease to compare the characteristics of psychiatric morbidity associated with each etiology.
Methods: After completing the subscales of the Symptom Checklist 90-R, a psychiatrist administered the Diagnostic Interview Schedule to all subjects. The psychiatric comorbidity in 35 patients with pain due to PHN was compared with a control group of 34 patients with the nonpainful aversive symptom of vertigo due to a peripheral vestibular disorder that caused unilateral hypofunction.
Results: PHN patients had significantly more symptoms of major depression and somatization disorder. No significant differences were found between groups for psychiatric diagnoses. Patients with PHN reported significantly less acutely distressing somatic symptoms.
Conclusion: These results suggest that the psychiatric symptoms of patients with PHN are distinct from nonspecific acute distress and may be related to the experience of suffering from chronic neuropathic pain. Patients with PHN may not meet criteria for a psychiatric diagnosis, but their psychiatric comorbidity places them at substantial risk for increased pain, suicidal ideation, sustained disability, and the numerous complications of excessive medical evaluation and treatment. Patients with PHN should be evaluated specifically for psychiatric symptoms to reduce potential negative consequences through appropriate treatment.",doi: 10.1016/s0022-3999(99)00076-8.,clark2000.pdf
63,102,103,Otol Neurotol,"M. L. Coad, A. Lockwood, R. Salvi and R. Burkard Characteristics of patients with gaze-evoked tinnitus 2001",PubMed,1.0,,,,,0.0,Characteristics of patients with gaze-evoked tinnitus,"Abstract
Objective: The authors describe symptoms and population characteristics in subjects who can modulate the loudness and/or pitch of their tinnitus by eye movements.
Study design: Data were obtained by questionnaire.
Setting: The study was conducted at a university center and a tertiary care center.
Patients: Respondents had the self-reported ability to modulate their tinnitus with eye movements.
Results: Ninety-one subjects reported having gaze-evoked tinnitus after posterior fossa surgery involving the eighth nerve. Eighty-seven of them underwent removal of a vestibular schwannoma (acoustic neuroma), two had bilateral eighth nerve tumors (one underwent bilateral tumor removal; the other unilateral tumor removal), one underwent removal of a cholesteatoma, and one underwent removal of a glomus jugulare tumor. Seventeen subjects who had never had posterior fossa surgery reported gaze-evoked tinnitus. Of those with vestibular schwannomas, tumor size ranged from small (<2 cm) to large (>4 cm). The gender distribution was 48.3% male and 51.7% female. In 77% of patients, the gaze-evoked tinnitus was localized to the surgical ear or side of head; 21.8% had bilateral tinnitus that was louder in the surgical ear or side of head. In 86 of 87 subjects, loudness of tinnitus changed with eye movement. Eye movement away from the central (eyes centered) position increased the loudness of tinnitus in all 86 subjects who responded to this question. Seventy-three of 85 (85.9%) patients indicated that pitch changed with eye movement, with pitch increasing in 64/72 (88.9%) of them. Eighty-three of 87 (95.4%) patients reported total loss of hearing in the surgical ear. Seventy of 83 (84.3%) patients reported facial nerve problems immediately after surgery, 52 of 87 (60%) reported persistent facial weakness, and 16 of 87 (18.4%) patients reported persistent double vision. In those 17 subjects with gaze-evoked tinnitus and no posterior fossa surgery, the majority of respondents (14/17, 82.4%) were male.
Conclusions: Gaze-evoked tinnitus after cerebellar pontine angle surgery is more common than was previously believed. In addition, posterior fossa surgery is not a prerequisite for the development of gaze-evoked tinnitus. It is likely that gaze-evoked tinnitus is a manifestation of functional reorganization. Gaze-evoked tinnitus could result from an unmasking of brain regions that respond to multiple stimulus/response modalities, and/or from anomalous cross-modality interactions, perhaps caused by collateral sprouting.",doi: 10.1097/00129492-200109000-00016.,coad2001.pdf
64,104,105,Exp Brain Res,"B. S. Cohen, J. Provasi, P. Leboucher and I. Israël Effects of vestibular disorders on vestibular reflex and imagery 2017",PubMed,1.0,,,,,1.0,Effects of vestibular disorders on vestibular reflex and imagery,"Abstract
The aim of this study was to establish the effect of vestibular lesion on vestibular imagery. Subjects were required to estimate verbally their passively travelled rotation angles in complete darkness, i.e., to activate vestibular imagery. During motion, the vestibulo-ocular reflex (VOR) was measured. Thus, we examined the coherence between the vestibulo-ocular reflex and self-rotation imagery, with vestibular-lesioned patients and healthy participants. Unilateral acute and chronic patients, bilateral patients, and healthy subjects were compared. The stimulus was a sequence of eight successive passive rotations, with four amplitudes (from 90° to 360°) in two directions. The VOR gain was lower in patients with unilateral lesions, for ipsilateral rotations. The healthy subjects had the highest gain and the bilateral group the lowest, on both rotation sides. Thanks to vestibular compensation after acute unilateral neuritis, the VOR gain increased in lesion side and decreased in healthy side, resulting in a similar gain in both sides. A deficit of vestibular imagery was found exclusively in patients with bilateral hyporeflexia, on both sides. The performance in vestibular imagery was good in the control group and correct in the unilateral patients. Finally, we found a significant correlation between the efficiency of the VOR and that of vestibular imagery, exclusively in the bilateral patients. The present study shows the complex relationship between vestibular imagery and the VOR. This imagery test contributes to another assessment of the spatial handicap of vestibular patients. It seems particularly interesting for patients with bilateral canal paresis and could be used to confirm this diagnosis.
Keywords: Cognitive task; Self-motion perception; Spatial imagery; Vestibular disorders.",doi: 10.1007/s00221-017-4959-7.,cohen2017.pdf
65,105,106,Laryngoscope,"H. S. Cohen, A. P. Mulavara, B. T. Peters, H. Sangi-Haghpeykar and J. J. Bloomberg Standing balance tests for screening people with vestibular impairments 2014",PubMed,1.0,,,,,0.0,Standing balance tests for screening people with vestibular impairments,"Abstract
Objectives/hypothesis: To improve the test standards for a version of the Romberg test and to determine whether measuring kinematic variables improved its utility for screening.
Study design: Healthy controls and patients with benign paroxysmal positional vertigo, postoperative acoustic neuroma resection, and chronic peripheral unilateral weakness were compared.
Methods: Subjects wore Bluetooth-enabled inertial motion units while standing on the floor or medium-density, compliant foam, with eyes open or closed, with head still or moving in pitch or yaw. Dependent measures were time to perform each test condition, number of head movements made, and kinematic variables.
Results: Patients and controls did not differ significantly with eyes open or with eyes closed while on the floor. With eyes closed, on foam, some significant differences were found between patients and controls, especially for subjects older than 59 years. Head movement conditions were more challenging than with the head still. Significantly fewer patients than controls could make enough head movements to obtain kinematic measures. Kinematics indicated that lateral balance control is significantly reduced in these patients compared to controls. Receiver operator characteristics and sensitivity/specificity analyses showed moderately good differences with older subjects.
Conclusions: Tests on foam with eyes closed, with head still or moving, may be useful as part of a screening battery for vestibular impairments, especially for older people.
Level of evidence: 3b.
Keywords: Balance testing; Romberg; screening; vestibular testing.",doi: 10.1002/lary.24314.,cohen2013.pdf
66,106,107,Rev Prat,C. Conraux Vestibular neuritis 1994,PubMed,0.0,1.0,Design,Review,,0.0,Not Found,Not Found,Not Found,No pdf
67,108,109,Arch Phys Med Rehabil,"S. Corna, A. Nardone, A. Prestinari, M. Galante, M. Grasso and M. Schieppati Comparison of Cawthorne-Cooksey exercises and sinusoidal support surface translations to improve balance in patients with unilateral vestibular deficit 2003",PubMed,1.0,,,,,1.0,Comparison of Cawthorne-Cooksey exercises and sinusoidal support surface translations to improve balance in patients with unilateral vestibular deficit,"Abstract
Objective: To compare the effectiveness of vestibular rehabilitation by using Cawthorne-Cooksey exercises with that of instrumental rehabilitation.
Design: The main study (n=32) used a pre-post rehabilitation (A-B) design; the ancillary studies used a subset of 11 patients 1 month before rehabilitation versus pre-post rehabilitation (A-A-B design) and 9 patients pre-post rehabilitation versus 1 month after (A-B-B design).
Setting: Division of physical therapy and rehabilitation at a scientific institute in Italy.
Participants: Patients (Cawthorne-Cooksey, n=17; instrumental rehabilitation, n=15) with a complete or incomplete unilateral vestibular lesion due to ischemic, inflammatory, cranial nerve VIII sectioning, or unknown cause.
Interventions: Cawthorne-Cooksey exercises or instrumental rehabilitation training consisting of standing with eyes open (EO) or closed (EC) on a platform moving, relative to the subjects, in the anteroposterior (AP) or mediolateral direction, at a sinusoidal translation frequency of 0.2 or 0.6Hz; training sessions for both interventions were twice daily, 30 minutes per session, for 5 days.
Main outcome measures: Body sway and subjective score of sway during quiet stance with EO or EC, with feet 10cm apart (FA) or together (FT); the standard deviation of the AP displacement of the malleolus, hip, and head during AP platform translations; the Dizziness Handicap Inventory (DHI); and performance-oriented evaluation of balance and gait (according to Tinetti).
Results: Both interventions improved patients' balance. Under each postural and visual condition, both groups showed reduction in body sway, and the post rehabilitation sway values approached those observed in normal subjects; improvement was significantly better for instrumental rehabilitation under FA EO, FA EC, and FT EC conditions. All patients reported a subjective feeling of increased steadiness. Sway recorded 1 month before treatment did not differ from that at the start of treatment. The follow-up evaluation showed persistence of effect. Parallel to the improved stability, a decrease in the SD of the displacement of hip and head in balancing on the movable platform was present in both groups; improvement was better in the instrumental rehabilitation group than the Cawthorne-Cooksey group under the EC condition. Balance and gait assessment improved to the same extent in both groups. Scores on the physical, functional, and emotional questions of the DHI improved significantly in both groups after treatment, but to a larger extent in the instrumental rehabilitation patients.
Conclusions: Both Cawthorne-Cooksey and instrumental rehabilitation are effective for treating balance disorders of vestibular origin. Improvement affects both control of body balance and performance of activities of daily living. The larger decrease in body sway and greater improvement of DHI after instrumental rehabilitation suggests that it is more effective than Cawthorne-Cooksey exercises in improving balance control.",doi: 10.1016/s0003-9993(03)00130-8.,corna2003.pdf
68,109,110,Laryngoscope,B. T. Crane and M. C. Schubert An adaptive vestibular rehabilitation technique 2018,PubMed,1.0,,,,statistically significant decrease in symptoms after 4 weeks of therapy.,1.0,An adaptive vestibular rehabilitation technique,"Abstract
Objectives/hypothesis: There is a large variation in vestibular rehabilitation (VR) results depending on type of therapy, adherence, and the appropriateness for the patient's level of function. A novel adaptive vestibular rehabilitation (AVR) program was developed and evaluated.
Study design: Technology and procedure development, and prospective multicenter trial.
Methods: Those with complete unilateral vestibular hypofunction and symptomatic at least 3 months with a Dizziness Handicap Inventory (DHI) >30 were eligible. Patients were given a device to use with their own computer. They were instructed to use the program daily, with each session lasting about 10 minutes. The task consisted of reporting orientation of the letter C, which appeared when their angular head velocity exceeded a threshold. The letter size and head velocity required were adjusted based on prior performance. Performance on the task was remotely collected by the investigator as well as a weekly DHI score.
Results: Four patients aged 31 to 74 years (mean = 51 years) were enrolled in this feasibility study to demonstrate efficacy. Two had treated vestibular schwannomas and two had vestibular neuritis. Starting DHI was 32 to 56 (mean = 42), which was reduced to 0 to 16 (mean = 11.5) after a month of therapy, a clinically and statistically significant (P < .05) improvement. The three who continued therapy an additional month improved to a DHI of 4.
Conclusions: This AVR method has advantages over traditional VR in terms of cost and customization for patient ability and obtained a major improvement in symptoms. This study demonstrated a clinically and statistically significant decrease in symptoms after 4 weeks of therapy.
Level of evidence: 2b. Laryngoscope, 128:713-718, 2018.
Keywords: Vertigo; dizziness; human; rehabilitation; vestibular.",doi: 10.1002/lary.26661.,crane2017.pdf
69,111,112,Curr Opin Neurol,I. S. Curthoys Vestibular compensation and substitution 2000,PubMed,0.0,1.0,Design,Review,,0.0,Vestibular compensation and substitution,"Abstract
This is a very brief update on the major papers since August 1998. Unilateral vestibular loss causes oculomotor, postural and sensory symptoms, all of which would be appropriate responses in a healthy person to a strong maintained angular and linear acceleration stimulus directed towards the healthy side. Within hours or days these static symptoms (so called because they are present without any externally imposed vestibular stimulation) reduce, and their progressive disappearance is called 'vestibular compensation'. However, careful testing with natural vestibular stimuli shows that the dynamic vestibular response after unilateral vestibular loss to passively imposed vestibular stimuli does not recover; it is usually asymmetric and functionally ineffective. Major recent developments are: (1) the permanent asymmetrical and functionally ineffective dynamic rotational vestibulo-ocular reflex responses to passive natural vestibular stimulation after unilateral vestibular loss and canal blocks in human patients; (2) evidence for the substitution of other sensory input and responses during vestibular compensation; (3) perceptual testing using visual perception of a horizontal line to confirm permanent otolith dysfunction; (4) the clear and substantial differences in post-unilateral vestibular loss vestibulo-ocular reflex responses between passive and active head turning; and (5) new results in brainstem physiology explaining the disappearance of static symptoms.",doi: 10.1097/00019052-200002000-00006.,No pdf
70,112,113,Auris Nasus Larynx,"M. Dagkiran, U. Tuncer, O. Surmelioglu, O. Tarkan, S. Ozdemir, F. Cetik and M. Kiroglu How does cochlear implantation affect five vestibular end-organ functions and dizziness? 2019",PubMed,0.0,1.0,Population,"Cochlear Implantation, not related to subject",,0.0,How does cochlear implantation affect five vestibular end-organ functions and dizziness?,"Abstract
Objective: To evaluate all five vestibular end-organ functions (lateral, anterior, posterior semicircular canal, utricule, and saccule) and to investigate the relationship between Dizziness Handicap Inventory (DHI) and vestibular functions prior to CI (cochlear implantation) and at postoperative day 3 and month 3.
Methods: A total of 42 patients (age 16-70years) with normal vestibular functions preoperatively and undergoing unilateral CI were included in this prospective descriptive study. Video head impulse test (vHIT) for three semicircular canal (SSC) functions, ocular vestibular-evoked myogenic potential (oVEMP) for utricule function, cervical vestibular-evoked myogenic potential (cVEMP) for saccule function and DHI for subjective vertigo symptoms were performed prior to CI and at postoperative day 3 and month 3.
Results: There was a significant impairment of vestibular function in 12 patients (28.5%) on the implantation side and significant DHI increase was observed in 13 of 42 (30.9%) patients at postoperative day 3 after CI (p<0.05). We found SSC dysfunction in 7 patients (16,6%) who underwent observation with vHIT, saccule dysfunction in 8 patients (19%) with cVEMP and utricule dysfunction in 5 patients (11.9%) with oVEMP on the operated side 3days after surgery (p<0.05). Posterior SSC functions (5 patients) were more affected than lateral SSC functions (3 patients). At postoperative month 3, six patients (14.2%) still had deteriorating results in the objective tests and significant DHI increase was continued in 4 (9.5%) patients (p<0.05). The deterioration in vHIT continued in only 1 (2.3%) patient (p>0.05). The deterioration in cVEMP continued in 5 (11.9%) patients (p<0.05). The deterioration in oVEMP continued in 2 (4.7%) patients (p>0.05). There was a significant correlation between DHI and objective vestibular tests both in the early and late postoperative period (r=0.795; p<0.05).
Conclusion: Our study showed that both canal and otolith functions can be damaged after CI especially in the early postoperative period. Surprisingly, posterior SSC functions were more affected than lateral SSC. Therefore, a gold standard vestibular test battery that can evaluate each of three SSC canals and two otoliths functions is essential. Since a single vestibular test for this purpose is not available, we recommend the use of the three available vestibular tests together. This test battery, which is capable of evaluating five vestibular end-organ functions in preoperative and postoperative vestibular evaluations, can provide more accurate results not only for CI but also for most otologic surgeries.
Keywords: Cervical vestibular-evoked myogenic potentials; Cochlear implantation; Dizziness handicap inventory; Five vestibular end-organ function; Oculer vestibular-evoked myogenic potentials; Video head impulse test.",doi: 10.1016/j.anl.2018.07.004.,dagkiran2018.pdf
71,113,114,Dermatol Online J,K. W. Dahle and R. D. Sontheimer The Rudolph sign of nasal vestibular furunculosis: questions raised by this common but under-recognized nasal mucocutaneous disorder 2012,PubMed,0.0,1.0,Design,Not related to subject ,,0.0,The Rudolph sign of nasal vestibular furunculosis: questions raised by this common but under-recognized nasal mucocutaneous disorder,"Abstract
Nasal vestibular furunculosis is a mucocutaneous disorder commonly seen in the general population. Despite its prevalence in clinical practice, it has been inconsistently described and labeled in the medical literature. We present a case of nasal vestibular furunculosis presenting as recurrent exquisitely tender unilateral erythema and edema of the nasal tip (i.e., the Rudolph sign--as in Rudolph The Red Nosed Reindeer). This symptom complex responded rapidly to topical intranasal mupirocin ointment treatment after having previously failed other treatments including a topical intranasal triple antibiotic ointment and oral doxycycline. This case is instructive as it describes a heretofore under-recognized, but not uncommon, mucocutaneous clinical entity that has been linked to more serious head and neck infections and likely has relevance to the intranasal carriage of Staphylococcus aureus. We review the limited published literature on this mucocutaneous disorder including its nosology and propose future lines of investigation for better defining its clinical significance and pathogenesis.",Not Found,No pdf
72,114,115,Exp Brain Res,"C. Dai, G. Y. Fridman, B. Chiang, N. S. Davidovics, T. A. Melvin, K. E. Cullen and C. C. Della Santina Cross-axis adaptation improves 3D vestibulo-ocular reflex alignment during chronic stimulation via a head-mounted multichannel vestibular prosthesis 2011",PubMed,0.0,1.0,Population,Animal study,,0.0,Cross-axis adaptation improves 3D vestibulo-ocular reflex alignment during chronic stimulation via a head-mounted multichannel vestibular prosthesis,"Abstract
By sensing three-dimensional (3D) head rotation and electrically stimulating the three ampullary branches of a vestibular nerve to encode head angular velocity, a multichannel vestibular prosthesis (MVP) can restore vestibular sensation to individuals disabled by loss of vestibular hair cell function. However, current spread to afferent fibers innervating non-targeted canals and otolith end organs can distort the vestibular nerve activation pattern, causing misalignment between the perceived and actual axis of head rotation. We hypothesized that over time, central neural mechanisms can adapt to correct this misalignment. To test this, we rendered five chinchillas vestibular deficient via bilateral gentamicin treatment and unilaterally implanted them with a head-mounted MVP. Comparison of 3D angular vestibulo-ocular reflex (aVOR) responses during 2 Hz, 50°/s peak horizontal sinusoidal head rotations in darkness on the first, third, and seventh days of continual MVP use revealed that eye responses about the intended axis remained stable (at about 70% of the normal gain) while misalignment improved significantly by the end of 1 week of prosthetic stimulation. A comparable time course of improvement was also observed for head rotations about the other two semicircular canal axes and at every stimulus frequency examined (0.2-5 Hz). In addition, the extent of disconjugacy between the two eyes progressively improved during the same time window. These results indicate that the central nervous system rapidly adapts to multichannel prosthetic vestibular stimulation to markedly improve 3D aVOR alignment within the first week after activation. Similar adaptive improvements are likely to occur in other species, including humans.",doi: 10.1007/s00221-011-2591-5.,dai2011.pdf
73,115,116,Hear Res,"C. Dai, G. Y. Fridman, N. S. Davidovics, B. Chiang, J. H. Ahn and C. C. Della Santina Restoration of 3D vestibular sensation in rhesus monkeys using a multichannel vestibular prosthesis 2011",PubMed,0.0,1.0,Population,Animal study,,0.0,Restoration of 3D vestibular sensation in rhesus monkeys using a multichannel vestibular prosthesis,"Abstract
Profound bilateral loss of vestibular hair cell function can cause chronically disabling loss of balance and inability to maintain stable vision during head and body movements. We have previously shown that chinchillas rendered bilaterally vestibular-deficient via intratympanic administration of the ototoxic antibiotic gentamicin regain a more nearly normal 3-dimensional vestibulo-ocular reflex (3D VOR) when head motion information sensed by a head-mounted multichannel vestibular prosthesis (MVP) is encoded via rate-modulated pulsatile stimulation of vestibular nerve branches. Despite significant improvement versus the unaided condition, animals still exhibited some 3D VOR misalignment (i.e., the 3D axis of eye movement responses did not precisely align with the axis of head rotation), presumably due to current spread between a given ampullary nerve's stimulating electrode(s) and afferent fibers in non-targeted branches of the vestibular nerve. Assuming that effects of current spread depend on relative orientation and separation between nerve branches, anatomic differences between chinchilla and human labyrinths may limit the extent to which results in chinchillas accurately predict MVP performance in humans. In this report, we describe the MVP-evoked 3D VOR measured in alert rhesus monkeys, which have labyrinths that are larger than chinchillas and temporal bone anatomy more similar to humans. Electrodes were implanted in five monkeys treated with intratympanic gentamicin to bilaterally ablate vestibular hair cell mechanosensitivity. Eye movements mediated by the 3D VOR were recorded during passive sinusoidal (0.2-5 Hz, peak 50°/s) and acceleration-step (1000°/s(2) to 150°/s) whole-body rotations in darkness about each semicircular canal axis. During constant 100 pulse/s stimulation (i.e., MVP powered ON but set to stimulate each ampullary nerve at a constant mean baseline rate not modulated by head motion), 3D VOR responses to head rotation exhibited profoundly low gain [(mean eye velocity amplitude)/(mean head velocity amplitude) < 0.1] and large misalignment between ideal and actual eye movements. In contrast, motion-modulated sinusoidal MVP stimuli elicited a 3D VOR with gain 0.4-0.7 and axis misalignment of 21-38°, and responses to high-acceleration transient head rotations exhibited gain and asymmetry closer to those of unilaterally gentamicin-treated animals (i.e., with one intact labyrinth) than to bilaterally gentamicin-treated animals without MVP stimulation. In comparison to responses observed under similar conditions in chinchillas, acute responses to MVP stimulation in rhesus macaque monkeys were slightly better aligned to the desired rotation axis. Responses during combined rotation and prosthetic stimulation were greater than when either stimulus was presented alone, suggesting that the central nervous system uses MVP input in the context of multisensory integration. Considering the similarity in temporal bone anatomy and VOR performance between rhesus monkeys and humans, these observations suggest that an MVP will likely restore a useful level of vestibular sensation and gaze stabilization in humans.",doi: 10.1016/j.heares.2011.08.008.,dai2011 (1).pdf
74,124,125,Neurosurgery,"A. R. de Ipolyi, I. Yang, A. Buckley, N. M. Barbaro, S. W. Cheung and A. T. Parsa Fluctuating response of a cystic vestibular schwannoma to radiosurgery: case report 2008",PubMed,0.0,1.0,Population,Brainstem ,,0.0,Fluctuating response of a cystic vestibular schwannoma to radiosurgery: case report,"Abstract
Objective: A vestibular schwannoma (VS) is a benign tumor of the VIIIth cranial nerve that can often be treated by microsurgery or radiosurgery and demonstrates high tumor control rates. Radiosurgery is typically performed as gamma knife surgery (GKS), although other modalities are being applied with increasing frequency. A differentiating feature in responsiveness to microsurgery or GKS is whether the VS is cystic or solid. A cystic VS is less responsive to GKS than a solid VS, representing a challenging clinical problem. GKS treatment of a cystic VS usually results in sustained expansion, sustained regression, or transient expansion followed by sustained regression. In this article, we report an atypical fluctuating course of a cystic VS after GKS, ultimately requiring surgical intervention.
Clinical presentation: A 66-year-old woman presented with asymmetric hearing loss and tinnitus. Magnetic resonance imaging revealed a 2.0-cm unilateral cystic VS within the cerebellopontine angle.
Intervention: After GKS with a 12-Gy dose to the 50% isodose line, the tumor expanded transiently to 3.2 cm and then regressed to 1.0 cm over the next 2 years. She presented several months later with new-onset dizziness, ataxia, and facial numbness. Magnetic resonance imaging revealed a 3.2-cm multicystic VS that compressed the brainstem. After microsurgical tumor excision, the patient's symptoms abated.
Conclusion: Our case report is a novel demonstration that a cystic VS that has regressed after GKS is still at risk for expansion. The mechanisms responsible for radiation-induced cystic tumor expansion have not been thoroughly elucidated. The risk of unpredictable tumor enlargement should be discussed with patients when considering GKS for cystic tumors.",doi: 10.1227/01.neu.0000325880.13494.f2.,deipolyi2008.pdf
75,128,129,B-ent,"C. Delbrouck, S. Hassid, G. Choufani, O. De Witte, D. Devriendt and N. Massager Hearing outcome after gamma knife radiosurgery for vestibular schwannoma: a prospective Belgian clinical study 2011",PubMed,1.0,,,,,0.0,Hearing outcome after gamma knife radiosurgery for vestibular schwannoma: a prospective Belgian clinical study,"Abstract
Introduction: Leksel Gamma Knife (LGK) radiosurgery is a safe and efficient therapeutic approach for vestibular schwannoma (VS) with low side effects. The goal of radiosurgery is not necessarily to cause significant tumour necrosis or to obtain a complete radiographic response, but to halt the tumour's growth permanently through its biological elimination. The 2 major aims of radiosurgery for VS are long-term tumour control and functional hearing preservation. The purpose of this study is to report our experience with LGK radiosurgery in the management of VS and to evaluate the hearing preservation rate after a minimum one-year follow-up.
Material and methods: Between January 2000 and January 2011, 415 patients with unilateral VS underwent LGK radiosurgery at the University Erasmus Hospital of Brussels. There were 349 patients with previously untreated VS (86 grade I, 96 grade II, 141 grade III, 9 grade IVa, 17 unknown grades, according to Koos) and 66 patients with post-operative residual tumour. All patients in our series underwent evaluation with high resolution neurodiagnostic imaging including computed tomography and magnetic resonance imaging, and clinical evaluation as well as audiological tests that included tonal and speech audiometries. The Gardner Robertson (GR) classification is used to report the results of this study. We identified 276 patients treated for VS with LGK, tested and retested with speech and tonal audiometries by the same team, and followed for a minimum of one year.
Results: Before LGK, 144 patients had serviceable (85 GR class I and 59 GR class II) hearing; 95 (65.97%) of these patients had preservation of serviceable hearing (Pure tone average < or = 50 db and Speech discrimination > or = 50%) at minimum one-year audiological follow-up. It was observed that 44 of the 85 GR class I patients (51.76%) maintained their level of audition and 66 of these (74.64%) preserved serviceable hearing. In the 34 patients with preradiosurgery non-serviceable hearing (GR class III-IV) 25 of these patients (73.52%) maintained their hearing. The tumour was stable or declining in size in 90.44% of cases.
Conclusion: LGK radiosurgery provides excellent tumour control in vestibular schwannomas and has low toxicity even after long-term follow-up.",Not Found,No pdf
76,130,131,J Neurophysiol,T. G. Deliagina and E. L. Pavlova Modifications of vestibular responses of individual reticulospinal neurons in lamprey caused by unilateral labyrinthectomy 2002,PubMed,0.0,1.0,Population,Animal study,,0.0,Modifications of vestibular responses of individual reticulospinal neurons in lamprey caused by unilateral labyrinthectomy,"Abstract
A postural control system in the lamprey is driven by vestibular input and maintains the dorsal-side-up orientation of the animal during swimming. After a unilateral labyrinthectomy (UL), the lamprey continuously rolls toward the damaged side. Normally, a recovery of postural equilibrium (""vestibular compensation"") takes about 1 mo. However, illumination of the eye contralateral to UL results in an immediate and reversible restoration of equilibrium. Here we used eye illumination as a tool to examine a functional recovery of the postural network. Important elements of this network are the reticulospinal (RS) neurons, which are driven by vestibular input and transmit commands for postural corrections to the spinal cord. In this study, we characterized modifications of the vestibular responses in individual RS neurons caused by UL and the effect exerted on these responses by eye illumination. The activity of RS neurons was recorded from their axons in the spinal cord by chronically implanted electrodes, and spikes in individual axons were extracted from the population activity signals. The same neurons were recorded both before and after UL. Vestibular stimulation (rotation in the roll plane through 360 degrees ) and eye illumination were performed in quiescent animals. It was found that the vestibular responses on the UL-side changed only slightly, whereas the responses on the opposite side disappeared almost completely. This asymmetry in the bilateral activity of RS neurons is the most likely cause for the loss of equilibrium in UL animals. Illumination of the eye contralateral to UL resulted, first, in a restoration of vestibular responses in the neurons inactivated by UL and in an appearance of vestibular responses in some other neurons that did not respond to vestibular input before UL. These responses had directional sensitivity and zones of spatial sensitivity similar to those observed before UL. However, their magnitude was smaller than before UL. Second, the eye illumination caused a reduction of the magnitude of vestibular responses on the UL side. These two factors tend to restore symmetry in bilateral activity of RS neurons, which is the most likely cause for the recovery of equilibrium in the swimming UL lamprey. Results of this study are discussed in relation to the model of the roll control system proposed in our previous studies as well as in relation to the vestibular compensation.",doi: 10.1152/jn.00315.2001.,deliagina2002.pdf
77,131,132,Arch Ital Biol,"T. G. Deliagina, L. B. Popova and G. Grant The role of tonic vestibular input for postural control in rats 1997",PubMed,0.0,1.0,Population,Animal study,,0.0,The role of tonic vestibular input for postural control in rats,"Abstract
Removal of a vestibular organ deprives the ipsilateral vestibular nuclei of tonic excitatory inflow from vestibular afferents, and thus evokes a central asymmetry, that is imbalance between tonic activity of the left and right vestibular nuclear complexes. In the present study, the effect of the central asymmetry upon a function of different motor systems was investigated in the freely behaving rats subjected to unilateral or bilateral labyrinthectomy (UL or BL). In four sets of experiments the following results have been obtained. 1. Seven UL-evoked symptoms (which reflect impairment of different motor systems) were qualitatively characterized. The short-lasting symptoms were: (1) body twisting, (2) rolling, (3, 4) extension of the fore- and hindlimb contralateral to UL, and (5) circling. These symptoms disappeared in a fixed order during recovery from anesthesia. During of expression of the symptoms was very short (< 1 hour) with the Halothan anesthesia and much longer (approximately 8 hours) with the chloral hydrate anesthesia. The long-lasting symptoms were (6) spontaneous ocular nystagmus, that persisted for 3 days after UL, and (7) head roll tilt, that persisted for at least several weeks after UL. 2. In BL-animals, stimulation of one of the 8th nerves was performed (by means of an implanted electrode; pulses 0.3 ms, 50 Hz, current up to 400 microA). By increasing gradually the strength of the stimulating current, we could evoke all the UL-symptoms but generally in the order (7-->1) which was the reverse as compared to the order of disappearance of the corresponding symptoms during recovery after UL (1-->7). These findings suggest that different symptoms need different levels of the central asymmetry for their appearance, and these levels also determine the order of disappearance of the symptoms during recovery from UL. 3. In UL-animals, by stimulating the 8th nerve on UL-side with a properly adjusted current (200-400 microA) we could immediately abolish all the symptoms except (6), which was, however, considerably reduced. This finding suggests that stimulation of the 8th nerve in UL-rats restores the central symmetry, which results in a concerted disappearance of almost all symptoms. In addition to the intermediate effects, stimulation of the 8th nerve in UL-animals resulted in a long-lasting effect, that is a reduction of the head roll tilt which persisted for at least 10 days after stimulation. 4. In BL-animals bilateral stimulation of the 8th nerve resulted in restoration of the muscular tone, and in considerable improvement of the control of the head position.",Not Found,No pdf
78,138,139,Brain,M. Dieterich and T. Brandt Functional brain imaging of peripheral and central vestibular disorders 2008,PubMed,0.0,1.0,Design,Review,,0.0,Functional brain imaging of peripheral and central vestibular disorders,"Abstract
This review summarizes our current knowledge of multisensory vestibular structures and their functions in humans. Most of it derives from brain activation studies with PET and fMRI conducted over the last decade. The patterns of activations and deactivations during caloric and galvanic vestibular stimulations in healthy subjects have been compared with those in patients with acute and chronic peripheral and central vestibular disorders. Major findings are the following: (1) In patients with vestibular neuritis the central vestibular system exhibits a spontaneous visual-vestibular activation-deactivation pattern similar to that described in healthy volunteers during unilateral vestibular stimulation. In the acute stage of the disease regional cerebral glucose metabolism (rCGM) increases in the multisensory vestibular cortical and subcortical areas, but simultaneously it significantly decreases in the visual and somatosensory cortex areas. (2) In patients with bilateral vestibular failure the activation-deactivation pattern during vestibular caloric stimulation shows a decrease of activations and deactivations. (3) Patients with lesions of the vestibular nuclei due to Wallenberg's syndrome show no activation or significantly reduced activation in the contralateral hemisphere during caloric irrigation of the ear ipsilateral to the lesioned side, but the activation pattern in the ipsilateral hemisphere appears 'normal'. These findings indicate that there are bilateral ascending vestibular pathways from the vestibular nuclei to the vestibular cortex areas, and the contralateral tract crossing them is predominantly affected. (4) Patients with posterolateral thalamic infarctions exhibit significantly reduced activation of the multisensory vestibular cortex in the ipsilateral hemisphere, if the ear ipsilateral to the thalamic lesion is stimulated. Activation of similar areas in the contralateral hemisphere is also diminished but to a lesser extent. These data demonstrate the functional importance of the posterolateral thalamus as a vestibular gatekeeper. (5) In patients with vestibulocerebellar lesions due to a bilateral floccular deficiency, which causes downbeat nystagmus (DBN), PET scans reveal that rCGM is reduced in the region of the cerebellar tonsil and flocculus/paraflocculus bilaterally. Treatment with 4-aminopyridine lessens this hypometabolism and significantly improves DBN. These findings support the hypothesis that the (para-) flocculus and tonsil play a crucial role in DBN. Although we can now for the first time attribute particular activations and deactivations to functional deficits in distinct vestibular disorders, the complex puzzle of the various multisensory and sensorimotor functions of the phylogenetically ancient vestibular system is only slowly being unraveled.",doi: 10.1093/brain/awn042.,dieterich2008.pdf
79,141,142,J Neurol,"J. Dlugaiczyk, M. Habs and M. Dieterich Vestibular evoked myogenic potentials in vestibular migraine and Menière's disease: cVEMPs make the difference 2020",PubMed,0.0,1.0,Outcome,"No symptom, signs",,0.0,Vestibular evoked myogenic potentials in vestibular migraine and Menière's disease: cVEMPs make the difference,"Abstract
Objective: Vestibular evoked myogenic potentials (VEMPs) have been suggested as biomarkers in the differential diagnosis of Menière's disease (MD) and vestibular migraine (VM). The aim of this study was to compare the degree of asymmetry for ocular (o) and cervical (c) VEMPs in large cohorts of patients with MD and VM and to follow up the responses.
Study design: Retrospective study in an interdisciplinary tertiary center for vertigo and balance disorders.
Methods: cVEMPs to air-conducted sound and oVEMPs to bone-conducted vibration were recorded in 100 patients with VM and unilateral MD, respectively. Outcome parameters were asymmetry ratios (ARs) of oVEMP n10p15 and cVEMP p13n23 amplitudes, and of the respective latencies (mean ± SD).
Results: The AR of cVEMP p13n23 amplitudes was significantly higher for MD (0.43 ± 0.34) than for VM (0.26 ± 0.24; adjusted p = 0.0002). MD-but not VM-patients displayed a higher AR for cVEMP than for oVEMP amplitudes (MD 0.43 ± 0.34 versus 0.23 ± 0.22, p < 0.0001; VM 0.26 ± 0.14 versus 0.19 ± 0.15, p = 0.11). Monitoring of VEMPs in single patients indicated stable or fluctuating amplitude ARs in VM, while ARs in MD appeared to increase or remain stable over time. No differences were observed for latency ARs between MD and VM.
Conclusions: These results are in line with (1) a more common saccular than utricular dysfunction in MD and (2) a more permanent loss of otolith function in MD versus VM. The different patterns of o- and cVEMP responses, in particular their longitudinal assessment, might add to the differential diagnosis between MD and VM.
Keywords: Menière’s disease; Saccule; Utricle; Vestibular evoked myogenic potentials; Vestibular migraine.",doi: 10.1007/s00415-020-09902-4.,10.1007@s00415-020-09902-4.pdf
80,145,146,J Vestib Res,"G. Dumas, A. Lion, G. C. Gauchard, G. Herpin, M. Magnusson and P. P. Perrin Clinical interest of postural and vestibulo-ocular reflex changes induced by cervical muscles and skull vibration in compensated unilateral vestibular lesion patients 2013",PubMed,1.0,,,,,0.0,Clinical interest of postural and vestibulo-ocular reflex changes induced by cervical muscles and skull vibration in compensated unilateral vestibular lesion patients,"Abstract
Skull vibration induces nystagmus in unilateral vestibular lesion (UVL) patients. Vibration of skull, posterior cervical muscles or inferior limb muscles alters posture in recent UVL patients. This study aimed to investigate the postural effect of vibration in chronic compensated UVL patients. Vibration was applied successively to vertex, each mastoid, each side of posterior cervical muscles and of triceps surae in 12 UVL patients and 9 healthy subjects. Eye movements were recorded with videonystagmography. Postural control was evaluated in eyes open (EO) and eyes closed (EC) conditions. Sway area, sway path, anteroposterior and medio-lateral sways were recorded.A vibration induced nystagmus (VIN) beating toward the healthy side was obtained for each UVL patient during mastoid vibration. In EO, only sway path was higher in UVL group during vibration of mastoids and posterior cervical muscles.The EO postural impairments of UVL patients could be related to the eye movements or VIN, leading to visual perturbations, or to a proprioceptive error signal, providing an erroneous representation of head position. The vibration-induced sway was too small to be clinically useful. Vestibulo-ocular reflex observed with videonystagmography during mastoid vibration seems more relevant to reveal chronic UVL than vestibulo-spinal reflex observed with posturography.",doi: 10.3233/VES-130468.,dumas2013.pdf
81,146,147,Ann Otolaryngol Chir Cervicofac,"G. Dumas, J. Michel, J. P. Lavieille and E. Ouedraogo Semiologic value and optimum stimuli trial during the vibratory test: results of a 3D analysis of nystagmus 2000",PubMed,1.0,,,,,0.0,[Semiologic value and optimum stimuli trial during the vibratory test: results of a 3D analysis of nystagmus],"Abstract
Nystagmus signaling vestibular dysfunction was observed after vibratory stimulation with a 100 Hz ABC stimulator in a population of 36 patients with unilateral labyrinthine pathology (ULP) (pre and postoperative neuromas, vestibular neurectomies) and 10 patients with vestibular neuritis. The stimulus was applied on 3 bony points of the skull (vertex and 2 mastoids) and 2 muscular points of the neck (right and left posterior cervical region). These results were compared with those in 95 normal subjects and 19 cases of central disease and were correlated on the same day with results of the caloric test and head shaking test (HST). A consistent nystagmus was found in only 6 % of the normal subjects (specificity 94 %) and in 10 % of the central lesions, but in 94 % of the 36 peripheral ULP. The sensitivity of the test was equivalent to the HST. The signal was optimized in 30 patients: stimulus frequency, amplitude, stimulator mass, form of the contact, patient tolerance. The best results were obtained for a frequency of 100 Hz and an amplitude of 0.5 mm (there was no response under 0.1 mm vibration amplitude). Under videoscopy and 3D videonystagmography, the direction or side of the nystagmus was constant, but its axis (horizontal, oblique or rotational) changed according to the location of the stimulator: on the mastoid (elective location of stimulation with responses in 94 % of cases) the axis was most often horizontal or horizontal rotational. On the vertex location (where nystagmus was observed in 60 % of cases) the axis of nystagmus was most often rotational or oblique and sometimes horizontal-rotational. The nystagmus showed short latency (less than 200 ms). It started and stopped as stimulation was initiated and interrupted. Nystagmus persisted for the duration of patient tolerance. This nystagmus generally signifies unilateral vestibular weakness rather than vestibular predominance. It is a good indicator of unilateral vestibular dysfunction and could serve as a useful test in clinical practice. We discuss the origin of the nystagmus which may originate in muscle proprioception (by propagation of the vibration to neck muscles) or in the labyrinth (simultaneous excitation of 3 canals on each side).",Not Found,No pdf
82,147,148,Otolaryngol Pol,"M. Durko, A. Jankowski, T. Durko, W. Gajewicz and A. Pajor Coexistence of acoustic neuroma and pineal region tumor in patient with sudden deafness 2008",PubMed,0.0,1.0,Population,in patient with sudden deafness,,0.0,[Coexistence of acoustic neuroma and pineal region tumor in patient with sudden deafness],"Abstract
Acoustic neuroma usually presents as an unilateral tumor, seldom - bilateral and rarely in coexistence with other central nervous system neoplasms. The following paper reports such a case of a 21-year-old male patient presented with sudden deafness in left ear accompanied with tinnitus and vertigo. Symptoms started 4 weeks prior hospitalization. Their aggravation has been observed 7 days before admission to the hospital. Audiometry revealed moderate sensorineural hearing loss in left ear (for low and middle frequencies), brainstem auditory evoked potentials were absent on the left side and ENG examination showed left peripheral vestibular impairment. Initially patient received i.v. vasodilatators showing 20-25 dB improvement in low frequencies after 3 days of treatment. MRI study revealed in the left internal acoustic meatus mass (7 x 7 x 14 mm) suggesting acoustic neuroma and an oval mass (7 x 9 x 14 mm) in the pineal gland presenting radiological features of pinealoma. Patient has been qualified for neurosurgical treatment. Acoustic neuroma has been removed by suboccipital approach and pinealoma has been left for further observation as it was found incidentally. Histopathological examination confirmed diagnosis of left VIII nerve schwannoma. The left facial palsy (House-Brackmann III/IV grade) and profound hearing loss appeared after surgery. The postoperative course shows no evidence of acoustic neuroma recurrence.",doi: 10.1016/S0030-6657(08)70242-7.,durko2008.pdf
83,148,149,J Neurosci,"S. Dutheil, G. Escoffier, A. Gharbi, I. Watabe and B. Tighilet GABA(A) receptor agonist and antagonist alter vestibular compensation and different steps of reactive neurogenesis in deafferented vestibular nuclei of adult cats 2013",PubMed,0.0,1.0,Population,Animal study,,0.0,GABA(A) receptor agonist and antagonist alter vestibular compensation and different steps of reactive neurogenesis in deafferented vestibular nuclei of adult cats,"Abstract
Strong reactive cell proliferation occurs in the vestibular nuclei after unilateral vestibular neurectomy (UVN). Most of the newborn cells survive, differentiate into glial cells and neurons with GABAergic phenotype, and have been reported to contribute to recovery of the posturo-locomotor functions in adult cats. Because the GABAergic system modulates vestibular function recovery and the different steps of neurogenesis in mammals, we aimed to examine in our UVN animal model the effect of chronic infusion of GABA(A) receptor (R) agonist and antagonist in the vestibular nuclei. After UVN and one-month intracerebroventricular infusions of saline, GABA(A)R agonist (muscimol) or antagonist (gabazine), cell proliferation and differentiation into astrocytes, microglial cells, and neurons were revealed using immunohistochemical methods. We also determined the effects of these drug infusions on the recovery of posturo-locomotor and oculomotor functions through behavioral tests. Our results showed that surprisingly, one month after UVN, newborn cells did not survive in the UVN-muscimol group whereas the number of GABAergic pre-existent neurons increased, and the long-term behavioral recovery of the animals was drastically impaired. Conversely, a significant number of newborn cells survived up to 1 month in the UVN-gabazine group whereas the astroglial population increased, and these animals showed the fastest recovery in behavioral functions. This study reports for the first time that GABA plays multiple roles, ranging from beneficial to detrimental on the different steps of a functional postlesion neurogenesis and further, strongly influences the time course of vestibular function recovery.",doi: 10.1523/JNEUROSCI.5691-12.2013.,dutheil2013.pdf
84,149,150,J Neurosci,"S. Dutheil, I. Watabe, K. Sadlaoud, A. Tonetto and B. Tighilet BDNF Signaling Promotes Vestibular Compensation by Increasing Neurogenesis and Remodeling the Expression of Potassium-Chloride Cotransporter KCC2 and GABAA Receptor in the Vestibular Nuclei 2016",PubMed,0.0,1.0,Population,Animal study,,0.0,BDNF Signaling Promotes Vestibular Compensation by Increasing Neurogenesis and Remodeling the Expression of Potassium-Chloride Cotransporter KCC2 and GABAA Receptor in the Vestibular Nuclei,"Abstract
Reactive cell proliferation occurs rapidly in the cat vestibular nuclei (VN) after unilateral vestibular neurectomy (UVN) and has been reported to facilitate the recovery of posturo-locomotor functions. Interestingly, whereas animals experience impairments for several weeks, extraordinary plasticity mechanisms take place in the local microenvironment of the VN: newborn cells survive and acquire different phenotypes, such as microglia, astrocytes, or GABAergic neurons, whereas animals eventually recover completely from their lesion-induced deficits. Because brain-derived neurotrophic factor (BDNF) can modulate vestibular functional recovery and neurogenesis in mammals, in this study, we examined the effect of BDNF chronic intracerebroventricular infusion versus K252a (a Trk receptor antagonist) in our UVN model. Results showed that long-term intracerebroventricular infusion of BDNF accelerated the restoration of vestibular functions and significantly increased UVN-induced neurogenesis, whereas K252a blocked that effect and drastically delayed and prevented the complete restoration of vestibular functions. Further, because the level of excitability in the deafferented VN is correlated with behavioral recovery, we examined the state of neuronal excitability using two specific markers: the cation-chloride cotransporter KCC2 (which determines the hyperpolarizing action of GABA) and GABAA receptors. We report for the first time that, during an early time window after UVN, significant BDNF-dependent remodeling of excitability markers occurs in the brainstem. These data suggest that GABA acquires a transient depolarizing action during recovery from UVN, which potentiates the observed reactive neurogenesis and accelerates vestibular functional recovery. These findings suggest that BDNF and/or KCC2 could represent novel treatment strategies for vestibular pathologies.
Significance statement: In this study, we report for the first time that brain-derived neurotrophic factor potentiates vestibular neurogenesis and significantly accelerates functional recovery after unilateral vestibular injury. We also show that specific markers of excitability, the potassium-chloride cotransporter KCC2 and GABAA receptors, undergo remarkable fluctuations within vestibular nuclei (VN), strongly suggesting that GABA acquires a transient depolarizing action in the VN during the recovery period. This novel plasticity mechanism could explain in part how the system returns to electrophysiological homeostasis between the deafferented and intact VN, considered in the literature to be a key parameter of vestibular compensation. In this context, our results open new perspectives for the development of therapeutic approaches to alleviate the vestibular symptoms and favor vestibular function recovery.
Keywords: BDNF; GABA; KCC2; gliogenesis; neurogenesis; vestibular compensation.",doi: 10.1523/JNEUROSCI.0945-16.2016.,dutheil2016.pdf
85,153,154,Otolaryngol Head Neck Surg,M. K. Evans and D. E. Krebs Posturography does not test vestibulospinal function 1999,PubMed,1.0,,,,,0.0,Posturography does not test vestibulospinal function,"Abstract
The clinical usefulness of posturography is unknown, despite its costing more than +500 per test in some areas of the United States, including Boston. We cross-sectionally and prospectively studied blinded vestibulo-ocular and vestibulospinal tests from 29 stable patients with chronic vestibular hypofunction; 22 patients were affected bilaterally (BVH), and 7 were affected unilaterally (UVH). Vestibulo-ocular function was assessed by electronystagmographic caloric stimulation and sinusoidal vertical axis rotation gains at 0.05 Hz. Vestibulospinal function was assessed by moving-platform and visualsurround posturography sensory organization tests (SOTs), paced and free gait in a gait laboratory, and clinical tests of timed gait and standing. Posturography SOT moving-platform tests 4 through 6, designed to assess vestibular function, correlated significantly (r < or = 0.72, P > or = 0.01) with vestibulo-ocular tests in 5 of 6 comparisons among BVH patients. Posturography SOT results, however, correlated poorly with other vestibulospinal measures: correlations were statistically significant for only 7 of 18 comparisons with clinical balance and gait function (r < or = 0.69, P > or = 0.01) and with 2 of 12 comparisons for gait laboratory dynamic stability measures (r < or = 0.55, P > or = 0.01) among the BVH patients. When both the platform and visual surround moved (SOT 6), however, correlations were statistically significant with static standing clinical measures (r = 0.51 to 0.69, P < 0.01) and with whole-body maximum moment arm during paced gait (r = 0.55, P < 0.01). Posturography scores for the UVH patients did not significantly correlate with any vestibulo-ocular or other vestibulospinal measures. These data indicate that among patients with BVH posturography SOT scores relate at best modestly with accepted measure of vestibulo-ocular function, less well with clinical measures of balance control, and poorly with dynamic gait-performance measures. We conclude that posturography SOT does not assess vestibulospinal function.",doi: 10.1016/S0194-5998(99)70401-8.,evans1999.pdf
86,156,157,Otol Neurotol,"M. Faralli, E. Molini, G. Ricci, R. Scardazza, F. Trabalzini, G. Altissimi and A. Frenguelli Study of vestibular evoked myogenic potentials in unilateral vestibulopathy: Otolithic versus canal function testing 2006",PubMed,0.0,1.0,Design,Italian,,0.0,Study of vestibular evoked myogenic potentials in unilateral vestibulopathy: Otolithic versus canal function testing,"Abstract
Objective: The study provides a qualitative evaluation of unilateral vestibulopathy by comparing otolithic and canal function, to establish possible relationships between the type of dysfunction observed and the evolving clinical pictures associated with it.
Study design: Retrospective study of a series of cases.
Setting: Department of Medical-Surgical Specialization, Otolaryngology and Cervicofacial Surgery Division, University of Perugia, Perugia, Italy.
Patients: Twenty patients whose medical history showed at least one episode corresponding to the clinical parameters of acute vestibulopathy.
Interventions: Study of vestibular function by recording VEMPs and repeating canal function testing at least 6 months after the first episode of vertigo.
Main outcome measures: Relationship between the type of vestibulopathy (canal and otolithic) and the clinical pictures observed.
Results: Paroxysmal positional vertigo, observed in 4 patients, was correlated with the presence of vestibular evoked myogenic potentials (VEMPs) and the absence of an ipsilateral canal response in all cases (100%). Persistent dizziness was observed in nine patients, and VEMPs were absent in all of them (100%); three (33.3%) showed the recovery of previously absent canal function. Comparison of responses in six patients with recurrent acute vestibulopathy showed persistent and complete loss of canal function in five cases (83.3%), whereas impairment of otolithic response was less constant (40%).
Conclusion: The combined VEMPs-canal test study shows predictive value regarding certain evolving clinical pictures of vestibulopathy. The absence of VEMPs confirms the role of otolithic dysfunction in the onset of dizziness. Likewise, it suggests that a vestibular origin of these disorders should be considered in cases that have shown aspecific symptoms since onset, without frank vertigo and with normal vestibular response to canal function testing.",doi: 10.1097/01.mao.0000231501.46534.30.,faralli2006.pdf
87,161,162,Semin Neurol,T. D. Fife and C. Giza Posttraumatic vertigo and dizziness 2013,PubMed,0.0,1.0,Design,Review,,0.0,Posttraumatic vertigo and dizziness,"Abstract
Dizziness and vertigo are common symptoms following minor head trauma. Although these symptoms resolve within a few weeks in many patients, in some the symptoms may last much longer and impede ability to return to work and full functioning. Causes of persisting or recurrent dizziness may include benign paroxysmal positional vertigo, so-called labyrinthine concussion, unilateral vestibular nerve injury or damage to the utricle or saccule, perilymphatic fistula, or less commonly traumatic endolymphatic hydrops. Some dizziness after head trauma is due to nonlabyrinthine causes that may be related to structural or microstructural central nervous system injury or to more complicated interactions between migraine, generalized anxiety, and issues related to patients self-perception, predisposing psychological states, and environmental and stress-related factors. In this article, the authors review both the inner ear causes of dizziness after concussion and also the current understanding of chronic postconcussive dizziness when no peripheral vestibular cause can be identified.",doi: 10.1055/s-0033-1354599.,giza2013.pdf
88,163,164,Baillieres Clin Neurol,C. A. Foster Vestibular rehabilitation 1994,PubMed,0.0,1.0,Design,Review,,0.0,Vestibular rehabilitation,"Abstract
Vestibular rehabilitation is a physical therapy programme for persons with symptomatic lesions of the vestibular system. When applied early in the course of recovery, it can hasten compensation. It can also reduce symptoms resulting from permanent deficits caused by vestibular injury. It has been shown to be effective when applied to patients with unilateral or bilateral losses, and reduces both dizziness and imbalance. Compensation occurs through tonic re-balancing at the level of the vestibular nuclei; by substitution of vision, proprioception and peripheral sensation for the missing vestibular input; and by the use of behavioural strategies to deal with residual deficits. The latter two mechanisms can be facilitated with rehabilitation exercises. Treatment methods must be varied, based on the patient's underlying disorder. The best prognosis for full recovery is for individuals with acute, unilateral vestibular injury. Patients with bilateral lesions will show improvement, but will have permanent deficits. Persons with progressive vestibular disorders, those having central involvement and persons with visual or somatosensory impairments may require more prolonged courses of treatment or demonstrate incomplete recovery. Patients with a previous history of vestibular loss with recent decompensation require a thorough re-evaluation to rule out these more complex problems. Rehabilitation includes vestibular exercises, management of vestibular suppressant medications, general conditioning and patient instruction. Exercises should be directed at static and active posture and balance, eye-head co-ordination and symptomatic dizziness. Balance exercises include practice with standing, walking and turning. Eye-head co-ordination exercises require head movement during visual fixation or visual target changes. Treatment of symptomatic dizziness is based upon habituation to the provoking stimulus, usually head or eye movement. Home exercises are combined with formal physical therapy sessions and patient education to complete the process of rehabilitation.",Not Found,No pdf
89,164,165,Laryngoscope,"C. A. Foster, B. D. Foster, J. Spindler and J. P. Harris Functional loss of the horizontal doll's eye reflex following unilateral vestibular lesions 1994",PubMed,1.0,,,,These cause permanent symptoms of blurred vision and dizzines,1.0,Functional loss of the horizontal doll's eye reflex following unilateral vestibular lesions,"Abstract
The doll's eye reflex represents the vestibulo-ocular reflex (VOR) elicited by high-acceleration head rotation. After complete unilateral vestibular lesions, the ipsilateral, horizontal doll's eye reflex is replaced by a series of ""catch-up"" saccades. These cause permanent symptoms of blurred vision and dizziness during ipsilateral turns. We compared normal controls and patients with complete surgical lesions or canal paresis of up to 9 years duration via electronystagmography (ENG) to determine the usefulness of the doll's eye test as a diagnostic test for complete vestibular lesions. This test was found to be more sensitive in diagnosis of such lesions than head-shaking nystagmus, rotatory directional preponderance, and spontaneous nystagmus. It is also useful to document VOR function in patients in whom caloric irrigation is contraindicated.",doi: 10.1288/00005537-199404000-00013.,foster1994.pdf
90,167,168,Eur Arch Otorhinolaryngol,"C. Fujimoto, N. Egami, M. Kinoshita, K. Sugasawa, T. Yamasoba and S. Iwasaki Idiopathic latent vestibulopathy: a clinical entity as a cause of chronic postural instability 2015",PubMed,1.0,,,, ILV could be a clinical entity accountable for postural instability,1.0,Idiopathic latent vestibulopathy: a clinical entity as a cause of chronic postural instability,"Abstract
The objective of this study is to describe a new clinical entity of idiopathic latent vestibulopathy (ILV), in which patients have unilateral or bilateral vestibulopathy combined with unsteadiness but without episodic vertigo, auditory disturbance, or a medical history suggesting the presence of vestibulopathy. A retrospective study of 1,233 consecutive new outpatients was conducted. Two-legged stance tasks were performed by 11 patients identified as having ILV in four conditions: eyes open with and without foam rubber, and eyes closed with and without foam rubber. We examined six parameters: the velocity of movement of the center of pressure (COP) with eyes closed/foam rubber, the envelopment area traced by the movement of the COP with eyes closed/foam rubber, Romberg's ratio of velocity and area with foam rubber, and the foam ratios of velocity and area with eyes closed. Multiple regression analyses were performed in order to explore the relationship between the presence of ILV and the six parameters recorded during foam posturography, while adjusting for the subjects' gender and age. The presence of ILV had a significantly positive relationship with the values of 4 of the 6 parameters. Even though six patients showed only unilateral vestibulopathy, their median value in all 6 parameters was greater than that of healthy controls. ILV could be a clinical entity accountable for postural instability.",doi: 10.1007/s00405-013-2834-0.,fujimoto2013.pdf
91,168,169,Otol Neurotol,"C. Fujimoto, T. Murofushi, K. Sugasawa, Y. Chihara, M. Ushio, T. Yamasoba and S. Iwasaki Assessment of postural stability using foam posturography at the chronic stage after acute unilateral peripheral vestibular dysfunction 2012",PubMed,1.0,,,,,1.0,Assessment of postural stability using foam posturography at the chronic stage after acute unilateral peripheral vestibular dysfunction,"Abstract
Objective: To investigate the utility of foam posturography for assessing equilibrium at the chronic stage after acute unilateral peripheral vestibulopathy.
Methods: Thirty-four consecutive patients (16 patients at the chronic stage) with acute unilateral peripheral vestibulopathy and absent caloric responses unilaterally were recruited, along with 66 healthy control subjects. Two-legged stance tasks were performed in 4 conditions: with eyes open or closed, with or without using foam rubber. We adopted 6 parameters: the movement velocity of the center of pressure, the envelopment area traced by the movement of the center of pressure with eyes closed/foam rubber, Romberg's ratios of velocity and area with foam rubber, and the foam ratios (the ratio of a parameter measured with and without foam rubber) of velocity and area with eyes closed.
Results: All 6 parameters were significantly higher in the patients in the acute/subacute stage (<3 mo) than in the control subjects (p < 0.0001). Five parameters, excluding the foam ratio of the area with eyes closed, were still significantly higher in the patients at the chronic stage (>3 mo) than in the control subjects (p < 0.01).
Conclusion: Foam posturography is useful for assessing equilibrium even at the chronic stage after acute unilateral peripheral vestibulopathy.",doi: 10.1097/MAO.0b013e3182487f48.,fujimoto2012.pdf
92,172,173,Acta Otolaryngol,"H. Fushiki, M. Ishida, S. Sumi, A. Naruse and Y. Watanabe Correlation between canal paresis and spontaneous nystagmus during early stage of acute peripheral vestibular disorders 2010",PubMed,0.0,1.0,Population,early stage of acute peripheral vestibular disorders,,0.0,Correlation between canal paresis and spontaneous nystagmus during early stage of acute peripheral vestibular disorders,"Abstract
Conclusions: This study demonstrates that the resolution period of spontaneous nystagmus (SN) may provide an indication of vestibular dysfunction on a particular day in the primary care setting.
Objective: We aimed to predict canal paresis using fundamental observations of SN during the early stage of acute peripheral vestibular disorders.
Methods: The study involved 87 patients who had recently experienced their first episode of acute spontaneous vertigo and direction-fixed horizontal nystagmus. Although they did not exhibit any other neurological deficits, they had been hospitalized with severe acute symptoms between 2004 and 2007. A correlation between the resolution period of SN and the results of laboratory caloric testing was reviewed.
Results: The receiver operating characteristic analysis showed that the resolution period of SN may be a predictive indicator of unilateral vestibular hypofunction in the acute stage. In about half of the patients, SN disappeared on the third day after their initial visit. However, in 20% of the patients SN still persisted on the eighth day. Among the patients with SN, the prevalence of canal paresis increased with the increase in the resolution period of SN. When SN was observed on the fifth day, the prevalence was approximately 70%.",doi: 10.3109/00016489.2010.497497.,fushiki2010.pdf
93,177,178,Arch Otolaryngol Head Neck Surg,"G. A. Gates, A. Verrall, J. D. Green, Jr., D. L. Tucci and S. A. Telian Meniett clinical trial: long-term follow-up 2006",PubMed,0.0,1.0,Population,"All had active, unilateral cochleovestibular disease",,0.0,Meniett clinical trial: long-term follow-up,"Abstract
Objective: To delineate 2-year efficacy of Meniett device therapy in people with classic, unilateral, Ménière's disease unresponsive to traditional medical treatment.
Design: A 2-year long-term unblinded follow-up after a prior randomized, placebo-controlled, multicenter clinical trial of the Meniett device for Ménière's disease.
Setting: Follow-up was performed remotely by using diaries and questionnaires mailed to the data coordinating center by the participants. Those who failed to mail their diaries were interviewed by telephone.
Participants: Sixty-one study participants agreed to use the Meniett device and report their symptoms for 2 years. All had active, unilateral cochleovestibular disease. Outcomes are available for 58 participants; 2 were unavailable for follow-up and 1 was excluded because of a concurrent condition that precluded Meniett device use.
Interventions: Participants were advised to adhere to a low-sodium diet, use the Meniett device 3 times daily, and maintain a patent tympanostomy tube in the affected ear. Diuretic and vestibular suppressant medications were used as needed.
Main outcome measures: Outcomes were based on the participants' daily diary, questionnaires, and telephone interviews. Three different analyses were prepared: tracking of vertigo frequency throughout the study, comparison of vertigo frequency before and at the end of Meniett device use (American Academy of Otolaryngology-Head and Neck Surgery Foundation reporting guideline), and Kaplan-Meier estimates of vertigo remission and recurrence.
Results: Vertigo levels gradually improved for most but not all participants. American Academy of Otolaryngology-Head and Neck Surgery Foundation class A (remission) or class B (greatly improved) results occurred in 67% (39/58) of participants, and class F (dropped out to receive surgical therapy) results occurred in 24%. Of the 44 nondropout participants, 39 (89%) had American Academy of Otolaryngology-Head and Neck Surgery Foundation group A or B outcomes. People who went into remission were highly likely (80%) to remain in remission long term; participants who achieved remission (20/43; 47%) did so within the first year of follow-up.
Conclusions: Use of the Meniett device was associated with a significant reduction in vertigo frequency in about two thirds of the participants, and this improvement was maintained long term. Therapy with the Meniett device is a safe and effective option for people with substantial vertigo uncontrolled by medical therapy.",doi: 10.1001/archotol.132.12.1311.,gates2006.pdf
94,178,179,Braz J Otorhinolaryngol,"J. M. Gazzola, F. F. Ganança, M. C. Aratani, M. R. Perracini and M. M. Ganança Clinical evaluation of elderly people with chronic vestibular disorder 2006",PubMed,1.0,,,,Dizziness is a chronic symptom in elderly patient,0.0,Clinical evaluation of elderly people with chronic vestibular disorder,"Abstract
Dizziness is common among the elderly.
Aim: To characterize social, demographic, clinical, functional and otoneurological data in elderly patients with chronic vestibular disorder.
Method: A sequential study of 120 patients with chronic vestibular disorder. Simple descriptive analyses were undertaken.
Results: Most of the patients were female (68.3%) with a mean age of 73.40+/-5.77 years. The average number of illnesses associated with the vestibular disorder was 3.83+/-1.84; the patients were taking on average 3.86+/-2.27 different medications. The most prevalent diagnosis on the vestibular exam was unilateral vestibular loss (29.8%) and the most prevalent etiology was metabolic vestibulopathy (40.0%) followed by benign paroxysmal positional vertigo (36.7%). Fifty-two patients (43.3%) had experienced dizziness for 5 years or more. Sixty-four patients (53.3%) had at least one fall in the last year and thirty-five (29.2%) had recurrent falls.
Conclusions: Most of the sample included females with associated diseases, and using many different drugs. The most prevalent vestibular diseases were metabolic and vascular labyrinth conditions. Dizziness is a chronic symptom in elderly patients. The association of two vestibular diseases is common. Falls are prevalent in chronic dizzy elderly patients.",doi: 10.1016/s1808-8694(15)30998-8.,gazzola2006.pdf
95,179,180,Rom J Morphol Embryol,"M. Georgescu, S. Stoian, C. A. Mogoantă and G. V. Ciubotaru Vestibulary rehabilitation--election treatment method for compensating vestibular impairment 2012",PubMed,1.0,,,,,0.0,Vestibulary rehabilitation--election treatment method for compensating vestibular impairment,"Abstract
Objective: This paper aims to reveal the actual benefit of vestibular rehabilitation (VR) in patients with unilateral vestibular loss.
Patient and methods: Case report of a young female patient with acute unilateral vestibular loss due to facial nerve schwannoma developed above the internal auditory canal (IAC) from where it seems to have entered the IAC. Betahistine associated to VR treatment was recommended due to persisting imbalance after tumor removal. The benefit of the combined therapy was evaluated objectively (sensory organization test) and subjectively (questionnaires regarding self-perception of the deficit in quality of life).
Results: Both evaluations revealed great improvement in stability (SOT scores) as well as in health-related quality of life (HRQoL)--improvement of self-perception scores of disequilibrium in all questionnaires used.
Conclusions: Combined recommended treatment (betahistine and VR) improves HRQoL after acute unilateral vestibular loss. It reduces self-perceived disability and intensity of symptoms during usual activities.",Not Found,No pdf
96,180,181,Gait Posture,"V. Ghulyan-Bedikian, M. Paolino and F. Paolino Short-term retention effect of rehabilitation using head position-based electrotactile feedback to the tongue: influence of vestibular loss and old-age 2013",PubMed,1.0,,,,chronic dizziness,1.0,Short-term retention effect of rehabilitation using head position-based electrotactile feedback to the tongue: influence of vestibular loss and old-age,"Abstract
Our objective was to evaluate whether the severity of vestibular loss and old-age (>65) affect a patient's ability to benefit from training using head-position based, tongue-placed electrotactile feedback. Seventy-one chronic dizzy patients, who had reached a plateau with their conventional rehabilitation, followed six 1-h training sessions during 4 consecutive days (once on days 1 and 4, twice on days 2 and 3). They presented bilateral vestibular areflexia (BVA), bilateral vestibular losses (BVL), unilateral vestibular areflexia or unilateral vestibular losses and were divided into two age-subgroups (≤65 and >65). Posturographic assessments were performed without the device, 4h before and after the training. Patients were tested with eyes opened and eyes closed (EC) on static and dynamic (passively tilting) platforms. The studied posturographic scores improved significantly, especially under test conditions restricting either visual or somatosensory input. This 4-h retention effect was greater in older compared to younger patients and was proportional to the degree of vestibular loss, patients with increased vestibular losses showing greater improvements. In bilateral patients, who constantly fell under dynamic-EC condition at the baseline, the therapy effect was expressed by disappearance of falls in BVL and significant prolongation in time-to-fall in BVA subgroups. Globally, our data showed that short training with head-position based, tongue-placed electrotactile biofeedback improves balance in chronic vestibulopathic patients some 16.74% beyond that achieved with standard balance physiotherapy. Further studies with longer use of this biofeedback are needed to investigate whether this approach could have long-lasting retention effect on balance and quality of life.
Keywords: Chronic dizziness rehabilitation; Electrotactile biofeedback; Posturography; Sensory substitution; Vestibular loss.",doi: 10.1016/j.gaitpost.2013.03.018.,ghulyan-bedikian2013.pdf
97,181,182,Otol Neurotol,"G. J. Gianoli and J. S. Soileau Chronic suppurative otitis media, caloric testing, and rotational chair testing 2008",PubMed,0.0,1.0,Population,patients with CSOM,,0.0,"Chronic suppurative otitis media, caloric testing, and rotational chair testing","Abstract
Objective: To determine the incidence of caloric and rotational chair testing (ROT) abnormalities in a group of patients with chronic suppurative otitis media (CSOM) and to correlate caloric test results with ROT.
Patients: Twenty-five patients with CSOM with or without cholesteatoma who were to undergo tympanomastoid surgery.
Interventions: Caloric and ROT.
Main outcome measures: History of dizziness. Vestibular test abnormalities defined by caloric weakness (CW), reduced gain, abnormal phase, or asymmetry on ROT.
Results: Among the 25 patients, 13 had bilateral CSOM-most with long-standing disease and history of previous surgical intervention. Of the 25 patients, 19 (76%) demonstrated either unilateral or bilateral CW. Eighteen (72%) demonstrated abnormalities on ROT. Eleven patients (44%) had complaints of vertigo/dizziness, although 2 of these patients had both normal caloric testing and ROT. Unilateral or bilateral CW was 80% accurate in predicting an ROT abnormality, whereas the symptom of vertigo/dizziness was only 48% accurate in predicting an ROT abnormality.
Conclusion: The incidence of CW among CSOM patients in this study was high and correlated well with abnormalities on ROT. Interestingly, ROT results correlated better with CW than symptoms of dizziness/vertigo. Although CW findings can be the result of technical limitations in testing patients with CSOM, ROT corroboration of these results suggest that they are valid findings.",doi: 10.1097/mao.0b013e31815c2589.,gianoli2008.pdf
98,182,183,Neuroreport,"D. P. Gilchrist, I. S. Curthoys, A. M. Burgess, A. D. Cartwright, K. Jinnouchi, H. G. MacDougall and G. M. Halmagyi Semicircular canal occlusion causes permanent VOR changes 2000",PubMed,0.0,1.0,Population,Animal study,,0.0,Semicircular canal occlusion causes permanent VOR changes,"Abstract
We measured the guinea pig horizontal vestibulo-ocular reflex (hVOR) to high acceleration impulsive head rotations following a unilateral lateral semicircular canal (LSCC) occlusion. We found a significant hVOR deficit for rotations toward the side of the occluded LSCC and this deficit did not show systematic changes over 3 months. We considered the LSCC nerve was still functional as shown by the normal appearance of the crista of the LSCC ampulla and also electrical stimulation of the LSCC. We conclude that the VOR during angular acceleration in response to high acceleration shows no adaptive plasticity following a unilateral LSCC occlusion.",doi: 10.1097/00001756-200008030-00036.,gilchrist2000.pdf
99,183,184,Phys Ther,"K. M. Gill-Body, D. E. Krebs, S. W. Parker and P. O. Riley Physical therapy management of peripheral vestibular dysfunction: two clinical case reports 1994",PubMed,1.0,,,,a 6-month history of disequilibrium ,1.0,Physical therapy management of peripheral vestibular dysfunction: two clinical case reports,"Abstract
We describe the treatment of two patients with peripheral vestibular dysfunction using a novel, staged exercise program. Response to treatment was documented. The first patient, a 62-year-old woman with unilateral vestibular dysfunction (UVD) and a 6-month history of disequilibrium following herpes zoster oticus resulting in damage to the right inner ear, was treated with an 8-week course of vestibular physical therapy. During the 8 weeks, the patient attended weekly physical therapy sessions and was trained to perform vestibular adaptation exercises on a daily basis at home. The second patient, a 53-year-old woman with progressive disequilibrium secondary to profound bilateral vestibular hypofunction (BVH), was treated with a 16-week course of vestibular physical therapy. During the first 8 weeks, the patient attended weekly physical therapy sessions and was trained to perform vestibular adaptation and substitution exercises on a daily basis at home. During the second 8 weeks, the patient continued performing vestibular physical therapy exercises at home independently. Vestibular function (sinusoidal vertical axis rotation testing), postural control (clinical tests and posturography), stability during the performance of selected activities of daily living (ADLs), and self-perception of symptoms and handicap were measured prior to and at the conclusion of treatment for both patients and at the midpoint of treatment for the patient with BVH. After 8 weeks of treatment, both patients reported improvements in self-perception of symptoms and handicap and demonstrated objective improvements in clinical balance tests, posturography, and several kinematic indicators of stability during the performance of selected ADLs. Further improvements were noted in the patient with BVH after 16 weeks of treatment. Improvements in postural control were noted after 8 weeks of treatment for the patient with UVD and after 16 weeks for the patient with BVH. Vestibular function improved during the course of treatment for the patient with UVD only. These case reports describe two different individualized treatment programs and document self-reported and laboratory-measured functional improvements in two patients with vestibular deficients--one with unilateral damage and one with bilateral damage.",doi: 10.1093/ptj/74.2.129.,gill-body1994.pdf
100,185,186,Arch Phys Med Rehabil,"M. Giray, Y. Kirazli, H. Karapolat, N. Celebisoy, C. Bilgen and T. Kirazli Short-term effects of vestibular rehabilitation in patients with chronic unilateral vestibular dysfunction: a randomized controlled study 2009",PubMed,1.0,,,,"in symptom, disability, balance, and postural stability",1.0,Short-term effects of vestibular rehabilitation in patients with chronic unilateral vestibular dysfunction: a randomized controlled study,"Abstract
Objective: To evaluate the short-term effects of vestibular rehabilitation on symptom, disability, balance, and postural stability in patients with chronic unilateral vestibular dysfunction.
Design: Randomized controlled trial.
Setting: Department of Physical Medicine and Rehabilitation, University Hospital.
Participants: Patients (N=42) with chronic vestibular dysfunction were divided into either a rehabilitation group (group 1) or a control group (group 2).
Interventions: Patients in group 1 were treated with a customized exercise program for 4 weeks, while the patients in the control group did not receive any treatment.
Main outcome measures: Subjects were assessed before and after the rehabilitation program with respect to symptoms (visual analog scale [VAS]), disability (Dizziness Handicap Inventory [DHI]), balance (Berg Balance Scale [BBS]), and postural stability (modified Clinical Test for Sensory Interaction on Balance [mCTSIB]).
Results: Significant improvements in all parameters (VAS, DHI, BBS, mCTSIB) were observed in group 1 (P<.05). When the 2 groups were compared, there were significant improvements in postexercise VAS, DHI (emotional, functional, physical, total), BBS, and mCTSIB (standing on a firm surface with eyes open, standing on a foam surface with eyes open, standing on a foam surface with eyes closed, mCTSIB mean) in favor of group 1 (P<.05). No significant improvements were seen in any parameters in the control group (P>.05).
Conclusions: Significant improvements were seen in symptom, disability, balance, and postural stability in chronic unilateral vestibular dysfunction after an exercise program. Customized exercise programs are beneficial in treatment of chronic unilateral vestibular dysfunction.",doi: 10.1016/j.apmr.2009.01.032.,giray2009.pdf
101,186,187,J Pharmacol Exp Ther,"C. M. Gliddon, C. L. Darlington and P. F. Smith Effects of chronic infusion of a GABAA receptor agonist or antagonist into the vestibular nuclear complex on vestibular compensation in the guinea pig 2005",PubMed,0.0,1.0,Population,Animal study,,0.0,Effects of chronic infusion of a GABAA receptor agonist or antagonist into the vestibular nuclear complex on vestibular compensation in the guinea pig,"Abstract
The aim of this study was to determine the effects of chronic infusion of a GABA(A) receptor agonist/antagonist into the ipsilateral or contralateral vestibular nuclear complex (VNC) on vestibular compensation, the process of behavioral recovery that occurs after unilateral vestibular deafferentation (UVD). This was achieved by a mini-osmotic pump that infused, over 30 h, muscimol or gabazine into the ipsilateral or contralateral VNC. Spontaneous nystagmus (SN), yaw head tilt (YHT), and roll head tilt (RHT) were measured. Infusion of muscimol or gabazine into either the ipsilateral or the contralateral VNC had little effect on SN compensation. In contrast, infusion of muscimol (250, 500, and 750 ng) into the contralateral VNC and gabazine (31.25, 62.5, and 125 ng) into the ipsilateral VNC significantly affected YHT and RHT (p < 0.05), but not their rate of compensation (p > 0.05). Interestingly, the effects of muscimol and gabazine on YHT and RHT were consistent throughout the first 30 h post-UVD. Infusion of muscimol (62.5, 125, and 250 ng) into the ipsilateral VNC and gabazine (125, 375, and 750 ng) into the contralateral VNC had little effect on YHT and RHT or their rate of compensation. These results suggest that the ipsilateral gabazine and contralateral muscimol infusions are modifying the expression of the symptoms without altering the mechanism of compensation. Furthermore, the neurochemical mechanism responsible for vestibular compensation can cope with the both the GABA(A) receptor-mediated and the UVD-induced decrease in resting activity.",doi: 10.1124/jpet.104.082172.,gliddon2005.pdf
102,188,189,Exp Brain Res,"C. M. Gliddon, A. J. Sansom, P. F. Smith and C. L. Darlington Effects of intra-vestibular nucleus injection of the group I metabotropic glutamate receptor antagonist AIDA on vestibular compensation in guinea pigs 2000",PubMed,0.0,1.0,Population,Animal study,,0.0,Effects of intra-vestibular nucleus injection of the group I metabotropic glutamate receptor antagonist AIDA on vestibular compensation in guinea pigs,"Abstract
Removal of the peripheral vestibular receptor cells in one inner ear (unilateral vestibular deafferentation, UVD) results in a syndrome of ocular motor and postural disorders, many of which disappear over time in a process of behavioural recovery known as vestibular compensation. Excitatory amino acid receptors, in particular the N-methyl-D-aspartate (NMDA) receptor, have been implicated in vestibular compensation; however, the metabotropic glutamate receptors (mGluRs) have not been studied in this context. The aim of this study was to determine whether group I mGluRs in the brainstem vestibular nucleus complex (VNC) ipsilateral to the UVD are involved in vestibular compensation of the static symptoms of UVD in guinea pig. The selective group I mGluR antagonist (RS)-1-aminoindan-1,5,dicarboxylic acid (AIDA) was continuously infused into the ipsilateral VNC for 30-min pre-UVD and 30-min post-UVD by cannula, at a rate of 1 microl/h, using one of four doses: 0.1 fg, 0.1 pg, 0.1 ng or 0.1 microg (n=5 animals in each case). In control conditions, a 0.1-fg (n=4) or 0.1-microg (n=5) NaOH vehicle was infused into the ipsilateral VNC using the same protocol. In order to control for the possibility that AIDA disrupted spontaneous neuronal activity in the VNC in normal animals, 0.1 microg AIDA (n=4) or 0.1 microg NaOH (n=2) was infused into the VNC in labyrinthine-intact animals. In both groups, static symptoms of UVD (i.e. spontaneous nystagmus, SN, yaw head tilt, YHT and roll head tilt, RHT) were measured at 8, 10, 12, 15, 20, 25, 30, 35, 45 and 50 h post-UVD. In addition, the righting reflex latency (RRL) was measured in labyrinthine-intact animals in order to assess whether AIDA impaired motor coordination in labyrinthine-intact animals. In UVD animals, the highest dose of AIDA significantly reduced SN frequency and changed its rate of compensation (P<0.001 and P<0.0001, respectively). This dose of AIDA also caused a significant reduction in YHT (P<0.005) as well as a significant change in its rate of compensation (P<0.0001). However, RHT was not significantly affected. In the labyrinthine-intact animals, AIDA infusion did not induce a UVD syndrome, nor did it significantly affect RRL. These results suggest that group I mGluRs in the ipsilateral VNC may be involved in the expression of ocular motor and some postural symptoms following UVD. Furthermore, group I mGluRs may not contribute to the resting activity of vestibular nucleus neurons.",doi: 10.1007/s002210000437.,gliddon2000.pdf
103,189,190,Hippocampus,"M. Goddard, Y. Zheng, C. L. Darlington and P. F. Smith Synaptic protein expression in the medial temporal lobe and frontal cortex following chronic bilateral vestibular loss 2008",PubMed,0.0,1.0,Population,Animal study,,0.0,Synaptic protein expression in the medial temporal lobe and frontal cortex following chronic bilateral vestibular loss,"Abstract
Several studies have reported that bilateral vestibular deafferentation (BVD) results in the disruption of place cell function and theta activity in the hippocampus. Recent magnetic resonance imaging (MRI) studies in humans demonstrated that bilateral but not unilateral vestibular loss is associated with a bilateral atrophy of the hippocampus. In this study we investigated whether BVD in rats resulted in changes in the expression of four proteins related to neuronal plasticity, synaptophysin, SNAP-25, drebrin and neurofilament-L, in the hippocampal subregions (CA1, CA2/3, the DG) and the entorhinal (EC), perirhinal (PRC) and frontal cortices (FC), using western blotting. At 6 months following BVD, there were no significant differences in the expression of synaptophysin in any region. There were also no significant differences in SNAP-25 expression in CA1, CA2/3, EC, PRC, or the FC; however, there was a significant increase in SNAP-25 expression in the DG compared to sham controls. Drebrin A and E expression was significantly reduced in the EC and drebrin A was significantly reduced in the FC of BVD animals. NF-L expression was not significantly different in CA1, CA2/3, DG, EC, or the PRC. However, its expression was significantly reduced in the FC of BVD animals. These data suggest that circumscribed neurochemical changes in SNAP-25, drebrin and NF-L expression occur in the DG, EC, and the FC over 6 months following BVD.",doi: 10.1002/hipo.20416.,goddard2008.pdf
104,191,192,Clin Otolaryngol,"W. P. Godefroy, D. Hastan and A. G. van der Mey Translabyrinthine surgery for disabling vertigo in vestibular schwannoma patients 2007",PubMed,1.0,,,,"severe, persistent or almost persistent dizziness or dysequilibrium",0.0,Translabyrinthine surgery for disabling vertigo in vestibular schwannoma patients,"Abstract
Objective: To determine the impact of translabyrinthine surgery on the quality of life in vestibular schwannoma patients with rotatory vertigo.
Study design: Prospective study in 18 vestibular schwannoma patients.
Setting: The study was conducted in a multispecialty tertiary care clinic.
Participants: All 18 patients had a unilateral intracanalicular vestibular schwannoma, without serviceable hearing in the affected ear and severely handicapped by attacks of rotatory vertigo and constant dizziness. Despite an initial conservative treatment, extensive vestibular rehabilitation exercises, translabyrinthine surgery was performed because of the disabling character of the vertigo, which considerably continued to affect the patients' quality of life.
Main outcome measures: Preoperative and postoperative quality of life using the Short Form 36 Health Survey (Short Form-36) scores and Dizziness Handicap Inventory (DHI) scores.
Results: A total of 17 patients (94%) completed the questionnaire preoperatively and 3 and 12 months postoperatively. All Short Form-36 scales of the studied patients scored significantly lower when compared with the healthy Dutch control sample (P < 0.05). There was a significant improvement of DHI total scores and Short Form-36 scales on physical and social functioning, role-physical functioning, role-emotional functioning, mental health and general health at 12 months after surgery when compared with preoperative scores (P < 0.05).
Conclusions: Vestibular schwannoma patients with disabling vertigo, experience significant reduced quality of life when compared with a healthy Dutch population. Translabyrinthine tumour removal significantly improved the patients' quality of life. Surgical treatment should be considered in patients with small- or medium-sized tumours and persisting disabling vertigo resulting in a poor quality of life.",doi: 10.1111/j.1365-2273.2007.01427.x.,godefroy2007.pdf
105,192,193,Otolaryngol Head Neck Surg,J. A. Goebel and P. Garcia Prevalence of post-headshake nystagmus in patients with caloric deficits and vertigo 1992,Pubmed,0.0,1.0,Population,in patients with caloric deficits and vertigo,,0.0,Prevalence of post-headshake nystagmus in patients with caloric deficits and vertigo,"Abstract
Post-headshake nystagmus (PHN) has recently been described as a clinically useful physical sign implying uncompensated asymmetric input from the vestibular end organs. A rapid 20-second headshake and sudden stop produces a jerk nystagmus of 5- to 20-second duration in certain individuals with symptoms suggestive of a peripheral vestibulopathy. This retrospective review of 214 patient evaluations was undertaken to study the associations between post-headshake nystagmus, caloric deficits after bithermal binaural irrigation, and the presence of vertigo. Both clinical observation of the nystagmus with eyes open (PHN-OBS) and routine EOG recording with eyes closed (PHN-EOG) were used. In patients with unilateral caloric deficits, 42% (18 of 43) had PHN-EOG, compared with 18% (3 of 17) in patients with bilateral dysfunction and 15% (23 of 154) in patients with normal calorics (p less than 0.001). In similar fashion, 26% (32 of 124) of patients with vertigo (recent or past) had PHN-EOG compared to 13% (12 of 90) of patients without vertigo (p less than 0.03). Finally, of 110 cases with both PHN-EOG and PHN-OBS performed, 45% (9 of 20) with PHN-EOG also had PHN-OBS, as opposed to only 4% (4 of 90) without PHN-EOG displaying PHN-OBS (p less than 0.0001). We conclude that the prevalence of post-headshake nystagmus is increased in patients with either a unilateral caloric deficit or a history of true vertigo, and is best detected in the absence of vision.",doi: 10.1177/019459989210600201.,goebel1992.pdf
106,193,194,Front Neurol,"N. Goldschagg, K. Feil, F. Ihl, S. Krafczyk, M. Kunz, J. C. Tonn, M. Strupp and A. Peraud Decompression in Chiari Malformation: Clinical, Ocular Motor, Cerebellar, and Vestibular Outcome 2017",PubMed,0.0,1.0,Population,patients with Chiari malformation type 1 ,,0.0,"Decompression in Chiari Malformation: Clinical, Ocular Motor, Cerebellar, and Vestibular Outcome","Abstract
Background: Treatment of Chiari malformation can include suboccipital decompression with resection of one cerebellar tonsil. Its effects on ocular motor and cerebellar function have not yet been systematically examined.
Objective: To investigate whether decompression, including resection of one cerebellar tonsil, leads to ocular motor, vestibular, or cerebellar deficits.
Patients and methods: Ten patients with Chiari malformation type 1 were systematically examined before and after (1 week and 3 months) suboccipital decompression with unilateral tonsillectomy. The work-up included a neurological and neuro-ophthalmological examination, vestibular function, posturography, and subjective scales. Cerebellar function was evaluated by ataxia rating scales.
Results: Decompression led to a major subjective improvement 3 months after surgery, especially regarding headache (5/5 patients), hyp-/dysesthesia (5/5 patients), ataxia of the upper limbs (4/5 patients), and paresis of the triceps and interosseal muscles (2/2 patients). Ocular motor disturbances before decompression were detected in 50% of the patients. These symptoms improved after surgery, but five patients had new persisting mild ocular motor deficits 3 months after decompression with unilateral tonsillectomy (i.e., smooth pursuit deficits, horizontally gaze-evoked nystagmus, rebound, and downbeat nystagmus) without any subjective complaints. Impaired vestibular (horizontal canal, saccular, and utricular) function improved in five of seven patients with impaired function before surgery. Posturographic measurements after surgery did not change significantly.
Conclusion: Decompression, including resection of one cerebellar tonsil, leads to an effective relief of patients' preoperative complaints. It is a safe procedure when performed with the help of intraoperative electrophysiological monitoring, although mild ocular motor dysfunctions were seen in half of the patients, which were fortunately asymptomatic.
Keywords: Chiari malformation; cerebellar tonsil; cerebellum; ocular motor function; suboccipital decompression.",doi: 10.3389/fneur.2017.00292.,goldschagg2017.pdf
107,195,196,Arch Med Res,F. B. Gómez-Alvarez and K. Jáuregui-Renaud Psychological symptoms and spatial orientation during the first 3 months after acute unilateral vestibular lesion 2011,PubMed,0.0,1.0,Outcome,Not chronic,,0.0,Psychological symptoms and spatial orientation during the first 3 months after acute unilateral vestibular lesion,"Abstract
Background and aims: We undertook this study to assess the correlation between the results of simple tests of spatial orientation and the occurrence of common psychological symptoms during the first 3 months after an acute, unilateral, peripheral, vestibular lesion.
Methods: Ten vestibular patients were selected and accepted to participate in the study. During a 3-month follow-up, we recorded the static visual vertical (VV), the estimation error of reorientation in the yaw plane and the responses to a standardized questionnaire of balance symptoms, the Dizziness Handicap Inventory (DHI), the depersonalization/derealization inventory by Cox and Swinson (DD), the Dissociative Experiences Scale (DES), the 12-item General Health Questionnaire (GHQ-12), the Zung Instrument for Anxiety Disorders and the Hamilton Depression Rating Scale.
Results: At week 1, all patients showed a VV >2° and failed to reorient themselves effectively. They reported several balance symptoms and handicap as well as DD symptoms, including attention/concentration difficulties; 80% of the patients had a Hamilton score ≥8. At this time the balance symptom score correlated with the DHI. After 3 months, all scores decreased. Multiple regression analysis of the differences from baseline showed that the DD score difference was related to the difference on the balance score, the reorientation error and the DHI score (p <0.01). No other linear relationships were observed (p >0.5).
Conclusions: During the acute phase of a unilateral, peripheral, vestibular lesion, patients may show poor spatial orientation concurrent with DD symptoms including attention/concentration difficulties, and somatic depression symptoms. After vestibular rehabilitation, DD symptoms decrease as the spatial orientation improves, even if somatic symptoms of depression persist.",doi: 10.1016/j.arcmed.2011.03.004.,10.1016@j.arcmed.2011.03.004.pdf
108,196,197,Neuroscience,"N. B. Goodson, B. L. Brockhoff, J. P. Huston and R. E. Spieler Time-dependent bidirectional effects of chronic caffeine on functional recovery of the dorsal light reflex after hemilabyrinthectomy in the goldfish Carassius auratus 2015",PubMed,0.0,1.0,Population,Animal study,,0.0,Time-dependent bidirectional effects of chronic caffeine on functional recovery of the dorsal light reflex after hemilabyrinthectomy in the goldfish Carassius auratus,"Abstract
Caffeine works through a variety of complex mechanisms to exert an often bidirectional set of functional and structural neurological changes in vertebrates. We investigated the effects of chronic caffeine exposure on functional recovery of the dorsal light reflex (DLR) in hemilabyrinthectomized common goldfish, Carassius auratus. In this lesion model, the unilateral removal of the vestibular organs results in a temporary loss of gravitationally modulated postural control which is quantifiable via the DLR. We compared the functional recovery over 24 days of post-surgery goldfish continuously held in a caffeine solution of 2.5mg/L (n=10), 5.0mg/L (n=10), 10.0mg/L (n=11), or 0.0mg/L control (n=9). Comparison to a sham surgery group (n=11) indicated statistically significant changes in the DLR of all hemilabyrinthectomized fish on day 1. The control group recovered over the study period and approached, but did not reach sham surgery DLR. Although the caffeine-treated fishes appeared to initiate some postural recovery within the first 2 weeks, beginning on day 10, all caffeine groups diverged from the control group with a deterioration of postural control. All three caffeine groups were significantly deficient in comparison with the control on days 10-24. These results suggest that caffeine exposure can at first be benign, but that high dosage or prolonged exposure hinders functional recovery.
Keywords: caffeine; functional recovery; hemilabyrinthectomy; neurotrauma; trauma.",doi: 10.1016/j.neuroscience.2015.02.038.,goodson2015.pdf
109,201,202,Acta Otorhinolaryngol Ital,"G. Guidetti, R. Guidetti, M. Manfredi and M. Manfredi Vestibular pathology and spatial working memory 2020",PubMed,1.0,,,,,0.0,Vestibular pathology and spatial working memory,"Abstract
Patologia vestibolare e memoria operativa spaziale.
Riassunto: Grazie ad ampie connessioni centrali il sistema vestibolare non evoca solo riflessi ma è anche collegato a processi cognitivi. Un numero sempre maggiore di studi suggerisce che ha un impatto sostanziale sulle funzioni cognitive. Queste interazioni cognitive comprendono la memoria, l’attenzione, l’immaginario mentale, la consapevolezza del corpo e la cognizione sociale. La memoria operativa spaziale è un tipo di memoria a breve termine che consente di archiviare e manipolare temporaneamente le informazioni spaziali. Ha una capacità limitata ed è piuttosto vulnerabile alle interferenze. Il test non verbale più importante per la valutazione della memoria di lavoro visuo-spaziale (VSWM) è il test a blocchi di Corsi, noto anche come il Test di span di Corsi. A tal fine, abbiamo valutato col test eCorsi Block-Tapping 263 pazienti affetti da deficit vestibolare cronico unilaterale o bilaterale (VL), prima e dopo 5 giorni di training vestibolare strumentale (IVT). I dati sono stati confrontati con quelli di altri 834 soggetti sottoposti allo stesso test: 430 persone sane (HP) e 404 pazienti affetti da VL cronica ma non trattati con IVT. A tutte le età il punteggio del test di Corsi era significativamente più alto (p < 0,0001) negli HP rispetto a entrambi i gruppi di VL. Il punteggio era significativamente più alto anche nei giovani rispetto ai vecchi sia nelle HP che nei VL. È significativamente più alto nei maschi che nelle femmine solo negli HP. Il nostro studio conferma l’interferenza significativa dell’input vestibolare sulla VSWM e la compromissione di questa funzione cognitiva in pazienti affetti da VL cronici mono o bilaterali. Esso mostra anche che IVT è in grado di migliorare la VSWM anche nei casi in cui il deficit è maggiore.
Keywords: corsi block-tapping test; spatial working memory; vestibular pathology; vestibular rehabilitation training.",doi: 10.14639/0392-100X-2189.,No pdf
110,202,203,Acta Otorhinolaryngol Ital,"G. Guidetti, D. Monzani, M. Trebbi and V. Rovatti Impaired navigation skills in patients with psychological distress and chronic peripheral vestibular hypofunction without vertigo 2008",PubMed,1.0,,,,we can look,0.0,Impaired navigation skills in patients with psychological distress and chronic peripheral vestibular hypofunction without vertigo,"Abstract in English, Italian
Few studies have focused on the role of the vestibular system for navigation and spatial memory functions in humans, with controversial results. Since most experimental settings were based on magnetic resonance imaging volumetry of the hippocampus and virtual navigation task on a PC, aim of this study was to investigate whether a well-compensated unilateral peripheral vestibular hypofunction in humans could interfere with navigation tasks while walking on memorized routes. A series of 50 unilateral labyrinthine-defective patients, without vertigo at the time of examination, and 50 controls were invited to visually memorize 3 different routes (a triangle, a circle and a square) on a grey carpet and then to walk along them clockwise and counter-clockwise (mental map navigation) with eyes closed. The same test was then repeated with eyes open (actual navigation) and a second time with eyes closed (mental navigation). Execution time was recorded in each test. In the same session, working spatial memory was assessed by the Corsi block test and all subjects completed the Symptom Check List (SCL-90) to assess depression and anxiety levels. Results showed that labyrinthine-defective patients presented higher levels of anxiety and depression and performed the Corsi block test with more difficulties than controls. All differences reached statistically significant level (p < 0.05). Moreover, patients needed more time than controls in the first and third navigation tasks (eyes closed). No difference was observed between clockwise and counter-clockwise walking, on all routes, either in patients or controls. Patients showed a greater improvement in the third navigation task, with respect to the first test, than controls, with no side-effect in relation to labyrinthine hypofunction. These data demonstrate that walking along memorized routes without vision is impaired by peripheral vestibular damage even if vestibular compensation prevents patients from suffering from vertigo and balance disturbances. This impairment could be due to a permanent deficit of visuo-spatial short-term memory as suggested by the Corsi block test results even if a residual sensori-motor impairment and/or an interference of psychological distress could not be excluded.",Not Found,No pdf
111,203,204,Indian J Otolaryngol Head Neck Surg,"S. K. Gupta, A. Upadhyay and R. K. Mundra Role of Electronystagmography in Diagnosis of Secondary BPPV in Elderly Patients with Vertigo: A Retrospective Study 2018",PubMed,0.0,1.0,Outcome,"No symptom, signs",,0.0,Role of Electronystagmography in Diagnosis of Secondary BPPV in Elderly Patients with Vertigo: A Retrospective Study,"Abstract
Elderly population is frequently affected by vertigo which affects their mobility and makes them vulnerable to fall and other morbidities. Often these patient visit neurologist and are often subjected to CT scan, MRI brain etc. to rule out a central cause of vertigo; whereas majority of these patients suffer from vestibular cause of vertigo. A schematic approach by detailed history, simple tests for vestibular functions like Dix Hallpike, supine roll and head impulse test give important clue to diagnosis. Often the diagnosis is benign paroxysmal positional vertigo (BPPV) which is treated by repositioning maneuver. There are often other vestibular causes which may be diagnosed by Electronystagmography (ENG), electrocochleography and other tests. This study was undertaken to study occurrence of secondary BPPV utilizing various parameters of ENG. The study group comprised of 131 patients from the neuro-otology proforma data base at ENT centre and vertigo clinic from January 2015 to December 2017. Inclusion criterion was male and female aged 51 years and above presenting with dizziness, imbalance, rotational vertigo, unsteadiness as the chief complaint. Exclusion criterion was BPPV relieved after Epley's maneuver, Otitis externa, acute Otitis media, Suppurative Otitis media, pre existing neurological condition and history of ear surgery. Neuro-otology Data obtained and the ENG findings were tabulated in the master chart and the observations interpreted and transferred to Claussen's butterfly chart. The study group comprised of 58 male (44.27%) and 73 female (55.73%) with a male female ratio of 1:1.25. ENG exhibited 36 patients (27.49) to have recurrent BPPV, 53 (40.45%) were found to have unilateral/bilateral canal paresis. Meniere's disease was diagnosed in 39 (29.77%) patients and brain stem pathology identified in 3 (2.29%) cases.
Keywords: BPPV; Electronystagmography; Vertigo.",doi: 10.1007/s12070-018-1449-6.,gupta2018.pdf
112,205,206,Acta Otolaryngol Suppl,"A. M. Hadj-Djilani Caloric tests on platform: ""paradoxical responsiveness"" 1995",PubMed,0.0,1.0,Outcome,"No symptom, signs",,0.0,"Caloric tests on platform: ""paradoxical responsiveness""","Abstract
This paper deals with the abnormal responsiveness of the paradoxical stabilizing type (SR) occurring after caloric tests (CALT) performed on a passive force platform. The normal response after CALT (cold/warm, monaurally performed) consists of transient ataxia and body sway towards the side of the nystagmic slow phase induced by a similar CALT. Quantitatively the vestibular responsiveness to CALT is defined as the quotient of lengths QL calculated with measures of recordings after CALT (cold and warm responses averaged) versus recordings at rest. A normal vestibular responsiveness is defined as 1.5 < QL < 2.5; a vestibular lesion corresponds to QL around 1.0 (0.8-1.2); the paradoxical stabilizing responsiveness SR-CALT corresponds to QL < 0.65 and represents a particular type of lesional response. We observed SR-CALT in 23 patients from a total of 135 patients with similar lesions (SR excepted) after CALT at the vestibulo-ocular and vestibulo-spinal levels. SR-CALT appeared unilaterally in 11 patients, bilaterally in 12 patients. About half of the patients were followed up (1-4 years) and later exhibited total lesions but no more SR-type responses. All the patients had chronic- or bilateral vestibular lesions, with acute worsening of vertigo complaints and a spell-like lesional evolutivity, due to Meniére's disease or evolutive lesions of diverse origin. Additionally other tests, particularly those involving the neck-vestibular interactions, could induce SR-type responses in these patients. The significance of SR-CALT is discussed and we hypothesize that SR possibly represents a particular kind of vestibular ""decompensation"" at the vestibulospinal level in cases of chronic but recent evolutive vestibular lesion.",Not Found,No pdf
113,208,209,Restor Neurol Neurosci,"G. M. Halmagyi, K. P. Weber and I. S. Curthoys Vestibular function after acute vestibular neuritis 2010",PubMed,0.0,1.0,Design,Review,,0.0,Vestibular function after acute vestibular neuritis,"Abstract
Purpose: To review the extent and mechanism of the recovery of vestibular function after sudden, isolated, spontaneous, unilateral loss of most or all peripheral vestibular function - usually called acute vestibular neuritis.
Methods: Critical review of published literature and personal experience.
Results: The symptoms and signs of acute vestibular neuritis are vertigo, vomiting, nystagmus with ipsiversive slow-phases, ipsiversive lateropulsion and ocular tilt reaction (the static symptoms) and impairment of vestibulo-ocular reflexes from the ipsilesional semicircular canals on impulsive testing (the dynamic symptoms). Peripheral vestibular function might not improve and while static symptoms invariably resolve, albeit often not totally, dynamic symptoms only improve slightly if at all.
Conclusions: The persistent loss of balance that some patients experience after acute vestibular neuritis can be due to inadequate central compensation or to incomplete peripheral recovery and vestibular rehabilitation has a role in the treatment of both.",doi: 10.3233/RNN-2010-0533.,halmagyi2010.pdf
114,212,213,Otol Neurotol,"A. Harun, Y. Agrawal, M. Tan, J. K. Niparko and H. W. Francis Sex and age associations with vestibular schwannoma size and presenting symptoms 2012",PubMed,0.0,1.0,Outcome,"No symptom, signs",,0.0,Sex and age associations with vestibular schwannoma size and presenting symptoms,"Abstract
Objective: To assess the association of sex and age with presenting symptoms and size of vestibular schwannoma at clinical presentation to our clinics.
Study design: Retrospective chart review.
Setting: Academic medical center.
Patients: Approximately 1,269 subjects diagnosed with unilateral vestibular schwannoma between 1997 and 2010.
Intervention: Demographic information, tumor characteristics, and treatment strategy were recorded.
Main outcome measure: Tumor size, patient-reported presence of hearing loss or dizziness at presentation.
Results: Male subjects had significantly larger tumors than female subjects at presentation (18.23 versus 16.81 mm, p = 0.031); this difference was particularly pronounced in patients younger than 40 years. Patient-reported symptoms at baseline also differed by sex: the prevalence of hearing loss was 95.1% in male subjects versus 90.3% in female subjects (p = 0.001), and the frequency of dizziness was 74.3% in female subjects versus 59.0% in male subjects (p<0.0001). In multivariate analyses, male subjects continued to have a borderline significant positive association with tumor size (p = 0.066) and were 2-fold more likely to have hearing loss (odds ratio [OR], 2.082; 95% confidence interval [CI], 1.300-3.336) but half as likely to have dizziness (OR, 0.501; 95% CI, 0.387-0.649) than female subjects. Additionally, for every 1-mm increase in tumor size, patients were more likely to report hearing loss by 14.7% (OR, 1.147; 95% CI, 1.106-1.191) and dizziness by 2.8% (OR, 1.028; 95% CI, 1.016-1.041).
Conclusion: We observed significant sex differences in the presentation and size of unilateral vestibular schwannomas. As management and treatment strategies are predicated on presenting symptoms and patient factors, these observations merit further study to further understand tumor biology, improve risk stratification, and optimize tumor management.",doi: 10.1097/MAO.0b013e31826dba9e.,harun2012.pdf
115,213,214,Eur Arch Otorhinolaryngol,"F. Hassepass, S. Arndt, A. Aschendorff, R. Laszig and T. Wesarg Cochlear implantation for hearing rehabilitation in single-sided deafness after translabyrinthine vestibular schwannoma surgery 2016",PubMed,0.0,1.0,Design,Not related to subject ,,0.0,Cochlear implantation for hearing rehabilitation in single-sided deafness after translabyrinthine vestibular schwannoma surgery,"Abstract
The aim of the study was to investigate the option of cochlear implantation (CI) in resultant single-sided deafness associated with unilateral translabyrinthine resection of sporadic vestibular schwannoma (VS). This is a retrospective study performed at Tertiary Care Academic Centre. Following extensive counselling regarding the potential for delayed CI, translabyrinthine VS resection was performed and an intracochlear placeholder was inserted to allow later CI in 11 patients who showed intraoperative microscopic confirmation of preserved cochlear nerve anatomy. Follow-up magnetic resonance imaging (MRI) and promontory testing were performed 1 year after surgery to confirm the absence of VS recurrence and viable cochlea. Confirmed CI candidates underwent a second procedure where the placeholder was removed and the CI inserted (4/11). Preimplant unaided and CI-aided evaluations at 12 and 24 months were performed for subjective and objective hearing outcomes. Tinnitus suppression was also measured for implant on and off effects. Available audiological data for three patients demonstrated significant hearing benefits for 'speech from deaf/implanted side, noise from the normal-hearing side' in all three patients and localisation ability improved for 2/3 patients. Subjective findings presented similar results. For the two patients with preimplant tinnitus, complete suppression occurred during active CI. CI is beneficial for hearing rehabilitation and tinnitus reduction in SSD patients with remaining viable cochlear nerve after translabyrinthine VS surgery. Counselling on the risks of intracochlear placeholder insertion and the inherent limitations for ongoing MRI investigations of VS recurrence is essential.
Keywords: Acoustic neurinoma; Cochlear implantation; Placeholder; Single-sided deafness; Vestibular schwannoma.",doi: 10.1007/s00405-015-3801-8.,hassepass2015.pdf
116,215,216,Gait Posture,"M. Henriksson, J. Henriksson and J. Bergenius Gait initiation characteristics in elderly patients with unilateral vestibular impairment 2011",PubMed,1.0,,,,vestibular patients (n=14) with chronic unsteadiness caused by a documented peripheral unilateral vestibular dysfunction,1.0,Gait initiation characteristics in elderly patients with unilateral vestibular impairment,"Abstract
The study tested the hypothesis that vestibular patients (n=14) with chronic unsteadiness caused by a documented peripheral unilateral vestibular dysfunction would display differences in muscular activation and movement pattern during gait initiation compared to age-, gender- and body-size-matched healthy Controls (n=14). The displacements of the whole body Center of Pressure (CoP) during the preparatory phase before the swing leg is lifted, were markedly different in vestibular patients. The backward shift during this phase was significantly smaller than in Controls, coupled with a larger secondary corrective forward shift of the CoP. Conversely, the CoP-shift in the M-L direction towards the stance leg was larger in the vestibular patients. Most vestibular patients lacked the anticipatory tibialis anterior (TA) burst, which normally is a prerequisite for the backward displacement of the CoP that precedes the forward movement. The vestibular patients displayed more pronounced TA-Gastrocnemius coactivation in the stance leg when the swing leg was lifted. The duration of the preparatory phase was significantly longer in vestibular patients than in Controls, with no time differences in the later gait initiation events. The vestibular patients started from a more symmetrical stance and with less M-L variation than the Controls. It is concluded that chronically impaired vestibular function leads to a different strategy to create forward momentum to the body. In addition, there is evidence that vestibular patients have diminished postural stability, or alternatively a more cautious behaviour, when initiating the second step.",doi: 10.1016/j.gaitpost.2011.02.018.,henriksson2011.pdf
117,216,217,J Neurosci,"R. G. Hernández, B. Benítez-Temiño, C. J. Morado-Díaz, M. A. Davis-López de Carrizosa, R. R. de la Cruz and A. M. Pastor Effects of Selective Deafferentation on the Discharge Characteristics of Medial Rectus Motoneurons 2017",PubMed,0.0,1.0,Population,Animal study,,0.0,Effects of Selective Deafferentation on the Discharge Characteristics of Medial Rectus Motoneurons,"Abstract
Medial rectus motoneurons receive two main pontine inputs: abducens internuclear neurons, whose axons course through the medial longitudinal fasciculus (MLF), and neurons in the lateral vestibular nucleus, whose axons project through the ascending tract of Deiters (ATD). Abducens internuclear neurons are responsible for conjugate gaze in the horizontal plane, whereas ATD neurons provide medial rectus motoneurons with a vestibular input comprising mainly head velocity. To reveal the relative contribution of each input to the oculomotor physiology, single-unit recordings from medial rectus motoneurons were obtained in the control situation and after selective deafferentation from cats with unilateral transection of either the MLF or the ATD. Both MLF and ATD transection produced similar short-term alterations in medial rectus motoneuron firing pattern, which were more drastic in MLF of animals. However, long-term recordings revealed important differences between the two types of lesion. Thus, while the effects of the MLF section were permanent, 2 months after ATD lesioning all motoneuronal firing parameters were similar to the control. These findings indicated a more relevant role of the MLF pathway in driving motoneuronal firing and evidenced compensatory mechanisms following the ATD lesion. Confocal immunocytochemistry revealed that MLF transection produced also a higher loss of synaptic boutons, mainly at the dendritic level. Moreover, 2 months after ATD transection, we observed an increase in synaptic coverage around motoneuron cell bodies compared with short-term data, which is indicative of a synaptogenic compensatory mechanism of the abducens internuclear pathway that could lead to the observed firing and morphological recovery.SIGNIFICANCE STATEMENT Eye movements rely on multiple neuronal circuits for appropriate performance. The abducens internuclear pathway through the medial longitudinal fascicle (MLF) and the vestibular neurons through the ascending tract of Deiters (ATD) are a dual system that supports the firing of medial rectus motoneurons. We report the effect of sectioning the MLF or the ATD pathway on the firing of medial rectus motoneurons, as well as the plastic mechanisms by which one input compensates for the lack of the other. This work shows that while the effects of MLF transection are permanent, the ATD section produces transitory effects. A mechanism based on axonal sprouting and occupancy of the vacant synaptic space due to deafferentation is the base for the mechanism of compensation on the medial rectus motoneuron.
Keywords: lesion-induced plasticity; motoneuron; oculomotor system.",doi: 10.1523/JNEUROSCI.1391-17.2017.,10.1523@JNEUROSCI.1391-17.2017.pdf
118,217,218,Brain Res,"R. Heskin-Sweezie, K. Farrow and D. M. Broussard Adaptive rescaling of central sensorimotor signals is preserved after unilateral vestibular damage 2007",PubMed,0.0,1.0,Population,Animal study,,0.0,Adaptive rescaling of central sensorimotor signals is preserved after unilateral vestibular damage,"Abstract
Adaptive rescaling is a widespread phenomenon that dynamically adjusts the input-output relationship of a sensory system in response to changes in the ambient stimulus conditions. Rescaling has been described in the central vestibular neurons of normal cats. After recovery from unilateral vestibular damage, the vestibulo-ocular reflex (VOR) remains nonlinear for rotation toward the damaged side. Therefore, rescaling in the VOR pathway may be especially important after damage. Here, we demonstrate that central vestibular neurons adjust their input-output relationships depending on the input velocity range, suggesting that adaptive rescaling is preserved after vestibular damage and can contribute to the performance of the VOR. We recorded from isolated vestibular neurons in alert cats that had recovered from unilateral vestibular damage. The peak velocity of 1-Hz sinusoidal rotation was varied from 10 to 120 degrees/s and the sensitivities and dynamic ranges of vestibular neurons were measured. Most neuronal responses showed significant nonlinearities even at the lowest peak velocity that we tested. Significant rescaling was seen in the responses of neurons both ipsilateral and contralateral to chronic unilateral damage. On the average, when the peak rotational velocity increased by a factor of 8, the average sensitivity to rotation decreased by roughly a factor of 2. Rescaling did not depend on eye movement signals. Our results suggest that the dynamic ranges of central neurons are extended by rescaling and that, after vestibular damage, adaptive rescaling may act to reduce nonlinearities in the response of the VOR to rotation at high speeds.",doi: 10.1016/j.brainres.2007.01.104.,heskin-sweezie2007.pdf
119,221,222,Eur Arch Otorhinolaryngol,"T. P. Hirvonen, T. Jutila and H. Aalto Subjective head vertical test reveals subtle head tilt in unilateral peripheral vestibular loss 2011",PubMed,1.0,,,,,0.0,Subjective head vertical test reveals subtle head tilt in unilateral peripheral vestibular loss,"Abstract
Utricular dysfunction has been indirectly measured with subjective visual horizontal or vertical testing. Video-oculography equipment with integrated head position sensor allows direct evaluation of head tilt. The aim was to assess head tilt after peripheral vestibular lesion by recording tilting of the head after excluding visual cues (static test condition), and after three lateral head tilts to both sides [subjective head vertical (SHV)]. Thirty patients with unilateral, peripheral vestibular loss were measured in the acute state, and 3 months later. Twenty healthy, age- and sex-matched subjects served as controls. Mean static tilt of 2.6 ± 1.1° in patients with acute vestibular loss differed significantly from that of 1.0 ± 0.4° in healthy subjects (p = 0.004), and from that of 1.1 ± 0.5° during the follow-up visit (p = 0.008). The mean SHV of 3.4 ± 0.7° in patients with acute vestibular loss was significantly more than that of 1.2 ± 0.5° in controls (p < 0.001). The SHV towards the lesion was 4.9 ± 1.0° while returning from the lesion side and 2.0 ± 1.0° while returning from the healthy side. The SHV was definitely abnormal in 60%, moderately abnormal in 20% and normal in 20% of the patients in acute state. Abnormal SHV persisted in only 20% of the patients indicating that recovery of the peripheral utricular function is occurring within months. In summary, head tilts slightly towards acute peripheral lesion, and this tilting is reinforced, when the head is actively moved on the lesion side.",doi: 10.1007/s00405-011-1560-8.,hirvonen2011.pdf
120,224,225,J Am Acad Audiol,"J. A. Honaker, T. E. Boismier, N. P. Shepard and N. T. Shepard Fukuda stepping test: sensitivity and specificity 2009",PubMed,0.0,1.0,Outcome,Not specified the group,,0.0,Fukuda stepping test: sensitivity and specificity,"Abstract
Background: A vestibulospinal test known as the Fukuda stepping test (FST) has been suggested to be a measure of asymmetrical labyrinthine function. However, an extensive review of the performance of this test to identify a peripheral vestibular lesion has not been reported.
Purpose: The purpose of this study was to evaluate the sensitivity and specificity of the standard FST and a head shaking variation for identification of a peripheral vestibular system lesion.
Research design: In this retrospective review, we compared performance on the FST with and without a head shaking component to electronystagmography (ENG) caloric irrigation unilateral weakness results.
Study sample: We studied these factors in 736 chronic dizzy patients.
Results: Receiving operating characteristics (ROC) analysis and area under the curve (AUC) indicated no significant benefit to performance from the head shaking variation compared to the standard FST in identifying labyrinthine weakness as classified by caloric unilateral weakness results.
Conclusions: These findings suggest that the FST with and without head shake component is not a reliable screening tool for peripheral vestibular asymmetry in chronic dizzy patients; however, future research may hold promise for the FST as a tool for patients with acute unilateral disorders.",doi: 10.3766/jaaa.20.5.4.,honaker2009.pdf
121,225,226,J Am Acad Audiol,J. A. Honaker and N. T. Shepard Performance of Fukuda Stepping Test as a function of the severity of caloric weakness in chronic dizzy patients 2012,PubMed,1.0,,,,symptom complaints,0.0,Performance of Fukuda Stepping Test as a function of the severity of caloric weakness in chronic dizzy patients,"Abstract
Background: The purpose of the Fukuda Stepping Test (FST) is to measure asymmetrical vestibulospinal reflex tone resulting from labyrinthine dysfunction. The FST is a low cost evaluation for dizzy patients; however, when compared with gold standard caloric irrigation unilateral weakness (UW) value ≥25%, the FST has not been shown to be a sensitive tool for identifying unilateral vestibular hypofunction.
Purpose: The purpose of this technical report is to further evaluate the clinical utility of FST with and without headshake as a function of increased caloric asymmetry for individuals with unilateral peripheral vestibular pathology.
Research design: Retrospective review of FST results with and without head shaking component as compared to gold standard, caloric irrigation UW outcome values at four severity levels: 0-24% UW (normal caloric value); 25-50% UW (mild caloric UW); 51-75% UW (moderate caloric UW); 76-100% UW (severe caloric UW).
Study sample: 736 chronic (≥8 wk symptom complaints) dizzy patients.
Results: Standard FST and FST following a head shake task are insensitive to detecting mild to moderate peripheral vestibular paresis. Increased test performance was observed for patients with severe canal paresis (>76% UW); however, continued inconsistencies were found in turn direction toward the severe unilateral vestibular dysfunction.
Conclusions: Overall, the FST provides little benefit to clinicians when used in the vestibular bedside examination.",doi: 10.3766/jaaa.23.8.6.,honaker2012.pdf
122,226,227,J Otolaryngol,"S. W. Hone, J. Nedzelski and J. Chen Does intratympanic gentamicin treatment for Meniere's disease cause complete vestibular ablation? 2000",PubMed,0.0,1.0,Outcome,"No symptom, signs",,0.0,Does intratympanic gentamicin treatment for Meniere's disease cause complete vestibular ablation?,"Abstract
Objective: To determine changes in vestibular function following intratympanic gentamicin (ITG) treatment for Meniere's disease and to correlate changes with the need for further treatment.
Study design: Prospective case series.
Patients: One hundred and three patients with disabling unilateral Meniere's disease who had failed a minimum of 6 months medical treatment.
Main outcome measures: Vestibular function was measured by electronystagmography (ENG) caloric testing before and serially following treatment. Caloric responses were classified as normal (excitability difference [ED] < 25%), bithermal response (ED > or = 25%), positive response to ice water only, and absent ice water response.
Results: Twenty-one percent of patients had a bithermal caloric response, 62% had an absent ice water response, and 17% had an ice water response only 1 month following treatment. Mean follow-up was 27.3 months (range = 1-106 months). Eighty-four patients had one treatment course only. Fourteen patients required a further course of treatment due to recurrence of vertigo; 38% of these had recovery of caloric function. Significantly more patients with normal caloric function prior to initial treatment required further treatment compared to those with initial reduced caloric function (p < .05). Patients rendered absent ice water responsive were significantly less likely to require further treatment than those with a persistent caloric response (p < .0001).
Conclusion: An absent ice water response is highly predictive of adequate vertigo control. Regimens of ITG that aim to completely ablate vestibular function are recommended.",Not Found,No pdf
123,227,228,Restor Neurol Neurosci,"S. K. Hong, J. H. Kim, H. J. Kim and H. J. Lee Changes in the gray matter volume during compensation after vestibular neuritis: a longitudinal VBM study 2014",PubMed,0.0,1.0,Outcome,"No symptom, signs",,0.0,Changes in the gray matter volume during compensation after vestibular neuritis: a longitudinal VBM study,"Abstract
Purpose: Peripheral vestibular dysfunction following vestibular neuritis (VN) often persists but functional recovery of balance can be variable. The authors compared structural changes in the brain before and after post-VN compensation and related it to the functional recovery.
Methods: Nine patients diagnosed with unilateral VN were included. Brain MRI and clinical observation were performed within 2 days of acute VN diagnosis and were repeated 3 months after the first exam. Voxel-based morphometry (VBM) analysis for longitudinal data was performed using VBM8 toolbox running within SPM8. Changes in local grey matter volume (GMV) were examined using a paired t-test and clinical relevance was tested using correlation analyses with functional improvement.
Results: Significant increases in GMV were observed in the vestibular cortex, bilateral hippocampus, visual cortices and the cerebellum. GMV decreased in cerebellar regions, including the vermis, and in the prefrontal cortex. Increases in GMV in visual cortices and cerebellum were associated with the poorest recovery of balance, which might be explained by functional substitution.
Conclusions: The structural layout of vestibular compensation suggests that memory and motor planning are closely related to this process. Vision seems to be a major source of functional substitution, as has been previously demonstrated. This study, however, is the first longitudinal analysis of brain structural changes associated with recovery of balance following unilateral VN.
Keywords: Vestibular neuronitis; neuronal plasticity; rehabilitation; voxel-based morphometry.",doi: 10.3233/RNN-140405.,hong2014.pdf
124,228,229,Front Neurol,"M. Honjo, K. Honda and T. Tsutsumi Unusual Vestibulo-Ocular Reflex Responses in Patients With Peripheral Vestibular Disorders Detected by the Caloric Step Stimulus Test 2020",PubMed,0.0,1.0,Outcome,"No symptom, signs",,0.0,Unusual Vestibulo-Ocular Reflex Responses in Patients With Peripheral Vestibular Disorders Detected by the Caloric Step Stimulus Test,"Abstract
The caloric step stimulus test consists of the changes in head position from the sitting to supine positions and continuous caloric irrigation. This test can provide a single labyrinth with a stimulus similar to constant head acceleration in rotational testing and, therefore, can evaluate vestibulo-ocular reflex (VOR) dynamics more precisely than can conventional methods. To assess the clinical utility of the test in the assessment of the VOR dynamics of diseases, we performed the test in patients with peripheral vestibular disorders, including sudden idiopathic hearing loss, vestibular neuritis, Meniere disease, vestibular Meniere disease, or chronic unilateral idiopathic vestibulopathy and normal controls. Slow-phase eye velocity (SPV) was measured with videonystagmography. We fitted the time course of SPV across 2 min to a mathematical model containing two exponential components and time constants: the caloric step VOR time constant (T 1) and caloric step VOR adaptation time constant (T 2). All responses of normal controls (n = 15 ears) were fit to the model. Several responses of the 101 ears of the patients differed from the time courses predicted by the model. We divided the data of 116 ears into four patterns based on SPV, T 1, and T 2. The thresholds for the classification were determined according to the lower limits of the capability of curve fitting for SPV and the upper limits of normal controls for T 1 and T 2. Seventy-eight ears followed pattern A (normal T 1 and T 2): the SPV trajectory formed a rapid rise with subsequent decay. Nineteen followed pattern B (normal T 1 and prolonged T 2): the SPV trajectory formed a rapid rise without decay. Six followed pattern C (prolonged T 1 and T 2): the SPV trajectory formed a slow rise. Thirteen ears followed pattern D: a low VOR response. There were no significant differences in time constants between the affected and healthy ears in patients with each disease. However, prolonged T 1 and T 2 were significantly more frequent in the affected ears than the healthy ears. In conclusion, the caloric step stimulus test can be potentially useful in detecting unusual VOR responses and thus reflect some pathological changes in the vestibular system.
Keywords: caloric test; peripheral vestibular disorders; time constant; vestibular adaptation; vestibulo-ocular reflex.",doi: 10.3389/fneur.2020.597562.,honjo2020.pdf
125,230,231,Int J Otolaryngol,J. Hornibrook A balance test for chronic perilymph fistula 2012,PubMed,0.0,1.0,Population,PLF,,0.0,A balance test for chronic perilymph fistula,"Abstract
Perilymph fistula is defined as a leak of perilymph at the oval or round window. It excludes other conditions with ""fistula"" tests due to a dehiscent semicircular canal from cholesteotoma and the superior canal dehiscence syndrome. First recognized as a complication of stapedectomy, it then became apparent that head trauma and barotraumatic trauma from flying or diving could be a cause. Descriptions of ""spontanenous"" perilymph fistulas with no trauma history followed. It is likely that most perilymph fistula patients have a congential potential weakness of the otic capsule at the round or oval window. The vestibular symptoms have been assumed to be due to endolymphatic hydrops, but there is poor evidence. Their unilateral disequilibrium, nausea, and subtle cognitive problems suggest they are due to otolith disfunction and that these patients have a specific balance abnormality, unlike subjects with unilateral vestibular hypofuction. In this series of twenty patients with a confirmed fistula a logical simplification of Singleton's ""eyes-closed turning"" test predicted a PLF in twelve with a trauma history. In four no cause was found. In three a prior traumatic event was later recalled, but one patient had concealed it.",doi: 10.1155/2012/163691.,hornibrook2012.pdf
126,231,232,Am J Otol,"W. House, A. Belal and F. Galey Pressure sensation in Meniere's disease 1980",PubMed,1.0,,,,,0.0,Pressure sensation in Meniere's disease,"Abstract
This article reports a case of Meniere's disease accompanied by a persistent feeling of pressure in the ear. The patient had undergone a series of surgical procedures to alleviate his symptoms. The pressure sensation was relieved only by translabyrinthine cochlear nerve section. The relationships of the result of translabyrinthine cochlear nerve section with the mechanism and pathway of the pressure sensation are discussed. Cochlear nerve section is recommended at the same time as vestibular nerve section for patients with unilateral Meniere's disease with severe pressure sensation in the ear.",Not Found,No pdf
127,232,233,Otol Neurotol,"T. W. Huang, P. W. Cheng and H. C. Su The influence of unilateral versus bilateral clicks on the vestibular-evoked myogenic potentials 2006",PubMed,0.0,1.0,Outcome,"No symptom, signs",,0.0,The influence of unilateral versus bilateral clicks on the vestibular-evoked myogenic potentials,"Abstract
Objective: Because a continuous muscular effort is required during recording of vestibular-evoked myogenic potentials, we assume vestibular-evoked myogenic potentials elicited by simultaneous bilateral clicks can be used as a more convenient mode compared with respective unilateral clicks. To investigate whether bilateral clicks provide the same information as unilateral clicks, we examined whether the responses are different between them in normal subjects and whether bilateral clicks have the same diagnostic value as vestibular-evoked myogenic potentials elicited by unilateral clicks in detecting retrolabyrinthine lesions.
Study design: Prospective study.
Setting: Academic tertiary referral center.
Subjects: Fourteen healthy volunteers and four patients with unilateral cerebellopontine angle tumors were enrolled in this study.
Interventions: Recordings of vestibular-evoked myogenic potential responses.
Main outcome measures: The latency of each peak (p13, n23), the peak-to-peak interval, and amplitude (p13-n23).
Results: Both unilateral and bilateral click stimulation of 28 ears (100%) produced vestibular-evoked myogenic potentials in normal subjects. The mean latencies of p13 and n23, peak-to-peak interval, and amplitude of vestibular-evoked myogenic potentials elicited with unilateral clicks were 11.62 +/- 0.99 ms, 19.74 +/- 1.30 ms, 8.12 +/- 1.66 ms, and 110.79 +/- 61.37 microV, respectively, whereas those elicited with bilateral clicks were 11.16 +/- 0.51 ms, 19.22 +/- 1.61 ms, 8.06 +/- 1.66 ms, and 111.77 +/- 40.98 microV, respectively. There was a significant difference (p < 0.05) in the latencies, but not for the interval and amplitude (p > 0.05). Four patients with unilateral cerebellopontine angle tumors and prolonged latencies of unilateral clicks vestibular-evoked myogenic potentials also showed latency prolongation in bilateral clicks vestibular-evoked myogenic potentials.
Conclusion: Although the use of bilateral acoustic stimulation shortens the vestibular-evoked myogenic potential latencies in normal subjects, it does not affect the bilateral clicks vestibular-evoked myogenic potential ability to detect retrolabyrinthine lesions. Bilateral clicks vestibular-evoked myogenic potentials are a more convenient mode with which to help diagnose both labyrinthine and retrolabyrinthine lesions than unilateral clicks vestibular-evoked myogenic potentials.",doi: 10.1097/01.mao.0000187048.66168.4d.,huang2006.pdf
128,233,234,Hippocampus,"K. Hüfner, D. A. Hamilton, R. Kalla, T. Stephan, S. Glasauer, J. Ma, R. Brüning, H. J. Markowitsch, K. Labudda, C. Schichor, M. Strupp and T. Brandt Spatial memory and hippocampal volume in humans with unilateral vestibular deafferentation 2007",PubMed,1.0,,,,impairment in spatial memory,0.0,Spatial memory and hippocampal volume in humans with unilateral vestibular deafferentation,"Abstract
Patients with acquired chronic bilateral vestibular loss were recently found to have a significant impairment in spatial memory and navigation when tested with a virtual Morris water task. These deficits were associated with selective and bilateral atrophy of the hippocampus, which suggests that spatial memory and navigation also rely on vestibular input. In the present study 16 patients with unilateral vestibular deafferentation due to acoustic neurinoma were examined 5- to 13-yrs post-surgery. Volumetry of the hippocampus was performed in patients and age- and sex-matched healthy controls by manually tracing the structure and by an evaluator-independent voxel-based morphometry. Spatial memory and navigation were assessed with a virtual Morris water task. No significant deficits in spatial memory and navigation could be demonstrated in the patients with left vestibular failure, whereas patients with right vestibular loss showed a tendency to perform worse on the respective tests. Impairment was significant only for one computed measure (heading error). The subtle deficiencies with right vestibular loss are compatible with the recently described dominance of the right labyrinth and the vestibular cortex in the right hemisphere. Volumetry did not reveal any atrophy of the hippocampus in either patient group.",doi: 10.1002/hipo.20283.,10.1002@hipo.20283.pdf
129,236,237,Otol Neurotol,"R. L. Humphriss, D. M. Baguley and D. A. Moffat Change in dizziness handicap after vestibular schwannoma excision 2003",PubMed,1.0,,,,,0.0,Change in dizziness handicap after vestibular schwannoma excision,"Abstract
Objective: To evaluate the change in dizziness handicap after translabyrinthine vestibular schwannoma excision.
Study design: Prospective administration of the Dizziness Handicap Inventory preoperatively and at 3 and 12 months postoperatively; retrospective review of case notes.
Setting: A tertiary referral neuro-otology clinic.
Patients: A total of 100 consecutive patients who had vestibular schwannomas excised between June 1998 and November 2001 and who had completed Dizziness Handicap Inventories preoperatively and at 3 and 12 months postoperatively.
Interventions: Translabyrinthine excision of a unilateral sporadic vestibular schwannoma; preoperative and postoperative generic vestibular rehabilitation exercises.
Main outcome measures: Dizziness Handicap Inventory scores.
Results: For most patients, dizziness handicap does not worsen postoperatively. However, for those in whom it does, dizziness handicap becomes significantly worse between preoperative and 3-month postoperative time points but then does not continue to decline. Tumor size, sex, and magnitude of preoperative canal paresis significantly affect the degree of change in handicap. Age, the presence of central vestibular system abnormalities, and the nature of the patient's principal presenting symptom have no effect on this handicap change.
Conclusions: These findings help the clinician in counseling the patient preoperatively about dizziness handicap to be expected postoperatively. In particular, the clinician is now able to take an informed and positive stance in the event of a severe canal paresis preoperatively.",doi: 10.1097/00129492-200307000-00021.,humphriss2003.pdf
130,238,239,ORL J Otorhinolaryngol Relat Spec,"D. Hydén Mumps labyrinthitis, endolymphatic hydrops and sudden deafness in succession in the same ear 1996",PubMed,0.0,1.0,Population,mumps,,0.0,"Mumps labyrinthitis, endolymphatic hydrops and sudden deafness in succession in the same ear","Abstract
Acute sensorineural hearing loss, mostly unilateral and reversible, is a well-known complication to mumps. Secondary endolymphatic hydrops, Ménière's syndrome, has rarely been associated with a previous mumps infection. This paper presents the case report of a woman who experienced unilateral hearing loss, vestibular symptoms and a caloric depression on the same ear during mumps. The symptoms and findings were reversible. Twelve years later she developed Ménière's symptoms in the same ear. This continued for 2 years after which she suddenly had a sensorineural hearing loss. This was localized in the mid- and high-tone area and was almost identical with the initial hearing loss 14 years earlier. Viral damage to the resorptive structures of the inner ear seems to have caused the hydrops. It also seemed to have weakened the neuronal structures of the ear, letting the initial damage become overt after repeated attacks of pathological pressure changes.",doi: 10.1159/000276866.,10.1159@000276866.pdf
131,239,240,Acta Otolaryngol Suppl,"D. Hydén, L. M. Odkvist and P. Kylén Vestibular symptoms in mumps deafness 1979",PubMed,0.0,1.0,Population,mumps,,0.0,Vestibular symptoms in mumps deafness,"Abstract
Deafness appears in as many as 4% of adult cases of epidemic parotitis. It is often severe, though reversible and is usually unilateral. Vertigo has been reported in mumps, as have occasional cases with impaired caloric reaction. Twenty cases of unilateral hearing impairment in mumps have been investigaed with audiometry and electronystagmography in order to determine the degree of permanent lesions. Nine of the patients had noted vertigo when falling ill with protitis. Five of these had normal calorics, 3 were impaired and one was without response in the deaf ear. No certain correlation between vertigo and permanent caloric impairment was found. An interesting finding was that 5 cases without vertigo showed an impaired or absent caloric responsiveness, which might confuse future diagnostics. Presumably, most patients with hearing impairment in mumps suffer vesticular damage, but the acute vertigo in early childhood is easily overlooked. No certain correlation between age at the onset of mumps and any permanent caloric disturbance was found. One mumps case is described, in which a severe hearing loss and caloric impairment returned to normal.",doi: 10.3109/00016487809123510.,10.3109@00016487809123510.pdf
132,242,243,Medicine (Baltimore),"D. H. Im, Y. S. Yang, H. Choi, S. Choi, J. E. Shin and C. H. Kim Pseudo-spontaneous nystagmus in horizontal semicircular canal canalolithiasis 2017",PubMed,1.0,,,,,0.0,Pseudo-spontaneous nystagmus in horizontal semicircular canal canalolithiasis,"Abstract
Benign paroxysmal positional vertigo (BPPV) involving horizontal semicircular canal (HSCC) is characterized by direction-changing positional nystagmus (DCPN) in a supine roll test, and the occurrence of spontaneous nystagmus in HSCC BPPV has been reported recently. The aim of this study is to investigate the characteristics of pseudo-spontaneous nystagmus (PSN) in patients with HSCC canalolithiasis, and evaluate the effect of the presence of PSN on treatment outcome.Between April 2014 and January 2016, 75 and 59 patients with HSCC canalolithiasis and cupulolithiasis, respectively, were enrolled. Spontaneous and positional nystagmus were examined.PSN was observed in 31 of 75 patients (41%) with HSCC canalolithiasis, and 55 of 59 patients (93%) with HSCC cupulolithiasis. PSN persisted during the period of observation, which was at least 1 minute in all patients with PSN. In HSCC canalolithiasis, direction-reversing nystagmus was observed in 58 patients (25 bilateral and 33 unilateral). Nine of 25 patients with bilateral direction-reversing nystagmus, and 22 of 33 patients with unilateral direction-reversing nystagmus showed PSN. None of 17 patients without direction-reversing nystagmus showed PSN. The direction of PSN corresponded to that of direction-reversing nystagmus in all 22 patients with unilateral direction-reversing nystagmus. The proportion of patients who recovered after 1 session of repositioning maneuver was not significantly different between patients with and without PSN (P = .867).PSN was observed more commonly in HSCC cupulolithiasis than canalolithiasis. The pathophysiologic mechanism underlying PSN can be explained by natural inclination of HSCC and medial to lateral orientation of the HSCC cupular axis in cupulolithiasis, and by spontaneous reversal of initial positional nystagmus (direction-reversing nystagmus) generated by short-term adaptation of vestibulo-ocular reflex in canalolithiasis. The presence of PSN in HSCC canalolithiasis may not affect the treatment outcome.",doi: 10.1097/MD.0000000000007849.,im2017.pdf
133,243,244,Auris Nasus Larynx,"H. Inui, T. Sakamoto, T. Ito and T. Kitahara Magnetic resonance-based volumetric measurement of the endolymphatic space in patients with Meniere's disease and other endolymphatic hydrops-related diseases 2019",PubMed,1.0,,,,,0.0,Magnetic resonance-based volumetric measurement of the endolymphatic space in patients with Meniere's disease and other endolymphatic hydrops-related diseases,"Abstract
Objective: To employ magnetic resonance imaging (MRI) to measure the volume of the inner ear endolymphatic space (ELS) in patients with acute low-tone sensorineural hearing loss (ALHL), sudden deafness (SD), cochlear Meniere's disease (cMD), and unilateral MD (uMD) compared with control subjects (CS) with chronic rhinosinusitis.
Methods: Forty-one patients with ALHL, 82 with SD, 48 with cMD, 72 with uMD, and 47 CS participated in the study. With the exception of all uMD patients, none of the subjects had vertigo. Images of the inner ear fluid space, positive perilymph signal, and positive endolymph signal were acquired using a 3-T MRI scanner. Three-dimensional images were reconstructed semi-automatically by using anatomical and tissue information to fuse the inner ear fluid space images and the ELS images.
Results: The cochlear ELS/total fluid space (TFS) volume ratio was 10.2±6.7% (mean±standard deviation) in the CS group, 12.1±5.7% in ALHL patients, 15.2±8.7% in SD patients, 18.1±8.2% in cMD patients, and 21.9±16.4% in uMD patients. The vestibular ELS/TFS volume ratio was 17.7±10.2% in the CS group, 18.9±8.3% in ALHL patients, 19.9±11.3% in SD patients, 22.5±13.7% in cMD patients, and 35.7±24.1% in uMD patients. The cochlear ELS/TFS volume ratio in patients with uMD was similar to that in the cMD group and significantly higher than that in the CS, ALHL, and SD groups (CS=ALHL<SD<cMD=uMD: p<0.05 for CS vs. SD and p<0.01 for CS vs. cMD). The vestibular ELS/TFS volume ratio in patients with uMD was significantly higher than that in the CS and all other patient groups (CS=ALHL=SD=cMD<uMD: p<0.01 for uMD vs. all other groups).
Conclusion: The cochlear ELS volume of patients with MD and other endolymphatic hydrops-related diseases differed from that of CS. Our results suggest that ALHL may not be caused by endolymphatic hydrops. We confirmed the presence of extended ELS in patients with SD.
Keywords: 3T-MRI quantitative measurement; Acute low-tone sensorineural hearing loss; Cochlear Meniere’s disease without vertigo; Extended endolymphatic space; Sudden deafness; Unilateral Meniere’s disease.",doi: 10.1016/j.anl.2018.11.008.,40167ae34973607bb0039fc94f0c7afe.pdf
134,247,248,J Vestib Res,"K. Jáuregui-Renaud, C. Aranda-Moreno, J. C. Villaseñor-Moreno, M. E. Giráldez Fernández, A. J. Maldonado Cano, M. F. Gutierrez Castañeda, I. Figueroa-Padilla and A. L. Saucedo-Zainos Derealization symptoms according to the subjective visual vertical during unilateral centrifugation in patients with type 2 diabetes mellitus 2019",PubMed,0.0,1.0,Population, in patients with type 2 diabetes mellitus,,0.0,Derealization symptoms according to the subjective visual vertical during unilateral centrifugation in patients with type 2 diabetes mellitus,"Abstract
Background: A recent study has shown variability on the perception of verticality during unilateral centrifugation among patients with type 2 diabetes mellitus; it is yet unknown if it is related to symptoms of unreality.
Objective: In patients with type 2 diabetes mellitus compared to age matched healthy volunteers, to assess depersonalization/derealization (DD) symptoms before and after unilateral centrifugation, according to the subjective visual vertical (SVV).
Methods: 47 patients with type 2 diabetes mellitus and 50 age matched healthy volunteers participated in the study. They replied to standardized questionnaires of symptoms related to balance, depression, and anxiety. Then, after neuro-otological evaluation, they completed a DD inventory before and after unilateral centrifugation (300°/s, 3.85 cm) with SVV estimation.
Results: Right/left asymmetric SVV during centrifugation was identified in 17 patients (36%) and no SVV change during centrifugation was identified in 6 patients (13%). Before centrifugation, patients with asymmetric SVV already reported some of the DD symptoms, while patients with no SVV change reported almost no DD symptoms. Unilateral centrifugation provoked an increase of DD symptoms in both healthy volunteers and the entire group of patients (repeated measures ANOVA, p < 0.01), except in the 6 patients with no SVV change. Before centrifugation, the DD score showed influence from the SVV subgroup and the evidence of depression (MANCoVA, p < 0.01); after centrifugation, which provoked asymmetry of the right/left utricular input, only the influence from depression persisted. No influence was observed from the characteristics of the subjects, including retinopathy, peripheral neuropathy (assessed by electromyography) or weight loss, or from the total score on the questionnaire of symptoms related to balance.
Conclusions: In patients with type 2 diabetes mellitus and healthy volunteers, utricular stimulation by unilateral centrifugation may provoke DD symptoms, with an influence from depression. The results support that the aphysiological utricular input given by unilateral centrifugation may contribute to create a misleading vestibular frame of reference, giving rise to 'unreal' perceptions.
Keywords: Depersonalization; derealization; diabetes mellitus; utricular macula; vestibular function.",doi: 10.3233/VES-190652.,10.3233@VES-190652.pdf
135,248,249,Otol Neurotol,"J. Jeong, J. Jung, J. M. Lee, M. J. Suh, S. H. Kwak and S. H. Kim Effects of Saccular Function on Recovery of Subjective Dizziness After Vestibular Rehabilitation 2017",PubMed,1.0,,,,,0.0,Effects of Saccular Function on Recovery of Subjective Dizziness After Vestibular Rehabilitation,"Abstract
Objective: We attempted to investigate whether the integrity of saccular function influences the severity of subjective dizziness after vestibular rehabilitation in vestibular neuritis.
Study design: Retrospective analysis.
Setting: Tertiary referral center.
Patients: Forty-six patients with acute unilateral vestibular neuritis were included.
Interventions: Diagnostic, therapeutic, and rehabilitative.
Main outcome measures: All the patients completed vestibular rehabilitation therapy until their computerized dynamic posturography and rotary chair test results were significantly improved. The rehabilitation patients were classified into the normal to mild subjective dizziness and moderate to severe subjective dizziness groups according to the dizziness handicap inventory score (cutoff of 40). Differences between the two groups were analyzed.
Results: After rehabilitation, 32.6% of the patients still complained of moderate to severe dizziness. Age, sex distribution, the presence of comorbidities, caloric weakness, pre- and postrehabilitation gain values in rotary chair test, postrehabilitation composite scores in posturography, and the duration of rehabilitation were not significantly different between the two groups. However, initial dizziness handicap inventory (DHI) score and composite score in dynamic posturography were worse and the proportion of patients with absent cervical vestibular-evoked myogenic potential in the moderate to severe group was much higher (93.3% vs. 35.5%, p < 0.001). After multiple regression analysis of those factors, initial DHI score and absent cervical vestibular-evoked myogenic potential response were identified as being associated with higher postrehabilitation DHI score.
Conclusion: Saccular dysfunction in acute vestibular neuritis can contribute to persistent subjective dizziness, even after the objective parameters of vestibular function tests have been improved by vestibular rehabilitation.",doi: 10.1097/MAO.0000000000001467.,jeong2017.pdf
136,250,251,Rinsho Shinkeigaku,K. Johkura Vertigo and dizziness 2021,PubMed,0.0,1.0,Design,japanese,,0.0,Not Found,Not Found,Not Found,No pdf
137,251,252,Neuroreport,"A. R. Johnston, A. Him and M. B. Dutia Differential regulation of GABA(A) and GABA(B) receptors during vestibular compensation 2001",PubMed,0.0,1.0,Population,Animal study,,0.0,Differential regulation of GABA(A) and GABA(B) receptors during vestibular compensation,"Abstract
We investigated changes in intrinsic excitability and GABA receptor efficacy in rat medial vestibular nucleus (MVN) neurons following 48 h and 7-10 days of behavioral recovery after unilateral labyrinthectomy (UL) in the rat. The mean in vitro discharge rate of rostral ipsilesional MVN cells at both time points was significantly higher than normal, indicating that the intrinsic excitability of the deafferented cells undergoes a sustained up-regulation during vestibular compensation. In slices from animals that had compensated for 7-10 days after UL, the responsiveness of rostral ipsilesional MVN cells to the GABA(A) agonist muscimol was not different from normal, while the responsiveness to the GABA(B) agonist baclofen was significantly down-regulated. This is in contrast to the situation soon after UL, where the efficacy of both GABA(A) and GABA(B) receptors is markedly down-regulated. The recovery of fast GABA(A) mediated neurotransmission by 7-10 days post-UL presumably enables ipsilesional cells to again respond to vestibular stimulation, through commissural inhibitory modulation from the intact side. The permanent loss of excitatory input from the lesioned side may be, in effect, counteracted by the long-term down-regulation of slow GABA(B) receptors in the de-afferented neurons.",doi: 10.1097/00001756-200103050-00033.,johnston2001.pdf
138,252,253,Int Tinnitus J,M. Józefowicz-Korczyńska and A. Pajor Evaluation of oculomotor tests in patients with tinnitus 2002,PubMed,0.0,1.0,Population,patients with tinnitus,,0.0,Evaluation of oculomotor tests in patients with tinnitus,"Abstract
Tinnitus as a symptom remains a serious multidisciplinary problem. Vertigo or dizziness is not noticed frequently in tinnitus patients, so vestibular function is not often studied. Because they are in close proximity to one another, the vestibular and hearing organs may influence each other. We decided to evaluate the results of the oculomotor reflex in tinnitus patients. We carried out clinical examinations and audiological and oculomotor tests in 50 tinnitus patients and 30 healthy persons. Such oculomotor tests as smooth-pursuit eye movement, optokinetic tests, and saccadic eye movement and gaze fixation were performed. Tinnitus was unilateral in 37 tinnitus patients (74%) and bilateral in 13 (26%). Twenty-two tinnitus patients (44%) reported previous remote episodes of vertigo and dizziness. Gaze-evoked nystagmus was absent in all cases. Morphological abnormalities and gain decreases in smooth-pursuit tests were recorded in 19 tinnitus patients (38%). Findings in the optokinetic test were incorrect in 10 (20%). The saccadic eye movement test showed disturbances in 18 tinnitus patients (36%). In 11 (22%), abnormal recordings were found in two tests and, in 10 (20%), abnormal recordings were found in all three tests. Our study suggests that computerized, quantitative electronystagmographic analysis in tinnitus patients should be interpreted carefully. A persistence of abnormal oculomotor recordings can suggest subclinical central vestibular system impairment.",Not Found,No pdf
139,254,255,Am J Otol,"T. T. Jung, J. H. Anderson and M. M. Paparella Cochleovestibular nerve sections in labyrinthectomized patients 1987",PubMed,1.0,,,,,0.0,Cochleovestibular nerve sections in labyrinthectomized patients,"Abstract
Labyrinthectomy is indicated for a patient who has unilateral peripheral labyrinthine disease with unserviceable hearing loss. For most patients, labyrinthectomy provides complete relief from intractable vertigo. Some patients continue to have persistent vertigo, however, even after a complete destructive labyrinthectomy. Only after cochleovestibular nerve sections were these patients relieved of intractable vertigo. Representative cases of cochleovestibular nerve sections in labyrinthectomized patients are presented. The reason why the cochleovestibular nerve section relieves the symptom of vertigo in labyrinthectomized patients is not clear. Labyrinthectomy destroys vestibular sense organs, while cochleovestibular nerve section eliminates spontaneous activity and prevents the possibility of nerve regeneration by excision of the ganglion. For those patients who required vestibular nerve sections, there may have been abnormal excitation of vestibular nerve fibers. This might be explained by incomplete labyrinthectomy, regeneration of vestibular nerve fibers, contribution from vestibular ganglia or nonfunctioning cochlea, and vascular loop syndrome.",Not Found,No pdf
140,255,256,Otol Neurotol,"M. Junicho, H. Fushiki, S. Aso and Y. Watanabe Prognostic value of initial electronystagmography findings in idiopathic sudden sensorineural hearing loss without vertigo 2008",PubMed,0.0,1.0,Population,with unilateral hearing loss,,0.0,Prognostic value of initial electronystagmography findings in idiopathic sudden sensorineural hearing loss without vertigo,"Abstract
Objective: We used electronystagmography (ENG) to characterize recurrent hearing loss and its progression to definite Ménière's disease in patients with idiopathic sudden sensorineural hearing loss (SSHL) without subjective vertigo.
Methods: We reviewed medical records of 1,334 patients with unilateral hearing loss initially diagnosed with idiopathic SSHL between 1985 and 2003 at our university hospital. Of the 1,334 patients, we examined 127 (86 with low-tone and 41 with high-tone SSHL) who underwent ENG within 30 days of the initial diagnosis and who could be followed up during the long term.
Results: Spontaneous nystagmus (SN) was observed in approximately half of the vertigo-unaccompanied group. Long-term follow-up with a mean of 67 months revealed that the recurrence rate of hearing loss was 51.2% in low-tone SSHL patients with SN. The recurrence rate of hearing loss was 27.9% in low-tone SSHL patients without SN. Progression to Ménière's disease occurred in 14.0% of the low-tone-type and 12.5% of the high-tone-type patients when SN was detected. In contrast, in both the low-tone-type and high-tone-type groups, none developed Ménière's disease when SN was absent.
Conclusion: Our results suggest that the initial ENG findings could provide prognostic information for idiopathic SSHL patients, even those who have no vestibular symptoms at the first visit.",doi: 10.1097/MAO.0b013e31817fdf94.,junicho2008.pdf
141,260,261,J Int Adv Otol,"A. Karataş, T. Yüce, I. T. Çebi, G. Acar Yüceant, C. Hacı and M. Salviz Evaluation of Cervical Vestibular-Evoked Myogenic Potential Findings in Benign Paroxysmal Positional Vertigo 2016",PubMed,0.0,1.0,Outcome,"No symptom, signs",,0.0,Evaluation of Cervical Vestibular-Evoked Myogenic Potential Findings in Benign Paroxysmal Positional Vertigo,"Abstract
Objective: Although there has been a wide consensus on the mechanism of nystagmus and clinical presentation of benign paroxysmal positional vertigo (BPPV), the neuroepithelial pathophysiology of BPPV still remains unclear. In this study, we aimed to clarify the pathophysiology of BPPV by evaluating the cervical vestibular-evoked myogenic potential (cVEMP) findings of patients.
Materials and methods: Thirty-six BPPV patients and 20 healthy volunteers were included. Bilateral cVEMP tests were performed on all participants. The participants were divided into the following three groups: those with a BPPV-affected ear, those with a BPPV-unaffected ear, and the healthy control group.
Results: There were no significant differences regarding the latencies of the first positive (p1) and negative (n1) peaks among the three groups. The mean normalized amplitude asymmetry ratio also did not differ between the BPPV and control groups. However, the normalized amplitudes of the BPPV patients (with both affected and unaffected ears) were significantly lower than those of the healthy control group.
Conclusion: We detected that the cVEMP data of the affected and unaffected ears of the BPPV patients was similar and that their normalized amplitudes significantly differed from those of the healthy controls. Eventually, we concluded that even if the symptoms of BPPV were unilateral, the findings suggest that the bilateral involvement of the macular neuroepithelium is important in understanding the pathophysiology of BPPV. This finding supports the conclusion that the pathophysiological process starts with neuroepithelial membrane degeneration and continues with otoconia separation.",doi: 10.5152/iao.2016.2170.,No pdf
142,261,262,Brain,"M. Karlberg, S. T. Aw, R. A. Black, M. J. Todd, H. G. MacDougall and G. M. Halmagyi Vibration-induced ocular torsion and nystagmus after unilateral vestibular deafferentation 2003",PubMed,1.0,,,,,0.0,Vibration-induced ocular torsion and nystagmus after unilateral vestibular deafferentation,"Abstract
Vibration is an excitatory stimulus for both vestibular and proprioceptive afferents. Vibration applied either to the skull or to the neck muscles of subjects after unilateral vestibular deafferentation induces nystagmus and a shift of the subjective visual horizontal. Previous studies have ascribed these effects to vibratory stimulation of neck muscle proprioceptors. Using scleral search coils, we recorded three-dimensional eye movements during unilateral 92 Hz vibration of the mastoid bone or of the sternocleidomastoid (SCM) muscle in 18 subjects with chronic unilateral vestibular deficits after vestibular neurectomy or neuro-labyrinthitis. Nine subjects had lost function of all three semicircular canals (SSCs) on one side, and the other nine had lost function of only the anterior and lateral SSCs. Vibration of the mastoid bone or of the SCM muscle on either side induced an ipsilesional tonic shift of torsional eye position of up to 6.5 degrees during visual fixation, as well as a nystagmus with horizontal, vertical and torsional components in darkness. Subjects who had lost function of all three SSCs on one side showed a larger shift in ocular torsion in response to SCM vibration than did subjects who had lost function of only two SSCs. The difference between ocular torsion produced by ipsilesional muscle or bone vibration was not significantly different from that produced by contralesional bone or muscle vibration. The vibration-induced nystagmus rotation axis tended to align with the pitch (y) axis of the head in subjects who had lost only anterior and lateral SSC function, and with the roll (x) axis of the head in subjects who had lost function of all three SSCs. We propose that the previously described vibration-induced shift of the subjective visual horizontal can be explained by the vibration-induced ocular torsion, and that the magnitude of ocular torsion is related to the extent of the unilateral vestibular deficit. While altered proprioceptive inputs from neck muscles might be important in the mechanism of vibration-induced ocular torsion and nystagmus after unilateral vestibular deafferentation, vibratory stimulation of vestibular receptors in the intact labyrinth also appears to have an important role.",doi: 10.1093/brain/awg091.,karlberg2003.pdf
143,266,267,Otolaryngol Head Neck Surg,A. Katsarkas and B. N. Segal Unilateral loss of peripheral vestibular function in patients: degree of compensation and factors causing decompensation 1988,PubMed,0.0,1.0,Design,Editorial Board,,0.0,Unilateral loss of peripheral vestibular function in patients: degree of compensation and factors causing decompensation,"Abstract
Unilateral surgical ablation of peripheral vestibular function has been suggested for the treatment of a number of diseases that involve vestibular dysfunction. The postoperative distressing symptoms usually subside with time, whereupon the patient is said to have clinically compensated. However, even in well-compensated patients, the initial symptoms may reappear--under certain conditions that are briefly discussed (decompensation)--and, in addition, vestibular gaze stabilization deficits, (apparently permanent) appear whenever moderately rapid head movements are imposed. Thus, surgical ablation of unilateral peripheral vestibular function should not be considered ""a treatment of choice,"" and should be performed in only carefully selected cases.",doi: 10.1177/019459988809800108.,katsarkas1988.pdf
144,267,268,Eur Arch Otorhinolaryngol,"E. Katsiari, D. G. Balatsouras, J. Sengas, M. Riga, G. S. Korres and J. Xenelis Influence of cochlear implantation on the vestibular function 2013",PubMed,0.0,1.0,Population,nilaterally cochlear implant patients,,0.0,Influence of cochlear implantation on the vestibular function,"Abstract
The aim of the present study was to examine the influence of cochlear implantation on vestibular function. The function of the horizontal semicircular canal, the saccular function, and the incidence of vestibular symptoms were assessed before and after cochlear implantation. Twenty unilaterally cochlear implant patients were evaluated preoperatively, 1 and 6 months postoperatively, with caloric testing with electronystagmography (ENG) recordings and vestibular evoked myogenic potentials (VEMP) testing. A medical history was taken from every subject, noting the presence or absence of vertigo before and after the operation. A possible correlation between the appearance of postoperative vertigo and age, sex, implant side, preoperative caloric results and VEMP status, and postoperatively recorded changes in caloric and VEMP testing was also investigated. A statistically significant difference was found in the percentages of canal paresis (p = 0.01) and the percentages of VEMP waveform absence (p = 0.002) between the repeated measurements in the implanted side, whereas in the non-implanted side no difference was (p > 0.05) found. Four patients complained of postoperative vestibular symptoms. In three of them the symptoms lasted less than 6 months postoperatively, but the fourth patient was still dizzy 6 months after cochlear implantation. No correlation was found between the above-mentioned factors and the occurrence of postoperative vertigo. In conclusion, although changes of the peripheral vestibular function of the implanted side were recorded in our patients, permanent vertigo was rare. Predictive factors for the occurrence of postoperative vestibular symptoms could not be identified.",doi: 10.1007/s00405-012-1950-6.,katsiari2012.pdf
145,270,271,Otolaryngol Head Neck Surg,"J. L. Kemink, S. A. Telian, M. D. Graham and L. Joynt Transmastoid labyrinthectomy: reliable surgical management of vertigo 1989",PubMed,1.0,,,,,0.0,Transmastoid labyrinthectomy: reliable surgical management of vertigo,"Abstract
Transmastoid labyrinthectomy has continued to be an important part of the surgical armamentarium for patients with vertigo and nonserviceable hearing loss. Continuing experience substantiates our earlier impression that the vestibular system usually accommodates rapidly to complete unilateral surgical ablation, regardless of age or degree of residual vestibular activity in the ear (as measured by preoperative bithermal caloric testing). Although the symptom of vertigo is reliably treated by transmastoid labyrinthectomy, a patient questionnaire has demonstrated a significant incidence of mild to moderate persisting postoperative dysequilibrium. Although this dysequilibrium is usually not debilitating, this questionnaire has demonstrated its existence more precisely than a retrospective review of the patients' clinical records. This study reviews 110 patients who underwent labyrinthectomy between 1978 and 1985. We remain impressed at the efficacy of the transmastoid labyrinthectomy in relieving the symptom of vertigo.",doi: 10.1177/019459988910100102.,kemink1989.pdf
146,271,272,Case Rep Pediatr,"E. Kepenekli-Kadayifci, A. Karaaslan, S. Atıcı, A. Binnetoğlu, M. Sarı, A. Soysal, G. Altınkanat and M. Bakır Recurrent bacterial meningitis in a child with mondini dysplasia 2014",PubMed,0.0,1.0,Population,Child,,0.0,Recurrent bacterial meningitis in a child with mondini dysplasia,"Abstract
Mondini dysplasia, also known as Mondini malformation, is a developmental abnormality of the inner and middle ears that can cause hearing loss, cerebrospinal fluid (CSF) leakage, and recurrent bacterial meningitis (RBM), which is defined as two or more episodes of meningitis separated by a period of convalescence and the complete resolution of all signs and symptoms. An accurate diagnosis of the underlying pathology is crucial to prevent further episodes from occurring. Herein, we present a three-year-old boy with RBM and unilateral sensorineural hearing loss. During the evaluation to determine the etiology of the RBM, cystic malformation in the cochlea and vestibular dilatation consistent with Mondini dysplasia were detected via computerized tomography (CT) of the temporal bone.",doi: 10.1155/2014/364657.,kepenekli-kadayifci2014.pdf
147,273,274,Neuropsychologia,"G. Kerkhoff, H. Hildebrandt, S. Reinhart, M. Kardinal, V. Dimova and K. S. Utz A long-lasting improvement of tactile extinction after galvanic vestibular stimulation: two Sham-stimulation controlled case studies 2011",PubMed,0.0,1.0,Population,left-sided tactile extinction due to chronic right hemisphere lesion,,0.0,A long-lasting improvement of tactile extinction after galvanic vestibular stimulation: two Sham-stimulation controlled case studies,"Abstract
Sensory extinction is frequent and often persistent after brain damage. Previous studies have shown the transient influence of sensory stimulation on tactile extinction. In the present two case studies we investigated whether subliminal galvanic vestibular stimulation (GVS) modulates tactile extinction. GVS induces polarity-specific changes in cerebral excitability in the vestibular cortices and adjacent cortical areas in the temporo-parietal cortex via polarization of the vestibular nerves. Two patients (DL, CJ) with left-sided tactile extinction due to chronic (5 vs. 6 (1/2) years lesion age) right-hemisphere lesions (right fronto-parietal in DL, right frontal and discrete parietal in CJ) were examined. Both showed normal tactile sensitivity to light touch and yielded 90-100% correct identifications in unilateral tactile stimulations for both hands. In Baseline investigations without GVS and Sham-GVS both showed stable left-sided tactile extinction rates of 40-55% (DL) and 49-72% (CJ). In contrast, one session of right-cathodal GVS (intensity: 0.6 mA, duration: 20 min) permanently improved tactile identification of identical stimuli, while a second session with left-cathodal GVS significantly reduced left-sided extinction rates for different stimuli in DL. Patient CJ's left-sided tactile extinction was significantly improved by left-cathodal GVS (0.5 mA, 20 min) for different stimuli, while right-cathodal GVS induced a significant reduction for identical materials. In contrast, Sham-stimulation was ineffective. Improvements remained stable for at least 1 year (DL) resp. 3 weeks (CJ). Control experiments ruled out improvements in tactile extinction merely by retesting. In conclusion, chronic tactile extinction may be permanently improved by GVS in a polarity-specific way.",doi: 10.1016/j.neuropsychologia.2010.11.014.,kerkhoff2011.pdf
148,275,276,J Neurophysiol,"S. I. Khan, C. C. Della Santina and A. A. Migliaccio Angular vestibuloocular reflex responses in Otop1 mice. II. Otolith sensor input improves compensation after unilateral labyrinthectomy 2019",PubMed,0.0,1.0,Population,Animal study,,0.0,Angular vestibuloocular reflex responses in Otop1 mice. II. Otolith sensor input improves compensation after unilateral labyrinthectomy,"Abstract
The role of the otoliths in mammals in the normal angular vestibuloocular reflex (VOR) was characterized in an accompanying study based on the Otopetrin1 (Otop1) mouse, which lacks functioning otoliths because of failure to develop otoconia but seems to have otherwise normal peripheral anatomy and neural circuitry. That study showed that otoliths do not contribute to the normal horizontal (rotation about Earth-vertical axis parallel to dorso-ventral axis) and vertical (rotation about Earth-vertical axis parallel to interaural axis) angular VOR but do affect gravity context-specific VOR adaptation. By using these animals, we sought to determine whether the otoliths play a role in the angular VOR after unilateral labyrinthectomy when the total canal signal is reduced. In five Otop1 mice and five control littermates we measured horizontal and vertical left-ear-down and right-ear-down sinusoidal VOR (0.2-10 Hz, 20-100°/s) during the early (3-5 days) and plateau (28-32 days) phases of compensation after unilateral labyrinthectomy and compared these measurements with baseline preoperative responses from the accompanying study. From similar baselines, acute gain loss was ~25% less in control mice, and chronic gain recovery was ~40% more in control mice. The acute data suggest that the otoliths contribute to the angular VOR when there is a loss of canal function. The chronic data suggest that a unilateral otolith signal can significantly improve angular VOR compensation. These data have implications for vestibular rehabilitation of patients with both canal and otolith loss and the development of vestibular implants, which currently only mimic the canals on one side. NEW & NOTEWORTHY This is the first study examining the role of the otoliths (defined here as the utricle and saccule) on the acute and chronic angular vestibuloocular reflex (VOR) after unilateral labyrinthectomy in an animal model in which the otoliths are reliably inactivated and the semicircular canals preserved. This study shows that the otolith signal is used to augment the acute angular VOR and help boost VOR compensation after peripheral injury.
Keywords: Otop1 mouse model; angular vestibuloocular reflex; otoconia-deficient mice; otolith contribution to angular vestibuloocular reflex; vestibuloocular reflex compensation.",doi: 10.1152/jn.00812.2018.,10.1152@jn.00812.2018.pdf
149,278,279,Hear Res,"C. Kim, J. H. Sohn, M. U. Jang, S. K. Hong, J. S. Lee, H. J. Kim, H. C. Choi and J. H. Lee Ischemia as a potential etiologic factor in idiopathic unilateral sudden sensorineural hearing loss: Analysis of posterior circulation arteries 2016",PubMed,0.0,1.0,Population,unilateral sudden sensorineural hearing loss,,0.0,Ischemia as a potential etiologic factor in idiopathic unilateral sudden sensorineural hearing loss: Analysis of posterior circulation arteries,"Abstract
The association between idiopathic sudden sensorineural hearing loss (ISSNHL) and the radiologic characteristics of the vertebrobasilar artery is unclear. We hypothesized that the degree and direction of vertebrobasilar artery curvature in the posterior circulation contribute to the occurrence of ISSNHL. We consecutively enrolled patients diagnosed with unilateral ISSNHL in two tertiary hospitals. Magnetic resonance images were performed in all patients to exclude specific causes of ISSNHL, such as vestibular schwannoma, chronic mastoiditis, and anterior inferior cerebellar artery infarct. We measured the following parameters of posterior circulation: vertebral and basilar artery diameter, the degree of basilar artery curvature (modified smoker criteria), and vertebral artery dominance. Pure tone audiometries were performed at admission and again 1 week and 3 months later. A total of 121 ISSNHL patients (mean age, 46.0 ± 17.3 years; 48.8% male) were included in these analyses. The proportion of patients with the left side hearing loss was larger than the proportion with the right side hearing loss (left, 57.9%; right, 42.1%). The majority of patients were characterized by a left dominant vertebral artery and right-sided basilar artery curvature. The direction of the basilar artery curvature was significantly associated with hearing loss lateralization (p = 0.036). Age and sex matched multivariable analyses revealed the absence of diabetes and right-sided basilar artery curvature as significant predictors for left sided hearing loss. There was no statistical difference between atherosclerotic cardiovascular risk score (high versus low) and hearing outcomes at 3 months. In ISSNHL, the laterality of hearing loss was inversely associated with the direction of basilar artery curvature. Our results, therefore, indicate the importance of vascular assessment when evaluating ISSNHL.
Keywords: Atherosclerosis; Basilar artery; Etiology; Ischemia; Sudden hearing loss.",doi: 10.1016/j.heares.2015.09.003.,kim2016.pdf
150,279,280,J Neurol Sci,"E. J. Kim, S. Y. Oh, J. S. Kim, T. H. Yang and S. Y. Yang Persistent otolith dysfunction even after successful repositioning in benign paroxysmal positional vertigo 2015",PubMed,0.0,1.0,Outcome,two months,,0.0,Persistent otolith dysfunction even after successful repositioning in benign paroxysmal positional vertigo,"Abstract
To evaluate utricular and saccular function during the acute and resolved phases of BPPV, ocular and cervical vestibular evoked myogenic potentials (VEMPs) were studied in 112 patients with BPPV and 50 normal controls in a referral-based University Hospital. Ocular (oVEMPs) and cervical VEMPs (cVEMPs) were induced using air-conducted sound (1000Hz tone burst, 100dB normal hearing level) at the time of initial diagnosis and 2 months after successful repositioning in patients with BPPV, and the results were compared with those of the controls. Abnormalities of cVEMPs and oVEMPs in patients with BPPV were prevalent and significantly higher compare to the healthy control group (p<0.01 in each VEMP by chi-square test). In the patient group, difference between the proportions of abnormal responses of cVEMP and oVEMP was not significant in both affected (p=0.37, chi-squared test) and non-affected (p=1.00) ears. The abnormalities were more likely reduced or absent responses rather than delayed ones; reduced or absent responses are 17.6% in cVEMPs (p=0.04, chi-square) and 21.6% in oVEMPs (p<0.01). The non-affected ear in the BPPV group also showed significantly higher abnormalities of cVEMP and oVEMP when compared to the control group. The follow-up VEMPs after repositioning maneuvers were not significantly different compared to the initial values from both stimulated affected and non-affected ears. Although most patients had unilateral BPPV, bilateral otolithic dysfunction was often shown by persistently reduced or absent cervical and ocular VEMPs, suggesting that BPPV may be caused by significant bilateral damage to the otolith organs.
Keywords: BPPV=benign paroxysmal positional vertigo; Cervical VEMPs; Ocular VEMPs; Saccule; Utricle; VEMPs=vestibular evoked myogenic potentials.",doi: 10.1016/j.jns.2015.09.012.,kim2015.pdf
151,280,281,Neurology,"H. A. Kim, J. H. Hong, H. Lee, H. A. Yi, S. R. Lee, S. Y. Lee, B. C. Jang, B. H. Ahn and R. W. Baloh Otolith dysfunction in vestibular neuritis: recovery pattern and a predictor of symptom recovery 2008",PubMed,0.0,1.0,Outcome,6 weeks,ocular tilt,0.0,Otolith dysfunction in vestibular neuritis: recovery pattern and a predictor of symptom recovery,"Abstract
Objectives: To prospectively follow patients with vestibular neuritis (VN), to compare the recovery pattern of canal and otolith dysfunction, and to determine which tests best predict symptom recovery.
Methods: Between March 2006 and December 2006, 51 consecutive patients with unilateral VN were enrolled within 7 days of onset (average 3 days). Otolith function tests included ocular torsion (OT), subjective visual vertical (SVV), and vestibular evoked myogenic potential (VEMP), and canal function tests included head-shaking nystagmus (HSN), caloric stimulation, and head-thrust testing. Patients returned for two follow-up evaluations at approximately 1 week and 6 weeks after the initial evaluation.
Results: On the first examination, all patients had abnormal HSN, caloric, and head-thrust test results, and at least one otolith-related test abnormality: abnormal tilt of SVV (48/51, 94%), abnormal OT (42/51, 82%), or abnormal VEMPs (25/51, 49%). The degree of SVV tilts correlated with the degree of OT for one or both eyes (p < 0.05). Skew deviation was observed in 7 patients (14%), and a complete ocular tilt reaction was detected in only 2 patients. On follow-up, otolith test results returned to normal more rapidly than canal test results. The head-thrust test was the best predictor of symptom recovery. Eighty percent of patients who continued to report dizziness at the last follow-up visit had a positive head-thrust test result, whereas only 10% of patients who were not dizzy had a positive head-thrust test result.
Conclusion: Otolith-related test abnormalities improve more rapidly than canal-related test abnormalities after vestibular neuritis. If patients have a positive head-thrust test result on follow-up, they are more likely to be dizzy.",doi: 10.1212/01.wnl.0000297554.21221.a0.,kim2008.pdf
152,282,283,Acta Otolaryngol,"M. T. Kim, J. H. Ahn, S. H. Kim, J. E. Choi, J. Y. Jung and M. Y. Lee Persistent static imbalance among acute unilateral vestibulopathy patients could be related to a damaged velocity storage system 2019",PubMed,0.0,1.0,Outcome,1 month follow up,,0.0,Persistent static imbalance among acute unilateral vestibulopathy patients could be related to a damaged velocity storage system,"Abstract
Background: Acute unilateral vestibulopathy (AUV) is common but, the course of disease recovery is variable. Moreover, the final recovery status might vary between subjects. The remaining symptoms of these patients indicate the poor recovery of static imbalance, which could limit social activities and decrease their quality of life. Objective: To determine the possible predictive parameters of prolonged static imbalance (PSI) among acute AUV, we compared several vestibular function test (VFT) results between control vestibulopathy (CV) and PSI patients. Materials and methods: Subjects were divided into two groups: PSI and CV. PSI was determined by the observation of spontaneous nystagmus at 1 month after discharge from the hospital. VFT results taken during the initial symptoms were compared. Results: Increased phase lead was observed in low-frequency stimulations (p < .05), while the other test results failed to reveal a significant difference. These results indicate that a larger phase lead, which is related to a decrease in the time constant, could be responsible for the delayed recovery of static imbalance. Conclusion and significance: The phase lead was higher in the PSI group compared to the CV group, suggesting the possible role of phase as a parameter to predict the delayed compensation of static imbalance.
Keywords: Static imbalance; acute unilateral vestibulopathy; phase lead; rotatory chair test.",doi: 10.1080/00016489.2019.1606438.,kim2019.pdf
153,284,285,Eur Arch Otorhinolaryngol,C. M. Kingma and H. P. Wit Asymmetric vestibular evoked myogenic potentials in unilateral Menière patients 2011,PubMed,0.0,1.0,Outcome,"No symptom, signs",,0.0,Asymmetric vestibular evoked myogenic potentials in unilateral Menière patients,"Abstract
Vestibular evoked myogenic potentials (VEMPs) were measured in 22 unilateral Menière patients with monaural and binaural stimulation with 250 and 500 Hz tone bursts. For all measurement situations significantly lower VEMP amplitudes were on average measured at the affected side compared to the unaffected side. Unilateral Menière patients have, in contrast to normal subjects, asymmetric VEMPs, indicating a permanently affected vestibular (most likely otolith) system at the side of hearing loss. The diagnostic value of VEMP amplitude asymmetry measurement in individual patients is low, because of the large overlap of the VEMP amplitude asymmetry range for unilateral Menière patients with that for normal subjects.",doi: 10.1007/s00405-010-1345-5.,kingma2010.pdf
154,285,286,Acta Otolaryngol,"G. Kirazli, S. Hepkarsi and T. Kirazli Evaluation of high frequency horizontal VOR parameters in patients with chronic bilateral and unilateral peripheral vestibulopathy: a preliminary study 2020",PubMed,1.0,,,,vestibular symptoms,1.0,Evaluation of high frequency horizontal VOR parameters in patients with chronic bilateral and unilateral peripheral vestibulopathy: a preliminary study,"Abstract
Background: Caloric test is one of the tests which evaluates the low frequency component of vestibular system for both diagnosis of the BPV and UPV.
Aims: The main objectives are to determine and increase the diagnostic value of BPV and UPV by evaluating the high frequency horizontal VOR parameters with HIMP, SHIMP and fHIT, to compare test results with healthy controls, and to evaluate correlation of these tests with vertigo dizziness imbalance (VDI) questionnaire results in these patients.
Material and methods: Six patients with BPV, ten patients with UPV and fifteen healthy controls were recruited. High frequency hVOR were evaluated with HIMP, SHIMP and fHIT. Vestibular symptoms and quality of life were assessed with VDI Questionnaire.
Results: Lower percentage of correct answers, and lower VOR gains were obtained in affected sides for BPV and UPV. HIMP elicited compensatory saccades in patients, whereas SHIMP elicited large anticompensatory saccades in controls and unaffected side of UPV, but no saccades in BPV. No correlation was found between VDI outcomes and all tests.
Conclusions: The results show that all tests are complementary each other and able to identify the affected labyrinth and to show residual vestibular function. These tests are thought to be important in the vestibular rehabilitation process.
Keywords: Functional head impulse test; head impulse test; suppression head impulse paradigm.",doi: 10.1080/00016489.2020.1810314.,10.1080@00016489.2020.1810314.pdf
155,290,291,Auris Nasus Larynx,"T. Kitahara, M. Sakagami, T. Ito, T. Shiozaki, K. Kitano, A. Yamashita, I. Ota, Y. Wada and T. Yamanaka Ménière's disease with unremitting floating sensation is associated with canal paresis, gravity-sensitive dysfunction, mental illness, and bilaterality 2019",PubMed,1.0,,,,,1.0,"Ménière's disease with unremitting floating sensation is associated with canal paresis, gravity-sensitive dysfunction, mental illness, and bilaterality","Abstract
Objective: The aim of the present study was to evaluate the association of neuro-otological examination, blood tests, and scoring questionnaire data with treatment-resistant intractability of persistent dizziness in Ménière's disease.
Methods: We managed 1520 successive vertigo/dizziness patients at the Vertigo/Dizziness Center in Nara Medical University from May 2014 to April 2018. Five hundred and twenty-two patients were diagnosed with Ménière's disease (522/1520; 34.3%) according to the 2015 diagnostic guideline of the International Classification of Vestibular Disorders. Among the patients with Ménière's disease there were 102 with intractable rotatory vertigo attacks for more than 3-6 months (102/522; 19.5%), including 20 bilateral cases (20/102; 19.6%), and 88 with intractable unremitting floating sensation rather than rotatory vertigo attacks for more than 3-6 months (88/522; 16.9%), including 28 bilateral cases (28/88; 31.8%). Sixty out of 88 cases with intractable unremitting floating sensation were unilateral and were enrolled for hospitalization to undergo neuro-otological examinations including pure-tone audiometry (PTA), the caloric test (C-test), vestibular evoked cervical myogenic potentials (cVEMP), subjective visual vertical (SVV) test, glycerol test (G-test), electrocochleogram (ECoG), inner ear magnetic resonance imaging (ieMRI), blood tests including anti-diuretic hormone (ADH) and bone alkaline phosphatase (BAP), and self-rating questionnaires of depression score (SDS). Data are presented as positive (+) ratios of the number of patients with examination and questionnaire data outside of the normal range.
Results: The ratios (+) were as follows: C-test=33.3% (20/60), cVEMP=25.0% (15/60), SVV=50.0% (30/60), G-test=55.0% (33/60), ECoG=63.3% (38/60), ieMRI=86.7% (52/60), ADH=35.0% (21/60), BAP=11.7% (7/60), and SDS=40.0% (24/60). Multivariate regression analysis revealed that the periods of persistent dizziness were significantly longer in unilateral Ménière's patients with C-test(+), SVV(+), and SDS(+) compared with those with negative findings. Additionally, the periods in bilateral cases were significantly longer than those in unilateral ones.
Conclusions: Although approximately 70% of patients with Ménière's disease are usually treatable through the appropriate conservative medical therapy, the presence of canal paresis, gravity-sensitive dysfunction, neurosis/depression, and bilaterality may make the persistent dizziness intractable and may thus require additional treatments.
Keywords: Bilateral; Canal paresis; Dizziness; Ménière’s disease; Self-rating questionnaires of depression score; Subjective visual vertical.",doi: 10.1016/j.anl.2018.07.003.,kitahara2018.pdf
156,291,292,Acta Otolaryngol Suppl,"T. Kitahara, N. Takeda, H. Kiyama and T. Kubo Molecular mechanisms of vestibular compensation in the central vestibular system--review 1998",PubMed,0.0,1.0,Design,Review,,0.0,Molecular mechanisms of vestibular compensation in the central vestibular system--review,"Abstract
Vestibular compensation consists of two stages: the inhibition of the contralesional medial vestibular nucleus (contra-MVe) activities at the acute stage after unilateral labyrinthectomy (UL) and the recovery and maintenance of the ipsilesional MVe (ipsi-MVe) spontaneous activities at the chronic stage after UL. In this paper, we reviewed molecular mechanisms of vestibular compensation in the central vestibular system using several morphological and pharmacological approaches in rats. Based on our examinations, we propose the following hypotheses: i) at the acute stage after UL, the activated neurons in the ipsi-MVe project their axons into the flocculus to inhibit the contra-MVe neurons via the NMDA receptor, nitric oxide (NO) and/or GABA-mediated signalling, resulting in the restoration of balance between intervestibular nuclear activities. ii) At the chronic stage after UL, the flocculus depresses the inhibitory effects on the ipsi-MVe neurons via protein phosphatase 2A (PP2A) beta, protein kinase C (PKC) and glutamate receptor (GluR) delta-2, to help the recovery and maintenance of ipsi-MVe activities.",Not Found,No pdf
157,292,293,JAMA Otolaryngol Head Neck Surg,"K. M. Ko, M. H. Song, J. H. Kim and D. B. Shim Persistent spontaneous nystagmus following a canalith repositioning procedure in horizontal semicircular canal benign paroxysmal positional vertigo 2014",PubMed,1.0,,,,,0.0,Persistent spontaneous nystagmus following a canalith repositioning procedure in horizontal semicircular canal benign paroxysmal positional vertigo,"Abstract
Importance: Nystagmus can occur spontaneously from multiple causes. Direction-changing positional nystagmus on the supine roll test is a characteristic clinical feature in horizontal semicircular canal benign paroxysmal positional vertigo. One of several mechanisms of spontaneous nystagmus is plugging of the otoconia, which has been described as a canalith jam.
Observations: We evaluated a 52-year-old woman with a history of geotropic variant of horizontal semicircular canal benign paroxysmal positional vertigo on the right side who had been treated with a modified Lempert maneuver 3 months earlier. The patient had persistent spontaneous nystagmus, despite a positional change after the canalith repositioning procedure. A bithermal caloric test result demonstrated unilateral canal paresis on the right side. The following day, the patient's symptoms and nystagmus had subsided. On a repeated bithermal caloric test, a normal response was demonstrated on both sides.
Conclusions and relevance: To our knowledge, this is the first report of a case that shows on video persistent nystagmus findings consistent with a canalith jam. We discuss a possible mechanism underlying this phenomenon.",doi: 10.1001/jamaoto.2013.6207.,ko2014.pdf
158,296,297,Laryngoscope,H. R. Konrad Clinical application of saccade-reflex testing in man 1991,PubMed,1.0,,,,Patients complaining of disequilibrium and visual disturbances frequently,0.0,Clinical application of saccade-reflex testing in man,"Abstract
Computer-aided measurements of saccade-reflex reaction times, velocities, and accuracies have become important tools in the detection of central nervous system pathology. Because of improved knowledge of the reflex pathways in man, saccade testing can assist in differentiating between brain stem, cerebellar, or cerebral disorders and point toward unilateral lesions. Saccade-reflex testing is also useful in determining disability and measuring over time the course of central nervous system disorders. Further work, correlating lesions observed by high-resolution imaging techniques with abnormalities in reflexes, continues to improve the understanding of saccade mechanisms in man. Specific cases are used to show the effects of anatomic lesions on changes in saccade reflexes. The results from 100 consecutive patients evaluated for dizziness are provided in order to illustrate the prevalence of saccade abnormalities and the relationship between abnormalities in vestibular and slow and fast eye-movement reflexes. Patients complaining of disequilibrium and visual disturbances frequently have abnormalities in the saccade system, abnormalities which are often overlooked in present clinical testing of the dizzy patient.",doi: 10.1002/lary.5541011207.,konrad1991.pdf
159,301,302,Acta Otolaryngol,"J. Kujala, H. Aalto, H. Ramsay and T. P. Hirvonen Simultaneous bilateral stapes surgery 2008",PubMed,0.0,1.0,Population,bilateral otosclerosis ,,0.0,Simultaneous bilateral stapes surgery,"Abstract
Conclusions: The patients recovered from the surgery as after unilateral surgery. The success rate for hearing improvement was good both subjectively and objectively, and this was also displayed in the quality of life. According to our study, simultaneous bilateral stapes surgery can be performed safely in selected patients with bilateral conductive hearing loss.
Objectives: Otosclerosis is bilateral in the majority of patients. In this study we evaluated the outcome of simultaneous bilateral stapes surgery.
Subjects and methods: Eighteen patients suffering from bilateral otosclerosis or osteogenesis imperfecta were prospectively included. After operation, hearing and vestibular function were followed by audiometry and visual feedback posturography (VFP). Patients estimated their hearing gain, the intensity of vestibular symptoms and quality of life score with a questionnaire during the follow-up period of 1 year.
Results: The mean improvement in pure-tone average (PTA) air conduction (PTA-AC) was 18 dB (range 1-41 dB). The mean air-bone gap (AB-GAP) diminished from 22 dB (range 10-41 dB) to 7 dB on both sides (range 0-18 dB). The mean preoperative score of 2.3 for hearing improved significantly to 4.1 (p<0.001). Vestibular symptoms were mild and temporary. The VFP was not permanently impaired in any of the patients. The quality of life score improved significantly from 3.4 to 1.3 postoperatively (p<0.001).",doi: 10.1080/00016480701749257.,kujala2008.pdf
160,305,306,Gait Posture,"F. S. Labini, A. Meli, Y. P. Ivanenko and D. Tufarelli Recurrence quantification analysis of gait in normal and hypovestibular subjects 2012",PubMed,1.0,,,,,0.0,Recurrence quantification analysis of gait in normal and hypovestibular subjects,"Abstract
The study of postural control processes during locomotion may provide useful outcome measures of stability for people with unilateral vestibular hypofunction (UVH). Since nonlinear analysis techniques can characterize complex behaviour of a system, this may highlight mechanisms underlying dynamic stability in locomotion, although only few efforts have been made. In particular, there have been no studies that use recurrence quantification analysis (RQA), which can be applied even to short and non-stationary data. The purpose of this study was to develop a new method for walking balance assessment measuring the complexity of head, trunk and pelvis three-dimensional accelerations and angular velocities during normal overground locomotion by means of RQA in normal subjects and UVH patients. The results showed differential effect of upper body parts on pattern regularity, with better head than pelvis stabilization in both groups of subjects. The RQA outputs such as percent determinism and recurrence were nevertheless significantly lower in the UVH group for all measures, suggesting that body accelerations and angular velocities, although not significantly different in amplitude, were more chaotic in patients. The observed lower regularity of upper body movements in UVH is consistent with an important role of the vestibular system in controlling dynamic stability during walking. The findings suggest that RQA can be used as a quantitative tool to assess walking performance and rehabilitation outcome in patients with different balance disorders.",doi: 10.1016/j.gaitpost.2011.08.004.,syloslabini2012.pdf
161,306,307,J Neurosci,"F. M. Lambert, D. Malinvaud, J. Glaunès, C. Bergot, H. Straka and P. P. Vidal Vestibular asymmetry as the cause of idiopathic scoliosis: a possible answer from Xenopus 2009",PubMed,0.0,1.0,Population,Animal study,,0.0,Vestibular asymmetry as the cause of idiopathic scoliosis: a possible answer from Xenopus,"Abstract
Human idiopathic scoliosis is characterized by severe deformations of the spine and skeleton. The occurrence of vestibular-related deficits in these patients is well established but it is unclear whether a vestibular pathology is the common cause for the scoliotic syndrome and the gaze/posture deficits or if the latter behavioral deficits are a consequence of the scoliotic deformations. A possible vestibular origin was tested in the frog Xenopus laevis by unilateral removal of the labyrinthine endorgans at larval stages. After metamorphosis into young adult frogs, X-ray images and three-dimensional reconstructed micro-computer tomographic scans of the skeleton showed deformations similar to those of scoliotic patients. The skeletal distortions consisted of a curvature of the spine in the frontal and sagittal plane, a transverse rotation along the body axis and substantial deformations of all vertebrae. In terrestrial vertebrates, the initial postural syndrome after unilateral labyrinthectomy recovers over time and requires body weight-supporting limb proprioceptive information. In an aquatic environment, however, this information is absent. Hence, the lesion-induced asymmetric activity in descending spinal pathways and the resulting asymmetric muscular tonus persists. As a consequence the mostly cartilaginous skeleton of the frog tadpoles progressively deforms. Lack of limb proprioceptive signals in an aquatic environment is thus the element, which links the Xenopus model with human scoliosis because a comparable situation occurs during gestation in utero. A permanently imbalanced activity in descending locomotor/posture control pathways might be the common origin for the observed structural and behavioral deficits in humans as in the different animal models of scoliosis.",doi: 10.1523/JNEUROSCI.2583-09.2009.,lambert2009.pdf
162,307,308,J Neurosci,"F. M. Lambert, D. Malinvaud, M. Gratacap, H. Straka and P. P. Vidal Restricted neural plasticity in vestibulospinal pathways after unilateral labyrinthectomy as the origin for scoliotic deformations 2013",Pubmed,0.0,1.0,Population,Animal study,,0.0,Restricted neural plasticity in vestibulospinal pathways after unilateral labyrinthectomy as the origin for scoliotic deformations,"Abstract
Adolescent idiopathic scoliosis in humans is often associated with vestibulomotor deficits. Compatible with a vestibular origin, scoliotic deformations were provoked in adult Xenopus frogs by unilateral labyrinthectomy (UL) at larval stages. The aquatic ecophysiology and absence of body-weight-supporting limb proprioceptive signals in amphibian tadpoles as a potential sensory substitute after UL might be the cause for a persistent asymmetric descending vestibulospinal activity. Therefore, peripheral vestibular lesions in larval Xenopus were used to reveal the morphophysiological alterations at the cellular and network levels. As a result, spinal motor nerves that were modulated by the previously intact side before UL remained permanently silent during natural vestibular stimulation after the lesion. In addition, retrograde tracing of descending pathways revealed a loss of vestibular neurons on the ipsilesional side with crossed vestibulospinal projections. This loss facilitated a general mass imbalance in descending premotor activity and a permanent asymmetric motor drive to the axial musculature. Therefore, we propose that the persistent asymmetric contraction of trunk muscles exerts a constant, uncompensated differential mechanical pull on bilateral skeletal elements that enforces a distortion of the soft cartilaginous skeletal elements and bone shapes. This ultimately provokes severe scoliotic deformations during ontogenetic development similar to the human syndrome.",doi: 10.1523/JNEUROSCI.4842-12.2013.,lambert2013.pdf
163,308,309,Front Neurol,F. M. Lambert and H. Straka The frog vestibular system as a model for lesion-induced plasticity: basic neural principles and implications for posture control 2012,PubMed,0.0,1.0,Population,Animal study,,0.0,The frog vestibular system as a model for lesion-induced plasticity: basic neural principles and implications for posture control,"Abstract
Studies of behavioral consequences after unilateral labyrinthectomy have a long tradition in the quest of determining rules and limitations of the central nervous system (CNS) to exert plastic changes that assist the recuperation from the loss of sensory inputs. Frogs were among the first animal models to illustrate general principles of regenerative capacity and reorganizational neural flexibility after a vestibular lesion. The continuous successful use of the latter animals is in part based on the easy access and identifiability of nerve branches to inner ear organs for surgical intervention, the possibility to employ whole brain preparations for in vitro studies and the limited degree of freedom of postural reflexes for quantification of behavioral impairments and subsequent improvements. Major discoveries that increased the knowledge of post-lesional reactive mechanisms in the CNS include alterations in vestibular commissural signal processing and activation of cooperative changes in excitatory and inhibitory inputs to disfacilitated neurons. Moreover, the observed increase of synaptic efficacy in propriospinal circuits illustrates the importance of limb proprioceptive inputs for postural recovery. Accumulated evidence suggests that the lesion-induced neural plasticity is not a goal-directed process that aims toward a meaningful restoration of vestibular reflexes but rather attempts a survival of those neurons that have lost their excitatory inputs. Accordingly, the reaction mechanism causes an improvement of some components but also a deterioration of other aspects as seen by spatio-temporally inappropriate vestibulo-motor responses, similar to the consequences of plasticity processes in various sensory systems and species. The generality of the findings indicate that frogs continue to form a highly amenable vertebrate model system for exploring molecular and physiological events during cellular and network reorganization after a loss of vestibular function.
Keywords: posture; proprioception; scoliosis; semicircular canals; skeletal deformation; spinal cord; utricle; vestibular.",doi: 10.3389/fneur.2012.00042.,lambert2012.pdf
164,309,310,J Am Acad Audiol,"R. Lazaro, L. Lundy and D. Zapala Delayed endolymphatic hydrops: a case study 2008",PubMed,1.0,,,,,1.0,Delayed endolymphatic hydrops: a case study,"Abstract
Delayed endolymphatic hydrops (DEH) is an unusual variation of Ménière's disease characterized by episodic vertigo that develops some time after the onset of a profound, typically unilateral sensorineural hearing loss. This case study describes a 48-year-old male who presented with complaints of episodic vertigo and disequilibrium 15 years following the onset of unilateral sensorineural hearing loss. The patient's history, audiologic findings, and vestibular evaluation led to the diagnosis of DEH. The case highlights the diagnostic and treatment challenges associated with this condition and focuses attention on principles that guide the audiologist in collecting evidence that aids in solving these challenges.",doi: 10.3766/jaaa.19.3.3.,lazaro2008.pdf
165,310,311,J Otolaryngol Head Neck Surg,"G. J. le Nobel, E. Hwang, A. Wu, S. Cushing and V. Y. Lin Vestibular function following unilateral cochlear implantation for profound sensorineural hearing loss 2016",PubMed,0.0,1.0,Population,sensorineural hearing loss (SNHL),,0.0,Vestibular function following unilateral cochlear implantation for profound sensorineural hearing loss,"Abstract
Background: Many Canadians are affected by sensorineural hearing loss (SNHL) and those with severe or profound hearing loss may have poor hearing function despite optimized hearing aids. Cochlear implants (CI) offer effective hearing rehabilitation for these patients, however, concern continues to exist regarding possible effects of CI on the vestibular system and balance. The objective of this study was to conduct a pilot study assessing the effects of unilateral cochlear implantation (CI) on balance and the vestibular system in post-lingually deafened adults.
Methods: Twelve patients were included in this pilot study and were assessed pre-operatively and at immediate, 1 week, and 1 month post-operative intervals. Assessments consisted of the dizziness handicap inventory (DHI), subjective visual vertical (SVV), and timed up-and-go testing (TUG). When applicable, testing was repeated with the CI on and off.
Results: Many patients were found to have deviated SVV at pre-operative and post-operative assessments. However, statistically significant changes were not seen when comparing pre-operative and post-operative SVV or when comparing SVV with the CI on and with the CI off. DHI was found to improve in five patients and worsen in two patients, however, no statistically significant change was found in DHI scores or with TUG testing.
Conclusions: This current pilot study does not indicate that CI surgery or implant activity influence vestibular or balance function, however, this pilot study is underpowered and greater numbers of patients would need be assessed to confirm these findings.
Keywords: Cochlear implant; Sensorineural hearing loss; Vestibular dysfunction.",doi: 10.1186/s40463-016-0150-6.,lenobel2016.pdf
166,311,312,J Neurol,"C. Lechner, R. L. Taylor, C. Todd, H. Macdougall, R. Yavor, G. M. Halmagyi and M. S. Welgampola Causes and characteristics of horizontal positional nystagmus 2014",PubMed,0.0,1.0,Outcome,"No symptom, signs",,0.0,Causes and characteristics of horizontal positional nystagmus,"Abstract
Direction changing horizontal positional nystagmus can be observed in a variety of central and peripheral vestibular disorders. We tested sixty subjects with horizontal positional nystagmus and vertigo on the Epley Omniax(®) rotator. Monocular video recordings were performed with the right or left ear down, in the supine and prone positions. Nystagmus slow-phase velocity (SPV) was plotted as a function of time. Thirty-one subjects diagnosed with horizontal canalolithiasis had paroxysmal horizontal geotropic nystagmus with the affected ear down (onset 0.8 ± 1 s, range 0-4.9 s, duration 11.7-47.9 s, peak SPV 79 ± 67°/s). The SPV peaked at 5-20 s and declined to 0 by 60 s; at 40 s from onset, the average SPV was 1.8 % of the peak. Nine subjects diagnosed with cupulolithiasis had persistent apogeotropic horizontal nystagmus (onset 0.7 ± 1.4 s, range 0-4.3 s). Peak SPV was 54.2 ± 31.8°/s and 26.6 ± 12.2°/s with unaffected and affected ears down, respectively. At 40 s, the average SPV had decayed to only 81 % (unaffected ear down) and 65 % (affected ear down) of the peak. Twenty subjects were diagnosed with disorders other than benign positional vertigo (BPV) [vestibular migraine (VM), Ménière's Disease, vestibular schwannoma, unilateral or bilateral peripheral vestibular loss]. Subjects with VM (n = 13) had persistent geotropic or apogeotropic horizontal nystagmus. On average, at 40 s from nystagmus onset, the SPV was 61 % of the peak. Two patients with Ménière's Disease had persistent apogeotropic horizontal nystagmus; the peak SPV at 40 s ranged between 28.6 and 49.5 % of the peak. Symptomatic horizontal positional nystagmus can be observed in canalolithiasis, cupulolithiasis and diverse central and peripheral vestibulopathies; its temporal and intensity profile could be helpful in the separation of these entities.",doi: 10.1007/s00415-013-7223-5.,lechner2014.pdf
167,312,313,Neurol Res,"H. Lee, S. I. Sohn, D. K. Jung, Y. W. Cho, J. G. Lim, S. D. Yi and H. A. Yi Migraine and isolated recurrent vertigo of unknown cause 2002",PubMed,0.0,1.0,Population,unknown cause,,0.0,Migraine and isolated recurrent vertigo of unknown cause,"Abstract
Chronic recurrent attacks of vertigo, not associated with any auditory or neurological symptoms, are a common reason for referral to our neurotology clinic. Even after an extensive neurotological evaluation, some cases remain undiagnosed. We prospectively evaluated 72 consecutive patients who presented to the clinic with isolated recurrent vertigo of unknown cause. All patients underwent diagnostic evaluation to exclude identifiable causes of isolated recurrent vertigo. We compared the prevalence of migraine, according to the International Headache Society (IHS) criteria, in the isolated recurrent vertigo group, with a sex- and age-matched control group of orthopedic patients. The prevalence of migraine according to IHS criteria was higher in the isolated recurrent vertigo group (61.1%) than in the control group (10%; p < 0.01). Only 16.7% of patients had an abnormal vestibular function test. The most common abnormal finding was a unilateral vestibular weakness to caloric stimulation. Our results suggest that migraine should be considered in the differential diagnosis of isolated recurrent vertigo of unknown cause.",doi: 10.1179/016164102101200726.,lee2002.pdf
168,313,314,Laryngoscope,"H. K. Lee, S. K. Ahn, S. Y. Jeon, J. P. Kim, J. J. Park, D. G. Hur, D. W. Kim, S. H. Woo and H. S. Kang Clinical characteristics and natural course of recurrent vestibulopathy: a long-term follow-up study 2012",PubMed,1.0,,,,,0.0,Clinical characteristics and natural course of recurrent vestibulopathy: a long-term follow-up study,"Abstract
Objectives/hypothesis: To investigate the clinical characteristics and the natural course of recurrent vestibulopathy (RV).
Study design: Retrospective study.
Methods: During the period April 2002 to February 2008, we reviewed the clinical records of 98 patients diagnosed with RV. All patients were approached by telephone and using a questionnaire. The analysis included age, sex distribution, natural history, pure-tone audiometry, caloric response, age at onset, and the characteristics of vertigo.
Results: Median follow-up was 63.1 months (range, 24-103 months). Patients had a mean age at onset of 39 years and a mean duration of 4.2 years. An obvious female predilection was found, and unilateral caloric paresis (≥ 25%) was seen in 35%. Of the 98 patients, symptoms resolved in 82% but were unchanged in 12%. RV developed to Ménière's disease in four patients and to migraine in two. No patient with RV developed a central nervous system disease or benign paroxysmal positional vertigo during follow-up.
Conclusions: The study suggests that in the majority of cases, vertigo spontaneously resolves and that the risks of development to Ménière's disease or migraine are low.",doi: 10.1002/lary.23188.,lee2012.pdf
169,314,315,Clin Neurophysiol,"J. M. Lee, M. J. Kim, J. W. Kim, D. B. Shim, J. Kim and S. H. Kim Vibration-induced nystagmus in patients with vestibular schwannoma: Characteristics and clinical implications 2017",PubMed,1.0,,,,,0.0,Vibration-induced nystagmus in patients with vestibular schwannoma: Characteristics and clinical implications,"Abstract
Objective: To investigate the clinical significance of vibration-induced nystagmus (VIN) in unilateral vestibular asymmetry and vestibular schwannoma.
Methods: Thirteen patients with vestibular schwannoma underwent the VIN test, in which stimulation was applied to the mastoid processes and sternocleidomastoid (SCM) muscles on the ipsilateral and contralateral sides of lesions. Preoperative VIN was measured, and changes in VIN were followed up for 6months after tumor removal. Significance of VIN was determined by evaluation of its sensitivity, correlation with vestibular function tests and tumor volume, and postoperative changes.
Results: The overall pre and postoperative sensitivities of VIN were 92.3% and 100%, respectively, considering stimulation at all four sites. Maximum slow-phase velocity (MSPV) of VIN was linearly correlated with caloric weakness and tumor volume, especially when stimulation was applied to the SCM muscle. Postoperative MSPV of VIN exhibited stronger linear correlation with postoperative changes in canal paresis value and inverse correlation with tumor size upon stimulation of the ipsilateral SCM muscle than upon stimulation of other sites. During the 6-month follow-up period, persistence of VIN without changes in MSPV was observed even after vestibular compensation.
Conclusions: Evoking VIN by stimulation of the mastoid processes and SCM muscles is effective for detecting vestibular asymmetry. It could also help determine the degree of vestibular asymmetry and volume of vestibular schwannoma if stimulation is applied to the SCM muscle.
Significance: The results of this study could provide clues for the basic application of VIN in patients with vestibular loss and vestibular schwannoma.
Keywords: Nystagmus; Vestibular loss; Vestibular schwannoma; Vibration.",doi: 10.1016/j.clinph.2017.02.023.,lee2017.pdf
170,315,316,J Epilepsy Res,"K. J. Lee, S. H. Jeong, I. C. Baek, A. Y. Lee and J. M. Kim A case of psychogenic dizziness mimicking vestibular epilepsy 2012",PubMed,0.0,1.0,Population,Epilepsy,,0.0,A case of psychogenic dizziness mimicking vestibular epilepsy,"Abstract
A 28-year-old patient presented with frequent episodes of clockwise whirling vertigo, with no ear symptoms or anxiety. He had a previous history of encephaloduroarteriosynangiosis from Moyamoya disease 3 years ago. We assumed that the ictus was a manifestation of vestibular epilepsy. Although the patient was monitored continuously with video and computerized electroencephalography equipment for 24 hours, his vertigo was not accompanied by electroencephalographic discharges. And thorough vestibular evaluation was normal. His symptom was alleviated by psychological support. Psychogenic dizziness may also manifest as recurrent whirling vertigo with unilateral directionality.
Keywords: EMU monitoring; Moyamoya disease; Psychogenic dizziness; Recurrent vertigo; Vestibular epilepsy.",doi: 10.14581/jer.12012.,No pdf
171,317,318,Acta Otolaryngol,"S. A. Lee, E. S. Lee, B. G. Kim, T. K. Lee, K. B. Sung, K. Hwang and J. D. Lee Acute vestibular asymmetry disorder: a new disease entity in acute vestibular syndrome? 2019",PubMed,1.0,,,,,0.0,Acute vestibular asymmetry disorder: a new disease entity in acute vestibular syndrome?,"Abstract
Background: Acute vestibular syndrome (AVS) is characterized by the rapid onset of vertigo, nausea, vomiting and gait unsteadiness, which lasts for days.
Aims/objectives: We report cases as acute vestibular asymmetry disorder (AVAD), with presentations that mimic vestibular neuritis (VN) but without central lesions.
Materials and methods: We retrospectively reviewed records of patients presenting with acute spontaneous vertigo lasting more than 24 h from January 2011 to June 2016. Among 341 patients, five showed different findings that did not indicate either VN or stroke. We analyzed the clinical features and vestibular assessments of these patients.
Results: All five patients showed spontaneous nystagmus continuing for several days. However, head impulse tests (HITs) did not reveal a corrective saccade. Brain magnetic resonance imaging showed no abnormal lesions. The bithermal caloric test revealed directional preponderance without canal paresis. Finally, the slow harmonic test of the rotatory chair revealed unilateral high gain and phase within the normal range, but a significantly asymmetric response was observed. No patients showed recurrence during follow-up.
Conclusions and significance: Our study suggests that a normal HIT in AVS is not always a dangerous sign indicating an acute stroke. From our observations, we propose that AVAD would be a new disease entity within AVS.
Keywords: Acute vestibular syndrome; magnetic resonance imaging; vertigo.",doi: 10.1080/00016489.2019.1599142.,10.1080@00016489.2019.1599142.pdf
172,319,320,Physiother Res Int,"K. Legters, S. L. Whitney, R. Porter and F. Buczek The relationship between the Activities-specific Balance Confidence Scale and the Dynamic Gait Index in peripheral vestibular dysfunction 2005",PubMed,1.0,,,,,0.0,The relationship between the Activities-specific Balance Confidence Scale and the Dynamic Gait Index in peripheral vestibular dysfunction,"Abstract
Background and purpose: People with vestibular dysfunction experience dizziness, vertigo and postural instability. The persistence of these symptoms may result in decreased balance confidence. The purpose of the present study was to examine the relationship between decreased balance confidence and gait dysfunction in patients with unilateral peripheral vestibular dysfunction.
Method: A retrospective review of 137 charts with the Activities-specific Balance Confidence (ABC) Scale and the Dynamic Gait Index (DGI) scores was completed. Spearman rank-order correlation analysis was performed of the total sample, by age group and by degree of vestibular weakness.
Results: A moderate correlation of r = 0.58 (p < 0.001) was found between the ABC Scale score and the DGI score in the total sample. Those with mild or moderate vestibular weakness had a correlation of r = 0.72 (p < 0.001) between the ABC Scale score and the DGI score, compared with a correlation of r = 0.48 in those with severe or total vestibular weakness.
Conclusions: Decreased balance confidence and increased fall risk are critical issues for people with vestibular dysfunction. The effects of aging did not have a significant impact on the relationship. The correlation between balance confidence and gait dysfunction was stronger in those with mild or moderate vestibular weakness, although those with severe or total weakness were more disabled by their vestibular symptoms.",doi: 10.1002/pri.20.,legters2005.pdf
173,324,325,Semin Neurol,R. F. Lewis Vertigo: some uncommon causes of a common problem 1996,PubMed,0.0,1.0,Design,Review,,0.0,Vertigo: some uncommon causes of a common problem,"Abstract
Vertigo, an extremely common symptom, may be caused by numerous disorders affecting the central or peripheral vestibular systems. Patients can usually be categorized into four groups based on the clinical presentation: monophasic, prolonged episodes of vertigo due to acute unilateral vestibular hypofunction; recurrent episodes of vertigo, due to transient vestibular dysfunction; vertigo provoked by changes in head position with respect to gravity (positional vertigo); and bilateral vestibulopathies, which present with imbalance and oscillopsia. Although each clinical syndrome is usually caused by a limited number of disorders, many less common entities must be considered in the differential diagnosis. This article reviews the clinical presentation of the less common causes of vestibular syndromes and discusses their medical and nonmedical management.",doi: 10.1055/s-2008-1040960.,lewis1996.pdf
174,326,327,J Neuroinflammation,"M. Liberge, C. Manrique, L. Bernard-Demanze and M. Lacour Changes in TNFα, NFκB and MnSOD protein in the vestibular nuclei after unilateral vestibular deafferentation 2010",PubMed,0.0,1.0,Population,Animal study,,0.0,"Changes in TNFα, NFκB and MnSOD protein in the vestibular nuclei after unilateral vestibular deafferentation","Abstract
Background: Unilateral vestibular deafferentation results in strong microglial and astroglial activation in the vestibular nuclei (VN) that could be due to an inflammatory response. This study was aimed at determining if markers of inflammation are upregulated in the VN after chemical unilateral labyrinthectomy (UL) in the rat, and if the inflammatory response, if any, induces the expression of neuroprotective factors that could promote the plasticity mechanisms involved in the vestibular compensation process. The expressions of inflammatory and neuroprotective factors after chemical or mechanical UL were also compared to verify that the inflammatory response was not due to the toxicity of sodium arsanilate.
Methods: Immunohistological investigations combined the labeling of tumor necrosis factor α (TNFα), as a marker of the VN inflammatory response, and of nuclear transcription factor κB (NFκB) and manganese superoxide dismutase (MnSOD), as markers of neuroprotection that could be expressed in the VN because of inflammation. Immunoreactivity (Ir) of the VN cells was quantified in the VN complex of rats. Behavioral investigations were performed to assess the functional recovery process, including both static (support surface) and dynamic (air-righting and landing reflexes) postural tests.
Results: Chemical UL (arsanilate transtympanic injection) induced a significant increase in the number of TNFα-Ir cells in the medial and inferior VN on both sides. These changes were detectable as early as 4 h after vestibular lesion, persisted at 1 day, and regained nearly normal values at 3 days. The early increase in TNFα expression was followed by a slightly delayed upregulation of NFκB 8 h after chemical UL, peaking at 1 day, and regaining control values 3 days later. By contrast, upregulation of MnSOD was more strongly delayed (1 day), with a peak at 3 days, and a return to control values at 15 days. Similar changes of TNFα, NFκB, and MnSOD expression were found in rats submitted to mechanical UL. Behavioral observations showed strong posturo-locomotor deficits early after chemical UL (1 day) and a complete functional recovery 6 weeks later.
Conclusions: Our results suggest that the upregulation of inflammatory and neuroprotective factors after vestibular deafferentation in the VN may constitute a favorable neuronal environment for the vestibular compensation process.",doi: 10.1186/1742-2094-7-91.,liberge2010.pdf
175,327,328,Otol Neurotol,"H. W. Lim, K. M. Kim, H. J. Jun, J. Chang, H. H. Jung and S. W. Chae Correlating the head shake-sensory organizing test with dizziness handicap inventory in compensation after vestibular neuritis 2012",Pubmed,1.0,,,,,0.0,Correlating the head shake-sensory organizing test with dizziness handicap inventory in compensation after vestibular neuritis,"Abstract
Objective: Despite complaints of dizziness, some patients with unilateral compensated vestibular weakness show normal results on Sensory Organization Test (SOT), which is being widely used for the evaluation of vestibular function compensation. The head shake-sensory organization test (HS-SOT) has been suggested to increase the sensitivity of SOT. In HS-SOT, the patient is required to shake head under Conditions 2 and 5 of traditional SOT. However, the sensitivity of HS-SOT remains unelucidated in patients with vestibular neuritis. The aim of this study was to determine the sensitivity of HS-SOT and SOT and compare them with the Dizziness Handicap Inventory (DHI) in detecting balance problems in patients with vestibular neuritis complaining of dizziness.
Setting: Tertiary referral center.
Patients: A prospective analysis was conducted on all vestibular neuritis patients between September 2009 and April 2011. Thirty-two patients with uncompensated vestibular neuritis were enrolled in this study. Patients with acute symptoms of dizziness, orthopedic problems, or any other severe underlying conditions were excluded.
Main outcome measures: Equilibrium and vestibular scores of SOT and equilibrium score ratios of HS-SOT and DHI were obtained from each patient after 1 week and 1, 2, and 6 months of the first attack of vestibular neuritis.
Results: HS-SOT is more correlated with the DHI than SOT by periods. One month after vestibular neuritis, the correlation between DHI and SOT, HS-SOT Conditions 2 and 5 were -0.301, -0.385, and -0.625, respectively. Six months after vestibular neuritis, the correlation between DHI and SOT, and HS-SOT Conditions 2 and 5 were -0.053, -0.337, and -0.394, respectively.
Conclusion: HS-SOT was more sensitive than SOT during the compensation of vestibular neuritis. Specifically, during the compensation of vestibular neuritis, HS-SOT Condition 5 was more correlated with DHI than HS-SOT Condition 2. The results suggest that HS-SOT provides more useful measures for the evaluation of vestibular compensation in vestibular neuritis.",doi: 10.1097/MAO.0b013e318241c0a6.,lim2012.pdf
176,330,331,Front Neurol,"M. Lindner, A. Gosewisch, E. Eilles, C. Branner, A. Krämer, R. Oos, E. Wolf, S. Ziegler, P. Bartenstein, T. Brandt, M. Dieterich and A. Zwergal Ginkgo biloba Extract EGb 761 Improves Vestibular Compensation and Modulates Cerebral Vestibular Networks in the Rat 2019",PubMed,0.0,1.0,Population,Animal study,,0.0,Ginkgo biloba Extract EGb 761 Improves Vestibular Compensation and Modulates Cerebral Vestibular Networks in the Rat,"Abstract
Unilateral inner ear damage is followed by behavioral recovery due to central vestibular compensation. The dose-dependent therapeutic effect of Ginkgo biloba extract EGb 761 on vestibular compensation was investigated by behavioral testing and serial cerebral [18F]-Fluoro-desoxyglucose ([18F]-FDG)-μPET in a rat model of unilateral labyrinthectomy (UL). Five groups of 8 animals each were treated with EGb 761-supplemented food at doses of 75, 37.5 or 18.75 mg/kg body weight 6 weeks prior and 15 days post UL (groups A,B,C), control food prior and EGb 761-supplemented food (75 mg/kg) for 15 days post UL (group D), or control food throughout (group E). Plasma levels of EGb 761 components bilobalide, ginkgolide A and B were analyzed prior and 15 days post UL. Behavioral testing included clinical scoring of nystagmus, postural asymmetry, head roll tilt, body rotation during sensory perturbation and instrumental registration of mobility in an open field before and 1, 2, 3, 5, 7, 15 days after UL. Whole-brain [18F]-FDG-μPET was recorded before and 1, 3, 7, 15 days after UL. The EGb 761 group A (75 mg/kg prior/post UL) showed a significant reduction of nystagmus scores (day 3 post UL), of postural asymmetry (1, 3, 7 days post UL), and an increased mobility in the open field (day 7 post UL) as compared to controls (group E). Application of EGb 761 at doses of 37.5 and 18.75 mg/kg prior/post UL (groups B,C) resulted in faster recovery of postural asymmetry, but did not influence mobility relative to controls. Locomotor velocity increased with higher plasma levels of ginkgolide A and B. [18F]-FDG-μPET revealed a significant decrease of the regional cerebral glucose metabolism (rCGM) in the vestibular nuclei and cerebellum and an increase in the hippocampal formation with higher plasma levels of ginkgolides and bilobalide 1 and 3 days post UL. Decrease of rCGM in the vestibular nucleus area and increase in the hippocampal formation with higher plasma levels persisted until day 15 post UL. In conclusion, Ginkgo biloba extract EGb 761 improves vestibulo-ocular motor, vestibulo-spinal compensation, and mobility after UL. This rat study supports the translational approach to investigate EGb 761 at higher dosages for acceleration of vestibular compensation in acute vestibular loss.
Keywords: Ginkgo biloba extract EGb 761; in vivo cerebral imaging; pharmacotherapy; small animal PET; unilateral vestibulopathy; vertigo; vestibular compensation.",doi: 10.3389/fneur.2019.00147.,10.3389@fneur.2019.00147.pdf
177,334,335,J Vestib Res,"B. Loader, W. Gruther, C. A. Mueller, G. Neuwirth, S. Thurner, K. Ehrenberger and C. Mittermaier Improved postural control after computerized optokinetic therapy based on stochastic visual stimulation in patients with vestibular dysfunction 2007",PubMed,1.0,,,,,0.0,Improved postural control after computerized optokinetic therapy based on stochastic visual stimulation in patients with vestibular dysfunction,"Abstract
Balance is accomplished by the congruent integration of visual, vestibular and somatosensory input and the execution of adequate control movements. With increasing age, nonlinear dynamics of central control systems become more regular. In unilateral vestibular dysfunction, sensory input to central systems is similarly less complex, because of one sided reduction of information influx. This study aimed to increase postural stability in patients with vestibular asymmetry and resulting disequilibrium by implementing a computerized visual training method relying on the principles of stochastic resonance. 24 subjects (average age 64a, 31-78a, 15 women, 9 men), with minimum 3 months of persisting disequilibrium due to vestibular dysfunction, were either treated with computerized optokinetic therapy (COKT), or solely observed. Treated patients were requested to read texts, stochastically moving in a previously defined matrix, during 10 sessions over three weeks. The Sensory Organization Test (SOT) was used for comparative posturographic measurements. COKT patients showed significant improvement in conditions 4, 6 and composite score. A significant post-therapeutic difference was seen between therapy and control groups in conditions 1, 6 and composite score. The results show a clinical benefit and we conclude COKT to be an effective rehabilitation method in patients with chronic disequilibrium.",Not Found,No pdf
178,340,341,J Neurol Surg B Skull Base,"G. Magliulo, G. Iannella, M. Ciniglio Appiani and M. Re Subtotal petrosectomy and cerebrospinal fluid leakage in unilateral anacusis 2014",PubMed,0.0,1.0,Population,patients with CSF leakage,,0.0,Subtotal petrosectomy and cerebrospinal fluid leakage in unilateral anacusis,"Abstract
Objective This study presents a group of patients experiencing recurrent cerebrospinal fluid (CSF) leakage associated with ipsilateral anacusis who underwent subtotal petrosectomies with the goal of stopping the CSF leak and preventing meningitis. Materials and Methods Eight patients with CSF leakage were enrolled: three patients with giant vestibular schwannomas had CSF leakage after gamma knife failure and subsequent removal via a retrosigmoid approach; two patients had malformations at the level of the inner ear with consequent translabyrinthine fistulas; two had posttraumatic CSF leakages; and one had a CSF leakage coexisting with an encephalocele. Two patients developed meningitis that resolved with antibiotic therapy. Each patient had preoperative anacusis and vestibular nerve areflexia on the affected side. Results The patients with congenital or posttraumatic CSF leaks had undergone at least one unsuccessful endaural approach to treat the fistula. All eight patients were treated successfully with a subtotal petrosectomy. The symptoms disappeared within 2 months postoperatively. No meningitis, signs of fistula, or other symptoms occurred during the follow-up. Conclusion A subtotal petrosectomy should be the first choice of treatment in patients with recurrent CSF leakage whenever there is associated unilateral anacusis.
Keywords: CSF leakage; subtotal petrosectomy; unilateral anacusis.",doi: 10.1055/s-0034-1376196.,iannella2014.pdf
179,344,345,NeuroRehabilitation,"M. Magnusson, M. Karlberg and F. Tjernström 'PREHAB': Vestibular prehabilitation to ameliorate the effect of a sudden vestibular loss 2011",PubMed,0.0,1.0,Outcome,"No symptom, signs",SAME WITH 344,0.0,'PREHAB': Vestibular prehabilitation to ameliorate the effect of a sudden vestibular loss,"Abstract
A sudden unilateral loss or impairment of vestibular function causes vertigo, dizziness and impaired postural function. In most occasions, everyday activities supported or not by vestibular rehabilitation programs will promote compensation and the symptoms subside. As the compensatory process requires sensory input, matching performed motor activity, both motor learning of exercises and matching to sensory input are required. If there is a simultaneous cerebellar lesion found during surgery of the posterior cranial fossa, there may be a risk of a combined vestibulo-cerebellar lesion, with reduced compensatory abilities and with prolonged or sometimes permanent disability. On the other hand, a slow gradual loss of unilateral function occurring as the subject continues well everyday activities may go without any prominent symptoms. We therefore implemented a pre treatment plan before planned vestibular lesions (prehab). This was first done in subject undergoing gentamicin treatment for Meniere's disease (MD). Subjects perform vestibular exercises for 14 days before the first gentamicin installation and then continue doing so until free of symptoms. Most subjects would only experience slight dizziness while losing vestibular function. We then expanded the approach to patients with brainstem tumours requiring surgery but with remaining vestibular function to ease postoperative symptoms and reduce risk of combined cerebello-vestibular lesions. This patient group was given gentamicin installations trans-tympanically before tumour sugary and then underwent prehab. In all cases there was a caloric loss, loss of VOR evident in the head impulse tests, impaired subjective vertical and horizontal, and reduced caloric function induced by the pre-surgery gentamicin treatment. The prehab eliminated spontaneous and positional nystagmus, subjective symptoms, and postural function up before surgery and allowed for rapid postoperative recovery.The concept of 'pre-lesion rehabilitation' where training is introduced before a planned lesion and if possible paralleled with a gradual function loss expands the potential of rehabilitation. Here it was used for vestibular lesions but it is possible that similar approaches may be developed for other situations, which include foreseeable loss of function.",doi: 10.3233/NRE-2011-0689.,magnusson2011.pdf
180,346,347,Neuroradiol J,"V. Maiolo, G. Savastio, G. C. Modugno and L. Barozzi Relationship between multidetector CT imaging of the vestibular aqueduct and inner ear pathologies 2013",PubMed,0.0,1.0,Outcome,"No symptom, signs",,0.0,Relationship between multidetector CT imaging of the vestibular aqueduct and inner ear pathologies,"Abstract
This study investigated the relationships between morphological changes in the vestibular aqueduct (VA) in different inner ear pathologies. Eighty-eight patients (34 males and 54 females, ranging from seven to 88 years of age; average age 49.2 years) with cochleovestibular disorders underwent temporal bone CT (with a 64-channel helical CT system according to temporal bone protocol parameters; 0.6 mm slice thickness, 0.6 mm collimation, bone reconstruction algorithm). All patients with cochleovestibular disorders who underwent temporal bone CT had been previously divided into six different suspected clinical classes: A) suspected pathology of the third window; B) suspected retrocochlear hearing loss; C) defined Ménière's disease; D) labyrinth lithiasis; E) recurrent vertigo. On CT images we analyzed the length, width and morphology of the VA, contact between the VA and the jugular bulb (JB), the thickness of the osseous capsule covering the semicircular canals, the pneumatization rate of the temporal bone and the diameter of the internal auditory canal. At the end of the diagnostic work-up all patients were grouped into six pathological classes, represented as follow: 1) benign paroxysmal positional vertigo (BPPV), 2) recurrent vertigo (RV), 3) enlarged vestibular aqueduct syndrome (EVAS), 4) sudden or progressive unilateral sensorineural hearing loss (SNHL), 5) superior semicircular canal dehiscence syndrome (SSCD), 6) recurrent vestibulocochlear symptoms in Ménière's disease. We evaluated 176 temporal bones in 88 patients. The VA was clearly visualized in 166/176 temporal bones; in ten ears the VA was not visualized. In 14 ears (11 patients, in three of whom bilaterally) we found an enlarged VA while in 31 ears the VA was significantly narrower. In 16 ears a dehiscence of the JB with the vestibular or cochlear aqueduct was noted. In all six patients with suspected EVAS we found a AV wider than 1.5 mm on CT scans; moreover CT identified four patients with large VA and ill-defined clinical symptoms. Most patients with BPPV (11 patients, Class 1) we did not find any VA abnormalities on CT scans, confirming the clinical diagnosis in ten patients; in the remaining patients we found an enlarged VA, not clinically suspected. In the RV class (eight patients, Class 2) we found three patients with negative CT scans, two patients with narrow aqueduct and subsequently reclassified as Ménière's disease patients, and three patients with ectasic JB dehiscence with the VA. In patients suffering from SNHL we found no statistically significant correlation with the morphological abnormalities. The clinical suspicion of SSCD was confirmed by CT in 11/13 patients (84.6 %); in addition another seven patients showed a thinning or dehiscence of the superior semicircular canals as the prevailing alteration on CT scans, and were reclassified in this group. Ménière's disease symptoms were correlated with a VA alteration in more than half of the cases; the most striking finding in this class was that the VA was significantly narrower (21 patients). Our study demonstrates that alterations of the VA morphology are not only related to EVAS but are also found in other inner ear pathologies such as Ménière's disease. Furthermore, MDCT may confirm the presence of correlations between the morphology of inner ear structures such as VA, semicircular canals or JB dehiscence, and alterations of vestibulocochlear function.
Keywords: bony labyrinth; cochleovestibular diseases; multidetector computed tomography; temporal bone; vestibular aqueduct.",doi: 10.1177/197140091302600612.,maiolo2013.pdf
181,347,348,J Neurosurg Pediatr,"G. E. K. Malina, D. M. Heiferman, L. N. Riedy, C. C. Szujewski, E. G. Rezaii, J. P. Leonetti and D. E. Anderson Pediatric vestibular schwannomas: case series and a systematic review with meta-analysis 2020",PubMed,0.0,1.0,Design,Review,,0.0,Pediatric vestibular schwannomas: case series and a systematic review with meta-analysis,"Abstract
Objective: Sporadic unilateral vestibular schwannomas are rare in the pediatric population. Little has been reported in the literature on the presentation, tumor size, response to surgical treatment, and recurrence rates in these younger patients. The authors' goal was to describe their institutional experience with pediatric sporadic vestibular schwannomas and to conduct a meta-analysis of the existing literature to provide further insight into the presentation, tumor characteristics, and surgical outcomes for these rare tumors to help direct future treatment strategies.
Methods: The authors performed a retrospective review of all patients 21 years of age or younger with unilateral vestibular schwannomas and without neurofibromatosis type 2 who underwent resection by the senior authors between 1997 and 2019. A systematic review of the literature and meta-analysis was also performed by entering the search terms ""pediatric"" and ""vestibular schwannoma"" or ""acoustic neuroma,"" as well as ""sporadic"" into PubMed. Presentation, treatment, clinical outcomes, and follow-up were analyzed.
Results: Fifteen patients were identified at the authors' institution, ranging in age from 12 to 21 years (mean 16.5 years). Common presenting symptoms included hearing loss (87%), headache (40%), vertigo (33%), ataxia (33%), and tinnitus (33%). At the time of surgery, the mean tumor size was 3.4 cm, with four 1-cm tumors. Four patients had residual tumor following their first surgery, 3 (75%) of whom had significant radiographic regrowth that required further treatment. The literature review identified an additional 81 patients from 26 studies with patient-specific clinical data available for analysis. This resulted in a total of 96 reported patients with an overall average age at diagnosis of 12.1 years (range 6-21 years) and an average tumor size of 4.1 cm.
Conclusions: Pediatric vestibular schwannomas present similarly to those in adults, although symptoms of mass effect are more common, as these tumors tend to be larger at diagnosis. Some children are found to have small tumors and can be successfully treated surgically. Residual tumors in pediatric patients were found to have a higher rate of regrowth than those in their adult counterparts.
Keywords: acoustic neuroma; oncology; sporadic; vestibular schwannoma.",doi: 10.3171/2020.3.PEDS19514.,No pdf
182,349,350,Acta Otorhinolaryngol Ital,L. Manzari Prolonged bone-conducted vibration in superior semicircular canal dehiscence and in otosclerosis: comparison of the 3D eye movement evaluation 2009,PubMed,0.0,1.0,Population,Otosclerosis,,0.0,Prolonged bone-conducted vibration in superior semicircular canal dehiscence and in otosclerosis: comparison of the 3D eye movement evaluation,"Abstract in English, Italian
Vibration-induced nystagmus, as clinical sign, was recently introduced in outpatient clinical practice for the study and evaluation of otoneurological patients. This response, which can only be evoked by bone conducted vibratory stimulation in the mastoid region or at the location on the forehead in the midline at the hairline, was essentially designed for patients with persistent unilateral vestibular deficit and was interpreted as the result of excitatory functional activity of the vestibular system on the non-affected side. Vibratory stimulation is, in fact, considered to reach both systems, which in the case of functional asymmetry, respond asymmetrically with greater excitatory activation on the more responsive side. On the other hand, little information is available concerning vibration-induced nystagmus in subjects with symmetrical vestibular function. The limited experience with this recently proposed test and incomplete knowledge regarding its mechanisms suggest that it must be investigated in clinical conditions, having a known pathophysiological basis: the responses obtained could help provide insight into the potential of this test and contribute to the diagnostic definition of the superior semicircular canal dehiscence or otosclerosis. Analysis of Vibration-induced nystagmus, recently proposed to study transmission of excitatory stimuli by bone conduction, may be appropriate for altered input caused by defects of the labyrinthine capsule. This promises to be an interesting new field of research.
Keywords: Superior semicircular canal dehiscence; Vestibular otosclerosis; Vestibulo-ocular reflex; Vibration induced nystagmus.",Not Found,No pdf
183,352,353,J Neurol,"H. J. Marcus, H. Paine, M. Sargeant, S. Wolstenholme, K. Collins, N. Marroney, Q. Arshad, K. Tsang, B. Jones, R. Smith, M. H. Wilson, H. M. Rust and B. M. Seemungal Vestibular dysfunction in acute traumatic brain injury 2019",PubMed,0.0,1.0,Population,Travma brain injury,,0.0,Vestibular dysfunction in acute traumatic brain injury,"Abstract
Traumatic brain injury (TBI) is the commonest cause of disability in under-40-year-olds. Vestibular features of dizziness (illusory self-motion) or imbalance which affects 50% of TBI patients at 5 years, increases unemployment threefold in TBI survivors. Unfortunately, vestibular diagnoses are cryptogenic in 25% of chronic TBI cases, impeding therapy. We hypothesized that chronic adaptive brain mechanisms uncouple vestibular symptoms from signs. This predicts a masking of vestibular diagnoses chronically but not acutely. Hence, defining the spectrum of vestibular diagnoses in acute TBI should clarify vestibular diagnoses in chronic TBI. There are, however, no relevant acute TBI data. Of 111 Major Trauma Ward adult admissions screened (median 38-years-old), 96 patients (87%) had subjective dizziness (illusory self-motion) and/or objective imbalance were referred to the senior author (BMS). Symptoms included: feeling unbalanced (58%), headache (50%) and dizziness (40%). In the 47 cases assessed by BMS, gait ataxia was the commonest sign (62%) with half of these cases denying imbalance when asked. Diagnoses included BPPV (38%), acute peripheral unilateral vestibular loss (19%), and migraine phenotype headache (34%), another potential source of vestibular symptoms. In acute TBI, vestibular signs are common, with gait ataxia being the most frequent one. However, patients underreport symptoms. The uncoupling of symptoms from signs likely arises from TBI affecting perceptual mechanisms. Hence, the cryptogenic nature of vestibular symptoms in TBI (acute or chronic) relates to a complex interaction between injury (to peripheral and central vestibular structures and perceptual mechanisms) and brain-adaptation, emphasizing the need for acute prospective, mechanistic studies.
Keywords: Concussion; Dizziness; Head injury; Head trauma; Vertigo.",doi: 10.1007/s00415-019-09403-z.,10.1007@s00415-019-09403-z.pdf
184,354,355,Otol Neurotol,E. Martin and N. Perez Hearing loss after intratympanic gentamicin therapy for unilateral Ménière's Disease 2003,PubMed,1.0,,,,,1.0,Hearing loss after intratympanic gentamicin therapy for unilateral Ménière's Disease,"Abstract
Objective: This study set out to evaluate the hearing changes that occur during intratympanic gentamicin therapy and to correlate them with the long-term effects of the treatment on the control of vertigo and on hearing.
Study design: This was a prospective study.
Setting: Tertiary medical center.
Patients: The 71 patients included in the study had been diagnosed with unilateral Ménière's Disease as defined within the 1995 American Academy of Otolaryngology-Head and Neck Surgery guidelines, and had been refractory to medical treatment for at least 1 year.
Intervention: Intratympanic injections of gentamicin at a concentration of 27 mg/ml were performed at weekly intervals until indications of vestibular hypofunction appeared in the treated ear. If there was a recurrence of the episodes of vertigo, an additional course of injections was performed.
Main outcome measure: The 1995 American Academy of Otolaryngology-Head and Neck Surgery criteria for reporting the treatment outcome for Ménière's Disease were used. During the period of gentamicin instillation, weekly audiograms were obtained. The results of the treatment were expressed in terms of control of vertigo and hearing level.
Results: Vertigo was controlled by gentamicin instillation in 83.1% of the 71 patients. Two years after the treatment, hearing loss as a result of the gentamicin injections was observed in only 11 (15.5%) patients. The recurrence of spells of vertigo after having initially achieved complete control was noted in 17 (23.9%) patients. Hearing loss at the end of the treatment occurred in 32.4% of the patients, but it was transitory so that 3 months after ending the treatment it was 12.7% and after 2 years it was 15.5%. Those patients in whom no change in their level of hearing occurred during the treatment needed another course of injections and presented poorer overall control of vertigo.
Conclusions: Ending weekly intratympanic injections when clinical signs of vestibular deafferentation appear results in the control of vertigo in the majority of patients. The hearing changes detected during the treatment are transitory and are the only clinical sign that predicts the response to gentamicin instillation.",doi: 10.1097/00129492-200309000-00018.,martin2003.pdf
185,355,356,Acta Otorrinolaringol Esp,E. Martín Sanz and N. Pérez Fernández Intratympanic gentamicin in patients with Ménière's disease: analysis of our protocol 2004,PubMed,0.0,1.0,Design,Spanish,,0.0,[Intratympanic gentamicin in patients with Ménière's disease: analysis of our protocol],"Abstract
Objective: The aim of this paper is to analyze the peculiarities of a protocol for treatment with intratympanic gentamicin in patients with Ménière's disease.
Material and methods: 71 patients with unilateral disabling Ménière's disease were followed for a period longer than two years after concluding the treatment. AAO-HNS criteria for reporting treatment results was followed. Gentamicin was applied weekly until of symptoms or signs of vestibular hypofunction were noticed.
Results: Control of vertigo was obtained in 83% of the patients while in 24% a second course was needed beacuse of vertigo recurrence. 66% of the patients developed a typical syndrome of unilateral vestibular hypofunction in the ear treated.
Conclusions: Ending weekly injections of gentamicin for the treatment of patients with Ménière's disease when signs of vestibular hypofunction appear warrants a control of vertigo similar to that obtained in other series.",doi: 10.1016/s0001-6519(04)78521-0.,10.1016@s0001-65190478521-0.pdf
186,356,357,Acta Otolaryngol,"E. Martin-Sanz, I. Ortega Crespo, J. Esteban-Sanchez and R. Sanz Postural stability in a population of dancers, healthy non-dancers, and vestibular neuritis patients 2017",Pubmed,1.0,,,,,0.0,"Postural stability in a population of dancers, healthy non-dancers, and vestibular neuritis patients","Abstract
Introduction: Several studies have indicated better balance control in dancers than in control participants, but some controversy remains. The aim of our study is to evaluate the postural stability in a cohort of dancers, non-dancers, compensated, and non-compensated unilateral vestibular neuritis (VN).
Methods: This is a prospective study of control subjects, dancers, and VN patients between June 2009 and December 2015. Dancers from the Dance Conservatory of Madrid and VN patients were referred to our department for analysis. After the clinical history, neuro-otological examination, audiogram, and caloric tests, the diagnosis was done. Results from clinical examination were used for the categorization of compensation situation. A computerized dynamic posturography was performed to every subject.
Results: Forty dancers and 38 women formed both 'dancer' and 'normal' cohorts. Forty-two compensated and 39 uncompensated patients formed both 'compensated' and 'uncompensated' cohorts. Dancers had significantly greater antero-posterior (AP) body sway than controls during condition 5 and 6 in the Sensory Organization Test (SOT) (p < .05). When we compared the uncompensated cohort with both control and dancers groups, we found significant greater body sway in every SOT studied condition (p < .05). While mean AP body say in SOT 5 and 6, showed greater values in compensated patients than the control group, the mean analysis did not show any statistical difference between the compensated and dancer groups, in such SOT conditions.
Conclusions: Dancers demonstrated greater sways than non-dancers when they relied their postural control on vestibular input alone. Compensated patients had a similar posturographic pattern that the dancers cohort, suggesting a similar shift from visual to somatosensory information.
Keywords: Balance; dance; dynamic posturography; vertigo.",doi: 10.1080/00016489.2017.1322711.,martin-sanz2017.pdf
187,357,358,Respir Physiol Neurobiol,"P. F. Martino, H. V. Forster, T. Feroah, J. Wenninger, M. Hodges and L. G. Pan Do neurotoxic lesions in rostral medullary nuclei induce/accentuate hypoventilation during NREM sleep? 2003",PubMed,0.0,1.0,Population,Animal study,,0.0,Do neurotoxic lesions in rostral medullary nuclei induce/accentuate hypoventilation during NREM sleep?,"Abstract
Experimentally induced neuronal dysfunction in respiratory regions of the rostral medulla decrease breathing more in anesthetized mammals than in awake mammals. Sleep is similar to anesthesia in that excitatory inputs to respiratory neurons are reduced compared to the awake state; thus, we hypothesized that neurotoxic lesions in rostral medullary nuclei would, relative to wakefulness (WK), induce and/or accentuate hypoventilation during non-rapid eye movement (NREM) sleep. To test the hypothesis, goats were studied between 21:00 h and 03:00 h: (1) before and 30 days after chronically implanting microtubules bilaterally into the rostral medulla and, (2) 9-15 h and 2-17 days after unilateral injections of 100 nl to 1 microl, 50 mM ibotenic acid into the vestibular, gigantocellularis reticularis, or facial nuclei, or the retrotrapezoid nucleus/parapyramidal region. Arterial blood was repeatedly sampled in all studies during WK, and NREM and rapid eye movement (REM) sleep states. There was no significant (P>0.10) change in Pa(CO(2)) between WK and NREM sleep (and REM sleep when sufficient data were obtained) before or after implantation of microtubules and in studies after creating the neurotoxic lesions. Breathing frequency also did not significantly (P>0.10) differ between states in any of the studies. The data thus did not support the hypothesis. We speculate that in goats efficient compensatory mechanisms maintain Pa(CO(2)) homeostasis during normal sleep and the same and/or other mechanisms maintain homeostasis when excitatory drive is further reduced by lesions in rostral medullary nuclei.",doi: 10.1016/s1569-9048(03)00186-1.,martino2003.pdf
188,360,361,NeuroRehabilitation,"S. Maslovara, S. Butkovic-Soldo, M. Peric, I. Pajic Matic and A. Sestak Effect of vestibular rehabilitation on recovery rate and functioning improvement in patients with chronic unilateral vestibular hypofunction and bilateral vestibular hypofunction 2019",PubMed,0.0,1.0,Design,Guideline,SAME WITH 359,0.0,Effect of vestibular rehabilitation on recovery rate and functioning improvement in patients with chronic unilateral vestibular hypofunction and bilateral vestibular hypofunction,"Abstract
Background: The minimal number of studies have documented the impact of Vestibular rehabilitation (VR) on the recovery rate of patients with Chronic Unilateral Vestibular Hypofunction (CUVH) and Bilateral Vestibular Hypofunction (BVH).
Objectives: The goal of the study was to show and compare the impact of vestibular rehabilitation (VR) in patients with CUVH and BVH.
Methods: We analysed the data of 30 patients with CUVH and 20 with BVH treated with VR. The patients with CUVH during their eight-week treatment were controlled every two weeks, while the patients with BVH were controlled every three months during their one-year treatment; they filled in the DHI and ABC questionnaires every time.
Results: In both groups of patients, there was significantly less disablement between the initial and final DHI scores (from 59-20 in CUVH and 74-41 in BVH group). There was a significant increase in the balance confidence between the initial and final ABC Scale in both groups of patients (from 49.5-90% in CUVH and 42-73% in BVH group).
Conclusions: Well-planned and individually adjusted system of vestibular exercises leads to a significant decrease in clinical symptoms and improvement of functioning and confidence in activities in both the CUVH and the BVH patients.
Keywords: Vestibular rehabilitation therapy; bilateral vestibular hypofunction; chronic unilateral vestibular hypofunction; outcome.",doi: 10.3233/NRE-182524.,10.3233@NRE-182524.pdf
189,363,364,Arch Otolaryngol,J. A. McClure and P. Lycett Vestibular asymmetry. Some theoretical and practical considerations 1983,PubMed,0.0,1.0,Design,Review,,0.0,Vestibular asymmetry. Some theoretical and practical considerations,"Abstract
Pathological vestibular asymmetry can be divided into static and dynamic types. Static asymmetry results from a unilateral change of the resting neural input. Acute, chronic, and recovery stages can be recognized if one interprets the direction and intensity of the resultant spontaneous nystagmus relative to the clinical picture. Static asymmetry is additive with induced asymmetry and manifests itself as directional preponderance or as the direction-fixed or direction-changing feature of positional nystagmus. Dynamic asymmetry refers to abnormal asymmetry induced by normal head movements. For example, with unilateral hypofunction, a greater gain is observed with head movement toward the unaffected side, suggesting nonlinearity as specified by Eswald's second law. Visually induced vestibular asymmetry is a form of dynamic asymmetry generated by convergence of visual-vestibular information, and causing symptoms in certain ""motion-active"" visual environments.",doi: 10.1001/archotol.1983.00800240048009.,mcclure1983.pdf
190,364,365,Front Neurol,"L. A. McGarvie, H. G. MacDougall, I. S. Curthoys and G. M. Halmagyi Spontaneous Recovery of the Vestibulo-Ocular Reflex After Vestibular Neuritis; Long-Term Monitoring With the Video Head Impulse Test in a Single Patient 2020",PubMed,0.0,1.0,Outcome,"No symptom, signs",,0.0,Spontaneous Recovery of the Vestibulo-Ocular Reflex After Vestibular Neuritis; Long-Term Monitoring With the Video Head Impulse Test in a Single Patient,"Abstract
Vestibular rehabilitation of patients in whom the level of vestibular function is continuously changing requires different strategies than in those where vestibular function rapidly becomes stable: where it recovers or where it does not and compensation is by catch-up saccades. In order to determine which of these situations apply to a particular patient, it is necessary to monitor the vestibulo-ocular reflex (VOR) gains, rather than just make a single measurement at a given time. The video Head Impulse Test (vHIT) is a simple and practical way to monitor precisely the time course and final level of VOR recovery and is useful when a patient has ongoing vestibular symptoms, such as after acute vestibular neuritis. In this study, we try to show the value of ongoing monitoring of vestibular function in a patient recovering from vestibular neuritis. Acute vestibular neuritis can impair function of any single semicircular canal (SCC). The level of impairment of each SCC, initially anywhere between 0 and 100%, can be accurately measured by the vHIT. In superior vestibular neuritis the anterior and lateral SCCs are the most affected. Unlike after surgical unilateral vestibular deafferentation, SCC function as measured by the VOR can recover spontaneously after acute vestibular neuritis. Here we report monitoring the VOR from all 6 SCCs for 500 days after the second attack in a patient with bilateral sequential vestibular neuritis. Spontaneous recovery of the VOR in response to anterior and lateral SCC impulses showed an exponential recovery with a time to reach stable levels being longer than previously considered or reported. VOR gain in response to low-velocity lateral SCC impulses recovered with a time constant of around 100 days and reached a stable level at about 200 days. However, in response to high-velocity lateral SCC and anterior SCC impulses, VOR gain recovered with a time constant of about 150 days and only reached a stable level toward the end of the 500 days monitoring period.
Keywords: VOR; VOR recovery; temporal profile; vHIT; vestibular neuritis; vestibulo-ocular reflex.",doi: 10.3389/fneur.2020.00732.,10.3389@fneur.2020.00732.pdf
191,365,366,Otol Neurotol,"W. J. McLean, A. S. Hinton, J. T. J. Herby, A. N. Salt, J. J. Hartsock, S. Wilson, D. L. Lucchino, T. Lenarz, A. Warnecke, N. Prenzler, H. Schmitt, S. King, L. E. Jackson, J. Rosenbloom, G. Atiee, M. Bear, C. L. Runge, R. H. Gifford, S. D. Rauch, D. J. Lee, R. Langer, J. M. Karp, C. Loose and C. LeBel Improved Speech Intelligibility in Subjects With Stable Sensorineural Hearing Loss Following Intratympanic Dosing of FX-322 in a Phase 1b Study 2021",PubMed,0.0,1.0,Population,chronic SNHL,,0.0,Improved Speech Intelligibility in Subjects With Stable Sensorineural Hearing Loss Following Intratympanic Dosing of FX-322 in a Phase 1b Study,"Abstract
Objectives: There are no approved pharmacologic therapies for chronic sensorineural hearing loss (SNHL). The combination of CHIR99021+valproic acid (CV, FX-322) has been shown to regenerate mammalian cochlear hair cells ex vivo. The objectives were to characterize the cochlear pharmacokinetic profile of CV in guinea pigs, then measure FX-322 in human perilymph samples, and finally assess safety and audiometric effects of FX-322 in humans with chronic SNHL.
Study designs: Middle ear residence, cochlear distribution, and elimination profiles of FX-322 were assessed in guinea pigs. Human perilymph sampling following intratympanic FX-322 dosing was performed in an open-label study in cochlear implant subjects. Unilateral intratympanic FX-322 was assessed in a Phase 1b prospective, randomized, double-blinded, placebo-controlled clinical trial.
Setting: Three private otolaryngology practices in the US.
Patients: Individuals diagnosed with mild to moderately severe chronic SNHL (≤70 dB standard pure-tone average) in one or both ears that was stable for ≥6 months, medical histories consistent with noise-induced or idiopathic sudden SNHL, and no significant vestibular symptoms.
Interventions: Intratympanic FX-322.
Main outcome measures: Pharmacokinetics of FX-322 in perilymph and safety and audiometric effects.
Results: After intratympanic delivery in guinea pigs and humans, FX-322 levels in the cochlear extended high-frequency region were observed and projected to be pharmacologically active in humans. A single dose of FX-322 in SNHL subjects was well tolerated with mild, transient treatment-related adverse events (n = 15 FX-322 vs 8 placebo). Of the six patients treated with FX-322 who had baseline word recognition in quiet scores below 90%, four showed clinically meaningful improvements (absolute word recognition improved 18-42%, exceeding the 95% confidence interval determined by previously published criteria). No significant changes in placebo-injected ears were observed. At the group level, FX-322 subjects outperformed placebo group in word recognition in quiet when averaged across all time points, with a mean improvement from baseline of 18.9% (p = 0.029). For words in noise, the treated group showed a mean 1.3 dB signal-to-noise ratio improvement (p = 0.012) relative to their baseline scores while placebo-treated subjects did not (-0.21 dB, p = 0.71).
Conclusions: Delivery of FX-322 to the extended high-frequency region of the cochlea is well tolerated and enhances speech recognition performance in multiple subjects with stable chronic hearing loss.",doi: 10.1097/MAO.0000000000003120.,No pdf
192,371,372,Eur Ann Otorhinolaryngol Head Neck Dis,"A. Meunier, P. Clavel, K. Aubry and J. Lerat A sudden bilateral hearing loss caused by inner ear hemorrhage 2020",PubMed,0.0,1.0,Population,sudden bilateral hearing loss,,0.0,A sudden bilateral hearing loss caused by inner ear hemorrhage,"Abstract
Introduction: Labyrinthine hemorrhage is a rare cause of sudden deafness and generally concerns only on one side.
Case summary: An 84-year-old man with a past medical history of myelomonocytic chronic leukemia (CMML) suffered from sudden bilateral hearing loss associated with vertigo. The audiogram revealed a left cophosis and a right profound deafness. Videonystagmography showed a left vestibular deficit. The MRI showed a spontaneous strong T1 weighted signal in the left and right labyrinths, corresponding to a bilateral inner ear hemorrhage (IEH). Dizziness resolved rapidly following vestibular physiotherapy, in contrast to hearing which did not improve at all and let the patient isolated in his environment. The patient successfully underwent cochlear implantation so that he could communicate.
Discussion: Most IEHs are unilateral and due to anticoagulants treatments and hematological diseases. Only rare cases have described bilateral labyrinth hemorrhage. This is the first case reported of bilateral labyrinth hemorrhage due to CMML.
Keywords: Chronic myelomonocytic leukemia; Dizziness; Hemorrhage; Inner ear; Sudden hearing loss.",doi: 10.1016/j.anorl.2019.05.021.,meunier2019.pdf
193,373,374,Eur Arch Otorhinolaryngol,"A. Micarelli, A. Viziano, E. Bruno, E. Micarelli, I. Augimeri and M. Alessandrini Gradient impact of cognitive decline in unilateral vestibular hypofunction after rehabilitation: preliminary findings 2018",Pubmed,1.0,,,,,0.0,Gradient impact of cognitive decline in unilateral vestibular hypofunction after rehabilitation: preliminary findings,"Abstract
Purpose: Considering recent advances in central cognitive- and age-related processing interfering with balance and sensory reweighting in uncompensated vestibular disorders, purpose of this study is to highlight the vestibular rehabilitation (VR) outcomes in a population of older adults and age-matched mild cognitive impairment (MCI) patients, both affected by unilateral vestibular hypofunction (UVH) and undergoing VR.
Methods: Vestibulo-ocular reflex (VOR), postural sway examination (respectively, performed by video head impulse test and static posturography) and dizziness-related and quality-of-life scores were collected in 12 UVH MCI individuals ≥ 55 years and 12 matched UVH older adults with age-appropriate cognitive function-cognitively evaluated by means of Mini-Mental State Examination (MMSE) and Alzheimer's Disease Assessment Scale-before and after a VR protocol.
Results: A significant post-treatment reduction in surface, length and power spectra (PS) values within low-frequency domain and an improvement in performance measures were recorded in both groups. Moreover, the VR protocol highlighted-when comparing pre-/post-treatment differences (Δ)-a significant (i) increase in Δ VOR gain; (ii) decrease in Δ surface and length and (iii) increase in Δ PS within low-frequency domain in older adults when compared to MCI patients. Positive correlations were found between MMSE and Δ Dynamic Gait Index, Δ surface and Δ PS within low-frequency domain when treating patients as 'a continuum' along the cognitive decline.
Conclusions: Present pilot findings suggest that the cognitive domain insight in older adults scheduled for VR protocols may positively impact on disability consequences.
Keywords: Aging; Cognitive decline; Mild cognitive impairment; Vestibular hypofunction; Vestibular rehabilitation.",doi: 10.1007/s00405-018-5109-y.,micarelli2018.pdf
194,376,377,Eur Ann Otorhinolaryngol Head Neck Dis,"G. Michel, F. Espitalier, A. S. Delemazure and P. Bordure Isolated lateral semicircular canal aplasia: Functional consequences 2016",PubMed,0.0,1.0,Population,persistent unilateral tinnitus,,0.0,Isolated lateral semicircular canal aplasia: Functional consequences,"Abstract
Introduction: Lateral semicircular canal aplasia is a malformation of the inner ear, usually associated with vestibular and cochlear malformations in the context of congenital malformation syndromes. We report a rare case of a young patient with isolated lateral semicircular canal aplasia and no associated vestibular symptoms.
Clinical case summary: A 20-year-old man with no personal or family history presented with persistent unilateral tinnitus for three years with no associated vestibular symptoms. Moderate unilateral right sensorineural hearing loss was detected. Magnetic resonance imaging demonstrated isolated aplasia of the right lateral semicircular canal. Videonystagmography revealed right hyporeflexia. Vestibular evoked myogenic potentials were absent after stimulation on the right side and normal on the left side.
Discussion: Although the morphological abnormalities appeared to be isolated on imaging, the patient presented functional signs of global cochlear, semicircular canal and otolithic lesions, probably related to a developmental disorder of the membranous labyrinth. Functional investigations must be performed in the presence of isolated semicircular canal aplasia, even when it is an incidental finding, to exclude more extensive labyrinthine lesions.
Keywords: Semicircular canals; Sensorineural hearing loss; Tinnitus; Vestibular labyrinth.",doi: 10.1016/j.anorl.2015.09.002.,michel2015.pdf
195,377,378,Rev Laryngol Otol Rhinol (Bord),"J. Michel, G. Dumas, J. P. Lavieille and R. Charachon Diagnostic value of vibration-induced nystagmus obtained by combined vibratory stimulation applied to the neck muscles and skull of 300 vertiginous patients 2001",PubMed,1.0,,,,,0.0,Diagnostic value of vibration-induced nystagmus obtained by combined vibratory stimulation applied to the neck muscles and skull of 300 vertiginous patients,"Abstract
On subjects with unilateral vestibular dysfunction, the application of a vibratory stimulation (100 Hz) to the two mastoids and the vertex, and to the right and left dorsal neck muscles produces a nystagmus directed towards the good ear in 85% of patients. Fixation must be suppressed by Frenzel's glasses or video nystagmoscopy. To be significant this nystagmus must appear in at least 3 of the 5 vibratory stimulated sites. On healthy subjects nystagmus is present in 6% of cases but never in those below 30 years. In subjects affected by central vertigo, nystagmus was elicited in 10% of cases and in subjects suffering from vertigo of unknown origin in 6% of cases. Vibration nystagmus which stops immediately after stimulation differs from head shaking nystagmus which is present in only 34% of unilateral vestibular dysfunctions. Vibration occasionally produces a pseudo-caloric nystagmus which persists after stimulation. We believe that vibratory stimulation is a useful test, quick and easy to perform. In conjunction with questionnaires, clinical examination, positional testing and the results of audiometry, it gives an immediate indication of a peripheral lesion when the vertigo is seen for the first time. With unilateral deafness, a positive test leads one to suspect an acoustic neuroma. Conversely if the test becomes negative after a vestibular neuritis when it was initially positive, it is a sign of recovery.",Not Found,No pdf
196,378,379,Clin Neurophysiol,"D. M. Miller, J. F. Baker and W. Z. Rymer Ascending vestibular drive is asymmetrically distributed to the inferior oblique motoneuron pools in a subset of hemispheric stroke survivors 2016",PubMed,0.0,1.0,Population,chronic stroke,,0.0,Ascending vestibular drive is asymmetrically distributed to the inferior oblique motoneuron pools in a subset of hemispheric stroke survivors,"Abstract
Objective: Aberrant vestibular nuclear function is proposed to be a principle driver of limb muscle spasticity after stroke. Although spasticity does not manifest in ocular muscles, we sought to determine whether altered cortical modulation of ascending vestibuloocular pathways post-stroke could impact the excitability of ocular motoneurons.
Methods: Nineteen chronic stroke survivors, aged 49-68 yrs. were enrolled. Vestibular evoked myogenic potentials (VEMPs) were recorded from the inferior oblique muscles of the eye using surface EMG electrodes. We assessed the impact of ascending otolith pathways on eye muscle activity and evaluated the relationship between otolith-ocular function and the severity of spasticity.
Results: VEMP responses were recorded bilaterally in 14/19 subjects. Response magnitude on the affected side was significantly larger than on the spared side. In a subset of subjects, there was a strong relationship between affected response amplitude and the severity of limb spasticity, as estimated using a standard clinical scale.
Conclusions: This study suggests that alterations in ascending vestibular drive to ocular motoneurons contribute to post-stroke spasticity in a subset of spastic stroke subjects. We speculate this imbalance is a consequence of the unilateral disruption of inhibitory corticobulbar projections to the vestibular nuclei.
Significance: This study potentially sheds light on the underlying mechanisms of post-stroke spasticity.
Keywords: Hemispheric stroke; Human; Motoneuron; Ocular vestibular evoked myogenic potentials; Otolith-ocular pathways; Post-stroke spasticity.",doi: 10.1016/j.clinph.2016.01.019.,miller2016.pdf
197,379,380,Clin Neurophysiol,"D. M. Miller, C. S. Klein, N. L. Suresh and W. Z. Rymer Asymmetries in vestibular evoked myogenic potentials in chronic stroke survivors with spastic hypertonia: evidence for a vestibulospinal role 2014",PubMed,0.0,1.0,Population,chronic stroke survivors,,0.0,Asymmetries in vestibular evoked myogenic potentials in chronic stroke survivors with spastic hypertonia: evidence for a vestibulospinal role,"Abstract
Objective: Indirect evidence suggests that lateralized changes in motoneuron behavior post-stroke are potentially due to a depolarizing supraspinal drive to the motoneuron pool, but the pathways responsible are unknown. In this study, we assessed vestibular evoked myogenic potentials (VEMPs) in the neck muscles of hemispheric stroke survivors with contralesional spasticity to quantify the relative levels of vestibular drive to the spastic-paretic and contralateral motoneuron pools.
Methods: VEMPs were recorded from each sternocleidomastoid muscle in chronic stroke survivors. Side-to-side differences in cVEMP amplitude were calculated and expressed as an asymmetry ratio, a proxy for the relative amount of vestibular drive to each side.
Results: Spastic-paretic VEMPs were larger than contralateral VEMPs in 13/16 subjects. There was a strong positive relationship between the degree of asymmetry and the severity of spasticity in this subset of subjects. Remaining subjects had larger contralateral responses.
Conclusion: Vestibular drive to cervical motoneurons is asymmetric in spastic stroke survivors, supporting our hypothesis that there is an imbalance in descending vestibular drive to motoneuron pools post-stroke. We speculate this imbalance is a consequence of the unilateral disruption of inhibitory corticobulbar projections to the vestibular nuclei.
Significance: This study sheds new light on the underlying mechanisms of post-stroke spasticity.
Keywords: Chronic stroke subjects; Hemispheric stroke; Human; Motoneuron; Post-stroke spasticity; Vestibular evoked myogenic potentials; Vestibulospinal.",doi: 10.1016/j.clinph.2014.01.035.,miller2014.pdf
198,380,381,Am J Otol,L. B. Minor Intratympanic gentamicin for control of vertigo in Meniere's disease: vestibular signs that specify completion of therapy 1999,PubMed,1.0,,,,,0.0,Intratympanic gentamicin for control of vertigo in Meniere's disease: vestibular signs that specify completion of therapy,"Abstract
Objective: To determine if a protocol of weekly intratympanic gentamicin injections administered until development of signs of unilateral vestibular hypofunction can alleviate vertigo while preserving hearing in patients with intractable vertigo caused by unilateral Meniere's disease.
Study design: The study design was a prospective investigational protocol.
Setting: The study was performed in outpatients at a tertiary referral center.
Patients: Entry criteria included a diagnosis of ""definite"" Meniere's disease according to the 1995 report of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS), intractable vertigo despite optimal medical therapy, no symptoms suggestive of Meniere's disease in the contralateral ear and serviceable hearing in the contralateral ear. The outcomes of the first 34 patients who entered the protocol are reported.
Intervention: A buffered gentamicin solution was injected into the middle ear at weekly intervals until development of spontaneous nystagmus, head-shaking-induced nystagmus, or head-thrust sign indicative of vestibular hypofunction in the treated ear.
Main outcome measure: The 1995 AAO-HNS criteria for reporting treatment outcome in Meniere's disease were used. The effects of treatment were assessed in terms of control of vertigo, disability status, hearing level, and quantitative measurement of vestibular function with caloric and rotatory chair tests.
Results: Vertigo was controlled in 91% of the patients. Profound hearing loss occurred as a result of gentamicin injection in one patient (3%). Intratympanic gentamicin was significantly less effective in controlling vertigo in patients who had previous otologic surgery on the affected ear. Recurrence of vertigo > or = 6 months after initially complete control was noted in seven patients (22%). Vertigo in six of these patients was eliminated by additional intratympanic gentamicin injections.
Conclusions: Ending weekly intratympanic gentamicin injections when clinical signs of unilateral vestibular hypofunction appear can control vertigo in most patients. Hearing loss directly attributable to gentamicin is uncommon. Treatment outcome is best in patients who have not had previous otologic surgery.",Not Found,No pdf
199,381,382,Auris Nasus Larynx,N. Mizushima and Y. Murakami Deafness following mumps: the possible pathogenesis and incidence of deafness 1986,PubMed,0.0,1.0,Population,unilateral deafness,,0.0,Deafness following mumps: the possible pathogenesis and incidence of deafness,"Abstract
Mumps is thought to be the most common cause of unilateral acquired sensorineural deafness in children. Mumps deafness is usually sudden in onset, profound or complete, and may be associated with vestibular symptoms. The authors' clinical survey of 55 patients with unilateral deafness which could reasonably be ascribed to mumps indicates that the hearing loss is exclusively unilateral, severe or total and permanent, and that approximately 45% of the patients experienced dysequilibrium of vestibular origin. An analysis of the present series of mumps deafness also suggests that the primary route of invasion of the virus is hematogenous, and thus the term ""viral endolymphatic labyrinthitis"" is proposed as the possible pathogenesis of the deafness, since both tympanogenic and meningogenic routes of viral invasion to the labyrinth can be excluded on the basis of the clinical and cerebrospinal fluid studies. This view of the pathogenesis, particularly that mumps meningitis is not associated with deafness, is supported by several reports including those of Vuori et al. (1962), Azimi et al., (1969), Lindsay (1973), Nadol (1978), etc. The incidence of deafness following mumps appears to be extremely low, approximately 1:20,000, as estimated by Everberg (1957).",doi: 10.1016/s0385-8146(86)80035-9.,mizushima1986.pdf
200,382,383,Eur J Neurol,"K. Möhwald, H. Hadzhikolev, S. Bardins, S. Becker-Bense, T. Brandt, E. Grill, K. Jahn, M. Dieterich and A. Zwergal Health-related quality of life and functional impairment in acute vestibular disorders 2020",PubMed,1.0,,,,,0.0,Health-related quality of life and functional impairment in acute vestibular disorders,"Abstract
Background and purpose: Acute vestibular symptoms have a profound impact on patients' well-being. In this study, health-related quality of life (HRQoL) and functional impairment were investigated prospectively in patients with different peripheral and central vestibular disorders during the acute symptomatic stage to decipher the most relevant underlying factors.
Methods: In all, 175 patients with acute vestibular disorders were categorized as central vestibular (CV, n = 40), peripheral vestibular (PV, n = 68) and episodic vestibular disorders (EV, n = 67). All patients completed scores to quantify generic HRQoL (European Quality of Life Score Five Dimensions Five Levels, EQ-5D-5L) and disease-specific HRQoL (Dizziness Handicap Inventory, DHI). Vestibular-ocular motor signs were assessed by video-oculography, vestibular-spinal control by posturography and verticality perception by measurement of subjective visual vertical.
Results: Patients with PV had a poorer HRQoL compared to patients with CV and EV (EQ-5D-5L/DHI: PV, 0.53 ± 0.31/56.1 ± 19.7; CV, 0.66 ± 0.28/43.3 ± 24.0; EV, 0.75 ± 0.24/46.7 ± 21.4). After adjusting for age, gender, cardiovascular risk factors and non-vestibular brainstem/cerebellar dysfunction patients with PV persisted to have poorer generic and disease-specific HRQoL (EQ-5D-5L -0.17, DHI +11.2) than patients with CV. Horizontal spontaneous nystagmus was a highly relevant factor for subgroup differences in EQ-5D-5L and DHI, whilst vertical spontaneous nystagmus, subjective visual vertical and sway path were not. EQ-5D-5L decreased significantly with more intense horizontal subjective visual vertical in CV (rho = -0.57) and PV (rho = -0.5) but not EV (rho = -0.13).
Conclusions: Patients with PV have the highest functional impairment of all patients with acute vestibular disorders. Vestibular-ocular motor disturbance in the yaw plane has more impact than vestibular-spinal or vestibular-perceptive asymmetry in the roll and pitch plane, suggesting that horizontal visual stability is the most critical for HRQoL.
Keywords: acute unilateral peripheral vestibulopathy; quality of life; recurrent vestibulopathies; vestibular stroke; video-oculography.",doi: 10.1111/ene.14318.,10.1111@ene.14318.pdf
201,384,385,Ugeskr Laeger,"M. N. Møller, P. Cayé-Tomasen and J. H. Thomsen Vestibular nerve section in the treatment of morbus Ménière 2009",PubMed,0.0,1.0,Design,Danish,,0.0,[Vestibular nerve section in the treatment of morbus Ménière],"Abstract
Introduction: Vestibular nerve section in the treatment of Mb. Ménière was introduced in Denmark in 1980. This treatment is centralised at Gentofte Hospital and we have previously published the results from 1980-1996. We here present the updated results from 2000-2007 with a total of 18 patients.
Material and methods: Systematic review of case journals and questionnaires regarding postoperative satisfaction, vertigo control and influence on daily activities.
Results: All patients achieved total vertigo spell control. In total 15 patients (83%) indicated satisfaction with the operation. Sixteen patients (89%) reported that vertigo had no, mild, or moderate influence on their daily activities. The difference between pre- and postoperative functional level was highly significant. Expected consequences of unilateral ablation in the form of imbalanced gait or lingering sensation of dizziness occurred to varying degrees in 14 patients (78%).
Complications: Two patients developed postoperative liquorrhoea and one patient partial facial palsy.
Conclusion: The results demonstrate that vestibular nerve section causes vertigo spell control and improved daily functional levels in patients with severe and otherwise untreatable Mb. Ménière. These results are in accordance with international publications. New prospects in vestibular rehabilitation promise significant reductions of the postoperative imbalance. Continued centralisation of the surgical intervention is recommended, as is providing patients with information of the positive results of this treatment.",Not Found,No pdf
202,385,386,Acta Otolaryngol Suppl,"H. Monobe, K. Sugasawa and T. Murofushi The outcome of the canalith repositioning procedure for benign paroxysmal positional vertigo: are there any characteristic features of treatment failure cases? 2001",PubMed,0.0,1.0,Outcome,no long term follow up,,0.0,The outcome of the canalith repositioning procedure for benign paroxysmal positional vertigo: are there any characteristic features of treatment failure cases?,"Abstract
To demonstrate the success rate of the canalith repositioning procedure (CRP) in our clinic and to establish any characteristic features of cases of treatment failure, we reviewed clinical records of 62 patients who were diagnosed with posterior semicircular canal-benign paroxysmal positional vertigo (BPPV) and treated with the CRP. The basic strategy of the CRP was to rotate the involved canal slowly in the plane of gravity so that free-floating materials could migrate into the utricle only once. After the procedure we instructed patients to keep their heads upright for 10 h and not to sleep on the affected ear for 2 weeks. After the initial treatment, successful results were obtained in 51 of the 62 patients (82.2%). After the second treatment, 56 patients (90.3%) experienced success. Six patients (9.7%) did not obtain resolution even after the second treatment. While 46 patients were diagnosed with idiopathic BPPV, in 16 patients a different diagnosis was determined (head injury in 7 patients, Ménière's disease in 2, vestibular neuritis in 2 and unilateral sensorineural hearing loss in 5). We categorized these 16 patients as having secondary BPPV. Patients with idiopathic BPPV showed a significantly higher success rate with CRP than those with secondary BPPV. Patients with secondary BPPV may have quantitatively or qualitatively different lesions than those with idiopathic BPPV.",doi: 10.1080/000164801750388081.,10.1080@000164801750388081.pdf
203,387,388,Laryngoscope,"L. Montes-Jovellar, F. Guillen-Grima and N. Perez-Fernandez Cluster analysis of auditory and vestibular test results in definite Menière's disease 2011",Pubmed,1.0,,,,,0.0,Cluster analysis of auditory and vestibular test results in definite Menière's disease,"Abstract
Objectives/hypothesis: To determine whether patients with Menière's disease can be grouped into distinct subtypes based on a cluster analysis of distinct disease parameters.
Study design: Prospective study at a tertiary center associated with a university hospital.
Methods: The study included 153 patients diagnosed with unilateral definite Menière's disease. The main variables employed were taken from auditory, vestibular, posturographic, and disability assessments.
Results: A four-cluster solution best fitted the data. Each cluster represented a distinct patient profile. Cluster 1 patients (13.1%) were the eldest, with the worst hearing bilaterally and good vestibular function but with a significant postural impact and a low level of disability. Cluster 2 patients (41.2%) were the least affected in all the parameters that were close to normal. Cluster 3 patients (34.6%) were the most affected, experiencing frequent and intense vertigo attacks, and they were visually dependent. Cluster 4 patients (11.1%) had strong asymmetric hearing between both ears and the most uncompensated vestibular deficit; they were moderately disabled.
Conclusions: We have identified four distinct profiles of patients with definite Menière's disease that we consider as ""mildly active elderly,"" ""mildly active young,"" ""active compensated,"" and ""active uncompensated."" We have demonstrated that only in a restricted population of patients can the American Academy of Otolaryngology-Head and Neck Surgery staging system provide analysis of subtypes of the disease.",doi: 10.1002/lary.21844.,montes-jovellar2011.pdf
204,389,390,J Clin Neurol,"S. Moon, B. Lee and D. Na Therapeutic effects of caloric stimulation and optokinetic stimulation on hemispatial neglect 2006",PubMed,0.0,1.0,Design,Review,,0.0,Therapeutic effects of caloric stimulation and optokinetic stimulation on hemispatial neglect,"Abstract
Hemispatial neglect refers to a cognitive disorder in which patients with unilateral brain injury cannot recognize or respond to stimuli located in the contralesional hemispace. Hemispatial neglect in stroke patients is an important predictor for poor functional outcome. Therefore, there is a need for effective treatment for this condition. A number of interventions for hemispatial neglect have been proposed, although an approach resulting in persistent improvement is not available. Of these interventions, our review is focused on caloric stimulation and optokinetic stimulation. These lateralized or direction-specific stimulations of peripheral sensory systems can temporarily improve hemispatial neglect. According to recent functional MRI and PET studies, this improvement might result from the partial (re)activation of a distributed, multisensory vestibular network in the lesioned hemisphere, which is a part of a system that codes ego-centered space. However, much remain unknown regarding exact signal timing and directional selectivity of the network.
Keywords: Caloric stimulation; Ego-centered space; Neglect; Optokinetic stimulation; Vestibular cortex.",doi: 10.3988/jcn.2006.2.1.12.,349cb4f5de878dd941e6d083a4124112.pdf
205,390,391,Auris Nasus Larynx,"H. Morimoto, Y. Asai, E. G. Johnson, Y. Koide, J. Niki, S. Sakai, M. Nakayama, K. Kabaya, A. Fukui, Y. Mizutani, T. Mizutani, Y. Ueki, J. Mizutani, T. Ueki and I. Wada Objective measures of physical activity in patients with chronic unilateral vestibular hypofunction, and its relationship to handicap, anxiety and postural stability 2019",PubMed,1.0,,,,,1.0,"Objective measures of physical activity in patients with chronic unilateral vestibular hypofunction, and its relationship to handicap, anxiety and postural stability","Abstract
Objective: Dizziness is one of the most common symptoms in the general population. Patients with dizziness experience balance problems and anxiety, which can lead to decreased physical activity levels and participation in their daily activities. Moreover, recovery of vestibular function from vestibular injury requires physical activity. Although there are reports that decreased physical activity is associated with handicap, anxiety, postural instability and reduced recovery of vestibular function in patients with chronic dizziness, these data were collected by self-report questionnaires. Therefore, the objective data of physical activity and the relationships between physical activity, handicap, anxiety and postural stability in patients with chronic dizziness are not clear. The purpose of this research was to objectively measure the physical activity of patients with chronic dizziness in daily living as well as handicap, anxiety and postural stability compared to healthy adults. Additionally, we aimed to investigate the relationships between physical activity, handicap, anxiety and postural stability in patients with chronic dizziness.
Methods: Twenty-eight patients with chronic dizziness of more than 3 months caused by unilateral vestibular hypofunction (patient group) and twenty-eight age-matched community dwelling healthy adults (healthy group) participated in this study. The amount of physical activity including time of sedentary behavior, light physical activity, moderate to vigorous physical activity and total physical activity using tri-axial accelerometer, self-perceived handicap and anxiety using questionnaires, and postural stability were measured using computerized dynamic posturography.
Results: The results showed worse handicap, anxiety and postural stability in the patient group compared to the healthy group. Objective measures of physical activity revealed that the patient group had significantly longer time of sedentary behavior, shorter time of light physical activity, and shorter time of total physical activity compared to the healthy group; however, time of moderate to vigorous physical activity was not significantly different between groups. Moreover, there were correlations between physical activity and postural stability in the patient group, while there were no correlations between physical activity, handicap or anxiety in the patient group.
Conclusion: These results suggest that objectively measured physical activity of the patients with chronic unilateral vestibular hypofunction is lower compared to the healthy adults, and less active patients showed decreased postural stability. However, the details of physical activity and causal effect between physical activity and postural stability were not clear and further investigation is needed.
Keywords: Accelerometer; Anxiety; Chronic dizziness; Inactivity; Physical activity; Postural stability.",doi: 10.1016/j.anl.2018.06.010.,morimoto2018.pdf
206,391,392,Acta Otolaryngol,S. Morinaka Effect of experimental acidosis on nystagmus in rabbits 1994,PubMed,0.0,1.0,Population,Animal study,,0.0,Effect of experimental acidosis on nystagmus in rabbits,"Abstract
Vertigo related to acidosis in Meniere's disease has been reported. This study was undertaken to ascertain whether acidosis has any effect on vertigo. Since patients with Meniere's disease usually show unilateral vestibular dysfunction, unilateral intratympanic injection of streptomycin sulfate (SM) was used to induce unilateral vestibular dysfunction in rabbits. Intratympanic SM injections induced vestibular destruction and elicited severe spontaneous nystagmus and ataxia. Then symptoms of acute vestibular upset gradually subsided and eventually disappeared completely. Three weeks after SM injections, in compensated rabbits, NH4Cl injection or CO2 inhalation was used to induce acidosis. Intravenous NH4Cl injection or CO2 inhalation induced nystagmus and ataxia again. In normal rabbits, no nystagmus was induced by NH4Cl injection or by CO2 inhalation. These results suggest that acidosis might be a cause of recurrence of vertigo in patients with unilateral vestibular dysfunction.",doi: 10.3109/00016489409126030.,morinaka1994.pdf
207,393,394,Otol Neurotol,"M. Morioka, S. Sugimoto, T. Yoshida, M. Teranishi, M. Kobayashi, N. Nishio, N. Katayama, S. Naganawa and M. Sone Dilatation of the Endolymphatic Space in the Ampulla of the Posterior Semicircular Canal: A New Clinical Finding Detected on Magnetic Resonance Imaging 2021",PubMed,0.0,1.0,Outcome,Imaging,,0.0,Dilatation of the Endolymphatic Space in the Ampulla of the Posterior Semicircular Canal: A New Clinical Finding Detected on Magnetic Resonance Imaging,"Abstract
Objectives: To investigate the clinical features of ears with dilatation of the endolymphatic space in the ampulla of the posterior semicircular canal on magnetic resonance imaging.
Study design: Retrospective study.
Setting: A university hospital.
Methods: This study included 1,842 ears from 934 patients who underwent 3-T magnetic resonance imaging with gadolinium to investigate the presence of endolymphatic hydrops. Age, sex distribution, hearing thresholds on pure-tone audiometry, and vestibular symptoms were compared between cases of unilateral and bilateral dilatation of the endolymphatic space in the ampulla of the posterior semicircular canal.
Results: Forty-eight ears (17 men and 14 women; mean age 49.9 yrs) showed dilatation of the endolymphatic space in the ampulla of the posterior semicircular canal. Age and the rate of chronic sensorineural hearing loss were significantly higher in the unilateral group (14 ears) than in the bilateral group (34 ears). The average hearing thresholds and rates of vestibular symptoms reported did not differ between unilateral and bilateral cases, but some patients showed positional nystagmus.
Conclusions: Dilatation of the endolymphatic space in the ampulla was observed selectively in the posterior semicircular canal, though its pathogenesis was not clear. Such dilatation is not usually accompanied by vestibular endolymphatic hydrops, and it may be a cause of vertigo and dizziness.",doi: 10.1097/MAO.0000000000003073.,No pdf
208,395,396,Otol Neurotol,"Y. Morita, K. Takahashi, S. Izumi, Y. Kubota, S. Ohshima and A. Horii Vestibular Involvement in Patients With Otitis Media With Antineutrophil Cytoplasmic Antibody-associated Vasculitis 2017",PubMed,0.0,1.0,Population,Patients With Otitis Media,,0.0,Vestibular Involvement in Patients With Otitis Media With Antineutrophil Cytoplasmic Antibody-associated Vasculitis,"Abstract
Objective: Otitis media (OM) with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (OMAAV) is a novel concept of ear disease that is characterized by progressive mixed or sensorineural hearing loss with occasional systemic involvement. Considering the accumulating knowledge about the characteristics of and treatment for auditory dysfunction in OMAAV, the objective of this study was to investigate the vestibular function and symptoms of patients with OMAAV.
Study design: Retrospective chart review.
Setting: University hospital.
Patients: Thirty-one OMAAV patients met criteria proposed by the OMAAV study group in Japan.
Main outcome measures: Clinical characteristics and vestibular tests.
Results: Eleven of 31 OMAAV patients had vestibular symptoms; 3 patients had acute vertigo attack with sudden hearing loss and 8 patients had chronic dizziness. Episodic vertigo was not seen in any of the patients. Three patients who received a less intensive therapy without immunosuppressive agents developed intractable persistent dizziness. All symptomatic patients and six of the nine OMAAV patients without vestibular symptoms showed unilateral or bilateral caloric weakness; therefore, vestibular involvement was present in 84% of OMAAV patients. Gain of vestibulo-ocular reflex was reduced in symptomatic patients. The eye-tracking test and optokinetic nystagmus revealed no evidence of central dysfunction.
Conclusion: Vestibular dysfunction was seen in 84% of OMAAV patients. One-third of OMAAV patients showed vestibular symptoms such as acute vertigo attack or chronic dizziness, which are of peripheral origin. One-third of the symptomatic patients developed intractable dizziness. Initial intensive treatment by combination therapy with steroid and immunosuppressive agents may be essential for preventing the development of intractable dizziness.",doi: 10.1097/MAO.0000000000001223.,morita2016.pdf
209,396,397,Clin Neurophysiol,"J. A. Müller, C. J. Bockisch and A. A. Tarnutzer Spatial orientation in patients with chronic unilateral vestibular hypofunction is ipsilesionally distorted 2016",PubMed,1.0,,,,,1.0,Spatial orientation in patients with chronic unilateral vestibular hypofunction is ipsilesionally distorted,"Abstract
Objective: Acute unilateral peripheral-vestibular hypofunction (UVH) shifts the subjective visual vertical (SVV) ipsilesionally, triggering central compensation that usually eliminates shifts when upright. We hypothesized that compensation is worse when roll-tilted.
Methods: We quantified SVV errors and variability in different roll-tilted positions (0°, ±45°, ±90°) in patients with chronic UVH affecting the superior branch (SVN; n=4) or the entire (CVN; n=9) vestibular nerve.
Results: Errors in SVN and CVN were not different. When roll-tilted ipsilesionally 45° (9.6±5.4° vs. -0.2±6.4°, patients vs. controls, p<0.001) and 90° (23.5±5.7° vs. 16.8±8.8°, p=0.003), the patient's SVV was shifted significantly towards the lesioned ear. When upright, only a trend was noted (3.6±2.2° vs. 0.0±1.2°, p=0.099); for contralesional roll-tilts shifts were not different from controls. Variability was larger for CVN than SVN (p=0.046). With increasing disease-duration, adjustment errors decayed for ipsilesional roll-tilt and upright (p⩽0.025).
Conclusions: The reason verticality perception was distorted for ipsilesional roll-tilts, may be the insufficient integration of contralesional otolith-input. Similar errors in SVN and CVN suggest a dominant utricular role in verticality perception, albeit the sacculus may improve precision of SVV estimates.
Significance: With deficiencies in central compensation being roll-angle dependent, extending SVV-testing to roll-tilted positions may improve identifying patients with chronic UVH.
Keywords: Graviception; Otolith organs; Sacculus; Subjective visual vertical; Utriculus; Vestibular neuropathy.",doi: 10.1016/j.clinph.2016.07.010.,10.1016@j.clinph.2016.07.010.pdf
210,398,399,Am J Otolaryngol,"G. T. Nager, S. A. Stein, J. P. Dorst, M. J. Holliday, D. W. Kennedy, K. W. Diehn and E. W. Jabs Sclerosteosis involving the temporal bone: clinical and radiologic aspects 1983",PubMed,0.0,1.0,Population,Scleroterosis,,0.0,Sclerosteosis involving the temporal bone: clinical and radiologic aspects,"Abstract
Sclerosteosis is one of the rare, potentially lethal, autosomal recessive, progressive, craniotubular sclerosing bone dysplasias. Syndactyly of the second and third or other fingers is evident at birth. Hyperostosis and sclerosis are most prominent in the skull and tubular bones, and are frequently associated with excessive height and weight. The typical facial deformity is apparent by the age of 5 years. The changes involving the temporal bone include a marked increase in overall dimensions, extreme sclerosis, and narrowing and constriction of the external ear canal, middle ear cleft, internal acoustic meatus, and falloppian canal. Impairment of hearing, as a rule bilateral, is a frequent presenting symptom which may manifest in early childhood. Initially it is an expression of interference with sound conduction; later it may become associated with a loss of sound perception. Impairment of facial nerve function is another salient feature which occasionally is present at birth. As a rule, it manifests initially as a unilateral, recurrent paresis, eventually progressing to a bilateral permanent partial loss of facial nerve function. Since impairments of hearing and facial nerve function are two of the salient features, present at birth or in early childhood, the responsibility for recognizing the disease often falls upon the otolaryngologist. The clinical and radiologic features permit not only early recognition of the disorder but also differentiation from similar bony dysplasias. Hyperosteosis and sclerosis of the skull lead to thickening and distortion of the calvaria, cranial base, and foramen magnum resulting in reduction of the intracranial volume, interference with the cerebral blood flow, resorption of cerebrospinal fluid, and gradual increase of intracranial pressure. Severe headaches resulting from this mechanism often develop in early adulthood, and several patients have died suddenly from impaction of the medulla oblongata in the foramen magnum. Decompression of the transverse sigmoid sinus and jugular bulb may be lifesaving, combined with a posterior, and if necessary, an anterior, craniectomy for decompression. Early decompression of the internal acoustic meatus and falloppian canal may help in the preservation of cochlear and facial nerve function.",doi: 10.1016/s0196-0709(83)80002-7.,nager1983.pdf
211,399,400,AJNR Am J Neuroradiol,"H. Nakamura, H. Jokura, K. Takahashi, N. Boku, A. Akabane and T. Yoshimoto Serial follow-up MR imaging after gamma knife radiosurgery for vestibular schwannoma 2000",PubMed,0.0,1.0,Outcome,"No symptom, signs",,0.0,Serial follow-up MR imaging after gamma knife radiosurgery for vestibular schwannoma,"Abstract
Background and purpose: Gamma knife radiosurgery has become an important treatment option for vestibular schwannoma. The effect of treatment can be assessed only by neuroimaging. We analyzed the evolution of follow-up MR imaging findings after gamma knife radiosurgery to provide information for the clinical management of these tumors.
Methods: Changes in tumor volume and enhancement were assessed visually on 341 follow-up MR studies obtained in 78 of 86 consecutive patients with unilateral vestibular schwannoma who underwent gamma knife radiosurgery.
Results: Follow-up MR studies were obtained between 10 and 63 months (mean, 34 months) after treatment. Tumor control rate was 81%. Changes in tumor volume were classified as temporary enlargement (41%), no change or sustained regression (34%), alternating enlargement and regression (13%), or continuous enlargement (12%). Temporary enlargement occurred within 2 years after radiosurgery. Changes in tumor enhancement were classified as transient loss of enhancement (84%), continuous increase in enhancement (5%), or no change in enhancement (11%). There was no significant correlation between changes in tumor volume and tumor enhancement. Areas of T2 hyperintensity in adjacent brain tissue appeared in 31% of patients.
Conclusion: Dynamic changes in vestibular schwannoma are seen on serial follow-up MR studies obtained after gamma knife radiosurgery. An increase in tumor size up to 2 years after radiosurgery is likely to be followed by regression. Changes in contrast enhancement are not predictive of clinical outcome. Neuroimaging follow-up is recommended.",Not Found,No pdf
212,401,402,J Clin Sleep Med,"M. Nakayama, A. Masuda, K. B. Ando, S. Arima, K. Kabaya, A. Inagaki, Y. Nakamura, M. Suzuki, H. Brodie, R. C. Diaz and S. Murakami A Pilot Study on the Efficacy of Continuous Positive Airway Pressure on the Manifestations of Ménière's Disease in Patients with Concomitant Obstructive Sleep Apnea Syndrome 2015",PubMed,0.0,1.0,Outcome,Sleep apne,,0.0,A Pilot Study on the Efficacy of Continuous Positive Airway Pressure on the Manifestations of Ménière's Disease in Patients with Concomitant Obstructive Sleep Apnea Syndrome,"Abstract
Objectives: To evaluate the effect of continuous positive airway pressure (CPAP) therapy on Ménière's disease patients with concomitant obstructive sleep apnea syndrome (OSAS), since recent reports suggest OSAS may cause dysfunction of the vestibular system.
Study design: Prospective study using CPAP administered to patients diagnosed with ""Definite Ménière's disease"" according to the guidelines of the American Academy of Otolaryngology--Head and Neck Surgery and combined with OSAS.
Setting: University hospital.
Methods: Twenty consecutive patients, 14 male and 6 female with active, unilateral, cochleovestibular Ménière's disease refractory to medical management who also had concurrent OSAS as defined by International Classification of Sleep Disorders, Second Edition were selected to undergo solitary CPAP therapy. Audiometric testing, caloric testing, and DHI survey were conducted before and after CPAP therapy and compared to assess effectiveness of CPAP therapy as utilized for treatment of Ménière's disease.
Results: Although caloric testing did not show significant difference, audiometric testing and results of dizziness handicap inventory were significantly improved (p < 0.05) after CPAP therapy only, without standard treatment for Ménière's disease.
Conclusion: Recent reports have suggested that OSAS may cause dysfunction of the vestibular system. We investigated whether standard therapy for OSAS would be of benefit in the management of vertigo and hearing loss in Ménière's disease patients. Our study cohort demonstrated significant improvement in both DHI and audiometric testing following solitary CPAP therapy for OSAS. Solitary CPAP therapy may become a new effective treatment strategy for Ménière's disease patients with OSAS, not just only for control of dizziness and vertigo but also for potential benefit of hearing.
Keywords: CPAP; DHI; Ménière's disease; OSAS; audiogram; caloric test; sleep.",doi: 10.5664/jcsm.5080.,nakayama2015.pdf
213,402,403,Int J Pediatr Otorhinolaryngol,"V. R. Nanduri, J. Pritchard, W. K. Chong, P. D. Phelps, K. Sirimanna and C. M. Bailey Labyrinthine involvement in Langerhans' cell histiocytosis 1998",PubMed,0.0,1.0,Design,Review,,0.0,Labyrinthine involvement in Langerhans' cell histiocytosis,"Abstract
Background: Langerhans' cell histiocytosis, a rare condition caused by the proliferation of abnormal Langerhans' cells ('LCH cells') and an accompanying granulomatous infiltrate, can affect several organs including the ear. External and middle ear involvement are common with a reported incidence as high as 61%. The bony labyrinth is resistant to erosion by the granulation tissue, thereby protecting the cochlea and vestibular structures. Probably for this reason, involvement of the inner ear is rare, with few case reports in the literature.
Patients: We report two girls, one with bilateral and the other with unilateral mastoid involvement, in whom there was invasion of the labyrinth. The first girl had 'single system' LCH affecting only bone and developed an acute hearing loss due to invasion of the cochlea, while the second had both bone and skin involvement and labyrinthine involvement was diagnosed on imaging prior to the onset of labyrinthine symptoms.
Conclusion: Inner ear involvement can lead to permanent deafness, which may be prevented by early institution of treatment. Threatened inner ear involvement requires urgent systemic medical therapy with steroids, possibly combined with chemotherapy.",doi: 10.1016/s0165-5876(98)00116-5.,nanduri1998.pdf
214,404,405,Evidence review for imaging to investigate the cause of non-pulsatile tinnitus: Tinnitus: assessment and management: Evidence review J,C. National Guideline 2020,PubMed,0.0,1.0,Design,Guideline,,0.0,Not Found,Not Found,Not Found,No pdf
215,406,407,Otol Neurotol,"E. Navari, N. Cerchiai and A. P. Casani Assessment of Vestibulo-ocular Reflex Gain and Catch-up Saccades During Vestibular Rehabilitation 2018",PubMed,1.0,,,,,0.0,Assessment of Vestibulo-ocular Reflex Gain and Catch-up Saccades During Vestibular Rehabilitation,"Abstract
Objective: To assess, in patients referred to vestibular rehabilitation (VR) for persistence of disability after acute unilateral vestibulopathy (AUV), whether the video head impulse test (vHIT) can be a useful technique to define the efficacy of the treatment.
Study design: Prospective clinical study.
Setting: Tertiary academic referral hospitals.
Patients: Thirty patients with residual symptoms after AUV were included.
Intervention: Patients underwent a 10-week VR program.
Main outcome measures: Evaluation of dizziness handicap inventory score, high-velocity vestibulo-ocular reflex gain, asymmetry index, and catch-up saccade parameters before and after VR.
Results: All patients reported a clear clinical improvement after VR, also demonstrated by better dizziness handicap inventory scores (p < 0.001). A consistent increased gain and decreased asymmetry index were also observed (p < 0.001 for both). Patients did not show any change in covert catch-up saccades, while a statistically significant reduction of the number and amplitude of the overt catch-up saccades was interestingly detected (p = 0.009 and p = 0.030, respectively).
Conclusion: VR is a valid approach for patients with residual disability after AUV. A reduction in number and amplitude of overt catch-up saccades seems useful to evaluate the efficacy of VR and to be related to clinical improvement.",doi: 10.1097/MAO.0000000000002032.,c0e9fa238cb8aae9b633b91831f66c65.pdf
216,407,408,Otol Neurotol,"B. A. Neff, J. P. Staab, S. D. Eggers, M. L. Carlson, W. R. Schmitt, K. M. Van Abel, D. K. Worthington, C. W. Beatty, C. L. Driscoll and N. T. Shepard Auditory and vestibular symptoms and chronic subjective dizziness in patients with Ménière's disease, vestibular migraine, and Ménière's disease with concomitant vestibular migraine 2012",PubMed,1.0,,,,,0.0,"Auditory and vestibular symptoms and chronic subjective dizziness in patients with Ménière's disease, vestibular migraine, and Ménière's disease with concomitant vestibular migraine","Abstract
Objective: To compare presentations of Ménière's disease (MD), vestibular migraine (VM), and Ménière's disease plus vestibular migraine (MDVM), with and without comorbid chronic subjective dizziness (CSD).
Study design: Retrospective review with diagnosis confirmed by consensus conference of investigators using published criteria for MD, VM, and CSD.
Setting: Ambulatory, tertiary dizziness clinic.
Patients: Approximately 147 consecutive patients with diagnoses of MD, VM, or MDVM, with/without comorbid CSD.
Interventions: Diagnostic consultation.
Main outcome measures: Similarities and differences between diagnostic groups in demographics; symptoms; and results of neurotologic, audiometric, and vestibular laboratory assessments.
Results: Seventy-six patients had MD, 55 MD alone. Ninety-two patients had VM, 71 VM alone. Twenty-one patients had MDVM, representing about one-quarter of those diagnosed with MD or VM. Clinical features thought to differentiate VM from MD were found in all groups. Twenty-seven patients with VM (38%) had ear complaints (subjective hearing loss, aural pressure, and tinnitus) during episodes of vestibular symptoms and headache, including 10 (37%) with unilateral symptoms. Conversely, 27 patients with MD alone (49%) had headaches with migraine features that did not meet full IHS diagnostic criteria, migrainous symptoms (photophobia, headache with vomiting), or first-degree relative with migraine. Including MDVM patients, 59% (45/76) of all patients with MD had migrainous features. Thirty-two patients had CSD; most (29; 91%) were in the VM group.
Conclusion: Comorbidity was common between MD and VM, and their symptoms overlapped. More specific diagnostic criteria are needed to differentiate these diseases and address their coexistence. CSD co-occurred with VM but was rarely seen with MD.",doi: 10.1097/MAO.0b013e31825d644a.,neff2012.pdf
217,415,416,Front Neurol,"I. Ocak, V. Topsakal, P. Van de Heyning, G. Van Haesendonck, C. Jorissen, R. van de Berg, O. M. Vanderveken and V. Van Rompaey Impact of Superior Canal Dehiscence Syndrome on Health Utility Values: A Prospective Case-Control Study 2020",PubMed,0.0,1.0,Outcome,"No symptom, signs",,0.0,Impact of Superior Canal Dehiscence Syndrome on Health Utility Values: A Prospective Case-Control Study,"Abstract
Introduction: Superior canal dehiscence syndrome (SCDS) is a condition characterized by a defect in the bone overlying the superior semicircular canal, creating a third mobile window into the inner ear. Patients can experience disabling symptoms and opt for surgical management. Limited data are available on the impact of SCDS on health-related quality of life (HRQoL) and disease-specific HRQoL more specifically. Objective: To perform a prospective analysis on generic HRQoL in SCDS patients compared to healthy age-matched controls. Methods: A prospective study was performed on patients diagnosed with SCDS and who did not undergo reconstructive surgery yet. Patients were recruited between November 2017 and January 2020 and asked to complete the Health Utility Index (HUI) Mark 2 (HUI2)/Mark 3 (HUI3) questionnaire. For the control group, age-matched participants without otovestibular pathology or other chronic pathology were recruited. The multi-attribute utility function (MAUF) score was calculated for the HUI2 and HUI3. Results of both groups were compared using the Mann-Whitney U test. Results: A total of 20 patients completed the questionnaire. Age ranged from 37 to 79 years with a mean age of 56 years (45% males and 55% females). The control group consisted of 20 participants with a mean age of 56.4 years and ranged from 37 to 82 years (35% males and 65% females). For the case group, median HUI2 MAUF score was 0.75 and median HUI3 MAUF score was 0.65. For the control group, the median scores were 0.88 and 0.86 respectively. There was a statistically significant difference for both HUI2 (p = 0.024) and HUI3 (p = 0.011). SCDS patients had a worse generic HRQoL than age-matched healthy controls. One patient with unilateral SCDS had a negative HUI3 MAUF score (-0.07), indicating a health-state worse than death. Conclusion: SCDS patients have significantly lower health utility values than an age-matched control group. This confirms the negative impact of SCDS on generic HRQoL, even when using an instrument that is not designed to be disease-specific but to assess health state in general. These data can be useful to compare impact on HRQoL among diseases.
Keywords: autophony; health-realeted quality of life; labyrinth diseases; vertigo; vestibular system.",doi: 10.3389/fneur.2020.552495.,ocak2020.pdf
218,418,419,Acta Vet Scand,"L. Østevik, K. Rudlang, T. Holt Jahr, M. Valheim and B. L. Njaa Bilateral tympanokeratomas (cholesteatomas) with bilateral otitis media, unilateral otitis interna and acoustic neuritis in a dog 2018",PubMed,0.0,1.0,Population,Animal study,,0.0,"Bilateral tympanokeratomas (cholesteatomas) with bilateral otitis media, unilateral otitis interna and acoustic neuritis in a dog","Abstract
Background: An aural cholesteatoma, more appropriately named tympanokeratoma, is an epidermoid cyst of the middle ear described in several species, including dogs, humans and Mongolian gerbils. The cyst lining consists of stratified, keratinizing squamous epithelium with central accumulation of a keratin debris. This case report describes vestibular ganglioneuritis and perineuritis in a dog with chronic otitis, bilateral tympanokeratomas and presumed extension of otic infection to the central nervous system.
Case presentation: An 11-year-old intact male Dalmatian dog with chronic bilateral otitis externa and sudden development of symptoms of vestibular disease was examined. Due to the dog's old age the owner opted for euthanasia without any further examination or treatment and the dog was submitted for necropsy. Transection of the ears revealed grey soft material in the external ear canals and pearly white, dry material consistent with keratin in the tympanic bullae bilaterally. The brain and meninges were grossly unremarkable. Microscopical findings included bilateral otitis externa and media, unilateral otitis interna, ganglioneuritis and perineuritis of the spiral ganglion of the vestibulocochlear nerve and multifocal to coalescing, purulent meningitis. A keratinizing squamous epithelial layer continuous with the external acoustic meatus lined the middle ear compartments, consistent with bilateral tympanokeratomas. Focal bony erosion of the petrous portion of the temporal bone and squamous epithelium and Gram-positive bacterial cocci were evident in the left cochlea. The findings suggest that meningitis developed secondary to erosion of the temporal bone and ganglioneuritis and/or perineuritis of the vestibulocochlear nerve.
Conclusions: Middle ear tympanokeratoma is an important and potentially life-threatening otic condition in the dog. Once a tympanokeratoma has developed expansion of the cyst can lead to erosion of bone and extension of otic infection to the inner ear, vestibulocochlear ganglion and nerve potentially leading to bacterial infection of the central nervous system.
Keywords: Cholesteatoma; Dog; Ear; Meningitis; Otitis interna; Tympanokeratoma.",doi: 10.1186/s13028-018-0386-4.,10.1186@s13028-018-0386-4.pdf
219,419,420,Auris Nasus Larynx,"R. Oya, T. Imai, T. Sato, A. Uno, Y. Watanabe, S. Okazaki, Y. Ohta, T. Kitahara, A. Horii and H. Inohara A high jugular bulb and poor development of perivestibular aqueductal air cells are not the cause of endolymphatic hydrops in patients with Ménière's disease 2018",PubMed,0.0,1.0,Outcome,"No symptom, signs",,0.0,A high jugular bulb and poor development of perivestibular aqueductal air cells are not the cause of endolymphatic hydrops in patients with Ménière's disease,"Abstract
Objective: The presence of endolymphatic hydrops in the inner ear, which can be detected with gadolinium-enhanced magnetic resonance imaging (Gd-MRI), is widely recognized as the main pathological cause of Ménière's disease (MD). However, the precise mechanisms underlying the development of endolymphatic hydrops remains unclear. One hypothesis proposes a relationship between the presence of a high jugular bulb (HJB) and MD, which disrupts the vestibular aqueduct leading to the development of endolymphatic hydrops. This study sought to identify anatomical features in MD patients using computed tomography (CT) images of the temporal bone.
Methods: Fifty-nine MD patients meeting the AAO-HNS diagnostic criteria and exhibiting endolymphatic hydrops in Gd-MRI were enrolled between July 2009 and December 2015. We only included MD patients who showed unilateral endolymphatic hydrops in Gd-MRI. Sixty-six patients with otosclerosis or facial palsy were also enrolled as control participants. In both groups, patients with other pathologies (e.g., chronic otitis media or cholesteatoma) and patients <16years old were excluded. HJB was defined as a JB that was observable in the axial CT image at the level where the round window could be visualized. JB surface area was measured on the axial image at the level where the foramen spinosum could be visualized. Finally, to investigate the relationship between the pneumatization of perivestibular aqueductal air cells and the existence of endolymphatic hydrops, the development of the air cells was rated using a three-grade evaluation system and the distance between the posterior semicircular canal (PSCC) and the posterior fossa dura was measured.
Results: The presence of HJB was observed in 22 of 59 affected sides of MD patients and in 17 healthy sides. The likelihood that HJB was detected on an affected side (22/39) was not significantly above chance (50%). The HJB detection rate did not significantly differ between the three groups (MD affected side, MD healthy side, and control patients). Furthermore, there were no significant group differences in JB surface area, distance between the PSCC and posterior fossa dura, or the development of perivestibular aqueductal air cells.
Conclusion: We did not find any relationship between the anatomy of the temporal bones and the existence of endolymphatic hydrops. Moreover, we found no evidence suggesting that HJB or poor development of perivestibular aqueductal air cells were the cause of endolymphatic hydrops in MD patients.
Keywords: Computed tomography; Endolymphatic hydrops; Gadolinium-enhanced magnetic resonance imaging; High jugular bulb; Ménière’s disease.",doi: 10.1016/j.anl.2017.09.014.,oya2017.pdf
220,421,422,Vestn Otorinolaringol,"V. T. Pal'chun, A. L. Guseva, E. V. Baybakova and A. A. Makoeva Recovery of vestibulo-ocular reflex in vestibular neuronitis depending on severity of vestibulo-ocular reflex damage 2019",PubMed,0.0,1.0,Design,Russian,,0.0,[Recovery of vestibulo-ocular reflex in vestibular neuronitis depending on severity of vestibulo-ocular reflex damage],"Abstract in English, Russian
Aim: The aim of this study is to evaluate clinical symptoms and recovery of vestibule-ocular reflex (VOR) in patients with vestibular neuronitis (VN) in dependence on severity of VOR damage according to video head impulse test (vHIT).
Patients and methods: 45 patients with VN and superior or both superior and inferior vestibular nerves involvement were recruited and horizontal gain was measured with vHIT. According to gain asymmetry the patients were divided in three groups: 11 patients with 8-19% gain asymmetry, 10 patients with 20-39% gain asymmetry and 24 patients with more than 40% gain asymmetry.
Results: Coexisting chronic heart and endocrinological diseases could contribute to greater damage of VOR in VN. In patients with less gain asymmetry the full recovery of gain on the affected side was more often. When gain asymmetry was more than 40%, only 10% of patients demonstrated full recovery of gain in 8-12 months. Dynamic visual acuity (DVA) could normalize in patients with clinically significant gain asymmetry. DVA stays decreased more often in patients with in the most gain asymmetry even after vestibular rehabilitation. Benign paroxysmal positional vertigo appeared in 8.9% of patients with VN and had no correlation with VOR asymmetry. Steroid treatment didn't show significant impact on VOR recovery in patients with VN.
Keywords: acute unilateral vestibulopathy; vestibular neuronitis; vestibular ocular reflex; vestibular rehabilitation; video head impulse test.",doi: 10.17116/otorino20198406133.,No pdf
221,422,423,Vestn Otorinolaringol,"V. T. Pal'chun, A. L. Guseva and S. P. Olimpieva Clinical features and treatment of multi-canal benign paroxysmal positional vertigo 2019",PubMed,0.0,1.0,Design,Russian,,0.0,[Clinical features and treatment of multi-canal benign paroxysmal positional vertigo],"Abstract in English, Russian
Objective: To reveal clinical features of natural history, diagnosis and treatment of multi-canal benign paroxysmal positional vertigo (m-BPPV).
Patients and methods: 640 patients with BPPV are evaluated. 80 (12.5%) patients had m-BPPV, 560 (87.5%) patients had single-canal BPPV. The analyses of involved canals and comparison of the course of the disease and effectiveness of treatment in m-BPPV and single-canal BPPV was done.
Results: m-BPPV accounts for 12.5% of all patients with BPPV. In m-BPPV mostly unilateral involvement of posterior and horizontal canals are involved, in bilateral BPPV often both posterior canals are involved. M-BPPV is more often associated with middle and inner ear diseases. Recurrences are more often observed in m-BPPV. For m-BPPV it is typical to have more severe clinical symptoms: constant dizziness, balance problems, intensive nausea and vomiting, frequent falls. M-BPPV is often resistant to treatment with repositioning maneuvers: more maneuvers, more follow-up consultations, carrying out home-based vestibular exercises by patients and use of mechanical chair in some cases are necessary to achieve successful treatment. In patients with m-BPPV residual dizziness after successful treatment often takes place, so that additional diagnosis and assessment is needed.
Keywords: benign paroxysmal positional vertigo; diagnostic positional tests; multi-canal benign paroxysmal positional vertigo; repositioning maneuvers.",doi: 10.17116/otorino20198406128.,No pdf
222,423,424,Int J Pediatr Otorhinolaryngol,"G. C. Palacios, M. S. Montalvo, M. I. Fraire, E. Leon, M. T. Alvarez and F. Solorzano Audiologic and vestibular findings in a sample of human immunodeficiency virus type-1-infected Mexican children under highly active antiretroviral therapy 2008",PubMed,0.0,1.0,Population,Children,,0.0,Audiologic and vestibular findings in a sample of human immunodeficiency virus type-1-infected Mexican children under highly active antiretroviral therapy,"Abstract
Objective: There is little information about audiologic and vestibular disorders in pediatric patients infected with the Human Immunodeficiency Virus type-1 (HIV-1). The aim of this study was to evaluate audiologic and vestibular disorders in a sample of HIV-1-infected children receiving Highly Active Antiretroviral Therapy.
Methods: Patients underwent pure tone audiometry, speech discrimination testing, auditory brainstem responses, electronystagmography, and rotatory testing. HIV-1 viral load and absolute CD4+ cell counts were registered.
Results: Twenty-three patients were included, aged 4.5 years (median, range 5 months to 16 years). Pure tone audiometry was carried out in 12 children over 4 years of age: 4 (33%) showed hearing loss, 2 were conductive. Auditory brainstem responses were measured in all 23 patients, suggesting conductive hearing loss in 6 and sensorineural hearing loss in 2. Most patients with conductive hearing loss had the antecedent of acute or chronic suppurative otitis media but with dry ears at the time of evaluation (p=0.003). Abnormal prolongations of interwave intervals in auditory brainstem responses were observed in 3 children (13%, 4 ears), an abnormal morphology in different components of auditory brainstem responses in 4 (17.4%, 7 ears), and abnormal amplitude patterns in 11 patients (48%, 17 ears). Vestibular tests were abnormal in all six patients tested, with asymmetries in caloric and rotatory tests. Although differences were not significant, in general, audiologic abnormalities were more frequent in patients with more prolonged HIV-1 infections, higher viral loads, or lower absolute CD4+ cell counts.
Conclusions: Conductive hearing loss associated with previous otitis media events, abnormalities in auditory brainstem responses suggesting disorders at different levels of the auditory pathways, and unilateral vestibular hyporeflexia were frequent findings in our sample of HIV-1-infected children under Highly Active Antiretroviral Therapy. These findings suggest that HIV-1-infected children should be submitted to audiologic and vestibular evaluation as early as possible in order to reduce their impact on the psychosocial development of these patients.",doi: 10.1016/j.ijporl.2008.08.002.,palacios2008.pdf
223,424,425,J Assoc Res Otolaryngol,"A. Palla, S. Marti and D. Straumann Head-shaking nystagmus depends on gravity 2005",PubMed,0.0,1.0,Design,Conference Abstract,,0.0,Head-shaking nystagmus depends on gravity,"Abstract
In acute unilateral peripheral vestibular deficit, horizontal spontaneous nystagmus (SN) increases when patients lie on their affected ear. This phenomenon indicates an ipsilesional reduction of otolith function that normally suppresses asymmetric semicircular canal signals. We asked whether head-shaking nystagmus (HSN) in patients with chronic unilateral vestibular deficit following vestibular neuritis is influenced by gravity in the same way as SN in acute patients. Using a three-dimensional (3-D) turntable, patients (N = 7) were placed in different whole-body positions along the roll plane and oscillated (1 Hz, +/-10 degrees ) about their head-fixed vertical axis. Eye movements were recorded with 3-D magnetic search coils. HSN was modulated by gravity: When patients lay on their affected ear, slow-phase eye velocity significantly increased upon head shaking and consisted of a horizontal drift toward the affected ear (average: 1.2 degrees /s +/-0.5 SD), which was added to the gravity-independent and directionally nonspecific SN. In conclusion, HSN in patients with chronic unilateral peripheral vestibular deficit is best elicited when they are lying on their affected ear. This suggests a gravity-dependent mechanism similar to the one observed for SN in acute patients, i.e., an asymmetric suppression of vestibular nystagmus by the unilaterally impaired otolith organs.",doi: 10.1007/s10162-004-4052-3.,palla2005.pdf
224,426,427,Ear Nose Throat J,"B. Pang, A. Costeloe, N. M. Jackson and S. Babu Incidence of Developing Contralateral Ménière's Disease in Patients Undergoing Transmastoid Labyrinthectomy for Unilateral Ménière's Disease 2021",PubMed,1.0,,,,,0.0,Incidence of Developing Contralateral Ménière's Disease in Patients Undergoing Transmastoid Labyrinthectomy for Unilateral Ménière's Disease,"Abstract
Objectives: To analyze the incidence of developing contralateral Ménière's disease (MD) in patients who undergo labyrinthectomy for vestibular dysfunction in unilateral MD.
Study design: Retrospective chart review.
Participants and methods: Adult patients with a diagnosis of MD who underwent surgical labyrinthectomy with minimum follow-up of 12 months were included. Patients who experienced chemical labyrinthectomy, surgical labyrinthectomy for a diagnosis other than MD, contralateral ear surgery, or bilateral MD before the labyrinthectomy were excluded. The key outcome measure is whether symptoms of MD developed in the contralateral ear post-labyrinthectomy. Statistical analysis was performed using χ2 (Fisher exact) test for discrete variables and the Student t test for continuous variables. A P value < .05 was considered significant.
Results: Of the140 patients who underwent labyrinthectomy for intractable vertigo due to unilateral MD, 84 had at least 1 year follow-up appointments. Twelve percent (10/84) of these patients developed contralateral MD, which was diagnosed by a neuro-otologist based on symptoms consistent with MD, including low-frequency sensorineural hearing loss. Average age in years is 63.12 (10.83; mean [SD]) at time of surgery. Average follow-up was 35.57 (15.89) months (range: 12-69 months).
Conclusion: The incidence of contralateral MD development in patients who underwent labyrinthectomy for unilateral MD is 12%. The current literature states that MD has a 30% bilateral involvement rate. Our incidence is significantly lower when compared to the current literature.
Keywords: Ménière’s; bilateral; contralateral; disease; endolymphatic hydrops; labyrinthectomy.",doi: 10.1177/0145561319854744.,10.1177@0145561319854744.pdf
225,427,428,Otolaryngol Head Neck Surg,M. S. Panosian and G. D. Paige Nystagmus and postural instability after headshake in patients with vestibular dysfunction 1995,PubMed,1.0,,,,,0.0,Nystagmus and postural instability after headshake in patients with vestibular dysfunction,"Abstract
Nystagmus after rapid head-shaking (post-headshake nystagmus) is often seen in patients with vestibulopathy. Post-headshake nystagmus is transient and is frequently associated with symptoms of dizziness, dysequilibrium, or vertigo. The phenomenon presumably reflects headshake-induced asymmetry in vestibulo-ocular reflex pathways, which persists after head-shaking stops. We postulated that the same vestibular imbalance that underlies post-headshake nystagmus might produce an equivalent in postural instability. To test this hypothesis, we investigated the effect of headshake on postural control and eye movements in patients who exhibited post-headshake nystagmus, vestibulopathy, or both. Postural instability was quantified with a dynamic platform device, whereas eye movements were recorded with electrooculography. Ten normal controls and 21 patients with a history of post-headshake nystagmus or unilateral vestibulopathy were evaluated. Subjects were tested for 20 seconds before and immediately after passive horizontal headshake (+/- 30-degree amplitude) at 2 Hz for 20 seconds. Postural stability was assessed while subjects stood with eyes closed, and the floor was modulated proportionally with sway. The difference in normalized peak-to-peak sway (equilibrium score) before and after headshake was assessed in all subjects and compared between groups. Post-headshake nystagmus was documented by electro-oculography recorded during posturography. Results for normal controls and vestibulopathic subjects without post-headshake nystagmus showed only a small transient decline in postural stability after headshake. Those with post-headshake nystagmus (regardless of caloric asymmetry) showed a robust decline in postural stability.(ABSTRACT TRUNCATED AT 250 WORDS)",doi: 10.1016/S0194-59989570273-3.,No pdf
226,429,430,Laryngoscope,S. C. Parisier and E. A. Birken Recurrent meningitis secondary to idiopathic oval window CSF leak 1976,PubMed,0.0,1.0,Population,,,0.0,Recurrent meningitis secondary to idiopathic oval window CSF leak,"Abstract
Bacterial meningitis remains a life-threatening infection even in the present antibiotic era; thus, any abnormality which predisposes a patient to a recurrence of this serious disease, must be identified and corrected. This report describes the histroy of a 12-year old boy with a profound neurosensory hearing loss, a related absence of vestibular function and a Mondini-type of temporal bone dysplasia who developed recurrent episodes of meningitis which were due to an idiopathic cerebrospinal fluid otorrhea. Even though the meningitis was labyrinthogenic in origin, the patient did not experience the associated symptoms of hearing loss and/or vertigo since the affected inner ear was clinically unreactive. By surgically exploring the middle ear, the presence of a cerebrospinal fluid otorrhea was confirmed. The leak was observed to be coming from a defect in the stapes footplate, and it was controlled by firmly packing the inner ear vestibule with muscle. A remarkable similarity exists between the patient described above and the 15 previously reported cases of meningitis due to a spontaneous cerebrospinal fluid otorrhea. Generally, the problem occurred in young children, the average age being 6.4 years; male and female were equally afflicted. All 15 previously reported cases had a severe neurosensory hearing loss which was unilateral in 10 individuals and bilateral in the other five. In 11 of the case reports, the vestibular function was evaluated, and the labyrinth was noted to be unreactive in the affected ear. An associated congenital abnormality of the inner ear was described in 11 of the patients reviewed. Anatomically, in 13 cases, the leak was observed to be coming from the oval window area. Other affected sites included one report of a fissure of the promontory and one report of a defect in the roof of the eustachian tube. Multiple surgical procedures were required in 11 of the 15 patients in order to identify the exact source of the otorrhea and to seal it permanently. In three cases, the successful procedure was a middle ear exploration with stapedectomy and packing of the inner ear vestibule. Overall, a total of 36 operations was performed in the 15 patients reviewed. In conclusion, when the physician is confronted by a case of meningitis in a patient with a unilateral or bilateral total loss of hearing and vestibular function, the possible presence of an idiopathic cerebrospinal fluid leak should be considered, expecially if radiographic studies demonstrate a temporal bone dysplasia. In these selected cases, if the etiology of the meningitis is obscure, a middle ear exploration should be performed both for diagnostic purposes as a means to ascertain definitely the presence of a leak and for therapeutic purposes to seal it effectively.",doi: 10.1288/00005537-197610000-00004.,parisier1976.pdf
227,430,431,Otol Neurotol,"M. K. Park, K. M. Kim, J. Jung, N. Lee, S. J. Hwang and S. W. Chae Evaluation of uncompensated unilateral vestibulopathy using the modified clinical test for sensory interaction and balance 2013",Pubmed,1.0,,,,,0.0,Evaluation of uncompensated unilateral vestibulopathy using the modified clinical test for sensory interaction and balance,"Abstract
Objective: To compare the results of the Modified Clinical Test for Sensory Interaction and Balance (mCTSIB) and the Sensory Organization Test (SOT) of computerized dynamic posturography (CDP) to better understand the role and limitations of the mCTSIB in the diagnosis and rehabilitation of patients with uncompensated unilateral vestibulopathy.
Study design: Prospective blind study.
Setting: Tertiary referral center.
Interventions: Ninety-eight patients with uncompensated unilateral vestibulopathy were enrolled. After diagnosis was established through ocular motor studies, head roll and Dix-Hallpike tests, caloric testing, and pure tone audiometry, the mCTSIB and SOT were administered simultaneously.
Main outcome measure: Composite or comprehensive scores and equilibrium scores.
Results: When composite or comprehensive scores were used to classify subjects as normal or abnormal, the mCTSIB and SOT showed significant agreement (p > 0.256). SOT condition 2 (eyes closed on a firm surface) showed a greater degree of correlation than did other conditions; the foam-surface or eyes-open conditions yielded poor correlation coefficients.
Conclusion: The mCTSIB can be used instead of the SOT in screening to distinguish normality from abnormality in dizzy patients with unilateral vestibulopathy. However, the degree of dizziness assessed by SOT condition was poorly correlated with mCTSIB results, especially in conditions with the eyes open and those using a foam surface.",doi: 10.1097/MAO.0b013e31827c9dae.,park2013.pdf
228,432,433,Arch Otolaryngol Head Neck Surg,"S. M. Parnes, Z. Spektor and N. Strominger Effects of lidocaine infusion in cats after unilateral labyrinthectomy 1988",PubMed,0.0,1.0,Population,Animal study,,0.0,Effects of lidocaine infusion in cats after unilateral labyrinthectomy,"Abstract
In the auditory/vestibular system, intravenous lidocaine hydrochloride administration has been reported to provide transient relief from severe tinnitus, reduce dizziness and emesis accompanying Meniere's disease, and sometimes improve audiometric thresholds in sensorineural hearing loss. In this study, the labyrinth was destroyed unilaterally in a series of cats. Animals constantly fell and demonstrated prominent contralateral nystagmus and a rotary motion of the head. Within four hours of a 4-mg/kg intravenous lidocaine hydrochloride injection, the cats were able to ambulate freely without falling. The nystagmus was reduced, and there was virtual absence of the rotary head motion. In contrast, the controls had persistent signs of vestibular disturbance. These results demonstrate that lidocaine infusion ameliorates the effects of unilateral labyrinthectomy in cats and thus may be a potential antivertiginous agent.",doi: 10.1001/archotol.1988.01860180067032.,parnes1988.pdf
229,434,435,J Vestib Res,"M. Patel, E. Roberts, Q. Arshad, K. Bunday, J. F. Golding, D. Kaski and A. M. Bronstein The ""broken escalator"" phenomenon: Vestibular dizziness interferes with locomotor adaptation 2020",PubMed,1.0,,,,,1.0,"The ""broken escalator"" phenomenon: Vestibular dizziness interferes with locomotor adaptation","Abstract
Background: Although vestibular lesions degrade postural control we do not know the relative contributions of the magnitude of the vestibular loss and subjective vestibular symptoms to locomotor adaptation.
Objective: To study how dizzy symptoms interfere with adaptive locomotor learning.
Methods: We examined patients with contrasting peripheral vestibular deficits, vestibular neuritis in the chronic stable phase (n = 20) and strongly symptomatic unilateral Meniere's disease (n = 15), compared to age-matched healthy controls (n = 15). We measured locomotor adaptive learning using the ""broken escalator"" aftereffect, simulated on a motorised moving sled.
Results: Patients with Meniere's disease had an enhanced ""broken escalator"" postural aftereffect. More generally, the size of the locomotor aftereffect was related to how symptomatic patients were across both groups. Contrastingly, the degree of peripheral vestibular loss was not correlated with symptom load or locomotor aftereffect size. During the MOVING trials, both patient groups had larger levels of instability (trunk sway) and reduced adaptation than normal controls.
Conclusion: Dizziness symptoms influence locomotor adaptation and its subsequent expression through motor aftereffects. Given that the unsteadiness experienced during the ""broken escalator"" paradigm is internally driven, the enhanced aftereffect found represents a new type of self-generated postural challenge for vestibular/unsteady patients.
Keywords: Meniere’s disease; Vestibular system; dizziness; locomotor adaptation; motor control; vertigo; vestibular neuritis.",doi: 10.3233/VES-200693.,patel2020.pdf
230,435,436,JAMA Otolaryngol Head Neck Surg,"S. S. Paul, L. E. Dibble, R. G. Walther, C. Shelton, R. K. Gurgel and M. E. Lester Characterization of Head-Trunk Coordination Deficits After Unilateral Vestibular Hypofunction Using Wearable Sensors 2017",PubMed,1.0,,,,,0.0,Characterization of Head-Trunk Coordination Deficits After Unilateral Vestibular Hypofunction Using Wearable Sensors,"Abstract
Importance: Individuals with vestibular hypofunction acutely restrict head motion to reduce symptoms of dizziness and nausea. This restriction results in abnormal decoupling of head motion from trunk motion, but the character, magnitude, and persistence of these deficits are unclear.
Objective: To use wearable inertial sensors to quantify the extent of head and trunk kinematic abnormalities in the subacute stage after resection of vestibular schwannoma (VS) and the particular areas of deficit in head-trunk motion.
Design, setting, and participants: This cross-sectional observational study included a convenience sample of 20 healthy adults without vestibular impairment and a referred sample of 14 adults 4 to 8 weeks after resection of a unilateral VS at a university and a university hospital outpatient clinic. Data were collected from November 12, 2015, through November 17, 2016.
Exposures: Functional gait activities requiring angular head movements, including items from the Functional Gait Assessment (FGA; range, 1-30, with higher scores indicating better performance), the Timed Up & Go test (TUG; measured in seconds), and a 2-minute walk test (2MWT; measured in meters).
Main outcomes and measures: Primary outcomes included peak head rotation amplitude (in degrees), peak head rotation velocity (in degrees per second), and percentage of head-trunk coupling. Secondary outcomes were activity and participation measures including gait speed, FGA score, TUG time, 2MWT distance, and the Dizziness Handicap Inventory score (range, 0-100, with higher scores indicating worse performance).
Results: A total of 34 participants (14 men and 20 women; mean [SD] age, 39.3 [13.6] years) were included. Compared with the 20 healthy participants, the 14 individuals with vestibular hypofunction demonstrated mean (SD) reduced head turn amplitude (84.1° [15.5°] vs 113.2° [24.4°] for FGA-3), reduced head turn velocities (195.0°/s [75.9°/s] vs 358.9°/s [112.5°/s] for FGA-3), and increased head-trunk coupling (15.1% [6.5%] vs 5.9% [5.8%] for FGA-3) during gait tasks requiring angular head movements. Secondary outcomes were also worse in individuals after VS resection compared with healthy individuals, including gait speed (1.09 [0.27] m/s vs 1.47 [0.22] m/s), FGA score (20.5 [3.6] vs 30.0 [0.2]), TUG time (10.9 [1.7] s vs 7.1 [0.8] s), 2MWT (164.8 [37.6] m vs 222.6 [26.8] m), and Dizziness Handicap Inventory score (35.4 [20.7] vs 0.1 [0.4]).
Conclusions and relevance: With use of wearable sensors, deficits in head-trunk kinematics were characterized along with a spectrum of disability in individuals in the subacute stage after VS surgery compared with healthy individuals. Future research is needed to fully understand how patterns of exposure to head-on-trunk movements influence the trajectory of recovery of head-trunk coordination during community mobility.",doi: 10.1001/jamaoto.2017.1443.,paul2017.pdf
231,439,440,Laryngoscope,"N. Perez, E. Martín and R. García-Tapia Intratympanic gentamicin for intractable Meniere's disease 2003",PubMed,1.0,,,,,1.0,Intratympanic gentamicin for intractable Meniere's disease,"Abstract
Objective: The study aimed to analyze the results of the intratympanic injection of gentamicin as a treatment option for patients with unilateral Meniere's disease who were refractory to medical treatment.
Study design: Prospective study in the setting of a tertiary care medical center.
Methods: Seventy-one patients with unilateral Meniere's disease according to 1995 American Academy of Otolaryngology-Head and Neck Surgery 1995 guidelines who had been unresponsive to medical therapy for at least 1 year were studied. Intratympanic injections of a prepared concentration of 27 mg/mL gentamicin were performed at weekly intervals until the development of symptoms and signs indicative of vestibular hypofunction in the treated ear. As the main outcome measure, the 1995 American Academy of Otolaryngology-Head and Neck Surgery criteria for reporting treatment outcome in Meniere's disease were used. The results of treatment were expressed in terms of control of vertigo, disability status (functional level and degree of overall impairment evaluated by the Dizziness Handicap Inventory and the University of California Los Angeles Dizziness Questionnaire), hearing level, and quantitative measurement of vestibular function.
Results: Vertigo was controlled in 83.1% of the 71 patients. Recurrence of vertigo spells after initially complete control was noted in 17 patients. In 13 of these patients, this was cured by another course of intratympanic injections of gentamicin. Functional level and measures of self-reported handicap were significantly and promptly lowered after treatment in the patients who attained control of vertigo. Hearing level as pure-tone average was unchanged 2 years after treatment, but hearing loss as a result of gentamicin injections occurred in 23 patients at the end of treatment and in 9 and 11 patients at 3 months and 2 years after the treatment, respectively. Vestibular function was kept normal or reduced in 49.3% of the patients, whereas in the rest of the patients vestibular areflexia was observed. Control of vertigo did not depend on the amount of vestibular damage.
Conclusions: Ending weekly intratympanic injections when clinical signs of vestibular deafferentation appear can control vertigo in the majority of patients, and it is a useful alternative, together with other surgical options, for the treatment of patients with Meniere's disease who do not respond to medical treatment.",doi: 10.1097/00005537-200303000-00013.,perez2003.pdf
232,441,442,Front Neurol,"R. J. Peterka, K. D. Statler, D. M. Wrisley and F. B. Horak Postural compensation for unilateral vestibular loss 2011",PubMed,1.0,,,,,0.0,Postural compensation for unilateral vestibular loss,"Abstract
Postural control of upright stance was investigated in well-compensated, unilateral vestibular loss (UVL) subjects compared to age-matched control subjects. The goal was to determine how sensory weighting for postural control in UVL subjects differed from control subjects, and how sensory weighting related to UVL subjects' functional compensation, as assessed by standardized balance and dizziness questionnaires. Postural control mechanisms were identified using a model-based interpretation of medial-lateral center-of-mass body-sway evoked by support-surface rotational stimuli during eyes-closed stance. The surface-tilt stimuli consisted of continuous pseudorandom rotations presented at four different amplitudes. Parameters of a feedback control model were obtained that accounted for each subject's sway response to the surface-tilt stimuli. Sensory weighting factors quantified the relative contributions to stance control of vestibular sensory information, signaling body-sway relative to earth-vertical, and proprioceptive information, signaling body-sway relative to the surface. Results showed that UVL subjects made significantly greater use of proprioceptive, and therefore less use of vestibular, orientation information on all tests. There was relatively little overlap in the distributions of sensory weights measured in UVL and control subjects, although UVL subjects varied widely in the amount they could use their remaining vestibular function. Increased reliance on proprioceptive information by UVL subjects was associated with their balance being more disturbed by the surface-tilt perturbations than control subjects, thus indicating a deficiency of balance control even in well-compensated UVL subjects. Furthermore, there was some tendency for UVL subjects who were less able to utilize remaining vestibular information to also indicate worse functional compensation on questionnaires.
Keywords: balance; compensation; posture; unilateral; vestibular.",doi: 10.3389/fneur.2011.00057.,peterka2011.pdf
233,442,443,Clujul Med,"M. Petri, M. Chirila, S. Bolboaca and M. Cosgarea Unilateral peripheral vestibular disorders in the emergency room of the ENT Department of Cluj-Napoca, Romania 2015",PubMed,1.0,,,,,0.0,"Unilateral peripheral vestibular disorders in the emergency room of the ENT Department of Cluj-Napoca, Romania","Abstract
Objective: To asses the management of unilateral peripheral vestibular disorders in the emergency room of the ENT Department of Cluj-Napoca, Romania.
Material and method: The study was prospective, non-randomized, and included the patients presented for dizziness or balance disorders at the emergency room of the ENT Department between March 2012 and March 2013. Demographic characteristics, specific clinical history, the onset of peripheral vestibular disorders, and co-morbidities were recorded. The patients charts included the type of onset and the treatment (medical, surgical, and rehabilitation) performed in the emergency room or, in case of hospital admission, the relieving measures for the vestibular symptoms with or without hearing recovery.
Results: One hundred and fifty-two subjects were included in our study, 97 with pure peripheral vestibular dysfunction (VD), 34 with cochlear-vestibular dysfunction (CVD), and 21 with Ménière's disease (MD). No significant differences were identified when the proportion of patients with a certain onset (acute, subacute or chronic) were compared. Hypertension was the most frequent co-morbidity in all investigated groups. No significant difference was observed when the relief of vertigo or hearing recovery were compared between all groups.
Conclusion: This first Romanian report on the management of unilateral peripheral vestibular disorders showed that early corticosteroids treatment associated with electrolytes, antiemetic, and vasodilation drugs led to the recovery of the vestibular function without any differences between the types of peripheral vestibular dysfunction. In addition, we obtained the complete recovery of the vestibular and acoustic dysfunction in the cases treated with metylprednisolone intratympanic injection.
Keywords: ENT emergency room; algoritm; dizziness; peripheral vestibular disorders; vertigo.",doi: 10.15386/cjmed-412.,petri2015.pdf
234,443,444,Physiol Behav,L. Petrosini Task-dependent rate of recovery from hemilabyrinthectomy: an analysis of swimming and locomotor performances 1984,PubMed,0.0,1.0,Population,Animal study,,0.0,Task-dependent rate of recovery from hemilabyrinthectomy: an analysis of swimming and locomotor performances,"Abstract
Guinea pigs were hemilabyrinthectomized or hemicerebellectomized and repeatedly tested on a swimming task and in the open field. Initially, hemilabyrinthectomized animals showed impaired swimming behavior which improved over time: within 21-25 days after the vestibular damage, the animals were able to swim around the tank with coordinated motor patterns. Only a slight tendency to turn towards the lesion side continued to be displayed. Hemicerebellectomized guinea pigs were significantly less impaired in their swimming ability since the very first test session. Both groups of animals showed similar recovery time courses in their open field activity. The data demonstrate a task-dependence in the rate of recovery following a unilateral labyrinthectomy and a substantial contribution by the labyrinth to swimming function.",doi: 10.1016/0031-9384(84)90050-7.,petrosini1984.pdf
235,448,449,J Am Acad Audiol,"E. G. Piker, G. P. Jacobson, D. L. McCaslin and S. L. Grantham Psychological comorbidities and their relationship to self-reported handicap in samples of dizzy patients 2008",Pubmed,1.0,,,,,0.0,Psychological comorbidities and their relationship to self-reported handicap in samples of dizzy patients,"Abstract
Factors such as anxiety, depression, somatic awareness, autonomic symptoms, and differences in coping strategies are known to affect dizziness handicap. We studied these factors in 63 consecutive ""dizzy"" patients. This sample was subgrouped into normals and patients with benign paroxysmal positional vertigo, compensated and uncompensated unilateral peripheral vestibular system impairment, or abnormal vestibular evoked myogenic potential as a single significant diagnostic finding. Results showed that (1) anxiety and depression occur with greater frequency in dizzy patients than in the normal population; (2) the magnitude of anxiety, depression, somatization, and autonomic symptoms does not differ significantly in subgroups of patients; (3) women tended to report greater handicap and somatic/autonomic symptoms; and (4) Dizziness Handicap Inventory total scores were correlated with patients' complaints of somatic/autonomic symptoms, anxiety, depression, and coping strategies. These findings suggest that self-reported measures represent unique pieces of information important for the management of dizzy patients.",doi: 10.3766/jaaa.19.4.6.,piker2008.pdf
236,449,450,Neuroreport,"L. Pizzamiglio, G. Vallar and F. Doricchi Gravity and hemineglect 1995",PubMed,0.0,1.0,Population,Hemineglect,,0.0,Gravity and hemineglect,"Abstract
Spatial cognition requires the integration of visual inputs with proprioceptive and vestibular information about the position of the eye, the head and the body. All these sources are used by the brain to produce multiple higher-order (e.g. egocentric) representations of space, subserving accurate spatial behaviour. Such spatial representations are disrupted by unilateral cerebral damage producing neglect in the contralateral side of space. In eight brain-damaged patients with left unilateral neglect the manipulation of gravitational-otolithic information, obtained by placing patients in a supine position, produced a significant reduction of the rightward directional error in the line bisection task in all cases. This finding suggests that, in patients with neglect, gravitational information is processed in a non-symmetrical fashion, with a rightward bias towards the side of the lesion. This is the first study showing that manipulation of gravitational input affects neuropsychological disorders of visuo-spatial processing.",Not Found,No pdf
237,451,452,Neurosurgery,B. E. Pollock Management of vestibular schwannomas that enlarge after stereotactic radiosurgery: treatment recommendations based on a 15 year experience 2006,PubMed,0.0,1.0,outcome,"No symptom, signs",,0.0,Management of vestibular schwannomas that enlarge after stereotactic radiosurgery: treatment recommendations based on a 15 year experience,"Abstract
Objective: Stereotactic radiosurgery is an effective alternative to surgical resection for the majority of patients with vestibular schwannomas (VS). However, after radiosurgery, the imaging characteristics of VSs are variable, and correct interpretation is critical to prevent unnecessary surgery for these patients.
Methods: A retrospective study of 208 consecutive patients with unilateral VS having radiosurgery between March 1990 and December 2001. Thirty (14%) patients had tumors that enlarged at least 2 mm after radiosurgery. The median follow-up after radiosurgery was 56 months (range 24-132 mo).
Results: The median time to tumor enlargement was 9 months (5-60 mo). The median volume increase was 75%. A loss of central enhancement was noted in 28 (93%) patients. Six (20%) patients had new symptoms noted at the time of tumor enlargement including hemifacial spasm (n = 2), ataxia (n = 2), trigeminal neuralgia (n = 1), and facial numbness (n = 1). Additional treatment was performed at the time of initial enlargement in 3 patients (resection, n = 2; ventriculoperitoneal shunt, n = 1). In the 28 patients who did not undergo resection at the time of initial enlargement, three patterns were identified on later imaging. Sixteen (57%) patients showed eventual tumor regression (type 1), and eight (29%) patients had tumors that increased and remained larger but did not show progressive enlargement (type 2). Four (14%) patients showed progressive enlargement on serial imaging (type 3) and underwent additional treatment (resection, n = 3; stereotactic radiation therapy, n = 1).
Conclusion: Tumor expansion after VS radiosurgery rarely denotes a failed procedure, and the majority of patients only require further imaging. Approximately one third of tumors that enlarge will remain increased in size compared with the time of radiosurgery but will not show sequential growth. Additional tumor treatment should be reserved only for patients who demonstrate progressive tumor enlargement on serial imaging (2% in this series).",doi: 10.1227/01.NEU.0000194833.66593.8B.,pollock2006.pdf
238,452,453,Neurosurgery,"B. E. Pollock, C. L. Driscoll, R. L. Foote, M. J. Link, D. A. Gorman, C. D. Bauch, J. N. Mandrekar, K. N. Krecke and C. H. Johnson Patient outcomes after vestibular schwannoma management: a prospective comparison of microsurgical resection and stereotactic radiosurgery 2006",PubMed,1.0,,,,,0.0,Patient outcomes after vestibular schwannoma management: a prospective comparison of microsurgical resection and stereotactic radiosurgery,"Abstract
Objective: The best management for patients with small- to medium-sized vestibular schwannomas (VS) is controversial.
Methods: : A prospective cohort study of 82 patients with unilateral, unoperated VS less than 3 cm undergoing surgical resection (n = 36) or radiosurgery (n = 46). Patients undergoing resection were younger (48.2 yr versus 53.9 yr, P = 0.03). The groups were similar with regard to hearing loss, associated symptoms, and tumor size. The mean follow-up period was 42 months (range, 12-62 mo).
Results: Normal facial movement and preservation of serviceable hearing was more frequent in the radiosurgical group at 3 months (P < 0.001), 1 year (P < 0.001), and at the last follow-up examination (P < 0.01) compared with the surgical resection group. Patients undergoing surgical resection had a significant decline in the following subscales of the Health Status Questionnaire 3 months after surgery: physical functioning (P = 0.006), role-physical (P < 0.001), energy/fatigue (P = 0.02), and overall physical component (P = 0.004). Patients in the surgical resection group continued to have a significant decline in the physical functioning (P = 0.04) and bodily pain (P = 0.04) subscales at 1 year and in bodily pain (P = 0.02) at the last follow-up examination. The radiosurgical group had no decline on any component of the Health Status Questionnaire after the procedure. The radiosurgical group had lower mean Dizziness Handicap Inventory scores (16.5 versus 8.4, P = 0.02) at the last follow-up examination. There was no difference in tumor control (100 versus 96%, P = 0.50).
Conclusion: Early outcomes were better for VS patients undergoing stereotactic radiosurgery compared with surgical resection (Level 2 evidence). Unless long-term follow-up evaluation shows frequent tumor progression at currently used radiation doses, radiosurgery should be considered the best management strategy for the majority of VS patients.",doi: 10.1227/01.NEU.0000219217.14930.14.,pollock2006 (1).pdf
239,454,455,J Neurol,"P. Popp, M. Wulff, K. Finke, M. Rühl, T. Brandt and M. Dieterich Cognitive deficits in patients with a chronic vestibular failure 2017",PubMed,0.0,1.0,Population,BVP,,0.0,Cognitive deficits in patients with a chronic vestibular failure,"Abstract
Behavioral studies in rodents and humans have demonstrated deficits of spatial memory and orientation in bilateral vestibular failure (BVF). Our aim was to explore the functional consequences of chronic vestibular failure on different cognitive domains including spatial as well as non-spatial cognitive abilities. Sixteen patients with a unilateral vestibular failure (UVF), 18 patients with a BVF, and 17 healthy controls (HC) participated in the study. To assess the cognitive domains of short-term memory, executive function, processing speed and visuospatial abilities the following tests were used: Theory of Visual Attention (TVA), TAP Alertness and Visual Scanning, the Stroop Color-Word, and the Corsi Block Tapping Test. The cognitive scores were correlated with the degree of vestibular dysfunction and the duration of the disease, respectively. Groups did not differ significantly in age, sex, or handedness. BVF patients were significantly impaired in all of the examined cognitive domains but not in all tests of the particular domain, whereas UVF patients exhibited significant impairments in their visuospatial abilities and in one of the two processing speed tasks when compared independently with HC. The degree of vestibular dysfunction significantly correlated with some of the cognitive scores. Neither the side of the lesion nor the duration of disease influenced cognitive performance. The results demonstrate that vestibular failure can lead to cognitive impairments beyond the spatial navigation deficits described earlier. These cognitive impairments are more significant in BVF patients, suggesting that the input from one labyrinth which is distributed into bilateral vestibular circuits is sufficient to maintain most of the cognitive functions. These results raise the question whether BVF patients may profit from specific cognitive training in addition to physiotherapy.
Keywords: Attention; Cognition; Memory; Vertigo; Vestibular failure; Vestibular rehabilitation.",doi: 10.1007/s00415-016-8386-7.,popp2017.pdf
240,455,456,JAMA Otolaryngol Head Neck Surg,"A. J. Priesol, M. Cao, C. E. Brodley and R. F. Lewis Clinical vestibular testing assessed with machine-learning algorithms 2015",PubMed,0.0,1.0,Outcome,"No symptom, signs",,0.0,Clinical vestibular testing assessed with machine-learning algorithms,"Abstract
Importance: Dizziness and imbalance are common clinical problems, and accurate diagnosis depends on determining whether damage is localized to the peripheral vestibular system. Vestibular testing guides this determination, but the accuracy of the different tests is not known.
Objective: To determine how well each element of the vestibular test battery segregates patients with normal peripheral vestibular function from those with unilateral reductions in vestibular function.
Design, setting, and participants: Retrospective analysis of vestibular test batteries in 8080 patients. Clinical medical records were reviewed for a subset of individuals with the reviewers blinded to the vestibular test data.
Interventions: A group of machine-learning classifiers were trained using vestibular test data from persons who were ""manually"" labeled as having normal vestibular function or unilateral vestibular damage based on a review of their medical records. The optimal trained classifier was then used to categorize patients whose diagnoses were unknown, allowing us to determine the information content of each element of the vestibular test battery.
Main outcomes and measures: The information provided by each element of the vestibular test battery to segregate individuals with normal vestibular function from those with unilateral vestibular damage.
Results: The time constant calculated from the rotational test ranked first in information content, and measures that were related physiologically to the rotational time constant were 10 of the top 12 highest-ranked variables. The caloric canal paresis ranked eighth, and the other elements of the test battery provided minimal additional information. The sensitivity of the rotational time constant was 77.2%, and the sensitivity of the caloric canal paresis was 59.6%; the specificity of the rotational time constant was 89.0%, and the specificity of the caloric canal paresis was 64.9%. The diagnostic accuracy of the vestibular test battery increased from 72.4% to 93.4% when the data were analyzed with the optimal machine-learning classifier.
Conclusions and relevance: Rotational testing should be considered the primary test to diagnose unilateral peripheral vestibular damage in patients with dizziness or imbalance. Most physicians, however, continue to rely on caloric tests to guide their diagnoses. Our results support a significant shift in the approach used to determine diagnoses in patients with vestibular symptoms.",doi: 10.1001/jamaoto.2014.3519.,priesol2015.pdf
241,458,459,Eur Arch Otorhinolaryngol,"S. Quaglieri, O. Gatti, E. Rebecchi, M. Manfrin, C. Tinelli, E. Mira and M. Benazzo Intratympanic gentamicin treatment 'as needed' for Meniere's disease. Long-term analysis using the Kaplan-Meier method 2014",PubMed,1.0,,,,,1.0,Intratympanic gentamicin treatment 'as needed' for Meniere's disease. Long-term analysis using the Kaplan-Meier method,"Abstract
In recent years, several titration or on-demand protocols using low-dose repeated intratympanic (IT) gentamicin injections have been adopted for the vertigo control in unilateral medical refractory Menière's disease (MD). Because of the frequent recurrence and the need to treat the patients several times, it is difficult to strictly follow the 1995 AAO-HNS criteria to classify the results. The Kaplan-Meier analysis provides an effective and simpler method to address these concerns. We report the results of a long-term study (7 years) on a large population of MD patients (174) treated with on-request low-dose delayed IT gentamicin injections analysed using the Kaplan-Meier survival method. Effective vertigo control was obtained with a single injection in 40.2% of the patients (excellent responders) and with repeated injections (2-9) in 43.7% of the patients (moderate responders). Only six patients (3.5%) needed to be submitted to vestibular neurectomy because of the persistence of vertigo attacks (non-responders). A subgroup of 22 patients (12.6%) reporting a late recurrence of vertigo attacks after an initial vertigo-free interval lasting more than 2 years (short-term responders) were successfully treated with a further cycle of injections. In no cases, we observed significant signs of cochlear or vestibular toxicity. Kaplan-Meier survival analysis provided an excellent method for reporting treatment success or failure in patients followed for variable length of time with our kind of protocol.",doi: 10.1007/s00405-013-2597-7.,quaglieri2013.pdf
242,461,462,Neurology,"A. Radtke, T. Lempert, M. A. Gresty, G. B. Brookes, A. M. Bronstein and H. Neuhauser Migraine and Ménière's disease: is there a link? 2002",PubMed,1.0,,,,,0.0,Migraine and Ménière's disease: is there a link?,"Abstract
Background: A possible link between Ménière's disease (MD) and migraine was originally suggested by Prosper Ménière. Subsequent studies of the prevalence of migraine in MD produced conflicting results.
Objective: To determine the lifetime prevalence of migraine in patients with MD compared to sex- and age-matched controls.
Methods: The authors studied 78 patients (40 women, 38 men; age range 29 to 81 years) with idiopathic unilateral or bilateral MD according to the criteria of the American Academy of Otolaryngology. Diagnosis of migraine with and without aura was made via telephone interviews according to the criteria of the International Headache Society. Additional information was obtained concerning the concurrence of vertigo and migrainous symptoms during Ménière attacks. The authors interviewed sex- and age-matched orthopedic patients (n = 78) as controls.
Results: The lifetime prevalence of migraine with and without aura was higher in the MD group (56%) compared to controls (25%; p < 0.001). Forty-five percent of the patients with MD always experienced at least one migrainous symptom (migrainous headache, photophobia, aura symptoms) with Ménière attacks.
Conclusions: The lifetime prevalence of migraine is increased in patients with MD when strict diagnostic criteria for both conditions are applied. The frequent occurrence of migrainous symptoms during Ménière attacks suggests a pathophysiologic link between the two diseases. Alternatively, because migraine itself is a frequent cause of audio-vestibular symptoms, current diagnostic criteria may not differentiate between MD and migrainous vertigo.",doi: 10.1212/01.wnl.0000036903.22461.39.,radtke2002.pdf
243,462,463,Acta Otolaryngol,"A. Radtke, M. von Brevern, M. Feldmann, F. Lezius, T. Ziese, T. Lempert and H. Neuhauser Screening for Menière's disease in the general population - the needle in the haystack 2008",PubMed,1.0,,,,,0.0,Screening for Menière's disease in the general population - the needle in the haystack,"Abstract
Conclusion: Based on clinical history alone, 98.4% of the population with vestibular vertigo do not qualify for a diagnosis of Menière's disease (MD). Although frequent in dizziness clinics, MD is rare in the general population.
Objective: To narrow down the prevalence of MD in the general population.
Subjects and methods: A representative sample adult population sample (n=4869) was screened for moderate or severe dizziness/vertigo. Subsequently, 1003 participants completed a validated neurotologic telephone interview on vestibular vertigo (VV). Prevalence of MD was determined by stepwise application of clinical criteria according to the AAO (1995): (1) at least two vertigo attacks of > or =20 min duration, (2) unilateral hearing loss, and (3) accompanying cochlear symptoms.
Results: Lifetime prevalence of VV was 7.4%. Of 243 participants with VV, 51 (21%) had recurrent vertigo lasting > or =20 min. Of these, nine reported unilateral hearing loss, and four had accompanying cochlear symptoms (1.6% of VV patients, population prevalence 0.12%).",doi: 10.1080/00016480701509933.,radtke2008.pdf
244,463,464,Eur Arch Otorhinolaryngol,"Y. C. Rah, J. H. Park, J. H. Park, B. Y. Choi and J. W. Koo Dizziness and vestibular function before and after cochlear implantation 2016",PubMed,0.0,1.0,Population,Cochlear implant,,0.0,Dizziness and vestibular function before and after cochlear implantation,"Abstract
Vestibular problems after cochlear implantation (CI) were explored by categorizing them according to clinical course and changes in objective vestibular function. The changes in vestibular function of 62 patients (66 ears) were analyzed and vestibular symptoms were divided into three categories by their time course and nature. Etiologies were determined by analyzing the symptoms in combination with changes in objective vestibular function, measured using the caloric and/or video head impulse test. Before surgery, vestibular function was normal in 31 cases (47.0 %), unilaterally hypofunctional in 14 (21.2 %), and bilaterally hypofunctional in 21 (31.8 %). Eight cases (12.1 %) reported dizziness before surgery. A total of 18 cases (27.3 %) experienced postoperative dizziness. Ten patients experienced immediate transient dizziness (including 2 cases of benign positional paroxysmal vertigo); four experienced immediate prolonged dizziness (including 3 cases of bilateral vestibular hypofunction); and four experienced recurrent episodic dizziness (including 3 cases of suspicious endolymphatic hydrops). The sums of the maximal slow-phase velocities (SPVs) of the implanted ears were changed from 22.70 ± 17.31 to 12.55 ± 12.02°/s after implantation (p = 0.004) with very little changes in the other side (32.65 ± 24.85-31.40 ± 29.10°/s). Careful review of vestibular status is an important step, especially when deciding implantation in the only vestibular functioning ear or bilateral implantation.
Keywords: Cochlear implantation; Dizziness; Vestibular function.",doi: 10.1007/s00405-016-3988-3.,rah2016.pdf
245,465,466,J Am Vet Med Assoc,C. F. Raphel Brain abscess in three horses 1982,PubMed,0.0,1.0,Population,Animal study,,0.0,Brain abscess in three horses,"Abstract
Three horses with brain abscesses had different clinical manifestations: 1 had a protracted clinical course whereas 2 had a short clinical course. Clinical signs in 2 horses (1 acute case, 1 chronic case) included unilateral loss of vision, head tilt, circling, abnormal mental status, and ataxia. The 3rd horse had bilateral loss of vision, altered mental status, and apparent deafness. Results of cerebrospinal fluid analysis were inconsistent. The horse with the protracted clinical course had paradoxic central vestibular disease.",Not Found,No pdf
246,466,467,Clin Otolaryngol Allied Sci,"V. V. Raut, R. M. Walsh, A. P. Bath, M. L. Bance, A. Guha, C. H. Tator and J. A. Rutka Conservative management of vestibular schwannomas - second review of a prospective longitudinal study 2004",PubMed,0.0,1.0,Design,Review,,0.0,Conservative management of vestibular schwannomas - second review of a prospective longitudinal study,"Abstract
Vestibular schwannomas have been traditionally managed with microsurgical removal and in recent years, stereotactic radiotherapy. However, there is a group of patients in whom a conservative management approach might represent a desirable alternative. The aim of this study was to determine the natural history and outcome following the conservative management of 72 patients with unilateral vestibular schwannomas. This is a prospective cohort review of a previously published group of patients [Clin. Otolaryngol. (2000) 25, 28-39] with unilateral vestibular schwannoma that were initially analysed at our institution in 1998 [Walsh R.M., Bath A.P., Bance M.L. et al., Clin. Otolaryngol. (2000) 25, 28]. The mean duration of follow-up was 80 months (range 52-242 months). All the patients in the study underwent serial magnetic resonance imaging (MRI) for assessment of tumour growth. Patients were deemed to have failed conservative management if there was evidence of rapid radiological tumour growth and/or increasing signs and symptoms, which necessitated active intervention. The mean tumour growth rate for the entire group at the second review was 1 mm/year (range -0.84-9.65 mm/year). The mean growth rate for cerebellopontine angle tumours (1.3 mm/year) was significantly greater than that of internal auditory canal (IAC) tumours (0 mm/year) (P = 0.005). The majority of tumours (87.14%) grew <2 mm/year. There was significant tumour growth seen in 38.9%, no or insignificant growth in 41.7%, and negative growth in 19.4%. Twenty-three patients (32%) failed conservative management at the second review. There was no difference in the outcome of these failed patients in comparison with patients who underwent primary treatment without a period of conservative management. The mean growth rate of tumours in patients that failed conservative management (3.1 mm/year) was significantly greater than that in patients who did not fail (0.2 mm/year) (P < 0.001). No factors predictive of tumour growth or failure of conservative management were identified. Hearing deterioration with pure tone averages (0.5, 1, 2, 3 kHz) and speech discrimination scores occurred irrespective of tumour growth. This prospective study further emphasizes the role of conservative management in selected cases of vestibular schwannomas. Tumours in this study confined to the IAC typically demonstrated minimal or no growth on serial MRI scanning. Regular follow-up with interval scanning is mandatory in all patients.",doi: 10.1111/j.1365-2273.2004.00852.x.,raut2004.pdf
247,468,469,Clin J Sport Med,"K. Reimer, V. Ellis, D. M. Cordingley, K. Russell and M. J. Ellis Benign Paroxysmal Positional Vertigo After Pediatric Sports-Related Concussion 2020",PubMed,0.0,1.0,Population,Children,,0.0,Benign Paroxysmal Positional Vertigo After Pediatric Sports-Related Concussion,"Abstract
Objective: Report the clinical findings and outcomes among pediatric patients diagnosed with benign paroxysmal positional vertigo (BPPV) after sports-related concussion (SRC).
Design: Retrospective case series.
Setting: Multidisciplinary pediatric concussion program.
Patients: Patients younger than 19 years with a sport or recreation activity-related concussion referred for comprehensive vestibular physiotherapy assessment.
Main outcome measure: Symptom resolution after targeted particle repositioning (PR).
Results: During the study period, 115 pediatric SRC patients underwent vestibular physiotherapy assessment including 12 (10.4%) who were diagnosed with BPPV. Unilateral posterior semicircular canal (SCC) BPPV was diagnosed in 8/12 (75%) patients, and unilateral anterior SCC BPPV diagnosed in 4/12 (25%) patients. Benign paroxysmal positional vertigo was successfully treated in all patients with a mean of 1.58 targeted PR maneuvers (range = 1-4).
Conclusions: Comprehensive management of pediatric SRC requires a multidisciplinary approach to address the heterogeneous pathophysiology of persistent postconcussion symptoms. Pediatric SRC patients with coexisting BPPV should be considered for targeted PR.",doi: 10.1097/JSM.0000000000000617.,reimer2018.pdf
248,469,470,Hno,U. Reker and H. Rudert Acute isolated vestibular paralysis. A clinical and electronystagmographic follow-up study in 28 patients 1977,PubMed,1.0,,,,unilateral acute vestibular paralysis (vestibular neuronitis),0.0,[Acute isolated vestibular paralysis. A clinical and electronystagmographic follow-up study in 28 patients],"Abstract
Twenty-eight patients with unilateral acute vestibular paralysis (vestibular neuronitis) were examined after a period of 4-140 months. Seventeen of these patients were examined by electronystagmography with caloric stimuli at 44 degrees, 30 degrees, 17 degrees and 0 degrees C. Most were free of subjective symptoms only one-third had slight unsteadiness after sudden head movement. Subjective symptoms were independent of the presence of permanent canal paralysis or partial recovery of caloric excitability. Spontaneous nystagmus of 3-6,6% intensities was found in 11 of 17 patients. The normal limit for physiological spontaneous nystagmus should therefore be below 3 degrees/s. The most reliable parameter was the maximum velocity of the slow phase, as a mean value of the 4 caloric responses (values corrected for spontaneous nystagmus). The results were: 6 patients with persistent canal paralysis; 4 patients with considerable hypoexcitability; and 7 patients with moderate hypoexcitability. In no patient complete restoration of normal caloric response was found. This is attributed to the described method of caloric testing, which permits exact measurement of small side differences in excitability.",Not Found,No pdf
249,471,472,Phys Ther,"C. N. Rinaudo, M. C. Schubert, P. D. Cremer, W. V. C. Figtree, C. J. Todd and A. A. Migliaccio Improved Oculomotor Physiology and Behavior After Unilateral Incremental Adaptation Training in a Person With Chronic Vestibular Hypofunction: A Case Report 2019",PubMed,1.0,,,,,1.0,Improved Oculomotor Physiology and Behavior After Unilateral Incremental Adaptation Training in a Person With Chronic Vestibular Hypofunction: A Case Report,"Abstract
Background and purpose: Traditional vestibular rehabilitation therapies are effective in reducing vestibular hypofunction symptoms, but changes to the vestibulo-ocular reflex (VOR) are minimal. This controlled case report describes an increase in VOR after 6 months of incremental VOR adaptation (IVA) training in a person with chronic unilateral vestibular hypofunction.
Case description: The participant was a 58-year-old female with a confirmed (Neurologist P.D.C.) left vestibular lesion stable for 2 years prior to entering a clinical trial examining the effects of daily IVA training. She was evaluated monthly for self-reported symptoms (dizziness handicap inventory), VOR function (video head impulse test), and VOR behavior (Dynamic Visual Acuity test). Intervention consisted of 6 months of 15 minutes per day unassisted training using the IVA training regime with a device developed in our laboratory. The take-home device enables the VOR response to gradually normalize on the ipsilesional side via visual-vestibular mismatch training. The intervention was followed by a 6-month wash-out and 3-month control period. The control condition used the same training device set to function like standard VOR training indistinguishable to the participant.
Outcomes: After the intervention, ipsilesional VOR function improved substantially. The VOR adapted both via a 52% increase in slow-phase response and via 43% earlier onset compensatory saccades for passive head movements. In addition, the participant reported fewer symptoms and increased participation in sports and daily activities.
Discussion: Here, a participant with chronic vestibular hypofunction showing improved oculomotor performance atypical for traditional vestibular rehabilitation therapies, subsequent to using the newly developed IVA technique, is presented. It is the first time to our knowledge an improvement of this magnitude has been demonstrated as well as sustained over an extended period of time.",doi: 10.1093/ptj/pzz083.,10.1093@ptj@pzz083.pdf
250,472,473,J Physiol,"L. Ris, B. Capron, C. de Waele, P. P. Vidal and E. Godaux Dissociations between behavioural recovery and restoration of vestibular activity in the unilabyrinthectomized guinea-pig 1997",PubMed,0.0,1.0,Population,Animal study,,0.0,Dissociations between behavioural recovery and restoration of vestibular activity in the unilabyrinthectomized guinea-pig,"Abstract
1. In the guinea-pig, a unilateral labyrinthectomy induces postural disturbances and an ocular nystagmus which abate or disappear over time. These behavioural changes are accompanied by an initial collapse and a subsequent restoration of the spontaneous activity in the neurones of the ipsilateral vestibular nuclei. Recently, it has been shown that the vestibular neuronal activity remained collapsed over at least 10 h whereas its restoration was complete 1 week after the lesion. The aims of this study were to determine when restoration of spontaneous activity in the partially deafferented vestibular neurones started and to compare the time courses of the behavioural and neuronal recoveries in guinea-pigs that had undergone a unilateral labyrinthectomy. 2. Neuronal discharge measurements were made using chronic extracellular recording of single unit activity. After a left labyrinthectomy, electrodes, were placed on the site of the destroyed labyrinth to enable stimulation of the left vestibular nerve. Behavioural measurements included chronic recording of eye movements by the scleral search coli technique. After a left labyrinthectomy, lateral deviation of the head, twisting of the head, and eye velocity of the slow phases of the nystagmus were measured. 3. The neuronal activity of the rostral part of the vestibular nuclear complex on the lesioned side was recorded in alert guinea-pigs over 4 h recording sessions between 12 and 72 h after the lesion. 4. The criterion used to select vestibular neurones for analysis was their recruitment by an electric shock on the vestibular nerve. In addition, in order to explore a uniform population, we focused on neurones recruited at monosynaptic latencies (0.85-1.15 ms). 5. For each recording period, the mean resting rate was calculated animal by animal and the grand mean of these individual resting rate means was calculated. Previously, a decline in the grand mean resting rate from 35.8 +/- 6.0 spikes s-1 (control state) to 7.1 +/- 4.2 spikes s-1 during the first 4 h after labyrinthectomy has been shown. In the present study, the first sign of recovery was observed during the 12-16 h recording period when the resting rate grand mean increased to 16.3 +/- 3.9 spikes s-1. This grand mean activity did not change significantly during the following 12 h. Thereafter, restoration of neuronal activity improved and was complete 1 week after the lesion. 6. Although the abatement of the vestibular symptoms roughly paralleled the restoration of neuronal activity in the vestibular nuclei, some discrepancies between the time courses of both phenomena emerged. An important step in postural recovery (the animals managed to stand up) and a major part of the abatement of the nystagmus occurred before the recovery of vestibular neuronal activity. In addition, lateral deviation of the head disappeared while restoration of the neuronal activity was incomplete, but significant head twisting was still evident when vestibular resting rates had recovered completely. 7. We conclude that restoration of neuronal activity in the ipsilateral vestibular nuclei starts 12 h after the lesion and that restoration of neuronal activity in the ipsilateral vestibular nuclei is not the only mechanism underlying behavioural vestibular compensation.",doi: 10.1113/jphysiol.1997.sp022037.,ris1997.pdf
251,473,474,J Neurophysiol,L. Ris and E. Godaux Neuronal activity in the vestibular nuclei after contralateral or bilateral labyrinthectomy in the alert guinea pig 1998,PubMed,0.0,1.0,Population,Animal study,,0.0,Not Found,Not Found,Not Found,No pdf
252,477,478,Neuroimage Clin,"R. E. Roberts, H. Ahmad, M. Patel, D. Dima, R. Ibitoye, M. Sharif, R. Leech, Q. Arshad and A. M. Bronstein An fMRI study of visuo-vestibular interactions following vestibular neuritis 2018",PubMed,1.0,,,,,1.0,An fMRI study of visuo-vestibular interactions following vestibular neuritis,"Abstract
Vestibular neuritis (VN) is characterised by acute vertigo due to a sudden loss of unilateral vestibular function. A considerable proportion of VN patients proceed to develop chronic symptoms of dizziness, including visually induced dizziness, specifically during head turns. Here we investigated whether the development of such poor clinical outcomes following VN, is associated with abnormal visuo-vestibular cortical processing. Accordingly, we applied functional magnetic resonance imaging to assess brain responses of chronic VN patients and compared these to controls during both congruent (co-directional) and incongruent (opposite directions) visuo-vestibular stimulation (i.e. emulating situations that provoke symptoms in patients). We observed a focal significant difference in BOLD signal in the primary visual cortex V1 between patients and controls in the congruent condition (small volume corrected level of p < .05 FWE). Importantly, this reduced BOLD signal in V1 was negatively correlated with functional status measured with validated clinical questionnaires. Our findings suggest that central compensation and in turn clinical outcomes in VN are partly mediated by adaptive mechanisms associated with the early visual cortex.
Keywords: Oscillopsia; Vertigo; Vestibular compensation; Vestibular neuritis; Visual-cortex; fMRI.",doi: 10.1016/j.nicl.2018.10.007.,73369decca1d10b3268245c1837398bf.pdf
253,478,479,Otolaryngol Clin North Am,D. Robertson and D. Ireland Evaluation and treatment of uncompensated unilateral vestibular disease 1997,Pubmed,0.0,1.0,Design,Review,,0.0,Evaluation and treatment of uncompensated unilateral vestibular disease,"Abstract
This article reviews the general literature regarding the clinical evaluation and treatment of a unilateral vestibular deficit. The clinical approach by the authors is highlighted with a focus on bedside examinations and cyclodeviation measurements. Vestibular rehabilitation is currently considered the best approach to rehabilitation at present, and its physiologic basis is reviewed. When applied early in the course of recovery, vestibular rehabilitation can hasten compensation and also reduce symptoms resulting from permanent deficits caused by vestibular injury.",Not Found,No pdf
254,479,480,Neuropsychologia,"I. H. Robertson, R. Tegnér, S. J. Goodrich and C. Wilson Walking trajectory and hand movements in unilateral left neglect: a vestibular hypothesis 1994",PubMed,0.0,1.0,Population,Neglect,,0.0,Walking trajectory and hand movements in unilateral left neglect: a vestibular hypothesis,"Abstract
This is the first systematic study of walking trajectories in unilateral neglect. Six patients with unilateral left neglect approached and walked through a doorway, and all six deviated to the right of centre when doing so. Four out of six significantly centred their walking trajectories by making left hand movements while approaching the doorway. The group effect of walking with no hand movements vs walking with hand movements was statistically significant. Age-matched control patients showed a similar but significant smaller rightward deviation. The results are interpreted in terms of recent research in limb activation effects on neglect (Robertson and North, Neuropsychologia 30, 553-563, 1992), and also in the light of research showing close anatomical correspondence between the cortical projections of the vestibular nerve on the one hand, and the hand/arm representational fields of the central sulcus on the other.",doi: 10.1016/0028-3932(94)90121-x.,robertson1994.pdf
255,480,481,J Am Acad Audiol,"A. I. Rodriguez, S. Zupancic, M. M. Song, J. Cordero, T. Q. Nguyen and C. Seifert Importance of an Interprofessional Team Approach in Achieving Improved Management of the Dizzy Patient 2017",PubMed,0.0,1.0,Population,Uni or Bi?,,0.0,Importance of an Interprofessional Team Approach in Achieving Improved Management of the Dizzy Patient,"Abstract
Background: Because of its multifaceted nature, dizziness is difficult for clinicians to diagnose and manage independently. Current treatment trends suggest that patients are often referred to the otolaryngologist for intervention despite having a nonotologic disorder. Additionally, many individuals with atypical presentations are often misdiagnosed and spend a significant amount of time waiting for consultation by the otolaryngologist. Few studies have alluded that implementation of an interprofessional team approach in the diagnosis and management of the dizzy patient can improve clinical decision-making. However, to the authors' knowledge, there is no information specifically quantifying the outcomes and potential benefits of using an interprofessional balance care team approach.
Purpose: To compare dizziness diagnoses trends and referral practices with and without the use of an interprofessional management approach within a university healthcare system.
Research design: Over the course of a 3-yr period, a retrospective review of the diagnosis and management of dizziness was performed with and without implementation of an interprofessional team. To observe potential differences, year 3 incorporated the interprofessional management approach while years 1-2 did not. The two periods were then compared to each other.
Study sample: A total of 134 patients referred to a university hearing clinic for a vestibular and balance function evaluation.
Data collection and analysis: Diagnoses and management trends were examined with descriptive statistics (percentages and frequencies). Fisher's exact tests, analysis of contingency tables, were conducted to evaluate the influence of interprofessional management on dizziness diagnoses and treatment patterns.
Results: Results demonstrated that before implementation of an interprofessional team approach, (1) referring clinicians used unspecific dizziness diagnosis codes (e.g., dizziness and giddiness), (2) a low number of patients with dizziness were referred for balance function testing, (3) diagnoses remained unspecific following the balance function assessment, and (4) the most frequently occurring vestibular diagnoses were unilateral vestibular hypofunction and benign paroxysmal positional vertigo. Following the use of an interprofessional management approach, it was determined that (1) disease-specific diagnoses increased, (2) patients with dizziness were referred for balance function testing mainly by otolaryngologists, (3) dizziness was considered to be multifaceted for a greater number of patients, (4) a larger percentage of patients were referred to a specialist other than the otolaryngologist as a result of their diagnosis, and (5) patients reported reduction or resolution of their symptoms.
Conclusions: An interprofessional management approach for the dizzy patient can lead to more specific diagnoses and provide alternative referral pathways to other health-care professionals (e.g., audiologists, physical therapists, and pharmacists) in an effort to reduce over-referral to one specialist. Future studies should address the utility of an interprofessional team approach in the overall management of patients with dizziness.",doi: 10.3766/jaaa.15054.,importance-of-an-interprofessional-team-approach-in-achieving-im-2016.pdf
256,481,482,Otolaryngol Head Neck Surg,"R. M. Rosenfeld, S. R. Schwartz, M. A. Pynnonen, D. E. Tunkel, H. M. Hussey, J. S. Fichera, A. M. Grimes, J. M. Hackell, M. F. Harrison, H. Haskell, D. S. Haynes, T. W. Kim, D. C. Lafreniere, K. LeBlanc, W. L. Mackey, J. L. Netterville, M. E. Pipan, N. P. Raol and K. G. Schellhase Clinical practice guideline: Tympanostomy tubes in children 2013",PubMed,0.0,1.0,Design,Guideline,,0.0,Not Found,Not Found,Not Found,No pdf
257,484,485,Eur Arch Otorhinolaryngol,"M. Rossi-Izquierdo, S. Santos-Pérez, J. P. Rubio-Rodríguez, A. Lirola-Delgado, A. Zubizarreta-Gutiérrez, E. San Román-Rodríguez, P. Juíz-López and A. Soto-Varela What is the optimal number of treatment sessions of vestibular rehabilitation? 2014",PubMed,1.0,,,,,0.0,What is the optimal number of treatment sessions of vestibular rehabilitation?,"Abstract
Vestibular rehabilitation is effective and safe in patients with instability. However, there is insufficient evidence for distinguishing between efficacies of different dosage of therapies. Therefore, the aim of the present study was to verify whether there were differences between two computerised dynamic posturography (CDP) therapies of different numbers of sessions, in order to establish the optimal strategy. We conducted a prospective, comparative study of two different dosage of CDP therapy (a 5-session group and another of 10-session group) in patients with instability due to chronic unilateral peripheral vestibular disorder. We used balanced block randomisation to include 13 patients in each group. Improvement was assessed using the Dizziness Handicap Inventory and the CDP with the sensorial organisation test (SOT) and limits of stability (LOS). We found a statistically significant improvement in both groups in composite score, visual and vestibular input (SOT); and in reaction time, distance and directional control (LOS). If we compare the groups regarding these improvements, we found that 10-session group showed a greater benefit in distance covered and directional control of LOS. Since significant improvement is obtained with only five sessions, we believe this to be the optimal number of treatment sessions for most patients with chronic unilateral peripheral vestibular disorder. Nevertheless, those patients with more reduced limits of stability, and consequently greater likelihood of falling as a result of their diminished base of support, are candidates for rehabilitation protocols with a greater number of sessions.",doi: 10.1007/s00405-013-2423-2.,rossi-izquierdo2013.pdf
258,485,486,Eur Arch Otorhinolaryngol,"M. Rossi-Izquierdo, S. Santos-Pérez and A. Soto-Varela What is the most effective vestibular rehabilitation technique in patients with unilateral peripheral vestibular disorders? 2011",PubMed,1.0,,,,SAME WITH 485,0.0,What is the most effective vestibular rehabilitation technique in patients with unilateral peripheral vestibular disorders?,"Abstract
Vestibular rehabilitation has been found to be effective and safe in patients with instability. There is insufficient evidence, however, for distinguishing between the efficacies of different rehabilitation techniques. The objective of this study is to verify whether there are differences between two instrumental vestibular rehabilitation techniques, computerised dynamic posturography (CDP) and optokinetic stimulation (OKN), in order to establish the optimal strategy for each patient. We conducted a prospective, comparative study of the two techniques (CDP and OKN) in patients with instability due to chronic unilateral peripheral vestibular disorder. We randomly included 12 patients in each group, performing the evaluation with the Dizziness Handicap Inventory and the CDP with the sensorial organisation test (SOT), rhythmic weight shift and limits of stability (LOS). We found a statistically significant improvement in both groups in average balance score according to the SOT. In the OKN group, however, improvement was greater in visual preference. The CDP group showed greater benefits in the visual and vestibular input and LOS. Patients with poor vestibular and visual input or with reduced LOS will benefit more from an exercise protocol with CDP. Patients with poor visual preference, however, are ideal candidates for rehabilitation with OKN.",doi: 10.1007/s00405-011-1532-z.,rossi-izquierdo2011.pdf
259,486,487,Am J Otol,"M. J. Ruckenstein, R. A. Cueva, D. H. Morrison and G. Press A prospective study of ABR and MRI in the screening for vestibular schwannomas 1996",PubMed,0.0,1.0,Outcome,"No symptom, signs",,0.0,A prospective study of ABR and MRI in the screening for vestibular schwannomas,"Abstract
The advent of magnetic resonance imaging (MRI) has significantly increased the clinician's ability to detect small vestibular schwannomas. This had led to controversy in the evaluation of patients with asymmetric sensorineural hearing loss, as some recent studies have suggested that the auditory brainstem response (ABR) does not adequately detect small tumors of the internal auditory canal and cerebellopontine angle. As these studies evaluated ABR results in patients already diagnosed with vestibular schwannomas, they could not determine the epidemiologic accuracy (validity) of the ABR as a screening test for retrocochlear pathology. We report on the preliminary results of an ongoing prospective study on the evaluation of patients with asymmetric sensorineural hearing loss. All patients with asymmetry in two or more pure-tone thresholds of > or = 15 decibels or asymmetry in speech discrimination scores of > or 15% or both entered the study and underwent both an ABR examination and an enhanced MRI scan. Based on preliminary results obtained from the first 47 patients entered in this study, the ABR screening test for retrocochlear pathology was determined to have a sensitivity of 63%, a specificity of 64%, a positive predictive value of 26%, and a negative predictive value of 89%. All patients in whom ABR failed to diagnose a vestibular schwannoma had unilateral hearing los. These results bring into question the validity of ABR as a screening test for retrocochlear pathology, particularly in cases of unilateral hearing loss. Continued patient enrollment in this study will allow the confirmation of these results.",Not Found,No pdf
260,490,491,Front Neurol,"D. Rujescu, M. Herrling, A. M. Hartmann, S. Maul, I. Giegling, B. Konte and M. Strupp High-risk Allele for Herpes Labialis Severity at the IFNL3/4 Locus is Associated With Vestibular Neuritis 2020",PubMed,0.0,1.0,Outcome,Gene,,0.0,High-risk Allele for Herpes Labialis Severity at the IFNL3/4 Locus is Associated With Vestibular Neuritis,"Abstract
Objective: Vestibular neuritis (VN) is a peripheral vestibular disorder leading to a sudden loss of unilateral vestibular function. Although the underlying etiological mechanisms for disease development are not yet known, there is evidence that a latent infection with herpes simplex virus type 1 (HSV-1) might be involved. The polymorphism rs12979860 has been associated with the severity of recurrent herpes labialis and hepatitis C virus (HCV) clearance and treatment outcome and is located within the first intron of the IFNL4 gene on chromosome 19.q13.2. This case control study was conducted to evaluate the association of rs12979860 with VN occurrence. Methods: DNA was extracted from EDTA blood of 151 VN patients and 1,775 healthy controls. Genotyping of rs12979860 was performed using iPLEX and MassARRAY Matrix Assisted Laser Desorption Ionization-Time of Flight (MALDI-TOF) mass spectrometry. For association analyses, an additive, dominant and recessive logistic regression model was calculated, using age and sex as covariates. Results: A significant association of rs12979860 with VN was obtained for the additive [OR = 1.51 (1.18-1.92); p = 9.23 × 10-4] and dominant models [OR = 2.15 (1.48-3.13); p = 5.86 × 10-5], with the T allele being more frequent in the VN group. Conclusion: By detecting a significant association of the rs12979860-T risk allele for herpes labialis severity with susceptibility to VN, this study gives further indirect evidence for an involvement of HSV-1 in VN pathology, thereby strengthening the virus hypothesis.
Keywords: HSV-1; IFNL3; IFNL4; vertigo; vestibular neuritis.",doi: 10.3389/fneur.2020.570638.,rujescu2020.pdf
261,492,493,Otolaryngol Pol,I. Rzewnicki The examination of vestibular system in patients with degenerative changes of the cervical spine 1995,PubMed,0.0,1.0,Population,Changes in cervical spine,,0.0,[The examination of vestibular system in patients with degenerative changes of the cervical spine],"Abstract
Degenerative changes of the cervical spine often cause the pains and vertigo as well as pathological results of otoneurological tests. The aim of the study was to estimate the frequency of the symptoms occurrence in the group of 146 patients, 63 male and 83 female, with degenerative changes of the cervical spine. Permanent or periodical headaches of various intensity occurred in 60% of the patients. Balance disturbances was observed in 74% of the patients, specially in women. In the cervical spine X-ray there were observed most frequently marginal degenerations with osteophytosis (16%), intervertebral disk narrowing (10%), and shallowing of the physiological lordosis (11%). In ENG examination, positional nystagmus (42-38%), gaze nystagmus (14-23%) were mainly recorded, with the eyes opened and closed. The eye-tracking pattern test was pathological in 57%. Optokinetic test results showed pathological records in 32% of the patients, unilateral weakness was observed in 22% and bilateral weakness in 17% of the patients. Observations mentioned above confirm frequent pathology and the necessity of early diagnosis and treatment of patients with degenerative changes of the cervical spine.",Not Found,No pdf
262,494,495,JAMA Otolaryngol Head Neck Surg,"S. Sadeghpour, F. Fornasari, J. Otero-Millan, J. P. Carey, D. S. Zee and A. Kheradmand Evaluation of the Video Ocular Counter-Roll (vOCR) as a New Clinical Test of Otolith Function in Peripheral Vestibulopathy 2021",PubMed,1.0,,,,,0.0,Evaluation of the Video Ocular Counter-Roll (vOCR) as a New Clinical Test of Otolith Function in Peripheral Vestibulopathy,"Abstract
Importance: Video-oculography (VOG) goggles have been integrated into the assessment of semicircular canal function in patients with vestibular disorders. However, a similar bedside VOG method for testing otolith function is lacking.
Objective: To evaluate the use of VOG-based measurement of ocular counter-roll (vOCR) as a clinical test of otolith function.
Design, setting, and participants: A case-control study was conducted to compare vOCR measurement among patients at various stages of unilateral loss of vestibular function with healthy controls. The receiver operating characteristic curve method was used to determine the diagnostic accuracy of the vOCR test in detecting loss of otolith function. Participants were recruited at a tertiary center including the Johns Hopkins outpatient clinic and Johns Hopkins Hospital, Baltimore, Maryland. Participants included 56 individuals with acute (≤4 weeks after surgery), subacute (4 weeks-6 months after surgery), and chronic (>6 months after surgery) unilateral vestibular loss as well as healthy controls. A simple bedside maneuver with en bloc, 30° lateral tilt of the head and trunk was used for vOCR measurement. The study was conducted from February 2, 2017, to March 10, 2019.
Intervention: In each participant vOCR was measured during static tilts of the head and trunk en bloc.
Main outcomes and measures: The vOCR measurements and diagnostic accuracy of vOCR in detecting patients with loss of vestibular function from healthy controls.
Results: Of the 56 participants, 28 (50.0%) were men; mean (SD) age was 53.5 (11.4) years. The mean (SD) time of acute unilateral vestibular loss was 9 (7) days (range, 2-17 days) in the acute group, 61 (39) days (range, 28-172 days) in the subacute group, and 985 (1066) days (range 185-4200 days) in the chronic group. The vOCR test showed reduction on the side of vestibular loss, and the deficit was greater in patients with acute and subacute vestibular loss than in patients with chronic loss and healthy controls (acute vs chronic: -1.81°; 95% CI, -3.45° to -0.17°; acute vs control: -3.18°; 95% CI, -4.83° to -1.54°; subacute vs chronic: -0.63°; 95% CI, -2.28° to 1.01°; subacute vs control: -2.01°; 95% CI, -3.65° to -0.36°; acute vs subacute: -1.17°; 95% CI, -2.88° to 0.52°; and chronic vs control: -1.37°; 95% CI, -2.96° to 0.21°). The asymmetry in vOCR between the side of vestibular loss and healthy side was significantly higher in patients with acute vs chronic loss (0.28; 95% CI, 0.06-0.51). Overall, the performance of the vOCR test in discriminating between patients with vestibular loss and healthy controls was 0.83 (area under the receiver operating characteristic curve). The best vOCR threshold to detect vestibular loss at the 30° tilt was 4.5°, with a sensitivity of 80% (95% CI, 0.62%-0.88%) and specificity of 82% (95% CI, 0.57%-1.00%).
Conclusions and relevance: The findings of this case-control study suggest that the vOCR test can be performed with a simple bedside maneuver and may be used to detect or track loss of otolith function.",doi: 10.1001/jamaoto.2021.0176.,No pdf
263,495,496,Eur J Neurol,"A. Saj, M. Bachelard-Serra, J. P. Lavieille, J. Honoré and L. Borel Signs of spatial neglect in unilateral peripheral vestibulopathy 2021",PubMed,1.0,,,,,0.0,Signs of spatial neglect in unilateral peripheral vestibulopathy,"Abstract
Background and purpose: In this study, the question of whether egocentric representation of space is impaired in chronic unilateral vestibulopathies was examined. The objective was to test current theories attributing a predominant role to vestibular afferents in spatial cognition and to assess whether representational neglect signs are common in peripheral vestibular loss.
Methods: The subjective straight-ahead (SSA) direction was investigated using a horizontal rod allowing the translation and rotation components of the body midline representation to be dissociated in 21 patients with unilateral vestibular loss (right, 13; left, eight) and in 12 healthy controls.
Results: Compared to the controls, the patients with unilateral vestibulopathy showed a translation bias of their SSA, without rotation bias. The translation bias was not lateralized towards the lesioned side as typically found for biases reported after unilateral vestibular loss. Rather, the SSA bias was rightward whatever the side of the vestibular loss. The translation bias correlated with the vestibular loss, as measured by caloric response and vestibulo-ocular reflex gain, but not with the subjective visual vertical or the residual spontaneous nystagmus.
Conclusion: The present data suggest that the dysfunctions of neural networks involved in egocentred and allocentred representations of space are differentially compensated for in unilateral vestibular defective patients. In particular, they suggest that asymmetrical vestibular inputs to cortical regions lead to representational spatial disturbances as does defective cortical processing of vestibular inputs in spatial neglect after right hemisphere stroke. They also highlight the predominant role of symmetrical and unaltered vestibular inputs in spatial cognition.
Keywords: spatial neglect; subjective straight-ahead; unilateral vestibular loss.",doi: 10.1111/ene.14701.,saj2021.pdf
264,497,498,Auris Nasus Larynx,"M. Sakagami, T. Kitahara, T. Okayasu, A. Yamashita, A. Hasukawa, I. Ota and T. Yamanaka Negative prognostic factors for psychological conditions in patients with audiovestibular diseases 2016",PubMed,1.0,,,,,0.0,Negative prognostic factors for psychological conditions in patients with audiovestibular diseases,"Abstract
Objective: To examine the backgrounds of patients with audiovestibular disease regarding what influences their psychological state.
Methods: During a 12-year period, 375 successive patients with audiovestibular diseases were enrolled in this study. Diseases included unilateral (n=174) and bilateral (n=51) Menière's disease, sudden deafness with vertigo (n=70), and vestibular neuritis (n=80). Diagnosis, sex, age, duration of disease, vertigo frequency, persistent nystagmus, and ipsilateral/contralateral hearing levels were recorded. Cornell Medical Index (domains III-IV=neurosis) and Self-Rating Depression Scale (score>40=depression) were applied during acute vertigo remissions in all patients.
Results: Neurosis and depression, respectively, were diagnosed in 62.7% and 82.4% of bilateral Menière's, 32.7% and 48.9% of unilateral Menière's, 15.7% and 38.6% of sudden deafness/vertigo, and 12.7% and 31.3% of vestibular neuritis patients. Multivariable logistic regression analysis showed that Menière's disease with longer disease duration (Oz 1.212; P=0.021) and worse hearing in the secondary affected ear (Oz 1.131; P=0.042); sudden deafness/vertigo with persistent nystagmus (Oz 1.895; P=0.005); and vestibular neuritis with longer disease duration (Oz 1.422; P=0.019) and persistent nystagmus (Oz 1.950; P=0.0003) had mental illness significantly more often than those with shorter-duration disease, better hearing and no persistent nystagmus.
Conclusion: Mental disorder increased in accordance with solo vertigo, vertigo/hearing loss, repeated symptoms, and bilateral lesions. Treatment strategies should be carefully constructed for patients with persistent nystagmus, long disease duration, and hearing loss in the secondary affected ear to avoid psychological disorders.
Keywords: Contralateral hearing level; Dizziness; Duration of disease; Mental illness; Persistent nystagmus.",doi: 10.1016/j.anl.2016.02.006.,sakagami2016.pdf
265,498,499,Curr Pediatr Rev,"I. Saliba, C. Dagher, E. El-Zir and F. G. Yammine A Pilot Study to Assess the Vestibular Apparatus Function with Videonystagmography During Chronic Otitis Media with Effusion 2015",PubMed,0.0,1.0,Population,Otitis media,,0.0,A Pilot Study to Assess the Vestibular Apparatus Function with Videonystagmography During Chronic Otitis Media with Effusion,"Abstract
Objective: To assess the effect of chronic middle ear effusion (CMEE) on balance and equilibrium.
Material and methods: Prospective study controlling two groups of children. The active arm consisted of children having a unilateral or bilateral CMEE that persisted for at least 3 months. The control group consisted of children presenting with normal middle ear. Children and parents in both groups were questioned about any symptom of vertigo, dizziness, disequilibrium or child's tendency to fall. ENT exam included an assessment with pneumatic and microscopic otoscopy, evaluation of the vestibular system with the Romberg test, the Fukuda test, the head-shaking test and the Starwalk test.
Results: The study group consisted of 15 children (mean = 6.5 years, SD = 2; 10 females and 5 males). The control group consisted also of 15 children (mean = 7.2 years, SD = 1.8; 8 females and 7 males). The duration of MEE was between 3 and 12 months (mean = 8 months). Three children (20%) in the study group had a history of vertigo, imbalance, disequilibrium and/or tendency to fall. None of the children in the control group had such a history (p = 0.22); Five children in the study group had abnormal head-shaking test, Fukuda and/or Starwalk tests (33.33%). Two children in the control group had such a finding (13.33%) (p = 0.39). Romberg test was normal in all children in both groups. In the study group, one child showed positional and spontaneous nystagmus on VNG testing. Another one showed positional nystagmus. Hence, 2 children had abnormal findings on VNG (13.33%). In the control group, VNG was normal in all children (p = 0.46). Tympanometry showed a type B curve in 26 ears, a type C curve in 3 ears and type A in one ear. In the control group all patients presented a type A curve.
Conclusion: This paper describes the first study using VNG in a population of children with CMEE. The presence of balance disturbances associated or not with hearing loss is of paramount importance to the clinician as to the indications of myringotomy with a tube intervention.",doi: 10.2174/1573396311666150702105027.,No pdf
266,499,500,Front Neurol,"Y. Saman, L. McLellan, L. McKenna, M. B. Dutia, R. Obholzer, G. Libby, M. Gleeson and D. E. Bamiou State Anxiety Subjective Imbalance and Handicap in Vestibular Schwannoma 2016",PubMed,1.0,,,,,0.0,State Anxiety Subjective Imbalance and Handicap in Vestibular Schwannoma,"Abstract
Introduction: Evidence is emerging for a significant clinical and neuroanatomical relationship between balance and anxiety. Research has suggested a potentially priming effect with anxiety symptoms predicting a worsening of balance function in patients with underlying balance dysfunction. We propose to show that a vestibular stimulus is responsible for an increase in state anxiety, and there is a relationship between increased state anxiety and worsening balance function.
Aims: (1) To quantify state anxiety following a vestibular stimulus in patients with a chronic vestibular deficit. (2) To determine if state anxiety during a vestibular stimulus would correlate with the severity of chronic balance symptoms and handicap.
Methods: Two separate cohorts of vestibular schwannoma (VS) patients underwent vestibular tests (electronystagmography, cervical and ocular vestibular evoked myogenic potentials, and caloric responses) and questionnaire assessments [vertigo handicap questionnaire (VHQ), vertigo symptom scale (VSS), and state-trait anxiety inventory (STAIY)]. Fifteen post-resection VS patients, with complete unilateral vestibular deafferentation, were assessed at a minimum of 6 months after surgery in Experiment 1 (Aim 1). Forty-five patients with VS in situ formed the cohort for Experiment 2 (Aim 2). Experiment 1: VS subjects (N = 15) with a complete post-resection unilateral vestibular deafferentation completed a state anxiety questionnaire before caloric assessment and again afterward with the point of maximal vertigo as the reference (Aim 1). Experiment 2: state anxiety measured at the point of maximal vertigo following a caloric assessment was compared between two groups of patients with VS in situ presenting with balance symptoms (Group 1, N = 26) and without balance symptoms (Group 2, N = 11) (Aim 2). The presence of balance symptoms was defined as having a positive score on the VSS-VER.
Results: In Experiment 1, a significant difference (p < 0.01) was found when comparing STAIY at baseline and at the peak of the subjective vertiginous response in post-resection patients with a unilateral vestibular deafferentation. In Experiment 2, VS in situ patients with balance symptoms had significantly worse state anxiety at the peak vertiginous response than patients without balance symptoms (p < 0.001), as did patients with a balance-related handicap (p < 0.001).
Conclusion: Anxiety symptoms during a vestibular stimulus may contribute to a priming effect that could explain worsening balance function.
Keywords: anxiety; balance; cognitive behavioral therapy; handicap; vestibular schwannoma.",doi: 10.3389/fneur.2016.00101.,saman2016.pdf
267,500,501,Hno,"A. Sandner, K. Neumann, S. Kösling and C. Rasinski Cogan's disease. Report of two cases 2010",PubMed,0.0,1.0,Population,Cogan disease,,0.0,[Cogan's disease. Report of two cases],"Abstract
Background: Cogan's disease is a diagnostic challenge. The typical form of this chronic inflammatory disease is characterized by non-syphilitic interstitial keratitis and acute audiovestibular impairment.
Case reports: The first patient had ""typical"" symptoms of Cogan's syndrome with recurrent keratoconjunctivitis, severe hearing loss and vertigo. Systemic cardiovascular manifestations occurred in the further course of the disease with multiple vascular stenoses of the carotids and vessels of the lower limbs. The second patient had ""atypical"" symptoms of Cogan's disease with progressive bilateral hearing loss and vestibular deficits, unilateral conjunctivitis and orbital swelling and unspecific symptoms, such as fever and headaches. Therapy with systemic and local corticoids was successful in both cases concerning ocular and systemic symptoms. The first patient had received additional therapy with methotrexate, but had already become deaf before therapy had started. Cochlear implantation was successfully carried out. In the second patient hearing loss was stationary under therapy and the patient could be provided with hearing aids.
Conclusion: Because of obligatory cochleovestibular symptoms the otorhinolaryngologist has a key position in diagnosis and therapy of this rare entity. Early diagnosis is a crucial prognostic factor concerning preservation or restitution of hearing function.",doi: 10.1007/s00106-009-1980-6.,sandner2009.pdf
268,502,503,Neuroreport,"D. W. Saxon, J. H. Anderson and A. J. Beitz Transtympanic tetrodotoxin alters the VOR and Fos labeling in the vestibular complex 2001",PubMed,0.0,1.0,Population,Animal study,,0.0,Transtympanic tetrodotoxin alters the VOR and Fos labeling in the vestibular complex,"Abstract
The sodium channel blocker tetrodotoxin (TTX) is an effective tool for blockade of action potentials. Unilateral transtympanic administration of 3 mM TTX produced behavioral symptoms similar to those following unilateral peripheral vestibular ablation. Complete resolution of visible symptoms occurred between 48 and 72 h post-TTX. Eye-coil recordings indicated a spontaneous nystagmus and a decrease in the VOR in TTX-treated animals. Neuronal activity in the central vestibular complex (VC), as monitored with Fos immunocytochemistry, revealed an asymmetric pattern of Fos labeling in the medial, inferior and superior vestibular nuclei and the prepositus hypoglossal nucleus. Although the spatio-temporal pattern of Fos labeling was consistent and reproducible at each time-point, changes were noted among time-points. Transient blockade with TTX may be useful for studying the central vestibular response to recurrent or episodic vestibular disruption in the intact system.",doi: 10.1097/00001756-200110080-00014.,saxon2001.pdf
269,503,504,Brain Res,D. W. Saxon and G. White Episodic blockade of cranial nerve VIII provokes asymmetric changes in lobule X of the rat 2004,PubMed,0.0,1.0,Population,Animal study,,0.0,Episodic blockade of cranial nerve VIII provokes asymmetric changes in lobule X of the rat,"Abstract
Although debilitating syndromes like Ménière's disease are in part characterized by recurrent or episodic vestibular disturbance the study of episodic vestibular disruption has only recently been possible with the introduction of a new model utilizing tetrodotoxin (TTX). In the present study, serial unilateral transtympanic administration of TTX produced behavioral symptoms indicative of transient vestibular disruption and novel patterns of Fos activity in the brainstem and cerebellum. Following two or three serial injections of TTX and a final survival time of 2 h, Fos immunocytochemistry revealed a distinct pattern of labeling in the brainstem that differed temporally from that observed following a single unilateral TTX injection. Specifically there was protracted expression of Fos in the beta subdivision of the inferior olive (IO) on the side ipsilateral to TTX treatment. In the cerebellum, the hallmark of episodic vestibular blockade was an asymmetric pattern of Fos labeling that involved all three layers of the cortex. In particular, there was prominent Fos labeling of Purkinje cells in the contra-TTX half of lobule X. In view of the fact that Fos labeling is not found in Purkinje cells following a single transient event or following peripheral vestibular ablation, it is suggested that Fos expression in Purkinje cells is a unique feature of episodic vestibular disruption and may represent a novel plastic response by a select population of Purkinje cells to episodic functional deafferentation.",doi: 10.1016/j.brainres.2003.10.048.,saxon2004.pdf
270,505,506,J Assoc Res Otolaryngol,"M. Scheibinger, D. C. Ellwanger, C. E. Corrales, J. S. Stone and S. Heller Aminoglycoside Damage and Hair Cell Regeneration in the Chicken Utricle 2018",PubMed,0.0,1.0,Population,Animal study,,0.0,Aminoglycoside Damage and Hair Cell Regeneration in the Chicken Utricle,"Erratum in
Correction to: Aminoglycoside Damage and Hair Cell Regeneration in the Chicken Utricle.
Scheibinger M, Ellwanger DC, Eduardo Corrales C, Stone JS, Heller S.
J Assoc Res Otolaryngol. 2018 Feb;19(1):31. doi: 10.1007/s10162-017-0650-8.
PMID: 29299694 Free PMC article.
Correction to: Aminoglycoside Damage and Hair Cell Regeneration in the Chicken Utricle.
Scheibinger M, Ellwanger DC, Corrales CE, Stone JS, Heller S.
J Assoc Res Otolaryngol. 2018 Aug;19(4):479-481. doi: 10.1007/s10162-018-0667-7.
PMID: 30076555 Free PMC article.",doi: 10.1007/s10162-017-0646-4.,scheibinger2017.pdf
271,507,508,Front Hum Neurosci,"L. Schmidt, K. S. Utz, L. Depper, M. Adams, A. K. Schaadt, S. Reinhart and G. Kerkhoff Now You Feel both: Galvanic Vestibular Stimulation Induces Lasting Improvements in the Rehabilitation of Chronic Tactile Extinction 2013",PubMed,0.0,1.0,Population,Chronic tactile ,,0.0,Now You Feel both: Galvanic Vestibular Stimulation Induces Lasting Improvements in the Rehabilitation of Chronic Tactile Extinction,"Abstract
Tactile extinction is frequent, debilitating, and often persistent after brain damage. Currently, there is no treatment available for this disorder. In two previous case studies we showed an influence of galvanic vestibular stimulation (GVS) on tactile extinction. Here, we evaluated in further patients the immediate and lasting effects of GVS on tactile extinction. GVS is known to induce polarity-specific changes in cerebral excitability in the vestibular cortices and adjacent cortical areas. Tactile extinction was examined with the Quality Extinction Test (QET) where subjects have to discriminate six different tactile fabrics in bilateral, double simultaneous stimulations on their dorsum of hands with identical or different tactile fabrics. Twelve patients with stable left-sided tactile extinction after unilateral right-hemisphere lesions were divided into two groups. The GVS group (N = 6) performed the QET under six different experimental conditions (two Baselines, Sham-GVS, left-cathodal/right-anodal GVS, right-cathodal/left-anodal GVS, and a Follow-up test). The second group of patients with left-sided extinction (N = 6) performed the QET six times repetitively, but without receiving GVS (control group). Both right-cathodal/left-anodal as well as left-cathodal/right-anodal GVS (mean: 0.7 mA) improved tactile identification of identical and different stimuli in the experimental group. These results show a generic effect of GVS on tactile extinction, but not in a polarity-specific way. These observed effects persisted at follow-up. Sham-GVS had no significant effect on extinction. In the control group, no significant improvements were seen in the QET after the six measurements of the QET, thus ruling out test repetition effects. In conclusion, GVS improved bodily awareness permanently for the contralesional body side in patients with tactile extinction and thus offers a novel treatment option for these patients.
Keywords: awareness; body; brain recovery; extinction; rehabilitation; touch; vestibular.",doi: 10.3389/fnhum.2013.00090.,schmidt2013.pdf
272,508,509,Neurology,"E. Schneider, S. Glasauer, M. Dieterich, R. Kalla and T. Brandt Diagnosis of vestibular imbalance in the blink of an eye 2004",PubMed,0.0,1.0,Population,Acute,,0.0,Diagnosis of vestibular imbalance in the blink of an eye,"Abstract
Background: In a recent study, the authors found that blinks in healthy volunteers always triggered ocular torsion quick phases during dynamic roll movements of the head. On the basis of this observation, they hypothesized that blinks in patients with a vestibular tone imbalance would also trigger torsional quick phases.
Methods: Using video-oculography with a fixation target, the authors recorded the ocular torsion position of the left eye of 37 participants while they made voluntary blinks once every 6 to 10 seconds. The participants were recruited from four groups: two age groups of healthy volunteers with a mean +/- SD age of 32 +/- 4 (n = 9) and 65 +/- 11 y (n = 9); patients with a unilateral vestibular disorder in an acute state (n = 12, 53 +/- 17 y); and those in a persisting state in which spontaneous nystagmus had already faded (n = 9, 65 +/- 13 y).
Results: In the control groups of healthy volunteers, blinks triggered no or only small quick phases on the order of 0.1 deg. In both patient groups blinks always triggered quick phases with significantly higher amplitudes of 1.85 +/- 1.02 deg and were followed by exponentially decaying slow-phases with time constants on the order of 1 to 2 seconds. Patients in the persisting state clearly differed from patients in the acute state in that their torsional spontaneous nystagmus had already vanished due to vestibular compensation. But surprisingly, these two groups did not show a large difference in terms of the effect of blinks on ocular torsion. The authors always observed torsional quick phases with the upper pole of the eye beating away from the side of the lesion.
Conclusions: Blinks are able to trigger torsional quick phases in patients with both acute and persisting vestibular disorders. The side of the impairment can be determined from the direction in which the eye is rotated after a blink. Thus, ocular torsion recordings during blinks can be used as a simple clinical test for a vestibular tone imbalance, particularly during a persisting failure in which spontaneous nystagmus has resolved and can therefore no longer be used for diagnosis.",doi: 10.1212/01.wnl.0000141144.02666.8c.,schneider2004.pdf
273,510,511,Clin Ther,"A. W. Scholtz, M. Schwarz, W. Baumann, D. Kleinfeldt and H. J. Scholtz Treatment of vertigo due to acute unilateral vestibular loss with a fixed combination of cinnarizine and dimenhydrinate: a double-blind, randomized, parallel-group clinical study 2004",PubMed,0.0,1.0,Population,Acute 4 weeks,,0.0,"Treatment of vertigo due to acute unilateral vestibular loss with a fixed combination of cinnarizine and dimenhydrinate: a double-blind, randomized, parallel-group clinical study","Abstract
Background: Acute unilateral vestibular loss is a balance disorder that is accompanied by vertigo symptoms and concomitant vegetative symptoms, including nausea and vomiting. Patients are frequently confined to bed rest but may continue to experience vertigo symptoms. A well-established antivertiginous therapy consisting of cinnarizine and dimenhydrinate at low doses may offer rapid relief of acute vertigo symptoms due to acute vestibular loss, without inhibiting physiological compensation processes.
Objective: The purpose of this study was to compare the clinical efficacy and tolerability of a fixed combination of cinnarizine 20 mg and dimenhydrinate 40 mg versus monotherapy with its respective components in the treatment of acute vertigo symptoms due to acute unilateral vestibular loss.
Methods: In this prospective, single-center, randomized, double-blind, parallel-group clinical study, 50 patients with acute vestibular vertigo were randomly assigned to receive 4 weeks of treatment (1 tablet 3 times daily) with a fixed combination of 20 mg cinnarizine and 40 mg dimenhydrinate, 20 mg cinnarizine alone, or 40 mg dimenhydrinate alone. All patients received a 15% mannitol infusion as standard therapy during the first 6 days of treatment. Efficacy was determined by the patients' assessments of vertigo symptoms after 1 and 4 weeks of treatment using a verbal rating scale (vertigo score) and by vestibulo-ocular and vestibulospinal tests. The primary efficacy criterion was defined as the relief of vertigo symptoms after 1 week of treatment.
Results: After 1 week of treatment, the fixed combination was significantly more effective than 20 mg cinnarizine (P < 0.001) and 40 mg dimenhydrinate (P < 0.01). After 4 weeks, the fixed combination was still significantly more effective than cinnarizine in reducing vertigo symptoms (P < 0.01) and significantly more effective than dimenhydrinate in improving the patients' balance while standing (P < 0.05). The tolerability of the fixed combination was rated good or very good by 100% of the patients (cinnarizine alone, 82.4%; dimenhydrinate alone, 94.4%). No serious adverse events occurred. Four patients in the fixed combination and the cinnarizine groups, and 6 patients in the dimenhydrinate group reported nonserious adverse events.
Conclusions: The results of this study suggest a distinct benefit in using a fixed combination of cinnarizine 20 mg and dimenhydrinate 40 mg versus the respective monotherapies in this population of patients with acute vestibular vertigo.",doi: 10.1016/s0149-2918(04)90130-0.,scholtz2004.pdf
274,511,512,Acta Otolaryngol,"U. Schönfeld, K. Helling and A. H. Clarke Evidence of unilateral isolated utricular hypofunction 2010",PubMed,1.0,,,,,0.0,Evidence of unilateral isolated utricular hypofunction,"Abstract
Conclusions: The findings demonstrate that an enduring unilateral utricular dysfunction, possibly together with canal hypofunction, can occur after labyrinthine disease or injury. They also suggest that unilateral, isolated utricular dysfunction - or utricle paresis - can occur, representing a novel entity in the differential diagnosis of peripheral vestibular function. The occurrence of subjective visual vertical (SVV) asymmetry in the presence of symmetric vestibular evoked myogenic potentials (VEMPs) also confirms that the information from the utricles, rather than the saccules, dominates SVV estimation.
Objectives: To determine the incidence of unilateral utricular hypofunction.
Methods: The retrospective clinical study deals with a selection of those vestibular patients who showed pathological responses to utricle testing. Peripheral vestibular function was examined in a group of 110 patients. Utricular function was evaluated by estimation of SVV during unilateral centrifugation. Bithermal caloric testing was performed to assess unilateral semicircular canal function. Saccular function was tested by measurement of VEMPs.
Results: A total of 46 patients were found with asymmetric SVV findings (p < 0.001 for healthy versus lesioned ear), but symmetric caloric responses and VEMPs. Statistical testing also verified that their SVV asymmetry factors were significantly higher than those calculated for caloric responses and VEMPs (p < 0.001).",doi: 10.3109/00016480903397686.,10.3109@00016480903397686.pdf
275,512,513,Laryngoscope,M. K. Schwaber and J. W. Hall Cochleovestibular nerve compression syndrome. I. Clinical features and audiovestibular findings 1992,PubMed,0.0,1.0,Design,Review,,0.0,Cochleovestibular nerve compression syndrome. I. Clinical features and audiovestibular findings,"Abstract
Cochleovestibular nerve compression syndrome (CNCS) is the term used to describe a group of audiovestibular symptoms thought to be due to a vessel compressing the cochleovestibular nerve. These symptoms include recurrent vertigo, continuous disequilibrium and acquired motion intolerance. Recently, Moller reported that CNCS can be diagnosed based on abnormalities in the auditory brainstem response (ABR). After specifically excluding all other vestibular disorders, 63 patients with symptoms suggestive of CNCS were identified. These patients were systematically evaluated with a standard neurotologic test battery, and the results were reviewed retrospectively. Hearing loss was found in 51 (81%) of 63 cases, including 33 cases of unilateral high-frequency loss and 14 cases of middle-frequency loss. ABR data were interpreted with respect to Moller's criteria, and abnormal studies were found in 42 (75%) of 56 cases. Abnormal electronystagmograms were found in 57 (93%) of 61 cases. Thirteen of the patients subsequently underwent a posterior fossa procedure for vertigo and, vessels were found in contact with the cochleovestibular nerve in 11 of 13 cases. The results of this study suggest that the majority of CNCS patients have neurotologic test findings that suggest an abnormality of the cochleovestibular nerve. The results and their implications are discussed.",doi: 10.1288/00005537-199209000-00012.,schwaber1992.pdf
276,513,514,Brain,"J. Schwoebel, R. Friedman, N. Duda and H. B. Coslett Pain and the body schema: evidence for peripheral effects on mental representations of movement 2001",PubMed,0.0,1.0,Population,No vest patients,,0.0,Pain and the body schema: evidence for peripheral effects on mental representations of movement,"Abstract
Some accounts of body representations postulate a real-time representation of the body in space generated by proprioceptive, somatosensory, vestibular and other sensory inputs; this representation has often been termed the 'body schema'. To examine whether the body schema is influenced by peripheral factors such as pain, we asked patients with chronic unilateral arm pain to determine the laterality of pictured hands presented at different orientations. Previous chronometric findings suggest that performance on this task depends on the body schema, in that it appears to involve mentally rotating one's hand from its current position until it is aligned with the stimulus hand. We found that, as in previous investigations, participants' response times (RTs) reflected the degree of simulated movement as well as biomechanical constraints of the arm. Importantly, a significant interaction between the magnitude of mental rotation and limb was observed: RTs were longer for the painful arm than for the unaffected arm for large-amplitude imagined movements; controls exhibited symmetrical RTs. These findings suggest that the body schema is influenced by pain and that this task may provide an objective measure of pain.",doi: 10.1093/brain/124.10.2098.,schwoebel2001.pdf
277,514,515,Laryngoscope,S. Seltzer and B. F. McCabe Perilymph fistula: the Iowa experience 1986,PubMed,0.0,1.0,Population,Perilymph fistula patients,,0.0,Perilymph fistula: the Iowa experience,"Abstract
Ninety-one patients with demonstrable perilymph fistulas presented with an amazing array of signs and symptoms ranging from unilateral tinnitus and aural fullness to sudden-and-profound hearing loss, roaring tinnitus, and whirling vertigo. Between 1977 and 1984, 214 exploratory tympanotomies for suspected perilymph fistula (PLF) were performed on 177 patients. One hundred six primary (initial) fistulas were found in 95 ears and 26 recurrent fistulas were identified. Eighty-two percent of the 91 patients with PLF had auditory symptoms, 8% with auditory symptoms as the sole complaint. Eighty-one percent of the patients had vestibular symptoms, 12% with vestibular symptoms alone. The type of hearing loss and the nature of the vestibular symptoms were widely variable. Of the 58 patients with preoperative auditory symptoms, 49% had improved hearing (23% improved to serviceable range), after closure of PLFs. Ninety-five percent of the patients who presented with vestibular symptoms had elimination of or decrease in their dizziness to the extent that it no longer interfered with their daily activities. The highest incidence of recurrent fistula was associated with grafts using fatty tissue. Patients with Mondini deformity were at particularly high risk for fistula recurrence.",doi: 10.1288/00005537-198601000-00007.,seltzer1986.pdf
278,515,516,Brain Res,"M. Shaabani, Y. Lotfi, S. M. Karimian, M. Rahgozar and M. Hooshmandi Short-term galvanic vestibular stimulation promotes functional recovery and neurogenesis in unilaterally labyrinthectomized rats 2016",PubMed,0.0,1.0,Population,Animal study,,0.0,Short-term galvanic vestibular stimulation promotes functional recovery and neurogenesis in unilaterally labyrinthectomized rats,"Abstract
Current experimental research on the therapeutic effects of galvanic vestibular stimulation (GVS) has mainly focused on neurodegenerative disorders. However, it primarily stimulates the vestibular nuclei and could be potentially effective in modulating imbalance between them in the case of unilateral labyrinthectomy (UL). Fifty male Wistar rats (180-220g) were used in 5 groups of 10: intact, sham, right-UL (RUL; without intervention), and two other right-UL groups with GVS intervention [one group treated with low rate GVS (GVS.LF; 6-7Hz), and the other treated with high rate GVS (GVS.HF; 17-18Hz)]. The UL models were prepared by intratympanic injection of sodium arsanilate. GVS protocols were implemented 30min/day and continued for 14 days via ring-shaped copper electrodes inserted subcutaneously over each mastoid. Functional recovery was assessed by several postural tests including support surface area, landing and air-righting reflexes, and rotarod procedure. Immunohistochemical investigations were performed on ipsi- and contra-lesional medial vestibular nuclei (MVN) using bromodeoxyuridine (BrdU) and Ki67, as markers of cell proliferation. Behavioral evaluations showed significant functional recovery of GVS-treated groups compared to RUL group. The percent of marked cells with BrdU and Ki67 were significantly higher in the ipsilesional MVN of both GVS-treated groups compared with other groups. Our findings confirmed the effectiveness of GVS-intervention in accelerating static and dynamic vestibular compensation. This could be explained by the cell proliferation in ipsilesional MVN cells and rapid rebalancing of the VNs and the modulation of their motor outputs. Therefore, GVS could be promising for rehabilitating patients with unilateral vestibular weakness.
Keywords: BrdU; Galvanic; Labyrinthectomy; Neurogenesis; Rat; Vestibular.",doi: 10.1016/j.brainres.2016.07.029.,shaabani2016.pdf
279,518,519,Front Neurol,"Q. Shen, C. Magnani, O. Sterkers, G. Lamas, P. P. Vidal, J. Sadoun, I. S. Curthoys and C. de Waele Saccadic Velocity in the New Suppression Head Impulse Test: A New Indicator of Horizontal Vestibular Canal Paresis and of Vestibular Compensation 2016",PubMed,1.0,,,,,0.0,Saccadic Velocity in the New Suppression Head Impulse Test: A New Indicator of Horizontal Vestibular Canal Paresis and of Vestibular Compensation,"Abstract
Objective: To determine whether saccadic velocity in the suppression head impulse paradigm (SHIMP) test is a reliable indicator of vestibular loss at the acute and at the chronic stage in patients suffering from different vestibular pathologies.
Methods: Thirty-five normal subjects and 57 patients suffering from different vestibular pathologies associated with unilateral vestibular loss (UVL) or bilateral vestibular loss (BVL) were tested in the SHIMPs paradigm. SHIMPs were performed by turning the head 10 times at high velocities to the left or right side, respectively. The patients were instructed to fixate on a red spot generated by a head-fixed laser projected on the wall. In this SHIMPs paradigm, healthy subjects made a large anti-compensatory saccade at the end of the head turn (a SHIMP saccade). The peak saccadic velocity, the percentage of the trials completed with saccades in 10 trials, and the latency of the saccades were quantified in each group. A video-head impulse test (v-HIT) was systematically performed in all of our subjects as well as a caloric test. The dizziness handicap inventory questionnaire was also given to chronic UVL and BVL patients.
Results: At the acute stage after a complete UVL, patients had zero or a few anti-compensatory saccades for low velocity head turns toward the lesioned side. These saccades had lower velocity than the anti-compensatory saccades recorded during head rotation toward the intact side and/or compared with the saccades measured in control subjects. At the chronic stage, some of the patients recovered the ability to perform SHIMP saccades at each head turn toward the lesioned side, but very often these saccades were of significantly lower velocity. In BVL patients, no anti-compensatory saccades, or only significantly smaller ones, could be detected for head turns to both sides.
Conclusion: SHIMP is a specific and sensitive test to detect a complete horizontal canal loss at the acute stage. In addition, it reflects the ability of patients with moderate horizontal vestibulo-ocular reflex gain decrease to generate anti-compensatory saccades in the chronic stage. In association with v-HIT, it allows determination of the residual vestibular function and to detect anti-compensatory saccades.
Keywords: IT gentamicin; Meniere’s disease; bilateral areflexia; horizontal vestibule–ocular reflex; saccade substitution; vestibular loss; vestibular schwannoma; video-head impulses.",doi: 10.3389/fneur.2016.00160.,shen2016.pdf
280,520,521,J Laryngol Otol,"J. C. Shotton, H. Ludman and R. Davies Persisting nystagmus following vestibular nerve section for Menière's disease 1989",PubMed,1.0,,,,,1.0,Persisting nystagmus following vestibular nerve section for Menière's disease,"Abstract
Unilateral vestibular nerve section (VNS) creates a state of acute dysequilibrium which resolves by a process of central compensation. This disturbance resolves quickly and central compensation is complete generally within a month with resolution of symptoms and signs. The course of central compensation following VNS will be similar to that seen after labyrinthectomy because the detachment of hemi-labyrinthine input that is achieved by both will be identical. Six patients are presented who have undergone VNS at least 2.7 years ago (Average 3.5 years); all of them have persisting spontaneous peripheral type horizontal jerk nystagmus, present with optic fixation in five. This is obvious clinically and was confirmed in each case by agreement of three independent observers and has been recorded by electronystagmography (ENG). They are free from marked vestibular symptoms. The explanations of mechanisms involved in central compensation are discussed with respect to this previously unrecorded clinical observation.",doi: 10.1017/s0022215100108667.,shotton1989.pdf
281,521,522,Laryngoscope,"A. Shupak, Z. Nachum, Y. Stern, D. Tal, A. Gil and C. R. Gordon Vestibular neuronitis in pilots: follow-up results and implications for flight safety 2003",PubMed,1.0,,,,,0.0,Vestibular neuronitis in pilots: follow-up results and implications for flight safety,"Abstract
OBJECTIVES To report our experience over the past 12 years with the evaluation and follow-up of pilots with vestibular neuronitis and to discuss points relevant to flight safety and the resumption of flying duties. STUDY DESIGN A retrospective, consecutive case series.METHODS Eighteen military pilots with vestibular neuronitis were examined and followed up. A complete otoneurological workup was performed, including both physical examination and laboratory evaluation. The latter included electro-oculography (EOG) and a rotatory chair test using the smooth harmonic acceleration protocol. RESULTS The mean patient age was 35 +/- 6 years (range, 23 to 42 y), and the average follow-up period was 20.5 +/- 12.8 months (mean +/- standard deviation [SD]; (range, 11 to 48 mo). Electro-oculography caloric test on presentation documented significant unilateral hypofunction in all patients. Thirteen of the 18 patients (72%) had abnormal smooth harmonic acceleration test results. None of the pilots reported any symptoms on follow-up. However, five (28%) had positive otoneurological examination findings, and eight (44%) still had significant caloric lateralization (>25%). The average caloric hypofunction was reduced from 67.8% +/- 29.3% at onset to 40% +/- 16% (mean +/- SD, <.05, paired test). Seven of the patients (39%) had additional electro-oculography findings beyond caloric hypofunction. These included spontaneous, positional, and positioning nystagmus. Smooth harmonic acceleration disease on follow-up was documented in eight patients (44%), five of whom had canal paresis. Eleven patients (61%) demonstrated residual vestibular damage on follow-up. In 6 of these 11 cases (55%), the laboratory evaluation revealed vestibular deficits otherwise undiagnosed by the bedside test battery. CONCLUSIONS The vestibular system plays a central role in orientation awareness and is often challenged by flying conditions. The finding that approximately 60% of pilots who have had vestibular neuronitis continue to show signs of vestibular malfunction, despite apparent clinical recovery, emphasizes the need for a complete vestibular evaluation, including specific bedside testing and laboratory examinations, before flying duties can be resumed.",doi: 10.1097/00005537-200302000-00022.,shupak2003.pdf
282,522,523,Indian J Otolaryngol Head Neck Surg,"L. Siampara, S. B. Mann, N. K. Panda and Y. N. Mehra Audiovestibular profile in unilateral chronic suppurative otitis media 1997",PubMed,0.0,1.0,Population,Otitis media patients,,0.0,Audiovestibular profile in unilateral chronic suppurative otitis media,"Abstract
AudioIogical tests including middle ear impedance test and vestibular function tests were administered to seventyfive patients of unilateral chronic suppurative otitis media. These patients were selected so as to exclude the influence of hereditory, drugs, systemic illness and the factors of aging. The subjects were subdivided into 3 groups : group 1 cases with central perforation; group 2 with marginal and group 3 with attic perforation respectively. On pure tone audiometry, 19 diseased ears (25.3%) showed sensorineural hearing loss of 40 dB or more at 4 KHz and 8 KHz. The difference in the mean bone conduction threshold of diseased and the nondiseased ears was statistically significant at 4 KHz and above. Results of specialised tests of hearing suggested cochlear pathology being responsible for sensorneural hearing loss. Electronystagmographic recording of saccades and bithermal caloric induced nystagmus revealed canal paresis on the diseased side in 4 patients (5.3%). These 4 patients had 15 years history of otorrhoea.",doi: 10.1007/BF03023784.,siampara1997.pdf
283,523,524,Int Tinnitus J,"J. Sichnarek, E. Mrazkova, E. Zathurecky and H. Tomaskova Comparing results from vestibular caloric stimulation and vHIT from a specialised outpatient clinic 2019",PubMed,0.0,1.0,Outcome,comparison,,0.0,Comparing results from vestibular caloric stimulation and vHIT from a specialised outpatient clinic,"Abstract
Background: Until recently, vestibular caloric stimulation was the only objective diagnostic method for isolating the function of the lateral semi-circular canals responsible for maintaining balance. Since 2014, the Video Head Impulse Test (vHIT) has been applied in the Czech Republic to investigate the function of all semi-circular canals. Studies conducted so far have shown that the results of these two methods do not often agree.
Methods: The aim of this study was to compare the results of vestibular caloric stimulation and vHIT in a cohort of patients with peripheral vestibular syndrome at a specialized outpatient clinic. The study lasted from July 2016 to August 2017 and included patients with unilateral peripheral vestibular syndrome (n=32; 24 females and 8 males, mean age 49.4 years) and a positive result with either vestibular caloric stimulation or vHIT.
Findings: 90% of the patients had a positive vestibular caloric stimulation result, while the vHIT was positive only in 50% of the patients. Both methods were positive in 13 subjects, vestibular caloric stimulation was positive and vHIT was negative in 16 subjects and in 3 cases vestibular caloric stimulation was negative and vHIT was positive. Based on these numbers, both methods concur in 45% of the cases. In 13 patients, apart from lateral canal disorders, vHIT revealed disorders in one of the vertical canals - the front right in 4, the rear right in 2, the front left in 3 and the rear left in 4. When sorted into subgroups of the ""TiTrATE"" diagnostic algorithm based on the time course and triggering factor, vHIT was found to be positive for acute spontaneous vertigo in 62.5% of cases. vHIT was negative for 70% of chronic and spontaneous episodic complaints.
Conclusions: The diagnosis of peripheral vestibular disorders should take the pathophysiological basis of the disease into account, as this can differ in peripheral disorders. This could then explain the discrepancy between the results of the two methods. The time course of the disease can be a predictor of the vHIT outcome. Localizing the impaired function of particular semi-circular canals using vHIT can inform selective vestibular rehabilitation.
Keywords: Vertigo; peripheral vestibular syndrome; vestibular rehabilitation; vestibule-ocular reflex.",doi: 10.5935/0946-5448.20190001.,No pdf
284,524,525,Ear Hear,"N. K. Singh, N. K. Keloth and S. Sinha Is There a Safe Level for Recording Vestibular Evoked Myogenic Potential? Evidence From Cochlear and Hearing Function Tests 2019",PubMed,0.0,1.0,Population,Healthy subjects,,0.0,Is There a Safe Level for Recording Vestibular Evoked Myogenic Potential? Evidence From Cochlear and Hearing Function Tests,"Abstract
Objective: There is a growing concern among the scientific community about the possible detrimental effects of signal levels used for eliciting vestibular evoked myogenic potentials (VEMPs) on hearing. A few recent studies showed temporary reduction in amplitude of otoacoustic emissions (OAE) after VEMP administration. Nonetheless, these studies used higher stimulus levels (133 and 130 dB peak equivalent sound pressure level [pe SPL]) than the ones often used (120 to 125 dB pe SPL) for clinical recording of VEMP. Therefore, it is not known whether these lower levels also have similar detrimental impact on hearing function. Hence, the present study aimed at investigating the effect of 500 Hz tone burst presented at 125 dB pe SPL on hearing functions.
Design: True experimental design, with an experimental and a control group, was used in this study. The study included 60 individuals with normal auditory and vestibular system. Of them, 30 underwent unilateral VEMP recording (group I) while the remaining 30 did not undergo VEMP testing (group II). Selection of participants to the groups was random. Pre- and post-VEMP assessments included pure-tone audiometry (250 to 16,000 Hz), distortion product OAE, and subjective symptoms. To simulate the time taken for VEMP testing in group I, participants in group II underwent these tests twice with a gap of 15 minutes.
Results: No participant experienced any subjective symptom after VEMP testing. There was no significant interear and intergroup difference in pure-tone thresholds and distortion product OAE amplitude before and after VEMP recording (p > 0.05). Furthermore, the response rate of cervical VEMP was 100% at stimulus intensity of 125 dB pe SPL.
Conclusions: Use of 500 Hz tone burst at 125 dB pe SPL does not cause any temporary or permanent changes in cochlear function and hearing, yet produces 100% response rate of cervical VEMP in normal-hearing young adults. Therefore, 125 dB pe SPL of 500 Hz tone burst is recommended as safe level for obtaining cervical VEMP without significantly losing out on its response rate, at least in normal-hearing young adults.",doi: 10.1097/AUD.0000000000000646.,e036abfbd6c803de6be7766f1bfa31b0.pdf
285,525,526,Int J Pediatr Otorhinolaryngol,L. P. Smith and S. Roy Treatment strategy for iatrogenic nasal vestibular stenosis in young children 2006,PubMed,0.0,1.0,Population,Children,,0.0,Treatment strategy for iatrogenic nasal vestibular stenosis in young children,"Abstract
Iatrogenic nasal vestibular stenosis is an uncommon complication of supportive care in neonates. There is minimal literature describing this entity; previous treatment strategies focus on correction with local flaps or skin grafts. We describe symptomatic iatrogenic vestibular stenosis treated successfully with endoscopic lysis of synechiae and nasal stenting. Three children with nasal stenosis were identified from 2003 to 2004 at a large academic tertiary care medical center. All patients were born premature (25-34 weeks). Two developed vestibular stenosis after extended use of nasal CPAP; one developed unilateral nasal stenosis 4 years after use of a nasal feeding tube. Age at time of surgical repair was from 4 months to 5 years. Two patients (4 and 5 months) presented with nasal airway obstruction, and difficulty breathing during feeding. One patient (5 years) presented with right-sided nasal obstruction and nasal whistling. Endoscopic lysis of nasal synechiae and release of vestibular scarring was performed in all three cases without complication. Nasal stenting with a modified endotracheal tube was used for 4-6 weeks. Topical Mitomycin C was utilized in two patients. All patients had complete resolution of airway symptoms after stent removal and all three remain asymptomatic 1 year after repair with no recurrence of vestibular stenosis. Nasal vestibular stenosis is a rare complication following supportive care in premature infants, causing airway and feeding difficulties in the obligate nasal breather. This can be successfully corrected with endoscopic repair, nasal stenting and application of Mitomycin C.",doi: 10.1016/j.ijporl.2006.01.015.,smith2006.pdf
286,526,527,Brain Res Brain Res Rev,P. F. Smith and I. S. Curthoys Mechanisms of recovery following unilateral labyrinthectomy: a review 1989,PubMed,0.0,1.0,Design,Review,,0.0,Mechanisms of recovery following unilateral labyrinthectomy: a review,"Abstract
This paper reviews the literature on the mechanisms responsible for the behavioural recovery which occurs following unilateral labyrinthectomy (UL), UL causes a syndrome of ocular motor and postural disorders, which diminish over time in a process of behavioural recovery known as vestibular compensation. Electrophysiological studies show that the VIIIth nerve does not undergo a functional recovery, therefore vestibular compensation has been attributed to CNS plasticity. However, the nature of the plasticity responsible for vestibular compensation is not understood. Single-neuron studies have demonstrated that a significant recovery of resting activity has occurred in the vestibular nuclei (VN) ipsilateral to the UL by the time symptoms such as spontaneous nystagmus and roll head tilt (static symptoms) have largely disappeared. However, many of the deficits in the response of VN neurons to head acceleration persist and may be permanent. This lack of recovery in the response of neurons to head acceleration correlates with the incomplete and sometimes poor recovery of the vestibulo-ocular and vestibulo-spinal reflex responses to head movement (dynamic symptoms). The major neuronal change in the VN during vestibular compensation appears to be the recovery of resting activity in the VN ipsilateral to the UL, although this recovery is more pronounced in the medial VN than in the lateral VN. The mechanism responsible for the regeneration of resting activity in VN neurons is unknown. In frogs, there is evidence to suggest that transcommissural synaptic input to the VN, from the contralateral (intact) labyrinth, increases in efficacy.(ABSTRACT TRUNCATED AT 250 WORDS)",doi: 10.1016/0165-0173(89)90013-1.,smith1989.pdf
287,527,528,Int J Occup Med Environ Health,"W. Smółka, K. Smółka, J. Markowski, J. Pilch, A. Piotrowska-Seweryn and A. Zwierzchowska The efficacy of vestibular rehabilitation in patients with chronic unilateral vestibular dysfunction 2020",PubMed,1.0,,,,,1.0,The efficacy of vestibular rehabilitation in patients with chronic unilateral vestibular dysfunction,"Abstract
Objectives: Vestibular rehabilitation leads to a gradual diminution of the subjective and objective symptoms that accompany the vestibular disorders. The aim of the study was to compare the impact of 2 different types of vestibular rehabilitation on vestibular compensation in patients with chronic unilateral vestibular dysfunction.
Material and methods: The study was conducted on a group of 58 subjects (43 females and 15 males) aged 40-64 years, who presented with chronic unilateral vestibular dysfunction and were hospitalized. The patients were randomly assigned to either of the 2 groups established. The study was conducted in a 6-week period. Group 1 consisted of patients who underwent customized group vestibular rehabilitation in an outpatient setting. The program was performed once a week for 1 h 30 min, under the supervision of a physiotherapist and a physiatrist. Group 2 was instructed to perform Cawthorne-Cooksey exercises and simple balance exercises twice a day for 15 min.
Results: An improvement in the outcomes of the Dynamic Gait Index as well as the Berg Balance Scale was statistically significant for group 1. The time for fulfilling the task in the Timed Up and Go Test improved in both groups (p < 0.05). The subjective estimation of the symptoms evaluated with the use of the Dizziness Handicap Inventory and the Visual Analogue Scale revealed a statistically significant improvement in both groups, yet it was higher in group 1.
Conclusions: The compensation achieved after 6 weeks of the customized, supervised outpatient rehabilitation program in group 1 was superior to the results of the home-based unsupervised Cawthorne-Cooksey and balance exercises. Int J Occup Med Environ Health. 2020;33(3):273-82.
Keywords: balance disorders; exercises; practical experience; rehabilitation; vestibular; working adults.",doi: 10.13075/ijomeh.1896.01330.,No pdf
288,528,529,J Laryngol Otol,"G. D. Smyth, A. G. Kerr and K. P. Singh Second ear stapedectomy--a continued controversy 1975",PubMed,0.0,1.0,Population,Stapedectomy patients,,0.0,Second ear stapedectomy--a continued controversy,"Abstract
This paper presents the results of an investigation into the effects of stapedectomy on vestibular function. We detected a disturbingly high incidence of vestibular abnormality in the results of caloric tests at three months postoperatively. Surprisingly, this was not usually accompanied by concurrent vestibular symptoms and there was no evidence of cochlear dysfunction in most cases. Although the caloric response at 12 months postoperatively showed an improvement in most instances, the responses rarely became symmetrical. We believe that a long-term alteration in vestibular response is not uncommon following stapedectomy. Although most patients will compensate quite quickly after unilateral stapedectomy we suspect that this occurs much less readily after bilateral stapedectomy and not at all should bilateral impairment of vestibular function occur. On the basis of this evidence, we submit that bilateral stapedectomy is justified only when vestibular function can be shown to be normal prior to the second ear operation.",doi: 10.1017/s0022215100081354.,smyth1975.pdf
289,530,531,Eur Arch Otorhinolaryngol,"O. A. Somefun, O. S. Giwa, B. A. Bamgboye, I. Okeke, II and A. A. Azeez Vestibular disorders among adults in a tertiary hospital in Lagos, Nigeria 2010",PubMed,1.0,,,,,0.0,"Vestibular disorders among adults in a tertiary hospital in Lagos, Nigeria","Abstract
Dizziness is not an uncommon complaint in the Otolaryngological clinics among other symptoms. To a large number of practitioners, the treatment of dizziness remains the same irrespective of the etiology, i.e., anti-vertiginous drugs. The objective of this study was to document the evaluation, causes and treatment of vestibular disorders among our patients. The design includes descriptive prospective study conducted in the Oto-rhino-laryngology and Orthopedic Clinics of Lagos University Teaching Hospital, Lagos and Nigerian Army Audiological Centre, 68 Nigerian Army Reference Hospital, Yaba, Lagos, Nigeria. Adult patients referred to the audiology clinic for dizziness had detailed history obtained by using structured questionnaire. General physical and neuro-otological examinations were done. Clinical diagnoses were made on standardized criteria. The patients had hearing evaluation, videonystagmography (VNG) evaluation using infrared videonystagmography system. X-ray of the cervical spine and computerized tomogram scan of internal auditory meatus and brain when indicated were done. A total of 102 patients were seen with age range between 21 and 90 years. Thirty patients (29.4%) recorded average duration of episode of vertiginous attacks in seconds, 69 (67.6%) recorded within minutes to hours and 3 (2.9%) with no definite pattern. Clinical signs on neuro-otological examination were elicited on 39 (38.2%) of the patients while on VNG the vestibular subtest mainly caloric test was abnormal unilaterally and bilaterally in 47 (46.1%) while with the oculomotor subtests, smooth pursuit tests were abnormal in 5 (6.9%), saccade tests were abnormal in 8 (7.8%) and OPK were abnormal in 9 (8.8%). Peripheral vestibular disorders are common of which benign paroxysmal positional vertigo (BPPV) was seen in 29 (28.4%), Meniere's disease in 22 (21.6%), recurrent vestibulopathy in 20 (19.6%), cervical vertigo in 18 (17.6%), psychogenic vertigo in 2 (2%), vestibular schwannoma, barotraumas and drug-induced vertigo in 1 (1%), respectively, central vestibular disorders of vascular origin 2 (2%), vertebrobasilar insufficiency in 1 (1%), post-traumatic vertigo in 3 (3%) and unknown in 2 (2%). In conclusion, peripheral vestibular disorders are common of which BPPV is the most prevalent. Pre-referral anti-vertiginous medication is common among general practitioners. The practising ORL/Head neck surgeon and orthopedic surgeons must be conversant with the tools of diagnosis, differential diagnosis and treatment.",doi: 10.1007/s00405-010-1272-5.,somefun2010.pdf
290,531,532,Am J Otolaryngol,"E. J. Son, D. H. Lee, J. H. Oh, J. H. Seo and E. J. Jeon Correlation between the dizziness handicap inventory and balance performance during the acute phase of unilateral vestibulopathy 2015",PubMed,0.0,1.0,Population,Acute term,,0.0,Correlation between the dizziness handicap inventory and balance performance during the acute phase of unilateral vestibulopathy,"Abstract
Purpose: The dizziness handicap inventory (DHI) is widely used to evaluate self-perceived handicap due to dizziness, and is known to correlate with vestibular function tests in chronic dizziness. However, whether DHI reflects subjective symptoms during the acute phase has not been studied. This study aims to investigate the correlations of subjective and objective measurements to highlight parameters that reflect the severity of dizziness during the first week of acute unilateral vestibulopathy.
Materials and methods: Thirty-seven patients with acute unilateral vestibulopathy were examined. Patients' subjective perceptions of dizziness were measured using the DHI, Vertigo Visual Analog Scale (VVAS), Disability Scale (DS), and Activity-Specific Balance Scale (ABC). Additionally, the oculomotor tests, Romberg and sharpened Romberg tests, functional reach test, and dynamic visual acuity tests were performed. The correlation between the DHI and other tests was evaluated.
Results: DHI-total scores exhibited a moderately positive correlation with VVAS and DS, and a moderately negative correlation with ABC. However, DHI-total score did not correlate with results of the Romberg, sharpened Romberg, or functional reach tests. When compared among four groups divided according to DHI scores, VVAS and DS scores exhibited statistically significant differences, but no significant differences were detected for other test results.
Conclusion: Our findings revealed that the DHI correlated significantly with self-perceived symptoms measured by VVAS and DS, but not ABC. There was no significant correlation with other balance function tests during the first week of acute vestibulopathy. The results suggest that DHI, VVAS and DS may be more useful to measure the severity of acute dizziness symptoms.",doi: 10.1016/j.amjoto.2015.07.011.,son2015.pdf
291,533,534,Audiol Neurootol,"A. Sprenger, E. Zils, G. Stritzke, A. Krüger, H. Rambold and C. Helmchen Do predictive mechanisms improve the angular vestibulo-ocular reflex in vestibular neuritis? 2006",PubMed,1.0,,,,,0.0,Do predictive mechanisms improve the angular vestibulo-ocular reflex in vestibular neuritis?,"Abstract
Recovery from vestibular neuritis (VN) is often incomplete which leads to persistent vestibular imbalance during rapid head movements. Patients with unilateral vestibular lesions have a larger gain of the horizontal vestibulo-ocular reflex during active compared to passive head movements. To test whether this gain increase is related to predictive mechanisms we studied 15 patients with VN and 14 control subjects during predictable and unpredictable passive horizontal head impulses in the light and darkness. The vestibulo-ocular reflex showed a significantly shorter latency and higher gain in the light for predictable head impulses towards the ipsilesional side. However, this effect is small and might contribute but cannot exclusively account for the gain increase during active head movements.",doi: 10.1159/000088926.,sprenger2006.pdf
292,534,535,Med Sci Monit,"T. Stankiewicz, M. Gujski, A. Niedzielski and L. P. Chmielik Virtual Reality Vestibular Rehabilitation in 20 Patients with Vertigo Due to Peripheral Vestibular Dysfunction 2020",PubMed,1.0,,,,,0.0,Virtual Reality Vestibular Rehabilitation in 20 Patients with Vertigo Due to Peripheral Vestibular Dysfunction,"Abstract
BACKGROUND Vestibular compensation is disrupted in patients with chronic vestibular syndrome. Vestibular rehabilitation is an exercise therapy that optimizes the process of vestibular compensation. This study aimed to evaluate virtual reality (VR) vestibular rehabilitation in 20 patients with vertigo due to peripheral vestibular dysfunction at a single center.Our study aim was to initially assess the impact of using virtual reality technology in vestibular rehabilitation. MATERIAL AND METHODS The subjects were 20 patients with unilateral vestibular hypofunction (UVH), as confirmed by videonystagmography. These were divided into 2 groups: Group 1 underwent vestibular rehabilitation using virtual reality and Group 2 was treated by conventional therapy. A VSS-SF questionnaire and the VAS scale were used to assess the effects and levels of patient satisfaction with therapy. RESULTS Both groups demonstrated significantly (P.",doi: 10.12659/MSM.930182.,No pdf
293,535,536,J Voice,"N. Steffen, V. P. Vieira, R. K. Yazaki and P. Pontes Modifications of vestibular fold shape from respiration to phonation in unilateral vocal fold paralysis 2011",PubMed,0.0,1.0,Population,Unilateral vocal fold paralyses,,0.0,Modifications of vestibular fold shape from respiration to phonation in unilateral vocal fold paralysis,"Abstract
The diversity of vestibular fold (VeF) behavior during phonation, as well as the lack of insight regarding both the anatomy and muscle fiber composition hinder our understanding of their role during phonation. The concave shape of the free margin of VeF appears to be standard, but little is known regarding the variability of this shape. We, therefore, sought to determine the laryngoscopic features related to changes in the free margin of the VeFs during phonation in patients with unilateral vocal fold paralysis. Laryngeal images from 39 patients with unilateral paralysis associated with recurrent laryngeal nerve damage were evaluated with regard to variations in length and shape of the VeFs (concave, straight, or convex) during both respiration and phonation. The VeFs on both the paralyzed and unaffected sides were analyzed during both phonation and respiration resulting in 156 total images. During phonation, all VeFs on the nonparalyzed side were straight or convex, whereas on the paralyzed side, only 20 of the 39 were straight or convex during phonation. During respiration, significant differences in the shape of the nonparalyzed side were observed. During phonation, a nonconcave appearance on the paralyzed side usually correlated with a similar appearance during respiration. VeF length decreased during phonation in 30 nonparalyzed VeFs in contrast to only 13 paralyzed folds. When subjects switched from respiration to phonation, the VeFs were typically nonconcave on the nonparalyzed side. In contrast, on the paralyzed side, nonconcave VeFs were consistent across both tasks. In patients with unilateral vocal fold paralysis, VeF conformation is likely determined from extralaryngeal than intrinsic muscle. These findings have important theoretical considerations for laryngeal treatment.",doi: 10.1016/j.jvoice.2009.05.001.,steffen2011.pdf
294,538,539,Neurology,"M. Strupp, V. Arbusow, K. P. Maag, C. Gall and T. Brandt Vestibular exercises improve central vestibulospinal compensation after vestibular neuritis 1998",PubMed,0.0,1.0,Population,Acute term,SAME WITH 538,0.0,Vestibular exercises improve central vestibulospinal compensation after vestibular neuritis,"Abstract
Objective and background: Animal experiments have shown that central vestibular compensation of unilateral peripheral vestibular lesions can be improved by vestibular exercises. There are, however, no equivalent clinical studies on the efficacy of such specific physiotherapy on acute unilateral peripheral vestibular lesions in humans.
Design and methods: To quantify the differential effects of specific vestibular exercises on central compensation in patients with an acute/subacute unilateral vestibular lesion (vestibular neuritis), we determined the time course of recovery of 1) the ocular torsion (OT) for the vestibulo-ocular system, 2) the subjective visual vertical (SVV) for perception, and 3) the total sway path (SP) values for postural control in 19 patients with and 20 patients without vestibular exercises. All patients had a persisting peripheral vestibular deficit for at least 30 days (statistical end point).
Results: Although normalization of OT and SVV was similar in the control and physiotherapy groups, the total SP values on day 30 after symptom onset differed significantly: 3.2 +/- 1.9 m/min in the physiotherapy group and 16.9 +/- 6.1 m/min in the control group (ANOVA, p < 0.001).
Conclusions: This prospective clinical study suggests that specific vestibular exercises improve vestibulospinal compensation in patients with acute peripheral vestibular lesions.",doi: 10.1212/wnl.51.3.838.,strupp1998.pdf
295,540,541,Acta Otolaryngol,C. H. Su and Y. H. Young Clinical significance of pathological eye movements in diagnosing posterior fossa stroke 2013,PubMed,0.0,1.0,Population,Susac syndrome,,0.0,Clinical significance of pathological eye movements in diagnosing posterior fossa stroke,"Abstract
Conclusion: Close observation of pathological eye movements such as disconjugate eye movements, multi-directional gaze nystagmus, and persistent unilateral gaze nystagmus may facilitate the effort of clinicians to arrange magnetic resonance imaging (MRI) study, because physical examinations may overlook the posterior fossa lesions.
Objective: This paper reviews our experience of patients with posterior fossa stroke via observation of pathological eye movements over the past 10 years.
Methods: Seventy patients with posterior fossa stroke manifested as acute vertiginous attack were admitted. All patients underwent examination of eye movements, MRI, and a battery of audiovestibular function tests.
Results: Of the 70 patients, 22 (31%) demonstrated pathological eye movements including persistent (>24 h) unilateral gaze nystagmus in 12 patients, and multi-directional gaze nystagmus in 10 patients. Conjugate eyes movements were identified in 18 patients, and disconjugate eye movements were shown in 4 patients including medial longitudinal fasciculus syndrome in 1, paramedian pontine reticular formation syndrome in 1, and one and a half syndrome in 2. The vestibular test battery revealed abnormal responses for >85% of the patients in each test. MRI demonstrated infarction or hemorrhage involving the brainstem in 12 patients, cerebellum in 8 patients, and both in 2 patients.",doi: 10.3109/00016489.2013.783716.,su2013.pdf
296,541,542,Int J Cancer,"J. H. Suh, G. H. Barnett, J. W. Sohn, P. A. Kupelian and B. H. Cohen Results of linear accelerator-based stereotactic radiosurgery for recurrent and newly diagnosed acoustic neuromas 2000",PubMed,1.0,,,,,0.0,Results of linear accelerator-based stereotactic radiosurgery for recurrent and newly diagnosed acoustic neuromas,"Abstract
Stereotactic radiosurgery (SRS) is used to treat acoustic neuromas, but additional information is needed to firmly establish its safety and efficacy. We review our experience over 7 years treating 29 consecutive patients with a modified linear accelerator (linac) SRS system. Between August 1989 and October 1995, 29 patients with a median age of 67 years (range 26 to 83) underwent linac SRS treatment. Twenty-five patients had unilateral acoustic neuromas, and four patients with neurofibromatosis type II had bilateral vestibular schwannoma. Eligibility criteria for SRS were recurrent tumors (n = 9), age >65 (n = 16), or patient preference (n = 6). Follow-up magnetic resonance imaging scans were performed on all patients. The most common presenting symptoms were hearing impairment (18 patients) and gait difficulties (17 patients). Ten patients were deaf in the affected ear prior to treatment. Doses to the periphery of the tumor ranged from 800 to 2,400 cGy (median 1, 600 cGy) prescribed to the 50% to 80% isodose line (median 80%). After a median radiographic follow-up of 49 months (range 4 to 110 months), 11 tumors were smaller, 17 were stable, and one had evidence of progression (at 41 months). The 5-year local disease control rate (Kaplan-Meier estimate) was 94%. Acute complications were minimal, with only two patients experiencing nausea and vomiting after the procedure. Long-term complications included new or progressive trigeminal and facial nerve deficits with estimated 5-year incidences of 15% and 32%, respectively. Subjective hearing reduction or loss occurred in 14 (74%) of the 19 patients who had useful hearing prior to treatment. Five patients died from unrelated causes. These results suggest that linac SRS provides excellent short-term tumor control rates. Since there was a high risk of cranial nerve neuropathy, we do not recommend using only computed tomography-based planning and high prescription doses. Int. J. Cancer (Radiat. Oncol. Invest.) 90, 145-151 (2000).",doi: 10.1002/1097-0215(20000620)90:3<145::aid-ijc4>3.0.co;2-v.,suh2000.pdf
297,542,543,Adv Otorhinolaryngol,S. Sulway and S. L. Whitney Advances in Vestibular Rehabilitation 2019,PubMed,0.0,1.0,Design,Review,,0.0,Advances in Vestibular Rehabilitation,"Abstract
Vestibular rehabilitation is an exercise-based program that has been in existence for over 70 years. A growing body of evidence supports the use of vestibular rehabilitation in patients with vestibular disorders, and evolving research has led to more efficacious interventions. Through central compensation, vestibular rehabilitation is able to improve symptoms of imbalance, falls, fear of falling, oscillopsia, dizziness, vertigo, motion sensitivity and secondary symptoms such as nausea and anxiety. Early intervention is advised for falls prevention and symptom management; however, symptomatic patients with chronic vestibular disorders may still demonstrate benefit from a course of vestibular rehabilitation. Recent advances in balance and gait training, gaze stability training, habituation training, use of virtual reality, biofeedback, and vestibular prostheses are discussed in this chapter in the context of unilateral and bilateral vestibular disorders.",doi: 10.1159/000490285.,sulway2019.pdf
298,543,544,JAMA Otolaryngol Head Neck Surg,"D. Q. Sun, B. K. Ward, Y. R. Semenov, J. P. Carey and C. C. Della Santina Bilateral Vestibular Deficiency: Quality of Life and Economic Implications 2014",PubMed,0.0,1.0,Population,LVAS,,0.0,Bilateral Vestibular Deficiency: Quality of Life and Economic Implications,"Abstract
Importance: Bilateral vestibular deficiency (BVD) causes chronic imbalance and unsteady vision and greatly increases the risk of falls; however, its effects on quality of life and economic impact are not well defined.
Objective: To quantify disease-specific and health-related quality of life, health care utilization, and economic impact on individuals with BVD in comparison with those with unilateral vestibular deficiency (UVD).
Design, setting, and participants: Cross-sectional survey study of patients with BVD or UVD and healthy controls at an academic medical center. Vestibular dysfunction was diagnosed by means of caloric nystagmography.
Interventions: Survey questionnaire.
Main outcomes and measures: Health status was measured using the Dizziness Handicap Index (DHI) and Health Utility Index Mark 3 (HUI3). Economic burden was estimated using participant responses to questions on disease-specific health care utilization and lost productivity.
Results: Fifteen patients with BVD, 22 with UVD, and 23 healthy controls participated. In comparison with patients with UVD and controls, patients with BVD had significantly worse DHI (P < .001) and HUI3 scores. Statistically significant between-group differences were observed for overall HUI3 score (P < .001) and for specific attributes including vision, hearing, ambulation, emotion, and pain (P < .001 for all). Generalized linear model analysis of clinical variables associated with HUI3 scores after adjustment for other variables (including sex, race, education, age, and frequency of dizziness-related outpatient clinic visits) showed that the presence of UVD (P < .001) or BVD (P < .001), increased dizziness-related emergency room visits (P = .002), and increased dizziness-related missed work days (P < .001) were independently associated with worse HUI3 scores. Patients with BVD and UVD incurred estimated mean (range) annual economic burdens of $13,019 ($0-$48,830) and $3531 ($0-$48,442) per patient, respectively.
Conclusions and relevance: Bilateral vestibular deficiency significantly decreases quality of life and imposes substantial economic burdens on individuals and society. These results underscore the limits of adaptation and compensation in BVD. Furthermore, they quantify the potential benefits of prosthetic restoration of vestibular function both to these individuals and to society.",doi: 10.1001/jamaoto.2014.490.,sun2014.pdf
299,545,546,PLoS One,"J. Swanenburg, E. Bäbler, R. Adelsberger, D. Straumann and E. D. de Bruin Patients with chronic peripheral vestibular hypofunction compared to healthy subjects exhibit differences in gaze and gait behaviour when walking on stairs and ramps 2017",PubMed,1.0,,,,,0.0,Patients with chronic peripheral vestibular hypofunction compared to healthy subjects exhibit differences in gaze and gait behaviour when walking on stairs and ramps,"Abstract
Objective: The aim of this study was to compare gaze behaviour during stair and ramp walking between patients with chronic peripheral vestibular hypofunction and healthy human subjects.
Methods: Twenty four (24) patients with chronic peripheral vestibular hypofunction (14 unilateral and 10 bilateral) and 24 healthy subjects performed stair and ramp up and down walks at self-selected speed. The walks were repeated five times. A mobile eye tracker was used to record gaze behaviour (defined as time directed to pre-defined areas) and an insole measurement device assessed gait (speed, step time, step length). During each walk gaze behaviour relative to i) detection of first transition area ""First TA"", ii) detection of steps of the mid-staircase area and the handrail ""Structure"", iii) detection of second transition area ""Second TA"", and iv) looking elsewhere ""Elsewhere"" was assessed and expressed as a percentage of the walk duration. For all variables, a one-way ANOVA followed by contrast tests was conducted.
Results: Patients looked significantly longer at the ""Structure"" (p<0.001) and ""Elsewhere"" (p<0.001) while walking upstairs compared to walking downstairs (p<0.013). Patients looked significantly longer at the ""Structure"" (p<0.001) and ""Elsewhere"" (p<0.001) while walking upstairs compared to walking downstairs (p<0.013). No differences between groups were observed for the transition areas with exception of stair ascending. Patients were also slower going downstairs (p = 0.002) and presented with an increased step time (p = 0.003). Patients were walking faster up the ramp (p = 0.014) with longer step length (p = 0.008) compared to walking down the ramp (p = 0.050) with shorter step length (p = 0.024).
Conclusions: Patients with chronic peripheral vestibular hypofunction differed in time directed to pre-defined areas during stair and ramp walking and looked longer at stair and ramp areas of interest during walking compared to healthy subjects. Patients did not differ in time directed to pre-defined areas during the stair-floor transition area while going downstairs, an area where accidents may frequently occur.",doi: 10.1371/journal.pone.0189037.,swanenburg2017.pdf
300,546,547,Front Neurol,"J. Swanenburg, F. Büchi, D. Straumann, K. P. Weber and E. D. de Bruin Exergaming With Integrated Head Turn Tasks Improves Compensatory Saccade Pattern in Some Patients With Chronic Peripheral Unilateral Vestibular Hypofunction 2020",PubMed,1.0,,,,,0.0,Exergaming With Integrated Head Turn Tasks Improves Compensatory Saccade Pattern in Some Patients With Chronic Peripheral Unilateral Vestibular Hypofunction,"Abstract
Background: This study aimed to determine whether vestibular rehabilitation using active video games (Exergames), including promoted head turns and unsupported locomotion, may facilitate vestibular compensation and gait in subjects with one-sided chronic peripheral vestibular hypofunction (cPVH). Methods: 12 patients with cPVH (mean age of 65 ± 12 years, 8 male) were recruited for this study. The study consisted of a four-week baseline control period T1-T2 followed by a four-week intervention period T2-T3. The intervention included exergames that required physical tasks such as steps, weight shifts or balance control to cognitive challenges, in a virtual environment to play the game. The subjects participated in a total of 176 min of exergaming in eight sessions. Because of the changing projection direction of the game to the wall, the subjects had to turn their heads constantly while playing the game. Dynamic visual acuity (DVA) was assessed. Vestibulo-Ocular reflex (VOR) gain deficit and cumulative overt saccade amplitude (COSA) were measured with the video head-impulse test. Additionally, the functional gait assessment (FGA), Extended Timed Get-Up-and-Go (ETGUG), and the Dizziness handicap inventory (DHI), were assessed. Results: DVA showed no significant group level change (p = 0.475, z = -0.714, d = 0.295) with a small effect size and improvements in five out of 12 subjects. Ipsilesional VOR gain did not improve (p = 0.157, z = -1.414, d = 0.481) on group level while there was an intermediate effect size and improvements in six out of 12 subjects. COSA got significant smaller (p = 0.006, z = -2.746, d = 1.354) with improvements in seven out of 12 subjects. The contralesional sides did not change. The FGA for the group significantly improved with an intermediate effect size (p < 0.001, z = -3.08, d = 1.617) and five individuals showed clinically relevant improvements. The ETGUG group value improved significantly with a strong effect size (p < 0.001, z = -2.67, d = 1.030), with seven individuals contributing to this change. The DHI showed no change (p = 0.172, z = -1.381, d = 0.592) neither on the group nor on the individuals' level. The game scores of the subjects improved during the intervention period of the intervention for every game. Conclusion: The results of this study demonstrate that exergaming with promoted head turns facilitates vestibular compensation in some subjects with cPVH. This is the first study that shows an improvement in cumulative overt saccade amplitude after exergaming in chronic vestibular subjects.
Keywords: dynamic visual acuity; exergaming; head turns; saccades; vestibular loss.",doi: 10.3389/fneur.2020.00601.,10.3389@fneur.2020.00601.pdf
301,548,549,Croat Med J,J. Szilasiová and E. Klímová Susac syndrome: retinocochleocerebral vasculopathy 2004,PubMed,0.0,1.0,Population,Susac syndrome,,0.0,Susac syndrome: retinocochleocerebral vasculopathy,"Abstract
Susac syndrome is a rare microangiopathy of cochlea, retina, and brain. We report a case of a 30-year-old man with Susac syndrome. The patient initially suffered from unilateral hearing loss associated with peripheral vestibular syndrome, and followed with recurrent arterial retinal occlusions and encephalopathy. The patient underwent clinical, laboratory, and neuroradiological examination. Laboratory tests were negative for systemic inflammatory or infectious disease. Signs of encephalopathy and vestibular syndrome regressed after 6 weeks, retinal obstructions were partially improved, and deafness remained unchanged. Two unexplained epileptic seizures had been documented 7 years before the development of typical clinical course. The etiology is still unknown and diagnosis was suggested by the clinical triad of bilateral sensorineural hearing loss on low frequency on audiology, recurrent bilateral retinal branch artery occlusions, and small multiple areas of signal hyperintensity in the white and gray matter on brain magnetic resonance T2-weighted images. The clinical course is self-limited and treatment options are not codified. Epileptic seizures, as those in our patient, may extend the clinical spectrum of Susac syndrome. This case also documents the possibility of multiphasic disease course.",Not Found,No pdf
302,549,550,Acta Otolaryngol,"S. Tabak, H. Collewijn and L. J. Boumans Deviation of the subjective vertical in long-standing unilateral vestibular loss 1997",PubMed,1.0,,,,,0.0,Deviation of the subjective vertical in long-standing unilateral vestibular loss,"Abstract
We evaluated changes in the subjectively perceived gravitational vertical as an index of imbalance in the function of the right and left otolith organs. In addition to normal subjects (n = 25), we measured patients with a longstanding (mean 4.5 year +/- 3.2 SD; range 0.5-11.5 years) unilateral vestibular loss after surgery for acoustic neuroma (n = 32), patients with partial unilateral vestibular loss (n = 7) and patients with bilateral vestibular hyporeflexia (n = 8). Normal subjects could accurately align a vertical luminous bar to the gravitational vertical in an otherwise completely dark room (mean setting -0.14 degree +/- 1.11 SD). Patients with left-sided (complete; n = 13) or right-sided (complete; n = 19 and partial; n = 7) unilateral vestibular loss made mean angular settings at 2.55 degrees +/- 1.57 (SD) leftward and 2.22 degrees (+/-1.96 SD) rightward, respectively. These means differed highly significantly from the normal mean (p < 0.00001). In the time interval investigated (0.5-11.5 years) the magnitude of the tilt angle showed no correlation with the time elapsed since the operation. The mean setting by patients with clinically bilateral vestibular loss (-1.17 degrees +/- 1.96 SD; n = 8) did not significantly differ from the control group. The systematic tilts of the subjective vertical in patients with a unilateral vestibular impairment were correlated with their imbalance in canal-ocular reflexes, as reflected by drift during head-oscillation at 2 Hz (r2 = 0.44) and asymmetries in VOR-gain for head-steps (r2 = 0.48-0.67). These correlations were largely determined, by the signs of the asymmetries; correlation between the absolute values of the VOR gain asymmetries and subjective vertical angles proved to be virtually absent. We conclude that the setting of the subjective vertical is a very sensitive tool in detecting a left-right imbalance in otolith function, and that small but significant deviations towards the defective side may persist for many years (probably permanently) after unilateral lesions of the labyrinth or the vestibular nerve.",doi: 10.3109/00016489709117982.,tabak1997.pdf
303,553,554,Brain Res,"K. Takeno, H. Shimogori, T. Takemoto, K. Tanaka, T. Mikuriya, H. Orita and H. Yamashita The systemic application of diazepam facilitates the reacquisition of a well-balanced vestibular function in a unilateral vestibular re-input model with intracochlear tetrodotoxin infusion using an osmotic pump 2006",PubMed,0.0,1.0,Population,model input..,,0.0,The systemic application of diazepam facilitates the reacquisition of a well-balanced vestibular function in a unilateral vestibular re-input model with intracochlear tetrodotoxin infusion using an osmotic pump,"Abstract
Diazepam is a popular medicine used in the treatment of acute vertigo. In the past, many studies investigating the effect of diazepam in peripheral vestibular destruction have been reported. However, no previous study has yet investigated the effect of diazepam on a model with a transient and reversible vestibular function similar to recurrent vertigo as seen in Meniere's disease. We thus made a peripheral vestibular re-input model by the unilateral intracochlear administration of tetrodotoxin (TTX) using an osmotic pump and then examined the influence of diazepam on the vestibular system in this model. Hartley white guinea pigs were intracochlearly administered with TTX on the right side for 3 days by an osmotic pump. Animals were divided into three groups, TTX alone (control group (n = 7)), TTX and an intraperitoneal diazepam injection once a day for 3 days (diazepam group (n = 6)) and vehicle injection (vehicle group (n = 6)). A caloric response and vestibuloocular reflex (VOR) were observed at 7 and 14 days after completing 3 days of TTX administration. Seven days after vestibular re-input, a directional preponderance of the nystagmus (DP) to the TTX-treated side was observed in the control and vehicle groups on VOR examination. DP was not observed in the diazepam group on any examined day. The R/L time ratio of caloric response showed no statistical difference between three groups on any examined day. These results suggest that diazepam may thus be useful for patients in an acute stage of peripheral vestibular vertigo by decreasing their vertiginous symptoms.",doi: 10.1016/j.brainres.2006.04.030.,takeno2006.pdf
304,554,555,Neurochirurgie,"M. Tamura, N. Murata, M. Hayashi and J. Régis Injury of the lacrimal component of the nervus intermedius function after radiosurgery versus microsurgery 2004",PubMed,0.0,1.0,Outcome,"No symptom, signs",,0.0,Injury of the lacrimal component of the nervus intermedius function after radiosurgery versus microsurgery,"Abstract
Rationale: Due to the synergetic role of the facial nerve and the nervus intermedius in the mechanical protection of the eye, vestibular schwannomas (VS) and/or their treatment are dangerous for the visual function. Our goal was to evaluate and compare the impact of the tumor itself, and the microsurgery (MS) or radiosurgery (RS).
Material and method: A functional questionnaire evaluating among other items the patient's complaints related to the eye was addressed to a series of 100 patients, 3 years after GKS of a previously unresected unilateral VS. Answers were compared with those of a group of 100 patients operated microsurgically. A Shirmer test was additionally performed before radiosurgery, and more than 2 years after radiosurgery in 46 patients.
Results: The risk of dry eye and burning eye was much higher in patients operated by MS compared to patients operated by GKS due to the high incidence of facial palsy in the former (57/99) and the its absence in the later (0/80). In the population operated microsurgically, the presence of a permanent facial palsy (57 patients among 99 responding to the questionnaire) was, of course, associated with a high rate of complaints about burning eye (n=18) and crying eye (n=23). Among patients from the two arms with no facial palsy, a dry eye was reported by 8/64 after GKS and 7/42 after MS (NS) and a burning eye by 9/64 after GKS and 9/42 after MS (NS). Thus patients with no clinical signs of impairement of the VII motor nerve accounted for 14% of the cases signs indicating injury of the intermedius nerve with the same probability whatever the kind of surgery. When no permanent facial palsy was observed a crocodile tear syndrome was more frequently observed after MS (4/42 versus 1/64, p=0.07). This suggests an early lesion of the VII motor and intermedius, and a subsequent abnormal regrowth. The only patient reporting a crocodile tear syndrome after GKS turned out to have presented transiently a discret deficit of orbicular muscle signaling transient partial facial nerve injury. In absence of facial palsy, a ""crying eye"" was reported more frequently after MS (16/42 versus 9/64, p=0.01), leading us to suspect frequent infraclinical VII nerve injury in patients with no obvious facial palsy operated by MS. Patients tested with Shirmer test, before and more than 2 Years after, were improved in 28.3%, stable in 56.5%, and worse in 15.2%.
Conclusions: This study is the first demonstrating that radiosurgery can induce nervus intermedius injury in a small percentage of cases (14%). These patients had been treated 11 years ago with what we can consider as ""archeoGKS technology"" compared to today's refinements. The impact of modern GKS on the nervus intermedius is currently under evaluation in our group. However, symptoms related to the eye either due to the injury of the nervus intermedius or of the VII motor or both are much more frequent after MS than after RS.",Not Found,No pdf
305,557,558,Rinsho Hoshasen,"H. Tanioka, A. Terahara, A. Furuta, T. Machida, M. Iio, T. Sirakawa and H. Zusho MR imaging of the inner ear; findings of Ménière's syndrome 1989",PubMed,0.0,1.0,Outcome,"No symptom, signs",,0.0,[MR imaging of the inner ear; findings of Ménière's syndrome],"Abstract
Symptoms in Ménière's disease are explained by hydrops of endolymphatic system with recurrent ruptures of the membranous labyrinth. The primary cause of the increased endolymphatic volume appears to be an imbalance between secretion and resorption of endolymph which may be due to an obstruction of the endolymphatic duct and sac, located in the vestibular aqueduct. Non-visualization or narrowing of the vestibular aqueduct of the paper have been demonstrated by conventional tomography and high resolution computed tomography (HR-CT). But the endolymphatic duct and sac can not be obtained by HR-CT and conventional tomography. Whereas, on MRI, these are identified. By MRI, we prospectively tried to demonstrate morphological alterations in 10 patients with Ménière's disease and in 4 patients with vestibular neuronitis. These were compared with a group of 20 normal men. Visualization of the endolymphatic duct and sac (vestibular aqueduct) on MRI was assessed. There was a distinctly decreased visualization of the vestibular aqueduct in the Ménière group and vestibular neuronitis group. We were able to confirm a statistically proven usefulness of the MRI technique in identifying an anatomical abnormality which is directly in correlation with the side of the lesion in cases of unilateral Ménière's disease.",Not Found,No pdf
306,558,559,Eur J Radiol,"H. Tanioka, H. Zusho, T. Machida, Y. Sasaki and T. Shirakawa High-resolution MR imaging of the inner ear: findings in Menière's disease 1992",PubMed,0.0,1.0,Outcome,"No symptom, signs",SAME WITH 558,0.0,High-resolution MR imaging of the inner ear: findings in Menière's disease,"Abstract
Symptoms in Menière's disease are characterized by hydrops of the endolymphatic system with recurrent rupture of the membranous labyrinth. The primary cause of the increased endolymphatic volume appears to be an imbalance between secretion and resorption of the endolymph which may be due to an obstruction of the membranous endolymphatic duct and sac, located in the vestibular aqueduct. The membranous endolymphatic duct and sac are not expected to be visualized using conventional tomography and high-resolution computed tomography (HR-CT), whereas, these are identified with high resolution MRI (HR-MRI). By HR-MRI, we proposed to demonstrate morphological alternation in 12 patients with Menière's disease, this group was compared with a group of 20 healthy subjects. The degree of visualization on HR-MRI of the membranous endolymphatic duct and sac running through the vestibular aqueduct in the bony canal was assessed. There was a distinct decrease in visualization of the membranous endolymphatic duct and sac in the Menière's group. The results confirm the value of the HR-MRI technique to identify an anatomical abnormality, which is directly correlated with the lesion in cases of unilateral Menière's disease.",doi: 10.1016/0720-048x(92)90211-q.,tanioka1992.pdf
307,561,562,Otolaryngol Head Neck Surg,"S. A. Telian, N. T. Shepard, M. Smith-Wheelock and J. L. Kemink Habituation therapy for chronic vestibular dysfunction: preliminary results 1990",PubMed,1.0,,,,,0.0,Habituation therapy for chronic vestibular dysfunction: preliminary results,"Abstract
Chronic vestibular dysfunction is often a frustrating problem for both patient and physician. A program of customized vestibular habituation therapy is introduced and its efficacy in a group of 65 patients is evaluated. Preliminary findings suggest that 59% of patients will have a dramatic improvement, after which their vestibular symptoms no longer cause any restriction in their lifestyles. An additional 23% of patients note considerable improvement, but have persistent symptoms that continue to restrict their activities. Vestibular habituation therapy is a rational, multidisciplinary approach to the treatment of chronic vestibular dysfunction that is a significant alternative to traditional pharmacologic management. Failure of vestibular compensation after involvement in a disciplined program of habituation therapy constitutes a much stronger indication for vestibular surgery in patients with unilateral peripheral lesions.",doi: 10.1177/019459989010300113.,telian1990.pdf
308,562,563,J Laryngol Otol,"A. Thakar, C. Anjaneyulu and R. C. Deka Vertigo syndromes and mechanisms in migraine 2001",PubMed,1.0,,,,,0.0,Vertigo syndromes and mechanisms in migraine,"Abstract
This paper attempts to define and categorize the vertigo associated with migraine. A retrospective chart review of 344 cases of vertigo identified 19 cases with headaches characteristic of migraine as per strictly defined criteria (International Headache Society, 1988). Four distinct types of vertiginous syndromes were noted. The commonest syndrome (Group I) manifested transient episodes of imbalance with additional momentary subjective rotary vertigo worsened by movement. The attacks lasted a few hours and evaluation in the inter-episode interval demonstrated no vestibular deficit. Group II manifested transient objective rotatory vertigo of from 10 minutes to a few hours but no demonstrable permanent vestibular deficit. Group III displayed symptoms and signs characteristic of benign paroxysmal positional vertigo (BPPV) and Group IV manifested a permanent unilateral labyrinthine weakness. Causation of vertigo by migraine was implied in 10 of 19 cases where the headache and vertigo occurred simultaneously and in two other cases where the vertigo improved with anti-migraine prophylactic treatment. Four distinct and characteristic vertigo syndromes have been noted with migraine. Their spectrum ranges from a transient reversible dysfunction to a more permanent destruction, and includes involvement of both the peripheral and the central vestibular systems.",doi: 10.1258/0022215011909251.,thakar2001.pdf
309,563,564,Trends Amplif,A. M. Tharpe and D. P. Sladen Causation of permanent unilateral and mild bilateral hearing loss in children 2008,PubMed,0.0,1.0,Population,Children,,0.0,Causation of permanent unilateral and mild bilateral hearing loss in children,"Abstract
Children with permanent unilateral or mild bilateral hearing loss have been a focus of concern by audiologists, educators, and physicians for at least 2 decades. These children are known to be at risk for psychoeducational difficulties. However, despite this concern, little has been learned about the causative factors of these hearing losses and how those factors might be contributing to child development. This review of known causes of permanent unilateral and mild bilateral hearing loss in children is meant to draw attention to the importance of the search for etiologic factors. That is, the identification of the hearing loss should not signal the end of the diagnostic process but, rather, the beginning of a search for causation. With the combined efforts of audiologists, otolaryngologists, pediatricians, geneticists, and other medical professionals, we may enhance our understanding of the primary causes of unilateral and mild bilateral hearing loss and, perhaps, create links between causative factors and psychosocial and psychoeducational outcomes.",doi: 10.1177/1084713807313085.,tharpe2008.pdf
310,566,567,Laryngoscope Investig Otolaryngol,A. Thompson-Harvey and T. C. Hain Symptoms in cervical vertigo 2019,PubMed,0.0,1.0,Population,Cervical vertigo,,0.0,Symptoms in cervical vertigo,"Abstract
Objective: To use a unique, 41-question survey to identify patient features distinguishing cervical vertigo from vestibular causes of vertigo and vestibular migraine.
Methods: In this study, a unique, 41-question survey was administered to 48 patients diagnosed with cervical vertigo (n = 16), migraine (n = 16), and vestibular vertigo (eg, unilateral vestibular paresis, Meniere's disease) (n = 16) to test the hypothesis that a set of distinct symptoms can characterize cervical vertigo. Responses between the three diagnostic groups were compared to identify questions which differentiated patients based on their symptoms.
Results: Eight questions were successful in differentiating vestibular vertigo from migraine and cervical vertigo. Symptoms endorsed by subjects with cervical vertigo overlapped substantially with subjects with well-established vestibular disturbances as well as symptoms of subjects with migraine. Twenty-seven percent of cervical vertigo subjects reported having true vertigo, 50% having headache, and 94% having neck pain.
Conclusion: Lacking knowledge of neck disturbance, the symptoms we elicited in our questionnaire suggest that cervical vertigo subjects may resemble migraine subjects who also have evidence of neck injury. Whether or not subjects with ""cervical vertigo"" also overlap with other diagnoses defined by a combination of symptoms and exclusion of objective findings such as chronic subjective dizziness and other variants of psychogenic dizziness remain to be established.
Level of evidence: IV.
Keywords: Cervical Vertigo; cervicogenic dizziness; migraine; neck injury; symptoms; vertigo.",doi: 10.1002/lio2.227.,thompson-harvey2018.pdf
311,567,568,J Laryngol Otol,"J. Thomsen, K. Zilstorff and M. Tos Acoustic neuromas (diagnostic value of testing the function of the trigeminal nerve, the cerebellum and optokinetic nystagmus) 1983",PubMed,0.0,1.0,Outcome,central involvement,,0.0,"Acoustic neuromas (diagnostic value of testing the function of the trigeminal nerve, the cerebellum and optokinetic nystagmus)","Abstract
The involvement of the trigeminal nerve, cerebellum, and optokinetic nystagmus in patients with acoustic neuromas, as well as the methods of investigation, are described. The corneal and/or facial sensibility was found to be reduced in 29 per cent of the whole series and in 53 per cent of tumors larger than 40 mm. There was a significant correlation between reduced corneal and/or facial sensibility and the findings of pressure at the trigeminal root at operation. Only three patients had a persistent reduction of trigeminal function post-operatively. Cerebellar dysfunction was found in 32 per cent, but significantly more frequently (58 per cent) in patients with tumors larger than 40 mm. Post-operatively, six patients had cerebellar symptoms in the form of gait disturbances; five of these patients had a supplementary suboccipital removal performed, after the initial translabyrinthine approach. A defective optokinetic nystagmus was found pre-operatively in 10 patients, nine of whom had tumors larger than 40 mm in diameter. All patients with a defective optokinetic nystagmus had a large anatomic impression in the pons at operation. In patients suspected of having an acoustic neuroma, symptoms from the trigeminal nerve, the cerebellum and the optokinetic nystagmus predict the presence of a large tumor and subsequent difficulties at operation. The symptoms were completely reversible in the vast majority of cases and post-operative symptoms persisted only in patients in whom tumor removal was difficult and the tumor very large. Testing of the trigeminal nerve, the cerebellum and the optokinetic nystagmus still deserves its place in the diagnostic work-up of patients with unilateral acoustic or vestibular symptoms, especially in cases with severe hearing impairment, which necessitate the use of tests that are independent of acoustic function.",doi: 10.1017/s0022215100095037.,thomsen1983.pdf
312,568,569,Exp Brain Res,"J. R. Tian, A. Ishiyama and J. L. Demer Effect of unilateral vestibular deafferentation on the initial human vestibulo-ocular reflex to surge translation 2007",PubMed,1.0,,,,,0.0,Effect of unilateral vestibular deafferentation on the initial human vestibulo-ocular reflex to surge translation,"Abstract
Transient whole-body surge (fore-aft) translation at 0.5 G peak acceleration was administered to six subjects with unilateral vestibular deafferentation (UVD), and eight age-matched controls. Subjects viewed eccentric targets to determine if linear vestibulo-ocular reflex (LVOR) asymmetry might lateralize otolith deficits. Eye rotation was measured using magnetic search coils. Immediately before surge, subjects viewed a luminous target 50 cm away, centered or displaced 10 degrees horizontally or vertically. The target was extinguished during randomly directed surges. LVOR gain relative to ideal velocity in subjects with UVD for the contralesional horizontally eccentric target (0.59 +/- 0.08, mean +/- SEM) did not differ significantly from normal (0.50 +/- 0.04), but gain for the ipsilesional eccentric target (0.35 +/- 0.02) was significantly less than normal (0.48 +/- 0.03, P < 0.05). Normal subjects had mean gain asymmetry for horizontally eccentric targets of 0.17 +/- 0.03, but asymmetry in UVD was significantly increased to 0.35 +/- 0.05 (P < 0.05). Four of six subjects with UVD had maximum gain asymmetry outside normal 95% confidence limits. Asymmetry did not correlate with UVD duration. Gain for 10 degrees vertically eccentric targets averaged 0.38 +/- 0.14 for subjects with UVD, insignificantly lower than the normal value of 0.75 +/- 0.15 (P > 0.05). Surge LVOR latency was symmetrical in UVD, and did not differ significantly from normal. There was no significant difference in response between dark and visible target conditions until 200 ms after surge onset. Chronic human UVD, on average, significantly impairs the surge LVOR for horizontally eccentric targets placed ipsilesionally, but this asymmetry is small relative to interindividual variation.",doi: 10.1007/s00221-006-0636-y.,tian2006.pdf
313,569,570,Neuroscience,"B. Tighilet, C. Manrique and M. Lacour Stress axis plasticity during vestibular compensation in the adult cat 2009",PubMed,0.0,1.0,Population,Animal study,,0.0,Stress axis plasticity during vestibular compensation in the adult cat,"Abstract
The postural, ocular motor, perceptive and neurovegetative syndromes resulting from unilateral vestibular neurectomy (UVN) symptoms could generate a stress and thereby activate the hypothalamo-pituitary-adrenal (HPA) axis. This study was aimed at determining whether UVN causes changes in the activity of the HPA axis, and if so, evaluating the time course of changes associated with UVN syndrome. At the cellular level, corticotropin-releasing factor (CRF) and arginine vasopressin (AVP) immunoreactivity (Ir) were analyzed and quantified in the paraventricular nucleus (PVN) and the vestibular nuclei (VN) complex of cats killed early (1 and 7 days) or late (30 and 90 days) after UVN. Dopamine-beta-hydroxylase (DbetaH), the enzyme synthesizing noradrenaline was examined in the locus coeruleus (LC) in these same cats. At the behavioral level, the time course of recovery of the postural and locomotor functions was quantified at the same postoperative delays in another group of UVN cats. Results showed a significant bilateral increase in the number of both AVP-Ir and CRF-Ir neurons in the PVN and an increase of DbetaH-Ir neurons in the LC at 1, 7 and 30 days after UVN. This increased number of neurons was no longer observed at 90 days. Conversely, a significant bilateral decrease of CRF-Ir neurons was observed in the VN at these same postlesion times, with a similar return to control values at 90 days. Our behavioral observations showed strong posturo-locomotor functional deficits early after UVN (1 and 7 days), which had recovered partially at 30 days and completely by 90 days postlesion. We demonstrate a long-lasting activation of the HPA axis, which likely reflects a chronic stress, experienced by the animals, which corresponds to the time course of full vestibular compensation, and which is no longer present when the animals are completely free of posturo-locomotor symptoms at 90 days.",doi: 10.1016/j.neuroscience.2009.02.070.,tighilet2009.pdf
314,570,571,PLoS One,"B. Tighilet, D. Péricat, A. Frelat, Y. Cazals, G. Rastoldo, F. Boyer, O. Dumas and C. Chabbert Adjustment of the dynamic weight distribution as a sensitive parameter for diagnosis of postural alteration in a rodent model of vestibular deficit 2017",PubMed,0.0,1.0,Population,Animal study,,0.0,Adjustment of the dynamic weight distribution as a sensitive parameter for diagnosis of postural alteration in a rodent model of vestibular deficit,"Abstract
Vestibular disorders, by inducing significant posturo-locomotor and cognitive disorders, can significantly impair the most basic tasks of everyday life. Their precise diagnosis is essential to implement appropriate therapeutic countermeasures. Monitoring their evolution is also very important to validate or, on the contrary, to adapt the undertaken therapeutic actions. To date, the diagnosis methods of posturo-locomotor impairments are restricted to examinations that most often lack sensitivity and precision. In the present work we studied the alterations of the dynamic weight distribution in a rodent model of sudden and complete unilateral vestibular loss. We used a system of force sensors connected to a data analysis system to quantify in real time and in an automated way the weight bearing of the animal on the ground. We show here that sudden, unilateral, complete and permanent loss of the vestibular inputs causes a severe alteration of the dynamic ground weight distribution of vestibulo lesioned rodents. Characteristics of alterations in the dynamic weight distribution vary over time and follow the sequence of appearance and disappearance of the various symptoms that compose the vestibular syndrome. This study reveals for the first time that dynamic weight bearing is a very sensitive parameter for evaluating posturo-locomotor function impairment. Associated with more classical vestibular examinations, this paradigm can considerably enrich the methods for assessing and monitoring vestibular disorders. Systematic application of this type of evaluation to the dizzy or unstable patient could improve the detection of vestibular deficits and allow predicting better their impact on posture and walk. Thus it could also allow a better follow-up of the therapeutic approaches for rehabilitating gait and balance.",doi: 10.1371/journal.pone.0187472.,tighilet2017.pdf
315,571,572,J Neurol Neurosurg Psychiatry,"F. Tjernström, P. A. Fransson, B. Kahlon, M. Karlberg, S. Lindberg, P. Siesjö and M. Magnusson Vestibular PREHAB and gentamicin before schwannoma surgery may improve long-term postural function 2009",PubMed,0.0,1.0,Outcome,"No symptom, signs",,0.0,Vestibular PREHAB and gentamicin before schwannoma surgery may improve long-term postural function,"Abstract
Background: Unilateral vestibular deafferentation (uVD), as performed in vestibular schwannoma surgery, results in a chronic vestibular deficit, though most of the insufficiency can be compensated by other sensory input. By vestibular training (prehabituation) performed before surgery, motor adaptation processes can be instigated before the actual lesion. The adaptation processes of the altered sensory input could be affected if the vestibular ablation and surgery were separated in time, by pretreating patients who have remaining vestibular function with gentamicin.
Objective: To determine whether presurgical deafferentation would affect postsurgery postural control also in a long-term perspective (6 months).
Method: 41 patients subjected to trans-labyrinthine schwannoma surgery were divided into four groups depending on the vestibular activity before surgery (with no clinical significant remaining function n = 17; with remaining function n = 8), whether signs of central lesions were present (n = 10), and if patients with remaining vestibular activity were treated with gentamicin with the aim to produce uVD before surgery (n = 6). The vibratory posturography recordings before surgery and at the follow-up 6 months after surgery were compared.
Results: The subjects pretreated with gentamicin had significantly less postural sway at the follow-up, both compared with the preoperative recordings and compared with the other groups.
Conclusion: The results indicate that by both careful sensory training and separating the surgical trauma and the effects of uVD in time, adaptive processes can develop more efficiently to resolve sensory conflicts, resulting in a reduction of symptoms not only directly after surgery but also perhaps up to 6 months afterwards.",doi: 10.1136/jnnp.2008.170878.,tjernstrom2009.pdf
316,572,573,J Otolaryngol,"R. D. Tomlinson, A. M. Rubin, I. R. Wallace and H. O. Barber Optokinetic afternystagmus and post rotatory nystagmus in patients with unilateral labyrinthine lesions 1984",PubMed,1.0,,,,,0.0,Optokinetic afternystagmus and post rotatory nystagmus in patients with unilateral labyrinthine lesions,"Abstract
The decay times of optokinetic afternystagmus (OKAN) and the vestibuloocular reflex (VOR) were measured in six subjects with chronic unilateral labyrinthectomy and in six age-matched controls. Both OKAN and VOR decay times showed parallel reduction following unilateral labyrinthectomy when the induced nystagmus beat toward the side of the lesion. The VOR decay time for nystagmus beating toward the contralateral side was also significantly reduced. Our findings support the view that the optokinetic system increases the vestibular decay time, that separate left and right velocity storage mechanisms do exist, but that the decoupling between the two sides is far from perfect.",Not Found,No pdf
317,573,574,Acta Otolaryngol Suppl,"K. Tomoda, N. Kubo, Y. Hosoda, M. Komeda, H. Cho, S. Shiraishi and T. Yamashita Infralabyrinthine approach to vestibular neurectomy in Menière's disease 1995",PubMed,1.0,,,,,0.0,Infralabyrinthine approach to vestibular neurectomy in Menière's disease,"Abstract
The infralabyrinthine approach to vestibular neurectomy was performed in 9 patients with unilateral Menière's disease. According to the AAOO (1972) criteria, 7 of 9 cases were graded as class B and the remaining 2 cases as class C. Otherwise, according to the AAO-HNS (1985) criteria, 6 patients who could be followed over 2 years were all graded as 'complete' at the vertigo control. The compensation of the spontaneous vestibular signs was rapid in the first 2 postoperative weeks, though an occasional imbalance on movement persisted even 3 years after the operation. No specific caloric reaction was elicited in any patient after warm or cold water irrigation of the operated side in any postoperative period. There have been no serious complications except a delayed facial palsy that appeared in one case one week after surgery. This approach offers access to the vestibular nerve with minimal risk and morbidity.",doi: 10.3109/00016489509121912.,tomoda1995.pdf
318,574,575,Clin Rehabil,"O. Topuz, B. Topuz, F. N. Ardiç, M. Sarhuş, G. Ogmen and F. Ardiç Efficacy of vestibular rehabilitation on chronic unilateral vestibular dysfunction 2004",PubMed,1.0,,,,,1.0,Efficacy of vestibular rehabilitation on chronic unilateral vestibular dysfunction,"Abstract
Objective: To assess the efficacy of vestibular rehabilitation exercises on patients with chronic unilateral vestibular dysfunction.
Design: Prospective study.
Setting: Physical Medicine and Rehabilitation Clinic and Otolaryngology Clinic of a tertiary referral hospital.
Subjects: One-hundred and twenty-five patients with unilateral chronic vestibular dysfunction were included in the study.
Interventions: Eight-week, two-staged (clinic and home) vestibular rehabilitation programme with components of Cawthorne-Cooksey and Norre exercises was applied.
Main outcome measures: Dizziness Handicap Inventory (DHI) and visual analogue scale (VAS) were completed three times (at the beginning, end of the second week and end of the treatment).
Results: Data for 112 patients in the first stage and 93 patients in the second stage were evaluated because of insufficient compliance of the other patients. The mean DHI score was decreased from 50.42 +/- 24.12 points to 21.21 +/- 15.97 points (p < 0.001) at the end of first two weeks, and to 19.93 +/- 19.33 points at the end of the whole treatment. The mean VAS score was decreased from 5.87 +/- 2.27 to 2.02 +/- 1.75 (p < 0.001) at the end of second week, and to 1.51 +/- 1.29 at the end of eighth week. In respect to both VAS and DHI scores, improvement was noted in 67 patients (77.4%). Age, gender and disability level had no predictive value about therapy outcome.
Conclusions: There was a fast recovery in the supervised exercise session, whereas there was no significant difference in the home exercise session. These findings suggest that either supervised exercise is better than home exercise or that 10 supervised sessions are sufficient to get the end result.",doi: 10.1191/0269215504cr704oa.,topuz2004.pdf
319,575,576,Laryngoscope,"D. J. Totten, N. F. Manzoor, J. Aulino, P. Santapuram and A. Rivas Persistent Conductive Hearing Loss After Tympanostomy Tube Placement Due to High-Riding Jugular Bulb 2021",PubMed,0.0,1.0,Population,Jugular bulbUS,,0.0,Persistent Conductive Hearing Loss After Tympanostomy Tube Placement Due to High-Riding Jugular Bulb,"Abstract
High-riding jugular bulb (HRJB) is a rare condition not often observed in the clinical setting that occurs in 1% to 3% of cases. The jugular bulb is not present at birth, and the precise size and location likely depends on a myriad of postnatal events. This report describes the case of a male adolescent who experienced persistent conductive hearing loss (CHL) unilaterally following bilateral tympanostomy tube placement. Subsequent workup included computed tomography, which identified a very high jugular bulb eroding the posterior semicircular canal and occluding the round window niche. The patient had no hearing or vestibular symptoms aside from CHL and continues to be observed on a regular basis. HRJB is a rare disorder that has been known to erode the posterior semicircular canal, resulting in possible tinnitus, vertigo, dizziness, and/or sensorineural hearing loss. CHL has been reported in HRJB cases, although it is uncommon. HRJB may result in CHL through a third-window defect shunting hydromechanical energy away from the round window or due to middle ear blockage. Imaging is useful in ascertaining rare causes of CHL, such as HRJB. Because HRJB is not easily fixable, it is important to recognize it as a rare cause of CHL for appropriate patient counseling. Possible interventions should be tailored to the patient after careful consideration of contralateral anatomy and likely benefits. Laryngoscope, 131:E1272-E1274, 2021.
Keywords: conductive hearing loss; hearing loss; jugular bulb; jugular bulb abnormalities.",doi: 10.1002/lary.28920.,totten2021.pdf
320,577,578,Sci Rep,"L. Trakolis, B. Bender, F. H. Ebner, U. Ernemann, M. Tatagiba and G. Naros Cortical and subcortical gray matter changes in patients with chronic tinnitus sustaining after vestibular schwannoma surgery 2021",PubMed,1.0,,,,,0.0,Cortical and subcortical gray matter changes in patients with chronic tinnitus sustaining after vestibular schwannoma surgery,"Abstract
Tinnitus is attributed to partial sensory deafferentation resulting in a central maladaptive neuroplasticity. Unfortunately, the agent of deafferentation is usually unknown or irreversible. In patients with unilateral vestibular schwannoma (VS), however, the auditory nerve is affected by a benign tumor. Hence, removal of the tumor can cease the tinnitus. In turn, sustaining complaints after surgery indicate cortical neuroplasticity. The present study is a cross sectional study which aims to track cortical structural changes by surface-based morphometry in 46 VS patients with sustained (i.e. centralized) or ceased (i.e. peripheral) tinnitus after surgery. A volumetric analysis of cortical and subcortical gray matter (GM) anatomy was performed on preoperative high-resolution MRI and related to the presence of hearing impairment, pre- and/or postoperative tinnitus. Patients with sustained (i.e. chronic) tinnitus showed an increased GM volume of the bilateral caudate nucleus, the contralateral superior colliculus, the middle frontal and middle temporal gyrus, the fusiform gyrus as well as the ipsilateral pars orbitalis when compared to those patients in whom tinnitus ceased postoperatively. Chronic tinnitus in VS patients is associated with characteristic structural changes in frontal, temporal and subcortical areas. Notably, a significant GM change of the caudate nucleus was detected providing further support for the striatal gaiting model of tinnitus.",doi: 10.1038/s41598-021-87915-3.,trakolis2021.pdf
321,578,579,Arch Phys Med Rehabil,"J. Treleaven, N. LowChoy, R. Darnell, B. Panizza, D. Brown-Rothwell and G. Jull Comparison of sensorimotor disturbance between subjects with persistent whiplash-associated disorder and subjects with vestibular pathology associated with acoustic neuroma 2008",PubMed,1.0,,,,,0.0,Comparison of sensorimotor disturbance between subjects with persistent whiplash-associated disorder and subjects with vestibular pathology associated with acoustic neuroma,"Abstract
Objective: To determine if differences exist in reported symptoms and in outcomes of sensorimotor tests (cervical joint position error [JPE], neck-influenced eye movement control, postural stability) between subjects with persistent whiplash and subjects with unilateral vestibular pathology associated with acoustic neuroma.
Design: Repeated measures, case controlled.
Setting: Tertiary institution and metropolitan hospital.
Participants: Twenty subjects with persistent whiplash, 20 subjects with acoustic neuroma, and 20 control subjects.
Interventions: Not applicable.
Main outcome measures: Symptom descriptors, Dizziness Handicap Inventory (short form), measures of cervical JPE, the smooth pursuit neck torsion (SPNT) test, and forceplate measures of postural stability in comfortable and narrow stances.
Results: The results showed differences in SPNT (P=.00), selected measures of postural stability (P<.04), and reported symptoms between the whiplash and vestibular groups. There was no between-group difference in cervical JPE (P>.27) or dizziness handicap (P>.69).
Conclusions: This study showed differences in sensorimotor disturbances between subjects with discreet whiplash and those with vestibular pathology associated with acoustic neuroma. The results support the SPNT test as a test of cervical afferent dysfunction. Further research into cervical JPE as a discreet test of cervical afferentation is warranted.",doi: 10.1016/j.apmr.2007.11.002.,treleaven2008.pdf
322,580,581,Acta Otolaryngol,"A. Tribukait, J. Bergenius and K. Brantberg Subjective visual horizontal during follow-up after unilateral vestibular deafferentation with gentamicin 1998",PubMed,1.0,,,,,0.0,Subjective visual horizontal during follow-up after unilateral vestibular deafferentation with gentamicin,"Abstract
The subjective visual horizontal (SVH) was measured by means of a small, rotatable, luminous line in darkness in the upright head and body position and at 10, 20 and 30 degrees of tilt to the right and left before, and repeatedly during a follow-up period of 1 year after intratympanic gentamicin instillations in 12 patients with recurrent vertigo attacks. This treatment caused a loss of the bithermal caloric responses on the diseased side. Shortly after treatment there was a significant tilt of SVH towards the treated side (group mean = 10.6 degrees). Repeated testing made it possible to characterize mathematically the changes with time for SVH. For the group of patients as a whole this otolithic component of vestibular compensation was best described by a power function, SVH = 8.65t(-0.16) degrees, where t is time in days after maximum tilt of SVH. After 1 year, SVH was still significantly tilted towards the treated side (group mean = 3.16 degrees). Gentamicin treatment also caused a significant reduction in the perception of head and body tilt towards the deafferented side, while the perception of tilt towards the healthy side did not show any significant changes. During follow-up there was a gradual improvement in the perception of tilt towards the treated side. However, a significant asymmetry in roll-tilt perception was still present 1 year after deafferentation. There was no correlation between SVH in the upright position and roll-tilt perception, suggesting that these parameters are to some extent dependent on different afferent input from the vestibular organ. They were also found to be complementary for the detection of vestibular disturbance.",doi: 10.1080/00016489850154595.,10.1080@00016489850154595.pdf
323,581,582,World Neurosurg,"E. L. Turcotte, D. P. Patra, K. R. Abi-Aad, M. E. Welz, P. A. Weisskopf and B. R. Bendok Microvascular Decompression and Transposition of the 8th Cranial Nerve Using a Fenestrated Clip 2020",Pubmed,0.0,1.0,Population,Unilateral tinnitus,,0.0,Microvascular Decompression and Transposition of the 8th Cranial Nerve Using a Fenestrated Clip,"Abstract
Neurovascular compression is a potential, yet rare cause of vertigo and unilateral tinnitus. Despite the high success rate of microvascular decompression (MVD) in other vascular compression syndromes, the outcome reported after MVD of the vestibulocochlear nerve is variable.1,2 The presence of combined symptoms of tinnitus and vertigo treated by MVD has demonstrated a higher predictive value for success.3 In this video, we present the case of a 68-year-old male who presented with vertigo and tinnitus refractory to medical management and vestibular therapy. Audiologic evaluation was normal apart from mild sensorineural hearing loss. Vestibular testing was suggestive of uncompensated right peripheral vestibulopathy. Magnetic resonance imaging with fast imaging employing steady-state acquisition sequences revealed vascular compression by the right anteroinferior cerebellar artery (AICA) at the cisternal component of vestibulocochlear nerve. After a multidisciplinary discussion, a microvascular decompression was performed through a right retrosigmoid craniotomy. The AICA was mobilized off the vestibulocochlear nerve and was secured to the petrous dura using a fenestrated clip. Indocyanine green angiography with Glow-800 was conducted before and after AICA transposition to confirm adequate flow through the mobilized vessel. Postoperatively, the patient's vestibular symptoms improved significantly. This case demonstrates that microvascular decompression can provide a satisfactory outcome in patients with unilateral tinnitus and vertigo associated with vascular compression in appropriately selected cases (Video 1).
Keywords: 8th cranial nerve; Glow-800; MVD; Microvascular decompression; Retrosigmoid craniotomy; Vascular compression; Vestibulocochlear nerve.",doi: 10.1016/j.wneu.2019.12.046.,turcotte2019.pdf
324,582,583,South Med J,"J. S. Turner, Jr. A practical approach to the patient with vertigo: an outline of diagnosis and management for the nonspecialist 1975",PubMed,0.0,1.0,Design,No study was performed,,0.0,A practical approach to the patient with vertigo: an outline of diagnosis and management for the nonspecialist,"Abstract
A careful history is the most important part of a medical examination for vertigo, especially to establish whether it is acute, chronic or recurrent. If the patient spontaneously volunteers ear complaints, such as fullness, tinnitus, or hearing loss, the cause is probably otologic and deserves immediate referral. If no otologic complaints are volunteered, the whole body becomes a source of investigation. All nonvital drugs should be withheld while the vertigo study is progressing. A complete physical examination and blood profile should be carried out. Roentgenograms of the skull and chest should be obtained. Accurate diagnosis and proper management are possible only with prolonged follow-up. Unnecessary expense, inconvenience, and discomfort for the patient can be avoided by a screening audiogram to identify unilateral hearing loss. All unilateral hearing loss should be investigated thoroughly in order to diagnose serious retrocochlear disease early.",doi: 10.1097/00007611-197502000-00027.,No pdf
325,583,584,J Laryngol Otol,"H. Tutar, V. B. Tutar, B. Gunduz and Y. A. Bayazit Transmastoid labyrinthectomy for disabling vertigo after cochlear implantation 2014",PubMed,0.0,1.0,Population,CI,,0.0,Transmastoid labyrinthectomy for disabling vertigo after cochlear implantation,"Abstract
Objective: To document the use of transmastoid labyrinthectomy in the treatment of disabling vertigo after unilateral cochlear implantation.
Methods: A 58-year-old man with severe-to-profound bilateral sensorineural hearing loss secondary to chronic otitis media underwent cochlear implantation in his right ear with a Pulsar Med-El device. The surgery was uneventful and the electrode was positioned correctly. He had episodic vertigo three months after implant surgery, and medical treatment and aggressive vestibular rehabilitation did not relieve the vertigo attacks.
Results: Right transmastoid labyrinthectomy was performed one year after cochlear implantation. The patient's symptoms were immediately relieved, and cochlear implant function was not adversely affected at follow up after three years.
Conclusion: Transmastoid labyrinthectomy seems to be an effective, safe method for ablating the vestibular end organ after unilateral cochlear implantation.",doi: 10.1017/S0022215114001960.,tutar2014.pdf
326,584,585,Arch Dis Child,A. Uneri and D. Turkdogan Evaluation of vestibular functions in children with vertigo attacks 2003,PubMed,0.0,1.0,Population,Children,,0.0,Evaluation of vestibular functions in children with vertigo attacks,"Abstract
Aim: To examine vestibular system functions in children with episodic vertigo attacks.
Methods: Thirty four children (20 males) aged 4-18 years with paroxysmal dizziness and/or vertigo attacks were evaluated. A medical history for vestibular symptoms and migraine was taken. Vestibular and auditory functions were assessed.
Results: Chronic headache attacks consistent with migraine were reported in 12 children and motion sickness was reported in 30. Family history in first degree relatives was positive for migraine in 29 children and for episodic vertigo in 22. Electronystagmography and videonystagmography showed two types of nystagmus: spontaneous vestibular nystagmus (41%) and benign paroxysmal positional nystagmus (BPPN) (59%). The first type of nystagmus was assessed as a sign of vestibulopathy and the patients with BPPN were diagnosed as having benign paroxysmal positional vertigo (BPPV). Audiometric examination in four cases revealed bilateral sensory neural hearing loss in low frequencies. Pure tone averages in 30 cases were within normal ranges; however low frequencies in 28 of them were approximately 10 dB lower than high frequencies. Unilateral caloric responses diminished in eight children.
Conclusions: Peripheral vestibular problems in childhood present in a wide spectrum, which varies from a short episode of dizziness to a typical vestibular attack with fluctuating sensory neural hearing loss or episodes of BPPV. A considerable number of these vestibular problems might be related to the migraine syndrome.",doi: 10.1136/adc.88.6.510.,uneri2003.pdf
327,587,588,Auris Nasus Larynx,"M. Ushio, T. Murofushi, W. Okita, M. Suzuki and K. Kaga The effectiveness of wedge shoes in patients with insufficient vestibular compensation 2007",PubMed,1.0,,,,,1.0,The effectiveness of wedge shoes in patients with insufficient vestibular compensation,"Abstract
Objectives: Patients who fail to achieve sufficient vestibular compensation after acute vestibular deafferentation show a tendency to deviate toward the affected side. This study evaluated the effectiveness of wedge shoes specially manufactured with a 4mm inclination on the affected side to patients with chronic vestibular insufficiency.
Methods: Subjects comprised 13 patients with chronic vestibular insufficiency for >6 months after acute unilateral vestibular dysfunction and 9 healthy volunteers. Subjects underwent vestibular tests wearing wedge shoes and regular shoes. Differences in results were compared.
Results: Patients showed significant improvements in the straight gait test (p<0.01), Unterberger-Fukuda stepping test (p<0.01) and posturography test (p=0.015) when wearing wedge shoes compared with wearing regular shoes.
Conclusion: Our results suggested that raising the lateral sole of shoes on the affected side could effectively ameliorate the effects of chronic vestibular insufficiency.",doi: 10.1016/j.anl.2006.09.004.,ushio2007.pdf
328,588,589,J Periodontol,"M. I. Vacas, M. Amer, A. P. Chiarenza, M. A. Luchelli, P. M. Mandalunis and J. C. Elverdin Influence of submandibulectomy on alveolar bone loss in rats 2008",PubMed,0.0,1.0,Population,Animal study,,0.0,Influence of submandibulectomy on alveolar bone loss in rats,"Abstract
Background: The incidence of dry mouth and its public health impact are increasing as the result of a progressively larger, medicated older population and because chronic diseases, like periodontitis, are prevalent pathologies among elderly patients. Periodontitis and continuous remodeling and rebuilding alveolar processes greatly affect the margin of the alveolar bone, and there is evidence indicating the role of submandibular glands in the regulation of immune/inflammatory reactions. The purpose of this study was to assess the effect of submandibular-sublingual complex ablation (Sx) on alveolar bone loss in rats submitted or not to ligature-induced experimental periodontal disease (EP).
Methods: Wistar male rats were submitted to Sx or sham operations (day 0). Two weeks later, unilateral EP was induced on the right mandibular first molars for 7 days with the contralateral side serving as control. Bone loss at the level of the dental pieces was estimated by bone histomorphometry on mesio-distally oriented sections of the molars and by the determination on lingual and vestibular mandibular surfaces of the distances from the cemento-enamel junction to the alveolar crest.
Results: Sx and EP significantly increased lingual and vestibular alveolar bone loss. Molars with EP exhibited greater lingual loss in Sx animals compared to those with the sham operation. EP induced similar interradicular bone loss in sham and Sx rats.
Conclusion: Sx has a deleterious effect on the periodontal tissues, particularly marginal alveolar bone, indicating the importance of the submandibular/sublingual glands in maintaining healthy periodontal conditions.",doi: 10.1902/jop.2008.070566.,vacas2008.pdf
329,594,595,Eur Arch Otorhinolaryngol,"E. Veroul, D. Sabban, L. Blexmann, B. Frachet, C. Poncet-Wallet and E. Mamelle Predictive factors of vertigo following cochlear implantation in adults 2020",PubMed,0.0,1.0,Population,CI patients,,0.0,Predictive factors of vertigo following cochlear implantation in adults,"Abstract
Objectives: The occurrence of vertigo after cochlear implantation surgery is one of the most common complications, and often transient. The purpose of this study was to evaluate the occurrence of vertigo after unilateral or bilateral cochlear implantation as well as to identify potential predictive factors.
Materials and methods: Patients who have undergone cochlear implantation and vestibular assessment pre- and postoperatively were included retrospectively. The presence of vertigo before and after surgery was noted. Postoperative vertigo duration was divided into 3 categories: immediate postoperative (less than 2 months), transient postoperative (between 2 months and 1 year), and persistent postoperative (greater than 1 year). Pre- and postoperative vestibular assessment results (caloric irrigation and VEMP tests) as well as patients' age, operated side, surgical technique for round window access, and characteristics of the electrode array were all analyzed as potential predictive factors of postoperative vertigo.
Results: A total of 166 cochlear implants (137 patients) were included in the study, with a mean age of 57.5 ± 16.4 years. Of these, 36% developed postoperative vertigo, of which 19.3% was immediately postoperative. At 1 year postoperatively, 6 cases (3.6%) had persistent disabling vertigo, with 2 cases (1.2%) having no history of vertigo prior to cochlear implantation. Regarding caloric irrigation, 21% of the patients had a vestibular deficiency before surgery, and the same percentage had decreased vestibular responses. At 2 months after cochlear implantation, 31% of the patients exhibited an alteration in their vestibular test results, and 23.5% had experienced immediate postoperative vertigo. None of the factors studied (age, operated side, surgical technique, electrode array characteristics, and vestibular test alteration) correlated with the occurrence of short-term or long-term postoperative vertigo.
Conclusion: The occurrence of vertigo after cochlear implantation is difficult to predict by the healthcare team and may develop into an invalidating condition. Each vestibular examination performed routinely only evaluates a specific vestibular organ dysfunction. Therefore, combining several vestibular assessments tests before and after cochlear implantation can increase their sensitivity of predicting the occurrence and eventual persistence of this symptom.
Keywords: Cochlear implant; Complication; Postoperative; Vertigo.",doi: 10.1007/s00405-020-06449-y.,10.1007@s00405-020-06449-y.pdf
330,595,596,Acta Otolaryngol,"D. Vibert, R. Häusler, A. B. Safran and F. Koerner Diplopia from skew deviation in unilateral peripheral vestibular lesions 1996",PubMed,1.0,,,,,0.0,Diplopia from skew deviation in unilateral peripheral vestibular lesions,"Abstract
Vertical diplopia from skew deviation is well described in brainstem lesions. The phenomenon can also result from peripheral vestibular lesions. During the past years, we have observed these ocular changes in the acute stage following unilateral vestibular neurectomy and labyrinthectomy (n = 13), as well as in series of patients suffering from idiopathic sudden unilateral peripheral vestibular or cochleo-vestibular deficit (n = 5). Diplopia from skew deviation was noted immediately following ablative vestibular procedures; in patients with idiopathic vestibular deficit, it was observed as an associated sign. In all patients, clinical evaluation revealed an acute unilateral peripheral vestibular loss, with spontaneous nystagmus toward the unaffected ear and absence of nystagmic response to caloric testing on the affected ear. Skew deviation was measured using the Hess-Weiss test, which is based on the haploscopic principle. Static visual vertical was evaluated with the original methods of vertical frame and Maddox rod techniques. Photographs were made of the ocular fundi, to measure the degree of cyclotorsion of both eyes. In our patients, we found skew deviation with hypotropia of the eye that was ipsilateral to the affected ear and conjugated cyclotorsion and tilt of the static visual vertical on the side of the affected ear. Skew deviation was the first sign to disappear within a few days; conjugated cyclotorsion and tilt of the static visual vertical persisted for weeks to months. The eye-head postural reaction, consisting of head tilt, conjugated eye cyclotorsion, skew deviation, and alteration of vertical perception directed toward the side of the lesion, is known as the Ocular Tilt Reaction (OTR). The mechanism is presumably related to a lesion of the otolithic organs and/or to changes in the afferent graviceptive pathways. In man, the OTR is often mild and unrecognized, masked by spontaneous nystagmus and marked neuro-vegetative symptoms. Our observations indicate that skew deviation, as a part of the OTR, occurs in patients with sudden peripheral vestibular lesions, whether surgical or non-surgical in origin.",doi: 10.3109/00016489609137816.,vibert1996.pdf
331,596,597,Acta Otolaryngol,"D. Vibert, P. Liard and R. Häusler Bilateral idiopathic loss of peripheral vestibular function with normal hearing 1995",PubMed,0.0,1.0,Population,BVP,,0.0,Bilateral idiopathic loss of peripheral vestibular function with normal hearing,"Abstract
From 1982 to 1993, 52 electronystagmograms (FNG) revealed an absent nystagmic reaction on both caloric (44 30 and 10 degrees C water irrigation) and rotatory pendular testing (0.05 Hz/peak velocity 60 degrees/s), which represents 0.6% of all FNG performed during this period. Among these examinations, 14 patients (27%) presented a bilateral idiopathic loss of vestibular function (BILVF) with normal hearing and without associated neurological symptoms. Two different groups emerged: one group with simultaneous onset of BILVF ( 10 patients), with sudden imbalance and disequilibrium, worse in darkness, with an absence of bilateral caloric and pendular response. The other group (4 patients) was characterized by sequential onset of BILVF. These patients experienced several episodes of acute vertigo with persistent imbalances caloric and pendular responses showed unilateral, then contralateral loss with or without recovery of function. Eleven were controlled with a follow-up from 1 to 7 years. Patients of both groups remained permanently or episodically symptomatic, but only 4 patients complained of persistent oscillopsia. Viral infections, systemic diseases (hypertension, hypothyroidism, asthma), immune reactions (vaccination) and toxic factors (herbicide exposure) may play a role in the etiology of this rare bilateral peripheral vestibulopathy.",doi: 10.3109/00016489509139375.,vibert1995.pdf
332,597,598,Neuroscience,"N. Vibert, A. Babalian, M. Serafin, J. P. Gasc, M. Mühlethaler and P. P. Vidal Plastic changes underlying vestibular compensation in the guinea-pig persist in isolated, in vitro whole brain preparations 1999",PubMed,0.0,1.0,Population,Animal study,,0.0,"Plastic changes underlying vestibular compensation in the guinea-pig persist in isolated, in vitro whole brain preparations","Abstract
Vestibular compensation for the postural and oculomotor deficits induced by unilateral labyrinthectomy is a model of post-lesional plasticity in the central nervous system. Just after the removal of one labyrinth, the deafferented, ipsilateral vestibular nucleus neurons are almost silent, and the discharge of the contralateral vestibular nucleus neurons is increased. The associated static disorders disappear in a few days, as normal activity is restored in both vestibular nuclei. In this study, we searched for traces of vestibular compensation in isolated whole brains taken from adult guinea-pigs. The electrophysiological responses evoked in control brains were compared to those evoked in brains taken from animals that had previously been labyrinthectomized. Guinea-pigs compensated for an initial labyrinthectomy within three days. In vivo, subsequent deafferentation of vestibular nucleus neurons on the intact side triggered ""Bechterew's phenomenon"": a new postural and oculomotor syndrome appeared, similar to the one induced by the first lesion, but directed to the newly deafferented side. These disturbances would be caused by the new imbalance between the discharges of neurons in the two vestibular nuclei triggered by the second deafferentation. Experiments were designed to search for a similar imbalance in vitro in brains taken from labyrinthectomized animals, where the intact vestibular nerve is cut during the dissection. Isolated whole brains were obtained from young guinea-pigs at various times (one to seven days) following an initial labyrinthectomy. An imbalance between the resting activities of medial vestibular nucleus neurons on both sides of the brainstem was revealed in brains taken more than three days after the lesion: their discharge was higher on the compensated, initially lesioned side than on the newly deafferented side. In some cases, an oscillatory pattern of discharge, reminiscent of the spontaneous nystagmus associated in vivo with Bechterew's syndrome, appeared in both abducens nerves. These data demonstrate that most of the changes underlying vestibular compensation persist, and can thus be investigated in the isolated whole brain preparation. Brains removed only one day after the lesion displayed normal commissural responses and symmetric spinal inputs to vestibular nucleus neurons. However, an unusually large proportion of the neurons recorded on both sides of the preparation had very irregular spontaneous discharge rates. These data suggest that the first stages of vestibular compensation might be associated with transient changes in the membrane properties of vestibular nucleus neurons. Brains taken from compensated animals displayed a significant, bilateral decrease of the inhibitory commissural responses evoked in the medial vestibular nucleus by single-shock stimulation of the contralateral vestibular nerve. The sensitivity of abducens motoneurons on the initially lesioned, compensated side to synaptic activation from the contralesional vestibular nucleus neurons was also decreased. Both changes may explain the long-term, bilateral decrease of vestibular-related reflexes observed following unilateral labyrinthectomy. Spinal inputs to vestibular nucleus neurons became progressively asymmetric: their efficacy was increased on the lesioned side and decreased on the intact one. This last modification may support a functional substitution of the deficient, vestibular-related synergies involved in gaze and posture stabilization by neck-related reflexes.",doi: 10.1016/s0306-4522(99)00172-4.,vibert1999.pdf
333,603,604,Laryngoscope,"P. A. Wackym, W. A. King, F. G. Barker and D. S. Poe Endoscope-assisted vestibular neurectomy 1998",PubMed,1.0,,,,,0.0,Endoscope-assisted vestibular neurectomy,"Abstract
Objective/hypothesis: In some instances endoscopes offer better visualization than the microscope and frequently allow less invasive surgery. This study was undertaken to determine whether endoscopy is safe and effective during neurectomy of the vestibular nerve.
Method: Ten patients with intractable unilateral Meniere's disease underwent a retrosigmoid craniotomy for neurectomy of the vestibular nerve. Endoscopy with a Hopkins telescope was used during each procedure to study posterior fossa anatomic relationships and to assist the neurectomy. Preoperative and postoperative audiometric evaluation was performed in all patients undergoing vestibular neurectomy. Nine of these patients had preoperative electronystagmography, and four patients completed postoperative electronystagmography. The 1995 American Academy of Otolaryngology-Head and Neck Surgery's Committee on Hearing and Equilibrium guidelines for the diagnosis and evaluation of therapy in Meniere's disease were used.
Results: Complete neurectomy was achieved in all 10 patients. Endoscopy allowed improved identification of the nervus intermedius and the facial, cochlear, and vestibular nerves and adjacent neurovascular relationships without the need for significant retraction of the cerebellum or brainstem. In addition, endoscopic identification of the cleavage plane between the cochlear and vestibular nerves medial to or within the internal auditory canal (n = 3) was not made with the 0-degree endoscope; however, identification was made with the 30- or 70-degree endoscope in all cases. In all patients with Meniere's disease, elimination of the recurrent episodes of vertigo (n = 10) or otolithic crisis of Tumarkin (n = 1) was achieved.
Conclusions: Posterior fossa endoscopy can be performed safely. Endoscope-assisted neurectomy of the vestibular nerve may offer some advantages over standard microsurgery including increased visualization, more complete neurectomy, minimal cerebellar retraction, and a lowered risk of cerebrospinal fluid leakage.",doi: 10.1097/00005537-199812000-00005.,wackym1998.pdf
334,604,605,J Clin Neurosci,"M. Wagemakers, W. Verhagen, B. Borne, D. Venderink, C. Wauters and L. Strobbe Bilateral profound hearing loss due to meningeal carcinomatosis 2005",PubMed,0.0,1.0,Population,Meningeal carcinomatosis,,0.0,Bilateral profound hearing loss due to meningeal carcinomatosis,"Abstract
Meningeal carcinomatosis (MC) is an uncommon form of metastasis of solid tumors. Hearing loss as the presenting symptom of MC is very uncommon. A patient with an esophageal signet ring cell carcinoma 3 years previously presented with sudden onset of profound hearing loss affecting both ears. He had no evidence of local tumor recurrence. Brain magnetic resonance imaging (MRI) showed swelling and increased signal intensity on T2 weighted images of both acoustic nerves and the right trigeminal nerve. After gadolinium administration, enhancement of both acoustic and trigeminal nerves was seen. He later developed unsteadiness and head-movement-dependent oscillopsia due to vestibular areflexia and diplopia. At that time MRI showed leptomeningeal enhancement. MC was diagnosed, although cerebrospinal fluid cytology could not confirm that diagnosis. The patient died 16 weeks after the onset of deafness. In patients with progressive unilateral and bilateral hearing loss, meningeal carcinomatosis should be considered, especially if there is a history of previous malignancy.",doi: 10.1016/j.jocn.2004.07.012.,wagemakers2005.pdf
335,605,606,Eur Arch Otorhinolaryngol,"J. H. Wagner, D. Basta, F. Wagner, R. O. Seidl, A. Ernst and I. Todt Vestibular and taste disorders after bilateral cochlear implantation 2010",PubMed,0.0,1.0,Population,Bilateral CI,,0.0,Vestibular and taste disorders after bilateral cochlear implantation,"Abstract
The objective of this study was to investigate the occurrence of vestibular receptor deficiency and taste disorders after bilateral cochlear implantation in postlingually deafened patients and to find out whether the risk for these complications is higher for the second implantation. In a retrospective cohort study, we examined 20 patients (11-58 years, mean age 41.5 years), implanted sequentially between 2000 and 2007 (mean period between cochlear implantation 32.9 ± 25 months). Pre- and postoperative vestibular testing was performed by subjective rating [Dizziness Handicap Inventory (DHI)], caloric irrigation [vestibuloocular reflex (VOR)] and by vestibular-evoked myogenic potential (VEMP) recordings for saccular function. The sense of taste was evaluated pre- and postoperatively by a questionnaire and testing (sour/sweet/bitter/salty bilaterally on the tongue). DHI evaluation showed a moderate not significant mean increase by 2.7 ± 7.7 SD points after the first and a significant increase by 9.4 ± 16.6 SD points after the second implantation. Ipsilateral VEMP responses disappeared in three ears (27.3%) after the first and in two ears (18.2%) after the second operation. VOR disappeared only once (5.9%) after the first implantation. One (5%) patient complained of a persisting disturbance of taste in the questionnaire after unilateral and 3 (15%) after bilateral implantation. Specific testing showed in one case (5%) a unilateral taste disorder after ipsilateral cochlear implantation. Our data show that there is a higher risk for subjective vertigo after the second implantation. The occurrence of unilateral and/or bilateral vestibular dysfunction and the potential risk of taste disorder should be included in the risk counseling before bilateral cochlear implantation to increase patients' and medicolegal safety in the decision-making process.",doi: 10.1007/s00405-010-1320-1.,wagner2010.pdf
336,606,607,Br J Urol,"A. Wakhlu, D. Dalela, R. K. Tandon, H. Chandra and A. K. Wakhlu The single ectopic ureter 1998",PubMed,0.0,1.0,Population,ectopic ureter,,0.0,The single ectopic ureter,"Abstract
OBJECTIVES To correlate renal function with the site of the ectopic orifice in patients with a single ectopic ureter and to evaluate the role of ureteric reimplantation in the preservation of renal function.
Patients and methods: Forty-four patients (41 female, age 1.5 months to 20 years) with a single ectopic ureter have been managed in our institution in the last 21 years. The classical symptom of continuous wetting with intermittent normal micturition was reported in most of the female patients. The investigative evaluation included intravenous urography (i.v.U), cysto-urethroscopy, vaginoscopy with retrograde ureteric catheterization, micturating cysto-urethrography (MCU) and ultrasonography. Diuretic renography was carried out in four patients after it became available in 1992. Renal function was assessed in relation to urinary tract anomalies and with outcome after ureteric re-implantation.
Results: Thirty-eight patients (two males) had a unilateral ectopic ureter; the ectopic orifice was vaginal in 12, vestibular in 11, urethral in nine, at the bladder neck in two, the seminal vesicle in one and undetermined in three. Twenty-one patients had renal and/or ureteric abnormalities, with reflux detected on MCU in three ureters. Associated anomalies included hypospadias (two, one female), skeletal anomalies (two), anorectal malformations (three), cryptorchidism (two), and unilateral cystic ovary (one). Two patients had preoperative hypertension. In 15 patients, renal function was considered sufficient to justify ureteric reimplantation, 14 of whom regained continence. One girl had suprapubic leakage from the bladder and died during secondary nephroureterectomy. Another girl had persistent incontinence; she was found to have contralateral duplex ureters with a vestibular ectopic orifice and was cured after upper polar heminephroureterectomy. i.v.U and renography carried out in two patients each within 4 weeks of surgery showed a moderate improvement in renal function. Eight patients reported for follow-up after ureteric reimplantation (mean duration 11 months); none had hypertension or urinary infection. Twenty-three patients with rudimentary kidneys underwent nephroureterectomy. Histopathological examination of the excised kidneys showed moderate to severe dysplasia with chronic pyelonephritis. Six patients (one male) had bilateral single ectopic ureters, with normal renal function in the five females. Unilateral reimplantation in the boy resolved the symptoms; one girl died before surgery and the other four underwent bilateral ureteric reimplantation, after which one was dry for up to 3 h while the other three were incontinent, one of whom subsequently underwent urinary diversion.
Conclusions: There was no clear correlation of renal function with the site of the ectopic ureteric orifice, as most of the patients with a vaginal ectopic ureter had sufficient renal function to justify renal preservation. Ureteric reimplantation preserved renal function, although the improvement after surgery was determined by the degree of renal dysplasia.",doi: 10.1046/j.1464-410x.1998.00719.x.,wakhlu1998.pdf
337,608,609,Laryngoscope,"R. M. Walsh, A. P. Bath, M. L. Bance, A. Keller and J. A. Rutka Consequences to hearing during the conservative management of vestibular schwannomas 2000",PubMed,1.0,,,,,0.0,Consequences to hearing during the conservative management of vestibular schwannomas,"Abstract
Objective: To estimate the risk of loss of serviceable hearing during the conservative management of vestibular schwannomas.
Study design: Retrospective case review.
Methods: Twenty-five patients with a radiological diagnosis of unilateral vestibular schwannoma were managed conservatively for a mean duration of 43.8 months (range, 12-194 mo). The pure-tone average (PTA) (0.5, 1, 2, and 3 kHz) and speech discrimination scores (SDS) were measured at regular intervals throughout the entire duration of follow-up. Serviceable hearing was defined using two criteria: 70% SDS/30 dB PTA (the 70/30 rule) and 50% SDS/50 dB PTA (the 50/50 rule). The size and growth rate of tumors were determined according to the American Academy of Otolaryngology-Head and Neck Surgery guidelines (1995). Intervention was recommended if there was evidence of continuous or rapid radiological tumor growth, and/or increasing symptoms or signs suggestive of tumor growth.
Results: The risk of loss of serviceable hearing for the total group was 43% using the 70/30 rule and 42% using the 50/50 rule. Tumor growth was considered significant (> 1 mm) in 8 tumors (32%) and nonsignificant in 17 (68%). The risk of loss of serviceable hearing for the tumor-growth group was 67% using the 70/30 rule and 80% using the 50/50 rule. In contrast, the risk of loss of serviceable hearing for the no tumor-growth group was 25% using the 70/30 rule and 14% using the 50/50 rule. No audiological factors predictive of tumor growth were identified.
Conclusions: There is a significant risk of loss of serviceable hearing during the conservative management of vestibular schwannomas. This risk appears to be greater in tumors that demonstrate significant growth.",doi: 10.1097/00005537-200002010-00012.,walsh2000.pdf
338,609,610,Rev Laryngol Otol Rhinol (Bord),"R. M. Walsh, A. P. Bath, M. L. Bance, A. Keller, C. H. Tator and J. A. Rutka The natural history of untreated vestibular schwannomas. Is there a role for conservative management? 2000",PubMed,1.0,,,,,0.0,Not Found,Not Found,Not Found,No pdf
339,610,611,Clin Otolaryngol Allied Sci,"R. M. Walsh, A. P. Bath, M. L. Bance, A. Keller, C. H. Tator and J. A. Rutka The role of conservative management of vestibular schwannomas 2000",PubMed,1.0,,,,,0.0,The role of conservative management of vestibular schwannomas,"Abstract
Although microsurgery is generally regarded as the conventional treatment of choice for most vestibular schwannomas, there remains a group of patients in whom a conservative management approach may be a desirable alternative. The aim of this study was to determine the natural history and outcome following the conservative management of 72 patients with unilateral vestibular schwannomas. The reasons for conservative management included poor general health, age, patient preference, small tumour size, minimal or no symptoms, and tumour in the only/better hearing ear. The mean duration of follow-up was 39.8 months (range 12-194 months). All patients underwent serial magnetic resonance imaging (MRI) for assessment of tumour growth. Patients were deemed to have failed conservative management if there was evidence of continuous or rapid radiological tumour growth and/or increasing symptoms or signs. The mean tumour growth rate, according to the 1995 guidelines of the American Academy of Otolaryngology/Head and Neck Surgery, was 1.16 mm/year (range: 0.75 9.65 mm/year). Approximately 83% of tumours grew at < 2 mm/year. Significant tumour growth was seen in 36.4%, no or insignificant growth in 50%, and negative growth in 13.6% of tumours. The growth rate of CPA tumours (1.4 mm/year) was significantly greater than that of IAC tumours (0.2 mm/year) (P = 0.001). Failure of conservative management, in which active treatment was required, occurred in 15.3%. The outcome of these patients appeared to be as favourable to a comparable group who underwent primary treatment, without a period of conservative management. The mean growth rate of tumours in patients who failed conservative management (4.2 mm/year) was significantly greater than that in patients who did not fail (0.5 mm/year) (P < 0.01). No factors predictive of tumour growth or failure of conservative management were identified. Deterioration of mean pure tone average (0.5, 1, 2, 3 kHz) and speech discrimination scores occurred regardless of whether radiological tumour growth was demonstrated or not. This study suggests that in a select number of cases of vestibular schwannoma, a conservative management approach may be appropriate. Regular follow-up with serial MRI is mandatory. Deterioration of auditory function occurs even in the absence of tumour growth.",doi: 10.1046/j.1365-2273.2000.00317.x.,walsh2000 (1).pdf
340,611,612,GMS Curr Top Otorhinolaryngol Head Neck Surg,L. E. Walther Procedures for restoring vestibular disorders 2005,PubMed,0.0,1.0,Design,No study was performed,,0.0,Procedures for restoring vestibular disorders,"Abstract
This paper will discuss therapeutic possibilities for disorders of the vestibular organs and the neurons involved, which confront ENT clinicians in everyday practice. Treatment of such disorders can be tackled either symptomatically or causally. The possible strategies for restoring the body's vestibular sense, visual function and co-ordination include medication, as well as physical and surgical procedures. Prophylactic or preventive measures are possible in some disorders which involve vertigo (bilateral vestibulopathy, kinetosis, height vertigo, vestibular disorders when diving (Tables 1 (Tab. 1) and 2 (Tab. 2)). Glucocorticoid and training therapy encourage the compensation of unilateral vestibular loss. In the case of a bilateral vestibular loss, it is important to treat the underlying disease (e.g. Cogan's disease). Although balance training does improve the patient's sense of balance, it will not restore it completely.In the case of Meniere's disease, there are a number of medications available to either treat bouts or to act as a prophylactic (e.g. dimenhydrinate or betahistine). In addition, there are non-ablative (sacculotomy) as well as ablative surgical procedures (e.g. labyrinthectomy, neurectomy of the vestibular nerve). In everyday practice, it has become common to proceed with low risk therapies initially. The physical treatment of mild postural vertigo can be carried out quickly and easily in outpatients (repositioning or liberatory maneuvers). In very rare cases it may be necessary to carry out a semicircular canal occlusion.Isolated disturbances of the otolith function or an involvement of the otolith can be found in roughly 50% of labyrinth disturbances. A specific surgical procedure to selectively block the otolith organs is currently being studied. When an external perilymph fistula involving loss of perilymph is suspected, an exploratory tympanotomy involving also the round and oval window niches must be carried out. A traumatic rupture of the round window membrane can, for example, also be caused by an implosive inner ear barotrauma during the decompression phase of diving. Dehiscence of the anterior semicircular canal, a relatively rare disorder, can be treated conservatively (avoiding stimuli which cause dizziness), by non-ablative ""resurfacing"" or by ""plugging"" the semicircular canal. A perilymph fistula can cause a Tullio-phenomenon resulting from a traumatic dislocation or hypermobility of the stapes, which can be surgically corrected. Vestibular disorders can also result from otosurgical therapy. When balance disorders persist following stapedectomy it is necessary to carry out a revision operation in order to either exclude a perilymph fistula or shorten the piston. Surgically reducing the size of open mastoid cavities (using for example porous hydroxylapatite or cartilage) can result in a reduction of vertiginous symptoms while nursing or during exposure to ambient air. Vestibular disturbances can occur both before and after vestibular nerve surgery (acoustic neuroma). Initially, good vestibular compensation can be expected after surgically removing the acoustic neuroma. An aberrant regeneration of nerve fibers of the vestibulocochlear nerve has been suggested as a cause for secondary worsening. Episodes of vertigo can be caused by an irritation of the vestibular nerve (vascular loop). Neurovascular decompression is generally regarded as the best surgical therapy. In the elderly, vestibular disturbances can severely limit quality of life and are often aggravated by multiple comorbidities. Antivertiginous drugs (e.g. dimenhydrinate) in combination with movement training can significantly reduce symptoms. Administering antivertiginous drugs over varying periods of time (e.g. transdermal scopolamine application via patches) as well as kinetosis training can be used as both prophylactically and as a therapy for kinetosis. Exposure training should be used as a prophylactic for height vertigo.
Keywords: labyrinth, rehabilitation; neurootology; oto-surgery; therapy; vestibular compensation; vestibular disturbances.",Epub 2005 Sep 28.,No pdf
341,612,613,Acta Otolaryngol,"M. C. Wang, C. Y. Liu, E. C. Yu, H. J. Wu and G. S. Lee Vestibular evoked myogenic potentials in chronic otitis media before and after surgery 2009",PubMed,0.0,1.0,Population,Otitis media,,0.0,Vestibular evoked myogenic potentials in chronic otitis media before and after surgery,"Abstract
Conclusion: The pathology of chronic otitis media (COM) could delay and reduce the energy transfer of sound to the inner ear. The significant improvement of postoperative vestibular evoked myogenic potential (VEMP) response rate and p13 latencies in the group of patients with no or negative postoperative ABG gain provided evidence that the sound energy inducing a VEMP might be different from the energy producing the auditory perception.
Objective: To evaluate the VEMP in patients with COM before and after surgery.
Subjects and methods: Twenty-four subjects with unilateral COM were enrolled. A pure tone audiogram and VEMP using 500 Hz unilateral short tone-burst stimulations were recorded before and 3 months after surgery. The postoperative VEMP responses were compared with the responses before surgery and the healthy controls.
Results: After surgery, the 500 Hz air-bone gap (ABG) decreased significantly and the VEMP response rate increased significantly from 41.7% to 66.7% (p<0.05, bi-test). However, both the preoperative and postoperative p13 latencies were significantly longer than those of the healthy controls (p<0.05, Wilcoxon rank-sum test). In the 18 patients whose 500 Hz ABG did not improve with surgery, the p13 latencies were significantly shorter postoperatively (p<0.05, sign test), and the response rate also improved significantly from 44.4% (8/18) to 77.8% (14/18) (p<0.05, bi-test).",doi: 10.3109/00016480802620654.,wang2009.pdf
342,613,614,Ear Hear,"S. J. Wang, W. J. Weng, F. S. Jaw and Y. H. Young Ocular and cervical vestibular-evoked myogenic potentials: a study to determine whether air- or bone-conducted stimuli are optimal 2010",PubMed,0.0,1.0,Population,Healthy subjects,,0.0,Not Found,Not Found,Not Found,No pdf
343,614,615,Hear Res,S. J. Wang and Y. H. Young Vestibular evoked myogenic potentials using simultaneous binaural acoustic stimulation 2003,PubMed,0.0,1.0,Population,Otitis media,,0.0,Vestibular evoked myogenic potentials using simultaneous binaural acoustic stimulation,"Abstract
The aim of this study is to investigate the feasibility of recording vestibular evoked myogenic potential (VEMP) using simultaneous binaural acoustic stimulation (B-VEMP), and compare it with that using monaural acoustic stimulation (M-VEMP). Seven healthy volunteers were evoked by initial B-VEMP test and subsequent M-VEMP test, whereas vice versa in another 7 volunteers. All 14 subjects demonstrated both B-VEMPs and M-VEMPs, without significant difference in the latencies of p13 and n23. When using interaural amplitude difference (IAD) ratio for interpreting amplitude, B-VEMPs did not differ significantly from that of M-VEMPs. Hence, B-VEMPs can produce information equivalent to M-VEMPs in terms of response rate, latencies, and IAD ratio in healthy subjects. Likewise, similar results were also shown in the patients with unilateral Meniere's disease. In conclusion, B-VEMPs provide neither different information nor less variability, as compared with M-VEMPs. In addition, B-VEMPs can offer information on unilateral inner ear (saccular) pathology similar to that by M-VEMPs. Furthermore, recording from binaural stimulation can be used as a possibly more convenient mode compared with two monaural recordings, especially when testing young or old or disabled patients, since a continuous muscular effort is required during recording.",doi: 10.1016/s0378-5955(03)00256-9.,wang2003.pdf
344,616,617,Auris Nasus Larynx,T. Watanabe and M. Suzuki Equilibrium test findings in patients with Bell's palsy 2006,PubMed,0.0,1.0,Population,Bell's palsy,,0.0,Equilibrium test findings in patients with Bell's palsy,"Abstract
Objective: We analyzed equilibrium test findings in patients with Bell's palsy to confirm that such findings occur not only in patients with Hunt's syndrome but also in patients with Bell's palsy.
Methods: Subjects were 83 patients with Bell's palsy, 45 patients with Hunt's syndrome, and 82 patients with unilateral chronic otitis media without history of vertigo or ear surgery (for control). They were treated in our inpatient department and underwent equilibrium testing during the period 1983-2002. All subjects were at least 20 years of age. The following were analyzed: (1) presence of vertigo, (2) presence of abnormal equilibrium test findings, (3) relation between the degree of paralysis and abnormal equilibrium test findings, and (4) relation between the degree of recovery from paralysis and abnormal equilibrium test findings. Equilibrium testing consisted of a gaze nystagmus test, a spontaneous nystagmus test, positional and positioning nystagmus tests, and a caloric test. The incidence of abnormal findings in each test was compared between the three groups.
Results: Abnormal equilibrium test findings were observed in patients with Bell's palsy. No association was observed between the results of equilibrium tests and the degree of facial paralysis in patients with Bell's palsy. However, some of the equilibrium test results were significantly associated with the degree of facial nerve recovery.
Conclusions: Although our study was limited in its lack of true control subjects, our data suggest that patients with Bell's palsy show a significantly high incidence of vestibular abnormalities.",doi: 10.1016/j.anl.2005.11.004.,watanabe2006.pdf
345,617,618,J Clin Neurosci,J. Waterston Chronic migrainous vertigo 2004,PubMed,1.0,,,,,1.0,Chronic migrainous vertigo,"Abstract
A series of 16 subjects is described who presented with chronic vertigo that was thought to be migrainous in nature. The vertigo occurred on a daily basis and had been present for six months or more. Common symptoms included motion-induced dizziness, positional vertigo and motion sensitivity. Investigations were frequently normal apart from the finding of atypical positional nystagmus in four subjects and unilateral vestibular hypofunction in two subjects. It was frequently not possible to make a diagnosis of migraine on the basis of International Headache Society criteria, however the dramatic beneficial response to anti-migraine therapy supported the hypothesis that the vertigo was migrainous in nature.",doi: 10.1016/j.jocn.2003.08.008.,waterston2004.pdf
346,618,619,Acta Otolaryngol,J. A. Waterston and G. M. Halmagyi Unilateral vestibulotoxicity due to systemic gentamicin therapy 1998,PubMed,1.0,,,,,0.0,Unilateral vestibulotoxicity due to systemic gentamicin therapy,"Abstract
Systemic gentamicin can cause acute bilateral, simultaneous, symmetrical loss of vestibular function manifested by symptoms and signs of chronic vestibular insufficiency (ataxia and oscillopsia). We report 6 patients presenting with ataxia and oscillopsia, but without a history of vertigo, who had severe unilateral loss of vestibular function on caloric testing. The absence of vertigo in these patients could be explained by two possible mechanisms: either, the unilateral loss of vestibular function was subacute, occurring over several days so that compensation could occur, or bilateral vestibular loss occurred which was then followed by asymmetrical recovery of vestibular function. The second hypothesis is supported by the observation that vestibular hair cells can regenerate after aminoglycoside damage.",doi: 10.1080/00016489850154586.,10.1080@00016489850154586.pdf
347,619,620,Laryngoscope,D. B. Welling Clinical manifestations of mutations in the neurofibromatosis type 2 gene in vestibular schwannomas (acoustic neuromas) 1998,PubMed,1.0,,,,,0.0,Clinical manifestations of mutations in the neurofibromatosis type 2 gene in vestibular schwannomas (acoustic neuromas),"Abstract
Vestibular schwannomas (acoustic neuromas) continue to cause significant facial nerve and hearing morbidity, despite marked improvement in diagnosis and treatment. Mutation of a tumor-suppressor gene on human chromosome 22 has been found to be associated with vestibular schwannoma formation. The central hypothesis of this study is that specific mutations in the neurofibromatosis type 2 (NF2) gene may produce specific clinical characteristics or phenotypic expressions. The purposes of this investigation are: 1. to determine what proportion of vestibular schwannomas from patients with spontaneous unilateral and familial bilateral schwannomas have mutations present within the NF2 gene; 2. to determine whether specific types of mutations are associated with a specific clinical manifestation of this disease; and 3. to further define the relationship between newly discovered mutations within the NF2 tumor-suppressor gene and possible clinical applications of this knowledge to advance diagnosis and treatment of patients with NF2 and spontaneous vestibular schwannomas. DNA from 61 schwannomas (29 unilateral vestibular schwannomas and 32 from patients with bilateral vestibular schwannomas [NF2]) were examined, and 33 unique mutations were identified. Significant differences were found in the frequency, distribution, and type of mutation between the NF2 schwannomas and the spontaneous vestibular schwannomas. Three clinical subtypes of NF2 were identified. In tumors from 28 patients, no mutations were identified. Of the 33 mutations identified in the NF2 gene, 30 were likely to result in loss of tumor-suppressor function from protein truncation; however, three milder mutations termed missense mutations were associated with milder clinical manifestations of the disease and had a slower estimated growth rate. Variable clinical presentation in patients whose tumors had severe or truncating types of mutations suggest that factors in addition to the mutation class are likely to be responsible for a portion of the clinical expression of disease. New diagnostic options are now available for NF2 that will improve the likelihood of hearing and facial nerve preservation and ultimately have significant impact on the management of vestibular schwannomas.",doi: 10.1097/00005537-199802000-00005.,welling1998.pdf
348,620,621,Hno,M. Westhofen Preoperative vestibular diagnosis in therapy of Menière's disease 1992,PubMed,0.0,1.0,Population,NO UVP,,0.0,[Significance of ultrahigh resolution computed tomography in the preoperative diagnosis of Menière's disease],"Abstract
By means of ultrahigh resolution computed tomography imaging of very small labyrinthine structures such as the vestibular aqueduct and the rima sacci endolymphatici is possible. Aim of the present study was to demonstrate the significance of ultrahigh resolution CT in the preoperative management of Menière's disease. The study was carried out on 16 patients who underwent endolymphatic mastoidal shunt operation. Postoperative imaging and clinical findings were compared. By means of ultrahigh resolution technique the vestibular aqueduct could be examined in all of our patients. Two CT-findings of atresia of the external aperture were confirmed intraoperatively. Preoperative ultrahigh resolution computed tomography is a reliable method to demonstrate the distinct variability of the oto-surgical landmarks for endolymphatic shunt operation. There is no reliable correlation between the width, shape and bony contrast of the vestibular aqueduct and the postoperative outcome. Thus in our opinion preoperative ultrahigh resolution computed tomography is mandatory for the preoperative management of Menière's disease.",doi: 10.1055/s-2007-997281.,leuwer1992.pdf
349,623,624,Audiol Res,J. White and P. Krakovitz Nystagmus in Enlarged Vestibular Aqueduct: A Case Series 2015,PubMed,0.0,1.0,Population,LVA,,0.0,Nystagmus in Enlarged Vestibular Aqueduct: A Case Series,"Abstract
Enlarged vestibular aqueduct (EVA) is one of the commonly identified congenital temporal bone abnormalities associated with sensorineural hearing loss. Hearing loss may be unilateral or bilateral, and typically presents at birth or in early childhood. Vestibular symptoms have been reported in up to 50% of affected individuals, and may be delayed in onset until adulthood. The details of nystagmus in patients with EVA have not been previously reported. The objectives were to describe the clinical history, vestibular test findings and nystagmus seen in a case series of patients with enlarged vestibular aqueduct anomaly. Chart review, included computed tomography temporal bones, infrared nystagmography with positional and positioning testing, caloric testing, rotary chair and vibration testing. Clinical history and nystagmus varied among the five patients in this series. All patients were initially presumed to have benign paroxysmal positional vertigo, but repositioning treatments were not effective, prompting referral, further testing and evaluation. In three patients with longstanding vestibular complaints, positional nystagmus was consistently present. One patient had distinct recurrent severe episodes of positional nystagmus. Nystagmus was unidirectional and horizontal. In one case horizontal nystagmus was consistently reproducible with seated head turn to the affected side, and reached 48 d/s. Nystagmus associated with enlarged vestibular aqueduct is often positional, and can be confused with benign paroxysmal positional vertigo. Unexplained vestibular symptoms in patients with unilateral or bilateral sensorineural hearing loss should prompt diagnostic consideration of EVA.
Keywords: enlarged vestibular aqueduct; nystagmus; vertigo.",doi: 10.4081/audiores.2015.120.,white2015.pdf
350,624,625,J Neurosurg,"R. G. Whitmore, C. Urban, E. Church, M. Ruckenstein, S. C. Stein and J. Y. Lee Decision analysis of treatment options for vestibular schwannoma 2011",PubMed,0.0,1.0,Design,Review,,0.0,Decision analysis of treatment options for vestibular schwannoma,"Abstract
Object: Widespread use of MR imaging has contributed to the more frequent diagnosis of vestibular schwannomas (VSs). These tumors represent 10% of primary adult intracranial neoplasms, and if they are symptomatic, they usually present with hearing loss and tinnitus. Currently, there are 3 treatment options for quality of life (QOL): wait and scan, microsurgery, and radiosurgery. In this paper, the authors' purpose is to determine which treatment modality yields the highest QOL at 5- and 10-year follow-up, considering the likelihood of recurrence and various complications.
Methods: The MEDLINE, Embase, and Cochrane online databases were searched for English-language articles published between 1990 and June 2008, containing key words relating to VS. Data were pooled to calculate the prevalence of treatment complications, tumor recurrence, and QOL with various complications. For parameters in which incidence varied with time of follow-up, the authors used meta-regression to determine the mean prevalence rates at a specified length of follow-up. A decision-analytical model was constructed to compare 5- and 10-year outcomes for a patient with a unilateral tumor and partially intact hearing. The 3 treatment options, wait and scan, microsurgery, and radiosurgery, were compared.
Results: After screening more than 2500 abstracts, the authors ultimately included 113 articles in this analysis. Recurrence, complication rates, and onset of complication varied with the treatment chosen. The relative QOL at the 5-year follow-up was 0.898 of normal for wait and scan, 0.953 for microsurgery, and 0.97 for radiosurgery. These differences are significant (p < 0.0052). Data were too scarce at the 10-year follow-up to calculate significant differences between the microsurgery and radiosurgery strategies.
Conclusions: At 5 years, patients treated with radiosurgery have an overall better QOL than those treated with either microsurgery or those investigated further with serial imaging. The authors found that the complications associated with wait-and-scan and microsurgery treatment strategies negatively impacted patient lives more than the complications from radiosurgery. One limitation of this study is that the 10-year follow-up data were too limited to analyze, and more studies are needed to determine if the authors' results are still consistent at 10 years.",doi: 10.3171/2010.3.JNS091802.,whitmore2011.pdf
351,625,626,Curr Treat Options Neurol,"S. L. Whitney, A. H. Alghadir and S. Anwer Recent Evidence About the Effectiveness of Vestibular Rehabilitation 2016",PubMed,0.0,1.0,Design,Review,,0.0,Recent Evidence About the Effectiveness of Vestibular Rehabilitation,"Abstract
Vestibular rehabilitation of persons with peripheral and central vestibular disorders requires a thorough evaluation and a customized plan of care. Collaboration of the various members of the treatment team optimizes outcomes. Early intervention appears to be better than referring patients who have developed chronic symptoms of balance loss, dizziness, anxiety, and depression. There is a body of emerging evidence that supports that the central nervous system has the capability to reweigh sensory inputs in order to improve function. There continues to be a dearth of knowledge related to how to treat persons with otolithic dysfunction as compared to those with semicircular canal damage. With the use of vestibular rehabilitation, patients are less likely to fall, are less dizzy, balance and gait improve, and quality of life is enhanced. Recent Cochrane reviews and a clinical practice guideline support the use of vestibular rehabilitation for persons with vestibular dysfunction. Typical symptoms and their management including dysregulated gait, falling, fear of falling, increased sway in standing, visual blurring, symptoms with complex visual scenes in the periphery, and weakness are all discussed with ideas for intervention. Any patient with a vestibular disorder may benefit from a trial of vestibular rehabilitation. A discussion of recent evidence and innovations related to vestibular rehabilitation is also included.
Keywords: Balance; Bilateral hypofunction; Dizziness; Peripheral hypofunction; Unilateral vestibular loss; Vestibular rehabilitation.",doi: 10.1007/s11940-016-0395-4.,whitney2016.pdf
352,627,628,Phys Ther,"K. Wilhelmsen and A. Kvåle Examination and treatment of patients with unilateral vestibular damage, with focus on the musculoskeletal system: a case series 2014",PubMed,1.0,,,,,1.0,"Examination and treatment of patients with unilateral vestibular damage, with focus on the musculoskeletal system: a case series","Abstract
Background and purpose: Persistent dizziness and balance problems have been reported in some patients with unilateral vestibular pathology. The purpose of this case series was to address the examination and treatment of musculoskeletal dysfunction in patients with unilateral vestibular hypofunction.
Case description: The musculoskeletal system was evaluated with the Global Physiotherapy Examination, dynamic balance was measured during walking with triaxial accelerometers positioned on the lower and upper trunk, and symptoms and functional limitations were assessed with standardized self-report measures. The 4 included patients had symptoms of severe dizziness that had lasted more than 1 year after the onset of vestibular dysfunction and a moderate level of perceived disability. Musculoskeletal abnormalities typically included postural misalignment, restricted abdominal respiration, restricted trunk movements, and tense muscles of the upper trunk and neck. The patients attended a modified vestibular rehabilitation program consisting of body awareness exercises addressing posture, movements, and respiration.
Outcomes: After the intervention, self-reported symptoms and perceived disability improved. Improvements in mobility and positive physical changes were found in the upper trunk and respiratory movements. The attenuation of mediolateral accelerations (ie, body oscillations) in the upper trunk changed; a relatively more stable upper trunk and a concomitantly more flexible lower trunk were identified during walking in 3 patients.
Discussion: The recovery process may be influenced by self-inflicted rigid body movements and behavior strategies that prevent compensation. Addressing physical dysfunction and enhancing body awareness directly and dizziness indirectly may help patients with unilateral vestibular hypofunction break a self-sustaining cycle of dizziness and musculoskeletal problems. Considering the body as a functional unit and including both musculoskeletal and vestibular systems in examination and treatment may be important.",doi: 10.2522/ptj.20130070.,wilhelmsen2014.pdf
353,628,629,Front Integr Neurosci,"D. Wilkinson, R. Morris, W. Milberg and M. Sakel Caloric vestibular stimulation in aphasic syndrome 2013",PubMed,0.0,1.0,Population,Aphasic syndrome,,0.0,Caloric vestibular stimulation in aphasic syndrome,"Abstract
Caloric vestibular stimulation (CVS) is commonly used to diagnose brainstem disorder but its therapeutic application is much less established. Based on the finding that CVS increases blood flow to brain structures associated with language and communication, we assessed whether the procedure has potential to relieve symptoms of post-stroke aphasia. Three participants, each presenting with chronic, unilateral lesions to the left hemisphere, were administered daily CVS for four consecutive weeks. Relative to their pre-treatment baseline scores, two of the three participants showed significant improvement on both picture and responsive naming at immediate and 1-week follow-up. One of these participants also showed improved sentence repetition, and another showed improved auditory word discrimination. No adverse reactions were reported. These data provide the first, albeit tentative, evidence that CVS may relieve expressive and receptive symptoms of aphasia. A larger, sham-controlled study is now needed to further assess efficacy.
Keywords: communication; language; neuro-stimulation; rehabilitation; stroke.",doi: 10.3389/fnint.2013.00099.,wilkinson2013.pdf
354,629,630,Musculoskelet Sci Pract,"K. Williams, A. Tarmizi and J. Treleaven Use of neck torsion as a specific test of neck related postural instability 2017",PubMed,0.0,1.0,Population,Neck related PI,,0.0,Use of neck torsion as a specific test of neck related postural instability,"Abstract
Background: Disturbed postural stability in neck pain (NP) is likely due to abnormal cervical afferent function. Several potential causes requires specific diagnostic tests. The neck torsion (head still body rotated) manoeuvre stimulates cervical but not vestibular receptors and identified abnormal cervical afferent input as the cause in patients with NP compared to healthy controls. Comparison between vestibular and NP subjects is now needed.
Aims: To compare individuals with unilateral vestibular loss (UVL), persistent NP and asymptomatic controls. It was hypothesized that neck torsion will increase postural stability in NP compared to both the asymptomatic and UVL groups.
Methods: Twenty UVL, 20 persistent NP and 20 asymptomatic control subjects underwent measurement of postural stability on a computerised force plate with eyes closed in comfortable stance under 5 conditions: neutral head, head rotated 45° (left and right) and neck torsion (left and right). Root mean square (rms) amplitude of sway was measured in the anterior posterior (AP) and medial lateral (ML) directions. Average torsion and torsion difference (average torsion - neutral neck) were calculated.
Results: NP subjects had significantly greater (p < 0.05) AP sway with average torsion and torsion difference compared to both control and UVL. There were no significant differences between control and UVL and no between group differences for neutral neck, rotation or rotation difference.
Conclusion: The results of the study suggest that the torsion manouever may identify cervical afferent causes of disturbed postural stability. This is important for guiding assessment and management of balance disturbances in patients.
Keywords: Balance; Neck pain; Torsion; Vestibular.",doi: 10.1016/j.msksp.2017.03.012.,williams2017.pdf
355,630,631,Can J Neurol Sci,"J. Willis, E. A. Atack and G. Kraag Relapsing polychondritis with multifocal neurological abnormalities 1984",PubMed,0.0,1.0,Population,Relapsing polychondritis,,0.0,Relapsing polychondritis with multifocal neurological abnormalities,"Abstract
A sixty-five year old woman developed relapsing polychondritis with three of the diagnostic criteria established by McAdam et al. (1976), namely bilateral auricular chondritis, ocular inflammation and both cochlear and vestibular dysfunction. Many authors have mentioned other neurological symptoms including unilateral facial weakness. This patient is the first case described with bilateral facial weakness and cerebral manifestations. Relapsing polychondritis, an uncommon, recurrent, inflammatory disorder affecting the cartilaginous tissues of the body (Jaksch-Wartenhorst, 1923; Herman, 1981), is regularly associated with audiovestibular dysfunction (Bollet et al., 1969; Cody et al., 1971; McAdam et al., 1976; Ridgway et al., 1979). McAdam et al. (1976) and Ridgway et al. (1979) have mentioned other neurological symptoms including unilateral facial weakness. We recently observed a patient with polychondritis and multifocal neurological abnormalities. We believe this is the first case described with bilateral facial nerve palsy and with cerebral manifestations.",doi: 10.1017/s0317167100045819.,willis1984.pdf
356,631,632,J Neurol Phys Ther,P. A. Winkler and B. Esses Platform tilt perturbation as an intervention for people with chronic vestibular dysfunction 2011,PubMed,1.0,,,,,0.0,Platform tilt perturbation as an intervention for people with chronic vestibular dysfunction,"Abstract
Background and purpose: Training to improve responses to perturbations may be beneficial for individuals with unilateral vestibular dysfunction. We evaluated the effects of an incrementally increasing surface tilt perturbation intervention for individuals with chronic vestibular pathology on gait, activities of daily living, and dizziness.
Methods: Participants (n = 29) were randomly assigned to 1 of 3 groups. The first group received random surface tilt perturbations of increasing angles and speed, half of the trials with vision-occluding goggles, 3 times weekly for 3 weeks (P group). The second group received tilt perturbation intervention (as above) plus a home program of vestibular rehabilitation exercises (P+EX group). The third group performed only the vestibular rehabilitation exercises (EX group). Outcome measures included temporospatial gait measures, Dynamic Gait Index (DGI), Dizziness Handicap Inventory (DHI), Patient Specific Functional Scale (PSFS), and a Perceived Outcomes Scale (POS).
Results: The P and P+EX groups showed greater improvement on the PSFS and the POS compared to the EX group. DGI scores indicated decreased fall risk in 8 of 9 individuals who participated in P or P+EX training and who initially scored below the 19-point cutoff score. Both the P and P+EX groups showed significant within-group changes on some gait characteristics, DGI, DHI, PSFS, and POS measures. The EX group showed within-group change only on the DHI.
Discussion and conclusion: Surface tilt perturbation training appears to be more effective for improving abilities at the activities and participation levels than vestibular exercises alone. In addition, tilt perturbation training reduced fall risk as measured by the DGI.",doi: 10.1097/NPT.0b013e31822a2af9.,winkler2011.pdf
357,633,634,Can Fam Physician,"V. Wu, E. A. Sykes, M. M. Beyea, M. T. W. Simpson and J. A. Beyea Approach to Ménière disease management 2019",PubMed,0.0,1.0,Design,Review,,0.0,Approach to Ménière disease management,"Abstract
Objective: To provide family physicians with an updated approach to the diagnosis and management of Ménière disease (MD), detailing the natural course of MD and describing how to initiate medical therapy while awaiting consultation with otolaryngology-head and neck surgery.
Sources of information: The approach is based on the authors' clinical practices and review articles from 1989 to 2018. Most of the cited studies provided level II or III evidence.
Main message: Ménière disease is an uncommon disorder of the inner ear causing vertigo attacks with associated unilateral hearing loss, tinnitus, and aural fullness. It has a degenerative course that often results in permanent sensorineural hearing loss. On average, MD stabilizes with no further vestibular attacks by about 8 years after the onset of symptoms; however, this is highly variable. Vertigo symptoms can be controlled through a combination of dietary salt restriction, stress reduction, and medical therapy (betahistine, diuretics, or both). These can be initiated by family physicians before consultation with otolaryngology-head and neck surgery. Symptoms refractory to such strategies can be treated using nonablative, and occasionally ablative, therapies.
Conclusion: A thorough history is key to the approach to and management of MD and permits differentiating MD from other vestibular and nonvestibular conditions.",Not Found,No pdf
358,636,637,Acta Otolaryngol,"E. Yamamoto, C. Mizukami and M. Ohmura Investigation of the external aperture of the vestibular aqueduct in Menière's disease by three-dimensional image analysis 1992",PubMed,0.0,1.0,Outcome,"No symptom, signs",,0.0,Investigation of the external aperture of the vestibular aqueduct in Menière's disease by three-dimensional image analysis,"Abstract
The width of the external aperture of the vestibular aqueduct was measured in patients with Meniere's disease using three-dimensional images. The width of the aperture on the affected side was significantly smaller compared with that in normal ears or ears with chronic otitis media. Also, the width of the aperture on the opposite (healthy) side in unilateral Meniere's disease was significantly smaller than in these two other groups. These findings suggest that the aqueduct is incompletely developed in patients with Meniere's disease and that this may be related to the pathogenesis of this condition. Also, in unilateral Meniere's disease the opposite ear runs a high risk of eventually developing the disease.",doi: 10.3109/00016489209100779.,yamamoto1992.pdf
359,639,640,Neuroreport,"T. Yamanaka, Y. Sawai, T. Murai, T. Nishimura and T. Kitahara Long-term effects of electrotactile sensory substitution therapy on balance disorders 2016",PubMed,1.0,,,,,1.0,Long-term effects of electrotactile sensory substitution therapy on balance disorders,"Abstract
This clinical research investigated whether a new type of rehabilitation therapy involving the use of a vestibular substitution tongue device (VSTD) is effective for severe balance disorders caused by unilateral vestibular loss. Sixteen patients with postural imbalances because of unilateral vestibular loss underwent training with VSTD. The VSTD transmits information on the head position to the brain through the tongue as substitutes for the lost vestibular information. The device's electrode array was placed on the tongue and participants were trained to maintain a centered body position by ensuring the electrical signals in the center of their tongue. All participants completed 10 min training sessions 2-3 times per day for 8 weeks. Functional gait assessments and the dizziness handicap inventory were, respectively, used to the evaluate participants' dynamic gait function and their severity of balance problems before and after the training period. All examined parameters improved after the 8-week training period. These changes were maintained for up to 2 years after the termination of the training program. Short-term training with VSTD had beneficial carry-over effects. VSTD training might represent a useful rehabilitation therapy in individuals with persistent balance disorders and might lead to long-term improvements in their balance performance and ability to perform daily and social activities.",doi: 10.1097/WNR.0000000000000606.,yamanaka2016.pdf
360,643,644,J Neurol,C. W. Yip and M. Strupp The Dizziness Handicap Inventory does not correlate with vestibular function tests: a prospective study 2018,PubMed,1.0,,,,,0.0,The Dizziness Handicap Inventory does not correlate with vestibular function tests: a prospective study,"Abstract
The Dizziness Handicap Inventory (DHI) is believed to quantitate the handicap related to the presence or severity of underlying vestibular dysfunction. However, patients with chronic vestibular diseases may manifest various degrees of behavioural and physiological adaptation resulting in variances of the DHI. Our primary study objective is to evaluate the correlation between the DHI and measurable vestibular parameters. Secondarily, we compared DHI among different vestibular disorders (central, peripheral and functional), and different types of anatomic deficits (semicircular canal vs otolithic). We also correlated the DHI and posturography. We prospectively evaluated 799 patients with precise vestibular diagnoses using video head impulse testing (vHIT), caloric irrigation, and cervical/ocular vestibular-evoked myogenic potentials (c/oVEMP). Posturography was done for 84 patients. All participants completed the DHI. No significant correlation was found between DHI and (1) vestibulo-ocular reflex parameters: unilateral weakness r = - 0.018, total calorics r = 0.055, vHIT right r = 0.007, vHIT left r = - 0.091, vHIT asymmetry r = 0.013; (2) otolith parameters: cVEMP amplitude right r = - 0.034, amplitude left r = - 0.004, asymmetry r = 0.016; oVEMP amplitude right r = 0.044, amplitude left r = - 0.007, asymmetry r = - 0.008. Patients with central vestibular disorders had higher DHI than those with peripheral (z = - 4.743, p = 0.001) or functional disorders (z = - 2.902, p = 0.004). DHI of patients with deficits of canal or otolith function did not differ significantly from those with no deficits (z = 2.153, p = 0.541). There was no significant correlation between DHI and postural sway on posturography. Therefore, the DHI does not correlate with vestibular tests, and neither reflects the presence nor severity of peripheral vestibular deficits.
Keywords: Caloric testing; Dizziness Handicap Inventory; Vestibular-evoked myogenic potential; Video head impulse test.",doi: 10.1007/s00415-018-8834-7.,yip2018.pdf
361,644,645,Neurosurgery,"S. Yomo, Y. Arkha, C. Delsanti, P. H. Roche, J. M. Thomassin and J. Régis Repeat gamma knife surgery for regrowth of vestibular schwannomas 2009",PubMed,0.0,1.0,Outcome,"No symptom, signs",,0.0,Repeat gamma knife surgery for regrowth of vestibular schwannomas,"Abstract
Objective: Gamma knife surgery (GKS) has become established as a minimally invasive treatment modality for patients with vestibular schwannomas. Treatment failure and/or tumor regrowth, however, is occasionally encountered, and microsurgical resection is usually warranted in such cases. The role of repeat GKS in these situations is still unclear. The goal of this study was to investigate whether repeat GKS is an effective treatment for recurrent vestibular schwannomas and to assess the conservation of residual neurological function.
Methods: Between July 1992 and December 2007, 1951 patients harboring a unilateral vestibular schwannoma were treated with GKS. Of these, 48 patients (2.5%) had to undergo a subsequent intervention because of progression or regrowth of the tumor. Repeat GKS was performed in a total of 15 patients, 8 of whom had more than 2 years of follow-up and were eligible to be enrolled in the present study. The median follow-up period after repeat GKS was 64 months, and the median interval between these interventions was 46 months. The median tumor volume was 0.51 and 1.28 mL at the initial and second GKS treatments, respectively. Patients received a median prescription dose of 12.0 Gy at both interventions.
Results: We report no cases of failure. Six patients demonstrated a significant reduction in tumor volume. In 1 patient, the final tumor volume was less than the initial volume. The other 2 patients showed stabilization of tumor growth. Useful hearing ability was preserved in only 1 of the 3 patients who had serviceable hearing ability at the time of the second GKS. Neither aggravation of facial nerve dysfunction nor other neurological deficits secondary to GKS were observed.
Conclusion: This is the first report to address repeat GKS for vestibular schwannomas. After long-term follow-up, repeat GKS with a low marginal dose seems to be a safe and effective treatment in selected patients harboring regrowth of small vestibular schwannomas that have previously been treated with GKS.",doi: 10.1227/01.NEU.0000327692.74477.D5.,yomo2009.pdf
362,648,649,Zh Nevrol Psikhiatr Im S S Korsakova,M. V. Zamergrad and O. S. Levin Metavestibular disorders and disorders of higher vestibular function 2017,PubMed,0.0,1.0,Design,Not related to subject ,,0.0,[Metavestibular disorders and disorders of higher vestibular function],"Abstract in English, Russian
Vertigo, instability, oscillopsia and concomitant autonomic disorders are classical and well-known symptoms of vestibular disorders. At the same time, recent studies suggest that there are more complicated vestibular dysfunctions caused by the cortical projections of the vestibular system. The central vestibular system includes parietal temporal cortex and insular, anterior intraparietal sulcus, posterior parietal and medial parts of the superior temporal gyrus, singular gyrus retrosplenial cortex, hippocampus and parahippocampal area. The central part of the vestibular system closely interacts with other afferent systems forming a multisensory structure of higher brain functions. Dysfunctions of higher vestibular function play an important role in the development of clinical syndromes including pusher syndrome, room tilt illusion, unilateral spatial neglect syndrome, impairment of spatial memory and navigation. These syndromes can develop due to the direct damage of the cortical vestibular system or as a result of disconnection between the vestibular cortex and other parts of the sensory cortex.
Keywords: impairment of spatial memory and navigation; pusher syndrome; room tilt illusion; unilateral spatial neglect syndrome; vestibular cortex; vestibular system.",doi: 10.17116/jnevro20171176211-15.,No pdf
363,650,651,Acta Otorhinolaryngol Ital,"D. Zanetti, N. Civiero, C. Balzanelli, M. Tonini and A. R. Antonelli Improvement of vestibular compensation by Levo-sulpiride in acute unilateral labyrinthine dysfunction 2004",PubMed,1.0,,,,,0.0,Improvement of vestibular compensation by Levo-sulpiride in acute unilateral labyrinthine dysfunction,"Abstract
L-sulpiride is the levorotatory enantiomer of sulpiride, a neuroleptic of the family of benzamide derivatives; it has a characteristic antagonist effect on central DA2 dopaminergic receptors and dopamine DA1 ""autoreceptors"". Its efficacy in the symptomatic control of acute vertigo spells has been recognized, apart from its well-known antiemetic, antidyspeptic and anti-depressant properties, at high dosages. To establish objective parameters of the results of its clinical application, a randomized prospective study was started comparing the effects of the drug in a group of 87 patients with vertigo of peripheral origin, with those in a control group treated with other vestibular suppressants. The drug was administered via the intravenous route, 25 mg t.i.d., for the first 3 days, then by oral administration, with the same schedule and dosage, for a further 7 days. After clinical evaluation of vestibular signs and symptoms, electronystagmographic recordings of rotatory tests were obtained, at admission and were then controlled after 6 months. A subjective Visual Analogue Scale was also delivered daily to the patients in order to monitor symptomatic improvements. When compared to conventional treatments, L-sulpiride appeared to induce a statistically significant faster recovery in unilateral vestibular lesions. An unexpected favourable outcome of treatment was the facilitation of spontaneous vestibular compensation, in terms of lesser residual labyrinthine dysfunction and reduction of recurrent vertigo attacks during the 6 months follow-up. The mechanisms of action of the drug and its interaction with the vestibular system are discussed.",Not Found,No pdf
364,651,652,Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi,"X. L. Zeng, J. T. Cen, Z. C. Li, S. Q. Zhang, J. Gu, T. Yuan, G. D. Yin, Z. Y. Wang and X. F. Wu Vertigo and sensorineural hearing loss due to syphilis: differential diagnosis and treatment 2016",PubMed,0.0,1.0,Population,Syphillis,,0.0,[Vertigo and sensorineural hearing loss due to syphilis: differential diagnosis and treatment],"Abstract
Objective:To analyze the etiology of repeatedly attacks of intractable vertigo and some types of sensorineural deafness whose clinical manifestation were not in conformity with the known spectrum diseases，and explore the screening method to prevent missed diagnosis or misdiagnosis, then provide references for clinical diagnosis and treatment for rare etiology. Method:The authors retrospectively analyzed the clinical manifestations, diagnosis, treatment and prognosis from 4 cases of vertigo sufferers and 2 cases of hearing impairment sufferers whose serological tests were positive for syphilis. All these 6 cases were treated with large doses of penicillin aqueous solutions (24 million U/d), multi-times intravenous infusion, the course of the treatment was 14 d. Result:The clinical manifestations of these 6 patients were lack of characteristic, as well as the results of hearing and vestibular function, imaging diagnosis. Positive syphilis detection of serology and cerebrospinal fluid tests were the main diagnostic basis. After anti-syphilis treatment, 5 cases got satisfied clinical symptoms improvement, 1 case suffered from low-tone sensorineural hearing loss, whose hearing fluctuated recurrently. Conclusion:Syphilis infection may damage the Ⅷ cranial nerve and then lead to vertigo and hearing loss, through chronic syphilitic osteitis of temporal bone, atrophy of organ of corti, osteolytic lesion surrounding the endolymphatic duct, and neurosyphilis. For patients presented with intractable vertigo, and those whose clinical manifestations are not in conformity with the known diseases of unilateral ear or bilateral ears rapidly progressive deafness, syphilis serology screening and validation tests are recommended in case of missed diagnosis or misdiagnosis.
Keywords: diagnosis, differential; hearing loss, sensorineural; neurosyphilis; otosyphilis; vertigo.",doi: 10.13201/j.issn.1001-1781.2016.08.005.,10.13201@j.issn.1001-1781.2016.08.005.pdf
365,652,653,Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi,"D. Zhang, Z. Fan, Y. Han, Y. Li and H. Wang Long-term efficacy of triple semicircular canal occlusion in the treatment of intractable Meniere's disease 2015",PubMed,1.0,,,,,0.0,[Long-term efficacy of triple semicircular canal occlusion in the treatment of intractable Meniere's disease],"Abstract
Objective: To explore the long-term efficacy and safety of triple semicircular canal occlusion (TSCO) in the treatment of intractable Meniere's disease (MD) so as to provide an alternative surgical procedure for treating this disorder.
Methods: Data from Forty-nine patients, who were referred to our hospital and diagnosed with unilateral MD strictly meeting the criteria issued by Chinese Academy of Otolaryngology-Head and Neck Surgery Committee (2006) from Dec. 2010 to Jul. 2012, were retrospectively analyzed in this work. Forty-nine patients, in whom the standardized conservative treatment was given at least one year and frequent vertigo still occurred, received TSCO. Vertigo control and auditory function were measured. Pure tone audiometry, caloric test, and cervical vestibular evoked myogenic potential (cVEMP) were performed for evaluation of audiological and vestibular function. Magnetic resonance hydrograph of inner ear was performed in patients received TSCO after 2 years for the observation of morphology of membranous labyrinth. Postoperative follow-up period was more than 2 years.
Results: According to the preoperative staging of hearing, among these 49 patients, there were 2 cases in stage II (with an average hearing threshold of 25-40 dBHL), 40 in stage III (41-70 dBHL) and 7 in stage IV (over 70 dBHL). Vertigo was controlled effectively in all 49 cases in two-year follow-up, of which 40 cases (81.6%) were completely controlled and 9 cases (18.4%) were substantially controlled after surgery. The rate of hearing preservation was 69.4% and the rate of hearing loss was 30.6%. Post-operatively, all patients suffered from temporary vertigo and balance disorders. Vertigo was disappeared in all patients within 3-5 days, while averagely recovered after 13.5 days. Two years afer treatment, loss of semicircular canal function by caloric test was found in the operation side of all patients and no change in cVEMP test was noted. All patients had no facial paralysis, cerebrospinal fluid leakage, and other complications. Magnetic resonance hydrograph of inner ear showed that endolymph fluid in the position of plugging had no water after 2-years of TSCO.
Conclusions: TSCO, which can reduce vertiginous symptoms effectively in patients with intractable MD in long-term follow-up, represents an effective and safe therapy for this disorder. TSCO is expected to be used as an alternative procedure for the treatment of MD in selected patients suffering from severe hearing loss or recurrence after endolymphatic sac surgery.",Not Found,No pdf
366,654,655,Hippocampus,"Y. Zheng, C. L. Darlington and P. F. Smith Impairment and recovery on a food foraging task following unilateral vestibular deafferentation in rats 2006",PubMed,0.0,1.0,Population,Animal study (rats),,0.0,Impairment and recovery on a food foraging task following unilateral vestibular deafferentation in rats,"Abstract
It has been suggested that the vestibular system may contribute to the development of higher cognitive function, especially spatial learning and memory that uses idiothetic cues (e.g., dead reckoning). However, few studies have been done using behavioral tasks that could potentially separate the animals' ability for dead reckoning from piloting. The food foraging task requires the animal to continuously monitor and integrate self-movement cues and generate an accurate return path. It has been shown that bilateral vestibular-lesioned rats were impaired on this task. The present study used the same task to further examine the contribution of vestibular information to spatial navigation by comparing unilateral and bilateral lesions and by testing the animals at different time points following the lesion. The results demonstrated that animals with unilateral vestibular deafferentation were impaired in performing the task in the dark at 3 months after the lesion, and this impairment disappeared at 6 months after the lesion. This supports the notion that vestibular information contributes to dead reckoning and suggests possible recovery of function over time after the lesion. Animals with bilateral vestibular deafferentation were not able to be tested on the foraging task because they exhibited behavior distinct from the unilateral-lesioned animals, with significant hesitation in leaving their home cage for as long as 6 months after the lesion.",doi: 10.1002/hipo.20149.,zheng2006.pdf
367,655,656,PLoS One,"Y. J. Zhou, J. Yu, Y. Z. Wu, L. Tian, Z. Han, J. Wang and F. L. Chi The potential dysfunction of otolith organs in patients after mumps infection 2017",PubMed,0.0,1.0,Population,Mumps ,,0.0,The potential dysfunction of otolith organs in patients after mumps infection,"Abstract
Objective: To investigate the relationship between mumps and the extent of hearing impairment and otolith organ damage.
Methods: A total of 27 patients with unilateral hearing impairment following mumps were enrolled. The degrees of hearing loss and otolith organ damage were confirmed by audiometric and vestibular evoked myogenic potential [VEMP] tests. All the results were compared and analyzed using Stata 13.0 software for Windows.
Results: The VEMP thresholds of the affected ears were significantly higher than those of the unaffected ears in both tests (cervical VEMP [cVEMP] test and ocular VEMP [oVEMP] test; p = 0.000 and 0.001, respectively). The mean cVEMP and oVEMP threshold values of the affected ears with hearing impairment for ≤10 years were significantly lower than those of affected ears with hearing impairment for >10 years [p = 0.009 and 0.004, respectively].
Conclusions: Deafness resulting from mumps is usually profound and permanent, which indicates severe damage to the cochlea due to the disease. The functions of otolith organs in the vestibular system are also impaired. Over time, the function of the otolith organs or their neural pathway may suffer secondary damage.",doi: 10.1371/journal.pone.0181907.,zhou2017.pdf
368,658,659,Nervenarzt,"A. Zwergal, V. Kirsch, J. Gerb, J. Dlugaiczyk, S. Becker-Bense and M. Dieterich Neuro-otology: at the borders of ear and brain 2018",PubMed,0.0,1.0,Design,Not related to subject ,,0.0,[Neuro-otology: at the borders of ear and brain],"Abstract
Vertigo and dizziness are frequent chief complaints in clinical practice. Symptoms may originate from otological, neurological, medical and psychiatric etiologies, which poses an interdisciplinary challenge. Systematic analysis of case history and clinical examination generally allow classification into peripheral-, central- or non-vestibular disorders. The most important criteria for differentiation are the timeline, quality of symptoms, modulating factors and accompanying symptoms. As concerns the clinical examination, the following tests are relevant: head impulse test, test for spontaneous nystagmus, positional nystagmus, central ocular motor signs and the Romberg test. However, neuro-otological disorders with combined peripheral and central vestibular pathology do exist. Occlusion of the anterior inferior cerebellar artery results in ischemia of the labyrinth and cerebellum and therefore causes acute vestibular syndrome and unilateral hearing loss. Repetitive attacks of vertigo or dizziness which are accompanied by ear symptoms and headaches may be due to an overlap syndrome of Menière's disease and vestibular migraine. In this case patients often have to be treated with a dual prophylactic medication to control symptoms. In case of chronic dizziness and instability of gait a subsample of patients may suffer from CANVAS, which is a combination of bilateral vestibulopathy, a cerebellar syndrome and polyneuropathy. Chronic dizziness with signs of peripheral and central vestibular dysfunction can also originate from tumors of the cerebellopontine angle with compression of central structures. In conclusion, the diagnostic algorithm in the workup of patients with vertigo and dizziness should always include tests for peripheral and central vestibular and ocular motor function.
Keywords: Bilateral vestibulopathy; Brain ischemia; Cerebellar syndromes; Menière’s disease; Vestibular migraine.",doi: 10.1007/s00115-018-0598-x.,zwergal2018.pdf
369,659,660,Brain Struct Funct,"A. Zwergal, J. Schlichtiger, G. Xiong, R. Beck, L. Günther, R. Schniepp, F. Schöberl, K. Jahn, T. Brandt, M. Strupp, P. Bartenstein, M. Dieterich, M. B. Dutia and C. la Fougère Sequential (18)FFDG µPET whole-brain imaging of central vestibular compensation: a model of deafferentation-induced brain plasticity 2016",PubMed,0.0,1.0,Design,Review,,0.0,Sequential [(18)F]FDG µPET whole-brain imaging of central vestibular compensation: a model of deafferentation-induced brain plasticity,"Abstract
Unilateral inner ear damage is followed by a rapid behavioural recovery due to central vestibular compensation. In this study, we utilized serial [(18)F]Fluoro-deoxyglucose ([(18)F]FDG)-µPET imaging in the rat to visualize changes in brain glucose metabolism during behavioural recovery after surgical and chemical unilateral labyrinthectomy, to determine the extent and time-course of the involvement of different brain regions in vestibular compensation and test previously described hypotheses of underlying mechanisms. Systematic patterns of relative changes of glucose metabolism (rCGM) were observed during vestibular compensation. A significant asymmetry of rCGM appeared in the vestibular nuclei, vestibulocerebellum, thalamus, multisensory vestibular cortex, hippocampus and amygdala in the acute phase of vestibular imbalance (4 h). This was followed by early vestibular compensation over 1-2 days where rCGM re-balanced between the vestibular nuclei, thalami and temporoparietal cortices and bilateral rCGM increase appeared in the hippocampus and amygdala. Subsequently over 2-7 days, rCGM increased in the ipsilesional spinal trigeminal nucleus and later (7-9 days) rCGM increased in the vestibulocerebellum bilaterally and the hypothalamus and persisted in the hippocampus. These systematic dynamic rCGM patterns during vestibular compensation, were confirmed in a second rat model of chemical unilateral labyrinthectomy by serial [(18)F]FDG-µPET. These findings show that deafferentation-induced plasticity after unilateral labyrinthectomy involves early mechanisms of re-balancing predominantly in the brainstem vestibular nuclei but also in thalamo-cortical and limbic areas, and indicate the contribution of spinocerebellar sensory inputs and vestibulocerebellar adaptation at the later stages of behavioural recovery.
Keywords: Rat; Unilateral labyrinthectomy; Vestibular compensation; µPET.",doi: 10.1007/s00429-014-0899-1.,zwergal2014.pdf
370,660,661,Laryngorhinootologie,"A. Zwickl, S. Tauber and W. J. Issing Deafness at Wiskott-Aldrich-syndrome 2007",PubMed,0.0,1.0,Population,Wiskott-Aldrich-syndrome,,0.0,[Deafness at Wiskott-Aldrich-syndrome],"Abstract
Introduction: The Wiskott-Aldrich-syndrome belongs to the phakomatoses. The hereditary transmission happens x-chromosomal recessive in the domain of Xp 11.3-Xp 11.22. Clinical evidence for that is given by thrombocytopenia, an eczema and a weakness of the immune system with a subsequent increased risk of frequent infections and a predisposition for a malignancies. A further characteristic of that disease is recurrent otitis media as described by Aldrich in 1954.
Patient: The case--as described above--is about a 28-year-old male patient developing an acute deafness on the left ear while he has been suffering from a surditas on the right ear for 5 years. 8 years ago a splenectomy was made, because of persistent thrombocytopenia. An additional clinical characteristic was a hemiballism, arising after a thalamusbleeding 5 years ago, a both-sided vestibular failure concerning both that has been existing for 2 years, as well as a maculopathia with a highly reduced visus on both sides.
Conclusions: The deafness arising in patients suffering from the Wiskott-Aldrich-syndrome represents a so far not described symptom of that illness.",doi: 10.1055/s-2006-944751.,zwickl2007.pdf