Canal Paresis In Caloric Test Research Articles

Vestibular function analysis of sudden sensorineural hearing loss with dizziness.

A considerable number of patients with sudden sensorineural hearing loss (SSNHL) have been reported to have dizziness. To analyze vestibular functions and identify the clinical characteristics of SSNHL with dizzinessMETHODS:71 patients with SSNHL who complained of dizziness were investigated retrospectively. The patients underwent vestibular function tests consisting of video-nystagmography, video head impulse test and vestibular evoked myogenic potentials. Among 35 patients with spontaneous nystagmus (SN), 21 showed ipsilesional posterior canal gain deficit, 11 showed a gain deficit in the posterior canal only and 9 showed both horizontal and posterior canal gain deficit in video head impulse test. In only one subject with bilateral horizontal canal gain deficit with contralesional SN, AICA infarction was observed.Among 36 patients without SN, 10 were diagnosed as benign paroxysmal positional vertigo and 5 had ipsilesional canal paresis in caloric test. Other 21 patients showed no abnormal signs in vestibular function tests. In VFT analysis of SSNHL with dizziness, diverse patterns were identified. In the absence of SN, no definite vestibular organ involvement was the most frequent. But in the case with SN, posterior canal deficit was most common and cerebellar ischemic stroke was rare.

Effects of migraine disease on the vestibulocochlear system

Objective: Migraine patients have tendency to have vestibular and auditory system problems. The aim of this study is to evaluate vestibule cochlear system of patients with migraine with Transient-evoked otoacoustic emissions (TEOAE) video-nystagmography (VNG) and caloric test. Methods: 39 patients diagnosed with migraine and control group of 21 healthy volunteers were included in this study. Before they were included in the study, all of them were examined and those who has acute otitis media, chronic otitis media, tympanic membrane perforation, external otitis, ear surgery history and head trauma were excluded from the study. All patients and volunteers were tested by TEOAE, VNG and caloric tests. In evaluating the statistical data, SPSS 15.0 was utilized. Results: When TEOAE values for the migraine group and for the control group are compared, it is found statistically significant that the TEOAE values for the migraine group is lower than those for the control group. This result shows that there can be a pathology that is able to affect cochlear functions in migraine disease. As for VNG test results, a statistically significant difference cannot be determined between migraine and control groups. Moreover, the identification of canal paresis in caloric test indicates that peripheral vestibular problems accompany migraine disease. Conclusion: Evaluating vestibulocochlear system of migraine patients with TEOAE, VNG and caloric tests has been an important task for identifying vestibular imperfections accompanying these patients and for predicting potential auricular pathologies. J Clin Exp Invest 2015; 6 (1): 1-4 Key words: Migraine, TEOAE, video-nystagmography

Video Head Impulse Test, 温度刺激検査, VEMP を用いた前庭神経炎の障害部位の検討

The aim of this study was to classify unilateral vestibular neuritis (VN) with caloric testing, cervical vestibular evoked myogenic potentials (C-VEMPs), ocular vestibular evoked myogenic potentials (O-VEMPs), and the video head impulse test (vHIT). Eight Patients (3 males and 5 females, mean age 55.6 years) with VN were studied. cVEMP and oVEMP (105 dBSPL 500 Hz short tone burst stimulation) were recorded. The caloric test and vHIT for the 3 semicircular canal were performed. The caloric test, cVEMP and oVEMP in combination with vHIT were able to allow the classification of 4 types of VN: entire VN, superior VN, inferior VN, and ampullary VN. In our case, 75% of the cases were entire VN, 12.5% were superior VN, and 12.5% were inferior VN. Three patients had only deficits of the horizontal and/or inferior semicircular canals or their ampullary nerves. One of eight VN patients had symptoms similar to benign paroxysmal positional vertigo after three weeks onset of VN. The results lead us to believe that clinical VN comprises vestibular neuritis and vestibular labyrinthitis. Currently, in Japan it would be essential that there is canal paresis in caloric test for VN diagnosis. We hope to include inferior VN within the diagnosis criteria of VN in the near future.

聴神経腫瘍の検討

Eight cases of small acoustic neurinoma were clinically analyzed along with a review of medical literature. The patients were 6 females and 2 males, ranging from 32 to 75 years old. Tinnitus was an initial symptom in 6 cases (75%) and was more frequent than hearing loss, although 2 cases had sudden onset hearing loss. Recognition of sudden onset hearing loss, tinnitus and vertigo as the initial symptoms is considered essential in detecting small acoustic neurinoma. Abnormal findings on pure tone audiogram were observed in 7 cases and abnormal findings on plain X-ray examination were observed in 6 cases. All cases showed abnormal findings on ABR while only 3 of 6 cases (50%)showed canal paresis in caloric test. MRI was most suitable for the demonstration of acoustic neurinoma in these cases. It is important for otolaryngologists to consider the possibility of acoustic neurinoma when patients complain of cochlear and vestibular symptoms. It is thought that patients in whom acoustic neurinoma is not excluded should be carefully observed and further examined until acoustic neurinoma is confirmed or definitely excluded.