[Precision evaluation in various caloric test technics for examination of the vestibular apparatus].
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Eighteen patients with a 22-channel cochlear implant were evaluated both pre- and postoperatively with vestibular function tests; caloric test and body balance test using stabilometry. Preoperative promontory stimulation results and postoperative psychophysical factors of the cochlear implant showed no correlation with the preoperative vestibular function test results. The results of speech perception tests were not affected by the degree of residual vestibular function in any of the patients. However, for patients with deafness for a period of 10 to 20 years, the degree of the residual vestibular function estimated by the caloric test showed a correlation with the results of speech perception tests, significantly in the consonant recognition score. The results, not of length or the Rombberg ratio, but rather of the area of body sway, showed a correlation with the results of speech perception tests; consonant recognition, in patients with a short duration of deafness. Therefore preoperative vestibular function results may be useful as a predictive factor in postoperative speech perception; consonant recognition, for patients with a short duration of deafness. Reduced results of caloric testing after surgery were found in one of 11 patients (9%) with residual vestibular function. The occurrence of vertigo immediately after surgery was observed in 5 of 18 patients (28%), but this symptom was transient. No change in stabilometry results, pre-versus post-operatively, was observed. Thus, vestibular damage after surgery was considered to be minimal.
In order to define the acute effects of a moderate quantity of alcohol on balance, related to the vestibular function, vestibulo-ocular reflex (VOR) test, caloric test and dynamic posturography (EquiTest) were performed. Ten healthy male volunteers aged 19-27 average 22.8) years old imbibed 1.5 ml whisky (alcohol content 43%) per kilogram of body weight within 5 min. Blood alcohol level (BAL) was measured before administration and then after 30, 90, and 150 min. Equilibrium examinations were performed immediately after each blood sample was taken. At the highest alcohol level, significant reductions were found in VOR gain, in the maximum slow-phase velocity of the caloric test and in the equilibrium score of the sensory organization test in condition 5, when compared with those before drinking. In some typical cases, the subjects' response in all tests were most disturbed at the time when the highest alcohol level was measured. From our results, we conclude that a moderate quantity of alcohol affects not only the oculomotor system but also the vestibular system. Furthermore, it was suggested that one of the reasons for postural instability after drinking alcohol may be reduced vestibular function.
Both the guinea pig and squirrel monkey were used in this study. An animal model for inner ear disease was established, and each animal was subjected to vestibular function tests consisting of spontaneous nystagmus recording, positional testing, caloric testing, and optokinetic stimulation testing. Recordings of nystagmus in the guinea pig and squirrel monkey were successfully obtained by using newly devised clip electrodes. A variety of nystagmic patterns in animal models following experimentally created perilymphatic fistula and labyrinthectomy are presented in this study.
1-10 years after the first examination, 56 children below 15 years of age with unilateral sensorineural hearing loss were re-examined with a test-battery consisting of puretone and speech audiometry, stapedius reflex tests, caloric tests, brainstem response audiometry and otoneurological tests. In no case was an acoustic tumour suspected on the basis of the test results. A small progression of the hearing loss occurred in only one ear. In no case did the healthy ears develop hearing loss during the observation period. Diagnostic procedures can in most of such cases be limited to pure-tone audiometry. Follow-up is indicated because some patients require advice considering education and evaluation regarding fitting of a hearing aid.
OBJECTIVE: To determine whether the nerves of origin of vestibular schwannomas can be predicted using vestibular evoked myogenic potentials (VEMPs). STUDY DESIGN: The study was a retrospective analysis. SETTING: The ear, nose, and throat department of Tokyo Medical and Dental University. PATIENTS: Twenty-eight patients undergoing removal of vestibular schwannomas were included in the study. INTERVENTIONS: Patients underwent pure tone audiometry, VEMP testing, caloric testing, and magnetic resonance imaging preoperatively. Hearing level, caloric weakness, maximum tumor size, and the nerves of origin of tumors were compared with VEMP testing. MAIN OUTCOME MEASURE: Results of VEMP testing. RESULTS: Comparisons between VEMPs and results of the other three examinations revealed no correlations. Complete disappearance of VEMPs was observed only in patients with tumors arising from inferior vestibular nerves. Patients in whom hearing was preserved tended to have preserved VEMPs. Some patients showed damaged hearing and normal VEMP results, although with inferior vestibular schwannomas. A patient with a tumor arising from a cochlear nerve exhibited preservation of VEMP, preserved caloric response, and moderate hearing loss. CONCLUSIONS: Inferior vestibular nerve function and hearing level were reflected in VEMP results. Prediction of the nerve of origin of a tumor was possible only in certain restricted cases.
OBJECTIVE: Dizziness and imbalance are uncommon in children, but often alarming for their families: a detailed interview and otoneurological examination are important for reaching a specific diagnosis and treatment. Children with vestibular disorders are thought to be difficult to examine: vestibular tests (caloric test, roto-acceleratory test, electronystagmography, opto-kinetic nystagmus, cranio-corpography and posturography) are used less frequently for children than in adult patients. The aim of the study was to determine whether the results of electronystagmography testing improve an emergency physician's diagnosis of dizziness in children. METHODS: Patients were selected on the basis of the following inclusion criteria: aged between 2 and 12 years and affected with vertiginous symptoms. All patients underwent the following instrumental examinations: blood tests, audiological screening, electronystagmography of spontaneous nystagmus or provoked by vestibular and optical stimulation and electroencephalogram. RESULTS: The results underlines an high incidence of central vertigo (83%): 52% of the children presented a prevailing unidirectional nystagmus at labyrinth stimulation and 48% of the children an asymmetry in the response of nystagmus at optical kinetic stimulation with quality alteration of shocks. CONCLUSIONS: Electronystagmography can register and evaluate the qualitative and quantitative characteristics of the nystagmic response and allow to distinguish between central or peripheric vertigo: different degrees and various combinations of the abnormal responses shown in optokinetic central test were the most characteristic of electronystagmography in patients with vestibular central vertigo.