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Vestibulo-ocular disturbances in rats exposed to organic solvents.

The influence of different kinds of industrial solvents on the vestibular function of rats has been studied by recording nystagmus, induced by accelerated rotation. The effect was related to the blood levels of the solvents. One group of solvents, including halogenated saturated hydrocarbons like dichloromethane, caused depression of the vestibulo-oculomotor reflex (VOR). Another group, including benzene compounds like xylene, toluene, styrene and cumene and halogenated unsaturated hydrocarbons like trichloroethylene caused an excitation of the VOR. The most striking chemical similarity between the different solvents in the last group is the occurrence of double-bonds. If the animals were exposed simultaneously to solvents from both groups the excitatory effect prevailed and was even potentiated. It is suggested that solvents cause depression or excitation of the VOR by interaction with central pathways in the reticular formation and the cerebellum.

Animals↗

[Ultrastructure of the vestibular apparatus in patients with Meniere's disease].

The vestibular labyrinth of eight patients with Menière's disease obtained by translabyrinthine vestibular neurectomy or transtympanal labyrinthectomy was studied with the light microscope and transmission electron microscope. Previous invasive therapy was transtympanal application of gentamicin in one patient and endolymphatic sac surgery in two patients. Some of the pathological findings were unspecific, e.g. mucoid degeneration of the subepithelial spaces, fibrous long spacing collagen and high amount of lipofuscin in different cell types. Cuticular laminated structures were seen in some of the specimen. A most interesting finding was the discrepancy of large numbers of sub- and intraepithelial nerve fibers and a significant degeneration of vestibular sensory cells with vacuoles and filament bundles. This points out the importance of combining labyrinthectomy and vestibular neurectomy in late stages of unilateral Menière's disease.

Adult↗

[Middle ear cholesteatoma].

Cholesteatoma is a serious form of chronic otitis media. The aim of this paper is to present the state of the art of disease management, including recent data from the literature and the authors' derived from their Mentors' teaching, Professor Pierre Roulleau (Paris, France) and Professor Robert Charachon (Grenoble, France). The main recent advances concern the use of cartilage grafts to reconstruct the canal wall and/or tympanic membrane (allowing a significant reduction in residual cholesteatoma) and progress in medical imaging allowing more acute preoperative determination of extension of the cholesteatoma (in order to propose an optimally designed surgical technique) and a less invasive postoperative follow-up.

Cholesteatoma, Middle Ear↗

Electronystagmography in congenital and acquired syphilitic otitis.

This study is an analysis of the electronystagmogram (ENG) changes in 17 patients with luetic vestibular disease with early and late acquired syphilis and congenital syphilis. Vestibular disturbances occurred in 80% of patients with luetic otitis. Among these patients the ENG gives signs of peripheral rather than central vestibular injury, and reduced vestibular response to caloric stimulation is the most common finding. Congenital syphilis patients have the greatest dysfunction, both in degree of ENG changes and incidence of bilaterality. We found no correlation between FTA-ABS levels and the amount of hearing impairment or vestibular injury. Treatment with penicillin and steroids had a beneficial subjective effect upon the symptoms of vertigo in over half the patients.

Adult↗

Auditory evoked potential alterations induced by pulsed ultrasound.

Diagnostic levels of pulsed ultrasound were applied abdominally over the uteri of pregnant rats for five minutes daily during the first 20 days of gestation. The average energy output of the ultrasound machine at the optimum focal length of the transducer (5.4 cm) was 7.2 mW/sq cm. Postnatal auditory evoked potentials demonstrated a significant alteration in the offspring of the treated animals when compared with similarly treated, but nonexposed controls. This alteration only occurred in the high frequency range. Neither light nor electron microscopy revealed significant morphologic alterations in the cochlear elements of the exposed offspring. Although a cochlear deficit occurred in a range known to be important to the rat's hearing, several issues make this data reassuring to clinicians using diagnostic levels of pulsed ultrasound: the total amount of ultrasound exposure was higher than would be expected with human use, the defect was mild, and the absence of clear-cut morphologic abnormalities may indicate the presence of a minimal, or even reversible, defect.

Acoustic Stimulation↗

Underrated neurotologic symptoms.

Patients present themselves with neurotologic symptoms which may be early and subtle indicators of active vestibular pathology. The frequently slighted complaints of light-headedness, imbalance and a floating sensation are as important as "true rotatory vertigo." Ear fullness, the most underinvestigated of neurotologic complaints may be a cardinal symptom. Occipital headaches are a frequent complaint of the dizzy patient. Blurred vision, and, in some severe peripheral disorders, diplopia are symptoms referrable to oculovestibular interaction. Visual stimulation intensifies vestibular symptoms. Stress may precipitate or increase dizziness in patients who have partially compensated for a vestibular deficit. Anxiety, fatigue and systemic illness are exemplary. Patient histories are presented to emphasize clinical relevance and therapeutic modalities.

Adolescent↗