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PubMed2006

Temporal bone imaging in GJB2 deafness.

OBJECTIVE: To describe temporal bone findings on computed tomography (CT) imaging in GJB2-related hearing loss (HL). We asked whether evaluation of the temporal bone is required in individuals with biallelic GJB2 mutations. STUDY DESIGN: Randomized, blinded, controlled, prospective measurement. METHODS: Blood from 264 pediatric cochlear implant users was analyzed for mutations in the GJB2 gene. Thirty-six aspects of the temporal bone on CT imaging were evaluated in 53 individuals (106 ears) with biallelic disease causing GJB2 mutations. A subset of patients was age matched and compared with normally hearing individuals. Subjects with biallelic GJB2 mutations were tested for mutations in the SLC26A4 gene to rule out Pendred syndrome as a confounding cause of large vestibular aqueduct syndrome. RESULTS: Approximately 53% of ears of subjects (72% of subjects) with biallelic GJB2 mutations had at least one temporal bone anomaly. The most common findings were 1) dilated endolymphatic fossa (28%); 2) hypoplastic modiolus (25%); 3) large vestibular aqueduct (8%); 4) hypoplastic horizontal semicircular canal (8%); 5) hypoplastic cochlea (4%). Compared with normally hearing individuals, the GJB2 group had hypoplasia of the cochlear nerve canal, lateral semicircular canal vestibule, internal auditory canal (t tests, P < .001), and were 11 times more likely to have a hypoplastic modiolus. Dilated endolymphatic fossae were 1.4 times more common in the GJB2 group, and large vestibular aqueducts were 3 times more common in the GJB2 group, as compared with normally hearing controls. CONCLUSIONS: Temporal bone anomalies are common in GJB2-related HL, and imaging of the temporal bone should be included in routine evaluation of these individuals.

Child↗
PubMed1989

Regeneration of the eighth cranial nerve. III. Central projections of the primary afferent fibers from individual vestibular receptors in the bullfrog.

The projection site in the central nervous system of individual end-organ branches of regenerated vestibular nerves was documented in bullfrogs. The eighth cranial nerve was surgically sectioned in 12 bullfrogs (Rana catesbeiana) and allowed to regenerate. Horseradish peroxidase was used to label the primary vestibular afferent fibers from the whole nerve (one frog) and the whole anterior branch (two frogs), and the individual receptor end-organ branches to the anterior semicircular canal (three frogs), the horizontal semicircular canal (three frogs), and the sacculus (three frogs). A sufficient number of fibers from the individual receptors were labeled in nine specimens to allow a description of their central projection pattern. The overall pattern of central projections of the regenerated nerves was similar to the pattern of normal nerves. In the eighth nerve root proper and in the area proximal to the vestibular nuclei, fibers from the anterior semicircular canal were ventral, fibers from the sacculus and posterior branch were dorsal, and fibers from the horizontal semicircular canal were in an intermediate position. In ventral, superior, and descending vestibular nuclei, a projection pattern was also identifiable in some specimens. The fibers of the anterior semicircular canal projected ventral to the fibers of the horizontal semicircular canal, with fibers from the posterior branch more dorsal. The saccular fibers projected to the dorsal aspect of the ventral nucleus and the ventral aspect of the dorsal nucleus. For the most part, projections in the regenerated specimens, as verified histologically, were comparable to individual end-organ projections previously identified in normal frogs. The only major discrepancy between the findings from the regenerated specimens and those from normal frogs was in the position of the vestibular tract and the innervation to the medial nucleus. The regenerated vestibular tract was shifted laterally in the brain stem. Regenerated thick and thin fibers were intermixed in the tract and projected to the medial nucleus. Normally, the thin fibers are lateral to the thick fibers in the tract. Therefore, the regenerated afferent fibers of the vestibular nerve selectively reinnervated the vestibular nuclei, and the fibers to the individual end-organs selectively reinnervated particular parts of the nuclei. In addition, the thick and thin regenerated fibers preserved the type of bouton endings normally found. The regenerated thick fibers had rare boutons en passant and a great number of collaterals, while the thin fibers had numerous boutons en passant and only a few collaterals.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2003

[Anatomy of sinus tympani].

30 temporal bones from adult cadavers of both sexes were examined. After the tympanic sinus was identified, its morphologic features were evaluated. Minimum distance from adjacent structures: lateral and posterior semicircular canal, facial nerve canal and jugular fossa were taken. Measurements were taken under operative microscope with eye-piece graduation of 0.05 mm accuracy. Four main morphologic types of entrance to the sinus and two main developmental forms--deep and shallow sinus were distinguished. Deep sinus coexisted with absence of bridge and conversely if bridge was seen sinus was shallow. Deep sinuses were located close to the facial canal, in some cases penetrating around the canal up to 2/3 of canal's circumference. This anatomical variation increase the risk of the facial nerve damage during the surgery. In most of cases tympanic sinus is oval in shape. It's long diameter lies in vertical plane. The mean distance between the sinus and adjacent structures were as following: facial nerve canal--1.5 mm, lateral semicircular canal--2.1 mm, posterior semicircular canal--1.59 mm, jugular fossa--5.5 mm. No differences dependent from gender and side were found.

Adult↗
PubMed1984

Axon collaterals of anterior semicircular canal-activated vestibular neurons and their coactivation of extraocular and neck motoneurons in the cat.

We studied the ascending and descending axonal trajectories of excitatory vestibular neurons related to the anterior semicircular canal, by means of local stimulation and spike-triggered signal averaging techniques in anesthetized cats. More than 200 vestibular neurons related to the ampullary nerve of the anterior semicircular canal (ACN) were identified as vestibulo-ocular neurons by antidromic stimulation of the contralateral inferior oblique (IO) muscle motoneuron pool. In the descending, medial and ventral lateral nuclei, about 60% of these vestibulo-ocular neurons were also activated antidromically by upper cervical spinal cord stimulation (vestibulo-ocular-collic (cervical) = VOC). These VOC neurons produced unitary EPSPs in the majority of neck extensor motoneurons located at the C1 segment. None of the VOC neurons had axons descending as far as the thoracic level. Most of these VOC neurons were activated monosynaptically following stimulation of the ACN. The conduction velocity of the descending axons of VOC neurons was approximately 63 m/s, which was significantly faster than that of the ascending axons. The remaining 40% of the vestibulo-ocular neurons were not activated antidromically following spinal cord stimulation at intensities of 1 mA or more (vestibulo-ocular = VO). Most of the VO neurons were activated polysynaptically by ACN stimulation. The superior vestibular nucleus contained VO neurons that were activated mono- and polysynaptically following ACN stimulation.

Animals↗
PubMed1984

Dimensional analysis and dynamic response characterization of mammalian peripheral vestibular structures.

Extensive morphometric measurements were made on the vestibular system of the rabbit ( Oryctulagus cuniculus), the gerbil (Meriones unguiculatus), the chinchilla (Chinchilla laniger ), and the squirrel monkey (Saimiri sciureus) from serial sections of temporal bones. Additionally, a more limited set of measurements were also completed on the owl monkey (Aotus trivirgatus), the Capuchin monkey (Cebus sp.), the harp seal ( Pagophilus groenlandicus Erxleben , 1777), and the two-toed sloth ( Choloepus sp.). The following measurements were made: 1) radius of curvature (R) of each membranous semicircular canal (herein called semicircular duct-see nomenclature in Nomina Anatomica (1968) ), 2) cross-sectional diameter of the ducts and the osseous semicircular canals, and 3) some pertinent morphometrics of the cristae ampullares and the utricle. In all species studied 1) the radii of curvature of the three semicircular ducts are dissimilar, with that of the lateral duct being as small as, or smaller than, those of the anterior and posterior ducts; 2) R for the anterior duct is largest in the harp seal and the rabbit; 3) the canal and duct dimensions are largest in the Capuchin and squirrel monkeys, the two-toed sloth, and the harp seal, and smallest in the gerbil; 4) the proportion of otic fluid "space" that is occupied by endolymph shows a ranking of gerbil greater than rabbit greater than two-toed sloth greater than chinchilla = owl monkey greater than squirrel monkey greater than Capuchin monkey greater than harp seal; and 5) the gross ampullary and utricular dimensions are largest in the harp seal and smallest in the gerbil. These measurements were used for determining the time constants describing semicircular-canal dynamics in the Steinhausen (1931, 1933) and Oman -Marcus (1980) equations.

Animals↗
PubMed1996

Torsional nystagmus during vertical pursuit.

We examined three patients with cavernous angioma within the middle cerebellar peduncle. Each patient had an unusual ocular motor finding: the appearance of a strong torsional nystagmus during vertical pursuit. The uncalled-for torsion changed direction when vertical pursuit changed direction. In one patient, we recorded eye movements with the magnetic field technique using a combined direction and torsion eye coil. The slow-phase velocity of the inappropriate torsional nystagmus was linearly related to the slow-phase velocity of vertical smooth pursuit, and changed direction when vertical pursuit changed direction. This torsional nystagmus also appeared during fixation suppression of the vertical vestibulo-ocular reflex (VOR), but was minimal during vertical head rotation when fixing a stationary target in the light. We suggest that inappropriately directed eye movements during pursuit might be another ocular motor sign of cerebellar dysfunction. Furthermore, we speculate that the signals used for vertical smooth pursuit are, at some stage, encoded in a semicircular canal VOR coordinate framework. To illustrate, for the vertical semicircular canals, vertical and torsional motion are combined on the same cells, with the anterior semicircular canals mediating upward movements and the posterior semicircular canals mediating downward movements. For the right labyrinth, however, both vertical semicircular canals produce clockwise slow phases (ipsilateral eye intorts, contralateral eye extorts). The opposite is true for the vertical semicircular canals in the left labyrinth; counterclockwise slow phases are produced. Hence, to generate a pure vertical VOR, the anterior or posterior semicircular canals on both sides of the head must be excited so that opposite-directed torsional components cancel. Thus, if pursuit were organized in a way similar to the VOR, pure vertical pursuit would require that oppositely-directed torsional components cancel in normals. If this did not happen, a residual torsional nystagmus could appear during attempted vertical pursuit.

Adult↗
PubMed1990

[CT findings of the temporal bones in Waardenburg's syndrome].

We reported three cases of Waardenburg's syndrome and discussed CT findings of the temporal bones. Two cases of these patients were mother and daughter. Case 1, a two-year-old girl, had lateral displacement of the medial canthi, a broad nasal root, hetero-chromic iridis, left ptosis, albinotic fundus, and bilateral congenital deafness. CT findings of the temporal bones showed enlarged vestibules, short lateral semicircular canal, and absent right posterior semicircular canal. The mother had congenital deafness, heterochromia iridis, and a white forelock and showed similar abnormal CT findings of the temporal bones. Case 2, a one-year-old boy, had lateral displacement of the medial canthi, a broad nasal root, partial heterochromia iridis, albinotic fundus, and bilateral congenital deafness. CT findings of the temporal bones showed enlarged vestibules and absence of semicircular canals except the right lateral semicircular canal. These cases were diagnosed as Waardenburg's syndrome on the basis of the characteristic features.

Abnormalities, Multiple↗
PubMed2002

Spatial orientation of caloric nystagmus in semicircular canal-plugged monkeys.

We studied caloric nystagmus before and after plugging all six semicircular canals to determine whether velocity storage contributed to the spatial orientation of caloric nystagmus. Monkeys were stimulated unilaterally with cold ( approximately 20 degrees C) water while upright, supine, prone, right-side down, and left-side down. The decline in the slow phase velocity vector was determined over the last 37% of the nystagmus, at a time when the response was largely due to activation of velocity storage. Before plugging, yaw components varied with the convective flow of endolymph in the lateral canals in all head orientations. Plugging blocked endolymph flow, eliminating convection currents. Despite this, caloric nystagmus was readily elicited, but the horizontal component was always toward the stimulated (ipsilateral) side, regardless of head position relative to gravity. When upright, the slow phase velocity vector was close to the yaw and spatial vertical axes. Roll components became stronger in supine and prone positions, and vertical components were enhanced in side down positions. In each case, this brought the velocity vectors toward alignment with the spatial vertical. Consistent with principles governing the orientation of velocity storage, when the yaw component of the velocity vector was positive, the cross-coupled pitch or roll components brought the vector upward in space. Conversely, when yaw eye velocity vector was downward in the head coordinate frame, i.e., negative, pitch and roll were downward in space. The data could not be modeled simply by a reduction in activity in the ipsilateral vestibular nerve, which would direct the velocity vector along the roll direction. Since there is no cross coupling from roll to yaw, velocity storage alone could not rotate the vector to fit the data. We postulated, therefore, that cooling had caused contraction of the endolymph in the plugged canals. This contraction would deflect the cupula toward the plug, simulating ampullofugal flow of endolymph. Inhibition and excitation induced by such cupula deflection fit the data well in the upright position but not in lateral or prone/supine conditions. Data fits in these positions required the addition of a spatially orientated, velocity storage component. We conclude, therefore, that three factors produce cold caloric nystagmus after canal plugging: inhibition of activity in ampullary nerves, contraction of endolymph in the stimulated canals, and orientation of eye velocity to gravity through velocity storage. Although the response to convection currents dominates the normal response to caloric stimulation, velocity storage probably also contributes to the orientation of eye velocity.

Animals↗
PubMed2003

Human vestibular memory studied via measurement of the subjective horizontal during gondola centrifugation.

Measurements of the subjective visual horizontal (SVH) were made in a large swing-out gondola centrifuge. Rotation of the centrifuge was anti-clockwise, as seen from above. Test subjects were seated upright in the gondola, facing forwards. In front of the subject, at a straight-ahead eye-level position, there was a narrow luminous line, which could be rotated, by remote control, about the visual axis. At gravitoinertial force levels of 1.1-1.3G the subjects were asked to indicate, by repeatedly setting the line in darkness, what they perceived as horizontal (the SVH). During gondola centrifugation, the head and body length axis is always parallel with the resultant gravitoinertial force vector (vectorial sum of earth gravity force and the centrifugal force) i.e., the horizontal plane of the head or body does not change with respect to the gravitoinertial horizontal. Hence, the otolith organs, as well as the somatosensory system, continually signal upright position. However, the swing-out of the gondola during acceleration of the centrifuge (25 degrees at 1.1G) is a roll (frontal plane) change-in-position stimulus to the vertical semicircular canals, thus creating an otolith-semicircular canal conflict. After acceleration of the centrifuge, the SVH was initially tilted up to 20 degrees to the right relative to the gravitoinertial horizontal. Since there was no roll-tilt stimulus to gravity receptors, this SVH tilt must be related to stimulation of the semicircular canals. However, it decayed much more slowly than any known effects of angular-velocity stimulation of the semicircular canals. The decay was bi-phasic with two time constants, the smaller in the region of 1-2 min, the other being too large to be reliably estimated on the basis of data collected during only 10 min. This persistence of the SVH tilt suggests a memory for angular changes in roll head position detected by the semicircular canals-a position-storage mechanism. Further, the SVH seems to be dependent on two different mechanisms related to semicircular canal stimulation.

Adult↗
PubMed1997

[Pathological localization of benign paroxysmal positional vertigo--from three-dimensional analysis of nystagmus].

Although it has been speculated that benign paroxysmal positional vertigo (BPPV) derives from the utricle or posterior semicircular canal, the origin of BPPV is still controversial. In this study, we investigated the role of the utricle and semicircular canals (especially the vertical semicircular canal) relative to BPPV by three-dimensional analysis, focusing on the horizontal, vertical, and torsional positions by applying our computerized eye movement analysis system. In 13 subjects who were diagnosed as having BPPV, we carried out the positioning nystagmus tests, and analyzed three components of nystagmus. By using a pendular rotation stimulus, we also measured three components of eye movement elicited from the vertical semicircular canals in 5 normal subjects and 2 subjects from whom acoustic tumors were removed by the translabyrinthine approach. We compared two components (vertical and torsional) of BPPV with those of eye movements elicited from the vertical semicircular canals. In BPPV, the slow phase velocity of the torsional component was greater than that of the vertical component. Conversely, the amplitude of the vertical component from the vertical semicircular canals was greater than that of the torsional component. From these results, by analyzing the vestibuloocular reflex of vertical semicircular canals, it is difficult to support the idea that the pathology of BPPV is located in the posterior semicircular canal alone.

Adult↗
PubMed1992

The significance for postoperative hearing of preserving the labyrinth in acoustic neurinoma surgery.

Among 186 patients with preoperative hearing, a total of 189 acoustic neurinomas were removed through a lateral suboccipital approach with anatomical preservation of the cochlear nerve. Functional hearing was preserved in 92 (49%) of these patients; despite anatomical preservation of the cochlear nerve, deafness was the result in 51% of the series. Many factors have been considered to cause hearing loss in patients whose cochlear nerve was intact after surgery; these include nerve retraction, nerve or cochlear ischemia, overheating and vibration damage to the nerve, and opening of the labyrinth. To evaluate the significance of injury to the labyrinth in postoperative hearing loss, a prospective study was undertaken. High-resolution computerized tomography studies through the inner ear with bone algorithm were performed pre- and postoperatively. The postoperative status of the labyrinth was classified into three patterns: intact, fenestrated, and widely opened. Injury to the labyrinth occurred in 30% of the cases. The most frequently injured labyrinth structures were the crus commune of the posterior and superior semicircular canals (52%), the posterior semicircular canal (23%), the vestibule (21%), and the superior semicircular canal (4%). A statistically significant relationship was found between injury to the labyrinth and deafness, elevated thresholds, and lower discrimination values at pure-tone audiograms and speech audiometry (p < 0.0001). The degree of the injury (comparison between fenestration and wide opening of the labyrinth) was also significantly related to postoperative deafness (p < 0.0001). Disturbance of the inner-ear fluids was considered to be the cause of the hearing loss. In 12 patients labyrinth injury was not associated with deafness. This finding may support the existence of mechanisms of cochlear protection. The homeostatic function of the endolymphatic sac was considered to play an important role in recovery of damaged hearing in these 12 cases.

Adolescent↗
PubMed2006

The anatomy of the tympanic sinus.

The tympanic sinus is one of the most important structures of the human temporal bone. Located in its vicinity are the round window, posterior semicircular canal and facial nerve. The study was performed on 30 temporal bones taken from adult cadavers of both sexes. After the tympanic sinus had been identified, its morphological features were evaluated. The sinus was then measured using a graticule with an accuracy of 0.05 mm. Also measured were the shortest distances from the tympanic sinus to the neighbouring structures (the lateral and posterior semicircular canal, the facial nerve canal and the jugular fossa). The measurements were performed under a surgical microscope with eye-piece graduation of 0.05 mm accuracy. Four main morphological types of fossa of the tympanic sinus and two main developmental forms, a deep sinus and a shallow sinus, were distinguished. The existence of a deep sinus was associated with absence of the bridge and the sinus was shallower when the bridge was prominent. The very deep sinuses were located close to the facial canal, in some cases penetrating deep in its vicinity (in some cases even going beyond two thirds of the canal's circumference), which poses a real risk of facial nerve damage during surgical removal of a lesion located in close proximity to the nerve. In most cases the tympanic sinus is elliptical in shape and its long diameter lies in the vertical plane (mean value: 2.73 x 2.23 mm). The mean distances from the tympanic sinus to the facial nerve canal, lateral semicircular canal, posterior semicircular canal and jugular fossa were 1.5 mm, 2.1 mm, 1.59 mm and 5.5 mm respectively. No correlation was observed between the measurement results and either sex or side.

Adult↗
PubMed2005

Otolith and canal integration on single vestibular neurons in cats.

In this review, based primarily on work from our laboratory, but related to previous studies, we summarize what is known about the convergence of vestibular afferent inputs onto single vestibular neurons activated by selective stimulation of individual vestibular nerve branches. Horizontal semicircular canal (HC), anterior semicircular canal (AC), posterior semicircular canal (PC), utricular (UT), and saccular (SAC) nerves were selectively stimulated in decerebrate cats. All recorded neurons were classified as either projection neurons, which consisted of vestibulospinal (VS), vestibulo-oculospinal (VOS), vestibulo-ocular (VO) neurons, or non-projection neurons, which we simply term "vestibular'' (V) neurons. The first three types could be successfully activated antidromically from oculomotor/trochlear nuclei and/or spinal cord, and the last type could not be activated antidromically from either site. A total of 1228 neurons were activated by stimulation of various nerve pair combinations. Convergent neurons were located in the caudoventral part of the lateral, the rostral part of the descending, and the medial vestibular nuclei. Otolith-activated vestibular neurons in the superior vestibular nucleus were extremely rare. A high percentage of neurons received excitatory inputs from two nerve pairs, a small percentage received reciprocal convergent inputs and even fewer received inhibitory inputs from both nerves. More than 30% of vestibular neurons received convergent inputs from vertical semicircular canal/otolith nerve pairs. In contrast, only half as many received convergent inputs from HC/otolith-nerve pairs, implying that convergent input from vertical semicircular canal and otolith-nerve pairs may play a more important role than that played by inputs from horizontal semicircular canal and otolith-nerve pairs. Convergent VS neurons projected through the ipsilateral lateral vestibulospinal tract (i-LVST) and the medial vestibulospinal tract (MVST). Almost all the VOS neurons projected through the MVST. Convergent neurons projecting to the oculomotor/trochlear nuclei were much fewer in number than those projecting to the spinal cord. Some of the convergent neurons that receive both canal and otolith input may contribute to the short-latency pathway of the vestibulocollic reflex. The functional significance of these convergences is discussed.

Animals↗
PubMed1988

Properties and localization of the anterior semicircular canal-activated vestibulocollic neurons in the cat.

Unit activities of secondary vestibular neurons that selectively responded to stimulation of the anterior semicircular canal nerve (ACN) were recorded extracellularly in the anesthetized cat. Axonal pathways and projections in the spinal cord of the ACN-activated neurons were examined by recording their antidromic responses to stimulation of the lateral and medial vestibulospinal tracts (LVST and MVST), and the bilateral neck extensor motoneuron pools in the C1 segment (C1 dorsal rami [DR] motoneuron pools). In order to determine whether the neurons had ascending axon collaterals to the extraocular motoneurons, the contralateral (c-) inferior oblique (IO) motoneuron pool was also stimulated. Twenty-seven neurons sent their axons to the ipsilateral (i-) C1DR motoneuron pool via the LVST without any projection to the extraocular motoneuron pool. All the cells except one were located in the ventral part of the lateral vestibular nucleus. This pathway produced monosynaptic EPSPs with short time-to-peak and short half-width in C1DR motoneurons (16/16 motoneurons). Eight neurons sent axons to the i-C1DR motoneuron pool via the MVST without any to the extraocular motoneuron pool. Cell somata were located in the descending nucleus or in the ventral part of the lateral nucleus. These neurons did not produce postsynaptic potentials (PSPs) in any C1DR motoneurons. All thirty-five neurons sending axons to the c-C1DR motoneuron pool have ascending axon collaterals to the c-IO motoneuron pool.

Action Potentials↗
PubMed2000

Vestibular neuritis: three-dimensional videonystagmography and vestibular evoked myogenic potential results.

Eight patients diagnosed with vestibular neuritis received the newly developed three-dimensional videonystagmography (3D VNG) and vestibular evoked myogenic potential (VEMP) examination in order to localize the lesion site. Two (25%) of the 8 patients exhibited spontaneous nystagmus with 3 components, indicating that both the horizontal semicircular canal (HSCC) and anterior semicircular canal (ASCC) were affected. The remaining 6 patients (75%) displayed only horizontal nystagmus, meaning that only the HSCC was involved. Seven (88%) of the 8 patients had bilateral normal VEMPs, revealing sparing of the posterior semicircular canal (PSCC). In a comparative study, another seven patients with vestibular neuritis 1 year post-treatment also received the caloric test, 3D VNG and VEMP examination. Only one patient exhibited spontaneous nystagmus. An absent caloric response of the lesioned side persisted in 5 (71%) of the 7 patients. However, all patients showed normal VEMPs bilaterally. 3D VNG and VEMP examination indicates that vestibular neuritis mainly affects the superior division of the vestibular nerve, which innervates the HSCC and ASCC. Meanwhile, the function of the PSCC and saccule, innervated by the inferior vestibular nerve, is preserved.

Adolescent↗
PubMed1996

Adaptation of primate vestibuloocular reflex to altered peripheral vestibular inputs. II Spatiotemporal properties of the adapted slow-phase eye velocity.

1. The ability of the vestibuloocular reflex (VOR) to undergo adaptive modification after selective changes in the peripheral vestibular system was investigated in rhesus monkeys by recording three-dimensional eye movements before and after inactivation of selective semicircular canals. In the preceding paper we showed that the horizontal VOR gain evoked by passive yaw oscillations after lateral semicircular canal inactivation recovers gradually over time in a frequency-specific manner. Here we present the spatial tuning of the adapted slow-phase eye velocity and describe its spatiotemporal properties as a function of time after canal inactivation. 2. The spatial organization of the VOR was investigated during oscillations at different head positions in the pitch, roll, and yaw planes, as well as in the right anterior/left posterior and left anterior/right posterior canal planes. Acutely after bilateral inactivation of the lateral semicircular canals, a small horizontal response could still be elicited that peaked during rotations in pitched head positions that would maximally stimulate vertical semicircular canals. In addition, the phase of horizontal slow-phase velocity abruptly reversed through 180 degrees at positions close to upright, similarly to torsional slow-phase velocity. These spatial response properties suggest that the small, residual horizontal response components that are present acutely after plugging of both lateral canals originate from vertical semicircular canal signals. 3. As the horizontal response amplitude increased over time, consistent changes were also observed in the spatiotemporal tuning of horizontal slow-phase velocity. 1) The spatiotemporal response properties of horizontal slow-phase velocity acquired noncosine tuning characteristics, primarily in the pitch plane, in the right anterior/left posterior and left anterior/right posterior canal planes. Accordingly, horizontal response amplitude was nonzero during rotation in any head position in these planes and response phase varied significantly as a function of head orientation. 2) The peak horizontal response amplitude shifted spatially over time, such that 5-10 mo after plugging it was maximal during rotations at head positions close to upright. 4. In parallel to these unique spatiotemporal response properties characterizing the adapted horizontal VOR, torsional slow-phase velocity also exhibited small spatiotemporal changes after lateral canal inactivation that tended to precede in time the changes associated with the horizontal response components. In contrast, vertical slow-phase velocity in the plugged animals was unaltered and continued to be characterized by cosine-tuned spatial properties in three dimensions. 5. Recovery of the horizontal response gain during yaw oscillations in upright position, as well as the unique, noncosine spatiotemporal characteristics of the adapted horizontal VOR, were also observed in an animal with all but one vertical semicircular canals inactivated. There was, however, no sign of VOR gain recovery up to 2 mo after all semicircular canals were inactivated. These results suggest that the observed recovery of horizontal VOR is at least partly due to signals originating from the remaining intact vertical canal(s). Even in the presence of a single intact vertical canal, the improvement in horizontal gaze stability is at least partly restored through spatiotemporal changes in the processing of vestibuloocular signals that improve the gain and spatial tuning of horizontal VOR at the expense of temporal response properties.

Adaptation, Physiological↗
PubMedDate not supplied

Benign paroxysmal positioning vertigo: diagnosis and therapy using video-oculographic control.

In this prospective study, 82 patients (40 males, 42 females, aged between 15 and 80 years) with benign paroxysmal positioning vertigo (BPPV) were treated with different positioning manoeuvres using video-oculographic control. The maximum age for females and males was 31 and 40 years respectively. After an interview about the special history related to vertigo imbalance symptoms and using video-oculographic control, we diagnosed 79 patients with BPPV of the posterior semicircular canal and 3 of the horizontal semicircular canal. The Dix-Hallpike and Cawthorne manoeuvres were used for the diagnosis of BPPV of the posterior semicircular canal and the McClure manoeuvre for the diagnosis of BPPV of the horizontal semicircular canal. 72% of the patients had an idiopathic BPPV and 12.2% were post-traumatic. 3.7% had BPPV after ear surgery and 2.4% were pregnant. 39 patients with posterior BPPV were treated with Semont's manoeuvre and 40 with Epley's. The 3 patients with horizontal BPPV were treated with Baloh's manoeuvre. More than half of the patients (52.5%) were free of symptoms after one session of Epley's manoeuvre and all of them after four sessions. 51.3% had no further symptoms after one session of Semont's manoeuvre and all of them after four sessions. These results, in agreement with the literature, show that the success rate of Semont's and Epley's manoeuvres is approximately the same. Video-oculographic control is helpful for the diagnosis and for the registration of the eye movements during the therapeutic manoeuvres.

Adolescent↗