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Vestibular findings in professional divers.

The purpose of the present study was to investigate possible inner ear changes related to professional diving, by the documentation of auditory and vestibular function in 13 asymptomatic professional divers and 12 nondiver controls. A higher average pure tone hearing threshold, although of no clinical significance, was found in the study group (8.53 +/- 4.85 versus 6.67 +/- 3.54 dB hearing level, p = .04). In the vestibular evaluation, the smooth harmonic acceleration test phase leads for 0.01, 0.02, and 0.04 Hz were significantly lower in the divers (0.01 Hz, 38.46 degrees +/- 7.15 degrees versus 45.83 degrees +/- 9.02 degrees, p = .02; 0.02 Hz, 21.08 degrees +/- 5.19 +/- versus 25.17 degrees +/- 5.78 degrees, p = .05: 0.04 Hz, 12.38 degrees +/- 3.69 degrees versus 14.25 degrees +/- 3.14 degrees, p = .05). We suggest that the lower smooth harmonic acceleration phase values found in the professional divers, reflecting longer vestibulo-ocular reflex primary time constants and enhancement of the velocity storage mechanism, are the result of a habituation process that augments the low-frequency response of the canal-ocular system.

Adult↗

Experiences with the butterfly chart.

The bithermal caloric test remains, four decades after its first description, the single most valuable test of vestibular function. However, there are several variations described in the exact procedure of caloric stimulation and in the method of evaluating and representing the test results. For the past 10 years, we have followed a procedure using a constant standardized stimulus and a particular system for caloric nystagmus representation, viz., the Butterfly Chart, and have found it to be very satisfactory. This paper describes our experience with the use of the Butterfly Chart and its clinical application in over 4,500 cases.

Adult↗

[Comparative study of vestibular autorotation test and caloric test for patients with peripheral vestibular disorders].

OBJECTIVE: To analyse the value of vestibular autorotation test (VAT) for assessing vestibular function. METHOD: VAT (WSR. USA) and caloric test (CT) were performed on 48 patients with peripheral vestibular disorders. Videonystagmograph (Synapsis. France) was used for caloric nystagmus recordings. The results of VAT were compared with that of CT. Parameters analysed in this study included gain, phase and asymmetry of VAT; the canal paresis (CP) and the directional preponderance (DP) of CT. That any of five parameters of VAT was abnormal or one of CP and DP appeared could be defined as abnormal VAT or abnormal CT. RESULT: VAT was found to be abnormal in 36 (75.0%) patients, including 32 (66.7%) patients (21 cases with decreased gain, 24 cases with lagged phase and 6 cases with asymmetry) in horizontal testing and 15 (31.2%) patients (7 cases with decreased or increased gain, 14 cases with lagged phase) in vertical testing. Four patients had abnormal vertical testing alone. Abnormal phase can be observed more frequently than abnormal gain. The abnormal parameters of phase and gain were consistent in the 2.0-6.0 Hz range. Asymmetry appeared in all cases in the 6.0-11.0 Hz range, consistent with the side of vestibular weakness tested by CT. Thirty-three patients (68.8%) showed CP or DP of CT (bilateral or unilateral CP 28 cases and DP 16 cases). VAT and CT showed abnormal results in 25 patients simultaneously, solo abnormal results were found in 11 patients and 8 patients respectively. There were 4 patients with normal results of both VAT and CT. Abnormal results of VAT combined with CT were assessed in 44 (91.7%) patients. When vestibular lesion was complete, results of VAT and CT were all abnormal and the abnormal parameters of VAT were observed at all frequencies of band tested. CONCLUSION: VAT is a vestibular test of high-frequencies and wide-bands and can indicate information of not only vestibular function in higher frequency band, but also vertical semicircular canal function. As the supplement of CT, error diagnosis can be partly avoided by VAT.

Adolescent↗