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PubMed1983

Vestibular caloric test and local anaesthesia: a nystagmographical study on pigeons.

The caloric test was conducted on pigeons before and after the application of infiltration anaesthesia around the investigated ear. After irrigation with the same amount of water at the same temperature, it was observed that following local anaesthesia the caloric response was intensified. This result suggests that the nerve supply and blood supply of the external ear may be one of the factors responsible for the large variability of caloric responses found in routine caloric investigations.

Anesthesia, Local↗
PubMed1998

Dexamethasone inner ear perfusion for the treatment of Meniere's disease: a prospective, randomized, double-blind, crossover trial.

OBJECTIVE: To investigate the benefits of intratympanic administration of dexamethasone in the treatment of unilateral Meniere's disease, with particular attention to the symptoms of hearing loss and tinnitus. STUDY DESIGN: A prospective, randomized, double-blind, crossover study comparing improvements in hearing loss, tinnitus, aural fullness, and caloric vestibular response secondary to intratympanic dexamethasone and sodium hyaluronate injection versus placebo consisting of saline and sodium hyaluronate. SETTING: A private otology/neurotology practice. PATIENTS: Twenty patients diagnosed with either definite or probable Meniere's disease as defined by the American Academy of Otolaryngology Head and Neck Surgery Committee on Hearing and Equilibrium. All patients were < or =21 years old and were not receiving any other form of treatment for their Meniere's disease. Each patient's primary symptoms of concern were hearing loss, aural fullness, and roaring tinnitus. INTERVENTIONS: Three consecutive daily administrations of intratympanic dexamethasone or placebo to the involved ear. MAIN OUTCOME MEASURES: Changes in audiometric pure-tone averages, speech reception thresholds, caloric vestibular responses, scores on the tinnitus handicap inventories, questionnaires, and telephone interview responses. RESULTS: No significant changes were observed in any measured parameter. Patients were unable to consistently identify which medication was dexamethasone and which was placebo. CONCLUSIONS: Intratympanic administration of dexamethasone in a group of patients with unilateral Meniere's disease (Shea's stage IV) showed no benefit over placebo for the treatment of hearing loss and tinnitus.

Adult↗
PubMed1982

Cisplatin vestibular ototoxicity: preliminary report.

Sixteen patients were monitored for vestibular ototoxicity while receiving cisplatin in dosages of 180 mg/M2. The incidence of preexisting vestibular functional abnormalities (31%) was higher than the incidence of ototoxicity (18%). Although the number of patients was not large enough for meaningful statistical comparison, the incidence of vestibular ototoxicity from cisplatin was low for the dosage levels employed. Based upon the results of this study, the following recommendations are made for monitoring cisplatin vestibular ototoxicity. 1. All patients should receive vestibular tests prior to cisplatin administration. 2. Subjects, who have reduced (or asymmetric) vestibular function upon pretherapy testing, should be monitored at least weekly for any change in function while receiving cisplatin. 3. Subjects who are normal prior to therapy need to be tested only when cumulative doses exceed 400 mg. The severe nausea and vomiting associated with cisplatin chemotherapy is not related to vestibular ototoxicity.

Adult↗
PubMed1990

The effects of socioeconomic status on hand size and strength, vestibular function, visuomotor integration, and praxis in preschool children.

Differences in hand size and strength, vestibular function, visuomotor integration, and praxis in preschool children as a function of socioeconomic status were investigated. Twenty-two children of lower socioeconomic status, aged 3 to 5 years, were each matched with a child of higher socioeconomic status on the basis of race, sex, hand dominance, age, height, and weight. Measures used were the Developmental Test of Visual-Motor Integration (Beery, 1982), hand size and strength, the Standing Balance subtests of the Southern California Sensory Integration Tests (Ayres, 1972), the Bowman Unilateral Hopping Test (Flannigan, 1987), the Southern California Postrotary Nystagmus Test (Ayres, 1975), the praxis tests of the Sensory Integration and Praxis Tests (SIPT) (Ayres, 1984), and the Bowman Quality of Prone Extension Scale (Etheredge, 1987). Analyses with two separate Hotelling's T2 for correlated samples (Huck, Cormier, & Bounds, 1974) revealed significant differences in hand size and strength as well as praxis, and subsequent post hoc analyses revealed better scores for the higher socioeconomic status group on right hand strength and on the Praxis on Verbal Command subtest of the SIPT. A paired t test also revealed that the higher socioeconomic status group scored better on visuomotor integration. Analysis with Hotelling's T2 revealed no significant differences between the two groups on the vestibular measures. The results of this study suggest that on certain tests used by occupational therapists, children from a higher socioeconomic status group may function at a higher developmental level than those from a lower socioeconomic status group. When interpreting clients' test results, therefore, therapists should consider the possible influence of socioeconomic status.

Child Development↗
PubMed2001

Dynamic visual acuity during transient and sinusoidal yaw rotation in normal and unilaterally vestibulopathic humans.

The vestibulo-ocular reflex (VOR) stabilizes gaze to permit clear vision during head movements. It has been supposed that VOR function might be inferred from dynamic visual acuity (DVA), the acuity during imposed head motion. We sought to determine effectiveness of DVA for detection and lateralization of unilateral vestibulopathy, using rigorous psychophysical methods. Seventeen normal and 11 unilaterally vestibulopathic subjects underwent measurement of optically best corrected DVA during head motion. A variable size letter "E" 6 m distant was displayed in oblique random orientations to determine binocular DVA by a computer controlled, forced choice method. Three types of whole-body yaw rotation were delivered by a servo-controlled chair synchronized with optotype presentation. Two types of motion were predictable: (1) steady-state 2.0-Hz rotation at 10-130 degrees/s peak velocity with repetitive optotype presentation only during head velocity exceeding 80% of peak; and (2) directionally predictable transients at peak accelerations of 1000, 1600 and 2800 degrees/s2 with optotype presentation for 300 ms. For neither of these predictable motions did DVA in vestibulopathic subjects significantly differ from normal, with suggestions from search coil recordings that this was due to predictive slow and saccadic eye movements. Unilaterally vestibulopathic subjects experienced a significant decrease in DVA from the static condition during ipsilesional rotation for all three peak head accelerations. Only during directionally unpredictable transients with 75 ms or 300 ms optotype presentation was the sensitivity of DVA in unilaterally vestibulopathic subjects significantly abnormal during ipsilesional rotation. The ipsilesional decrease in DVA with head motion was greater for 75 ms than 300 ms optotype presentation. Search coil recordings confirmed hypometric compensatory eye movements during DVA testing with unpredictable, ipsilesional rotation. Receiver-operator characteristic analysis indicated ideal detection and lateralization of unilateral vestibulopathy by DVA tested with a 75-ms optotype exposure for unpredictable transient rotations to a peak acceleration of 2800 degrees/s. DVA can reliably detect unilateral deafferentation only if precautions are taken to prevent compensation by predictive slow eye movements and saccades.

Adaptation, Physiological↗