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At least 1,693 records · Page 94Linked to original sources
PubMed1984

The physiopathological, clinical and therapeutic aspects of vertigo in peripheral vestibular lesions.

The characteristics of vertigo in the pathology of vestibular peripheral lesions are differentiated and described. Symptomatological and clinical aspects are also discussed in the light of the physiopathological mechanisms of vestibular compensation. The therapeutic problem of vertigo is treated on the basis of experimental research on the inhibitory effect of some drugs on the vestibulo-ocular reflex.

Adult↗
PubMed1986

Posture testing (posturography) in the diagnosis of peripheral vestibular pathology.

In patients with peripheral vestibular deficiencies, the testing of posture or "posturography" can give specific information about any compensation obtained in the vestibulospinal reflex (VSR). We have used the statokinesimetric parameter of length in this study. Nearly 50% of the patients with unilateral vestibular hypofunction as well as those patients with paroxysmal positional vertigo (PPV) show abnormal results. These findings indicate deficient compensation at the vestibulospinal level, which is independent of any compensation already achieved at the vestibulo-ocular level. The tests used for the latter, such as positioning and rotational tests, are unable to provide information about the degree of compensation reached in the VSR. The examinations used in the different modalities of sensory interaction can show the presence of influences of ocular fixation and changes of head position. We have observed three types of deviant interaction. Our posturographic data have allowed us to assess functional situations in a more precise way. Any rehabilitation exercises used should be adapted according to these data.

Humans↗
PubMed1997

Results of bone conduction following surgery for chronic ear disease.

Preoperative and postoperative bone conduction thresholds were compared in 181 chronic ears operated on over a 5-year period between 1990 to 1994. In the majority (92%) of cases the bone conduction thresholds remained unchanged (+/-10 dB). Nine ears (5%) showed better thresholds after surgery, with improvements ranging from 11 dB to 25 dB. This improvement was especially noted in ears with severe tympanic pathology. One ear with a large labyrinthine fistula became totally deaf after surgery. In 5 ears (3%) bone-conduction thresholds deteriorated, but remained measurable at all frequencies tested. In these latter cases this impairment ranged from 11 dB to 27 dB. Cholesteatomatous ears having intact ossicular chains were found to be at the highest risk of inner ear damage when "canal wall-down" mastoidectomies were performed. Methods for prevention of sensorineural hearing loss following chronic ear surgery are discussed.

Adolescent↗
PubMed1996

MRI of the inner ear: use of modified GRASS and fast spin-echo sequences. A preliminary study.

We report our experience with MRI of the normal and pathological inner ear with fast spin-echo and modified gradient recalled at steady state sequences. Although earlier studies on temporal bone MRI were discouraging, improvements in MR technology combined with the use of paramagnetic contrast media can make MRI a useful diagnostic tool for the assessment of inner ear pathology. Conventional spin-echo imaging seems not to be the modality of choice because of the relatively thick slices and the long acquisition times.

Chronic Disease↗
PubMedDate not supplied

Ultrastructure of the vestibular sensory organs in delayed endolymphatic hydrops.

Vestibular sensory organs were examined ultrastructurally in two cases of delayed endolymphatic hydrops. The patients, two women, 27 and 16 years of age, suffered profound sensory hearing loss in childhood and experienced severe, recurrent vertigo. Specimens were obtained by a translabyrinthial vestibular nerve transection. We studied the utricular macula and the lateral and posterior cristae in one case, and the utricular macula, the anterior and posterior cristae, and the vestibular ganglion in the other. The otoconia and the otoconial membrane, the sensory epithelia, and the vestibular ganglion appeared fairly normal. Although the entire vestibular end organs were not studied in these cases, it was surprising that the ultrastructural findings did not conclusively identify vestibular end organ pathology as the cause of the vertigo attacks.

Adolescent↗
PubMed2005

Pneumolabyrinth following traumatic luxation of the stapes into the vestibule.

Pneumolabyrinth can result from traumatic luxation of stapes into the vestibule. The diagnosis of stapes luxation following a head injury can be delayed especially if the otoscopic examination is within normal limits. Here a 15-year-old girl presenting with vertigo and nystagmus following a blunt head injury was presented, whose computerized tomography revealed air in the vestibule and cochlea (pneumolabyrinth) and stapes was found to be luxated into the vestibule.

Adolescent↗
PubMed1983

Effects of stimulus repetition rate and frequency on the auditory brainstem response in normal cochlear-impaired, and VIII nerve/brainstem-impaired subjects.

The effects of signal repetition rate and frequency on the auditory brainstem responses of normal listeners, of persons with cochlear lesions, and of persons with VIII nerve/brainstem lesions were evaluated. The normal group exhibited more waves I and II than did the cochlear and VIII/brainstem groups. The normal and cochlear groups exhibited more waves III and V than did the VIII nerve/brainstem group. The latency of wave I was not different among groups, whereas wave V was significantly later in the VIII nerve/brainstem group than in the other groups. Waves I, III, and V were later for 50/s than for 10/s. Waves I and III displayed shorter latencies for 4000 Hz than for 2000 Hz, whereas wave V displayed similar latencies for the two stimuli. In conclusion, cochlear pathology (less than or equal to 65 dB HL) does not prolong the latencies of waves I and V. A dual mechanism is discussed to explain the rate-dependent latency shift of wave V.

Adult↗
PubMed2001

Transtympanic tetrodotoxin alters the VOR and Fos labeling in the vestibular complex.

The sodium channel blocker tetrodotoxin (TTX) is an effective tool for blockade of action potentials. Unilateral transtympanic administration of 3 mM TTX produced behavioral symptoms similar to those following unilateral peripheral vestibular ablation. Complete resolution of visible symptoms occurred between 48 and 72 h post-TTX. Eye-coil recordings indicated a spontaneous nystagmus and a decrease in the VOR in TTX-treated animals. Neuronal activity in the central vestibular complex (VC), as monitored with Fos immunocytochemistry, revealed an asymmetric pattern of Fos labeling in the medial, inferior and superior vestibular nuclei and the prepositus hypoglossal nucleus. Although the spatio-temporal pattern of Fos labeling was consistent and reproducible at each time-point, changes were noted among time-points. Transient blockade with TTX may be useful for studying the central vestibular response to recurrent or episodic vestibular disruption in the intact system.

Animals↗
PubMed2005

Etanercept treatment for autoimmune inner ear disease: results of a pilot placebo-controlled study.

PURPOSE: Autoimmune Inner Ear Disease (AIED) is an idiopathic progressive, often bilateral, sensironeural hearing loss that occurs over weeks to months, generally resulting in significant auditory disability. Response to treatment with immunomodulators other than corticosteroids has been poor. Data from a guinea pig model of AIED and a recent open label trial of etanercept suggested potential treatment benefit. Based on these preliminary results, we conducted a pilot placebo controlled trial of etanercept in AIED patients. METHODS: Twenty AIED patients were enrolled in a 12-week blinded placebo (PLA) controlled randomized clinical trial of etanercept (ETA) with 25 mg SC twice weekly. Patients received treatment for 8 weeks with a 4-week follow-up off-treatment. The primary study endpoint was an improvement in pure tone threshold (PTA) of 10 Db in two consecutive frequencies and/or improvement in speech discrimination of >12% at week 8. RESULTS: Patient demographics were similar for the ETA and PLA patients. Seventeen subjects (8 ETA, 9 PLA) completed the trial. The 3 dropouts were due to lack of efficacy. One ETA and 2 PLA subjects achieved the primary endpoint (p > 0.999). One ETA and 1 PLA pt demonstrated improved in hearing loss and vertigo severity by VAS and hearing disability. No safety issues were observed. CONCLUSION: The results of this pilot trial demonstrate that etanercept 25 mg twice weekly for 8 weeks was no better than placebo for treatment of AIED in this patient population.

Auditory Threshold↗
PubMed1980

Apical lesions of the cochlea in idiopathic endolymphatic hydrops and other disorders: pathophysiological implications.

Apical lesions of the cochlea may be caused by direct trauma, impairment of blood supply, contamination of perilymphatic fluid and endolymphatic hydrops. It is proposed that endolymphatic hydrops causes apical lesions when endolymph or its components leak into the perilymphatic fluid and pass through the helicotrema to degrade the tissue fluid environment of the sensory and neural structures in this area.

Aged↗
PubMedDate not supplied

Comparison of vestibular subjective sensation and nystagmus responses during computerized harmonic acceleration tests.

A comparison was made between the phase of vestibulo-ocular reflex (VOR) responses to sinusoidal rotatory tests and the phase of the subjective sensation (SS) to rotation. A parallelism was found between the results of both sets of data such that they behaved in accordance with the prediction of the pendulum model of vestibular function. The time constant of the VOR (17.5 seconds) was longer, however, than that of the SS (13 seconds). Measurements in patients with unilateral labyrinthine pathology also showed comparable changes in both responses. One group of patients with complete unilateral labyrinthine paralysis showed an advance of the phase of the VOR and of the SS. However, phase measurements in the group of patients with only partial unilateral labyrinthine paralysis were not significantly different statistically from those of normal subjects.

Caloric Tests↗
PubMedDate not supplied

Perilymph fistula: the Stanford experience.

Seventy-eight tympanotomies were performed to determine the presence of perilymph fistulas (PLFs); of these, 51% were found. The oval and round windows of all patients were grafted, whether PLFs were present or not. Of those patients with PLFs, 64% had resolution of their major symptom; when no PLF was found, 44% had a similar outcome. We concluded that 1) PLFs often behave as if they are epiphenomena in relation to hearing and balance, 2) PLFs can be intermittent, 3) PLF surgery is disappointing for restoration of hearing in sudden hearing loss when compared to the rate of spontaneous recovery, 4) stabilizing a fluctuating or progressive loss is a more realistic goal, and 5) establishing preoperative criteria for exploration is still a problem.

Adolescent↗