Reliability of Air Caloric Response in Healthy Volunteers and Patients With Chronic Otitis Media

Background and Objectives: To investigate reliability of the air caloric testcompared to the water caloric test and to determine whether anatomical alterationsdue to chronic otitis media (COM) influence air caloric response. Materials andMethods: Fifty-six subjects without vestibulopathy (24 healthy individuals ascontrol group and 32 patients with unilateral COM as experimental group) wereincluded. The bithermal water and air caloric test were sequentially conductedin control group. The bithermal air caloric tests, high-resolution temporal bonecomputed tomography and endoscopic photography of the ear drum were obtainedfrom experimental group. Results: Although maximal slow phase velocities andtime to reach peak velocity using water irrigation were significantly higher andshorter, respectively, than those by air irrigation in normal subjects, caloricparameters on air caloric test agreed well with those of water caloric testing.However, inverted nystagmus occurred in 16 ears of 16 subjects, which waspredominantly presented during warm air stimulation in the com patient group.The large tympanic membrane perforation and asymmetrical mastoidpneumatization were significant parameters affecting caloric response. Thepresented prediction model for cold-induced mspvs corresponded with observedvalues according to mastoid pneumatization. Conclusion: Although the aircaloric stimuli resulted in a reliable response in healthy subjects, air caloricresults among com patients affected by anatomical alteration as well as irrigationtemperature. Presented mathematical model for cold induced mspv could serveas a good reference in measuring true vestibular function in com patients.This study was supported by grant no.02-2008-019 from the SNUBH research fund.OAIID:oai:osos.snu.ac.kr:snu2012-01/102/0000005485/9SEQ:9PERF_CD:SNU2012-01EVAL_ITEM_CD:102USER_ID:0000005485ADJUST_YN:YEMP_ID:A076326DEPT_CD:801CITE_RATE:0FILENAME:1203평형학회지_Caloric.pdfDEPT_NM:의학과EMAIL:[email protected]_YN:NCONFIRM:

5-Hydroxytryptamine induced plasma extravasation in the mouse inner ear : possible mechanism of episodic dysfunction of the inner ear

학위논문(박사)--서울대학교 대학원 :의학과 이비인후과학 전공,2004.Docto

진주종 각질세포에서의 아포토시스

학위논문(석사)--서울대학교 대학원 :의학과 이비인후과학전공,1998.Maste

상반고리관 피열증후군

Superior canal dehiscence (SCD) syndrome is characterized by sound and pressure induced vertigo accompanying vertical-torsional nystagmus. Since the severity of symptoms and signs in SCD may depend on the amount of bony dehiscence of the superior semicircular canal, typical clinical presentations are not always accompanied in every patient. And symptoms of SCD are frequently vague and non-specific, such as aural fullness, disequilibrium or floating sensation of dizziness. Routine vestibular laboratory tests cannot provide disease-specific diagnostic clue, which makes this diagnosis more difficult. This review provides information to understand the pathophysiologic mechanism of symptoms and signs in SCD, and characteristic features of diagnostic tests targeted to SCD.OAIID:oai:osos.snu.ac.kr:snu2011-01/102/0000005485/6SEQ:6PERF_CD:SNU2011-01EVAL_ITEM_CD:102USER_ID:0000005485ADJUST_YN:NEMP_ID:A076326DEPT_CD:801FILENAME:2011한이인지_SCDreview.pdfDEPT_NM:의학과EMAIL:[email protected]_YN:NCONFIRM:

Vibration-Induced Nystagmus After Acute Peripheral Vestibular Loss: Comparative Study With Other Vestibule-Ocular Reflex Tests in the Yaw Plane

Objective: To validate the role of vibration-induced nystagmus (VIN) detecting vestibular asymmetry by comparing several vestibulo-ocular reflex (VOR) parameters in the yaw plane.Study Design: Prospective validation study for diagnostic test.Setting: Tertiary referral center.Patients: Seventy-four patients with unilateral vestibular loss of acute onset without a history of fluctuating vestibular function and 24 healthy volunteers.Intervention: Spontaneous nystagmus, head-shaking nystagmus (HSN), and VIN using a 100 Hz handheld vibrator were recorded using a videonystagmography system. Canal paresis on the caloric test and the time constant (TC) on the step velocity test were examined as parameters of the laboratory test.Main Outcome Measures: Correlation analysis between horizontal VOR parameters was performed. Receiver operating characteristic (ROC) curves of these parameters were plotted, and the area under the ROC curve (AUC) was compared according to the lower limiting value of TC on step velocity test as well as the presence of unilateral vestibular loss.Results: VIN was observed in 64 (86%) of 74 patients, and it was directed toward the contralesional side in 98%. VIN showed a significant positive correlation with the canal paresis (r = 0.416, p < 0.001) and a negative correlation with the TC (r = -0.351, p < 0.005). ROC curves of several VOR parameters were compared according to the presence of unilateral vestibular loss. The AUC of VIN was 0.882, and the cutoff intensity of VIN was 2.5 degrees per second. The AUCs of the HSN and spontaneous nystagmus were 0.774 and 0.661, respectively.Conclusion: The lateralization value of VIN was comparable with caloric test and superior to HSN. VIN is a useful vestibular test detecting vestibular asymmetry in the evaluation of dizziness.This study was supported by grant no. 02-2008-019 from the SNUBH Research Fund.OAIID:oai:osos.snu.ac.kr:snu2011-01/102/0000005485/1SEQ:1PERF_CD:SNU2011-01EVAL_ITEM_CD:102USER_ID:0000005485ADJUST_YN:YEMP_ID:A076326DEPT_CD:801CITE_RATE:1.904FILENAME:2011VIN_ON.pdfDEPT_NM:의학과EMAIL:[email protected]_YN:YCONFIRM:

Enlarged vestibular aqueduct may precipitate benign paroxysmal positional vertigo in children

Conclusions: Enlarged vestibular aqueduct (EVA) may precipitate secondary benign paroxysmal positional vertigo (BPPV), especially in pediatric populations, as well as paretic dysfunction of the vestibular end organ. Objectives: EVA is characterized by the early onset of sudden or progressive sensorineural hearing loss with or without vestibular dysfunction. However, vestibular dysfunction in patients with EVA has not been described as frequently as hearing loss, and an association with BPPV has not been previously reported. By reviewing the cochleo-vestibular status of three children and two young adults with EVA who had been diagnosed with BPPV, characteristic features of BPPV in EVA patients were investigated and possible pathogenetic mechanisms are speculated. Methods: A retrospective review of medical records was conducted for five patients with EVA who presented with BPPV from January 2004 to July 2009. Clinical courses, characteristics of vertigo and audiovestibular laboratory findings were reviewed. Results: Among 26 patients with radiologically confirmed EVA, 5 (19.2%) exhibited positional nystagmus compatible with BPPV through Dix-Hallpike and head-roll tests. Hearing loss usually accompanied BPPV attacks, and BPPV was recurrent in three patients. Multiple semicircular canals were frequently involved in each episode, and different canals were also involved in recurrent cases. Canalith repositioning procedures were usually successful without difficulty.OAIID:oai:osos.snu.ac.kr:snu2012-01/102/0000005485/4SEQ:4PERF_CD:SNU2012-01EVAL_ITEM_CD:102USER_ID:0000005485ADJUST_YN:YEMP_ID:A076326DEPT_CD:801CITE_RATE:1.084FILENAME:2012Acta_EVA_BPPV.pdfDEPT_NM:의학과EMAIL:[email protected]_YN:YCONFIRM:

Atlantoaxial Rotary Subluxation After Tympanoplasty

Objective: To describe a case of the atlantoaxial rotary subluxation (AARS) after tympanoplasty and discuss its mechanism and management.Patients: A 10-year-old boy.Interventions: Cervical spine plain radiography followed by cervical traction.Main Outcome Measures: Range of motion and radiologic follow-up.Results: The patient showed painful torticollis and rotation and fixation of the head to the right side (cock robin sign). Increased atlantodens interval and asymmetry between facet joints were found on cervical plain radiography. Full functional recovery and reduction of subluxation were achieved by conservative cervical traction.Conclusion: Forced surgical positioning of head rotation to the contralateral ear down and restriction during otologic surgery under general anesthesia may complicate AARS, especially in pediatric otologic surgery patients.OAIID:oai:osos.snu.ac.kr:snu2011-01/102/0000005485/7SEQ:7PERF_CD:SNU2011-01EVAL_ITEM_CD:102USER_ID:0000005485ADJUST_YN:YEMP_ID:A076326DEPT_CD:801CITE_RATE:1.904FILENAME:2011AARS_ON.pdfDEPT_NM:의학과EMAIL:[email protected]_YN:YCONFIRM:

Comorbid Benign Paroxysmal Positional Vertigo in Idiopathic Sudden Sensorineural Hearing Loss: An Ominous Sign for Hearing Recovery

Objective: To determine characteristics and their prognostic value in idiopathic sudden sensorineural hearing loss (ISSNHL) with comorbid ipsilateral benign paroxysmal positional vertigo (BPPV).Study Design: Retrospective chart review.Setting: Tertiary referral center.Patients: Of the 374 patients with a diagnosis of ISSNHL at Seoul National University Bundang Hospital from January 2004 to December 2009, 32 patients (8.6%) with comorbid BPPV were recruited and compared with matched ISSNHL patients without BPPV.Interventions: Otologic and neurotologic examinations, pure-tone audiometry (PTA), vestibular function tests, and brain magnetic resonance imagings.Main Outcome Measures: Comparison of the findings of serial audiograms for 6 months and vestibular function tests in patients with ISSNHL and concurrent BPPV with those in age-matched ISSNHL patients without BPPV.Results: Patients with BPPV showed higher PTA averages than those without BPPV on initial and follow-up audiograms. Moreover, the improvement in PTA was less in the BPPV group than in the control. BPPV most commonly involved the posterior canal (17/32, 53.1%), followed by the horizontal canal (8/32, 25%), both the posterior and horizontal canals (6/32, 18.8%), and the anterior canal (1/32, 3.1%). Thirteen (40.6%) of 32 patients had recurrences of BPPV, 9 within a week and another 2 within 3 months.Conclusion: Comorbid BPPV is a negative prognostic indicator of auditory function in ISSNHL. Concurrent BPPV in ISSNHL suggests combined damage to the utricle and may indicate severe and widespread labyrinthine damage, leading to the poor prognosis.OAIID:oai:osos.snu.ac.kr:snu2012-01/102/0000005485/1SEQ:1PERF_CD:SNU2012-01EVAL_ITEM_CD:102USER_ID:0000005485ADJUST_YN:YEMP_ID:A076326DEPT_CD:801CITE_RATE:1.904FILENAME:BPPV_SSNHL_ON2012.pdfDEPT_NM:의학과EMAIL:[email protected]_YN:YCONFIRM: