Vestibular thresholds for yaw rotation about an earth-vertical axis as a function of frequency.

Perceptual direction detection thresholds for yaw rotation about an earth-vertical axis were measured at seven frequencies (0.05, 0.1, 0.2, 0.5, 1, 2, and 5 Hz) in seven subjects in the dark. Motion stimuli consisted of single cycles of sinusoidal acceleration and were generated by a motion platform. An adaptive two-alternative categorical forced-choice procedure was used. The subjects had to indicate by button presses whether they perceived yaw rotation to the left or to the right. Thresholds were measured using a 3-down, 1-up staircase paradigm. Mean yaw rotation velocity thresholds were 2.8 deg s(-1) for 0.05 Hz, 2.5 deg s(-1) for 0.1 Hz, 1.7 deg s(-1) for 0.2 Hz, 0.7 deg s(-1) for 0.5 Hz, 0.6 deg s(-1) for 1 Hz, 0.4 deg s(-1) for 2 Hz, and 0.6 deg s(-1) for 5 Hz. The results show that motion thresholds increase at 0.2 Hz and below and plateau at 0.5 Hz and above. Increasing velocity thresholds at lower frequencies qualitatively mimic the high-pass characteristics of the semicircular canals, since the increase at 0.2 Hz and below would be consistent with decreased gain/sensitivity observed in the VOR at lower frequencies. In fact, the measured dynamics are consistent with a high pass filter having a threshold plateau of 0.71 deg s(-1) and a cut-off frequency of 0.23 Hz, which corresponds to a time constant of approximately 0.70 s. These findings provide no evidence for an influence of velocity storage on perceptual yaw rotation thresholds

Quality of life after gamma knife radiosurgery treatment in patients with a vestibular schwannoma: the patient’s perspective

This study evaluates the impact of gamma knife radiosurgery (GKRS) on the quality of life (QOL) of patients with a sporadic vestibular schwannoma (VS). This study pertains to 108 VS patients who had GKRS in the years 2003 through 2007. Two different QOL questionnaires were used: medical outcome study short form 36 (SF36) and Glasgow benefit inventory (GBI). Radiosurgery was performed using a Leksell 4C gamma knife. The results of the QOL questionnaires in relation to prospectively and retrospectively gathered data of the VS patients treated by GKRS. Eventually, 97 patients could be included in the study. Their mean tumor size was 17 mm (range 6–39 mm); the mean maximum dose on the tumor was 19.9 Gy (range 16–25.5 Gy) and the mean marginal dose on the tumor was 11.1 (range 9.3–12.5 Gy). SF36 scores showed results comparable to those for a normal Dutch population. GBI showed a marginal decline in QOL. No correlation was found between QOL and gender, age, tumor size, or radiation dose. Increased audiovestibular symptoms after GKRS were correlated with a decreased GBI score, and decreased symptoms were correlated with a higher QOL post-GKRS. In this study shows that GKRS for VS has little impact on the general QOL of the VS patient. However, there is a wide range in individual QOL results. Individual QOL was influenced by the audiovestibular symptoms. No predictive patient, tumor, or treatment factors for QOL outcome after GKRS could be determined. Comparison with microsurgery is difficult because of intra group variability

Major bleeding of the upper aerodigestive tract due to oral anticoagulant/antibiotic interactions

INTRODUCTION Although a well-known complication in certain medical specialties, major bleeding due to the interaction between oral anticoagulants and antibiotics has been rarely reported concerning the upper aerodigestive tract. We report three cases of life-threatening bleeding of the upper aerodigestive tract in a context of antibiotic therapy in patients treated with oral anticoagulants. CASE SERIES Three male patients under coumadin anticoagulation therapy presented major bleeding in three different contexts (epistaxis, peritonsillar abscess and postoperative course after total laryngectomy). Surgical intervention for hemostasis was required in all cases, with coagulation correction in two. Complications were severe anemia (2/3) and chronic heart failure (1/3). DISCUSSION/CONCLUSIONS Interactions between two drugs commonly used in otolaryngology can result in major bleeding. The goal of this article is to raise practitioners' awareness of a potentially fatal, although rare, complication. We also review the main preventive strategies

Adaptation to Steady-State Electrical Stimulation of the Vestibular System in Humans

Efforts are being made toward the development of a vestibular implant. If such a device is to mimic the physiology of the vestibular system, it must first be capable of restoring a baseline or "rest" activity in the vestibular pathways and then modulating it according to the direction and velocity of head movements. The aim of this study was to assess whether a human subject could adapt to continuous electrical stimulation of the vestibular system, and whether it was possible to elicit artificial smooth oscillatory eye movements via modulation of the stimulation