Casani, Augusto Pietro

Castellucci, Andrea

Mandalà, Marco

Martellucci, Salvatore

Yacovino, Dario Andres

English

Archivio della Ricerca - Università di Pisa

TYPE EditorialPUBLISHED 12 June 2023DOI 10.3389/fneur.2023.1226601OPEN ACCESSEDITED AND REVIEWED BYMichael Strupp,Ludwig Maximilian University ofMunich, Germany*CORRESPONDENCESalvatore Martelluccidott.martellucci@gmail.comRECEIVED 21 May 2023ACCEPTED 26 May 2023PUBLISHED 12 June 2023CITATIONMartellucci S, Mandalà M, Casani AP,Yacovino DA and Castellucci A (2023) Editorial:Acute Unilateral Vestibulopathy: clinicalpresentation, instrumental patterns, evolutionand management. Front. Neurol. 14:1226601.doi: 10.3389/fneur.2023.1226601COPYRIGHT© 2023 Martellucci, Mandalà, Casani, Yacovinoand Castellucci. This is an open-access articledistributed under the terms of the CreativeCommons Attribution License (CC BY). The use,distribution or reproduction in other forums ispermitted, provided the original author(s) andthe copyright owner(s) are credited and thatthe original publication in this journal is cited, inaccordance with accepted academic practice.No use, distribution or reproduction ispermitted which does not comply with theseterms.Editorial: Acute UnilateralVestibulopathy: clinicalpresentation, instrumentalpatterns, evolution andmanagementSalvatore Martellucci1*, Marco Mandalà2, Augusto Pietro Casani3,Dario Andres Yacovino4 and Andrea Castellucci51Otorhinolaryngology Unit, Hospital Santa Maria Goretti, Latina, Italy, 2University of Siena, Siena, Italy,3Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy,4Department of Neurology, Dr. César Milstein Hospital, Buenos Aires, Argentina, 5Department of Surgery,ENT Unit, Azienda USL-IRCCS, Reggio Emilia, ItalyKEYWORDSAcute Unilateral Vestibulopathy, BPPV, hearing loss, video head impulse test (vHIT), headshaking test, medical therapies, vestibular compensationEditorial on the Research TopicAcute Unilateral Vestibulopathy: clinical presentation, instrumentalpatterns, evolution and managementAcute Unilateral Vestibulopathy: clinical presentation, instrumental patterns, evolutionandmanagement Acute Unilateral Vestibulopathy (AUV) represents severe, continuous, andlong-lasting vertigo with sudden onset due to acute damage involving either the vestibularnerve or the labyrinthine end-organs. Although most subjects recover spontaneously,several patients develop residual disorders, such as chronic dizziness, disequilibrium, spatialdisorientation, and limitations in daily activities. More than a century after the firstdescription, Acute Unilateral Vestibulopathy (AUV) is a syndrome whose etiopathogenesisis still debated. It represents a challenging and intriguing pathology for clinicians from adiagnostic and therapeutic point of view, particularly for the aspects linked to its evolutionand the development of vestibular compensation (1, 2).As the title indicates, this Research Topic entitled “Acute Unilateral Vestibulopathy:clinical presentation, instrumental patterns, evolution, and management” covers some of themultiple aspects associated with losing the function of one of the two labyrinths in the lightof the latest international guidelines (3, 4).Two articles in this collection address the issue of the epidemiology and relativeetiopathogenesis of AUV. Viberti et al. assessed the epidemiological features of AUV inthree different districts in Italy, showing how the estimated incidence is higher thanpreviously reported in the literature. During the COVID-19 pandemic, the epidemiologyof several diseases has changed worldwide. The impact of COVID-19 vaccination onAUV development in the setting of a tertiary interdisciplinary neurotology center wasretrospectively investigated by Schmid et al..Frontiers inNeurology 01 frontiersin.orgMartellucci et al. 10.3389/fneur.2023.1226601The video head impulse test (vHIT) is an irreplaceable toolfor recognizing the different AUV patterns in an emergencydepartment and following their evolution over time. Alfarghalet al. after a comprehensive literature review, examined the VORgain assessed using the vHIT in acute vestibular syndromes andproposed a grading scale for the severity of VOR impairment oflateral semicircular canal similar to the current grading for hearingloss based on pure tone audiometry. The clinical implications ofvHIT in patients suffering from BPPV secondary to idiopathicsudden sensorineural hearing loss were investigated by Liu et al.who demonstrated that in this subpopulation, the vestibularfunction and, in particular, the posterior semicircular canal appearsto be impaired compared to what was found in patients affectedby idiopathic BPPV. The vHIT devices currently in use usuallyrecord the track from only one eye. A newer vHIT device allowinga simultaneous record of binocular vHIT has been the subjectof a cross-sectional, prospective study by Striteska, Chovanec etal.. The article provided normative values reflecting the conjugacyof eye movement responses to horizontal binocular vHIT inhealthy participants.Vestibular damage and hypofunction could be associatedwith sudden sensorineural hearing loss since cochleovestibularstructures share the same vascularization and are in closeanatomical proximity. A retrospective study was conducted byCastellucci et al. to evaluate the specific lesion patterns of vestibulardamage in patients presenting with sudden sensorineural hearingloss with or without vertigo and assess the prognostic roleof vestibular dysfunctions on hearing recovery, suggesting thatvestibular evaluation in SSNHL can provide helpful information onhearing recovery and underlying etiologies.The ability to compensate and the strategies with whichthis occurs represent the main question when diagnosing avestibulopathy. Bedside and instrumental test batteries providesuggestions on each patient’s ability to recover, but to date, thereneeds to be more data on the prognostic value of each test. In aprospective observational case-control study, Striteska, Valis et al.aimed to assess the ability of a head-shaking test (HST) to reflectvestibular compensation in patients after acute vestibular loss,showing how the intensity of nystagmus induced by HST decreasedexponentially over time, declining to the value of the control grouponce vestibular compensation was satisfactory and sufficient fora patient’s everyday life. In contrast, well-detectable head-shakinginduced nystagmus in subjects with insufficient clinical recoverypatients served as an objective indicator of poorly compensatedunilateral vestibular loss. Vestibular compensation is strictly linkedto the level of physical activity practiced after the acute event andreflects the patient’s quality of life. The association between the levelof physical activity and chronic dizziness was assessed by Van Laeret al. in a retrospective cohort study on 66 patients who underwentvestibular schwannoma resection.The onset of an acute vestibular syndrome requires urgentpharmacological management due to the critical procession ofsymptoms accompanying the event, which therapeutic choicesand intervention timing can positively or negatively influence.Viola et al. reviewed the pharmacological therapeutic option,correlating them to the differential and, as far as possible, to theetiological diagnosis.Finally, this Research Topic includes Finally, this ResearchTopic includes the description of some clinical cases peculiar torarity and iconography: the ossification of a posterior semicircularcanal following an AUV and mimicking inferior vestibular neuritiswas reported by Comacchio and Castellucci whereas three cases ofcerebellitis in anti-Yo paraneoplastic syndrome were described anddiscussed by Kherallah et al..The Editors hope that this Research Topic can represent avaluable contribution for all clinicians involved in otoneurology,particularly those involved in diagnosing and treating patientsaffected by acute vestibular syndromes.Author contributionsSM and ACast wrote the manuscript. All editors designedthe Research Topic, reviewed the manuscript, and approved thesubmitted version. All authors contributed to the article andapproved the submitted version.AcknowledgmentsWe thank the authors for their commitment to this ResearchTopic by sending their manuscripts and sharing their research data.We also thank the reviewers for their efforts and precious insights.Conflict of interestThe authors declare that the research was conducted in theabsence of any commercial or financial relationships that could beconstrued as a potential conflict of interest.Publisher’s noteAll claims expressed in this article are solely those of theauthors and do not necessarily represent those of their affiliatedorganizations, or those of the publisher, the editors and thereviewers. Any product that may be evaluated in this article, orclaim that may be made by its manufacturer, is not guaranteed orendorsed by the publisher.Frontiers inNeurology 02 frontiersin.orgMartellucci et al. 10.3389/fneur.2023.1226601References1. Halmagyi GM, Weber KP, Curthoys IS. Vestibular function after acute vestibularneuritis. Restor Neurol Neurosci. (2010) 28:37–46. doi: 10.3233/RNN-2010-05332. Bronstein AM, Dieterich M. Long-term clinical outcomein vestibular neuritis. Curr Opin Neurol. (2019) 32:174–80. doi: 10.1097/WCO.00000000000006523. Strupp M, Bisdorff A, Furman J, Hornibrook J, Jahn K,Maire R, et al. Acute unilateral vestibulopathy/vestibular neuritis:diagnostic criteria. J Vestib Res. (2022) 32:389–406. doi: 10.3233/VES-2202014. Hashimoto M, Koizuka I, Yamashita H, Suzuki M, Omori K, Origasa H,et al. Committee for clinical practice guidelines of japan society for equilibriumresearch. Diagnostic and therapeutic strategies for vestibular neuritis of the Japansociety for equilibrium research. Auris Nasus Larynx. (2022). doi: 10.1016/j.anl.2022.12.005Frontiers inNeurology 03 frontiersin.org

Editorial: Acute Unilateral Vestibulopathy: clinical presentation, instrumental patterns, evolution and management

Salvatore Martellucci

Marco Mandalà

Augusto Pietro Casani

Dario Andres Yacovino

Andrea Castellucci

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https://arpi.unipi.it/bitstream/11568/1215831/2/fneur-14-1226601.pdf

Editorial: Acute Unilateral Vestibulopathy: clinical presentation, instrumental patterns, evolution and management

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