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Hope SJ, Govender S, Taylor RL, Kwok BYC, Pogson JM, Nham B, Wang C, Young AS, Dyball AC, Kong JHK, Welgampola MS, Rosengren SM. The role of cochlear and vestibular afferents in long-latency cervical vestibular evoked myogenic potentials. Int J Audiol 2024:1-8. [PMID: 38739080 DOI: 10.1080/14992027.2024.2341101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 04/01/2024] [Indexed: 05/14/2024]
Abstract
OBJECTIVE To examine the origin of cervical vestibular evoked myogenic potential (cVEMP) late waves (n34-p44) elicited with air-conducted click stimuli. DESIGN Using a retrospective design, cVEMPs from normal volunteers were compared to those obtained from patients with vestibular and auditory pathologies. STUDY SAMPLE (1) Normal volunteers (n = 56); (2) severe-to-profound sensorineural hearing loss (SNHL) with normal vestibular function (n = 21); (3) peripheral vestibular impairment with preserved hearing (n = 16); (4) total vestibulocochlear deficit (n = 23). RESULTS All normal volunteers had ipsilateral-dominant early p13-n23 peaks. Late peaks were present bilaterally in 78%. The p13-n23 response was present in all patients with SNHL but normal vestibular function, and 43% had late waves. Statistical comparison of these patients to a subset of age-matched controls showed no significant difference in the frequencies, amplitudes or latencies of their ipsilateral early and late peaks. cVEMPs were absent in all patients with vestibular impairment. CONCLUSION The presence of long-latency cVEMP waves was not dependent on the integrity of sensorineural hearing pathways, but instead correlated with intact vestibular function. This finding conflicts with the view that these late waves are cochlear in origin, and suggests that vestibular afferents may assume a more prominent role in their generation.
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Affiliation(s)
- Stuart J Hope
- Department of Linguistics, Macquarie University, Sydney, Australia
| | - Sendhil Govender
- Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Camperdown, Australia
| | - Rachel L Taylor
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
- Department of Physiology, University of Auckland, Auckland, New Zealand
| | - Belinda Y C Kwok
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Jacob M Pogson
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Benjamin Nham
- Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Camperdown, Australia
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Chao Wang
- Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Camperdown, Australia
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Allison S Young
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Alyssa C Dyball
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Jonathan H K Kong
- Department of Otolaryngology, Royal Prince Alfred Hospital, Camperdown, Australia
- Discipline of Surgery, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
- Department of Otolaryngology, Head and Neck Surgery, Macquarie University, North Ryde, Australia
| | - Miriam S Welgampola
- Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Camperdown, Australia
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Sally M Rosengren
- Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Camperdown, Australia
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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Castellucci A, Botti C, Delmonte S, Bettini M, Lusetti F, Brizzi P, Ruberto R, Gamberini L, Martellucci S, Malara P, Armato E, Renna L, Ghidini A, Bianchin G. Vestibular assessment in sudden sensorineural hearing loss: Role in the prediction of hearing outcome and in the early detection of vascular and hydropic pathomechanisms. Front Neurol 2023; 14:1127008. [PMID: 36873440 PMCID: PMC9975513 DOI: 10.3389/fneur.2023.1127008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 01/30/2023] [Indexed: 02/17/2023] Open
Abstract
Introduction Predicting hearing outcome in sudden sensorineural hearing loss (SSNHL) is challenging, as well as detecting the underlying pathomechanisms. SSNHL could be associated with vestibular damage since cochleo-vestibular structures share the same vascularization, along with being in close anatomical proximity. Whereas viral inflammations and autoimmune/vascular disorders most likely represent the involved aetiologies, early-stage Menière's disease (MD) can also present with SSNHL. Since an early treatment could beneficially influence hearing outcome, understanding the possible etiology plays a pivotal role in orienting the most appropriate treatment. We aimed to evaluate the extent of vestibular damage in patients presenting with SSNHL with or without vertigo, investigate the prognostic role of vestibular dysfunctions on hearing recovery and detect specific lesion patterns related to the underlying pathomechanisms. Methods We prospectively evaluated 86 patients with SSNHL. Audio-vestibular investigation included pure-tone/speech/impedance audiometry, cervical/ocular-VEMPs, vHIT and video-Frenzel examination. White matter lesions (WML) were evaluated on brain-MRI. Patients were followed-up and divided into "SSNHL-no-vertigo," "SSNHL+vertigo" and "MD" subgroups. Results Hearing was more impaired in "SSNHL+vertigo" patients who exhibited either down-sloping or flat-type audiograms, and was less impaired in "MD" where low frequencies were mostly impaired (p < 0.001). Otolith receptors were more frequently involved than semicircular canals (SCs). Although the "SSNHL-no-vertigo" subgroup exhibited the lowest vestibular impairment (p < 0.001), 52% of patients developed otolith dysfunctions and 72% developed nystagmus. Only "MD" subjects showed anterior SC impairment and upbeating spontaneous/positional nystagmus. They more frequently exhibited cervical-VEMPs frequency tuning (p = 0.036) and ipsilesional spontaneous nystagmus (p < 0.001). "SSNHL+vertigo" subjects presented with more frequently impaired cervical-VEMPs and posterior SC and with higher number of impaired receptors (p < 0.001). They mainly exhibited contralesional spontaneous and vibration-induced nystagmus (p < 0.05) and only they showed the highest WML score and "vascular" lesion patterns (p < 0.001). Concerning the outcomes, hearing was better in "MD" and worse in "SSNHL+vertigo" (p < 0.001). Hearing recovery was mostly affected by cervical-VEMPs impairment and the number of involved receptors (p < 0.05). Patients with "vascular" lesion patterns presented with the highest HL degree and WML score (p ≤ 0.001), while none of them exhibited a complete hearing recovery (p = 0.026). Conclusions Our data suggest that vestibular evaluation in SSNHL can provide useful information on hearing recovery and underlying aetiologies.
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Affiliation(s)
- Andrea Castellucci
- ENT Unit, Department of Surgery, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Cecilia Botti
- ENT Unit, Department of Surgery, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Ph.D. Program in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Silvia Delmonte
- Audiology and Ear Surgery Unit, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Margherita Bettini
- Audiology and Ear Surgery Unit, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Francesca Lusetti
- ENT Unit, Department of Surgery, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Pasquale Brizzi
- Audiology and Ear Surgery Unit, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Rosanna Ruberto
- Audiology and Ear Surgery Unit, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Lisa Gamberini
- Audiology and Ear Surgery Unit, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Pasquale Malara
- Audiology and Vestibology Service, Centromedico Bellinzona, Bellinzona, Switzerland
| | - Enrico Armato
- ENT Unit, SS. Giovanni e Paolo Hospital, Venice, Italy
| | - Luigi Renna
- ENT Unit, Department of Surgery, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Audiology and Ear Surgery Unit, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Angelo Ghidini
- ENT Unit, Department of Surgery, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Giovanni Bianchin
- Audiology and Ear Surgery Unit, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
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Ramirez-Salas JE, Benito-Orejas JI, Bauer M, Viveros-Díez P, Cifuentes-Navas VA, Duque-Holguera V. Manifestaciones clínicas del síndrome de Ramsay-Hunt en una serie de 20 casos. REVISTA ORL 2020. [DOI: 10.14201/orl.22750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Introducción y objetivo: la experiencia clínica nos ha mostrado las distintas formas de presentación y la variabilidad sintomatológica que puede revelar el síndrome de Ramsay-Hunt o herpes zóster ótico. Las descripciones que ofrece la literatura nos han servido para corroborar los hallazgos de un conjunto de pacientes, cuyas características y evolución hemos ido reuniendo en el tiempo. Dada la importancia del tratamiento precoz, el objetivo de este trabajo ha consistido en realizar una exposición estructurada de este complejo síndrome con sus diversas manifestaciones. Método: estudio retrospectivo. Resultados: 20 pacientes ejemplifican los diferentes aspectos de este proceso. Discusión: se trata de una patología infrecuente, con una tríada sintomática patognomónica que consiste en otalgia, erupción vesicular y parálisis facial. Sin embargo, este síndrome no siempre se expresa de forma completa ni con la aparición de los síntomas en el orden indicado, añadiéndose con frecuencia otros cocleovestibulares. La posibilidad de que la infección se propague de forma centrífuga y centrípeta facilita el que se afecten otros nervios sensitivos y motores, ocasionando una polineuropatía craneal (herpes zóster cefálico) y raquídea o incluso, con mucha menor frecuencia, la aparición de una meningoencefalitis. No conocemos con precisión los mecanismos por los que progresa este proceso ni los factores desencadenantes, aunque en ocasiones les haya predisponentes. Establecer un diagnóstico es fundamental para iniciar el tratamiento, cuya precocidad facilita la resolución del proceso. Conclusiones: siendo la sospecha clínica la principal herramienta de un diagnóstico precoz, nos ha parecido de interés realizar esta revisión, dada la infrecuencia del herpes zóster ótico.
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Longridge NS. Vestibular evoked myogenic potentials: what are they for? An opinion; a hypothesis. Acta Otolaryngol 2020; 140:1-3. [PMID: 32149556 DOI: 10.1080/00016489.2019.1704545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 11/02/2019] [Indexed: 10/24/2022]
Affiliation(s)
- Neil S Longridge
- Division of Otolaryngology, Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, Canada
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Canale A, Caranzano F, Lanotte M, Ducati A, Calamo F, Albera A, Lacilla M, Boldreghini M, Lucisano S, Albera R. Comparison of VEMPs, VHIT and caloric test outcomes after vestibular neurectomy in Menière’s disease. Auris Nasus Larynx 2018; 45:1159-1165. [DOI: 10.1016/j.anl.2018.04.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 03/21/2018] [Accepted: 04/20/2018] [Indexed: 10/17/2022]
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van den Boogert T, van Hoof M, Handschuh S, Glueckert R, Guinand N, Guyot JP, Kingma H, Perez-Fornos A, Seppen B, Johnson Chacko L, Schrott-Fischer A, van de Berg R. Optimization of 3D-Visualization of Micro-Anatomical Structures of the Human Inner Ear in Osmium Tetroxide Contrast Enhanced Micro-CT Scans. Front Neuroanat 2018; 12:41. [PMID: 29872380 PMCID: PMC5972190 DOI: 10.3389/fnana.2018.00041] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 04/27/2018] [Indexed: 11/30/2022] Open
Abstract
Introduction: Knowledge of the neuro-anatomical architecture of the inner ear contributes to the improvement and development of cochlear and vestibular implants. The present knowledge is mainly based on two-dimensional images (histology) or derived models that simplify the complexity of this architecture. This study investigated the feasibility of visualizing relevant neuro-anatomical structures of the inner ear in a dynamic three-dimensional reproduction, using a combination of staining, micro-CT imaging and an image processing algorithm. Methods: Four fresh cadaveric temporal bones were postfixed with osmium tetroxide (OsO4) and decalcified with EDTA. Micro-CT was used for scanning at 10 μm (4 scans) and 5.5 μm (1 scan) voxel resolution. A new image processing algorithm was developed and the scans were visualized in open source software. Results: OsO4 enhanced the contrast in all scans and the visualization was substantially improved by the image processing algorithm. The three-dimensional renderings provided detailed visualization of the whole inner ear. Details were visible up to the size of individual neurons, nerve crossings and the specific neuro-anatomical structures such as the tunnel of Corti. Conclusion: The combination of OsO4, micro-CT and the proposed image processing algorithm provides an accurate and detailed visualization of the three-dimensional micro-anatomy of the human inner ear.
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Affiliation(s)
- Thomas van den Boogert
- Division of Balance Disorders, Department of Otorhinolaryngology, Head, and Neck Surgery, Faculty of Health Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Marc van Hoof
- Division of Balance Disorders, Department of Otorhinolaryngology, Head, and Neck Surgery, Faculty of Health Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Stephan Handschuh
- VetCore Facility for Research, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Rudolf Glueckert
- Department of Otorhinolaryngology, Medical University Innsbruck, Innsbruck, Austria
| | - Nils Guinand
- Department of Clinical Neurosciences, Service of Otorhinolaryngology, Head, and Neck Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - Jean-Philippe Guyot
- Department of Clinical Neurosciences, Service of Otorhinolaryngology, Head, and Neck Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - Herman Kingma
- Division of Balance Disorders, Department of Otorhinolaryngology, Head, and Neck Surgery, Faculty of Health Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, Netherlands
- Vestibular Laboratory, Faculty of Physics, Tomsk State National Research University, Tomsk, Russia
| | - Angelica Perez-Fornos
- Department of Clinical Neurosciences, Service of Otorhinolaryngology, Head, and Neck Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - Bart Seppen
- Division of Balance Disorders, Department of Otorhinolaryngology, Head, and Neck Surgery, Faculty of Health Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Lejo Johnson Chacko
- Department of Otorhinolaryngology, Medical University Innsbruck, Innsbruck, Austria
| | | | - Raymond van de Berg
- Division of Balance Disorders, Department of Otorhinolaryngology, Head, and Neck Surgery, Faculty of Health Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, Netherlands
- Vestibular Laboratory, Faculty of Physics, Tomsk State National Research University, Tomsk, Russia
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Abstract
Patients with herpes zoster oticus (HZO) may commonly show symptoms associated with 7th and 8th cranial nerve (CN VII and CN VIII) dysfunction. The aim of this study is to investigate the characteristics of hearing loss in patients with HZO and discuss possible mechanisms.Ninety-five HZO patients who showed at least one of the symptoms of CN VII and CN VIII dysfunction between January 2007 and October 2014 were included in this study. Hearing loss was defined when the mean thresholds of pure tone audiometry (PTA) in speech frequency (0.5 kHz + 1 kHz + 2 kHz/3) or isolated high frequency (4 kHz + 8 kHz/2) were greater than 10 dB in the affected ear compared with the healthy ear, and a total of 72 patients were classified as the hearing loss group.The difference of mean PTA thresholds between affected and healthy ears was significantly greater in the high frequency range than in low range (20.0 ± 11.5 dB vs. 12.9 ± 15.7 dB, P = 0.0026) in patients with hearing loss (n = 72). The difference between affected and healthy ear was significantly greater in patients with vertigo (n = 34) than those without vertigo (n = 38) in both the high (P = 0.033) and low (P = 0.024) frequency ranges. In contrast, the differences between affected and healthy ears were not significantly different between patients with facial palsy (n = 50) and those without facial palsy (n = 22) in both the high (P = 0.921) and low (P = 0.382) frequency ranges.In patients with HZO, hearing loss is more severe in the high frequency range than in the low frequency range. Hearing impairment is more severe in patients with vertigo than in those without vertigo in both the high and low frequency ranges, even though the degree of hearing impairment is not significantly different between patients with and without facial palsy. These findings indicate that the mechanisms of viral spread from CN VII to CN VIII may differ between vestibular and audiologic deficits.
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Wang J, Chi FL, Zhao H, Xin Y. Projection from the Cochlear Nucleus to the Peripheral Vestibule in Wistar Rats. ACTA ACUST UNITED AC 2011; 73:229-36. [DOI: 10.1159/000330038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Accepted: 06/08/2011] [Indexed: 11/19/2022]
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Vestibular function outcomes after vestibular neurectomy in Meniere disease: Can vestibular neurectomy provide complete vestibular deafferentation? Auris Nasus Larynx 2010; 37:308-13. [DOI: 10.1016/j.anl.2009.06.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2008] [Revised: 05/30/2009] [Accepted: 06/19/2009] [Indexed: 11/20/2022]
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Tian GY, Xu DC, Huang DL, Liao H, Huang MX. The topographical relationships and anastomosis of the nerves in the human internal auditory canal. Surg Radiol Anat 2008; 30:243-7. [DOI: 10.1007/s00276-008-0311-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2007] [Accepted: 01/21/2008] [Indexed: 11/24/2022]
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