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Chen ZC, Zhang YZ, Zhao HD, Wei X, Murofushi T, Hu J, Cheng Y, Chen FY, Xu XD, Xu M, Zhang Q. Retro-labyrinthine Lesion Site Detected by Galvanic Vestibular Stimulation Elicited Vestibular-evoked Myogenic Potentials in Patients with Auditory Neuropathy. Curr Med Sci 2021; 41:695-704. [PMID: 34403094 DOI: 10.1007/s11596-021-2411-5] [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: 04/18/2021] [Accepted: 07/18/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Auditory neuropathy (AN) is a unique pattern of hearing loss with preservation of hair cell function. The condition is characterized by the presence of otoacoustic emissions (OAE) or cochlear microphonic (CM) responses with severe abnormalities of the auditory brainstem response (ABR). The vestibular branches of the VIII cranial nerve and the structures innervated by it can also be affected. However, the precise lesion sites in the vestibular system are not well characterized in patients with AN. METHODS The air-conducted sound (ACS) vestibular-evoked myogenic potentials (VEMPs) and galvanic vestibular stimuli (GVS)-VEMPs were examined in 14 patients with AN. RESULTS On examination of VEMPs (n=14, 28 ears), the absent rates of ACS-cervical VEMP (cVEMP), ACS-ocular VEMP (oVEMP), GVS-cVEMP, GVS-oVEMP and caloric test were 92.9% (26/28), 85.7% (24/28), 67.9% (19/28), 53.6% (15/28), and 61.5% (8/13), respectively. Impaired functions of the saccule, inferior vestibular nerve, utricle, superior vestibular nerve, and horizontal semicircular canal were found in 25.0% (7/28), 67.9% (19/28), 32.1% (9/28), 53.6% (15/28) and 61.5% (8/13) patients, respectively. On comparing the elicited VEMPs parameters of AN patients with those of normal controls, both ACS-VEMPs and GVS-VEMPs showed abnormal results in AN patients (such as, lower presence rates, elevated thresholds, prolonged latencies, and decreased amplitudes). CONCLUSION The study suggested that patients with AN often have concomitant vestibular disorders. Retro-labyrinthine lesions were more frequently observed in this study. GVS-VEMPs combined with ACS-VEMPs may help identify the lesion sites and facilitate detection of areas of vestibular dysfunction in these patients.
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Affiliation(s)
- Zi-Chen Chen
- Department of Otorhinolaryngology, Head, and Neck Surgery, Second Affiliated Hospital of Xi'an Jiaotong University School of Medicine, Xi'an, 710000, China.,Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200082, China.,Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, 200082, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, 200082, China
| | - Yu-Zhong Zhang
- Department of Otorhinolaryngology, Head, and Neck Surgery, Second Affiliated Hospital of Xi'an Jiaotong University School of Medicine, Xi'an, 710000, China.,Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200082, China.,Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, 200082, China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, 200082, China
| | - Huan-di Zhao
- Department of Otorhinolaryngology, Head, and Neck Surgery, Second Affiliated Hospital of Xi'an Jiaotong University School of Medicine, Xi'an, 710000, China
| | - Xinyu Wei
- Department of Otorhinolaryngology, Head, and Neck Surgery, Second Affiliated Hospital of Xi'an Jiaotong University School of Medicine, Xi'an, 710000, China
| | - Toshihisa Murofushi
- Department of Otolaryngology, Teikyo University School of Medicine Mizonokuchi Hospital, Kawasaki, 213-0001, Japan
| | - Juan Hu
- Department of Otorhinolaryngology, Head, and Neck Surgery, Second Affiliated Hospital of Xi'an Jiaotong University School of Medicine, Xi'an, 710000, China
| | - Ying Cheng
- Department of Otorhinolaryngology, Head, and Neck Surgery, Second Affiliated Hospital of Xi'an Jiaotong University School of Medicine, Xi'an, 710000, China
| | - Fei-Yun Chen
- Department of Otorhinolaryngology, Head, and Neck Surgery, Second Affiliated Hospital of Xi'an Jiaotong University School of Medicine, Xi'an, 710000, China
| | - Xin-da Xu
- Department of Otorhinolaryngology, Affiliated Ophthalmology and Otolaryngology Hospital of Fudan University, Shanghai, 200082, China
| | - Min Xu
- Department of Otorhinolaryngology, Head, and Neck Surgery, Second Affiliated Hospital of Xi'an Jiaotong University School of Medicine, Xi'an, 710000, China.
| | - Qing Zhang
- Department of Otorhinolaryngology, Head, and Neck Surgery, Second Affiliated Hospital of Xi'an Jiaotong University School of Medicine, Xi'an, 710000, China. .,Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200082, China. .,Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, 200082, China. .,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, 200082, China.
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Is Asymmetric Hearing Loss a Risk Factor for Vestibular Dysfunction? Lesson From Big Data Analysis Based on the Korean National Health and Nutrition Survey. Otol Neurotol 2019; 40:1339-1345. [PMID: 31592821 DOI: 10.1097/mao.0000000000002374] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate whether asymmetric hearing loss affects vestibular function. STUDY DESIGN Retrospective cross-sectional study. PATIENTS Data from the 2010 Korean National Health and Nutrition Survey for adults aged 40 years or more were used. INTERVENTIONS The modified Romberg test and pure-tone audiometry were performed. Data were analyzed using a complex sample χ test of independence and complex sample logistic regression analysis. MAIN OUTCOME MEASURES Vestibular dysfunction and hearing thresholds. RESULTS The overall prevalence of vestibular dysfunction was 3.3% (95% confidence interval [CI], 2.5-4.3%). In adults more than 40 years of age, multivariate linear regression analyses showed that the odds ratio (OR) of vestibular dysfunction was 3.067 times higher than the reference for a 30-dB difference in hearing thresholds between both ears (CI, 1.481-6.351; p = 0.007) after adjusting for factors associated with vestibular dysfunction. Among these individuals, the risk of equilibrium disturbance was higher in the presence of low-frequency asymmetric hearing loss (OR, 2.148; CI, 1.216-3.793; p = 0.009); on the other hand, high-frequency asymmetry did not lead to a higher risk. CONCLUSIONS As low-frequency asymmetric hearing thresholds tend to coexist with vestibular dysfunction in adults, those with asymmetric hearing loss should be closely monitored.
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Ye H, Xing Y, Zhang L, Zhang J, Jiang H, Ding D, Shi H, Yin S. Bilirubin-induced neurotoxic and ototoxic effects in rat cochlear and vestibular organotypic cultures. Neurotoxicology 2018; 71:75-86. [PMID: 30578813 DOI: 10.1016/j.neuro.2018.12.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 12/16/2018] [Accepted: 12/18/2018] [Indexed: 12/15/2022]
Abstract
Exposure to high levels of bilirubin in hyperbilirubinemia patients and animal models can result in sensorineural deafness. However, the mechanisms underlying bilirubin-induced damage to the inner ear, including the cochlear and vestibular organs, remain unknown. The present analyses of cochlear and vestibular organotypic cultures obtained from postnatal day 3 rats exposed to bilirubin at varying concentrations (0, 10, 50, 100, or 250 μM) for 24 h revealed that auditory nerve fibers (ANFs) and vestibular nerve endings were destroyed even at low doses (10 and 50 μM). Additionally, as the bilirubin dose increased, spiral ganglion neurons (SGNs) and vestibular ganglion neurons (VGNs) exhibited gradual shrinkage in conjunction with nuclei condensation or fragmentation in a dose-dependent manner. The loss of cochlear and vestibular hair cells (HCs) was only evident in explants treated with the highest concentration of bilirubin (250 μM), and bilirubin-induced major apoptosis most likely occurred via the extrinsic apoptotic pathway. Thus, the present results indicate that inner ear neurons and fibers were more sensitive to, and exhibited more severe damage following, bilirubin-induced neurotoxicity than sensory HCs, which illustrates the underlying causes of auditory neuropathy and vestibulopathy in hyperbilirubinemia patients.
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Affiliation(s)
- Haibo Ye
- Department of Otorhinolaryngology, Affiliated Sixth People's Hospital of Shanghai Jiaotong University, 600 Yishan Road, Shanghai 200233, PR China
| | - Yazhi Xing
- Department of Otorhinolaryngology, Affiliated Sixth People's Hospital of Shanghai Jiaotong University, 600 Yishan Road, Shanghai 200233, PR China
| | - Ling Zhang
- Department of Otorhinolaryngology, Affiliated Sixth People's Hospital of Shanghai Jiaotong University, 600 Yishan Road, Shanghai 200233, PR China
| | - Jianhui Zhang
- Department of Otolaryngology Head and Neck Surgery, The Third People's Hospital of Chengdu, PR China
| | - Haiyan Jiang
- Center for Hearing and Deafness, Department of Communicative Disorders and Sciences State, University of New York at Buffalo, 137 Cary Hall, 3435 Main Street, Buffalo, NY 14214, USA
| | - Dalian Ding
- Department of Otorhinolaryngology, Affiliated Sixth People's Hospital of Shanghai Jiaotong University, 600 Yishan Road, Shanghai 200233, PR China; Center for Hearing and Deafness, Department of Communicative Disorders and Sciences State, University of New York at Buffalo, 137 Cary Hall, 3435 Main Street, Buffalo, NY 14214, USA.
| | - Haibo Shi
- Department of Otorhinolaryngology, Affiliated Sixth People's Hospital of Shanghai Jiaotong University, 600 Yishan Road, Shanghai 200233, PR China.
| | - Shankai Yin
- Department of Otorhinolaryngology, Affiliated Sixth People's Hospital of Shanghai Jiaotong University, 600 Yishan Road, Shanghai 200233, PR China
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Singh NK, Sinha SK, Barman A. Assessment of otolith mediated neural reflexes through cervical and ocular vestibular evoked myogenic potentials in individuals with auditory neuropathy spectrum disorders. HEARING BALANCE AND COMMUNICATION 2016. [DOI: 10.3109/21695717.2016.1152047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Emami SF, Farahani F. Saccular dysfunction in children with sensorineural hearing loss and auditory neuropathy/auditory dys-synchrony. Acta Otolaryngol 2015; 135:1298-303. [PMID: 26246016 DOI: 10.3109/00016489.2015.1076169] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
CONCLUSION There is a correlation between the AN/AD disorder and the saccular dysfunction in children with severe sensorineural hearing loss, which means that saccular dysfunction can be a concomitant sign of AN/AD. In conclusion, the term of audio-vestibular dys-synchrony (AVS) is a more suitable description for this condition. OBJECTIVES Patients with auditory neuropathy/auditory dys-synchrony (AN/AD) characteristically demonstrate poor neural responses from the vestibulocochlear nerve and brainstem while displaying evidence of intact outer hair cells function. Therefore, the objective of this study is studying of the relationship of the saccular dysfunction with AN/AD disorder in children with sensorineural hearing loss. METHODS In this cross-sectional study, 100 children with bilateral severe-to-profound sensorineural hearing losses underwent audiologic tests and cervical vestibular-evoked myogenic potentials (cVEMPs) at the Audiology Department of Hamadan University of Medical Sciences (Hamadan, Iran). RESULTS Eleven children with bilateral severe sensorineural hearing loss were given to unilateral AN/AD disorder (11 ears), and two children (4 ears) had bilateral AN/AD (total = 13 children). The ears with AN/AD took the form of unrepeatable or absent waves of ABR and presence of OAEs. The statistical analysis of an independent t-test between AN/AD ears as compared to non-AN/AD ears of these 13 children showed that the mean latencies of p13 and the mean latencies of n23 and the mean peak-to-peak amplitude had significant differences.
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Affiliation(s)
| | - Farhad Farahani
- b 2 Department of Otolaryngology, Faculty of Medicine, Hamadan University of Medical Sciences , Hamadan, Iran
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Unal M, Vayisoglu Y. Auditory neuropathy/dyssynchrony: a retrospective analysis of 15 cases. Int Arch Otorhinolaryngol 2015; 19:151-5. [PMID: 25992171 PMCID: PMC4399183 DOI: 10.1055/s-0034-1390328] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Accepted: 08/25/2014] [Indexed: 10/27/2022] Open
Abstract
Introduction Auditory neuropathy/dyssynchrony (AN/AD) comprises a spectrum of pathology affecting the auditory pathways anywhere from the inner hair cells to the brainstem. It is characterized by an absent or atypical auditory brainstem response (ABR) with preservation of the cochlear microphonics and/or otoacoustic emissions (OAEs). Objective Retrospective analysis of patients with AN/AD. Methods Fifteen patients with AN/AD were included in this study and their records were retrospectively investigated. Results Possible etiology of AN/AD was neonatal hyperbilirubinemia in three patients, family history of hearing loss in three patients, consanguineous marriage in two patients, head trauma in two patients, mental motor retardation in one patient, cerebrovascular disease in one patient, and there was no apparent cause in three patients. Conclusion Otolaryngologists should keep in mind the diagnosis of AN/AD especially in patients complaining of difficulty in hearing and speech and audiological evidence of disassociation between pure tone and speech audiometry. ABR and OAE testing is recommended in these patients for AN/AD diagnosis.
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Affiliation(s)
- Murat Unal
- Department of Otorhinolaryngology, Mersin University, Mersin, Turkey
| | - Yusuf Vayisoglu
- Department of Otorhinolaryngology, Mersin University, Mersin, Turkey
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Prabhu P. Acquired auditory neuropathy spectrum disorder after an attack of chikungunya: case study. Eur Arch Otorhinolaryngol 2015; 273:257-61. [PMID: 25728940 DOI: 10.1007/s00405-015-3578-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2015] [Accepted: 02/23/2015] [Indexed: 11/27/2022]
Abstract
Auditory neuropathy spectrum disorder (ANSD) is a retrocochlear disorder in which the cochlear functioning is normal but the transmission in the auditory neural pathway is affected. The present study reports of a 14-year-old teenager with acquired ANSD after an attack of chikungunya. He reported symptoms of difficulty in understanding speech, tinnitus and vertigo when exposed to loud sounds. The audiological characteristics suggested auditory neuropathy spectrum disorder with raising audiogram configuration. The results of tinnitus evaluation showed low-pitched tinnitus and it was persistent causing significant handicap to him based on self report tinnitus handicap questionnaire results. The results of depression, anxiety and stress scale also suggested symptoms of mild depression and anxiety. Chikungunya virus is suspected to be neurotropic in nature which can damage auditory nerve cells and may have caused ANSD. The result also shows presence of tullio's phenomenon and absence of cervical vestibular evoked myogenic potentials suggesting damage to the vestibular neuronal system. The possible pathophysiology of chikungunya virus causing ANSD and vestibular symptoms needs to be explored further in future studies.
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Affiliation(s)
- Prashanth Prabhu
- Department of Audiology, All India Institute of Speech and Hearing, Manasagangothri, Naimisham Campus, Mysore, 570006, Karnataka, India.
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Santarelli R, Rossi R, Scimemi P, Cama E, Valentino ML, La Morgia C, Caporali L, Liguori R, Magnavita V, Monteleone A, Biscaro A, Arslan E, Carelli V. OPA1-related auditory neuropathy: site of lesion and outcome of cochlear implantation. ACTA ACUST UNITED AC 2015; 138:563-76. [PMID: 25564500 PMCID: PMC4339771 DOI: 10.1093/brain/awu378] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Santarelli et al. reveal that hearing impairments in patients carrying OPA1 missense mutations are the result of disordered synchrony in auditory nerve fibre activity owing to degeneration of terminal dendrites. Cochlear implantation improves speech perception and synchronous activation of auditory pathways in these patients by bypassing the lesion site. Hearing impairment is the second most prevalent clinical feature after optic atrophy in dominant optic atrophy associated with mutations in the OPA1 gene. In this study we characterized the hearing dysfunction in OPA1-linked disorders and provided effective rehabilitative options to improve speech perception. We studied two groups of OPA1 subjects, one comprising 11 patients (seven males; age range 13–79 years) carrying OPA1 mutations inducing haploinsufficiency, the other, 10 subjects (three males; age range 5–58 years) carrying OPA1 missense mutations. Both groups underwent audiometric assessment with pure tone and speech perception evaluation, and otoacoustic emissions and auditory brainstem response recording. Cochlear potentials were recorded through transtympanic electrocochleography from the group of patients harbouring OPA1 missense mutations and were compared to recordings obtained from 20 control subjects with normal hearing and from 19 subjects with cochlear hearing loss. Eight patients carrying OPA1 missense mutations underwent cochlear implantation. Speech perception measures and electrically-evoked auditory nerve and brainstem responses were obtained after 1 year of cochlear implant use. Nine of 11 patients carrying OPA1 mutations inducing haploinsufficiency had normal hearing function. In contrast, all but one subject harbouring OPA1 missense mutations displayed impaired speech perception, abnormal brainstem responses and presence of otoacoustic emissions consistent with auditory neuropathy. In electrocochleography recordings, cochlear microphonic had enhanced amplitudes while summating potential showed normal latency and peak amplitude consistent with preservation of both outer and inner hair cell activities. After cancelling the cochlear microphonic, the synchronized neural response seen in both normally-hearing controls and subjects with cochlear hearing loss was replaced by a prolonged, low-amplitude negative potential that decreased in both amplitude and duration during rapid stimulation consistent with neural generation. The use of cochlear implant improved speech perception in all but one patient. Brainstem potentials were recorded in response to electrical stimulation in five of six subjects, whereas no compound action potential was evoked from the auditory nerve through the cochlear implant. These findings indicate that underlying the hearing impairment in patients carrying OPA1 missense mutations is a disordered synchrony in auditory nerve fibre activity resulting from neural degeneration affecting the terminal dendrites. Cochlear implantation improves speech perception and synchronous activation of auditory pathways by bypassing the site of lesion.
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Affiliation(s)
- Rosamaria Santarelli
- 1 Department of Neurosciences, University of Padova, Via Giustiniani 2, 35128 Padova, Italy 2 Audiology and Phoniatrics Service, Treviso Regional Hospital, Piazza Ospedale 1, 31100 Treviso, Italy
| | - Roberta Rossi
- 1 Department of Neurosciences, University of Padova, Via Giustiniani 2, 35128 Padova, Italy 2 Audiology and Phoniatrics Service, Treviso Regional Hospital, Piazza Ospedale 1, 31100 Treviso, Italy
| | - Pietro Scimemi
- 1 Department of Neurosciences, University of Padova, Via Giustiniani 2, 35128 Padova, Italy 2 Audiology and Phoniatrics Service, Treviso Regional Hospital, Piazza Ospedale 1, 31100 Treviso, Italy
| | - Elona Cama
- 1 Department of Neurosciences, University of Padova, Via Giustiniani 2, 35128 Padova, Italy 2 Audiology and Phoniatrics Service, Treviso Regional Hospital, Piazza Ospedale 1, 31100 Treviso, Italy
| | - Maria Lucia Valentino
- 3 Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Via Ugo Foscolo 7, 40123 Bologna, Italy 4 IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Via Altura 3, 40139 Bologna, Italy
| | - Chiara La Morgia
- 3 Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Via Ugo Foscolo 7, 40123 Bologna, Italy 4 IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Via Altura 3, 40139 Bologna, Italy
| | - Leonardo Caporali
- 3 Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Via Ugo Foscolo 7, 40123 Bologna, Italy 4 IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Via Altura 3, 40139 Bologna, Italy
| | - Rocco Liguori
- 3 Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Via Ugo Foscolo 7, 40123 Bologna, Italy 4 IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Via Altura 3, 40139 Bologna, Italy
| | - Vincenzo Magnavita
- 1 Department of Neurosciences, University of Padova, Via Giustiniani 2, 35128 Padova, Italy 2 Audiology and Phoniatrics Service, Treviso Regional Hospital, Piazza Ospedale 1, 31100 Treviso, Italy
| | - Anna Monteleone
- 2 Audiology and Phoniatrics Service, Treviso Regional Hospital, Piazza Ospedale 1, 31100 Treviso, Italy
| | - Ariella Biscaro
- 2 Audiology and Phoniatrics Service, Treviso Regional Hospital, Piazza Ospedale 1, 31100 Treviso, Italy
| | - Edoardo Arslan
- 1 Department of Neurosciences, University of Padova, Via Giustiniani 2, 35128 Padova, Italy 2 Audiology and Phoniatrics Service, Treviso Regional Hospital, Piazza Ospedale 1, 31100 Treviso, Italy
| | - Valerio Carelli
- 3 Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Via Ugo Foscolo 7, 40123 Bologna, Italy 4 IRCCS Institute of Neurological Sciences of Bologna, Bellaria Hospital, Via Altura 3, 40139 Bologna, Italy
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Nash R, Veness J, Wyatt M, Raglan E, Rajput K. Vestibular function in children with auditory neuropathy spectrum disorder. Int J Pediatr Otorhinolaryngol 2014; 78:1269-73. [PMID: 24880924 DOI: 10.1016/j.ijporl.2014.05.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Revised: 05/04/2014] [Accepted: 05/06/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Children with auditory neuropathy spectrum disorder (ANSD) account for about 10% of paediatric patients referred for cochlear implantation. Vestibulopathy may be associated with ANSD, and may have implications when formulating management plans in this patient group. We wanted to determine the incidence and predictive factors for vestibulopathy in this patient group to guide vestibular testing in this patient population, and give insight to the aetiology of ANSD. METHODS We reviewed the outcomes of vestibular function testing in a cohort of paediatric patients with ANSD. RESULTS Probable or definite vestibulopathy was seen in 42% of patients who were tested. Vestibulopathy was associated with medical co-morbidities, but was not associated with imaging findings. CONCLUSIONS Vestibulopathy is relatively prevalent in this patient group, and should be considered when planning the investigation and management of children with ANSD.
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Affiliation(s)
- Robert Nash
- Department of ENT, Great Ormond Street Hospital, WC1N 3JH London, UK.
| | - John Veness
- Department of Audiology, Great Ormond Street Hospital, WC1N 3JH London, UK
| | - Michelle Wyatt
- Department of ENT, Great Ormond Street Hospital, WC1N 3JH London, UK
| | - Ewa Raglan
- Department of Audiology, Great Ormond Street Hospital, WC1N 3JH London, UK
| | - Kaukab Rajput
- Cochlear Implant Department, Great Ormond Street Hospital, WC1N 3JH London, UK
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Sinha SK, Shankar K, Sharanya R. Cervical and Ocular Vestibular Evoked Myogenic Potentials Test Results in Individuals with Auditory Neuropathy Spectrum Disorders. Audiol Res 2013; 3:e4. [PMID: 26557342 PMCID: PMC4627123 DOI: 10.4081/audiores.2013.e4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 06/04/2013] [Accepted: 06/10/2013] [Indexed: 11/23/2022] Open
Abstract
Auditory neuropathy spectrum disorder is a clinical disorder where the outer hair cell functioning is intact but the functioning of the auditory nerve is affected. Since, the 8(th) nerve is constituted by both the auditory and vestibular branch of nerve fibers, there are chances that the vestibular nerve might also be affected. Hence, the current study was carried out in order to determine the functioning of vestibular nerve in individuals with auditory neuropathy. A total of 11 participants were considered for the current study. Cervical vestibular evoked myogenic potentials (cVEMPs) and ocular vestibular evoked myogenic potentials (oVEMPs) were administered using the conventional protocol. In all the participants (100%) the oVEMPs were absent whereas in 20 ears out of 22 ears tested (90.90%) the cVEMPs were absent. The results of the present study indicate a high incidence of vestibular involvement in individuals with auditory neuropathy spectrum disorders. Also, it necessitates the inclusion of vestibular tests in the test battery used to assess individuals with auditory neuropathy spectrum disorder.
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Affiliation(s)
- Sujeet Kumar Sinha
- Department of Audiology, All India Institute of Speech and Hearing , Mysore, India
| | - Kruthika Shankar
- Department of Audiology, All India Institute of Speech and Hearing , Mysore, India
| | - Raja Sharanya
- Department of Audiology, All India Institute of Speech and Hearing , Mysore, India
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Sinha SK, Bohra V, Sanju HK. Comparison of Cervical and Ocular Vestibular Evoked Myogenic Potentials in Dancers and Non-Dancers. Audiol Res 2013; 3:e6. [PMID: 26557344 PMCID: PMC4627122 DOI: 10.4081/audiores.2013.e6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Revised: 10/18/2013] [Accepted: 10/18/2013] [Indexed: 11/23/2022] Open
Abstract
The objective of the study was to assess the sacculocollic and otolith ocular pathway function using cervical vestibular evoked myogenic potentials (cVEMP) and ocular vestibular myogenic potentials (oVEMP) in dancers and non dancers. Total 16 subjects participated in the study. Out of 16 participants, 8 were trained in Indian classical form of dance (dancers) and other 8 participants who were not trained in any dance form (non dancers). cVEMP and oVEMP responses were recorded for all the subjects. Non Parametric Mann-Whitney U test revealed no significant difference between dancers and non dancers for the latency and amplitude parameter for cVEMP and oVEMP, i.e. P13, N23 latency and P13-N23 complex amplitude and N10, P14 latency, N10-P14 complex amplitude respectively. The vestibular system comprises of several structures. It is possible that the dance style practiced by the dancer’s group assessed in this study does not contribute towards improving the plasticity of the sacculocollic and otolith-ocular pathways. It can be concluded that not all forms of dance training brings about a change in the plasticity of the sacculocollic and otolithocular pathways.
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Affiliation(s)
- Sujeet Kumar Sinha
- Department of Audiology, All India Institute of Speech and Hearing , India
| | - Vaishnavi Bohra
- Department of Audiology, All India Institute of Speech and Hearing , India
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