Evaluation of subjectivity in the interpretation of videonystagmography

Evaluation of postural stability and vestibulo-ocular reflex in adults with chronic suppurative otitis media

PURPOSE

To evaluate the vestibulospinal reflex and vestibulo-ocular reflex (VOR) in patients with chronic suppurative otitis media (CSOM) using posturography and the video head impulse test (vHIT).

METHODS

Sixty-five patients with CSOM and 65 healthy participants as controls were included. Patients with CSOM were instructed to complete the dizziness handicap inventory (DHI). All participants underwent otoscopy, pure-tone audiometry, posturography sensory organization test (SOT), and vHIT.

RESULTS

Patients with CSOM exhibited a high prevalence of dizziness. The CSOM group had poor SOT vestibular scores compared to the control group. Patients with CSOM had worse sways in the antero-posterior and mediolateral planes. The CSOM group was divided into two subgroups according to the type of hearing loss. SOT vestibular scores were significantly poorer in the mixed hearing loss group than those in the conductive hearing loss group. We found a positive correlation between disease duration and poor SOT vestibular scores. Moreover, poor SOT vestibular scores correlated with high DHI scores. We found abnormalities in the vHIT results in the CSOM group in the form of low VOR gain and corrective saccades.

CONCLUSION

Our study provides clinical evidence of dizziness, poor postural control, and VOR abnormalities in patients with CSOM. The presence of sensory elements of hearing loss in patients with CSOM appears to be positively associated with vestibular dysfunction.

Investigation into the verification of the Synapsys videonystagmography (VNG) Ulmer calibration system

OBJECTIVE

To assess the accuracy and stability of the Synapsys VNG Ulmer calibration system when the goggles and infrared camera are repositioned, and the accuracy of the equipment's geometric calibration system.

DESIGN

Prospective data collection involved participants conducting the system's horizontal calibration test. Eye measurements were then recorded for a 60° deviation (looking from 30° right to -30° left) and repeated after the goggles and infrared camera were removed/repositioned. Participants' eye measurements were also recorded after the geometric calibration had been activated.

STUDY SAMPLE

Twenty-two participants with no history of visual or vestibular pathology were recruited for this study.

RESULTS

No significant differences were found when the goggles were removed and replaced (p = 0.21); when the infrared camera was repositioned within the goggles (p = 0.50); or when the goggles were removed and the camera repositioned (p = 0.18) after horizontal calibration. A significant difference was found during the assessment of geometric calibration (p < 0.01).

CONCLUSIONS

Calibration is not affected by removal or repositioning of the goggles and/or infrared camera within the goggles, therefore suggesting recalibration may not be necessary. Caution should be exercised when using the equipment's geometric calibration and should only be used when the patient is unable to conduct the system's horizontal calibration test.

[The evaluation of the efficiency of kinesitherapy in the patients with mixed-type vertigo]

INTRODUCTION

The aim of this work was to evaluate the efficiency of kinesitherapy in the patients with mixed-type vertigo.

MATERIAL AND METHODS

The study was conducted on a randomized group of 35 patients, 21 women and 14 men aged 24-75 years (mean age 42.5 years), who were treated at the Department of Otolaryngology and Laryngological Oncology Medical University Teaching Hospital in Lodz for mixed-type vertigo. The inclusion criteria were an interview, physical and otorhinolaryngological examinations, laboratory investigations, complete audiological and otoneurological examinations, including BERA and VNG, USG examination of the blood vessels to the cranium, and CT of the cervical spine. Each patient underwent an individually selected set of habituation exercises, corrective exercises for posture and its orientation in space through 2 months. The efficiency of the implemented therapy was evaluated after two weeks, one month and two months with the use of the complete videonystagmographic test and Silvoniemi's criteria.

RESULTS

The mean excitability of the labyrinths was 25.38 degrees/s before rehabilitation and 22.26 degrees/s after rehabilitation, absolute directional preponderance was 7.62 degrees/s and 1.92 degrees/s respectively, relative directional preponderance was 31.36 degrees/s and 12.57 degrees/s, and unilateral deficit 32.12 degrees/s and 14.34 degrees/s. The subjective evaluation of the vertigo intensification based on the 5 stages of Silvoniemi's scale indicates that the mean point-based evaluation reported by the patients at the beginning of the therapy was 3.85 points, whereas after the therapy was 2.91 points after two weeks, 2.35 points after one month, and 1.2 points after two months.

CONCLUSIONS

Kinesitherapy is an alternative and very effective method for treating mixed-type vertigo.