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Kim CH, Kim H, Jung T, Lee DH, Shin JE. Clinical characteristics of benign paroxysmal positional vertigo after traumatic brain injury. Brain Inj 2024; 38:341-346. [PMID: 38297437 DOI: 10.1080/02699052.2024.2310790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 01/23/2024] [Indexed: 02/02/2024]
Abstract
INTRODUCTION The aim of the present study was to evaluate the characteristics of brain injury and to assess the relationship between them and treatment outcomes in patients with traumatic benign paroxysmal positional vertigo (t-BPPV). MATERIALS AND METHODS Sixty-three consecutive patients who were diagnosed with BPPV within 2 weeks after head trauma were included. RESULTS Cerebral concussion, intracranial hemorrhages (ICH), skull fracture without ICH, and hemorrhagic contusion were observed in 68%, 24%, 5%, and 3% of t-BPPV patients, respectively. BPPV with single canal involvement was observed in 52 (83%) patients and that with multiple canal involvement was observed in 11 (17%) patients. The number of treatment sessions was not significantly different according to the cause of head trauma (p = 0.252), type of brain injury (p = 0.308) or location of head trauma (p = 0.287). The number of recurrences was not significantly different according to the cause of head trauma (p = 0.308), type of brain injury (p = 0.536) or location of head trauma (p = 0.138). CONCLUSION The present study demonstrated that there were no significant differences in treatment sessions until resolution and the mean number of recurrences according to the type of brain injury.
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Affiliation(s)
- Chang-Hee Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University Medical Center, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Hansol Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University Medical Center, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Taesik Jung
- Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University Medical Center, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Dong-Han Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University Medical Center, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Jung Eun Shin
- Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University Medical Center, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea
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Pérez-Fernández N, Saez Coronado S, Zulueta-Santos C, Neria Serrano F, Rey-Martinez J, Blanco M, Manrique-Huarte R. A Paradoxical Clinical Coincidence: Benign Paroxysmal Positional Vertigo and Bilateral Vestibulopathy. J Clin Med 2023; 12:jcm12103413. [PMID: 37240519 DOI: 10.3390/jcm12103413] [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: 04/16/2023] [Revised: 04/30/2023] [Accepted: 05/02/2023] [Indexed: 05/28/2023] Open
Abstract
Benign paroxysmal positional vertigo (BPPV) and bilateral vestibulopathy (BVL) are two completely different forms of vestibular disorder that occasionally occur in the same patient. We conducted a retrospective review searching for that coincidence in our database of the patients seen over a 15-year period and found this disorder in 23 patients, that is 0.4%. More frequently they occurred sequentially (10/23) and BPPV was diagnosed first. Simultaneous presentation occurred in 9/23 patients. It was subsequently studied, but in a prospective manner, in patients with BPPV on all of whom a video head impulse test was performed to search for bilateral vestibular loss; we found it was slightly more frequent (6/405). Both disorders were treated accordingly, and it was found that the results follow the general trend in patients with only one of those disorders.
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Affiliation(s)
- Nicolás Pérez-Fernández
- Department of Otorhinolaryngology, Marquesado de Santa Marta 1, Clínica Universidad de Navarra, 28047 Madrid, Spain
- Department of Otorhinolaryngology, Clínica Universidad de Navarra, 31008 Pamplona, Spain
| | - Sara Saez Coronado
- Department of Otorhinolaryngology, Hospital Universitario de Móstoles, 28938 Madrid, Spain
| | - Cristina Zulueta-Santos
- Department of Otorhinolaryngology, Marquesado de Santa Marta 1, Clínica Universidad de Navarra, 28047 Madrid, Spain
| | - Fernando Neria Serrano
- Department of Otorhinolaryngology, Facultad de Medicina, Universidad Francisco de Vitoria, 28223 Madrid, Spain
| | - Jorge Rey-Martinez
- Department of Otorhinolaryngology, Hospital Universitario Donostia, 20014 San Sebastian, Spain
| | - Melisa Blanco
- Department of Otorhinolaryngology, Marquesado de Santa Marta 1, Clínica Universidad de Navarra, 28047 Madrid, Spain
| | - Raquel Manrique-Huarte
- Department of Otorhinolaryngology, Clínica Universidad de Navarra, 31008 Pamplona, Spain
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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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Choi HG, Lee CH, Yoo DM, Min C, Park B, Kim SY. Effects of short- and long-term exposure to air pollution and meteorological factors on Meniere's disease. Sci Rep 2021; 11:16063. [PMID: 34373509 PMCID: PMC8352931 DOI: 10.1038/s41598-021-95491-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 07/23/2021] [Indexed: 11/30/2022] Open
Abstract
The association between air pollutants and Meniere’s disease has not been explored. The present study investigated the relationship between meteorological factors and air pollutants on Meniere’s disease. Participants, aged ≥ 40 years, of the Korean National Health Insurance Service-Health Screening Cohort were included in this study. The 7725 patients with Meniere’s disease were matched with 30,900 control participants. The moving average meteorological and air pollution data of the previous 7 days, 1 month, 3 months, and 6 months before the onset of Meniere’s disease were compared between the Meniere’s disease and control groups using conditional logistic regression analyses. Additional analyses were conducted according to age, sex, income, and residential area. Temperature range; ambient atmospheric pressure; sunshine duration; and levels of SO2, NO2, O3, CO, and PM10 for 1 month and 6 months were associated with Meniere’s disease. Adjusted ORs (odds ratios with 95% confidence interval [CI]) for 1 and 6 months of O3 concentration were 1.29 (95% CI 1.23–1.35) and 1.31 (95% CI 1.22–1.42), respectively; that for the 1 and 6 months of CO concentration were 3.34 (95% CI 2.39–4.68) and 4.19 (95% CI 2.79–6.30), respectively. Subgroup analyses indicated a steady relationship of O3 and CO concentrations with Meniere’s disease. Meteorological factors and air pollutants were associated with the rate of Meniere’s disease. In particular, CO and O3 concentrations were positively related to the occurrence of Meniere’s disease.
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Affiliation(s)
- Hyo Geun Choi
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Korea.,Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, Korea.,Hallym Institute for Environmental Diseases (HIED), Chuncheon, Korea
| | - Chang Ho Lee
- Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Dae Myoung Yoo
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Korea
| | - Chanyang Min
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Korea.,Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Bumjung Park
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, Korea
| | - So Young Kim
- Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
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Yetiser S, Ince D. Direction-fixed positional nystagmus following head-roll testing: how is it related with a vestibular pathology? J Otol 2021; 16:123-127. [PMID: 34220980 PMCID: PMC8241700 DOI: 10.1016/j.joto.2020.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 11/21/2020] [Accepted: 11/30/2020] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE The goal of this study is to analyze the clinical view of patients with direction-fixed positional nystagmus (DFPN) following head-roll maneuver. METHODS Sixty patients with DFPN were reviewed retrospectively. Patients were categorized into 3 groups according to the direction of nystagmus based on rotation side. Associated problems were documented, and cumulative data were compared between groups. One-way analysis of variance (ANOVA test) was used for statistical analysis (P < 0.05). RESULTS Thirty-three patients (55%) had stronger nystagmus beating towards the direction of head-roll (Group-A). Three patients developed geotropic LC-BPPV. Fourteen patients had inner ear disease. Sixteen patients (27%) had stronger nystagmus beating against the direction of head roll (Group-B). Nine patients had inner ear disease. None of the patients tested with head-shaking had change of direction of nystagmus. Eleven patients (18%) had DFPN with equal velocity during right or left head-roll maneuver (Group-C). Of those, nine patients had inner ear disease. None of the patients had change of direction of nystagmus. Comparison of the incidence of associated problems (migraine, vestibular neuronitis, Meniere's disease etc.) in each group was not statistically significant (P˃0.05). CONCLUSION Patients with DFPN should be followed for a possibility of vestibular pathology since vestibular problem was documented for more than half of the patients in the follow-up. On the other hand, DFPN could be related with a temporary reason (thermal, physical or drug effect etc.) in some patients who do not exhibit any associated disease. Head-shaking testing is recommended to expose the lateral canal BPPV. But the incidence is low.
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Affiliation(s)
- Sertac Yetiser
- Anadolu Medical Center, Dept of ORL & HNS, Gebze, 41400, Kocaeli, Turkey
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Association between Chronic Obstructive Pulmonary Disease and Ménière's Disease: A Nested Case-Control Study Using a National Health Screening Cohort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094536. [PMID: 33923368 PMCID: PMC8123129 DOI: 10.3390/ijerph18094536] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 04/21/2021] [Accepted: 04/21/2021] [Indexed: 11/16/2022]
Abstract
This study explored the relation between Ménière's disease and chronic obstructive pulmonary disease (COPD). The ≥40-year-old population of the Korean National Health Insurance Service-Health Screening Cohort was included. In total, 7734 Ménière's disease patients and 30,936 control participants were enrolled. Control participants were matched for age, sex, income, and region of residence with Ménière's disease participants. The odds of having Ménière's disease given a history of COPD were analyzed using conditional logistic regression. Subgroup analyses were conducted according to age, sex, income, and region of residence. The odds of having Ménière's disease were found to be 1.18-fold higher with a history of COPD than with no history of COPD (95% confidence intervals (CI) = 1.06-1.32, E-value (CI) = 1.64 (1.31)). The ≥60 years old, male, low-income, and rural subgroups showed increased odds of developing Ménière's disease when a history of COPD was reported. A history of COPD was associated with an increased risk of Ménière's disease in the adult population.
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Positional Nystagmus after Acute Vertiginous Attack in Meniere's Disease. Audiol Res 2021; 11:55-62. [PMID: 33562076 PMCID: PMC7931113 DOI: 10.3390/audiolres11010007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 01/28/2021] [Accepted: 02/04/2021] [Indexed: 11/17/2022] Open
Abstract
There have been no reports regarding nystagmus observed immediately after the end of an acute vertiginous attack in patients with Meniere’s disease. The aim of this study was to demonstrate positional direction-changing nystagmus in patients with Meniere’s disease, and to discuss the mechanism that underlies this nystagmus. Video-nystagmography was recorded in two patients with definite Meniere’s disease, who showed positional direction-changing nystagmus during the period immediately after a vertigo attack. In one patient, video-nystagmographic recording was conducted 5 h after an episode of vertigo attack, and it showed very weak, persistent positional geotropic direction-changing nystagmus. In the other patient, video-nystagmographic recording was conducted 23 h after an episode of vertigo attack, and it showed very weak, persistent positional apogeotropic direction-changing nystagmus. Our patients exhibited very weak, persistent positional direction-changing nystagmus, which was geotropic in one and apogeotropic in the other. This type of positional nystagmus has been reported in other inner ear disorders and it cannot be clearly explained by typical benign paroxysmal positional vertigo. The change in chemical composition and/or electrolyte concentration of the inner ear fluid, although still unclear, may underlie the production of this characteristic nystagmus in these patients.
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Yetiser S. Spontaneous Direction-Changing or Reversing Positional Nystagmus without Changing Head Position during Head-Roll/Head-Hanging Maneuvers: Biphasic Positional Nystagmus. J Audiol Otol 2020; 25:43-48. [PMID: 33327706 PMCID: PMC7835436 DOI: 10.7874/jao.2020.00332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 09/16/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Conflicting mechanisms have been reported about spontaneous reversal of positional nystagmus during head-roll maneuver in patients with benign paroxysmal positional vertigo (BPPV). The objective of this study is to review the reports about the characteristics and possible mechanisms of reversing positional nystagmus and to present seven new cases. SUBJECTS AND METHODS Seven cases (5 males, 2 females; 4 left-sided, 3 right-sided) were recruited among 732 patients with BPPV seen outpatient clinic between 2009 and 2019. Diagnosis of lateral canal canalolithiasis was confirmed when transient geotropic nystagmus was documented during head-roll test. Reversing positional nystagmus was analyzed in each case and clinical characteristics of the patients were documented. RESULTS The age of patients was ranging between 30 to 64 years (46.44±10.91). Duration of symptoms was short (21.34±19.74). Six of them had a story of head trauma. Initial latency was short. First, intense geotropic nystagmus was observed following provocative head-roll position on the affected side. There was short "silent phase". Then, a longer second-phase of reversed nystagmus was noted. Total duration of nystagmus was 78.40±6.82 seconds. Maximal slow phase velocity was 24.05±6.34 deg/sec. All patients were cured with barbeque maneuver. CONCLUSIONS Ipsilateral reversing positional nystagmus during head-roll maneuver is due to lateral canal canalolithiasis. Mechanism is likely to be due to endolymphatic double flow. Bilateral cases may be due to simultaneous co-existence of canalolithiasis and cupulolithiasis. Longer recording of nystagmus is recommended not to miss the cases with spontaneous direction-changing positional nystagmus.
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Affiliation(s)
- Sertac Yetiser
- Department of Otorhinolaryngology, Head and Neck Surgery, Anadolu Medical Center, Kocaeli, Turkey
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Association between Ménière's disease and thyroid diseases: a nested case-control study. Sci Rep 2020; 10:18224. [PMID: 33106572 PMCID: PMC7588449 DOI: 10.1038/s41598-020-75404-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 10/15/2020] [Indexed: 12/12/2022] Open
Abstract
The association of thyroid disease and Ménière’s disease would suggest that both are autoimmune diseases. This study aimed to investigate the relation of goiter, hypothyroidism, thyroiditis, hyperthyroidism, and autoimmune thyroiditis with Ménière’s disease. The Korean National Health Insurance Service-Health Screening Cohort data from 2002 through 2015 were used. The 8183 adult patients with Ménière’s disease were 1:4 matched with the 32,732 individuals of the control group for age, sex, income, and region of residence. The previous histories of thyroid disorders including goiter, hypothyroidism, thyroiditis, and hyperthyroidism were investigated using conditional logistic regression analyses. Subgroup analyses were conducted, including for age and sex. Smoking, alcohol consumption, obesity, Charlson Comorbidity Index, histories of benign paroxysmal vertigo, vestibular neuronitis, other peripheral vertigo, thyroid cancer, and levothyroxine medication were adjusted in the models. The histories of goiter (5.7% vs. 4.2%), hypothyroidism (4.7% vs. 3.6%), thyroiditis (2.1% vs. 1.6%), hyperthyroidism (3.6% vs. 2.5%), and autoimmune thyroiditis (0.99% vs. 0.67%) were higher in the Meniere’s disease group than in the control group (all P < 0.05). The histories of goiter, hypothyroidism, and hyperthyroidism were associated with Ménière’s disease (adjusted odds ratio (OR) = 1.19 [95% confidence interval (CI) = 1.04–1.36] for goiter, 1.21 [95% CI 1.02–1.44] for hypothyroidism, and 1.27 [95% CI 1.09–1.49] for hyperthyroidism, each of P < 0.05). In subgroup analyses, hypothyroidism was associated with Ménière’s disease in < 65-year-old women. Hyperthyroidism was related with Ménière’s disease in women overall. Thyroid diseases of goiter, hypothyroidism, and hyperthyroidism were associated with Ménière’s disease.
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Lee J, Choi B, Noh H, Jeong H, Shin JE, Kim CH. Nystagmus in Ramsay Hunt syndrome with or without dizziness. Neurol Sci 2020; 42:193-198. [PMID: 32592105 DOI: 10.1007/s10072-020-04536-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 06/21/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND The presence of dizziness has been reported as a negative prognostic factor for recovery of facial palsy in Ramsay Hunt syndrome (RHS). The aim of this study was to investigate the incidence and patterns of nystagmus in RHS patients without dizziness, and discuss possible mechanisms. We also compared the severity and prognosis of facial palsy between RHS patients with and without dizziness. METHODS From January 2014 to January 2019, 36 patients diagnosed with RHS (27 with dizziness and 9 without dizziness) were included. Patterns of nystagmus were examined and categorized using video-nystagmography. House-Brackmann(HB) grade of facial palsy was compared between RHS patients with and without dizziness. RESULTS Not only RHS patients with dizziness exhibited nystagmus in most cases (96%, 26 of 27) but also as many as 67% (6 of 9) of RHS patients without dizziness exhibited nystagmus, though the intensity was remarkably weak. In both groups of RHS with and without dizziness, direction-fixed nystagmus and direction-changing positional nystagmus were observed. Initial HB grade and recovery of facial palsy after treatment were not significantly different between RHS with and without dizziness. CONCLUSION Various patterns of nystagmus including direction-fixed and positional direction-changing nystagmus were observed in RHS patients, and inflammation of the vestibular nerve and inner ear end organs may be responsible for the production of nystagmus in these patients. The results support that the evaluation of vestibular function may be necessary even in RHS patients who do not complain of dizziness or vertigo.
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Affiliation(s)
- Jiyeon Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University Medical Center, Research Institute of Medical Science, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul, 05030, Republic of Korea
| | - BoYoon Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University Medical Center, Research Institute of Medical Science, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul, 05030, Republic of Korea
| | - Haemin Noh
- Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University Medical Center, Research Institute of Medical Science, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul, 05030, Republic of Korea
| | - Hamin Jeong
- Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University Medical Center, Research Institute of Medical Science, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul, 05030, Republic of Korea
| | - Jung Eun Shin
- Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University Medical Center, Research Institute of Medical Science, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul, 05030, Republic of Korea
| | - Chang-Hee Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University Medical Center, Research Institute of Medical Science, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul, 05030, Republic of Korea.
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Kim SY, Lee CH, Min C, Park IS, Choi HG. Bidirectional analysis of the association between Ménière's disease and depression: Two longitudinal follow-up studies using a national sample cohort. Clin Otolaryngol 2020; 45:687-694. [PMID: 32337847 DOI: 10.1111/coa.13558] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 04/08/2020] [Accepted: 04/18/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVE This study aimed to delineate the causal relationship between Ménière's disease and depression. DESIGN Two longitudinal follow-up studies. MAIN OUTCOME MEASURES The 2002-2013 Korean National Health Insurance Service-Health Screening Cohort was used. In study I, Ménière's disease patients were 1:4 matched with the control I group for age group, sex, income group and region of residence, and the occurrence of depression was observed. In study II, the depression patients were 1:4 matched with the control II group for the same variables, and the occurrence of Ménière's disease was observed. The stratified Cox proportional hazard model was used. Subgroup analyses were performed according to age and sex. RESULTS In study I, 6.9% (420/6044) of the Ménière's disease patients and 3.7% (885/24 176) of the control I participants experienced depression. The adjusted hazard ratio (HR) of Ménière's disease for depression was 1.94 (95% confidence intervals [CI] = 1.73-2.18, P < .001). In study II, 1.6% (490/31 649) of the depression patients and 1.0% (1240/126 596) of the control II participants were diagnosed with Ménière's disease. The adjusted HR of depression for Ménière's disease was 1.58 (95% CI = 1.43-1.76, P < .001). All age and sex subgroups demonstrated higher HRs of Ménière's disease for depression (study I) and depression for Ménière's disease (study II). CONCLUSION Ménière's disease patients showed an increased likelihood of depression. Conversely, depression patients showed an elevated likelihood of Ménière's disease.
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Affiliation(s)
- So Young Kim
- Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Chang Ho Lee
- Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Chanyang Min
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Korea.,Graduate School of Public Health, Seoul National University, Seoul, Korea.,Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, Korea
| | - Il-Seok Park
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Dongtan, Korea
| | - Hyo Geun Choi
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Korea.,Graduate School of Public Health, Seoul National University, Seoul, Korea.,Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, Korea
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