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Kalaiyarasan R, Sinha SK. Masseter and cervical vestibular evoked myogenic potentials in individuals with auditory neuropathy. Int J Audiol 2024:1-9. [PMID: 39264092 DOI: 10.1080/14992027.2024.2399788] [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: 04/23/2024] [Revised: 08/26/2024] [Accepted: 08/28/2024] [Indexed: 09/13/2024]
Abstract
OBJECTIVE This study aimed to explore the functional integrity of vestibulo-masseteric and sacculo-collic reflex pathways in individuals with Auditory Neuropathy (AN). The study also aimed at finding the correlation between mVEMP and cVEMP response parameters for AN and healthy individuals. DESIGN Standard group comparison research design. STUDY SAMPLE Individuals with AN (n = 20); age-gender matched healthy individuals (n = 20) were recruited. Each participant underwent routine audiological evaluation; mVEMP and cVEMP testing. mVEMP and cVEMP were recorded using 500 Hz tone burst stimulus for all the participants. RESULTS Most of the AN individuals had no mVEMP (ipsilateral & contralateral - 60%; bilateral - 50%) and cVEMP (60%) responses. There was no significant association (p > 0.05) between the duration of AN with mVEMP and cVEMP findings. However, a significant correlation (p < 0.05) was found for EMG rectified amplitude of mVEMP and cVEMP in AN. CONCLUSION The results of this study suggested an impaired function of the vestibulomassteric and sacculocollic reflex pathways in individuals with AN. Vestibular evaluation should be included as a part of the regular test battery for individuals with AN.
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Affiliation(s)
- R Kalaiyarasan
- Department of Audiology, All India Institute of Speech and Hearing, Mysore, India
| | - Sujeet Kumar Sinha
- Center of Excellence for person with Tinnitus and Vestibular Disorders, Department of Audiology, All India Institute of Speech and Hearing, Mysore, India
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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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Singh NK, Firdose H. Characterizing the impact of advancing age on 500 Hz tone-burst evoked ocular-vestibular evoked myogenic potentials. Eur Arch Otorhinolaryngol 2021; 278:4259-4268. [PMID: 33454811 DOI: 10.1007/s00405-020-06542-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 12/01/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE Ageing is process that brings about steady decline in most of the systems, and vestibular system is no different. Although the effects of advancing age on the functioning of the semicircular canals and saccule has been well explored, its impact on the utricle remains the least studied component. While some researchers have investigated the effect of advancing age on the utricular functioning by virtue of studying ocular-vestibular evoked myogenic potentials (oVEMP), the use of smaller sample sizes would hamper the generalization of their results. Therefore, the present study aimed at investigating the effect of advancing age on oVEMP using a substantially larger sample size than the predecessors. METHODS A total of 480 individuals in the age range of 10-70 years were used as participants and were divided into six age groups, each one defined as a decade. Contralateral oVEMPs were elicited by 500-Hz tone-bursts and averaged over 200 sweeps to obtain the final waveform. RESULTS There was a significant decline in the response rates, prolongation of latencies and reduction of peak-to-peak amplitude of oVEMP with increasing age after 50 years (p < 0.05). However, there was no significant difference among the age groups until 50 years of age on any of these parameters (p > 0.05). Further, there was no significant change in inter-aural amplitude difference ratio with increasing age (p > 0.05). CONCLUSION The results of the study confirm significant impact of the ageing process on oVEMP after the age of 50 years and, therefore, age appropriate norms should be considered when using oVEMP for investigating utricular functioning in an individual, especially after the age of 50 years.
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Affiliation(s)
- Niraj Kumar Singh
- Department of Audiology, All India Institute of Speech and Hearing, Mansagangothri, Mysore, 570006, India.
| | - Husna Firdose
- Department of Audiology, All India Institute of Speech and Hearing, Mansagangothri, Mysore, 570006, India
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Sinha SK, Neupane AK, Gururaj K. Importance of Vestibulo-ocular Reflex Gain and Refixation Saccade Analysis in Individuals with Auditory Neuropathy Spectrum Disorder. Int Arch Otorhinolaryngol 2020; 24:e140-e148. [PMID: 32256833 PMCID: PMC6828562 DOI: 10.1055/s-0039-1697004] [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: 03/22/2018] [Accepted: 06/23/2019] [Indexed: 10/25/2022] Open
Abstract
Introduction Auditory neuropathy spectrum disorder (ANSD) features the presence of otoacoustic emissions, poor speech identification score and absent auditory brainstem response. Objective The present study was designed to evaluate the functioning of all six semicircular canals in individuals with ANSD and to compare it with those of normal-hearing individuals. Methods A total of 50 individuals participated in the present study, in which Group I comprised 25 normal-hearing individuals, and Group II comprised 25 individuals with ANSD. All of the participants underwent case history, pure tone audiometry, immittance, otoacoustic emissions, auditory evoked response and video head impulse test (vHIT). Results The independent sample t-test revealed significantly lower vestibulo-ocular reflex gain values in individuals with ANSD. A presence of 100% corrective refixation saccades was observed in the same group. The Pearson correlation test revealed no significant correlation between vestibulo-ocular reflex (VOR) gain with duration of hearing loss and pure tone thresholds for any of the three orthogonal planes. The chi-squared test revealed no association between the VOR gain values and the presence or absence of saccades in any of the semicircular canals ( p > 0.05). Conclusion Huge percentages of individuals with ANSD have been found to have associated vestibular dysfunction as well. Therefore, the vHIT can be used as one of the important tests of the vestibular test battery to evaluate all six semicircular canals in individuals with ANSD.
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Affiliation(s)
- Sujeet Kumar Sinha
- Department of Audiology, All India Institute of Speech and Hearing, Mysore, Karnataka, India
| | - Anuj Kumar Neupane
- Department of Audiology, All India Institute of Speech and Hearing, Mysore, Karnataka, India
| | - Krithika Gururaj
- Department of Audiology, All India Institute of Speech and Hearing, Mysore, Karnataka, India
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Hu J, Chen Z, Zhang Y, Xu Y, Ma W, Zhang Y, Wang J, Chen Y, Xu M, Yang H, Zhang Q. Vestibular dysfunction in patients with auditory neuropathy detected by vestibular evoked myogenic potentials. Clin Neurophysiol 2020; 131:1664-1671. [PMID: 32089450 DOI: 10.1016/j.clinph.2020.02.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 01/15/2020] [Accepted: 02/05/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This study aimed to determine vestibular involvement in patients with auditory neuropathy (AN) using ocular vestibular evoked myogenic potential (oVEMP), cervical vestibular evoked myogenic potential (cVEMP), caloric tests, video Head Impulse Tests (vHIT), and Suppression Head Impulse Paradigm (SHIMP) tests. METHODS Twenty-two patients with AN (study group) and 50 age-and-gender-matched healthy subjects (control group) were enrolled. All patients underwent air-conducted sound oVEMP and cVEMP tests. In the study group, 20 patients underwent a caloric test, 10 patients underwent a video Head Impulse Test (vHIT), and nine patients underwent the Suppression Head Impulse Paradigm (SHIMP) test. RESULTS Significant differences in VEMP abnormalities were found between the two groups. Most AN patients showed no VEMP response, while only a few patients showed VEMP responses with normal parameters. Some AN patients presented abnormal VEMP parameters, including thresholds, latencies, and amplitudes. The abnormal rate (including no response and abnormal parameters) was 91% in the cVEMP test and 86% in the oVEMP test. No significant difference was found between oVEMP and cVEMP abnormalities. AN patients exhibited a 70% abnormal rate in the caloric test. Most AN patients showed normal VOR gains. Most patients showed no overt corrective saccades in vHIT, and exhibited normal anticompensatory saccades in the SHIMP test. CONCLUSION Many AN patients experience vestibular dysfunction, which may be detected by using a vestibular functional test battery. SIGNIFICANCE VEMP abnormalities might reflect the status and degree of vestibular involvement in AN.
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Affiliation(s)
- Juan Hu
- Department of Otorhinolaryngology, Head and Neck Surgery, The 2nd Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, PR China
| | - Zichen Chen
- Department of Otorhinolaryngology, Head and Neck Surgery, The 2nd Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, PR China
| | - Yuzhong Zhang
- Department of Otorhinolaryngology, Head and Neck Surgery, The 2nd Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, PR China
| | - Yong Xu
- Department of Otorhinolaryngology, Head and Neck Surgery, The 2nd Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, PR China; Department of Otorhinolaryngology, Head and Neck Surgery, Yanliang 141 Hospital, Xi'an 710089, Shaanxi Province, PR China
| | - Weijun Ma
- Department of Otorhinolaryngology, Head and Neck Surgery, The 2nd Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, PR China
| | - Yan Zhang
- Department of Otorhinolaryngology, Head and Neck Surgery, The 2nd Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, PR China
| | - Junli Wang
- Department of Otorhinolaryngology, Head and Neck Surgery, The 2nd Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, PR China
| | - Yanfei Chen
- Department of Otorhinolaryngology, Head and Neck Surgery, The 2nd Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, PR China
| | - Min Xu
- Department of Otorhinolaryngology, Head and Neck Surgery, The 2nd Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, PR China
| | - Hui Yang
- Department of Otorhinolaryngology, Head and Neck Surgery, The 2nd Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, PR China.
| | - Qing Zhang
- Department of Otorhinolaryngology, Head and Neck Surgery, The 2nd Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, PR China; Department of Otorhinolaryngology, Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, PR China.
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Singh NK, Raul A, Malik G, Sao T. Intersession Variations in Frequency Tuning of Ocular Vestibular Evoked Myogenic Potentials in Healthy Individuals. Am J Audiol 2019; 28:407-413. [PMID: 31461334 DOI: 10.1044/2019_aja-ind50-18-0105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objective Frequency tuning of ocular vestibular evoked myogenic potential (oVEMP), which is the stimulus frequency corresponding to the largest oVEMP amplitude, has been used to diagnose cases with Ménière's disease and differentiate them from cases with benign paroxysmal positional vertigo with a high degree of sensitivity and specificity. However, this measure of oVEMP is carved out of the peak-to-peak amplitude of oVEMP, and studies on test-retest reliability of amplitude of oVEMP have shown moderate-to-excellent reliability of amplitude. This would theoretically render the frequency tuning of oVEMP susceptible to variations across multiple recordings. This being the case, erroneous conclusions regarding the presence of Ménière's disease could be made if the frequency tuning varies between recordings. However, there is no published report regarding the test-retest reliability of frequency tuning measure of oVEMP even in healthy individuals, to the best of our knowledge. Therefore, this study aimed to study the test-retest reliability of frequency tuning of oVEMP in healthy individuals. Method The study included 20 healthy adults in the age range of 18-25 years. All participants underwent oVEMP recording in 4 different sessions, with each session consisting of oVEMP recording for octave and midoctave tone-burst frequencies from 250 to 2000 Hz. Results The results revealed no significant difference in frequency tuning of oVEMP among the sessions (p > .05). The intraclass correlation coefficient for frequency tuning data was found to be .857. Conclusion The frequency tuning of oVEMP has excellent test-retest reliability and therefore lends itself to applications requiring multiple sessions of recording.
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Affiliation(s)
- Niraj Kumar Singh
- Department of audiology, All India Institute of Speech and Hearing, Mysuru.,BASLP Unit, ENT Department, Netaji Subhash Chandra Bose Medical College, Jabalpur, India
| | - Aradhana Raul
- BASLP Unit, ENT Department, Netaji Subhash Chandra Bose Medical College, Jabalpur, India
| | - Garima Malik
- BASLP Unit, ENT Department, Netaji Subhash Chandra Bose Medical College, Jabalpur, India
| | - Tulsi Sao
- BASLP Unit, ENT Department, Netaji Subhash Chandra Bose Medical College, Jabalpur, India.,Department of ENT, BASLP Course, Pandit Jawahar Lal Nehru Memorial Medical College and Dr. Bhim Rao Ambedkar Memorial Hospital, Raipur, India
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Gargeshwari A, Jha RH, Singh NK, Kumar P. Behavioural and objective vestibular assessment in persons with osteoporosis and osteopenia: a preliminary investigation. Braz J Otorhinolaryngol 2018; 84:744-753. [PMID: 29030130 PMCID: PMC9442882 DOI: 10.1016/j.bjorl.2017.08.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 07/20/2017] [Accepted: 08/26/2017] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION Calcium is vital for the functioning of the inner ear hair cells as well as for the neurotransmitter release that triggers the generation of a nerve impulse. A reduction in calcium level could therefore impair the peripheric vestibular functioning. However, the outcome of balance assessment has rarely been explored in cases with osteopenia and osteoporosis, the medical conditions associated with reduction in calcium levels. OBJECTIVE The present study aimed to investigate the impact of osteopenia and osteoporosis on the outcomes of behavioural and objective vestibular assessment tests. METHODS The study included 12 individuals each in the healthy control group and osteopenia group, and 11 individuals were included in the osteoporosis group. The groups were divided based on the findings of bone mineral density. All the participants underwent behavioural tests (Fukuda stepping, tandem gait and subjective visual vertical) and objective assessment using cervical and ocular vestibular evoked myogenic potentials. RESULTS A significantly higher proportion of the individuals in the two clinical groups' demonstrated abnormal results on the behavioural balance assessment tests (p<0.05) than the control group. However, there was no significant difference in latencies or amplitude of cervical vestibular evoked myogenic potential and oVEMP between the groups. The proportion of individuals with absence of ocular vestibular evoked myogenic potential was significantly higher in the osteoporosis group than the other two groups (p<0.05). CONCLUSION The findings of the present study confirm the presence of balance-related deficits in individuals with osteopenia and osteoporosis. Hence the clinical evaluations should include balance assessment as a mandatory aspect of the overall audiological assessment of individuals with osteopenia and osteoporosis.
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Affiliation(s)
- Aditi Gargeshwari
- All India Institute of Speech and Hearing, Department of Audiology, Manasagangothri, Karnataka, India
| | - Raghav Hira Jha
- All India Institute of Speech and Hearing, Department of Audiology, Manasagangothri, Karnataka, India.
| | - Niraj Kumar Singh
- All India Institute of Speech and Hearing, Department of Audiology, Manasagangothri, Karnataka, India
| | - Prawin Kumar
- All India Institute of Speech and Hearing, Department of Audiology, Manasagangothri, Karnataka, India
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Singh NK, Barman A. Inter-frequency amplitude ratio of oVEMP for differentiating Meniere’s disease from BPPV: clinical validation using a double-blind approach. Int J Audiol 2018; 58:21-28. [DOI: 10.1080/14992027.2018.1529440] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Niraj Kumar Singh
- Department of Audiology, All India Institute of Speech and Hearing, Mysore, India
| | - Animesh Barman
- Department of Audiology, All India Institute of Speech and Hearing, Mysore, India
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Prabhu P, Jamuar P. Evaluation of Dizziness Handicap in Adolescents and Adults with Auditory Neuropathy Spectrum Disorder. Int Arch Otorhinolaryngol 2018; 22:14-18. [PMID: 29371893 PMCID: PMC5783682 DOI: 10.1055/s-0037-1602693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 03/09/2017] [Indexed: 12/03/2022] Open
Abstract
Introduction
Vestibular symptoms and damage to the vestibular branch of the eighth cranial nerve is reported in individuals with auditory neuropathy spectrum disorder (ANSD). However, the real life handicap caused by these vestibular problems in individuals with ANSD is not studied.
Objective
The present study attempted to evaluate the dizziness-related handicap in adolescents and adults with ANSD.
Method
The dizziness handicap inventory (DHI) was administered to 40 adolescents and adults diagnosed with ANSD. The study also attempted to determine if there is any gender effect on DHI scores and its correlation to the reported onset of hearing loss.
Results
The results of the study showed that adolescents and adults with ANSD had a moderate degree of dizziness-related handicap. The dizziness affected their quality of life, causing emotional problems. There was no gender effect, and the level of the handicap was greater in the cases in which the onset of the hearing loss was reported soon after the diagnosis of ANSD. There could be a vestibular compensation that could have resulted in a reduction in symptoms in individuals in whom the onset of the hearing loss was reported later on.
Conclusion
Thus, a detailed assessment of vestibular problems and their impact on quality of life is essential in adolescents and adults with ANSD. Appropriate management strategies should be considered to resolve their vestibular problems and improve their quality of life.
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Affiliation(s)
- Prashanth Prabhu
- Department of Audiology, All India Institute of Speech and Hearing, Naimisham Campus Manasagangothri, Mysore, Karnataka, India
| | - Pratyasha Jamuar
- Department of Audiology, All India Institute of Speech and Hearing, Naimisham Campus Manasagangothri, Mysore, Karnataka, India
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Prabhu P, Jamuar P. Prevalence of vestibular symptoms in individuals with auditory neuropathy spectrum disorder - A retrospective study. Intractable Rare Dis Res 2017; 6:46-49. [PMID: 28357181 PMCID: PMC5359352 DOI: 10.5582/irdr.2016.01098] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The objective of the study was to retrospectively determine the prevalence of vestibular symptoms in individuals with auditory neuropathy spectrum disorder (ANSD). It was also attempted to determine the prevalence of vestibular symptoms and factors (gender and age of reported hearing loss) that could affect the prevalence in individuals with ANSD. The vestibular symptoms reported in the case history were analyzed in individuals diagnosed with ANSD. The symptoms reported by a total of 316 individuals (185 females and 131 males) with ANSD were analyzed. The result of the study showed that one in five individuals with ANSD reported at least one of the vestibular symptom. The vestibular symptoms were in more females and in individuals with earlier onset of hearing loss. The result of the study supports that there is a vestibular damage in individuals with ANSD. However, it is essential to carry out prospective studies validating these vestibular symptoms with objective vestibular tests before generalizing the results.
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Affiliation(s)
- Prashanth Prabhu
- Department of Audiology, All India Institute of Speech and Hearing, Mysore, India
- Address correspondence to: Dr. Prashanth Prabhu, Department of Audiology, All India Institute of Speech and Hearing, Manasagangothri, Naimisham Campus, Mysore, Karnataka 570006, India. E-mail:
| | - Pratyasha Jamuar
- Department of Audiology, All India Institute of Speech and Hearing, Mysore, India
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Frequency–Amplitude Ratio of Ocular Vestibular-Evoked Myogenic Potentials for Detecting Meniere’s Disease: A Preliminary Investigation. Ear Hear 2016; 37:365-73. [DOI: 10.1097/aud.0000000000000263] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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12
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Lucieer F, Vonk P, Guinand N, Stokroos R, Kingma H, van de Berg R. Bilateral Vestibular Hypofunction: Insights in Etiologies, Clinical Subtypes, and Diagnostics. Front Neurol 2016; 7:26. [PMID: 26973594 PMCID: PMC4777732 DOI: 10.3389/fneur.2016.00026] [Citation(s) in RCA: 102] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 02/19/2016] [Indexed: 01/03/2023] Open
Abstract
Objective To evaluate the different etiologies and clinical subtypes of bilateral vestibular hypofunction (BVH) and the value of diagnostic tools in the diagnostic process of BVH. Materials and methods A retrospective case review was performed on 154 patients diagnosed with BVH in a tertiary referral center, between 2013 and 2015. Inclusion criteria comprised (1) imbalance and/or oscillopsia during locomotion and (2) summated slow phase velocity of nystagmus of less than 20°/s during bithermal caloric tests. Results The definite etiology of BVH was determined in 47% of the cases and the probable etiology in 22%. In 31%, the etiology of BVH remained idiopathic. BVH resulted from more than 20 different etiologies. In the idiopathic group, the percentage of migraine was significantly higher compared to the non-idiopathic group (50 versus 11%, p < 0.001). Among all patients, 23.4% were known with autoimmune disorders in their medical history. All four clinical subtypes (recurrent vertigo with BVH, rapidly progressive BVH, slowly progressive BVH, and slowly progressive BVH with ataxia) were found in this population. Slowly progressive BVH with ataxia comprised only 4.5% of the cases. The head impulse test was abnormal in 94% of the cases. The torsion swing test was abnormal in 66%. Bilateral normal hearing to moderate hearing loss was found in 49%. Blood tests did not often contribute to the determination of the etiology of the disease. Abnormal cerebral imaging was found in 21 patients. Conclusion BVH is a heterogeneous condition with various etiologies and clinical characteristics. Migraine seems to play a significant role in idiopathic BVH and autoimmunity could be a modulating factor in the development of BVH. The distribution of etiologies of BVH probably depends on the clinical setting. In the diagnostic process of BVH, the routine use of some blood tests can be reconsidered and a low-threshold use of audiometry and cerebral imaging is advised. The torsion swing test is not the “gold standard” for diagnosing BVH due to its lack of sensitivity. Future diagnostic criteria of BVH should consist of standardized vestibular tests combined with a history that is congruent with the vestibular findings.
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Affiliation(s)
- F Lucieer
- Department of Otorhinolaryngology and Head and Neck Surgery, Division of Balance Disorders, Faculty of Health Medicine and Life Sciences, Maastricht University Medical Center, School for Mental Health and Neuroscience , Maastricht , Netherlands
| | - P Vonk
- Faculty of Health, Medicine and life Sciences, University of Maastricht , Maastricht , Netherlands
| | - N Guinand
- Service of Otorhinolaryngology and Head and Neck Surgery, Department of Clinical Neurosciences, Geneva University Hospitals , Geneva , Switzerland
| | - R Stokroos
- Department of Otorhinolaryngology and Head and Neck Surgery, Division of Balance Disorders, Faculty of Health Medicine and Life Sciences, Maastricht University Medical Center, School for Mental Health and Neuroscience , Maastricht , Netherlands
| | - H Kingma
- Department of Otorhinolaryngology and Head and Neck Surgery, Division of Balance Disorders, Faculty of Health Medicine and Life Sciences, Maastricht University Medical Center, School for Mental Health and Neuroscience, Maastricht, Netherlands; Faculty of Physics, Tomsk State Research University, Tomsk, Russian Federation
| | - Raymond van de Berg
- Department of Otorhinolaryngology and Head and Neck Surgery, Division of Balance Disorders, Faculty of Health Medicine and Life Sciences, Maastricht University Medical Center, School for Mental Health and Neuroscience, Maastricht, Netherlands; Faculty of Physics, Tomsk State Research University, Tomsk, Russian Federation
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13
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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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