Sun-Uk Lee1, Hyo-Jung Kim2, Ja-Won Koo3, Ji-Soo Kim4. 1. Department of Neurology, Ajou University College of Medicine, Ajou University Hospital, Suwon, Republic of Korea. 2. Department of Biomedical Laboratory Science, Kyungdong University, Goseong, Republic of Korea. 3. Department of Otolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. 4. Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Abstract
OBJECTIVES/HYPOTHESIS: To aid in diagnosis of Meniere's disease (MD) during the attacks using caloric and head-impulse tests (HITs). STUDY DESIGN: Retrospective case series review. METHODS: We analyzed the results of bithermal caloric and HITs during the attacks in 16 patients with MD. Quantitative analyses of HITs were conducted using a magnetic search coil technique. RESULTS: In unilateral MD (14 patients, 42 semicircular canals), the head impulse gain of the vestibulo-ocular reflex (VOR) was either normal (28 of 42, 67%), decreased (8 of 42, 19%), or increased (6 of 42, 14%) for each semicircular canal in the affected ear. Likewise, the head impulse VOR gain was either normal (29 of 42, 69%), increased (11 of 42, 26%), or decreased (2 of 42, 5%) in the intact ear. The VOR gain for the horizontal canal was significantly lower on the affected side (P = 0.013). However, the VOR gains for the anterior and posterior canals did not differ between the sides (P = 0.270, P = 0.282). In bilateral MD (two patients, 12 semicircular canals), the VOR gain was either decreased (6 of 12, 50%) or normal (6 of 12, 50%) in either ear. In contrast, the caloric responses were usually decreased in the affected ear (7 of 11, 64%, including one with bilateral MD). CONCLUSION: During the attacks of MD, HITs showed varied results between the ears and among the canals, although the caloric responses were usually decreased in the involved ear. These dissociations suggest a frequency-dependent impairment of canal function or mechanical property of the endolymphatic hydrops during the attacks of MD. LEVEL OF EVIDENCE: 4. Laryngoscope, 127:702-708, 2017.
OBJECTIVES/HYPOTHESIS: To aid in diagnosis of Meniere's disease (MD) during the attacks using caloric and head-impulse tests (HITs). STUDY DESIGN: Retrospective case series review. METHODS: We analyzed the results of bithermal caloric and HITs during the attacks in 16 patients with MD. Quantitative analyses of HITs were conducted using a magnetic search coil technique. RESULTS: In unilateral MD (14 patients, 42 semicircular canals), the head impulse gain of the vestibulo-ocular reflex (VOR) was either normal (28 of 42, 67%), decreased (8 of 42, 19%), or increased (6 of 42, 14%) for each semicircular canal in the affected ear. Likewise, the head impulse VOR gain was either normal (29 of 42, 69%), increased (11 of 42, 26%), or decreased (2 of 42, 5%) in the intact ear. The VOR gain for the horizontal canal was significantly lower on the affected side (P = 0.013). However, the VOR gains for the anterior and posterior canals did not differ between the sides (P = 0.270, P = 0.282). In bilateral MD (two patients, 12 semicircular canals), the VOR gain was either decreased (6 of 12, 50%) or normal (6 of 12, 50%) in either ear. In contrast, the caloric responses were usually decreased in the affected ear (7 of 11, 64%, including one with bilateral MD). CONCLUSION: During the attacks of MD, HITs showed varied results between the ears and among the canals, although the caloric responses were usually decreased in the involved ear. These dissociations suggest a frequency-dependent impairment of canal function or mechanical property of the endolymphatic hydrops during the attacks of MD. LEVEL OF EVIDENCE: 4. Laryngoscope, 127:702-708, 2017.
Authors: B F van Esch; K Abolhosseini; S Masius-Olthof; H J van der Zaag-Loonen; P P G van Benthem; Tj D Bruintjes Journal: J Vestib Res Date: 2018 Impact factor: 2.354
Authors: Ji-Soo Kim; David E Newman-Toker; Kevin A Kerber; Klaus Jahn; Pierre Bertholon; John Waterston; Hyung Lee; Alexandre Bisdorff; Michael Strupp Journal: J Vestib Res Date: 2022 Impact factor: 2.354