Morgane Marc1, Charlotte Hautefort1, Jean-Pierre Guichard2, Philippe Herman1, Emmanuel Houdart2, Michel Toupet3, Michael Eliezer4. 1. Department of Head and Neck Surgery, Lariboisière University Hospital, Paris, France. 2. Neuroradiology Unit, Department of Neuroradiology, Lariboisière University Hospital, 75010, Paris, France. 3. Centre d'Explorations Fonctionnelles Otoneurologiques, Paris, France. 4. Neuroradiology Unit, Department of Neuroradiology, Lariboisière University Hospital, 75010, Paris, France. michael.eliezer@aphp.fr.
Abstract
INTRODUCTION: Unilateral vestibular atelectasis (UVA), an entity first described by Merchant and Schuknecht in 1988, has rarely been reported in vivo as of yet. We specify here the clinical characteristics of 22 patients diagnosed with UVA. MATERIALS AND METHODS: Patients with a radiological diagnosis of UVA who underwent delayed inner ear MRI were included between April 2017 and January 2020. Full clinical testing including ocular infrared video-oculography, oVEMPs, cVEMPs, vHIT, bithermal caloric testing and auditory testing was performed. RESULTS: There were 13 men and 9 women, of mean age 58.6 ± 13.7 years. Onset was more frequently sudden (73%) than insidious (27%) though both clinical presentations were reported, and positional vertigo was described in 41% of cases. There were only two (9%) patients reporting Tullio's phenomenon. Vestibular testing showed that in 90% of cases, there was utricular dysfunction on oVEMP, while in 77% of cases, saccular function was preserved on cVEMP. vHIT showed high-velocity canal function impairment in all 22 patients: 8 patients (36%) had one impaired canal, 5 (23%) had two and 9 (41%) had all three canals affected. Caloric tests found complete unilateral areflexia, in 65% of tested cases, and partial deficiency in 35% of cases. Nine patients (40%) displayed asymmetrical hearing. CONCLUSION: We described in this study the various clinical presentations of a disease rarely reported in vivo, UVA. Initial clinical presentation can appear similar to an acute vestibular deficit, a recurrent positional vertigo, or fluctuating dizziness.
INTRODUCTION: Unilateral vestibular atelectasis (UVA), an entity first described by Merchant and Schuknecht in 1988, has rarely been reported in vivo as of yet. We specify here the clinical characteristics of 22 patients diagnosed with UVA. MATERIALS AND METHODS:Patients with a radiological diagnosis of UVA who underwent delayed inner ear MRI were included between April 2017 and January 2020. Full clinical testing including ocular infrared video-oculography, oVEMPs, cVEMPs, vHIT, bithermal caloric testing and auditory testing was performed. RESULTS: There were 13 men and 9 women, of mean age 58.6 ± 13.7 years. Onset was more frequently sudden (73%) than insidious (27%) though both clinical presentations were reported, and positional vertigo was described in 41% of cases. There were only two (9%) patients reporting Tullio's phenomenon. Vestibular testing showed that in 90% of cases, there was utricular dysfunction on oVEMP, while in 77% of cases, saccular function was preserved on cVEMP. vHIT showed high-velocity canal function impairment in all 22 patients: 8 patients (36%) had one impaired canal, 5 (23%) had two and 9 (41%) had all three canals affected. Caloric tests found complete unilateral areflexia, in 65% of tested cases, and partial deficiency in 35% of cases. Nine patients (40%) displayed asymmetrical hearing. CONCLUSION: We described in this study the various clinical presentations of a disease rarely reported in vivo, UVA. Initial clinical presentation can appear similar to an acute vestibular deficit, a recurrent positional vertigo, or fluctuating dizziness.
Authors: F Rubin; F Simon; B Verillaud; P Herman; R Kania; C Hautefort Journal: Eur Ann Otorhinolaryngol Head Neck Dis Date: 2017-12-20 Impact factor: 2.080
Authors: M Eliezer; G Poillon; A Gillibert; J Horion; Y Cruypeninck; E Gerardin; N Magne; A Attyé Journal: Diagn Interv Imaging Date: 2018-02-15 Impact factor: 4.026
Authors: Angela Wenzel; Bryan K Ward; Michael C Schubert; Amir Kheradmand; David S Zee; Georgios Mantokoudis; John Patrick Carey Journal: Otol Neurotol Date: 2014-06 Impact factor: 2.311