Research in Vestibular Science

Jae Yun Jung

23 Articles

Analysis of Clinical Features in Patients Showing Bilateral Vestibulopathy with Vestibular Function Test: Dong Hyun Kim, Jeong Hyun Lee, Bong Jik Kim, Chung Ku Rhee, Jae Yun Jung; Res Vestib Sci. 2014;13(2):47-52.

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Abstract PDF: Background and Objectives: Caloric test and rotatory chair test have been adopted in diagnosing bilateral vestibulopathy. However, most of patients who were confirmed by the diagnostic testing not complained typical symptoms of bilateral vestibulopathy such as ossilopsia and ataxia. Patients who do not have typical symptoms of bilateral vestibulopathy, were often diagnosed with bilateral vestibulopathy by caloric test and slow harmonic acceleration test (SHA). The aim of this study is to assess the clinical features between groups classified according to the caloric test and SHA test, and possibly to investigate the representative test in the diagnosis of bilateral vestibulopathy. Materials and Methods: Seventy-five patients were divided into three groups: (A) patients diagnosed with the caloric test only, (B) patients diagnosed with SHA test only, (C) patients satisfying the diagnostic criteria of both tests. Clinical characteristics, the results of physical examination, hearing test and vestibular function test (VFT) were compared among three groups. Results: There was no difference in clinical characteristics and results of physical examination among three groups. Regarding VFT results, only in step velocity test, The proportion of patients who showed low gain value on both sides were higher in group C than that of group A and B. No difference was observed in the other VFT results among three groups. Conclusion: We could not predict the clinical features of bilateral vestibulopathy by the results of VFT, and could not find preferable test in diagnosing bilateral vestibulopathy.

Predictive Value of Rectified Vestibular Evoked Myogenic Potential in Determining Lesion Side in Unilateral Vestibulopathy Patients: Hye Ran Son, Bong Jik Kim, Chung Ku Rhee, Jae Yun Jung; Res Vestib Sci. 2013;12(4):121-126.

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Abstract: Background and Objectives: Rectified vestibular evoked myogenic potential (rVEMP) is a relatively new method that simultaneously measures the muscle contraction power during VEMP recording and corrects the difference of contraction power afterwards. Several studies showed rVEMP is more reliable than non-rectified VEMP (nVEMP). However, those studies evaluated usefulness of rVEMP in patients with normal vestibular function. Thus, we evaluate the effect of rectification to predict lesion side in unilateral vestibulopathy patients. Materials and Methods: One-hundred nine acute unilateral vestibulopathy patients whom VEMP were performed in were included retrospectively. We regarded hearing loss side as lesion side in sudden hearing loss (n=33), meniere’s disease (n=29) and in vestibular neuritis (n=45), the side of positive head thrust test with canal paresis >30% was regarded as a lesion side. We excluded bilateral vestibulopathy. The inter-aural amplitude difference (IAD) ratio was calculated by the nVEMP and rVEMP. Results: Mismatch rate between nVEMP and rVEMP was 36.61%, match rate was 49.54%, opposition rate was 13.76%. rVEMP predicted lesion side on 15 patients of mismatch group correctly, while nVEMP predicted lesion side on 25 patients of mismatch group. There was no significant difference in IAD ratio between nVEMP and rVEMP in patients who showed lesion side weakness on both nVEMP and rVEMP. But, the younger the patient was, the more chance of mismatch was significantly (p=0.03). Conclusion: There was no more corrective role in determining lesion side by rectification in unilateral vestibulopathy. Thus rVEMP might not be helpful for predicting lesion side in unilateral vestibulopathy.

Cochleovestibular Otosclerosis Without Conductive Hearing Loss: Woo Sung Na, Sang Hyun Park, Chung Ku Rhee, Jae Yun Jung; Res Vestib Sci. 2013;12(1):22-26.

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Abstract: Otosclerosis typically starts around stapes footplate presenting conductive hearing loss initially. However, otosclerosis may involve cochlea and vestibule causing sensorineural hearing loss and dizziness. We report a case of cochleovestibular otosclerosis without conductive hearing loss featuring Meniere’s disease.

Apogeotropic Positional Nystagmus in Pontine Infarction: Hye Ran Son, Jae Yun Jung, Myung Whan Suh; Res Vestib Sci. 2012;11(3):105-109.

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Abstract: It is thought that horizontal canal benign paroxysmal positional vertigo (BPPV) is the most common cause of apogeotropic direction-changing positional nystagmus (DCPN). But there are many reports about cerebellar or brainstem lesions as the cause of apogeotropic DCPN. We also report a 72-year-old male patient who showed apogeotropic DCPN, but was proven to have a pontine infarction. The patients complained of disequilibrium which has lasted for 3-4 years and aggravated recently. The symptom was present only when he stood up, and was absent as soon as he sat down. He was not able to successfully perform the Romberg test and tandem gait on physical examination. Vestibular function test revealed apogeotropic DCPN without spontaneous nystagmus. Rotation chair test and caloric test results were all within normal limit. On the brain magnetic resonance imaging, newly detected infarction in the left basal ganglia, pons and right parietal lobe was found. Although horizontal canal BPPV is the most common cause of apogeotropic DCPN, we should be aware that there can be patients with central origin DCPN. In this report, we present the detailed history of this patient and tried to point out the clues to suspect central lesion in patients with apogeotropic DCPN.

Gender Difference of Clinical Characteristics in Meniere’s Disease: Se Young An, Hye Ran Son, Myung Whan Suh, Chung Ku Rhee, Jae Yun Jung; Res Vestib Sci. 2012;11(3):88-91.

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Abstract: Background and Objectives: Meniere’s disease (MD) is a clinical cluster of common symptoms by various causes rather than a single disease entity. Many causes such as autoimmune, allergy, vascular insufficiency have been thought to be related with Meniere’s disease. We assumed that different pathologic mechanisms have contribution in each gender. With this premise, we compared clinical characteristics between male and female patients to determine if there is any difference indicating heterogeneous underlying pathology. Materials and Methods: We reviewed medical records of 61 patients (43 female, 18 male) who were diagnosed as unilateral definite MD and underwent vestibular function test and audiologic evaluation (more than two times of pure tone audiometry during the follow-up period) from October 2005 to December 2011. Results: The average duration of dizziness in females was longer than in males. In the worst ipsilateral pure tone audiometry, low frequency thresholds were lower in females than in males. Female had lesser hearing difference at all frequencies between the sides and showed more hearing fluctuation than male. There was no significant difference between male and female in the vestibular function test. Conclusion: These results are insufficient to suggest that the pathogenesis of MD differs between the genders. However, some differences between the genders prompt a need for future studies involving more patients.

A Case of Bilateral Benign Paroxysmal Positional Vertigo in Bilateral Mondini Malformation With Right Enlarged Vestibular Aqueduct Syndrome: Min Young Lee, Sung Do Jung, Myung Whan Suh, Jae Yun Jung; Res Vestib Sci. 2012;11(2):77-80.

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Abstract PDF: Enlarged vestibular aqueduct syndrome (EVAS) is well known congenital bony ear anomaly. It’s audiologic symptoms and radiological findings are reported in many literatures. However vestibular symptoms of EVAS are rarely reported. A patient with right EVAS developed sudden spinning vertigo on casual observation. He is diagnosed as bilateral benign paroxysmal positional vertigo and recovered by canal repositioning maneuver. We present this case with reviews of previous literatures.

Conservative Management of Horizontal Canal Benign Paroxysmal Positional Vertigo Resistant to Treatment: Hye Ran Son, Chung Ku Rhee, Myung Whan Suh, Jae Yun Jung; Res Vestib Sci. 2011;10(4):141-144.

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Abstract PDF: Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo. Although it is easily cured by repositioning maneuvers for the majority of patients, it can be resistant to treatment in rare cases. Surgery can be considered for such patients with intractable BPPV. But surgery may be followed by some side effects such as hearing loss and persistent disequilibrium. We report a 77-year-old-female patients who had positional vertigo for 5 years in despite of repositioning maneuver at several hospitals. We performed repeated repositioning maneuvers twice a day for 1 month. Her symptom and nystagmus finally subsided after 2 months. Repeated aggressive repositioning maneuver may be an alternative for surgery for patients with intractable BPPV.

Clinical Comparison Between Ocular and Cervical Vestibular Evoked Myogenic Potentials: Il Kwon Cho, Myung Whan Suh, Tae Hyun Moon, Chung Ku Rhee, Jae Yun Jung; Res Vestib Sci. 2011;10(2):68-73.

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Abstract PDF: Background and Objectives: The goal of this study was to compare the outcome between cervical vestibular-evoked myogenic potential (cVEMP) and ocular VEMP (oVEMP) in the patients with definite vestibular dysfunction. Also, the subjective discomfort level was compared between cVEMP, classic oVEMP and head positioned oVEMP (a new method designed by the authors). Materials and Methods: Eighteen patients with dizziness associated with unilateral vestibular hypofunction were included in this study. Vestibular neuritis, Ramsay-hunt syndrome and sudden sensorineural hearing loss with vertigo were included in unilateral vestibular hypofunction disease. cVEMP, classic oVEMP, and head positioned oVEMP were assessed and compared. To compare the subjective discomfort during the tests, visual analogue scale on discomfort was checked. Results: There was a discrepancy between the cVEMP and classic oVEMP in 31.3% of the cases. The classic oVEMP were associated with more discomfort than the cVEMP. But, there was no difference between the classic and head positioned oVEMP. Conclusion: Since a substantial discrepancy was identified between the cVEMP and oVEMP, the pathways involved in cVEMP and oVEMP are likely different even with the same air conduction tone stimuli. The head positioned oVEMP may be an alternative to the classic oVEMP which has similar results and subjective discomfort levels.

Competence in Suppressing the Visual Fixation among Different Types of Frenzel Glasses: Sungdo Jung, Jae Yun Jung, Chung Ku Rhee, Myung Whan Suh; Res Vestib Sci. 2010;9(4):134-138.

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Abstract PDF: Background and Objectives: Several manufacturers supply different types of Frenzel glasses, but the quality of these varied Frenzel glasses seems to be quite different. The aim of this study was to compare the competence in suppressing visual fixation (VF) among different types of Frenzel glasses. The second aim was to develop a new type of Frenzel glasses which is cheaper and more convenient to carry, but has an equivalent competence. Materials and Methods: Four different types of Frenzel glasses were evaluated: 30 diopter Frenzel glasses manufactured by Nagashima (N), 10 diopter Frenzel glasses manufactured by Jungang (J), 13 diopter conventional magnifying glasses (M) and 17 diopter Fresnel lens glasses assembled by the authors. The amplitude of the spontaneous nystagmus (SN) was measured though the electronystagmography system. The SN was measured 35 times from 15 patients who were diagnosed as vestibular neuritis. Results: The mean amplitude of the SN was 8.8±3.2°/sec when measured with the videonystagmography goggles. When the same SN was measured through the 4 different Frenzel glasses, it was 7.5±2.8 (N), 6.3±3.0 (F), 6.2±3.0 (M), and 5.7±2.6 (J) °/sec respectively. The amplitude of the SN was significantly bigger when wearing the N glasses compared to the other 3 glasses. The SN was significantly smaller when wearing the J glasses compared to the F glasses. Conclusion: The competence of suppressing VF was significantly different among the varied types of glasses. The F glasses seem to have a similar or better competence with the J glasses. F glasses seems to be a fairly good alternative which is very portable and cheap.

Nystagmus in the Ictal Period of Vertebrobasilar Insufficiency: Kun Woo Kim, Chang Min Lee, Jae Yun Jung, Myung Whan Suh; Res Vestib Sci. 2010;9(3):114-117.

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Abstract PDF: The nystagmus of vertebrobasilar insufficiency (VBI) patients is not clearly understood. In this article we report a videonystagmography (VNG) result which had been recorded in a VBI patient during his ictal period. The spontaneous nystagmus was purely torsional toward the left side. During the various positional tests, up beating left torsional and right horizontal nystagmus was found. Right beating horizontal nystagmus was stronger when the head was turned to the left side. But we were not able to explain the exact mechanism of this nystagmus. Although the mechanism is not fully understood the pattern of nystagmus reported in this article may be helpful in distinguishing VBI from other diseases by means of VNG recording.

Effect of Preset Angle on Subjective Visual Vertical/Horizontal: Comparison between Normal Subjects and Patients with Dizziness: Tae Hyun Moon, Sung Hyen Bae, Myung Whan Suh, Chung Ku Rhee, Jae Yun Jung; Res Vestib Sci. 2010;9(2):52-57.

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Abstract PDF: Background and Objectives Subjective visual vertical (SVV) and subjective visual horizontal (SVH) are well known otolith function tests. Patients with acute unilateral vestibular weakness have a tendency to set the bar toward the side of the lesion in SVV and SVH tests. The object of this article is to identify the effect of preset angle on SVV and SVH tests in normal subjects and patients with dizziness. Materials and Methods From October 2008 to March 2009, thirty healthy volunteers, twenty eight vestibular neuritis (VN) patients (14-uncompensated, 14-compensated), Twenty five patients who had migrainous vertigo (MV) were enrolled. All subjects performed the test two times in each of the clockwise and counter-clockwise preset angle. Results In normal subjects, there was significant influence by preset angle on SVV test, not on SVH test. In VN patients with nystagmus, both SVH and SVV were not influenced by preset angle. In VN patients without nystagmus and in MV patients, there were significant influence by preset angle on both SVV and SVH tests. Conclusion SVV and SVH values depend on the direction of the preset angle in MV and uncompensated VN patients. The preset angle should be considered in the interpretation of SVV and SVH values.

Positional Nystagmus in Acute and Subacute Vestibular Neuritis: Do Joon Lee, Jae Yun Jung, Chung Ku Rhee, Myung Whan Suh; Res Vestib Sci. 2010;9(1):21-26.

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Abstract PDF: Background and Objectives By understanding the typical pattern of nystagmus during diverse positional change, we might be able to diagnose the subacute vestibular neuritis (VN) more accurately. The aim of this study was to identify the typical pattern of positional nystagmus in compensated and uncompensated VN patients. Materials and Methods The videonystagmography of 182 patients who were diagnosed as VN were reviewed retrospectively. The patients were classified into two groups by the presence or absence of spontaneous nystagumus (SN). The amplitude of nystagmus evoked by head roll test (HRT) and body roll test (BRT) were compared between the lesion side (ipsilateral, i) and the healthy side (contralateral, c). Results In the VN patients with SN, positional nystagmus was stronger on the iHRT and iBRT compared to the cHRT and cBRT, respectively. But in the VN patients without SN, this pattern of nystagmus was not evident. Although a stronger nystagmus was found in the iBRT compared to the cBRT, the mean amplitude of nystagmus was not significantly different. Also there was no difference in the nystagmus between the iHRT and cHRT. Conclusion The typical pattern of positional nystagmus which can be found in the VN with SN was not evident in VN without SN. Positional nystagmus may not be able to give us useful information on diagnosing subacute VN.

Possibility of Misdiagnosing the Lesion Side in Unilateral Vestibular Weakness: Il Kwon Cho, Jae Yun Jung, Chung Ku Rhee, Myung Whan Suh; Res Vestib Sci. 2009;8(2):168-173.

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Abstract PDF: Sudden sensorineural Hearing Loss with Vertigo (SHLV) is characteristic of sudden onset vertigo and unilateral hearing loss, due to acute and profound deterioration in a vestibular and cochlear system. It is relatively easy to determine the lesion side in SHLV, because the patient will complain of unilateral hearing loss. But, it might not beapplicable to vestibular neuritis case, and several vestibular function tests may be helpful in deciding the lesion side. We have recently encountered a patient with SHLV whose caloric and SHA did not match with the lesion side. We speculated that the uncompensated dynamic defect and imbalance of the cerebellar clamping has been implicated in this lab finding. Although the exact mechanism of this curious finding cannot be explained by this single case report, we should consider that one could make a mistake to determine the involved site just only by lab finding in vestibular neuritis.

Auditory Neuropathy Accompanying Unilateral Vestibulopathy: Hye Young Kim, Jae Yun Jung, Chung Ku Rhee, Myung Whan Suh; Res Vestib Sci. 2009;8(1):60-65.

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Abstract PDF: Auditory neuropathy is a term used to describe abnormal auditory brain stem response (ABR) in the presence of preserved cochlear outer hair cell functions which can be measured by otoacoustic emissions (OAE). We report a case of auditory neuropathy accompanying unilateral vestibular hypofunction and benign paroxysmal positional vertigo. The patient was a 50-year-old man who had experienced hearing loss and tinnitus which started two weeks ago. He had taken several medicines for the last few months due to his lung cancer and tuberculosis. ABR and OAE were checked and the results were compatible with auditory neuropathy. To evaluate his vestibular function, video nystagmography, rotatory chair and oculomotor test were checked. The results were compatible with left unilateral vestibular loss and left lateral canal cupulolithiasis. But the patient experienced nearly no vertigo during his daily life. As presented in this case, most of the auditory neuropathy patients do not complain of vertigo. This is probably due to long term central compensation or maybe due to the decreased nerve conduction of the vertiginous sensation. Vestibular evaluation may be crucial in order to detect masked vestibular dysfunction and to protect these patients from imbalance accidents. Key Words: Auditory neuropathy; Vestibular Neuronitis; Evoked Potentials, Auditory, Brain Stem; Otoacoustic Emissions

Clinical Implication of Dissociation between Subjective Visual Horizontal and Subjective Visual Vertical: Tae Hyun Moon, Sung Hyen Bae, Il Kwon Cho, Myung Whan Suh, Chung Ku Rhee, Jae Yun Jung; Res Vestib Sci. 2009;8(1):37-42.

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Abstract PDF: Background and Objectives Subject visual vertical (SVV) and subject visual horizontal (SVH) is well known otolith function test. Patients with acute unilateral vestibular weakness fail to set the test bar within normal range in SVH/SVV showing abnormal deviation toward lesion side. In some cases, SVH and SVV are deviated towards different directions, and analysis of these findings is rarely reported. The authors analyzed correlation of SVH/SVV and other vestibular function tests in patients with various vestibular diseases. Materials and Methods From April 2005 to July 2007, total 234 patients who had admitted for dizziness were enrolled. All patients were divided in two groups, non-dissociation group (n=215) and dissociation group (n=19). Correlation of SVH, SVV, Videonystagmography (VNG), the rotating chair test was compared. Results 8.1% of patients showed dissociation between SVH and SVV. Clinical features did not showed significant difference between groups. In non-dissociation group, SVH/SVV showed correlation with VNG, rotating chair test. However in dissociation group, VNG and rotating chair test revealed high rate of consistency with deviation of SVH than that of SVV. Also direction of SVH and dizziness had higher consistency (88.9%) than that of SVV (11.1%). Conclusion The SVH showed consistency with other vestibular function test and may be more reliable than SVV when the result is dissociated. Key Words: Subjective visual vertical; Subjective visual horizontal; Dissociation

Bilateral Vestibular Hypofunction Induced by Unilateral Herpes Zoster Oticus: Sung Won Chung, Jae Yun Jung, Chung Ku Rhee, Myung Whan Suh; J Korean Bal Soc. 2008;7(2):207-212.

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Abstract PDF: Herpes zoster oticus usually accompanies vestibulopathy on the ipsilateral ear. However we have encountered two herpes zoster oticus patients with bilateral vestibulopathies. Bilateral vestibulopathy was detected on the 2nd month and 19th day of herpes zoster oticus, respectively. While the contralateral vestibulopathy was detected 2 month after the ipsilateral vestibulopathy in the first patient, the vestibular function deteriorated simultaneously on the 19th day in the second patient. It seems that the bilateral vestibulopathy was caused by an autoimmune process in both cases, but the initiating event is different. The ipsilateral vestibular damage may have sensitized the immune system in the first patient resulting in sympathetic vestibulopathy. But in the second patient, the ipsilateral cochlear damage may have sensitized the immune system resulting in simultaneous bilateral vestibulopathy. Key words: Herpes zoster oticus, Bilateral vestibulopathy, Autoimmune, Sympathetic vestibulopathy

Multicenter study on the treatment pattern of Ménière’s disease in Korea: Sung Kwang Hong, Eui Kyung Koh, Kyu Sung Kim, Kyoung Ho Park, Hong Ju Park, Seong Ki Ahn, Joong Ho Ahn, Won Sang Lee, Gi Jung Im, Jae Yun Jung, Won Ho Chung, Gyu Cheol Han, Sung Won Chae, Ja Won Koo; J Korean Bal Soc. 2008;7(2):174-181.

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Abstract PDF: Background and Objectives: It is hard to determine the efficacy of several treatment options of Ménière’s disease since dynamic course of the disease and diverse rate of recurrence. Few modalities are regarded as ‘effective’ in the viewpoint of evidence based medicine. Study was conducted to know the current status of treatment options for Ménière’s disease. Materials and Methods: A multicenter survey was conducted using questionnaires to collect information on current status of treatment patterns in Ménière’s disease. The questionnaire answered by neurotologic surgeons working at 12 institutes in Korea was analyzed. Results: Low salt diet was always instructed to their patients, but 8 out of 12 responders (67%) did not emphasis on the amount of dietary salt. Duration of pharmacotherapy was ranged from 3 to 12 months. Intratympanic steroid injection was performed in 8 institutes (67%). Every institute agreed on the role of intratympanic gentamicin application. Treatment options for intractable patients were asked. Endolymphatic sac surgery, intratympanic steroid, Meniette device and intratympanic aminoglycoside injection were answered in patients who hope to preserve residual hearing. On the contrary, in patients without serviceable hearing, intratympanic jnjection of aminoglycosides (9/12, 75%) dominated as the next treatment option. Conclusions: Most institutes provide similar patterns of practice in medical treatment. The application of intratympanic aminoglycoside is also agreed in intractable patients without serviceable hearing. However, thoughts about the role and detailed methods of the surgical and adjunctive treatment options were not agreed, especially in intractable patients with good hearing. Further clinical studies and discussions would be necessary to provide consensus for the best treatment of Ménière’s disease in Korea. Key words : Ménière’s disease, Pharmacotherapy, Surgery, Aminoglycosides

Delayed Postoperative Vertigo After Tympanomastoidectomy Due to Simultaneous Serous Labyrinthitis and BPPV: Yun Ho Kim, Jae Yun Jung, Chung Ku Rhee, Myung Whan Suh; J Korean Bal Soc. 2008;7(1):89-95.

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Abstract PDF: Postoperative vertigo after tympanomastoidectomy can be attributed to several causes such as inner ear damage due to excessive ossicle handling, labyrinthitis, BPPV resulting from vibration of drilling, iatrogenic lateral semicircular canal damage, and perilymphtic fistula. Differential diagnosis is critical for the proper management and prognosis of accompanied sensorineural hearing loss, but it may be difficult in some cases. Especially it is quite difficult to distinguish between the serous and suppurative labyrinthitis. In this article we present a case with simultaneous serous labyrinthitis and BPPV. The patient developed whirling vertigo and hearing loss on the 5th day after tympanomastoidectomy. After conservative treatment with steroid and antibiotics, his hearing recovered to preoperative level. We retrospectively reviewed the pitfalls to make a correct diagnosis in this patient and the serial change in nystagmus during the treatment period. The usefullness of the rotation chair test to predict the prognosis of sensorineural hearing loss in labyrinthitis was also discussed.

The Correlation of Benign Paroxysmal Vertigo of Childhood And Migraine: Jae Yun Jung, Hye Young Kim, Myung Whan Suh, Chung Ku Rhee; J Korean Bal Soc. 2008;7(1):55-59.

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Abstract PDF: Background and Objectives: Many authors have suggested close relationship between benign paroxysmal vertigo of childhood (BPVC) and migraine. But the relationship between the two is not clearly determined. Therefore we investigate clinical features and the course in children with BPVC and the possibility of evolution of migraine in BPVC. Materials and Methods: We interviewed 30 subjects having enough medical records and fitted to BPVC category who visited otorhinolaryngology for vertigo from 1995 to 2006 year. Results: The BPVC was the most common diagnosis in our hospital and migraine associated vertigo was followed. The main features of the children with BPVC were in agreement with previous reports. The major differences were later age of onset, having trigger factor and non-spinning type of vertigo. During the follow up, 8 children developed migraine. Females were dominant duration of illness was longer in this group. Almost of them suffered from motion sickness and had more family history of migraine, which was maternal dominant. Conclusions: The long term close follow-up may be needed in BPVC having possibility of evolution to migraine.

Results of Otolithic Function Testing and Related Clinical Features in Unilateral Definite Meniere’s Disease: Jae Yun Jung, Jeong Beom Kim, Tae Hyun Moon, Yong Won Chung, Chung Ku Rhee; J Korean Bal Soc. 2007;6(2):207-213.

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Abstract PDF: Background and Objectives: The purpose of this study is to identify the typical pattern of otolithic function tests in unilateral definite Ménière’s disease patients. And we compared with clinical features and other tests results of patients who showed abnormal otolithic function tests. Materials and Method: We reviewed 42 patients (29 patients are female and 13 patients are male) who were diagnosed as unilateral definite Ménière’s disease and underwent otolithic function tests in Hospital from December 2005 to April 2007. Results: The patients who showed abnormal findings in vestibular evoked myogenic potential (VEMP) have suffered for longer period than the others. Those results of VEMP had positive correlation with summating potential/action potential (SP/AP) ratio. The average deviation of subjective visual vertical/ horizontal (SVV/SVH) were relatively higher in that disease patients than normal controls. There was no significant relation between VEMP results and other clinical features and result of other tests (caloric test and pure tone audiometry). Conclusion: The longer prevalence period of Ménière’s disease is, the more susceptability of abnormal VEMP we can expect. In those, SVV/H can go out of normal range. Like a electrocochleography, otolithic function test could play a supportive role in diagnosing of Ménière’s disease.

The Effect of Balance Exercise Using Exercise Ball on Balance Function of Elderly: Suk Joon Lee, Jai Hwan Hyun, Yong Soo Lee, Hyun Ju Lee, Hyun Jung Lee, Jae Yun Jung, Chung Ku Rhee; J Korean Bal Soc. 2007;6(2):132-137.

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Abstract PDF: Background and Objectives: Vestibular rehabilitation is an important therapy to treat dizziness in elderly. The aim of this study is to evaluate the effect of balance and resistance exercises in improving balance function in elderly. Methods: Sixty elderlies between the age of 65 to 80 years old were divided into two groups; the control group and exercise group. The exercise group carried out balance and resistance exercises using an exercise ball for 60 minutes each time, 3 times/week for 16 weeks. The elderlies in both groups went through sensory organization test (SOT) and motor control test (MCT) of Equi test pre-series of exercise and post-series of exercise. Results: Conditions 4 and 6 of SOT in control group and conditions 3, 4, 5, and 6 of exercise group showed significantly higher scores in post-exercise compared to those of pre-exercise status. In condition 4, the score was significantly higher in exercise group compared to that of control group. In sensory analysis, the visual and vestibule analyses ratio of post-exercise were significantly higher compared to those of pre-exercise status. The visual analysis ratio of exercise group was significantly higher compared to that of control group. In MCT, the latency of medium forward of exercise group was significantly decreased compared to that of control group in post-exercise status. Conclusion: The results of this study showed that the balance and resistance exercises using an exercise ball was effective in improving various scores and ratio of SOT and sensory analyses in the elderly. This kind of exercises appears to improve balance function in the elderly. The balance and resistance exercises using exercise ball may be effective exercises to improve balance function of chronic dizziness including presbyastasis.

Correlation between Spontaneous Nystagmus and Vestibular Function Test Parameters according to Gender and Age in Vestibular Neuritis: Jae Yun Jung, Eun Seok Lim, Young Saeng Kim, Min Young Lee, Yong Won Chung, Chung Ku Rhee; J Korean Bal Soc. 2006;5(2):248-252.

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Abstract PDF: Background
and Objectives: There are caloric test, SCEP, DP in Step velocity and VOR asymmetry in SHA test as parameters for evaluation in unilateral peripheral vestibulopathy in parameter of vestibular function test. The aim of this study is to assess the correlation between these parameters and intensity of spontaneous nystagmus in vestibular neuritis. Materials and Method: We evaluated 75 patients who were diagnosed as vestibular neuritis with 3 degree spontaneous nystagmus at vestibular function test lab from January 2000 to July 2005 in Dankook university hospital. The correlations between direction and intensity of spontaneous nystagmus and monothermal caloric test, SCEP and DP in step velocity, VOR asymmetry (0.01, 0.04, 0.16 Hz) in SHA test were analysed. And correlations according to sex, age were also analysed.
Results
The correlation coefficient between intensity of spontaneous nystagmus and monothermal caloric test was 0.60. The correlation coefficient between intensity of spontaneous nystagmus and SCEP was 0.35. The correlation coefficient between intensity of spontaneous nystagmus and Tc DP was 0.36 and it showed no significant correlation. The correlation coefficient between intensity of spontaneous nystagmus and VOR asymmetry (0.01, 0.04, 0.16) was 0.57, 0.46, 0.51, respectively and there was higher correlation in man, age under 60.
Conclusion
Intensity of spontaneous nystagmus showed close relations to monothermal caloric test, VOR asymmetry of SHA, Tc DP, SCEP DP in sequence. In addition, young male patients tends to be closely related to intensity of spontaneous nystagmus. Key Words : Spontaneous nystagmus, Vestibular function test, Vestibular neuritis

A Promotive Effect of Low Level Laser on Hair Cell Viability in Postnatal Organotypic Culture of Rat Utricles: Yong Won Chung, Jin Chul Ahn, Eun Seok Lim, Young Saeng Kim, Min Young Lee, Jae Yun Jung, Chung Ku Rhee; J Korean Bal Soc. 2006;5(1):29-34.

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Abstract PDF: Background
and Objectives: To culture and maintain mammalian hair cells is still a big challenge. In this study, long-term organotypic culture of rat utricular maculae was established to study vestibular hair cell. The effects of low level laser on hair cell viability in postnatal organotypic culture of rat utricles were investigated. Materials and Method: Uticular explants were prepared from postnatal 2 to 7 rats and cultured. To improve hair cell survival, the utricles were irradiated daily with low level laser. Whole-mount utricles were stained with FM1-43 which is known to be an efficient marker to identify live hair cells in cultured tissues. Such cells visualized directly through tissue culture dish with cover glass bottom by Confocal laser scanning microscope at specific time points.
Results
The explanted utricular hair cells were cultured for up to 31 days in in vitro culture system. In low level laser irradiation group, utricular hair cells were more survived at 24 DIV and 31 DIV.
Conclusion
These results suggest that low level laser promotes hair cell viability in utricular explants. Key Words : Organotypic culture, Low level laser, FM 1-43, Utricle

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