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Volume 15 (1); March 2016
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Reviews
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Vestibular Rehabilitation for Patient with Bilateral Peripheral Vestibular
Deficit
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Hyun Woo Park, Seong Ki Ahn
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Res Vestib Sci. 2016;15(1):1-4.
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Abstract
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- Bilateral vestibular deficit affects far fewer patients than unilateral deficit, and
thus has been understudied. When bilateral vestibular organs are injured, loss of
input of vestibulo-ocular and vestibulo-spinal reflex that normally stabilize the
eyes and body, affected patients suffer blurred vision during head movement,
postural instability, and disequilibrium. Vestibular rehabilitation therapy is an
exercise-based treatment program designed to promote vestibular adaptation and
substitution. The rationale for the exercises, which originated from the observation
that patients who were active recovered faster, was based on the supposition that
the head movements that provoke the patient’s dizziness play an important role
in hastening the recovery process. Here the author reviews the clinical manifestation
and treatment of bilateral vestibular deficit that include vestibular
rehabilitation therapy and vestibular device that studied today.
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Functional Neuroimaging in Neuro-Otology
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Jae Jin Song
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Res Vestib Sci. 2016;15(1):5-10.
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Abstract
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- Neuro-otologic symptoms such as dizziness, hearing loss, or tinnitus give rise to
peripheral change-induced neuroplasticity or central pathology-induced structural
or functional changes. In this regard, functional neuroimaging modalities such as
positron emission tomography (PET), functional magnetic resonance imaging
(fMRI), magnetoencephalography (MEG), quantitative electroencephalography
(qEEG), or functional near infrared spectroscopy have provided researchers with
possibility to observe neuro-otologic disease-induced central functional changes.
Among these methods, PET and fMRI are advantageous over qEEG or MEG
with regard to spatial resolution, while qEEG and MEG are advantageous over
PET or fMRI with regard to temporal resolution. Also, fMRI or MEG is not
suitable for patients with implanted devices, whereas PET is not ideal for
repetitive measures due to radiation hazard. In other words, as these modalities
are complementary to one another, researchers should choose optimum imaging
modality on a case by case basis. Hereinafter, representative functional neuroimaging
modalities and their application to neuro-otologic research will be
summarized.
Original Articles
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Vestibulo-Ocular Reflex Recordings of Small Rodents using a Novel
Marker Array
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Mi Joo Kim, Jiyeon Lee, Eui Jae Hong, Eun Ji Lee, Yu Jin Min, Dong Ju Lee, Nam Beom Kim, Gyu Cheol Han
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Res Vestib Sci. 2016;15(1):11-16.
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Abstract
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- Objective: Recording the nystagmus of small experimental rodents is an integral
technique in vestibular research. Theoretically, the size and the shape of markers
strongly affect the analysis of 3 dimensional nystagmus.
Methods
The nystagmus of 6 healthy ICR mice were recorded and their gain
values were compared using 200 μm, 300 μm, 400 μm, and 600 μm isosceles
triangle markers at the peak velocity of 60o/sec and 100o/sec with the rotational
stimulations of 0.1 Hz, 0.2 Hz, and 0.5 Hz.
Results
The gain values of 3 different sizes of the markers showed no significant
differences in horizontal- vertical-torsional component. However, it was unable
to record the nystagmus with 200 μm markers since the markers were too small
to be placed and stayed on the center of the pupils.
Conclusion
Technicians can decide the size of the markers from 200 to 600 ?m
to record the nystagmus of mice, depending on the technicians’ skills.
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Long-Term Outcomes of Canalith Repositioning for Benign Paroxysmal
Positional Vertigo: Kaplan-Meier Estimate
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Gu Il Rhim
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Res Vestib Sci. 2016;15(1):17-21.
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Abstract
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- Objective: The objective of this study is to determine the long-term recurrence
rate of benign paroxysmal positional vertigo (BPPV) and the factors associated
to such recurrence.
Methods
Retrospective review was performed for 295 patients diagnosed as
idiopathic BPPV. After successful resolution by particle repositioning maneuver,
all patients were followed up by visiting clinic or telephone. A study period was
1?56 months and average follow up period for study population after the initial
treatment was 26 months. The rate of recurrence was estimated according to the
method
of Kaplan-Meier and compared by the log-rank test.
Results
Overall recurrence rate by Kaplan-Meier estimate was 50% at 30 months.
Kaplan-Meier estimate suggests the effect of patient age, sex and visit of
treatment sessions in initial episode on BPPV recurrence over 3 year follow-up
period. Recurrent rate was significantly higher in patients aged 40 years or older
(p<0.013) and in patients with three or more visit of treatment sessions (p<0.015).
However, there was no significant association between recurrence rate and sex.
Conclusion
The long-term recurrence of BPPV was associated with age above
40 years and the number of visit for treatment sessions. This finding suggests
that the recurrence of BPPV may be related with aging process.
Case Reports
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A Case of Dolichoectasia of Vertebrobasilar Artery Presenting
Simultaneous Bilateral Sudden Sensorineural Hearing Loss with Vertigo
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Bum Ki Cho, Oh Joon Kwon, Dong Hyun Kim, Chang Woo Kim
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Res Vestib Sci. 2016;15(1):22-26.
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Abstract
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- Sudden sensorineural hearing loss (SNHL) develops usually in unilateral ear
without known etiology. In contrast, bilateral sudden SNHL is mostly related to
serious systemic diseases and have a severe hearing loss and poor prognosis
compared than unilateral one. We describe here a 59-year-old man presented with
a bilateral sudden SNHL and vertigo possibly attributed to dolichoectasia in
vertebrobasilar artery, and discuss the possible mechanism.
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Periodic Alternating Nystagmus in Patients with Cerebellar Abscess
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Hyung Lee, Hyun Ah Kim
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Res Vestib Sci. 2016;15(1):27-29.
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Abstract
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- Periodic alternating nystagmus (PAN) is characterized by a periodical reversal
in the direction of the nystagmus. Acquired PAN is caused by lesions of the
inferior cerebellar vermis, causing disinhibition of the velocity storage mechanism,
which is mediated by the vestibular nuclei. An eighty-year-old woman with
abscess in midline cerebellum experienced dizziness and imbalance. We observed
short period PAN with 7?8 seconds.