Research in Vestibular Science

Case Report

A Case of Tumarkin Otolithic Crisis Treated with Intratympanic Gentamicin Injection: Soo Hyun Joo, Hong-Ju Kim, Hyun-Ji Kim, Kyu-Sung Kim; Res Vestib Sci. 2020;19(1):22-28. Published online March 15, 2020; DOI: https://doi.org/10.21790/rvs.2020.19.1.22

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Abstract PDF: Tumarkin otolithic crisis is an abrupt attack of falling without loss of consciousness because of peripheral vestibular disorders. It occurs without warning in patients with late stage or end-stage of Meniere’s disease. It is an otologic emergency due to the risk of fall down injury, and has been treated with labyrinthectomy, vestibular neurectomy, and intratympanic gentamicin injection. Many reports have reported the efficacy of intratympanic injection of gentamicin (ITIG) as chemical ablation. We report a 58-year-old man with Tumarkin otolothic crisis from Meniere’s disease who presented with sudden drop attack while driving a taxi. He has suffered from recurrent rotatory vertigo accompanied by fluctuating hearing loss and tinnitus in the right ear for years. Despite medical treatment over the next 2 months, he experienced three more sudden drop attacks. He got chemical ablation with ITIG and remains without sudden drop attack until fourteen months later. Tumarkin otolithic crisis is a life-threatening otologic emergency. What we have experienced in this case is that for the safety and quality of life of the patient who suffers from Tumarkin otolithic crisis, aggressive vestibular function ablation with high dose ITIG is necessary.

Review

Vestibular Responses to Gravity Alterations: Nguyen Nguyen, Gyutae Kim, Kyu-Sung Kim; Res Vestib Sci. 2020;19(1):1-5. Published online March 15, 2020; DOI: https://doi.org/10.21790/rvs.2020.19.1.1

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Abstract PDF: Due to the adaptation to environments on Earth, various health-related issues are raised when exposed to different circumstances in space. Of environmental factors in space, gravity alteration has been considered as one of critical environmental changes. The primary inner organ to detect the gravity change is the vestibular system, especially otolith organs, and some limited researches have conducted to understand its mechanical and physiological properties. However, the related consequences were not consistent in despite of well description in systemic effects ranged from the peripheral vestibular system to the central nervous system. Here, we revisited the neuronal and behavioral effects of the gravity alteration on the relevant organs through this review. By representing previous studies for the gravity effects on the peripheral and central vestibular system, this review would provide the concrete understanding of the vestibular responses to the gravity alteration. Also, the physiological responses are expected to provide the useful resources to understand the systemic vestibular responses under the gravity alteration.

Essay

The 4th Joint Meeting of Japan Society of Equilibrium Research and Korean Balance Society: A Conference Report: Ho Yun Lee, Kyu-Sung Kim; Res Vestib Sci. 2019;18(1):24-26. Published online March 15, 2019; DOI: https://doi.org/10.21790/rvs.2019.18.1.24

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Case Report

Autoimmune Inner Ear Disease Mimicking Bilateral Ménièreʼs Disease: A Case Report: Hong-Ju Kim, Yoon-Gi Choi, Hyun Ji Kim, Kyu-Sung Kim; Res Vestib Sci. 2018;17(1):28-34. Published online March 15, 2018; DOI: https://doi.org/10.21790/rvs.2018.17.1.28

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2 Crossref

Abstract PDF

Autoimmune inner ear disease (AIED) is a rare disease, accounting for <1% of all cases of hearing impairment or dizziness. It is characterized by sensorineural hearing loss (SNHL) or vestibular dysfunction that results from an immunemediated process. Clinical features of AIED is SNHL that progresses over weeks to month with fluctuating hearing symptoms. Because there are no diagnostic laboratory and clinical feature, response to immunosuppressive therapy were important for diagnosis of AIED. Many diseases such as sudden SNHL and Meniere disease may also mimic AIED, a broad differential must be maintained in patients suspected of having AIED. We report a case of a 46-year-old female who presented with sudden hearing loss and vertigo. We could diagnose her as AIED with systemic lupus erythematous. The symptoms were improved treated with steroids.

Citations

Citations to this article as recorded by

Sensorineural Hearing Loss of Suspected Autoimmune Etiology: Two Cases of Cogan’s Syndrome
Jungmin Ahn, Brian Kim, Kyoung Rai Cho, Young-Soo Chang
Korean Journal of Otorhinolaryngology-Head and Nec.2021; 64(12): 943. CrossRef
A Case of Autoimmune Sensorineural Hearing Loss Responding to Cytotoxic Agent
Yong Woo Lee, Jin Lee, Min-Beom Kim, Sun O Chang
Korean Journal of Otorhinolaryngology-Head and Nec.2019; 62(8): 470. CrossRef

A Case of Autoimmune Inner Ear Disease Mimicking Bilateral Ménièreʼs Disease: Hong-Ju Kim, Yoon-Gi Choi, HyunJi Kim, Kyu-Sung Kim; Received February 1, 2018 Accepted March 8, 2018 Published online March 8, 2018; [Accepted]

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Abstract: Autoimmune inner ear disease(AIED) is a rare disease, accounting for <1% of all case of hearing impairment or dizziness. It is characterized by sensorineural hearing loss(SNHL) or vestibular dysfunction that result from an immune-mediated process. Clinical feature of AIED is SNHL that progresses over weeks to months and fluctuating hearing symptoms. Because there’s no diagnostic laboratory test, clinical features and re-sponse to immunosuppressive therapy were important for diagnosis of AIED. Many disease such as sudden sensorineural hearing loss and Meniere's disease may also mimic AIED, a broad differential must be maintained in patients suspected of having AIED. We report a case of a 46-year-old female who presented with sudden hearing loss and vertigo. We could diagnose her as AIED with systemic lupus erythematous(SLE). The symptoms were improved treated with steroids.

Original Articles

Usefulness Assessment of Cochlear Hydrops Analysis Masking Procedure Test in Progress of Ménièreʼs Disease: Young-Joo Ko, Hyun Ji Kim, Dae-Young Kim, Tae-Suk Kyung, Kyu-Sung Kim; Res Vestib Sci. 2017;16(1):17-22. Published online March 15, 2017; DOI: https://doi.org/10.21790/rvs.2017.16.1.17

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Abstract PDF: Objective: There were few recent study concern about usefulness of cochlear hydrops analysis masking procedure (CHAMP) in progression of Ménièreʼs disease. The purpose of this study is to analyze changes in the CHAMP as advancement of Ménièreʼs disease.
Methods
We studied 19 cases of ‘Definite’ group of Ménièreʼs disease. We assumed progression of Ménièreʼs disease would be checked by pure tone threshold by four tone average (4PTA), low tone average (LPTA). We also compared electrocochleography (ECoG), dizziness handicap inventory (DHI), tinnitus handicap inventory (THI) as parameters for progression of Ménièreʼs disease to CHAMP latency delay and amplitude ratio. Chi-square test was used as a statistical method.
Results
In the group of patients had abnormal amplitude ratio, ECoG value were not improved, but there was not statistically significant (odds ratio [OR]=5.727, p＞0.05). Better DHI and THI score were not necessarily construed as the improvement value in the CHAMP (p＞0.05). In amplitude ratio abnormal group, 4PTA was aggravated, but not statistically significant (OR=1.5, p＞0.05). In the group of patient had abnormality in both latency delay and amplitude ratio, LPTA was relatively aggravated (OR in latency delay: 2, OR in amplitude ratio: 10); however, reveals no statistically significance between them (p＞0.05). Change of ECoG, hearing threshold including 4PTA and LPTA with progression of Ménièreʼs disease were not correlated significantly with latency delay or amplitude ratio of CHAMP.
Conclusion
We conclude that CHAMP does not reflect clinical features with progression of Ménièreʼs disease.

The Linear Transmission of the Vestibular Neural Information by Galvanic Vestibular Stimulation: Gyutae Kim, Sangmin Lee, Kyu-Sung Kim; Res Vestib Sci. 2016;15(4):132-140. Published online December 12, 2016; DOI: https://doi.org/10.21790/rvs.2016.15.4.132

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Abstract PDF: Objective: Growing hypotheses indicate the galvanic vestibular stimulation (GVS) as an alternative method to manage the symptoms of parkinson’s disease (PD). GVS is easy and safe for use, and non-invasive. However, it is elusive how the neural information caused by GVS is transmitted in the central nervous system and relieves PD symptoms. To answer this question, we investigated the transmission of neural information by GVS in the central vestibular system, focused on vestibular nucleus (VN).
Methods
Twenty guinea pigs were used for this study for the extracellular neuronal recordings in the VN. The neuronal responses to rotation and GVS were analyzed by curve-fitting, and the numerical responding features, amplitudes and baselines, were computed. The effects of stimuli were examined by comparing these features.
Results
Twenty six vestibular neurons (15 regular and 11 irregular neurons) were recorded. Comparing the difference of baselines, we found the neural information was linearly transmitted with a reduced sensitivity (0.75). The linearity in the neural transmission was stronger in the neuronal groups with regular (correlation coefficient [Cor. Coef.]=0.91) and low sensitive units (Cor. Coef.=0.93), compared with those with irregular (Cor. Coef.=0.86) and high-sensitive neurons (Cor. Coef.=0.77).
Conclusion
The neural information by GVS was linearly transmitted no matter what the neuronal characteristics were.

갈바닉 자극에 의한 전정 신경정보의 선형적 이동: Gyutae Kim, Sangmin Lee, Kyu-Sung Kim; Received September 12, 2016 Accepted November 1, 2016 Published online November 1, 2016; [Accepted]

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Abstract: Objective: Growing hypotheses indicate the galvanic vestibular stimulation (GVS) as an alternative method to manage the symptoms of parkinson’s disease (PD). GVS is easy and safe for use, and non-invasive. However, it is elusive how the neural information caused by GVS is transmitted in the central nervous system and relieves PD symptoms. To answer this question, we investigated the transmission of neural information by GVS in the central vestibular system, focused on vestibular nucleus (VN). Methods: Twenty guinea pigs were used for this study for the extracellular neuronal recordings in the VN. The neuronal responses to rotation and GVS were analyzed by curve-fitting, and the numerical responding features, amplitudes and baselines, were computed. The effects of stimuli were examined by comparing these features. Results: Twenty six vestibular neurons (15 regular and 11 irregular neurons) were recorded. Comparing the difference of baselines, we found the neural information was linearly transmitted with a reduced sensitivity (0.75). The linearity in the neural transmission was stronger in the neuronal groups with regular (Cor.Coef.=0.91) and low sensitive units (Cor.Coef.=0.93), compared with those with irregular (Cor.Coef.=0.86) and high-sensitive neurons (Cor.Coef.=0.77). Conclusion: The neural information by GVS was linearly transmitted no matter what the neuronal characteristics were.

Review

A History for Experimental Animal Models of Endolymphatic Hydrops: Hyun Ji Kim, Kyu-Sung Kim; Res Vestib Sci. 2016;15(3):65-69. Published online September 15, 2016; DOI: https://doi.org/10.21790/rvs.2016.15.3.65

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Abstract PDF: It is known that endolymphatic hydrops is a pathophysiologic mechanism of Meniere’s disease, while the detailed role is not fully clarified. Study for endolymphatic hydrops mainly represents a pathologic histologic finding found only in the post-mortem examination of temporal bone, so endolymphatic hydrops animal models have played important role in terms of understanding how hydrops affects the function of the inner ear. Numerous challenges with diverse animals and techniques have been tried to reveal the possible pathophysiology of endolymphatic hydrops and develop an effective treatment. This review shows historical background and technical advances in experimental animal model for endolymphatic hydrops and Meniere’s disease.

Erratum

Electrophysiology of Vestibular System: Eunjin Park, Kyu-Sung Kim, Jihoon Jo; Res Vestib Sci. 2013;12:S89-S89. Published online June 1, 2013

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Abstract PDF: Electrophysiological study of the vestibular nerve cells how to fish, amphibians, reptiles, birds and mammals from a variety of research results. However, the small number of experimental animals used in this study toward higher organisms is inconvenient. Thus, in vitro or in vivo experiments using a mouse or a rat, electrophysiological studies in the vestibular organs of the study, a statistically significant level, many of the experimental results can be achieved. It is easier to prepare for dealing with experimental laboratory animals. Gene mouse mutants related to the genetic map of the mouse study, there has been significant progress, as well as vestibular and auditory development has become. In conclusion, applied or basic research associated with the vestibular nerve in rodents, such as rats and electrophysiological studies, considering the characteristics of the vestibular system, and how the mouse is a need for the development of an experimental model. In this paper, we briefly explained the common electrophysiological studies, experimental methods, and applied on the vestibular nerve afferent examples.

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