Research in Vestibular Science

Original Article

Comparison of the outcomes of treatment with an oral diuretics with steroid and steroid only for acute low-tone hearing loss: a prospective randomized controlled trial: Seok Min Hong, Yeso Choi, Sung Min Park, Jae Yong Byun; Res Vestib Sci. 2024;23(3):95-100. Published online September 15, 2024; DOI: https://doi.org/10.21790/rvs.2024.012

3,616 View
35 Download

Abstract PDF: Objectives
This study aimed to compare the efficacy of a combined steroid and diuretic (isosorbide) treatment with that of steroid-only treatment in patients with acute low-tone sensorineural hearing loss (ALHL).
Methods
A total of 34 patients with ALHL were recruited between January 2018 and December 2019 and randomized into two groups: a steroid-with-diuretic (isosorbide) group and a steroid-only group. The steroid-with-diuretic group received oral methylprednisolone for 10 days and isosorbide for 14 days, while the steroid-only group received methylprednisolone for 10 days. Hearing outcomes were measured using pure-tone audiometry at 8 weeks posttreatment. The outcomes were the absolute hearing gain at low frequencies (125, 250, and 500 Hz) and the recovery rate, which was classified into complete, partial, unchanged, progressive, and fluctuating.
Results
Of 34 patients, 30 (15 in each group) were analyzed. No significant differences were observed in baseline characteristics between the groups. The steroid-with-diuretic group showed higher absolute hearing gains at all three low frequencies than the steroid-only group, but the differences were not statistically significant complete recovery was observed in 13 patients in each group, with partial recovery in two patients in the steroid-with-diuretic group and unchanged outcomes in two patients in the steroid-only group. No patient exhibited disease progression.
Conclusions
Although combined steroid and diuretic therapy yielded better hearing outcomes than steroid-only therapy, the differences were not statistically significant. Further studies with larger sample sizes and extended follow-up periods are necessary to confirm these findings.

Case Report

A case of vertebrobasilar dolichoectasia manifesting as sudden sensorineural hearing loss with vertigo: Young Jae Lee, Wonyong Baek, Gi-Sung Nam; Res Vestib Sci. 2024;23(1):32-36. Published online March 15, 2024; DOI: https://doi.org/10.21790/rvs.2024.004

10,895 View
95 Download

Abstract PDF: Vertebrobasilar dolichoectasia (VBD) is a rare vascular condition characterized by the elongation, widening, and tortuosity of the vertebrobasilar artery. It can lead to various symptoms due to compression of cranial nerves and brainstem structures. We report a rare case of VBD presenting as sudden sensorineural hearing loss (SSNHL) with vertigo and spontaneous downbeat nystagmus in a 65-year-old woman with a history of hypertension. Magnetic resonance imaging revealed a tortuous and dilated right vertebrobasilar artery compressing the brainstem and left 8th cranial nerve root entry zone, without signs of acute cerebellar stroke. The compression of the anterior inferior cerebellar artery and cervicomedullary junction was also noted, suggesting a vascular cause for her symptoms. Following high-dose steroid treatment, the patient showed significant hearing improvement. This case underscores the importance of considering VBD in patients with unexplained SSNHL and vertigo, highlighting the role of detailed vascular imaging in the diagnosis and management of such cases.

Original Articles

Comparison of vestibular evoked myogenic potentials between low and high tone idiopathic sudden sensorineural hearing loss: Sang-Wook Park, Sang Yun Lee, Somi Ryu, Jung Woo Lee, Chae Dong Yim, Dong Gu Hur, Seong-Ki Ahn; Res Vestib Sci. 2024;23(1):11-15. Published online March 15, 2024; DOI: https://doi.org/10.21790/rvs.2024.001

3,499 View
50 Download

Abstract PDF: Objectives
Vestibular evoked myogenic potentials (VEMP) have been reported to be useful in evaluating not only vestibular function but also the prognosis of idiopathic sudden sensorineural hearing loss (ISSNHL) patients. Even though low frequency, high frequency, and all frequency-involved ISSNHL groups tend to show varied clinical characteristics, there is a lack of data using VEMP results to analyze these subgroups. We investigated if the VEMP test is a valuable tool to predict recovery from hearing loss in association with different frequencies.
Methods
A total of 26 ISSNHL patients were divided into three different groups impaired with low tone (ascending type), high tone (descending type), and all tones (flat type) based on the initial audiograms. Each group included five, 10, and 11 patents, respectively, and their VEMP results were compared between the three subgroups.
Results
Abnormal VEMP results were found in five of the total 26 ISSNHL patients (19.2%). Two (40.0%), one (10.0%), and two (18.1%) patients of low tone, high tone, and all tone hearing loss groups, respectively, showed abnormal VEMP results. However, there was no statistically significant difference between the three groups.
Conclusions
Even though VEMP is known as a valuable tool for predicting the prognosis of ISSNHL patients, it does not seem to reflect frequency-sensitive aspects of ISSNHL.

Clinical Characteristics of Sudden Sensorineural Hearing Loss Accompanying Benign Paroxysmal Positional Vertigo: Sung Min Park, Bin Kwon, Sung Won Li, Seok Min Hong, Sung Kyun Kim; Res Vestib Sci. 2020;19(2):71-78. Published online June 15, 2020; DOI: https://doi.org/10.21790/rvs.2020.19.2.71

8,308 View
132 Download
1 Crossref

Abstract PDF

Objectives
Idiopathic unilateral sudden sensorineural hearing loss (SSNHL) with simultaneous benign paroxysmal vertigo (BPPV) is known to be associated with poor hearing recovery. We aimed to investigate clinical findings in patients with SSNHL with BPPV and analyze prognostic factors including presence of BPPV related to hearing outcome.
Methods
We retrospectively reviewed the electronic medical data of 14 patients with concurrent SSNHL and BPPV (combined group). We selected 52 patients without BPPV as a control group who have matched initial threshold of pure tone audiometry and age of each patient in the combined group. We evaluated clinical characteristics of all participants and compared hearing outcomes between the 2 groups. A multivariate logistic regression analysis was performed to investigate the factors related to hearing recovery.
Results
Initial mean pure tone audiometry (PTA) threshold of combined group was 90.36±26.2 dB. Posterior canal was most commonly involved (n=7, 50%), and 8 (57%) patients showed abnormal video head impulse test results. There was no significant difference between hearing recovery rates of combined and control group (p=0.237) and mean pure tone audiometry threshold changes were not significantly different between the 2 groups (p=0.942). Old age (≥60 years), high initial PTA threshold (＞90 dB), and obesity (body mass index ≥ 25 kg/m²) were poor prognostic predictors.
Conclusions
There was no difference between hearing outcomes of combined group and profound SSNHL only group. BPPV was not a significant prognostic factor of SSNHL patients.

Citations

Citations to this article as recorded by

Which Is More Important for the Prognosis of Sudden Sensorineural Hearing Loss with Vertigo, Canal Paresis or Benign Paroxysmal Positional Vertigo?
Yong-Hwi An, Hyun Joon Shim
Research in Vestibular Science.2021; 20(3): 101. CrossRef

Comparison of Predictive Parameters between the Video Head Impulse Test and Caloric Test: Chun Han, Seung Won Paik, Hui Joon Yang, Sang Yoo Park, Ji Hyeon Lee, Young Joon Seo; Res Vestib Sci. 2020;19(2):55-61. Published online June 15, 2020; DOI: https://doi.org/10.21790/rvs.2020.19.2.55

9,957 View
131 Download
1 Crossref

Abstract PDF

Objectives
The aim of this paper was to determine if a correlation exists between video head impulse test (vHIT) and electronystagmography with caloric test (ENG). More specifically, comparison of covert and overt value from vHIT test with cold and warm stimulation value from ENG test.
Methods
Retrospective study of our single institue from the period of January 2015 to January 2017 enrolled 91 patients. Patients were divided into 3 groups by their diagnosis of either vestibular neuritis (VN), Meniere disease, or sudden sensorineural loss with vertigo accordingly. Each of the patients’ both ENG and vHIT data were recorded and parameters were evaluated.
Results
VN group was the only group to show a significant correlation between canal paresis (CP) with covert and overt saccades. Further analysis was done in the VN group and result showed covert saccade showing a larger area under the receiver operation characteristic curve value (0.77) compared to overt saccades (0.70), implying that covert saccade is a more accurate parameter for the prediction of the CP value. Furthermore, a positive correlation was seen between the gain value and the cold caloric stimulation value as well as between warm caloric stimulation value.
Conclusions
The value of our study lies in the fact that we have attempted to find a correlation between different parameters of 2 different vestibular tests. We concluded that the evaluation of overt nystagmus by the bedside head thrust test is inappropriate for predicting CP, and a vHIT is required to accurately evaluate vestibular function.

Citations

Citations to this article as recorded by

A Comparative Analysis of the Vestibulocochlear Function in Patients with Isolated Semicircular Canal Hypofunction Using a Video Head Impulse Test
Yu Jung Park, Min Young Lee, Ji Eun Choi, Jae Yun Jung, Jung Hwa Bahng
Research in Vestibular Science.2023; 22(2): 34. CrossRef

Does 125-Hz Pure-Tone Thresholds Have Prognostic Value in Patients with Sudden Sensorineural Hearing Loss and Vertigo?: Yong-Hwi An, Hyun Joon Shim; Res Vestib Sci. 2020;19(1):6-11. Published online March 15, 2020; DOI: https://doi.org/10.21790/rvs.2020.19.1.6

6,283 View
152 Download

Abstract PDF: Objectives
To analyze 125-Hz pure-tone thresholds in dizzy patients with sudden sensorineural hearing loss (SSNHL) and to investigate the relationship between 125-Hz thresholds and the prognosis of SSNHL with vertigo.
Methods
Hearing and vestibular function tests including 125-Hz pure-tone were performed in 132 patients with SSNHL and 65 subjects with normal hearing. Audiometric follow-up was performed at 6 months after initial visit. Intergroup and intragroup comparison of 125 Hz was made between SSNHL and control groups.
Results
Twenty-four patients (18.2%) had normal thresholds at 125 Hz in SSNHL group, whereas all subjects showed normal at 125 Hz in control group. None with average hearing threshold at 250 and 500 Hz≥30 dB had normal threshold at 125 Hz. There was no significant relationship between 125-Hz threshold and results of vestibular function test. There was no correlation between 125-Hz threshold and hearing recovery in SSNHL group.
Conclusions
There might be no need to assess 125-Hz pure-tone threshold in patients with SSNHL, because it is enough to evaluate thresholds of 250 and 500 Hz for low frequency.

Comparison of Treatment Outcomes between Intratympanic Steroid Injection and Oral Diuretics in Patients with Acute Low Frequency Sensorineural Hearing Loss with Vertigo: Yong-Hwi An, Hyun Joon Shim; Res Vestib Sci. 2019;18(4):111-117. Published online December 15, 2019; DOI: https://doi.org/10.21790/rvs.2019.18.4.111

8,498 View
92 Download

Abstract PDF: Objectives
Sudden sensorineural hearing loss and Meniere disease can be managed with intratympanic steroid injection (ITSI) as a primary treatment. The aim of this study was to compare the effectiveness of ITSI versus oral diuretics for acute low frequency sensorineural hearing loss (LFHL) with vertigo.
Methods
A total 76 patients with LFHL that had developed within previous 2 weeks were enrolled and categorized into 2 groups: treated with ITSI four times on 4 consecutive days (ITSI group; 42 patients) and treated with diuretics orally for 2 weeks (diuretics group; 34 patients). After 6 months, we analyzed treatment outcomes using subjective improvement and audiometric change.
Results
Hearing thresholds at low frequencies ≤500 Hz were significantly improved in both ITSI and diuretics group (p＜0.05). The cure rate of ITSI group was not significantly higher than that of diuretics group (54.8% vs. 52.9%, p＞0.05). For subjective symptoms, there were no significant differences of improvement rate in both groups (ITSI 64.3% vs. diuretics 61.8%, p＞0.05). In pure tone audiometry, the improvement rate of ITSI group was not significantly different from that of diuretics group (78.6% vs. 70.6%, p＞0.05). There was a significant correlation between the cure rate and duration of symptoms.
Conclusions
Both ITSI and diuretics are effective treatment modalities for acute LFHL with vertigo within 2 weeks of development. There is no difference of treatment outcomes between ITSI and diuretics in patients with acute LFHL and vertigo.

The Value of Posterior Semicircular Canal Function in Predicting Hearing Recovery of Sudden Sensorineural Hearing Loss: Jung-Woo Shin, Sang Woo Kim, Youn Woo Kim, Wook Jang, Bo He Kim, Yun-Sung Lim, Seok-Won Park, Chang Gun Cho, Joo Hyun Park; Res Vestib Sci. 2019;18(4):103-110. Published online December 15, 2019; DOI: https://doi.org/10.21790/rvs.2019.18.4.103

7,810 View
142 Download
6 Crossref

Abstract PDF

Objectives
Postulated etiologies for idiopathic sudden sensorineural hearing loss (SSNHL) include viral cochleitis, microvascular events. If SSNHL is caused by vascular compromise of common cochlear artery that supplies cochlea and posterior semicircular canal (PC), PC also can be damaged with cochlea. We aim to evaluate the prognostic value of PC function in relation to hearing recovery of SSNHL.
Methods
Seventy-six patients who were diagnosed and treated for SSNHL and who underwent video head impulse test (vHIT) and follow-ups for more than 3 months were reviewed retrospectively. We defined impairment of PC function as lower PC gain (＜0.7) or definite overt/covert saccade in vHIT. Patients were divided into 3 groups: group 1, SSNHL without dizziness; group 2, SSNHL with dizziness and impaired PC function; group 3, SSNHL with dizziness, but intact PC function. Hearing thresholds were repeatedly measured on the initial visit, 1 week, 1 month, and 3 months after treatment. Treatment outcome was analyzed by comparing hearing recovery rate using Siegel’s criteria and posttreatment audiometric changes among 3 groups.
Results
Thirty-two (29.6%), 33 (30.6%), and 43 patients (39.8%) were included into the groups 1, 2, and 3, respectively. The hearing recovery rate of the group 2 (39.4%) was significantly lower than that of groups 1 (65.6%) and 3 (65.1%) (p=0.043). Pre- and posttreatment changes of the PTA threshold was significantly lower in group 2 than group 1 (p=0.009). The change of speech discrimination in each group were not different.
Conclusions
Our findings suggest that the presence of PC impairment may be a poor prognostic sign for hearing recovery in patients with SSNHL.

Citations

Citations to this article as recorded by

Artificial Neural Network-Assisted Classification of Hearing Prognosis of Sudden Sensorineural Hearing Loss With Vertigo
Sheng-Chiao Lin, Ming-Yee Lin, Bor-Hwang Kang, Yaoh-Shiang Lin, Yu-Hsi Liu, Chi-Yuan Yin, Po-Shing Lin, Che-Wei Lin
IEEE Journal of Translational Engineering in Healt.2023; 11: 170. CrossRef
Vestibular mapping in Ramsay-Hunt syndrome and idiopathic sudden sensorineural hearing loss
Joon-Pyo Hong, Jung-Yup Lee, Min-Beom Kim
European Archives of Oto-Rhino-Laryngology.2023; 280(12): 5251. CrossRef
A Comparative Analysis of the Vestibulocochlear Function in Patients with Isolated Semicircular Canal Hypofunction Using a Video Head Impulse Test
Yu Jung Park, Min Young Lee, Ji Eun Choi, Jae Yun Jung, Jung Hwa Bahng
Research in Vestibular Science.2023; 22(2): 34. CrossRef
Video head impulse test for the assessment of vestibular function in patients with idiopathic sudden sensorineural hearing loss without vertigo
N Battat, O J Ungar, O Handzel, R Abu Eta, Y Oron
The Journal of Laryngology & Otology.2023; 137(12): 1374. CrossRef
Vestibular mapping assessment in idiopathic sudden sensorineural hearing loss
Hee Won Seo, Jae Ho Chung, Hayoung Byun, Seung Hwan Lee
Ear & Hearing.2022; 43(1): 242. CrossRef
Association of Metabolic Syndrome with Sensorineural Hearing Loss
Hwa-Sung Rim, Myung-Gu Kim, Dong-Choon Park, Sung-Soo Kim, Dae-Woong Kang, Sang-Hoon Kim, Seung-Geun Yeo
Journal of Clinical Medicine.2021; 10(21): 4866. CrossRef

Incidence of Progression into Ménière Disease from Idiopathic Sudden Sensorineural Hearing Loss: Midterm Follow-up Study: Byeong Min Lee, Jin Hyun Seo, Hyun Woo Park, Hyun Jin Lee, Dong Gu Hur, Seong Ki Ahn; Res Vestib Sci. 2018;17(3):95-101. Published online September 18, 2018; DOI: https://doi.org/10.21790/rvs.2018.17.3.95

7,753 View
206 Download

Abstract PDF: Objectives
Ménière disease is a clinical syndrome characterized by the four major symptoms of episodic vertigo, sensorineural hearing loss, tinnitus, and aural fullness. Sensorineural hearing loss, especially low frequency, is the characteristic type of audiogram in Ménière's disease. However, it is difficult to distinguish idiopathic sudden sensorineural hearing loss (ISSNHL) with vertigo from the first attack of Ménière disease. The purpose of this study was to investigate the incidence of progression into Ménière Disease from low frequency ISSNHL.
Methods
Two hundred eighty-three patients were included in this study. We classified the patients with ISSNHL according to the hearing loss in audiogram and analyzed how many of them actually progressed to Ménière disease based on diagnosis criteria.
Results
Among the 240 patients, 37.1% (89 patients) were confirmed low frequency ISSNHL and 14.6% (13 patients) of them were diagnosed with Meniere disease.
Conclusions
This study showed that the progression from low frequency ISSNHL to Ménière disease was higher than other frequency ISSNHL, as in other studies.

Vestibular Function and Prognosis of Sudden Sensorineural Hearing Loss with Vertigo: Se A Lee, Hyo Jun Kim, Bo Gyung Kim, Jong Dae Lee; Res Vestib Sci. 2018;17(3):90-94. Published online September 18, 2018; DOI: https://doi.org/10.21790/rvs.2018.17.3.90

8,470 View
169 Download

Abstract PDF: Objectives
Vertigo combined with sudden sensorineural hearing loss (SSNHL) is known as a poor prognostic factor. We investigated clinical findings and vestibular function tests in patients of SSNHL with vertigo to find the prognostic factors.
Methods
We retrospectively evaluated data on the patients diagnosed with SSNHL with vertigo at Bucheon Soonchunhyang University Hospital from March 2009 to February 2018. We reviewed medical records and the results of vestibular function tests and audiometry.
Results
Of the 68 patients, 30 (44.1%) showed profound hearing loss and 53 (77.9%) showed poor recovery. Age and the degree of initial hearing loss showed negative prognostic factor in hearing recovery. Abnormal results of cervical vestibular evoked myogenic potentials (cVEMP) also showed significantly differences between good and poor recovery groups.
Conclusions
In this study, most of the patients of SSNHL with vertigo showed poor recovery. Age, degree of initial hearing loss, and the abnormal result of the cVEMP have a negative effect on the prognosis of hearing recovery.

Prognosis of Sudden Low Frequency Hearing Loss during Long-term Follow-up: Ji Hyung Kim, Sang Hyun Kwak, Seong Hoon Bae, Sung Hunh Kim, Gi-Sung Nam; Res Vestib Sci. 2018;17(3):102-108. Published online September 18, 2018; DOI: https://doi.org/10.21790/rvs.2018.17.3.102

11,127 View
551 Download
1 Crossref

Abstract PDF

Objectives
The prognosis of sudden low frequency hearing loss (SLFHL) is relatively good, but recurrences of hearing loss and possible progression to Meniere’s disease is still a clinically important concern. This study was conducted to confirm the rate at which SLFHL proceeds to Meniere’s disease.
Methods
We retrospectively analyzed the medical records of 160 SLFHL patients who were followed up for more than 6 months from September 2005 to August 2013. Progression, initial hearing level, recovery and recurrence of hearing loss were reviewed.
Results
106 patients (66.25%) had complete hearing recovery, 32 (20%) had recurrent hearing loss. Of the 32 recurrent group, 15 (9.38%) had progressed to Meniere’s disease after average of 1.7±1.4 years. The mean age of nonrecurrent group was higher than recurrent group (55.3±14.6 and 48.0±13.4, respectively, p=0.011). The threshold of 250Hz was significantly higher in the nonrecurrent group compared with recurrent group (p=0.047).
Conclusions
In patients with SLFHL, recurrence at relatively young age should be considered with the possibility of progression to Meniere’s disease.

Citations

Citations to this article as recorded by

Findings of Intravenous Gadolinium Inner Ear Magnetic Resonance Imaging in Patients With Acute Low-Tone Sensorineural Hearing Loss
Hee Won Seo, Yikyung Kim, Hyung-Jin Kim, Won-Ho Chung, Young Sang Cho
Clinical and Experimental Otorhinolaryngology.2023; 16(4): 334. CrossRef

Case Reports

Superficial Siderosis with Peripheral Dizziness: Report of 2 Cases: Tae-Hoon Kim, Jin-Hyuk Huh, Moon-Suh Park, Jae-Yong Byun; Res Vestib Sci. 2018;17(2):60-66. Published online June 15, 2018; DOI: https://doi.org/10.21790/rvs.2018.17.2.60

9,623 View
129 Download
1 Crossref

Abstract PDF

Superficial siderosis (SS) of the central nervous system is a rare disease, which is caused by the accumulation of iron from the hemoglobin in the superficial layer of the brain, spinal cord, and central parts of cranial nerves. The etiology of SS is the accumulation of hemosiderin in the subarachnoid space due to chronic or repeated hemorrhage resulting in progressive and irreversible neurological dysfunction. The cause of the disease is aneurysm, trauma, tumor, and vascular malformation. In most cases, the cause of bleeding is unknown. Clinical features include sensorineural hearing loss, cerebellar ataxia, and myelopathy. Until now, magnetic resonance imaging (MRI) has only been diagnosed and there is no standardized treatment. We will investigate clinical features and MRI findings of SS disease in the central nervous system using 2 patient cases.

Citations

Citations to this article as recorded by

A Case of Patient with Bilateral Cochleovestibular Function Loss due to Infratentorial Superficial Siderosis
Gyuman Lee, Youngmin Mun, Dae Bo Shim
Research in Vestibular Science.2023; 22(3): 83. CrossRef

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

11,018 View
150 Download
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

Original Article

Significance of 125 Hz Pure-Tone Thresholds for Dizzy Patients with Low Frequency Sensorineural Hearing Loss: Yong-Hwi An, Hyun Joon Shim; Res Vestib Sci. 2017;16(4):108-112. Published online December 15, 2017; DOI: https://doi.org/10.21790/rvs.2017.16.4.108

8,477 View
160 Download

Abstract PDF: Objectives
To measure 125 Hz pure-tone thresholds in patients with low frequency sensorineural hearing loss (LFHL) and vertigo and to evaluate the necessity of 125 Hz thresholds for assessment of LFHL with vertigo. Methods: Pure tone audiometry including 125 Hz was performed in 25 dizzy patients with LFHL ≤500 Hz and 25 age-matched subjects with normal hearing. Patients with sudden sensorineural hearing loss and vertigo were excluded. Comparison of 125 Hz between LFHL and control groups, and comparison of 125 Hz and other frequencies in LFHL group was made. Results: Mean pure-tone thresholds at 125 Hz in LFHL group (41.7±7.5 dB) was higher than that in normal controls (12.8±6.4 dB). Three (12%) patients had normal thresholds at 125 Hz in LFHL group, whereas all subjects showed normal at 125 Hz in control group. None with average hearing thresholds at 250 and 500 Hz ≥35 dB had normal threshold at 125 Hz. There was a significant correlation between 125 Hz and other low frequencies in LFHL group (250 Hz; r=0.79, 500 Hz; r=0.66). Conclusions: Not every patient of LFHL with vertigo has abnormal hearing threshold at 125 Hz, although all subjects with normal hearing is within normal limits at 125 Hz. Measurement of 125 Hz pure-tone threshold is highly recommended when a mild LFHL exists.

Case Report

A Case of Labyrinthitis Ossificans Presenting as an Intractable Benign Paroxysmal Positional Vertigo: Dong Hyun Kim, Jae Moon Sung, Hwi Kyeong Jung, Chang Woo Kim; Res Vestib Sci. 2017;16(3):92-96. Published online September 15, 2017; DOI: https://doi.org/10.21790/rvs.2017.16.3.92

8,801 View
84 Download

Abstract PDF: Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibular disorder. It is easily cured with canal repositioning maneuvers, but some patients are resistant to the repositioning maneuver and require surgical intervention. Labyrinthitis ossificans is the pathologic condition that fibrous tissue and new bone occupy the membranous labyrinthine space. It occurs as a sequela of inner ear inflammation resulting from diverse causes, mostly bacterial meningitis and otitis media. We describe here a 42-year-old female patient with refractory posterior semicircular canal (PSCC) BPPV and adhesive otitis media in same ear. Otoscopic examination revealed adhesive tympanic membrane without middle ear space and temporal bone computed tomography showed complete ossification of the labyrinth at the same side. We performed a canal wall down mastoidectomy and PSCC occlusion. The patient had complete resolution of paroxysmal vertigo and positional nystagmus, postoperatively.

Original Article

Intratympanic Steroid Treatment versus Intratympanic Steroid and Diuretics Combination Treatment in Patients with Acute Low Frequency Sensorineural Hearing Loss with Vertigo: Hyeon Sik Oh, Hyun Joon Shim, Yong-Hwi An; Res Vestib Sci. 2017;16(3):85-91. Published online September 15, 2017; DOI: https://doi.org/10.21790/rvs.2017.16.3.85

10,055 View
153 Download

Abstract PDF: Objectives
Intratympanic dexamethasone (ITD) is a standard treatment for patients with sudden sensorineural hearing loss. The aim of this study was to evaluate the effectiveness of ITD vs. combination of ITD and diuretics for acute low frequency sensorineural hearing loss (LFHL) with vertigo. Methods: A total 31 patients with LFHL that had developed within previous 2 weeks were enrolled and categorized into two groups: treated with ITD four times on 4 consecutive days (ITD group; 17 patients) and treated with ITD in the same way and diuretics orally for 2 weeks (combination group; 14 patients). After 6 months, we analyzed treatment outcomes using subjective improvement and audiometric change. Results: Hearing thresholds at low frequencies ≤500 Hz were significantly improved in both ITD only and combination group (p＜0.05). The cure rate of combination group was not significantly higher than that of ITD only group (57.1% vs. 52.9%, p＞0.05). For subjective symptoms, there were no significant differences of improvement rate in both groups (combination 64.3% vs. ITD only 64.7%, p＞0.05). In pure tone audiometry, the improvement rate of combination group was not significantly different from that of ITD only group (71.4% vs. 76.5%, p＞0.05). There was a significant correlation between the complete recovery rate and duration of symptoms. Conclusion: ITD alone is an effective treatment modality for acute LFHL with vertigo within 2 weeks of development. Combined ITD and diuretics have no additive effect for the recovery of hearing in patients with LFHL.

Review

Diagnostic Criteria for M?nier?’s Disease: Jose A Lopez-Escamez, John Careyb, Won Ho Chung, Joel A Goebeld, Mans Magnusson, Marco Mandala, David E Newman-Tokerg, Michael Strupp, Mamoru Suzuki, Franco Trabalzini, Alexandre Bisdorff; Res Vestib Sci. 2015;14(3):67-74.

2,851 View
80 Download

Abstract PDF: This paper presents diagnostic criteria for M?nier?’s disease jointly formulated by the Classification Committee of the B?r?ny Society, The Japan Society for Equilibrium Research, the European Academy of Otology and Neurotology, the Equilibrium Committee of the American Academy of Otolaryngology-Head and Neck Surgery, and the Korean Balance Society. The classification includes two categories: definite M?ni?re's disease and probable Meni?re's disease. The diagnosis of definite M?ni?re's disease is based on clinical criteria and requires the observation of an episodic vertigo syndrome associated with low- to medium- frequency sensorineural hearing loss and fluctuating aural symptoms (hearing, tinnitus and/or fullness) in the affected ear. Duration of vertigo episodes is limited to a period between 20 minutes and 12 hours. Probable M?nier?'s disease is a broader concept defined by episodic vestibular symptoms (vertigo or dizziness) associated with fluctuating aural symptoms occurring in a period from 20 minutes to 24 hours.

Case Report

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.

2,551 View
11 Download

Abstract PDF: 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.

Original Article

Acute Low Tone Sensorineural Hearing Loss: Consideration for Progression to Meniere’s Disease: Yoon Suk Oh, Kyu Sung Kim, Hoseok Choi, Kyu Jin Kim; Res Vestib Sci. 2010;9(1):16-20.

4,285 View
122 Download

Abstract PDF: Background and Objectives Low tone sensorineural hearing loss is deterioration in audiometric low frequencies (250 and 500 Hz), preservation of high frequencies (2, 4, and 8 kHz). The aim of this study is to find out differences of clinical manifestation and prognosis of acute low tone sensorineural hearing loss (ALHL), a subtype of sudden sensorineural hearing loss, and potential progression to Meniere’s diseases. Materials and Methods Among 465 patients with unilateral hearing loss initially diagnosed with sudden sensorineural hearing loss, we analyzed clinical characteristics of 96 patients who had acute low tone sensorineural hearing loss, but had no history of previous ALHL. ResultsThe clinical features of ALHL include a predominance of female suffers (72.9%), more dizziness (36%), high incidence of sound perception change (16.7%), tinnitus (42.8%), and ear fullness (20.8%). The prognosis shows recovery in 67.7% of patients. However, 24.0% of patients show recurrence of low tone loss, and 15.6% develop Meniere’s disease. Specially, if the dizziness symptoms were accompanied, progression to Meniere’s disease was more common (31.4%). Conclusion Our results appear that clinical characteristics were different in the ALHL patients compared to the idiopathic sensorineural hearing loss patients. Therefore, when dizziness, ear fullness and tinnitus are accompanied with low tone hearing loss, an appropriate patient education on possible progression to Meniere’s disease is necessary.

Case Report

Acute Sensorineural Hearing Loss with Simultaneous Ipsilateral Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo: Report of a Case and Review of the Literature: Ji Hee Lee, Seong Hae Jeong, Eung Seok Oh, Eun Hee Sohn, Ae Young Lee, Jae Moon Kim; Res Vestib Sci. 2009;8(2):156-160.

2,644 View
13 Download

Abstract PDF: Benign paroxysmal positional vertigo (BPPV) originating from the posterior semicircular canal (pSCC) is a common vestibular disorder. Advanced age, head or ear trauma, other inner ear disorders, female sex and osteopenia/osteoporosis are known predisposing factors for pSCC BPPV. An association with simultaneous ipsilateral sudden deafness remains to be elucidated. We report a 62-year old woman with sudden deafness and simultaneous ipsilateral pSCC BPPV.

Original Articles

Clinical Consideration of Vestibular Evoked Myogenic Potential in Dizzy Patients: Young Hwa Yoo, Seong Cheon Bae, Jae Hyun Seo, Ki Hong Chang, Sang Won Yeo; J Korean Bal Soc. 2007;6(2):176-180.

2,211 View
17 Download

Abstract PDF: Background and Objectives: Vestibular evoked myogenic potential (VEMP) is a relatively new diagnostic tool that is in the process of being investigated in patients with specific vestibular disorders. In this study, we examed the responses of VEMP in patients who complained of dizzines. Materials and Method: Eighty-six patients with complaint of dizziness and ten normal volunteers are included in this study. Among these patients, forty-six patients were diagnosed as unilateral vestibulopathy (A), five patients were bilateral vestibulopathy (B), nine patients were sudden sensorineural hearing loss with vertigo (C), fifteen patients were benign paroxysmal positional vertigo (D) and eleven patients were Meniere's disease (E). We compared VEMP parameters in each group. Results: In each group, abnormal response in VEMP was 33%(A), 0%(B), 11%(C), 12%(D) and 36%(E) respectively. and there was no absent VEMP formation, and there was no abscent VEMP formation. Conclusion: VEMP is a promising method for diagnosing and following patients with many vestibular disorders.

Analysis of Parameters of Vestibular-Evoked Myogenic Potentials in Sudden Sensorineural Hearing Loss without Vertigo: Min Hyun Park, Woo Jin Jeong, Jae Jun Song, Ji Soo Kim, Ja Won Koo; J Korean Bal Soc. 2005;4(2):206-211.

2,523 View
16 Download

Abstract PDF: Background
and Objective: Vestibular evoked myogenic potentials (VEMP) has been promoted as a means of assessing the integrity of saccular function. Even though sacculospinal reflex may not be influenced by abnormality of cochlear pathway, saccule is closely related with cochlea in its embryological development and also in geographic location. So authors hypothesized the presence of functional alterations of saccule in patients with sudden sensorineural hearing loss who do not complain of vertigo, since saccular dysfunction may not induce subjective vestibular symptoms or signs. Authors tested saccular function in those patients using VEMP and analyzed the parameters according to other clinical indicators. Materials and Method: From July to September 2005, 22 patients who diagnosed with unilateral sudden sensorineural hearing loss without vertigo were enrolled. The patients who had vertigo as initial symptom or showed spontaneous nystagmus were excluded. All patients received conventional audiometry, tone-burst VEMP test, and caloric test. We analyzed P13 and N23 latency, interpeak amplitude and asymmetric ratio of amplitude. The patients divided to complete hearing recovery, partial recovery, and no response group according to treatment outcome. The correlation between parameters and treatment result was analyzed.
Results
In 2 out of 22 patients (9.1%), VEMP waves were not detected. There was no latency delay in affected ear. But the interpeak amplitude of the affected ear was significantly smaller than that of healthy side (paired t test, p=0.02). Patients who did not respond to treatment showed smaller interpeak amplitude than those who showed complete recovery.
Conclusion
Most patients of idiopathic sudden sensorineural hearing loss without vertigo seem to show normal VEMP waves. But some parameters regarding amplitude had abnormal findings in affected ear. Further studies with larger sample size seem to be necessary to elucidate such outcomes.

First
Prev
Page of 1
Next
Last

Search