Clinical Comparison Between Ocular and Cervical Vestibular Evoked Myogenic Potentials / 대한평형의학회지

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.

Effect of Preset Angle on Subjective Visual Vertical/Horizontal: Comparison between Normal Subjects and Patients with Dizziness / 대한평형의학회지

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.

Viability of Chondrocytes in the Crushed Septal Cartilage Depending on Degree of Crushing and Their Mechanism of Cell Death / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: To analyze the viability of chondrocytes according to different degrees of crushing and to investigate the mechanism of cell death in the crushed cartilage. SUBJECTS AND METHOD: Septal cartilages were obtained from 22 patients and cartilage pieces were allocated to four groups; normal, mildly crushed, moderately crushed and severely crushed. The cartilage specimens were stained with hematoxylin-eosin and examined under light microscope. The viability of the chondrocytes and the mechanism of cell death were assessed using confocal laser scanning microscopy. RESULTS: As crushing intensity increased, chondrocyte viability significantly decreased. The mechanism of cell death was mainly due to necrosis rather than apoptosis. CONCLUSION: The viability of chondrocytes in the crushed cartilage depends on the degree of crushing. The mechanism of cell death after crushing is mainly necrosis. Therefore, for the clinical use of the crushed cartilage, slight overcorrection and standardization of the degree of crushing are recommended.

A Case of Lipoma of Epiglottis / 대한이비인후과학회지

Lipoma is one of the most common benign neoplasm in the subcutaneous tissues, but the lipoma of larynx is rare as fewer than 100 cases have been reported in the world. The symptoms are variable, but it has clinical importance when lipoma does occur, for they can cause unpredictable airway obstruction, particularly during the induction of general anesthesia. In this article, we report a case of lipoma of the epiglottis with a review of the related literature. We successfully treated the tumor with tracheostomy and surgery.

Clinical Implication of Dissociation between Subjective Visual Horizontal and Subjective Visual Vertical / 대한평형의학회지

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.

Results of Otolithic Function Testing and Related Clinical Features in Unilateral Definite Meniere's Disease

BACKGROUND AND OBJECTIVES: The purpose of this study is to identify the typical pattern of otolithic function tests in unilateral definite Meniere'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 Meniere'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 Meniere'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 Meniere's disease.