Assessment of Saccular Function in Patients With Noise Induced Hearing Loss

BACKGROUND AND OBJECTIVES: Considering saccular receptors are coupled physically with the auditory receptors, VEMP test may provide the information that in the noise induced hearing loss with or without dizziness, damage to the vestibular system, especially saccule is a potential organ with cochlear damage. MATERIAL AND METHODS: 11 patients (22 ears) with HF-SNHL greater than 55dB and 10 patients (10 ears) with sudden hearing loss of varying degree HL as positive control but without clinical manifestations of vestibular pathology tested for vestibular function test was enrolled. VEMP test was done. The results were compared with those of 9-healthy referents (18 ears) examined in the same way. RESULTS: VEMP wave was significantly abolished as twelve of 22 (54.5%) with HF-SNHL, five of 13 (38.5%) and Control group (100%). Though there was no statistically significant relation with P13, N23 latency delay in each group, NIHL showed P13, N23 latency delay trend compared with controls. CONCLUSIONS: Patients with noise induced hearing loss showed significantly more saccular deterioration, estimated as negative VEMP responses than did the controls. This suggests subclinical disturbances of the vestibular system especially of the saccule in noise induced hearing loss.

Benign Recurrent Vertigo: Clinical Manifestations And Vestibular Function Test

BACKGROUND AND OBJECTIVES: Benign recurrent vertigo has been defined as recurrent spells of vertigo lasting minutes to hours without cochlear and neurologic signs. The etiology is still unclear, but viral and vasospastic etiology as migraine equivalent has been suggested. We attempt to analyze the symptoms and vestibular function test of Benign recurrent vertigo that has clinically diagnosed. MATERIALS AND METHODS: We analyzed retrospectively the clinical characteristics and vestibular function test including ocular-motor test, rotation test and computerized dynamic posturography from 100 patients with a Benign recurrent vertigo diagnosis. RESULTS: Eight two percent of the patients were female, mean age was 52 years, and mean duration of prevalence was 47.3 months. In the characteristics of vertigo, 91% of patients have spinning sensation during attack. The vertigo attacks most commonly lasts several hours (57%), and frequency of attack is three to twelve time per year in 47%. A high incidence (40%) of headache was detected, but incidence of other associated symptoms including fluctuating hearing loss (3%), tinnitus (27%), aural fullness (9%) was relatively low. The incidence of spontaneous nystagmus and positional nystagmus was 18% and 10% each. Saccadic undershoot was observed in 21% of patients, but it was not associated with other ocular-motor test abnormalities. In rotation test, low gain, phase lead and asymmetry was observed in 18%, 3% and 9%, respectively. There were no abnormal findings in posturography. CONCLUSIONS: Although benign recurrent vertigo did not show any characteristic clinical findings or vestibular function test, it deserves to be considered for differential diagnosis of episodic vertigo.