Examination of Utricular Response Using oVEMP and Unilateral Centrifugation Rotation Testing.

OBJECTIVES: Significant advancements have been made toward the clinical assessment of utricular function through ocular vestibular-evoked myogenic potentials (oVEMP) and unilateral centrifugation (UCF) testing. To date, no study has examined intrasubject relationships between these measures. The study hypothesis was that intrasubject responses from oVEMP and UCF testing would be correlated inasmuch as both tests have been reported to assess utricular function. DESIGN: UCF rotations and oVEMP testing were performed on healthy volunteers, aged 18 to 62 years. A within-subject study design compared and correlated UCF outcome measures of ocular counterroll, subjective visual vertical, and ocular counterroll-gravitational inertial acceleration slope against peak to peak oVEMP N1-P1 amplitude. RESULTS: Correlational analyses failed to reveal any significant relationships between oVEMP amplitude and UCF responses suggesting that these tests may be inciting different response properties within the utricular system. CONCLUSIONS: Various anatomical and physiological differences within the utricle, in addition to the fundamental differences in stimulus properties between the oVEMP and UCF tests, could explain the lack of significant correlations between these measures and suggest that oVEMP and UCF testing may be complimentary in their evaluation of the utricular system. These data reinforce the complexities of the utricular system and provide further insight into the difficulties encountered in its clinical assessment.

Auditory profile in superficial siderosis of the central nervous system: a prospective study.

OBJECTIVE: To identify auditory pathology resulting from superficial siderosis of the central nervous system (SSCN), auditory site of lesion, and a clinical profile for differential diagnosis and development of recommendations. STUDY DESIGN: Prospective study. SETTING: Academic clinical center. PATIENTS: Ten participants with SSCN (the largest prospective evaluation of audiologic status reported to date). INTERVENTION(S): Demographics, clinical characteristics and history, audiometric evaluation, and Tinnitus Handicap Inventory (THI). MAIN OUTCOME MEASURE(S): Type and degree of hearing loss, relationship to clinical course of SSCN, and expected results based on age and sex. RESULTS: Sensorineural hearing loss (SNHL) is the most common symptom in SSCN (100%). Tinnitus (100%), imbalance (80%), and gait disorder (80%) were also frequently reported. Hearing loss is typically bilateral, asymmetric, progressive, sloping, and exceeds expected hearing loss related to age and sex. Hearing loss may be cochlear and/or retrocochlear in origin. Decreased word recognition is possible, and traditional amplification may offer limited benefit. CONCLUSION: We observed significant audiometric findings in all participants. SSCN variably and pathologically targets the auditory system without regard for duration of disorder. A long asymptomatic phase and lack of predictive relationship between duration and severity of hearing loss makes suspicion of SSCN based solely on audiometric battery difficult; however, asymmetric hearing loss exceeding expectations, particularly with history of head trauma or previous neurosurgical procedure, should raise a red flag and trigger further medical evaluation including MRI. Diagnosis of SSCN may alter expectations for audiologic prognosis and is a critical component for comprehensive management of SSCN patients.

The AuD Program at Gallaudet University.

Gallaudet University was among the first universities to address the American Speech-Language-Hearing Association mandate to universities to convert the entry level clinical audiology degree from a master's degree to a clinical doctoral (AuD) degree. The Gallaudet AuD program was approved in 1998 and graduated its first AuD class in 2002. The purpose of this article is to describe the Gallaudet AuD program, the process of converting from a master's program to an AuD program, the impact of converting the program, and current challenges. It is hoped that this description will be useful to those who are currently developing AuD programs.