ABSTRACT
A total of 13 patients, who were diagnosed with localized brainstem lesions using MRI, were investigated. The diagnoses were multiple sclerosis in five patients, brainstem hemorrhage in three patients, pontomedullary infarction in one patient and Wallenberg's syndrome in four patients. In addition, 42 ears of 21 normal adult volunteers were also examined. In a patient with upper brainstem lesions mainly affecting the midbrain, the auditory brainstem response (ABR) was abnormal but the vestibular-evoked myogenic potential (VEMP) was normal. In four patients with middle brainstem lesions which mainly affected the pons, both ABR and VEMP were abnormal. In five patients with lower brainstem lesions which mainly affected the medulla, the ABR was normal but the VEMP was abnormal. In those patients with middle-to-lower brainstem lesions, a disappearance of VEMP reactions, delay of the positive-negative (PN) wave, increase in PN interpeak latency and decrease in PN amplitude on the affected side were confirmed. In conclusion, the VEMP test comprises a useful new diagnostic method for identifying lower brainstem lesions.
Subject(s)
Brain Stem/pathology , Evoked Potentials, Auditory/physiology , Vestibule, Labyrinth/physiology , Adolescent , Adult , Aged , Cerebral Infarction/diagnosis , Electromyography/methods , Electronystagmography , Evoked Potentials, Auditory, Brain Stem/physiology , Female , Humans , Magnetic Resonance Imaging , Male , Medulla Oblongata/blood supply , Medulla Oblongata/pathology , Middle Aged , Muscle, Skeletal , Pons/blood supply , Pons/pathologyABSTRACT
The influence of septal perforation on results of acoustic rhinometry was studied using cases of septal perforation and a human-nose model. Acoustic rhinometry was conducted before and after closing the perforation (average 16 mm in diameter, 23 mm from the nostril) by thin cotton patches in 33 cases (19 men and 14 women). The decrease in cross-sectional area and volume after closure was statistically significant. A human-nose model with septal holes ranging from 5, 10, 15, to 20 mm and locations ranging from 20, 40, to 50 mm from the nostril was studied by acoustic rhinometry. Our results suggest that the effect of perforations on the measurement is much greater in anterior perforations than in posterior perforations.
