Morphological correlation between caloric tests and vestibular hydrops in Ménière's disease using intravenous Gd enhanced inner ear MRI

Choi, Ji Eun; Kim, Yi Kyung; Cho, Young Sang; Lee, Kieun; Park, Hyun Woo; Yoon, Sung Hoon; Kim, Hyung Jin; Chung, Won Ho

doi:10.1371/journal.pone.0188301

Cited by 38 publications

(38 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In our study also caloric tests showed better sensitivity compared to VHIT especially in patients with chronic complaints. 14 Our results suggest that unilateral vestibular hypo activity is the cornerstone in the diagnosis of peripheral vestibular lesions as stated in many other researches. However, it has to be evaluated with other data in order to find out the exact location of the lesion.…”

Section: Discussionsupporting

confidence: 77%

See 1 more Smart Citation

Electronystagmographic analysis of peripheral vertigo

Suresh¹,

Narendran²

2020

Int J Otorhinolaryngol Head Neck Surg

View full text Add to dashboard Cite

Background: Examination of the vestibulo-ocular reflex is still the investigation of choice for evaluating the vestibular function to rule out peripheral causes. Aim and objectives were to compare the electronystagmographic changes of all peripheral forms of vertigo and to highlight its significance in the diagnosis and management of the same.Methods: This is a prospective study done after obtaining ethical committee approval in a total of 100 patients attending the ENT OPD at Sri Muthukumaran Medical College Hospital & Research Institute with chief complaints of vertigo. Patients diagnosed with chronic suppurative otitis media, hypertensive patients, h/o seizures, recent cardiac illness or patients on cardiac investigations, psychotic disorders, documented CNS lesions, cervical spondylitis, h/o recent eye/ ear surgery are excluded from this study. ENG analysis includes occulomotor testing, positional testing and caloric stimulation. Evaluation of gait and balance is done followed by maneuver induced vertigo testing (dix hallpike and fistula test) along with PTA. Statistical analysis was done using independent sample t test and chi square test to check the hypothesis using statistical package for social studies SPSS version 17. Results: The observations of ENG like spontaneous nystagmus and bi-thermal caloric test responses are represented on a claussens butterfly chart and the corresponding bar codes were obtained. The inferences for different forms of vertigo were studied.Conclusions: ENG is now an accepted routine and basic investigation in the management of all patients suffering from equilibrium disorders. Management consists of diagnosing the underlying pathology and treatment of the same.

show abstract

Section: Discussionsupporting

confidence: 77%

“…Also, the extent of hydrops correlates with the extent of caloric weakness with normal VHIT tests. 7,12,14 Choi et al of 2007 also pointed out the same discrepency. In our study also caloric tests showed better sensitivity compared to VHIT especially in patients with chronic complaints.…”

Section: Discussionmentioning

confidence: 90%

Electronystagmographic analysis of peripheral vertigo

Suresh¹,

Narendran²

2020

Int J Otorhinolaryngol Head Neck Surg

View full text Add to dashboard Cite

show abstract

“…Thus, hydrops of endolymphatic duct could be the cause of caloric deficit without compromising the vestibulo-ocular reflex (VOR) response in vHIT. In the author’s other paper, we found out the morphological correlation between caloric tests and vestibular hydrops in MD patients with normal vHIT 30 . The patients with abnormal vHIT were excluded.…”

Section: Discussionmentioning

confidence: 79%

Usefulness of Intravenous Gadolinium Inner Ear MR Imaging in Diagnosis of Ménière’s Disease

Cho

Ahn

Choi

et al. 2018

Sci Rep

Self Cite

View full text Add to dashboard Cite

This study aimed to investigate the usefulness of the intravenous gadolinium enhanced inner ear magnetic resonance imaging (IV-Gd inner ear MRI) in diagnosing Ménière’s disease(MD) and find a correlation between the degree of endolymphatic hydrops(EH) and the audiovestibular tests. Total 29 patients diagnosed with unilateral definite MD were enrolled. All patients underwent IV-Gd inner ear MRI and auditory and vestibular function tests such as pure tone audiometry (PTA), electrocochleography (ECoG), cervical vestibular evoked myogenic potential (cVEMP) and caloric test. The hydrops ratio in the cochlea and vestibule were significantly higher in the affected side than the unaffected side (p < 0.001). Average pure-tone thresholds for 0.5, 1 k, 2 k, and 4 k Hz correlated significantly with cochlear and vestibular hydrops (p < 0.01) in the affected side. When comparing the SP/AP ratio of ECoG with hydrops ratio in the vestibule, the affected and unaffected ears showed a significant difference (p < 0.05). Similarly, the results of the caloric test also showed a significant correlation (p < 0.05) with relative vestibular hydrops. However, the cVEMP response was not related to the hydrops ratio in the cochlea or vestibule. This study presents pertinent data with appropriate correlations with auditory vestibular functional testing which demonstrates the usefulness of IV-Gd inner ear MRI as a diagnostic method for visualizing the endolymphatic hydrops in MD.

show abstract

“…The distended membranous duct of the horizontal SCC has been suggested to permit convective recirculation within the duct, leading to a diminished thermally-induced pressure gradient across the cupula and thus to less deflection of the cupula and hair cells and less caloric nystagmus. This assumption is supported by the observation that, in MD patients with normal vHIT results, the reduced caloric response was correlated with the severity of vestibular hydrops (as demonstrated by intravenous gadolinium-enhanced MRI of the inner-ear) (21). Second, the dual frequency hypothesis proposes that a differential activation of vestibular hair cells by stimuli with different frequencies might be responsible for the dissociation.…”

Section: Discussionmentioning

confidence: 88%

Dissociation of Caloric and Video Head Impulse Tests in Patients With Delayed Endolymphatic Hydrops

Leng

Liu

2020

Front. Neurol.

View full text Add to dashboard Cite

Delayed endolymphatic hydrops (DEH) represents a rare clinical entity characterized by intermittent vertigo attacks mimicking those of Ménière's disease (MD) in a patient with a prior sensorineural hearing loss. Some vestibular tests have been employed in patients with DEH. These tests provide useful diagnostic information and facilitate clinical decision-making. Here, we retrospectively studied the features of video head impulse test (vHIT) and examined its relationship with caloric test used in DEH patients. Included in this study were 17 patients with ipsilateral DEH and 2 with contralateral DEH. Among them, 73.7% (14/19) showed abnormal caloric test response (76.5% in ipsilateral DEH and 50% in contralateral DEH). Meanwhile, only 15.8% (3/19) of patients yielded abnormal horizontal vHIT results (11.8% in ipsilateral DEH and 50% in contralateral DEH). Abnormal caloric response in the presence of a preserved vHIT was common in DEH patients, especially those with ipsilateral DEH. This dissociation might be a distinctive pattern of vestibular deficit in DEH.

show abstract

Morphological correlation between caloric tests and vestibular hydrops in Ménière's disease using intravenous Gd enhanced inner ear MRI

Cited by 38 publications

References 29 publications

Electronystagmographic analysis of peripheral vertigo

Electronystagmographic analysis of peripheral vertigo

Usefulness of Intravenous Gadolinium Inner Ear MR Imaging in Diagnosis of Ménière’s Disease

Dissociation of Caloric and Video Head Impulse Tests in Patients With Delayed Endolymphatic Hydrops

Contact Info

Product

Resources

About