The experiments behind the Tullio phenomenon

Addams-Williams, J; Wu, K; Ray, Jaydip

doi:10.1017/s0022215114000280

Cited by 12 publications

(15 citation statements)

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“…In the early twentieth century Pietro Tullio observed in pigeons that when a hole was made in a semicircular canal, the labyrinth became responsive to externally applied sound stimuli, inducing eye and head movements in the plane of the fenestrated canal (14, 15). Subsequent work by Huizinga attributed this observation to creating a new low-resistance pathway through the inner ear (16).…”

Section: Historical Contextmentioning

confidence: 99%

Superior Canal Dehiscence Syndrome: Lessons from the First 20 Years

2017

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Superior semicircular canal dehiscence syndrome was first reported by Lloyd Minor and colleagues in 1998. Patients with a dehiscence in the bone overlying the superior semicircular canal experience symptoms of pressure or sound-induced vertigo, bone conduction hyperacusis, and pulsatile tinnitus. The initial series of patients were diagnosed based on common symptoms, a physical examination finding of eye movements in the plane of the superior semicircular canal when ear canal pressure or loud tones were applied to the ear, and high-resolution computed tomography imaging demonstrating a dehiscence in the bone over the superior semicircular canal. Research productivity directed at understanding better methods for diagnosing and treating this condition has substantially increased over the last two decades. We now have a sound understanding of the pathophysiology of third mobile window syndromes, higher resolution imaging protocols, and several sensitive and specific diagnostic tests. Furthermore, we have a treatment (surgical occlusion of the superior semicircular canal) that has demonstrated efficacy. This review will highlight some of the fundamental insights gained in SCDS, propose diagnostic criteria, and discuss future research directions.

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Section: Historical Contextmentioning

confidence: 99%

Superior Canal Dehiscence Syndrome: Lessons from the First 20 Years

2017

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“…Thus, the dehiscent canal may be identified based on nystagmus characteristics (for details, see Chapters 3.2.2 to 3.2.5). Sound-induced vertigo (Tullio phenomenon) [139,140] When air-conducted sound (ACS) is transferred from the middle to the inner ear in case of a third-window syndrome, part of the sound energy follows the path of least resistance to the newly created opening of the bony capsule. The resulting abnormal endolymph displacement causes deflection of stereocilia with a subsequent change of hair cell potential and afferent discharge in the affected canal, resulting in vertigo and nystagmus according to Ewaldʼs laws (▶ Fig.…”

Section: Pathophysiology and Cardinal Symptomsmentioning

confidence: 99%

“…Generally, pressure- or sound-induced vertigo and nystagmus can be triggered in all disorders of the middle and inner ear where the membranous labyrinth comes into direct contact with the stapes footplate 140 , e. g., inflammatory causes as mentioned in the first description of Hennebertʼs signs for patients with syphilis 157 , malformations of the middle ear, or post-operative / -traumatic scar formation between the stapes footplate and the vestibule 236 237 .…”

Section: Episodic Vestibular Syndromesmentioning

confidence: 99%

“…Generell kann ein druck- oder lärminduzierter Schwindel/Nystagmus bei allen Erkrankungen des Mittel- und Innenohres ausgelöst werden, bei denen es zu einem direkten Kontakt zwischen dem membranösen Labyrinth und der Stapesfussplatte kommt 140 . Hierzu zählen insbesondere entzündliche Ursachen, wie aus der Erstbeschreibung des Hennebert-Zeichens bei Patienten mit Syphilis hervorgeht 157 , Fehlbildungen des Mittelohres oder postoperative/-traumatische Vernarbungen zwischen Stapesfussplatte und Vestibulum 236 237 .…”

Section: 282 Andere Differenzialdiagnosenunclassified

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Seltene Erkrankungen des vestibulären Labyrinths: von Zebras, Chamäleons und Wölfen im Schafspelz

Dlugaiczyk

2021

Laryngorhinootologie

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ZusammenfassungDie Differenzialdiagnose von Erkrankungen des vestibulären Labyrinths stellt eine grosse Herausforderung dar, da sich hinter dem sehr häufigen Leitsymptom «Schwindel» viele verschiedene und v. a. seltene Erkrankungen verbergen können. Der vorliegende Beitrag gibt einen Überblick über die für den HNO-Arzt wichtigen seltenen Erkrankungen des vestibulären Labyrinths ausgehend von ihrer klinischen Präsentation als akutes (AVS), episodisches (EVS) oder chronisches vestibuläres Syndrom (CVS). Der Schwerpunkt liegt dabei auf den EVS, sortiert nach ihrer Dauer und dem Vorhandensein von Triggern (Sekunden, ohne Trigger: Vestibularisparoxysmie, Tumarkin-Krise; Sekunden, lärm- und druckinduziert: Syndrome des «dritten Fensters»; Sekunden bis Minuten, positionsabhängig: seltene Varianten und Differenzialdiagnosen des benignen paroxysmalen Lagerungsschwindels; Stunden bis Tage, spontan: intralabyrinthäre Schwannome, Tumoren des endolymphatischen Sacks, Autoimmunerkrankungen des Innenohres). Des Weiteren werden seltene Differenzialdiagnosen eines AVS (Neuritis vestibularis inf., Otolithenfunktionsstörungen, vaskuläre Ursachen, akute bilaterale Vestibulopathie) und eines CVS (bilaterale Vestibulopathie) erläutert. Dabei werden insbesondere die entscheidenden diagnostischen Massnahmen für die Identifikation der einzelnen Krankheitsbilder und die Warnzeichen für potentiell gefährliche Ursachen (z. B. Labyrinthinfarkt/-blutung) dargelegt. Somit dient dieser Beitrag dem HNO-Arzt in Klinik und Praxis als eine Art «Vademecum» für die zügige Identifikation und zeitnahe Therapie seltener Erkrankungen des Gleichgewichtsorgans.

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“…They are thought to reflect a reflex arc in which stimulation of the saccule and utricle generate a myogenic response in the ipsilateral sternocleidomastoid (i.e., cervical or cVEMPs) (15) or the contralateral inferior oblique (i.e., ocular or oVEMPs), respectively (16)(17)(18). These organs normally respond to loud acoustic stimuli, but in the setting of a third window, responses are exaggerated (19,20). Unsurprisingly, then, VEMPs have become an increasingly important part of the diagnostic battery for SCD.…”

Section: Introductionmentioning

confidence: 99%

Ocular Vestibular-Evoked Myogenic Potential Amplitudes Elicited at 4 kHz Optimize Detection of Superior Semicircular Canal Dehiscence

et al. 2020

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Conclusion: Our results suggest that accounting for 4 kHz oVEMP amplitude can improve detection of SCD compared to the binary presence of n10 response. The 4 kHz oVEMP amplitude cutoff that maximizes sensitivity and specificity for our cohort is 15 uV. Our results also suggest that 4 kHz oVEMP amplitudes align better with symptomatic SCD cases compared to cases in which there is radiographic SCD but no characteristic symptoms.

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The experiments behind the Tullio phenomenon

Abstract: The experimental studies behind his contribution to vestibular physiology are described within this paper, as are some of the further developments that have been made.

Cited by 12 publications

References 10 publications

Superior Canal Dehiscence Syndrome: Lessons from the First 20 Years

Superior Canal Dehiscence Syndrome: Lessons from the First 20 Years

Seltene Erkrankungen des vestibulären Labyrinths: von Zebras, Chamäleons und Wölfen im Schafspelz

Ocular Vestibular-Evoked Myogenic Potential Amplitudes Elicited at 4 kHz Optimize Detection of Superior Semicircular Canal Dehiscence

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