Three Cases of Cochleosaccular Endolymphatic Hydrops without Vertigo Revealed by Furosemide-Loading Vestibular Evoked Myogenic Potential Test

Seo, Toru; Node, Michiko; Miyamoto, Atsushi; Yukimasa, Akiko; Terada, Tomonori; Sakagami, Masafumi

doi:10.1097/00129492-200309000-00019

Cited by 20 publications

(10 citation statements)

References 12 publications

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“…There are authors who assume that the balance problems associated with otosclerosis are caused by saccular dysfunction originating from endolymphatic or saccular hydrops [36–39] or direct invasion of the otosclerotic focus to the saccular macula or saccular afferents [35,40]. A 2012 study by Saka et al [33] found that balance problems in otosclerosis were associated with abnormal results for BC-VEMP.…”

Section: Discussionmentioning

confidence: 99%

Contribution of Vestibular-Evoked Myogenic Potential (VEMP) testing in the assessment and the differential diagnosis of otosclerosis

Korres

2014

Med Sci Monit

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BackgroundThe aim of this prospective clinical study was to evaluate the clinical importance of Vestibular-Evoked Myogenic Potentials (VEMPs) in the assessment and differential diagnosis of otosclerosis and otologic diseases characterized by “pseudo-conductive” components. We also investigated the clinical appearance of balance disorders in patients with otosclerosis by correlating VEMP results with the findings of caloric testing and pure tone audiometry(PTA).Material/MethodsAir-conducted(AC) 4-PTA, bone-conducted(BC) 4-PTA, air-bone Gap(ABG), AC, BC tone burst evoked VEMP, and calorics were measured preoperatively in 126 otosclerotic ears.ResultsThe response rate of the AC-VEMPs and BC-VEMPs was 29.36% and 44.03%, respectively. Statistical differences were found between the means of ABG, AC 4-PTA, and BC 4-PTA in the otosclerotic ears in relation to AC-VEMP elicitability. About one-third of patients presented with disequilibrium. A statistically significant interaction was found between calorics and dizziness in relation to PTA thresholds. No relationship was found between calorics and dizziness with VEMPs responses.ConclusionsAC and BC VEMPs can be elicited in ears with otosclerosis. AC-VEMP is more vulnerable to conductive hearing loss. Evaluation of AC-VEMP thresholds can be added in the diagnostic work-up of otosclerosis in case of doubt, enhancing differential diagnosis in patients with air-bone gaps. Otosclerosis is not a cause of canal paresis or vertigo.

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Section: Discussionmentioning

confidence: 99%

Contribution of Vestibular-Evoked Myogenic Potential (VEMP) testing in the assessment and the differential diagnosis of otosclerosis

Korres

2014

Med Sci Monit

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“…fluctuating hearing loss, tinnitus, and recurrent vertigo. Seo et al [17] reported that patients with cochleosaccular hydrops revealed by VEMP did not complain of any recurrent vertigo but of recurrent short-lasting disequilibrium. Three patients in our series suffered from recurrent disequilibrium lasting for a short duration (cases 1, 4, and 7).…”

Section: Discussionmentioning

confidence: 99%

Vestibular-evoked myogenic potential in response to bone-conducted sound in patients with otosclerosis

Saka

Seo

Fujimori

et al. 2012

Acta Oto-Laryngologica

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Conclusion:Saccular dysfunction is a major cause of balance problems in patients with otosclerosis. Vestibular-evoked myogenic potential in response to bone-conducted sound (BC-VEMP) testing is useful for diagnosis of these patients.Objectives:The purpose of this study was to elucidate the origin of balance problems in patients with otosclerosis using BC-VEMP.Methods:Subjects comprised 25 patients with unoperated otosclerosis (9 men and 16 women). They were divided into two groups depending on type of balance problems. Results of cochleo-vestibular functions including pure-tone audiometry, caloric testing, and BC-VEMP testing were compared between the two groups.Results:Ten patients had complained of dizziness and/or vertigo (disequilibrium group), and the other 15 patients had not (Non-disequilibrium group). Nine patients showed abnormal results on BC-VEMP testing in the disequilibrium group, while one patient had abnormal results in the non-disequilibrium group (p < 0.001).

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“…Indeed, Seo et al . [15] described three cases without vertigo, involving patients with cochleosaccular endolymphatic hydrops, revealed by furosemide-loading vestibular evoked myogenic potential test.…”

Section: Discussionmentioning

confidence: 99%

Meniere′s disease: Still a mystery disease with difficult differential diagnosis

Vassiliou

Vlastarakos²,

Maragoudakis³

et al. 2011

Ann Indian Acad Neurol

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One hundred and forty-six years after its first description, the differential diagnosis of Meniere’s disease remains very challenging. The aim of the present study is to review the current knowledge on the advantages and disadvantages of the new diagnostic methods for Meniere’s disease. The importance of accurate diagnosis for primary healthcare systems is also discussed. An extensive search of the literature was performed in Medline and other available database sources. Information from electronic links and related books were also included. Controlled clinical studies, prospective cohort studies, retrospective cohort studies, cross-sectional studies, case reports, written guidelines, systematic reviews, and books were selected. The typical clinical triad of symptoms from the vestibular and cochlear systems (recurrent vertigo, fluctuating sensorineural hearing loss and tinnitus) is usually the key for clinical diagnosis. Glycerol dehydration test and electrocochleography are the main diagnostic tests in current practice, while vestibular evoked myogenic potentials may be used in disease staging. Imagine techniques are not specific enough to set alone the diagnosis of Meniere’s disease, although they may be necessary to exclude other pathologies. Recently developed 3D MRI protocols can delineate the perilymphatic/endolymphatic spaces of the inner ear and aid diagnosis. Meniere’s disease is a continuous problem for the patients and affects their quality of life. Taking into account the frequent nature of the disease in certain countries, efforts for reliable diagnosis, prompt referral, and successful management are undoubtedly cost-effective for healthcare systems.

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Three Cases of Cochleosaccular Endolymphatic Hydrops without Vertigo Revealed by Furosemide-Loading Vestibular Evoked Myogenic Potential Test

Abstract: The patients in cases 2 and 3 complained of a short-lasting sensation of falling down. Severe disequilibrium that prohibited standing up was noted in all cases. It was suggested that these symptoms were caused by saccular hydrops.

Cited by 20 publications

References 12 publications

Contribution of Vestibular-Evoked Myogenic Potential (VEMP) testing in the assessment and the differential diagnosis of otosclerosis

Contribution of Vestibular-Evoked Myogenic Potential (VEMP) testing in the assessment and the differential diagnosis of otosclerosis

Vestibular-evoked myogenic potential in response to bone-conducted sound in patients with otosclerosis

Meniere′s disease: Still a mystery disease with difficult differential diagnosis

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