Research in Vestibular Science

Original Articles

Influence of Otoliths on the Vestibulo-Ocular Reflex in Horizontal Canal Benign Paroxysmal Positional Vertigo: Hee Soo Yoon, Jae Yeong Jeong, Jae Ho Chung, Ha Young Byun, Chul Won Park, Seung Hwan Lee; Res Vestib Sci. 2020;19(2):49-54. Published online June 15, 2020; DOI: https://doi.org/10.21790/rvs.2020.19.2.49

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Abstract PDF: Objectives
The aim of the study was to evaluate the possible alteration of the vestibulo-ocular reflex (VOR) in patients with horizontal canal benign paroxysmal positional vertigo (h-BPPV) using the video head impulse test (vHIT).
Methods
This was a prospective case-control study of BPPV patients. We includeed 133 patients with h-BPPV who underwent the vHIT prior to the positioning test. The control group consisted of 76 normal subjects who also underwent the vHIT. The vHIT parameters of gain and asymmetry were assessed, and clinical parameters such as treatment duration, number of canalith reposition maneuvers executed and recurrence rates were evaluated. The VOR and clinical parameters were compared between the h-BPPV and control group. The VOR parameters of h-BPPV canalolithiasis were also compared with those of cupulolithiasis.
Results
The mean age of the patients was 56.5 years and the male to female ratio was 1:2.02. Of the patients, 75 were diagnosed as having the canalolithiasis type of h-BPPV, while the other 58 had the cupulolithiasis type. The mean vHIT gains of the ipsi-lesional horizontal canal plane were 1.13 and 1.15 in the h-BPPV and control group, respectively (p=0.564). However, the asymmetry of the VOR was significantly higher in the h-BPPV than the control group (p=0.013), while the gains and asymmetries of the vHIT in the canalolith and cupulolith types were not significantly different (p=0.454, p=0.826).
Conclusions
The asymmetry of VOR is significantly elevated in the cupulolith type of hBPPV.

Multicenter Study on the Clinician’s Diagnostic and Therapeutic Approaches for Benign Paroxysmal Positional Vertigo in Korea: Eun Ju Jeon, Won Ho Chung, Jeong Hwan Choi, Eui Cheol Nam, Hong Ju Park, Jong Dae Lee, Won Sang Lee, Kyu Sung Kim, Eui Kyung Goh, Ja Won Koo, Min Bum Kim, Min Beom Kim, Se Hyung Kim, Young Jin Kim, Chang Hee Kim, Sung Il Nam, Seog Kyun Mun, Ga Young Park, Sang Yoo Park, Shi Nae Park, Chang Hoon Bae, Sung Hyun Boo, Myung Whan Suh, Jae Hyun Seo, Eun Jin Son, Jae Jun Song, Jae Jin Song, Joong Wook Shin, Dae Bo Shim, Seong Ki Ahn, Hye Youn Youm, Shin Young Yoo, Dong Hee Lee, Seung Hwan Lee, Chang Ho Lee, Hyun Seok Lee, Hwan Ho Lee, Hyo Jeong Lee, Yun Hoon Choung, Seung Hyo Choi, Jee Sun Choi, Seok Min Hong, Sung Kwang Hong; Res Vestib Sci. 2013;12(3):79-92.

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Abstract: Background and Objectives: It is necessary to establish the most efficient diagnostic and therapeutic method for benign paroxysmal positional vertigo (BPPV), which is appropriate for Korean healthcare system. We aimed to evaluate current state of Korean clinician’s diagnostic and therapeutic approaches for BPPV. Materials and Methods: A 16-item survey was emailed to the members of dizziness department of Otology Research Interest Group in the Korean Otologic Society (n=68). 43 were returned and analyzed. Results: All respondents (100%) used Dix-Hallpike test as a diagnostic tool for vertical canal-BPPV. Supine roll test was used for diagnosing lateral canal BPPV in nearly all the respondents (97.7%). Epley maneuver was chosen as otolith repositioning maneuver (ORM) for posterior canal BPPV in all respondents and barbecue rotation (BBQ) was used for treating lateral canal BPPV with geotropic nystagmus in 95.3% of respondents. Extreme variation was noted for therapeutic approach of lateral canal BPPV with ageotropic nystagmus BBQ, with 4 kinds of ORM and adjunctive measures to liberate otolith from cupula, while BBQ was again the most commonly used ORM (76.7%). Conclusion: The development of practical and efficient ORM for lateral canal BPPV with ageotropic nystagmus is necessary.

Clinical Review of Dizziness Patients Who Visited Emergency Room: Ki Yong Kim, Hyun Jung Min, Seung Hwan Lee, Chul Won Park; Res Vestib Sci. 2011;10(2):56-62.

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Abstract PDF: Background and Objectives: As most dizziness symptoms are vaigue, and misdiagnosis of central dizziness can be life threatening, diagnosis of the dizziness is difficult. Especially, in the emergency room with a restricted environment, it must be more difficult. The aim of this study is to find out and correct the aspects requiring a modification for diagnosis in patients of dizziness who visited emergency room. Materials and Methods: The authors retrospectively have reviewed the charts of 458 patients with dizziness who visited the emergency room at Hanyang University Guri Hospital from April 2008 to March 2009 and researched the various informations such as diagnosis, clinical feature, physical findings, present illness, past history, consulted department, and visiting season, etc. Results: The average age of patients was 61 years old. Even though there was a difference at the diagnosis distribution between age groups, non specific dizziness and benign paroxysmal positional vertigo was the most frequent diagnosis. Checking the dizziness characters like whirling sense, autonomic symptoms and progressing features was important. And vestibular function tests such as nystagmus test and rotatory test like post head shaking or head thrust test were helpful for differential diagnosis of dizziness in emergency room. Patients with central vertigo were older (71.2 year) and had more past medical histories. But there was no seasonal frequency difference of dizziness.Conclusion: As at emergency room, the differential diagnosis of dizziness is important but difficult, integrated medical knowledge of several departments associated with dizziness is required.

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