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Two Cases of Barotraumatic Perilymph Fistula Mimicking Atypical Benign Paroxysmal Positional Vertigo with Sudden Hearing Loss
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Jung Joo Lee, Gwanghui Ryu, Il Joon Moon, Won Ho Chung
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Res Vestib Sci. 2015;14(1):26-31.
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 Abstract
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- Barotraumatic perilymph fistula is difficult to diagnose and needs diagnosis of
suspicion. Symptoms like hearing loss, tinnitus, ear fullness and positional
dizziness can develop following barotrauma such as valsalva, nose blowing,
straining and diving, etc. We reported 2 cases of perilymph fistula following
barotrauma. The patients developed hearing loss, tinnitus and ear fullness
followed by sudden onset of positional dizziness mimicking benign paroxysmal
positional vertigo (BPPV). On positional tests, the direction of nystagmus has
changed over time. In addition, the characteristics of nystagmus on positional test
were not similar to typical BPPV, which showed longer duration of nystagmus,
no reversibility and no fatigability. We concluded that barotraumatic perilymph
fistula could present as hearing loss with positional dizziness mimicking sudden
hearing loss with BPPV. The differential diagnostic points were history of
barotrauma, time sequence of development of hearing loss and positional
dizziness, and atypical positional nystagmus unlike BPPV.
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Residual Vestibulo-Ocular Reflex Result in Better Functional Outcomes in Bilateral Vestibulopathy
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Ji Eun Choi, Gwanghui Ryu, Young Sang Cho, Won Ho Chung
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Res Vestib Sci. 2014;13(4):89-95.
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Abstract
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- Background
and Objectives: The patients with bilateral vestibulopathy (BV) suffer
from unsteadiness and oscillopsia, and despite of appropriate rehabilitation,
permanent disability is inevitable. However, the level of functional outcomes
could be influenced by whether there is residual vestibulo-ocular reflex (VOR)
or not. Under the hypothesis that residual VOR function could result in better
performances, we tried to compare in functional outcomes between complete and
incomplete BV. Materials and Methods: Fifty patients who have been diagnosed
with BV in our institution were retrospectively reviewed retrospectively between
2008 and 2012. We classified them into complete BV group (n=19) and
incomplete BV (n=31) group according to the presence of residual VOR. Among
them, 31 patients responded to telephone survey (6 in complete group and 25
in incomplete group). The survey includes 5 categories such as the subjective
dizziness restriction on daily life, oscillopsia, unsteadiness and depression. Each
score ranged from 0 to 4 and patients were asked twice in different time period.
Results
There was no difference in etiology between complete and incomplete
group. Incomplete group showed significant improvement in dizziness, restriction
on daily life, oscillopsia and unsteadiness compared to complete group. Among
5 catergories, dizziness score was significantly improved in incomplete group
(each mean improved sore±standard deviation; dizziness 1.84±0.83, oscillopsia
0.44±0.64, unsteadiness 1±1.09, depression 0.24±0.86 restriction on daily life
1.16±0.97). Conclusion: The presence of residual VOR function had better
functional outcomes in bilateral vestibulopathy.
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