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A Case of Congenital Nystagmus Showing Reversed Optokinetic Nystagmus
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Han Cheol Lee, Seungjoon Yang, Sung Huhn Kim, Seong Hoon Bae
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Res Vestib Sci. 2023;22(3):95-96. Published online September 15, 2023
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DOI: https://doi.org/10.21790/rvs.2023.22.3.95
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 PDF Supplementary Material
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Ménièreʼs Disease and Electrophysiology
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Sung Huhn Kim
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Res Vestib Sci. 2017;16(1):1-9. Published online March 15, 2017
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DOI: https://doi.org/10.21790/rvs.2017.16.1.1
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 Abstract
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- Inner ear is composed of cochlea, vestibule, and endolymphatic sac which are enclosed by thin layer of epithelial cells. The enclosed space is filled with fluid named as endolymph where the [K＋] is high and [Na＋] is low. This unique ion composition is very important in maintaining normal hearing and balance function by providing K＋ ions into sensory hair cells, which finally depolarize hair cells to facilitate the transport of sound and acceleration stimulation to central nervous system. The ion composition of inner ear is maintained by various ion transport through ion channels, transporters, and exchangers in the inner ear sensory and extra-sensory epithelium. The disruption of normal endolymphatic ion composition by the deterioration of the function of those ion channels can cause dysfunction of sensory epithelium, which consequently results in hearing and balance disorders. One of the possible pathology from the disruption of inner ear ion homeostasis is endolymphatic hydrops which is a phenomenon of excessive fluid accumulation of inner ear. The dysfunction of ion channels in inner ear epithelium can be an etiology of Ménièreʼs disease since endolymphatic hydrops is a main pathological finding of the disease. In this review, we discussed about the possible pathological mechanism of Ménièreʼs disease as a perspective of channelopathy as well as the role of various ion channels in the regulation of inner ear fluid volume based on the findings revealed by electrophysiological studies.
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Multicenter Randomized Study on the Efficacy of Isosorbide in Patients with Mèniére's Disease
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Hyun Woo Park, Won Ho Chung, Sung Huhn Kim, Kyu Sung Kim, Jong Woo Chung, Sung Won Chae, Ja Won Koo, Bo Gyung Kim, Eui Kyung Goh, Gyu Cheol Han
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Res Vestib Sci. 2016;15(2):44-50. Published online June 15, 2016
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Abstract
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- Objective: Mèniére's disease is one of the most common causes of episodic vestibular syndrome that shows symptom complexes of recurrent vertigo, hearing loss, tinnitus and ear fullness. Isosorbide (Isobide) is a osmotic diuretics which has been used for Meniere's disease to reduce the endolymphatic pressure. The purpose of this study was to evaluate the efficacy of isosorbide in the treatment of Mèniére's disease by comparing the combined therapy of isosorbide and betahistine (Meniace) to betahistine only.
Methods
Among 220 patients enrolled with Mèniére's disease from 9 centers, 187 patients completed this clinical study. Patients were randomly subjected either to betahistine alone therapy at dose of 6 mg three times a day (n=97) or to combined therapy with isosorbide (dose of 30 mL three times a day) and betahistine (n=90) for 12 weeks. Two groups were compared at 4 and 12 weeks after treatment on frequency of vertigo, hearing level (pure tone audiometry, speech audiometry), electocochleography (ECoG), tinnitus (Tinnitus Handicap Inventory, THI) and quality of life (Korean functional level scale, Korean dizziness handicap inventory).
Results
During first 4 weeks after treatment, the frequency of vertigo was not reduced in either betahistine alone therapy group or combined therapy group. However, between 8 and 12 weeks, the frequency of vertigo was significantly reduced in either group, and in the combined group frequency of vertigo was more significantly reduced than in the betahistine alone therapy group (p=0.041). The hearing level, ECoG, tinnitus and quality of life was not significantly different between two groups.
Conclusion
Isosorbide and betahistine combined therapy were more effective for vertigo control than betahistine alone therapy. Isosorbide is an effective diuretic in vertigo control in definite Mèniére's disease.
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KBS
