Research in Vestibular Science

Volume 19 (3); September 2020

Original Articles

Effect of Korean Red Ginseng on Early Vestibular Function Restoration after Unilateral Labyrinthectomy: Jiyeon Lee, Mi Joo Kim, Gyu Cheol Han; Res Vestib Sci. 2020;19(3):79-88. Published online September 15, 2020; DOI: https://doi.org/10.21790/rvs.2020.19.3.79

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Abstract PDF: Objectives
Vertigo is a common condition. Definitive treatment is to induce vestibular compensation. Currently, no medications have been discovered that enhance vestibular functional restoration. The current study was conducted to evaluate the ability of ordinary Korean red ginseng (KRG) to induce vestibular compensation.
Methods
Twelve Sprague-Dawley rats were divided into two groups. Five rats (KRG group) were fed KRG extract (100 mg/kg) for 2 weeks before undergoing unilateral labyrinthectomy (ULx). The remaining seven rats (control group) were untreated before ULx. After surgery, all animals were housed in the same environment without being fed additional extract. To evaluate vestibular function, gain of the horizontal nystagmus to 0.2 Hz with a peak velocity of 100°/second sinusoidal rotation was compared and analyzed before ULx as well as 3 and 7 days after surgery.
Results
Before the operation, gain of the control and KRG group were 0.81±0.05 and 0.88±0.08, respectively, with 0.2-Hz stimulation. This value decreased to 0.43±0.08 and 0.53±0.08, respectively on 3 days after operation (p=0.047), and it was 0.40±0.06 and 0.68±0.11, respectively on 7 days after surgery. The difference of gain between the two groups was statistically significant at each 3 and 7 days (p＜0.05). By confirming c-Fos protein expression in medial vestibular nuclei, the functional effect of KRG causing vestibular modulation was confirmed.
Conclusions
Rats treated with KRG showed more rapid and complete recovery after acute vestibular loss compared to untreated animals. Therefore, KRG could be one of candidate for the useful medication of vestibular diseases.

Positional Audiometry in Patients with Light Cupula: A Preliminary Study: Jiyeon Lee, Dong-Han Lee, Jung Eun Shin, Chang-Hee Kim; Res Vestib Sci. 2020;19(3):89-94. Published online September 15, 2020; DOI: https://doi.org/10.21790/rvs.2020.19.3.89

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1 Crossref

Objectives
Light cupula is characterized by persistent geotropic direction-changing positional nystagmus in a supine head-roll test. The purpose of this study is to investigate if hearing level is influenced by the change of head position in light cupula under the assumption that relative density difference similarly occurs between the tectorial membrane and endolymph.
Methods
Twelve patients with unilateral light cupula who underwent positional audiometry were included in this study. Pure tone thresholds were compared among three head positions.
Results
Hearing threshold in pure tone audiometry (PTA) of the affected ear was not different from that of the healthy ear. PTA thresholds of the affected side were not significantly different in three head positions; upright seating, cochlear apex-up, and cochlear apex-down positions.
Conclusions
Although positional change of nystagmus direction is the most significant clinical feature of light cupula, positional change of hearing level was not observed in those patients. The lack of positional influence on hearing may be explained as follows: (1) the heavier endolymph phenomenon occurs only in the vestibular end organ without involving the cochlea; (2) the light cupula phenomenon is more likely to occur due to light debris mechanism rather than heavier endolymph or lighter cupula mechanism; and (3) the effects of light cupula could be modified by outer hair cells, which work for tuning in the cochlea, even though light tectorial membrane or heavy endolymph occurs.

Citations

Citations to this article as recorded by

Light cupula phenomenon: a systematic review
Nilüfer Bal, Melike Altun, Elif Kuru, Meliha Basoz Behmen, Ozge Gedik Toker
The Egyptian Journal of Otolaryngology.2022;[Epub] CrossRef

Intravenous Zoledronic Acid in Elderly Patients with Benign Paroxysmal Positional Vertigo and Osteoporosis: Dong Won Kwack, Hyemi Lee, Dong Wook Kim; Res Vestib Sci. 2020;19(3):95-98. Published online September 15, 2020; DOI: https://doi.org/10.21790/rvs.2020.19.3.95

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Abstract PDF: Objectives
Benign paroxysmal positional vertigo (BPPV), a common cause of vertigo in the elderly, shares common pathogenic mechanisms with osteoporosis. We investigated the efficacy and safety of intravenous zoledronic acid in elderly patients with BPPV and osteoporosis.
Methods
We performed a 3-year observational study with elderly patients who were diagnosed with BPPV and osteoporosis. The recurrence of BPPV and changes in bone mineral densitometry (BMD) scores were evaluated one year after the administration of intravenous zoledronic acid.
Results
We enrolled 101 elderly patients with BPPV and 54 of them (53.5%) met the diagnostic criteria for osteoporosis. Intravenous zoledronic acid was administered in 51 patients. The recurrence of BPPV was observed in only two of 49 patients (4.1%) at 1 year’s follow-up. The mean lowest T-score of BMD improved from –3.23±0.51 to –3.05±0.58 (p=0.001).
Conclusions
Our study showed that the treatment of osteoporosis can be considered to prevent the recurrence of BPPV in the elderly. Further placebo-controlled studies are needed to estimate accurately the efficacy of zoledronic acid in the prevention of recurrence of BPPV in the elderly.

The Periodic Fluctuation of Intra-Annual Distribution of Benign Paroxysmal Positional Vertigo and Meteorological Parameters: Chae Dong Yim, Ki Ju Cho, Hyun Jin Lee, Dong Gu Hur, Rock-Bum Kim, Seong-Ki Ahn; Res Vestib Sci. 2020;19(3):99-103. Published online September 15, 2020; DOI: https://doi.org/10.21790/rvs.2020.19.3.99

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Abstract PDF: Objectives
The influence of specific meteorological conditions, such as solar radiation quantity, duration of sunshine, and their covariation on the incidence of benign paroxysmal positional vertigo (BPPV) has been rarely investigated. Aiming at better predictions of the monthly variation of BPPV, we investigated variations in the monthly incidence of BPPV patients and meteorological parameters.
Methods
A total of 2,111 patients who had been diagnosed with BPPV at one institution were analyzed retrospectively. Monthly counts of BPPV patients were analyzed for incidence distributions throughout the 5 years. The relationship between intra-annual distribution of BPPV and meteorological parameters was compared by the time series analysis.
Results
The lowest monthly incidence of BPPV patients was found in September and the highest monthly incidence was found in December. Statistically, as a result of the time series analysis, a periodic fluctuation of both quantity of solar radiation (p=0.004) and percentage of sunshine duration (p=0.002) was identified, but a periodic fluctuation of both number of BPPV patients (p=0.316) and sunshine duration (p=0.057) was not identified.
Conclusions
Unlike previous studies, the results of time series analysis did not confirm that there is a periodic fluctuation in the incidence of BPPV patients. The incidence of BPPV may be more affected by other factors than by meteorological parameters.

Case Report

Acute Peripheral Vestibular Syndrome in Relapsing Polychondritis: Haemin Noh, Dong-Han Lee, Jung Eun Shin, Chang-Hee Kim; Res Vestib Sci. 2020;19(3):104-109. Published online September 15, 2020; DOI: https://doi.org/10.21790/rvs.2020.19.3.104

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Abstract PDF Supplementary Material: Relapsing polychondritis is a rare multisystemic autoimmune disorder of unknown etiology and characterized by recurrent episodes of inflammation affecting the cartilaginous tissues. Otologic manifestation such as auricular chondritis is one of the most frequent presenting symptoms in relapsing polychondritis, and inner ear symptoms, such as hearing loss, tinnitus, and vertigo, may develop in 7% to 42% of the patients. In this study, we present a 42-year-old male patient with relapsing polychondritis, who experienced two separate episodes of acute vestibular syndrome at the interval of 6 years. At the first vertigo attack, the patient showed left-beating spontaneous nystagmus with sudden hearing loss on the right side, and a bithermal caloric test revealed canal paresis on the right side. At the second vertigo attack, he showed right-beating spontaneous nystagmus, and a bithermal caloric test, compared to that during the first vertigo attack, revealed additional decrease in caloric response on the left side.

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