Research in Vestibular Science

A Case of Labyrinthitis Ossificans Presenting as an Intractable Benign Paroxysmal Positional Vertigo: Dong Hyun Kim, Jae Moon Sung, Hwi Kyeong Jung, Chang Woo Kim; Res Vestib Sci. 2017;16(3):92-96. Published online September 15, 2017; DOI: https://doi.org/10.21790/rvs.2017.16.3.92

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Abstract PDF: Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibular disorder. It is easily cured with canal repositioning maneuvers, but some patients are resistant to the repositioning maneuver and require surgical intervention. Labyrinthitis ossificans is the pathologic condition that fibrous tissue and new bone occupy the membranous labyrinthine space. It occurs as a sequela of inner ear inflammation resulting from diverse causes, mostly bacterial meningitis and otitis media. We describe here a 42-year-old female patient with refractory posterior semicircular canal (PSCC) BPPV and adhesive otitis media in same ear. Otoscopic examination revealed adhesive tympanic membrane without middle ear space and temporal bone computed tomography showed complete ossification of the labyrinth at the same side. We performed a canal wall down mastoidectomy and PSCC occlusion. The patient had complete resolution of paroxysmal vertigo and positional nystagmus, postoperatively.

난치성 양성돌발두위현훈의 양상을 보이는 화골성 내이염 1예: Dong Hyun Kim, Jae Moon Sung, Hwi Kyeong Jung, Chang Woo Kim; Received July 14, 2017 Accepted August 17, 2017 Published online August 17, 2017; [Accepted]

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Abstract: Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibular disorder. It is easily cured with canal repositioning maneuvers, but some patients are resistant to the repositioning maneuver and require surgical intervention. Labyrinthitis ossificans is the pathologic condition that fibrous tissue and new bone occupy the membranous labyrinthine space. It occurs as a sequela of inner ear inflammation resulting from diverse causes, mostly bacterial meningitis and otitis media. We describe here a 42-year-old female patient with refractory posterior semicircular canal (PSCC) BPPV and adhesive otitis media in same ear. Otoscopic examination revealed adhesive tympanic membrane without middle ear space and temporal bone CT showed complete ossification of the labyrinth at the same side. We planned performed a canal wall down mastoidectomy and PSCC occlusion. The patient had complete resolution of her BPPV symptom including paroxysmal vertigo and positional nystagmus, postoperatively.

A Case of Dolichoectasia of Vertebrobasilar Artery Presenting Simultaneous Bilateral Sudden Sensorineural Hearing Loss with Vertigo: Bum Ki Cho, Oh Joon Kwon, Dong Hyun Kim, Chang Woo Kim; Res Vestib Sci. 2016;15(1):22-26.

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Abstract PDF: Sudden sensorineural hearing loss (SNHL) develops usually in unilateral ear without known etiology. In contrast, bilateral sudden SNHL is mostly related to serious systemic diseases and have a severe hearing loss and poor prognosis compared than unilateral one. We describe here a 59-year-old man presented with a bilateral sudden SNHL and vertigo possibly attributed to dolichoectasia in vertebrobasilar artery, and discuss the possible mechanism.

A Case of Posterior Inferior Cerebellar Artery Infarction Presenting with Sudden Hearing Loss and Vertigo: Sang Hyo Lee, Go Woon Kim, Bum Ki Cho, Chang Woo Kim; Res Vestib Sci. 2013;12(4):136-139.

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Abstract: Sudden hearing loss and vertigo are the typical presentation of anterior inferior cerebellar artery infarction, but may rarely occur in posterior inferior cerebellar artery (PICA) infarction. Here we describe a 65-year-old man who presented with sudden hearing loss in his left ear and severe vertigo. The diffusion-weighted magnetic resonance imaging revealed acute infarction in the territory of PICA and cerebral angiography showed non-visualization of left vertebral artery. Sudden hearing loss and vertigo may be a presentation of PICA infarction.

A Case of Anterior Inferior Cerebellar Artery Infarction Initially Presented a Sudden Sensorineural Hearing Loss with a Normal Diffusion-weighted Brain MRI: Han Shin Kim, Jeong In Oh, Moon Il Park, Chang Woo Kim; Res Vestib Sci. 2009;8(2):147-151.

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Abstract PDF: A sudden hearing loss with vertigo may originate from vascular insufficiency and sometimes presents as a prodrome of anterior inferior cerebellar artery infarction. Here we describe the case of a 48-year-old male patient who presented with a sudden onset of hearing loss in his right ear and severe, whirling type dizziness without associated neurological signs or symptoms. The diffusion-weighted magnetic resonance imaging (MRI) was normal on initial presentation, but 4 weeks after the onset of symptoms, the patient developed ipsilateral facial paralysis and dysarthria. A follow-up MRI revealed acute infarction in the territory of the anterior inferior cerebellar artery, involving the right lateral pons, right middle cerebellar peduncle, and inferolateral cerebellum.

A Case of Cerebellopontine Angle Osteoma Causing Sudden Hearing Loss with Vertigo: Woo Jin Bae, Seung Hern Ha, Sun Min Park, Chang Woo Kim; Res Vestib Sci. 2009;8(1):66-69.

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Abstract PDF: Osteomas arising from the internal auditory canal (IAC) and locating in the cerebellopontine angle (CPA) are rare. These tumors may cause compression of the IAC with varying degree of hearing loss, vertigo, and tinnitus but sometimes asymptomatic. Here we present a 60-year-old female patient presented with a hearing loss of sudden onset in her right ear and recurrent dizziness of whirling type. Magnetic resonance imaging and computed tomography revealed CPA osteoma arising from the porus of the IAC. Osteomas should be considered as differential diagnosis in patients with sudden hearing loss and vertigo. Key Words: Osteoma; Cerebellopontine angle; Hearing Loss, Sudden

The Correlation between the Change in the Degree of the Canal Paresis in Bithermal Caloric Test and the Degree of Hearing Loss after Chemical Labyrinthectomy in Patients with Meniere's Disease: Chang Woo Kim, San Ho Jung, Won Sang Lee; J Korean Bal Soc. 2004;3(2):404-409.

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Abstract PDF: Background
and Objectives : The chemical labyrinthectomy with aminoglycoside is a good method for vertigo control in Meniere's disease. It is relatively non-invasive and easy procedure, but hearing loss is a awful complication. We aimed to evaluate the relationship between the change in the degree of canal paresis in bithermal caloric test and the degree of hearing change. Materials and Methods : Sixty-five patients of Meniere's disease who underwent chemical labyrinthectomy with streptomycin between October 1997 and December 2001 were included in this study. The minimum follow-up period for the patients was 24 months. Medical records were analyzed retrospectively. Criteria had been prescribed in 1995 by the American Academy of Otolaryngology-Head and Neck Surgery were used. Forty patients were tested a caloric response before and after the chemical labyrinthectomy. We analyzed the vertigo control rate, the change of the canal paresis and the change of hearing level.
Results
: Vertigo was controlled in 90.8% of the 65 patients. Twelve patients of total 65 patients were decreased hearing level more than 10 ㏈ after this procedure. Even though the severity of canal paresis increased, the hearing ability of most patients was unaffected. Some patients who had only slight canal paresis happened to suffer from hearing loss.
Conclusion
: There was no correlation between the change in the degree of canal paresis in the bithermal caloric test and the degree of the hearing change.

The study of galvanic vestibular stimulation in patients of total unilateral vestibular loss: Hyun Jik Kim, Chang Woo Kim, Won Sang Lee; J Korean Bal Soc. 2003;2(2):211-217.

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Abstract PDF: Objectives
The aim of this study was to observe the nystagmus of totally unilateral vestibular function loss on galvanic vestibular stimulation and the diagnostic value of galvanic vestibular stimulation. Additionally we wanted to evaluate which portions may be stimulated by galvanic vestibular stimulation. Materials and Methods: We evaluated the three parameters of galvanic stimulation in fourteen patients with totally unilateral vestibular function loss, 1)spontaneous nystagmus, 2)galvanic stimulating nystagmus, 3)Post galvanic stimulating nystagmus through 3-dimensional video-oculography technique.
Results
When negative electrode was attached to the intact side, The nystagmus on galvanic vestibular stimulation was directed to the negative electrode side in all patients and post galvanic stimulating nystagmus was directed to the opposite side but on functional loss side, we couldn't detect any nystagmus on galvanic vestibular stimulation and in 10 patients, post galvanic stimulating nystagmus was observed and directed to the intact side.
Conclusions
Galvanic vestibular stimulation is very useful for evaluating the vestibular function and for diagnosing the vestibular disease.

Results of otolith reposition therapy in posterior semicircular canal BPPV: Sung Hun Kim, Ju Hyoung Lee, Mi Ran Bae, Chang Woo Kim, Soo Young Lee, Won Sang Lee; J Korean Bal Soc. 2003;2(1):107-112.

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Abstract PDF: Background
and objectives: Benign paroxysmal positional vertigo (BPPV) has been well controlled with otolith reposition therapy. Posterior canal is known as the most common site of BPPV. The purpose of this study was to study the therapeutic result of reposition therapy in posterior canal BPPV, to investigate the unusual cases such as recurred cases and type changed cases during the reposition maneuver, and to figure out the therapeutic strategy. Materials and methods: One hundred and ten patients diagnosed posterior canal BPPV were included in this study. Epley maneuver was performed once a day until nystagmus disappeared. We analyzed the number of treatment, changing type, recurrence and the relationship between recurrence and age or sex of patients.
Result
All cases except 2 were recovered by Epley maneuver. In 11 cases, the type of disease was changed, and the treatment of these cases were changed according to new type and origin. Overall recurrence rate was 15%, and they were completely treated with reposition therapy. There was no correlation between recurrence and age, sex of patients.
Conclusion
All most cases were cured with Epley maneuver. The type of the disease was possibly changeable. Recurrence rate was relative high, and close follow up was required.

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