Vestibular signs and symptoms of volumetric abnormalities of the vestibular aqueduct

2007 ◽  
Vol 122 (6) ◽  
pp. 557-563 ◽  
Author(s):  
L Manzari
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Motion Sickness ◽  
Auditory Brainstem ◽  
Vestibular Evoked Myogenic Potentials ◽  
Resonance Imaging ◽  
Vestibular Evoked Myogenic Potential ◽  
Vestibular Aqueduct ◽  
Brainstem Response

AbstractObjective:The objective of this study was to identify a pattern of signs, symptoms and neuroradiological findings which would assist investigation of vestibular function (especially otolith function) in a group of adult patients with anatomical alterations of the endolymphatic aqueduct and sac.Methods:Fifteen subjects affected by volumetric abnormalities of the vestibular aqueduct were selected from a cohort of patients referred to a tertiary referral neurotological centre between 1 January 2004 and 30 June 2006. All patients underwent accurate clinical history-taking and were evaluated using a standardised set of bedside and instrumental neurotological tests (i.e. audiometry, auditory brainstem response and vestibular evoked myogenic potentials). After these tests, each patient underwent computed tomography and magnetic resonance imaging in order to accurately evaluate the middle ear, labyrinthine capsule and internal auditory canals. These evaluations confirmed clinical suspicion of volumetric abnormalities of the vestibular aqueduct and endolymphatic sac.Results:All the patients with a defined volumetric alteration in the region of the vestibular aqueduct and endolympatic sac reported a typical pattern of symptoms and signs. The most obvious and frequent symptoms in these patients were migraine-related vertigo (using the Neuhauser criteria, 10 of 15, 66.6 per cent), ‘motion sickness’ (12 of 15, 80 per cent), oscillopsia (nine of 15, 60 per cent) and dizziness (14 of 15, 93.3 per cent). Clinical examination results for the selected patients allowed some useful speculative conclusions. During neurotological evaluation, two instrumental methodologies were especially useful diagnostically: vestibular evoked myogenic potentials of the neck, and the mastoid vibration test at 100 Hz.Conclusions:Dysfunction of the vestibular aqueduct is suggested by symptomatology characterised by: migraine-related vertigo, unstable or recurring oscillopsia, lowering of the vestibular evoked myogenic potential threshold, hypoacusis, anamnestic report of motion sickness, and nystagmus induced by mastoid vibration and head-shaking. Computed tomography and magnetic resonance imaging are needed in order to confirm clinical suspicions.

Relative diagnostic importance of electronystagmography and magnetic resonance imaging in vestibular disorders

2009 ◽  
Vol 123 (8) ◽  
pp. 851-856 ◽  
Author(s):  
S Korres ◽  
M Riga ◽  
G Papacharalampous ◽  
T Chimona ◽  
V Danielidis ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Clinical Examination ◽  
Auditory Brainstem ◽  
Resonance Imaging ◽  
Central Nervous System Dysfunction ◽  
Number Of Patients ◽  
Brainstem Response ◽  
Aetiological Diagnosis ◽  
Conclusive Diagnosis

AbstractObjective:The aim of this study was to investigate the contribution of electronystagmography and magnetic resonance imaging to the aetiological diagnosis of vertigo and unsteadiness, in a population in which the history and clinical examination provide no conclusive diagnosis of the origin of the dysfunction (i.e. peripheral or central).Patients and methods:This retrospective study included 102 patients, who underwent full ENT clinical evaluation, history and neurotological assessment (including pure tone audiography, auditory brainstem response testing, electronystagmography and magnetic resonance imaging).Results:Electronystagmography contributed to establishment of a diagnosis in 53/102 patients (52 per cent), whereas magnetic resonance imaging did the same in four of 102 patients (3.9 per cent).Conclusion:Electronystagmography remains the most useful examination for aetiological diagnosis of patients with vertigo and unsteadiness, since the actual number of patients with vertigo and unsteadiness of central origin is small (3.9 per cent), even in a population in which history and clinical examination may indicate an increased probability of central nervous system dysfunction.

Unilateral auditory neuropathy spectrum disorder: retrocochlear lesion in disguise?

2014 ◽  
Vol 129 (S1) ◽  
pp. S38-S44 ◽  
Author(s):  
A Mohammadi ◽  
P Walker ◽  
K Gardner-Berry
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Auditory Neuropathy ◽  
Cochlear Nerve ◽  
Spectrum Disorder ◽  
Resonance Imaging ◽  
Auditory Neuropathy Spectrum Disorder ◽  
Cochlear Nerve Aplasia ◽  
Brainstem Response

AbstractObjective:To investigate whether the aetiology for hearing impairment in neonates with unilateral auditory neuropathy spectrum disorder could be explained by structural abnormalities such as cochlear nerve aplasia, a cerebellopontine angle tumour or another identifiable lesion.Methods:In this prospective case series, 17 neonates were diagnosed with unilateral auditory neuropathy spectrum disorder on electrophysiological testing. Diagnostic audiology testing, including auditory brainstem response testing, was supplemented with computed tomography and/or magnetic resonance imaging.Results:Ten of the neonates (59 per cent) showed evidence for cochlear nerve aplasia. Of the remaining seven, four were shown to have another abnormality of the temporal bone on imaging. Only three neonates (18 per cent) were not diagnosed with cochlear nerve aplasia or another lesion. Three computed tomography scans were reported as normal, but subsequent magnetic resonance imaging revealed cochlear nerve aplasia.Conclusion:Auditory neuropathy spectrum disorder as a unilateral condition mandates further investigation for a definitive diagnosis. This series demonstrates that most neonates with unilateral auditory neuropathy spectrum disorder had pathology as visualised on computed tomography and/or magnetic resonance imaging scans. Magnetic resonance imaging is an appropriate first-line imaging modality.

scholarly journals Clinical observation of auditory brainstem response. Evaluation of waveforms with magnetic resonance imaging.

1990 ◽  
Vol 33 (4) ◽  
pp. 266-272
Author(s):  
Masahiro Ishikawa ◽  
Hiroshi Hosoi ◽  
Kiyotaka Murata ◽  
Noriko Tamaki ◽  
Hisaya Tanaka ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Auditory Brainstem Response ◽  
Clinical Observation ◽  
Auditory Brainstem ◽  
Response Evaluation ◽  
Resonance Imaging ◽  
Brainstem Response

scholarly journals Large endolymphatic sac. A congenital deformity of the inner ear shown by magnetic resonance imaging

1997 ◽  
Vol 111 (8) ◽  
pp. 754-756 ◽  
Author(s):  
P. D. Phelps ◽  
C. F. O. Mahoney ◽  
L. M. Luxon
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Endolymphatic Sac ◽  
Congenital Deformity ◽  
Resonance Imaging ◽  
Vestibular Aqueduct ◽  
Large Vestibular Aqueduct Syndrome ◽  
Magnetic Resonance Imaging Mri ◽  
Large Vestibular Aqueduct

AbstractFluctuant and progressive hearing impairment in a patient with a wide vestibular aqueduct has been called the ‘large vestibular aqueduct syndrome’. Recently reports of magnetic resonance imaging (MRI) studies describe enlargement of the endolymphatic sac and duct in patients shown to have large vestibular aqueducts by computed tomography (CT). A patient with progressive deafness was shown to have borderline or slightly enlarged vestibular aqueducts by re-formatted sagittal CT. However, MRI in axial and sagittal planes gave a more satisfactory demonstration of both aqueduct and endolymphatic sac enlargement.

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