Dynamic posturography for staging of patients with Ménière's disease

2009 ◽  
Vol 123 (8) ◽  
pp. 863-867 ◽  
Author(s):  
A Daneshi ◽  
N Bozorgzadeh ◽  
A Asghari ◽  
H E Jome ◽  
P Mirhaj ◽  
...  

AbstractObjective:In recent years, techniques such as computerised dynamic posturography have facilitated objective evaluation of patients with balance disorders. In this study, we used computerised dynamic posturography for clinical staging of Ménière's disease.Material and methods:We applied a computerised dynamic posturography sensory organisation test to 53 patients with American Academy of Otolaryngology criteria of Ménière's disease. The following parameters were considered in data analysis: computerised dynamic posturography scores for testing the patient's centre of gravity with a mobile surface, immobile visual surroundings and eyes closed, scores for testing with a mobile surface, mobile visual surroundings and eyes open, and vestibular ratio. We used four hearing threshold stages (although we had no patients at stage four).Results and discussion:This study did not observe a statistically significant correlation between audiometric hearing thresholds and computerised dynamic posturography scores. Computerised dynamic posturography scores showed statistically significant variation with time elapsed since the last vertigo attack. Although our results showed an increasing trend in computerised dynamic posturography scores as Ménière's disease activity level decreased from recent post-attack (i.e. less than one week since last attack) through late post-attack (i.e. one week to 60 days since last attack) to inactive (i.e. more than 60 days since last attack), these differences were not statistically significant.

2002 ◽  
Vol 11 (6) ◽  
pp. 391-404
Author(s):  
P.S. Dimitri ◽  
C. Wall ◽  
S.D. Rauch

Although patient symptoms and an audiogram can typically identify the affected ear or ears in Ménière's disease, there are some cases where this differentiation is problematic. This paper concentrates on the sole use of vestibular test data to discriminate between unilateral and bilateral Ménière's disease. Patients that were known to have peripheral unilateral vestibular hypofunction (n = 104) were used as learning groups to define a region in multidimensional measurement space consisting of four vestibular test scores which summarized data from electronystagmography, sinusoidal harmonic acceleration, and computerized dynamic posturography tests. A multivariate boundary was created from the unilateral learning group that determined thresholds for identifying bilateral vestibular hypofunction. Patients with bilateral Ménière's disease (n = 23) and with bilateral ototoxicity (n = 19) were then used as test subjects to determine the sensitivity of the multivariate boundary. Results showed up to a increase in estimated test sensitivity (specificity = 95%) bilateral vestibular hypofunction.


2005 ◽  
Vol 15 (3) ◽  
pp. 161-168 ◽  
Author(s):  
Pasqualina M. Picciotti ◽  
Antonella Fiorita ◽  
Walter Di Nardo ◽  
Nicola Quaranta ◽  
Gaetano Paludetti ◽  
...  

In this study, we investigated whether vestibular evoked myogenic potentials (VEMPs) and dynamic posturography (DP) are useful in the evaluation of the vestibular function in patients affected by active monoaural Menière's disease (MD) treated with intratympanic gentamycin. Twelve subjects affected by monoaural MD were treated with weekly intratympanic injections of 0.5 ml of gentamycin at a concentration of 20 mg/ml. VEMPs were used to test saccular function, while postural control was analyzed by DP. The results obtained with these two techniques were compared with those obtained by using bithermal caloric test. The mean follow-up was 15.3 months (6–28 months). Therapy resulted in complete absence of the caloric response in six subjects (50) and in caloric test-induced asymmetry in the remaining individuals, ranging from 83 to 27. At follow-up, eleven patients (91.6%) were free of vertigo, while one patient had two vertigo spells 9 months after treatment. Before treatment, VEMPs were present in the affected ear of eleven patients. After treatment VEMPs were absent in all the patients. At the end of follow-up, reappearance of VEMPs was observed in two patients, with no changes in latency values and amplitude ratio. DP demonstrated a reduction of the Composite Score (CS) one week after therapy, with a prevalent reduction of the vestibular component. After 6 months, there was an improvement of the CS and, in particular, of the vestibular component. The present study demonstrates that bithermal caloric test and VEMPs allow for the functional evaluation of both the horizontal semicircular canal and the sacculus, suggesting that these techniques might be used together to monitor the efficacy of intratympanic gentamycin therapy. In addition, our data indicate that DP might provide important information on compensation phenomena and show that intratympanic gentamycin can improve postural control in MD patients.


2010 ◽  
Vol 61 (1) ◽  
pp. 34-40
Author(s):  
Esther Doménech-Vadillo ◽  
Lourdes Montes-Jovellar ◽  
Jorge Rey-Martínez ◽  
Nicolás Pérez-Fernández

Sign in / Sign up

Export Citation Format

Share Document