scholarly journals Unilateral Multicanalicular Vestibular Lithiasis of Right Horizontal and Posterior Semicircular Canals: An Unusual Case

2021 ◽  
Author(s):  
Ajay Kumar Vats
Keyword(s):  
Semicircular Canal ◽  
Unusual Case ◽  
Semicircular Canals ◽  
Posterior Semicircular Canal ◽  
Gelatinous Matrix ◽  
History Of ◽  
Head Roll ◽  
The Individual ◽  
Treatment Priorities ◽  
Torsional Nystagmus

AbstractVestibular lithiasis (canalolithiasis as well as cupulolithiasis) commonly exists in monocanalicular forms involving one of the three semicircular canals, frequent posterior, less frequent horizontal, and very rarely anterior. It is treated with canal clearing maneuvers intended to reposition the otoconia from the semicircular canal (where they have inappropriately entered) through the utricular exit in the nonampullary arm of the semicircular canal to the utricle (where they normally remain as a part of utricular gelatinous matrix). The cases of multicanalicular vestibular lithiasis with the involvement of more than one semicircular canal require meticulous identification of the involved canals and multiple different canal-clearing maneuvers for effective treatment. A 70-year-old male patient with no significant history of previous medical or otologic illnesses or head trauma presented with a 1-day history of vertigo with positional aggravation. A one-time performed diagnostic supine head roll test elicited three different patterns of positional nystagmus, each with an accurate localizing and lateralizing value. Diagnosis of unilateral multicanalicular vestibular lithiasis of right horizontal and posterior semicircular canals was entertained based on the pattern of the elicited positional nystagmi on the supine roll test. The upbeating torsional nystagmus that localizes the involvement to the posterior semicircular canal was paradoxically elicited by supine head roll test and not by the Dix–Hallpike test. As horizontal semicircular canalolithiasis causes severe symptoms, its treatment preceded that of concurrent posterior semicircular canalolithiasis. The patient was successfully treated with multiple sessions of canalith repositioning maneuvers (CRMs) spread over 24 hours. It is important to perform both positional tests, namely Dix–Hallpike maneuver, and supine head roll test, in cases suspected to have multicanalicular vestibular lithiasis. The positionings may need to be repeated several times to unveil multiple nystagmi, each with different localizing and lateralizing values. Identifying treatment priorities with CRM for the individual semicircular canals is crucial, and the canal that is liable to cause severe symptoms needs early clearance of the otoconial debris. If a CRM fails to clear a semicircular canal, an alternative maneuver may need to be executed. Clinicians involved in the care of cases with multicanalicular vestibular lithiasis should be well versed with all possible backup maneuvers for clearing each of the three semicircular canals.

scholarly journals Persistent Upbeat Positional Nystagmus in a Patient with Bilateral Posterior Canal Benign Paroxysmal Positional Vertigo

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Akihide Ichimura ◽  
Shigeto Itani
Keyword(s):  
Supine Position ◽  
Benign Paroxysmal Positional Vertigo ◽  
Semicircular Canals ◽  
Downbeat Nystagmus ◽  
Positional Vertigo ◽  
Head Roll ◽  
The Right ◽  
Upbeat Nystagmus ◽  
Torsional Nystagmus ◽  
Paroxysmal Positional Vertigo

Here, we report a patient with persistent positional upbeat nystagmus in a straight supine position with no evident abnormal central nervous system findings. A 43-year-old woman with rotatory positional vertigo and nausea visited our clinic 7 days after the onset. Initially, we observed persistent upbeat nystagmus in straight supine position with a latency of 2 s during the supine head roll test. However, an upbeat nystagmus disappeared on turning from straight to the left ear-down supine position, and while turning from the left to right ear-down position, an induced slight torsional nystagmus towards the right for >22 s was observed. In the Dix–Hallpike test, the left head-hanging position provoked torsional nystagmus towards the right for 50 s. In prone seated position, downbeat nystagmus with torsional component towards the left was observed for 45 s. Neurological examination and brain computed tomography revealed no abnormal findings. We speculated that persistent positional upbeat nystagmus in this patient was the result of canalolithiasis of benign paroxysmal positional vertigo of bilateral posterior semicircular canals.

The incidence of tympanogenic labyrinthitis ossificans

2014 ◽  
Vol 128 (7) ◽  
pp. 618-620 ◽  
Author(s):  
H-Y Lin ◽  
Y-K Fan ◽  
K-C Wu ◽  
M-T Shu ◽  
C-C Yang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Head And Neck Cancer ◽  
Cochlear Implants ◽  
Semicircular Canal ◽  
Lateral Semicircular Canal ◽  
Posterior Semicircular Canal ◽  
High Resolution Computed Tomography ◽  
Labyrinthitis Ossificans ◽  
Computed Tomography Scans ◽  
History Of

AbstractObjective:To estimate the incidence of tympanogenic labyrinthitis ossificans.Methods:The records of patients treated with mastoidectomy for various tympanogenic aetiologies from January 2007 to December 2011 were retrospectively reviewed. Patients whose high-resolution computed tomography scans showed evidence of labyrinthine calcification of the temporal bone were enrolled. Patients with a history of head and neck cancer, meningitis, and otosclerosis, and patients with cochlear implants, were excluded from this study.Results:A total of 195 patients were enrolled in this study; 4 of the patients presented with calcification in the inner ear. Therefore, the incidence of tympanogenic labyrinthitis ossification was 2 per cent. The computed tomography findings revealed: (1) cochlear calcifications of the basal and middle turn in two patients; and (2) vestibular, superior semicircular canal, posterior semicircular canal and lateral semicircular canal calcification in one, four, three and two patients, respectively.Conclusion:The incidence of tympanogenic labyrinthitis ossification in patients who had undergone a mastoidectomy was 2 per cent.

scholarly journals NEUROANATOMÍA DEL SAURÓPODO TITANOSAURIO NARAMBUENATITAN PALOMOI DEL CRETÁCICO SUPERIOR DE PATAGONIA, ARGENTINA.

2020 ◽  
Author(s):  
Ariana Paulina-Carabajal ◽  
Leonardo Filippi ◽  
Fabien Knoll
Keyword(s):  
Semicircular Canal ◽  
Upper Cretaceous ◽  
Semicircular Canals ◽  
Lateral View ◽  
Phylogenetic Position ◽  
Posterior Semicircular Canal ◽  
X Ray ◽  
Anterior Semicircular Canal ◽  
X Ray Computed ◽  
The Brain

this taxon has uncertain phylogenetic relationships within the clade. An X-ray Computed Tomography (CT) scan of the holotypebraincase allowed the first reconstruction of the brain and inner ear of this taxon, making it possible to compare the neuroanatomy with thatof closely related forms. Except for the slightly sigmodal shape of the endocast in lateral view—considered a basal condition—, the brainshows derived titanosaurian traits such as a poorly developed dorsal expansion and a single exit for Cranial Nerve (CN) XII. In contrast, the innerear exhibits slender and long semicircular canals (the anterior semicircular canal is distinctly longer than the posterior semicircular canal), whichis a character present in more basal representatives of the group, such as Sarmientosaurus. We consider, however, the morphology of theinner ear as an unreliable indicator of phylogenetic position. Furthermore, there is a remarkable similarity between the morphology of theendocast of Narambuenatitanand the possible saltasaurid from (FAM 03.064), from the Upper Cretaceous of Fox-Amphoux-Métisson, France,suggesting saltasaurine affinities for the Argentinean taxon.

scholarly journals Labyrinthine Reactions and Their Relation to the Clinical Tests

1937 ◽  
Vol 30 (7) ◽  
pp. 905-916 ◽  
Author(s):  
W. J. McNally
Keyword(s):  
Semicircular Canal ◽  
Semicircular Canals ◽  
Careful Analysis ◽  
The Body ◽  
Tilt Test ◽  
Head Turning ◽  
Second Mode ◽  
Protective Reaction ◽  
The Individual ◽  
Vertical Semicircular Canals

The rapid tilt test has shown that the vertical semicircular canals are in close connexion with the whole postural body musculature. Nystagmus reactions are only a small part of semicircular canal sphere of control. Further knowledge of the reaction-pattern of the body musculature resulting from the stimulation of each semicircular canal will help in diagnosing a lesion, not only of the individual semicircular canals, but also—even more important—of its intracranial connexions. The few reaction patterns already known, but not recognized as such, namely post-pointing, falling, and head turning, are true compensatory reactions, more easily understood if so considered and grouped with the protective reactions to the tilt tests. Recognition of the two modes of utricular action is essential to a correct analysis of tilt test reactions. The slow tilt described by Grahe and others, is an excellent test for “first mode” utricular action, but not for “second mode” action or for vertical semicircular canals. The quick tilt is primarily a test of vertical semicircular canal action, but normally the reaction is complicated by reactions from “second mode” utricular stimulation. If this fact is not taken into account the analysis of a reaction to a quick tilt may be misleading. When performing a quick tilt test, in addition to watching for the absence of the protective reaction (due to loss of one or both labyrinths), the investigator should try to note whether there is a tendency for the patient to be more easily thrown in the direction of the tilt—owing to a lesion of the vertical canals, the utricles being intact (“second mode” utricular action)—or whether there is a tendency for the patient to over-compensate (owing to a lesion of the utricles, the vertical canals being intact). If, in addition to the usual equilibrial tests, the quick tilt test is used in this way and a careful analysis is made of the reactions of patients with labyrinthine or intracranial lesions, diagnosis of lesions of individual labyrinthine end-organs or of their intracranial connexions may become a routine procedure in the clinic just as it is now possible in the laboratory.

scholarly journals A Case of Right Apogeotropic Posterior Semicircular Canal BPPV that Initially Emulated as Left Anterior Semicircular Canal BPPV

2020 ◽  
Author(s):  
Ajay Kumar Vats ◽  
Sudhir Kothari ◽  
Anirban Biswas
Keyword(s):  
Semicircular Canal ◽  
Benign Paroxysmal Positional Vertigo ◽  
Posterior Semicircular Canal ◽  
Positional Vertigo ◽  
Epley Maneuver ◽  
History Of ◽  
Anterior Semicircular Canal ◽  
The Right ◽  
Paroxysmal Positional Vertigo

AbstractIn any patient with a history of rotational vertigo triggered by changes in the position of head relative to the gravity, whose oculomotor patterns elicit a positional downbeating nystagmus (p-DBN), the localization could be either central in the brainstem, midline cerebellum, or at the craniocerebral junction; or else peripheral due to one of the rare variants of benign paroxysmal positional vertigo of vertical semicircular canals. Most serious causes of central vertigo in patients with p-DBN can be diagnosed by magnetic resonance imaging of the posterior fossa and craniovertebral junction. However, the peripheral p-DBN could be either due to anterior semicircular canal benign paroxysmal positional vertigo (ASC-BPPV) or a recently described apogeotropic variant of posterior semicircular canal BPPV (apo-PSC-BPPV) and the two are almost impossible to differentiate initially. The usual clinical scenario in apo-PSC-BPPV is diagnosing it initially as ASC-BPPV. However, following diagnostic or therapeutic positioning maneuvers for the purported ASC-BPPV, the positional oculomotor pattern changes to an upbeating nystagmus with the reversal in the direction of the torsion as well, localizing it to the contralateral PSC with respect to the ASC initially diagnosed. The initial oculomotor pattern observed on the right Dix–Hallpike test in this patient, of a short latency downbeating left torsional (from the patient’s perspective) positional nystagmus suggested a diagnosis of left ASC-BPPV, which was accordingly treated with multiple sessions of reverse Epley maneuvers daily for a week. At the end of the week, a verifying right Dix–Hallpike test elicited an upbeating right torsional (from the patient’s perspective) positional nystagmus. It is extremely unlikely that this patient had resolution of her initial left ASC-BPPV with the daily sessions of reverse Epley maneuvers carried over a week and immediately suffered from commoner geotropic variant of the right PSC-BPPV (geo-PSC-BPPV). It is plausible to interpret that this patient suffered from the right apo-PSC-BPPV from the very outset, and the reverse Epley maneuver performed for the ostensive left ASC-BPPV led to an intracanal shift of otoconial debris from its nonampullary to the ampullary arm resulting in right geo-PSC-BPPV. The reasons why situations like this outwit the clinician resulting in inaccurate localization as well as lateralization is discussed. The patient was successfully treated with right Epley maneuver after transformation to geo-PSC-BPPV and was asymptomatic at follow-up for 4 weeks. A peripheral p-DBN with torsional component in any patient with a history of positionally triggered vertigo can be either ASC-BPPV or apo-PSC-BPPV. A very close follow-up at a short interval of time with meticulously executed positional tests is the only definitive way to differentiate the two conditions.

Acute Vestibular Paralysis in Herpes Zoster Oticus

1979 ◽  
Vol 88 (3) ◽  
pp. 303-310 ◽  
Author(s):  
Leonard Proctor ◽  
John Lindsay ◽  
Henry Perlman ◽  
Gregory Matz
Keyword(s):  
Herpes Zoster ◽  
Semicircular Canal ◽  
Disease Process ◽  
Semicircular Canals ◽  
Caloric Test ◽  
Lateral Semicircular Canal ◽  
Posterior Semicircular Canal ◽  
Herpes Zoster Oticus ◽  
Eye Closure

A case of herpes zoster oticus is presented in which the lateral and superior semicircular canals of the labyrinth were affected unilaterally. The results of several electronystagmographic examinations are described and correlated with the patient's description of symptoms. This case study indicates that disease affecting the lateral semicircular canal is reliably detected by the conventional caloric test. However, the fact that the posterior semicircular canal remained intact could not be inferred from the results of the caloric test in this case. Also, the appearance of nystagmus upon eye closure appears to have been a more sensitive index of the state of the disease process than was the caloric test.

Evaluation of Vertical Semicircular Canal Function in Patients With Vestibular Schwannoma

2018 ◽  
Vol 128 (2) ◽  
pp. 113-120 ◽  
Author(s):  
Keishi Fujiwara ◽  
Hiroko Yanagi ◽  
Shinya Morita ◽  
Kimiko Hoshino ◽  
Atsushi Fukuda ◽  
...  
Keyword(s):  
Vestibular Schwannoma ◽  
Semicircular Canal ◽  
Vestibular Function ◽  
Semicircular Canals ◽  
Vestibular Nerve ◽  
Head Impulse Test ◽  
Posterior Semicircular Canal ◽  
Vestibulo Ocular Reflex ◽  
Anterior Semicircular Canal ◽  
Vertical Semicircular Canal

Objectives: The aim of this study was to investigate vertical semicircular canal function in patients with vestibular schwannoma (VS) by video head impulse test (vHIT). Methods: Fifteen patients with VS who had not received any treatment, including surgery or stereotactic radiotherapy, before vHIT examination were enrolled. Vestibulo-ocular reflex gain and catch-up saccade in vHIT were evaluated. Results: Dysfunction of anterior and posterior semicircular canals was detected by vHIT in 26.7% and 60.0%, respectively. Six patients (40.0%) demonstrated abnormalities referable to both vestibular nerve divisions. Abnormalities referable to the superior vestibular nerve were identified in 3 patients (20.0%), while 3 patients (20.0%) demonstrated a pattern indicative of inferior vestibular nerve involvement. Anterior semicircular canal vHIT produced fewer abnormalities than did either horizontal or posterior semicircular canal vHIT. Conclusions: Dysfunction of the semicircular canals, including the vertical canals, in patients with VS was detected by vHIT. The anterior semicircular canal was less frequently involved than the horizontal or posterior semicircular canal. The examination of the vertical canals by vHIT is useful in the evaluation of vestibular function in patients with VS.

The harp seal, Pagophilus groenlandicus (Erxleben, 1777). XXI. The structure of the vestibular apparatus

1972 ◽  
Vol 50 (11) ◽  
pp. 1357-1361 ◽  
Author(s):  
F. Ramprashad ◽  
K. E. Money ◽  
K. Ronald
Keyword(s):  
Semicircular Canal ◽  
Semicircular Canals ◽  
Harp Seal ◽  
Body Orientation ◽  
Sensory Cells ◽  
Vestibular Apparatus ◽  
Posterior Semicircular Canal ◽  
Pagophilus Groenlandicus ◽  
Sensory Hairs

The structure of the large vestibular apparatus of the harp seal (Pagophilus groenlandicus) is similar to that of other mammals. However, the posterior semicircular canal is the smallest of the three canals and the plane of the lateral is below that of the posterior semicircular canal. An additional sensory end organ (crista neglecta) is present about 0.75 mm from the posterior crista. The neuroepithelium of the crista neglecta is similar to that of the crista of the semicircular canals and consists of large supporting and sensory cells, the sensory hairs of which project into the cupula. No otoconia were seen on the crista neglecta as were present on the otolithic membrane of the maculae utriculi and sacculi. A large macula utriculi and crista neglecta may be necessary for body orientation during diving.

Analysis of the coplanarity of functional pairs of semicircular canals using three-dimensional images reconstructed from temporal bone magnetic resonance imaging

2015 ◽  
Vol 129 (5) ◽  
pp. 430-434 ◽  
Author(s):  
D-K Kim ◽  
D-R Kim ◽  
S H Jeong ◽  
G J Kim ◽  
K-H Chang ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Temporal Bone ◽  
Semicircular Canal ◽  
Three Dimensional ◽  
Semicircular Canals ◽  
Normal Subjects ◽  
Magnetic Resonance Images ◽  
Posterior Semicircular Canal ◽  
Horizontal Semicircular Canal ◽  
The Right

AbstractObjectives:This study was conducted to investigate the angles and orientation of semicircular canals, and the coplanarity of functional canal pairs.Methods:Fluid signals in semicircular canals were reconstructed with three-dimensional reconstruction software using 20 temporal bone magnetic resonance images of normal subjects. The angles between each pair of semicircular canals were measured.Results:The mean angles between the anterior and horizontal semicircular canal plane, the horizontal and posterior semicircular canal plane, and the anterior and posterior semicircular canal plane were 83.7°, 82.5° and 88.4°, respectively. Pairs of contralateral synergistic canal planes were formed 15.1° between the right and left horizontal semicircular canal planes, 21.2° between the right anterior and left posterior semicircular canal, and 21.7° between the left anterior and right posterior semicircular canal.Conclusion:Each semicircular canal makes an almost right angle with other canals, but synergistically acting functional canal pairs of both ears do not lie in exactly the same plane.

Question of Reference Frames: Visual Direction-Selective Neurons in the Accessory Optic System of Goldfish

2009 ◽  
Vol 102 (5) ◽  
pp. 2781-2789 ◽  
Author(s):  
Olivia Andrea Masseck ◽  
Klaus-Peter Hoffmann
Keyword(s):  
Semicircular Canal ◽  
Reference Frames ◽  
Semicircular Canals ◽  
Visual Direction ◽  
Optic System ◽  
Posterior Semicircular Canal ◽  
Accessory Optic System ◽  
Horizontal Canal ◽  
Goldfish Carassius Auratus ◽  
Maximal Activation

We investigated if visual direction-selective neurons in the pretectal area (APT) of goldfish ( Carassius auratus auratus) preferred visual stimuli resulting from rotations around axes corresponding to the best responsive axes of the semicircular canals [optic flow that is consistent to a maximal activation of the horizontal canal pair (yaw), to a maximal activation of the right anterior/left posterior semicircular canal pair (RALP), and to a maximal activation of the left anterior/right posterior semicircular canal pair (LARP)]. Our sample of neurons recorded in the left pretectum had two preferred axes of rotation: first, rotation around the yaw axis and second, rotation around the RALP axis. Both axes of rotation correspond to best responsive axes of the semicircular canals. For this reason, coding in a reference frame defined by the vestibular system or the pulling direction of the eye muscles is suggested. In our population of recorded APT neurons, we did not find segregation of different preferred axes of rotation into different anatomical structures. Furthermore in all axes no bias for clockwise or counterclockwise rotations was obvious. This is particularly noteworthy for the yaw axis because preference for temporo-nasal and naso-temporal rotations was found at the same recording side. Hence we conclude that in fish the accessory optic system may consist of one nucleus on each side of the midbrain only, the APT. Segregation into different nuclei coding for different axes and different senses of rotation probably first developed in amphibians.

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