REPLY TO THE COMMENTARY ON LUIS ET AL. “SPONTANEOUS PLUGGING OF THE HORIZONTAL SEMICIRCULAR CANAL WITH REVERSIBLE CANAL DYSFUNCTION AND RECOVERY OF VESTIBULAR EVOKED MYOGENIC POTENTIALS”

Background: Vestibular function (specifically, horizontal semicircular canal function) can be assessed across a broad frequency range using several different techniques. The head impulse test is a qualitative test of horizontal semicircular canal function that can be completed at bedside. Recently, a new instrument (video head impulse test [vHIT]) has been developed to provide an objective assessment to the clinical test. Questions persist regarding how this test may be used in the overall vestibular test battery. Purpose: The purpose of this case report is to describe vestibular test results (vHIT, rotational testing, vestibular evoked myogenic potentials, and balance and gait performance) in an individual with a 100% unilateral caloric weakness who was asymptomatic for dizziness, vertigo or imbalance. Data Collection and/or Analysis: Comprehensive assessment was completed to evaluate vestibular function. Caloric irrigations, rotary chair testing, vHIT, and vestibular evoked myogenic potentials were completed. Results: A 100% left-sided unilateral caloric weakness was observed in an asymptomatic individual. vHIT produced normal gain with covert saccades. Conclusions: This case demonstrates the clinical usefulness of vHIT as a diagnostic tool and indicator of vestibular compensation and functional status.

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Spontaneous Plugging of the Horizontal Semicircular Canal With Reversible Canal Dysfunction and Recovery of Vestibular Evoked Myogenic Potentials

Otology & Neurotology ◽

10.1097/mao.0b013e318287f343 ◽

2013 ◽

Vol 34 (4) ◽

pp. 743-747 ◽

Cited By ~ 15

Author(s):

Leonel Luis ◽

João Costa ◽

Fernando Vaz Garcia ◽

Josep Valls-Solé ◽

Thomas Brandt ◽

...

Keyword(s):

Semicircular Canal ◽

Vestibular Evoked Myogenic Potentials ◽

Horizontal Semicircular Canal

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Clinical Characteristics of Patients With Dizziness/Vertigo Accompanied by Posterior Semicircular Canal Hypofunction

Frontiers in Medicine ◽

10.3389/fmed.2021.589969 ◽

2021 ◽

Vol 8 ◽

Author(s):

Zheyuan Li ◽

Bo Liu ◽

Hongli Si ◽

Kangzhi Li ◽

Bo Shen ◽

...

Keyword(s):

Inner Ear ◽

Semicircular Canal ◽

Clinical Characteristics ◽

Disease Onset ◽

Vestibular Migraine ◽

Vestibular Evoked Myogenic Potentials ◽

Caloric Test ◽

Horizontal Semicircular Canal ◽

Inner Ear Disease ◽

Autoimmune Inner Ear Disease

Objective: To investigate the clinical characteristics of patients with dizziness/vertigo accompanied by loss of the posterior canal(s) (LPC).Methods: Clinical data of 23 patients with LPC were collected. We determined video-head-impulse test (vHIT) gains of all six semicircular canals and correlated vHIT findings with other vestibulo-cochlear tests, including caloric test, ocular and cervical vestibular-evoked myogenic potentials (oVEMP, cVEMP), pure tone audiometry (PTA), and analyzed the differences in clinical manifestations of patients with LPC with different etiologies.Results: LPC was identified in 23 patients. At the time of disease onset, most patients presented with dizziness (47.8%) and vertigo (30.4%) only, and some patients (21.7%) complained of unsteadiness. Among these 23 patients with LPC, there were 14 (60.9%) patients of isolated LPC (ILPC), 21 (91.3%) patients of unilateral LPC (ULPC), and 2 (8.7%) patients of bilateral LPC (BLPC). (1) Among 14 patients with ILPC, 13 (92.9%) patients had unilateral ILPC, the rate of ipsilesional impairment on caloric test, or oVEMP/cVEMP test or PTA ipsilesionally was 53.8% (7/13) in patients with unilateral ILPC. The causes of unilateral ILPC were vertigo/dizziness of unclear origin (38.5%), labyrinthine infarction (15.4%), vestibular migraine (15.4%), and other diseases (30.8%); (2) among 21 patients with ULPC, 7 patients (33.3%) were accompanied with horizontal semicircular canal hypofunction ipsilesionally, the abnormal rate of caloric test, or oVEMP/cVEMP tests or PTA ipsilesionally was 57.1%. The causes of ULPC were vertigo/dizziness of unclear origin (33.3%), autoimmune inner ear disease (14.3%), labyrinthine infarction (14.3%), vestibular neuritis (9.5%), vestibular migraine (9.5%), and other diseases (19.0%); (3) among two patients with BLPC, one patient presented with unsteadiness, the causes of BLPC were vestibular paroxysmia and autoimmune inner ear disease.Conclusion: vHIT is a fast and effective method for assessing LPC, which can be used to detect isolated PC dysfunction. The causes of ILPC were peripheral origin or central origin. Patients with ILPC and ULPC mostly presented with dizziness/vertigo, and ULPC was often accompanied by ipsilateral vestibulo-cochlear impairment.

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Commentary On Luis et al “Spontaneous Plugging of the Horizontal Semicircular Canal With Reversible Canal Dysfunction and Recovery of Vestibular Evoked Myogenic Potentials” (Otology and Neurotology 2013, DOI

Otology & Neurotology ◽

10.1097/mao.0000000000000184 ◽

2014 ◽

Vol 35 (2) ◽

pp. 377-379

Author(s):

Ian S. Curthoys ◽

Leonardo Manzari

Keyword(s):

Semicircular Canal ◽

Vestibular Evoked Myogenic Potentials ◽

Horizontal Semicircular Canal

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Skull Vibration-Induced Nystagmus Test in a Human Model of Horizontal Canal Plugging

Audiology Research ◽

10.3390/audiolres11030028 ◽

2021 ◽

Vol 11 (3) ◽

pp. 301-312

Author(s):

Georges Dumas ◽

Christol Fabre ◽

Anne Charpiot ◽

Lea Fath ◽

Hella Chaney-Vuong ◽

...

Keyword(s):

Semicircular Canal ◽

Vestibular Function ◽

Human Model ◽

Vestibular Evoked Myogenic Potentials ◽

Head Impulse Test ◽

Slow Phase ◽

Caloric Test ◽

Horizontal Semicircular Canal ◽

Horizontal Canal ◽

Tertiary Referral Center

Background/Aim: the aim of this study was to assess the skull vibration-induced nystagmus test (SVINT) results and vestibular residual function after horizontal semicircular canal (HSCC) plugging. Methods: In this retrospective chart review performed in a tertiary referral center, 11 patients who underwent unilateral horizontal semicircular canal plugging (uHSCCP) for disabling Menière’s disease (MD) were included. The skull vibration-induced nystagmus (SVIN) slow-phase velocity (SPV) was compared with the results of the caloric test (CaT), video head impulse test (VHIT), and cervical vestibular-evoked myogenic potentials (cVEMP) performed on the same day. Results: Overall, 10 patients had a strong SVIN beating toward the intact side (Horizontal SVIN-SPV: 8.8°/s ± 5.6°/s), 10 had a significant or severe ipsilateral CaT hypofunction, 10 had an ipsilateral horizontal VHIT gain impairment, and 3 had altered cVEMP on the operated side. Five had sensorineural hearing worsening. SVIN-positive results were correlated with CaT and horizontal VHIT (HVHIT) results (p < 0.05) but not with cVEMP. SVIN-SPV was correlated with CaT hypofunction in % (p < 0.05). Comparison of pre- and postoperative CaT % hypofunction showed a significant worsening (p = 0.028). Conclusion: SVINT results in a human model of horizontal canal plugging are well correlated with vestibular tests exploring horizontal canal function, but not with cVEMP. SVINT always showed a strong lesional nystagmus beating away from the lesion side. SVIN acts as a good marker of HSCC function. This surgical technique showed invasiveness regarding horizontal canal vestibular function.

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