scholarly journals Treatment of Vestibular Disorders (Inner Ear Balance Problems)

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Courtney D. Hall ◽  
Susan J. Herdman ◽  
Susan L. Whitney ◽  
Eric R. Anson ◽  
Wendy J. Carender ◽  
...  
2004 ◽  
Vol 279 (44) ◽  
pp. 46065-46072 ◽  
Author(s):  
Botond Bánfi ◽  
Brigitte Malgrange ◽  
Judit Knisz ◽  
Klaus Steger ◽  
Michel Dubois-Dauphin ◽  
...  

Reactive oxygen species (ROS) play a major role in drug-, noise-, and age-dependent hearing loss, but the source of ROS in the inner ear remains largely unknown. Herein, we demonstrate that NADPH oxidase (NOX) 3, a member of the NOX/dual domain oxidase family of NADPH oxidases, is highly expressed in specific portions of the inner ear. As assessed by real-time PCR, NOX3 mRNA expression in the inner ear is at least 50-fold higher than in any other tissues where its expression has been observed (e.g.fetal kidney, brain, skull). Microdissection andin situhybridization studies demonstrated that NOX3 is localized to the vestibular and cochlear sensory epithelia and to the spiral ganglions. Transfection of human embryonic kidney 293 cells with NOX3 revealed that it generates low levels of ROS on its own but produces high levels of ROS upon co-expression with cytoplasmic NOX subunits. NOX3-dependent superoxide production required a stimulus in the absence of subunits and upon co-expression with phagocyte NADPH oxidase subunits p47phoxand p67phox, but it was stimulus-independent upon co-expression with colon NADPH oxidase subunits NOX organizer 1 and NOX activator 1. Pre-incubation of NOX3-transfected human embryonic kidney 293 cells with the ototoxic drug cisplatin markedly enhanced superoxide production, in both the presence and the absence of subunits. Our data suggest that NOX3 is a relevant source of ROS generation in the cochlear and vestibular systems and that NOX3-dependent ROS generation might contribute to hearing loss and balance problems in response to ototoxic drugs.


2021 ◽  
Vol 8 (9) ◽  
pp. 327-330
Author(s):  
Amira Fitriananda Putri ◽  
Hanik Badriyah Hidayat

Introduction: Systemic lupus erythematosus (SLE) is a chronic inflammatory disease with multiorgan involvement based on an autoimmune process. SLE, although rare, is associated with comorbid vertigo. Vertigo in SLE is caused by a disturbance in the balance system in the inner ear. Few journals discuss SLE related to vertigo. We will report a case SLE with complaints of recurrent vertigo. Case: A-37-year-old woman came with complaints of recurrent vertigo since 1 day ago with a duration of about 15 minutes associated with nausea, vomiting and nystagmus. Patient did not complain tinnitus or hearing disorders. The patient has been diagnosed as SLE since two years ago. The physical examination showed normal and Neuro-otological examination revealed nystagmus horizontal unidirectional, negative skew deviation test, positive Head Impulse Test (HIT). Conclusion: Patients with a diagnosis of SLE can find comorbid peripheral vestibular disorders such as vertigo where there is an antibody mechanism that can damage the inner ear. Treatment of audiovestibular symptoms is usually strongly associated with systemic conditions and in patients with vertigo used betahistine to treatment. Keywords: SLE, Inner Ear, Vertigo.


2008 ◽  
Vol 18 (1) ◽  
pp. 51-58
Author(s):  
Valerie A. Street ◽  
Jeremy C. Kallman ◽  
Paul D. Strombom ◽  
Naomi F. Bramhall ◽  
James O. Phillips

The inner ear contains the developmentally related cochlea and peripheral vestibular labyrinth. Given the similar physiology between these two organs, hearing loss and vestibular dysfunction may be expected to occur simultaneously in individuals segregating mutations in inner ear genes. Twenty-two different genes have been discovered that when mutated lead to non-syndromic autosomal dominant hearing loss. A review of the literature indicates that families segregating mutations in 13 of these 22 genes have undergone formal clinical vestibular testing. Formal assessment revealed vestibular dysfunction in families with mutations in ten of these 13 genes. Remarkably, only families with mutations in the COCH and MYO7A genes self-report considerable vestibular challenges. Families segregating mutations in the other eight genes do not self-report significant balance problems and appear to compensate well in everyday life for vestibular deficits discovered during formal clinical vestibular assessment. An example of a family (referred to as the HL1 family) with progressive hearing loss and clinically-detected vestibular hypofunction that does not report vestibular symptoms is described in this review. Notably, one member of the HL1 family with clinically-detected vestibular hypofunction reached the summit of Mount Kilimanjaro.


Neurology ◽  
2020 ◽  
Vol 96 (1) ◽  
pp. 34-38
Author(s):  
Kemar E. Green ◽  
Jacob M. Pogson ◽  
Jorge Otero-Millan ◽  
Daniel R. Gold ◽  
Nana Tevzadze ◽  
...  

Patients with acute vestibular disorders are often a diagnostic challenge for neurologists, especially when the evaluation must be conducted remotely. The clinical dilemma remains: Does the patient have a benign peripheral inner ear problem or a worrisome central vestibular disorder, such as a stroke? The use of a focused history and the virtual HINTS (head impulse test, nystagmus evaluation, and test of skew) examination are key steps towards correctly diagnosing and triaging the acute vertiginous patient. When looking for signs of vestibulo-ocular dysfunction, there are important technological and practical considerations for an effective clinical interpretation.


2021 ◽  
Vol 35 ◽  
pp. 205873842110273
Author(s):  
Virginia Fancello ◽  
Stavros Hatzopoulos ◽  
Virginia Corazzi ◽  
Chiara Bianchini ◽  
Magdalena B Skarżyńska ◽  
...  

To describe the audio-vestibular disorders related to the newly SARS-CoV-2 infection, including the possible ototoxicity side-effects related to the use of drugs included in the SARS-CoV-2 treatment protocols. A systematic review was performed according to the PRISMA protocol. The Medline and Embase databases were searched from March 1, 2020 to April 9, 2021. Initially the search yielded 400 manuscripts, which were reduced to 15, upon the application of inclusion criteria. Sensorineural hearing loss (SNHL) is the most frequent audio-vestibular symptom described, occurring alone or in association with tinnitus and vertigo. The etiopathogenesis of the inner ear disorders related to COVID-19 infection is still poorly understood. The number of reports of COVID-19 infections associated to audio-vestibular disorders is increasing; even if the quality of the studies available is often insufficient, audio-vestibular disorders should be considered as possible manifestations to be included among the symptoms of this infection.


2021 ◽  
Vol 12 ◽  
Author(s):  
Kenna D. Peusner ◽  
Nina M. Bell ◽  
June C. Hirsch ◽  
Mathieu Beraneck ◽  
Anastas Popratiloff

In congenital vestibular disorders (CVDs), children develop an abnormal inner ear before birth and face postnatal challenges to maintain posture, balance, walking, eye-hand coordination, eye tracking, or reading. Only limited information on inner ear pathology is acquired from clinical imaging of the temporal bone or studying histological slides of the temporal bone. A more comprehensive and precise assessment and determination of the underlying mechanisms necessitate analyses of the disorders at the cellular level, which can be achieved using animal models. Two main criteria for a suitable animal model are first, a pathology that mirrors the human disorder, and second, a reproducible experimental outcome leading to statistical power. With over 40 genes that affect inner ear development, the phenotypic abnormalities resulting from congenital vestibular disorders (CVDs) are highly variable. Nonetheless, there is a large subset of CVDs that form a common phenotype of a sac-like inner ear with the semicircular canals missing or dysplastic, and discrete abnormalities in the vestibular sensory organs. We have focused the review on this subset, but to advance research on CVDs we have added other CVDs not forming a sac-like inner ear. We have included examples of animal models used to study these CVDs. Presently, little is known about the central pathology resulting from CVDs at the cellular level in the central vestibular neural network, except for preliminary studies on a chick model that show significant loss of second-order, vestibular reflex projection neurons.


2019 ◽  
Vol 122 (6) ◽  
pp. 2272-2283 ◽  
Author(s):  
Hayley E. Seal ◽  
Sigmund J. Lilian ◽  
Anastas Popratiloff ◽  
June C. Hirsch ◽  
Kenna D. Peusner

Children with congenital vestibular disorders show delayed motor development and challenges in maintaining posture and balance. Computed tomography images reveal that these children have abnormal inner ears in the form of a sac, with the semicircular canals missing or truncated. Little is known about how this inner ear abnormality affects central vestibular development. At present, mice with the chromodomain helicase DNA-binding protein 7 mutation are the most common model for studying congenital vestibular disorders, despite forming multiple diverse inner ear phenotypes and inducing abnormal cerebellar and visual system development. To identify the effects of a sac-like inner ear on central vestibular development, we have designed and implemented a new model, the anterior-posterior axis rotated otocyst (ARO) chick, which forms a sac-like inner ear in 85% of cases. The ARO chick is produced by anterior-posterior rotation of the otocyst at embryonic day 2. Here, we describe for the first time the 15% of ARO chicks that form three small semicircular canals and rename the ARO chicks forming sacs (ARO/s chicks). The basic features of the vestibular sensory organs in ARO/s chicks are similar to those found in patients’ sacs, and ARO/s hatchlings experience balance and walking problems like patients. Thus, ARO/s chicks have a reproducible inner ear phenotype without abnormalities in vestibular-related structures, making the model a relatively simple one to evaluate the relationship between the sac-like inner ear pathology and formation of the central vestibular neural circuitry. Here, we describe unpublished details on the surgical approaches to produce ARO chicks, including pitfalls and difficulties to avoid. NEW & NOTEWORTHY This paper describes simple techniques for chick otocyst rotation resulting in a sac-like inner ear (85%), the common phenotype in congenital vestibular disorders. We now describe anterior-posterior axis rotated otocyst chicks, which form three small canals (15%), and rename chicks forming a sac (ARO/s chicks). Basic protocols and potential complications of otocyst rotation are described. With the use of ARO/s chicks, it will be possible to determine how the vestibular neural circuit is modified by sac-like inner ear formation.


2021 ◽  
pp. 1-3
Author(s):  
Anne Charpiot ◽  
Léa Fath ◽  
Francis Veillon ◽  
Aïna Venkatasamy ◽  
Daniel Baumgartner

Endolymphatic hydrops is defined as an accumulation of endolymph in the inner ear leading to a buildup of pressure and distortion of intralabyrinthine structures. The pressure variation is neither obvious nor easy to measure and remains not clearly confirmed. The distortion of endolymphatic structures has been the main described phenomenon since Hallpike, Cairns and Yamakawa in 1938. However, some clinical symptoms associated with endolymphatic hydrops are in addition to the typical triad of symptoms of Meniere’s disease. This introduction to the state of the art is an analysis of the relationship between hydrops and clinical vestibular disorders, with a focus on the dynamics of endolymphatic hydrops. The distortion of endolabyrinthine structures can be considered as a dynamic process modeled with mechanical elastic behavior.


Author(s):  
C.D. Fermin ◽  
M. Igarashi

Otoconia are microscopic geometric structures that cover the sensory epithelia of the utricle and saccule (gravitational receptors) of mammals, and the lagena macula of birds. The importance of otoconia for maintanance of the body balance is evidenced by the abnormal behavior of species with genetic defects of otolith. Although a few reports have dealt with otoconia formation, some basic questions remain unanswered. The chick embryo is desirable for studying otoconial formation because its inner ear structures are easily accessible, and its gestational period is short (21 days of incubation).The results described here are part of an intensive study intended to examine the morphogenesis of the otoconia in the chick embryo (Gallus- domesticus) inner ear. We used chick embryos from the 4th day of incubation until hatching, and examined the specimens with light (LM) and transmission electron microscopy (TEM). The embryos were decapitated, and fixed by immersion with 3% cold glutaraldehyde. The ears and their parts were dissected out under the microscope; no decalcification was used. For LM, the ears were embedded in JB-4 plastic, cut serially at 5 micra and stained with 0.2% toluidine blue and 0.1% basic fuchsin in 25% alcohol.


ASHA Leader ◽  
2006 ◽  
Vol 11 (2) ◽  
pp. 5-21
Author(s):  
Faith W. Akin ◽  
Owen D. Murnane
Keyword(s):  

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