Acute vestibular syndrome characterized by vertigo, spontaneous nystagmus, and postural instability is caused by a unilateral injury to either peripheral or central vestibular structures. However, central vestibular syndromes, such as labyrinthine ischemia due to occlusion of anterior inferior cerebellar artery (AICA), may cause abrupt unilateral labyrinthine dysfunction that mimics peripheral vestibulopathy. Here we report an AICA infarction with isolated flocculus lesion on magnetic resonance imaging mimicking acute labyrinthitis with vertigo, unidirectional horizontal-torsional nystagmus, ipsilesional sensorineural hearing impairment, and positive head-thrust test without any typical findings of floccular lesion.
Arteries ; Ear, Inner ; Hearing Loss ; Infarction ; Ischemia ; Labyrinthitis ; Magnetic Resonance Imaging ; Vertigo ; Vestibular Neuronitis

Sensorineural hearing loss (SNHL) that is seldom cited as a Kawasaki disease (KD) complication is known as an additional, potentially severe, and frequently irreversible sequel. Furthermore the vestibular functions of KD have been underestimated and it could be an important complication combined with SNHL in KD. We described a case that a 4 year-old boy who developed vestibular loss with SNHL has recovered successfully with a combined treatment.
Ear, Inner* ; Hearing Loss, Sensorineural ; Humans ; Labyrinthitis* ; Male ; Mucocutaneous Lymph Node Syndrome*

Cholesteatoma of the temporal bone usually occurs in the attic (epitympanic cavity) and extends easily into the mastoid antrum through the aditus ad antrum. Since atti-coantral cholesteatoma can lead to clinically serious complications, successful patient management requires an accurate knowledge of the extent of the condition. All com-plications of cholesteatoma are in fact related to bony erosion and may be classified as labyrinthitis, extracranial complication, meningitis, dural sinus obstruction, or parenchymal inflammation. This paper describes the diverse MR manifestations of the complications arising from atticoantral cholesteatoma.
Cholesteatoma* ; Ear ; Ear, Inner ; Humans ; Inflammation ; Labyrinthitis ; Mastoid ; Meningitis ; Temporal Bone

BACKGROUND AND OBJECTIVES: Benign paroxysmal positional vertigo (BPPV) generally involves a single semicircular canal (single canal BPPV) but it has been reported that more than one semicircular canal on either the same or the opposite side can be involved in 6.8-20% of the cases (multiple canal BPPV). In this study, the clinical characteristics of multiple canal BPPV were analyzed and compared to those of single canal BPPV. MATERIALS AND METHODS: Retrospective analysis was performed on 1054 consecutive patients diagnosed with BPPV. Multiple canal BPPV was diagnosed when the combination of typical nystagmus was provoked by the Dix-Hallpike and supine head roll tests. Canalith repositioning maneuver was performed sequentially starting with the semicircular canal causing more severe nystagmus or symptoms. Clinical characteristics and the treatment course were statistically compared between single canal BPPV and multiple canal BPPV. RESULTS: Among the 1054 patients, single canal BPPV was diagnosed in 1005 patients (95.4%) while multiple canal BPPV was diagnosed in 49 patients (4.6%). BPPV involving semicircular canals on the same side was more common (79.6%) than BPPV with bilateral involvement. The most common combination of the involved canals was ipsilateral posterior and horizontal semicircular canals (63.3%). Multiple canal BPPV was significantly more associated with underlying otologic diseases, especially labyrinthitis. Multiple canal BPPV required more treatment sessions and longer duration of treatment to achieve resolution of nystagmus and symptoms. CONCLUSIONS: As all cases of multiple canal BPPV were treated successfully although a longer duration of treatment and more treatment sessions were required compared to single canal BPPV, the results of our study could aid in making an accurate diagnosis and providing appropriate treatment of multiple canal BPPV.
Diagnosis ; Ear Diseases ; Ear, Inner ; Head ; Humans ; Labyrinthitis ; Retrospective Studies ; Semicircular Canals* ; Vertigo*

Serous or suppurative labyrinthitis is one of the intratemporal complications of acute or chronic otitis media. Labyrinthitis can occur by meningogenic or hematogenous infection. Major symptoms of labyrinthitis are vertigo and hearing loss. The disease progresses in two phases; serous labyrinthitis, so called toxic labyrinthitis, and suppurative labyrinthitis. If labyrinthitis treated at serous phase, hearing could be saved. But, if the disease progressed to suppurative phase, hearing loss is difficult to recover. Therefore it is very important to distinguish these two phases of labyrinthitis when treating the patient. In general, the direction of nystagmus during labyrinthitis is helpful sign to distinguish these two phases. We report here on an unusual case of acute serous labyrinthitis complicated with chronic otitis media showing atypical pattern with a review of the related literatures.
Ear, Inner ; Hearing ; Hearing Loss ; Humans ; Labyrinthitis ; Otitis ; Otitis Media ; Vertigo

Labyrinthitis causes damage to inner ear structure, and in turn hearing loss and vertigo. Labyrinthitis is classified as otogenic labyrinthitis and meningogenic labyrinthitis. Otogenic labyrinthitis can be diagnosed early through otoscopic examination. However, when there are no characteristic neurologic symptoms in patients with meningogenic labyrinthitis, clinicians can overlook the underlying meningitis and this may lead to the peripheral vertigo. We encountered an unusual case of meningogenic labyrinthitis that is misdiagnosed as peripheral dizziness.
Dizziness ; Ear, Inner ; Hearing Loss ; Humans ; Labyrinthitis ; Meningitis ; Meningitis, Bacterial ; Neurologic Manifestations ; Vertigo

There are a number of reports on the pathologies of vestibular disorders. However, these studies included only a few examples, which were not quantitative but merely anecdotal or descriptive. However, a single tissue section may be relevant to a specific disease in multiple ways. The histopathological characteristics of common peripheral vestibulopathies, including benign paroxysmal positional vertigo, Ménière's syndrome, labyrinthitis, vestibular neuritis, and ototoxicity, have been described. A recent study validated a new quantitative method for determining vestibular otopathology. Detailed quantitative analyses of vestibular pathology are required to obtain a deeper understanding of the vestibular system. Such studies will likely reveal the pathophysiological causes of specific diseases by elucidating the correlations between structural and functional features. Therefore, histopathological studies of vestibular disorders should be performed.
Benign Paroxysmal Positional Vertigo ; Ear, Inner ; Labyrinthitis ; Methods ; Pathology ; Temporal Bone ; Vestibular Neuronitis

Tuberculosis otitis media is a very rare cause of otorrhea, so that it is infrequently considered in differential diagnosis because clinical symptoms are nonspecific, and standard microbiological and histological tests for tuberculosis often give false-negative results. We present a rare case presenting as a rapidly progressive facial paralysis with severe dizziness and hearing loss on the ipsilateral side that was managed with facial nerve decompression and anti-tuberculosis therapy. The objective of this article is to create an awareness of ear tuberculosis, and to consider tuberculosis in the differential diagnosis of chronic otitis media with complications.
Decompression ; Diagnosis, Differential ; Dizziness ; Ear ; Ear, Inner ; Facial Nerve ; Facial Paralysis ; Hearing Loss ; Labyrinthitis ; Otitis ; Otitis Media ; Tuberculosis

The incidence of a surgical mastoiditis developing from acute otitis meida (AOM) has been decreased, But otitis media should still be considered a potentially dangerous disease because the clinical course is less predictable now than in the past. Significant and life-threatening complications may occur, including acute coalescent mastoiditis, intracranial complications, facial paralysis, subperiosteal abscess, etc. Incidence of otogenic cerebellar abscess has decreased, But the mortality rate in the literature is still high. There have been no reports in the Korean literature on acute coalescent mastoiditis with otogenic cerebellar abscess due to acute otitis media, but recently, we encountered a patient experiencing an acute coalecent mastoiditis, a supparative labyrinthitis and an otogenic cerebellar abscess due to acute otitis media all at the same time. Although the patient was treated with parenteral antibiotics, mastoidectomy, labyrinthectomy, and excision of the abscess via craniotomy, he passed away on the 62nd days after craniotomy. We report this case with a review of literature.
Abscess* ; Anti-Bacterial Agents ; Craniotomy ; Ear, Inner ; Facial Paralysis ; Humans ; Incidence ; Labyrinthitis ; Mastoid* ; Mastoiditis* ; Mortality ; Otitis Media* ; Otitis*

BACKGROUND AND OBJECTIVES: Particular repositioning maneuver (PRM) have been recommended as a treatment of benign paroxysmal positional vertigo (BPPV). Some patients require multiple treatments for remission, although most of the patients are treated at the first trial of single maneuver. The purpose of this study was to evaluate risk factors for the treatment failure in patients with posterior canal BPPV (p-BPPV) and horizontal canal BPPV (h-BPPV). SUBJECTS AND METHOD: Retrospective review was performed for the 287 patients diagnosed as BPPV visiting the dizziness clinic between February 2011 and August 2012. The diagnostic criteria for BPPV were met by following the guidelines provided by the American Academy of Otolaryngology-Head and Neck Surgery. Patients were classified into two groups: Group 1 (treatment success) that requires only 1 PRM and Group 2 (treatment failure) that requires more than 2 PRMs. We analyzed the relationship between treatment failure and the clinical characteristics, and studied the etiology of BPPV. RESULTS: The study included 183 patients with p-BPPV, 54 patients with h-BPPV (geotropic type), and 50 patients with h-BPPV (apogeotropic type). The type of BPPV and average numbers of PRM required for remission were significantly related with treatment failure by statistical analysis (p<0.05, respectively). Statistically significant correlation was demonstrated between the history of ipsilateral inner ear viral infection (acute vestibular neuritis, sudden sensorineural hearing loss) and treatment failure (p<0.05). CONCLUSION: Multiple PRMs may be required in patients with h-BPPV (apogeotropic type) or with secondary BPPV caused by ipsilateral inner ear viral disease. Clinically, this information may be used to provide helpful information for clinicians performing PRM to treat BPPV.
Dizziness ; Ear, Inner ; Hearing ; Humans ; Labyrinthitis ; Neck ; Retrospective Studies ; Risk Factors ; Treatment Failure ; Vertigo ; Vestibular Neuronitis ; Virus Diseases