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Monostotic Fibrous Dysplasia of the Temporal Bone with Unilateral Vestibular Weakness and Sensorineuronal Hearing Loss.

Jae Ho BAN ; Chi Yeul PARK ; Jong Kyu LEE ; No Hee LEE

Journal of the Korean Balance Society.2005;4(1):58-62.

Fibrous dysplasia is an uncommon benign disorder of unknown etiology. The disease was first described by McCune and Albright in separate publications in 1937. The term, fibrous dysplasia was suggested by Lichtenstein in 1938. The disease has since been found to have 3 different variants: monostotic, polyostotic, and McCune-Albright syndrome. It is a slowly progressive bony disorder where normal bone is replaced by abnormal fibrosseous tissue. Involvement of fibrous dysplasia of the temporal bone is usually unilateral. The squama becomes thickened and the pneumatic system is obliterated. Because fibrous dysplasia shows a predilection for the facial and cranial bone, where it causes deformity and dysfunction. In this paper, we report a case of fibrous dysplasia of the temporal bone. We discuss the characterisitic features of this specific location of the disease, the differential diagnosis, and the treatment policy. We also address the issue of vertigo.
Congenital Abnormalities ; Diagnosis, Differential ; Dizziness ; Fibrous Dysplasia, Monostotic* ; Fibrous Dysplasia, Polyostotic ; Hearing Loss* ; Hearing* ; Temporal Bone* ; Vertigo

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Acute Vestibular Neuritis in Children.

You Ree SHIN ; Yun Hoon CHOUNG ; Yoon Tae KIM

Journal of the Korean Balance Society.2005;4(1):53-57.

The acute vestibular neuritis is rarely seen in children and it is hard to find the related reports. In this paper, we report three cases of acute vestibular neuritis less than 15 years old that we experienced during last 10 years. The three cases are 14 and 11-year old boys and a 12-year-old-girl. They complained vertigo without hearing loss. Only one of three cases had previous common cold history and they showed all negative reactions in virus blood tests. After medical treatment and early rehabilitation, vertigo was completely controlled within 3 weeks and there was no recurrent symptoms so far. This recovery in children seems to be faster and more complete than in adults.
Adolescent ; Adult ; Child* ; Common Cold ; Hearing Loss ; Hematologic Tests ; Humans ; Rehabilitation ; Vertigo ; Vestibular Neuronitis*

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Jerky Seesaw Nystagmus in Isolated Internuclear Ophthalmoplegia.

Kyungmi OH ; Jae Hong CHANG ; Kun Woo PARK ; Dae Hie LEE ; Kwang Dong CHOI ; Ji Soo KIM

Journal of the Korean Balance Society.2005;4(1):49-52.

The authors report jerky seesaw nystagmus, extorsional downbeating in the right eye and intorsional upbeating in the left eye, in a patient with right internuclear ophthalmoplegia (INO). This pattern of nystagmus may occur by disrupting pathways from contralateral posterior and anterior semicircular canals by a lesion in the medial longitudinal fasciculus. Depending on damage to the pathways from contralateral vertical canals, various patterns of dissociated torsional-vertical nystagmus may accompany INO.
Humans ; Ocular Motility Disorders* ; Semicircular Canals

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A Case of Contralateral Benign Paroxysmal Positional Vertigo after Mastoidectomy.

Sung Lyong HONG ; Ji Soo KIM ; Ja Won KOO

Journal of the Korean Balance Society.2005;4(1):45-48.

Otologic surgery and surgical drilling of the skull are well known precipitating factors of secondary benign paroxysmal positional vertigo (BPPV). Especially if BPPV is developed after ear surgery, operated ear has been thought as the side of BPPV with little doubt. Recently we experienced a patient of BPPV developed 3 days after mastoidectomy. Positional test showed nystagmus with pure horizontal component and it was geotropic direction changing nature depending on the head position. Initial location of the particles was assumed in the lateral semicircular canal of operated ear, but following repositioning maneuver, positional nystagmus was compatible with anterior semicircular canal of contralateral ear. With this case report, authors suggest plausible mechanisms of the contralateral side BPPV after mastoid surgery as follows. Surgical position during mastoid surgery (contralateral ear down) and postoperative bulky mastoid compressive dressing usually kept the patient's head to the contralateral side can be precipitating factors for migration of detached particles into the semicircular canal of dependent position. Anyway, appropriate differential diagnosis and management plans should be prompted using bed side vestibular evaluation, since serious irreversible inner ear complications are more frequent cause of postoperative vertigo than BPPV.
Bandages ; Diagnosis, Differential ; Ear ; Ear, Inner ; Head ; Humans ; Mastoid ; Nystagmus, Physiologic ; Otitis Media ; Precipitating Factors ; Semicircular Canals ; Skull ; Vertigo*

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The History of Meniere's Disease: Until the Discovery of Endolymphatic Hydrops (1862-1938).

Kyu Sung KIM

Journal of the Korean Balance Society.2005;4(1):35-41.

Author divided the history of Meniere's disease into a three part based on two important historical affairs, the novel concept of Prosper Meniere which reported in 1861, and the discovery of temporal bone histopathology of endolymphatic hydrops by Hallpike and Yamakawa in 1938. This article traces the period since Prosper Meniere's report until discovery of endolymphatic hydrops.
Endolymphatic Hydrops* ; History of Medicine ; Meniere Disease* ; Temporal Bone

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Efficacy of Rotating Chair Test And Caloric Test For The Diagnosis of Acute Unilateral Vestibular Neuritis.

Heung Eog CHA ; Chae Young LIM ; Gyu Cheol HAN ; Chang Hyun CHO ; Byung Ki YOON ; Min Kwan BAEK ; Ju Hyoung LEE

Journal of the Korean Balance Society.2008;7(1):43-47.

BACKGROUND AND OBJECTIVES: The acute unilateral vestibular neuritis is fairly a common disease and the precise diagnostic tool is needed for the selection of effective treatments. Therefore, we studied the clinical usefulness of the rotatory chair test and caloric test which have been commonly used in patient of acute unilateral vestibular neuritis. MATERIALS AND METHODS: One hundred and sixty four patients who were diagnosed with acute unilateral vestibular neuritis from August of 2004 to June of 2007 were included. Their medical records of the rotating chair test and caloric test were reviewed retrospectively to study the correlation of the two tests. RESULTS: Of 164 patients, 101 patients (61.6%) and 88 patients (53.7%) showed significant canal paresis (CP) and directional preponderance (DP) on the caloric tests that corresponded with the physical exam. 130 patients (79.3%) and 84 patients (51.2%) showed significant asymmetry and time constant (Tc) on the rotating chair test that corresponded with the predictive direction with spontaneous nystagmus. CONCLUSIONS: For acute unilateral vestibular neuritis patients, the asymmetry of the rotatory chair test showed the highest correlation with clinical findings. But physical exam should be preceded because neither rotator chair test nor caloric test yields a specific correlation with the physical exam. Especially, single test only may too many false negative results. For these tests can reduce false positive cases of the physical exam and raise the specificity of the diagnosis, the planning of proper treatments should be followed thereafter.
Caloric Tests ; Humans ; Medical Records ; Paresis ; Retrospective Studies ; Sensitivity and Specificity ; Vestibular Neuronitis

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Clinical Significance of Vestibular Evoked Myogenic Potentials in Patients With Benign Paroxysmal Positional Vertigo.

Won Sun YANG ; Dae Bo SHIM ; Won Sang LEE

Journal of the Korean Balance Society.2008;7(1):38-42.

OBJECTIVES: To investigate the vestibular evoked myogenic potentials (VEMP) results in benign paroxysmal positional vertigo (BPPV) patients and to verify its clinical applications in BPPV. SUBJECTS AND METHODS: Forty-one patients with diagnosis of BPPV and 92 healthy volunteers who underwent VEMP testing. Patients were treated by canalith repositioning maneuvers according to the affected canal, and testing of VEMP was performed at diagnosis and after treatment. RESULTS: VEMP results of BPPV patients showed prolonged p13 and n23 latencies compared with those of the control group, and we could not find any significant difference in VEMP latencies between patients with posterior and horizontal canal type of BPPV. The number of times that the maneuver was repeated did not correlate with the degree of latency prolongation, but in the "no response" group, the number of times was considerably greater than those in the "response" group. CONCLUSIONS: We found that VEMP latencies are increased in BPPV patients, which may signify neuronal degenerative changes in the macula of the saccule. When an extensive neuronal damage was suspected by VEMP results such as "no response" in VEMP, the disease progress showed a chronic and resistive course. Therefore, we propose that VEMP could be a useful method to determine a clinical prognosis of patients with BPPV.
Humans ; Neurons ; Prognosis ; Saccule and Utricle ; Vertigo ; Vestibular Evoked Myogenic Potentials

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Follow-up Changes of Eye Movements by Caloric Stimulation in Patients With Vestibular Neuritis.

Mun Su PARK ; Ga Hyun PARK ; Yong Soo JEONG ; Yeo Jin LEE ; Jung Eun SHIN ; Hong Ju PARK

Journal of the Korean Balance Society.2008;7(1):33-37.

BACKGROUND AND OBJECTIVES: A significant recovery of resting activity in the vestibular nuclei ipsilateral to the unilateral labyrinthectomy has been reported by the time symptoms such as spontaneous nystagmus and roll head tilt have largely disappeared. However, the dynamic vestibular response after unilateral vestibular loss to passively imposed vestibular stimuli does not recover. MATERIALS AND METHODS: We investigated changes of the caloric responses in 32 patients with vestibular neuritis during in- and out-patient visits separated by 2 months in an attempt to identify changes brought about by peripheral and/or central compensation processes. RESULTS: The slow-phase eye velocities stimulated by warm caloric stimulation at acute and follow-up stage were 6.6+/-6.6 degrees/s, 9.5+/-9.9 degrees/s in the lesioned side; 28.4+/-19.1 degrees/s, 24.5+/-11.6 degrees/s in the intact side. The slow-phase eye velocities stimulated by cold caloric stimulation at acute and follow-up stage were 5.9+/-7.7 degrees/s, 10.3+/-8.2 degrees/s in the lesioned side; 19.8+/-10.3 degrees/s, 18.8+/-9.9 degrees/s in the intact side. CONCLUSION: Our findings show that the recovery of caloric responses comes mostly from the recovery of the eye responses to the caloric stimulation in the lesioned side and the eye responses to the caloric stimulation in the intact side does not change over time after vestibular neuritis.
Caloric Tests ; Cold Temperature ; Compensation and Redress ; Eye ; Eye Movements ; Follow-Up Studies ; Head ; Humans ; Outpatients ; Reflex, Vestibulo-Ocular ; Vestibular Neuronitis ; Vestibular Nuclei

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3-D Model of The Oculomotor Fascicular Arrangement Within The Midbrain Using Brain MRI.

Jeong Ho PARK ; Du Shin JEONG ; Sun Ah PARK ; Tae Kyeong LEE ; Ki Bum SUNG

Journal of the Korean Balance Society.2008;7(1):22-32.

BACKGROUND AND PURPOSE: The oculomotor nerve fascicles arise along its entire length and sweep ventrally to exit the midbrain at the medial edge of the crus cerebri. A rostro-caudal topography among the fascicular fibers is relatively well established. There are, however, some controversies whether medio-lateral topography also exists. METHODS: We retrospectively reviewed the clinical records and MRI of the 8 patients showing isolated oculomotor nerve palsy due to midbrain infarction. Brain MRI was performed using a 1.5-T magnet with 2mm thickness and 0.1 mm slice interval. The anterior-posterior axis(X) was defined as the midline crossing the center of the cerebral aqueduct and the medio-lateral axis(Y) as the line crossing the same point. For rostro-caudal measurement, the intercommissural line was used as base line of the Z axis. The location of the lesions was defined by measuring actual distance of the margins of the lesions in millimeter from each axis; anterior, right, and caudal direction was defined as positive values in X, Y and Z coordinates, respectively. RESULTS: The mean values and range of the X, Y and Z are as follows: X=7.56+/-4.34, 1< or =X< or =15; Y=3.43+/-1.37, 0< or =Y< or =6; Z=6.51+/-3.91, 0< or =Z< or =12.5. CONCLUSIONS: The distribution of all the MRI lesions was 0< or =|Y|< or =6 (mm), 0< or =|Z|< or =12.5 (mm) in mediolateral and rostrocaudal direction respectively, which is almost the same as the previously reported divergent range of the oculomotor fascicles in midbrain tegmentum. We suggest that our method of three dimensional measurements of the MRI lesion in midbrain tegmentum could be a useful tool for the study of oculomotor fascicular arrangement.
Axis, Cervical Vertebra ; Brain ; Cerebral Aqueduct ; Humans ; Infarction ; Magnets ; Mesencephalon ; Oculomotor Nerve ; Oculomotor Nerve Diseases ; Retrospective Studies

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Assessment of Saccular Function in Patients With Noise Induced Hearing Loss.

In Kuk HWANG ; Ji Hyun MOON ; Young Hyo KIM ; Kyu Sung KIM ; Yun Gun JUNG ; Hoseok CHOI

Journal of the Korean Balance Society.2008;7(1):17-21.

BACKGROUND AND OBJECTIVES: Considering saccular receptors are coupled physically with the auditory receptors, VEMP test may provide the information that in the noise induced hearing loss with or without dizziness, damage to the vestibular system, especially saccule is a potential organ with cochlear damage. MATERIAL AND METHODS: 11 patients (22 ears) with HF-SNHL greater than 55dB and 10 patients (10 ears) with sudden hearing loss of varying degree HL as positive control but without clinical manifestations of vestibular pathology tested for vestibular function test was enrolled. VEMP test was done. The results were compared with those of 9-healthy referents (18 ears) examined in the same way. RESULTS: VEMP wave was significantly abolished as twelve of 22 (54.5%) with HF-SNHL, five of 13 (38.5%) and Control group (100%). Though there was no statistically significant relation with P13, N23 latency delay in each group, NIHL showed P13, N23 latency delay trend compared with controls. CONCLUSIONS: Patients with noise induced hearing loss showed significantly more saccular deterioration, estimated as negative VEMP responses than did the controls. This suggests subclinical disturbances of the vestibular system especially of the saccule in noise induced hearing loss.
Dizziness ; Hearing ; Hearing Loss ; Hearing Loss, Sudden ; Humans ; Noise ; Saccule and Utricle ; Vestibular Function Tests

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