• Journal of Audiology & Otology
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• v.23 no.1
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• pp.33-38
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• 2019

Background and Objectives: Determination of the lesion side based on the direction of the nystagmus could result in confusions to the clinicians due to mismatch between the vestibular function tests and also between vestibular and audiologic features. To minimize these mistakes, we elucidated the clinical manifestation and vestibular function test results in cases with recovery spontaneous nystagmus (rSN). Subjects and Methods: Patients who visited ENT clinic of tertiary referral hospital for acute onset continuous vertigo from January 2008 to December 2011 were enrolled. In these patients, we assessed onset time of vertigo, time point of paralytic spontaneous nystagmus (SN) and time point of rSN. At each time point of SN, vestibular function tests and hearing function tests were performed. Results: We confirmed the rSN among patients with unilateral vestibulopathy and demonstrated that high gain of the rotatory chair test (slow harmonic acceleration) and/or mismatch of the SN direction and contralateral caloric weakness could indicate the recovery state of patients and nystagmus observed in this stage is recovery phase nystagmus. Conclusions: In acute vestibulopathy patients, recovery phase nystagmus was observed and on this stage of disease vestibular function tests shows several features that could predict recovery state.

• Korean Journal of Audiology
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• v.23 no.1
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• pp.33-38
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• 2019

Background and Objectives: Determination of the lesion side based on the direction of the nystagmus could result in confusions to the clinicians due to mismatch between the vestibular function tests and also between vestibular and audiologic features. To minimize these mistakes, we elucidated the clinical manifestation and vestibular function test results in cases with recovery spontaneous nystagmus (rSN). Subjects and Methods: Patients who visited ENT clinic of tertiary referral hospital for acute onset continuous vertigo from January 2008 to December 2011 were enrolled. In these patients, we assessed onset time of vertigo, time point of paralytic spontaneous nystagmus (SN) and time point of rSN. At each time point of SN, vestibular function tests and hearing function tests were performed. Results: We confirmed the rSN among patients with unilateral vestibulopathy and demonstrated that high gain of the rotatory chair test (slow harmonic acceleration) and/or mismatch of the SN direction and contralateral caloric weakness could indicate the recovery state of patients and nystagmus observed in this stage is recovery phase nystagmus. Conclusions: In acute vestibulopathy patients, recovery phase nystagmus was observed and on this stage of disease vestibular function tests shows several features that could predict recovery state.

• Research in Vestibular Science
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• v.17 no.4
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• pp.170-174
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• 2018

Epidural anesthesia has significantly advanced in neuraxial anesthesia and analgesia. It is used for surgical anaesthesia and treatment of chronic pain. Hearing loss during or after epidural anesthesia is rare, and it is known to occur by the change of the intracranial pressure. Cerebrospinal fluid is connected with perilymph in the cochlear and vestibule that is important to hearing and balance. If the intracranial pressure is abruptly transferred to the inner ear, perilymph can be leak, that called perilymphatic fistula, dizziness, and hearing loss can occur suddenly. We report a 65-year-old woman who presented with acute onset dizziness and hearing loss during the epidural nerve block for back pain, wherein we speculated a possibility of perilymphatic fistula as the mechanism of hearing loss and dizziness. The mechanism of dizziness and hearing loss was suspected with perilymphatic fistula.

• Journal of Korean Neurosurgical Society
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• v.30 no.8
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• pp.1028-1032
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• 2001

The report of massive intratumoral hemorrhage from vestibular schwannoma is rare. A 66-year-old female who had suffered from disturbance of hearing for one year developed severe headache and dizziness. Brain MRI showed crescent shaped mass in the left cerebellopontine angle. A left suboccipital approach revealed an $3{\times}3cm$-sized encapsulated mass. The tumor was totally extirpated together with clot. Histologically the tumor was schwannoma with massive hemorrhage. Postoperative course was uneventful. The authors report the rare case of vestibular schwannoma presenting with intratumoral hemorrhage with review of possible pathophysiology and associated factor.

• Journal of Oral Medicine and Pain
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• v.44 no.3
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• pp.123-126
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• 2019

Vestibular schwannoma, also known as acoustic neuroma, is a rare benign brainstem tumor surrounding the vestibular division of the 8th cranial nerve. The presenting symptoms are hearing loss, tinnitus, and dizziness. Unabated growth can compress 5th (trigeminal nerve) and 7th (facial nerve) cranial nerve, which can cause nerve dysfunction such as orofacial pain, sensory abnormalities, or trigeminal neuralgia. We report a 51-year-old woman who presented with orofacial dysesthesia on her left side of the face with abnormal findings on 5th cranial nerve and 8th (vestibulocochlear nerve) cranial nerve examination. Brain magnetic resonance imaging scan revealed cerebellopontine angle tumor. She was referred to a neurosurgeon and diagnosed with vestibular schwannoma.

• Journal of Yeungnam Medical Science
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• v.31 no.1
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• pp.1-8
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• 2014

Dizziness can be classified mainly into 4 types: vertigo, disequilibrium, presyncope, and lightheadedness. Among these types, vertigo is a sensation of movement or motion due to various causes. The main causes of peripheral vertigo are benign paroxysmal positional vertigo (BPPV), acute vestibular neuritis (AVN), and Meniere's disease. BPPV is one of the most common causes of peripheral vertigo. It is characterized by brief episodes of mild to intense vertigo, which are triggered by specific changes in the position of the head. BPPV is diagnosed from the characteristic symptoms and by observing the nystagmus such as in the Dix-Hallpike test. BPPV is treated with several canalith repositioning procedures. AVN is the second most common cause of peripheral vertigo. Its key symptom is the acute onset of sustained rotatory vertigo without hearing loss. It is treated with symptomatic therapy with antihistamines, anticholinergic agents, anti-dopaminergic agents, and gamma-aminobutyric acid-enhancing agents that are used for symptoms of acute vertigo. Meniere's disease is characterized by episodic vertigo, fluctuating hearing loss, and tinnitus. It is traditionally relieved with life-style modification, a low-salt diet, and prescription of diuretics. However, diagnosis and treatment of the peripheral vertigo can be difficult without knowledge of BPPV, AVN, and Meniere's disease. This article provides information on the differential diagnosis of peripheral vertigo in BPPV, AVN, and Meniere's disease.

• The Journal of Internal Korean Medicine
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• v.25 no.3
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• pp.551-558
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• 2004

The purpose of this study is to develop an aproach to diagnosis and treatment of sequelae after removal of vestibular schwannoma through Oriental Medicine. An eighty year-old woman with sequelae after removal of vestibular schwannoma was observed and treated. She had difficulty of hearing, facial nerve palsy, dizziness and was generally weak. She was treated with herb medications for these symptoms. Having been treated for 27 days in hospital her symptoms improved. This report provides evidence for application of herbal medicine in treatment of sequelae. However, more cases are required for an in depth study of oriental treatments for this ailment in order to open this method of treatment to general application.

• Annals of Clinical Neurophysiology
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• v.24 no.2
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• pp.84-89
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• 2022

Vestibular dysfunction has rarely been reported in MELAS syndrome. A 40-year-old male with long-term diabetes and hearing loss experienced a stroke-like episode with hemisensory disturbance and lactic acidosis. Brain MRI showed temporo-parieto-occipital cortical lesions, and a final diagnosis was made of MELAS syndrome with the mitochondrial 3243A>G mutation. Neuro-otologic evaluations revealed anterior-canal-sparing bilateral impairments of the vestibulo-ocular reflex in the video head impulse test and no caloric paresis. This unique pattern of vestibular dysfunction may aid in diagnosing MELAS syndrome.

• Journal of Genetic Medicine
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• v.11 no.2
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• pp.63-68
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• 2014

Purpose: The mutation of the SLC26A4 gene is the second most common cause of congenital hearing loss after GJB2 mutations. It has been identified as a major cause of autosomal recessive nonsyndromic hearing loss associated with enlarged vestibular aqueduct and Pendred syndrome. Although most studies of SLC26A4 mutations have dealt with hearing-impaired patients, there are a few reports on the frequency of these mutations in the general population. The purpose of this study was to evaluate the prevalence of SLC26A4 mutations that cause inherited deafness in the general Korean population. Materials and Methods: We obtained blood samples from 144 Korean individuals with normal hearing. The samples were subjected to polymerase chain reaction to amplify the entire coding region of the SLC26A4 gene, followed by direct DNA sequencing. Results: Sequencing analysis of this gene identified 5 different variants (c.147C>G, c.225G>C, c.1723A>G, c.2168A>G, and c.2283A>G). The pathogenic mutation c.2168A>G (p.H723R) was identified in 1.39% (2/144) of the subjects with normal hearing. Conclusion: These data provide information about carrier frequency for SLC26A4 mutation-associated hearing loss and have important implications for genetic diagnostic testing for inherited deafness in the Korean population.

• Journal of Audiology & Otology
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• v.23 no.2
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• pp.96-102
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• 2019

Background and Objectives: Temporal bone fracture (TBF) is a common occurrence in cases of head trauma. Although the incidence of temporal bone concussion (TBC) has increased in cases of head trauma, it has not been extensively studied. We assessed the characteristics of TBF and TBC in patients with head trauma. Subjects and Methods: We conducted a retrospective review of 432 patients with head injury who visited our hospital between January 2011 and April 2016. Of these patients, 211 who met the inclusion criteria were included in the study. Their clinical characteristics, causes of injury, and hearing function were analyzed. Results: Among the 211 patients, 157 had TBFs and 54 had TBCs. Ear symptoms were more common among patients with TBF than among those with TBC. Car accidents were the most common cause of both TBF and TBC, but assault and sports injuries were more common among patients with TBC than among those with TBF. The occurrence of facial palsy in both cases of TBF and TBC. Hearing loss was observed among 35 patients with TBF and 11 patients with TBC. However, patients with TBF showed conductive hearing loss with an air-bone gap. Hearing function of these patients with TBF recovered with a reduced air-bone gap, but the patients with TBC showed little recovery. Conclusions: Emergency physicians should focus more on temporal bone injury in patients with head trauma. Therefore, an early complete diagnostic battery, which includes high-resolution computed tomography, audiometric tests, neurologic examination, and vestibular tests, be performed in patients with head trauma.