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Titre du document / Document title

Sound- and/or pressure-induced vertigo due to bone dehiscence of the superior semicircular canal

Auteur(s) / Author(s)

MINOR L. B. (1) ; SOLOMON D. (2) ; ZINREICH J. S. (3) ; ZEE D. S. (4) ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

(1) Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, Md, ETATS-UNIS
(2) Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, ETATS-UNIS
(3) Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, Md, ETATS-UNIS
(4) Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, Md, ETATS-UNIS

Résumé / Abstract

Objectives: To present symptoms, patterns of nystagmus, and computed tomographic scan identification of patients with sound- and/or pressure-induced vertigo due to dehiscence of bone overlying the superior semicircular canal. To describe anatomical findings and outcome in 2 patients undergoing plugging of the superior semicircular canal for treatment of these symptoms. Design and Setting: Prospective study of a case series in a tertiary care referral center. Patients and Results: Eight patients with vertigo, oscillopsia, and/or disequilibrium related to sound, changes in middle ear pressure, and/or changes in intracranial pressure were identified in a 2-year period. Seven of these patients also had vertical-torsional eye movements induced by these sound and/or pressure stimuli. The direction of the evoked eye movements could be explained by excitation or inhibition of the superior semicircular canal in the affected ear. Computed tomographic scans of the temporal bones identified dehiscence of bone overlying the affected superior semicircular canal in each case. Disabling disequilibrium in 2 patients prompted plugging of the dehiscent superior canal through a middle cranial fossa approach. Symptoms were improved in each case. One patient developed recurrent symptoms requiring an additional plugging procedure and developed sensorineural hearing loss several days after this second procedure. Conclusions: We have identified patients with a syndrome of vestibular symptoms induced by sound in an ear or by changes in middle ear or intracranial pressure. These patients can also experience chronic disequilibrium. Eye movements in the plane parallel to that of the superior semicircular canal were evoked by stimuli that have the potential to cause ampullofugal or ampullopetal deflection of this canal's cupula in the presence of a dehiscence of bone overlying the canal. The existence of such deshiscences was confirmed with computed tomographic scans of the temporal bones. Surgical plugging of the affected canal may be beneficial in patients with disabling symptoms.

Revue / Journal Title

Archives of otolaryngology, head & neck surgery    ISSN  0886-4470   CODEN AONSEJ 

Source / Source

1998, vol. 124, no3, pp. 249-258 (32 ref.)

Langue / Language

Anglais

Editeur / Publisher

American Medical Association, Chicago, IL, ETATS-UNIS  (1986-2012) (Revue)

Mots-clés anglais / English Keywords

Vertigo

;

Induction

;

Sound pressure

;

Dehiscence

;

Bone

;

Semicircular canal

;

Nystagmus

;

Computerized axial tomography

;

Plugging

;

Technique

;

Result

;

Case study

;

Diagnosis

;

Etiology

;

Treatment

;

Adult

;

Male

;

Female

;

Human

;

ENT disease

;

Nervous system diseases

;

Equilibrium disorder

;

Eye disease

;

Oculomotor syndrome

;

Radiodiagnosis

;

Medical imagery

;

Surgery

;

Mots-clés français / French Keywords

Vertige

;

Induction

;

Pression acoustique

;

Déhiscence

;

Os

;

Canal semicirculaire

;

Nystagmus

;

Tomodensitométrie

;

Colmatage

;

Technique

;

Résultat

;

Etude cas

;

Diagnostic

;

Etiologie

;

Traitement

;

Adulte

;

Mâle

;

Femelle

;

Homme

;

ORL pathologie

;

Système nerveux pathologie

;

Trouble équilibre

;

Oeil pathologie

;

Oculomotricité syndrome

;

Radiodiagnostic

;

Imagerie médicale

;

Chirurgie

;

Mots-clés espagnols / Spanish Keywords

Vértigo

;

Inducción

;

Presión acústica

;

Dehiscencia

;

Hueso

;

Conducto semicircular

;

Nistagmo

;

Tomodensitometría

;

Taponamiento

;

Técnica

;

Resultado

;

Estudio caso

;

Diagnóstico

;

Etiología

;

Tratamiento

;

Adulto

;

Macho

;

Hembra

;

Hombre

;

ORL patología

;

Sistema nervioso patología

;

Trastorno equilibrio

;

Ojo patología

;

Oculomotricidad síndrome

;

Radiodiagnóstico

;

Imageneria medical

;

Cirugía

;

Localisation / Location

INIST-CNRS, Cote INIST : 3041, 35400007507867.0010

Nº notice refdoc (ud4) : 2180716



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