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Adv Clin Exp Med 2020 Jun;29(6):751-755

Department and Clinic of Otolaryngology Head and Neck Surgery, Wroclaw Medical University, Poland.

Sensory-neural hearing loss in people over 50 - senile deafness - is currently an increasing problem due to the growing proportion of the elderly people in the population. We can find a number of worldwide publications on hearing loss and dizziness in peri-menopausal women, but the data is inconsistent. Reports describing the influence of sex hormones on the ear and its aging are similarly controversial. Read More

Front Neurol 2020 29;11:470. Epub 2020 May 29.

Aix Marseille Université-CNRS, Laboratoire de Neurosciences Sensorielles et Cognitives, LNSC UMR 7260, Equipe Physiopathologie et Thérapie des Désordres Vestibulaires, Marseille, France.

The vestibular system plays a crucial role in maintaining postural balance. Unilateral vestibular lesions result in a typical syndrome characterized by postural imbalance, altered locomotor patterns and gaze stabilization, as well as cognitive and neurovegetative disorders. One of the main difficulties encountered in the development of new anti-vertigo drugs is the lack of sensitivity in the evaluation of this syndrome. Read More

J Neurol 2020 Jun 11. Epub 2020 Jun 11.

Department of Neurology, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistraße 15, 81377, Munich, Germany.

Strong static magnetic fields, as used in magnetic resonance imaging (MRI), stimulate the vestibular inner ear leading to a state of imbalance within the vestibular system that causes nystagmus. This magnetic vestibular stimulation (MVS) also modulates fluctuations of resting-state functional MRI (RS-fMRI) networks. MVS can be explained by a Lorentz force model, indicating that MVS is the result of the interaction of the static magnetic field strength and direction (called "B0 magnetic field" in MRI) with the inner ear's continuous endolymphatic ionic current. Read More

Acta Otorrinolaringol Esp 2020 Jun 7. Epub 2020 Jun 7.

Unidad de Gestión Clínica de Otorrinolaringología, Hospital Universitario Virgen Macarena, Sevilla, España.

Background And Objective: In our country, there are no series of patients that have described the incidence of the different diseases which cause balance disorders (BD) in primary care. The objective of this study is to calculate the incidence of each disease to propose specific training measures.

Materials And Method: Prospective cross-sectional study. Read More

J Neurol 2020 May 27. Epub 2020 May 27.

Department of Neurology, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.

The usefulness of brain imaging studies in dizzy patients presenting to the emergency department (ED) is controversial. We aimed to assess the 'real-world' probability of ischemic stroke and other acute brain lesions (ABLs) in these patients to create an algorithm that helps decision-making on whether which and when brain imaging is needed. By reviewing medical records, we identified 610 patients presenting with dizziness, vertigo or imbalance to our university hospital's ED and receiving neurological workup. Read More

J Neurol 2020 May 26. Epub 2020 May 26.

UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.

Introduction: CNS cavernomas are a type of raspberry-shaped vascular malformations that are typically asymptomatic, but can result in haemorrhage, neurological injury, and seizures. Here, we present a rare case of a brainstem cavernoma that was surgically resected whereafter an upbeat nystagmus presented postoperatively.

Case Report: A 42-year old man presented with sudden-onset nausea, vomiting, vertigo, blurred vision, marked imbalance and difficulty swallowing. Read More

J Neurol 2020 May 22. Epub 2020 May 22.

German Center for Vertigo and Balance Disorders and Institute for Clinical Neurosciences, Ludwig Maximilians Universität, Marchioninistr. 15, 81377, Munich, Germany.

Historical descriptions of fear at heights date back to Chinese and Roman antiquity. Current definitions distinguish between three different states of responses to height exposure: a physiological height imbalance that results from an impaired visual control of balance, a more or less distressing visual height intolerance, and acrophobia at the severest end of the spectrum. Epidemiological studies revealed a lifetime prevalence of visual height intolerance including acrophobia in 28% of adults (32% in women; 25% in men) and 34% among prepubertal children aged 8-10 years without gender preponderance. Read More

Disabil Rehabil Assist Technol 2020 May 18:1-11. Epub 2020 May 18.

Vestibular Rehabilitation, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, USA.

Virtual reality (VR) interventions can simulate real-world sensory environments. The purpose of this study was to test the feasibility of a novel VR application (app) developed for a Head Mounted Display (HMD) to target dizziness, imbalance and sensory integration in a functional context for patients with vestibular disorders. Here we describe the design of the app as well as self-reported and functional outcomes in vestibular patients before and after participating in vestibular rehabilitation using the app. Read More

J Int Adv Otol 2020 Apr;16(1):111-116

Department of Medicine and Surgery, University of Salerno, Salerno, Italy.

Air-bone gaps (ABGs) are commonly found in patients with conductive or mixed hearing loss generally due to outer- and/or middle-ear diseases such as otitis externa, tympanic membrane perforation, interruption or fixation of the ossicular chain, and chronic suppurative otitis media. ABGs can also be found in correlation with inner-ear disorders, such as endolymphatic hydrops, enlarged vestibular aqueduct syndrome, semicircular canal dehiscence, gusher syndrome, cochlear dehiscence, and Paget disease's as well cerebral vascular anomalies including dural arteriovenous fistula. The typical clinical presentation of inner-ear conditions or cerebral vascular anomalies causing ABGs includes audiological and vestibular symptoms like vertigo, oscillopsia, dizziness, imbalance, spinning sensation, pulsatile or continuous tinnitus, hyperacusis, autophony, auricular fullness, Tullio's phenomenon, and Hennebert's sign. Read More

Eur J Neurol 2020 May 13. Epub 2020 May 13.

Neurosurgery Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.

Background And Purpose: Although Labrune syndrome is a well-known disorder characterized by a typical neuroradiological triad, namely leukoencephalopathy, intracranial calcifications and cysts, there are no reports of systemic involvement in this disorder. This paper attempts to describe a peculiar clinical manifestation related to a novel mutation in the SNORD118 gene.

Methods: Clinical examination, brain and total-body imaging, and neurophysiological and ophthalmological investigations were performed. Read More

Eur Arch Otorhinolaryngol 2020 Apr 21. Epub 2020 Apr 21.

University Hospital Zurich, Frauenklinikstrasse 24, 8091, Zurich, Switzerland.

Benign paroxysmal positional vertigo (BPPV) is the most common type of vertigo, caused by otoconia falling from the utricle into a semicircular canal (SCC). After successful repositioning maneuvers residual dizziness (RD) has been described and several reasons are used to explain RD. It can last for only a few days or weeks, but also much longer. Read More

Front Neurol 2020 3;11:157. Epub 2020 Mar 3.

Department of Neurology, Seoul National University College of Medicine, Seoul, South Korea.

Vestibular neuritis (VN) is the most common cause of acute prolonged spontaneous vertigo, and is characterized by acute unilateral vestibular hypofunction, probably due to inflammation of the vestibular nerve. VN is diagnosed at the bedside when there is spontaneous horizontal-torsional nystagmus beating away from the side of the lesion, abnormal head impulse tests for the semicircular canals involved on the lesion side, and when other neurological symptoms and signs are absent. Here, as a neuro-otologist, I describe my experience during an attack of VN and discuss how it may help physicians to better understand why and what a patient feels during attacks of vertigo. Read More

Auris Nasus Larynx 2020 Mar 13. Epub 2020 Mar 13.

Department of Neurology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.

Objective: The aim of this study is to compare the balance ability, anxiety level and motion sickness susceptibility in Vestibular Migraine (VM) patients, migraineurs without history of vertigo (Migraine-only, MO) and healthy controls (HC). We tested the hypothesis that VM patients have worse balance performance and higher anxiety level and motion sickness than MO and HC group.

Methods: This cross-sectional study included of 123 definite VM patients, 58 MO patients and 49 HCs. Read More

J Neurol Phys Ther 2020 Apr;44(2):156-163

Army-Baylor University Doctoral Program in Physical Therapy, Fort Sam Houston, Texas (C.W.H.); University of Pittsburgh, Pittsburgh, Pennsylvania (T.J.H., S.L.W., P.M.D., J.M.F., A.L.R.); University of Southern California/Rancho Los Amigos National Rehabilitation Center, Los Angeles, California (N.L.D.); University of St Augustine for Health Sciences, Austin, Texas (K.M.A.); and Yeungnam University College, Nam-gu, Daegu, South Korea (Y.H.K.).

Background And Purpose: Persons with vestibular disorders are known to have slower gait speed with greater imbalance and veering during dual-task walking than healthy individuals, but the cerebral mechanisms are unknown. The purpose of this study was to determine whether individuals with visual vertigo (VV) have different cerebral activation during dual-task walking compared with control subjects.

Methods: Fourteen individuals with VV and 14 healthy controls (CON) were included (mean 39 years old, 85% women). Read More

Otol Neurotol 2020 Jun;41(5):e607-e614

Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, California.

Hypothesis: Endolymphatic hydrops (EH) associated with cochlear implantation are associated with vestibular dysfunction.

Background: Vestibular dysfunction is a known risk after cochlear implantation (CI). CI has been shown to cause cochlear hydrops due to fibrosis surrounding the ductus reuniens. Read More

Semin Neurol 2020 Feb 11;40(1):116-129. Epub 2020 Feb 11.

Division of Brain Sciences, Imperial College London, Charing Cross Hospital, London, United Kingdom.

Environmental circumstances that result in ambiguity or conflict with the patterns of sensory stimulation may adversely affect the vestibular system. The effect of this conflict in sensory information may be dizziness, a sense of imbalance, nausea, and motion sickness sometimes even to seemingly minor daily head movement activities. In some, it is not only exposure to motion but also the observation of objects in motion around them such as in supermarket aisles or other places with visual commotion; this can lead to dizziness, nausea, or a feeling of motion sickness that is referred to as . Read More

J Otolaryngol Head Neck Surg 2020 Feb 5;49(1). Epub 2020 Feb 5.

Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.

Background: Vestibular symptoms such as vertigo and imbalance are known to occur in some cochlear implant patients during the immediate postoperative period; however, acute vertigo in implanted children occurring remotely from the postoperative period has not been previously well-described.

Case Presentation: A three-year-old girl with a history of bilateral sequential cochlear implantation presented with acute labyrinthitis associated with sudden onset of vertigo, balance impairment, and decline in right cochlear implant function 2 years after her most recent implant surgery. We describe her audiological and vestibular testing results during both the acute phase and following medical management and recovery. Read More

Orv Hetil 2020 Feb;161(6):208-213

Fül-Orr-Gégészeti és Fej-Nyaksebészeti Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Szigony u. 36., 1083.

Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibular disorder. The most important symptom is vertigo, which is triggered by changes in head position and sometimes is accompanied by vegetative symptoms. Furthermore, etiology may be subcategorized into idiopathic and secondary (connected to other vestibular disorder, like Ménière's disease, vestibular neuritis, or vestibular migraine). Read More

Semin Neurol 2020 Feb 28;40(1):59-66. Epub 2020 Jan 28.

Department of Neurology, Health Services Research Program, University of Michigan, Ann Arbor, Michigan.

The acute vestibular syndrome (AVS) is a label for presentations of new-onset severe dizziness, vertigo, or imbalance, with examination findings of nystagmus or gait unsteadiness. The prototypical AVS presentation is the acute unilateral vestibulopathy due to vestibular neuritis. Stroke is also a serious concern in patients with AVS. Read More

Geriatr Gerontol Int 2020 Jan 19;20(1):42-46. Epub 2019 Nov 19.

Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan.

Aim: This study investigated the evolution of vestibular disorders in dizzy older adults from young-old to middle-old to oldest-old individuals, which has been less examined in detail so far.

Methods: A total of 3714 older patients with vertigo/dizziness in a university hospital were retrospectively reviewed and divided into three groups; namely, the young-old group aged 65-74 years (n = 2307), the middle-old group aged 75-84 years (n = 1176) and the oldest-old group aged ≥85 years (n = 231). All patients underwent an inner ear test battery comprising audiometry, caloric test, cervical and ocular vestibular-evoked myogenic potential tests, and foam posturography. Read More

Otolaryngol Head Neck Surg 2020 Feb 5;162(2):241-247. Epub 2019 Nov 5.

Harvard Medical School, Boston, Massachusetts, USA.

Objectives: Understand the prevalence of vestibular symptoms in US children.

Study Design: Cross-sectional analysis.

Setting: 2016 National Health Interview Survey. Read More

Front Neurol 2019 15;10:1075. Epub 2019 Oct 15.

Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States.

We aim to propose the term "vertebral artery compression syndrome" to describe a group of patients with a variety of clinical symptoms caused by vertebral artery compression of the medulla or spinal cord. We conducted the prospective case study in a university teaching hospital. Eleven patients who fulfilled the diagnostic criteria of vertebral artery compression syndrome and 22 age- and sex- matched controls were recruited. Read More

PLoS One 2019 31;14(10):e0224605. Epub 2019 Oct 31.

Department of Otorhinolaryngology-Head & Neck Surgery, Dankook University Hospital, Cheon-an, Republic of Korea.

In our previous study, we found that horizontal ocular deviation (OD) was significantly increased in patients with unilateral vestibular neuritis (VN). This study is aimed to compare the measurements of horizontal OD in various diseases which can present as acute vertigo in the emergency department. We retrospectively reviewed patients who visited the emergency department and underwent brain MRI due to acute vertigo. Read More

Eur Arch Otorhinolaryngol 2020 Jan 21;277(1):103-113. Epub 2019 Oct 21.

, 29 Bd Dubouchage, 06000, Nice, France.

Purpose: Patients with acute peripheral unilateral hypofunction (UVH) complain of vertigo and dizziness and show posture imbalance and gaze instability. Vestibular rehabilitation therapy (VR) enhances the functional recovery and it has been shown that gaze stabilization exercises improved the dynamic visual acuity (DVA). Whether the effects of VR depend or not on the moment when it is applied remains however unknown, and investigation on how the recovery mechanisms could depend or not on the timing of VR has not yet been tested. Read More

Int J Occup Med Environ Health 2019 Oct 7;32(5):723-733. Epub 2019 Oct 7.

Nofer Institute of Occupational Medicine, Łódź, Poland (Audiology and Phoniatrics Clinic).

Objectives: The aim of this study was to investigate whether the restriction in neck rotation and increased neck muscle tension could be causally related to vertigo and dizziness.

Material And Methods: Seventy-one patients reporting vertigo and/or imbalance were divided into 2 groups: 45 subjects with unilateral restriction (R+) and 26 without restriction (R-) of cervical rotation and muscle tension in the clinical flexion-rotation test. The normal caloric test was the inclusion criterion. Read More

Clin Pharmacol 2019 1;11:117-125. Epub 2019 Aug 1.

Audiovestibology Unit, G. Rummo Hospital, Benevento, Italy.

Purpose: To assess if a polyphenol compound supplementation (Vertigoval) could improve residual dizziness earlier after benign paroxysmal positional vertigo (BPPV) and relieve patients from this disabling symptomatology.

Methods: In this prospective, multicentric study, 127 patients were randomized in the treatment group (TG), who received a 60-day supplementation, while 131 patients were randomized in the control group (CG), who did not receive any medication. The dizziness handicap inventory (DHI) score, static posturography, and the visual analog scale (VAS) for both dizziness (D-VAS) and nausea/vomit (N/V-VAS) were used as measures of outcome at baseline and after 30 and 60 days. Read More

BMC Neurol 2019 Sep 3;19(1):219. Epub 2019 Sep 3.

Laboratory of Vestibular NeuroAdaptation, Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins University, Baltimore, MD, 21205, USA.

Background: Amongst the most challenging diagnostic dilemmas managing patients with vestibular symptoms (i.e. vertigo, nausea, imbalance) is differentiating dangerous central vestibular disorders from benign causes. Read More

Front Neurosci 2019 14;13:836. Epub 2019 Aug 14.

Clinical Medical Testing Center, People's Hospital of Zhengzhou Affiliated to Southern Medical University, Zhengzhou, China.

Background And Purpose: To test the hypothesis that the imbalance between matrix metalloproteinases (MMPs) and tissue inhibitor of metalloproteinases (TIMPs) may play a potential role in bridging vertebrobasilar dolichoectasia (VBD) with lacunar infarction (LI) and white matter hyperintensities (WMH).

Methods: We studied 212 patients with vertigo who underwent multimodal magnetic resonance imaging (MRI) tests for VBD, LI, and WMH identification. We investigated biomarkers of VBD with magnetic resonance angiography (MRA) via various physical characteristics of the vertebrobasilar arteries (VBAs). Read More

Zhonghua Yi Xue Za Zhi 2019 Jul;99(28):2197-2202

Department of Otolaryngology, First Affiliated Hospital of Sun Yat-sen University, Institute of Otolaryngology, Sun Yat-sen University, Guangzhou 510080, China.

To explore the possible causes and mechanisms of sudden deafness with vertigo. Between August 2016 and December 2017, 74 patients with sudden deafness and vertigo were hospitalized in the Department of Otolaryngology, First Affiliated Hospital of Sun Yat-sen University. Among them, 36 were male and 38 were female, aged 18-75 (40. Read More

Clin Lab 2019 Aug;65(8)

Background: Vertigo and acute cerebral infarction (ACI) patients show similar symptoms such as dizziness and imbalance. This study was to investigate the diagnostic values of neutrophil counts and neutrophil to lymphocyte ratio (NLR) in distinguishing patients with ACI from those with vertigo.

Methods: This retrospective study was performed and data were gathered from medical records of patients with vertigo symptoms from the Department of Emergency and Neurology Clinics who were admitted to the Fourth Affiliated Hospital Zhejiang University School of Medicine between August 2017 and January 2019. Read More

Indian J Community Med 2019 Apr-Jun;44(2):166-168

School of Public Health, SRM IST, Kancheepuram, Tamil Nadu, India.

Background: Injuries have become a major public health concern. Recent data show that globally over 5 million people lose their life due to injury every year. Especially in low- and middle-income countries, people living below the poverty line are drastically scathed due to injuries. Read More

Pract Neurol 2019 Dec 20;19(6):492-501. Epub 2019 Jul 20.

Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Central Clinical School, University of Sydney, Camperdown, New South Wales, Australia

Four vestibular presentations caused by six different disorders constitute most of the neuro-otology cases seen in clinical practice. 'Acute vestibular syndrome' refers to a first-ever attack of acute, spontaneous, isolated vertigo and there are two common causes: vestibular neuritis / labyrinthitis and cerebellar infarction. Recurrent positional vertigo is most often caused by benign paroxysmal positional vertigo and less commonly is central in origin. Read More

J Clin Neurol 2019 Jul;15(3):339-346

Department of Neurology, Ludwig Maximilians University, Munich, Germany.

Background And Purpose: Conflicting results about vestibular function in progressive supranuclear palsy (PSP) prompted a systematic examination of the semicircular canal function, otolith function, and postural stability.

Methods: Sixteen patients with probable PSP [9 females, age=72±6 years (mean±SD), mean disease duration=3.6 years, and mean PSP Rating Scale score=31] and 17 age-matched controls were examined using the video head impulse test, caloric testing, ocular and cervical vestibular evoked myogenic potentials (o- and cVEMPs), video-oculography, and posturography. Read More

Prog Brain Res 2019 23;248:303-317. Epub 2019 May 23.

German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-Universität München, Munich, Germany; Clinical Neuroscience, Ludwig-Maximilians-Universität München, Munich, Germany.

Unilateral peripheral vestibular lesions not only lead to vertigo, nystagmus and imbalance, but also to a bias in the perception of verticality, which can be measured as tilt of the subjective visual vertical (SVV). Previously, this tilt has been assumed to be caused by a residual otolith bias, for example, because unequal numbers of active haircells on both sides of the utricular striola might result in an imbalance of the firing rates of central otolith neurons. Here we propose that a tilt of the subjective visual vertical might as well be caused by a vertical semicircular canal bias in the roll axis after unilateral peripheral lesions. Read More

J Neurol 2019 Jun 20. Epub 2019 Jun 20.

Blacktown Neurology Clinic, Blacktown, NSW, 2148, Australia.

A retrospective analysis of the horizontal video head impulse test (vHIT) results and caloric testing results was undertaken on 644 patients who attended a neuro-otology outpatient facility. Presenting symptoms included spontaneous vertigo, positional vertigo, imbalance or chronic subjective dizziness. For 570 patients, the results of vHIT and caloric testing were concordant. Read More

Med Hypotheses 2019 Jul 2;128:17-20. Epub 2019 May 2.

University Hospital Zurich, Switzerland.

Hypothesis: Lack of otoconia or otoconial loss may be the major reason for increasing imbalance with age, posttraumatic dizziness and residual dizziness as well as other so far unexplained imbalance affecting probably millions of people.

Background: It is written in every textbook that we need sensation of gravity for stable gait and stance, especially on two legs. Lack of otoconia is known to cause lifelong balance problems in animals. Read More

Orv Hetil 2019 Jun;160(25):967-972

Fül-Orr-Gégészeti és Fej-, Nyaksebészeti Klinika, Pécsi Tudományegyetem, Általános Orvostudományi Kar, Klinikai Központ Pécs, Munkácsy M. u. 2., 7621.

The existence of cervical vertigo is still a question under debate. The basic hypothesis of the disease is that the abnormalities of the neck cause dizziness. The name itself is not accurate, as on the basis of the descriptions we cannot talk about true vertigo. Read More

J Neurol 2019 Oct 14;266(10):2430-2433. Epub 2019 Jun 14.

Imperial College Healthcare NHS Trust, London, UK.

Traumatic brain injury (TBI) is the commonest cause of disability in under-40-year-olds. Vestibular features of dizziness (illusory self-motion) or imbalance which affects 50% of TBI patients at 5 years, increases unemployment threefold in TBI survivors. Unfortunately, vestibular diagnoses are cryptogenic in 25% of chronic TBI cases, impeding therapy. Read More

Biochem Biophys Rep 2019 Sep 15;19:100649. Epub 2019 May 15.

Department of Otolaryngology - Head and Neck Surgery, Nara Medical University, Kashihara, Nara, Japan.

Vestibular hair cells (V-HCs) in the inner ear have important roles and various functions. When V-HCs are damaged, crippling symptoms, such as vertigo, visual field oscillation, and imbalance, are often seen. Recently, several studies have reported differentiation of embryonic stem (ES) cells, as pluripotent stem cells, to HCs, though a method for producing V-HCs has yet to be established. Read More

Z Gerontol Geriatr 2019 Jul 3;52(4):316-323. Epub 2019 Jun 3.

Molecular Neurology, University Hospital, Erlangen, Germany.

Background: Personal autonomy in advanced age critically depends on mobility in the environment. Geriatric patients are often not able to walk safely with sufficient velocity. In many cases, multiple factors contribute to the deficit. Read More

World Neurosurg 2019 Sep 24;129:e303-e310. Epub 2019 May 24.

Department of Neurosurgery, University of California, Los Angeles, California, USA; Department of Radiation Oncology, University of California, Los Angeles, California, USA; Department of Head and Neck Surgery, University of California, Los Angeles, California, USA; Jonsson Comprehensive Cancer Center, University of California, Los Angeles, California, USA; Los Angeles Biomedical Research Institute, University of California, Los Angeles, California, USA; Harbor-UCLA Medical Center, University of California, Los Angeles, California, USA; David Geffen School of Medicine, University of California, Los Angeles, California, USA. Electronic address:

Background: Vestibular schwannomas (VS) are benign intracranial neoplasms arising from the eighth cranial nerve for which targeted radiation therapy (RT) has proved increasingly successful. However, long-term hearing and related cranial nerve outcomes have been disputed for the 3 current RT modalities.

Objective: To determine differences in hearing preservation for patients treated with stereotactic radiosurgery (SRS), fractionated stereotactic radiotherapy (FSRT), or hypofractionated stereotactic radiotherapy (hypoFSRT) for VS. Read More

World Neurosurg 2019 Sep 17;129:157-163. Epub 2019 May 17.

Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA. Electronic address:

Background: Vestibular schwannomas (VS) are common slow-growing tumors that typically present with the insidious progression of unilateral hearing loss, tinnitus, vertigo, and gait imbalance. Clinically significant intratumoral acute hemorrhage is exceedingly rare and can present with the acute onset of symptoms, neurologic deterioration, and significant dysfunction of cranial nerves VII and VIII. We discuss a 40-year-old man who developed mild hearing loss and headaches over the course of a month before presenting with a large acutely hemorrhagic vestibular schwannoma. Read More

Cureus 2019 Mar 4;11(3):e4172. Epub 2019 Mar 4.

Surgery, Medical School of National and Kapodistrian University of Athens, Athens, GRC.

The fractures of the first cervical spine vertebrae (atlas) represent 7% of all the overall cervical spine fractures. Hypoplasia of the vertebral artery is also rare (10% of the general population), but even rarer is the combination of those both conditions. This combination should always be identified and treated because sometimes it can be extremely dangerous for the patient. Read More

Clin Pract Cases Emerg Med 2019 May 4;3(2):115-118. Epub 2019 Mar 4.

David Geffen School of Medicine at the University of California Los Angeles, Department of Head and Neck Surgery, Los Angeles, California.

Pneumolabyrinth, defined as air within the labyrinth on high-resolution computed tomography, suggests that a perilymphatic fistula (PLF) is present. PLF describes an abnormal communication between the middle and inner ear, and can result in deafness, vertigo, and imbalance. In the setting of a penetrating injury to the temporal bone or inner ear, pneumolabyrinth should trigger prompt otolaryngology consultation and urgent surgical exploration. Read More

J Pain Palliat Care Pharmacother 2018 Dec 3;32(4):197-200. Epub 2019 May 3.

In December 2017, my mother was diagnosed with an end-stage pancreatic cancer. In the following weeks, she had to be taken to the emergency room frequently due to worsening infections, electrolyte imbalance, and vertigo, which often led to delirium. The doctors treating her were well qualified but lacked education and training about palliative and end-of-life care issues, which was reflected in their clinical practice. Read More

Acta Otolaryngol 2019 Jul 3;139(7):598-603. Epub 2019 May 3.

a Department of Otorhinolaryngology Head and Neck Surgery , the First Affiliated Hospital of Sun Yat-sen University , Guangzhou , China.

Inner ear hemorrhage is increasingly recognized as a cochlear lesion that can cause profound sudden sensorineural hearing loss (SSNHL). To investigate changes of cochlear and vestibular function and to compare therapeutic recovery from profound SSNHL induced by different etiologies. Eighty patients with profound SSNHL (≥90 dB) were divided into an inner ear hemorrhage group and a non-inner ear hemorrhage group by MRI. Read More

Otolaryngol Head Neck Surg 2019 09 23;161(3):478-484. Epub 2019 Apr 23.

1 Norwegian National Advisory Unit on Vestibular Disorders, Haukeland University Hospital, Bergen, Norway.

Objective: To evaluate the association between hearing and postural balance.

Study Design: Retrospective cross-sectional study.

Setting: Tertiary care otolaryngology clinic. Read More

Adv Otorhinolaryngol 2019 15;82:143-149. Epub 2019 Jan 15.

Aging in vestibular structures with loss of hair cells in the inner ear starts early in life, but vestibular function usually remains relatively unimpaired up to advanced ages. However, dizziness and imbalance are common in the elderly and have substantial impact on the quality of life. Dizziness interferes with the everyday activities of 30% of persons over age 70. Read More

Adv Otorhinolaryngol 2019 15;82:127-133. Epub 2019 Jan 15.

Head motion recorded by the vestibular labyrinths is conveyed to specific brainstem and cerebellar structures that relay velocity information to eye muscles to stabilize vision, and to the axial and limb muscles necessary to stabilize balance. Neural networks enhance and extend the primary vestibular signal, and create adaptation to movement when appropriate. Pathological lesions to one or more of these structures may cause central vertigo and imbalance, and may be localized by specific forms of nystagmus and other abnormal neurological signs. Read More