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Surgical Treatment of an Endolymphatic Sac Tumor

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Clinical characteristics associated with isolated unilateral utricular dysfunction.

Stanley Pelosi¹, Daniel Schuster, Gary P Jacobson

¹Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, USA. stanley.pelosi@vanderbilt.edu

American Journal of Otolaryngology

|June 14, 2013

Summary

Isolated unilateral ocular vestibular evoked myogenic potential (oVEMP) abnormalities may indicate increased postural instability and swaying sensations. Further research can clarify vestibular impairments from utricular dysfunction.

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Area of Science:

Neuroscience
Otolaryngology
Vestibular System

Background:

Ocular vestibular evoked myogenic potential (oVEMP) tests sound-induced activation of extraocular muscles, originating from the utricle and superior vestibular nerve.
Isolated unilateral oVEMP abnormalities with normal balance function tests (BFT) are not well-characterized, and their clinical significance is unclear.

Purpose of the Study:

To characterize isolated unilateral oVEMP abnormalities in a large patient series.
To determine the clinical significance of these abnormalities in patients with vestibular complaints.

Main Methods:

Retrospective review of adult patients with vestibular complaints at a neurotologic referral center.
Identification of patients with isolated unilateral oVEMP abnormalities.
Comparison of vestibular symptoms, Dizziness Handicap Inventory (DHI), and Hospital Anxiety and Depression Scale (HADS) scores between patients with abnormal oVEMP and those with normal BFT results.

Main Results:

Thirty-one adult patients with isolated unilateral oVEMP abnormalities were identified.
Patients with abnormal oVEMP showed a higher prevalence of postural instability (p=0.046) and swaying/rocking sensation (p=0.04) compared to those with normal BFT.
No significant differences were found in other symptoms, age, gender, diagnoses, DHI, or HADS scores between the groups.

Conclusions:

This study represents the largest series on isolated unilateral oVEMP abnormalities.
Results suggest a potential link between isolated unilateral oVEMP abnormalities and increased postural instability and swaying sensations.
Further investigation using other postural stability measures may better define vestibular impairments associated with isolated unilateral utricular dysfunction.