Sudden sensorineural hearing loss with simultaneous positional vertigo showing persistent geotropic...

Area of Science:

• Otolaryngology
• Neurology
• Vestibular Science

Background:

• Sudden sensorineural hearing loss (SSNHL) is an otologic emergency.
• Positional vertigo is a common vestibular disorder.
• The simultaneous occurrence of SSNHL and positional vertigo is not well understood.

Purpose of the Study:

• To describe clinical characteristics of patients with simultaneous SSNHL and geotropic direction-changing positional nystagmus (DCPN).
• To investigate the underlying pathophysiology of this condition.

Main Methods:

• Retrospective case series review.
• Study included 17 patients with SSNHL and simultaneous positional vertigo exhibiting geotropic DCPN.

Main Results:

• All patients presented with persistent geotropic DCPN on the supine head-roll test.
• Nystagmus intensity was greater when turning the head towards the SSNHL side in 15/17 patients.
• The null plane was consistently found on the same side as the SSNHL in 9 patients, suggesting a "light cupula" phenomenon.

Conclusions:

• A "light cupula" mechanism in the lateral semicircular canal may explain positional vertigo in patients with SSNHL.
• Persistent geotropic DCPN and a same-sided null plane are key findings in these cases.