Association between Third Mobile Window Disorders and Symptom Reduction Using a Noise Cancelling Device: Inverse...

Area of Science:

• Neuroscience
• Ophthalmology
• Audiology

Background:

• Post-traumatic brain injury (TBI) dizziness is challenging to diagnose.
• Vestibular pathology is often the source of persistent dizziness after TBI.
• Identifying the specific vestibular cause requires specialized diagnostic methods.

Purpose of the Study:

• To investigate the utility of noise cancellation devices (NCDs) in identifying vestibular pathology in TBI patients with dizziness.
• To explore the association between NCD response, vertical heterophoria (VH), and third mobile window disorder (TMWD).

Main Methods:

• Retrospective case series of TBI patients with dizziness and diagnosed VH.
• Evaluation with NCDs for patients unresponsive to microprism lenses or with hyperacusis.
• Vestibular testing for patients showing symptom reduction with NCDs.
• Medical and/or surgical treatment for diagnosed TMWD.

Main Results:

• Fourteen patients with TBI dizziness and VH were identified.
• A positive response to NCDs was observed in patients with underlying vestibular abnormalities.
• Vestibular testing revealed third mobile window disorder (TMWD) in all identified patients.
• Medical or surgical treatment led to symptom reduction or resolution in all patients.

Conclusions:

• Noise cancellation devices can aid in identifying vestibular dysfunction in TBI patients with dizziness.
• A positive NCD response in TBI patients with VH suggests TMWD.
• Treatment of TMWD, medically or surgically, can resolve post-TBI dizziness.
• The phenomenon observed may represent an inverse Tullio phenomenon.