Bilateral Vestibular Atelectasis as a Fluctuating Bilateral Vestibulopathy: A Case Report Care

The vestibular atelectasis (VA) is a very rarely reported clinical and radiological condition characterized by the collapse of the labyrinthine membrane. Clinical features include symptoms which mimic endolymphatic hydrops; bilateral forms are rarely reported in the literature. Tullio's sign was reported in a few cases. In this paper, we report an original case of bilateral fluctuating VA associated with a rare posterior semicircular canal (SSC) dehiscence variant. A 54-year-old patient presented with evolving and fluctuating bilateral vestibulopathy associated with a pressureinduced nystagmus. Vestibular assessment revealed a bilateral vestibulopathy affecting low and mid velocities, with fluctuating high-velocity impairment. Exploration of the otolithic system showed preserved saccular activity and an absence of utriculo-ocular response. Radiological evaluation demonstrated bilateral VA and a dehiscence of the right posterior SSC. We provide clinical elements to better understand this entity, and propose a new hypothesis for the presence of a previously reported Tullio sign in VA.