Deviation of the Subjective Vertical in Long-standing Unilateral Vestibular Loss
We evaluated changes in the subjectively perceived gravitational vertical as an index of imbalance in the function of the right and left otolith organs. In addition to normal subjects (n =25), we measured patients with a longstanding (mean 4.5 year ± 3.2 SD; range 0.5-11.5 years) unilateral vestibul...
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| Veröffentlicht in: | Acta oto-laryngologica 1997, Vol.117 (1), p.1-6 |
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| creator | Tabak, S. Collewijn, H. Boumans, L. J. J. M. |
| description | We evaluated changes in the subjectively perceived gravitational vertical as an index of imbalance in the function of the right and left otolith organs. In addition to normal subjects (n =25), we measured patients with a longstanding (mean 4.5 year ± 3.2 SD; range 0.5-11.5 years) unilateral vestibular loss after surgery for acoustic neuroma (n = 32), patients with partial unilateral vestibular loss (n = 7) and patients with bilateral vestibular hyporeflexia (n = 8). Normal subjects could accurately align a vertical luminous bar to the gravitational vertical in an otherwise completely dark room (mean setting -0.14° ± 1.11 SD). Patients with leftsided (complete; n = 13) or rightsided (complete; n = 19 and partial; n = 7) unilateral vestibular loss made mean angular settings at 2.55° ± 1.57 (SD) leftward and 2.22° (±1.96 SD) rightward, respectively. These means differed highly significantly from the normal mean (p < 0.00001). In the time interval investigated (0.5-11.5 years) the magnitude of the tilt angle showed no correlation with the time elapsed since the operation. The mean setting by patients with clinically bilateral vestibular loss (- 1.17° ± 1.96 SD; n = 8) did not significantly differ from the control group. The systematic tilts of the subjective vertical in patients with a unilateral vestibular impairment were correlated with their imbalance in canal-ocular reflexes, as reflected by drift during head-oscillation at 2 Hz (r2 = 0.44) and asymmetries in VOR-gain for head-steps (r2 = 0.48-0.67). These correlations were largely determined by the signs of the asymmetries; correlation between the absolute values of the VOR gain asymmetries and subjective vertical angles proved to be virtually absent. We conclude that the setting of the subjective vertical is a very sensitive tool in detecting a left-right imbalance in otolith function, and that small but significant deviations towards the defective side may persist for many years (probably permanently) after unilateral lesions of the labyrinth or the vestibular nerve. |
| doi_str_mv | 10.3109/00016489709117982 |
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J. J. M.</creator><creatorcontrib>Tabak, S. ; Collewijn, H. ; Boumans, L. J. J. M.</creatorcontrib><description>We evaluated changes in the subjectively perceived gravitational vertical as an index of imbalance in the function of the right and left otolith organs. In addition to normal subjects (n =25), we measured patients with a longstanding (mean 4.5 year ± 3.2 SD; range 0.5-11.5 years) unilateral vestibular loss after surgery for acoustic neuroma (n = 32), patients with partial unilateral vestibular loss (n = 7) and patients with bilateral vestibular hyporeflexia (n = 8). Normal subjects could accurately align a vertical luminous bar to the gravitational vertical in an otherwise completely dark room (mean setting -0.14° ± 1.11 SD). Patients with leftsided (complete; n = 13) or rightsided (complete; n = 19 and partial; n = 7) unilateral vestibular loss made mean angular settings at 2.55° ± 1.57 (SD) leftward and 2.22° (±1.96 SD) rightward, respectively. These means differed highly significantly from the normal mean (p < 0.00001). In the time interval investigated (0.5-11.5 years) the magnitude of the tilt angle showed no correlation with the time elapsed since the operation. The mean setting by patients with clinically bilateral vestibular loss (- 1.17° ± 1.96 SD; n = 8) did not significantly differ from the control group. The systematic tilts of the subjective vertical in patients with a unilateral vestibular impairment were correlated with their imbalance in canal-ocular reflexes, as reflected by drift during head-oscillation at 2 Hz (r2 = 0.44) and asymmetries in VOR-gain for head-steps (r2 = 0.48-0.67). These correlations were largely determined by the signs of the asymmetries; correlation between the absolute values of the VOR gain asymmetries and subjective vertical angles proved to be virtually absent. We conclude that the setting of the subjective vertical is a very sensitive tool in detecting a left-right imbalance in otolith function, and that small but significant deviations towards the defective side may persist for many years (probably permanently) after unilateral lesions of the labyrinth or the vestibular nerve.</description><identifier>ISSN: 0001-6489</identifier><identifier>EISSN: 1651-2251</identifier><identifier>DOI: 10.3109/00016489709117982</identifier><identifier>PMID: 9039472</identifier><identifier>CODEN: AOLAAJ</identifier><language>eng</language><publisher>Stockholm: Informa UK Ltd</publisher><subject>acoustic neuroma ; Biological and medical sciences ; Ear, Inner - physiopathology ; Eye Movements - physiology ; Functional Laterality - physiology ; Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics ; human ; Humans ; Medical sciences ; Meniere Disease - physiopathology ; Neuroma, Acoustic - physiopathology ; ocular torsion ; Orientation - physiology ; otolith ; Otolithic Membrane - physiology ; Posture ; Reflex, Vestibulo-Ocular ; Space life sciences ; Space Perception - physiology ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the ear, the auditive nerve and the facial nerve ; Torsion Abnormality ; unilateral and bilateral vestibular loss ; utricle ; Vestibular Diseases - diagnosis ; Vestibular Diseases - physiopathology ; Vestibular Function Tests ; Vestibular Nerve - physiopathology ; Vestibule, Labyrinth - physiology</subject><ispartof>Acta oto-laryngologica, 1997, Vol.117 (1), p.1-6</ispartof><rights>1997 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted 1997</rights><rights>1997 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c525t-1b296f2ab0e56b07f2f735944f2c8b0bf32e9acee7a91a9ca64d9392c0299a513</citedby><cites>FETCH-LOGICAL-c525t-1b296f2ab0e56b07f2f735944f2c8b0bf32e9acee7a91a9ca64d9392c0299a513</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.tandfonline.com/doi/pdf/10.3109/00016489709117982$$EPDF$$P50$$Ginformahealthcare$$H</linktopdf><linktohtml>$$Uhttps://www.tandfonline.com/doi/full/10.3109/00016489709117982$$EHTML$$P50$$Ginformahealthcare$$H</linktohtml><link.rule.ids>314,776,780,4010,27900,27901,27902,59620,59726,60409,60515,61194,61229,61375,61410</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2549433$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9039472$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tabak, S.</creatorcontrib><creatorcontrib>Collewijn, H.</creatorcontrib><creatorcontrib>Boumans, L. J. J. M.</creatorcontrib><title>Deviation of the Subjective Vertical in Long-standing Unilateral Vestibular Loss</title><title>Acta oto-laryngologica</title><addtitle>Acta Otolaryngol</addtitle><description>We evaluated changes in the subjectively perceived gravitational vertical as an index of imbalance in the function of the right and left otolith organs. In addition to normal subjects (n =25), we measured patients with a longstanding (mean 4.5 year ± 3.2 SD; range 0.5-11.5 years) unilateral vestibular loss after surgery for acoustic neuroma (n = 32), patients with partial unilateral vestibular loss (n = 7) and patients with bilateral vestibular hyporeflexia (n = 8). Normal subjects could accurately align a vertical luminous bar to the gravitational vertical in an otherwise completely dark room (mean setting -0.14° ± 1.11 SD). Patients with leftsided (complete; n = 13) or rightsided (complete; n = 19 and partial; n = 7) unilateral vestibular loss made mean angular settings at 2.55° ± 1.57 (SD) leftward and 2.22° (±1.96 SD) rightward, respectively. These means differed highly significantly from the normal mean (p < 0.00001). In the time interval investigated (0.5-11.5 years) the magnitude of the tilt angle showed no correlation with the time elapsed since the operation. The mean setting by patients with clinically bilateral vestibular loss (- 1.17° ± 1.96 SD; n = 8) did not significantly differ from the control group. The systematic tilts of the subjective vertical in patients with a unilateral vestibular impairment were correlated with their imbalance in canal-ocular reflexes, as reflected by drift during head-oscillation at 2 Hz (r2 = 0.44) and asymmetries in VOR-gain for head-steps (r2 = 0.48-0.67). These correlations were largely determined by the signs of the asymmetries; correlation between the absolute values of the VOR gain asymmetries and subjective vertical angles proved to be virtually absent. We conclude that the setting of the subjective vertical is a very sensitive tool in detecting a left-right imbalance in otolith function, and that small but significant deviations towards the defective side may persist for many years (probably permanently) after unilateral lesions of the labyrinth or the vestibular nerve.</description><subject>acoustic neuroma</subject><subject>Biological and medical sciences</subject><subject>Ear, Inner - physiopathology</subject><subject>Eye Movements - physiology</subject><subject>Functional Laterality - physiology</subject><subject>Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics</subject><subject>human</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>Meniere Disease - physiopathology</subject><subject>Neuroma, Acoustic - physiopathology</subject><subject>ocular torsion</subject><subject>Orientation - physiology</subject><subject>otolith</subject><subject>Otolithic Membrane - physiology</subject><subject>Posture</subject><subject>Reflex, Vestibulo-Ocular</subject><subject>Space life sciences</subject><subject>Space Perception - physiology</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the ear, the auditive nerve and the facial nerve</subject><subject>Torsion Abnormality</subject><subject>unilateral and bilateral vestibular loss</subject><subject>utricle</subject><subject>Vestibular Diseases - diagnosis</subject><subject>Vestibular Diseases - physiopathology</subject><subject>Vestibular Function Tests</subject><subject>Vestibular Nerve - physiopathology</subject><subject>Vestibule, Labyrinth - physiology</subject><issn>0001-6489</issn><issn>1651-2251</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1997</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kN1LHDEUxYNU7Gr9A3wozEPp27T5mMxM0Jdi7QcsKFh9He5kb9ws2USTjMX_vll2FaTg0-Vyfudy7iHkhNEvglH1lVLK2qZXHVWMdarne2TGWslqziV7R2Ybvd4A78lhSqvNqnp5QA4UFarp-IxcfcdHC9kGXwVT5SVW19O4Qp3tI1a3GLPV4Crrq3nwd3XK4BfW31U33jrIGIt2iynbcXIQC5PSB7JvwCU83s0jcvPj4s_5r3p--fP3-bd5rSWXuWYjV63hMFKU7Ug7w00npGoaw3U_0tEIjgo0YgeKgdLQNgslFNeUKwWSiSPyeXv3PoaHqWQY1jZpdA48hikNXd-LpqWygGwL6ljiRTTDfbRriE8Do8OmxeG_Fovn4-74NK5x8eLY1Vb0TzsdUunHRPDapheMy0Y1QhTsbItZb0Jcw98Q3WLI8ORCfPaIt1KcvrIvEVxeaog4rMIUfan3jR_-AcPOntY</recordid><startdate>1997</startdate><enddate>1997</enddate><creator>Tabak, S.</creator><creator>Collewijn, H.</creator><creator>Boumans, L. J. J. M.</creator><general>Informa UK Ltd</general><general>Taylor & Francis</general><general>Taylor and Francis</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>8BM</scope></search><sort><creationdate>1997</creationdate><title>Deviation of the Subjective Vertical in Long-standing Unilateral Vestibular Loss</title><author>Tabak, S. ; Collewijn, H. ; Boumans, L. J. J. M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c525t-1b296f2ab0e56b07f2f735944f2c8b0bf32e9acee7a91a9ca64d9392c0299a513</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1997</creationdate><topic>acoustic neuroma</topic><topic>Biological and medical sciences</topic><topic>Ear, Inner - physiopathology</topic><topic>Eye Movements - physiology</topic><topic>Functional Laterality - physiology</topic><topic>Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics</topic><topic>human</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Meniere Disease - physiopathology</topic><topic>Neuroma, Acoustic - physiopathology</topic><topic>ocular torsion</topic><topic>Orientation - physiology</topic><topic>otolith</topic><topic>Otolithic Membrane - physiology</topic><topic>Posture</topic><topic>Reflex, Vestibulo-Ocular</topic><topic>Space life sciences</topic><topic>Space Perception - physiology</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the ear, the auditive nerve and the facial nerve</topic><topic>Torsion Abnormality</topic><topic>unilateral and bilateral vestibular loss</topic><topic>utricle</topic><topic>Vestibular Diseases - diagnosis</topic><topic>Vestibular Diseases - physiopathology</topic><topic>Vestibular Function Tests</topic><topic>Vestibular Nerve - physiopathology</topic><topic>Vestibule, Labyrinth - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tabak, S.</creatorcontrib><creatorcontrib>Collewijn, H.</creatorcontrib><creatorcontrib>Boumans, L. J. J. 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M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Deviation of the Subjective Vertical in Long-standing Unilateral Vestibular Loss</atitle><jtitle>Acta oto-laryngologica</jtitle><addtitle>Acta Otolaryngol</addtitle><date>1997</date><risdate>1997</risdate><volume>117</volume><issue>1</issue><spage>1</spage><epage>6</epage><pages>1-6</pages><issn>0001-6489</issn><eissn>1651-2251</eissn><coden>AOLAAJ</coden><abstract>We evaluated changes in the subjectively perceived gravitational vertical as an index of imbalance in the function of the right and left otolith organs. In addition to normal subjects (n =25), we measured patients with a longstanding (mean 4.5 year ± 3.2 SD; range 0.5-11.5 years) unilateral vestibular loss after surgery for acoustic neuroma (n = 32), patients with partial unilateral vestibular loss (n = 7) and patients with bilateral vestibular hyporeflexia (n = 8). Normal subjects could accurately align a vertical luminous bar to the gravitational vertical in an otherwise completely dark room (mean setting -0.14° ± 1.11 SD). Patients with leftsided (complete; n = 13) or rightsided (complete; n = 19 and partial; n = 7) unilateral vestibular loss made mean angular settings at 2.55° ± 1.57 (SD) leftward and 2.22° (±1.96 SD) rightward, respectively. These means differed highly significantly from the normal mean (p < 0.00001). In the time interval investigated (0.5-11.5 years) the magnitude of the tilt angle showed no correlation with the time elapsed since the operation. The mean setting by patients with clinically bilateral vestibular loss (- 1.17° ± 1.96 SD; n = 8) did not significantly differ from the control group. The systematic tilts of the subjective vertical in patients with a unilateral vestibular impairment were correlated with their imbalance in canal-ocular reflexes, as reflected by drift during head-oscillation at 2 Hz (r2 = 0.44) and asymmetries in VOR-gain for head-steps (r2 = 0.48-0.67). These correlations were largely determined by the signs of the asymmetries; correlation between the absolute values of the VOR gain asymmetries and subjective vertical angles proved to be virtually absent. We conclude that the setting of the subjective vertical is a very sensitive tool in detecting a left-right imbalance in otolith function, and that small but significant deviations towards the defective side may persist for many years (probably permanently) after unilateral lesions of the labyrinth or the vestibular nerve.</abstract><cop>Stockholm</cop><pub>Informa UK Ltd</pub><pmid>9039472</pmid><doi>10.3109/00016489709117982</doi><tpages>6</tpages></addata></record> |
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| subjects | acoustic neuroma Biological and medical sciences Ear, Inner - physiopathology Eye Movements - physiology Functional Laterality - physiology Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics human Humans Medical sciences Meniere Disease - physiopathology Neuroma, Acoustic - physiopathology ocular torsion Orientation - physiology otolith Otolithic Membrane - physiology Posture Reflex, Vestibulo-Ocular Space life sciences Space Perception - physiology Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the ear, the auditive nerve and the facial nerve Torsion Abnormality unilateral and bilateral vestibular loss utricle Vestibular Diseases - diagnosis Vestibular Diseases - physiopathology Vestibular Function Tests Vestibular Nerve - physiopathology Vestibule, Labyrinth - physiology |
| title | Deviation of the Subjective Vertical in Long-standing Unilateral Vestibular Loss |
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