A group of patients with congenital endotropia or exotropia was investigated in their capacity to... more A group of patients with congenital endotropia or exotropia was investigated in their capacity to perform reflex eye movements. Some patients had a successful surgical correction of their eye defect. The functions measured were the vestibulo-oculomotor reflex, the feedback control loop for searching and following eye movements and the optomotor reflex. A loss in the functional capacity was displayed in all the tests done. The average value of the losses found for the whole group, according to the test used, were from 8 to 27% for the vestibulo-oculomotor reflex; 22 to 42% for the eye tracking feedback loop, and 48% for the optomotor reflex. The deficit was not due to the incorrect eye position, because the successfully operated subjects had the same magnitude of the motor defect than the non-operated patients.
The vestibulo-ocular reflex was studied at high frequencies of active head rotation (2 to 6 Hz) i... more The vestibulo-ocular reflex was studied at high frequencies of active head rotation (2 to 6 Hz) in twenty-three patients with benign positional vertigo (BPPV). Gain and phase measurements were obtained in the vertical and horizontal planes, and the results were compared to those of a control group consisting of 19 asymptomatic age-matched subjects. In the horizontal plane, the phase lead was significantly smaller in patients with BPPV as compared to controls (p < 0.01 at all frequencies). Vertical results did not differ from normals. These findings challenge "cupulolithiasis" as an explanation of the mechanism of BPPV's symptoms.
International Archives of Otorhinolaryngology, 2017
Introduction Benign paroxysmal positional vertigo is a generally benign condition that responds t... more Introduction Benign paroxysmal positional vertigo is a generally benign condition that responds to repositioning maneuvers and frequently resolves spontaneously. However, for some patients it can become a disabling condition in which surgery must be considered. Two different surgical techniques exist, singular neurectomy and posterior semicircular canal occlusion. Objective The objective of this study is to review the current status of singular nerve section and posterior semicircular canal occlusion as treatments for intractable benign paroxysmal positional vertigo, and to determine if there are published data available that favors one over the other. Data Sources MEDLINE and OLDMEDLINE databases of the National Library of Medicine. Data Synthesis Four studies regarding singular neurectomy and 14 reports on semicircular canal occlusion were analyzed. Both techniques are reported to provide similar symptomatic benefit, with low risk of hearing loss and balance impairment. However, a...
... 1, 2012 Introducción En todo el mundo se han colocado en adultos y niños más de 120000 implan... more ... 1, 2012 Introducción En todo el mundo se han colocado en adultos y niños más de 120000 implantes cocleares, 1 con lo que se ha proveído a estos pacientes de señales e información auditivas necesarias para generar la conciencia acerca del sonido y la percepción del ...
To determine whether vestibular autorotation tests (VAT) would show significant differences in ve... more To determine whether vestibular autorotation tests (VAT) would show significant differences in vestibular oculomotor reflex (VOR) parameters in vertiginous patients before and after treatment with flunarizine. Prospective study in a tertiary referral academic center. Twenty-three patients (10 men, 13 women, mean age 45.57 years, mean length of disease 99.48 days, mean treatment 38.61 days), with vertigo due to vestibular neuritis, underwent VAT testing before and after treatment with 5 mg of flunarizine daily. The parameter improvement value (IV) resulted from subtracting posttreatment from pretreatment VAT numerical values. Regarding subjective improvement, 3 patients (13%) said they had none, 5 (21.7%) expressed moderate progress, 9 (39.1) considered the results satisfactory, and 6 (26%) became asymptomatic. The VAT results gave high positive IV for horizontal restriction, low positive for horizontal and vertical gains and horizontal asymmetry, and negative IV for horizontal phase and vertical restriction. Regarding the individual frequencies, horizontal and vertical gains improved in all the frequencies tested except one. The horizontal phase improved at low frequencies (2.0 and 2.3 Hz) and deteriorated from 2.7 to 3.9 Hz. Vertical and horizontal restriction showed both improvement and deterioration. Horizontal asymmetry displayed improvement from -0.01 at 2.0 Hz to 0.50 at 5.9 Hz, deteriorating from -0.41 at 9.0 Hz. Flunarizine is useful in the treatment of vertigo caused by vestibular neuritis. VAT is a valid instrument for the objective and quantitative evaluation of the vestibular-oculomotor reflexes.
A method is needed to measure parameters of vertigo and disequilibrium. Our objective was to asce... more A method is needed to measure parameters of vertigo and disequilibrium. Our objective was to ascertain whether the vestibular autorotation test (VAT) gives numerical data on the vestibular oculomotor reflex (VOR) that are useful for clinical research. A VAT was carried out on 17 healthy young volunteers twice, with an interval of 7 days (group A), and on a single occasion on another 17 volunteers of similar age and health (group B). The parameters studied were vertical and horizontal gains and phases and horizontal eye velocity symmetry. The resulting values were paired inter-session in the same individuals of group A, and between the first test of group A with the test in group B, chosen at random. Variances for the sets of numbers in each parameter as a whole and for each frequency of stimulation were calculated and statistical validity was determined. No significant differences were found between the inter-session and inter-individual results. Variances of gain (horizontal and vertical) were small, but variances of phase and symmetry were large. An analysis of frequencies of stimulation revealed that variances increased with the elevation of frequency. For clinical research and evaluation, the VAT affords sufficiently consistent figures for vertical and horizontal gain in the entire spectrum of frequencies tested (2-5.9 Hz) and for horizontal phases between 2-3.9 Hz. Vertical phases and horizontal asymmetry vary too greatly for our stated purpose.
A prospective study was undertaken to determine whether stapedectomy can safely be performed in a... more A prospective study was undertaken to determine whether stapedectomy can safely be performed in an outpatient setting. Twenty patients with otosclerosis amenable to surgical treatment were divided into two groups; those in the hospitalized group were admitted the day before surgery and discharged 24 hours after the procedure. The patients in the ambulatory group were admitted on the day surgery was scheduled and released 1 or 2 hours after the procedure. We analyzed the intensity and duration of postoperative vertigo, and the hearing gain obtained, studying the speech frequencies(500 to 2000 Hz) separately from the high frequencies (4000 to 8000 Hz). No significant difference was found at 1, 3, and 6 months of follow-up in any of the parameters studied, concluding that small-fenestra stapedectomy can safely be performed as an outpatient procedure.
A prospective study was undertaken to determine whether stapedectomy can safely be performed in a... more A prospective study was undertaken to determine whether stapedectomy can safely be performed in an outpatient setting. Twenty patients with otosclerosis amenable to surgical treatment were divided into two groups; those in the hospitalized group were admitted the day before surgery and discharged 24 hours after the procedure. The patients in the ambulatory group were admitted on the day surgery was scheduled and released 1 or 2 hours after the procedure. We analyzed the intensity and duration of postoperative vertigo, and the hearing gain obtained, studying the speech frequencies(500 to 2000 Hz) separately from the high frequencies (4000 to 8000 Hz). No significant difference was found at 1, 3, and 6 months of follow-up in any of the parameters studied, concluding that small-fenestra stapedectomy can safely be performed as an outpatient procedure.
A group of patients with congenital endotropia or exotropia was investigated in their capacity to... more A group of patients with congenital endotropia or exotropia was investigated in their capacity to perform reflex eye movements. Some patients had a successful surgical correction of their eye defect. The functions measured were the vestibulo-oculomotor reflex, the feedback control loop for searching and following eye movements and the optomotor reflex. A loss in the functional capacity was displayed in all the tests done. The average value of the losses found for the whole group, according to the test used, were from 8 to 27% for the vestibulo-oculomotor reflex; 22 to 42% for the eye tracking feedback loop, and 48% for the optomotor reflex. The deficit was not due to the incorrect eye position, because the successfully operated subjects had the same magnitude of the motor defect than the non-operated patients.
The vestibulo-ocular reflex was studied at high frequencies of active head rotation (2 to 6 Hz) i... more The vestibulo-ocular reflex was studied at high frequencies of active head rotation (2 to 6 Hz) in twenty-three patients with benign positional vertigo (BPPV). Gain and phase measurements were obtained in the vertical and horizontal planes, and the results were compared to those of a control group consisting of 19 asymptomatic age-matched subjects. In the horizontal plane, the phase lead was significantly smaller in patients with BPPV as compared to controls (p < 0.01 at all frequencies). Vertical results did not differ from normals. These findings challenge "cupulolithiasis" as an explanation of the mechanism of BPPV's symptoms.
International Archives of Otorhinolaryngology, 2017
Introduction Benign paroxysmal positional vertigo is a generally benign condition that responds t... more Introduction Benign paroxysmal positional vertigo is a generally benign condition that responds to repositioning maneuvers and frequently resolves spontaneously. However, for some patients it can become a disabling condition in which surgery must be considered. Two different surgical techniques exist, singular neurectomy and posterior semicircular canal occlusion. Objective The objective of this study is to review the current status of singular nerve section and posterior semicircular canal occlusion as treatments for intractable benign paroxysmal positional vertigo, and to determine if there are published data available that favors one over the other. Data Sources MEDLINE and OLDMEDLINE databases of the National Library of Medicine. Data Synthesis Four studies regarding singular neurectomy and 14 reports on semicircular canal occlusion were analyzed. Both techniques are reported to provide similar symptomatic benefit, with low risk of hearing loss and balance impairment. However, a...
... 1, 2012 Introducción En todo el mundo se han colocado en adultos y niños más de 120000 implan... more ... 1, 2012 Introducción En todo el mundo se han colocado en adultos y niños más de 120000 implantes cocleares, 1 con lo que se ha proveído a estos pacientes de señales e información auditivas necesarias para generar la conciencia acerca del sonido y la percepción del ...
To determine whether vestibular autorotation tests (VAT) would show significant differences in ve... more To determine whether vestibular autorotation tests (VAT) would show significant differences in vestibular oculomotor reflex (VOR) parameters in vertiginous patients before and after treatment with flunarizine. Prospective study in a tertiary referral academic center. Twenty-three patients (10 men, 13 women, mean age 45.57 years, mean length of disease 99.48 days, mean treatment 38.61 days), with vertigo due to vestibular neuritis, underwent VAT testing before and after treatment with 5 mg of flunarizine daily. The parameter improvement value (IV) resulted from subtracting posttreatment from pretreatment VAT numerical values. Regarding subjective improvement, 3 patients (13%) said they had none, 5 (21.7%) expressed moderate progress, 9 (39.1) considered the results satisfactory, and 6 (26%) became asymptomatic. The VAT results gave high positive IV for horizontal restriction, low positive for horizontal and vertical gains and horizontal asymmetry, and negative IV for horizontal phase and vertical restriction. Regarding the individual frequencies, horizontal and vertical gains improved in all the frequencies tested except one. The horizontal phase improved at low frequencies (2.0 and 2.3 Hz) and deteriorated from 2.7 to 3.9 Hz. Vertical and horizontal restriction showed both improvement and deterioration. Horizontal asymmetry displayed improvement from -0.01 at 2.0 Hz to 0.50 at 5.9 Hz, deteriorating from -0.41 at 9.0 Hz. Flunarizine is useful in the treatment of vertigo caused by vestibular neuritis. VAT is a valid instrument for the objective and quantitative evaluation of the vestibular-oculomotor reflexes.
A method is needed to measure parameters of vertigo and disequilibrium. Our objective was to asce... more A method is needed to measure parameters of vertigo and disequilibrium. Our objective was to ascertain whether the vestibular autorotation test (VAT) gives numerical data on the vestibular oculomotor reflex (VOR) that are useful for clinical research. A VAT was carried out on 17 healthy young volunteers twice, with an interval of 7 days (group A), and on a single occasion on another 17 volunteers of similar age and health (group B). The parameters studied were vertical and horizontal gains and phases and horizontal eye velocity symmetry. The resulting values were paired inter-session in the same individuals of group A, and between the first test of group A with the test in group B, chosen at random. Variances for the sets of numbers in each parameter as a whole and for each frequency of stimulation were calculated and statistical validity was determined. No significant differences were found between the inter-session and inter-individual results. Variances of gain (horizontal and vertical) were small, but variances of phase and symmetry were large. An analysis of frequencies of stimulation revealed that variances increased with the elevation of frequency. For clinical research and evaluation, the VAT affords sufficiently consistent figures for vertical and horizontal gain in the entire spectrum of frequencies tested (2-5.9 Hz) and for horizontal phases between 2-3.9 Hz. Vertical phases and horizontal asymmetry vary too greatly for our stated purpose.
A prospective study was undertaken to determine whether stapedectomy can safely be performed in a... more A prospective study was undertaken to determine whether stapedectomy can safely be performed in an outpatient setting. Twenty patients with otosclerosis amenable to surgical treatment were divided into two groups; those in the hospitalized group were admitted the day before surgery and discharged 24 hours after the procedure. The patients in the ambulatory group were admitted on the day surgery was scheduled and released 1 or 2 hours after the procedure. We analyzed the intensity and duration of postoperative vertigo, and the hearing gain obtained, studying the speech frequencies(500 to 2000 Hz) separately from the high frequencies (4000 to 8000 Hz). No significant difference was found at 1, 3, and 6 months of follow-up in any of the parameters studied, concluding that small-fenestra stapedectomy can safely be performed as an outpatient procedure.
A prospective study was undertaken to determine whether stapedectomy can safely be performed in a... more A prospective study was undertaken to determine whether stapedectomy can safely be performed in an outpatient setting. Twenty patients with otosclerosis amenable to surgical treatment were divided into two groups; those in the hospitalized group were admitted the day before surgery and discharged 24 hours after the procedure. The patients in the ambulatory group were admitted on the day surgery was scheduled and released 1 or 2 hours after the procedure. We analyzed the intensity and duration of postoperative vertigo, and the hearing gain obtained, studying the speech frequencies(500 to 2000 Hz) separately from the high frequencies (4000 to 8000 Hz). No significant difference was found at 1, 3, and 6 months of follow-up in any of the parameters studied, concluding that small-fenestra stapedectomy can safely be performed as an outpatient procedure.
Uploads