Research Article

Subjective visual vertical in patients with unilateral definite Meniere's diseases

Abstract

Background and Aim: Subjective visual vertical (SVV) test is a clinical tool to evaluate the utricular function and the gravity perception pathways in peripheral and central vestibular lesions. Meniere’s disease (MD) involves cochlear and otolithic organs. The prevalence and features of otolithic dysfunction in the acute phase of this disease are unknown. The aim of this study was to evaluate of SVV test in the acute phase of MD and to investigate the validity of SVV test for detection of otolithic disorders in MD patients.
Methods: Thirty two patients with unilateral definite Meniere's disease and thirty two normal subjects were enrolled in this study. Pure tone audiometry, tympanometry, and SVV test were performed.
Results: There was no significant difference between the mean SVV in the normal group and the mean SVV in the healthy side of the patient group, while a significant difference was observed between the mean SVV in the normal group and the mean SVV in the affected side of the patient groups. Also, in the patient group, the difference in the mean SVV between the healthy and affected sides was significant.
Conclusion: Patients with MD have difficulties in perception of verticality that is probably due to utricular dysfunction. In order to improve the level of diagnosis of MD it is suggested to add SVV test to the test battery.

1. Kumagami H, Sainoo Y, Fujiyama D, Baba A, Oku R, Takasaki K, et al. Subjective visual vertical in acute attacks of Ménière's disease. Otol Neurotol. 2009;30(2):206-9.
2. Arenberg IK, Balkany TJ, Goldman G, Pillsbury RC 3rd. The incidence and prevalence of Meniere's disease -- a statistical analysis of limits. Otolaryngol Clin North Am. 1980;13(4):597-601.
3. Minor LB, Schessel DA, Carey JP. Ménière's disease. Curr Opin Neurol. 2004;17(1):9-16.
4. Young YH, Huang TW, Cheng PW. Assessing the stage of Meniere's disease using vestibular evoked myogenic potentials. Arch Otolaryngol Head Neck Surg. 2003;129(8):815-8.
5. Zarei M, Adel Ghahraman M, Daneshi A, Emamjomeh H, Memar F, Akbari M, et al. Comparison of the prevalence and latency of vestibular evoked myogenic potentials in normal participants and symptomatic and asymptomatic Meniere's disease patients. Audiol. 2009;18(1-2):36-44. Persian.
6. Andrews JC. Intralabyrinthine fluid dynamics: Meniere disease. Curr Opin Otolaryngol Head Neck Surg. 2004;12(5):408-12.
7. Chiarovano E, Zamith F, Vidal PP, de Waele C. Ocular and cervical VEMPs: a study of 74 patients suffering from peripheral vestibular disorders. Clin Neurophysiol. 2011;122(8):1650-9.
8. de Waele C, Tran Ba Huy P, Diard JP, Freyss G, Vidal PP. Saccular dysfunction in Meniere's disease. Otol Neurotol. 1999;20(2):223-32.
9. Rauch SD, Zhou G, Kujawa SG, Guinan JJ, Herrmann BS. Vestibular evoked myogenic potentials show altered tuning in patients with Ménière's disease. Otol Neurotol. 2004;25(3):333-8.
10. Taylor RL, Wijewardene AA, Gibson WP, Black DA, Halmagyi GM, Welgampola MS. The vestibular evoked-potential profile of Ménière's disease. Clin Neurophysiol. 2011;122(6):1256-63.
11. Pagarkar W, Bamiou DE, Ridout D, Luxon LM. Subjective visual vertical and horizontal: effect of the preset angle. Arch Otolaryngol Head Neck Surg. 2008;134(4):394-401.
12. Valko Y, Hegemann SC, Weber KP, Straumann D, Bockisch CJ. Relative diagnostic value of ocular vestibular evoked potentials and the subjective visual vertical during tilt and eccentric rotation. Clin Neurophysiol. 2011;122(2):398-404.
13. Brandt T, Strupp M. General vestibular testing. Clin Neurophysiol. 2005;116(2):406-26.
14. Faralli M, Lapenna R, Mandalà M, Trabalzini F, Ricci G. The first attack of Ménière's disease: a study through SVV perception, clinical and pathogenetic implications. J Vestib Res. 2014;24(5-6):335-42.
15. Kingma H. Function tests of the otolith or statolith system. Curr Opin Neurol. 2006;19(1):21-5.
16. Kobayashi H, Hayashi Y, Higashino K, Saito A, Kunihiro T, Kanzaki J, et al. Dynamic and static subjective visual vertical with aging. Auris Nasus Larynx. 2002;29(4):325-8.
17. Akin FW, Murnane OD. Subjective visual vertical test. Semin Hear. 2009;30(4):281-6.
18. Böhmer A, Mast F. Assessing otolith function by the subjective visual vertical. Ann N Y Acad Sci. 1999;871:221-31.
19. Böhmer A, Mast F, Jarchow T. Can a unilateral loss of otolithic function be clinically detected by assessment of the subjective visual vertical? Brain Res Bull. 1996;40(5-6):423-7; discussion 427-9.
20. Manzari L, Tedesco AR, Burgess AM, Curthoys IS. Ocular and cervical vestibular-evoked myogenic potentials to bone conducted vibration in Ménière's disease during quiescence vs during acute attacks. Clin Neurophysiol. 2010;121(7):1092-101.
21. Friedmann G. The judgement of the visual vertical and horizontal with peripheral and central vestibular lesions. Brain. 1970;93(2):313-28.
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IssueVol 26 No 2 (2017) QRcode
SectionResearch Article(s)
Keywords
Meniere’s disease otolith subjective visual vertical test
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How to Cite
1.
Hosseini Fard A, Yazdani N, Rezazadeh N, Sharifian Alborzi M, Akbarzadeh Bagheban A. Subjective visual vertical in patients with unilateral definite Meniere’s diseases. Aud Vestib Res. 2017;26(2):105-111.