Research Article

Vibration-induced nystagmus in patients with chronic unilateral Meniere's disease


Background and Aim: Meniere's disease (MD) is one of the inner ear disorders associated with fluctuating hearing loss, vertigo, ear fullness, and tinnitus. Vestibular stimulation delas with the integrity of the peripheral vestibular system and may cause nystagmus due to the functional asymmetry between right and lef peripheral vestibular system. This study aimed to assess the vibration-induced nystagmus (VIN) in patients with chronic unilateral MD and investigate the effectiveness of this test in detecting the affected ear in these patients.
Methods: This study was conducted on 29 patients with chronic unilateral MD. For this purpose, spontaneous nystagmus (SN) and VIN at frequencies of 30 Hz and 100 Hz were recorded by videonystagmography test under five recording conditions. The vibratory stimulation was presented to both healthy and affected ears. Collected were analyzed in SPSS v.22 software.
Results: Vibratory stimulation compared to the unstimulated condition, revealed a significant difference in eye movements for both healthy and affected ears. Moreover, the difference between VIN and SN in the affected ear was much greater than in the healthy ear.
Conclusion: In patients with chronic unilateral MD, 100 Hz vibratory stimulation of the affected ear induces more reliable nystagmus than 30 Hz stimulation and unstimulated condition. The VIN test can be used for the evaluation of the vestibular system function and is a promising technique to detect the MD ear.

1. Christopher LH, Wilkinson EP. Meniere's disease: Medical management, rationale for vestibular preservation and suggested protocol in medical failure. Am J Otolaryngol. 2021;42(1):102817. doi: 10.1016/j.amjoto.2020.102817
2. Paparella MM. Pathology of Meniere's disease. Ann Otol Rhinol Laryngol Suppl. 1984;112:31-5. doi: 10.1177/00034894840930s406
3. Gates GA. Meniere's disease review 2005. J Am Acad Audiol. 2006;17(1):16-26. doi: 10.3766/jaaa.17.1.3
4. Lopez-Escamez JA, Carey J, Chung W-H, Goebel JA, Magnusson M, Mandalà M, et al. Diagnostic criteria for Menière's disease. J Vestib Res. 2015;25(1):1-7. doi: 10.3233/VES-150549
5. Michel O, Hess A, Su J, Bloch W, Stennert E, Addicks K. Expression of inducible nitric oxide synthase (iNOS/NOS II) in the hydropic cochlea of guinea pigs. Hear Res. 2000;143(1-2):23-8. doi: 10.1016/s0378-5955(00)00018-6
6. Takeda T, Takeda S, Kakigi A. A possible mechanism of the formation of endolymphatic hydrops and its associated inner ear disorders. Auris Nasus Larynx. 2020;47(1):25-41. doi: 10.1016/j.anl.2019.09.005
7. Park HJ, Shin JE, Lim YC, Shin HA. Clinical significance of vibration-induced nystagmus. Audiol Neurootol. 2008;13(3):182-6. doi: 10.1159/000113508
8. Park HJ, Lee YJ, Park MS, Kim JM, Shin JE. Test-retest reliability of vibration-induced nystagmus in peripheral dizzy patients. J Vestib Res. 2010;20(6):427-31. doi: 10.3233/VES-2010-0389
9. Dumas G, Curthoys IS, Lion A, Perrin P, Schmerber S. The skull vibration-induced nystagmus test of vestibular function—a review. Front Neurol. 2017;8:41. doi: 10.3389/fneur.2017.00041
10. Dumas G, Michel J, Lavieille JP, Ouedraogo E. [Semiologic value and optimum stimuli trial during the vibratory test: results of a 3D analysis of nystagmus]. Ann Otolaryngol Chir Cervicofac. 2000;117(5):299-312. French.
11. Xie S, Guo J, Wu Z, Qiang D, Huang J, Zheng Y, et al. Vibration-induced nystagmus in patients with unilateral peripheral vestibular disorders. Indian J Otolaryngol Head Neck Surg. 2013 ;65(4):333-8. doi: 10.1007/s12070-013-0638-6
12. Dumas G, Perrin P, Ouedraogo E, Schmerber S. How to perform the skull vibration-induced nystagmus test (SVINT). Eur Ann Otorhinolaryngol Head Neck Dis. 2016;133(5):343-348. doi: 10.1016/j.anorl.2016.04.002
13. Dumas G, Perrin P, Schmerber S. Nystagmus induced by high frequency vibrations of the skull in total unilateral peripheral vestibular lesions. Acta Otolaryngol. 2008;128(3):255-62. doi: 10.1080/00016480701477677
14. Shaabani M, Naghibi N, Bakhshi E. Comparing mastoid and posterior cervical muscles vibration effects on eye movement in normal subjects. Aud Vestib Res. 2019;28(4):242-8 doi: 10.18502/avr.v28i4.1460
15. Lee SU, Kee HJ, Sheen SS, Choi BY, Koo JW, Kim JS. Head-shaking and vibration-induced nystagmus during and between the attacks of unilateral Ménière’s disease. Otol Neurotol. 2015;36(5):865-72. doi: 10.1097/MAO.0000000000000743
16. Ohki M, Murofushi T, Nakahara H, Sugasawa K. Vibration-induced nystagmus in patients with vestibular disorders. Otolaryngol Head Neck Surg. 2003;129(3):255-8. doi: 10.1016/S0194-5998(03)00529-1
17. Kwang Hong S, Koo J-W, Soo Kim J, Park M-H. Implication of vibration induced nystagmus in Meniere's disease. Acta Otolaryngol Suppl. 2007;(558):128-31. doi: 10.1080/03655230701625019
18. 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. doi: 10.1097/MAO.0b013e3181925010
19. Luryi AL, Morse E, Michaelides E. Pathophysiology and diagnosis of Meniere’s disease. In: Babu S, Schutt CA, Bojrab DI, editors. Diagnosis and treatment of vestibular disorders. 1st ed. Cham, Springer; 2019. p. 165-88. doi: 10.1007/978-3-319-97858-1_13
20. Vassiliou A, Vlastarakos PV, Maragoudakis P, Candiloros D, Nikolopoulos TP. Meniere’s disease: Still a mystery disease with difficult differential diagnosis. Ann Indian Acad Neurol. 2011;14(1):12-8. doi: 10.4103/0972-2327.78043
21. Committee on Hearing and Equilibrium. Committee on Hearing and Equilibrium guidelines for the diagnosis and evaluation of therapy in Menière's disease. American Academy of Otolaryngology-Head and Neck Foundation, Inc. Otolaryngol Head Neck Surg. 1995;113(3):181-5. doi: 10.1016/S0194-5998(95)70102-8
22. Dumas G, Karkas A, Perrin P, Chahine K, Schmerber S. High-frequency skull vibration-induced nystagmus test in partial vestibular lesions. Otol Neurotol. 2011;32(8):1291-301. doi: 10.1097/MAO.0b013e31822f0b6b
23. Grill E, Heuberger M, Strobl R, Saglam M, Holle R, Linkohr B, et al. Prevalence, determinants, and consequences of vestibular hypofunction. results from the KORA-FF4 survey. Front Neurol. 2018;9:1076. doi: 10.3389/fneur.2018.01076
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Meniere's disease spontaneous nystagmus vibration-induced nystagmus chronic definite vestibular vibrator

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How to Cite
Mosharaf Dehkordi E, Shaabani M, Kouhi A, Vahedi M. Vibration-induced nystagmus in patients with chronic unilateral Meniere’s disease. Aud Vestib Res. 2021;:287-293.