Development of a reduced-calorie high pressure processed sapodilla (Manilkara zapota L.) jam based on rheological, textural, and sensory properties.

High pressure technology (400 MPa at 27 ± 1.5 °C for 10 min) was applied for the processing of jam, and target was the reduction (∼47%) of sugar requirement by using a fiber-rich fruit, that is, sapodilla. Different formulations of jam containing various combinations of pectin (0.5 to 5.0%), sugar (45 to 65%), and acid (0.5 to 1) were investigated for textural, rheological, and sensory properties of the pressure-processed jam. The textural parameters mainly hardness (varied 16 to 594 g force) of the jam samples were significantly (P < 0.01) affected by the formulation ingredients viz. sugar and pectin content. Also, an interaction effect (P < 0.01) of sugar and pectin was observed on the jam hardness. The rheological parameters (gel strength, K') also varied (1036 to 2852 Pa) with the change in total soluble solids (TSS) and pectin content. However, the samples having lower TSS content (e.g. 45%) and appropriate pectin content (4.0, 4.5, or 5.0%) were similar (P > 0.05) to the samples having higher TSS content (65%) and corresponding pectin level (0.5, 1.0, or 1.5%) based on the rheological properties. On the other hand, the samples with middle levels of pectin at the corresponding TSS level (45 to 65%) were highest (score of >6 on seven-point hedonic scale) and equally preferred (P > 0.05) by the sensory panelist based on overall acceptability calculated from the scores obtained for sensory attributes viz. color, aroma, sweetness, sourness, texture, and spreadability. Therefore, the jam formulation containing sapodilla pulp as a base material, TSS 45%, pectin 4.5%, and citric acid 0.5% was determined to be the preferred formulation for the production of reduced-calorie, pressure-processed jam based on its gel strength, overall acceptability, and storage stability. PRACTICAL APPLICATION: High-fiber fruit was used for the development of a reduced-calorie high pressure processed jam in this study. The inherited or externally added fiber can favor the reduction in sugar requirement of a food product particularly those processed by high pressure, leading to reduction in calories. The findings of this study can be used for the development of novel HPP products with functional properties.

Behavioural improvement in a minimally conscious state after caloric vestibular stimulation: evidence from two single case studies.

OBJECTIVE: To investigate whether caloric vestibular stimulation, a non-invasive form of neuro-modulation, alters the level of awareness in people residing in a minimally conscious state. DESIGN: Single-case ( n = 2), prospective, controlled (ABAB) efficacy study. SETTING: Tertiary, neuro-rehabilitation inpatient ward within a university hospital. PARTICIPANTS: Two individuals in a minimally conscious state. INTERVENTION: Left ear caloric vestibular stimulation was performed in two four/five-week blocks interleaved with two four/five-week blocks of sham stimulation. Session duration and frequency gradually increased within each block from once per day for 10 minutes (Week 1) to once per day for 20 minutes (Week 2) to 20 minutes twice per day in the remaining weeks. MEASURES: Wessex Head Injury Matrix, JFK Coma Recovery Scale - Revised. RESULTS: Both participants' Wessex Head Injury Matrix scores indicated a transition from involuntary (i.e. mechanical vocalization) to voluntary (i.e. gesture making, selective responses to family members) behaviour that was time-locked to the onset of active stimulation. In one participant, this improvement persisted for at least four weeks after active stimulation, while in the other it diminished two weeks after stimulation. Allied, although less dramatic, changes were seen on the arousal and auditory subscales of the JFK Coma Recovery Scale - Revised. CONCLUSION: The data provide the first evidence that vestibular stimulation may help improve outcome in a low awareness state, although further studies are needed to replicate effect and determine longer-term benefit.

Bilateral simultaneous sudden sensorineural hearing loss.

OBJECTIVE: This study adopted an inner ear test battery and MR imaging in patients with bilateral sudden sensorineural hearing loss (SSNHL) to investigate their causes, disease extent, and evaluate hearing outcome. PATIENTS AND METHODS: From 1995 to 2014, 16 patients with bilateral SSNHL received audiometry, caloric test and MR imaging. Vestibular-evoked myogenic potential (VEMP) test was added to the test battery after 2000. RESULTS: Percentages of abnormal mean hearing level (MHL), cervical VEMP test, ocular VEMP test, and caloric test in patients with bilateral SSNHL were 100% (32/32), 100% (12/12), 100% (4/4), and 81% (26/32), respectively, implying that not only the cochlear part but also the vestibular part was severely affected in both ears. Causes of bilateral SSNHL were neoplasm in 5 patients, stroke in 5, meningitis in 1, and unknown in 5. Post-treatment MHL did not significantly differ from pre-treatment MHL indicating poor hearing outcome. Seven patients (44%) had passed away within 5years after onset, 2 patients were lost, and 7 patients survived. CONCLUSION: Via MR imaging, causes of bilateral SSNHL were identified for 69% of cases. Both cochlear and vestibular endorgans/afferents were identified to be severely affected bilaterally by the vestibular test battery and resulted in poor hearing outcome. A high mortality rate (44%) indicates that bilateral SSNHL is an ominous sign for a more sinister underlying disease.

The patients associated with TMPRSS3 mutations are good candidates for electric acoustic stimulation.

OBJECTIVES: To clarify the frequency of TMPRSS3 mutations in the hearing loss population, genetic analysis was performed, and detailed clinical characteristics were collected. Optical intervention for patients with TMPRSS3 mutations was also discussed. METHODS: Massively parallel DNA sequencing (MPS) was applied for the target exon-sequencing of 63 deafness genes in a population of 1120 Japanese hearing loss patients. RESULTS: Hearing loss in 5 patients was found to be caused by compound heterozygous TMPRSS3 mutations, and their detailed clinical features were collected and analyzed. Typically, all of the patients showed ski slope type audiograms and progressive hearing loss. Three of the 5 patients received electric acoustic stimulation (EAS), which showed good results. Further, the onset age was found to vary, and there were some correlations between genotype and phenotype (onset age). CONCLUSIONS: MPS is a powerful tool for the identification of rare causative deafness genes, such as TMPRSS3. The present clinical characteristics not only confirmed the findings from previous studies but also provided clinical evidence that EAS is beneficial for patients possessing TMPRSS3 mutations.

Cervical vestibular evoked myogenic potentials and caloric test results in individuals with auditory neuropathy spectrum disorders.

Auditory neuropathy spectrum disorder is a type of hearing loss where outer hair cell function are normal (as evidenced by the preservation of OAEs and cochlear microphonics), whereas auditory nerve functions are abnormal (as evidenced by abnormal auditory brainstem evoked potentials beginning with wave I of the ABR) and acoustic reflexes to ipsilateral and contralateral tones are absent. It is likely that in cases with auditory neuropathy spectrum disorder not only the cochlear nerve, but also the vestibular nerves might get involved. The present study was conducted with an aim of finding out the inferior and superior vestibular nerve involvement through cervical vestibular evoked myogenic potentials and Caloric test results respectively in individuals with Auditory Neuropathy Spectrum Disorders. Total 26 participants who fulfilled the criteria of auditory neuropathy spectrum disorder participated for the study. Vestibular evoked myogenic potentials results showed absence of responses from most of the subjects also caloric responses showed bilateral hypofunctional responses in most of the participants, which is suggestive of involvement of both the inferior as well as superior vestibular nerve in individuals with auditory neuropathy spectrum disorders. Additionally there was no association between the pattern and degree of hearing loss to caloric test results and vestibular evoked myogenic potentials results findings.

Bilateral Vestibulopathy with Alcohol Abuse and Vitamin Deficiency / 대한평형의학회지

Bilateral vestibulopathy (BV) is a clinical entity with impaired function of bilateral peripheral vestibular system, which is characterized by movement-induced vertigo, oscillopsia and gait unsteadiness. Among various etiologies of BV, alcohol and vitamin B deficiency has rarely been reported. We experienced a case of BV with vitamin B deficiency in a 24-year-old man who was previously exposed to alcohol. He had osillopsia and gait unsteadiness as a primary symptom, and was treated successfully with vestibular rehabilitation and vitamin supplement. Bithermal caloric test, rotatory chair test and head impulse test showed the result compatible with BV.

The diagnostic value of vestibular evoked myogenic potentials in patients with Meniere's disease.

OBJECTIVE: To estimate the sensitivity and specificity of vestibular evoked myogenic potentials (VEMPs) in comparison with caloric test in diagnosing Meniere's disease (MD) among patients with dizziness. METHODS: Data were retrospectively collected from 1,170 consecutive patients who underwent vestibular tests. Among them, 114 patients were diagnosed as having unilateral definite MD. VEMPs in response to clicks and short tone burst stimulation as well as caloric tests were performed. The sensitivity and specificity of each test were evaluated. The results of each test were compared with hearing level and staging of MD. RESULTS: The sensitivity and specificity of VEMPs were 50.0% and 48.9%, while those of the caloric test were 37.7% and 51.2%, respectively. There was no significant difference in hearing level between patients appropriately or inappropriately identified by VEMPs, whereas there was a significant difference in those of the caloric test. Combined use of VEMP and caloric test increased the sensitivity to 65.8%. CONCLUSION: Although the sensitivity and specificity of VEMPs in diagnosing MD were not high, they were comparable to those of caloric test. VEMPs as well as caloric testing may give additional information as part of a diagnostic test battery for detecting vestibular abnormalities in MD.

Ocular vestibular evoked myogenic potentials in response to air-conducted sound and bone-conducted vibration in vestibular schwannoma.

OBJECTIVE: To clarify the origin and pathways of ocular vestibular evoked myogenic potentials (oVEMPs) to air-conducted sound (ACS), we compared the results of oVEMPs with ACS, with oVEMPs with bone-conducted vibration (BCV), cervical VEMPs (cVEMPs) with ACS, and the caloric test in patients with unilateral vestibular schwannoma (VS). STUDY DESIGN: Retrospective review. SETTING: Tertiary referral center. PATIENTS: Forty-five patients with untreated unilateral VS. MAIN OUTCOME MEASURE: Each patient underwent vestibular tests, including oVEMPs to ACS, oVEMPs to BCV, cVEMPs to ACS, and caloric tests. The correlations among these tests were evaluated. RESULTS: Of the 45 patients recruited, 28 patients (63%) showed reduced or absent oVEMPs to ACS solely on the affected side. There were no significant differences in abnormal response ratios among oVEMPs to ACS, oVEMPs to BCV, cVEMPs to ACS, or the caloric test. The results of oVEMPs to ACS had a significant correlation with those of oVEMPs to BCV and the caloric test (p < 0.05) but not with those of cVEMPs to ACS (p > 0.05). CONCLUSION: These findings support the hypothesis that oVEMP in response to ACS are predominantly mediated by the superior vestibular nerve and probably reflect the function of the utricle.

Do patients who experience episodic tilting or translational sensations in the pitch plane have abnormal sacculo-collic reflexes?

The otolith-collic and otolith-ocular reflexes of patients who experienced episodic tilting or translational sensations in the pitch plane without any other vestibular symptoms were assessed using cervical vestibular evoked myogenic potentials (cVEMP) and ocular vestibular evoked myogenic potentials (oVEMP). Eleven patients (4 men and 7 women, mean age=40.4) were enrolled. All of the patients complained of episodic tilting or translational sensations in the pitch plane. Patients with a medical history of rotatory vertigo, loss of consciousness, head trauma, or symptoms of central nervous dysfunction or proprioceptive dysfunction and those who had been definitely diagnosed with a disease that causes disequilibrium were excluded. All 11 patients underwent cVEMP and caloric tests. Ten patients participated in the oVEMP tests. Seven of the 11 patients exhibited unilateral cVEMP absences, two displayed bilateral cVEMP absences, one demonstrated unilaterally decreased cVEMP, and one displayed normal cVEMP. Concerning oVEMP, 2 of the 10 patients showed unilateral oVEMP absences, 2 displayed bilateral oVEMP absences, 2 exhibited unilaterally decreased oVEMP, and 4 displayed normal oVEMP. All patients exhibited normal bilateral caloric responses. These findings were distinct from the results obtained for patients who experienced episodic lateral tilting sensations in previous studies. While most of the latter patients exhibited abnormal oVEMP, the patients in the present study tended to display abnormal cVEMP. These results suggest that patients with episodic tilting or translational sensations in the pitch plane suffer from saccular dysfunction. We propose "idiopathic otolithic vertigo" as a clinical entity and suggest that it is caused by idiopathic saccular dysfunction and/or utricular dysfunction.

Short-term retention effect of rehabilitation using head position-based electrotactile feedback to the tongue: influence of vestibular loss and old-age.

Our objective was to evaluate whether the severity of vestibular loss and old-age (>65) affect a patient's ability to benefit from training using head-position based, tongue-placed electrotactile feedback. Seventy-one chronic dizzy patients, who had reached a plateau with their conventional rehabilitation, followed six 1-h training sessions during 4 consecutive days (once on days 1 and 4, twice on days 2 and 3). They presented bilateral vestibular areflexia (BVA), bilateral vestibular losses (BVL), unilateral vestibular areflexia or unilateral vestibular losses and were divided into two age-subgroups (≤65 and >65). Posturographic assessments were performed without the device, 4h before and after the training. Patients were tested with eyes opened and eyes closed (EC) on static and dynamic (passively tilting) platforms. The studied posturographic scores improved significantly, especially under test conditions restricting either visual or somatosensory input. This 4-h retention effect was greater in older compared to younger patients and was proportional to the degree of vestibular loss, patients with increased vestibular losses showing greater improvements. In bilateral patients, who constantly fell under dynamic-EC condition at the baseline, the therapy effect was expressed by disappearance of falls in BVL and significant prolongation in time-to-fall in BVA subgroups. Globally, our data showed that short training with head-position based, tongue-placed electrotactile biofeedback improves balance in chronic vestibulopathic patients some 16.74% beyond that achieved with standard balance physiotherapy. Further studies with longer use of this biofeedback are needed to investigate whether this approach could have long-lasting retention effect on balance and quality of life.

Biofeedback improves postural control recovery from multi-axis discrete perturbations.

BACKGROUND: Multi-axis vibrotactile feedback has been shown to significantly reduce the root-mean-square (RMS) sway, elliptical fits to sway trajectory area, and the time spent outside of the no feedback zone in individuals with vestibular deficits during continuous multidirectional support surface perturbations. The purpose of this study was to examine the effect of multidirectional vibrotactile biofeedback on postural stability during discrete multidirectional support surface perturbations. METHODS: The vibrotactile biofeedback device mapped tilt estimates onto the torso using a 3-row by 16-column tactor array. The number of columns displayed was varied to determine the effect of spatial resolution upon subject response. Torso kinematics and center of pressure data were measured in six subjects with vestibular deficits. Transient and steady state postural responses with and without feedback were characterized in response to eight perturbation directions. Four feedback conditions in addition to the tactors off (no feedback) configuration were evaluated. Postural response data captured by both a force plate and an inertial measurement unit worn on the torso were partitioned into three distinct phases: ballistic, recovery, and steady state. RESULTS: The results suggest that feedback has minimal effects during the ballistic phase (body's outbound trajectory in response to the perturbation), and the greatest effects during the recovery (return toward baseline) and steady state (post-recovery) phases. Specifically, feedback significantly decreases the time required for the body tilt to return to baseline values and significantly increases the velocity of the body's return to baseline values. Furthermore, feedback significantly decreases root mean square roll and pitch sway and significantly increases the amount of time spent in the no feedback zone. All four feedback conditions produced comparable performance improvements. Incidences of delayed and uncontrolled responses were significantly reduced with feedback while erroneous (sham) feedback resulted in poorer performance when compared with the no feedback condition. CONCLUSIONS: The results show that among the displays evaluated in this study, no one tactor column configuration was optimal for standing tasks involving discrete surface perturbations. Feedback produced larger effects on body tilt versus center of pressure parameters. Furthermore, the subjects' performance worsened when erroneous feedback was provided, suggesting that vibrotactile stimulation applied to the torso is actively processed and acted upon rather than being responsible for simply triggering a stiffening response.

Vestibular evoked myogenic potential in unilateral vestibular hypofunction.

CONCLUSION: The patients with unilateral chronic vestibular hypofunction detected by caloric test demonstrated at least some sort of altered vestibular evoked myogenic potential (VEMP) in 63.63% of the cases. The VEMP altered side was the same as the unilateral vestibular hypofunction side in 54.54% of the cases and was the opposite side in 24.24%. The VEMP test improved functional vestibular assessment in patients with unilateral caloric hypofunction. OBJECTIVES: To analyze VEMP in patients with chronic dizziness and unilateral vestibular hypofunction and verify findings according to the side and structures involved. METHODS: This was an observational study. In all, 66 subjects were evaluated by VEMP (tone bursts/1000 Hz/100 dBnHL/bandpass filtered 10-1500 Hz/4.3 Hz rate), 33 with unilateral vestibular hypofunction, detected by caloric test and clinical data, and 33 control subjects, matched by gender and age. Amplitude of the p13-n23, asymmetry index of the amplitude, p13 and n23 latencies, p13 and n23 interaural difference and threshold were analyzed. Simple descriptive analysis was carried out using the t test, Shapiro-Wilks test, and Mann-Whitney test, p < 0.05. RESULTS: VEMP was altered in patients with unilateral vestibular hypofunction in 63.63% of cases. Thirteen of them were ipsilateral to the vestibular hypofunction and three were contralateral to the vestibular hypofunction. In five cases, VEMP were bilaterally altered.

The mitochondrial A3243G mutation involves the peripheral vestibule as well as the cochlea.

OBJECTIVES/HYPOTHESIS: To evaluate vestibular function in patients with the mitochondrial A3243G mutation. STUDY DESIGN: Data from patients with the A3243G mutation attending an academic tertiary referral center were prospectively recorded. METHODS: The clinical histories of 13 unrelated patients with the mitochondrial A3243G mutation (six mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes; and seven maternally inherited diabetes and deafness) were recorded, in particular their history of vestibular symptoms. Vestibular examinations including caloric testing and vestibular evoked myogenic potentials in response to air-conducted sound (ACS-VEMPs) were performed. In seven patients who showed abnormal ACS-VEMP, VEMP in response to galvanic stimuli (galvanic-VEMP) were also recorded. RESULTS: Eleven of the 13 patients had vestibular symptoms. The age of onset of vestibular symptoms was significantly later than the ages of onset of hearing loss and diabetes mellitus (P < .05). Ten of the 13 patients showed abnormal caloric responses, whereas 12 patients showed abnormal ACS-VEMPs on one or both sides. All of the seven patients who underwent galvanic-VEMP testing showed normal responses. CONCLUSIONS: The A3243G mutation is associated with vestibular dysfunction involving both the superior and inferior vestibular nerve systems. Furthermore, our results from galvanic-VEMP testing suggests that a labyrinthine lesion is primarily responsible for the symptoms of vestibular dysfunction.

Association of air-conducted sound oVEMP findings with cVEMP and caloric test findings in patients with unilateral peripheral vestibular disorders.

CONCLUSION: This study showed that the ocular vestibular evoked myogenic potential (oVEMP) in response to air-conducted sound (ACS) reflects functions of different parts of the vestibular labyrinth from cervical VEMP (cVEMP). OBJECTIVE: To determine whether the origin of the vestibular end organs of the oVEMP in response to ACS (500 Hz tone bursts) is the same as that of cVEMP. METHODS: Twenty patients definitively diagnosed with unilateral Meniere's disease (MD), 6 patients with unilateral vestibular neuritis (VN), and 7 healthy subjects were enrolled. In these subjects, the oVEMP and cVEMP to air-conducted 500 Hz tone bursts (125 dBSPL) were measured. The patients also underwent caloric tests. RESULTS: The MD patients did not show a significant association between their ACS oVEMP findings and ACS cVEMP findings but there was an association of ACS oVEMP findings with caloric test findings. When the MD patients were classified into four stages based on their hearing levels, the patients showed abnormal findings at earlier stages on ACS cVEMP than on other tests. While all six VN patients showed abnormal findings on ACS oVEMP and caloric tests, only two patients showed abnormal ACS cVEMPs. These findings support the hypothesis that the oVEMP in response to ACS predominantly reflects utricular functions while ACS cVEMP reflects saccular functions.

Ocular and cervical VEMPs: a study of 74 patients suffering from peripheral vestibular disorders.

OBJECTIVE: This study compared the results of ocular and cervical vestibular evoked myogenic potentials (VEMPs) tests for healthy subjects with those for patients suffering from vestibular diseases to try to determine the clinical usefulness of combined ocular and cervical STB VEMP testing. METHODS: Thirty-two healthy volunteers and 74 patients with unilateral vestibular dysfunction underwent tests for ocular and cervical VEMPs induced by AC 100 dB nHL 500 Hz STB combined with caloric and audiometric tests. RESULTS: In healthy subjects, the mean P13-N23 peak-to-peak amplitude of cervical VEMPs was much larger than the mean n1-p1 peak-to-peak amplitude of ocular VEMPs. In patients, cervical and ocular VEMPs may be dissociated. The peak-to-peak amplitude of both cervical and ocular tests was abnormally in most of patients suffering from vestibular lesions. No correlations were found between VEMPs, the degree of hearing loss and/or of horizontal canalar paresis. CONCLUSIONS: Ocular and cervical VEMPs provide complementary information about saccular and utricular otolithic function. SIGNIFICANCE: Testing of ocular and cervical VEMPs allows the crossed vestibulo-ocular reflex and ipsilateral sacculo-collic reflex to be determined. These tests can help describe vestibular lesions and assess the effects of treatment and should therefore be used clinically.

Application of autogenic training in patients with Ménière disease.

Data are limited on the role of psychotherapy in the treatment of Ménière disease. We sought to document the effect of a psychotherapeutic technique known as autogenic training on clinical outcome in Ménière disease. Six patients with Ménière disease were studied. Retrospective chart review was conducted. All patients were refractory to conventional therapy and completed a course of autogenic training, which was offered as a complementary treatment. Autogenic training with initial psychological counseling was conducted by a clinical psychologist during 45-min sessions. Outcome measures assessed were the frequency of vertigo and functional levels 2 years after initiation of autogenic training. Functional levels were evaluated according to the 1995 guidelines of the American Academy of Otolaryngology-Head Neck Surgery (AAO-HNS). As a personality measure, we used the Maudsley Personality Inventory (MPI), devised by Eysenck, which measures neuroticism (N), extraversion (E), and propensity to lie (L). Five of six patients showed improved functional level after three to eight sessions of psychotherapy; hearing level did not change. The score of the N scale of the MPI was closely related to the number of psychotherapy sessions. Prognosis was evaluated based on the AAO-HNS reporting guidelines, as follows: A = 3, B = 1, C = 1, F = 1. The value of N in MPI was closely related to the number of psychological counseling sessions (R = 0.97, P < 0.05). In conclusion, autogenic training may enhance the mental well-being of patients with Ménière disease and improve clinical outcome.

Does caloric vestibular stimulation modulate tinnitus?

Caloric vestibular stimulation (CVS) has been demonstrated to transiently modulate a variety of cognitive functions. These effects are associated with the brain activation induced by CVS, involving the temporal-parietal cortex, anterior cingulate cortex and insular cortex, which are thought to form a multimodal vestibular cortical network. The present study investigated the effect of CVS upon tinnitus. Twenty patients undergoing vestibular function tests for symptoms of imbalance and who reported tinnitus were asked to rate their tinnitus using visual analogue measures of pitch and intensity immediately before and after CVS (H(2)O at 44°C) in the ear ipsilateral to the tinnitus. One patient was excluded due to test findings indicative of a central vestibular abnormality. The mean VAS pitch (pre-post) changed from 5.65 to 5.28 (95% confidence interval (-0.87, 0.12), p-value 0.13) and the mean change in intensity changed from 5.21 to 4.43 (95% confidence interval (-1.60, 0.04), p-value 0.06). The findings indicate that there is no consistent influence of CVS upon tinnitus, and we propose that perceived pitch and intensity of tinnitus are independent of the multimodal vestibular network that is activated by CVS.

Contralateral Suppression of Transient Evoked Otoacoustic Emission in Vestibular Neuritis / 대한평형의학회지

BACKGROUND AND OBJECTIVES: The etiology of vestibular neuritis is unknown. Many investigators have suggested that this condition spares the inferior vestibular nerve system. However, others have reported that the lesion sometimes affects the inferior vestibular nerve system based on vestibular evoked myogenic potential. The function of the inferior vestibular nerve was studied in acute vestibular neuritis by monitoring medial olivocochlear bundle (MOCB) function. Under normal conditions, contralateral acoustic stimulation has inhibitory effects on ipsilateral otoacoustic emissions through the MOCB. MATERIALS AND METHODS: Twenty patients that presented with dizziness and spontaneous nystagmus, and were confirmed to have acute vestibular neuritis by rotatory chair and caloric testing were enrolled in this study. We evaluated the evoked otoacoustic emissions with and without contralateral acoustic stimulation in both ears in all patients. The percent loss of normal inhibitory action on otoacoustic emissions was determined in the normal and affected ears. RESULTS: All patients showed inhibitory effects in response to contralateral acoustic stimulation on evoked otoacoustic emissions in normal ears. Fifteen patients (75%) had an absence of contralateral suppression of otoacoustic emissions on the affected side. CONCLUSION: The findings of this study suggest the presence of dysfunction of the MOCB in patients with acute vestibular neuritis.

Sound-induced vertigo due to bone dehiscence of the lateral semicircular canal.

Dehiscence of the lateral semicircular canal (LSCD) has been reported much but mainly in association with cholesteatoma and canal wall down mastoidectomy, while idiopathic LSCD was rarely reported. Bassim reported one case with lateral semicircular canal dehiscence, but presented no vestibular or auditory symptoms. The patient in this study complained significant sound-induced vertigo and autophony in his right ear. The axis of nystagmus was orthogonal to the lateral semicircular canal, and no torsional or vertical motions were observed, so pathology of the lateral semicircular canal was preferentially considered. Benign paroxysmal positional vertigo was excluded since vertigo attacks had no relation to the change of head position. The dehiscence of the right lateral semicircular canal was then confirmed through the high-resolution temporal bone computer tomography scan and the reconstructed images. The cause of the LSCD is poorly understood, since no history of head trauma, otological infection or surgery was documented.