Evidence of unilateral isolated utricular hypofunction.
CONCLUSIONS
The findings demonstrate that an enduring unilateral utricular dysfunction, possibly together with canal hypofunction, can occur after labyrinthine disease or injury. They also suggest that unilateral, isolated utricular dysfunction - or utricle paresis - can occur, representing a novel entity in the differential diagnosis of peripheral vestibular function. The occurrence of subjective visual vertical (SVV) asymmetry in the presence of symmetric vestibular evoked myogenic potentials (VEMPs) also confirms that the information from the utricles, rather than the saccules, dominates SVV estimation.


OBJECTIVE
To determine the incidence of unilateral utricular hypofunction.


METHODS
The retrospective clinical study deals with a selection of those vestibular patients who showed pathological responses to utricle testing. Peripheral vestibular function was examined in a group of 110 patients. Utricular function was evaluated by estimation of SVV during unilateral centrifugation. Bithermal caloric testing was performed to assess unilateral semicircular canal function. Saccular function was tested by measurement of VEMPs.


RESULTS
A total of 46 patients were found with asymmetric SVV findings (p < 0.001 for healthy versus lesioned ear), but symmetric caloric responses and VEMPs. Statistical testing also verified that their SVV asymmetry factors were significantly higher than those calculated for caloric responses and VEMPs (p < 0.001).
Schönfeld
Uwe
U
Department of Otorhinolaryngology, Charité, University Medicine Berlin, Berlin, Germany.
Helling
Kai
K
Clarke
Andrew H
AH
D000293:Adolescent; D000328:Adult; D002150:Caloric Tests; D003937:Diagnosis, Differential; D004576:Electromyography; D005071:Evoked Potentials / Q000502:physiology; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D006801:Humans; D007699:Kinesthesis / Q000502:physiology; D007759:Labyrinth Diseases / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D008575:Meniere Disease / Q000175:diagnosis* / Q000503:physiopathology; D008875:Middle Aged; D009334:Neck Muscles / Q000294:innervation; D009949:Orientation / Q000502:physiology; D010037:Otolithic Membrane / Q000503:physiopathology; D004856:Postural Balance / Q000502:physiology; D011434:Proprioception / Q000502:physiology; D012444:Saccule and Utricle / Q000503:physiopathology*; D012815:Signal Processing, Computer-Assisted; D014724:Vestibular Function Tests; D014725:Vestibular Nerve / Q000503:physiopathology; D055815:Young Adult