title: Sudden sensorineural hearing loss with simultaneous positional vertigo showing persistent geotropic direction-changing positional nystagmus.
abstract: OBJECTIVE
  To characterize the clinical features of patients who simultaneously developed ipsilateral sudden sensorineural hearing loss (SSNHL) and positional vertigo showing geotropic direction-changing positional nystagmus (DCPN) on a supine head-roll test, and to address the possible pathophysiology of the disease.
  
  
  METHODS
  Retrospective case series review.
  
  
  METHODS
  We conducted a retrospective case series study in 17 patients with SSNHL and simultaneous positional vertigo showing geotropic DCPN.
  
  
  RESULTS
  All 17 patients showed persistent geotropic DCPN without latency in the supine head-roll test. The intensity of nystagmus was stronger when the patient's head was turned to the lesion side of SSNHL in 15 of 17 patients. We sought to identify a null plane in nine patients, and the null plane was identified on the same side as the SSNHL in all nine patients, which was thought to be caused by the "light cupula" of the lateral semicircular canal in the same ear as the SSNHL.
  
  
  CONCLUSIONS
  A light cupula mechanism may be one of the causes of positional vertigo in patients with SSNHL. In these cases, persistent geotropic DCPN is observed in the supine head-roll test and the null plane can be identified on the same side as the hearing loss.
authors.affiliation: *Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea; and †Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Chang-Hee
authors.initials: CH
authors.lastname: Kim
authors.forename: Jee Min
authors.initials: JM
authors.lastname: Choi
authors.forename: Hyo Vin
authors.initials: HV
authors.lastname: Jung
authors.forename: Hong Ju
authors.initials: HJ
authors.lastname: Park
authors.forename: Jung Eun
authors.initials: JE
authors.lastname: Shin
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009759:Nystagmus, Pathologic / Q000503:physiopathology*; D012189:Retrospective Studies; D012665:Semicircular Canals / Q000503:physiopathology; D014717:Vertigo / Q000150:complications / Q000503:physiopathology*; D014724:Vestibular Function Tests; D055815:Young Adult