ORIGINAL RESEARCH
Acute Vestibular Findings in Patients with Vestibular Neuritis
Vestibüler Nöritli Hastalarda Akut Dönem Vestibüler Bulgular
Received Date : 10 Apr 2025
Accepted Date : 20 May 2025
Available Online : 17 Jun 2025
Ercan KARABABAa,b, Hatice Kübra BOZKURTa,b, Bülent SATARc
aUniversity of Health Sciences Gülhane Faculty of Health Sciences, Department of Audiology, Ankara, Türkiye
bUniversity of Health Sciences, Gülhane Training and Research Hospital, Department of Otorhinolaryngology, Ankara, Türkiye
cUniversity of Health Sciences, Gülhane Faculty of Medicine, Department of Otorhinolaryngology, Ankara, Türkiye
Doi: 10.24179/kbbbbc.2025-111170 - Makale Dili: EN
Journal of Ear Nose Throat and Head Neck Surgery. 2025;33(3):115-20.
Copyright © 2020 by Turkey Association of Society of Ear Nose Throat and Head Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: This study aimed to analyze static and dynamic
vestibular dysfunction in the acute phase of vestibular neuritis
(VN) using videonystagmography (VNG). Material and Methods:
Twenty-one patients (11 females, 10 males) aged between 20-63 years,
who were diagnosed with VN and presented within 72 hours of symptom
onset without having received any medical treatment, were included.
The VNG test protocol involved the assessment of spontaneous
nystagmus, gaze-evoked nystagmus, Head Shake Test (HST), Head
Roll Test (HRT), and Dix-Hallpike Test (DH). The slow phase velocity
(SPV) of the nystagmus observed in each test was measured and analyzed.
Results: The mean age of the participants was 44.14±14.63
years, with no significant age difference between females and males
(p>0.05). Spontaneous nystagmus was observed to the right in 10 patients
(47.64%) and to the left in 11 patients (52.38%). Correlation analysis
showed a moderate positive correlation between spontaneous
nystagmus SPV and gaze right nystagmus (p=0.019), as well as left
HRT (p=0.005). A strong positive correlation was found between spontaneous
nystagmus SPV and HST, supine HRT, right HRT, right DH,
and left DH (p=0.001). Conclusion: Our findings suggest that the maximum
SPV of spontaneous nystagmus in VN shows strong positive correlations
with dynamic vestibular tests, reflecting asymmetric
involvement of the vestibular system. Re-recording spontaneous nystagmus
in the supine HRT position may improve directionality analysis
and aid in the more accurate interpretation of caloric test results.
Keywords: Vestibular neuritis; positional test; spontaneous nystagmus; gaze; acute
ÖZET
Amaç: Vestibüler nörit (VN) tanılı hastalarda, videonistagmografi
(VNG) kullanılarak akut dönem vestibüler disfonksiyonun statik
ve dinamik testlerde analiz edilmesi amaçlanmıştır. Gereç ve Yöntemler:
Çalışmaya, VN tanısı almış, semptom başlangıcından itibaren
72 saat içinde başvuran ve herhangi bir medikal tedavi almamış, yaşları
20-63 arasında değişen toplam 21 hasta (11 kadın, 10 erkek) dâhil
edilmiştir. VNG test protokolü kapsamında spontan nistagmus, gaze
nistagmus, Baş Sallama Testi (HST), Baş Yuvarlama Testi (HRT) ve
Dix-Hallpike Testi (DH) uygulanmıştır. Tüm testlerde nistagmusun
yavaş faz hızı [slow phase velocity (SPV)] ölçülerek analiz edilmiştir.
Bulgular: Katılımcıların yaş ortalaması 44,14±14,63 yıl olup, kadın ve
erkek katılımcılar arasında yaş açısından anlamlı bir fark saptanmamıştır
(p>0,05). Spontan nistagmus yönü 10 hastada (%47,64) sağa, 11
hastada (%52,38) sola doğru izlenmiştir. Korelasyon analizinde, spontan
nistagmus SPV’si ile gaze sağ nistagmus (p=0,019) ve sol HRT
(p=0,005) arasında orta düzeyde, baş sallama nistagmusu, supin HRT,
sağ HRT, sağ DH ve sol DH arasında yüksek düzeyde pozitif yönde
korelasyon bulunmuştur (p=0,001). Sonuç: Bulgularımız, VN’de spontan
nistagmusun maksimum SPV’nin dinamik vestibüler testlerle yüksek
düzeyde pozitif korelasyon gösterdiğini ve vestibüler sistemin
asimetrik tutulumunu yansıttığını ortaya koymuştur. Supin HRT pozisyonunda
spontan nistagmus kaydının yeniden yapılması, yön üstünlüğü
analizinin daha doğru gerçekleştirilmesine katkı sağlayabilir ve
kalorik test sonuçlarının daha sağlıklı yorumlanmasını mümkün kılabilir.
Anahtar Kelimeler: Vestibüler nörit; pozisyonel test; spontan nistagmus; gaze; akut
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