J Am Acad Audiol
DOI: 10.1055/s-0044-1791208
Case Report

Selective Bilateral Posterior Canal Dysfunction: A Case Series Investigation into the Clinical Trends and Associative Factors

Evalena R. Behr
1   Section of Audiology, Vestibular and Balance Disorders Program, Head and Neck Department, Integrated Surgical Institute, Cleveland Clinic, Cleveland, Ohio
,
Julie A. Honaker
1   Section of Audiology, Vestibular and Balance Disorders Program, Head and Neck Department, Integrated Surgical Institute, Cleveland Clinic, Cleveland, Ohio
› Institutsangaben

Abstract

Background The video head impulse test measures high-frequency vestibulo-ocular function of all six semicircular canals. Isolated semicircular canal dysfunction has been correlated with several peripheral and central vestibular etiologies. Selective bilateral posterior canal dysfunction is a trend seen in the clinical setting but less commonly reported in the medical literature.

Purpose The purpose of this work is to explore the clinical profile of bilateral posterior canal dysfunction along with other presenting factors such as hearing loss, increased age, and associated nystagmus patterns.

Method A case series of three patients (age range: 67–74 years) is presented to illustrate the similarities and clinical associations between vestibular and balance history, medical history, and vestibular test results.

Results All three patient cases presented with below reference range posterior semicircular canal function on video head impulse testing. Two patients also presented with down-beating nystagmus, and two endorsed subjective hearing loss while the third presented with presbycusis.

Conclusion Selective bilateral posterior canal dysfunction in association with advanced age, presbycusis, and signs of down-beating nystagmus may be associated with vestibulocochlear degenerative processes. Yet, central disorders, technical and patient factors may present clinical challenges to elucidate the cause.

Previous Presentation

A portion of this manuscript was presented as a poster at the 2022 American Academy of Audiology 2023 Annual Conference, Seattle, WA.




Publikationsverlauf

Eingereicht: 14. September 2023

Angenommen: 15. Dezember 2023

Artikel online veröffentlicht:
16. Dezember 2024

© 2024. American Academy of Audiology. This article is published by Thieme.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Büki B, Hanschek M, Jünger H. Vestibular neuritis: involvement and long-term recovery of individual semicircular canals. Auris Nasus Larynx 2017; 44 (03) 288-293
  • 2 Mukherjee P, Chiarovano E, Cheng K, Manzari L, McGarvie LA, MacDougall HG. Video-head impulse test in superior canal dehiscence. Acta Otolaryngol 2021; 141 (05) 471-475
  • 3 Castellucci A, Malara P, Brandolini C. et al. Isolated horizontal canal hypofunction differentiating a canalith jam from an acute peripheral vestibular loss. Am J Otolaryngol 2019; 40 (02) 319-322
  • 4 Castellucci A, Botti C, Martellucci S. et al. Spontaneous upbeat nystagmus and selective anterior semicircular canal hypofunction on video head impulse test: a new variant of canalith jam?. J Audiol Otol 2022; 26 (03) 153-159
  • 5 Chen L, Halmagyi GM. Central lesions with selective semicircular canal involvement mimicking bilateral vestibulopathy. Front Neurol 2018; 9: 264
  • 6 Castellucci A, Piras G, Del Vecchio V, Ferri GG, Ghidini A, Brandolini C. Which inner ear disorders lie behind a selective posterior semicircular canal hypofunction on video head impulse test?. Otol Neurotol 2021; 42 (04) 573-584
  • 7 Tarnutzer AA, Bockisch CJ, Buffone E, Weber KP. Association of posterior semicircular canal hypofunction on video-head-impulse testing with other vestibulo-cochlear deficits. Clin Neurophysiol 2017; 128 (08) 1532-1541
  • 8 Lee J-Y, Lee YW, Chang SO, Kim M-B. Vestibular function analysis of sudden sensorineural hearing loss with dizziness. J Vestib Res 2020; 30 (03) 203-212
  • 9 Seo HW, Chung JH, Byun H, Lee SH. Vestibular mapping assessment in idiopathic sudden sensorineural hearing loss. Ear Hear 2022; 43 (01) 242-249
  • 10 Guerra Jiménez G, Pérez Fernández N. Reduction in posterior semicircular canal gain by age in video head impulse testing. Observational study. Acta Otorrinolaringol Esp 2016; 67 (01) 15-22
  • 11 Lerchundi F, Laffue AH, Olivier M, Gualtieri FJ. Bilateral posterior semicircular canal dysfunction: a new finding with video head impulse test. J Neurol 2020; 267 (08) 2347-2352
  • 12 Leigh R, Zee D. The Neurology of Eye Movements Fourth Edition. Contemporary Neurology Series. 2006; 70 (01) All-All
  • 13 Curthoys IS, McGarvie LA, MacDougall HG. et al. A review of the geometrical basis and the principles underlying the use and interpretation of the video head impulse test (vHIT) in clinical vestibular testing. Front Neurol 2023; 14: 1147253
  • 14 Maeda Y, Takao S, Abe-Fujisawa I, Kariya S, Ando M. Relationship between spontaneous nystagmus and video head impulse test findings among patients with chronic neurotologic conditions. J Clin Neurosci 2022; 99: 244-247
  • 15 Glasauer S, von Lindeiner H, Siebold C, Büttner U. Vertical vestibular responses to head impulses are symmetric in downbeat nystagmus. Neurology 2004; 63 (04) 621-625
  • 16 Walker MF, Zee DS. Asymmetry of the pitch vestibulo-ocular reflex in patients with cerebellar disease. Ann N Y Acad Sci 2005; 1039 (01) 349-358
  • 17 Halmagyi GM, Chen L, MacDougall HG, Weber KP, McGarvie LA, Curthoys IS. The video head impulse test. Front Neurol 2017; 8: 258
  • 18 Mantokoudis G, Saber Tehrani AS, Kattah JC. et al. Quantifying the vestibulo-ocular reflex with video-oculography: nature and frequency of artifacts. Audiol Neurotol 2015; 20 (01) 39-50
  • 19 Jay DR, Cane D, Howe S. Age is a greater influence on small saccades than target size in normal subjects on the horizontal video head impulse test. Front Neurol 2019; 10: 328
  • 20 Janky KL, Patterson JN, Shepard NT, Thomas MLA, Honaker JA. Effects of device on video head impulse test (vHIT) gain. J Am Acad Audiol 2017; 28 (09) 778-785
  • 21 Patterson J, Rodriguez A, Barin K, Janky KL. Effect of gaze angle during the vertical video head impulse test across two devices in healthy adults and subjects with vestibular loss. Otol Neurotol 2020; 41 (06) e751-e758
  • 22 Patterson JN, Bassett AM, Mollak CM, Honaker JA. Effects of hand placement technique on the video head impulse test (vHIT) in younger and older adults. Otol Neurotol 2015; 36 (06) 1061-1068
  • 23 Janky KL, Patterson J, Shepard N. et al. Video head impulse test (vHIT): the role of corrective saccades in identifying patients with vestibular loss. Otol Neurotol 2018; 39 (04) 467-473