Skull vibration induced nystagmus in patients with superior semicircular canal dehiscence

G. Dumas, H. Tan, L. Dumas, P. Perrin, A. Lion, S. Schmerber*

*Corresponding author for this work

    Research output: Contribution to journalArticleResearchpeer-review

    24 Citations (Scopus)

    Abstract

    Objective: To establish optimum stimulus frequency and location of bone conducted vibration provoking a skull vibration induced nystagmus (SVIN) in superior semi-circular canal dehiscences. Methods: SVIN 3D components in 40 patients with semi-circular canal dehiscence (27 unilateral and 13 bilateral) were compared with a group of 18 patients with severe unilateral vestibular loss and a control group of 11 volunteers. Results: In unilateral semi-circular canal dehiscences, SVIN torsional and horizontal components observed on vertex location in 88% beat toward the lesion side in 95%, and can be obtained up to 800 Hz (around 500 Hz being optimal). SVIN slow-phase-velocity was significantly higher on vertex stimulation at 100 and 300 Hz (P = 0.04) than on mastoids. SVIN vertical component is more often upbeating than downbeating. A SVIN was significantly more often observed in unilateral than bilateral semi-circular-canal dehiscences (P = 0.009) and with a higher slow phase velocity (P = 0.008). In severe unilateral vestibular lesions the optimal frequency was 100 Hz and SVIN beat toward the intact side. The mastoid stimulation was significantly more efficient than vertex stimulation at 60 and 100 Hz (P < 0.01). Conclusion: SVIN reveals instantaneously in unilateral semi-circular canal dehiscences a characteristic nystagmus beating, for the torsional and horizontal components, toward the lesion side and with a greater sensitivity toward high frequencies on vertex stimulation. SVIN three components analysis suggests a stimulation of both superior semi-circular canal and utricle. SVIN acts as a vestibular Weber test, assessing a vestibular asymmetrical function and is a useful indicator for unilateral semi-circular canal dehiscence.

    Original languageEnglish
    Pages (from-to)263-272
    Number of pages10
    JournalEuropean Annals of Otorhinolaryngology, Head and Neck Diseases
    Volume136
    Issue number4
    DOIs
    Publication statusPublished - Sept 2019

    Keywords

    • High frequencies stimulations
    • Severe unilateral vestibular lesion
    • Skull vibration induced nystagmus
    • Superior canal dehiscence
    • SVIN optimal frequency
    • SVIN optimal location

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