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Positional Audiometry in Patients with Light Cupula: A Preliminary Study

Research in Vestibular Science 2020년 19권 3호 p.89 ~ 94
이지연, 이동한, 신정은, 김창희,
소속 상세정보
이지연 ( Lee Ji-Yeon ) - Konkuk University School of Medicine Konkuk University Medical Center Department of Otorhinolaryngology-Head and Neck Surgery
이동한 ( Lee Dong-Han ) - Konkuk University School of Medicine Konkuk University Medical Center Department of Otorhinolaryngology-Head and Neck Surgery
신정은 ( Shin Jung-Eun ) - Konkuk University School of Medicine Konkuk University Medical Center Department of Otorhinolaryngology-Head and Neck Surgery
김창희 ( Kim Chang-Hee ) - Konkuk University School of Medicine Konkuk University Medical Center Department of Otorhinolaryngology-Head and Neck Surgery

Abstract


Objectives: Light cupula is characterized by persistent geotropic direction-changing positional nystagmus in a supine head-roll test. The purpose of this study is to investigate if hearing level is influenced by the change of head position in light cupula under the assumption that relative density difference similarly occurs between the tectorial membrane and endolymph.

Method: Twelve patients with unilateral light cupula who underwent positional audiometry were included in this study. Pure tone thresholds were compared among three head positions.

Results: Hearing threshold in pure tone audiometry (PTA) of the affected ear was not different from that of the healthy ear. PTA thresholds of the affected side were not significantly different in three head positions; upright seating, cochlear apex-up, and cochlear apex-down positions.

Conclusions: Although positional change of nystagmus direction is the most significant clinical feature of light cupula, positional change of hearing level was not observed in those patients. The lack of positional influence on hearing may be explained as follows: (1) the heavier endolymph phenomenon occurs only in the vestibular end organ without involving the cochlea; (2) the light cupula phenomenon is more likely to occur due to light debris mechanism rather than heavier endolymph or lighter cupula mechanism; and (3) the effects of light cupula could be modified by outer hair cells, which work for tuning in the cochlea, even though light tectorial membrane or heavy endolymph occurs.

키워드

Light cupula; Positional audiometry; Vertigo; Nystagmus; Hearing loss

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