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Spatial orientation and disorientation in flight
Published in Nicholas Green, Steven Gaydos, Hutchison Ewan, Edward Nicol, Handbook of Aviation and Space Medicine, 2019
Nicholas Green, Steven Gaydos, Hutchison Ewan, Edward Nicol
G excess effect: Head movement when experiencing significant Gz may cause transient sensations of aircraft attitude change, commonly pitch up/down.Probably caused by atypical stimulation of otoliths; often worse with quick head movements.
Evaluation of Balance
Published in John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed, Paediatrics, The Ear, Skull Base, 2018
Another way of obtaining controlled stimulation of the otolith is to rotate the subject about an axis which is tilted (off-vertical axis rotation (OVAR)) or orthogonal (‘barbeque-spit rotation’) with respect to the gravitational vector; in these tests the stimulus is provided by the continuous reorientation of the head with respect to gravity.140,141 It is important to note that, whenever the linear acceleration is generated by rotation, the otolith response is assessed either by subtracting the component due to angular motion (e.g. subtracting head-eccentric response from head-centred response, in the head-eccentric test) or by waiting until the angular VOR has ceased (e.g. in OVAR or BBQ rotation). Finally, a simple way of stimulating the otoliths is head tilt with respect to gravity. This can be refined with precision gimbals systems (Figures 62.27a and b).142 A summary of the stimulation techniques for otolith assessment is presented in Figures 62.27, 62.28 and 62.29.
Geriatric Assessment and the Physical Examination of the Older Adult
Published in K. Rao Poduri, Geriatric Rehabilitation, 2017
Presbycusis is very common in the elderly. Hearing aids can facilitate the retention of cerumen. Refer to Section 2.5.14. Otoliths of the semicircular canals and the consequent positional vertigo are common causes of dizziness in the elderly.
Patterns of vestibular function in patients with dizziness after COVID-19 vaccination; dual tertiary referral center study
Published in Acta Oto-Laryngologica, 2022
Joonsik Yoon, Min Seok Song, Sang-Yeon Lee, Moo Kyun Park, Jun Ho Lee, Seung Ha Oh, Min Young Lee, Myung-Whan Suh
Four patients had a history of dizziness events 3–30 years ago (BPPV in two patients and vestibulopathy in two patients). However, the subjective feeling of dizziness was different from past dizziness events in all cases. Nystagmus, whether it was spontaneous or positional, was detected in all patients. Most of them were horizontal nystagmus. But two patients showed torsional and a patient showed vertical nystagmus (Table 2). Semicircular dysfunction was observed in all patients. The results of gains and the presence of catch-up saccade of three semicircular canals are shown in Table 3. Four patients showed unilateral gain decreases with horizontal nystagmus towards the contralesional side. Among them, two patients showed multicanal weakness (anterior and lateral), and canal paresis was observed in these patients. Meanwhile, otolith dysfunction was only observed in two patients. Concurrent acute sensory neural hearing loss was documented in one patient.
The effect of sport training on otolith function in adults with profound sensorineural hearing loss
Published in Hearing, Balance and Communication, 2021
Homa Zarrinkoob, Arash Bayat, Nasim Kaka
The absence and impairment of vestibular evoked potentials indicated otolithic dysfunction. However, in the analysis of the medical records of “non-athletes deaf” patients, neither the physicians nor the patients noticed balance dysfunctions or otolith involvements. It has been suggested that vestibular dysfunction in hearing-impaired individuals can be a debilitating condition that leads to oscillopsia, imbalance, and increased risk of falls [21]. Patients with vestibular deficit have difficulty conducting activities of daily living such as driving, climbing stairs, and walking, and these patients also report increased dependence on others, reduced life satisfaction, and decreased productivity [22–24]. Ernst et al. [25] also showed that younger patients with otolith dysfunction are at risk in their everyday life, especially when they are moving fast (e.g. in a car) without full visual control of the surrounding (e.g. in the dark).
An exploration of vestibular function pre and post unilateral cochlear implantation
Published in Cochlear Implants International, 2020
F. S. Obeidat, S. L. Bell, Eyles Julie
In the present study, there appeared to be an association between short-term dizziness and postoperative changes in VEMP responses in CI recipients, although the sample size is low. However, not all the implanted patients who showed loss of saccular or utricular function also suffered from dizziness postoperatively. The incidence of dizziness in the deaf patients was low and short-lived following implantation. Only three of the deaf patients (1, 4, and 7) reported some dizziness for a couple of days or weeks following surgery. (It should be noted that in the current study we relied on self-report of balance disorder using the VRBQ. Future work could include measurements of functional balance). In all these patients, otolith function was affected by implantation. This appears to be consistent with short-term dizziness resulting from a change in otolith function that is then compensated for. The short term dizziness associated with a change in VEMP responses also suggests that the VEMP response indicates underlying otolith function and is not simply altered due to a change in sound transmission from implantation.