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Anatomy and Physiology of Balance
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Nishchay Mehta, Andrew Forge, Jonathan Gale
The vestibular system is housed in the labyrinth of each ear. The main components of the vestibular system are three semicircular canals and two otolith organs (utricle and saccule). The three semicircular canals (superior, posterior, and lateral) detect angular acceleration in orthogonal planes. The utricle and saccule detect linear acceleration in primarily horizontal and vertical planes, respectively, as well as head position in relation to gravity.
Dizziness
Published in Henry J. Woodford, Essential Geriatrics, 2022
The labyrinthine structures form a key part of the peripheral vestibular system. They include three semi-circular canals that contain sensory structures and fluid (seeFigure 13.2). They are able to detect rotational movement. Benign paroxysmal positional vertigo (BPPV) is caused by free-floating debris within these semi-circular canals that causes inappropriate activation of the sensory structures. It presents as acute episodes of short-lasting vertigo (seconds to minutes) often induced by specific movements such as rolling over in bed or looking up to hang out washing. There may be associated nausea and vomiting. It can be diagnosed by the Hallpike test – seeFigure 13.3. It is best treated by the Epley manoeuvre – a series of movements that transfer the debris within the semi-circular canal into the utricle where it no longer causes any symptoms.7
Principles of neuromotor development
Published in Mijna Hadders-Algra, Kirsten R. Heineman, The Infant Motor Profile, 2021
Mijna Hadders-Algra, Kirsten R. Heineman
The vestibular system assists human beings in spatial orientation and balance control. Structural development of the labyrinth with its semicircular canals and otoliths (responsible for the detection of angular and linear acceleration, respectively) occurs in large part during the first half of gestation (Jeffery and Spoor 2004). The presence of the vestibularocular reflex and the Moro reflex in preterm infants indicates that the vestibular system is functionally active prior to term age (Dubowitz et al. 1999; vestibular-ocular reflex: personal observation).
Diffusion tensor imaging and auditory tractography to evaluate cochlear implant candidacy: a pilot study
Published in Acta Oto-Laryngologica, 2023
Badr E. Mostafa, Yasser Abdel Azim, Lobna Elfiky
M.A, 3 years old boy with bilateral profound SNHL. Right side showed IP 1 associated with a single vestibulocochlear nerve and a small nerve passing through the widened cochlear aperture. Left sided showed CH 4, with markedly stenotic internal auditory canal and absent or significantly hypoplastic left cochlear nerve. There were abnormalities of the vestibular system. Cochlear nuclei, SOC, IC, MGB, thalamic nuclei and Heschel’s gyrus all showed mild subvolumia bilaterally. There was reduced FA and abnormally elevated ADC of both auditory tracts. There was mildly larger and more robust representation of the left side compared to the right side, which would indicate better status of right ear controlled by the left auditory area Heschel’s gyrus. Findings suggest possible indication for right sided implantation (Figure 4).
Comparison between caloric and video-head impulse tests in Ménière’s disease and vestibular neuritis
Published in International Journal of Audiology, 2023
András Molnár, Stefani Maihoub, László Tamás, Ágnes Szirmai
A total of 109 patients (24 men, 85 women; mean age: 55.6 n = 26) and vestibular neuritis of the superior parts of the vestibular nerve (n = 27) were examined. Fifty-six patients with a normal vestibular system were also examined as controls. The latter group had been referred to neurotology for suspected sensorineural hearing loss and/or tinnitus without evidence of vertigo, dizziness, or other vestibular symptoms and had undergone a complete neurotological examination that failed to indicate any pathologies in vestibular function. In our clinical expertise, this group of patients always undergoes a detailed neurotological examination; therefore, sufficient clinical data were available to include them as a control group.
Vestibular function in children with generalized epilepsy and treated with valproate
Published in Expert Review of Clinical Pharmacology, 2022
Sherifa Ahmed Hamed, Amira Mohamed Osiely
The vestibular system is divided into peripheral and central components. The peripheral component is composed of the semicircular canals, otolith (saccule and utricle) organs and the superior and inferior vestibular nerves. The central component begins from the point of entrance of vestibular nerves to the brainstem, the medial and lateral vestibular nuclei and the central inter-relations and connections to the thalamus and cerebral cortex. The semicircular canals sense horizontal angular head accelerations. Their afferents project to the medial vestibular nuclei via the vestibulo-ocular reflex (VOR). They provide reflexive ocular motor responses for maintenance of gaze stability. The otolith organs sense linear acceleration and static tilt in relation to gravity. Their afferents project to the lateral vestibular nucleus via the vestibulo-spinal reflex (VSR) for postural control and via connections to the cerebellar neurons, thalamus, and higher-cortical areas for balance, self-motion, and gravity direction [14].