Clinical characteristics in unilateral vestibular atelectasis
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Clinical characteristics in unilateral vestibular atelectasis Morgane Marc1 · Charlotte Hautefort1 · Jean‑Pierre Guichard2 · Philippe Herman1 · Emmanuel Houdart2 · Michel Toupet3 · Michael Eliezer2 Received: 9 April 2020 / Revised: 3 September 2020 / Accepted: 5 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Introduction Unilateral vestibular atelectasis (UVA), an entity first described by Merchant and Schuknecht in 1988, has rarely been reported in vivo as of yet. We specify here the clinical characteristics of 22 patients diagnosed with UVA. Materials and methods Patients with a radiological diagnosis of UVA who underwent delayed inner ear MRI were included between April 2017 and January 2020. Full clinical testing including ocular infrared video-oculography, oVEMPs, cVEMPs, vHIT, bithermal caloric testing and auditory testing was performed. Results There were 13 men and 9 women, of mean age 58.6 ± 13.7 years. Onset was more frequently sudden (73%) than insidious (27%) though both clinical presentations were reported, and positional vertigo was described in 41% of cases. There were only two (9%) patients reporting Tullio’s phenomenon. Vestibular testing showed that in 90% of cases, there was utricular dysfunction on oVEMP, while in 77% of cases, saccular function was preserved on cVEMP. vHIT showed highvelocity canal function impairment in all 22 patients: 8 patients (36%) had one impaired canal, 5 (23%) had two and 9 (41%) had all three canals affected. Caloric tests found complete unilateral areflexia, in 65% of tested cases, and partial deficiency in 35% of cases. Nine patients (40%) displayed asymmetrical hearing. Conclusion We described in this study the various clinical presentations of a disease rarely reported in vivo, UVA. Initial clinical presentation can appear similar to an acute vestibular deficit, a recurrent positional vertigo, or fluctuating dizziness. Keywords Vestibular atelectasis · Endolymphatic hydrops · cVEMP · oVEMP · Acute vestibular syndrome · Positional vertigo
Introduction Unilateral vestibular atelectasis (UVA) is an entity first described by Merchant and Schuknecht in a histopathological study as the unilateral collapse of the ampullas and utricle as the only reasonable explanation for the clinical history of vertigo [1]. It is characterized as one of two types: Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00415-020-10220-y) contains supplementary material, which is available to authorized users. * Michael Eliezer [email protected] 1
Department of Head and Neck Surgery, Lariboisière University Hospital, Paris, France
2
Neuroradiology Unit, Department of Neuroradiology, Lariboisière University Hospital, 75010 Paris, France
3
Centre d’Explorations Fonctionnelles Otoneurologiques, Paris, France
a primary type, of which there are two forms of onset, paroxysmal and insidious; and a secondary type, occurring in patients with previously known inner
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