Alvarez-Gomez, L. (Laura)
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- Vestibulo-cochlear fuction after cochlear implantation in patients with Meniere's disease(European Academy of Otology and Neuro-Otology, 2018) Manrique, M. (Manuel); Manrique-Huarte, R. (Raquel); Perez-Fernandez, N. (Nicolás); Calavia, D. (Diego); Alvarez-Gomez, L. (Laura); Huarte-Irujo, A. (Alicia)OBJECTIVES: To measure the auditory (pure tone audiometry and word recognition scores) and vestibular (video head impulse test and vestibular myogenic potentials) outcomes in patients diagnosed with Meniere’s disease (MD) who underwent cochlear implantation. MATERIAL AND METHODS: This prospective study included 23 cochlear implant users with MD and 29 patients diagnosed with far-advanced otosclerosis (the control group). RESULTS: The preoperative mean pure tone average thresholds were 99 and 122.5 dB for the Meniere’s and control groups, respectively. Word recognition scores after cochlear implant yielded a median of 80% and 72% for the Meniere’s and control groups, respectively. Semicircular canal gain was not observed to vary post implantation (mean variation for lateral, posterior, and anterior plane was 0, 0.03, and 0, respectively). The mean ocular and cervical myogenic potentials asymmetry varied as 9.65% and 18.39%, respectively. CONCLUSIONS: The auditory performance improved in patients with MD similar to the general cochlear implant population. No major dysfunction of otolithic or semicircular canal function was demonstrated after the implantation surgery
- Endolymphatic hydrops severity in magnetic resonance imaging evidences disparate vestibular test results(Elsevier, 2019) Garcia-de-Eulate, R. (Reyes); Domínguez-Echávarri, P.D. (Pablo Daniel); Manrique-Huarte, R. (Raquel); Perez-Fernandez, N. (Nicolás); Calavia, D. (Diego); Arbizu, L. (Lorea); Zubieta, J.L. (José L.); Alvarez-Gomez, L. (Laura); Guajardo-Vergara, C. (Carlos)Objectives: It has been suggested that in Ménière’s disease (MD) a dissociated result in the caloric test (abnormal result) and video head-impulse test (normal result) probably indicates that hydrops affects the membranous labyrinth in the horizontal semicircular canal (HSC). The hypothesis in this study is that based on endolymphatic hydrops’ cochleocentric progression, hydrops should also be more severe in the vestibule of these patients than in those for whom both tests are normal. Methods: 22 consecutive patientswith unilateral definiteMDwere included and classified as NNif both tests were normal or AN if the caloric test was abnormal. MRI evaluation of endolymphatic hydrops was carried out with a T2-FLAIR sequence performed 4 h after intravenous gadolinium administration. The laterality and degree of vestibular endolymphatic hydrops and the presence or absence of cochlear endolymphatic hydrops were recorded. Demographic data, audiometric and vestibular evoked myogenic potentials were collected, and video head-impulse and caloric tests were performed. Results: Patients in both groups (NN and AN) were similar in terms of demographic data and hearing loss. The interaural asymmetry ratio was significantly higher for ocular and cervical VEMP in patients in the AN group. There was a significantly higher degree of hydrops in the vestibule of the affected ear of AN patients (x2 ; p = 0.028). Conclusion: Significant canal paresis in the caloric test is associated with more severe endolymphatic hydrops in the vestibule as detected with gadolinium-enhanced MRI and with a more severe vestibular deficit.
- Bilateral Vestibular Hypofunction in the Time of the Video Head Impulse Test(2020) Manrique-Huarte, R. (Raquel); Perez-Fernandez, N. (Nicolás); Alvarez-Gomez, L. (Laura)Objectives: Bilateral vestibulopathy is a clinical syndrome in which laboratory testing plays a crucial diagnostic role. We aimed to establish the frequency of detection of that finding in a tertiary level hospital considering the new methods of laboratory vestibular examination nowadays in use, with respect to the conventional caloric and rotatory chair test approaches. Design: Two similar time periods (5 years) were retrospectively evaluated, and the demographic, clinical data and test results from 4,576 patients were reviewed. In the first period, the diagnosis was based on caloric and rotatory chair tests and, in the second, on the video head impulse test. Results: Of the patients included, 3.77% in the first period and 4.58% in the second met the criteria for bilateral vestibular hypofunction; there was no significant difference between both periods. Conclusions: The functional vestibular evaluation to detect bilateral deficiency makes no significant difference to the number of patients diagnosed with a bilateral vestibulopathy. New diagnostic categories probably depend not only on the availability and accessibility of complete vestibular and visual-vestibular evaluation, but also on recent advances in defining vestibular disorders. Bilateral vestibular hypofunction manifests with very different patterns. Progress in more detailed definition (clinical and laboratory) is needed, in particular when all 6 semicircular canals and both maculae are available for testing.