European Archives of Oto-Rhino-Laryngology

, Volume 270, Issue 8, pp 2207–2214 | Cite as

Involvement of peripheral vestibular nerve in individuals with auditory neuropathy

  • Sujeet Kumar Sinha
  • Animesh Barman
  • Niraj Kumar Singh
  • G. Rajeshwari
  • R. Sharanya
Otology

Abstract

The vestibulocochlear nerve is a sensory nerve that serves the organs of hearing and equilibrium. Neuropathies of the nerve, particularly auditory neuropathy may be caused by primary demyelination or by axonal diseases. In disorders affecting the cochlear nerve, it is probable that the vestibular nerve is involved as well. There are isolated reports of the involvement of the inferior vestibular nerve (using vestibular-evoked myogenic potentials) in individuals with AN. However, there is a dearth of information on the involvement of the superior vestibular nerve and other functions such as optokinetic, saccade and vestibulo-occular reflex. A total of three subjects diagnosed as having auditory neuropathy, underwent an extensive vestibular assessment consisting of clinical tests of stability (Romberg, Fukuda stepping test), administration of dizziness questionnaire developed by Maryland hearing and balance centre, cervical vestibular-evoked myogenic potentials and a standard electronystagmography test battery. In the present study, the entire subject population assessed showed hypofunctional caloric responses and absent VEMPs. Two out of the three subjects were asymptomatic of vestibular dysfunction. On the clinical tests of stability, two subjects showed deviations to the right, while one subject performed normally. Thus, the present study indicates a possible involvement of peripheral vestibular nerve involvement in individuals with auditory neuropathy.

Keywords

Auditory neuropathy Vestibular-evoked myogenic potentials Electronystagmography Vestibular neuropathy 

References

  1. 1.
    Sheykholeslami K, Kaga K, Murofushi T, Hughes DW (2000) Vestibular function in auditory neuropathy. Acta Otolaryngol (Stockh) 120:849–854CrossRefGoogle Scholar
  2. 2.
    Starr A, Picton TW, Sininger Y, Hood LJ, Berlin CI (1996) Auditory neuropathy. Brain 119:741–753PubMedCrossRefGoogle Scholar
  3. 3.
    Davis H, Hirsh SK (1979) A slow brainstem response for low frequency audiometry. Audiology 18:445–465PubMedCrossRefGoogle Scholar
  4. 4.
    Berlin CI, Hood LJ, Goforth-Barter L, Bordelon J (1999) Clinical application of auditory efferent studies. In: Berlin CI (ed) The efferent auditory system: basic sciences and clinical applications. Singular-Thompson Learning, San Diego, pp 105–124Google Scholar
  5. 5.
    Tang TPY, McPherson B, Yuen KCP, Wong LLN, Lee JSM (2004) Auditory neuropathy/auditory dys-synchrony in school children with hearing loss: frequency of occurrence. Int J Pediatr Otorhinolaryngol 68:175–183PubMedCrossRefGoogle Scholar
  6. 6.
    Kumar UA, Jayram MM (2006) Prevalence and audiological characteristics in individuals with auditory neuropathy/auditory dys-synchrony. Int J Audiol 45:360–366PubMedCrossRefGoogle Scholar
  7. 7.
    Fujikawa S, Starr A (2000) Vestibular neuropathy accompanying auditory and peripheral neuropathies. Arch Otolaryngol Head Neck Surg 126:1463–1456Google Scholar
  8. 8.
    Sheykholeslami K, Schmerber S, Kermany MH, Kaga K (2005) Sacculo-collic pathway dysfunction accompanying auditory neuropathy: case report. Acta Otolaryngol (Stockh) 125:786–791CrossRefGoogle Scholar
  9. 9.
    Kumar K, Sinha SK, Singh NK, Bharti AK, Barman A (2007) Vestibular evoked myogenic potential as a tool to identify vestibular involvement in auditory neuropathy. Asia P J Sp Lang Hear 10(3):181–187Google Scholar
  10. 10.
    Kaga K (2009) Auditory nerve disease, new classification: auditory and vestibular neuropathy. In: Kaga K, Starr A (eds) Neuropathy of the auditory and vestibular eighth cranial nerves. Springer Press, Japan, pp 13–20CrossRefGoogle Scholar
  11. 11.
    Kumar K, Sinha SK, Bharti AK, Barman A (2011) Comparison of vestibular evoked myogenic potentials elicited by click and short duration tone burst stimuli. J Laryngol Otol 125:343–347PubMedCrossRefGoogle Scholar
  12. 12.
    Claussen CF, von Schlachta I (1972) Butterfly chart for caloric nystagmus evaluation. Archives of Otolaryngol 96:371–375CrossRefGoogle Scholar
  13. 13.
    Kirtane MV, Merchant SN, Medikeri SB (1986) Experiences with butterfly chart. J Laryngol Otol 02:157–164CrossRefGoogle Scholar
  14. 14.
    Starr A, Michalewski HJ, Zeng FG, Fujikawa-Brooks S, Linthicum F, Kim CS, Winnier D, Keats B (2003) Pathology and physiology of auditory neuropathy with a novel mutation in the MPZ gene (Tyr145-Ser). Brain 126:1604–1619PubMedCrossRefGoogle Scholar
  15. 15.
    Quarles RH, Macklin WB, Morell P (2006) Myelin formation, structure and biochemistry. In: Siegel G, Albers RW, Brady S, Price D (eds) Basic neurochemistry, 7th edn. Elsevier Academic Press, London, pp 51–72Google Scholar
  16. 16.
    Babin RW, Liu C, Aschenbrener C (1984) Histopathology of sensory deafness in neurosarcoidosis. Ann Otol Rhinol Laryngol 93:389–393PubMedGoogle Scholar
  17. 17.
    von Brevern M, Lempert MT et al (1997) Selective vestibular damage in neurosarcoidosis. Ann Neurol 42:117–120CrossRefGoogle Scholar
  18. 18.
    Frohman EM, Tusa R, Mark AS, Comblath DR (1996) Vestibular dysfunction in chronic inflammatory demyelinating polyneuropathy. Ann Neurol 39:529–535PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Sujeet Kumar Sinha
    • 1
  • Animesh Barman
    • 1
  • Niraj Kumar Singh
    • 1
  • G. Rajeshwari
    • 2
  • R. Sharanya
    • 1
  1. 1.Department of AudiologyAll India Institute of Speech and HearingMysoreIndia
  2. 2.Department of OtorhinolaryngologyAll India Institute of Speech and HearingMysoreIndia

Personalised recommendations