Fumiaki Fujiwara

Comparative Study of Computerized Trapezoid Rotation Test and Sinusoidal Harmonic Acceleration Test

By using the Contraves computerized rotary chair system, trapezoid rotation (TR) test and sinusoidal harmonic acceleration (SHA) test were performed on each subject on the same day. The results in 25 normal volunteers and 145 patients with peripheral vestibular disorders were as follows: 1) As regards directional preponderance, the results of two rotation tests agreed in 75.9% of all patients, but a discrepancy was found in the rest. Abnormality was detected by TR test in 57.2% of all patients, and, less frequently, in 45.5% by SHA test. 2) In normal subjects, the maximum slow phase velocity of nystagmus provoked by TR test was greater than that of nystagmus provoked by SHA test using angular acceleration of a magnitude comparable to that in TR test. 3) As to the detection of abnormal VOR gain, the results of two rotation tests agreed in 100% of patients with bilateral vestibular disorders. However, in patients with unilateral vestibular disorders, the detection rate was higher for SHA test than that for TR test.

A Test for Predicting the Next Episode in Ménière’s Disease

It would be very adventageous in the treatment of patients with Meniere’s disease to be able to predict the onset of the next episode and possibly prevent it by careful management. However, despite extensive research, an exact marker to warn of an impending episode is still obscure [1, 2]. Alfero [3] reported the diagnostic significance of fullness in the ear, which could be evoked by the increase of endolymphatic pressure. However, according to Schmidt et al. [4], only half of Meniere’s patients mentioned this feeling of fullness, and, in any event, this sensation did not always precede the attack. Other symptoms, such as increased occipital pain and changes in hearing are unreliable as signals for an oncoming attack of vertigo.

Steroid therapy for syphilis of the labyrinth.

Five patients with syphilis of the labyrinth were treated with corticosteroids, and their hearing was tested before and after treatment.1) Those with rapid hearing loss in the early stage showed improvement of 12.1±6.8dB in the pure tone audiogram after treatment.2) Hearing improvement of those, who had no progressive hearing loss was 2.2±6.4dB.3) The difference between the two groups was statistically significant (p=0.05).4) The effect of steroid therapy on hearing loss generally noted within the first 10 days.Therefore, it seems rational to avoid the long term use of steroids, because of possible side-effects. Adequate anti-syphilitic therapy must also be used.