Res Vestib Sci.  2020 Sep;19(3):89-94. 10.21790/rvs.2020.19.3.89.

Positional Audiometry in Patients with Light Cupula: A Preliminary Study

Affiliations
  • 1Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
  • 2Research Institute of Medical Science, Konkuk University, Seoul, Korea

Abstract


Objectives
Light cupula is characterized by persistent geotropic direction-changing positional nystagmus in a supine head-roll test. The purpose of this study is to investigate if hearing level is influenced by the change of head position in light cupula under the assumption that relative density difference similarly occurs between the tectorial membrane and endolymph.
Methods
Twelve patients with unilateral light cupula who underwent positional audiometry were included in this study. Pure tone thresholds were compared among three head positions.
Results
Hearing threshold in pure tone audiometry (PTA) of the affected ear was not different from that of the healthy ear. PTA thresholds of the affected side were not significantly different in three head positions; upright seating, cochlear apex-up, and cochlear apex-down positions.
Conclusions
Although positional change of nystagmus direction is the most significant clinical feature of light cupula, positional change of hearing level was not observed in those patients. The lack of positional influence on hearing may be explained as follows: (1) the heavier endolymph phenomenon occurs only in the vestibular end organ without involving the cochlea; (2) the light cupula phenomenon is more likely to occur due to light debris mechanism rather than heavier endolymph or lighter cupula mechanism; and (3) the effects of light cupula could be modified by outer hair cells, which work for tuning in the cochlea, even though light tectorial membrane or heavy endolymph occurs.

Keyword

Light cupula; Positional audiometry; Vertigo; Nystagmus; Hearing loss; 가벼운팽대부마루; 체위성청력검사; 현훈; 안진; 난청
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