Vertigo: Eustachian tube function should be tested before vestibular
function
Eustachian tube dysfunction (ETD) is defined by symptoms and signs of pressure dysregulation in the middle ear. Vertigo
associated with ETD is caused in most (and perhaps all) instances by unilateral Eustachian tube obstruction or by more
complete obstruction one side than the other. Vertigo due to unilateral ETD was first defined as â??alternobaric vertigoâ?Â
(or â??vertigo altenobaricaâ??), by Dr. Claes Lundgren who coined the term in 1965 to describe vertigo in deep-sea divers.
The fundamental mechanism of ABV is asymmetrical middle ear pressures. This diagnosis can also be applied to cases
at ground level, no matter how minute the difference in pressure is. Persistent ABV at ground level is associated with
abnormal vestibular function test results. ABV should be differentiated from any condition conferring active risk of
vertigo or severe disequilibrium. Vestibular organ dysfunction is caused by poorly regulated pressure in the middle ears.
Vestibular organs are dependent variable organs. Every clinical test currently used to assess vestibular function should
ideally be performed in a state where pressures in the middle ear cavities are well within normal range, and perfectly
balanced between the ears. Taking these points into consideration, I would like to (1) propose that ABV be included in
the ETD Consensus Statement as an official symptom of ETD, (2) reiterate that Eustachian tube function should be tested
before vestibular function, and (3) call for case studies and research into cases of vertigo where Eustachian tube function
was assessed before vestibular function.. Author(s): Hee-Young Kim Abstract |
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