Practica Oto-Rhino-Laryngologica

A Case of Bilateral Meniere's Disease with Alternatively See-saw Fluctuations of Bilateral Hearing Impairments

Kanemasa Mizukoshi, Kyoko Kuroda, Yukio Watanabe, Naoki Ohhashi, Kazum ...

1980 Volume 73 Issue 11special Pages 1825-1831
Published: November 15, 1980
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.73.11special_1825

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In most patients with bilateral Meniere's disease, there is a lapse of 10 years between the involvement of the first and the second ear (Greven & Oosterveld 1975). However, we encountered a 47 years old man with bilateral Meniere's disease, in whom the interval between the onset of the impairment in first the right ear and then left ear occurred after 24 years.
One of the most characteristic features in this patient was the alternatively see-saw fluctuation of the bilateral hearing impairment after the second involvement. In this characteristic fluctuation of hearing impairment, the unilateral hearingloss improves while the contralateral worsens at the same episode, resembling the action of see-saw. These fluctuations in hearing impairment were observed during the glycerol test, and after endolymphatic sac surgery. Therefore, we assumed that the alternative fluctuation of bilateral hearing impairments could be one of the events of bilateral Meniere's disease, caused by passing osmolarity disorders in the right and the left ear, alternatively.

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Histopathology of Temporal Bones with Endolymphatic Collapse

Tetsuo Ishii, Minoru Toriyama, Jun-Ichi Suzuki

1980 Volume 73 Issue 11special Pages 1832-1841
Published: November 15, 1980
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.73.11special_1832

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We report here in the histopathology of 9 temporal bones from 5 patients. These bones showed various types of endolymphatic collapse in the saccule and cochlear duct. The hearing acuity before death varied from total deafness to normal bone conduction. The hearing impairment was strongly dependent on flattening of the organ of Corti or atrophy of the tectorial membrane. Endolymphatic collapse, however, had little influence on the auditory function. In two, there was a history of labyrinthitis, and the etiology was unknown in the other 3. The endolymphatic collapse was attributed to a decrease in endolymph and such may be caused by a disorder of the endolymphregulating mechanism in the inner ear.

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Electrocochleographic Study of a Case of Bilateral Meniere's Disease

Nozomu Mori, Takashi Matsunaga

1980 Volume 73 Issue 11special Pages 1842-1847
Published: November 15, 1980
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.73.11special_1842

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A case of bilateral Meniere's disease was investigated by extratympanic electrocochleography both during a period of impaired hearing and during a period of fairly good hearing.
After a vertiginous attack, conventional audiometry showed progression of the hearing loss in the right ear, while the hearing loss in the left ear remained unchanged.
In the right ear, the significant changes in electrocochleographic findings after the attack were elevation of the AP response shreshold, the prolongation of N₁ latency, and an increase in the SP/AP ratio.
In the left ear, N₁ latency had been prolonged, the AP waveform was broad, no SP component was detected, and there were no significant changes in the electrocochleographic findings.
Clinical evaluations of changes in the electrocochleographic findings after a vertiginous attack were discussed.

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Long Term Observation of Meniere's Disease Following the Endolymphatic Shunt Operation

Takashi Matsunaga, Hitoshi Ogino, Etsuko Tagami, Mitsuhiro Sano, Shini ...

1980 Volume 73 Issue 11special Pages 1848-1855
Published: November 15, 1980
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.73.11special_1848

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The results of postoperative questionnaires to patients with Meniere's disease who had undergone the endolymphatic sac decompression operation (subarachnoid shunt operation) at Osaka University Hospital are reported.
In three among the patients with Meniere's disease who had undergone the surgery (Yamakawa & Naito's 1st method) between 1951 and 1956 replied 20 years after the operation (June, 1971).
In this reply, two of 3 patients had no further attacks of vertigo, one noted that the vertigo was less frequent and less severe. Two patients noted that tinnitus was decreased. In one patient the tinnitus remained. One patient considered the results successful as regards hearing ability. Two patients considered that their hearing was stabilized. After 30 years (Feb. 1979), two of them replied that their condition was the same as in the previous reply and there was a worsening of hearing in one patient.
Another thirteen patients, who had undergone the operation between 1971 and 1977, answered three to eight years after the operation.
Four had no further attacks of vertigo, in 6 the vertigo was less frequent, and in 3 it was less severes. Therefore, the vertigo was completely relieved or improved in all these patients. Four patients noted that tinnitus was decreased. In 8 patients the tinnitus was still present. One noted that tinnitus was increased. As for hearing, 2 patients were satisfied with the results. Eight patients considered that their hearing was stabilized, and 3 stated that their hearing had worsened.
Subjectively, all the patients were satisfied with the results of the surgery.

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Significance of the Furosemide Test in the Endolymphatic Shunt Operation

Shin-ichi Okumura, Takashi Matsunaga, Toshi Naito

1980 Volume 73 Issue 11special Pages 1856-1860
Published: November 15, 1980
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.73.11special_1856

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We applied the Furosemide test using pendular rotation stimuli to the patients with Ménière's disease for the purpose of diagnosis of endolymphatic hydrops. In patients with probable Ménière's disease, after the administration of Furosemide in doses of 20mg intravenously, the DP index of the pendular rotation test improved to within normal ranges, as a result of prompt diuretic activity.
In this report, we evaluated 4 patients with Ménière's disease who have been given the Furosemide test before and after the endolymphatic shunt operation. Three of 4 patients with Ménière's disease showed a positive Furosemide test while the other patient showed a negative Furosemide test, before the operation. The surgery was the endolymphatic shunt operation, by Naito's 2nd method. After the operation, the Furosemide test was again performed in the 4 patients. The results were all negative. In patients with a positive Furosemied test before the operation, the prognosis of the disease was good and they had no further attacks of vertigo. In the other patient with negative test results before the operation, episodes of vertigo persisted.
Thus, it is considered that a positive Furosemide test can be used as a diagnostic as well as a prognostic tool and also may be used to determine indications for surgery.

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The Longitudinal Observation of Meniere's Disease

Mitsuhito Sano, Takashi Matsunaga, Yuriko Suizu, Hitoshi Ogino, Toru M ...

1980 Volume 73 Issue 11special Pages 1861-1865
Published: November 15, 1980
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.73.11special_1861

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1. We sent out a questionnaire to Meniere's disease patients treated at Osaka University Hospital and Kansai Rosai Hospital to determine the course of the disease in these patients. The subjects included 170 patients treated at Osaka University Hospital and 15 treated at Kansai Rosai Hospital. We investigated the course of vertigo attacks, tinnitus, hearing impairment, a full feeling in the ear, hyperacusis, nausea, vomiting, headache and general fatigue.
2. Results
a. The percentage of recovery was about 40.
b. In 60 percent of the cases, the symptoms of vertigo disappeared within 3 years but 3 years medical care was necessary.
c. In a few, hearing impairment increased day by day due to aging or repetition of attacks.
d. In half the number of patients, there was no change in tinnitus and hearing impairment.
e. Symptoms of hyperacusis, headache, general fatigue continued while nausea and vomiting disappeared after a short time.

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Electrocochleographic Study of Meniere's Disease

Takashi Fukaya, Atsushi Komatsuzaki

1980 Volume 73 Issue 11special Pages 1866-1873
Published: November 15, 1980
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.73.11special_1866

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Electrocochleography (ECOG) reflects the functional state of the cochlea, and can be used as a tool of clinical otology. It is thus valuable when making a diagnosis of the different pathological conditions which affect the cochlea.
In the present series, 16 ears in patients with Meniere's disease were examined by ECOG. As a control, 6 normal hearing ears and 10 high tone loss ears also served as subjects. Short tone bursts were used as stimuli, and the trans-tympanic recording method was used.
Main findings in the case of Meniere's disease are summarized as follows.
(1) The N1 thresholds were similar to the subjective ones.
(2) The waveforms of the AP-SP potentials recorded in Meniere's cases were broad.
(3) Both in Meniere's ears and high tone loss ears, a positive summating potential (SP⁺) was recorded when using high frequency tone bursts.
(4) In the ears of those with Meniere's disease, the large negative summating potential (SP^-) was obvious for low frequency tone bursts.
(5) In the fluctuant stage of hearing loss, the negative summating potential (SP^-) amplitude related to the attack of Meniere's disease, but not to the degree of hearing loss.
(6) In those with Meniere's disease, the input-output curves of N1 amplitude were rather steep compared to normal ears, and a steep slope thus was indicative of a positive recruitment.
(7) In the late stage of Meniere's disease, the difference between those with the disease and those with a high tone loss was not evident using ECOG.

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Results of Skin Test for Food Allergy in Cases of Meniere's Disease

Jiro Hozawa, Hisaki Saito, Fumihito Suzuki, Mariko Hakamada, Masaru Ha ...

1980 Volume 73 Issue 11special Pages 1874-1878
Published: November 15, 1980
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.73.11special_1874

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Twenty-three patients with Meniere's disease were divided into two groups from results of the skin test, using 34 sorts of food allergens. Ten were positive group (Group P) and the other 13 were negative (Group N). The difference between group P and group N was not evident in serum immunological tests. However, it was interesting that the type of fluctuating hearing loss was seen more frequently in group P than group N.

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Effects of Optokinetic Stimulation on the Center of Gravity in Patients with Ménière's Disease

Kiichiro Taguchi

1980 Volume 73 Issue 11special Pages 1879-1892
Published: November 15, 1980
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.73.11special_1879

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Effects of the horizontal and vertical optokinetic stimulation on the body's center of gravity in patients with Ménière's disease were investigated using an optokinetic stimulator of Jung's type, a straingauge-platform and a minicomputer.
The following results were obtained.
1. Three types of the locus patterns traced by the center of gravity were obtained during the optokinetic stimulation. The centripetal type was observed in 10 subjects, the left and right type in 5 and the forward and backward type in 5. All those with bilateral Ménière's disease showed the forward and backward type.
2. Total length of the locus during one minute of standing gradually increased up to 90deg/sec of stimulus speed and then decreased. However, there were many exceptional cases in which there was an irregular course of going up and down in the locus length.
3. Most of the subjects who belonged to the centripetal type or the left and right type showed the following values in the ratio of the anteroposterior component to the lateral component of the locus, that is, “Y/X ratio was below 1.00 in the horizontal optokinetic stimulation, while in the vertical stimulation it was over 1.00”. Those with the forward and backward type gave larger figures than 1.00 throught the examination.
4. A few of the patients showed the standard two-phasic course in the position of the center of gravity.
5. The averaged spectral frequencies were calculated and some characteristic results were obtained, depending upon the types of the locus.

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Caloric Nystagmic Response of Patients with Ménière's Disease in Long-term Follow-up Observation

Kiichiro Taguchi, Masato Kikukawa, Kiyotaka Higaki, Tomoyuki Nakano

1980 Volume 73 Issue 11special Pages 1893-1898
Published: November 15, 1980
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.73.11special_1893

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It is most difficult to evaluate the prognosis of patients with Ménière's disease. We estimated the relationship between the activity of the disease and the caloric nystagmic response by reviewing long-term follow-up observation on these patients.
Sixty-four patients aged 15 to 56 at the onset of the disease were investigated. The items for investigation were frequency of attack, spontaneous or positional nystagmus, caloric nystagmus, postrotatory nystagmus, hearing impairment, blood pressure (including the Schellong's test), treatment received and so on.
The following conclusions were obtained.
1. Estimation of the prognosis cannot be made at the first examination of the patient.
2. The attacks occurred most frequently in the patients who tended to show DP in the caloric nystagmic response, over a long period of time.
3. There were some in whom the caloric nystagmic response changed from DP to CP after a short time, or in whom there was no caloric difference between the left and right ears after a short period with caloric DP.

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A Case Control Study on Meniere's Disease

Kimihiro Nakae, Atsushi Komatsuzaki

1980 Volume 73 Issue 11special Pages 1899-1906
Published: November 15, 1980
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.73.11special_1899

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A case-control study of Meniere's disease was made on the pationts with otolaryngological disturbances in Tokyo University Hospital. 14.6 percent of Meniere's disease patients had hypotonia at the time of attack and the percent was significantly higher than 6-8 percent of the control patients.
Mental and/or physical strain, irritation, trouble, lack of sleep and some foods strongy contributed to occurrence of Meniere's disease, although ear-splitting noise, smoking and menstruation had mild effects. As for a sense of tasts, Meniere's disease patients were a little more fond of a sour taste than the control patients.
Meniere's disease patients more raised cats than the control patients. There was no difference between both groups regarding history of occupation, medical history, urban and rural factors and complications, except for hypotonia.
Those with long period of attack suspension (long period group) had a higher sex ratio than those with a short period of attack suspension (short period group). In the short period group there was a higher frequency of disturbance of the circulatory system (i. e. arteriosclerosis, hypertension, hypotonia, cerebrovascular disease, heart and/or vascular disease).
The short period group had more raised small birds as pets than the long period group
Monthly occurrence of Meniere's disease showed an increase in spring (March-May) and in autumn (August-October).
Average age of onset of Meniere's disease had annually increased.

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Study on Ranges of Fluctuated Hearing Disturbances in Meniere's Disease

Kohji Tokumasu, Rokuro Kawano, Naoki Tashiro, Kazuyoshi Goto, Yoko Hir ...

1980 Volume 73 Issue 11special Pages 1907-1913
Published: November 15, 1980
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.73.11special_1907

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The threshold of hearing were investigated by repeated audiometries in the cases of Meniere's disease, who were treated mostly medicinally. The test subjects were 38 patients including 8 bilateral cases. Mean period for follow-up-study was over one year. Audiograms obtained in both the first and the final test and in both the most improved and the most worsened stage were compared. The results, which were confirmed statistically are as follows:
In unilateral cases, the mean value of the threshold of hearing in 8000Hz was higher than in 500Hz and the gain of improved hearing in 500Hz was 16.7dB in the best hearing stage. The difference of thresholds in 500Hz between in the best and the worst stage was 27.5dB in unilateral cases.
The threshold in 8000Hz in the worst stage was higher in bilateral cases than in unilateral.

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Three Years Experience with Acupuncture Treatment for Meniere's Disease

Naoko Kikuchi, Fumihiko Shirota, Hisako Fujita, Junko Sugiyama, Takuya ...

1980 Volume 73 Issue 11special Pages 1914-1918
Published: November 15, 1980
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.73.11special_1914

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Meniere's disease patients unresponsive to medical treatment underwent 10-15 regular 20 minute sessions of acupuncture during a three year period. The results in 23 patients with repeated attacks of vertigo were followed over ten times the maximum interval between attacks before treatment. In cases of reoccurrence, the frequency and magnitude of attacks before and after the treatment were compared. The therapy was effective in nine. Of the remaining fourteen, eleven underwent additional acupuncture treatment which was effective in six. Thus, the overall result was favorable in fifteen (65%). Among these patients tinnitus in 25% and hearing in 13% improved.

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Natural Course of Meniere's Disease

A Consideration of Criteria for Improvement for MD

Tatsuo Maki, Takashi Tokita, Hideo Miyata, Tomiyasu Saito, Masahiko Ha ...

1980 Volume 73 Issue 11special Pages 1919-1926
Published: November 15, 1980
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.73.11special_1919

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Case histories of patients with Meniere's disease were studied regarding character, duration, intensity of vertigo and length of the intervals of occurrence. The purpose of this study was to demonstrate of natural course of Meniere's disease and obtain criteria for the improvement of recurrence of vertiginous attacks by medical treatment, as distinct from spontaneous relief, following the natural course of the disease.
Forty patients diagnosed as having Meniere's disease were included in the study. The diagnosis was based on the criteria of diagnosis of Meniere's disease by Tokita et al. (1967).
During examinations of the natural course of Meniere's disease, the following types were observed.
(1) In 6 cases, a definitive spell appeared repeatedly in the same season once or twice every year.
(2) In 4 cases, a definitive severe spell with long intervals changed to a slight spell.
(3) In 5, there was a gradual decrease of recurrence of vertiginous attacks, with time.
(4) In 12, burst of spell occurred continuously from the time of onset.
(5) In 5, repetition of single definitive spell and burst of spell appeared with irregular alternation.
(6) In 2, Lermoyez's disease was finally diagnosed as Meniere's disease.
(7) There were two with a sudden deafness at onset.
(8) Nine experienced vertigo induced by transient ischemic attacks or orthostatic dysregulation before the onset of Meniere's disease.
The natural course of Meniere's disease varied with the individual. The longest period without attack of vertigo by spontaneous relief following natural course of the disease was from 1 month to 8 years. Thus, it was most difficult to determine the improvement of vertigo by medical treatment, as distinct from spontaneous relief. For determination of the improvement of vertigo by medical effects, abscence of a spell for 10 times the average interval before treatment (criteria by American Academy of Ophthalmology and Otology) and for 3 times of the longest period without attack of vertigo before treatment are required.

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Studies on Predisposition to Meniere's Disease

Tomiyasu Saito, Takashi Tokita, Hideo Miyata, Tatsuo Maki, Masahiko Ha ...

1980 Volume 73 Issue 11special Pages 1927-1935
Published: November 15, 1980
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.73.11special_1927

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To clarify predisposing factors that constitute disturbances in the labyrinth in cases of Meniere's disease, examination was conducted to probe into the loading equilibrium test as well as internal and laboratory examinations. Since such are insufficient to explain what constitutes the disturbance of the labyrinth, attempts were made to investigate local factors.
For this purpose, a list of predisposing factors leading to labyrinthine disturbances was madeout to investigate (I) general matters, (II) factors inducing vertigo, (III) past and present history of diseases (for general factor examination). Furthermore, for the purpose of tracking down local factors, investigations were made about (IV) the surrounding disease, (V) hereditary factors and (VI) the presence of any abnormality in the ear that lead one to assume the existence of local factors.
In the survey of 58 cases of Meniere's disease, the local factor examination showed the following results: Nine cases (15.5%) had otitis media, eight (13.8%) complained frequently of a feeling of fullness in the ear, 18 (31.0%) have been hard of hearing for some, 19 (32.8%) have had a tinnitus for some time, 17 (29.3%) had habitual headaches, one (1.7%) facial paralysis, 11 (19.0%) past injuries to the head and neck, and 21 (36.2%) stiff shoulders.
As for headaches, vascular headaches accounted for six, muscle contracting headaches six, association headaches three, and unknown origin two. Regarding the hard of hearing, many cases coincided with the affected side of Meniere's disease, while the side diseased by otitis media did not correspond with the side affected by Meniere's disease.

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Platelet Function in Patients of Ischemic Cerebral Vascular Disease and Ménière's Disease

Masakuni Kameyama, Hideo Shio, Yuzo Ohtsuki, Satoru Miyata

1980 Volume 73 Issue 11special Pages 1936-1940
Published: November 15, 1980
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.73.11special_1936

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ADP-induced platelet aggregation was examined in patients with a history of ischemic cerebral vascular disease (CVD). When a threshold concentration of ADP for production of the secondary platelet aggregation was taken as a marker of platelet function, no remarkable difference was observed between CVD patients and control subjects. However, when thrombosis of perforating arteries diagnosed from computotomography findings was compared with that of main trunks of cerebral arteries, enhanced platelet aggregation was noted in the patients of perforating artery occulsion. The role of platelet aggregability in thrombogenesis thus seems to be manifested more readily in this type of vessel branching. As previously reported, platelet aggregation is remarkably enhanced in the presence of red blood cells. Our results also suggested that higher platelet aggregability might be compensated for by a lower hematocrit value.
β-Thromboglobulin (βTG), a new indicator of intravascular platelet activation, was determined in plasma of CVD patients but no increase was observed in the chronic phase after the attack. In patients with Ménière's disease, the BTG level was elevated during the attack, but was within normal range in the intermittent periods.

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Serum Dopamine-β-Hydroxylase Activities in the Various Disorders with Symptoms of Dizziness or Vertigo

Masakuni Kameyama, Satoru Miyata, Hideo Shio

1980 Volume 73 Issue 11special Pages 1941-1948
Published: November 15, 1980
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.73.11special_1941

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Serum dopamine-β-hydroxylase (DBH) activities were examined in 110 patients complaining of dizziness or vertigo. The enzyme was measured by the photometric assay method of Nagatsu and Udenfriend.
The mean serum DBH activity of 17 patients was 16.1±8.3 units and there was no significant difference from findings in the normal controls (18.2±6.7 units).
Dizziness and vertigo were often complained of by patients with cerebrovascular diseases, particularly thrombosis of the posterior cerebral artery or vertebro-basilar insufficiency, as well as other neurological diseases such as spino-cerebellar degeneration, normal pressure hydrocephalus, cerebellar hemorrhage, cerebellar tumor, Parkinson's disease, essential tremor, amyotrophic lateral sclerosis etc.
Computed tomography (CT) of the brain was performed on 71 patients. Serum DBH activities in the patients with normal CT scan findings exhibited no significant change, while activities in patients with CT findings of cerebral atrophy, cerebellopontine atrophy and localized low density areas exhibited comparatively low values.
In the dysautonomic patients with dizziness or vertigo, the serum DBH activities exhibited wide varieties, but there were 5 with values under 5 units.
No significant change was seen on the enzyme activity during attacks of vertigo or after the caloric test, in the same individual.

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Patients with Meniere's Disease without Vertigo

Koichi Yasuda, Atsuko Kitajima

1980 Volume 73 Issue 11special Pages 1949-1954
Published: November 15, 1980
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.73.11special_1949

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There are patients who complain of a feeling of fullness in the ear and earache suggestive of acute tubotympanic catarrh or otitis media but in whom the tympanic membranes are entirely free from abnormalities and the Eustachian tubes show no evidence of obstruction on inflation by the eustachian catheter. These patients may show spontaneous nystagmus and deviations of labyrinthine origin on equilibrium tests, evidence of inner ear injury, but nevertheless they say they have never had an attack of vertigo. Audiometric tests reveal a 20 to 40dB elevation of the threshold in low frequency ranges and the hearing loss is not always of the sensorineural type.
We encountered 25 patients with such symptoms during the 1-year period from September 1, 1977 to August 31, 1978. None of these patients had a history of trauma, drug therapy or fever that might have an etiologic relation with the disorder. Many affirmed the presence of stress as a precipitating cause in their past history, while some reported the occurrence of symptoms in repeated episodes. These findings led us to assume that the condition before us, even though lacking in vertigo, is none other than Meniere's disease.
For these patients we prescribed rest, oral steroids and intravenous xylocaine. After 10-14 days of this combined regimen the patients were free from subjective symptoms (a feeling of fullness and otalgia), abnormalities on equilibrium tests (nystagmus and deviation) and perceptive deafness.
Williams advocated the concept of “endolymphatic hydrops without vertigo” and stated that when the process of Meniere's disease is confined to the cochlea. Vestibular symptoms, notably vertigo, may not appear. In our present series, however, the abnormalities on equilibrium tests clearly indicated the presence of a disturbance in the vestibular segment of the labyrinth, and the disease entity in these cases is therefore quite distinct from the one which was designated as “endolymphatic hydrops without vertigo” by Williams. When a patient has no vertiginous attacks in the presence of a lesion in the vestibular segment of the end-organ, the cause of such a failure to develop vertigo must be sought from the psychological aspect.
A psychological test using the Cornell medical index demonstrated that the patients in our present series showed a lesser tendency to neurosis than did Meniere's disease patients in general. This finding may be interpreted as indicating that Meniere's disease patients without vertigo are relatively insensitive to somatic distress, including vertigo.

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Recurrent Vertigo with Unilateral or Bilateral Sensorineural Hearing Loss of Unkown Etiology

Tsutomu Yamazaki, Sachie Watanabe, Hideo Kozaki, Takao Abe, Kazuo Yama ...

1980 Volume 73 Issue 11special Pages 1955-1964
Published: November 15, 1980
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.73.11special_1955

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The records of 22 patients with unilateral or bilateral sensorineural hearing loss of unknown etiology who had recurrent vertigo and were seen at Sapporo General Hospital between 1974 and 1979 were studied. As a result, they were classified in following four groups:
The first group included patients with recurrent vertigo with fluctuating hearing loss and tinnitus, and the causes of vertigo or deafness were attributed to abnormality of the vestibular aqueduct or endolymphatic sac, measles virus and otitis media. In two patients with endolymphatic hydrops caused by otitis media, progressive hydrops (Shuknecht, 1976) was demonstrated by the glycerol test and by clinical findings. (Paparella. 1979)
The second group included patients of recurrent vertigo without fluctuating hearing loss and tinnitus, and the etiology of vertigo or deafness was sepeculated to be associated with virus related mumps.
The third group included two patients with endolymphatic hydrops as demonstrated by the glycerol test after sudden sensorineural deafness and vestibular paralysis, the etiology of which was presumed to be vasular lesions, those similar to vertigo of delayed onset after sudden deafness (Nadol, 1975), but in some patients were considered to be caused by viral infection. We observed one patient after sudden sensorineural imparment and vestibular disorders who had recurrent attacks of vertigo with fluctuating hearing loss and and tinnitus, in relation to an allergic disposition.

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Cerebellopontine Tumor (Glioblastoma and Acoustic Neurinoma) with Episodic Vetigo or Fluctuating Hearing Loss as Relatated to Ménière's Disease

Tsutomu Yamazaki, Sachie Watanabe, Hideo Kozaki, Takao Abe, Kazuo Yama ...

1980 Volume 73 Issue 11special Pages 1965-1970
Published: November 15, 1980
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.73.11special_1965

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Recently, we encountered three patients in whom episodic vertigo and fluctuating deafness was associated with cerbellopontine-angle tumors or an acoustic tumor.
We wish to emphasize the association between Ménière's disease and cerebello-pontine-angle tumors or acoustic neurinoma by describing the case history of three patients who presented complaints of fluctuating hearing loss and recurrent vertigo.

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Personality Profile in Meniere's Disease (2)

Difference with the Cervicogenic Acoustico Equilibrium Disorder and the Orthostatic Disregulation in the Maudsley Personality Inventory Test

Shoji Takayasu, Sanae Katori, Kazunobu Astuta

1980 Volume 73 Issue 11special Pages 1971-1980
Published: November 15, 1980
Released on J-STAGE: November 04, 2011

DOIhttps://doi.org/10.5631/jibirin.73.11special_1971

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Both the Cornell Medical Index test and the Maudsley Personality Inventory test were administered to 150 vertiginous patients who were 54 with Meniere's disease and 96 with the cervicogenic acoustico-equilibrium disorder or the orthostatic disregulation as the control, due to verify what personality elements are specific in Meniere's disease and due to determine whether each disorder of control might be categorized as independent from Meniere's disease or must involve into it as the background factors.
In the Maudsley Personality Inventory, the patients with Meniere's disease had a fundamental character of moderate extraversion and low neuroticism that is manifested as E₀N^- category, while the patients of the control had commonly a character of moderate extraversion and moderate neuroticism categorized as E₀N₀.
Further difference was found between them in the Cornell Medical Index. The former character was divided into some subtypes according to various psychosomatic conditions without neurosis while the latter was superimposed with various grade of neurosis which had gradually grown up in proportion to the period affected by vertigo.
These observations confirmed in our viewpoint that the Meniere's disease and the two diseases of the control should be in the different category each other.

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