UNASSIGNED: Meniere\'s disease (MD) is an ear-related vestibular disorder accompanied by vertigo, hearing loss, and tinnitus. The anatomical structure and spatial position of the semicircular canals are important for understanding vestibular function and disease; however, research on MD and the effect of anatomical changes in the semicircular canals is limited. This study explored the relationship between the spatial location of the semicircular canals and MD using ultra-high-resolution computed tomography (U-HRCT) and intelligent segmentation.
UNASSIGNED: Isotropic U-HRCT images obtained from patients with MD and healthy controls (HCs) were retrospectively analyzed. We extracted the semicircular canal structures and extracted their skeleton. The plane of the skeleton of each semicircular canal was fitted separately. The mutual angles between the semicircular canals, and the angles between each semicircular canal and each plane of the coordinate system were measured.
UNASSIGNED: Among 45 MD-affected ears (MDAEs), 33 MD-healthy ears (MDHEs), and 45 HC ears, the angle between the superior and lateral semicircular canals (LSCs) and the angle between the superior and posterior semicircular canals (PSCs) were larger in the MDAE and MDHE groups than the HC group (P<0.01), while the angle between the posterior and LSCs was smaller in the MDAE group than the HC group (P<0.001). The angles between the superior and PSCs and coronal plane (CP) of the coordinate system were significantly smaller in the MDAE and MDHE groups than the HC group (P<0.01); however, the angles between the LSC and axial plane and CP were significantly larger in the MDAE and MDHE groups than the HC group (P<0.001).
UNASSIGNED: Spatial position changes in the semicircular canals may be the anatomical basis of MD.

Objective:To explore the correlation between the parameters of suppression head impulse paradigm（SHIMP） and changes in dizziness handicap inventory（DHI） scores. Additionally, to evaluate the degree of vertigo and prognosis of patients with acute vestibular neuritis through SHIMP parameters. Methods:Thirty-three patients with acute vestibular neuritis were enrolled for DHI evaluation, vHIT and SHIMP. A secondary DHI score were evaluated after after two weeks, once patients no longer exhibited spontaneous nystagmus. The decrease in the second DHI score was used as the efficacy index（EI）. All patients were divided into significantly effective group, effective group and ineffective group based on EI. Differences of the VOR gain values of SHIMP and the anti-compensatory saccade were compared among the three groups. Results:There were 13 cases in the significant effective group, 11 cases in the effective group, and 9 cases in the ineffective group. ①The mean gain of the horizontal semicircular canal in the significant effective group, the effective group, and the ineffective group was（0.50±0.11）, （0.44±0.12）, and（0.34±0.08）, respectively. The difference between the significant effective group and the ineffective group was statistically significant（P<0.01）. The gain of horizontal semicircular canal was positively correlated with EI（r=0.538 5, P<0.01） 。②The occurrence rate of the anti-compensatory saccade in the significant effective group, the effective group, and the ineffective group was（51.23±19.59）, （33.64±17.68）, and（13.78±11.81）, respectively. Pairwise comparisons between each group showed statistical significance（P<0.05）. The occurrence rate of anti-compensatory saccade was positively correlated with EI（r=0.658 2, P<0.01）. Conclusion:The horizontal semicircular canal gain and the occurrence rate of the anti-compensatory saccade in SHIMP for patients with acute vestibular neuritis were closely correlated with decrease in DHI score.
目的：探讨视频头脉冲抑制试验（suppression head impulse paradigm，SHIMP）的参数与眩晕障碍量表（dizziness handicap inventory，DHI）评分改变的相关性，以期通过SHIMP的相关参数来评估急性前庭神经炎的眩晕程度及预后。 方法：选取急性前庭神经炎患者33例，行DHI量表评估、vHIT和SHIMP检查，病程达2周且不伴自发性眼震时再次行DHI量表评估。以第二次DHI评分的下降幅度，作为疗效指标（efficacy index，EI）。将所有患者按照疗效分为显效、有效和无效3组。比较3组患者SHIMP的前庭眼反射增益值及反代偿扫视波出现率之间的差异。 结果：显效组13例，有效组11例，无效组9例。①在各组水平半规管增益均值比较中，显效组增益均值为（0.50±0.11）；有效组增益均值为（0.44±0.12）；无效组增益均值为（0.34±0.08）。显效组与无效组增益均值差异有统计学意义（P<0.01）。水平半规管增益值与EI呈正相关（r=0.538 5，P<0.01）；②在各组水平半规管反代偿扫视波出现率均值比较中，显效组反代偿扫视波出现率均值为（51.23±19.59）；有效组反代偿扫视波出现率均值为（33.64±17.68）；无效组反代偿扫视波出现率均值为（13.78±11.81）。各组间两两比较均差异有统计学意义（P<0.05）。水平半规管反代偿扫视波出现率与EI呈正相关（r=0.658 2，P<0.01）。 结论：急性前庭神经炎患者SHIMP检查中的增益值以及反代偿扫视波出现率与DHI评分下降幅度密切相关。.

暂无摘要。

Objective:To explore the clinical value of supine median³ nystagmus in the accurate diagnosis of horizontal semicircular canal benign paroxysmal positional vertigo（HC-BPPV）. Methods:A total of 187 patients with HC-BPPV admitted to the First Affiliated Hospital of Xi\'an Jiaotong University from June 2020 to March 2021 were selected. Among them 42 cases of Cupulolithiasis and 145 cases of Canalithiasis. The nystagmus parameters of patients left and right supine position and supine median³ position were recorded in detail by RART. According to the direction of supine median³ nystagmus, patients were divided into three groups: group A（nystagmus to weak side）, group B（nystagmus to strong side）, group C（negative nystagmus）. The canalith repositioning manoeuvres（CRM） was carried out by utility of an automatic vestibular function diagnosis and therapy system（SRM-IV）. The cure rate of CRM in three groups of HC-BPPV patients was compared, Multivariate logistic regression analysis was performed to analyze the influencing factors of CRM for HC-BPPV. Results:The cure rates of group A, group B and group C were 81.58%, 16.13% and 56.25%, respectively. The difference among the three groups was statistically significant. Then a pairwise comparison of group A, B and C, the difference was statistically significant（χ²A-B=40.294,P<0.001,χ²B-C=14.528, P<0.001,χ²A-C=11.606, P=0.001）; the results of multivariate logistic regression analysis showed that the direction of supine median³ nystagmus and BMI were the influencing factors of CRM for HC-BPPV. Conclusion:The direction, intensity and duration of supine median³ nystagmus play an important role in determining the responsibility semicircular canal of HC-BPPV.
目的：探讨仰卧正中位³眼震特征在水平半规管良性阵发性位置性眩晕（horizontal canal benign paroxysmal positional vertigo，HC-BPPV）责任半规管准确判定及疗效预估中的临床价值。 方法：选取2020年6月至2021年3月就诊于西安交通大学第一附属医院耳鼻咽喉头颈外科并确诊为HC-BPPV的患者187例，其中嵴顶结石症42例，管石症145例。采取快速轴位滚转试验（rapid axial roll test，RART）并详细记录患者在双耳下及仰卧正中位³引出的眼震参数，按照仰卧正中位³眼震方向分为3组：A组（眼震向弱侧）、B组（眼震向强侧）、C组（眼震阴性）。通过全自动前庭功能诊治系统（SRM-Ⅳ）进行复位治疗，比较3组HC-BPPV患者的复位治愈率，并进行多因素logistic回归分析HC-BPPV复位疗效的影响因素。 结果：A组治愈率81.58%（62/76），B组治愈率16.13%（5/31），C组治愈率56.25%（45/80），3组治愈率比较，差异有统计学意义（χ²=40.038，P<0.001），3组两两比较，患者治愈率差异均有统计学意义（χ²A-B=40.294，P<0.001，χ²B-C=14.528，P<0.001，χ²A-C=11.606，P=0.001）。多因素logistic回归分析结果显示：仰卧正中位³眼震方向及BMI是HC-BPPV复位疗效的影响因素。 结论：仰卧正中位³眼震的方向、强度及持续时间在判定HC-BPPV责任半规管中有重要意义。.

Objective: To investigate the altered function of the semicircular canal and otolith graviceptive pathway in patients diagnosed with motion sickness disorder (MSD) based on the diagnostic criteria of the Bárány society, and explore its relevance to the pathogenesis of MSD. Methods: This is a case-control study. Twenty patients with MSD and age-and sex-matched healthy controls without a history of MSD from the Department of Neurology of Aerospace Center Hospital between March and August 2022 were recruited. All subjects completed the motion sickness susceptibility questionnaire-short version (MSSQ-short) and the motion sickness assessment questionnaire (MSAQ). Canal function was evaluated using caloric stimulation test and video head impulse test (vHIT), and subjective visual vertical/horizontal (SVV/SVH) and vestibular evoked myogenic potential (VEMP) were employed to assess otolith graviceptive function. Differences in vestibular function and correlations between the two groups were analyzed. Results: Each group consisted of 20 cases (9 males and 11 females). The mean age of the MSD and control groups was (26.9±3.9) years and (27.0±3.4) years, respectively. The scores of MSSQ-short [27.0 (22.5, 38.8) vs 1.2 (0, 3.2), P<0.001] and MSAQ [70.1 (54.5, 78.1) vs 11.8 (11.1, 13.9), P<0.001] were significantly higher in the MSD group compared with those of the control group. Evaluation of canal function revealed a significantly higher incidence of caloric stimulation intolerance in MSD patients (60.0%, 12/20) compared with that of the control group (20.0%, 4/20) (P=0.010). Evaluation of otolith graviceptive pathway indicated no significant difference in SVV, SVH and cervical VEMP (cVEMP) abnormality rates between the two groups (all P>0.05). The ocular VEMP (oVEMP) abnormality rate was significantly higher in the MSD group (55.0%, 11/20) than that of the control group (10.0%, 2/20) (P=0.002), with a delayed P1-wave latency compared with the control group [(18.4±1.2) ms vs (17.6±0.8) ms, P=0.018]. Further correlation analysis revealed that P1-wave latency in oVEMP was positively correlated with MSSQ-short (r=0.486, P=0.002) and MSAQ (r=0.391, P=0.015) scores, and duration of caloric intolerance symptoms (r=0.377, P=0.004). Conclusion: The presence of hypersensitivity to caloric stimulation and delayed latency of otolith function in patients with MSD suggests a \"separation\" between semicircular canal and otolithic function, which may be related to sensory conflict.
目的： 探讨基于Bárány协会诊断标准纳入的运动病（MSD）患者半规管与耳石重力通路功能改变及可能的发病机制。 方法： 病例对照研究。纳入2022年3至8月招募的20例MSD患者（MSD组）及20名性别、年龄相匹配，无MSD病史的健康对照（对照组），在航天中心医院完成研究。所有受试者均完成运动不耐受易感性问卷简版（MSSQ-short）、运动不耐受评估问卷（MSAQ），完善基于半规管功能的双温试验、视频头脉冲试验（vHIT）和耳石重力通路功能的主观视觉垂直/水平（SVV/SVH）、前庭诱发肌源性电位（VEMP）的功能评价，分析MSD患者前庭功能改变情况，并进一步探讨MSD可能的发病机制。 结果： 每组20例受试者中，男9例，女11例；MSD组年龄（26.9±3.9）岁，对照组年龄（27.0±3.4）岁。MSD组MSSQ-short得分［27.0（22.5，38.8）分比1.2（0，3.2）分，P<0.001］和MSAQ得分［70.1（54.5，78.1）分比11.8（11.1，13.9）分，P<0.001］均高于对照组。半规管功能评价结果显示，MSD患者双温试验不耐受的发生率（60.0%，12/20）高于对照组（20.0%，4/20）（P=0.010）。耳石重力通路评价结果显示，SVV、SVH、颈性VEMP（cVEMP）异常率两组差异均无统计学意义（均P>0.05）。MSD组眼性VEMP（oVEMP）异常率（55.0%，11/20）高于对照组（10.0%，2/20）（P=0.002），其中P1波潜伏期较对照组延迟［（18.4±1.2）ms比（17.6±0.8）ms，P=0.018］。相关性分析结果显示，oVEMP的P1波潜伏期与MSSQ-short（r=0.486，P=0.002）、MSAQ（r=0.391，P=0.015）得分及双温不耐受症状持续时间（r=0.377，P=0.004）均呈正相关。 结论： MSD患者存在半规管刺激的高敏及耳石器潜伏期延迟受损，提示半规管和耳石器功能“分离”现象，可能参与MSD感觉冲突的发生。.

BACKGROUND: Cholesteatoma is a rare disease characterized by the accumulation of keratinized squamous epithelial cells in the middle ear or mastoid cavity. Vertigo and facial palsy, which are rare complications, may indicate erosion into the semicircular canals or the fallopian canal.
METHODS: A 40-year-old woman presented to our clinic with progressive right-sided hearing loss over 5 years (primary concern). Approximately 10 years ago, the patient had developed acute right-sided facial weakness with no additional symptoms. A neurologist at another hospital had diagnosed her condition as Bell\'s palsy and treated it accordingly.
METHODS: Adult-onset congenital cholesteatoma in the hypotympanum.
METHODS: Combined endoscopic and microscopic removal of the cholesteatoma.
RESULTS: Physical examination revealed slight improvement in right-sided peripheral facial palsy.
CONCLUSIONS: Routine eardrum examination is recommended for patients presenting with isolated peripheral facial palsy. If necessary, a patient should be referred to an otologist for further evaluation and treatment.

Different head positions affect the responses of the vestibular semicircular canals (SCCs) to angular movement. Specific head positions can relieve vestibular disorders caused by excessive stimulating SCCs. In this study, we quantitatively explored responses of human SCCs using numerical simulations of fluid-structure interaction and vestibulo-ocular reflex (VOR) experiments under different forward-leaning angles of the head, including 0°, 10°, 20°, 30°, 40°, 50°, and 60°. It was found that the horizontal nystagmus slow-phase velocity and corresponding biomechanical responses of the cupula in horizontal SCC increased with the forward-leaning angles of the head, reached a maximum when the head was tilted 30° forward, and then gradually decreased. However, no obvious vertical or torsional nystagmus was observed in the VOR experiments. In the numerical model of bilateral SCCs, the biomechanical responses of the cupula in the left anterior SCC and the right anterior SCC showed the same trends; they decreased with the forward-leaning angles, reached a minimum at a 40° forward tilt of the head, and then gradually increased. Similarly, the biomechanical responses of the cupula in the left posterior SCC and in the right posterior SCC followed a same trend, decreasing with the forward-leaning angles, reaching a minimum at a 30° forward tilt of the head, and then gradually increasing. Additionally, the biomechanical responses of the cupula in both the anterior and posterior SCCs consistently remained lower than those observed in the horizontal SCCs across all measured head positions. The occurrence of these numerical results was attributed to the consistent maintenance of mutual symmetry in the bilateral SCCs with respect to the mid-sagittal plane containing the axis of rotation. This symmetry affected the distribution of endolymph pressure, resulting in biomechanical responses of the cupula in each pair of symmetrical SCCs exhibiting same tendencies under different forward-leaning angles of the head. These results provided a reliable numerical basis for future research to relieve vestibular diseases induced by spatial orientation of SCCs.

Objective:To observe the results of dynamic visual acuity screening tests in patients with peripheral vertigo and explore its clinical significance. Methods:The number of 48 healthy volunteers were enrolled as control group and 25 peripheral vertigo patients as experimental group. In the experimental group, there are 12 patients with vestibular neuritis, 1 patient with Hunt syndrome, 5 patients with sudden deafness with vertigo and 7 patients with bilateral vestibular dysfunction. Horizontal and vertical dynamic visual acuity screening tests were performed on them. The number of lost rows of horizontal and vertical dynamic visual acuity was compared between the control group and the experimental group to figure out if there is a statistical difference. The number of lost rows of horizontal and vertical dynamic visual acuity was compared within the experimental group to figure out if there is a statistical difference. The two groups of 18 cases of unilateral vestibular function decline and 7 cases of bilateral vestibular function decline in the experimental group were compared with the control group, and figure out if there is a statistical difference. Results:The median number of lost rows of horizontal dynamic visual acuity in 48 healthy volunteers was 1.5 and median number of lost rows of vertical dynamic visual acuity was 1.0 in the control group. The median number of lost rows of horizontal dynamic visual acuity of 26 healthy volunteers was 6 and median number of lost rows of vertical dynamic visual acuity was 5 in the experimental group. Compared to the experimental group, the number of lost rows both have statistical significance in horizontal and vertical dynamic visual acuity（P<0.01）. The comparison of horizontal and vertical lost rows within the test group also have statistical significance（P<0.01）. Twenty five patients with exceptional vestibular disease in the experimental group were divided into unilateral vestibular function reduction group（n=18） and bilateral vestibular function reduction group（n=7）. Compared with the control group, there was significant differences in the number of horizontal and vertical lost rows（P<0.01） within the three groups. After pairwise comparison, the number of lost rows of horizontal and vertical in the control group was significantly lower than that in the unilateral vestibular function reduction group and the bilateral vestibular function reduction group（P<0.01）. There was a highly significant correlation between the number of horizontally lost rows of DVA and the mean vHIT values of bilateral horizontal semicircular canals in 25 patients（P<0.01）; and a highly significant correlation between the number of vertically lost rows of DVA and the mean vHIT values of vertical semicircular canals in 4 groups bilaterally（P<0.01）. Conclusion:The Dynamic Visual Acuity Screening Test is a useful addition to existing tests of peripheral vestibular function, particularly the vHIT test, and provides a rapid assessment of the extent of 2 Hz VOR impairment in patients with reduced vestibular function.
目的：观察外周性眩晕患者动态视敏度（dynamic visual acuity, DVA）筛查试验结果并探讨其临床意义。 方法：48名健康志愿者作为对照组，25例外周性眩晕患者作为试验组，其中前庭神经炎患者12例，Hunt综合征患者1例，突发性聋伴眩晕5例，双侧前庭功能下降患者7例。进行水平与垂直动态视敏度筛查试验。将试验组与对照组的水平、垂直动态视敏度丢失行数进行比较；对试验组内水平、垂直丢失行数进行比较；将试验组内单、双侧前庭功能分别与对照组进行比较。 结果：对照组水平DVA丢失行数中位数为1.5，垂直DVA丢失行数中位数为1.0；试验组水平DVA丢失行数中位数为6.0，垂直DVA丢失行数中位数为5.0。对照组和试验组的水平、垂直丢失行数比较差异均有统计学意义（P<0.01）。试验组组内水平和垂直丢失行数比较差异有统计学意义（P<0.01）。将试验组分为单侧前庭功能下降组（18例）和双侧前庭功能下降组（7例），与对照组进行对比，3组两两比较，水平和垂直丢失行数比较差异均有统计学意义（P<0.01），对照组水平和垂直DVA丢失行数明显分别低于单侧前庭功能下降组和双侧前庭功能下降组，单侧前庭功能下降组的水平和垂直丢失行数明显低于双侧前庭功能下降组（P<0.01）。25例外周性眩晕患者水平丢失行数与双侧水平半规管vHIT均值之间呈显著相关关系（P<0.01）；垂直丢失行数与双侧垂直半规管vHIT均值之间呈显著相关关系（P<0.01）。 结论：DVA筛查试验是现有外周前庭功能检查特别是vHIT测试的有效补充，能快速评估前庭功能下降患者的2 Hz 前庭眼反射损伤程度。.

Semicircular canal occlusion（SCO） is a surgical technique widely used for treating vertigo symptoms. It is primarily aimed at treating benign paroxysmal positional vertigo（BPPV）, Ménière\'s disease（MD）, labyrinthine fistula, and superior semicircular canal dehiscence syndrome, among others. This review aims to comprehensively summarize the development, evolution, relevant basic research, and clinical applications of semicircular canal occlusion, especially the application of endoscopic technology in recent years, and explore its practical value in the field of surgical treatment for vertigo.
摘要: 半规管阻塞术（semicircular canal occlusion，SCO）是一种广泛应用于治疗眩晕相关疾病的手术术式，主要用于治疗良性阵发性位置性眩晕、梅尼埃病、迷路瘘管与上半规管裂综合征等。本综述旨在全面总结SCO的发展演变，相关基础研究和临床应用，特别是近年来内镜技术在其中的应用，探讨其在眩晕外科领域中的应用价值。.

OBJECTIVE: Report three cases of simultaneous triple semicircular canal occlusion (TSCO) and cochlear implantation (CI) as the treatment of intractable Meniere\'s disease (MD).
METHODS: Patients with MD can present occasionally with intractable vertigo and profound sensorineural hearing loss (SNHL). TSCO and CI have been proposed to control vertigo and restore profound deafness in patients with MD separately. However, a few studies have reported simultaneous TSCO and CI in the same surgical procedure for the treatment of MD. In the present study, we described three patients with MD showing incapacitating vertigo and severe SNHL who underwent simultaneous TSCO and CI after examinations of auditory system, vestibular system, and imaging. Their symptoms were significantly alleviated during the follow-up period.
CONCLUSIONS: The combined TSCO and CI remains a viable treatment option which is effective for the control of vertigo as well as the restoring of hearing in patients with MD.