Vestibular atelectasis

Vestibular atelectasis: Decoding pressure and sound‐induced nystagmus with bilateral vestibulopathy
Sinisa Maslovara MD, PhD  Silva Butkovic‐Soldo MD, PhD  Ivana Pajic‐Matic MD, PhD  Anamarija Sestak MD
First published: 13 December 2018 https://doi.org/10.1002/lary.27724
All authors undertook conceptual thinking around the article's focus, interpretation of data, discussion formulation, and the write‐up. All authors revised and approved the final manuscript. The authors assert that all procedures contributing to this work comply with the ethical standards of the national and institutional guidelines on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008.
The authors have no funding, financial relationships, or conflicts of interest to disclose.
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Abstract
We present the case of a 27‐year‐old male who presented with vertigo when pressing the entrance of his right auditory meatus and exposing his right ear to loud noise. A diagnostic procedure revealed bilateral labyrinth weakness, which was confirmed by caloric and rotational testing. The ocular vestibular evoked myogenic potentials investigation demonstrated a significant weakness of the right utriculus, whereas the cervical vestibular evoked myogenic potentials were normal, indicating preservation of the saccular response. Radiologic studies did not show evidence of labyrinthine dehiscence. We suspect the newly described association of this clinical syndrome with the previously described histopathology of vestibular atelectasis accounts for these findings.

Laryngoscope, 129:1685–1688, 2019



Vestibular atelectasis: Myth or reality?
Michael Eliezer MD  Arnaud Attyé MD  Jean‐Pierre Guichard MD  Hélène Vitaux MD  Antoine Guillonnet MD  Michel Toupet MD  Philippe Herman MD, PhD … See all authors
First published: 10 January 2019 https://doi.org/10.1002/lary.27793 Cited by: 1
The authors have no funding, financial relationships, or conflicts of interest to disclose.
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Abstract
Objectives/Hypothesis
Because delayed post‐contrast three‐dimensional fluid‐attenuated inversion recovery imaging sequences enable the distinction between the utricle and the saccule, we raised the hypothesis that patients with vestibular atelectasis (VA) could show unilateral collapse of the utricle and the ampullas on imaging.

Study Design
Retrospective case series.

Methods
We retrospectively reviewed 200 patients who underwent 3 T magnetic resonance imaging (MRI) after intravenous administration of gadolinium. MRI scans were assessed for the presence of VA. The endolymphatic space was considered as collapsed when the utricle and at least two ampullas were not visible or were barely visible.

Results
We reported four patients with VA on MRI responsible for atypical clinical presentations of acute vestibular deficit. All patients presented a specific involvement of the pars superior sensory captors (utricle, ampullas), preserving the pars inferior sensory captors (cochlea and saccule). This was confirmed both clinically and on MRI.

Conclusions
Our study is the first to describe in vivo unilateral collapse of the pars superior on delayed postcontrast MRI in patients with a clinical unilateral vestibular loss.

Level of Evidence
4

Laryngoscope, 129:1689–1695, 2019