Graduation Year

2004

Document Type

Dissertation

Degree

Au.D.

Degree Granting Department

Audiology

Major Professor

Roberts, Richard A.

Co-Major Professor

Gans, Richard E.

Keywords

compensation, vestibular nucleus, caloric weakness, optokinetic nystagmus

Abstract

Traditionally, results from caloric testing and optokinetic nystagmus (OKN) testing are analyzed separately because caloric testing is a measure of peripheral function and OKN testing is considered to be a measure of central function. However, there is a connection between the visual system and the vestibular system in the vestibular nucleus of the brainstem. The purpose of this paper was to determine whether a relationship exists between optokinetic nystagmus results and unilateral caloric weakness results. This was determined by conducting a retrospective study of forty patients who exhibited a unilateral caloric weakness greater than or equal to twenty percent and symptoms consistent with an uncompensated vestibulopathy. Patients were later divided into two groups based on involved side. A control group consisting of ten subjects with no reported hearing or vestibular problems was also recruited.

When the data of all subjects with a unilateral caloric weakness was considered together, no correlation was found between caloric response (right and left ear) and optokinetic results (gain and slow phase velocity). However, a potential trend emerged at the slow stimulus velocity (15 degrees) when comparing the patients with a right caloric weakness to those with a left caloric weakness. Subjects with a right caloric weakness showed decreased OKN gain for the right eye with a right-moving stimulus compared to the subjects with a left caloric weakness. Alternatively, subjects with a left caloric weakness showed decreased OKN gain for the left eye with a left-moving stimulus compared to the subjects with a right caloric weakness. We conclude that interpretation of OKN along with caloric results may offer potential for identification and tracking of compensation after a unilateral loss of vestibular function, but further research is needed.

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