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Vestibulocochlear Symptoms Caused by Vertebrobasilar Dolichoectasia.

Abstract：

OBJECTIVES:Vertebrobasilar dolichoectasia (VBD), an elongation and distension of vertebrobasilar artery, may present with cranial nerve symptoms due to nerve root compression. The objectives of this study are to summarize vestibulocochlear manifestations in subjects with VBD through a case series and to discuss the needs of thorough oto-neurotologic evaluation in VBD subjects before selecting treatment modalities. METHODS:Four VBD subjects with vestibulocochlear manifestations were reviewed retrospectively. VBD was confirmed by either brain or internal auditory canal magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA). Patient information, medical history, MRI/MRA findings, and audiometry or vestibular function tests were reviewed according to patient's specific symptom. RESULTS:Of the four subjects, three presented with ipsilesional sensorineural hearing loss (SNHL), three with paroxysmal recurrent vertigo, and two with typewriter tinnitus. The MRI/MRA of the four subjects revealed unilateral VBD with neurovascular compression of cisternal segment or the brainstem causing displacement, angulation, or deformity of the cranial nerve VII or VIII that corresponded to the symptoms. CONCLUSION:Vestibulocochlear symptoms such as SNHL, recurrent paroxysmal vertigo, or typewriter tinnitus can be precipitated from a neurovascular compression of the vestibulocochlear nerve by VBD. Because proper medical or surgical treatments may stop the disease progression or improve audio-vestibular symptoms in subjects with VBD, a high index of suspicion and meticulous radiologic evaluation are needed when vestibulocochlear symptoms are not otherwise explainable, and if VBD is confirmed to cause audiovestibular manifestation, a thorough oto-neurotologic evaluation should be performed before initial treatment.

journal_name

Clin Exp Otorhinolaryngol

journal_title

Clinical and experimental otorhinolaryngology

authors

Huh G,Bae YJ,Woo HJ,Park JH,Koo JW,Song JJ

doi

10.21053/ceo.2019.00780

subject

Has Abstract

pub_date

2020-05-01 00:00:00

pages

123-132

issue

eissn

1976-8710

issn

2005-0720

pii

ceo.2019.00780

journal_volume

pub_type

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Vestibulocochlear Symptoms Caused by Vertebrobasilar Dolichoectasia.