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There is a close interaction of the gravity detecting balance organs, the maculae of the saccule and utricle of the inner ear, with the hearing system of the inner ear. The need for this is that although they detect the sensations specific to their own function there is interference with this function due to overlap of wavelengths used by both systems resulting in extraordinary stimulation of the other system for both hearing and balance.

Eighteen patients were evaluated for dizziness and imbalance resulting from whiplash associated disorder. Assessment consisted of standard caloric testing and Computerized Dynamic Posturography [CDP]. Although the standard vestibular tests showed no abnormalities in any of these patients, thirteen of them had abnormalities on CDP. The concept of dizziness is variously attributed to problems from the neck, brainstem or bloodflow to the brain and is ill defined in the literature. In our patients, efforts were made to delineate specifically the patient's complaints by careful history, which included anecdotal problems the patient reported that were recognized as possibly coming from the balance system of the inner ear. Dizziness may be attributable to a vestibular site of lesion, with the CDP results supporting a provisional diagnosis that somehow implicates the balance system of the inner ear.

Tandem walking testing is a "standard" clinical technique for assessing balance and gait, but it is not a standardized test. We wished to develop a protocol by which we could measure sway during tandem walking at a patient's preferred cadence and at an altered cadence, which might be more challenging.Fifteen patients with vestibular complaints were evaluated with standard tandem walking testing while wearing the Swaystar belt-mounted accelerometer and were also assessed in the same way with tandem walking at two altered cadences.We measured tandem walking sway amplitude and sway velocity with eyes open in both pitch and roll planes at a patient's preferred cadence, at 75% of their preferred cadence, and at 125% of their preferred cadence.We measured total sway amplitude and sway velocity in pitch and roll planes during tandem walking with eyes open while wearing Swaystar to see if there was any increase in sway at nonpreferred cadences.There was no correlation between preferred cadence and the age of the patient. However, there was a significant increase in both sway amplitude and sway velocity at both of the nonpreferred cadences.Disruption of a patient's preferred cadence may present an unnatural task, and this challenge to a patient's innate gait may help detect subtle vestibular disease.

Objectif: Supporter l'hypothese que le syndrome connu sous le nom de visual vestibular mismatch (VVM) peut etre induit par une pathologie vestibulaire peripherique. Devis: Etude retrospective de dossiers avec questionnaire prospectif. Localisation: Clinique externe de soins tertiaires et quaternaires. Methodes: Nous avons etudie les dossiers de 28 patients traites pour maladie de Meniere. Leurs reponses a un questionnaire sur le VVM administre avant traitement ont ete comparees a celles donnees lors d'un questionnaire telephonique en suivi de traitement. Ces questionnaires ont aussi ete compares a ceux remplis par 100 controles sans pathologie de l'oreille. Variables: Reponse des patients au questionnaire sur le VVM. Resultats: Dix-sept des 28 patients avaient du VVM. Le traitement a la gentamycine a augmente le nombre de reponses positives. Il n'y avait pas de correlation entre le developpement du VVM, les tests caloriques, et la performance a la posturographie. Aucun controle ne presentait de symptomes de VVM. Conclusion: Nous concluons que le developpement de VVM indique l'apparition ou la deterioration d'une maladie vestibulaire puisqu'il peut etre induit ou exacerbe par la therapie a la gentamycine. Puisqu'il n'y a pas de correlation entre le VVM et les tests caloriques, nous suggerons qu'un dommage otolitique pourrait etre responsable pour l'apparition de ces symptomes.