Is there any relationship between unilateral vestibular neuritis and internal acoustic canal measurements?

Objectives: In this study, we aimed to compare the internal acoustic canal (IAC) measurements of the affected and unaffected sides of patients with unilateral vestibular neuritis (VN) on magnetic resonance imaging (MRI).Patients and Methods: January 2017 and December 2019, a total of 120 patients (65 males, 55 females; mean age 58.3±12.5 years; range, 21 to 83 years) who were diagnosed with VN according to clinical findings, video head impulse test (vHIT), and MRI findings were enrolled in this study. All measurements were performed on the axial constructive interference in steady state (CISS) sequences. The IAC inlet, mid-canal, and outlet widths were measured at the most distinctive cross-section of the facial nerve and superior vestibular nerve bifurcation. While calculating the length of IAC, the points were taken on the basis of where the inlet and outlet widths of the canal were measured.Results: According to the vHIT results, a single semicircular canal (SCC) was affected in 102 (85%) patients, while more than one SCC was affected in 18 (15%) patients. The inlet, mid-canal and outlet values of the affected side were significantly lower than those of the unaffected side (p0.05). All of these parameters were slightly higher in males; however, this difference was not statistically significant (p>0.05).Conclusion: Our study results showed that the widths of the IAC were lower in the affected side of patients with unilateral VN. These findings may help to explain why acute VN cases occur only unilaterally, suggesting that a small sectional diameter of the IAC is a potential risk factor for VN.

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1. Bartual-Pastor J. Vestibular neuritis: etiopathogenesis. Rev Laryngol Otol Rhinol (Bord) 2005;126:279-81.
2. Moretti G, Manzoni GC, Caffarra P, Parma M. "Benign recurrent vertigo" and its connection with migraine. Headache 1980;20:344-6.
3. Oh AK, Lee H, Jen JC, Corona S, Jacobson KM, Baloh RW. Familial benign recurrent vertigo. Am J Med Genet 2001;100:287-91.
4. Strupp M, Brandt T. Peripheral vestibular disorders. Curr Opin Neurol 2013;26:81-9.
5. Arbusow V, Schulz P, Strupp M, Dieterich M, von Reinhardstoettner A, Rauch E, et al. Distribution of herpes simplex virus type 1 in human geniculate and vestibular ganglia: implications for vestibular neuritis. Ann Neurol 1999;46:416-9.
6. Aw ST, Fetter M, Cremer PD, Karlberg M, Halmagyi GM. Individual semicircular canal function in superior and inferior vestibular neuritis. Neurology 2001;57:768-74.
7. Karlberg M, Annertz M, Magnusson M. Acute vestibular neuritis visualized by 3-T magnetic resonance imaging with high-dose gadolinium. Arch Otolaryngol Head Neck Surg 2004;130:229-32.
8. Silvoniemi P. Vestibular neuronitis. An otoneurological evaluation. Acta Otolaryngol Suppl 1988;453:1-72.
9. Strupp M, Arbusow V, Maag KP, Gall C, Brandt T. Vestibular exercises improve central vestibulospinal compensation after vestibular neuritis. Neurology 1998;51:838-44.
10. Strupp M, Zingler VC, Arbusow V, Niklas D, Maag KP, Dieterich M, et al. Methylprednisolone, valacyclovir, or the combination for vestibular neuritis. N Engl J Med 2004;351:354-61.
11. Hasuike K, Sekitani T, Imate Y. Enhanced MRI in patients with vestibular neuronitis. Acta Otolaryngol Suppl 1995;519:272-4.
12. Fundakowski CE, Anderson J, Angeli S. Cross-sectional vestibular nerve analysis in vestibular neuritis. Ann Otol Rhinol Laryngol 2012;121:466-70.
13. Yilmaz HB, Safak Yalcin K, Çakan D, Paksoy M, Erdogan BA, Sanli A. Is There a Relationship Between Bell’s Palsy and Internal Auditory Canal? Indian J Otolaryngol Head Neck Surg 2015;67:319-23.
14. Kim JS, Kim HJ. Inferior vestibular neuritis. J Neurol 2012;259:1553-60.
15. Taylor RL, McGarvie LA, Reid N, Young AS, Halmagyi GM, Welgampola MS. Vestibular neuritis affects both superior and inferior vestibular nerves. Neurology 2016;87:1704-12.
16. Lv YF, Zhang DG, Fan ZM, Li YW, Xu JL, Liu XF, et al. Frequency and position characteristics of the vestibular dysfunction in vestibular neuritis patients. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2016;30:602-5.
17. Lin CM, Young YH. Identifying the affected branches of vestibular nerve in vestibular neuritis. Acta Otolaryngol 2011;131:921-8.
18. Gianoli G, Goebel J, Mowry S, Poomipannit P. Anatomic differences in the lateral vestibular nerve channels and their implications in vestibular neuritis. Otol Neurotol 2005;26:489-94.
19. Goebel JA, O'Mara W, Gianoli G. Anatomic considerations in vestibular neuritis. Otol Neurotol 2001;22:512-8.
20. Kumral TL, Yıldırım G, Yılmaz HB, Ulusoy S, Berkiten G, Onol SD, et al. Is it necessary to do temporal bone computed tomography of the internal auditory canal in tinnitus with normal hearing? ScientificWorldJournal 2013;2013:689087.