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Semin Neurol 2013; 33(03): 185-194
DOI: 10.1055/s-0033-1354598
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Vestibular Neuritis

Seong-Hae Jeong
1   Department of Neurology, Chungnam National University Hospital, Daejeon, Korea
,
Hyo-Jung Kim
2   Biomedical Research Institute, Seoul National University Bundang Hospital, Seongnam, Korea
,
Ji-Soo Kim
3   Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
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Publikationsdatum:
21. September 2013 (online)

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Abstract

Vestibular neuritis is the most common cause of acute spontaneous vertigo. Vestibular neuritis is ascribed to acute unilateral loss of vestibular function, probably due to reactivation of herpes simplex virus in the vestibular ganglia. The diagnostic hallmarks of vestibular neuritis are spontaneous horizontal-torsional nystagmus beating away from the lesion side, abnormal head impulse test for the involved semicircular canals, ipsilesional caloric paresis, decreased responses of vestibular-evoked myogenic potentials during stimulation of the affected ear, and unsteadiness with a falling tendency toward the lesion side. Vestibular neuritis preferentially involves the superior vestibular labyrinth and its afferents. Accordingly, the function of the posterior semicircular canal and saccule, which constitute the inferior vestibular labyrinth, is mostly spared in vestibular neuritis. However, because the rare subtype of inferior vestibular neuritis lacks the typical features of vestibular neuritis, it may be misdiagnosed as a central vestibular disorder. Even in the patient with the typical pattern of spontaneous nystagmus observed in vestibular neuritis, brain imaging is indicated when the patient has unprecedented headache, negative head impulse test, severe unsteadiness, or no recovery within 1 to 2 days. Symptomatic medication is indicated only during the acute phase to relieve the vertigo and nausea/vomiting. Vestibular rehabilitation hastens the recovery. The efficacy of topical and systemic steroids requires further validation.

Keywords

vestibular neuritis - vertigo - nystagmus - head impulse test - vestibular evoked myogenic potential
 

  • References

  • 1 Baloh RW, Kerber KA. Clinical Neurophysiology of the Vestibular System. 4th ed. New York: Oxford University Press; 2011
    CrossrefSuche in Google Scholar
  • 2 Dix MR, Hallpike CS. The pathology, symptomatology and diagnosis of certain common disorders of the vestibular system. Ann Otol Rhinol Laryngol 1952; 61 (4) 987-1016
    CrossrefPubMedSuche in Google Scholar
  • 3 Kroenke K, Hoffman RM, Einstadter D. How common are various causes of dizziness? A critical review. South Med J 2000; 93 (2) 160-167 , quiz 168
    PubMedSuche in Google Scholar
  • 4 Brandt T, Dieterich M, Strupp M. Vertigo and dizziness: common complaints. London: Springer; 2005
    Suche in Google Scholar
  • 5 Sekitani T, Imate Y, Noguchi T, Inokuma T. Vestibular neuronitis: epidemiological survey by questionnaire in Japan. Acta Otolaryngol Suppl 1993; 503: 9-12
    PubMedSuche in Google Scholar
  • 6 Strupp M, Brandt T. Vestibular neuritis. Semin Neurol 2009; 29 (5) 509-519
    Thieme ConnectPubMedSuche in Google Scholar
  • 7 Halmagyi GM, Weber KP, Curthoys IS. Vestibular function after acute vestibular neuritis. Restor Neurol Neurosci 2010; 28 (1) 37-46
    PubMedSuche in Google Scholar
  • 8 Halmagyi GM, Curthoys IS. A clinical sign of canal paresis. Arch Neurol 1988; 45 (7) 737-739
    CrossrefPubMedSuche in Google Scholar
  • 9 Halmagyi GM, Aw ST, Cremer PD, Curthoys IS, Todd MJ. Impulsive testing of individual semicircular canal function. Ann N Y Acad Sci 2001; 942: 192-200
    PubMedSuche in Google Scholar
  • 10 Halmagyi GM, Colebatch JG. Vestibular evoked myogenic potentials in the sternomastoid muscle are not of lateral canal origin. Acta Otolaryngol Suppl 1995; 520 (Pt 1) 1-3
    PubMedSuche in Google Scholar
  • 11 Rosengren SM, McAngus Todd NP, Colebatch JG. Vestibular-evoked extraocular potentials produced by stimulation with bone-conducted sound. Clin Neurophysiol 2005; 116 (8) 1938-1948
    CrossrefPubMedSuche in Google Scholar
  • 12 Fetter M, Dichgans J. Vestibular neuritis spares the inferior division of the vestibular nerve. Brain 1996; 119 (Pt 3) 755-763
    CrossrefPubMedSuche in Google Scholar
  • 13 Aw ST, Fetter M, Cremer PD, Karlberg M, Halmagyi GM. Individual semicircular canal function in superior and inferior vestibular neuritis. Neurology 2001; 57 (5) 768-774
    CrossrefPubMedSuche in Google Scholar
  • 14 Shin BS, Oh SY, Kim JS , et al. Cervical and ocular vestibular-evoked myogenic potentials in acute vestibular neuritis. Clin Neurophysiol 2012; 123 (2) 369-375
    CrossrefPubMedSuche in Google Scholar
  • 15 Lin CM, Young YH. Identifying the affected branches of vestibular nerve in vestibular neuritis. Acta Otolaryngol 2011; 131 (9) 921-928
    CrossrefPubMedSuche in Google Scholar
  • 16 Bartolomeo M, Biboulet R, Pierre G, Mondain M, Uziel A, Venail F. Value of the video head impulse test in assessing vestibular deficits following vestibular neuritis. Eur Arch Otorhinolaryngol 2013; ; Epub ahead of print
    PubMedSuche in Google Scholar
  • 17 Walther LE, Blödow A. Ocular vestibular evoked myogenic potential to air conducted sound stimulation and video head impulse test in acute vestibular neuritis. Otol Neurotol 2013; 34 (6) 1084-1089
    CrossrefPubMedSuche in Google Scholar
  • 18 Kim JS, Kim HJ. Inferior vestibular neuritis. J Neurol 2012; 259 (8) 1553-1560
    CrossrefPubMedSuche in Google Scholar
  • 19 Kim JS, Lee H. Inner ear dysfunction due to vertebrobasilar ischemic stroke. Semin Neurol 2009; 29 (5) 534-540
    Thieme ConnectPubMedSuche in Google Scholar
  • 20 Choi KD, Lee H, Kim JS. Vertigo in brainstem and cerebellar strokes. Curr Opin Neurol 2013; 26 (1) 90-95
    CrossrefPubMedSuche in Google Scholar
  • 21 Lee H, Sohn SI, Cho YW , et al. Cerebellar infarction presenting isolated vertigo: frequency and vascular topographical patterns. Neurology 2006; 67 (7) 1178-1183
    CrossrefPubMedSuche in Google Scholar
  • 22 Hotson JR, Baloh RW. Acute vestibular syndrome. N Engl J Med 1998; 339 (10) 680-685
    CrossrefPubMedSuche in Google Scholar
  • 23 Baloh RW. Clinical practice. Vestibular neuritis. N Engl J Med 2003; 348 (11) 1027-1032
    CrossrefPubMedSuche in Google Scholar
  • 24 Lee H, Kim BK, Park HJ, Koo JW, Kim JS. Prodromal dizziness in vestibular neuritis: frequency and clinical implication. J Neurol Neurosurg Psychiatry 2009; 80 (3) 355-356
    CrossrefPubMedSuche in Google Scholar
  • 25 Silvoniemi P. Vestibular neuronitis. An otoneurological evaluation. Acta Otolaryngol Suppl 1988; 453: 1-72
    PubMedSuche in Google Scholar
  • 26 Suzuki JI, Cohen B. Head, eye, body and limb movements from semicircular canal nerves. Exp Neurol 1964; 10: 393-405
    CrossrefPubMedSuche in Google Scholar
  • 27 Leigh RJ, Zee DS. The neurology of eye movements. 4th ed. New York, NY: Oxford University Press; 2006
    Suche in Google Scholar
  • 28 Choi KD, Oh SY, Kim HJ, Koo JW, Cho BM, Kim JS. Recovery of vestibular imbalances after vestibular neuritis. Laryngoscope 2007; 117 (7) 1307-1312
    CrossrefPubMedSuche in Google Scholar
  • 29 Choi KD, Kim JS, Kim HJ , et al. Hyperventilation-induced nystagmus in peripheral vestibulopathy and cerebellopontine angle tumor. Neurology 2007; 69 (10) 1050-1059
    CrossrefPubMedSuche in Google Scholar
  • 30 Brandt T, Dieterich M. Vestibular falls. J Vestib Res 1993; 3 (1) 3-14
    PubMedSuche in Google Scholar
  • 31 Davis LE. Viruses and vestibular neuritis: review of human and animal studies. Acta Otolaryngol Suppl 1993; 503: 70-73
    PubMedSuche in Google Scholar
  • 32 Arbusow V, Schulz P, Strupp M , et al. Distribution of herpes simplex virus type 1 in human geniculate and vestibular ganglia: implications for vestibular neuritis. Ann Neurol 1999; 46 (3) 416-419
    CrossrefPubMedSuche in Google Scholar
  • 33 Arbusow V, Derfuss T, Held K , et al. Latency of herpes simplex virus type-1 in human geniculate and vestibular ganglia is associated with infiltration of CD8+ T cells. J Med Virol 2010; 82 (11) 1917-1920
    CrossrefPubMedSuche in Google Scholar
  • 34 Esaki S, Goshima F, Kimura H , et al. Auditory and vestibular defects induced by experimental labyrinthitis following herpes simplex virus in mice. Acta Otolaryngol 2011; 131 (7) 684-691
    CrossrefPubMedSuche in Google Scholar
  • 35 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 (3) 489-494
    CrossrefPubMedSuche in Google Scholar
  • 36 Bergström B. Morphology of the vestibular nerve. II. The number of myelinated vestibular nerve fibers in man at various ages. Acta Otolaryngol 1973; 76 (2) 173-179
    CrossrefPubMedSuche in Google Scholar
  • 37 Choi KD, Oh SY, Park SH, Kim JH, Koo JW, Kim JS. Head-shaking nystagmus in lateral medullary infarction: patterns and possible mechanisms. Neurology 2007; 68 (17) 1337-1344
    CrossrefPubMedSuche in Google Scholar
  • 38 Jorns-Häderli M, Straumann D, Palla A. Accuracy of the bedside head impulse test in detecting vestibular hypofunction. J Neurol Neurosurg Psychiatry 2007; 78 (10) 1113-1118
    CrossrefPubMedSuche in Google Scholar
  • 39 Perez N, Rama-Lopez J. Head-impulse and caloric tests in patients with dizziness. Otol Neurotol 2003; 24 (6) 913-917
    CrossrefPubMedSuche in Google Scholar
  • 40 Weber KP, Aw ST, Todd MJ, McGarvie LA, Curthoys IS, Halmagyi GM. Head impulse test in unilateral vestibular loss: vestibulo-ocular reflex and catch-up saccades. Neurology 2008; 70 (6) 454-463
    CrossrefPubMedSuche in Google Scholar
  • 41 MacDougall HG, Weber KP, McGarvie LA, Halmagyi GM, Curthoys IS. The video head impulse test: diagnostic accuracy in peripheral vestibulopathy. Neurology 2009; 73 (14) 1134-1141
    CrossrefPubMedSuche in Google Scholar
  • 42 Kim HA, Hong JH, Lee H , et al. Otolith dysfunction in vestibular neuritis: recovery pattern and a predictor of symptom recovery. Neurology 2008; 70 (6) 449-453
    CrossrefPubMedSuche in Google Scholar
  • 43 Curthoys IS, Dai MJ, Halmagyi GM. Human ocular torsional position before and after unilateral vestibular neurectomy. Exp Brain Res 1991; 85 (1) 218-225
    PubMedSuche in Google Scholar
  • 44 Tabak S, Collewijn H, Boumans LJ. Deviation of the subjective vertical in long-standing unilateral vestibular loss. Acta Otolaryngol 1997; 117 (1) 1-6
    CrossrefPubMedSuche in Google Scholar
  • 45 Vibert D, Häusler R. Long-term evolution of subjective visual vertical after vestibular neurectomy and labyrinthectomy. Acta Otolaryngol 2000; 120 (5) 620-622
    CrossrefPubMedSuche in Google Scholar
  • 46 Zwergal A, Rettinger N, Frenzel C, Dieterich M, Brandt T, Strupp M. A bucket of static vestibular function. Neurology 2009; 72 (19) 1689-1692
    CrossrefPubMedSuche in Google Scholar
  • 47 Kushiro K, Zakir M, Ogawa Y, Sato H, Uchino Y. Saccular and utricular inputs to sternocleidomastoid motoneurons of decerebrate cats. Exp Brain Res 1999; 126 (3) 410-416
    CrossrefPubMedSuche in Google Scholar
  • 48 Govender S, Colebatch JG. Ocular vestibular evoked myogenic potential (oVEMP) responses in acute vestibular neuritis. Clin Neurophysiol 2012; 123 (5) 1054-1055 , author reply 1055–1056, discussion 1056–1057
    CrossrefPubMedSuche in Google Scholar
  • 49 Isu N, Graf W, Sato H , et al. Sacculo-ocular reflex connectivity in cats. Exp Brain Res 2000; 131 (3) 262-268
    CrossrefPubMedSuche in Google Scholar
  • 50 Curthoys IS. The interpretation of clinical tests of peripheral vestibular function. Laryngoscope 2012; 122 (6) 1342-1352
    CrossrefPubMedSuche in Google Scholar
  • 51 Brantberg K, Tribukait A, Fransson PA. Vestibular evoked myogenic potentials in response to skull taps for patients with vestibular neuritis. J Vestib Res 2003; 13 (2-3) 121-130
    PubMedSuche in Google Scholar
  • 52 Halmagyi GM, Carey JP. Vestibular evoked myogenic potentials - we live in interesting times. Clin Neurophysiol 2010; 121 (5) 631-633
    CrossrefPubMedSuche in Google Scholar
  • 53 Rosengren SM, Kingma H. New perspectives on vestibular evoked myogenic potentials. Curr Opin Neurol 2013; 26 (1) 74-80
    CrossrefPubMedSuche in Google Scholar
  • 54 Ushio M, Iwasaki S, Murofushi T , et al. The diagnostic value of vestibular-evoked myogenic potential in patients with vestibular schwannoma. Clin Neurophysiol 2009; 120 (6) 1149-1153
    CrossrefPubMedSuche in Google Scholar
  • 55 Curthoys IS, Iwasaki S, Chihara Y, Ushio M, McGarvie LA, Burgess AM. The ocular vestibular-evoked myogenic potential to air-conducted sound; probable superior vestibular nerve origin. Clin Neurophysiol 2011; 122 (3) 611-616
    CrossrefPubMedSuche in Google Scholar
  • 56 Baloh RW, Jacobson KM, Beykirch K, Honrubia V. Horizontal vestibulo-ocular reflex after acute peripheral lesions. Acta Otolaryngol Suppl 1989; 468: 323-327
    PubMedSuche in Google Scholar
  • 57 Brantberg K, Magnusson M. The dynamics of the vestibulo-ocular reflex in patients with vestibular neuritis. Am J Otolaryngol 1990; 11 (5) 345-351
    CrossrefPubMedSuche in Google Scholar
  • 58 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 (2) 229-232
    CrossrefPubMedSuche in Google Scholar
  • 59 Halmagyi GM, Weber KP, Curthoys IS. Vestibular function after acute vestibular neuritis. Restor Neurol Neurosci 2010; 28 (1) 37-46
    PubMedSuche in Google Scholar
  • 60 Monstad P, Økstad S, Mygland A. Inferior vestibular neuritis: 3 cases with clinical features of acute vestibular neuritis, normal calorics but indications of saccular failure. BMC Neurol 2006; 6: 45
    CrossrefPubMedSuche in Google Scholar
  • 61 Halmagyi GM, Aw ST, Karlberg M, Curthoys IS, Todd MJ. Inferior vestibular neuritis. Ann N Y Acad Sci 2002; 956: 306-313
    CrossrefPubMedSuche in Google Scholar
  • 62 Kim JS, Kim HJ. Inferior vestibular neuritis. J Neurol 2012; 259 (8) 1553-1560
    CrossrefPubMedSuche in Google Scholar
  • 63 Gliddon CM, Darlington CL, Smith PF. GABAergic systems in the vestibular nucleus and their contribution to vestibular compensation. Prog Neurobiol 2005; 75 (1) 53-81
    CrossrefPubMedSuche in Google Scholar
  • 64 Strupp M, Arbusow V, Maag KP, Gall C, Brandt T. Vestibular exercises improve central vestibulospinal compensation after vestibular neuritis. Neurology 1998; 51 (3) 838-844
    CrossrefPubMedSuche in Google Scholar
  • 65 Lacour M, Tighilet B. Plastic events in the vestibular nuclei during vestibular compensation: the brain orchestration of a “deafferentation” code. Restor Neurol Neurosci 2010; 28 (1) 19-35
    PubMedSuche in Google Scholar
  • 66 Jacobson GP, Pearlstein R, Henderson J, Calder JH, Rock J. Recovery nystagmus revisited. J Am Acad Audiol 1998; 9 (4) 263-271
    PubMedSuche in Google Scholar
  • 67 Allum JH, Ledin T. Recovery of vestibulo-ocular reflex-function in subjects with an acute unilateral peripheral vestibular deficit. J Vestib Res 1999; 9 (2) 135-144
    PubMedSuche in Google Scholar
  • 68 Allum JH, Adkin AL. Improvements in trunk sway observed for stance and gait tasks during recovery from an acute unilateral peripheral vestibular deficit. Audiol Neurootol 2003; 8 (5) 286-302
    PubMedSuche in Google Scholar
  • 69 Allum JH, Yamane M, Pfaltz CR. Long-term modifications of vertical and horizontal vestibulo-ocular reflex dynamics in man. I. After acute unilateral peripheral vestibular paralysis. Acta Otolaryngol 1988; 105 (3-4) 328-337
    CrossrefPubMedSuche in Google Scholar
  • 70 Herdman SJ. Vestibular rehabilitation. Curr Opin Neurol 2013; 26 (1) 96-101
    CrossrefPubMedSuche in Google Scholar
  • 71 Huppert D, Strupp M, Theil D, Glaser M, Brandt T. Low recurrence rate of vestibular neuritis: a long-term follow-up. Neurology 2006; 67 (10) 1870-1871
    CrossrefPubMedSuche in Google Scholar
  • 72 Kim YH, Kim KS, Kim KJ, Choi H, Choi JS, Hwang IK. Recurrence of vertigo in patients with vestibular neuritis. Acta Otolaryngol 2011; 131 (11) 1172-1177
    CrossrefPubMedSuche in Google Scholar
  • 73 Mandalà M, Santoro GP, Awrey J, Nuti D. Vestibular neuritis: recurrence and incidence of secondary benign paroxysmal positional vertigo. Acta Otolaryngol 2010; 130 (5) 565-567
    CrossrefPubMedSuche in Google Scholar
  • 74 Brandt T. Phobic postural vertigo. Neurology 1996; 46 (6) 1515-1519
    CrossrefPubMedSuche in Google Scholar
  • 75 Lee H, Kim JS, Chung EJ , et al. Infarction in the territory of anterior inferior cerebellar artery: spectrum of audiovestibular loss. Stroke 2009; 40 (12) 3745-3751
    CrossrefPubMedSuche in Google Scholar
  • 76 Kim JS, Cho KH, Lee H. Isolated labyrinthine infarction as a harbinger of anterior inferior cerebellar artery territory infarction with normal diffusion-weighted brain MRI. J Neurol Sci 2009; 278 (1-2) 82-84
    CrossrefPubMedSuche in Google Scholar
  • 77 Kim HA, Lee H. Isolated vestibular nucleus infarction mimicking acute peripheral vestibulopathy. Stroke 2010; 41 (7) 1558-1560
    CrossrefPubMedSuche in Google Scholar
  • 78 Lee H, Cho YW. A case of isolated nodulus infarction presenting as a vestibular neuritis. J Neurol Sci 2004; 221 (1-2) 117-119
    CrossrefPubMedSuche in Google Scholar
  • 79 Park HK, Kim JS, Strupp M, Zee DS. Isolated floccular infarction: impaired vestibular responses to horizontal head impulse. J Neurol 2013; 260 (6) 1576-1582
    CrossrefPubMedSuche in Google Scholar
  • 80 Kim DR, Lee HJ, Kim HJ, Hong SK. Dynamic changes in the inner ear function and vestibular neural pathway related to the progression of labyrinthine infarction in patient with an anterior inferior cerebellar artery infarction. Otol Neurotol 2011; 32 (9) 1596-1599
    CrossrefPubMedSuche in Google Scholar
  • 81 Thömke F, Hopf HC. Pontine lesions mimicking acute peripheral vestibulopathy. J Neurol Neurosurg Psychiatry 1999; 66 (3) 340-349
    CrossrefPubMedSuche in Google Scholar
  • 82 Kattah JC, Talkad AV, Wang DZ, Hsieh YH, Newman-Toker DE. HINTS to diagnose stroke in the acute vestibular syndrome: three-step bedside oculomotor examination more sensitive than early MRI diffusion-weighted imaging. Stroke 2009; 40 (11) 3504-3510
    CrossrefPubMedSuche in Google Scholar
  • 83 Tarnutzer AA, Berkowitz AL, Robinson KA, Hsieh YH, Newman-Toker DE. Does my dizzy patient have a stroke? A systematic review of bedside diagnosis in acute vestibular syndrome. CMAJ 2011; 183 (9) E571-E592
    CrossrefPubMedSuche in Google Scholar
  • 84 Chen L, Lee W, Chambers BR, Dewey HM. Diagnostic accuracy of acute vestibular syndrome at the bedside in a stroke unit. J Neurol 2011; 258 (5) 855-861
    CrossrefPubMedSuche in Google Scholar
  • 85 Newman-Toker DE, Kattah JC, Alvernia JE, Wang DZ. Normal head impulse test differentiates acute cerebellar strokes from vestibular neuritis. Neurology 2008; 70 (24 Pt 2) 2378-2385
    CrossrefPubMedSuche in Google Scholar
  • 86 Cnyrim CD, Newman-Toker D, Karch C, Brandt T, Strupp M. Bedside differentiation of vestibular neuritis from central “vestibular pseudoneuritis”. J Neurol Neurosurg Psychiatry 2008; 79 (4) 458-460
    CrossrefPubMedSuche in Google Scholar
  • 87 Kremmyda O, Kirchner H, Glasauer S, Brandt T, Jahn K, Strupp M. False-positive head-impulse test in cerebellar ataxia. Front Neurol 2012; 3: 162
    PubMedSuche in Google Scholar
  • 88 Kerber KA. Vertigo and dizziness in the emergency department. Emerg Med Clin North Am 2009; 27 (1) 39-50 , viii
    CrossrefPubMedSuche in Google Scholar
  • 89 Strupp M, Zingler VC, Arbusow V , et al. Methylprednisolone, valacyclovir, or the combination for vestibular neuritis. N Engl J Med 2004; 351 (4) 354-361
    CrossrefPubMedSuche in Google Scholar
  • 90 Fishman JM, Burgess C, Waddell A. Corticosteroids for the treatment of idiopathic acute vestibular dysfunction (vestibular neuritis). Cochrane Database Syst Rev 2011; 11 (5) CD008607
    PubMedSuche in Google Scholar
  • 91 Wegner I, van Benthem PP, Aarts MC, Bruintjes TD, Grolman W, van der Heijden GJ. Insufficient evidence for the effect of corticosteroid treatment on recovery of vestibular neuritis. Otolaryngol Head Neck Surg 2012; 147 (5) 826-831
    CrossrefPubMedSuche in Google Scholar
  • 92 Sparrer I, Duong Dinh TA, Ilgner J, Westhofen M. Vestibular rehabilitation using the Nintendo® Wii Balance Board — a user-friendly alternative for central nervous compensation. Acta Otolaryngol 2013; 133 (3) 239-245
    CrossrefPubMedSuche in Google Scholar
  • 93 Della Santina CC, Potyagaylo V, Migliaccio AA, Minor LB, Carey JP. Orientation of human semicircular canals measured by three-dimensional multiplanar CT reconstruction. J Assoc Res Otolaryngol 2005; 6 (3) 191-206
    CrossrefPubMedSuche in Google Scholar
  • 94 Blanks RH, Curthoys IS, Markham CH. Planar relationships of the semicircular canals in man. Acta Otolaryngol 1975; 80 (3-4) 185-196
    CrossrefPubMedSuche in Google Scholar