Vestibular Atelectasis: A Narrative Review and Our Experience
Abstract
1. Introduction
2. Materials and Methods
3. Discussion
4. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
AC | Air-conducted |
AR | Asymmetry ratio |
ASC | Anterior semicircular canal |
BCT | Bithermal caloric test |
BLB | Blood–labyrinth barrier |
BVP | Bilateral vestibulopathy |
CSF | Cerebrospinal fluid |
cVEMPs | Cervical vestibular-evoked myogenic potentials |
EH | Endolymphatic hydrops |
FLAIR | Fluid attenuated inversion recovery |
HRCT | High-resolution computed tomography |
ILS | Intralabyrinthine schwannoma |
MD | Meniere’s disease |
MRI | Magnetic resonance imaging |
LSC | Lateral semicircular canal |
oVEMPs | Ocular vestibular-evoked myogenic potentials |
PLF | Perilymphatic fistula |
PSC | Posterior semicircular canal |
SC | Semicircular canal |
SNHL | Sensorineural hearing loss |
SVINT | Skull vibration-induced nystagmus test |
UVL | Unilateral vestibular loss |
VA | vestibular atelectasis |
VEMPs | Vestibular-evoked myogenic potentials |
vHIT | Video head impulse test |
VN | Vestibular neuritis |
VOR | Vestibulo-ocular reflex |
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Authors | Year | Type of Article | Field of the Study | N° of Cases with VA | Site of VA | Brief Description | Vestibular Assessment |
---|---|---|---|---|---|---|---|
Merchant and Schuknecht [1] | 1988 | Original Article | Histopathological | 11/426 | Unilateral degeneration of the superior labyrinth (SCs + utricle) | First histopathological evidence of a new clinical entity. Distinction between primary and secondary variants and possible pathophysiological explanations. | BCT: different responses (either normal or irregular responses) |
Nadol and Schuknecht [17] | 1990 | Original Article | Histopathological | 1/14 | Unilateral degeneration of the superior labyrinth (SCs + utricle) | Classification of the causes of vertigo in the elderly illustrated through clinical and histopathological cases. | / |
Kehetarpal [18] | 1991 | Original Article | Histopathological | 2 | Unilateral degeneration of the inferior labyrinth (cochlea + saccule) | First description of cochleo-saccular atelectasis in patient with idiopathic sudden SNHL. | / |
Nomura et al. [22] | 1992 | Original Article | Animal model | / | / | An experimentally induced PLF in guinea pigs causes a collapse of the membranous labyrinth. | Paretic spontaneous nystagmus and positional nystagmus with the lesioned ear undermost. BCT: different responses (either areflexia, normal responses or irregular responses). |
Nomura et al. [26] | 1992 | Case Report | Clinical | / | / | Two patients with PLF. | Positional nystagmus with the lesioned ear undermost BCT: different responses (either normal or irregular responses). |
Young et al. [24] | 1992 | Original Article | Animal model | / | Partial collapse (floating labyrinth) or total collapse (VA) of the membranous labyrinth | The term ‘floating labyrinth’ corresponds to partial VA. | Paretic spontaneous nystagmus and positional nystagmus with the lesioned ear undermost. |
Young et al. [23] | 1992 | Original Article | Animal model | 6/46 | Partial collapse of the membranous labyrinth (floating labyrinth) | Floating labyrinth as an intermediate stage VA and a normal membranous labyrinth. | BCT: different responses (either areflexia, normal responses or irregular responses). |
Nadol [19] | 1995 | Original Article | Histopathological | 2 | / | VA can be included in the differential diagnosis with VN. | / |
Kawaguchi et al. [27] | 2010 | Original Article | Animal model | / | / | “Waltzing” guinea pig: a new model for studying VA. Labyrinthine collapse resulting in severe degeneration in the dark cell area. | / |
Viana et al. [20] | 2013 | Original Article | Histopathological | 1 | Bilateral degeneration of all the SCs with saccule and utricle preservation | Idiopathic Dandy Syndrome. Reduction in neurons in Scarpa’s and Spiral’s ganglions. | / |
Wenzel et al. [2] | 2014 | Original Article | Clinical | 4 | Bilateral SCs and utricular collapse associated with sound/pressure-induced vertigo and normal hearing | First description of sound/pressure-induced vertigo in VA. Pathophysiological explanation: dissociation between low- and high-frequency responses. | BCT: bilateral areflexia vHIT: bilateral VOR reduction for all the SCs |
Finn et al. [3] | 2018 | Case Report | Clinical | 1 | BVP. | Sound/pressure-induced nystagmus, no hearing loss. BCT: bilateral areflexia. vHIT: bilateral VOR reduction for all the SCs cVEMPs: normal, oVEMPs: bilateral reduction. | |
Heidenreich et al. [48] | 2018 | Original Article | Clinical | 3 | BVP with sound/pressure-induced vertigo | EcochG application in patients with BVP. | Sound/pressure-induced nystagmu. BCT: bilateral hypofunction. Rotatory chair: decreased gain vHIT: bilateral VOR reduction for all the SCs cVEMPs: normal. |
Maslovara et al. [5] | 2018 | Case Report | Clinical | 1 | Bilateral VA | Sound/pressure-induced nystagmus. BCT: bilateral areflexia. cVEMPs: normal, oVEMPs: bilateral reduction. | |
Roy et al. [4] | 2019 | Case Report | Clinical | 1 | Bilateral VA | Sound-induced nystagmus. | |
Eliezer et al. [7] | 2019 | Original Article | Radiological | 4/200 | Unilateral VA with collapse of the superior labyrinth (SCs + utricle) | First description in vivo of VA with 3T -MRI and radiological definition of partial and total labyrinthine collapse. | BCT: unilateral areflexia. vHIT: VOR gain. reduction for LSC and PSC. cVEMPs: normal. oVEMPs: absent. |
Eliezer et al. [8] | 2019 | Case Report | Clinical | 1 | Bilateral VA with collapse of the superior labyrinth (SCs + utricle) | First description in vivo of bilateral labyrinthine collapse. VA as a cause of BVP. | BCT: bilateral areflexia. vHIT: bilateral VOR reduction for all the SCs. oVEMPs: bilaterally absent. |
Eliezer et al. [53] | 2020 | Original Article | Clinical | 21/42 | Bilateral VA with collapse of the superior labyrinth (SCs + utricle) | Electrophysiological and MRI findings in patient with BVP. | vHIT: bilateral VOR reduction for all the SCs (ASC spared in four cases, LSC spared in one case). cVEMPs: impaired (5/21). oVEMPa: impaired (19/21). |
Marc et al. [6] | 2020 | Original Article | Clinical | 22 | Unilateral VA | Description of various clinical presentation of unilateral VA. | Sound-induced vertigo (2/22). BCT: hypo/areflexia. vHIT: VOR reduction for one or more SCs. cVEMPs: abnormal in 54% of cases. oVEMP:s abnormal in 82% of cases. |
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Tozzi, A.; Castellucci, A.; Martellucci, S.; Malara, P.; Eliezer, M.; Ferrulli, G.; Ruberto, R.R.; Brizzi, P.; Armato, E.; Marchetti, A.; et al. Vestibular Atelectasis: A Narrative Review and Our Experience. Audiol. Res. 2025, 15, 61. https://doi.org/10.3390/audiolres15030061
Tozzi A, Castellucci A, Martellucci S, Malara P, Eliezer M, Ferrulli G, Ruberto RR, Brizzi P, Armato E, Marchetti A, et al. Vestibular Atelectasis: A Narrative Review and Our Experience. Audiology Research. 2025; 15(3):61. https://doi.org/10.3390/audiolres15030061
Chicago/Turabian StyleTozzi, Andrea, Andrea Castellucci, Salvatore Martellucci, Pasquale Malara, Michael Eliezer, Giuseppe Ferrulli, Rosanna Rita Ruberto, Pasquale Brizzi, Enrico Armato, Alessio Marchetti, and et al. 2025. "Vestibular Atelectasis: A Narrative Review and Our Experience" Audiology Research 15, no. 3: 61. https://doi.org/10.3390/audiolres15030061
APA StyleTozzi, A., Castellucci, A., Martellucci, S., Malara, P., Eliezer, M., Ferrulli, G., Ruberto, R. R., Brizzi, P., Armato, E., Marchetti, A., Marchioni, D., Ghidini, A., & Moratti, C. (2025). Vestibular Atelectasis: A Narrative Review and Our Experience. Audiology Research, 15(3), 61. https://doi.org/10.3390/audiolres15030061