Display options
Cite
Walther LE. Procedures for restoring vestibular disorders. GMS Curr Top Otorhinolaryngol Head Neck Surg. 2005;4:Doc05
Walther, L. E. (2005). Procedures for restoring vestibular disorders. GMS current topics in otorhinolaryngology, head and neck surgery, 4Doc05.
Walther, Leif Erik. "Procedures for restoring vestibular disorders." GMS current topics in otorhinolaryngology, head and neck surgery vol. 4 (2005): Doc05.
Walther LE. Procedures for restoring vestibular disorders. GMS Curr Top Otorhinolaryngol Head Neck Surg. 2005;4:Doc05. Epub 2005 Sep 28. PMID: 22073053; PMCID: PMC3201005.
Copy Download .nbib Format: NLM
Share it on

GMS Curr Top Otorhinolaryngol Head Neck Surg. 2005;4:Doc05. Epub 2005 Sep 28.

Procedures for restoring vestibular disorders.

GMS current topics in otorhinolaryngology, head and neck surgery

Leif Erik Walther

Affiliations

  1. Department for Otolaryngology and Head and Neck Surgery, University Hospital Aachen.

PMID: 22073053 PMCID: PMC3201005

Abstract

This paper will discuss therapeutic possibilities for disorders of the vestibular organs and the neurons involved, which confront ENT clinicians in everyday practice. Treatment of such disorders can be tackled either symptomatically or causally. The possible strategies for restoring the body's vestibular sense, visual function and co-ordination include medication, as well as physical and surgical procedures. Prophylactic or preventive measures are possible in some disorders which involve vertigo (bilateral vestibulopathy, kinetosis, height vertigo, vestibular disorders when diving (Tables 1 (Tab. 1) and 2 (Tab. 2)). Glucocorticoid and training therapy encourage the compensation of unilateral vestibular loss. In the case of a bilateral vestibular loss, it is important to treat the underlying disease (e.g. Cogan's disease). Although balance training does improve the patient's sense of balance, it will not restore it completely.In the case of Meniere's disease, there are a number of medications available to either treat bouts or to act as a prophylactic (e.g. dimenhydrinate or betahistine). In addition, there are non-ablative (sacculotomy) as well as ablative surgical procedures (e.g. labyrinthectomy, neurectomy of the vestibular nerve). In everyday practice, it has become common to proceed with low risk therapies initially. The physical treatment of mild postural vertigo can be carried out quickly and easily in outpatients (repositioning or liberatory maneuvers). In very rare cases it may be necessary to carry out a semicircular canal occlusion.Isolated disturbances of the otolith function or an involvement of the otolith can be found in roughly 50% of labyrinth disturbances. A specific surgical procedure to selectively block the otolith organs is currently being studied. When an external perilymph fistula involving loss of perilymph is suspected, an exploratory tympanotomy involving also the round and oval window niches must be carried out. A traumatic rupture of the round window membrane can, for example, also be caused by an implosive inner ear barotrauma during the decompression phase of diving. Dehiscence of the anterior semicircular canal, a relatively rare disorder, can be treated conservatively (avoiding stimuli which cause dizziness), by non-ablative "resurfacing" or by "plugging" the semicircular canal. A perilymph fistula can cause a Tullio-phenomenon resulting from a traumatic dislocation or hypermobility of the stapes, which can be surgically corrected. Vestibular disorders can also result from otosurgical therapy. When balance disorders persist following stapedectomy it is necessary to carry out a revision operation in order to either exclude a perilymph fistula or shorten the piston. Surgically reducing the size of open mastoid cavities (using for example porous hydroxylapatite or cartilage) can result in a reduction of vertiginous symptoms while nursing or during exposure to ambient air. Vestibular disturbances can occur both before and after vestibular nerve surgery (acoustic neuroma). Initially, good vestibular compensation can be expected after surgically removing the acoustic neuroma. An aberrant regeneration of nerve fibers of the vestibulocochlear nerve has been suggested as a cause for secondary worsening. Episodes of vertigo can be caused by an irritation of the vestibular nerve (vascular loop). Neurovascular decompression is generally regarded as the best surgical therapy. In the elderly, vestibular disturbances can severely limit quality of life and are often aggravated by multiple comorbidities. Antivertiginous drugs (e.g. dimenhydrinate) in combination with movement training can significantly reduce symptoms. Administering antivertiginous drugs over varying periods of time (e.g. transdermal scopolamine application via patches) as well as kinetosis training can be used as both prophylactically and as a therapy for kinetosis. Exposure training should be used as a prophylactic for height vertigo.

Keywords: labyrinth, rehabilitation; neurootology; oto-surgery; therapy; vestibular compensation; vestibular disturbances

References

  1. Laryngol Rhinol Otol (Stuttg). 1988 May;67(5):240-4 - PubMed
  2. Acta Otolaryngol Suppl. 1993;503:74-8 - PubMed
  3. Ann Otol Rhinol Laryngol. 1994 May;103(5 Pt 1):389-94 - PubMed
  4. Lin Chuang Er Bi Yan Hou Ke Za Zhi. 1999 Jul;13(7):291-2 - PubMed
  5. Acta Otolaryngol. 1993 May;113(3):261-2 - PubMed
  6. Ear Nose Throat J. 1996 Jul;75(7):416-21 - PubMed
  7. Adv Otorhinolaryngol. 1981;27:159-67 - PubMed
  8. Acta Otolaryngol Suppl. 1988;460:149-53 - PubMed
  9. Can Med Assoc J. 1936 Apr;34(4):369-81 - PubMed
  10. Anat Rec. 1995 Jun;242(2):259-66 - PubMed
  11. HNO. 1971 Mar;19(3):81-7 - PubMed
  12. Ear Nose Throat J. 1999 Aug;78(8):595-8, 600 - PubMed
  13. AJNR Am J Neuroradiol. 2004 Feb;25(2):222-32 - PubMed
  14. J Laryngol Otol. 1989 Dec;103(12):1161-6 - PubMed
  15. Ann N Y Acad Sci. 2002 Apr;956:306-13 - PubMed
  16. J Neurol Neurosurg Psychiatry. 1994 Feb;57(2):190-7 - PubMed
  17. Acta Otolaryngol. 2000 Aug;120(5):672-4 - PubMed
  18. Eur Arch Otorhinolaryngol. 2000;257(7):362-5 - PubMed
  19. Otolaryngol Clin North Am. 1993 Oct;26(5):845-56 - PubMed
  20. Am J Otol. 1993 Nov;14(6):576-9 - PubMed
  21. HNO. 1988 Aug;36(8):315-7 - PubMed
  22. Acta Otorhinolaryngol Ital. 2002 Dec;22(6):376-9 - PubMed
  23. Acta Otolaryngol. 1983 May-Jun;95(5-6):402-6 - PubMed
  24. Clin Otolaryngol Allied Sci. 1999 Aug;24(4):316-23 - PubMed
  25. Ann N Y Acad Sci. 1997 Dec 29;830:243-52 - PubMed
  26. Laryngoscope. 1996 Apr;106(4):476-8 - PubMed
  27. Laryngorhinootologie. 1996 Jun;75(6):372-6 - PubMed
  28. Ann Otol Rhinol Laryngol. 1990 May;99(5 Pt 1):330-4 - PubMed
  29. Acta Otolaryngol Suppl. 1991;485:120-2 - PubMed
  30. Ear Nose Throat J. 2001 Feb;80(2):76-8, 81-2, 84 passim - PubMed
  31. Otol Neurotol. 2004 Jul;25(4):544-52 - PubMed
  32. Laryngorhinootologie. 2004 Mar;83(3):164-72 - PubMed
  33. HNO. 1993 Jun;41(6):296-300 - PubMed
  34. Clin Otolaryngol Allied Sci. 1998 Feb;23(1):34-41 - PubMed
  35. Arch Otolaryngol Head Neck Surg. 1994 Dec;120(12):1339-41 - PubMed
  36. Acta Otolaryngol. 1988 May-Jun;105(5-6):439-44 - PubMed
  37. J Am Geriatr Soc. 1994 Sep;42(9):937-46 - PubMed
  38. J Med Assoc Thai. 1995 Jun;78(6):289-97 - PubMed
  39. Arch Otolaryngol Head Neck Surg. 2000 May;126(5):617-22 - PubMed
  40. Otolaryngol Clin North Am. 1983 Feb;16(1):123-7 - PubMed
  41. Am J Otol. 1991 Sep;12(5):336-40 - PubMed
  42. Cochrane Database Syst Rev. 2001;(1):CD001873 - PubMed
  43. HNO. 1989 Jul;37(7):276-80 - PubMed
  44. Laryngorhinootologie. 1999 Aug;78(8):455-61 - PubMed
  45. Ear Hear. 1999 Oct;20(5):403-9 - PubMed
  46. C R Seances Soc Biol Fil. 1948 Jun;142(11-12):747-9 - PubMed
  47. Brain. 1964 Mar;87:141-52 - PubMed
  48. Arch Otolaryngol. 1985 Aug;111(8):491-3 - PubMed
  49. Laryngol Rhinol Otol (Stuttg). 1979 Jun;58(6):509-15 - PubMed
  50. Am J Otolaryngol. 1982 Mar-Apr;3(2):117-27 - PubMed
  51. Ann Otol Rhinol Laryngol. 1986 Jan-Feb;95(1 Pt 1):32-5 - PubMed
  52. Am J Otol. 1992 Jan;13(1):18-22 - PubMed
  53. Am J Otol. 1987 Jul;8(4):294-300 - PubMed
  54. Acta Otolaryngol. 1991;111(2):319-26 - PubMed
  55. Laryngoscope. 1956 Jul;66(7):859-70 - PubMed
  56. Z Laryngol Rhinol Otol. 1968 Jun;47(6):442-8 - PubMed
  57. Arch Otolaryngol. 1967 May;85(5):544-7 - PubMed
  58. Am J Otol. 1999 Mar;20(2):209-19 - PubMed
  59. Arch Dis Child. 2003 Jun;88(6):510-1 - PubMed
  60. Neuroscience. 2003;116(4):963-72 - PubMed
  61. Otol Neurotol. 2002 Nov;23(6):926-32 - PubMed
  62. J Vestib Res. 1998 Jul-Aug;8(4):325-9 - PubMed
  63. Ann N Y Acad Sci. 2001 Oct;942:79-94 - PubMed
  64. Ann Otol Rhinol Laryngol. 1956 Sep;65(3):692-706 - PubMed
  65. Laryngoscope. 1999 Jul;109(7 Pt 2):1-17 - PubMed
  66. J Vestib Res. 1995 Mar-Apr;5(2):67-107 - PubMed
  67. Z Laryngol Rhinol Otol. 1967 Oct;46(10):709-27 - PubMed
  68. Otol Neurotol. 2003 Sep;24(5):800-6 - PubMed
  69. Otolaryngol Clin North Am. 2002 Jun;35(3):591-606 - PubMed
  70. J Comp Neurol. 1998 Jul 20;397(1):69-88 - PubMed
  71. Acta Otolaryngol Suppl. 1997;526:58-66 - PubMed
  72. Otolaryngol Head Neck Surg. 1995 Jun;112(6):738-41 - PubMed
  73. Ann N Y Acad Sci. 2002 Apr;956:230-41 - PubMed
  74. Ear Nose Throat J. 2004 Jun;83(6):394-8 - PubMed
  75. Int Tinnitus J. 1999;5(1):50-2 - PubMed
  76. Otolaryngol Head Neck Surg. 2000 Mar;122(3):334-9 - PubMed
  77. Neurology. 1998 Sep;51(3):838-44 - PubMed
  78. Curr Med Res Opin. 1986;10(4):209-14 - PubMed
  79. Laryngorhinootologie. 2003 Jan;82(1):44-61; quiz 62-6 - PubMed
  80. Antimicrob Agents Chemother (Bethesda). 1963;161:1-7 - PubMed
  81. Exp Brain Res. 2003 Jan;148(1):117-27 - PubMed
  82. Laryngorhinootologie. 2003 Oct;82(10):687-92 - PubMed
  83. Am J Otol. 1996 Mar;17(2):278-82 - PubMed
  84. Ear Nose Throat J. 1999 Jun;78(6):443-6 - PubMed
  85. HNO. 1997 Apr;45(4):210-5 - PubMed
  86. HNO. 2004 Jun;52(6):525-32 - PubMed
  87. Acta Otolaryngol Suppl. 1988;455:82-5 - PubMed
  88. Ann N Y Acad Sci. 2001 Oct;942:300-5 - PubMed
  89. Otol Neurotol. 2004 May;25(3):339-44 - PubMed
  90. HNO. 2000 May;48(5):346-56 - PubMed
  91. Ann N Y Acad Sci. 1997 Dec 29;830:306-13 - PubMed
  92. Eur Arch Otorhinolaryngol. 1998;255(3):119-23 - PubMed
  93. Am J Otol. 1992 Jan;13(1):23-30 - PubMed
  94. Z Laryngol Rhinol Otol. 1961 Jan;40:68-77 - PubMed
  95. Laryngorhinootologie. 2004 Feb;83(2):88-95 - PubMed
  96. Eur J Med Res. 1996 May 24;1(8):361-8 - PubMed
  97. Curr Opin Neurol. 2000 Feb;13(1):13-8 - PubMed
  98. HNO. 2001 Jul;49(7):538-42 - PubMed
  99. Am J Otol. 1989 Jul;10(4):259-61 - PubMed
  100. Clin Otolaryngol Allied Sci. 1996 Jun;21(3):208-11 - PubMed
  101. Cochrane Database Syst Rev. 2004;(2):CD003162 - PubMed
  102. Auris Nasus Larynx. 1994;21(2):118-21 - PubMed
  103. Hear Res. 2004 May;191(1-2):90-100 - PubMed
  104. Nervenarzt. 1997 Jun;68(6):443-58 - PubMed
  105. Laryngorhinootologie. 2000 Jun;79(6):327-31 - PubMed
  106. Ann Otol Rhinol Laryngol. 1978 Nov-Dec;87(6 Pt 1):743-8 - PubMed
  107. HNO. 1986 Oct;34(10):417-23 - PubMed
  108. Ugeskr Laeger. 2000 Oct 9;162(41):5501-3 - PubMed
  109. Laryngorhinootologie. 1999 Apr;78(4):204-9 - PubMed
  110. Arch Klin Exp Ohren Nasen Kehlkopfheilkd. 1968;191(2):545-51 - PubMed
  111. Arch Otolaryngol. 1981 May;107(5):271-7 - PubMed
  112. Adv Otorhinolaryngol. 2002;59:149-55 - PubMed
  113. Acta Otolaryngol. 1995 Mar;115(2):158-61 - PubMed
  114. Acta Otolaryngol Suppl. 1957;132:1-42 - PubMed
  115. Eur Arch Otorhinolaryngol. 2002 May;259(5):239-42 - PubMed
  116. Arch Neurol. 1988 Jul;45(7):737-9 - PubMed
  117. Brain. 1998 Sep;121 ( Pt 9):1749-58 - PubMed
  118. Neurology. 2002 Nov 12;59(9):1442-4 - PubMed
  119. HNO. 1994 Jul;42(7):429-33 - PubMed
  120. Laryngorhinootologie. 2000 May;79(5):253-9 - PubMed
  121. J Laryngol Otol. 1995 Jun;109(6):499-502 - PubMed
  122. ORL J Otorhinolaryngol Relat Spec. 2003 Mar-Apr;65(2):84-90 - PubMed
  123. Adv Otorhinolaryngol. 1988;42:290-3 - PubMed
  124. Adv Otorhinolaryngol. 2002;60:124-36 - PubMed
  125. Otolaryngol Head Neck Surg. 2000 Mar;122(3):340-5 - PubMed
  126. Laryngorhinootologie. 1999 Jul;78(7):387-93 - PubMed
  127. Laryngorhinootologie. 1997 Sep;76(9):519-22 - PubMed
  128. J Laryngol Otol. 1969 Aug;83(8):787-91 - PubMed
  129. HNO. 1998 Apr;46(4):296-300 - PubMed
  130. Cornea. 2002 May;21(4):356-9 - PubMed
  131. Acta Otolaryngol. 2003 Jan;123(2):133-7 - PubMed
  132. Otolaryngol Clin North Am. 2002 Jun;35(3):607-19, viii - PubMed
  133. Acta Otolaryngol. 1973 Aug-Sep;76(2):162-72 - PubMed
  134. Nervenarzt. 1994 Aug;65(8):505-10 - PubMed
  135. Am J Otol. 1989 Mar;10(2):150-5 - PubMed
  136. Acta Otolaryngol. 1989 May-Jun;107(5-6):467-73 - PubMed
  137. HNO. 2001 Apr;49(4):307-15 - PubMed
  138. Am J Otol. 1996 May;17(3):421-4 - PubMed
  139. J Laryngol Otol. 1991 Dec;105(12):1109-12 - PubMed
  140. Neurology. 1996 Jul;47(1):94-7 - PubMed
  141. Eur J Pharmacol. 1995 Mar 14;275(3):291-3 - PubMed
  142. Scand Audiol Suppl. 1986;26:33-6 - PubMed
  143. Arch Neurol. 1989 Mar;46(3):281-4 - PubMed
  144. Otolaryngol Head Neck Surg. 1984 Apr;92(2):229-32 - PubMed
  145. Laryngorhinootologie. 2000 Feb;79(2):77-80 - PubMed
  146. ORL J Otorhinolaryngol Relat Spec. 1986;48(5):287-92 - PubMed
  147. Auris Nasus Larynx. 1997 Apr;24(2):119-24 - PubMed
  148. Adv Otorhinolaryngol. 1983;30:350-4 - PubMed
  149. Laryngorhinootologie. 2002 May;81(5):368-80 - PubMed
  150. Laryngol Rhinol Otol (Stuttg). 1984 Sep;63(9):464-7 - PubMed
  151. Zhonghua Er Bi Yan Hou Ke Za Zhi. 1997 Jun;32(3):153-6 - PubMed
  152. Laryngorhinootologie. 2001 Apr;80(4):177-81 - PubMed
  153. Ann Otolaryngol Chir Cervicofac. 2002 Apr;119(2):73-80 - PubMed
  154. Ann N Y Acad Sci. 1999 Nov 28;884:410-24 - PubMed
  155. HNO. 1988 Aug;36(8):305-7 - PubMed
  156. J Laryngol Otol. 1966 Oct;80(10):1041-53 - PubMed
  157. Ann Otol Rhinol Laryngol. 1978 May-Jun;87(3 Pt 1):300-5 - PubMed
  158. Auris Nasus Larynx. 1986;13(2):79-89 - PubMed
  159. Acta Otolaryngol. 2018 Mar;138(3):247-250 - PubMed
  160. Ann Otol Rhinol Laryngol. 2000 Jan;109(1):30-2 - PubMed
  161. Laryngoscope. 1997 Jan;107(1):90-4 - PubMed
  162. Laryngol Rhinol Otol (Stuttg). 1988 Mar;67(3):100-5 - PubMed
  163. Arch Otolaryngol. 1973 Feb;97(2):109-11 - PubMed
  164. Otolaryngol Head Neck Surg. 1989 Jan;100(1):22-9 - PubMed
  165. Acta Otolaryngol Suppl. 1963;192:SUPPL 192:121+ - PubMed
  166. Neuroimage. 2002 Aug;16(4):873-82 - PubMed
  167. Nervenarzt. 1986 Mar;57(3):163-6 - PubMed
  168. Clin Ther. 2004 Jun;26(6):866-77 - PubMed
  169. Acta Otolaryngol. 2002 Jun;122(4):386-91 - PubMed
  170. Laryngorhinootologie. 1995 Dec;74(12):720-3 - PubMed
  171. HNO. 1997 Mar;45(3):112-3 - PubMed
  172. Otolaryngol Head Neck Surg. 1981 Mar-Apr;89(2):197-203 - PubMed
  173. J Vestib Res. 1998 Nov-Dec;8(6):427-33 - PubMed
  174. Laryngoscope. 2000 Feb;110(2 Pt 1):236-40 - PubMed
  175. HNO. 1953-1954;4(6):166-8 - PubMed
  176. Am J Otol. 1991 Sep;12(5):388-93 - PubMed
  177. HNO. 1997 Mar;45(3):123-7 - PubMed
  178. Laryngoscope. 2002 Feb;112(2):243-7 - PubMed
  179. Otolaryngol Head Neck Surg. 2004 Apr;130(4):426-9 - PubMed
  180. AJNR Am J Neuroradiol. 2000 Aug;21(7):1334-6 - PubMed
  181. Acta Otolaryngol. 1991;111(2):182-7 - PubMed
  182. Laryngoscope. 2004 Jul;114(7):1143-6 - PubMed
  183. Laryngoscope. 2004 Jan;114(1):102-5 - PubMed
  184. Hear Res. 1986;22:297-304 - PubMed
  185. Am J Otol. 1999 May;20(3):357-63 - PubMed
  186. Biomed Sci Instrum. 2004;40:441-6 - PubMed
  187. AJNR Am J Neuroradiol. 1998 Sep;19(8):1437-40 - PubMed
  188. Laryngoscope. 1961 Nov;71:1363-85 - PubMed
  189. HNO. 2002 Jul;50(7):671-8; quiz 679, 681 - PubMed
  190. CMAJ. 2003 Sep 30;169(7):681-93 - PubMed
  191. Acta Otolaryngol Suppl. 2000;543:108-10 - PubMed
  192. Acta Otolaryngol. 1995 Mar;115(2):154-7 - PubMed
  193. HNO. 2001 Mar;49(3):180-7 - PubMed
  194. Auris Nasus Larynx. 1987;14(1):17-21 - PubMed
  195. HNO. 1990 Apr;38(4):154-7 - PubMed
  196. Otolaryngol Head Neck Surg. 1992 Sep;107(3):399-404 - PubMed
  197. Arch Ital Otol Rinol Laringol. 1963;76:SUPPL 46:21-6 - PubMed
  198. Arch Otolaryngol Head Neck Surg. 1998 Aug;124(8):879-85 - PubMed
  199. Ann N Y Acad Sci. 1997 Dec 29;830:120-9 - PubMed
  200. Acta Otolaryngol Suppl. 1997;526:50-3 - PubMed
  201. Otolaryngol Clin North Am. 1983 Feb;16(1):197-203 - PubMed
  202. Adv Otorhinolaryngol. 1999;55:82-110 - PubMed
  203. ORL J Otorhinolaryngol Relat Spec. 1988;50(6):377-81 - PubMed
  204. Am J Otol. 1988 Nov;9(6):441-7 - PubMed
  205. Laryngol Rhinol Otol (Stuttg). 1980;59(12):804-7 - PubMed
  206. Laryngoscope. 1962 Jun;72:713-29 - PubMed
  207. Brain Dev. 2001 Mar;23(1):38-41 - PubMed
  208. J Laryngol Otol. 1957 Aug;71(8):524-7 - PubMed
  209. Acta Otolaryngol Suppl. 1991;485:104-7 - PubMed
  210. Proc R Soc Med. 1946 Mar;39(5):270-3 - PubMed
  211. Rev Laryngol Otol Rhinol (Bord). 1969 Nov-Dec;90(11):661-72 - PubMed
  212. Am J Otol. 1996 May;17(3):416-20 - PubMed
  213. Microsc Res Tech. 1997 Feb 1;36(3):201-11 - PubMed
  214. J Otolaryngol. 2003 Dec;32(6):351-61 - PubMed
  215. Laryngoscope. 1997 Jan;107(1):83-9 - PubMed
  216. Ann Otol Rhinol Laryngol. 1973 Jan-Feb;82(1):23-35 - PubMed
  217. Otolaryngol Head Neck Surg. 1989 Jan;100(1):6-16 - PubMed
  218. Ear Nose Throat J. 2000 Sep;79(9):732-4, 736-7 - PubMed
  219. Ann N Y Acad Sci. 1992 May 22;656:725-31 - PubMed
  220. J Otolaryngol. 1981 Oct;10(5):343-58 - PubMed
  221. Audiol Neurootol. 2001 Sep-Oct;6(5):259-62 - PubMed
  222. Otolaryngol Head Neck Surg. 1996 Jul;115(1):38-41 - PubMed
  223. Jpn J Pharmacol. 1991 Jan;55(1):101-6 - PubMed
  224. BMJ. 2003 Mar 29;326(7391):673 - PubMed
  225. HNO. 2001 Jul;49(7):543-7 - PubMed
  226. Arch Otolaryngol Head Neck Surg. 1994 May;120(5):552-9 - PubMed
  227. Laryngorhinootologie. 2001 Jun;80(6):308-12 - PubMed
  228. HNO. 1970 Jul;18(7):205-10 - PubMed
  229. Otolaryngol Head Neck Surg. 1991 Jan;104(1):52-7 - PubMed
  230. J Vestib Res. 1997 Jan-Feb;7(1):1-6 - PubMed
  231. Nihon Jibiinkoka Gakkai Kaiho. 2002 May;105(5):557-63 - PubMed
  232. Nervenarzt. 2004 Mar;75(3):281-302 - PubMed
  233. Int Tinnitus J. 2002;8(2):115-23 - PubMed
  234. J Laryngol Otol. 1987 Mar;101(3):229-35 - PubMed
  235. Arch Otolaryngol. 1980 Aug;106(8):484-5 - PubMed
  236. Ann Otol Rhinol Laryngol. 1997 Feb;106(2):129-34 - PubMed
  237. Acta Otolaryngol. 1998 Nov;118(6):769-73 - PubMed
  238. HNO. 1985 Jun;33(6):262-70 - PubMed
  239. Otolaryngol Clin North Am. 1996 Apr;29(2):333-42 - PubMed
  240. Ann N Y Acad Sci. 2001 Oct;942:179-91 - PubMed
  241. Acta Otolaryngol Suppl. 1997;526:54-7 - PubMed
  242. HNO. 2003 Nov;51(11):898-902 - PubMed
  243. Laryngoscope. 1964 Sep;74:1262-82 - PubMed
  244. Am J Otol. 1997 Sep;18(5):586-9 - PubMed
  245. J Neurol. 1998 Jun-Jul;245(6-7):314-21 - PubMed
  246. Science. 2003 Oct 10;302(5643):282-6 - PubMed
  247. J Laryngol Otol. 2002 Sep;116(9):723-5 - PubMed
  248. J Neurol Neurosurg Psychiatry. 2002 Mar;72(3):366-72 - PubMed
  249. Laryngoscope. 2001 Dec;111(12):2100-4 - PubMed
  250. Arch Otolaryngol. 1985 Sep;111(9):609-12 - PubMed
  251. Laryngoscope. 2004 Feb;114(2):216-22 - PubMed
  252. Neuroimaging Clin N Am. 2001 May;11(2):263-73, ix - PubMed
  253. Arch Otorhinolaryngol. 1976 Sep 16;212(4):385-91 - PubMed
  254. Ther Umsch. 1995 Nov;52(11):724-31 - PubMed
  255. Acta Otolaryngol. 2001 Jul;121(5):610-5 - PubMed
  256. Laryngoscope. 2001 Nov;111(11 Pt 1):2046-9 - PubMed
  257. Auris Nasus Larynx. 1984;11(2):79-90 - PubMed
  258. Acta Otolaryngol. 2002 Jan;122(1):28-30 - PubMed
  259. Int J Clin Pharmacol Ther. 2003 Apr;41(4):171-81 - PubMed
  260. ORL J Otorhinolaryngol Relat Spec. 1997 Jan-Feb;59(1):4-9 - PubMed
  261. Acta Otolaryngol. 1980 Mar-Apr;89(3-4):283-94 - PubMed
  262. Ann Otol Rhinol Laryngol. 1976 May-Jun;85(3 pt 1):310-26 - PubMed
  263. Z Gerontol Geriatr. 1998 Aug;31(4):286-9 - PubMed
  264. Audiol Neurootol. 2003 Nov-Dec;8(6):316-21 - PubMed
  265. Laryngoscope. 1995 Sep;105(9 Pt 1):934-7 - PubMed
  266. Am J Otol. 1992 Sep;13(5):416-22; discussion 422-5 - PubMed
  267. Trans Am Laryngol Rhinol Otol Soc. 1956;(60th Meeting):589-600 - PubMed
  268. Acta Otolaryngol Suppl. 1991;485:78-83 - PubMed
  269. Anasthesiol Intensivmed Notfallmed Schmerzther. 1999 May;34(5):288-95 - PubMed
  270. Arch Otolaryngol. 1977 Jun;103(6):355-7 - PubMed
  271. Rev Laryngol Otol Rhinol (Bord). 1991;112(2):149-52 - PubMed
  272. Acta Otolaryngol Suppl. 1991;485:145-54 - PubMed
  273. Laryngol Rhinol Otol (Stuttg). 1982 Jan;61(1):4-8 - PubMed
  274. HNO. 1988 Aug;36(8):301-4 - PubMed
  275. Laryngoscope. 1965 Oct;75(10):1539-46 - PubMed
  276. Adv Otorhinolaryngol. 2002;60:54-66 - PubMed
  277. Laryngoscope. 2003 Nov;113(11):1903-7 - PubMed
  278. HNO. 1998 Dec;46(12):1000-2 - PubMed
  279. Laryngoscope. 1982 Aug;92(8 Pt 1):853-8 - PubMed
  280. Laryngorhinootologie. 1998 Apr;77(4):179-84 - PubMed
  281. Laryngoscope. 1999 Jan;109(1):59-64 - PubMed
  282. Acta Otolaryngol. 2001 Jul;121(5):616-21 - PubMed
  283. Acta Otolaryngol Suppl. 1994;510:107-10 - PubMed
  284. N Engl J Med. 2004 Jul 22;351(4):354-61 - PubMed
  285. HNO. 2000 Nov;48(11):822-7 - PubMed
  286. Laryngoscope. 1984 Jun;94(6):758-67 - PubMed
  287. Eur Arch Otorhinolaryngol. 1991;248(4):209-17 - PubMed
  288. Acta Otolaryngol Suppl. 2000;543:99-101 - PubMed
  289. Otolaryngol Head Neck Surg. 1995 Jun;112(6):670-5 - PubMed
  290. HNO. 1987 Jul;35(7):267-9 - PubMed
  291. Auris Nasus Larynx. 1998 May;25(2):203-7 - PubMed
  292. Adv Otorhinolaryngol. 2001;58:110-27 - PubMed
  293. Am J Otol. 1997 Nov;18(6):726-33 - PubMed
  294. Acta Otolaryngol. 1996 Jul;116(4):576-80 - PubMed
  295. Proc R Soc Med. 1946 Mar;39(5):273-8 - PubMed
  296. Am J Otol. 1998 May;19(3):337-40 - PubMed
  297. Am J Otol. 1985 Sep;6(5):371-7 - PubMed
  298. Otolaryngol Head Neck Surg. 1985 Oct;93(5):615-21 - PubMed
  299. Otolaryngol Clin North Am. 2002 Jun;35(3):529-45, vi - PubMed
  300. Br Med J. 1936 Jul 25;2(3942):175-7 - PubMed
  301. Naunyn Schmiedebergs Arch Pharmacol. 2004 Jun;369(6):570-5 - PubMed
  302. Rev Laryngol Otol Rhinol (Bord). 1977 Nov-Dec;98(11-12):535-9 - PubMed
  303. Arch Otolaryngol Head Neck Surg. 1997 Jan;123(1):53-6 - PubMed
  304. Laryngoscope. 1992 Sep;102(9):988-92 - PubMed
  305. Am J Otolaryngol. 2004 Jan-Feb;25(1):33-7 - PubMed
  306. Laryngoscope. 1976 Dec;86(12):1777-91 - PubMed
  307. Hear Res. 2003 Aug;182(1-2):34-42 - PubMed
  308. Ann Otol Rhinol Laryngol. 2004 Jul;113(7):526-30 - PubMed
  309. ORL J Otorhinolaryngol Relat Spec. 1986;48(2):116-23 - PubMed

Publication Types