Prolonged bone-conducted vibration in superior semicircular canal dehiscence and in otosclerosis: comparison of the 3D eye movement evaluation.

Vibration-induced nystagmus, as clinical sign, was recently introduced in outpatient clinical practice for the study and evaluation of otoneurological patients. This response, which can only be evoked by bone conducted vibratory stimulation in the mastoid region or at the location on the forehead in the midline at the hairline, was essentially designed for patients with persistent unilateral vestibular deficit and was interpreted as the result of excitatory functional activity of the vestibular system on the non-affected side. Vibratory stimulation is, in fact, considered to reach both systems, which in the case of functional asymmetry, respond asymmetrically with greater excitatory activation on the more responsive side. On the other hand, little information is available concerning vibration-induced nystagmus in subjects with symmetrical vestibular function. The limited experience with this recently proposed test and incomplete knowledge regarding its mechanisms suggest that it must be investigated in clinical conditions, having a known pathophysiological basis: the responses obtained could help provide insight into the potential of this test and contribute to the diagnostic definition of the superior semicircular canal dehiscence or otosclerosis. Analysis of Vibration-induced nystagmus, recently proposed to study transmission of excitatory stimuli by bone conduction, may be appropriate for altered input caused by defects of the labyrinthine capsule. This promises to be an interesting new field of research.