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Objective: To retrospectively analyze the results of auditory examination,vestibular function examination and laboratory examination of 63 patients diagnosed as vestibular neuritis.Methods:A total of 63 patients diagnosed with vestibular neuritis hospitalized in the Department of Otolaryngology, Head and Neck Surgery of the Third Affiliated Hospital of Sun Yat-sen University, from October 2012 to December 2022 were recruited. All patients met the diagnostic criteria for the 2022 Bárány association vestibular neuritis. Clinical data and the results of pure tone audiometry, electrocochleogram, video electronystagmogram, caloric test, cervical vestibuloevoked myogenic potential（cVEMP）, ocular vestibuloevoked myogenic potential（oVEMP）, video head impulse test（vHIT） was collected.A total of 63 age-and sex-matched healthy subjects in the physical examination center were randomly selected as the control group. The differences of blood indexs and lipid metabolism indexes between the two groups were compared. Results: In patients with vestibular neuritis, 50 out of 63 patients presented normal threshold in pure tone audiometry, 8 out of 63 patients had bilateral high-frequency sensorineural hearing loss and 5 out of 63 patients had unilateral mild high-frequency sensorineural hearing loss, 56 out of 63 cases completed the electrocochleogram, of which 3 cases had a binaural-SP/AP amplitude ratio≥0.4, 5 cases had monaural amplitude ratio ≥0.4. Fifty-five out of 63 patients completed the caloric test with CP values greater than 30% in all. The ratio of patients completed cVEMP, oVEMP and vHIT were 46 cases, 22 cases and 30 cases, respectively. 17 out of 63 cases completed all the four vestibular function tests. According to these tests, 49 patients could determine the extent of injury，including 27 cases with unilateral superior vestibular nerve injury, 21 cases with unilateral superior and inferior vestibular nerve injury and 1 case with unilateral inferior vestibular nerve injury. There were significant differences in neutrophil value（ P <0.001）, lymphocyte value（ P <0.005）, neutrophil/lymphocyte ratio（ P <0.001） and apolipoprotein A1（ P <0.001） between patient group and control group. Inflammatory markers were risk factors for patients with vestibular neuritis. The OR values of neutrophil value and blood neutrophil/lymphocyte ratio were 1.81（1.38-2.37, P <0.001） and 2.11（1.41-3.16, P <0.001）, respectively. Apolipoprotein A1 was a protective factor for patients with vestibular neuritis, and the OR value was 0.004（0.001-0.042, P <0.001）. Conclusion: Electrocochleogram could be used in vestibular neuritis patients with normal pure tone threshold to test whether there is hidden hearing loss in these patients. Neutrophil value, lymphocyte value, neutrophil/lymphocyte ratio and apolipoprotein A1 were correlated with vestibular neuritis. The Neutrophil value and neutrophil/lymphocyte ratio were risk factors for morbidity., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To explore the correlation between the parameters of suppression head impulse paradigm（SHIMP） and changes in dizziness handicap inventory（DHI） scores. Additionally, to evaluate the degree of vertigo and prognosis of patients with acute vestibular neuritis through SHIMP parameters. Methods: Thirty-three patients with acute vestibular neuritis were enrolled for DHI evaluation, vHIT and SHIMP. A secondary DHI score were evaluated after after two weeks, once patients no longer exhibited spontaneous nystagmus. The decrease in the second DHI score was used as the efficacy index（EI）. All patients were divided into significantly effective group, effective group and ineffective group based on EI. Differences of the VOR gain values of SHIMP and the anti-compensatory saccade were compared among the three groups. Results: There were 13 cases in the significant effective group, 11 cases in the effective group, and 9 cases in the ineffective group. ①The mean gain of the horizontal semicircular canal in the significant effective group, the effective group, and the ineffective group was（0.50±0.11）, （0.44±0.12）, and（0.34±0.08）, respectively. The difference between the significant effective group and the ineffective group was statistically significant（ P <0.01）. The gain of horizontal semicircular canal was positively correlated with EI（ r =0.538 5, P <0.01） 。②The occurrence rate of the anti-compensatory saccade in the significant effective group, the effective group, and the ineffective group was（51.23±19.59）, （33.64±17.68）, and（13.78±11.81）, respectively. Pairwise comparisons between each group showed statistical significance（ P <0.05）. The occurrence rate of anti-compensatory saccade was positively correlated with EI（ r =0.658 2, P <0.01）. Conclusion: The horizontal semicircular canal gain and the occurrence rate of the anti-compensatory saccade in SHIMP for patients with acute vestibular neuritis were closely correlated with decrease in DHI score., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To observe the results of dynamic visual acuity screening tests in patients with peripheral vertigo and explore its clinical significance. Methods: The number of 48 healthy volunteers were enrolled as control group and 25 peripheral vertigo patients as experimental group. In the experimental group, there are 12 patients with vestibular neuritis, 1 patient with Hunt syndrome, 5 patients with sudden deafness with vertigo and 7 patients with bilateral vestibular dysfunction. Horizontal and vertical dynamic visual acuity screening tests were performed on them. The number of lost rows of horizontal and vertical dynamic visual acuity was compared between the control group and the experimental group to figure out if there is a statistical difference. The number of lost rows of horizontal and vertical dynamic visual acuity was compared within the experimental group to figure out if there is a statistical difference. The two groups of 18 cases of unilateral vestibular function decline and 7 cases of bilateral vestibular function decline in the experimental group were compared with the control group, and figure out if there is a statistical difference. Results: The median number of lost rows of horizontal dynamic visual acuity in 48 healthy volunteers was 1.5 and median number of lost rows of vertical dynamic visual acuity was 1.0 in the control group. The median number of lost rows of horizontal dynamic visual acuity of 26 healthy volunteers was 6 and median number of lost rows of vertical dynamic visual acuity was 5 in the experimental group. Compared to the experimental group, the number of lost rows both have statistical significance in horizontal and vertical dynamic visual acuity（ P <0.01）. The comparison of horizontal and vertical lost rows within the test group also have statistical significance（ P <0.01）. Twenty five patients with exceptional vestibular disease in the experimental group were divided into unilateral vestibular function reduction group（ n =18） and bilateral vestibular function reduction group（ n =7）. Compared with the control group, there was significant differences in the number of horizontal and vertical lost rows（ P <0.01） within the three groups. After pairwise comparison, the number of lost rows of horizontal and vertical in the control group was significantly lower than that in the unilateral vestibular function reduction group and the bilateral vestibular function reduction group（ P <0.01）. There was a highly significant correlation between the number of horizontally lost rows of DVA and the mean vHIT values of bilateral horizontal semicircular canals in 25 patients（ P <0.01）; and a highly significant correlation between the number of vertically lost rows of DVA and the mean vHIT values of vertical semicircular canals in 4 groups bilaterally（ P <0.01）. Conclusion: The Dynamic Visual Acuity Screening Test is a useful addition to existing tests of peripheral vestibular function, particularly the vHIT test, and provides a rapid assessment of the extent of 2 Hz VOR impairment in patients with reduced vestibular function., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: This study aims to compare the examination results of the vestibular evoked myogenic potential（VEMP） and video head impulse testing（vHIT） in patients with vestibular neuritis（VN）, thus exploring the methods to distinguish superior and inferior vestibular nerve damages in VN patients, and their feasibility. Methods: A total of 25 patients with unilateral VN treated in the Otology Department of the First Hospital of Qinhuangdao from May 2018 to July 2021 were recruited. They were respectively tested for ocular VEMP（oVEMP）, cervical VEMP（cVEMP） and vHIT, and the examination results were analyzed. Results: Examination results of oVEMP showed that 96%（24/25） patients had one-ear abnormalities with the amplitude decline or no waveform introduced, and 4%（1/25） patient had no waveform introduced of both ears. The overall abnormal rate examined by oVEMP was 100%（26/26）. Examination results of cVEMP showed that 36%（9/25） patients had one-ear abnormalities with the amplitude decline or no waveform introduced, and 4%（1/25） patients had no waveform introduced of both ears. The overall abnormal rate examined by cVEMP was 40%（10/25）, and 60%（15/25） patients had normal waveforms of both ears. Examination results of vHIT showed that 100%（25/25） patients had semicircular canal gain decline of one side, 92%（23/25） had anterior Semicircular canal decline of one side, and 36%（9/25） had posterior semicircular canal decline of one side. VEMP and vHIT results were compared. Examination results of VEMP showed that 60%（15/25） VN patients had superior vestibular nerve damage, and 40%（10/25） had both superior and inferior vestibular nerve damages. Examination results of vHIT showed that 64%（16/25） VN patients had superior vestibular nerve damage, and 36%（9/25） had both superior and inferior vestibular nerve damages. There was no significant difference in the ratio of VN patients with superior and inferior vestibular nerve damages examined by VEMP or vHIT（ χ ²=0.085, P >0.05）. The matching ratio of VEMP and vHIT results was 80%（20/25）, and the non-matching ratio was 20%（5/25）. Conclusion: Consistent results obtained from both VEMP and vHIT can preliminarily identify the type of vestibular nerve damage. If their results are not consistent, it is recommended not to identify the scope of the vestibular nerve damage., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To analyze the site of vestibular nerve damaged in patients with acute vestibular neuritis. Methods: Fifty-seven patients with acute vestibular neuritis were recruited, and each patient underwent caloric irrigation test, video head impulse test（vHIT） and vestibular evoked myogenic potentials（VEMPs）. The results were further analyzed. Results: Analysis of abnormal rates of different vestibular function tests: the abnormal rate of caloric irrigation test, horizontal semicircular canal vHIT, anterior semicircular canal vHIT, and posterior semicircular canal vHIT were 92.98%, 92.98%, 92.98%, and 52.63%, respectively. The abnormal rate of cervical vestibular evoked myogenic potentials（cVEMP） and ocular vestibular evoked myogenic potentials（oVEMP） were 52.63% and 89.47%. The abnormal rate of caloric irrigation test, horizontal semicircular canal vHIT, anterior semicircular canal vHIT, and oVEMP were significantly higher than posterior semicircular canal vHIT and cVEMP（ P <0.01）. Combination analysis of different vestibular function tests: there are twenty-six patients（45.61%, superior and inferior vestibular nerve） with abnormal caloric irrigation test, video head impulse test, and VEMPs. There are twenty-five patients（43.86%, superior vestibular nerve） with abnormal caloric irrigation test, horizontal semicircular canal vHIT, anterior semicircular canal vHIT, and oVEMP. There are 4 patients（7.02%, inferior vestibular nerve） with abnormal posterior semicircular canal vHIT and cVEMP. There are two patients（3.51%, ampullary vestibular nerve） with abnormal caloric irrigation test, horizontal semicircular canal vHIT, and anterior semicircular canal vHIT. The rate of superior and inferior vestibular neuritis and superior vestibular neuritis were significantly higher than inferior vestibular neuritis and ampullary vestibular neuritis（ P <0.01）. Conclusion: Acute vestibular neuritis subtypes can be divided into four categories: superior and inferior vestibular neuritis, superior vestibular neuritis, inferior vestibular neuritis, and ampullary vestibular neuritis. Video head impulse test can accurately assess the site of vestibular nerve damage in patients with acute vestibular neuritis. In addition, vHIT combined with VEMPs can provide objective evidence for the diagnosis of ampullary vestibular neuritis., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To evaluate the value of high intensity stimulation training of semicircular canal of SRM-Ⅳ vertigo diagnosis and treatment system in the rehabilitation of vestibular neuritis. Methods: To analyze 68 patients with vestibular neuritis treated in Department of Otorhinolaryngology Head and Neck Surgery, Shijiazhuang People's Hospital from January 2020 to January 2021, conduct spontaneous nystagmus and head toss test, and perform spontaneous nystagmus and rotation test of SRM-Ⅳvertigo system, compare the positive rate of the side of disease was between the two. To randomly divide 68 patients into treatment group 1, 2 and control group, the control group with drugs, treatment group 1 with drugs and vestibular rehabilitation training exercise, treatment group 2 with additional high intensity stimulation training of semicircular canal at one week after onset, on the basis of drug therapy and vestibular rehabilitation training exercise. At 2 weeks and 1 month, through swivel chair test negative rate, DHI score, compare the efficacy of the three groups. Results: Spontaneous nystagmus combined with head toss test confirmed 80.9% of the side of the disease, spontaneous nystagmus and rotation test of SRM-Ⅳ vertigo system confirmed 100%, the difference is statistically significant（ P <0.05）. Compared with the control group and the treatment group 1, the negative conversion rate of the rotation test in the treatment group 2 at the second week and the first month of treatment, the difference is statistically significant（ P <0.05, the second week χ²=6.474, the first month χ²=6.245）; the DHI score of treatment group 2 was statistically significant compared with that of control group and treatment group 1 at the second week and first month of treatment（ P <0.05, the second week F =13.578, the first month F =28.599）. Conclusion: SRM-Ⅳ vertigo diagnosis and treatment system semicircular canal high intensity stimulation training has a certain role in the rehabilitation treatment of vestibular neuritis. It is simple to operate, patient tolerance and compliance are good, and it is worth promoting., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To explore the correlation between the parameters of video head impulse test （vHIT）and dizziness handicap inventory （DHI） score in patients with vestibular neuritis. Methods: Clinical data of 46 patients with vestibular neuritis were retrospectively analyzed. All the patients underwent DHI evaluation and vHIT examination. They were divided into mild handicap group, moderate handicap group and severe handicap group according to DHI score. The correlations between the parameters of vHIT and DHI score were compared among the three groups. The important parameters of vHIT were compared including vestibulo-ocular reflex （VOR） gain, gain asymmetry ratio （GA）, abnormal saccade dispersion （PR%）. Results: Of the 46 patients, 10 were in the mild handicap group, 21 in the moderate handicap group, and 15 in the severe handicap group. ①In the comparison of the mean value of lateral semicircular canal VOR gain, the vHIT gain of patients with mild, moderate and severe handicap were 0.64±0.06, 0.53±0.11 and 0.37±0.10, respectively, the mean value of VOR gain was negatively correlated with DHI score among the three groups（ r =-0.545, P <0.001）, and the pairwise comparisons among the three groups was statistically significant（ P <0.05）. In comparison of the mean values of lateral semicircular canal GA, the GA values of mild, moderate and severe handicap groups were 46.40±21.81, 47.59±15.17 and 56.57±17.39, respectively, there was no significant linear correlation between GA values and DHI scores among the three groups（ r =0.246, P >0.05）, there was no significant difference between the three groups（ P >0.05）. In comparison of the mean PR% of the lateral semicircular canal, the mean PR% of patients with mild, moderate and severe handicap group were 32.00±10.62, 53.82±17.09 and 76.00±10.01, respectively, PR% was positively correlated with DHI score（ r =0.726, P <0.001）, and the comparison among the three groups was statistically significant（ P <0.05）. ②The vertical semicircular canal vHIT gain of patients with mild, moderate and severe handicap was 0.63±0.06, 0.52±0.15 and 0.38±0.16, respectively, the mean of VOR gain was negatively correlated with DHI score among the three groups（ r =-0.487, P <0.01）, the comparison of mild-severe and moderate-severe group was statistically significant（ P <0.05）, while there was no significant difference between the mild and moderate group（ P >0.05）. In the comparison of the mean values of vertical semicircular canal GA, the GA values of mild, moderate and severe handicap groups were 40.40±15.31, 46.10±19.59 and 47.87±18.05, respectively, there was no significant linear correlation between GA values and DHI scores among the three groups（ r =0.047, P >0.05）, there was no significant difference in GA among the three groups（ P >0.05）. The PR% of patients with mild, moderate and severe handicap were 42.40±15.39, 54.14±17.60 and 64.93±10.95, respectively, there was a positive significant correlation between PR% and DHI score（ r =0.454, P <0.05）, there was statistically significant in the comparison of mild-severe group（ P <0.05）, while there was no statistical significance between the other groups（ P >0.05）. Conclusion: The VOR gain and PR% value of vHIT in patients with vestibular neuritis are closely related to the DHI score, which can evaluate the vestibular function and the degree of vertigo., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To investigate the impact of time interval from symptoms onset to vestibular rehabilitation on the recovery of patients in the acute phase of vestibular neuritis. Methods: Thirty-one patients with vestibular neuritis treated in outpatient and inpatient settings from December 2019 to July 2021 were selected and randomly divided into vestibular rehabilitation group and general treatment group. The vestibular rehabilitation group was subdivided into early-intervention group （1-week after symptom onset） and late-intervention group （2-week after symptom onset） according to the interval from the onset to vestibular rehabilitation. The differences in DP, UW, VOR, DHI, BBS and SAS values at 1 month and 3 months after treatment were compared among early-intervention group（11 cases）, late-intervention group （10 cases） and general treatment group（10 cases）. Results: For patients in the vestibular rehabilitation group and the general treatment group, DP, UW, VOR gain, DHI score and SAS score were significantly different after treatment （ P <0.05） and no significant difference was found in BBS score （ P >0.05 ）. Pairwise comparisons between early-intervention and late-intervention group showed that the DP, UW and VOR gain were significantly different （ P <0.05）, while the score of DHI and SAS were not significantly different （ P >0.05）. Conclusion: Vestibular rehabilitation therapy can accelerate vestibular compensation, relieve vertigo symptoms and anxiety symptoms in patients with vestibular neuritis. It is better to be carried out within 1 week after symptom onset., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To analyze results obtained from high frequency semicircular canal function test in patients with unilateral vestibular neuronitis in the acute phase, aiming to provide references for clinical vestibular rehabilitation. Methods: A total of 49 patients with unilateral vestibular neuronitis in the acute phase were enrolled in this study. They were subjected to video head impulse test（vHIT） and vestibular autorotation test（VAT）. Test results were analyzed in detail. Results: vHIT results showed that 100% of patients presented a lower lateral horizontal semicircular canal gain than normal control, 93.88% presented a lower anterior semicircular canal gain, and 22.45% presented a lower posterior semicircular canal gain. VAT results showed: ①81.63%（40/49） of patients had a decline of horizonal VAT gain,83.67% （41/49） had an abnormal horizonal phase shift, and 63.27%（31/49） had an abnormal horizontal symmetry. ②32.65% （16/49） of patients had a decline of vertical VAT gain, and 16.33%（8/49） had abnormal vertical phase shift. Comparison results between vHIT and VAT data showed: ①There is a statistical difference between the rate of abnormal decline of vHIT horizonal semicircular canal gain and that of abnormal decline of VAT gain（ P <0.01）. There is a statistical difference between the rate of abnormal decline of vHIT anterior semicircular canal gain and that of abnormal decline of vertical VAT gain（ P <0.01）. No significant difference was found between the rate of abnormal decline of vHIT posterior semicircular canal gain and that of abnormal decline of vertical VAT gain（ P >0.05）. ②100% of patients presented a lower vHIT lateral horizontal semicircular canal gain than normal one, and 63.27% of patients had an abnormal VAT horizontal symmetry, which was statistically significant（ P <0.01）. ③The rate of abnormal decline of vertical VAT gain was 63.64% in patients with all declines of vHIT lateral horizontal, anterior and posterior semicircular canal gain, which was 23.68% in patients with declines of vHIT lateral horizontal and anterior semicircular canal gain. The difference was statistically significant（ P <0.05）. Conclusion: vHIT is superior to VAT in the high-frequency semicircular canal function test of unilateral vestibular neuronitis patients in the acute phase. VAT can be used as an important supplement, and the combination of vHIT and VAT can more accurately guide the vestibular rehabilitation., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To detect the impairment degree and recovery process of the semicircular canals of patients with vestibular neuritis（VN） by video head impulse test（vHIT） over different periods. Method: The clinical data of patients with VN, who were diagnosed by Vertigo clinic'physicians in the Department of ENT, Dalian Municipal Central Hospital from Sept. 2018 to Sept. 2019, were analyzed and followed up at 1 and 3 month. The damage degree and recovery process of each semicircular canal function were evaluated by vHIT. Result: During the onset period, 89.7% horizontal semicircular canal HSC, 86.2% anterior semicircular canal ASC and 44.8% posterior semicircular canal PSC were abnormal in 29 patients. 23.8% HSC were back to normal, 75.0% ASC were back to normal, 15.4% PSC were back to normal at 1 month; 47.1% HSC were back to normal, 87.5%ASC were back to normal, 25.0% PSC were back to normal at 3 month. Conclusion: vHIT can effectively and dynamically detect the damage and recovery of the high-frequency region of the semicircular canal in patients with VN; the damaged function of the ASC is best recovered, followed by the HSC., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To analyze the clinical features of secondary benign paroxysmal positional vertigo (BPPV) and provide evidence for its precise diagnosis and treatment. Method: There were 942 patients with vertigo related to BPPV, including 204 patients with primary BPPV, 592 patients with vestibular migraine (VM), 83 patients with Meniere's disease (MD), 48 patients with vestibular neuronitis (VN), and 15 patients with sudden sensorineural hearing loss (SSNHL) accompanied by vertigo.There were 127 patients with BPPV secondary to vertigo in MD, VN, VM, and SSNHL. All patients received otolith repositioning treatment by hand or instrument based on detailed medical history. Secondary BPPV patients are treated according to the principle of diagnosis and treatment of primary BPPV. The incidence of secondary BPPV in each related disease was counted, and the difference between primary and secondary BPPV in gender, age, affected semicircular canal, number of reductions, and vertigo control rate was compared. Result: ①The incidence of MD, VN, sudden vertigo, and VM secondary BPPV were 36.1% (30/83), 35.4%(17/48), 33.3% (5/15), and 12.7% (75/592). ②In patients with BPPV secondary to MD, the proportion of multi-semicircular canals involved was higher than that of primary BPPV, the difference was statistically significant ( P <0.05), and there was no significant difference in the distribution of semicircular canals involved among the remaining diseases. ③The vertigo control rate of BPPV secondary to MD and VM was lower than that of primary BPPV, and the difference was statistically significant ( P <0.05). ④The repositioning time of BPPV secondary to VM (2.88±2.32) and MD (2.53±1.14) was higher than that of primary BPPV (2.37±1.77). The difference was statistically significant ( P <0.05). There was no significant difference in the repositioning time between other secondary BPPV and primary BPPV. Conclusion: Common causes of secondary BPPV include MD, VN, SSNHL, and VM. Same as primary BPPV, the secondary BPPV was more common in women and the posterior semicircular canal was most affected. BPPV secondary to MD is more susceptible to multi-semicircular canals involvement than primary BPPV. Detailed medical history combined with targeted examination is conducive to the accurate diagnosis of BPPV. Secondary BPPV can also be treated by manipulation or instrument, however, the effect is worse than primary BPPV. Secondary BPPV should be treated according to the treatment principle of primary disease besides otolith repositioning., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To explore the epidemiological characteristics and to help accomplish accurate diagnosis and treatment strategies by analyzing the composition and clinical features of various diseases with acute constant vertigo. Method: We retrospectively analyzed medical records (including name, sex, age, diabetes, hypertension, history of vertigo, family history, etc.),otoneurological examination, vestibular function tests and radiological examination of patients with acute vestibular syndrome.We classified various diseases according to diagnostic criteria, and then analyze the clinical data. Result: A total of 77 patients with acute vestibular syndrome were enrolled in this study. It included 34 patients with vestibular neuritis, 18 patients with sudden sensorineural deafness with vertigo, 1 with vestibular schwannoma, 6 with acute vestibular syndrome with migraine, 3 with Hunter syndrome with vertigo, 1 with vertigo after trauma,1 with acute bilateral vestibulopathy, 9 with acute vertigo syndrome with other etiology, 3 with acute labyrinthitis, and 1 with posterior circulation infarction. There were no significant differences in the age and course of disease between different etiologies ( P >0.05). There were statistical differences between vestibular neuritis and sudden sensorineural deafness with vertigo among head impulse test and hearing loss ( P <0.05). There was significant difference in hearing between sudden sensorineural deafness with vertigo and acute vertigo syndrome ( P <0.05). Conclusion: Most of the acute vestibular syndrome patients attending the otorhinolaryngology head and neck surgery clinic were peripheral acute vestibular syndrome, vestibular neuritis, and sudden sensorineural deafness with vertigo.Patients with acute vestibular syndrome with migraine are not rare, and central vertigo can also be seen., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To analyze the etiological characteristics of patients in department of ENT with chief complaint of vertigo or dizziness in order to reduce the rate of misdiagnosis and wrong treatment. Method: A total of 3 137 patients in department of ENT with chief complaint of vertigo or dizziness from Sep 2015 to Sep 2017 were included and the etiologies were clarified retrospectively. And in which with any of the 8 kinds of disease including benign paroxysmal positional vertigo(BPPV), vestibular neuritis, vestibular migraine (VM), Meiniére disease, recurrent vestibular disease, sudden deafness with vertigo, psychogenic vertigo, posterior circulation ischemia (PCI) together 2 138 patients were further stratified analyzed by gender and age. Result: ①Etiological characteristics of patients with vertigo or dizziness：among the 3 137 patients with vertigo or dizziness in ENT department in our hosipital, the peripheral diseases of vestibular were the most common disease with a total of 1 607 cases, accounting for 51.23%. And there were 506 cases of the central diseases of vestibular accounting for 16.13%, 382 cases of other systemic diseases accounting for 12.18%, 85 cases（2.71%）of psychogenic vertigo, 557 cases （17.76%）of unknown etiology. ②Analysis of the frequent and serious causing of patients with vertigo or dizziness: among the 2 138(68.15%) patients with vertigo or dizziness, BPPV with a total of 827 cases (26.36%) was the most prevalent,while 215(25.99%) of them were diagnosed as self-cured BPPV,vestibular neuritis and VM were the second prevalent with 420 cases (13.39%) and 329 cases (10.49%) respectively, Meiniére disease, recurrent vestibular disease, sudden deafness with vertigo were the third prevalent with 209 cases (6.66%), 144 cases (4.59%), 102 cases (3.25%), respectively; well psychogenic vertigo and PCI were relatively rare, with respectively 85 cases (2.71%) and 22 cases (0.70%). Eotiology analysis stratified by age: The causes of vertigo or dizziness were ranged with age, and patients of 50-70 years old were most common with a total of 1 011 cases, accounting for 49.6%. Etiology analysis stratified by gender: There was gender difference in patients with vertigo or dizziness,such as BPPV, VM, recurrent vestibular disease, sudden deafness with vertigo and psychogenic vertigo were common in female, while PCI in male insteadly. Conclusion: ①Among the patients with vertigo or dizziness, the pheripheral diseases of vestibular are the most prevalent, in which BPPV takes the highest accidence. ②Patients ranging from 50 to 70 years old take the main parts in patients with vertigo or dizziness. And there is an obvious gender difference in patients with BPPV, VM, recurrent vestibular disease, sudden deafness with vertigo, psychogenic vertigo and PCI.

Objective: To compare the results of caloric tests and video head impulse tests (VHIT) in patients with vestibular migraine (VM) and vestibular neuritis (VN), so as to provide help for the differential diagnosis of the two patients. Method: Retrospectively analyze VM and VN patients within 2 weeks of onset from August 1, 2016 to December 31, 2017 in neurology clinic of the Changzheng Hospital of Second Military Medical University, all patients were examined by caloric tests and VHIT, and the results of the two groups were compared and analyzed. Result: The 40 cases of VM patients， among them, 23 cases were abnormal in caloric test, 17 cases showed unilateral canal paresis, 6 cases showed bilateral weakness, the unilateral abnormality rate was higher than that of bilateral abnormality（ P <0.01）. 8 cases were abnormal in VHIT, 3 cases had unilateral vestibulo-ocular reflex (VOR) gain decline, 5 cases had bilateral VOR gain decline, unilateral and bilateral VHIT abnormal rate had no difference ( P >0.05). The 45 cases of VN patients. Among them, 45 cases were abnormal in caloric test, 37cases showed unilateral canal paresis, 8 cases showed bilateral weakness, the unilateral abnormality rate was higher than that of bilateral abnormality（ P <0.001). 35 cases were abnormal in VHIT, 21 cases had unilateral VOR gain decline, 14 cases had bilateral VOR gain decline, unilateral and bilateral VHIT abnormal rate had no difference ( P > 0.05). By statistical analysis, the abnormal rate of caloric test of VN and VM were higher than that of VHIT, and the abnormal rate of caloric test and VHIT in VM patients were lower than that of VN. The slow phase velocity (SPV) and the VHIT gain of the three group of semicircular canals of strong and weak caloric response sides in the VM patients were higher than those of the corresponding canals in the VN patients. Conclusion: The low frequency damage of vestibule function of semicircular canals in VN and VM patients is more than that of high frequency. Compared with VM, the high and low frequency damage of the semicircular canals in VN patients are more common( P <0.05), and prone to high and low frequency simultaneous involvement ( P <0.001). From the SPV of caloric test and VHIT gain values, the degree of damage to the high and low frequency semicircular canals of in VN patients was more serious than that in VM patients., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

estibular neuronitis is one of the leading causes of peripheral vertigo. Inflammation confined to the vestibular system, and the cochlear, central nervous system and hearing are normal. The disease may be associated with viral infections, but the virus serological positive rate is not high. Vestibular-evoked myogenic potential and head impulse test can be used for sub-type diagnosis, and improve the detection rate of inferior vestibular neuronitis.Corticosteroids therapy is still controversial, and had not been included in VN conventional treatment. Vestibular rehabilitation is helpful in building central compensatory earlier for VN patients, and if the compensate for VN completely was the final basis of aviation medicine evaluation. This review focuses on the clinical manifestation, etiology, diagnosis, differential diagnosis，corticosteroids and rehabilitation therapy, and aviation medicine identification of VN., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To investigate clinical application of head impulse test with video recording eye movements in the diagnosis of vertigo., Method: The video head impulse test(vHIT) was used to measure the eye saccades and velocity gain in 95 patients with vertigo which were divided into two groups, peripheral vertigo (47 cases) and central vertigo(48 cases); the characteristics of eye saccades and velocity gain of six semicircular canals in different patients with vertigo were analyzed, and were compared between the two groups., Result: The vHIT result in patients with peripheral vertigo: in 22 patients (23 affected ears) with Meniere's disease, 21 ears were abnormal (91. 3%); the vHIT results in 4 patients with vestibular schwannoma, 2 patients with vestibular neuritis, 5 patients with delayed endolymphatic hydrops, 6 patients with sudden hearing loss accompanied vertigo, and 8 patients with vestibular dysfunction, were abnormal with correct saccades and/or lower velocity gain of vHIT. The abnormal vHIT results were also found in 35 of 48 patients (72. 9%) with central vertigo, which including posterior cerebral circulation ischemia(7 patients), cerebral infarction/stroke(6 patients), and dizziness with vertigo(17 patients) and others(18 patients). Abnormal rate of vHIT in patients with peripheral vertigo was 95. 7% (45/47), which was significantly higher than that (72. 9%) in patients with central vertigo., Conclusion: It is easy to perform the vHIT which without adverse reactions. We can record high-frequency characteristics of vestibular-ocular reflex among six semicircular canals through vHIT. The vHIT results which show the function of vestibular ocular reflex in different diseases with vertigo, can help discriminate peripheral vertigo from central vertigo, and it is a practical assessment method for vertigo.

Objective: To explore the clinical characteristics, pathological mechanism, diagnose, differential diagnosis and the treatment of vascular compressive vestibular neuropathy., Method: The authors retrospectively studied 2 cases of vascular compressive vestibular neuropathy about clinical characteristics, auditory tests, vestibular tests and imaging examine results, pharmacotherapy results and reviewed the related documents., Result: There were some common clinical characteristics: (1) Vertigo and disequilibrium could be elicited by any physical activity and head movement and abated with complete bed rest; (2) Symptoms and signs can't be improved by vestibular suppressant medications; (3) When taken Dix-Hallpike test, true vertigo or a spinning sensation appeared during head movement, when head skilled at any position,the symptoms disappeared; (4) The suffering lateral often showed high frequency sensorineural hearing loss ,the ABR of the suffering lateral showed prolonged inter wave latency of I-III wave; (5) Vestibular tests showed central lesion; (6) Occupying lesion can be ruled out by CT and MRI, MRI showed neurovascular compression of vestibular nerve; (7) Taking carbamazepine plus baclofen or only Tegretol orally can alleviate symptoms. A great deal of surgeries confirmed neurovascular compression of cranial nerve U as a disease entity, the offending artery mainly anterior inferior cerebellar artery. Microvascular decompression of cranial nerve VIII can successfully relieve vertigo., Conclusion: Neurovascular compression of cranial nerve VIII is a disease entity beyond question. It's major characters were vertigo and disequilibrium which elicited by any physical activity and head movement, magnetic resonance tomographic angiography can give valuable information for diagnosis and treatment. Microvascular decompression can effectively relieve vertigo.