Document Detail

Persistent alternobaric vertigo at ground level.
MedLine Citation:
PMID:  22294503     Owner:  NLM     Status:  MEDLINE    
We recently encountered a 15-year-old female with bilateral tympanostomy tubes who manifested persistent severe vertigo, at ground level, secondary to a unilateral middle-ear pressure of +200 mm H(2)O elicited by an obstructed tympanostomy tube in the presence of chronic nasal obstruction. We believe this is a previously unreported scenario in which closed-nose swallowing insufflated air into her middle ears, resulting in sustained positive middle-ear pressure in the ear with the obstructed tube. Swallowing, when the nose is obstructed, can result in abnormal negative or positive pressures in the middle ear, which has been termed the Toynbee phenomenon. In patients who have vertigo, the possibility that nasal obstruction and the Toynbee phenomenon are involved should be considered.
Charles D Bluestone; J Douglas Swarts; Joseph M Furman; Robert F Yellon
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, N.I.H., Extramural     Date:  2012-01-31
Journal Detail:
Title:  The Laryngoscope     Volume:  122     ISSN:  1531-4995     ISO Abbreviation:  Laryngoscope     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-03-21     Completed Date:  2012-05-29     Revised Date:  2014-09-08    
Medline Journal Info:
Nlm Unique ID:  8607378     Medline TA:  Laryngoscope     Country:  United States    
Other Details:
Languages:  eng     Pagination:  868-72     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.
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MeSH Terms
Acoustic Impedance Tests
Diagnosis, Differential
Ear, Middle / physiopathology
Eustachian Tube / physiopathology*
Middle Ear Ventilation / methods
Vertigo / diagnosis*,  physiopathology,  surgery
Grant Support
007667//PHS HHS; P50 DC007667/DC/NIDCD NIH HHS; P50 DC007667-06/DC/NIDCD NIH HHS

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