Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Association Between Third Mobile Window Disorders and Symptom Reduction Using a Noise Cancelling Device (NCD): Inverse Tullio Phenomena

Version 1 : Received: 10 April 2023 / Approved: 11 April 2023 / Online: 11 April 2023 (05:49:05 CEST)

A peer-reviewed article of this Preprint also exists.

Feinberg, D.; Rosner, M.; Gianoli, G. Association between Third Mobile Window Disorders and Symptom Reduction Using a Noise Cancelling Device: Inverse Tullio Phenomena. Audiol. Res. 2023, 13, 516-527. Feinberg, D.; Rosner, M.; Gianoli, G. Association between Third Mobile Window Disorders and Symptom Reduction Using a Noise Cancelling Device: Inverse Tullio Phenomena. Audiol. Res. 2023, 13, 516-527.

Abstract

Identifying a vestibular source of pathology in patients complaining of post-traumatic brain injury (TBI) dizziness can be difficult. We describe a possible new method utilizing the reduction of post-TBI symptom (including dizziness) with the use of a noise cancellation device (NCD). This retrospective case series included patients with TBI and dizziness presenting to a binocular vision specialty clinic, who were diagnosed with a vertical heterophoria (VH). If they did not respond adequately to microprism lenses and/or if they experienced hyperacusis, they were evaluated with an NCD. If there was marked reduction of TBI symptoms (including dizziness), the patients were referred to a neuro-otologist for vestibular diagnostic evaluation and treatment. Fourteen patients were identified and found to have abnormalities on vestibular testing consistent with Third Mobile Window Disorder (TMWD). All were treated with a 6-week medical protocol (diuretics, no straining, low sodium/no caffeine diet). Five responded positively, requiring no further treatment. Nine required surgical intervention and responded positively. In conclusion, 14 patients with post-concussive dizziness and VH, a positive response to NCD was associated with abnormal vestibular testing, a diagnosis of TMWD, and symptom reduction/resolution with a medical or surgical approach. The removal of sound resulting in reduction or resolution of vestibular symptoms represents an Inverse Tullio Phenomena.

Keywords

Tullio Phenomena; Noise Cancellation Device; Dizziness; Vertical Heterophoria; Third Mobile Window Disorder; Binocular Vision Dysfunction

Subject

Medicine and Pharmacology, Otolaryngology

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