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Air Caloric Stimulation With Tympanic Membrane Perforation
Author(s) -
Barber Hugh O.,
Harmand William M.,
Money Kenneth E.
Publication year - 1978
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.1978.88.7.1117
Subject(s) - caloric theory , stimulation , perforation , tympanic membrane perforation , medicine , anatomy , surgery , tympanoplasty , engineering , mechanical engineering , punching
Warm air caloric stimulation in an ear with tympanic membrane perforation or mastoidectomy cavity often causes contralateral nystagmus. Secondary nystagmus is common. Our evidence with squirrel monkeys and patients indicates that the primary “inversion” results from endolymph cooling due to evaporative cooling of the mucus lining the middle ear cavity, by the dry air stimulus. Disconjugate horizontal nystagmus was found in a patient with large eardrum perforation, after cold air caloric stimulation. The effect probably resulted from stimulation of the anterior or posterior vertical semicircular canal. Inverted or disconjugate caloric nystagmus after air stimulation is much more frequently due to tympanic membrane perforation, or moisture in the external ear, than to central nervous system disease.