Dysfunction along the continuum of vestibulocochlear anatomy, and the corresponding spectrum of clinical presentation: how little we know, and what else we need to learn

Abstract

Objective: Explore how the terminology of some vestibulocochlear diseases leads to a misleading nosology that probably misrepresents the underlying neuroanatomy and pathology.

Methods: Review what is known and unknown about neuroanatomical localization of some common vestibulocochlear diseases.

Results: Literature on this topic often conveys, or strongly implies, discreteness of neuroanatomical localization and corresponding deficits, when in fact several common vestibulocochlear disorders are more likely to involve a continuum both in anatomy and in clinical presentation.

Conclusion: Having recognized the misleading nature of the common classifications of these diseases, we suggest several strategies for improving diagnosis. Some of these suggestions are immediately applicable to the practice of vestibular medicine; others have potential relevance for emerging and future therapeutics.

Keywords:

• Peripheral vestibular function
• vestibular testing
• semicircular canals
• otolith organs

Disclosure statement

The authors report no financial disclosures or benefits.