Andres Soto-Varela

University of Santiago de Compostela | USC · Department of Dermatology and Otolaryngology

Patients with bilateral vestibulopathy (BVP) suffer from postural imbalance during daily life conditions, which in turn leads to a high frequency of falls. Unfortunately, vestibular rehabilitation has only modest and somewhat inconsistent effects in this patient group. Approximately 50% of BVP patients show an improved postural control after conven...

Introduction Vestibular symptoms, including vertigo, dizziness, and gait unsteadiness, are a frequent reason of urgent medical assistance. Their causes are numerous and diverse, including neurological, otorhinolaryngological, and systemic diseases. Therefore, following a systematic approach is essential to differentiate striking but benign conditio...

Patients with bilateral vestibulopathy (BVP) suffer from postural imbalance during daily life conditions which in turn leads to a high frequency of falls. Unfortunately, vestibular rehabilitation has only modest and somewhat inconsistent effects in this patient group. Approximately fifty percent of BVP-patients show an improved postural control aft...

The Head Impulse Test, the most widely accept test to assess the vestibular function, comprises rotations of the head based on idealized orientations of the semicircular canals, instead of their individual arrangement specific for each patient. In this study, we show how computational modelling can help personalize the diagnosis of vestibular disea...

Background: Meniere Disease (MD) is an inner ear syndrome, characterized by episodes of vertigo, tinnitus and fluctuating sensorineural hearing loss. The pathological mechanism leading to sporadic MD is still poorly understood, however an allergic inflammatory response seems to be involved in some patients with MD. Objective: Decipher an immune...

Background Meniere Disease (MD) is an inner ear syndrome, characterized by sensorineural hearing loss associated with episodes of vertigo, tinnitus, and aural fullness. The pathological mechanism leading to sporadic MD is still poorly understood, however an inflammatory response seems to be involved in some patients with MD. Methods We performed m...

Background: Essential tremor (ET) is a neurological disorder characterized primarily by action tremor. Balance impairments in ET patients were formerly considered to be uncommon and simply age-related. However quantitative assessment with posturography has revealed impairments in control of both static and dynamic balance. Research question: The...

Background Meniere’s disease (MD) is an inner ear disease defined by episodes of vertigo associated with sensorineural hearing loss initially affecting low- to medium frequencies, tinnitus, and aural fullness. Familial aggregation has been reported in 9-10% of MD patients showing, mostly, an autosomal dominant inheritance pattern with incomplete pe...

Meniere Disease (MD) is a multifactorial disorder of the inner ear characterized by vertigo attacks associated with sensorineural hearing loss and tinnitus with a significant heritability. Although MD has been associated with several genes, no epigenetic studies have been performed on MD. Here we performed whole-genome bisulfite sequencing in 14 MD...

Background Vestibular rehabilitation (VR), specifically, VR with dynamic computerized posturography (CDP) has proven to be useful to improve balance and reduce the risk of falling in old patients. Its major handicap is probably its cost, which has hindered its generalisation. One solution to reduce this cost is performing VR with mobile posturograp...

Meniere Disease (MD) is a multifactorial disorder of the inner ear characterized by vertigo attacks associated with sensorineural hearing loss and tinnitus with a significant heritability. Although MD has been associated with several genes, no epigenetic studies have been performed in MD. Here we performed whole genome bisulfite sequencing in 14 MD...

Background: Meniere disease (MD) is an inner ear disorder associated with comorbidities such as autoimmune diseases or migraine. This study describes clinical and cytokine profiles in MD according to the age of onset of the condition. Methods: A cross-sectional study including 83 MD patients: 44 with early-onset MD (EOMD, <35 years old), and 39...

Background: Meniere disease (MD) is an inner ear disorder associated with comorbidities such as autoimmune diseases or migraine. This study describes clinical and cytokine profile in MD according to the age of onset of the condition. Methods: A cross-sectional study including 83 MD patients: 44 with early onset MD (EOMD, <35 years old), and 39 with...

The MYO7A gene encodes a motor protein with a key role in the organization of stereocilia in auditory and vestibular hair cells. Rare variants in the MYO7A (Myosin VIIa) gene may cause autosomal dominant (AD) or autosomal recessive (AR) sensorineural hearing loss (SNHL) accompanied by vestibular dysfunction and/or retinitis pigmentosa (Usher syndro...

Background: tinnitus is a heterogeneous condition associated with audiological and/or mental disorders. Chronic, severe tinnitus is reported in 1% of the population and it shows a relevant heritability, according to twins, adoptees and familial aggregation studies. The genetic contribution to severe tinnitus is unknown since large genomic studies...

A retrospective study of 106 patients with vestibular schwannoma (VS) conducted in the population of Galicia, visited to University Hospital Santiago de Compostela from February 21, 1992, to March 3, 2014. The clinical manifestations of the VS vary and include unilateral high-frequency sensorineural hearing loss, tinnitus, imbalance, pressure in th...

Background: The diagnosis of benign paroxysmal positional vertigo (BPPV) involving the lateral semicircular canal (LSC) is traditionally entrusted to the supine head roll test, also known as supine head yaw test (SHYT), which usually allows identification of the pathologic side and BPPV form (geotropic vs. apogeotropic). Nevertheless, SHYT may not...

Objective: To assess the perception of disability in patients with presbyvestibulopathy and to determine the factors (demographic, balance test scores, and comorbidities) that determine higher levels of disability. Material and Methods: This was a cross-sectional study conducted in a tertiary university hospital. There were 103 patients who fulfill...

Objective: To compare the results from the modified Timed Up and Go Test (TUG) with posturographic variables, the subjective perception of disability due to gait instability, and the number of falls in a sample of the elderly population with imbalance, to confirm that the TUG Test is a useful clinical instrument to assess the tendency to fall in in...

Purpose: Vestibular rehabilitation (VR) using posturography systems has proved useful in improving balance among elderly patients with postural instability. However, its high cost hinders its use. The objective of this study is to assess whether two different protocols of VR with posturography, one of them longer (ten sessions) and the other short...

Background Although patient environment is a factor to consider when planning a vestibular rehabilitation program, there are no studies correlating this factor to outcomes of balance assessment. Aim To evaluate whether there are differences in objective evaluation of balance in elderly patients at risk of falls according to the environment in whic...

Objectives: Meniere's disease (MD) is a rare inner ear disorder characterized by sensorineural hearing loss, episodic vertigo, and tinnitus. Familial MD has been reported in 6 to 9% of sporadic cases, and few genes including FAM136A, DTNA, PRKCB, SEMA3D, and DPT have been involved in single families, suggesting genetic heterogeneity. In this study...

Background Our previous study has shown that vestibular rehabilitation (VR) is an effective technique to reduce falls in elderly patients. It would be interesting to establish patients’ clinical characteristics in which vestibular rehabilitation is expected to be more effective. Aims Evaluate factors that could modify rehabilitation outcomes in el...

A retrospective study of 106 patients with vestibular schwannoma (VS) conducted in the population of Galicia, who visited the University Hospital Santiago de Compostela from February 21, 1992, to March 3, 2014. The clinical manifestations of the sun vary greatly and include unilateral high-frequency sensorineural hearing loss, tinnitus, imbalance,...

Objectives: Meniere's disease (MD) is a rare inner ear disorder characterized by sensorineural hearing loss, episodic vertigo and tinnitus. Familial MD has been reported in 6-9% of sporadic cases, and few genes including FAM136A, DTNA, PRKCB, SEMA3D and DPT have been involved in single families, suggesting genetic heterogeneity. In this study, the...

Vestibular Migraine (VM) and Meniere's Disease (MD) are episodic vestibular syndromes defined by a set of associated symptoms such as tinnitus, hearing loss or migraine features during the attacks. Both conditions may show symptom overlap and there is no biological marker to distinguish them. Two subgroups of MD patients have been reported, accordi...

Background Accidental falls, especially for the elderly, are a major health issue. Balance disorders are one of their main causes. Vestibular rehabilitation (VR) has proven to be useful in improving balance of elderly patients with instability. Its major handicap is probably its cost, which has prevented its generalisation. So, we have designed a c...

Background Our previous study had shown the effectiveness of vestibular rehabilitation (VR) in improving balance in elderly patients, assessed immediately afterwards. AimsThe main goal of the present study is to consider whether this improvement in balance assessment turns out in a reduction of the number of falls. Methods139 elderly patients with...

Benign paroxysmal positional vertigo is the most frequent episodic vestibular disorder. The purpose of this guide, requested by the committee on otoneurology of the Spanish Society of Otolaryngology and Head and Neck Surgery, is to supply a consensus document providing practical guidance for the management of BPPV. It is based on the Barany Society...

Objectives: Dietary changes are useful in the management of Menière’s disease; regarding alcohol, many clinicians recommend to avoid or reduce its consumption. However, there are no researches aimed to evaluate whether habitual alcohol consumption is more prevalent and/or more intense in patients with Menière’s disease. Methods: Cross-sectional, ob...

Epidemiological studies have found a higher prevalence of allergic symptoms and positive prick tests in patients with Meniere's disease (MD); however the effect of allergenic extracts in MD has not been established. Thus, this study aims to determine the effect of Aspergillus and Penicillium stimulation in cytokine release and gene expression profi...

Objective: To describe the pattern of dynamic posturography or its role in diagnosis in patients with cerebellar ataxia with neuropathy and vestibular arreflexia syndrome (CANVAS). Materials and methods: We present and describe posturographic data of four patients diagnosed with the CANVAS syndrome in a tertiary hospital. Results: In all patie...

Benign Paroxysmal Positional Vertigo is the most frequent episodic vestibular disorder. The purpose of this guide, requested by the committee on otoneurology of the Spanish Society of Otolaryngology and Head and Neck Surgery, is to supply a consensus document providing practical guidance for the management of BPPV. It is based on the Barany Society...

A 54-year-old patient seen in the otoneurology clinic with a year history of dizzy spells which lasted for hours, with an ilussion of rotation of objects, accompanied by vegetative reactions. The dizzy spells presented with continuous tinnitus in the right ear and ipsilateral hearing loss. Audiometry showed mixed hearing loss of the right ear pred...

Balance becomes more precarious with age, and even without pathological disorders, the physiological decline in balance that occurs with age is a factor that also favors falls. So the aim of the present study is to assess the short-term effectiveness of three different methods of vestibular rehabilitation, compared to a control group, in improving...

Objectives: Although it is commonly recognized that dietary restrictions may improve the clinical course of Menière's disease, their effectiveness has not been definitely demonstrated. The aim of this study was to examine whether caffeine consumption could be involved in Menière's disease. Methods: Cross-sectional, observational, case-control study...

Vestibular schwannoma is a benign tumor arising from the myelin sheath of the vestibulocochlear nerve. As the tumor grows, it compresses structures and nerves in Internal Acoustic Canal (IAC) and may also prolapses into the cerebellopontine angle (CPA). Conventional neurosurgery in many cases follows post-surgical complications as hearing loss. Acc...

Objectives: To define clinical subgroups by cluster analysis in patients with unilateral Meniere disease (MD) and to compare them with the clinical subgroups found in bilateral MD. Design: a cross-sectional study with a two-step cluster analysis. Settings: a tertiary referral multicenter study. Participants: Nine hundred eighty-eight adult p...

Objective To determine whether demographic characteristics or balance examination findings can predict the adherence of older people with instability to a vestibular rehabilitation programme. Methods A prospective case–control study was conducted of 120 patients aged 65 years or more (mean age, 77.3 ± 6.33 years). Two groups were classified accord...

Meniere disease (MD) is a heterogeneous clinical condition characterized by sensori-neural hearing loss, episodic vestibular symptoms, and tinnitus associated with several comorbidities, such as migraine or autoimmune disorders (AD). The frequency of bilateral involvement may range from 5 to 50%, and it depends on the duration of the disease. We ha...

OBJECTIVE: The therapeutic use of ototoxic drugs is relatively common, particularly in patients with severe diseases. It is likely that disturbances of balance in these patients are underestimated by clinicians. MATERIALS and METHODS: The purpose of this study was to identify drugs involved in the vestibulotoxic origin of instability in a group of...

OBJECTIVE: Impaired balance in patients with Parkinson's disease (PD) leads to loss of balance and frequent falls. Computerized dynamic posturography allows the assessment of stance tasks whereas mobile posturography analyzes the balance in free-field conditions, where falls among PD patients commonly occur (e.g. sitting down or standing up). The...

Paciente de 54 años, sin antecedentes personales de interés. Atendida en consultas de Otoneurología por clínica de un año de evolución de crisis vertiginosas de horas de duración, con ilusión de giro de objetos,acompa˜nadas de cortejo vegetativo. Las crisis cursa-ban con acúfeno continuo en oído derecho e hipoacusia ipsilateral.

Conclusions: There was a difference in average score of the sensory organization test (SOT) of the case group (elderly instability) compared to the control group (healthy subjects). Cases had worse scores on the limits of stability (LOS) than controls, but were only able to confirm statistically significant differences in the movement velocity. Obj...

Meniere’s Disease (MD) is a complex disorder associated with an accumulation of endolymph in the membranous labyrinth in the inner ear. It is characterized by recurrent attacks of spontaneous vertigo associated with sensorineural hearing loss (SNHL) and tinnitus. The SNHL usually starts at low and medium frequencies with a variable progression to h...

Objectives: To analyze the equilibriometric differences between 2 populations of elderly patients (young elderly and very elderly) with instability induced solely by age. Methods: Cross-sectional study, with 2 study groups classified according to patient age (cut-points in twenty-fifth and seventy-fifth percentiles of the age of the sample). Po...

Fear of falling (FOF) is a common problem among the elderly. The purpose of this study is to evaluate whether there is a correlation between FOF, estimated via the short FES-I test, and objective evaluation of balance in a group of elderly patients with age-related instability. The balance of 139 subjects of more than 65 years of age is evaluated b...

Acknowledgement of the age effects on postural control and balance is essential to differentiate between physiological changes and actual pathological alterations of the elderly. The aim of this study is to establish the age-related postural changes recorded by the Computerized Dynamic Posturography. 70 healthy individuals (35 males and 35 females)...

The aim of the study is to assess whether obesity affects balance in elderly patients with postural instability. It is a case-control study, with cases defined by BMI ≥30 kg/m(2), and developed in a third level university hospital. We included 135 patients aged 65 years old or more who presented postural instability. Balance assessment was through...

The purpose of the study was to evaluate self-perceived handicap in patients with definite Menière's disease (MD). A cross-sectional study was conducted. To examine the self-perception of disability, participants completed a DHI (Dizziness Handicap Inventory). Parameters compared with DHI scores: sex, age, unilateral/bilateral affectation, time ela...

Evaluate the effectiveness of vestibular rehabilitation (VR) to improve the balance in older people, assessed immediately afterwards. SECONDARY OBJECTIVES: (a) To verify the maintenance of improvement of the balance achieved in the medium term (6-12 months). (b) To consider whether this improvement results in a reduction in the number of falls. (c)...

The sensory organization test (SOT) is the gold-standard test for the study of postural control with posturographic platforms. Three registers of Conditions 3, 4, 5 and 6 are conducted to find an arithmetic mean of the 3, with the time that this entails. The aim of this study was to determine whether a single record for each SOT condition would giv...

The sensory organization test (SOT) is the gold-standard test for the study of postural control with posturographic platforms. Three registers of Conditions 3, 4, 5 and 6 are conducted to find an arithmetic mean of the 3, with the time that this entails. The aim of this study was to determine whether a single record for each SOT condition would giv...

Meniere's disease is an episodic vestibular syndrome associated with sensorineural hearing loss (SNHL) and tinnitus. Patients with MD have an elevated prevalence of several autoimmune diseases (rheumatoid arthritis, systemic lupus erythematosus, ankylosing spondylitis and psoriasis), which suggests a shared autoimmune background. Functional variant...

Objective The aim of this study is to determine whether clinical and instrumental examination of balance can predict the risk of falls in elderly patients with instability. Methods Study design: It is a case control study, with cases defined by falls in the last year, developed in a third level university hospital. Patients Seventy patients aged...

Vestibular evoked myogenic potentials (VEMPs) are currently considered a diagnostic tool for studying the vestibular system, specifically the saccule and inferior vestibular nerve. This prospective study aimed at evaluating the impact of patient position and type of acoustic stimulus on VEMPs results using 60 healthy subjects who underwent otoscopy...

To assess whether a subjective questionnaire that measures the disability caused by balance disorders in daily life activities is correlated to objective assessment of balance in elderly patients with age-related instability. We included 37 subjects aged 65 years or more who presented balance disorders induced solely by age. Balance assessment was...

Introduction Parkinson’ disease (PD) is one of the most prevalent neurodegenerative diseases, and more than half of patients with PD experience falls. Research for clinically useful risk factors predicting falls has yielded inconsistent findings so far. Hence the aim of the study is to validate two different posturography techniques and one modifie...