{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T04:35:14Z","timestamp":1792470914211,"version":"4.5.0"},"reference-count":48,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,1,22]],"date-time":"2024-01-22T00:00:00Z","timestamp":1705881600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Audiology Research"],"abstract":"<jats:p>The third window syndrome, often associated with the Tullio phenomenon, is currently most often observed in patients with a superior semicircular-canal dehiscence (SCD) but is not specific to this pathology. Clinical and vestibular tests suggestive of this pathology are not always concomitantly observed and have been recently complemented by the skull-vibration-induced nystagmus test, which constitutes a bone-conducted Tullio phenomenon (BCTP). The aim of this work was to collect from the literature the insights given by this bedside test performed with bone-conducted stimulations in SCD. The PRISMA guidelines were used, and 10 publications were included and analyzed. Skull vibration-induced nystagmus (SVIN), as observed in 55 to 100% of SCD patients, usually signals SCD with greater sensitivity than the air-conducted Tullio phenomenon (ACTP) or the Hennebert sign. The SVIN direction when the test is performed on the vertex location at 100 Hz is most often ipsilaterally beating in 82% of cases for the horizontal and torsional components and down-beating for the vertical component. Vertex stimulations are more efficient than mastoid stimulations at 100 Hz but are equivalent at higher frequencies. SVIN efficiency may depend on stimulus location, order, and duration. In SCD, SVIN frequency sensitivity is extended toward high frequencies, with around 400 Hz being optimal. SVIN direction may depend in 25% on stimulus frequency and in 50% on stimulus location. Mastoid stimulations show frequently diverging results following the side of stimulation. An after-nystagmus observed in 25% of cases can be interpreted in light of recent physiological data showing two modes of activation: (1) cycle-by-cycle phase-locked activation of action potentials in SCC afferents with irregular resting discharge; (2) cupula deflection by fluid streaming caused by the travelling waves of fluid displacement initiated by sound or vibration at the point of the dehiscence. The SVIN direction and intensity may result from these two mechanisms\u2019 competition. This instability explains the SVIN variability following stimulus location and frequency observed in some patients but also discrepancies between investigators. SVIN is a recent useful insight among other bedside examination tests for the diagnosis of SCD in clinical practice.<\/jats:p>","DOI":"10.3390\/audiolres14010009","type":"journal-article","created":{"date-parts":[[2024,1,23]],"date-time":"2024-01-23T10:54:26Z","timestamp":1706007266000},"page":"96-115","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Skull Vibration-Induced Nystagmus in Superior Semicircular Canal Dehiscence: A New Insight into Vestibular Exploration\u2014A Review"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8311-0322","authenticated-orcid":false,"given":"Georges","family":"Dumas","sequence":"first","affiliation":[{"name":"Department of Oto-Rhino-Laryngology Head and Neck Surgery, University Hospital, 38043 Grenoble, France"},{"name":"Research Unit 3450 DevAH\u2014Development, Adaptation and Handicap, Faculty of Medicine, University of Lorraine, 54500 Vandoeuvre-l\u00e8s-Nancy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9416-5038","authenticated-orcid":false,"given":"Ian","family":"Curthoys","sequence":"additional","affiliation":[{"name":"Vestibular Research Laboratory, School of Psychology, University of Sydney, Sydney, NSW 2006, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2874-5672","authenticated-orcid":false,"given":"Andrea","family":"Castellucci","sequence":"additional","affiliation":[{"name":"ENT Unit, Department of Surgery, Azienda USL, IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Dumas","sequence":"additional","affiliation":[{"name":"INSERM UMR 1039 Bioclinic Radiopharmaceutics Laboratory, University Grenoble Alpes, 38700 La Tronche, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5491-8779","authenticated-orcid":false,"given":"Laetitia","family":"Peultier-Celli","sequence":"additional","affiliation":[{"name":"Research Unit 3450 DevAH\u2014Development, Adaptation and Handicap, Faculty of Medicine, University of Lorraine, 54500 Vandoeuvre-l\u00e8s-Nancy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Armato","sequence":"additional","affiliation":[{"name":"Research Unit 3450 DevAH\u2014Development, Adaptation and Handicap, Faculty of Medicine, University of Lorraine, 54500 Vandoeuvre-l\u00e8s-Nancy, France"},{"name":"Department of Neurosciences, University of Padova, 35100 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"Malara","sequence":"additional","affiliation":[{"name":"Audiology & Vestibology Service, Centromedico, 6500 Bellinzona, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Perrin","sequence":"additional","affiliation":[{"name":"Research Unit 3450 DevAH\u2014Development, Adaptation and Handicap, Faculty of Medicine, University of Lorraine, 54500 Vandoeuvre-l\u00e8s-Nancy, France"},{"name":"Department of Paediatric Oto-Rhino-Laryngology, University Hospital of Nancy, 54500 Vandoeuvre-l\u00e8s-Nancy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00e9bastien","family":"Schmerber","sequence":"additional","affiliation":[{"name":"Department of Oto-Rhino-Laryngology Head and Neck Surgery, University Hospital, 38043 Grenoble, France"},{"name":"INSERM UMR 2015, Brain Tech Laboratory, 38700 La Tronche, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/S0196-0709(00)80068-X","article-title":"Superior canal dehiscence syndrome","volume":"21","author":"Minor","year":"2000","journal-title":"Am. 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