ADAPTATION TO VESTIBOLOPATHIES 

Otorinolaringologia 2005 September;55(3):175-7

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: Italian

Subjective visual vertical in chronic vestibular deficits

Vannucchi P.

Dipartimento di Scienze Chirurgiche Oto-Neuro-Oftalmologiche Università degli Studi di Firenze, Firenze

The judgement of Subjective Visual Vertical (VVS) and Subjective Visual Horizontal in erect posture depends on integration of inputs from ocular, vestibular and propriocetive systems. In normal conditions the ocular system has a principal role, also after its exclusion the capacity of spatial orientation is only a little lower.
In the presence of a vestibular pathology (peripherical and/or central), the straight line indicated by patient as vertical, could not be the same as the real gravitational one and it could be inclined from the left or right. In the acute phase patients incline straight line (also over 15°) toward damaged side.
This inclination progressively reduces itself so much that VVS values can be used as longitudinal study of macular utricular functionality restoration after acute vestibular damage.
In conclusion VVS is a simple and useful test for static evaluation of vestibular and utricular compensation trend, even if we still do not know with precision what are the factors influencing VVS and its behaviour in time.