09-11, 07:00–07:30 (Europe/Istanbul), Equlibirium 1
High-frequency bone-conducted vibration is not merely “very fast motion”: for a sinusoid of fixed displacement, jerk scales with ω³ and becomes the dominant mechanical feature at ~60–100 Hz. This keynote will link the physics of vibration/jerk to the dual-channel vestibular periphery, highlighting the preferential activation of Type I hair cells, calyx synapses and irregular afferents. Clinical translation will focus on how BCV-VEMPs and skull vibration-induced nystagmus (SVIN) probe this transient pathway in unilateral vestibular loss, Ménière’s disease and third-window syndromes.
Purpose: to provide a unified, engineering-based and clinically actionable framework for interpreting vibratory vestibular tests. The lecture will (i) formalize why high-frequency vibration is “jerk-dominated”, (ii) explain the biological substrate that encodes jerk-rich inputs (Type I/calyx/irregular system), and (iii) translate these principles into practical diagnostic guidance for selecting and interpreting BCV-VEMPs and SVIN, improving pattern recognition and decision-making across common peripheral vestibular disorders and third-window pathology
Leonardo Manzari is an otorhinolaryngologist with a long-standing clinical and scientific focus on otoneurology, vestibology, and vestibular rehabilitation. He received his MD from Università Cattolica del Sacro Cuore, Rome (1988) and completed his specialization in Otorhinolaryngology and Cervico-Facial Pathology at Università dell’Aquila degli Abruzzi (1993).He served as Registrar in the Department of ENT at the University of Edinburgh (1995–1996). From 2007 to 2024, he was Associate Researcher at the Vestibular Research Laboratory, University of Sydney (Australia), responsible for the clinical validation of research in otoneurology under the supervision of Prof. Ian S. Curthoys.His research interests include vestibular diagnostics and clinical translation, with recognized contributions to the development and clinical validation of the video Head Impulse Test (vHIT), now widely adopted for vestibulo-ocular reflex assessment. He has particular expertise in ocular and cervical vestibular evoked myogenic potentials (oVEMPs/cVEMPs) and a current focus on vibratory stimulation and skull-applied vibration as vestibular probes.He is author of over 110 peer-reviewed publications and has contributed to international literature on VEMPs, vestibular neuritis, Ménière’s disease, and third-window syndromes. He has been invited as speaker/chairman at major meetings including multiple Bárány Society Congresses, IFOS World Congress events, and international vertigo-focused meetings.Dr. Manzari serves on the boards of the Prosper Ménière Society and the International Vestibular Society, and is Past President of the Associazione Italiana Otorinolaringoiatri Libero Professionisti (AIOLP). He is a member of several national and international scientific societies and editorial boards (including Frontiers in Neurology, Audiology Research, Healthcare, and others). In 2023 he was listed among the top 2% most influential scientists worldwide (Stanford/Elsevier ranking).