Ostrowski V B, Byskosh A, Hain T C
Department of Otolaryngology-Head and Neck Surgery, Northwestern University Medical School, Chicago, Illinois, USA.
Otol Neurotol. 2001 Jan;22(1):61-5. doi: 10.1097/00129492-200101000-00012.
The goal of the investigation was to determine if vector analysis of nystagmus in a patient with the Tullio phenomenon could determine the source of the nystagmus.
The Tullio phenomenon consists of the combination of vertigo and abnormal eye and/or head movements provoked by sound. Dehiscence of the superior semicircular canal can be found in certain patients with the Tullio phenomenon.
The patient was tested with pure tones ranging from 250 to 3,000 Hz at 95dB HL. The time course of the three-dimensional vector of eye movement, including torsion and vertical and horizontal displacement angles was determined by individual stop-frame analysis of digitized video.
Torsion amplitude varied from 1 to 7 degrees; vertical amplitude varied from 1 to 5 degrees; and horizontal amplitude varied less than 1.5 degrees. The maximal response occurred on stimulation of the right ear with a 1,250-Hz 95-dB HL tone. This elicited a reliable counterclockwise torsional and down-beating fast phase nystagmus as seen from the examiner's point of view. Comparison of the nystagmus with known canal vectors identified the right superior semicircular canal as the source of stimulation. High-resolution computed tomography scan of the temporal bone showed a definite right superior canal dehiscence.
The origin of nystagmus from the Tullio phenomenon can be identified by calculating the three-dimensional vector of the observed nystagmus. We show that vector analysis of the observed eye movement can be used to infer the source of nystagmus in these patients. The development of real-time, three-dimensional vector analysis of nystagmus is desirable.
本研究的目的是确定对患有图利奥现象的患者进行眼球震颤矢量分析是否能够确定眼球震颤的来源。
图利奥现象由声音诱发的眩晕以及异常的眼球和/或头部运动组成。在某些患有图利奥现象的患者中可发现上半规管裂开。
对该患者使用95dB HL的250至3000Hz纯音进行测试。通过对数字化视频的逐帧分析确定眼球运动三维矢量的时间进程，包括扭转以及垂直和水平位移角度。
扭转幅度为1至7度；垂直幅度为1至5度；水平幅度变化小于1.5度。最大反应出现在用1250Hz 95dB HL纯音刺激右耳时。从检查者的角度看，这引发了可靠的逆时针扭转和向下跳动的快相眼球震颤。将该眼球震颤与已知的半规管矢量进行比较，确定右半规管为刺激源。颞骨的高分辨率计算机断层扫描显示右半规管有明确裂开。
通过计算观察到的眼球震颤的三维矢量可以确定图利奥现象引起的眼球震颤的起源。我们表明，观察到的眼球运动的矢量分析可用于推断这些患者眼球震颤的来源。开发实时三维眼球震颤矢量分析是可取的。
