Humphriss R L, Baguley D M, Moffat D A
Department of Audiology, Addenbrooke's Hospital, Hills Road, Cambridge CB2 2QQ, UK.
Clin Otolaryngol Allied Sci. 2003 Dec;28(6):514-9. doi: 10.1046/j.1365-2273.2003.00753.x.
The aim of this study was to calculate the sensitivity of the head-shake test for peripheral and central vestibular dysfunction associated with unilateral sporadic vestibular schwannoma and to discuss the feasibility of using the head-shake test as a screening test. The study group consisted of 102 patients with unilateral sporadic vestibular schwannomas, who were seen consecutively for preoperative vestibular assessment, including the head-shake test. The sensitivity of the head-shake test for vestibular schwannoma was found to be 22%, and the sensitivity and specificity of the head-shake test for canal paresis (>/=25%) were found to be 27% and 88%, respectively. Patients with abnormalities in the central vestibular system and with a greater canal paresis were more likely to have head-shake nystagmus, although, even for severe canal paresis, the sensitivity of the test remained low at 36%. The direction of nystagmus was found to be contra-lateral to the side of the tumour in 86% of patients. It was concluded that the head-shake test is of insufficient sensitivity to be used as a screening test either for vestibular schwannoma or for vestibular-system abnormalities associated with vestibular schwannoma. The deduction is made that the head-shake test is of insufficient sensitivity or specificity to be of clinical value as a screening test for vestibular dysfunction in a general population with symptoms of imbalance.
本研究的目的是计算摇头试验对与单侧散发性前庭神经鞘瘤相关的外周性和中枢性前庭功能障碍的敏感性，并探讨将摇头试验用作筛查试验的可行性。研究组由102例单侧散发性前庭神经鞘瘤患者组成，这些患者连续接受术前前庭评估，包括摇头试验。发现摇头试验对前庭神经鞘瘤的敏感性为22%，对半规管轻瘫（≥25%）的摇头试验敏感性和特异性分别为27%和88%。中枢前庭系统异常且半规管轻瘫程度较重的患者更有可能出现摇头性眼球震颤，不过，即使对于严重的半规管轻瘫，该试验的敏感性仍较低，为36%。在86%的患者中，发现眼球震颤方向与肿瘤侧相反。得出的结论是，摇头试验的敏感性不足以用作前庭神经鞘瘤或与前庭神经鞘瘤相关的前庭系统异常的筛查试验。由此推断，摇头试验的敏感性或特异性不足以作为有失衡症状的普通人群前庭功能障碍筛查试验的临床价值。
