Cassandro E, Chiarella G, Catalano M, Gallo L V, Marcelli V, Nicastri M, Petrolo C
Department of Experimental and Clinical Medicine G. Salvatore, Audiology Unit, Magna Graecia University, Catanzaro, Italy.
Acta Otorhinolaryngol Ital. 2003 Aug;23(4):251-6.
Besides Tullio's phenomenon, resulting from anatomic changes in the labyrinth, a hypersensitivity to acoustic stimuli of the saccular structures appears to be the underlying cause of the vestibular responses detected in some patients. In order to evaluate the incidence of vestibular symptoms triggered by acute exposure to auditory stress (disco music), 40 subjects aged between 18 and 26 years, with no audiological and vestibular disorders, were submitted to otoneurologic tests. Subjects were exposed to disco music [intensity 128 dB (C)], for 3 hours. Tests have been carried out before and immediately after exposure. Canalar and macular functions have been evaluated using vestibular investigation techniques and vestibular evoked myogenic potentials. When compared to baseline data, post-exposure test results did not reveal any canalar damage. Pre- and post-exposure recordings of the vestibular-oculomotor reflex threshold have shown no significant changes. Conversely, post-stimulus recordings have shown a significant increase in the amplitude of the vestibular evoked myogenic potential response, thus indicating a possible irritative involvement of the macular receptor. This result suggests a direct action upon the receptor by acoustic stimulation which could, therefore, be the underlying cause of vestibular symptoms reported by patients following exposure to sufficiently intense acoustic stimuli. Prior to this study. a questionnaire concerning the relationship between habitual disco visiting and audio-vestibular symptoms has been completed by 310 students at the University of Catanzaro. This survey revealed a significant incidence of vestibular symptoms due to acoustic stress (Tullio's phenomenon) which led us to hypothesise that balance disorders due to auditory stress are much more frequent than commonly held, particularly since, in many cases, diagnoses is unknown or not easy due to the difficult procedures by which these conditions are diagnosed.
除了由迷路解剖结构变化引起的图利奥现象外，球囊结构对听觉刺激的超敏反应似乎是一些患者检测到前庭反应的根本原因。为了评估急性暴露于听觉压力（迪斯科音乐）引发的前庭症状的发生率，40名年龄在18至26岁之间、无听力学和前庭疾病的受试者接受了耳神经学测试。受试者暴露于迪斯科音乐[强度128分贝（C）]3小时。在暴露前和暴露后立即进行测试。使用前庭检查技术和前庭诱发肌源性电位评估半规管和黄斑功能。与基线数据相比，暴露后测试结果未显示任何半规管损伤。前庭眼动反射阈值的暴露前和暴露后记录均未显示出显著变化。相反，刺激后记录显示前庭诱发肌源性电位反应的幅度显著增加，从而表明黄斑感受器可能受到刺激性累及。这一结果表明，声刺激对感受器有直接作用，因此可能是患者在暴露于足够强烈的声刺激后报告的前庭症状的根本原因。在这项研究之前，卡坦扎罗大学的310名学生完成了一份关于习惯性去迪斯科舞厅与听觉前庭症状之间关系的问卷。这项调查显示，由于声压力导致的前庭症状发生率很高（图利奥现象），这使我们推测，由于听觉压力导致的平衡障碍比普遍认为的更为常见，特别是因为在许多情况下，由于诊断这些病症的程序困难，诊断不明或不容易。
