Basta D, Todt I, Eisenschenk A, Ernst A
Department of Otolaryngology at ukb, Hospital of the University of Berlin (Charité Medical School), Warener Str. 7, D-12683 Berlin, Germany.
Hear Res. 2005 Jun;204(1-2):111-4. doi: 10.1016/j.heares.2005.01.006.
Vestibular evoked myogenic potentials (VEMPs) can be recorded from sternocleidomastoid muscle (SCM) in clinical practice. The aim of the present study was to investigate VEMPs upon direct electrical stimulation of the human inferior vestibular nerve to evidence the vestibulocollic reflex arch and their saccular origin, respectively. Seven subjects were stimulated at the inferior (IVN) and superior (SVN) vestibular nerve. The EMG signals of the SCM were recorded. These recordings were compared to air- and bone-conduction evoked VEMPs with respect to latency and shape. All subjects showed normal VEMPs upon acoustic stimulation with a latency of 12.8+/-1.4 ms for P13, and 22.7+/-2.0 ms for the N23 pre-operatively. Upon direct electrical stimulation of the IVN, the mean latency of the positive peak was 9.1+/-2.2 and 13.2+/-2.3 ms for the negative one. No contralateral SCM response was found. Electrical stimulation of the SVN did not result in any EMG response of the SCM. The study shows experimental evidence of the vestibulocollic reflex by direct electrical stimulation of the human IVN for the first time. The method can be utilized to map VIIIth nerve subdivisions and to intraoperatively monitor IVN integrity in a real-time mode.
在临床实践中，可以从胸锁乳突肌（SCM）记录前庭诱发肌源性电位（VEMPs）。本研究的目的是分别通过直接电刺激人下前庭神经来研究VEMPs，以证实前庭颈反射弧及其球囊起源。对7名受试者的下前庭神经（IVN）和上前庭神经（SVN）进行刺激，并记录SCM的肌电图信号。将这些记录与气导和骨导诱发的VEMPs在潜伏期和波形方面进行比较。所有受试者术前经声刺激时VEMPs均正常，P13潜伏期为12.8±1.4毫秒，N23潜伏期为22.7±2.0毫秒。直接电刺激IVN时，正向波峰的平均潜伏期为9.1±2.2毫秒，负向波峰的平均潜伏期为13.2±2.3毫秒。未发现对侧SCM反应。电刺激SVN未导致SCM出现任何肌电图反应。该研究首次通过直接电刺激人IVN显示了前庭颈反射的实验证据。该方法可用于绘制第八脑神经分支图，并在术中实时监测IVN的完整性。
