Rey-Martínez J, Rama-López J, Soledad Boleas M, Perez N, Artieda J
Clínica Universitaria de Navarra, Department of Otorhinolaryngology, Pío XII 36, 31008 Pamplona, Navarra, Spain.
Rev Laryngol Otol Rhinol (Bord). 2005;126(3):159-63.
To present the cases of two patients that developed unilateral vestibular hypofunction after systemic treatment with ototoxic agents, although they manifested symptoms more typical of bilateral vestibular hypofunction.
The patients were seen after having recovered from their initial illnesses, and both of them denied suffering any spells of vertigo, loss of hearing during the treatment or tinnitus.
In both patients, oscillopsia and vestibular ataxia were of varying intensity. Bedside vestibular examination, caloric and rotatory chair testing, and vestibular evoked myogenic potentials were congruent with a complete unilateral loss of vestibular function. Audiometry was normal in one case whereas in the other, there was a moderate bilateral sensorineural loss of hearing that was present before treatment and that did not change during the course of the treatment.
The existence of unilateral vestibular loss was an unsuspected finding but after careful bedside examination, it was confirmed through extensive vestibular testing. However, this infrequent finding responded very well to vestibular rehabilitation. Different mechanisms are proposed to explain this phenomenon, although there is still no clear evidence of which may account for the responses observed.
报告两例患者在用耳毒性药物进行全身治疗后出现单侧前庭功能减退的病例，尽管他们表现出的症状更典型地属于双侧前庭功能减退。
患者在从最初疾病康复后前来就诊，两人均否认在治疗期间有任何眩晕发作、听力丧失或耳鸣。
两名患者的视振荡和前庭共济失调程度各异。床边前庭检查、冷热试验和转椅试验以及前庭诱发肌源性电位均与单侧前庭功能完全丧失相符。听力测试中，一例正常，而另一例在治疗前存在中度双侧感音神经性听力损失，且在治疗过程中未发生变化。
单侧前庭功能丧失是一个未被怀疑的发现，但经过仔细的床边检查后，通过广泛的前庭测试得到了证实。然而，这一罕见发现对前庭康复治疗反应良好。虽然对于哪种机制可能解释所观察到的反应尚无明确证据，但提出了不同机制来解释这一现象。
