Dumas G, Perrin P, Morel N, N'Guyen D Q, Schmerber S
CHU Grenoble, Service ORL, BP 217, F-38043 Grenoble cedex 09, France.
Rev Laryngol Otol Rhinol (Bord). 2005;126(4):235-42.
Results of the skull vibratory test (SVT) in partial unilateral vestibular peripheral lesions (PUVL) are different from the results in total vestibular lesions (TUVL).
To reveal a correlation between the results of the analysis of the skull vibratory nystagmus (SVN) horizontal component and the side of the lesion; to correlate these results with the stimulus frequency. To find out a predictive correlation between the SVN horizontal and vertical components and the topography of a vestibular lesion. To appreciate the degree of vestibular deafferentation (extended to high frequencies) provoked by gentamicin labyrinthectomy and its efficiency in Meniere's disease.
53 patients with a SVN and a PUVL were included and compared with 10 TUVL and 10 normal subjects. Protocol included a HST (2 Hz), a SVT at 30, 60 and 100 Hz and a caloric test. Recordings were performed with a 2D and 3D VNG device.
In PUVL, SVN at 30, 60 and 100 Hz was obtained in 80, 90 and 90% of cases respectively. SVN is correlated with the side of the lesion at 30, 60 and 100 Hz respectively in 65%, 63%, 80% of cases. SVN is not correlated with the side of the lesion in 20% of Meniere's disease, in 8% of vestibular neuritis and in 6% of vestibular schwannoma. In PUVL HSN is correlated with the side of the lesion in 69% of cases. The direction of the HSN and of the SVN was different in 23% when the nystagmus attended at the same time for both tests. In PUVL the direction of the SVN is different at 100 Hz and 30 Hz in 16% of cases when they are concomittant on the same patient. After Gentamicine labyrinthectomy, the coherence of the results in caloric test, HSN and SVN (areflexy and lesional nystagmus beating toward the safe side) was correlated with the efficiency of the therapy. A SVN vertical component was met in 10% of PUVL (essentially in anterior canal dehiscence and few cases of partial labyrinthitis). The horizontal SVN SPV is significantly slower in PUVL than in TUVL patients (p=0.0004).
The SVT is a vestibular global and rapid test which explores high frequencies. In PUVL the direction of SVN is not always predictive of the side of the lesion and is sometimes depending on the stimulus frequency, the state of the vestibular lesion, the vestibular structure concerned (1/2 circular canals or otolithic organs) and the kind of sensory cells implicated in the lesion. In TUVL The direction of the SVN is always coherent with the side of the lesion (this is useful to predict the efficiency of a Gentamicine Labyrinthectomy). A SVN vertical component can mean a lesion of the vertical canal in PUVL.
部分单侧前庭周围性病变（PUVL）的头颅振动试验（SVT）结果与完全性前庭病变（TUVL）的结果不同。
揭示头颅振动性眼震（SVN）水平成分分析结果与病变侧别之间的相关性；将这些结果与刺激频率相关联。找出SVN水平和垂直成分与前庭病变部位之间的预测相关性。评估庆大霉素迷路切除术后前庭传入阻滞（扩展至高频）的程度及其在梅尼埃病中的疗效。
纳入53例有SVN和PUVL的患者，并与10例TUVL患者和10例正常受试者进行比较。方案包括冷热试验（HST，2Hz）、30Hz、60Hz和100Hz的SVT以及冷热试验。使用二维和三维视频眼震图（VNG）设备进行记录。
在PUVL中，分别有80%、90%和90%的病例在30Hz、60Hz和100Hz时获得SVN。在30Hz、60Hz和100Hz时，SVN分别在65%、63%、80%的病例中与病变侧别相关。在20%的梅尼埃病、8%的前庭神经炎和6%的前庭神经鞘瘤中，SVN与病变侧别无关。在PUVL中，69%的病例水平性热眼震（HSN）与病变侧别相关。当两种试验同时出现眼震时，23%的情况下HSN和SVN的方向不同。在PUVL中，当同一患者同时出现100Hz和30Hz的SVN时，16%的病例中二者方向不同。庆大霉素迷路切除术后，冷热试验、HSN和SVN（无反应性和向安全侧跳动的病变性眼震）结果的一致性与治疗效果相关。10%的PUVL中出现SVN垂直成分（主要在前庭半规管裂和少数部分性迷路炎病例中）。PUVL患者水平SVN慢相速度（SPV）显著慢于TUVL患者（p = 0.0004）。
SVT是一种全面且快速的前庭试验，可探测高频。在PUVL中，SVN的方向并不总是能预测病变侧别，有时取决于刺激频率、前庭病变状态、涉及的前庭结构（半规管或耳石器官的一半）以及病变中涉及的感觉细胞类型。在TUVL中，SVN的方向始终与病变侧别一致（这有助于预测庆大霉素迷路切除术的疗效）。在PUVL中，SVN垂直成分可能意味着垂直半规管病变。
