Chen Chun-Nan, Wang Shou-Jen, Wang Chi-Te, Hsieh Wu-Shiun, Young Yi-Ho
Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Audiol Neurootol. 2007;12(1):59-63. doi: 10.1159/000097248. Epub 2006 Nov 20.
This study presents a novel method for recording vestibular evoked myogenic potential (VEMP) in newborns, used to investigate the maturation of sacculocollic reflex at birth. Twenty full-term newborns aged 2-5 days old were enrolled in this study. During natural sleep, each newborn underwent distortion product otoacoustic emission test, and VEMP test using the head rotation method. For comparison, 20 healthy adults also underwent VEMP test using the same method. Based on adult criteria, 40 newborn ears revealed normal VEMPs in 40%, prolonged VEMPs in 35%, and absent VEMPs in 25%, indicating that great variation exists in the maturation of the sacculocollic reflex at birth. Comparison of VEMP characteristics between healthy newborns and adults revealed nonsignificant difference in the response rate and the latency of n23. However, significant differences existed in the latency of p13, interpeak p13-n23 interval and p13-n23 amplitude between newborns and adults. In conclusion, VEMPs in newborns can be easily recorded by the head rotation method. Prolonged or absent VEMPs in newborns may reflect incomplete maturity of the sacculocollic reflex pathway, especially the myelination. A further large number of newborns receiving MRI scan for other reasons may undergo VEMP test to verify this hypothesis.
本研究提出了一种记录新生儿前庭诱发肌源性电位(VEMP)的新方法,用于研究出生时球囊脊髓反射的成熟情况。本研究纳入了20名2 - 5日龄的足月儿。在自然睡眠期间,对每名新生儿进行了畸变产物耳声发射测试,以及使用头部旋转法的VEMP测试。作为对照,20名健康成年人也采用相同方法进行了VEMP测试。按照成人标准,40只新生儿耳朵中,40%的VEMP正常,35%的VEMP延长,25%的VEMP缺失,这表明出生时球囊脊髓反射的成熟情况存在很大差异。健康新生儿与成年人之间VEMP特征的比较显示,反应率和n23潜伏期无显著差异。然而,新生儿与成年人在p13潜伏期、p13 - n23峰间期和p13 - n23波幅方面存在显著差异。总之,采用头部旋转法可轻松记录新生儿的VEMP。新生儿VEMP延长或缺失可能反映球囊脊髓反射通路成熟不完全,尤其是髓鞘形成。大量因其他原因接受MRI扫描的新生儿可能需进行VEMP测试以验证这一假设。