Hirvonen Meeli, Aalto Heikki, Petteri Hirvonen Timo
Department of Otolaryngology, Helsinki University Central Hospital, Helsinki, Finland.
Acta Otolaryngol. 2008 Nov;128(11):1215-20. doi: 10.1080/00016480801908027.
Motorized head impulse rotator is an effective technique to assess peripheral vestibular function. Approximately a quarter of patients with vestibular schwannoma (VS) had preserved preoperative responses. Vestibular disability could not be predicted based on vestibulo-ocular reflex (VOR) performance during motion stimuli, or in the caloric test.
To explore motorized head impulse rotator for evaluation of angular horizontal VOR in patients with VS, and to compare these responses to those of the caloric test and the symptoms.
We prospectively recorded head and eye position during unpredictable motorized head impulses in 38 patients with VS. We calculated gain and asymmetry of VOR (mean +/- 95% CI), and the results were compared to those of the caloric test and a questionnaire regarding dizziness, hearing and quality of life.
The VOR during motorized impulses was abnormal in 71% of patients. Asymmetry in gain correlated significantly (p < 0.001) with unilateral weakness in the caloric test. Preoperative gain was significantly lowered to 0.83 +/- 0.08 on the ipsilateral side compared to 0.98 +/- 0.06 on the contralateral side. Postoperative gain on the operated side of 0.53 +/- 0.05 was significantly different from preoperative gain (p < 0.001). Findings in vestibular tests did not correlate with subjective sensation of dizziness.
电动头部脉冲旋转器是评估外周前庭功能的有效技术。约四分之一的前庭神经鞘瘤（VS）患者术前反应保留。基于运动刺激期间的前庭眼反射（VOR）表现或冷热试验，无法预测前庭功能障碍。
探讨电动头部脉冲旋转器用于评估VS患者的水平角VOR，并将这些反应与冷热试验结果及症状进行比较。
我们前瞻性记录了38例VS患者在不可预测的电动头部脉冲期间的头部和眼睛位置。我们计算了VOR的增益和不对称性（平均值±95%CI），并将结果与冷热试验结果以及一份关于头晕、听力和生活质量的问卷结果进行比较。
71%的患者在电动脉冲期间VOR异常。增益不对称性与冷热试验中的单侧眼震减弱显著相关（p < 0.001）。术前患侧增益显著降低至0.83±0.08，而对侧为0.98±0.06。术后手术侧增益为0.53±0.05，与术前增益显著不同（p < 0.001）。前庭测试结果与头晕的主观感觉无关。
