Wang Mao-Che, Liu Chia-Yu, Yu Eric Chen-Hua, Wu Huei-Jun, Lee Guo-She
Department of Otolaryngology, Taipei Veterans General Hospital, and School of Medicine, National Yang-Ming University, No. 155 Sec. 1 Li-Nong Street, Bei-Tou, Taipei, Taiwan.
Acta Otolaryngol. 2009 Nov;129(11):1206-11. doi: 10.3109/00016480802620654.
The pathology of chronic otitis media (COM) could delay and reduce the energy transfer of sound to the inner ear. The significant improvement of postoperative vestibular evoked myogenic potential (VEMP) response rate and p13 latencies in the group of patients with no or negative postoperative ABG gain provided evidence that the sound energy inducing a VEMP might be different from the energy producing the auditory perception.
To evaluate the VEMP in patients with COM before and after surgery.
Twenty-four subjects with unilateral COM were enrolled. A pure tone audiogram and VEMP using 500 Hz unilateral short tone-burst stimulations were recorded before and 3 months after surgery. The postoperative VEMP responses were compared with the responses before surgery and the healthy controls.
After surgery, the 500 Hz air-bone gap (ABG) decreased significantly and the VEMP response rate increased significantly from 41.7% to 66.7% (p<0.05, bi-test). However, both the preoperative and postoperative p13 latencies were significantly longer than those of the healthy controls (p<0.05, Wilcoxon rank-sum test). In the 18 patients whose 500 Hz ABG did not improve with surgery, the p13 latencies were significantly shorter postoperatively (p<0.05, sign test), and the response rate also improved significantly from 44.4% (8/18) to 77.8% (14/18) (p<0.05, bi-test).
慢性中耳炎(COM)的病理改变可延迟并减少声音向内耳的能量传递。术后听性脑干反应(ABG)增益无或为负的患者组中,前庭诱发肌源性电位(VEMP)反应率和p13潜伏期有显著改善,这表明诱发VEMP的声能可能与产生听觉感知的能量不同。
评估COM患者手术前后的VEMP。
纳入24例单侧COM患者。在手术前及术后3个月记录纯音听力图和使用500Hz单侧短音爆刺激的VEMP。将术后VEMP反应与术前反应及健康对照进行比较。
术后,500Hz气骨导间距(ABG)显著降低,VEMP反应率从41.7%显著提高至66.7%(p<0.05,双侧检验)。然而,术前和术后的p13潜伏期均显著长于健康对照(p<0.05,Wilcoxon秩和检验)。在18例500Hz ABG术后未改善的患者中(p<0.05,符号检验),p13潜伏期术后显著缩短,反应率也从44.4%(8/18)显著提高至77.8%(14/18)(p<0.05,双侧检验)。