Schönfeld Uwe, Helling Kai, Clarke Andrew H
Department of Otorhinolaryngology, Charité, University Medicine Berlin, Berlin, Germany.
Acta Otolaryngol. 2010 Jun;130(6):702-7. doi: 10.3109/00016480903397686.
The findings demonstrate that an enduring unilateral utricular dysfunction, possibly together with canal hypofunction, can occur after labyrinthine disease or injury. They also suggest that unilateral, isolated utricular dysfunction - or utricle paresis - can occur, representing a novel entity in the differential diagnosis of peripheral vestibular function. The occurrence of subjective visual vertical (SVV) asymmetry in the presence of symmetric vestibular evoked myogenic potentials (VEMPs) also confirms that the information from the utricles, rather than the saccules, dominates SVV estimation.
To determine the incidence of unilateral utricular hypofunction.
The retrospective clinical study deals with a selection of those vestibular patients who showed pathological responses to utricle testing. Peripheral vestibular function was examined in a group of 110 patients. Utricular function was evaluated by estimation of SVV during unilateral centrifugation. Bithermal caloric testing was performed to assess unilateral semicircular canal function. Saccular function was tested by measurement of VEMPs.
A total of 46 patients were found with asymmetric SVV findings (p < 0.001 for healthy versus lesioned ear), but symmetric caloric responses and VEMPs. Statistical testing also verified that their SVV asymmetry factors were significantly higher than those calculated for caloric responses and VEMPs (p < 0.001).
研究结果表明，在迷路疾病或损伤后，可能会出现持续性单侧椭圆囊功能障碍，可能还伴有半规管功能减退。研究还表明，可能会出现单侧、孤立的椭圆囊功能障碍——即椭圆囊轻瘫，这代表了外周前庭功能鉴别诊断中的一种新情况。在前庭诱发肌源性电位（VEMP）对称的情况下主观视觉垂直（SVV）不对称的出现也证实，在SVV估计中，来自椭圆囊而非球囊的信息占主导地位。
确定单侧椭圆囊功能减退的发生率。
这项回顾性临床研究涉及挑选出的那些对椭圆囊测试呈现病理反应的前庭患者。对一组110例患者进行外周前庭功能检查。通过单侧离心过程中SVV的估计来评估椭圆囊功能。进行冷热试验以评估单侧半规管功能。通过测量VEMP来测试球囊功能。
共发现46例患者存在SVV不对称结果（健侧耳与患侧耳相比，p < 0.001），但冷热试验反应和VEMP对称。统计检验还证实，他们的SVV不对称因子显著高于冷热试验反应和VEMP计算得出的因子（p < 0.001）。
