Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Bucheon, Korea.
Eur Arch Otorhinolaryngol. 2011 Oct;268(10):1427-30. doi: 10.1007/s00405-010-1426-5. Epub 2011 Feb 17.
This study evaluates the otolith function of patients with head trauma, postulating that otolith dysfunction is a cause of nonspecific dizziness after head trauma. We prospectively enrolled 28 patients referred within 3 months after head trauma between March 2007 and December 2009. Pure tone audiometry, caloric testing and otolith function tests, including cervical vestibular evoked myogenic potential (cVEMP) and subjective visual vertical (SVV) tests, were performed on all patients. The relationship between otolith function and otologic symptoms was analyzed. Of the 28 patients with head trauma, 18 complained of dizziness and 12 experienced hearing loss, including 6 patients who complained of both. On defining otolith dysfunction as an abnormal cVEMP or abnormal SVV, a significant difference in otolith dysfunction existed between the groups with and without dizziness [72 (13/18) vs. 20% (2/10)]. In contrast, no significant difference in otolith dysfunction was detected between the abnormal and normal hearing groups. A significant number of the patients who complained of nonspecific dizziness after trauma had abnormal otolith function. After trauma, when patients complain of dizziness, vestibular function tests, including otolith function tests, should be considered.
本研究评估了头部外伤患者的耳石功能，推测耳石功能障碍是头部外伤后非特异性头晕的一个原因。我们前瞻性地招募了 2007 年 3 月至 2009 年 12 月头部外伤后 3 个月内就诊的 28 例患者。对所有患者进行纯音测听、冷热试验和耳石功能测试，包括颈性前庭诱发肌源性电位（cVEMP）和主观垂直视觉（SVV）测试。分析了耳石功能与耳科症状之间的关系。在 28 例头部外伤患者中，18 例诉头晕，12 例诉听力损失，其中 6 例同时诉头晕和听力损失。将耳石功能障碍定义为 cVEMP 异常或 SVV 异常时，有头晕和无头晕组之间的耳石功能障碍差异有统计学意义[72%（13/18）与 20%（2/10）]。相比之下，听力异常组和听力正常组之间的耳石功能障碍无显著差异。大量在创伤后出现非特异性头晕的患者存在异常的耳石功能。在创伤后，当患者出现头晕时，应考虑进行包括耳石功能测试在内的前庭功能测试。
