Crovetto-De la Torre Miguel A, Whyte-Orozco Jaime, Crovetto-Martínez Rafael, Whyte-Orozco Ana, Obón-Nogués Jesús A, Martínez-Rodríguez Adelina
Servicio de Otorrinolaringología, Hospital de Basurto, Universidaddel País Vasco, España.
Rev Neurol. 2011 Jun 16;52(12):751-8.
The medical history of vertigo must be updated to accommodate current knowledge. In 1998 a new cause of vertigo associated with a structural anomaly was reported: superior semicircular canal dehiscence. This condition causes vestibular and auditory disorders, which are frequently associated, and a well-directed medical history allows a suspected diagnosis to be reached: the subject may suffer from vertigo triggered by loud sounds (Tullio's phenomenon) and by changes in pressure within the ear or in the intracranial space, when Valsalva's manoeuvres are performed or on pressing on the tragus (Hennebert's sign). It is not uncommon for subjects to suffer from a chronic imbalance that is exacerbated by the aforementioned precipitating factors. One frequent auditory symptom of superior semicircular canal dehiscence is autophony in the dehiscent ear, associated with hypoacusis of its transmission. This article outlines the questions that must be included in the medical history of vertigo in order to determine whether these dehiscences are present or not. The diagnostic procedures that are best suited to confirming it are also addressed. Superior semicircular canal dehiscence can be resolved satisfactorily by surgery.
眩晕的病史必须更新以跟上当前的认知。1998年,一种与结构异常相关的眩晕新病因被报道:上半规管裂。这种情况会导致前庭和听觉障碍,这两种障碍常常同时出现,一份针对性强的病史有助于做出疑似诊断:患者可能会在听到巨响(图利奥现象)以及在进行瓦尔萨尔瓦动作或按压耳屏时,因耳内或颅内压力变化而引发眩晕(亨内贝尔征)。患者出现由上述诱发因素加重的慢性平衡失调的情况并不少见。上半规管裂常见的一种听觉症状是患耳自听过强,并伴有传音性听力减退。本文概述了眩晕病史中必须包含的问题,以便确定是否存在这些裂。还讨论了最适合确诊的诊断程序。上半规管裂可通过手术得到满意解决。