Brantberg Krister, Verrecchia Luca
Department of Audiology and Neurotology, Karolinska University Hospital, Stockholm, Sweden.
Acta Otolaryngol. 2012 Oct;132(10):1077-83. doi: 10.3109/00016489.2012.689858. Epub 2012 Jul 10.
Testing cervical vestibular evoked myogenic potential (cVEMP) in response to 90 dB nHL clicks can, in contrast to high-intensity 500 Hz tone bursts, be used as a screening test for superior canal dehiscence (SCD) syndrome.
cVEMP testing has its key clinical significance for evaluating saccular and inferior vestibular nerve function, but also for assessment of vestibular hypersensitivity to sounds in patients with SCD syndrome. The routine stimulus used in cVEMP testing is high-intensity 500 Hz tone bursts. The aim of the present study was to compare the high-intensity tone burst stimulation with less intense click stimulations for the diagnosis of SCD syndrome.
cVEMP amplitudes in response to 500 Hz tone bursts and clicks were studied in 38 patients with SCD syndrome unilaterally.
cVEMP testing using high-intensity 500 Hz tone bursts did not consistently distinguish SCD patients. This nonfunctioning of high-intensity 500 Hz stimulation is most likely due to saturation. With 90 and 80 dB nHL clicks there is low risk for saturation and both these click stimulations were effective. Testing with both 80 and 90 dB nHL clicks did not have any significant advantage over just using 90 nHL dB clicks.
与高强度500Hz短纯音相比，测试90dB nHL短声诱发的颈肌前庭诱发肌源性电位（cVEMP）可作为上半规管裂（SCD）综合征的筛查试验。
cVEMP测试对于评估球囊和前庭下神经功能具有关键临床意义，对于评估SCD综合征患者对声音的前庭超敏反应也具有重要意义。cVEMP测试中常用的刺激是高强度500Hz短纯音。本研究的目的是比较高强度短纯音刺激与强度较低的短声刺激对SCD综合征的诊断价值。
对38例单侧SCD综合征患者进行了500Hz短纯音和短声诱发的cVEMP波幅研究。
使用高强度500Hz短纯音进行cVEMP测试并不能始终区分SCD患者。高强度500Hz刺激失效很可能是由于饱和。90dB nHL和80dB nHL短声的饱和风险较低，这两种短声刺激均有效。80dB nHL和90dB nHL短声测试与仅使用90dB nHL短声相比没有任何显著优势。
