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耳硬化症患者围手术期骨导眼震前庭诱发肌源性电位。

Perioperative bone-conducted ocular vestibular-evoked myogenic potentials in otosclerosis patients.

机构信息

Department of Otorhinolaryngology and Head and Neck Surgery, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands.

出版信息

Otol Neurotol. 2013 Aug;34(6):1109-14. doi: 10.1097/MAO.0b013e318283969a.

Abstract

OBJECTIVE

Vestibular symptoms are seen variably in patients with otosclerosis, both in patients with the disease and in patients after treatment with stapes surgery. The goal of this study was to objectify any changes of the bone-conducted (BC) ocular vestibular evoked myogenic potentials (oVEMPs) in patients with otosclerosis before and after stapes surgery.

STUDY DESIGN

Twenty-six healthy subjects and 27 patients with otosclerosis were tested in a tertiary care center, and 11 of the patients were tested preoperatively and postoperatively. The ears of patients were divided in 4 groups: normal ears, otosclerotic ears, ears after primary stapes surgery, and ears after revision surgery. The stimulus used in oVEMP testing was a BC stimulus delivered by a mini-shaker at stimulus frequencies of 250 and 500 Hz. oVEMP characteristics were the n1 and p1 latencies, n1 - p1 amplitude, and threshold.

RESULTS

No significant differences were seen in all oVEMP characteristics between the 4 groups of ears without surgery nor in the ears that were tested preoperatively and postoperatively.

CONCLUSION

No or undetectably little damage to the utricle is caused by both otosclerotic disease and stapes surgery. There is no additive value of screening with BC oVEMPs perioperatively in otosclerotic patients.

摘要

目的

耳硬化症患者的前庭症状表现多样,既有疾病本身引起的,也有镫骨手术后引起的。本研究旨在客观评估耳硬化症患者镫骨手术后骨导(BC)眼震性前庭诱发肌源性电位(oVEMP)的任何变化。

研究设计

在一家三级护理中心对 26 名健康受试者和 27 例耳硬化症患者进行了测试,其中 11 例患者进行了术前和术后测试。患者的耳朵分为 4 组:正常耳朵、耳硬化症耳朵、初次镫骨手术后的耳朵和翻修手术后的耳朵。oVEMP 测试使用 BC 刺激,由微型振荡器在 250 和 500 Hz 的刺激频率下发出。oVEMP 的特征包括 n1 和 p1 潜伏期、n1-p1 幅度和阈值。

结果

无手术的 4 组耳朵之间以及术前和术后测试的耳朵之间,所有 oVEMP 特征均无显著差异。

结论

耳硬化症和镫骨手术均不会对耳石器造成或可察觉的损害。在耳硬化症患者中,手术期间进行 BC oVEMP 筛查没有附加价值。

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