Xie Su Jiang, Jia Hong Bo, Xu Po, Zheng Ying Juan
Vestibular Laboratory, Institute of Aviation Medicine, Air Force, No. 28 Fucheng Rd., Beijing 100142, China.
Ear Nose Throat J. 2013 Jun;92(6):E27.
Spatial disorientation in airplane pilots is a leading factor in many fatal flying accidents. Spatial orientation is the product of integrative inputs from the proprioceptive, vestibular, and visual systems. One condition that can lead to sudden pilot incapacitation in flight is vestibular neuritis. Vestibular neuritis is commonly diagnosed by a finding of unilateral vestibular failure, such as a loss of caloric response. However, because caloric response testing reflects the function of only the superior part of the vestibular nerve, it cannot detect cases of neuritis in only the inferior part of the nerve. We describe the case of a Chinese naval command fighter pilot who exhibited symptoms suggestive of vestibular neuritis but whose caloric response test results were normal. Further testing showed a unilateral loss of vestibular evoked myogenic potentials (VEMPs). We believe that this pilot had pure inferior nerve vestibular neuritis. VEMP testing plays a major role in the diagnosis of inferior nerve vestibular neuritis in pilots. We also discuss this issue in terms of aeromedical concerns.
飞机飞行员的空间定向障碍是许多致命飞行事故的主要因素。空间定向是本体感觉、前庭和视觉系统综合输入的结果。一种可导致飞行员在飞行中突然丧失能力的情况是前庭神经炎。前庭神经炎通常通过单侧前庭功能衰竭的表现来诊断，比如冷热试验反应消失。然而，由于冷热试验仅反映前庭神经上部的功能，它无法检测出仅累及神经下部的神经炎病例。我们描述了一名中国海军歼击机飞行员的病例，该飞行员表现出提示前庭神经炎的症状，但冷热试验结果正常。进一步检查显示单侧前庭诱发肌源性电位（VEMP）缺失。我们认为这名飞行员患有单纯性下神经前庭神经炎。VEMP检测在飞行员下神经前庭神经炎的诊断中起主要作用。我们还从航空医学的角度讨论了这个问题。
