Choi Jin Woong, Kang Seong Il, Rhee Ji Hye, Choi Byung Yoon, Kim Ji-Soo, Koo Ja-Won
Department of Otolaryngology-Head and Neck Surgery, Chungnam National University School of Medicine, Daejeon, South Korea.
Eur Arch Otorhinolaryngol. 2015 Jul;272(7):1613-7. doi: 10.1007/s00405-014-2952-3. Epub 2014 Mar 8.
Acute unilateral vestibular loss presents as ocular torsion (OT) and caloric unilateral weakness (UW). However, the amount of OT is frequently dissociated from UW depending on when the examination was performed and the extent and cause of the vestibular lesion. This study evaluated the relationship between OT and UW in peripheral vestibular diseases, including Ménière's disease (MD) and vestibular neuritis (VN), and determined whether it contributed to OT as a means of differentiating between the two diseases. A retrospective chart review was performed in 64 patients with VN and 67 patients with MD. We divided the patients into three groups according to the interval from symptom onset to when the tests were performed: within 7 (group A), from 8 to 30 (group B) and over 30 (group C) days. UW, OT and the chronological correlation/dissociation between the two parameters were analyzed. For the 64 patients with VN, the degree of OT and severity of UW were positively correlated in group A (r = 0.749, P < 0.001). OT and UW were significantly dissociated with time (P < 0.001). For the 67 patients with MD, no correlation between the degree of OT and severity of UW was seen in MD group A. No significant dissociation change was revealed among the groups (P = 0.114). The OT abnormality is remarkable during the acute phase of VN, whereas it might not be remarkable immediately after a vertigo attack in MD. This finding can be used to differentiate MD and VN, especially when no definite hearing loss is seen or VN recurs.
急性单侧前庭功能丧失表现为眼球扭转（OT）和冷热试验单侧减弱（UW）。然而，OT的程度常常与UW分离，这取决于检查的时间以及前庭病变的范围和病因。本研究评估了外周前庭疾病（包括梅尼埃病（MD）和前庭神经炎（VN））中OT与UW之间的关系，并确定其是否有助于通过OT来区分这两种疾病。对64例VN患者和67例MD患者进行了回顾性病历审查。我们根据从症状发作到进行检查的时间间隔将患者分为三组：7天内（A组）、8至30天（B组）和超过30天（C组）。分析了UW、OT以及这两个参数之间的时间相关性/分离情况。对于64例VN患者，A组中OT程度与UW严重程度呈正相关（r = 0.749，P < 0.001）。OT与UW随时间显著分离（P < 0.001）。对于67例MD患者，MD组A中OT程度与UW严重程度之间未见相关性。各组之间未发现显著的分离变化（P = 0.114）。OT异常在VN急性期明显，而在MD中眩晕发作后可能不明显。这一发现可用于区分MD和VN，尤其是在未见明确听力损失或VN复发时。
