Fujimoto Chisato, Egami Naoya, Kinoshita Makoto, Sugasawa Keiko, Yamasoba Tatsuya, Iwasaki Shinichi
Department of Otolaryngology, Faculty of Medicine, The University of Tokyo, Japan.
Department of Otolaryngology, Faculty of Medicine, The University of Tokyo, Japan.
Clin Neurophysiol. 2015 May;126(5):1033-8. doi: 10.1016/j.clinph.2014.07.028. Epub 2014 Aug 23.
To investigate the extent of vestibular lesions in idiopathic sudden hearing loss (ISHL) with vertigo.
We reviewed the clinical records of 25 consecutive new patients with ISHL with vertigo. We classified patients based on their pattern of vestibular dysfunction. All patients showed cochlear damage and were labeled C (cochlear) type. If a patient showed abnormal cervical vestibular evoked myogenic potential (cVEMP), ocular VEMP (oVEMP) or caloric responses, an S (saccule), U (utricule) or L (lateral semicircular canal) respectively was added to their label.
All patients underwent cVEMPs and caloric tests. Sixteen (64%) and 13 (52%) showed abnormal cVEMPs and caloric responses, respectively, on the affected side. Among the 23 patients who underwent oVEMPs, 10 (43%) showed abnormal oVEMPs on the affected side. Of these 23 patients, 6 (26%) were classified as C type, 4 (17%) as CS type, 1 (4%) as CL type, 1 (4%) as CSU type, 2 (9%) as CSL type, 1 (4%) as CUL type, 8 (35%) as CSUL type.
The vestibular end organs close to the cochlea tended to be preferentially affected.
It is likely that vestibular dysfunction extends from organs close to the cochlea to those further from the cochlea.
探讨伴眩晕的特发性突聋（ISHL）患者前庭病变的程度。
我们回顾了25例连续性新发伴眩晕的ISHL患者的临床记录。我们根据患者前庭功能障碍的模式进行分类。所有患者均有耳蜗损伤，标记为C（耳蜗）型。如果患者的颈前庭诱发肌源性电位（cVEMP）、眼VEMP（oVEMP）或冷热试验反应异常，则分别在其标记后添加S（球囊）、U（椭圆囊）或L（外侧半规管）。
所有患者均接受了cVEMP和冷热试验。患侧分别有16例（64%）和13例（52%）cVEMP和冷热试验反应异常。在接受oVEMP检查的23例患者中，患侧有10例（43%）oVEMP异常。在这23例患者中，6例（26%）被分类为C型，4例（17%）为CS型，1例（4%）为CL型，1例（4%）为CSU型，2例（9%）为CSL型，1例（4%）为CUL型，8例（35%）为CSUL型。
靠近耳蜗的前庭终器往往更容易受到影响。
前庭功能障碍可能从靠近耳蜗的器官扩展到远离耳蜗的器官。
