An Se-Young, Kim Bong Jik, Suh Myung-Whan, Rhee Chung-Ku, Jung Jae Yun
Department of ORL-HNS, College of Medicine, Dankook University , Cheonan.
Acta Otolaryngol. 2014 Nov;134(11):1134-9. doi: 10.3109/00016489.2014.936623.
Abstract Conclusion: Any test for visual fixation suppression by itself is insufficient for screening central pathology and should be interpreted in conjunction with other neurotologic findings.
We evaluated the correlation of visual fixation suppression (VFS) under three different test conditions (spontaneous nystagmus, caloric stimulation, and slow harmonic acceleration, SHA), as well as the diagnostic accuracy of each test for predicting central pathology, in dizzy patients.
We retrospectively reviewed cases in a tertiary referral center; 504 consecutive dizzy patients who visited the ENT clinic were enrolled. The fixation index (FI, slow component velocity during fixation/slow component velocity before fixation × 100%) for the caloric test and spontaneous nystagmus was calculated and failure was indicated when the FI was greater than 60%. VFS during the SHA test at a frequency of 0.04 Hz was also performed and gain more than 0.2 was considered as failure of VFS.
The incidence of VFS failure was 5.4% in the caloric test, 3.4% in spontaneous nystagmus, and 2.3% in the SHA test, respectively. Significant correlation was found only between the caloric test and the SHA test (r = 0.341, p < 0.001). The sensitivity of VFS in different tests did not exceed 35%. The specificity of VFS was highest (96.4%) in the 0.04 Hz SHA test, and exceeded 80% in the other tests.
摘要结论：任何视觉固视抑制测试本身都不足以筛查中枢性病变，应结合其他神经耳科学检查结果进行解读。
我们评估了三种不同测试条件（自发性眼震、冷热试验和慢谐波加速度，SHA）下视觉固视抑制（VFS）的相关性，以及每种测试对头晕患者中枢性病变预测的诊断准确性。
我们回顾性分析了一家三级转诊中心的病例；纳入了504例连续就诊于耳鼻喉科门诊的头晕患者。计算冷热试验和自发性眼震的固视指数（FI，固视时慢相速度/固视前慢相速度×100%），当FI大于60%时提示固视失败。还进行了频率为0.04Hz的SHA测试时的VFS，增益大于0.2被认为是VFS失败。
冷热试验、自发性眼震和SHA测试中VFS失败的发生率分别为5.4%、3.4%和2.3%。仅在冷热试验和SHA测试之间发现显著相关性（r = 0.341，p < 0.001）。不同测试中VFS的敏感性均未超过35%。VFS的特异性在0.04Hz SHA测试中最高（96.4%），在其他测试中超过80%。
