人工耳蜗植入中的前庭功能：客观与主观的相关性
Vestibular function in cochlear implantation: Correlating objectiveness and subjectiveness.
作者信息
Batuecas-Caletrio Angel, Klumpp Micah, Santacruz-Ruiz Santiago, Benito Gonzalez Fernando, Gonzalez Sánchez Enrique, Arriaga Moises
机构信息
Department of Otorhinolaryngology, Otoneurology Unit, University Hospital of Salamanca, University of Salamanca, Salamanca, Spain.
Department of Otolaryngology and Neurosurgery, Louisiana State University Health Sciences-New Orleans, Division of Otology and Neurotology-Hearing and Balance Center, Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana, U.S.A.
出版信息
Laryngoscope. 2015 Oct;125(10):2371-5. doi: 10.1002/lary.25299. Epub 2015 Apr 17.
OBJECTIVE
To evaluate vestibular function before and after cochlear implantation (CI) STUDY DESIGN: A prospective descriptive study.
MATERIAL AND METHODS
Thirty consecutive patients with profound sensorineural hearing loss undergoing CI. Objective assessment of vestibular function was performed with the caloric test and video head impulse test (vHIT) in patients before and after CI. Dizziness Handicap Inventory (DHI) was used for subjective assessment before and after CI.
RESULTS
Thirty patients received CI with 21 by round window approach and nine by anteroinferior cochleostomy. Vestibular results were categorized into four groups: no changes (20 patients), changes in the caloric test and vHIT (3 patients, all with DHI changes; P = 0.0001), changes in vHIT gain but not in caloric test (3 patients, all with DHI changes; P = 0.005), no changes in the caloric test and vHIT gain but only saccades appear (4 patients, all with DHI changes; P = 0.011).
CONCLUSIONS
Although CI is a safe surgery with few major complications, it is a procedure that can produce dizziness. The vHIT reveals that 30% of patients demonstrate postoperative change in vestibular function. Therefore, when examining a CI patient with postoperative symptoms of dizziness, results of the vHIT test and gain as well as the presence of saccades, along with an increase DHI score, are parameters to consider in their evaluation.
LEVEL OF EVIDENCE
目的
评估人工耳蜗植入（CI）前后的前庭功能。
研究设计
前瞻性描述性研究。
材料与方法
连续30例重度感音神经性听力损失患者接受CI。在CI前后，对患者进行冷热试验和视频头脉冲试验（vHIT）以客观评估前庭功能。使用头晕残障量表（DHI）对CI前后进行主观评估。
结果
30例患者接受CI，其中21例采用圆窗入路，9例采用前下耳蜗造瘘术。前庭结果分为四组：无变化（20例患者）；冷热试验和vHIT有变化（3例患者，均有DHI变化；P = 0.0001）；vHIT增益有变化但冷热试验无变化（3例患者，均有DHI变化；P = 0.005）；冷热试验和vHIT增益无变化但仅出现扫视（4例患者，均有DHI变化；P = 0.011）。
结论
尽管CI是一种安全的手术，主要并发症较少，但它是一种可能导致头晕的手术。vHIT显示30%的患者术后前庭功能有变化。因此，在检查有术后头晕症状的CI患者时，vHIT测试结果、增益以及扫视的存在，以及DHI评分的增加，都是评估中需要考虑的参数。
证据级别
4级。
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