Ban Jae Ho, Kim Min-Beom, Hong Seok Min
1Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea; and 2Department of Otorhinolaryngology-Head and Neck Surgery, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea.
Ear Hear. 2016 Mar-Apr;37(2):243-6. doi: 10.1097/AUD.0000000000000232.
Clinicians sometimes treat patients with relatively long-duration geotropic direction-changing positional nystagmus (DCPN), without latency. Recently, the concept of a "light cupula" in the lateral canal that reveals persistent geotropic DCPN has been introduced. In the present study, we investigated the immediate and short-term therapeutic findings in long-duration DCPN.
The authors prospectively compared the therapeutic efficacy of a canalith-repositioning procedure (CRP) in short- and long-duration geotropic DCPN.
In patients with long-duration DCPN, the authors found no immediate therapeutic effect, and the number of patients showing short-term effects (on the next day) was very low compared with the comparable figure among those with short-duration DCPN. In addition, no cases exhibited canal conversion after the CRP.
Our results suggest that CRP is not useful in patients with long-duration geotropic DCPN, and the pathogenesis of long-duration geotropic DCPN may not originate from free-floating debris but from deflection of the cupula.
临床医生有时会治疗患有持续时间相对较长的地向性变向性位置性眼球震颤（DCPN）且无潜伏期的患者。最近，外侧半规管中“轻嵴帽”的概念被引入，其表现为持续性地向性DCPN。在本研究中，我们调查了长期DCPN的即刻和短期治疗结果。
作者前瞻性地比较了管石复位术（CRP）对短期和长期地向性DCPN的治疗效果。
在长期DCPN患者中，作者未发现即刻治疗效果，与短期DCPN患者相比，显示短期效果（次日）的患者数量非常少。此外，CRP后无病例出现半规管转换。
我们的结果表明，CRP对长期地向性DCPN患者无效，长期地向性DCPN的发病机制可能并非源于自由漂浮的碎片，而是源于嵴帽的偏移。
