[应用视频头脉冲试验评估伴眩晕的突发性聋患者前庭上下神经损伤范围]

[Evaluation of the injured range of vestibular superior and inferior nerves in sudden deafness patients with vertigo using video head impulse test].

作者信息

Hou Lingxiao, Chen Taisheng, Xu Kaixu, Wang Wei, Li Shanshan, Liu Qiang, Wen Chao, Cheng Yan, Zhao Hui, Ma Yuanxu, Lin Peng

机构信息

First Center Clinic College, Tianjin Medical University, Tianjin 300192, China.

Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Center Hospital, Otorhinolaryngology Institute of Tianjin, Tianjin 300192, China; Email:

出版信息

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Sep;50(9):718-23.

PMID:26696342

Abstract

OBJECTIVE

To discuss the video head impulse tests (vHIT) application values in assessment of the vestibular nerves, function in sudden deafness patients with vertigo.

METHODS

There were 60 cases (120 ears) of healthy volunteers as control group, and 182 cases (182 ears) of sudden deafness with vertigo patients as study group. The study group received vHIT and caloric test, and the control group received vHIT. Functions of vestibular superior and inferior nerves were analyzed by the gains of vHIT and the nystagmus, s unilateral weakness of caloric test, with SPSS17.0 software.

RESULTS

The values of vHIT-G of the six semicircular canals in the control group were normal distribution and no statistical significance among them (F = 0.005, P = 1.000). The vHIT-G averages of both sides of anterior, horizontal and posterior semicircular canals were (15.20 ± 11.00) %, (15.30 ± 13.30) %, and (15.15 ± 14.72) % respectively. In the study group, the vHIT-G of the affected side were (21.73 ± 14.84) %, (21.20 ± 28.24) %, and (19.22 ± 23.50) %, with normal distribution, and in which statistical significance was detected comparing with those in the control group (P < 0.05). The positive rates were 26.9% (49/182) in vHIT, 70.3% (128/182) in caloric test. Significant difference (P < 0.05) was observed between vHIT and caloric test examined by chi-square test. According to the results of vHIT, there were 15 cases (8.2%) damaged vestibular superior and inferior nerves areas, 19 cases (10.4%) damaged the superior vestibular nerve area, and 15 cases (8.2%) damaged the inferior vestibular nerve area. In combination with caloric test results, it was shown that there were 29 cases (15.9%) damaged vestibular superior and inferior nerves areas, 101 cases (55.5%) damaged the superior vestibular nerve area, and 1 case (0.5%) damaged the inferior vestibular nerve area.

CONCLUSIONS

vHIT can assess the function of six semicircular canals and illustrate high frequency of vestibular nerves. Caloric test combined with vHIT have more advantages to comprehensive assess vestibular damage of sudden deafness patients with vertigo.

摘要

目的

探讨视频头脉冲试验（vHIT）在评估突发性聋伴眩晕患者前庭神经功能中的应用价值。

方法

选取60例（120耳）健康志愿者作为对照组，182例（182耳）突发性聋伴眩晕患者作为研究组。研究组接受vHIT和冷热试验，对照组接受vHIT。采用SPSS17.0软件，通过vHIT增益值和冷热试验眼震慢相角速度、单侧优势比分析前庭上下神经功能。

结果

对照组6个半规管的vHIT增益值呈正态分布，差异无统计学意义（F = 0.005，P = 1.000）。双侧前、水平和后半规管vHIT增益平均值分别为（15.20±11.00）%、（15.30±13.30）%和（15.15±14.72）%。研究组患侧vHIT增益值分别为（21.73±14.84）%、（21.20±28.24）%和（19.22±23.50）%，呈正态分布，与对照组比较差异有统计学意义（P < 0.05）。vHIT阳性率为26.9%（49/182），冷热试验阳性率为70.3%（128/182）。χ²检验显示vHIT与冷热试验结果差异有统计学意义（P < 0.05）。根据vHIT结果，前庭上下神经均受损15例（8.2%），上前庭神经受损19例（10.4%），下前庭神经受损15例（8.2%）。结合冷热试验结果，前庭上下神经均受损29例（15.9%），上前庭神经受损101例（55.5%），下前庭神经受损1例（0.5%）。