Chen Liang, Xu Hui, Wang Wu-Qing, Zhang Qing-Quan, Lv Qiao-Ying, Song Xi-Cheng
Otorhinolaryngology Head and Neck Surgery Department, Affiliated Yantai Yuhuangding Hospital of Qingdao University Medical College, Yantai City, Shandong Province, China.
Stomatology Department, Affiliated Yantai Yuhuangding Hospital of Qingdao University Medical College, Yantai City, Shandong Province, China.
J Otolaryngol Head Neck Surg. 2016 Jun 21;45(1):39. doi: 10.1186/s40463-016-0152-4.
Cervical and ocular vestibular evoked myogenic potentials (c/oVEMPs) reflect otolith function. Up-to-date, there are no published reports on the systemic evaluation of otolith function in Ménière's Disease (MD) nor are there any reports on the differences in VEMPs between patients with early and late stage MD. The aim of this study was to evaluate the difference in c/oVEMPs between patients with MD and normal controls, as well as between patients with early and late stage MD.
Thirty patients with unilateral MD and thirty healthy subjects (as normal controls) were prospectively enrolled. c/oVEMPs using 500 Hz tone-burst stimuli were performed. VEMP tests were repeated 3 times on each subject to ensure reliability and reproducibility of responses. VEMPs were defined as present or absent. Abnormal VEMP was defined by lack of VEMP response.
In the control group, abnormal cVEMPs and oVEMPs responses were detected in 6.67 and 3.34 % respectively. In MD patients (20 with early stage MD [ES-MD], 10 with late stage MD [LS-MD]), abnormal cVEMPs and oVEMPs responses were detected in 40 and 16.7 % respectively. More patients with MD showed abnormal responses in c/oVEMPs as compared to the control group (p < 0.05). cVEMPs was more often abnormal as compared to oVEMPs in MD patients (p < 0.05). There was a significant difference in abnormal cVEMP responses between ES-MD patients (25 %) and LS-MD patients (70 %) (p < 0.05). Difference in abnormal oVEMP responses (ES-MD, 5 %; LS-MD, 40 %) was significant (p < 0.05).
An increased occurrence of abnormal c/oVEMP recordings appeared in MD patients, possibly as a result of hydrops of the otolith. cVEMPs were more often abnormal in MD patients as compared to oVEMPs, suggesting that saccular dysfunction may be more common than utricular dysfunction. Furthermore, o/cVEMP abnormalities in the LS-MD group were significantly higher than those in the ES-MD group, suggesting the trend that otolith damage is gradually increasing with the aggravation of cochlear injury in MD.
颈肌和眼肌前庭诱发肌源性电位(c/oVEMPs)反映耳石功能。目前,尚无关于梅尼埃病(MD)耳石功能系统评估的 published 报告,也没有关于MD早期和晚期患者VEMPs差异的报告。本研究的目的是评估MD患者与正常对照组之间以及MD早期和晚期患者之间c/oVEMPs的差异。
前瞻性纳入30例单侧MD患者和30例健康受试者(作为正常对照组)。使用500Hz短纯音刺激进行c/oVEMPs检测。对每个受试者重复进行3次VEMP测试,以确保反应的可靠性和可重复性。VEMPs定义为存在或不存在。异常VEMP定义为无VEMP反应。
在对照组中,分别有6.67%和3.34%的患者检测到异常cVEMPs和oVEMPs反应。在MD患者中(20例早期MD[ES-MD],10例晚期MD[LS-MD]),分别有40%和16.7%的患者检测到异常cVEMPs和oVEMPs反应。与对照组相比,更多的MD患者在c/oVEMPs中表现出异常反应(p<0.05)。在MD患者中,cVEMPs比oVEMPs更常出现异常(p<0.05)。ES-MD患者(25%)和LS-MD患者(70%)之间异常cVEMP反应存在显著差异(p<0.05)。异常oVEMP反应的差异(ES-MD,5%;LS-MD,40%)显著(p<0.05)。
MD患者中异常c/oVEMP记录的发生率增加,可能是耳石积水的结果。与oVEMPs相比,MD患者中cVEMPs更常出现异常,表明球囊功能障碍可能比椭圆囊功能障碍更常见。此外,LS-MD组的o/cVEMP异常明显高于ES-MD组,提示MD中耳石损伤随着耳蜗损伤的加重而逐渐增加的趋势。