Jung Jinsei, Suh Michelle J, Kim Sung Huhn
Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.
The Airway Mucus Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
Laryngoscope. 2017 Apr;127(4):921-926. doi: 10.1002/lary.26122. Epub 2016 Jul 4.
We performed the video head impulse test (vHIT) and caloric test in patients with enlarged vestibular aqueducts (EVA). We compared the results with those found in Ménière's disease (MD) and acute vestibular neuritis to clarify the characteristics of vestibular dysfunction in EVA and to suggest reasons for the discrepancy between the vHIT and caloric tests in endolymphatic hydrops.
Retrospective analysis.
Ten patients with EVA and confirmed biallelic SLC26A4 genetic mutations were enrolled. The results of video head impulse and caloric tests were analyzed and compared with those of patients diagnosed with MD (n = 76) or acute vestibular neuritis (n = 19).
Among patients with EVA, 40% showed unilateral caloric weakness and 30% had recurrent episodes of vertigo. All patients with recurrent vertigo had caloric weakness. However, only 25% of patients with abnormal caloric test results had abnormal vHIT results. The discrepancy between the caloric test and vHIT results was also found in patients with MD, but not in patients with acute vestibular neuritis (abnormal vHIT results in 47.3% and 94.7% of patients with unilateral caloric weakness, respectively).
Unilateral vestibular dysfunction was identified in 40% of patients with EVA by the caloric test, but caloric test results were not correlated with vHIT results. This finding was similar in patients with MD. Hence, it is possible that endolymphatic hydrops, a common pathologic feature of both EVA and MD, could cause the discrepancy, and that vestibulopathy in endolymphatic hydrops might be restricted to the low-frequency range.
我们对大前庭导水管综合征（EVA）患者进行了视频头脉冲试验（vHIT）和冷热试验。我们将结果与梅尼埃病（MD）和急性前庭神经炎患者的结果进行比较，以阐明EVA中前庭功能障碍的特征，并提示内淋巴积水时vHIT和冷热试验结果存在差异的原因。
回顾性分析。
纳入10例确诊为双等位基因SLC26A4基因突变的EVA患者。分析视频头脉冲试验和冷热试验的结果，并与诊断为MD（n = 76）或急性前庭神经炎（n = 19）的患者的结果进行比较。
在EVA患者中，40%表现为单侧冷热试验减弱，30%有眩晕反复发作。所有眩晕反复发作的患者均有冷热试验减弱。然而，冷热试验结果异常的患者中只有25%的vHIT结果异常。MD患者也发现了冷热试验和vHIT结果之间的差异，但急性前庭神经炎患者未发现（单侧冷热试验减弱的患者中vHIT结果异常的分别为47.3%和94.7%）。
通过冷热试验在40%的EVA患者中发现了单侧前庭功能障碍，但冷热试验结果与vHIT结果不相关。这一发现与MD患者相似。因此，内淋巴积水作为EVA和MD的共同病理特征，可能导致了这种差异，并且内淋巴积水中的前庭病变可能局限于低频范围。
4。《喉镜》，127:921 - 926，2017年。
