Çoban Kübra, Aydın Erdinç, Özlüoğlu Levent Naci
Department of Otorhinolaryngology, Başkent University Alanya Hospital, Antalya, Turkey.
J Int Adv Otol. 2017 Apr;13(1):100-104. doi: 10.5152/iao.2016.2626. Epub 2017 Jan 13.
Idiopathic intracranial hypertension (IIH) can be manifested by audiological and vestibular complaints. The aim of the present study is to determine the audio-vestibular pathologies and their pathophysiologies in this syndrome by performing current audio-vestibular tests.
The study was performed prospectively on 40 individuals (20 IIH patients, 20 healthy volunteers). Pure tone audiometry, tympanometry, vestibular evoked myogenic potentials, and electronystagmography tests were performed in both groups and the results were compared.
The mean age of both groups was found to be 30.2±18.7. There were 11 females and 9 males in each group. The study group patients had significantly worse hearing levels. Pure tone averages were significantly higher in both ears of the study group (p<0.05). Ten patients (50%) in the study group and one healthy volunteer (5%) had pathologic ENG, possibly related to central pathologies (p=0.008). Eight patients (40%) and one (5%) control had variable abnormal VEMP records (p=0008).
Many IIH patients initially visit otolaryngology clinics since cochlear and vestibular systems are frequently affected in this condition. Our test results suggest inner ear pathologies in these patients. Higher incidence of inferior vestibular nerve and/or saccule dysfunction is detected as a novelty. Increased intracranial pressure may affect the inner ear with similar mechanisms as in hydrops.
特发性颅内高压（IIH）可表现为听力学和前庭方面的主诉。本研究的目的是通过进行当前的听-前庭测试来确定该综合征中的听-前庭病变及其病理生理学。
对40名个体（20例IIH患者，20名健康志愿者）进行前瞻性研究。两组均进行了纯音听力测定、鼓室图、前庭诱发肌源性电位和眼震电图测试，并比较结果。
发现两组的平均年龄为30.2±18.7。每组有11名女性和9名男性。研究组患者的听力水平明显更差。研究组双耳的纯音平均听阈显著更高（p<0.05）。研究组中有10名患者（占50%）和1名健康志愿者（占5%）出现病理性眼震电图，可能与中枢病变有关（p=0.008）。8名患者（占40%）和1名对照者（占5%）的前庭诱发肌源性电位记录有不同程度异常（p=0.008）。
由于在这种情况下耳蜗和前庭系统经常受到影响，许多IIH患者最初会前往耳鼻喉科诊所就诊。我们的测试结果提示这些患者存在内耳病变。检测到下前庭神经和/或球囊功能障碍的发生率较高，这是一个新发现。颅内压升高可能通过与梅尼埃病类似的机制影响内耳。
