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双侧大前庭导水管综合征患者外周前庭功能测试结果的对比

Contrasting results of tests of peripheral vestibular function in patients with bilateral large vestibular aqueduct syndrome.

作者信息

Zhou Yu-Juan, Wu Yong-Zhen, Cong Ning, Yu Jing, Gu Jun, Wang Jing, Chi Fang-Lu

机构信息

Department of Otology and Skull Base Surgery, Eye Ear Nose & Throat Hospital, Fudan University, Shanghai, China; Shanghai Auditory Medical Center, Shanghai, China; Key Laboratory of Hearing Science, Ministry of Health, Shanghai, China.

Department of Otology and Skull Base Surgery, Eye Ear Nose & Throat Hospital, Fudan University, Shanghai, China; Shanghai Auditory Medical Center, Shanghai, China; Key Laboratory of Hearing Science, Ministry of Health, Shanghai, China.

出版信息

Clin Neurophysiol. 2017 Aug;128(8):1513-1518. doi: 10.1016/j.clinph.2017.05.016. Epub 2017 Jun 7.

Abstract

OBJECTIVE

To analyze and summarize the effect of bilateral large vestibular aqueducts in peripheral vestibular organ function.

METHODS

Eighteen patients with bilateral large vestibular aqueduct syndrome (LVAS; Study Group) and 18 healthy volunteers (Control Group) were investigated using audiometry, caloric test, sensory organization test (SOT), and vestibular-evoked myogenic potential (VEMP) tests.

RESULTS

All 18 patients (36 ears) exhibited sensorineural hearing loss. For cervical VEMP (cVEMP), the Study Group showed lower thresholds (Study Group vs.

CONTROL GROUP

71.4vs. 75.3dBnHL; p=0.006), N1 latencies (24.1vs. 25.2ms; p=0.026) and shorter P1 (15.3vs. 16.6ms; p=0.003), and higher amplitudes (400.7vs. 247.2µV; p<0.001) than the Control Group. For ocular VEMP (oVEMP), the Study Group had lower thresholds (79.3vs. 81.8dBnHL; p=0.046) and higher amplitudes (40.6vs. 14.4µV; p<0.001) than the Control Group. Fourteen of 16 patients (87.5%) who completed caloric tests had abnormal results, and 10 of 18 patients (55.6%) exhibited abnormal results in SOTs.

CONCLUSIONS

The hyperfunction of vestibular test in otolithic organs and the hypofunction of vestibular test in semicircular canals, as well as the dysfunction in the balance test were demonstrated in patients with LVAS.

SIGNIFICANCE

Our findings can help clinicians gain a better understanding of the characteristics of vestibular organ function in patients with LVAS, which can facilitate optimal targeted treatment.

摘要

目的

分析并总结双侧大前庭导水管对周围前庭器官功能的影响。

方法

对18例双侧大前庭导水管综合征患者(研究组)和18名健康志愿者(对照组)进行听力测定、冷热试验、感觉组织试验(SOT)和前庭诱发肌源性电位(VEMP)测试。

结果

18例患者(36耳)均表现为感音神经性听力损失。对于颈肌前庭诱发肌源性电位(cVEMP),研究组的阈值较低(研究组与对照组:71.4对75.3dBnHL;p=0.006),N1潜伏期较短(24.1对25.2ms;p=0.026),P1较短(15.3对16.6ms;p=0.003),且振幅较高(400.7对247.2µV;p<0.001)。对于眼肌前庭诱发肌源性电位(oVEMP),研究组的阈值较低(79.3对81.8dBnHL;p=0.046),振幅较高(40.6对14.4µV;p<0.001)。16例完成冷热试验的患者中有14例(87.5%)结果异常,18例患者中有10例(55.6%)在感觉组织试验中结果异常。

结论

大前庭导水管综合征患者表现出耳石器官前庭试验功能亢进、半规管前庭试验功能减退以及平衡试验功能障碍。

意义

我们的研究结果有助于临床医生更好地了解大前庭导水管综合征患者前庭器官功能的特点,从而有助于进行最佳的靶向治疗。

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