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前庭诱发肌源性电位在梅尼埃病诊断中的临床应用

The Clinical Utility of Vestibular-Evoked Myogenic Potentials in the Diagnosis of Ménière's Disease.

作者信息

Maheu Maxime, Alvarado-Umanzor Jenny Marylin, Delcenserie Audrey, Champoux François

机构信息

School of Speech Language Pathology and Audiology, Université de Montréal, Montreal, QC, Canada.

Psychology, Université de Montréal, Montreal, QC, Canada.

出版信息

Front Neurol. 2017 Aug 15;8:415. doi: 10.3389/fneur.2017.00415. eCollection 2017.

Abstract

Ménière's disease (MD) is a condition that has been proposed over 150 years ago, which involves audiological and vestibular manifestations, such as aural fullness, tinnitus, vertigo, and fluctuating hearing thresholds. Over the past few years, many researchers have assessed different techniques to help diagnose this pathology. Vestibular-evoked myogenic potential (VEMP) is an electrophysiological method assessing the saccule (cVEMP) and the utricule (oVEMP). Its clinical utility in the diagnosis of multiple pathologies, such as superior canal dehiscence, has made this tool a common method used in otologic clinics. The main objective of the present review is to determine the current state of knowledge of the VEMP in the identification of MD, such as the type of stimuli, the frequency tuning, and the interaural asymmetry ratio of the cVEMP and the oVEMP. Results show that the type of stimulation, the frequency sensitivity shift and the interaural asymmetry ratio (IAR) could be useful tool to diagnose and describe the evolution of MD. It is, however, important to emphasize that further studies are needed to confirm the utility of VEMP in the identification of MD in its early stage, using either bone-conduction vibration or air-conduction stimulation, which is of clinical importance when it comes to early intervention.

摘要

梅尼埃病(MD)是150多年前提出的一种病症,涉及听觉和前庭表现,如耳胀满感、耳鸣、眩晕和听力阈值波动。在过去几年中,许多研究人员评估了不同技术以帮助诊断这种病症。前庭诱发肌源性电位(VEMP)是一种评估球囊(cVEMP)和椭圆囊(oVEMP)的电生理方法。它在诊断多种病症(如半规管裂)中的临床效用使该工具成为耳科诊所常用的方法。本综述的主要目的是确定VEMP在梅尼埃病识别方面的当前知识状态,如刺激类型、频率调谐以及cVEMP和oVEMP的双耳不对称率。结果表明,刺激类型、频率敏感性变化和双耳不对称率(IAR)可能是诊断和描述梅尼埃病进展的有用工具。然而,必须强调的是,需要进一步研究以确认VEMP在梅尼埃病早期识别中的效用,无论是使用骨传导振动还是气传导刺激,这在早期干预方面具有临床重要性。

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