Niewiadomski Piotr, Bielińska Marzena, Pietkiewicz Piotr, Olszewski Jurek
The Otolaryngology, Laryngological Oncology, Audiology and Phoniatry Clinic of the Clinical University Hospital in Łódź Head of the Clinic: Professor Jurek Olszewski, MD, PhD.
Otolaryngol Pol. 2017 Oct 30;71(5):18-28. doi: 10.5604/01.3001.0010.5313.
The aim of the study was to evaluate the neck torsion test in objective examinations of patients with vertigo and/or hearing loss.
The study was conducted in 100 patients, including 54 women and 46 men aged 17-79 years, who were divided into two groups: I - 50 patients, including 30 women and 20 men aged 17-79 years (mean age 49.92 years) with dizziness and/or hearing impairments, and confirmed asymmetry of intracranial vessels, II - 50 patients - the control group, including 24 women and 26 men aged 20-71 years without dizziness and/or hearing disorders and without disturbance in the construction of intracranial vessels. For each patient, the following tests were carried out: subjective, objective otorhinolaryngological, Doppler ultrasound specifying the diameter of vertebral and carotid arteries and the velocity of blood flow in these vessels, audiological diagnostics, including the examination of latency of waves I, III, V of the auditory evoked potentials of the brain stem, otoneurological diagnostics with used the neck torsion test.
It appears from the analysis of the material presented that the application of the neck torsion test in the Doppler ultrasound results in the fact that the difference in the mean systolic velocity of blood flow in vertebral artery is higher on the side opposite to the turning of the neck, and the increase in the average diastolic blood flow velocity in the vertebral artery on the side of the test being performed and its reduction on the opposite side in the study group, when compared to the control group. The value of the wave I, II, V latency in the ABR test during the neck torsion test is extended more in the study group than in the controls, on the side of the performed test. The performed neck torsion test in the VNG test increases the occurrence of both, square waves and nystagmus (much higher in the study group than in the controls).
The application of the neck torsion test in the Doppler ultrasound, ABR and VNG test in patients with vertigo and/or hearing loss means that these tests become functional, thereby increasing their diagnostic value and may be used to monitor the rehabilitation of inner ear disorders.
本研究的目的是评估在眩晕和/或听力损失患者的客观检查中颈部扭转试验的效果。
该研究对100名患者进行,其中包括54名女性和46名男性,年龄在17 - 79岁之间,分为两组:第一组 - 50名患者,包括30名女性和20名男性,年龄在17 - 79岁之间(平均年龄49.92岁),有头晕和/或听力障碍,且颅内血管不对称得到确认;第二组 - 50名患者为对照组,包括24名女性和26名男性,年龄在20 - 71岁之间,无头晕和/或听力障碍,且颅内血管结构无异常。对每位患者进行了以下检查:主观、客观的耳鼻喉科检查,通过多普勒超声确定椎动脉和颈动脉的直径以及这些血管中的血流速度,听力诊断,包括脑干听觉诱发电位I、III、V波潜伏期的检查,使用颈部扭转试验进行耳神经学诊断。
从所呈现材料的分析来看,在多普勒超声检查中应用颈部扭转试验的结果是,椎动脉平均收缩血流速度在颈部转动相反侧的差异更大,并且在研究组中,与对照组相比,在进行试验一侧的椎动脉平均舒张血流速度增加,而在相反侧降低。在颈部扭转试验期间,研究组ABR试验中I、II、V波潜伏期的值比对照组在进行试验的一侧延长得更多。在VNG试验中进行的颈部扭转试验增加了方波和眼球震颤的发生率(研究组比对照组高得多)。
在眩晕和/或听力损失患者中,在多普勒超声、ABR和VNG试验中应用颈部扭转试验意味着这些试验变得更具功能性;从而提高了它们的诊断价值,并且可用于监测内耳疾病的康复情况。