Gong Q P, Zhang Y, Li Y J, Xu X R, Luo J Y
Chinese PLA Center of Clinical Aviation Medicine, Vertigo Clinical Research Center of Aerospace, Air Force General Hospital of PLA, Beijing,100142, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018 Feb;32(4):260-263. doi: 10.13201/j.issn.1001-1781.2018.04.005.
To conclude the four types of nystagmus in the final position during canalith repositioning procedure (CRP) for posterior canal benign paroxysmal positional vertigo (PC-BPPV), and predict the outcome of CRP therapy. Nystagmus were recorded by an infrared charge-coupled devicecamera when underwent CRP therapy, which observed in the final position and concluded into four types. Two hundred and twenty-three patients were included in our research and the results as follow. ①The nystagmus replicates the initial nystagmus during the Hallpike maneuver, which suggests therapeutic outcome,128 cases in total (57.4%). ②The direction of vertical component is composite while the rotary component is the same, also deeming a successful trial, 35 cases (15.7%). ③The direction of both vertical component and rotary component isreverse to the initial, which indicates a poor response, 36 cases (16.1%). ④Twenty-four cases (10.8%) showed no certain nystagmus but exhibit horizontal nystagmus in roll-test, denoting that the otolith moves to the lateral semicircular. At this appointment, the horizontal nystagmus can resolute after several times of barbecue maneuver. There is a significant difference of the one-time success rate (²=46.198, <0.01) and the mean treatment times (=10.048, <0.01) between cupulolithiasis and canalolithiasis PC-BPPV. Different nystagmus in the final position of CRP maneuver is important in predicting the repositioning outcome. The one-time success rate of canalolithiasis is better than cupulolithiasis.
总结后半规管良性阵发性位置性眩晕(PC-BPPV)行半规管结石复位法(CRP)时终末位的四种眼震类型,并预测CRP治疗效果。对接受CRP治疗的患者,采用红外电荷耦合器件相机记录其眼震情况,观察终末位眼震并归纳为四种类型。纳入223例患者,结果如下:①眼震重复Hallpike试验初始眼震,提示治疗有效,共128例(57.4%)。②垂直成分方向混合而旋转成分方向相同,也视为试验成功,35例(15.7%)。③垂直成分和旋转成分方向均与初始相反,提示反应不佳,36例(16.1%)。④24例(10.8%)未出现特定眼震,但在滚转试验中出现水平眼震,提示耳石移至外半规管。此时,经数次烧烤试验后水平眼震可消失。壶腹嵴顶结石症和半规管结石症PC-BPPV的一次成功率(χ²=46.198,P<0.01)和平均治疗次数(t=10.048,P<0.01)有显著差异。CRP操作终末位不同眼震类型对预测复位效果有重要意义。半规管结石症的一次成功率优于壶腹嵴顶结石症。