Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea.
Otol Neurotol. 2018 Dec;39(10):e1084-e1090. doi: 10.1097/MAO.0000000000002005.
To investigate the incidence of nystagmus in patients with sudden sensorineural hearing loss (SSNHL) without dizziness, and to evaluate the correlation of the presence of nystagmus with hearing recovery in those patients.
Retrospective study.
Tertiary referral academic medical center.
Thirty-eight patients with SSNHL who did not complained of dizziness were enrolled.
The presence of nystagmus was evaluated by recording eye movements, and if present, nystagmus was classified as direction-fixed or positional nystagmus. Vestibular function tests were performed, including caloric test.
Of 33 idiopathic SSNHL patients without dizziness, nystagmus was observed in 22 patients (67%), of which 14 patients exhibited direction-fixed nystagmus, and 8 patients exhibited direction-changing nystagmus. Among the 14 patients with direction-fixed nystagmus, 9 displayed the paretic type, and 5 displayed the irritative type. Direction-changing nystagmus (n = 8) was defined as that in which the direction of nystagmus was changed in a supine head-roll test, and the geotropic type and apogeotropic type were observed in two and six patients, respectively. The mean initial pure tone threshold was 58.2 ± 28.1 dB and 57.3 ± 20.0 dB in SSNHL patients with and without nystagmus, respectively, which was not significantly different (p = 0.925). When hearing improvement was compared according to the presence of nystagmus, 39% (8 of 21) of patients with nystagmus were found to belong in the good prognosis group, and 72% (8 of 11) of patients without nystagmus were found to belong in the good prognosis group, which showed marginal statistical significance (p = 0.063).
Nystagmus was observed in two-thirds of idiopathic SSNHL patients without dizziness, and the pattern of nystagmus was either direction fixed or direction changing. Because hearing recovery was worse in patients with nystagmus than those without it, the diagnosis of nystagmus, even in SSNHL patients without dizziness, may be important in evaluating the hearing prognosis.
研究无头晕突发性聋（SSNHL）患者的眼球震颤发生率，并评估眼球震颤与这些患者听力恢复的相关性。
回顾性研究。
三级转诊学术医疗中心。
纳入 38 例无头晕主诉的 SSNHL 患者。
通过记录眼球运动来评估眼球震颤的存在，如果存在，将眼球震颤分为固定方向或位置性眼球震颤。进行前庭功能测试，包括冷热试验。
在 33 例无头晕的特发性 SSNHL 患者中，22 例（67%）患者观察到眼球震颤，其中 14 例表现为固定方向的眼球震颤，8 例表现为变向眼球震颤。在 14 例固定方向的眼球震颤患者中，9 例为麻痹型，5 例为激惹型。变向眼球震颤（n=8）定义为在仰卧位头滚试验中眼球震颤方向发生改变，2 例为向地性，6 例为背地性。SSNHL 患者有眼球震颤和无眼球震颤的初始纯音阈值分别为 58.2±28.1dB 和 57.3±20.0dB，差异无统计学意义（p=0.925）。根据眼球震颤的存在比较听力改善情况时，有眼球震颤的 21 例患者中 39%（8 例）属于预后良好组，无眼球震颤的 11 例患者中 72%（8 例）属于预后良好组，差异有统计学意义（p=0.063）。
在无头晕的特发性 SSNHL 患者中，有三分之二观察到眼球震颤，其形式为固定方向或变向。由于有眼球震颤的患者听力恢复比无眼球震颤的患者差，因此即使在无头晕的 SSNHL 患者中，眼球震颤的诊断对评估听力预后也可能很重要。
