El-Badry Mohamed Mohamed, Gamal Reham, Fawzy Amira
Audio-Vestibular Unit, Minia University, Minia, Egypt.
Eur Arch Otorhinolaryngol. 2018 Dec;275(12):2925-2931. doi: 10.1007/s00405-018-5149-3. Epub 2018 Sep 26.
The aim of the current work was to evaluate the function of the saccule and inferior vestibular nerve in children with auditory neuropathy spectrum disorder (ANSD) by recording the cervical-evoked myogenic potentials (C-VEMP) on those children and to compare C-VEMP results in ANSD children of pre-lingual onset to those in ANSD children of post-lingual onset.
The study included 38 ANSD children of pre-lingual onset, 16 ANSD children of post-lingual onset, and 20 control children. All participant children were subjected to C-VEMP testing using 500 Hz tone burst stimuli.
The vast majority of ANSD children of pre-lingual onset (35 out of 38; 92.1%) had bilateral intact C-VEMP response with C-VEMP parameters (amplitude, asymmetric ratio, latency, and inter-aural latency difference) that were not statistically different than those in the control children. Only three children had bilateral absent C-VEMP response. On the other hand, the majority of ANSD children of post-lingual onset (11 out of 16; 68.75%) had bilateral absent C-VEMP response. The remaining five children had bilateral intact C-VEMP response with C-VEMP parameters that were not statistically different than those in the control children.
The pathology of ANSD spares the saccule and inferior vestibular nerve in the vast majority of ANSD children of pre-lingual onset, while it involves them in the majority of ANSD of post-lingual onset reflecting different site(s) of lesion between the two ANSD categories. Such results have important clinical implications as regards to the management of ANSD in children.
本研究的目的是通过记录儿童听觉神经病谱系障碍(ANSD)患者的颈肌源性电位(C-VEMP)来评估球囊和前庭下神经的功能,并比较语前起病的ANSD儿童与语后起病的ANSD儿童的C-VEMP结果。
该研究纳入了38名语前起病的ANSD儿童、16名语后起病的ANSD儿童和20名对照儿童。所有参与研究的儿童均使用500Hz短纯音刺激进行C-VEMP测试。
绝大多数语前起病的ANSD儿童(38名中的35名;92.1%)双侧C-VEMP反应正常,其C-VEMP参数(振幅、不对称率、潜伏期和双耳潜伏期差)与对照儿童相比无统计学差异。只有三名儿童双侧C-VEMP反应缺失。另一方面,大多数语后起病的ANSD儿童(16名中的11名;68.75%)双侧C-VEMP反应缺失。其余五名儿童双侧C-VEMP反应正常,其C-VEMP参数与对照儿童相比无统计学差异。
在绝大多数语前起病的ANSD儿童中,ANSD的病理改变不累及球囊和前庭下神经,而在大多数语后起病的ANSD中则累及,这反映了两种ANSD类型之间不同的病变部位。这些结果对于儿童ANSD的管理具有重要的临床意义。