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极重度语前感音神经性听力损失的病因与前庭诱发肌源性电位结果的关系

The Relationship between the Etiology of Profound Prelingual Sensorineural Hearing Loss and the Results of Vestibular-Evoked Myogenic Potentials.

作者信息

Takeuti Alice Andrade, Correa Ana Paula Sousa, Leao Elisa Morais, Favero Mariana Lopes

机构信息

Division of Education and Rehabilitation of Communication Disorders (Derdic), Speech Therapy Department, Pontifícia Universidade Católica de São Paulo, São Paulo, Brazil.

出版信息

Int Arch Otorhinolaryngol. 2019 Jan;23(1):1-6. doi: 10.1055/s-0038-1649491. Epub 2018 Jul 5.

Abstract

Cervical vestibular-evoked myogenic potentials (cVEMPs) are biphasic, short latency potentials, which represent the inhibition of the contraction of the sternocleidomastoid muscle (SCM) mediated by the saccule, the inferior vestibular nerve, the vestibular nuclei and the medial vestibular spinal tract.  To evaluate the response of cVEMPs in individuals with profound prelingual bilateral cochlear hearing loss.  A prospective case-control study. A total of 64 volunteers, divided into a study group (31 patients with profound prelingual sensorineural hearing loss) and a control group (33 subjects matched for age and gender with psychoacoustic thresholds of ≤ 25 dB HL between 500 and 8,000 Hz) were submitted to the cVEMP exam. The causes of hearing loss were grouped by etiology and the involved period.  The subjects of the study group are more likely to present changes in cVEMPs compared to the control group (35.5% versus 6.1% respectively;  = 0.003), with an odds ratio (OR) of 8.52 (  = 0.009). It means that they had 8.52-fold higher propensity of presenting altered cVEMP results. There were no statistically significant differences between the latencies, the interamplitude and the asymmetry index. Regarding the etiology, there was a statistically significant difference when the cause was infectious, with an OR of 15.50 (  = 0.005), and when the impairment occurred in the prenatal period, with an OR of 9.86 (  = 0.009).  The present study showed abnormalities in the sacculocolic pathway in a considerable portion of individuals with profound prelingual sensorineural hearing loss due to infectious and congenital causes, as revealed by the cVEMP results.

摘要

颈前庭诱发肌源性电位(cVEMPs)是双相、短潜伏期电位,代表球囊、前庭下神经、前庭核和内侧前庭脊髓束介导的胸锁乳突肌(SCM)收缩抑制。 评估先天性双侧重度耳蜗性听力损失个体的cVEMPs反应。 一项前瞻性病例对照研究。共有64名志愿者,分为研究组(31例先天性重度感音神经性听力损失患者)和对照组(33名年龄和性别匹配、500至8000Hz心理声学阈值≤25dB HL的受试者),接受cVEMP检查。听力损失原因按病因和受累时期分组。 与对照组相比,研究组受试者更有可能出现cVEMPs变化(分别为35.5%和6.1%; =0.003),优势比(OR)为8.52( =0.009)。这意味着他们出现cVEMP结果改变的倾向高8.52倍。潜伏期、波幅间差值和不对称指数之间无统计学显著差异。关于病因,当病因是感染性时,有统计学显著差异,OR为15.50( =0.005),当损伤发生在胎儿期时,OR为9.86( =0.009)。 本研究表明,cVEMP结果显示,相当一部分因感染性和先天性原因导致先天性重度感音神经性听力损失的个体,其球囊-结肠通路存在异常。

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