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糖皮质激素与前庭神经炎长期结局中的前庭康复治疗的比较。

Corticosteroids versus vestibular rehabilitation in long-term outcomes in vestibular neuritis.

机构信息

Department of ENT, Audiology Unit, Faculty of Medicine, Mansoura University, Egypt.

出版信息

J Vestib Res. 2018;28(5-6):417-424. doi: 10.3233/VES-180645.

Abstract

BACKGROUND

The management strategy for functional recovery after vestibular neuritis (VN) has not yet been established. Therapeutic choices involve corticosteroids, vestibular rehabilitation therapy (VRT) and the combination of corticosteroids with VRT.

OBJECTIVE

The present study aimed to compare the efficacy of corticosteroids, vestibular rehabilitation, and combination of them in terms of subjective and objective improvement in patients with VN.

METHODS

A prospective randomized study was conducted on 60 patients with acute vestibular neuritis within 3 days after symptom onset. The patients were divided into three groups; steroid group treated with corticosteroids (n = 20), VRT group (n = 20) managed with vestibular rehabilitation exercises and combination group (n = 20) received combined (corticosteroids and vestibular exercises). Groups were compared by caloric lateralization, vestibular myogenic potential amplitude asymmetry and Dizziness Handicap Inventory scores, both at presentation and up to 12 months.

RESULTS

The study found no statistically significant difference between the three groups of the study at the end of the follow up period.

CONCLUSION

Corticosteroids and VRT seem to be equivalently effective in patients with VN. The study proposes that corticosteroids may accelerate the recovery of VN, with no more beneficial role in the long-term prognosis of the disease.

摘要

背景

前庭神经炎(VN)后功能恢复的管理策略尚未确定。治疗选择包括皮质类固醇、前庭康复治疗(VRT)以及皮质类固醇与 VRT 的联合应用。

目的

本研究旨在比较皮质类固醇、前庭康复以及它们联合应用在改善 VN 患者的主观和客观症状方面的疗效。

方法

对发病后 3 天内的 60 例急性前庭神经炎患者进行前瞻性随机研究。患者分为三组:皮质类固醇组(n=20)用皮质类固醇治疗,前庭康复组(n=20)用前庭康复锻炼治疗,联合组(n=20)接受联合治疗(皮质类固醇和前庭锻炼)。在就诊时和 12 个月时,通过冷热偏侧性、前庭肌源性电位幅度不对称和眩晕障碍量表(Dizziness Handicap Inventory,DHI)评分比较各组。

结果

在随访期末,三组之间没有统计学上的显著差异。

结论

皮质类固醇和 VRT 似乎对 VN 患者同样有效。本研究提出,皮质类固醇可能会加速 VN 的恢复,但在疾病的长期预后方面没有更多的益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db75/9249297/255d37c794ad/ves-28-ves180645-g001.jpg

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