Chen J Y, Yang J, Zhang Q, Wang W, Ma X B, Mei L, Shen J L, Shen M, Chen X P
Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine; Institute of Ophthalmology, School of Medicine, Shanghai Jiaotong University; Shanghai key Laboratory of Ear and Nose Disease Transformation, Shanghai, 200092, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2019 Mar;33(3):232-236. doi: 10.13201/j.issn.1001-1781.2019.03.012.
This study was to analyze the results of video head impulse test (vHIT) of benign paroxysmal vertigo of childhood (BPVC) in order to determine the potential value of vHIT in the diagnosis and treatment for BPVC and to discuss its possible pathogenesis of BPVC. Thirty-six children with BPVC were enrolled. No hearing loss and skull abnormality were found in these children as assessed by pure tone audiometry, acoustic impedance, CT or MRI scan. The vHIT was carried out, and main outcome measures were the gain of vestibulo-ocular reflex, gain asymmetry, and refixation saccades. Eleven healthy children were selected as normal control who came to our hospital for doing a routine checkup and have no history of dizziness. The differences of vHIT results between these two groups were analyzed. ①The vHIT results in control group were normal. In all BPVC subjects, abnormalities were detected in 9 patients (25.0%),including vHIT gains decline in 3 patients, abnormal symmetry in 4 patients, and abnormal isolated overt saccades in 2 patients.②The average saccadic gain in different canals of BPVC group was 1.03±0.14, 1.01±0.15, 1.13±0.31, 1.18±0.36, 1.21±0.33, 1.14±0.30 in left horizontal, right horizontal, left anterior, right posterior, right anterior, left posterior canal, respectively; while in normal group, it was 1.14±0.15, 1.18±0.09, 1.16±0.30, 1.18±0.40, 1.34±0.26, 1.30±0.20, respectively. Significant statistical difference was found only in horizontal canals between these two groups (<0.05). ③Asymmetry of the three pairs of conjugated semicircular canals was 0.04±0.07 (horizontal canal), 0.06±0.04 (left anterior and right posterior canal), 0.06±0.04 (right anterior and left posterior canal) in BPVC group, respectively; while in control group, it was 0.02±0.02, 0.04±0.03, 0.04±0.04,respectively. There was no statistical difference between the two groups (>0.05). A certain proportion of abnormal peripheral vestibule function in children with BPVC was found. vHIT is a "child friendly," relatively easytouse, and simple tool to evaluate each of the 6 semicircular canals, which may offer some potential clinical information for assessing the vestibule dysfunction for BPVC.
本研究旨在分析儿童良性阵发性眩晕(BPVC)视频头脉冲试验(vHIT)的结果,以确定vHIT在BPVC诊断和治疗中的潜在价值,并探讨BPVC可能的发病机制。纳入36例BPVC患儿。通过纯音听力测定、声阻抗、CT或MRI扫描评估,这些患儿均未发现听力损失和颅骨异常。进行vHIT检查,主要观察指标为前庭眼反射增益、增益不对称性和重新注视扫视。选取11名来我院进行常规体检且无头晕病史的健康儿童作为正常对照。分析两组vHIT结果的差异。①对照组vHIT结果正常。在所有BPVC患儿中,9例(25.0%)检测到异常,包括3例vHIT增益下降、4例对称性异常和2例孤立性明显扫视异常。②BPVC组不同半规管的平均扫视增益在左侧水平半规管、右侧水平半规管、左侧前半规管、右侧后半规管、右侧前半规管、左侧后半规管分别为1.03±0.14、1.01±0.15、1.13±0.31、1.18±0.36、1.21±0.33、1.14±0.30;而正常组分别为1.14±0.15、1.18±0.09、1.16±0.30、1.18±0.40、1.34±0.26、1.30±0.20。两组仅在水平半规管存在显著统计学差异(<0.05)。③BPVC组三对半规管的不对称性在水平半规管为0.04±0.07,左侧前半规管与右侧后半规管为0.06±0.04,右侧前半规管与左侧后半规管为0.06±0.04;而对照组分别为0.02±0.02、0.04±0.03、0.04±0.04。两组之间无统计学差异(>0.05)。发现一定比例的BPVC患儿存在外周前庭功能异常。vHIT是一种“儿童友好型”、相对易于使用且简单的工具,可用于评估6个半规管中的每一个,这可能为评估BPVC的前庭功能障碍提供一些潜在的临床信息。