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[突发性感音神经性听力损失伴眩晕患者的前庭功能测试及其临床意义]

[Vestibular function test in patients sudden sensorineural hearing loss patients with vertigoand its clinical significance].

作者信息

Fei S X, Wang F, Wang M H, Huang Y

机构信息

College of Medical Technology,Zhejiang Chinese Medical University,Hangzhou,310053,China.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2019 Aug;33(8):749-752. doi: 10.13201/j.issn.1001-1781.2019.08.016.

Abstract

The aim of this study is to analyze the results of vestibular function tests and clinical value of patients with sudden sensorineural hearing loss (SSHL) and vertigo. Twelve cases(24 ears) of unilateral SSHL with vertigo were included in the study group. 11 age and sex matched normal subjects(22 ears) were recruited as the normal control group. Both patients and normal subjects underwent carolic tests, ocular vestibular evoked myogenic potential (oVEMP), and cervical vestibular evoked myogenic potential (cVEMP) in bilateral ears. The results were compared between the subjects and the normal control group. The rate of positive oVEMP was 25.0% in the affected ear and 50.0% in the contralateral ear in patients with SSHL and vertigo, and 90.9% in normal subjects; while the rate of positive cVEMP was 58.3% in the affected ear and 58.3% in the contralateral ear in patients with SSHL and vertigo, and 90.9% in normal subjects. There were no significant differences between the affected and contralateral ears (>0.05). Compared to normal subjects, oVEMP and cVEMP in both the affected and contralateral ears were significantly reduced (<0.05). The parameters of oVEMP and cVEMP (N1 latency, P1 latency, amplitudes) were not significantly different among the groups(<0.05). Compared to normal subjects, the threshold difference of oVEMP and cVEMP in both the affected and contralateral ears werehigher than the normal subjects(<0.05). Among 12 SSHL patients who underwent caloric test, 9 were found with unilateral semicircular canal weakness(CP>25%), and the abnormal rate was 75% (9/12). Patients with vertigo with vertigo have impaired conduction function in the ipsilateral and contralateral vestibular pathways, mainly due to decreased vestibular evoked myogenic potential, increased threshold, and abnormal cold and heat tests. The vestibular function test provides an objective basis for assessing the inner ear injury in patients with vertigo.

摘要

本研究旨在分析突发性感音神经性听力损失(SSHL)伴眩晕患者的前庭功能测试结果及临床价值。研究组纳入12例(24耳)单侧SSHL伴眩晕患者。选取11例年龄和性别匹配的正常受试者(22耳)作为正常对照组。患者和正常受试者均接受双耳冷热试验、眼前庭诱发肌源性电位(oVEMP)和颈前庭诱发肌源性电位(cVEMP)检查。将受试者的检查结果与正常对照组进行比较。SSHL伴眩晕患者患侧耳oVEMP阳性率为25.0%,对侧耳为50.0%,正常受试者为90.9%;而SSHL伴眩晕患者患侧耳cVEMP阳性率为58.3%,对侧耳为58.3%,正常受试者为90.9%。患侧耳与对侧耳之间差异无统计学意义(>0.05)。与正常受试者相比,患侧耳和对侧耳的oVEMP和cVEMP均显著降低(<0.05)。各研究组之间oVEMP和cVEMP的参数(N1潜伏期、P1潜伏期、波幅)差异无统计学意义(<0.05)。与正常受试者相比,患侧耳和对侧耳oVEMP和cVEMP的阈值差异均高于正常受试者(<0.05)。在12例接受冷热试验的SSHL患者中,9例存在单侧半规管功能减弱(CP>25%),异常率为75%(9/12)。伴有眩晕的患者同侧和对侧前庭通路传导功能受损,主要表现为前庭诱发肌源性电位降低、阈值升高以及冷热试验异常。前庭功能测试为评估眩晕患者内耳损伤提供了客观依据。

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